Zeitschrift fur Medizinische Physik最新文献

{"title":"An automated pipeline for computation and analysis of functional ventilation and perfusion lung MRI with matrix pencil decomposition: TrueLung","authors":"Orso Pusterla ,&nbsp;Corin Willers ,&nbsp;Robin Sandkühler ,&nbsp;Simon Andermatt ,&nbsp;Sylvia Nyilas ,&nbsp;Philippe C. Cattin ,&nbsp;Philipp Latzin ,&nbsp;Oliver Bieri ,&nbsp;Grzegorz Bauman","doi":"10.1016/j.zemedi.2024.08.001","DOIUrl":"10.1016/j.zemedi.2024.08.001","url":null,"abstract":"<div><h3>Purpose</h3><div>To introduce and evaluate TrueLung, an automated pipeline for computation and analysis of free-breathing and contrast-agent free pulmonary functional magnetic resonance imaging.</div></div><div><h3>Materials and Methods</h3><div>Two-dimensional time-resolved ultra-fast balanced steady-state free precession acquisitions were transferred to TrueLung, which included image quality checks, image registration, and computation of perfusion and ventilation maps with matrix pencil decomposition. Neural network whole-lung and lobar segmentations allowed quantification of impaired relative perfusion (R_Q) and fractional ventilation (R_FV). TrueLung delivered functional maps and quantitative outcomes, reported for clinicians in concise documents.</div><div>We evaluated the pipeline using 1.5T data from 75 children with cystic fibrosis by assessing the feasibility of functional MR imaging, average scan time, and the robustness of the functional outcomes. Whole-lung and lobar segmentations were manually refined when necessary, and the impact on R_Q and R_FV was quantified.</div></div><div><h3>Results</h3><div>Functional imaging was feasible in all included CF children without any dropouts. On average, 7.9 ± 1.8 (mean±SD) coronal slice positions per patient were acquired, resulting in a mean scan time of 6min 20s per patient. The whole pipeline required 20min processing time per subject. TrueLung delivered the functional maps of all the subjects for radiological assessment. Quality controlling maps and segmentations lasted 1min 12s per patient. The automated segmentations and quantification of whole-lung defects were satisfying in 88% of patients (97% of slices) and the lobar quantification in 73% (93% of slices). The segmentations refinements required 16s per patient for the whole-lung, and 2min 10s for the lobe masks.</div><div>The relative differences in R_FV and R_Q between fully-automated and manually refined data were 0.7% (1.2%) and 2.0% (2.9%) for whole-lung quantification (median, [third quartile]), and excluding two outliers, 1.7% (3.9%) and 1.2% (3.8%) for the lobes, indicating the refinements could be potentially omitted in several patients.</div></div><div><h3>Conclusions</h3><div>TrueLung quickly delivers functional maps and quantitative outcomes in an objective and standardized way, suitable for radiological and pneumological assessment with minimal manual input. TrueLung can be used for clinical research in cystic fibrosis and might be applied across various lung diseases.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 452-469"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305511","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":"Safety in MR-enhanced daily adaptive SBRT Radiotherapy using a conventional C-arm linear accelerator: An FMEA approach","authors":"Lotte Wilke,&nbsp;Sebastian M. Christ,&nbsp;Riccardo Dal Bello,&nbsp;Elizabeth Denney,&nbsp;Silvia Fabiano,&nbsp;Hubert S. Gabryś,&nbsp;Klara Kefer,&nbsp;Michael Mayinger,&nbsp;Ina Nilo,&nbsp;Sophie Perryck,&nbsp;Jens von der Grün,&nbsp;Matthias Guckenberger,&nbsp;Stephanie Tanadini-Lang","doi":"10.1016/j.zemedi.2025.05.002","DOIUrl":"10.1016/j.zemedi.2025.05.002","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>MR-guided adaptive Radiotherapy has the potential to compensate for interfractional changes in patient anatomy. Modern hybrid devices, which combine MR and linear accelerator technologies, have been clinically implemented but their costs may prevent broad adoption. To accelerate the adoption of MR-guided adaptive radiotherapy, we developed a workflow for MR-enhanced daily adaptive Radiotherapy on a C-arm linac using a dedicated MR simulator and a patient transfer shuttle system. A failure mode and effects analysis (FMEA) was performed to identify possible risks in this newly developed workflow.</div></div><div><h3>Materials and Methods</h3><div>A workflow for MR-enhanced daily adaptive SBRT (MEDAS) on a Varian Truebeam linac was developed using a stand-alone 1.5T MR-simulator and patient transfer using a shuttle system. The different process steps were conceptualized in a multidisciplinary team and an FMEA of the different process steps was performed as well as measures for mitigation of possible risks were discussed.</div></div><div><h3>Results</h3><div>The FMEA identified 23 failure modes across eight process steps, with the majority occurring during base plan preparation and adaptive planning. Seventeen (74%) failure modes were classified as low risk, while six (26%) were assessed as medium risk. No high-risk failure modes were identified. Risk mitigation measures, including workflow automation and checklist enhancements, successfully reduced all failure modes to low risk while not introducing new risks</div></div><div><h3>Conclusion</h3><div>We developed a workflow for MEDAS on a conventional C-Arm linac. In this process, an FMEA was performed in a multidisciplinary team. The FMEA identified and addressed six medium-risk failure modes within the MEDAS workflow. Through further automation and adaption of existing checklists, the occurrence- and discover probability was successfully reduced, such that these failure modes are decreased to a low risk.