Medical Dosimetry最新文献

{"title":"Comment on \"Establishing a knowledge-based planning model for left-sided breast cancer patients receiving hypofractionated postmastectomy and regional nodal irradiation\".","authors":"Maajid Mohi Ud Din Malik","doi":"10.1016/j.meddos.2026.06.004","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.06.004","url":null,"abstract":"","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473957","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":"Multifractionation knowledge-based planning model for the stereotactic treatment of ocular tumors.","authors":"Chase Cochran, Shane McCarthy, William St Clair, Damodar Pokhrel","doi":"10.1016/j.meddos.2026.06.005","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.06.005","url":null,"abstract":"<p><p>Linear accelerator-based stereotactic radiosurgery and stereotactic radiotherapy (SRS/SRT) are commonly used in the treatment of ocular malignancies. However, a substantial portion of the treatment planning process relies on manual plan optimization to achieve acceptable plan quality, leading to increased planning time and variability among planners. In this work, we demonstrate the feasibility of adapting a single-fraction model to a multifraction-capable knowledge-based planning model for ocular malignancies using noncoplanar treatment geometries. This approach has the potential to significantly improve planning efficiency for ocular SRS/SRT treatments. A previously validated HyperArc-based RapidPlan model for single-fraction (25 Gy) ocular SRS was adapted and further trained to handle 3- and 5-fraction prescriptions (42 Gy/3 Fx and 50 Gy/5 Fx). The knowledge-based planning (KBP) model was trained on 86 synthetic HyperArc plans and retrospectively tested on 24 datasets. Treatment planning was performed in the Varian Eclipse treatment planning system with the Acuros XB dose algorithm. Metrics included the Radiation Therapy Oncology Group conformity index, Paddick conformity index, gradient index, heterogeneity index, organ-at-risk (OAR) doses, and delivery accuracy via portal dosimetry patient-specific quality assurance (QA) and an in-house Monte Carlo second check. Across 1-, 3-, and 5-fraction ocular SRS/SRT regimens, the KBP model-based plans produced comparable target conformity, gradient, homogeneity, and coverage metrics, with no clinically meaningful differences between fractionation schemes. Differences in mean target dose (∼1%) were negligible. Most OAR constraints were met; optic nerve and lacrimal gland sparing were consistently achievable except when the OARs were included within the planning target volume, while lens and skin constraints were more challenging. Plan optimization was efficient (median ∼14 minutes), delivery times decreased with increased fractionation, and all KBP plans met patient-specific QA criteria with high pass rates during end-to-end testing and validation. These results demonstrate that a single RapidPlan model can generate high-quality ocular SRS plans across 1-, 3-, and 5-fraction schemes. The rapid generation of these KBP plans allows multiple fractionation schemes to be explored on a per-patient basis in a timely manner that would otherwise be clinically impractical with conventional manual planning.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474015","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":"Leveraging gEUD objectives in the development and clinical implementation of a RapidPlan knowledge-based planning model for lung SBRT in Eclipse.","authors":"Navid Khaledi, Erin Helgason, Michael Smyth, David Sasaki","doi":"10.1016/j.meddos.2026.06.003","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.06.003","url":null,"abstract":"<p><p>To provide a detailed and reproducible description of the development and clinical implementation of a RapidPlan knowledge‑based planning (KBP) model for lung stereotactic body radiotherapy (SBRT) in Eclipse v15.6, including training dataset composition, model analytics, objective template design, and prospective validation. A RapidPlan model was constructed using 161 coplanar VMAT SBRT plans calculated with Acuros XB (2.0 mm grid) and 6 MV FFF beams. Structure matching, outlier identification, and DVH prediction behavior were assessed using Varian Model Analytics report. A unified optimization