Journal of Applied Clinical Medical Physics最新文献

{"title":"Head-to-head: Anthropomorphic phantoms for evaluating the effect of skin tone on the accuracy of surface imaging systems","authors":"Elizabeth L. Covington,&nbsp;Dennis N. Stanley,&nbsp;Ashanti Lawson,&nbsp;Scott Hadley,&nbsp;Alexander Moncion,&nbsp;Rodney J. Sullivan,&nbsp;John B. Fiveash,&nbsp;Richard A. Popple","doi":"10.1002/acm2.70188","DOIUrl":"https://doi.org/10.1002/acm2.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To study the localization accuracy of two commercial surface imaging (SI) systems used for intrafraction motion monitoring during stereotactic radiosurgery (SRS) and quantify the difference in accuracy due to skin tone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using a publicly available CT dataset, anthropomorphic phantoms were 3D printed using filament in four skin tones: rose tan, light brown, medium brown, and dark brown (3DUniverse, Chicago, IL, USA). Three SI systems from two vendors were utilized to measure the SI-reported offsets of the stationary phantoms in various gantry and couch configurations to create SRS-like conditions, including when the gantry obscured one camera pod. At each position, approximately 5 s of offsets were averaged to obtain the SI-reported offset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All SI systems reported larger offsets for all phantoms at non-zero couch angles. The medium brown and dark brown phantoms showed the largest magnitudes at non-zero couch angles, increasing further when a camera pod was obstructed. For two SI systems, the position of the phantom for medium and dark brown phantoms could not be resolved at certain gantry/couch positions, and offsets up to 5 mm were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Characterization of SI systems using 3D-printed phantoms in a spectrum of skin tones can be used to determine the accuracy of SI tracking under treatment-like conditions. All SI systems showed decreased accuracy with darker skin-toned phantoms, which increased with an obstructed camera view.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624882","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":"Improving efficiency in lung SAbR planning using integrated tools for X-ray based adaptive radiotherapy","authors":"Justin Visak,&nbsp;Brien Washington,&nbsp;Chien-Yi Liao,&nbsp;Sean Domal,&nbsp;David Parsons,&nbsp;Yuanyuan Zhang,&nbsp;Shahed Badiyan,&nbsp;Kenneth Westover,&nbsp;Mu-Han Lin","doi":"10.1002/acm2.70195","DOIUrl":"https://doi.org/10.1002/acm2.70195","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the feasibility of translating clinical lung stereotactic ablative radiotherapy (SAbR) templates from Ethos1.1 to Ethos2.0, leveraging new features to facilitate dose fall-off and automate patient-specific beam arrangement. This study aims to streamline planning processes and support broader adoption of online adaptive radiotherapy (ART) for lung SAbR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We selected fifteen patients previously treated with adaptive lung SAbR using the Ethos1.1 system, each receiving 40–60 Gy in 5 fractions. Plans were reoptimized in Ethos2.0 using identical parameters (rIMRT) to their clinical counterpart. To evaluate new integrated features, we utilized high-fidelity (HF) mode with and without automatic treatment geometry selection (HF-cIMRT, HF-aIMRT/VMAT). These strategies were compared to assess the impact of Ethos2.0's new features on plan quality and efficiency using RTOG-based metrics and enhanced plan deliverability analysis. Statistical significance was assessed using paired Student's <i>t</i>-tests (<i>α</i> = 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All plans reoptimized in Ethos2.0 demonstrated acceptable plan quality. No statistically significant differences in maximum organ-at-risk doses were observed between evaluated strategies and the clinical plan. For complex cases, human-selected beam geometry proved superior to automated geometry. HF-enabled plans significantly reduced total monitor units, with HF-aVMAT, HF-cIMRT, and HF-aIMRT reporting 3142.4 ± 997.4 (<i>p</i> &lt; 0.001), 3401.8 ± 516.1 (<i>p</i> &lt; 0.001), and 3225.6 ± 484.2 (<i>p</i> &lt; 0.001) compared to clinical 5424.9 ± 1353.4. A trade-off was observed in conformity index, which was 1.06 ± 0.08 (<i>p</i> = 0.006), 1.05 ± 0.06 (<i>p</i> = 0.003), and 1.03 ± 0.05 (<i>p</i> = 0.05) for HF-aIMRT, HF-cIMRT, and HF-aVMAT plans compared to clinical 1.01 ± 0.03.