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 423-427"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218098","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":"Enhancing clinical safety in radiation oncology: A data-driven approach to risk management","authors":"Lukas Sölkner,&nbsp;Dietmar Georg,&nbsp;Uwe Wolff,&nbsp;Andreas Renner,&nbsp;Joachim Widder,&nbsp;Gerd Heilemann","doi":"10.1016/j.zemedi.2025.02.003","DOIUrl":"10.1016/j.zemedi.2025.02.003","url":null,"abstract":"<div><h3>Purpose</h3><div>To demonstrate a data-driven risk management (RM) strategy in radiation oncology using an in-house developed web-based incident reporting system. The system leverages real-time analytics to enhance clinical risk prioritization and management, improving patient safety and treatment efficiency.</div></div><div><h3>Methods</h3><div>We developed and implemented a web-based incident reporting system that allows any staff member to report incidents in real time, supporting anonymous submissions and capturing detailed incident data. The collected data are followed up in monthly meetings of a dedicated multidisciplinary RM team that decides on respective interventions. Over five years, incident data were analyzed to assess the effectiveness of safety barriers—pre-planning, physics, and pre-treatment checks—in capturing incidents before they impact patient care and safety. The analysis focused on incident frequencies and the workflow steps where errors originated versus where they were detected, highlighting deficiencies and guiding improvements. When specific issues increased, a Failure Mode and Effects Analysis (FMEA) was initiated to identify and prioritize failure modes and implement corrective actions, such as new safety barriers or refining existing safety measures.</div></div><div><h3>Results</h3><div>The web-based incident reporting system enhances responsive incident reporting and tailors RM strategies effectively. Data analysis reveals incident frequencies and detection points, identifying errors that bypass safety barriers and enabling targeted countermeasures. Despite safety barriers intercepting many incidents, critical gaps were identified. Since implementing data-driven RM in 2019, the average number of process steps between incident cause and detection could be halved. Resource analysis indicates increased allocation is needed; development required approximately 150 h, and RM averages 20% of a full-time equivalent position.</div></div><div><h3>Conclusion</h3><div>Implementing the web-based incident reporting system has advanced RM in radiation oncology, ensuring legal compliance and enhancing safety through real-time analytics. The system effectively identifies and mitigates risks, strengthening QA barriers as evidenced by decreased time between error origin and detection. Adequate resource allocation is essential to sustain these improvements. Increasing full-time equivalent allocations for RM activities is recommended.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 408-415"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143589167","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":"Influence of skin flap thickness on the transmission characteristics of middle ear implant audio processors","authors":"Laura Fröhlich ,&nbsp;Torsten Rahne ,&nbsp;Alexander Müller ,&nbsp;Oliver Dziemba","doi":"10.1016/j.zemedi.2024.08.002","DOIUrl":"10.1016/j.zemedi.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>To measure signal transmission characteristics for audio processors of an active middle ear implant as a function of skin flap thickness, i.e., distance between audio processor and the implant’s receiver coil.</div></div><div><h3>Methods</h3><div>Output sound pressure levels for 90 dB input sound pressure level (OSPL90), reference test gains as function of frequency for an input sound pressure level of 60 dB (RTG60), and reference test gains (RTG - high frequency averages) were recorded in a hearing aid test box for Samba 2 Hi, Samba 2 Lo, and AP404 audio processors (MED-EL, Innsbruck, Austria) positioned on an implant-in-the-box and distances of 0–10 mm between audio processors and the receiver coil.</div></div><div><h3>Results</h3><div>For all audio processors, the OSPL90 and RTG decreased linearly with increasing distance. The effect was dependent on audio processor type and the strongest reduction was observed for Samba 2 Lo. Between distances of 0 mm and 10 mm, the relative change of RTG was - 9,9 dB for Samba 2 Hi, −10,3 dB for AP404, and −27,7 dB for Samba 2 Lo.</div></div><div><h3>Conclusions</h3><div>Skin thickness is a clinically significant factor which has to be considered in VSB treatment. In combination with insufficient transducer coupling or in patients with hearing thresholds close to the indication criteria limit, a thick skin flap could lead to loss of transmitted energy resulting in insufficient audiological outcome with the active middle ear implant.