Journal of Applied Clinical Medical Physics最新文献

{"title":"Stereotactic radiotherapy for metastatic brain tumors: A comparative analysis of dose distributions among VMAT, Helical TomoTherapy, CyberKnife, Gamma Knife, and ZAP-X","authors":"Toshihiro Suzuki,&nbsp;Masahide Saito,&nbsp;Ryutaro Nomura,&nbsp;Hikaru Nemoto,&nbsp;Naoto Yanagisawa,&nbsp;Ryuma Sawada,&nbsp;Zennosuke Mochizuki,&nbsp;Naoki Sano,&nbsp;Hiroshi Onishi,&nbsp;Hiroshi Takahashi","doi":"10.1002/acm2.70046","DOIUrl":"10.1002/acm2.70046","url":null,"abstract":"<p>This study evaluates various radiotherapy techniques for treating metastatic brain tumor (BT), focusing on non-coplanar volumetric modulated arc radiotherapy (NC-VMAT), coplanar VMAT (C-VMAT), Helical TomoTherapy (HT), CyberKnife (CK), Gamma Knife (GK), and ZAP-X. CT images and structures of 12 patients who underwent CK for a single BT were utilized. Twelve treatment plans were created for each planning device. All plans adopted the approach of prescription doses to planning target volume D99.5%. They were divided into stereotactic radiosurgery (SRS) (prescription dose; 21–23 Gy) and stereotactic radiotherapy (SRT) (prescription dose; 30–36.5 Gy) groups and the same parameters evaluated included Gradient Index (GI), Paddick Conformity Index (CI), and treatment time (t-time). In the SRS group, mean values of GI and CI values were: NC-VMAT (4.28, 0.60), C-VMAT (5.61, 0.44), HT (4.68, 0.42), CK (4.31, 0.61), GK (2.81, 0.82), and ZAP-X (2.99, 0.80). In the SRT group: NC-VMAT (3.27, 0.84), C-VMAT (3.81, 0.82), HT (3.76, 0.65), CK (2.98, 0.77), GK (2.61, 0.90), and ZAP-X (2.80, 0.84). There were no significant differences in the mean values of CI and GI between ZAP-X and GK in both groups (<i>p</i> &gt; 0.05). NC-VMAT and C-VMAT had shorter t-time than other techniques in both groups. ZAP-X is relatively superior in CI and GI for small tumors, similar to GK, while differences with NC-VMAT and CK diminish as tumor volume increases. ZAP-X, CK, and GK have longer t-time than other treatment techniques, regardless of volume.</p>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70046","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556890","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":"Monte Carlo modeling of radiation dose from radiation therapy with superficial x-rays","authors":"Reham Barghash,&nbsp;Tiffany W. Martin,&nbsp;Amber R. Prebble,&nbsp;Del Leary","doi":"10.1002/acm2.70062","DOIUrl":"10.1002/acm2.70062","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Superficial x-rays (50–100 kVp) are used for treating non-melanoma skin cancer and intraoperative radiation therapy (IORT). At these energies, the photoelectric effect significantly increases absorbed dose to bone compared to soft tissue.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used EGSnrc MC simulations to investigate bone dose enhancement during radiotherapy with the Sensus SRT-100 machine. Simulated beams were validated against laboratory measurements and compared to a commercial treatment planning system (SmART-ATP). Transmission simulations indirectly predicted bone dosage. Simulated beams were utilized as a mock treatment plan from a human cone-beam computed tomography (CBCT) image.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>EGSnrc accurately modeled the Sensus SRT-100 beams (100, 70, and 50 kVp) with a root mean square error (RMSE) of percentage depth dose ratios between Monte Carlo predictions and lab measurements of 1.66, 0.47, and 0.99, respectively. PDDs from simulations of a water phantom with bone slabs showed peak doses at water–bone interfaces relative to surface doses. At 0.3 cm depth bone slab, doses reached 410%, 490%, and 510% for 50, 70, and 100 kVp, respectively. At 1.5 cm depth, doses were 140%, 215%, and 270%. At 2.5 cm depth, peak doses were 74%, 130%, and 170% for 50, 70, and 100 kVp, respectively. A simulated treatment plan (4 Gy surface dose) using a CBCT of a human head predicted the dose to the skull to be around 20, 19, and 15 Gy for the 100, 70, and 50 kVp beams, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The study demonstrated EGSnrc's efficiency in conjunction with SmART-ATP for treatment planning. MC simulations