Journal of Applied Clinical Medical Physics最新文献

{"title":"Correction to: \"Impact of CT calibration curves on radiotherapy planning using diagnostic CT scans and a planning CT supporting DirectDensity reconstruction\".","authors":"","doi":"10.1002/acm2.70572","DOIUrl":"https://doi.org/10.1002/acm2.70572","url":null,"abstract":"","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70572"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of dose allocation between high- and low-kV scans on virtual monoenergetic image quality in developmental dual-energy cone-beam CT for image-guided radiotherapy.","authors":"Andrew Keeler, Luke Layman, Ha Nguyen, Jason Luce, Mathias Lehmann, John C Roeske, Hyejoo Kang","doi":"10.1002/acm2.70545","DOIUrl":"https://doi.org/10.1002/acm2.70545","url":null,"abstract":"<p><strong>Background: </strong>Dual-energy cone-beam CT (DE-CBCT) offers potential as an advanced imaging technique for image-guided radiation therapy (IGRT) through the production of virtual monoenergetic images (VMI). CBCT-VMI can show enhanced image quality, with improved CNR and reduced nonuniformity artifacts, compared to polychromatic images. However, optimized DE-CBCT protocols are required for clinical application. In particular, the impact of the dose allocation between the two acquisition energies on the resulting VMI image quality remains to be assessed.</p><p><strong>Purpose: </strong>This study evaluates the impact of different dose allocation strategies between the low- and high-energy scans on the image quality of DE-CBCT derived VMI.</p><p><strong>Methods: </strong>A series of seven DE-CBCT scans were performed using various dose allocations ranging from 10% Low-energy/90% High-energy (LE/HE) to 70%/30% LE/HE in 10% intervals while maintaining a constant total imaging dose. To assess the impact of the dose allocation strategies, VMI were reconstructed at 40, 60, 80, and 100 keV and evaluated for Hounsfield Unit (HU) accuracy, relative contrast-to-noise ratio (rCNR) enhancement, and HU uniformity compared to a dose-matched clinical CBCT protocol.</p><p><strong>Results: </strong>DE-CBCT protocols between 20%/80% and 70%/30% LE/HE showed significant improvements over the clinical protocol, with CNR values improving by an average of 18%-32% at 60 keV and non-uniformity artifacts reduced to negligible levels without loss of HU accuracy. Statistical comparison between these DE-CBCT protocols further showed that the specific dose allocation had statistically insignificant impact on the resulting VMI image quality between 20%/80% and 50%/50% LE/HE at any energy. Of the remaining DE protocols, 70%/30% showed a significant decrease in HU accuracy while 10%/90%, 60%/40%, and 70%/30% showed reduced rCNR enhancement at some energies.</p><p><strong>Conclusions: </strong>Overall, a wide range of dose allocations are shown to produce comparably near-optimal VMI quality. This finding supports protocol design flexibility for future clinical DE-CBCT implementations.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70545"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13120888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning \"super resolution\" versus iterative reconstruction: Phantom-based image quality assessment.","authors":"Stephanie M Leon, Daniella Fabri, Colin J Schaeffer, Edmond A Olguin","doi":"10.1002/acm2.70597","DOIUrl":"https://doi.org/10.1002/acm2.70597","url":null,"abstract":"<p><strong>Background: </strong>Deep learning reconstruction (DLR) algorithms have begun replacing iterative reconstruction (IR) in CT. Besides the potential to reduce noise, the application of artificial intelligence can also allow for \"super resolution,\" allowing traditional CT systems to produce images with improved spatial resolution by training against higher-resolution images. This study aims to characterize the image quality produced by a DLR \"super resolution\" algorithm.</p><p><strong>Purpose: </strong>This study compares Canon's Precise IQ Engine (PIQE) Cardiac, a DLR algorithm, with the AIDR Enhanced 3D iterative reconstruction (IR) algorithm using quantitative phantom-based image quality measurements.