template was assembled with explicit target priorities, a PTV gEUD objective, and gradient‑focused constraints addressing near‑target fall‑off and chest‑wall interfaces. The model was prospectively validated on 21 patients by comparing KBP plans with previously approved clinical plans. Model Analytics indicated stable DVH prediction bands after refinement; 4 plans were removed for atypical geometric or dosimetric behavior. The finalized template produced clinically acceptable plans for both peripheral and central tumors across the prescription range represented in the training set. In validation, most plans met target and OAR criteria on first optimization; where needed, minor adjustments (typically <10 minutes) resolved remaining issues. This technical note provides a complete, practical workflow for constructing a lung SBRT RapidPlan model in Eclipse v15.6. The reported training selection, analytics‑based refinement, and optimization template parameters enable other centers to reproduce or adapt the model for standardized SBRT planning without outcome comparisons.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425980","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":"Predictive dosimetric parameters for adaptive replanning in proton beam therapy for thoracic cancer.","authors":"Nrusingh C Biswal, Hua-Ren Cherng, Abdul K Parchur, Baoshe Zhang, David Alicia, Elizabeth Manuel, Kai Sun, ByongYong Yi, Matthew J Ferris, Zaker Rana","doi":"10.1016/j.meddos.2026.06.002","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.06.002","url":null,"abstract":"<p><p>Proton beam therapy (PBT) offers the advantage of delivering high doses of localized radiation therapy while sparing surrounding normal tissue, making it highly suitable for thoracic malignancies. However, the precision of PBT also makes it susceptible to treatment-related changes in the tumor or target volume, patient anatomy, and surrounding tissues, necessitating adaptive replanning. This study retrospectively analyzed the treatment plans of 180 thoracic cancer patients treated at an academic proton therapy center between 2020 and 2023. We investigated whether treatment planning dosimetric parameters, such as robustness, dose maximum, and doses to organs at risk in initial plans, can predict the need for adaptive replanning. Significant predictors identified include clinical target volume (CTV), heart volume, plan Dmax, mean lung dose, lung V20, lung V5, mean heart dose, heart V50, and spinal cord Dmax. Among those parameters, CTV and heart volume independently predict the need for replanning, and the cutoff values are 191 cc and 888 cc, respectively. Per 100-cc increase, odds of replanning increased by 15% for CTV volume (OR 1.15; 95% CI, 1.02 to 1.31) and 26% for heart volume (OR 1.26; 95% CI, 1.03 to 1.55). Our results suggest that monitoring these parameters can help identify plans that require closer scrutiny and more frequent scanning during the course of treatment to evaluate and adjust initial plans. This study contributes to optimizing the scheduling of quality assurance CT (QACT) scans, enhancing patient care by predicting which patients are likely to benefit from adaptive replanning.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148388200","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":"Prospective clinical implementation of the robust optimization planning technique in long-course photon radiotherapy treatment for lung cancer.","authors":"Francesco Dionisi, Marco D'Andrea, Isabella Sperduti, Erminia Infusino, Lucia Goanta, Anna Ianiro, Antonella Soriani, Lamberto Widesott, Giuseppe Sanguineti","doi":"10.1016/j.meddos.2026.06.001","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.06.001","url":null,"abstract":"<p><p>Optimizing photon radiotherapy techniques is crucial in the integrated treatment of lung cancer. We prospectively evaluated the clinical implementation of the robust optimization (RO) technique in comparison with the conventional planning target volume (PTV) optimization (PTVO) technique. Unresectable stage III non-small cell lung cancer (NSCLC) or limited small cell lung cancer patients undergoing definitive radiotherapy were eligible. For each patient, 2 planning approaches were compared: (1) internal target volume (ITV)-based RO, with 0.5 cm setup uncertainties