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lung SAbR planning strategies can be effectively transitioned from Ethos1.1 to Ethos2.0, improving workflow efficiency with high-fidelity mode and minor adjustments. Automated beam geometry tools enhance planner efficiency for both IMRT and VMAT. To address increased ART workload and staffing demands, leveraging integrated automation tools is essential. The planning strategies presented in this study are straightforward and reproducible for ART-enabled clinics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70195","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624746","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":"Evaluation of a Monte Carlo based EPID system for patient-specific IMRT and VMAT quality assurance","authors":"Wuji Sun,&nbsp;Chao Ge,&nbsp;Yinghua Shi,&nbsp;Xiaohe He,&nbsp;Li Xiao,&nbsp;Yanfang Liu,&nbsp;Zhi Wang,&nbsp;Tianlong Ji,&nbsp;Huidong Wang","doi":"10.1002/acm2.70178","DOIUrl":"https://doi.org/10.1002/acm2.70178","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to evaluate the performance of a new electronic portal imaging device (EPID) system with a Monte Carlo (MC) based algorithm for patient-specific quality assurance (PSQA), ensuring its reliability and effectiveness in treatment verification efficiency and precision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixteen patients with various tumor sites were divided evenly into two groups for dynamic intensity-modulated radiation therapy and volumetric modulated arc therapy verification. Measurements were performed on a UIH uRT-linac 506c linear accelerator with a Varex Imaging XRD 1642 EPID. The performance of the EPID was assessed for sensitivity to errors in monitor units, collimator angle, field offset, field size, and multi-leaf collimator functionality. Treatment plans were modified for each error and verified to determine the capability of the system to detect perturbations from the planned dose distribution, which was quantitatively analyzed using γ index analysis (2%/2 mm, 10% low-dose threshold). Additionally, the ArcCHECK phantom was employed to validate the EPID system for PSQA and induced error detection. Pearson's correlation coefficient was employed to assess correlations between γ passing rates and induced errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EPID system showed high accuracy in dose linearity and error detection, with γ passing rates consistently above 95% for original plans. Sensitivity tests indicated strong correlations between induced errors and γ passing rates, confirming the capability of this system to detect subtle dosimetric discrepancies and supporting its application for PSQA. Both EPID and ArcCHECK demonstrated comparable γ passing rates in PSQA of standardized plans and treatment plans, with EPID showing higher or comparable sensitivity to tested errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The EPID Plan QA system showed promising accuracy and sensitivity in detecting errors, proving to be a reliable tool for PSQA. Its seamless integration into clinical workflows is expected to enhance treatment verification efficiency and ensure precise radiotherapy delivery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70178","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144624881","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":"Evaluation of the TrueBeam machine-performance-check (MPC): Collimator device check (CDC)","authors":"Michael Barnes,&nbsp;Andrew Dipuglia,&nbsp;Brad Beeksma,&nbsp;Joerg Lehmann","doi":"10.1002/acm2.70171","DOIUrl":"https://doi.org/10.1002/acm2.70171","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the Varian machine performance check (MPC) collimator devices check (CDC) for routine MLC and jaw testing as part of an AAPM compliant linac QA program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>CDC MLC positioning, MLC backlash, jaw positioning, and jaw parallelism were each assessed for repeatability and concordance with conventional QA. MLC and jaw positioning were also assessed for sensitivity. Measurement time and repeatability of CDC were assessed by timing and recording five successive measurements on a single linac. Concordance was assessed monthly over 5 months on four linacs, conducted during the same session as conventional QA. MLC positioning was compared to an advanced picket fence test, while jaw positioning and parallelism were compared to department in-house EPID based methods. MLC backlash was compared to the Varian built-in method. Sensitivity was assessed via deliberately introduced errors except for MLC backlash, which was assessed via correlation between methods across leaf banks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>CDC requires 4:09 (min:s) ± 1.8 s (2 SD) to perform. Repeatability was measured to be: 0.02 mm for both MLC positioning and backlash, 0.15 mm for jaw positioning and 0.009° for jaw parallelism (2 SD). Concordance was observed for mean MLC positioning to within 0.32 , 0.08 mm for MLC backlash, 0.6 mm for jaw positioning and 0.06° for jaw parallelism. MLC and jaw positioning sensitivity were observed with maximum mean difference between methods of 0.18  and 0.71 mm, respectively. MLC backlash correlation