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 483-490"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305512","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":"Intra-fractional lung tumor motion monitoring using arbitrary gantry angles during radiotherapy treatment","authors":"Sepideh Hatamikia ,&nbsp;Soraya Elmirad ,&nbsp;Hugo Furtado ,&nbsp;Gernot Kronreif ,&nbsp;Elisabeth Steiner ,&nbsp;Wolfgang Birkfellner","doi":"10.1016/j.zemedi.2024.03.004","DOIUrl":"10.1016/j.zemedi.2024.03.004","url":null,"abstract":"<div><div>Intensity-based 2D/3D registration using kilo-voltage (kV) and mega-voltage (MV) on-board imaging is a promising approach for real-time tumor motion tracking. So far, the performance of the kV images as well as kV-MV image pairs for 2D/3D registration using only one gantry angle (in anterior-posterior (AP) direction) has been investigated on patient data. In stereotactic body radiation therapy (SBRT), however, various gantry angles are typically used. This study attempts to answer the question of whether automatic 2D/3D registration is possible using kV images as well as kV-MV image pairs for gantry angles other than the AP direction. We also investigated the effect of additional portal MV images paired with kV images to improve 2D/3D registration in extracting cranio-caudal (CC) and AP displacement at arbitrary gantry angles and different fractions. The kV and MV image sequences as well as 3D volume data from five patients suffering from non-small cell lung cancer undergoing SBRT were used. Diaphragm motion served as the reference signal. The CC and AP displacements resulting from the registration results were compared with the corresponding reference motion signal. Pearson correlation coefficients (R value) was used to calculate the similarity measure between reference signal and the extracted displacements resulting from the registration. Signals we found that using 2D/3D registration tumor motion in 5 degrees of freedom (DOF) with kV images and in 6 degrees of freedom with kV-MV image pairs can be extracted for most gantry angles in all patients. Furthermore, our results have shown that the use of kV-MV image pairs increases the overall chance of tumor visibility and therefore leads to more successful extraction of CC as well as AP displacements for almost all gantry angles in all patients. We observed an improvement in registration of at least 0.29% more gantry angle for all patients when we used kV-MV images compared to kV images alone. In addition, an improvement in the R-value was observed in up to 16 fractions in various patients.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 503-513"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140764797","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":"UN Scientific Committee on the levels and effects of exposure to ionizing radiation celebrates its 70th anniversary","authors":"Ferid Shannoun ,&nbsp;Anna A. Friedl","doi":"10.1016/j.zemedi.2025.10.002","DOIUrl":"10.1016/j.zemedi.2025.10.002","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 388-392"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145484620","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":"Assessment of attenuation properties for SLA and SLS 3D-printing materials in X-ray imaging and nuclear medicine","authors":"Stefan Weber ,&nbsp;Andreas Block ,&nbsp;Felix Bärenfänger","doi":"10.1016/j.zemedi.2024.02.003","DOIUrl":"10.1016/j.zemedi.2024.02.003","url":null,"abstract":"<div><div>In recent years, access to 3D printers has become increasingly affordable. Alongside industrial and private applications, the significance of 3D printing in the clinical context is also growing. For instance, 3D printing processes enable the production of individual anatomical models that can be used to support patient communication or aid in surgical planning. While filament 3D printing is common, stereolithography (SLA) and selective laser sintering (SLS) printing processes offer higher precision. For the use of 3D printing materials in radiology, understanding their attenuation properties concerning ionizing radiation is crucial. Polymethyl methacrylate (PMMA) serves as an important reference material for radiological applications in this regard.</div><div>In this research, linear- and mass attenuation coefficients of 38 SLA-/SLS-materials from Formlabs (Somerville, Massachusetts, USA) and PMMA will be determined through intensity measurements in nuclear medicine for the radionuclides technetium-99 m and iodine-131, as well as for X-ray imaging in the range of 60 kVp - 110 kVp tube voltage. Based on the mass attenuation coefficients, correction factors in respect to PMMA will be calculated for each material. A significant number of materials exhibit a deviance within approximately <span><math><mrow><mo>±</mo></mrow></math></span>5% in respect to PMMA regardless of radiation energy. However, certain materials from the dental and industrial application show deviances up to +500% at the lower end of radiation energy spectrum. In conclusion, most materials can be considered equivalent to PMMA with only minor adjustments required. Materials with high deviances can be utilized as high-contrast materials in custom X-ray phantoms.