</p><p><strong>Materials and methods: </strong>Scans of the American College of Radiology (ACR) Gammex 464 image quality phantom with and without a torso-sized elliptical ring were acquired using CTDI_vol of 2.6, 15.7, and 32.9 mGy. Each experimental condition was scanned 20 times. Reconstructions used AIDR with a cardiac kernel and PIQE Cardiac with both 512 × 512 and 1024 × 1024 matrices. The task-based modulation transfer function (MTF_task) was calculated for Teflon, acrylic, polyethylene, and air inserts. Contrast-to-noise ratio (CNR) and low-contrast object specific CNR (CNR_LO) were calculated for the 25-mm and 6-mm low-contrast disks in module 2 of the phantom. NPS and noise magnitude were calculated from the module's background.</p><p><strong>Results: </strong>Both versions of PIQE showed improvement in MTF_task over AIDR for most frequencies, with PIQE 1024 outperforming PIQE 512. Larger differences were noted at higher contrast levels and with the smaller phantom. NPS curves for PIQE 512 and PIQE 1024 were nearly identical at all doses. AIDR showed a noise magnitude at least 44% higher than PIQE for all scenarios. The NPS shapes differed between AIDR and PIQE, producing noticeably different noise textures that were dose- and phantom size-dependent. CNR_LO values were similar between PIQE 512 and PIQE 1024 and were higher than those of AIDR for most scenarios; however, AIDR outperformed PIQE for the 6-mm objects at the medium and high doses. Use of PIQE on the 25-mm disk permits dose reductions in the small phantom without loss of CNR_LO.</p><p><strong>Conclusion: </strong>PIQE provides substantial image quality improvements over AIDR in phantom-based quantitative measurements. The potential for dose reduction is also noted. PIQE 1024 can be used to improve the spatial resolution over PIQE 512, with no apparent trade-offs in image quality.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70597"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of an optically stimulated luminescence radiometer based on sodium chloride and gold nanoparticles for improving radiation detection in radiography.","authors":"Mus'ab S Alkasasbeh, Khalid Hassan Ibnaouf, Naser M Ahmed, Azhar Abdul Rahman, Thair Hussein Khazaalah, Dheyaa Nabeel Abbas, Hajo Idriss, Monther Alsboul","doi":"10.1002/acm2.70539","DOIUrl":"https://doi.org/10.1002/acm2.70539","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate sodium chloride doped with gold nanoparticles (NaCl + GNPs) as a low-cost, reusable optically stimulated luminescence (OSL) material for diagnostic radiology, and to benchmark its luminescence performance against the commercial standard, aluminum oxide doped with carbon (Al₂O₃:C).</p><p><strong>Methods: </strong>NaCl + GNPs detectors were fabricated through solution-based doping, solvent evaporation, pellet pressing, and two-stage thermal treatment. Structural characterization was verified via UV-Vis spectroscopy. OSL performance was assessed under diagnostic X-ray energies ranging from 40 to 150 kVp, using Al₂O₃:C as the reference. Evaluated parameters included OSL signal linearity, reproducibility, bleaching efficiency, fading behavior, minimum detectable signal (MDS), energy dependence, and mass scaling. Measurements were performed using equal and variable detector masses (20-60 g) across a dose range of approximately 6-60 mGy.</p><p><strong>Results: </strong>NaCl + GNPs exhibited strong linearity (R² > 0.99) across the tested exposure range and produced reproducible OSL signals over repeated irradiations. The material demonstrated an energy-dependent increase in luminescence comparable to Al₂O₃:C, with the 40 g NaCl + GNPs sample achieving 96-97% of the Al₂O₃:C OSL signal at 150 kVp. Increasing detector mass enhanced luminescence output proportionally, with 60 g samples exceeding the reference material at energies above 100 kVp. Bleaching efficiency was notably high, with consistently minimal residual signal, confirming excellent reusability. The MDS was approximately equivalent to 0.4-0.5 mGy in relative terms. However, NaCl + GNPs showed faster fading, with ∼50% signal loss over 9 h, indicating the importance of timely readout or controlled storage.