A personalized tumor kV-IORT navigation system based on hybrid twin

IF 2.2 4区医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of Applied Clinical Medical Physics Pub Date : 2025-09-19 DOI:10.1002/acm2.70243

Shan Jiang, Shuo Yang, Zhiyong Yang, Daguang Zhang, Yingkai Luan, Zeyang Zhou

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引用次数: 0

Abstract

Purpose

This study proposes a multidimensional hybrid twin navigation system to enhance applicator placement accuracy in low-energy x-ray intraoperative radiotherapy (kV-IORT), particularly for less-experienced practitioners. The system integrates augmented reality (AR) and digital twin technologies to improve intraoperative precision and usability.

Methods

The system comprises three core modules: (1) a holographic dose (Holo-dose) model visualizing clinically relevant radiation layers based on Zeiss TARGIT data, (2) a patient-specific applicator positioning strategy with real-time AR feedback adapted to tumor bed geometry, and (3) a bidirectional hybrid twin control linking a physical radiotherapy robot with its virtual twin for precise navigation. Phantom experiments utilized a 20 mm spherical applicator within a 30 mm tumor bed boundary. Target dose range was 18.50–19.50 Gy (15 mm radius) over 25 min. Accuracy was evaluated via root mean square error (RMSE) and target registration error (TRE). Mean RMSE was 0.383 mm (phantom) and 0.106 mm (robot); mean TRE was 0.41 mm.

Results

The system significantly enhanced positioning accuracy for novice users. Medical students achieved an average precision of 2.971 mm (p = 0.00015), and inexperienced physicians reached 2.803 mm (p = 0.00038). No significant improvement was observed for experienced surgeons (p > 0.05), indicating the system's potential as a training and assistance tool. The average System Usability Scale (SUS) score was 83.5, suggesting high user satisfaction, especially among younger participants.

Conclusions

The hybrid twin navigation system significantly improved applicator placement accuracy for novice users, demonstrating its value as an effective training and assistance tool for kV-IORT. High user satisfaction and sub-millimeter registration and alignment accuracy confirm its potential for clinical translation, particularly in enhancing usability and precision for less-experienced practitioners.

Abstract Image

查看原文本刊更多论文

基于混合孪生体的个性化肿瘤kV-IORT导航系统。

目的：本研究提出了一种多维混合双导航系统，以提高低能x线术中放疗（kV-IORT）的施药器放置精度，特别是对于经验不足的从业者。该系统集成了增强现实（AR）和数字孪生技术，以提高术中精度和可用性。方法：该系统包括三个核心模块：(1)基于蔡司TARGIT数据的可视化临床相关放射层的全息剂量（Holo-dose）模型；(2)适应肿瘤床几何形状的具有实时AR反馈的针对患者的施药器定位策略；(3)将物理放疗机器人与其虚拟孪生体连接起来进行精确导航的双向混合孪生控制。幻影实验在30毫米肿瘤床边界内使用了一个20毫米的球形涂抹器。靶剂量范围为18.50 ~ 19.50 Gy （15mm半径），超过25min。准确度通过均方根误差（RMSE）和目标配准误差（TRE）进行评估。平均RMSE为0.383 mm（幻影）和0.106 mm（机器人）；结果：该系统显著提高了新手的定位精度。医学生平均精度为2.971 mm (p = 0.00015)，无经验医师平均精度为2.803 mm （p = 0.00038）。经验丰富的外科医生没有观察到明显的改善（p < 0.05），表明该系统作为培训和辅助工具的潜力。系统可用性量表（SUS）的平均得分为83.5，表明用户满意度很高，尤其是在年轻的参与者中。结论：混合双导航系统显著提高了新手使用者的涂抹器放置准确性，证明了其作为kV-IORT有效培训和辅助工具的价值。高用户满意度和亚毫米级配准精度证实了其在临床翻译中的潜力，特别是在提高经验不足的从业者的可用性和精度方面。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Applied Clinical Medical Physics 医学-核医学

CiteScore

3.60

自引率

19.00%

发文量

331

审稿时长

3 months

期刊介绍： Journal of Applied Clinical Medical Physics is an international Open Access publication dedicated to clinical medical physics. JACMP welcomes original contributions dealing with all aspects of medical physics from scientists working in the clinical medical physics around the world. JACMP accepts only online submission. JACMP will publish: -Original Contributions: Peer-reviewed, investigations that represent new and significant contributions to the field. Recommended word count: up to 7500. -Review Articles: Reviews of major areas or sub-areas in the field of clinical medical physics. These articles may be of any length and are peer reviewed. -Technical Notes: These should be no longer than 3000 words, including key references. -Letters to the Editor: Comments on papers published in JACMP or on any other matters of interest to clinical medical physics. These should not be more than 1250 (including the literature) and their publication is only based on the decision of the editor, who occasionally asks experts on the merit of the contents. -Book Reviews: The editorial office solicits Book Reviews. -Announcements of Forthcoming Meetings: The Editor may provide notice of forthcoming meetings, course offerings, and other events relevant to clinical medical physics. -Parallel Opposed Editorial: We welcome topics relevant to clinical practice and medical physics profession. The contents can be controversial debate or opposed aspects of an issue. One author argues for the position and the other against. Each side of the debate contains an opening statement up to 800 words, followed by a rebuttal up to 500 words. Readers interested in participating in this series should contact the moderator with a proposed title and a short description of the topic