Abstract
BACKGROUND: Phantoms are essential in medical imaging, providing reproducible and quantitative means for system and protocol evaluation, image quality assessment, and dosimetry without patient exposure. Additive manufacturing enables rapid, accurate fabrication of phantoms ranging from simple geometries to complex anthropomorphic models. Ongoing developments in 3D printing technologies and polymer formulations have enhanced mechanical properties and printability, but also affect X-ray attenuation behaviour, necessitating an update with current materials to facilitate the choice of appropriate materials mimicking body tissues in radiographic phantoms. METHODS: Attenuation properties of 27 photopolymer resins and 22 thermoplastic filaments (based on PLA, ABS, HIPS, PETG/PCTG, and PVB) were quantified using a clinical CT scanner at 70-140 kV to establish reference data for material selection. RESULTS: At 120 kV, resins exhibited attenuation values between 124 and 384 Hounsfield Units (HU), and filaments ranged from -69 to 308 HU (PLA-based filaments: 160 to 241 HU, ABS: -32 to 43 HU, PETG/PCTG: 151 to 308 HU, and HIPS: -69 to -22 HU). Energy dependence of HU values is presented from 70 to 140 kV tube potential. Compared to the 2021 study, a wider selection of X-ray opacities is available. Regarding SLA/DLP printing, resins with higher attenuation were identified, and flexible resins that had provided a choice of low attenuation printing materials in the range of 60 to 90 HU at 120 kV tended to replicate attenuation properties closer to rigid photopolymers; i.e., HU values were slightly higher. In FDM filaments, a wide variation in different PLA-, ABS-, and HIPS-based filaments is found. In copolymers from the PET/PCTG/PETG family, very inhomogeneous X-ray attenuations are still found, as anticipated. CONCLUSIONS: The range of X-ray attenuation observed demonstrates that commercially available 3D printing materials can replicate clinically relevant tissues and tissue-equivalent contrasts. Furthermore, the available range of attenuations has increased, as has the finer gradation of these materials. These findings support the design of patient- and task-specific imaging phantoms for optimization of acquisition protocols, image quality evaluation, and radiation dose studies, as well as facilitate the selection of appropriate phantom materials.