</p><p><strong>Conclusions: </strong>Gold nanoparticle incorporation enhances the luminescent efficiency and usability of NaCl, producing a material that is low-cost, scalable, and highly effective in bleaching. Although slightly less sensitive than Al₂O₃:C, the NaCl + GNPs detectors demonstrate strong performance, favorable reproducibility, and minimal residual signal, making them a practical option for clinical, educational, and resource-limited dosimetry applications.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70539"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of ion recombination and polarity effects in high dose rate electron beams.","authors":"Ratna Sari Dewi, Mardon Limena, Dwi Seno Kuncoro Sihono, Poonam Yadav, Supriyanto Ardjo Pawiro","doi":"10.1002/acm2.70600","DOIUrl":"10.1002/acm2.70600","url":null,"abstract":"<p><strong>Background: </strong>Accurate dosimetry is essential for enhancing the effectiveness and safety of radiotherapy treatment. High dose rate electron (HDRE) beams, a dose rate up to ten times higher at the measurement point than standard electron beam at the same Monitor Unit (MU). The increased ionization density raises concern about ion recombination effects, which may affect the reliability of ionization chamber readings.</p><p><strong>Purpose: </strong>This study aims to evaluate the effects of ion recombination ( <math> <semantics><msub><mi>k</mi> <mi>s</mi></msub> <annotation>${{k}_s}$</annotation></semantics> </math> ) and polarity ( <math> <semantics><msub><mi>k</mi> <mrow><mi>p</mi> <mi>o</mi> <mi>l</mi></mrow> </msub> <annotation>${{k}_{pol}}$</annotation></semantics> </math> ) across various dosimetry protocols in order to determine the most suitable approach for HDRE settings.</p><p><strong>Methods: </strong>Measurements were carried out using Elekta VersaHD, linear accelerator at 6 MeV and 10 MeV both in standard and HDRE modes using three ionization chambers: IBA PPC40, FC65-P and CC13. Data were collected at a source-to-surface distance (SSD) of 100 cm, referring to the standard dosimetry protocols TRS-398 and AAPM TG-51, along with a modified method. Modified method using beam quality conversion factor ( <math> <semantics><msubsup><mi>k</mi> <mi>Q</mi> <mo>'</mo></msubsup> <annotation>$k_Q^{prime}$</annotation></semantics> </math> ) derived from Monte Carlo simulation and specific adjustment was applied to PPC40, where the Effective Point of Measurement was determined to be 1.39 mm from the window surface.</p><p><strong>Results: </strong>Based on three dosimetry protocols, all ionization chambers showed improved performance, with the <math> <semantics><msub><mi>k</mi> <mi>s</mi></msub> <annotation>${{k}_s}$</annotation></semantics> </math> values decreasing by approximately 0.4% to 3% as the operational voltage increased from 100 to 400 V, indicating enhanced charge collection and less recombination effects. In contrast, all of <math> <semantics><msub><mi>k</mi> <mrow><mi>p</mi> <mi>o</mi> <mi>l</mi></mrow> </msub> <annotation>${{k}_{pol}}$</annotation></semantics> </math> values remained remarkably stable, ranging from 0.9962 to 1.0001. This study evaluated ion recombination and polarity effects in HDRE beams using plane parallel and cylindrical chambers.</p><p><strong>Conclusions: </strong>Based on data variations, we recommend elevated operating voltage (400 V) than typical voltage (300 V) to reduce ion recombination in HDRE beams. Furthermore, modified method can be alternative to measure the accuracy of charge readings for absolute dosimetry.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70600"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SpineMAE: A bone-window self-supervised and structure-aware framework for 3D cervical vertebra segmentation and fracture classification.","authors":"Qing Liang, Jingding Zhao, Fang Yang, Lin Shi, Yang Song, Xianjun Chen, Zewen Shi, Qingjiang Pang","doi":"10.1002/acm2.70575","DOIUrl":"10.1002/acm2.70575","url":null,"abstract":"<p><strong>Introduction: </strong>Accurate segmentation and classification of cervical spine fractures are essential for timely diagnosis and clinical decision-making in trauma care. Existing deep learning approaches often require extensive manual annotations and struggle to maintain anatomical consistency across vertebral levels, limiting their reliability and generalization.