Journal of Applied Clinical Medical Physics最新文献

{"title":"Improving organ dose sparing in left-sided breast cancer with yaw-limited volumetric modulated arc therapy: A dosimetric comparison to conventional and intensity modulated radiation therapy approaches.","authors":"Gerhard Pollul, Sascha Grossmann, Heiko Karle, Tilman Bostel, Heinz Schmidberger","doi":"10.1002/acm2.70041","DOIUrl":"https://doi.org/10.1002/acm2.70041","url":null,"abstract":"<p><strong>Background: </strong>To assess the dose-sparing capabilities of a yaw-limited volumetric modulated arc therapy (YL_VMAT) beam setup for adjacent organs at risk (OAR) in comparison with 3D-conventional radiation therapy (3D-CRT), intensity-modulated radiation therapy (IMRT) and conventional VMAT for radiation therapy in left-sided breast cancer patients.</p><p><strong>Methods: </strong>In total, 80 treatment plans for 20 patients, of which 10 patients underwent CT-scans in deep inspiration breath-hold (DIBH) and 10 patients in free-breathing (FB) technique. Besides generally tangential-weighted static and IMRT beams, VMAT treatment plans with approximately 270° arc length have been compared and analyzed to a multi-field, yaw-adapted, unconventional partial VMAT technique retrospectively. The prescription dose was set to 40.05 Gy in 15 fractions.</p><p><strong>Results: </strong>We achieved a more pronounced steeper dose falloff directed from the thoracic wall to the adjacent lung tissue resulting in a significantly better ipsilateral lung and considerably cardiac dose sparing using the YL_VMAT method in general. Compared with standard techniques (IMRT, VMAT, 3D-CRT), YL-VMAT in combination with DIBH can achieve lower mean doses for the heart (1.05 Gy vs. 1.73 Gy, 2.16 Gy and 1.44 Gy), the left anterior descending (LAD) artery (3.68 Gy vs. 6.53 Gy, 5.13 Gy and 8.64 Gy) and the left lung (3.59 Gy vs. 5.39 Gy, 4.79 Gy and 5.87 Gy), respectively. Also with FB, the corresponding mean doses for the left lung and cardiac structures were lower with the YL-VMAT method than with IMRT (heart: 1.70 Gy vs. 2.44 Gy; LAD: 6.50 Gy vs. 11.97 Gy; left lung: 3.10 Gy vs. 4.72 Gy), VMAT (heart: 1.70 Gy vs. 2.52 Gy; LAD: 6.50 Gy vs. 9.06 Gy; left lung: 3.10 Gy vs. 4.46 Gy) and 3D-CRT (heart: 1.70 Gy vs. 2.78 Gy; LAD: 6.50 Gy vs. 15.09 Gy; left lung: 3.10 Gy vs. 5.77 Gy). In addition, we found out superiority of YL_VMAT for the V5, V10, and V20 Gy to the left lung. For DIBH and FB, all differences for the left lung were significant, with p < 0.05.</p><p><strong>Conclusions: </strong>With the YL_VMAT technique, dose exposures to radiosensitive OARs like the lung, heart and LAD artery can be reduced considerably to very low values in comparison to already established planning methods. The benefits must be weighed against the potential risks induced by an increased dose exposure to the contralateral breast.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70041"},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531446","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":"Measurement of CT radiation beam width with a pencil ionization chamber and radiopaque mask.","authors":"Rani Al-Senan, David M Gauntt, Gary T Barnes","doi":"10.1002/acm2.70027","DOIUrl":"https://doi.org/10.1002/acm2.70027","url":null,"abstract":"<p><strong>Purpose: </strong>This study compares fan beam CT scanner radiation beam widths measured with a pencil ionization chamber-radiopaque mask technique with commonly used film and computed radiography (CR) measurements.</p><p><strong>Methods: </strong>For a given fan beam CT scanner x-ray beam, the ionization chamber-mask technique determines the radiation beam width by exposing a 100 mm pencil chamber with and without a radiopaque cylindrical mask of known width that is a fraction of the nominal beam width. Additional widths can then be measured using the same kV, mAs, and pre-patient filtration without the mask. CT scanner radiation beam width measurements with the technique were compared with film and CR techniques.</p><p><strong>Results: </strong>Measurements from 20 different detector configurations/focal spot combinations on fan beam CT scanners from two manufacturers are presented. The root mean square (RMS) difference between the ionization chamber-mask measured beam widths and film measurements was 0.31 mm, with a similar RMS difference of 0.28 mm with CR measurements. These results compare favorably with the RMS difference between film and CR measurements, which was 0.35 mm.