</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 491-502"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121807","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":"Editorial Board + Consulting Editorial Board","authors":"","doi":"10.1016/S0939-3889(25)00138-2","DOIUrl":"10.1016/S0939-3889(25)00138-2","url":null,"abstract":"","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Page iii"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766157","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":"Low-Dose radiation risk in medicine: a look at risk models, challenges, and future prospects","authors":"Forough Jafarian-Dehkordi,&nbsp;Christoph Hoeschen","doi":"10.1016/j.zemedi.2025.07.002","DOIUrl":"10.1016/j.zemedi.2025.07.002","url":null,"abstract":"<div><div>The application of ionizing radiation in medical diagnostics and treatments has been transformative in advancing healthcare for the benefit of patients. However, with these advancements comes the need to understand and mitigate the risks of ionizing radiation. While the role of radiation in medicine is undeniable, its potential to induce malignancies and genetic alterations requires careful application and understanding. This review provides an overview about the radiobiology of radiation risk, and then go through the evolution, challenges, and inherent uncertainties surrounding radiation risk models. In the end, it looks at the impact of the technological and methodological progress that has influenced the radiation protection and shapes our understanding of radiation risk. The search for references was conducted in Google Scholar and PubMed using the keywords ’low radiation,’ ’radiation risk,’ ’risk models,’ ’radiation protection,’ and ’uncertainty.’</div></div>","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 4","pages":"Pages 393-400"},"PeriodicalIF":4.2,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144719332","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":"Pilot study on high-resolution radiological methods for the analysis of cerebrospinal fluid (CSF) shunt valves","authors":"Martin P. Pichotka ,&nbsp;Moritz Weigt ,&nbsp;Mukesch J. Shah ,&nbsp;Maximilian F. Russe ,&nbsp;Thomas Stein ,&nbsp;T. Billoud ,&nbsp;Jürgen Beck ,&nbsp;Jakob Straehle ,&nbsp;Christopher L. Schlett ,&nbsp;Dominik v. Elverfeldt ,&nbsp;Marco Reisert","doi":"10.1016/j.zemedi.2023.11.001","DOIUrl":"10.1016/j.zemedi.2023.11.001","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Despite their life-saving capabilities, cerebrospinal fluid (CSF) shunts exhibit high failure rates, with a large fraction of failures attributed to the regulating valve. Due to a lack of methods for the detailed analysis of valve malfunctions, failure mechanisms are not well understood, and valves often have to be surgically explanted on the mere suspicion of malfunction.&lt;/div&gt;&lt;div&gt;The presented pilot study aims to demonstrate radiological methods for comprehensive analysis of CSF shunt valves, considering both the potential for failure analysis in design optimization, and for future clinical in-vivo application to reduce the number of required shunt revision surgeries. The proposed method could also be utilized to develop and support in situ repair methods (e.g. by lysis or ultrasound) of malfunctioning CSF shunt valves.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;The primary methods described are contrast-enhanced radiographic time series of CSF shunt valves, taken in a favorable projection geometry at low radiation dose, and the machine-learning-based diagnosis of CSF shunt valve obstructions. Complimentarily, we investigate CT-based methods capable of providing accurate ground truth for the training of such diagnostic tools. Using simulated test and training data, the performance of the machine-learning diagnostics in identifying and localizing obstructions within a shunt valve is evaluated regarding per-pixel sensitivity and specificity, the Dice similarity coefficient, and the false positive rate in the case of obstruction free test samples.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Contrast enhanced subtraction radiography allows high-resolution, time-resolved, low-dose analysis of fluid transport in CSF shunt valves. Complementarily, photon-counting micro-CT allows to investigate valve obstruction mechanisms in detail, and to generate valid ground truth for machine learning-based diagnostics.&lt;/div&gt;&lt;div&gt;Machine-learning-based detection of valve obstructions in simulated radiographies shows promising results, with a per-pixel sensitivity &gt;70%, per-pixel specificity &gt;90%, a median Dice coefficient &gt;0.8 and &lt;10% false positives at a detection threshold of 0.5.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This ex-vivo study demonstrates obstruction detection in cerebro-spinal fluid shunt valves, combining radiological methods with machine learning under conditions compatible to future in-vivo application.&lt;/div&gt;&lt;div&gt;Results indicate that high-resolution contrast-enhanced subtraction radiography, possibly including time-series data, combined with machine-learning image analysis, has the potential to strongly improve the diagnostics of CSF shunt valve failures. The presented method is in principle suitable for in-vivo application, considering both measurement geometry and radiological dose. Further research is needed to validate these results on real-world data and to refine the employed methods.&lt;/div&gt;&lt;div&gt;","PeriodicalId":54397,"journal":{"name":"Zeitschrift fur Medizinische Physik","volume":"35 3","pages":"Pages 331-342"},"PeriodicalIF":4.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138679829","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}