</p><p><strong>Methods: </strong>We propose a unified three-stage framework that integrates self-supervised representation learning, structure-aware segmentation, and vertebra-level classification. A bone-window 3D masked autoencoder first pretrains the encoder to learn bone-sensitive volumetric features from unlabeled CT scans. The pretrained encoder is then transferred to a structure-aware 3D U-Net that incorporates bone-likelihood and edge priors with geometry-consistency regularization for anatomically coherent vertebral segmentation. Finally, a vertebra-level classification head performs fracture prediction using ROI features with positional embeddings to encode anatomical context.</p><p><strong>Results: </strong>Evaluated on the RSNA Cervical Spine Fracture Detection dataset, the proposed method achieved a Dice score of 89.23% for cervical vertebra segmentation. For vertebra-level fracture classification, it achieved an AUC of 0.969 with sensitivity of 0.788 and specificity of 0.962 (macro-averaged across C1-C7), outperforming CNN- and transformer-based baselines.</p><p><strong>Conclusions: </strong>The proposed framework provides a robust, interpretable, and data-efficient solution for automated cervical spine fracture detection and localization. By combining self-supervised 3D pretraining with anatomy-aware modeling, it offers a practical pathway toward clinically reliable AI-assisted diagnosis in spinal imaging.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70575"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13137942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing proton therapy: Dosimetric superiority of proton arc therapy over IMPT in esophageal cancer treatment.","authors":"Xiaoda Cong, Ebin Sebastian, Peilin Liu, Xiaoqiang Li, James Dolan, Raymond Dalfson, Martin Soukup, Etienne Lessard, Rohan L Deraniyagala, Craig W Stevens, Peter Y Chen, Xuanfeng Ding","doi":"10.1002/acm2.70607","DOIUrl":"10.1002/acm2.70607","url":null,"abstract":"<p><strong>Background and aims: </strong>Esophageal cancer presents significant treatment challenges due to its proximity to critical structures such as the heart, lungs, and spinal cord. While intensity-modulated proton therapy (IMPT) improves dose conformity, it is limited by factors such as the number of beam angles and lateral penumbra. Proton arc therapy (PAT) may overcome these issues by utilizing continuous gantry rotation to enhance conformity and spare organs-at-risk (OARs). This study compared PAT and IMPT in esophageal cancer, focusing on dosimetric outcomes, and dose-averaged linear energy transfer (LET_d) distributions.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on ten esophageal cancer patients with variable tumor characteristics. Treatment plans were created using Monaco v6.1 treatment planning system for both PAT and IMPT, maintaining identical robustness parameters (± 5 mm setup and ± 3.5% range uncertainties). Both modalities were prescribed a total dose of 50.4 Gy(RBE) in 28 fractions, ensuring ≥95% clinical target volume (CTV) coverage in the worst-case scenarios. Key metrics, including conformity index (CI), heterogeneity index (HI), and LET_d, were compared. Robustness evaluations were performed across 21 worst-case scenarios to assess plan quality and OAR sparing.</p><p><strong>Results: </strong>PAT demonstrated superior dose conformity (CI: 0.67 ± 0.17 vs. 0.54 ± 0.13; p < 0.01) and reduced lung V20 (6.88% vs. 13.44%; p < 0.01) compared to IMPT. Critical structure sparing, including reduced spinal cord doses (max dose of (30.93 ± 10.85) Gy(RBE) vs (23.22 ± 9.55) Gy(RBE), p = 0.02), was achieved without compromising CTV coverage. PAT showed higher LET_d within the CTV and lower LET_d in adjacent organs-at-risk relative to IMPT, without statistically significant differences. While the clinical significance remains uncertain, this pattern may support more refined biological dose shaping.</p><p><strong>Conclusions: </strong>PAT emerged as a promising modality for esophageal cancer treatment, delivering improved dose conformity and reduced OAR exposure. These advantages suggest PAT's potential to decrease radiation-associated complications and improve therapeutic outcomes, warranting further clinical validation.