</p><p><strong>Conclusion: </strong>This study demonstrates that radiation beam widths of fan beam CT scanners can be measured using the ionization chamber-radiopaque mask method with an RMS accuracy of better than 0.5 mm. We demonstrate the method is applicable to nominal beam widths ranging from 1 to 40 mm.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70027"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523416","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":"A review of artificial intelligence in brachytherapy.","authors":"Jingchu Chen, Richard L J Qiu, Tonghe Wang, Shadab Momin, Xiaofeng Yang","doi":"10.1002/acm2.70034","DOIUrl":"10.1002/acm2.70034","url":null,"abstract":"<p><p>Artificial intelligence (AI) has the potential to revolutionize brachytherapy's clinical workflow. This review comprehensively examines the application of AI, focusing on machine learning and deep learning, in various aspects of brachytherapy. We analyze AI's role in making brachytherapy treatments more personalized, efficient, and effective. The applications are systematically categorized into seven categories: imaging, preplanning, treatment planning, applicator reconstruction, quality assurance, outcome prediction, and real-time monitoring. Each major category is further subdivided based on cancer type or specific tasks, with detailed summaries of models, data sizes, and results presented in corresponding tables. Additionally, we discuss the limitations, challenges, and ethical concerns of current AI applications, along with perspectives on future directions. This review offers insights into the current advancements, challenges, and the impact of AI on treatment paradigms, encouraging further research to expand its clinical utility.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70034"},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515836","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":"Characterization of a prototype rapid kilovoltage x-ray image guidance system designed for a linear accelerator radiation therapy unit.","authors":"Theodore Arsenault, Jonathan Arrue, Kenneth Gregg, Atallah Baydoun, Atefeh Rezai, Christian Langmack, Lauren Henke, Daniel E Spratt, Rojano Kashani, Alex Price","doi":"10.1002/acm2.70060","DOIUrl":"https://doi.org/10.1002/acm2.70060","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates a novel cone-beam computed tomography (CBCT) imaging solution integrated onto a conventional C-arm linear accelerator (linac) with increased gantry speed. The purpose is to assess the impact of improved imaging hardware and reconstruction algorithms on image quality.</p><p><strong>Methods: </strong>Hypersight-CBCT (HS-CBCT) system was compared with the original system (OG-CBCT) on a TrueBeam linac. Performance tests included mechanical, geometric, setup accuracy, and image quality assessment. Image quality metrics were evaluated using conventional CBCT reconstruction and advanced iterative reconstruction (iCBCT), fast iCBCT, and iCBCT with metal artifact reduction. Dosimetry measurements were acquired.</p><p><strong>Results: </strong>The HS-CBCT system acquired images in 24.0-44.0s (half trajectory/full trajectory), faster than the OG-CBCT system's acquisition time of 33.5-60.5s (half trajectory/full trajectory). The HS-CBCT system's faster gantry speed resulted in comparable image quality to the OG-CBCT. It improved high-contrast resolution, modulation transfer function, and low-contrast visibility. The faster gantry speed also produced lower radiation doses. The system's uniformity and resolution also improved, particularly with full-fan acquisition techniques.</p><p><strong>Conclusion: </strong>The novel HS-CBCT system on a conventional C-arm linac exhibits superior imaging capabilities compared to the OG-CBCT. Faster gantry speed, larger imaging area, and advanced reconstruction algorithms contribute to enhanced image quality and reduced dose. The study provides comprehensive insights into the new system's performance, serving as a benchmark for future linac installations and highlighting potential benefits in clinical applications. Further investigations are suggested for 4D acquisitions and long-term machine performance.