Journal of Applied Clinical Medical Physics最新文献

{"title":"Development and evaluation of a water-profile-based calibration method for 2D ionization chamber arrays in medical linear accelerator quality assurance","authors":"Kihong Pak, Sung-woo Kim, Byungchul Cho, Jungwon Kwak, Seonghoon Jeong, Kyeongyun Park, Jisoo Kim, Jonghan Park, Si Yeol Song, Seonyeong Noh, Jongin Oh, Seokjin Kang, Chiyoung Jeong","doi":"10.1002/acm2.70830","DOIUrl":"https://doi.org/10.1002/acm2.70830","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To develop and evaluate a water-profile-based (WP) calibration method for two-dimensional (2D) ionization chamber arrays used in medical linear accelerator (linac) quality assurance (QA), and to compare its accuracy, efficiency, and cross-energy applicability with the manufacturer-provided wide-field (WF) calibration method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Beam profiles were measured using an IC Profiler (ICP) and a 3D water scanner on three TrueBeam linacs (TB1–TB3) at five photon energies (4, 6, 10 MV flattened; 6, 10 MV flattening-filter-free [FFF]) with a 20 × 20 cm<sup>2</sup> field size at a depth of 10 cm. A total of 240 profiles were acquired across eight independent measurement sessions. The WP method derived adjusted calibration factors (ACFs) by directly matching ICP detector responses to water-scanner reference profiles, and was evaluated under three strategies: (i) machine-specific (single linac reference), (ii) machine-integrated (reference pooled across three linacs), and (iii) cross-energy applicability across 20 inter-energy combinations. Performance metrics included per-detector relative differences (mean absolute error [MAE] and standard deviation [SD]) and beam profile characterization (symmetry and flatness). Paired <i>t</i>-tests (<i>n</i> = 30) compared the machine-integrated WP method with the WF method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The WF method yielded a per-detector MAE of 0.31%, with symmetry and flatness MAEs of 0.49% and 0.44%, respectively. The WP method significantly reduced these uncertainties to 0.15–0.16% (per-detector), 0.21–0.27% (symmetry), and 0.27–0.28% (flatness), with medium-to-large effect sizes (Cohen's <i>d</i> = 0.55–0.99; all <i>p</i> < 0.01). Cross-energy application of WP-derived ACFs yielded a per-detector MAE of 0.25%, higher than that of energy-specific WP calibration but lower than that of the WF method in this dataset. Total calibration time decreased from approximately 75 min (WF) to 10–15 min (WP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For the tested 20 × 20 cm<sup>2</sup> field on TrueBeam linacs with a CC13/Blue Phantom2 water-scanner reference, the proposed WP calibration method provided closer agreement with the water-scanner reference and a substantially shorter calibration time than the manufacturerprovided WF method. Machine-integrated calibration is recommended for routine multi-linac implementation, while energy-specific ACFs should be used whenever feasible to maximize accuracy.</p>\u0000 </sec","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70830","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048233","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":"Maskless head and neck radiotherapy using surface-guided radiation therapy: initial clinical feasibility of real-time setup, intrafraction monitoring, and automatic beam-hold","authors":"Adi Robinson, Shravan Kandula","doi":"10.1002/acm2.70809","DOIUrl":"https://doi.org/10.1002/acm2.70809","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Thermoplastic immobilization remains standard for head and neck radiation therapy, but rigid face masks may produce clinically meaningful anxiety, claustrophobia, and treatment intolerance in some patients. Surface-guided radiation therapy (SGRT) provides non-ionizing surface setup guidance and continuous intrafraction motion monitoring, potentially enabling reduced-immobilization treatment approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To describe and initially evaluate the clinical feasibility of a thermoplastic-maskless head and neck radiation therapy workflow using a posterior dorsal shell, SGRT-guided setup, cone-beam computed tomography (CBCT) verification, and real-time intrafraction monitoring with automatic beam-hold.