From May 2021 the European regulation EU2017/745 covers the manufacture of medical devices in healthcare facilities under certain conditions. In this context, the use of 3D printing and free software can be combined to provide a solution to some of the problems for which no commercial product can be found in brachytherapy.

What we present here is a procedure for the design, using open source software, and manufacture, with Fused Deposition Modeling technology, of brachytherapy surface moulds.

The procedure starts with a CT scan of the patient treatment area with radiopaque markers. 3D slicer software is then used to delimit the applicator mould that follows the patient's surface. After this, we use the Freecad software to design the channels where we will insert the plastic tubes through which the radiation source will deliver the treatment. We also use the Meshmixer software to make the final delimitation of the applicator edges as well as to find and correct any inconsistency.

Moulds created by means of 3D printing allow us to combine the precise fit to the patient's surface of homemade solutions with the geometric accuracy between catheters of commercial products. This is clearly seen when treating small and irregular surfaces such as the ear pinna.

Manufacture of brachytherapy surface moulds with FDG technology is a good example of customized solutions in healthcare facilities supported by new European legistation. If we add to this the use of free open source software, we are facing an alternative to classics solutions used up to now in superficial brachytherapy.