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70060"},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501459","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":"Expert panel on monitoring radiation doses from recurrent medical diagnostic procedures: Sixth Gilbert W. Beebe Webinar","authors":"Donald P. Frush,&nbsp;Armin Ansari,&nbsp;James A. Brink,&nbsp;Ourania Kosti,&nbsp;David B. Larson,&nbsp;Martha S. Linet,&nbsp;Mahadevappa Mahesh,&nbsp;Ioannis Sechopoulos,&nbsp;Jenia Vassileva","doi":"10.1002/acm2.70022","DOIUrl":"10.1002/acm2.70022","url":null,"abstract":"<p>Recurrent imaging is an essential tool for patient care but with an attendant dose from radiation exposure. Recurrent imaging has been the subject of increasing scrutiny and debate based largely on the risk from increasing cumulative doses. However, the accountability for and actions with recurrent imaging as a special component in the general construct of radiation protection in medicine is unclear. This is demonstrated by the perspectives provided by the various imaging community experts. Some perspectives may be different, but many share a common ground. Understanding these various perspectives illustrates the wide-ranging optics in considering benefits and costs in the recurrent imaging paradigm and, moreover, the value in pursuing multi-stakeholder-derived harmonization for recurrent imaging and radiation dose. This move towards consensus would be to the benefit of the imaging community, referrers, and other related healthcare professionals, as well as patients, their caregivers, and the public.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515838","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 bulk density assignment of bone on MRI-based abdominal region radiotherapy planning for MR-linac workflow.","authors":"Kota Abe, Masato Tsuneda, Yukio Fujita, Yukinao Abe, Takashi Uno","doi":"10.1002/acm2.70059","DOIUrl":"https://doi.org/10.1002/acm2.70059","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the present study was to evaluate the impact of bone relative electron density (rED) assignment on radiotherapy planning for the abdominal region.</p><p><strong>Methods: </strong>Twenty patients who received abdominal radiotherapy using MR-Linac and underwent magnetic resonance imaging (MRI) and computed tomography (CT) simulation were analyzed. The reference plan (RP) was established using both CT and MR image sets (RP_CT and RP_MRI). The RP_MRI utilized the bulk density method. The recalculated RPs derived from various rED assignment methods were evaluated for comparison on both datasets. The RPs were recalculated by excluding rED assignment for bones (scenario A). Based on the International Commission on Radiation Units and Measurements report, lung contours were assigned rED of 0.258, and body contours were assigned 1.000 (scenario B) and 1.019 (scenario C). Dose volume histogram (DVH) differences between the three recalculated scenarios and RPs were evaluated. D95, D99, and D1cc were evaluated for target volumes, including gross tumor volume, internal target volume, and planning target volume. DVH parameters, including D1cc for each abdominal organ at risk (OAR) and the mean dose to the liver and kidneys, were evaluated. Three-dimensional local gamma analysis was conducted to assess dose distribution differences between the three recalculated scenarios and RPs.</p><p><strong>Results: </strong>In all scenarios of the CT- and MRI-based validation, the average gamma pass rates (2%/2 mm) were higher than 95%. In the CT-based validation, all target DVHs across the 20 patients showed that none exceeded 2% error in scenario A, whereas 2% and 14% exceeded the threshold in scenarios B and C, respectively. For OARs in CT and MRI-based validation, absolute maximum dose differences when compared with those of the RP were 0.19 Gy and 0.22 Gy, respectively, in scenario A.</p><p><strong>Conclusion: </strong>Excluding bone rED considerations in abdominal treatment planning may not yield notable clinical differences.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70059"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501460","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":"Effects of cardiac motion on dose distribution during stereotactic arrhythmia radioablation treatment: A simulation and phantom study.","authors":"Takayuki Miyachi, Takeshi Kamomae, Fumitaka Kawabata, Kuniyasu Okudaira, Mariko Kawamura, Shunichi Ishihara, Shinji Naganawa","doi":"10.1002/acm2.70021","DOIUrl":"https://doi.org/10.1002/acm2.70021","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac motion may degrade dose distribution during stereotactic arrhythmia radioablation using the CyberKnife system, a robotic radiosurgery system. This study evaluated the dose distribution changes using a self-made cardiac dynamic platform that mimics cardiac motion.