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ten patients with head and neck cancer were treated without a thermoplastic face mask. Patients were positioned in a posterior dorsal shell. Daily setup began with SGRT followed by CBCT verification and couch correction. During delivery, SGRT (AlignRT v6.3, Vision RT, London, UK) monitored head position in six degrees of freedom (6DoF); automatic beam-hold was triggered when translational displacement exceeded 2 mm or rotational displacement exceeded 2°. Post-treatment CBCT and SGRT log files were reviewed for every fraction to characterize residual displacement, threshold events, and repositioning. Intrafraction motion and residual displacement were summarized as medians with interquartile range (IQR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 330 delivered fractions, sgrt-recorded intrafraction motion was small:: per-axis signed real-time deltas had a median [IQR] of 0.10 mm [−0.15, 0.30] translationally and 0.10° [−0.05, 0.20] rotationally. No fraction had a mean real-time delta exceeding the ± 2 mm/ ± 2° tolerance, and automatic beam-hold interruptions occurred in approximately 2% of fractions (7 of 330); no fraction was abandoned. Per-axis post-treatment CBCT residuals were −0.01 mm [−0.04, 0.05] translationally and 0.15° [−0.40, 0.55] rotationally. All patients completed the maskless course; 3 of 10 had previously declined or been unable to tolerate mask-based treatment, and all reported the maskless workflow to be well tolerated on an end-of-course questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A thermoplastic-maskless head and neck workflow using SGRT, CBCT verification, predefined beam-hold th","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70809","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048433","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 hybrid deep learning framework for automated treatment planning in cervical cancer radiotherapy","authors":"Haiyan Jiang, Zengtai Yuan, Zihao Liu, Yuxiang Wang, Wei Hu, Bing Yan, Yidong Yang","doi":"10.1002/acm2.70806","DOIUrl":"https://doi.org/10.1002/acm2.70806","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radiation therapy treatment planning is a time-consuming trial-and-error process, and the plan quality is heavily dependent on planners' experiences, resulting in a strong demand for automated planning methods that can rapidly generate uniformly high-quality plans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aimed to develop a hybrid automated deep learning-based plan optimization (HALO) framework, integrating deep learning fluence prediction and optimization, multileaf collimator (MLC) sequencing, and GPU-accelerated Monte Carlo dose computation. HALO was designed to ensure robust plan generation for cervical cancer intensity-modulated radiation therapy (IMRT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The proposed HALO framework incorporated several functional modules. First, a dose-guided Fluence Prediction Network (DG-FPN) was developed. A total of 120 cervical cancer clinical IMRT plans were collected to train the DG-FPN, of which 90 plans were assigned for training, 10 for validation, and 20 for testing. The neural network took patients' computed tomography (CT) anatomy as input and predicted the 3D dose distribution and fluence maps. Next, the predicted fluence maps were further optimized to meet dose-volume constraints (DVCs), and then the refined fluence maps were converted into deliverable segments using an MLC sequencing algorithm. Finally, dose calculation was performed using a GPU-accelerated Monte Carlo engine. The 20 patients in the testing set were used to evaluate the HALO method, and the plan deliverability was validated by patient-specific IMRT Quality Assurance (QA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The DG-FPN achieved superior fluence prediction accuracy compared to previous work, with a median mean absolute error (MAE) of 0.055 and a structural similarity index (SSIM) of 0.94. The automated framework generated high-quality plans and reduced dose to adjacent OARs, with V<sub>50Gy</sub> decreased from 46.5 ± 5.0% to 41.5 ± 4.8% (<i>p</i> = 0.008)for bladder, V<sub>35Gy</sub> decreased from 31.5 ± 8.2% to 29.2 ± 7.5% (<i>p</i> = 0.024) for small intestine, while preserving PTV homogeneity and conformity. Importantly, the entire treatment planning time was within 3 minutes, with fluence optimization time decreased by an average of 82.6% after using deep learning prediction. The mean gamma passing rate under the 2%/2 mm criterion for the patient-specific IMRT QA achieved 97.37 ± 1.01%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 ","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70806","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048376","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":"Fine wine, art, and medical physicist bibliometrics: Things that improve with age","authors":"Sundari Mehta, J John Lucido III, Douglas Moseley, Catherine Holly Frank, Christopher L. Deufel","doi":"10.1002/acm2.70811","DOIUrl":"https://doi.org/10.1002/acm2.70811","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Bibliometric