effectively quantified bone dose enhancement during superficial x-ray radiotherapy, highlighting its importance in treatment planning and dose calculations. Clinicians should consider measuring bone depth prior to treatment to avoid excessive bone dose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70062","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556820","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 HyperSight iterative CBCT for dose calculation in online adaptive radiotherapy for pelvis and breast patients compared to synthetic CT","authors":"Jingwei Duan,&nbsp;Joel A. Pogue,&nbsp;Dennis N. Stanley,&nbsp;Sui Shen,&nbsp;Natalie N. Viscariello,&nbsp;Carlos E. Cardenas,&nbsp;Richard A. Popple,&nbsp;Joseph Harms","doi":"10.1002/acm2.70038","DOIUrl":"10.1002/acm2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose/objectives</h3>\u0000 \u0000 <p>Recent technological advancements have increased efficiency for clinical deliverability of online-adaptive-radiotherapy (oART). Previous cone-beam-computed-tomography (CBCT) generations lacked the ability to provide reliable Hounsfield-units (HU), thus requiring oART workflows to rely on synthetic-CT (sCT) images derived through deformable-image-registration (DIR) between the planning CT (pCT) and the daily CBCT. These sCTs are prone to errors stemming from DIR, potentially contributing to dosimetric errors. This study aims to evaluate the capability of direct dose calculation using a novel CBCT platform, HyperSight (Varian-Medical-Systems), as an alternative for sCT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods/materials</h3>\u0000 \u0000 <p>To validate the HyperSight iterative CBCT (HS-iCBCT) HU accuracy, 125 kV and 140 kV HS-iCBCT calibration curves were benchmarked against a pCT calibration curve. To determine the clinical impact of HS-iCBCT compared to sCT, daily adaptive sessions from 47 oART fractions from 10 patients were analyzed. For these patients, HS-iCBCT was acquired for daily adaption, and sCT was generated as part of the standard adaptive workflow. After daily adaption, dose was recalculated directly using the HS-iCBCT, and the HS-iCBCT and sCT dose distributions were compared by γ-index and dose-volume-histogram (DVH) analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean HU differences of pCT minus HS-iCBCT (140/125 kV) were −40.97/−57.79, 9.86/21.74, and 87.22/158.20 for lung, water, and bone. In the patient cohort, the median gamma passing rates between HS-iCBCT and sCT-based dose calculations for 3%/2 mm and 1%/1 mm were 99.57 and 96.45% with 10% threshold, and 99.92% and 86.15% with 80% threshold. Dosimetric deviations in high dose regions were concentrated in areas with larger deformation, that is, surface change and variable bladder/bowel filling. The median (min-max) D98%/V100% absolute deviations were 0.3(0.0–1.6)/0.0(0.0–13.7) and 0.4(0.0–1.4)/0.5(0.0–17.5) for CTVs and PTVs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The HS-iCBCT platform with iterative reconstruction provides dose calculation comparable to sCT for pelvis and breast patients. However, acceptable, yet noticeable, dose discrepancies between HS-iCBCT and sCT exist, particularly in high-dose regions. Further investigations are needed to benchmark these methods against ground truth measurements.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70038","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542057","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":"Effects of simultaneous multislice acceleration on the stability of radiomics features in parametric maps of IVIM and DKI in uterine cervical cancer","authors":"Shuangquan Ai,&nbsp;Wei Peng,&nbsp;Rong Hou,&nbsp;Huiting Zhang,&nbsp;Robert Grimm,&nbsp;Zilong Yuan,&nbsp;Yulin Liu","doi":"10.1002/acm2.70063","DOIUrl":"10.1002/acm2.