</p><p><strong>Methods: </strong>The cardiac dynamic platform was operated with amplitudes of 5 and 3.5 mm along the superior-inferior (SI) and left-right (LR) directions, respectively. The respiratory motion tracking of the CyberKnife system was applied when respiratory motion, simulated using a commercial platform, was introduced. The accuracy of respiratory motion tracking was evaluated by the correlation error between infrared markers and a fiducial marker. The dose distribution was compared with and without cardiac motion. The evaluations included error in the centroid analysis of the irradiated dose distribution, dose profile analysis in the SI and LR directions, and dose distribution analysis comparing the irradiated and planned dose distributions.</p><p><strong>Results: </strong>Cardiac motion increased the correlation error in the direction of motion. Cardiac motion displaced the centroid by up to 0.23 and 0.19 mm in the SI and LR directions, respectively. Cardiac motion blurring caused the distance of the isodose lines to become smaller (bigger) at higher (lower) doses in the SI direction. The gamma pass rate was reduced by cardiac motion but exceeded 94.1% with 1 mm/3% for all conditions. Respiratory motion tracking was also effective under cardiac motion. The cardiac motion slightly varied the dose at the edges of the irradiation volume.</p><p><strong>Conclusion: </strong>While cardiac motion increased respiratory tracking correlation errors, its effects on dose distribution were limited in this study. Further studies using motion phantoms that are close to a human or individual patient are necessary for a more detailed understanding of the effects of cardiac motion.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70021"},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492118","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":"Measurement of stopping power ratio of chemo-ports using energy spectrum extracted from integral depth dose","authors":"Rosette Gonzalez,&nbsp;Stephen Olis,&nbsp;Sina Mossahebi,&nbsp;Weiguang Yao","doi":"10.1002/acm2.70052","DOIUrl":"10.1002/acm2.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In proton radiotherapy, the stopping power ratio (SPR) of non-biological materials must be independently measured with proton beams for accurate dose calculation. Small-size chemo-ports challenge the measurement. The purpose of this work is to measure the SPR of chemo-ports by using the energy spectra of the proton pencil beams.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and materials</h3>\u0000 \u0000 <p>Chemo-ports used in this study were irradiated in both lateral and vertical directions by 100-, 160-, and 200-MeV monoenergetic proton pencil beamlets. The integrated depth doses (IDDs) were acquired using a multi-layer ion chamber (MLIC), with and without the chemo port in front of the MLIC. The energy spectrum (ES) of the IDD was extracted. The water equivalent thickness (WET) of the chemo-port was determined from the shift in corresponding peaks in the spectra. To reduce the effect of spot size and its Gaussian distribution on the measurement, the measurements were repeated with a lead collimator (5 mm circular opening) in front of the chemo-ports. Additionally, the WET values were also obtained by a conventional approach that calculated the shift of the peaks in the IDDs rather than in the energy spectra.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The complex internal structure of the chemo-port was reflected in multiple peaks in the ES. The measured WET values from different energy beamlets agreed within 0.5 mm (4.6%) of each other using the ES method, while agreement up to 1 mm was observed from the traditional approach. When the collimator was used, the agreement was decreased to within 1.1 and 8 mm from the ES method and conventional approach, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Proton SPRs of chemo ports can be successfully measured using the ES method. Better agreement of the measured WET values from different energy pencil beams was obtained from the ES method than from a conventional approach. The use of a collimator can decrease accuracy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500811","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":"Evaluating artifact-free four-dimensional computer tomography with 16 cm detector array","authors":"Inhwan Yeo,&nbsp;Wei Nie,&nbsp;Jiajin Fan,&nbsp;Mindy Joo,&nbsp;Michael Correa,&nbsp;Qianyi Xu","doi":"10.1002/acm2.70056","DOIUrl":"10.1002/acm2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate a 16 cm-array axial four-dimensional computer tomography (4DCT) in comparison with a 4 cm-array 4DCT in the presence of respiration irregularity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Ten traces of lung tumor motion from CyberKnife treatments were imported to move the lung