indicators are widely used to evaluate faculty productivity, yet these metrics change with career stage, evolving authorship practices, and technological shifts in how science is produced. This study examines patterns of scholarly output among radiation therapy medical physics faculty at leading cancer centers and provides a framework and quantitative metrics for managing career age- and era-based effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Peer-reviewed articles (1969–2025) were collected from Scopus for 397 Ph.D. medical physics faculty at the 20 U.S. cancer centers most highly ranked by US News and World Report in 2025. The bibliometric measures included annual rates of authorships (<span></span><math>\u0000 <semantics>\u0000 <mover>\u0000 <mi>A</mi>\u0000 <mo>̇</mo>\u0000 </mover>\u0000 <annotation>$dot{A} $</annotation>\u0000 </semantics></math>), first/last authorships (<span></span><math>\u0000 <semantics>\u0000 <mover>\u0000 <mrow>\u0000 <mi>F</mi>\u0000 <mi>L</mi>\u0000 </mrow>\u0000 <mo>̇</mo>\u0000 </mover>\u0000 <annotation>$dot{FL} $</annotation>\u0000 </semantics></math>), monograph-equivalents (<span></span><math>\u0000 <semantics>\u0000 <mover>\u0000 <mrow>\u0000 <mi>M</mi>\u0000 <mi>E</mi>\u0000 </mrow>\u0000 <mo>̇</mo>\u0000 </mover>\u0000 <annotation>$dot{ME} $</annotation>\u0000 </semantics></math>), as well as the cumulative h-index and contribution-normalized ha-index. Career age was defined by year of first publication. Productivity distributions were evaluated by career age using empirical cumulative distribution functions derived from 2016–2025 data. Era-dependent fluctuations (1990–2025) were examined using age-normalized metrics and trends in authorship team size. Tabulated bibliometrics as a function of career age are provided for evaluation of individual performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Productivity increased substantially with career age, peaking in late career. Senior faculty produced approximately two-fold higher annual output than early-career peers. At career ages of 1, 10, 20, 30, and 40 years, the median bibliometric rate","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70811","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048331","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":"MPLA case: A proposal for purchasing SRS/SBRT QA equipment","authors":"Joel St-Aubin,&nbsp;Alonso Gutierrez,&nbsp;Erica Kinsey,&nbsp;Cassandra Stambaugh,&nbsp;Dongxu Wang","doi":"10.1002/acm2.70807","DOIUrl":"10.1002/acm2.70807","url":null,"abstract":"<p>This work of fiction is part of a case study series developed by the medical physics leadership academy (MPLA). It is designed to generate discussion of the managerial and leadership challenges medical physicists can face. Through discussion and quantitative analysis, the case aims to teach learners basic finance concepts and build their ability to gather and analyze financial information for capital budgeting decisions. In this case, medical physicist Dr. Angel Allende is a junior physicist who started a new position at a cancer center with two linear accelerators. A recent upgrade outfitted one linear accelerator with state-of-the-art capabilities for image-guided stereotactic radiation therapy. Dr. Allende is tasked by the chief medical physicist to establish a new stereotactic quality assurance (QA) program at the cancer center. The physics team needs to prepare a business case for obtaining the necessary QA software and equipment. Unfortunately, Dr. Allende anticipates complications due to the existing budget appearing too low. Despite having never done capital budgeting before, Dr. Allende doesn't want to turn down this unique opportunity. This case study falls under the scope of and is supported by the MPLA, a committee in the American Association of Physicists in Medicine (AAPM).</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70807","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038583","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 Faraday cup-style detector as a beam diagnostic system for ultra-high dose rate (FLASH) electron beams","authors":"Alan Lopez,&nbsp;Alexander Baikalov,&nbsp;Kevin Liu,&nbsp;Nolan Esplen,&nbsp;Stefan Bartzsch,&nbsp;Emil Schüler","doi":"10.1002/acm2.70819","DOIUrl":"10.1002/acm2.70819","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Beam diagnostic systems are essential for the development and quality assurance of ultra-high dose rate (UHDR) radiation sources to enable reliable delivery of FLASH radiotherapy (RT). Critically, suitable beam diagnostic systems for electron FLASH sources are lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>In this study, we evaluated a Faraday cup–style beam collector (BC), the BC-145-Al, on an UHDR electron linac for FLASH-RT applications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The BC performance was benchmarked against a reference alternating-current current transformer (ACCT) across a wide range of beam currents and pulse structures to test the BC's charge linearity and signal resolution capabilities. Two termination impedances were tested: 200 kΩ and 13 Ω.