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The aim of this study was to investigate the influence of the simultaneous multislice acceleration (SMS) technique as well as two-dimensional (2D) and three-dimensional (3D) tumor segmentations on radiomics features (RFs) within the parametric maps of cervical cancer, which were computed by intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI). Additionally, the study sought to identify those RFs that could characterize the clinical stages (low-stage vs. high-stage) of cervical cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Multi-<i>b</i>-value diffusion-weighted imaging (DWI) of 40 patients with cervical cancer were collected using the SMS technique with acceleration factors (AF) of 1–3. RFs were extracted from parametric maps representing pure diffusion coefficient (D), pseudodiffusion coefficient (D*), perfusion fraction (f), mean diffusivity (MD), and mean kurtosis (MK). A total of 93 2D and 93 3D RFs were extracted from per parametric map. The concordance correlation coefficient (CCC) and coefficients of variation (COV) were used to jointly assess the stability of features. Finally, the intra-class correlation coefficient (ICC) was used for intra-group consistency assessment. Receiver operating characteristic (ROC) curve was used to evaluate diagnostic performance of stable features in distinguishing lower and higher stages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Feature stability decreased with higher AF. Among these features, 9.1% of 2D and 12.7% of 3D RFs were stable (CCC &gt; 0.9 and COV ≤ 0.1). ADC maps had the highest stability, whileas D^* and f maps had the lowest stability and 3D features were more stable than 2D features. A total of 5 2D and 25 3D stable features were identified that could distinguish lower and higher stages (AUC = 0.66–0.83).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SMS demonstrated impact on the stability of RFs in IVIM and DKI parametric maps, particularly for D* and f maps. Multi-<i>b</i>-value DWI with SMS (AF = 2) was recommended for clinical radiomics research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70063","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537174","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 auto-contouring accuracy in reduced CT dose images for radiopharmaceutical therapies: Denoising and evaluation of 177Lu DOTATATE therapy dataset","authors":"Hung-Te Yang,&nbsp;Kuan-Yin Ko,&nbsp;Ching-Ching Yang","doi":"10.1002/acm2.70066","DOIUrl":"10.1002/acm2.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Reducing radiation dose attributed to computed tomography (CT) may compromise the accuracy of organ segmentation, an important step in ¹⁷⁷Lu DOTATATE therapy that affects both activity and mass estimates. This study aimed to facilitate CT dose reduction using deep learning methods for patients undergoing serial single photon emission computed tomography (SPECT)/CT imaging during ¹⁷⁷Lu DOTATATE therapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The ¹⁷⁷Lu DOTATATE patient dataset hosted in Deep Blue Data was used in this study. The noise insertion method incorporating the effect of bowtie filter, automatic exposure control, and electronic noise was applied to simulate images at four reduced dose levels. Organ segmentation was carried out using the TotalSegmentator model, while image denoising was performed with the DenseNet model. The impact of segmentation performance on the dosimetry accuracy of ¹⁷⁷Lu DOTATATE therapy was quantified by calculating the percent difference between a dose rate map segmented with a reference mask and the same dose rate map segmented with a test mask (PD_dose) for spleen, right kidney, left kidney, and liver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Before denoising, the mean ± standard deviation of PD_dose for all critical organs were 2.31 ± 2.94%, 4.86 ± 9.42%, 8.39 ± 14.76%, 12.95 ± 19.99% in CT images at dose levels down to 20%, 10%, 5%, 2.5% of the normal dose, respectively. After denoising, the corresponding results were 1.69 ± 2.25%, 2.84 ± 4.46%, 3.72 ± 4.22%, 7.98 ± 15.05% in CT images at dose levels down to 20%, 10%, 5%, 2.5% of the normal dose, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>As dose reduction increased, CT image segmentation gradually deteriorated, which in turn deteriorated the dosimetry accuracy of ¹⁷⁷Lu DOTATATE therapy. Improving CT image quality through denoising could enhance ¹⁷⁷Lu DOTATATE dosimetry, making it a valuable tool to support CT dose reduction for patients undergoing serial SPECT/CT imaging during treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 4","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537176","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":"Human papillomavirus (HPV) prediction for oropharyngeal cancer based on CT by using off-the-shelf features: A dual-dataset study","authors":"Junhua Chen,&nbsp;Yanyan Cheng,&nbsp;Lijun Chen,&nbsp;Banghua Yang","doi":"10.1002/acm2.70061","DOIUrl":"10.1002/acm2.