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70607"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13143515/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nominal plan robustness may predict plan degradation in proton therapy for oropharyngeal head-and-neck cancer.","authors":"Mark J Zakhary, Daniel Redell, David Alicia, Jenna Jatczak, Nrusingh C Biswal, Sina Mossahebi, Kai Sun, Reid Bark, Jason K Molitoris, Byongyong Yi","doi":"10.1002/acm2.70585","DOIUrl":"https://doi.org/10.1002/acm2.70585","url":null,"abstract":"<p><strong>Background: </strong>Proton therapy for head-and-neck (HN) cancer offers superior organ-at-risk sparing compared to photon therapy, but is challenged by frequent anatomical changes during treatment. These changes need to be monitored with routine verification CTs (vCTs), which are used to trigger adaptive replans when deemed necessary by the clinical team.</p><p><strong>Purpose: </strong>To investigate whether nominal plan robustness evaluation (RE) data-specifically the magnitude and spatial characteristics of high-dose regions (hotspots)-can predict the development of clinically significant hotspots on verification CTs (vCTs) and guide planning strategies that minimize the need for adaptive replanning.</p><p><strong>Methods: </strong>This retrospective study analyzed 46 patients with p16-positive oropharyngeal cancer treated with proton therapy. Clinical treatment plans were robustly evaluated using 12 uncertainty scenarios combining 3 mm setup and ± 3.5% range errors. Each plan was recalculated on periodic vCTs throughout the treatment course to assess plan degradation. The maximum RE hotspot magnitude and location were compared with vCT hotspot characteristics. A subset of five cases underwent proof-of-concept replanning to reduce RE hotspots and assess downstream vCT dose effects.</p><p><strong>Results: </strong>Patients requiring adaptive replanning due to vCT hotspots had significantly higher RE hotspot magnitudes of the nominal plan compared to those who did not (p = 0.008). For replanned cases, higher RE hotspots were moderately correlated with closer proximity of RE and vCT hotspots (r = -0.59, p = 0.009). Across all patients, a modest correlation (r = 0.58, p < 0.001) was observed between RE and vCT hotspot magnitudes. Further, the rate of plan degradation over the course of treatment via hotspot formation was found to increase with increasing RE hotspot magnitude. Replanning to reduce RE hotspots led to an average 5.6% reduction in vCT hotspot dose for the five patients studied, suggesting that reducing RE hotspots may reduce the frequency of replans.</p><p><strong>Conclusions: </strong>Nominal plan robustness evaluation is predictive of both the magnitude and location of hotspots observed on vCTs, and plans with higher RE hotspots tend to degrade faster over the treatment course. Minimizing RE hotspots during treatment planning may reduce the need for adaptive replanning and enhance clinical workflow efficiency.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70585"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13134370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical implementation and evaluation of a patient-specific surface-guided clearance mapping system for collision avoidance and noncoplanar beam planning.","authors":"Siqiu Wang, Eric Chambers, Ruiqi Li, Yesenia Gonzalez, Xinran Zhong, Zohaib Iqbal, Kara James, Jennifer Cleaton, David Sher, Andrew Godley, David Parsons","doi":"10.1002/acm2.70548","DOIUrl":"https://doi.org/10.1002/acm2.70548","url":null,"abstract":"<p><strong>Purpose/objectives: </strong>Collision avoidance is critical in external beam radiotherapy to ensure patient safety and plan deliverability. Limited understanding of the collision-free treatment space risks both patient safety and unnecessary exclusion of useful beams-particularly in noncoplanar setups-resulting in suboptimal plans. Conventional methods (manual clearance checks or CT-based assessments, etc.) are either labor-intensive or fail to account for collision-prone anatomy outside the scan. We investigated and clinically implemented a virtual patient-specific clearance mapping system and evaluated its utility as a noncoplanar beam selection tool to improve plan quality.