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The highly time-resolved signal of the BC was charge-proportional when terminated at 200 kΩ and current-proportional when terminated at 13 Ω, agreeing well with the time-resolved ACCT signal. The cumulative signals from the BC and ACCT showed excellent agreement, maintaining linearity with a deviation of less than ± 0.5% over 50 consecutive pulses (4-µs pulse width, 120-Hz pulse repetition frequency [PRF]). The BC/ACCT signal ratio remained stable within ± 0.5% as the PRF increased from 5 to 120 Hz at constant pulse width. Pulse width measurements from both detectors were also consistent within ± 0.5% across all nominal pulse width values (0.5–4 µs). When the charge per pulse was modulated by either increasing the pulse width or decreasing the source-to-surface distance (from 32.3 to 19.3 cm), the BC signal remained approximately linear with respect to the ACCT signal; however, the BC/ACCT ratio deviated by up to ± 6% across this range.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The BC produced highly time-resolved absolute charge measurements of a pulsed UHDR electron beam across a large range of beam parameters. These results support its potential as a beam diagnostic system for both preclinical studies and clinical applications of electron FLASH radiotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70819","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038592","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":"Assessing the role of plan complexity and target geometry through multi-institutional gel based end-to-end QA in multi-focal single isocenter stereotactic radiosurgery","authors":"Despoina Stasinou,&nbsp;Kalliopi Platoni,&nbsp;Vasiliki Margaroni,&nbsp;Kyveli Zourari,&nbsp;Emmanouil Zoros,&nbsp;Niko Papanikolaou,&nbsp;Evangelos Pappas","doi":"10.1002/acm2.70758","DOIUrl":"10.1002/acm2.70758","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Single-isocenter stereotactic radiosurgery enables efficient treatment of multiple brain metastases (SI-MBM SRS), but demands high geometric accuracy. Plan complexity metrics are increasingly used as indicators for quality assurance (QA) performance, however their applicability to SRS remains uncertain, particularly in the context of multi-institutional variability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study evaluated the relationship between plan complexity, target geometry, and end-to-end dosimetric QA outcomes for SI-MBM SRS across multiple institutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-two SI-MBM SRS plans from different centers and platforms were delivered to polymer gel phantoms, providing high-resolution 3D dose measurements. Gamma passing rates (GPRs) were calculated under 3%/2 mm, 5%/2 mm and 5%/1 mm criteria and were correlated with eleven established complexity metrics calculated per plan. Geometric factors, including target equivalent diameter and distance-to-isocenter, were analyzed. Receiver-operating-characteristic (ROC) analysis was performed to identify optimal thresholds for predicting QA pass/fail (≥90% GPR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No statistically significant differences between the different linacs and treatment planning systems were found, nor strong or consistent correlations between complexity metrics and GPRs. In contrast, geometric parameters were more influential: off-axis distance and target size significantly affected QA performance, with the largest differences observed for far-off-axis lesions. ROC analysis identified optimal thresholds of 34.9 mm for distance-to-isocenter and 4.8 mm for equivalent diameter in predicting QA outcomes (AUC∼0.60-0.65), although the predictive performance remained modest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this multi-institutional, gel-based end-to-end study of SI-MBM SRS, target geometry was a stronger QA performance predictor than complexity metrics. These findings emphasize the importance of geometry-aware QA strategies and the need for further standardized, multi-institutional evaluations to clarify the interplay between complexity, geometry, and machine performance in