in cardinal directions around ITV and (2) PTVO, with PTV = ITV+0.5 cm isotropic expansion. Comparison included nominal and robust target coverage (TC), healthy tissue sparing, and, for NSCLC patients, estimated dose to immune cells (EDIC) and normal tissue complication probability (NTCP) values for pulmonary, esophageal toxicity, and 24-month mortality. Robustness evaluation (RE) acceptance criteria were ITV V95% ≥ 95% and spinal cord maximum dose < 45 Gy in all perturbed scenarios. Each enrolled patient was actually treated with the plan (RO or standard PTVO) that was judged superior in terms of TC and organs at risk (OAR) sparing. The Wilcoxon test was used for data analysis. p < 0.05 was considered statistically significant. Between June 2024 and June 2025, 24 patients were prospectively enrolled. Nominal TC metrics were comparable between RO and PTVO. Lungs, heart, and esophagus doses were significantly reduced with RO. RO significantly reduced EDIC (p = 0.002), pulmonary (p = 0.0015), and esophageal (p = 0.003) NTCP values. TC and cord maximum dose acceptance criteria at RE were fulfilled in 99.4%/99.4% and in 100%/91% of the perturbed scenarios for RO and PTVO, respectively. At planning comparison, the RO was selected for the actual clinical treatment and delivery in 21 (87%) patients. The first clinical implementation of RO for lung cancer radiotherapy was feasible and promising; RO represents a valid alternative to PTVO in this setting.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354536","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 case study of inhale and exhale split-course VMAT treatment to minimize dose to ribs.","authors":"Jacob De Los Santos, Nazifa Bakar, Haley Paletta, Nishele Lenards, Ashley Hunzeker, Elizabeth Weiss","doi":"10.1016/j.meddos.2026.05.008","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.05.008","url":null,"abstract":"<p><p>Treating at breath-hold has been used to mitigate dose to the organs at risk while maintaining target stability and dose coverage. The breath-hold technique has been used in conjunction with stereotactic body irradiation for the treatment of lung lesions. However, utilizing a breath-hold technique does not help to decrease dose to the ribs when the target is in proximity to the chest wall. The researchers in this case study aimed to demonstrate an alternative route to reduce dose to the chest wall via a novel method of splitting the course of treatment between the inhalation breath-hold and exhalation breath-hold phases of breathing. In this study, the tumor position and movement throughout the respiratory cycle gave ample opportunity to deliver an ablative dose while also decreasing dose to the chest wall and ribs utilizing this \"split-course\" technique. To minimize the dose and potential for side effects, the course of treatment was divided into 4 fractions of inhalation breath-hold treatment and 4 fractions of exhalation breath-hold treatment. This plan was designed specifically for the patient to help reduce late side effects from radiation therapy. The split-course treatment method significantly decreased the dose to the chest wall and rib. The patient was followed up with evaluations over 9 months after treatment and indicated no pain in the chest.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148354522","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":"Dosimetric comparison of target coverage, dose gradient, and low-dose bath in left-sided accelerated partial breast irradiation: CyberKnife versus conventional linac-based noncoplanar VMAT and 3D-CRT.","authors":"Vijay Kumar Mogulagani, Mohan Raj Uthiran, Arjunan Manikandan, Madhuri Dumpala","doi":"10.1016/j.meddos.2026.05.007","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.05.007","url":null,"abstract":"<p><p>To compare target coverage, dose gradient, organ-at-risk (OAR) sparing, and low-dose bath between CyberKnife (CK) and noncoplanar linac-based techniques, including noncoplanar volumetric modulated arc therapy (VMAT) and noncoplanar three-dimensional conformal radiotherapy (3DCRT), for left-sided accelerated partial breast irradiation (APBI). Fifteen patients previously treated with CyberKnife for left-sided APBI were retrospectively replanned using noncoplanar VMAT and noncoplanar 3DCRT on the Monaco