</p><p><strong>Materials/methods: </strong>The system integrates full-body, patient-specific surfaces-acquired during simulation using near-infrared imaging-with interactive 3D linac/couch models. Clearance mapping accuracy was validated through phantom measurements and a comparative analysis with manual clearance checks of 60 patients across treatment sites. Workflow efficiency data were reported over three years of clinical implementation. A workflow for patient-specific non coplanar beam selection was proposed and evaluated in 20 lung stereotactic body radiation therapy (SBRT) and 18 breast stereotactic partial breast irradiation (sPBI) cases.</p><p><strong>Results: </strong>The clearance mapping accuracy was within ± 1° (gantry/couch rotation) of phantom measurements. For 60 patients, the virtual predictions accurately identified all potential clearance issues, while manual verification missed 5 collision events. Virtual checks saved approximately 15 min of linac and therapist time per plan and eliminated an average 6.2-clinical hour planning delay. With the proposed beam selection workflow, noncoplanar replans for lung SBRT improved target conformality (Paddick Conformity Index from 0.89 to 0.91, p < 0.01) and reduced low dose spillage. For breast sPBI, heart mean dose was lowered (103 cGy to 68 cGy, p < 0.01). Delivery time increased by approx. 30s per plan.</p><p><strong>Conclusions: </strong>The virtual clearance mapping system outperformed manual verification, streamlined clinical workflow, and could significantly improve plan quality through efficient noncoplanar beam selection. It has replaced manual verification at our institution.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70548"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13106023/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147772086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FilmQADose: Open-source software for radiochromic film dosimetry.","authors":"Eduardo Herrera-Alba, Carlos Contreras-Quiroz, Juliana Sandoval-Navia, Jaider Vásquez, Carlos Ávila","doi":"10.1002/acm2.70602","DOIUrl":"https://doi.org/10.1002/acm2.70602","url":null,"abstract":"<p><strong>Purpose: </strong>FilmQADose is an open-source, Python-based software for radiochromic film dosimetry, designed to provide medical physicists with a freely available, extensible tool for two-dimensional dose verification in radiotherapy. It covers the full film QA workflow, from calibration curve generation to plan-to-film comparison, targeting clinical and research centers that require an accessible alternative to commercial solutions.</p><p><strong>Development and validation methods: </strong>The software was developed in Python using open-source scientific libraries for image processing, curve fitting, DICOM handling, and gamma analysis. Core functionalities include rational and polynomial calibration models, multichannel dose reconstruction, normalized cross-correlation template matching for automatic alignment, and gamma analysis. Validation was performed using irradiated Gafchromic EBT3 films in square field, pyramidal, and breast IMRT plans. Measured dose maps were compared against treatment planning system calculations using 3%/3 mm gamma criteria.</p><p><strong>Data format and usage notes: </strong>FilmQADose processes TIFF images acquired from flatbed scanners and DICOM RT Dose files exported from treatment planning systems. Output dose maps are generated in DICOM 2D format. The software is implemented in Python with standard scientific Python dependencies and includes a graphical user interface built using PySide6. The source code, documentation, and usage guides are publicly available at: eduardoh27.github.io/FilmQADose.</p><p><strong>Potential applications: </strong>The software supports clinical quality assurance in IMRT dose verification, as well as for research applications in radiochromic film dosimetry methodology. A limitation is the absence of lateral response artifact correction and recent machine-learning-based calibration methods.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 5","pages":"e70602"},"PeriodicalIF":2.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}