SRS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70758","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030241","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":"An institutional experience of a scripting-driven automation of the emergent palliative radiotherapy workflow","authors":"Shadab Momin,&nbsp;Eduard Schreibmann,&nbsp;Justin Roper,&nbsp;Beth Ghavidel,&nbsp;Maxine Washington,&nbsp;Oluwatosin Kayode,&nbsp;Pretesh Patel,&nbsp;Ashish Patel,&nbsp;Hania Al-Hallaq,&nbsp;Yulia Lyatskaya","doi":"10.1002/acm2.70814","DOIUrl":"10.1002/acm2.70814","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;Emergency palliative radiotherapy is often delivered under time-constrained and high-stress conditions, frequently bypassing conventional computed tomography (CT) simulation and relying on nonstandard workflows. These factors increase variability and the potential for error.&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 work describes the development, implementation, and early clinical evaluation of a simulation-free, cone-beam CT (CBCT) based emergency radiotherapy workflow that leverages treatment planning system (TPS) scripting to standardize and automate deterministic steps while preserving clinical oversight.&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;An ESAPI scripting-driven emergency workflow was developed within the TPS to automate prescription handling, plan generation, beam configuration, dose calculation, and setup preparation using CBCT images. Safety checks were implemented in the form of prompts with the appropriate actions required. Alternatively, manual input was retained for image verification and treatment field borders definition. The workflow was implemented across multiple clinical sites within a single healthcare system and evaluated through dosimetric comparison of CT- and CBCT-based planning. Metric parameters such as workflow time, reductions in manual interactions, and pre- and post-training survey outcomes of automated 3D workflow were compared to the same parameters of the conventional 2D workflow.&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 automated workflow successfully generated clinically acceptable emergency treatment plans with minimal manual input. CBCT-based dose calculations demonstrated agreement with CT-based planning within 2.5% when heterogeneity corrections were enabled and within 4.7% when disabled. Automation eliminated 33 manual data entry steps present in the 2D workflow and enabled treatment delivery with average on-table time of approximately an hour. Survey results demonstrated strong staff support for automation, with over 90% anticipating improvement prior to training and 100% reporting perceived improvement following training. Staff comfort and confidence improved post-training, and concerns regarding workflow clarity and safety decreased.&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;A scripting-based, simulation-free emergency radiotherapy workflow was developed for safe and standardized palliative treatments while maintaining establish","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024974","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":"Seeing radiation: Applications of an imaging survey meter in radiation oncology","authors":"Patrick N. McDermott,&nbsp;Robert C. Halford,&nbsp;Brayden Halvorson,&nbsp;Ian Lake,&nbsp;Jian Liang,&nbsp;Akin Ogretici,&nbsp;Avery Peterson,&nbsp;Evelyn Sebastian,&nbsp;Xiangkun Xu","doi":"10.1002/acm2.70801","DOIUrl":"10.1002/acm2.70801","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background and purpose&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Radiation shielding surveys require location and evaluation of radiation hotspots in shielding barriers. This process is normally done by using a conventional survey meter and slowly moving the survey meter manually across the face of the barrier. It would be advantageous to have a radiation image of the barrier showing hot spots. This would hasten the process, potentially reveal hidden hot spots and provide clear and unprecedented documentation for a variety of radiation sources, including HDR afterloaders, linacs, Gamma Knife and CT simulators. The purpose of this study is to evaluate a new survey instrument that can superimpose radiation “heat” maps on optical images, allowing the user to “see” the radiation distribution.&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;A new survey instrument, the RAVIN (manufactured by M3D, Inc. Ann Arbor MI) has been evaluated for potential use in shielding surveys of linac vaults, HDR suites, Gamma Knife, CT simulators, and the search for lost radioactive seeds. This instrument also provides a NIST traceable calibrated measurement of the exposure rate or the air-kerma rate. In addition, the instrument can show the spectrum of the measured radiation and can identify a wide range of commonly used isotopes. Comparisons have been made with conventional survey meters.