coefficient between methods across leaf banks was observed to 0.84 and 0.9 for banks A and B, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MPC CDC has been demonstrated to provide acceptably equivalent MLC and jaw positioning assessment to standard methods and could conceivably be used in a linac QA program for these purposes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615106","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":"Modified total skin electron treatment for a paraplegic patient","authors":"Thomas Martin,&nbsp;Geoff Nelson,&nbsp;David Gaffney,&nbsp;Christian Dial,&nbsp;Martin Szegedi,&nbsp;Prema Rassiah","doi":"10.1002/acm2.70162","DOIUrl":"https://doi.org/10.1002/acm2.70162","url":null,"abstract":"<p>Total Skin Electron Therapy (TSET) has been a highly effective treatment for mycosis fungoides (MF). However, the standard TSET treatment requires the patient to stand upright in six different positions for an extended time period, which may not be possible for some patients. Herein, is reported a modified TSET is reported to accommodate a paraplegic patient. Two dual beams of 6 MeV, commissioned for the standard TSET, were used for treatment. The patient's treatment surface was maintained within 190–240 cm isocenter to surface distance (ISD) and 100 cm horizontally. In vivo measurement showed that a ± 30% dose uniformity was achieved at the patient's surface.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70162","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615281","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":"A statistical approach to automated analysis of the low-contrast object detectability test for the large ACR MRI phantom","authors":"Ali M. Golestani,&nbsp;Julia M. Gee","doi":"10.1002/acm2.70173","DOIUrl":"https://doi.org/10.1002/acm2.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Regular quality control checks are essential to ensure the quality of MRI systems. The American College of Radiology (ACR) has developed a standardized large phantom test protocol for this purpose. However, the ACR protocol recommends manual measurements, which are time-consuming, labor-intensive, and prone to variability, impacting accuracy and reproducibility. Although some aspects of the ACR evaluation have been automated or semi-automated, tests like low-contrast object detectability (LCOD), remain challenging to automate. LCOD involves assessing the visibility of objects at various contrast levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this research is to propose and evaluate an automated approach for LCOD testing in MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The automated Python code generates a one-dimensional profile of image intensities along radial paths from the center of the contrast disk. These profiles are compared to templates created from the disc's geometric information using general linear model statistical tests. A total of 80 image volumes (40 T1- and 40 T2-weighted) were assessed twice by two human evaluators and the proposed Python code.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Human raters showed intra-rater variability (Cohen's Kappa 0.941, 0.962), while the Python code exhibited perfect intra-rater agreement. Inter-rater agreement between the code and humans was comparable to human-to-human agreement (Cohen's Kappa 0.878 between the two human raters vs. 0.945, and 0.783 between the code and human raters). A stress test revealed both human raters and the code assigned higher scores to lower bandwidth images and lower scores to higher bandwidth images.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The proposed automated method eliminates intra-rater variability and achieves strong inter-rater agreement with human raters. These findings suggest the method is reliable and suitable for clinical settings, showing high concordance with human assessments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615108","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":"Phantom-based comparative analysis of contrast-enhanced mammography systems: Image quality and performance evaluation","authors":"Giulia Bruschi,&nbsp;Valerio Ricciardi,&nbsp;Paolo De Marco,&nbsp;Daniela Origgi","doi":"10.1002/acm2.70163","DOIUrl":"https://doi.org/10.1002/acm2.70163","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Contrast-enhanced mammography (CEM) is a technique that exploits the combination of two projections at different energies to produce an energy-subtracted (ES) image to highlight the uptake of iodinated contrast medium in breast lesions. The aim of this study is to analyze and compare the performance of different CEM systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four mammography systems of different vendors (Fujifilm Amulet Innovality, Hologic 3Dimensions, IMS Giotto Class, GE Senographe Pristina) were compared employing a