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aims to develop a novel predictive model for determining human papillomavirus (HPV) presence in oropharyngeal cancer using computed tomography (CT). Current image-based HPV prediction methods are hindered by high computational demands or suboptimal performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To address these issues, we propose a methodology that employs a Siamese Neural Network architecture, integrating multi-modality off-the-shelf features—handcrafted features and 3D deep features—to enhance the representation of information. We assessed the incremental benefit of combining 3D deep features from various networks and introduced manufacturer normalization. Our method was also designed for computational efficiency, utilizing transfer learning and allowing for model execution on a single-CPU platform. A substantial dataset comprising 1453 valid samples was used as internal validation, a separate independent dataset for external validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our proposed model achieved superior performance compared to other methods, with an average area under the receiver operating characteristic curve (AUC) of 0.791 [95% (confidence interval, CI), 0.781–0.809], an average recall of 0.827 [95% CI, 0.798–0.858], and an average accuracy of 0.741 [95% CI, 0.730–0.752], indicating promise for clinical application. In the external validation, proposed method attained an AUC of 0.581 [95% CI, 0.560–0.603] and same network architecture with pure deep features achieved an AUC of 0.700 [95% CI, 0.682–0.717]. An ablation study confirmed the effectiveness of incorporating manufacturer normalization and the synergistic effect of combining different feature sets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, our proposed model not only outperforms existing counterparts for HPV status prediction but is also computationally accessible for use on a single-CPU platform, which reduces resource requirements and enhances clinical usability.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537177","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 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,&nbsp;Sascha Grossmann,&nbsp;Heiko Karle,&nbsp;Tilman Bostel,&nbsp;Heinz Schmidberger","doi":"10.1002/acm2.70041","DOIUrl":"10.1002/acm2.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70041","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":"OA","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,&nbsp;David M. Gauntt,&nbsp;Gary T. Barnes","doi":"10.1002/acm2.70027","DOIUrl":"10.1002/acm2.70027","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70027","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of artificial intelligence in brachytherapy","authors":"Jingchu Chen,&nbsp;Richard L. J. Qiu,&nbsp;Tonghe Wang,&nbsp;Shadab Momin,&nbsp;Xiaofeng Yang","doi":"10.1002/acm2.70034","DOIUrl":"10.1002/acm2.70034","url":null,"abstract":"<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":"26 6","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70034","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":"OA","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,&nbsp;Jonathan Arrue,&nbsp;Kenneth Gregg,&nbsp;Atallah Baydoun,&nbsp;Atefeh Rezai,&nbsp;Christian Langmack,&nbsp;Lauren Henke,&nbsp;Daniel E. Spratt,&nbsp;Rojano Kashani,&nbsp;Alex Price","doi":"10.1002/acm2.70060","DOIUrl":"10.1002/acm2.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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>\u0000 </section>\u0000 </div>","PeriodicalId":14989,"journal":{"name":"Journal of Applied Clinical Medical Physics","volume":"26 5","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/acm2.70060","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}