treatment planning system. All plans were generated using a 2-mm dose calculation grid and normalized to achieve comparable target coverage (V98% ≥ 95% of the prescribed dose of 30 Gy in 5 fractions). Dose-volume parameters for planning target volume (PTV), OARs, gradient index (GI), conformity index (CI), and low-dose bath volumes were analyzed. Statistical comparison was performed using paired two-tailed t-tests. CyberKnife demonstrated significantly superior dose conformity and gradient, with the lowest GI (2.65) compared with VMAT (3.22) and 3DCRT (3.52) (p < 0.01). Mean doses and low-dose volumes (V3 to V20 Gy) to the heart, left anterior descending (LAD) coronary artery, and left ventricle (LV), ipsilateral lung, contralateral lung, contralateral breast, and chest wall were significantly lower with CyberKnife. However, the use of noncoplanar beam arrangements in VMAT and 3DCRT resulted in clinically acceptable dose fall-off and comparable GI values, particularly between noncoplanar VMAT and 3DCRT. Target coverage metrics (V98% and V100%) were comparable across all techniques. CyberKnife provides superior dose gradient and reduced low-dose bath for left-sided APBI. Nevertheless, noncoplanar VMAT and noncoplanar 3DCRT demonstrate favorable and clinically acceptable dosimetric performance, indicating that noncoplanar linac-based techniques may serve as viable alternatives where CyberKnife is unavailable.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148340999","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":"Cross-prescription validation of knowledge-based planning in prostate VMAT using a structured validation framework.","authors":"Soma Sawada, Motoharu Sasaki, Yuji Nakaguchi, Takeshi Kamomae, Yuto Yamaji, Yuki Kanazawa, Shintaro Tsuda, Kanako Sakuragawa, Hitoshi Ikushima","doi":"10.1016/j.meddos.2026.05.009","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.05.009","url":null,"abstract":"<p><p>Knowledge-based planning (KBP) has been widely adopted to improve plan quality, consistency, and efficiency in prostate volumetric-modulated arc therapy (VMAT), but adaptation to different prescription regimens often requires rebuilding separate models, which may be impractical in routine clinical settings. This study investigated the practical feasibility of reusing a KBP model across prescription regimens with nonequivalent dose-constraint systems in prostate VMAT. A model trained for conventional fractionation (78 Gy in 39 fractions) was evaluated using a 3-step framework consisting of closed-loop validation for reproducibility, open-loop validation for generalizability to previously unseen patients, and cross-prescription validation for reuse in moderate hypofractionation (60 Gy in 20 fractions) planned under a different clinical constraint framework. Model-generated plans were compared with manual plans using target dose metrics, organ-at-risk dose-volume indices, and plan quality metric scores. The model reproduced the dosimetric characteristics of the training dataset under standardized conditions and maintained clinically acceptable dosimetric performance in independent cases. When reused for a different prescription regimen, the model achieved comparable overall plan quality and acceptable organ-at-risk sparing, despite slight reductions in target dose homogeneity. These results suggest that KBP model reuse may reduce the need for repeated model rebuilding and provide a practical approach to efficient and standardized prostate VMAT planning, particularly in institutions with limited case numbers or limited resources for model development and maintenance.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341070","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":"Dosimetric evaluation of beam block techniques in helical tomotherapy for extranodal nasal-type NK/T-cell lymphoma.","authors":"Lin Zhu, Bailin Zhang, Qiang He, Geng Yang, Huaizhi Jin, Fei Li, Haoyu Meng, Wanwei Jian, Xuetao Wang","doi":"10.1016/j.meddos.2026.04.008","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.04.008","url":null,"abstract":"<p><p>The aim of the study was to evaluate the dosimetric effects of different virtual beam block combinations on target coverage, organ at risk (OAR) sparing, and delivery efficiency in helical tomotherapy (HT) for extranodal nasal-type