commercial dedicated phantom, equipped with a breast-equivalent target slab with four different iodine concentrations (IC) inserts. Acquisition parameters and average glandular dose (AGD) were collected at different phantom thicknesses (30–80 mm). Contrast-to-noise ratio (CNR) and linearity of IC response with phantom thickness were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>AGDs (mGy) were in ranges 0.82–3.10, 0.90–6.25, 1.08–3.30, and 0.74–3.63 for Fujifilm, Hologic, GE, and IMS, respectively. High-energy AGD accounted for up to 41.5%, 25.6%, 40.5%, and 23.8% of the total dose for Fujifilm, Hologic, IMS, and GE, respectively. CNR increased with IC and generally decreased with increasing phantom thickness. In recombined images, Hologic, Fujifilm, and GE showed good linearity of IC response with phantom thickness and overlapping trends (maximum error = 1%) for all thicknesses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Similarities and differences in image quality and dose were found depending on the different technical and image processing characteristics of the different vendors. Linearity of IC at various thicknesses might be further exploited in clinical scenarios to differentiate between suspicious breast lesions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70163","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615300","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":"Enhancing proton therapy quality assurance with custom-designed Octopoint phantom and Gafchromic film","authors":"Xueyan Tang,&nbsp;Chris J. Beltran,&nbsp;Keith M. Furutani,&nbsp;Graham S. Gilson,&nbsp;Jon Gustafson,&nbsp;Michael G. Herman,&nbsp;Shima Ito,&nbsp;Jed E. Johnson,&nbsp;Jon J. Kruse,&nbsp;Kenneth M. Long,&nbsp;Daniel W. Mundy,&nbsp;Nicholas B. Remmes,&nbsp;Ali M. Tasson,&nbsp;Thomas J. Whitaker,&nbsp;Witold Matysiak,&nbsp;Erik J. Tryggestad","doi":"10.1002/acm2.70156","DOIUrl":"https://doi.org/10.1002/acm2.70156","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Proton therapy offers precise tumor targeting while minimizing damage to surrounding healthy tissue, making it especially valuable for treating tumors near critical organs and in pediatric patients. However, its success depends on accurate beam delivery, requiring rigorous quality assurance (QA) to maintain treatment precision and effectiveness.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aims to standardize the measurement of key aspects of proton therapy delivery, such as gantry and couch isocentricity, spot position accuracy, and spot size consistency. The goal is to enhance the delivery accuracy of proton therapy across various clinical settings, improving patient outcomes.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The QA framework uses the Octopoint phantom, Gafchromic film, and spot position monitor (SPM) log data to evaluate proton beam isocentricity, spot position, and spot size. The Octopoint phantom, made from acrylic, was used with Gafchromic films at various gantry and couch angles to measure isocentricity. MATLAB tools were used to analyze spot positions, and SPM logs provided verification. Sensitivity tests were conducted to assess the system's response to intentional shifts and errors, ensuring alignment with clinical QA standards.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The Octopoint phantom's stepwise two-dimensional (2D) fitting process, validated against film-measured dose profiles, accurately identified beam and ball bearing (BB) centroid locations. Isocentricity tests conducted over 8 months across four gantries demonstrated consistent beam-to-BB radial offsets. The phantom showed excellent repeatability, with a maximum standard deviation of 0.1 mm across various couch-gantry combinations. Sensitivity testing across all axes revealed a strong alignment between intended shifts and measured values. Over the course of a year, film measurements tracked spot position and size consistency, with deviations remaining within acceptable clinical limits. Comparisons with SPM data further confirmed the system's reliability in maintaining beam accuracy across different gantry angles and energy levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study presents a reliable QA framework for ensuring precision in proton therapy delivery. By combining the Octopoint phantom, Gafchromic film analysis, and SPM log file evaluation, we effectively measured isocentricity, spot po","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70156","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615301","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":"Optimizing cardio-respiratory motion management in stereotactic arrhythmia radioablation through mid-position planning target volume","authors":"Adèle Gabillaud,&nbsp;Louis Rigal,&nbsp;Raphaël Martins,&nbsp;Renaud De Crevoisier,&nbsp;Juan Cisneros,&nbsp;Loïg Duvergé,&nbsp;Mathieu Lederlin,&nbsp;Nolwenn Delaby,&nbsp;Karim Benali,&nbsp;Antoine Simon,&nbsp;Julien Bellec","doi":"10.1002/acm2.70170","DOIUrl":"https://doi.org/10.1002/acm2.