cylinder, containing a spherical target, of a phantom. Images were acquired for the lung that moved to each of the 10-positions/phases (1) step-wisely by nominal helical scan at each movement (ground truth), (2) continuously by 4D scan with the 16 cm array, and (3) the same with the 4 cm array, involving table shift. Irregularities, consisting of baseline shift and/or amplitude change of the traces in their second periods, affected #3 scan only in its second table position. The full-widths at half maximum of the target in the direction of the motion were determined on the average (Ave) CT, maximum-intensity (Mip) CT, and a phase (MP) CT that is associated with the maximum error, comparing #2 and 3 with #1. Three tumor-shaped targets were also imaged, and overlap ratios of them from #2 and 3 with the targets from #1 were inter-compared. Hounsfield unit (HU)s of the targets were also compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average difference in the spherical-target length between #2 and #1 was found to be 0.28 ± 0.15 cm on AveCT, 0.00 ± 0.18 cm on MipCT, and 0.07 ± 0.06 cm on MPCT, showing agreement. The average difference between #3 and #1 was 0.34 ± 0.23 cm on AveCT, 0.48 ± 0.31 cm on MipCT, and 0.56 ± 0.50 cm on MPCT, showing disagreement. The overlap ratios were better with #2 than with #3 for all tumor-shaped targets in each phase CT and MipCT, but they were not perfect for #2 due to motion averaging and phase sorting limitations. The differences in HUs were smaller with #2 than with #3, but not fully satisfactory with #2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>4DCT with the 16 cm array needs to be used to minimize the impact of the irregularity.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483260","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":"Exploring surface-guided systems for intelligent breathing-adapted four-dimensional computed tomography: A comparison to infrared-based reflective marker systems.","authors":"Niklas Lackner, Andre Karius, Rainer Fietkau, Christoph Bert, Juliane Szkitsak","doi":"10.1002/acm2.70054","DOIUrl":"https://doi.org/10.1002/acm2.70054","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluates the technical feasibility of adapting a surface monitoring system, designed for conventional four-dimensional computed tomography (4DCT), to an intelligent, breathing-adapted 4DCT and examines its potential to expand the currently limited range of supported surrogate systems.</p><p><strong>Methods: </strong>In an experimental phantom setting, we compared breathing curve quality and its impact on breathing-adapted 4DCT generation between a surface monitoring camera and our clinical infrared (IR) system, using a research-grade IR camera coupled with a radiation detector as an independent reference. Breathing curves from the surface monitoring system and the research-grade camera were corrected for table motion. We assessed the influence of differences in breathing curves on the automatic selection of parameters before scanning, intelligent X-ray triggering during acquisition, and the differences of binning point selection for reconstruction as well as image quality. Additionally, we simulated the impact of latency on image quality and measured the observed latencies between the surrogate systems relative to an X-ray measurement.</p><p><strong>Results: </strong>During table movement, discrepancies were found in breathing signals from the surface monitoring system compared to the clinical and reference systems. After correcting for table motion, the surface monitoring system's curves aligned consistently with those of the other systems with amplitude (AMP) variations of less than 10% and breathing rate (BR) variations of less than 1%. Corrected curves showed improved performance in their ability to generate breathing-adapted 4DCTs. The clinical IR system showed a 45 ms latency advantage over the surface monitoring system, impacting image quality as simulated.</p><p><strong>Conclusions: </strong>After correcting surface monitoring breathing curves, satisfactory agreement with the clinical and independent reference systems was achieved. With modifications, the surface monitor solution could serve as a suitable surrogate for breathing-adapted 4DCT. In our experimental setting, the surface monitoring system had a 45 ms delay relative to the clinical system, potentially affecting image quality.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":" ","pages":"e70054"},"PeriodicalIF":2.0,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143483261","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}