NK/T-cell lymphoma (ENKTCL-NT). In addition, normal tissue complication probability (NTCP) modeling was used to assess the biological impact on OARs and to inform optimal treatment planning strategies. Twenty-six patients with stage I-II ENKTCL-NT were retrospectively analyzed. Three virtual beam block configurations for the lens and eyeball-B-OFF, B-LEN, and B-L&E-were generated. Dosimetric parameters of the target volume, physical and biological indices of OARs, monitor units (MUs), and beam-on time (BOT) were compared among the plans. Dose delivery accuracy was verified using the ArcCHECK phantom. All 3 plans achieved clinically acceptable target coverage without significant differences in target dosimetric parameters. Compared with B-OFF, B-LEN significantly reduced the maximum dose (D_max), mean dose (D_mean), equivalent uniform dose (EUD), and NTCP of the bilateral lenses (all p < 0.05) but did not significantly affect the eyeball dose (p > 0.05). B-L&E provided further protection: relative to B-LEN, it reduced the D_max of the left and right lenses by 3.4% and 5.9%, D_mean by 5.0% and 4.9%, and median NTCP by 10.3% and 21.4%, respectively (all p < 0.05). It also significantly lowered the D_max and D_mean of the eyeballs (p < 0.05). No significant differences were observed among the 3 plans for the brainstem, spinal cord, optic chiasm, or optic nerves (p > 0.05). Compared with B-OFF, B-L&E increased the MUs by 17.9% and BOT by 58 s (19.0%). Gamma passing rates (3%/2 mm) exceeded 90% for all the plans, meeting the American Association of Physicists in Medicine Task Group No. 218 (AAPM TG-218) clinical criteria. The virtual beam block technique in HT effectively reduces radiation exposure to the lens and eyeball while maintaining target coverage in ENKTCL-NT. The B-L&E configuration offers the greatest OAR protection, and B-LEN may be preferable when shorter treatment times are required.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148279652","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":"The dosimetric impact to bladder utilizing the Varian Edge linear accelerator for prostate stereotactic body radiation therapy.","authors":"Cassandra Sonnicksen, Leia Haugland, Kelsey Slater, Nishele Lenards, Ashley Hunzeker, Brittni McKane","doi":"10.1016/j.meddos.2026.05.005","DOIUrl":"https://doi.org/10.1016/j.meddos.2026.05.005","url":null,"abstract":"<p><p>Stereotactic body radiation therapy (SBRT) is increasingly utilized for low and intermediate grade prostate cancer, offering advantages in reducing toxicities to critical structures and improving dose conformity. However, minimizing bladder toxicity remains challenging due to the organ's close proximity to the target. The Varian Edge linear accelerator utilizes high-resolution 2.5 mm multileaf collimators, enabling enhanced beam shaping and potentially improving organ at risk sparing. Limited data exist on the dosimetric impact of prostate SBRT planned with the Varian Edge linear accelerator. The goal of this study was to evaluate bladder toxicity in prostate SBRT planning by comparing treatment plans generated for delivery on the Varian TrueBeam and Varian Edge linear accelerators. It was hypothesized that plans utilizing the Varian Edge linear accelerator would result in a volume of the bladder receiving 34 Gy (V_{34 Gy}) ≤ 5 cubic centimeters (cc), volume of the bladder receiving 37 Gy ≤ 5 cc, dose to the most exposed 1 cc (D_{1 cc)} of the bladder ≤ 38.06 Gy, and maximum dose to 0.03 cc (D_{0.03 cc}) of the bladder ≤ 38.06 Gy. Ten patients were retrospectively analyzed, and the results demonstrated significant reductions in the V_{34 Gy} and V_{37 Gy} of the bladder for the plans designed for delivery on the Varian Edge linear accelerator. There were no meaningful differences observed for the D_{1 cc} and D_{0.03 cc.} While the Varian Edge linear accelerator provides measurable dosimetric advantages in reducing intermediate dosing to the bladder, larger prospective studies with long-term follow-up are needed to determine whether these reductions translate into improved quality of life and reduced urinary toxicity.</p>","PeriodicalId":49837,"journal":{"name":"Medical Dosimetry","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148220548","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}