&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;Heat maps have been acquired for the open door of a linac vault, linac head activation, an HDR afterloader, a Gamma Knife, the entrance to a CT simulator and an I-125 seed. The camera provides some interesting information about the spectrum of radiation encountered in different shielding circumstances in radiation oncology. An example is the spectrum of radiation emerging from a thick linac 18 MV concrete primary barrier. The instrument shows a pronounced peak between 100 and 150 keV, with a long high energy, but low amplitude tail. Comparison with ionization chamber survey meters shows that this instrument can accurately measure air kerma rates from continuous high energy sources of radiation but cannot be used to measure air kerma rates from pulsed linac beams due to its relatively long dead time of 30 µs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The RAVIN camera is an innovative instrument that allows visualization of radiation under some circumstances while simultaneously accumulating an energy spectrum. The ability to “see” radiation is remarkable. This instrument is, however, probably not useful for routine radiation surveys of barriers in ra","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024937","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":"Feasibility of lattice radiation therapy using a noncoplanar vertex arrangement and dynamic conformal arcs","authors":"Haixia Cui,&nbsp;Wei Huang,&nbsp;Xin Yi,&nbsp;Wenli Lu,&nbsp;Qingfeng Jiang","doi":"10.1002/acm2.70818","DOIUrl":"10.1002/acm2.70818","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;Current Lattice radiation therapy (LRT) mainly uses inverse IMRT/VMAT optimization, which is time-consuming and complex; however the high modulation complexity compromises dosimetric accuracy and blurs the peak‑to‑valley dose ratio.&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 presents a simple noncoplanar vertex arrangement for dynamic conformal arc (DCA)‑based LRT and evaluates its feasibility.&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;Different noncoplanar vertex geometries were generated in a water phantom, and DCA‑based LRT plans were designed using Eclipse v15.6 (Varian). The LRT target volume (LTV) was the union of all vertices. Single‑fraction 20‑Gy plans were generated with three coplanar 6‑MV FFF beams and calculated with AcurosXB calculation. Optimal vertex geometry was selected based on high‑dose proportion (measured with the volume ratio of prescribed dose structure to GTV [V&lt;sub&gt;Dp&lt;/sub&gt; / V&lt;sub&gt;GTV&lt;/sub&gt;], and the volume ratio of LTV to GTV [V&lt;sub&gt;LTV&lt;/sub&gt; / V&lt;sub&gt;GTV&lt;/sub&gt;]), GTV dose metrics, heterogeneity(measured with peak-to-valley-dose-ratio [PVDR], Volume Dose Ratio [VDR] and other three dose ratios defined as Dose matrix of ‘peak’ / ‘valley’ [Dp / D&lt;sub&gt;95% Gap&lt;/sub&gt;, D&lt;sub&gt;mean LTV&lt;/sub&gt; / D&lt;sub&gt;mean Gap&lt;/sub&gt;, and D&lt;sub&gt;2cc GTV&lt;/sub&gt;/ D&lt;sub&gt;95% Gap&lt;/sub&gt;]), valley dose (D&lt;sub&gt;95% Gap&lt;/sub&gt; and D&lt;sub&gt;5% Gap&lt;/sub&gt;) and normal tissue(NT) max dose, dose profiles/isodose distributions and plan complexity (MCS, SAS, MU/cGy). The same strategy was applied to two gastrointestinal stromal tumor (GIST) patients with evaluation of OAR sparing and planning time.&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;In the phantom, six noncoplanar vertex configurations and one coplanar vertex configuration were generated, and corresponding DCA plans were designed for each. All plans achieved a high‑dose volume proportion exceeding 1% and EUD&lt;sub&gt;GTV&lt;/sub&gt; of 5.07 Gy - 6.78 Gy, with high dose heterogeneity (high PVDR, Dp / D&lt;sub&gt;95% Gap&lt;/sub&gt;, D&lt;sub&gt;mean V&lt;/sub&gt; / D&lt;sub&gt;mean Gap&lt;/sub&gt; and moderate VDR). Plan complexity remained low across all configurations, with MCS ranged 0.68–0.79. Optimal vertex geometry was 1-cm diameter with a 4-cm center‑to‑center distance, providing a favorable balance between dose heterogeneity and valley dose sparing. Moreover, the DCA plan based on noncoplanar vertex arrangement yielded dose distributions comparable to those of the non-coplanar plan with couch rotation. Importantly, both normal tissue (NT) doses in all phantom plans were very low. The clinical a","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"27 10","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024956","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}