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose/objective</h3>\u0000 \u0000 <p>This study proposes an implementation of the mid-position (MidP) approach to compensate for cardio-respiratory motions in the context of Stereotactic Arrhythmia Radioablation (STAR) and evaluates its benefits compared to an internal target volume (ITV) approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Fifteen patients who underwent STAR for refractory ventricular tachycardia in our institution were included in this retrospective planning study. For each patient, a cardiac-gated four-dimensional computed tomography (4D-CT_card) scan and a respiratory-gated four-dimensional computed tomography (4D-CT_resp) were acquired. All patients were treated using a volumetric modulated arc therapy technique using an in-treatment Cone-Beam CT (CBCT) image guidance. The MidP approach was implemented to compensate for uncertainties, including cardio-respiratory motions characterized using the 4D-CT_card and 4D-CT_resp scans, and the inter-fraction motions measured using the CBCT scans. For comparison purposes, the ITV approach was also implemented. Both approaches were compared in terms of planning target volume (PTV) volumes, doses to organs-at-risk, and clinical target volume (CTV) doses, assessed using a 4D modeling method that estimates the accumulated dose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared with the ITV method, the MidP approach resulted in a mean [min-max] relative PTV volume reduction of 30% [19%, 48%] (<i>p</i> &lt; 0.001, Wilcoxon signed rank test). The mean [min-max] D95% CTV coverage was 105% [101%–114%] and 107% [101%–117%] of the prescription dose for MidP and ITV-based plans, respectively. The median dose to the whole heart was significantly lower with MidP-based plans with a mean difference of −0.5 Gy (<i>p</i> = 0.0084). The near-maximum dose (D1%) delivered to left coronary arteries, aorta, and stomach was systematically lower with the MidP-based plans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared to ITV based approach, the use of MidP strategy for treatment planning of STAR leads to significantly smaller PTV and lower surrounding OAR doses while still achieving a clinically acceptable CTV coverage.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70170","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615113","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":"Analysis of the institutional free market in accredited medical physics graduate programs","authors":"Brian W. Pogue,&nbsp;Alexander P. Niver","doi":"10.1002/acm2.70164","DOIUrl":"https://doi.org/10.1002/acm2.70164","url":null,"abstract":"<p>Medical Physics education is largely delivered through accredited programs where admission numbers and funding for students are controlled by the individual institutions providing the educational programs. Public data from these accredited graduate programs, along with funding data, can be used to analyze institutionally driven trends in the market for providing this education. Temporal trends from 2017 to 2023 show robust growth in MS graduates, increasing at an average of 17.7 per year, as compared to steady but modest growth in PhDs, increasing by 3.6 per year. The current ratio is 2:1 in MS:PhD for total annual graduates in North America. Trends in funding show self-funding of MS students is a dominant pathway in domestic programs, with this being less dominant in international programs. Those programs dominated by accredited MS education have their largest fraction of faculty in radiation oncology departments, whereas those dominated by PhD education have their largest fraction of faculty in radiology departments. Overall, NIH funding in the space of radiation diagnostics and therapeutics has been largely static over this timeframe, but with a notable recent rise in NCI funding in the last 5 years. This can be contrasted to a substantial 5X–6X rise in NIH funding for engineering research programs during this same period, with significant increases in trainee funding there. Taken as a whole, this survey shows that growth in the field of medical physics education is dominated by MS graduates, presumably servicing the expanded growth needs for well-trained clinical physicists. However, the research infrastructure that supports PhD training in medical physics seems likely to be growing modestly and has missed the growth trend of NIH funding to non-accredited programs such as biomedical engineering.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 7","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70164","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615109","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}