Physica Medica-European Journal of Medical Physics最新文献

{"title":"Corrigendum to \"Tumor control probability analysis in carbon-ion radiotherapy for prostate cancer considering the oxygen effect\" [Phys. Med. 143 (2026) 105744].","authors":"Yushi Wakisaka, Shuka Fukuda, Toshiro Tsubouchi, Noriaki Hamatani, Masashi Yagi, Mayu Nakata, Yuki Tominaga, Kazuhiko Hayashi, Masaaki Takashina, Kazumasa Minami, Teiji Nishio, Tatsuaki Kanai","doi":"10.1016/j.ejmp.2026.105802","DOIUrl":"https://doi.org/10.1016/j.ejmp.2026.105802","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":" ","pages":"105802"},"PeriodicalIF":2.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing radiation dose and image quality in pediatric head CT: a comparison between children’s and regional hospitals in the Canadian province of Nova Scotia","authors":"Elena Tonkopi ,&nbsp;Tahani Ahmad ,&nbsp;Yulia Kotlyarova ,&nbsp;Jessica Kimber ,&nbsp;Megan Iwaskow ,&nbsp;Catherine Gunn","doi":"10.1016/j.ejmp.2026.105750","DOIUrl":"10.1016/j.ejmp.2026.105750","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare radiation doses and image quality from pediatric head CT examinations performed at a children’s hospital and general regional hospitals, and to propose local diagnostic reference levels (LDRLs).</div></div><div><h3>Methods</h3><div>Data were retrospectively collected from five scanners in three hospitals; only routine non-specialized examinations were included. Patients were grouped by age: &lt;1, 1–5, 6–10, and 11–15 years. LDRLs were determined as the 75th percentile of the pooled dose indices distributions and modeled as continuous functions of patients’ AP thickness and age using quantile regression. Samples of 25 studies from each scanner were randomly selected and blinded for qualitative and quantitative image quality analysis. Differences in radiation doses between scanners were assessed using the Kruskal–Wallis test. Factors potentially affecting image quality were evaluated using the Pearson correlation coefficient.</div></div><div><h3>Results</h3><div>The dose survey included 358 studies, of which 125 were assessed for image quality. LDRLs were established as discrete quantities in each age group and modeled as an exponential-type function. Differences in dose indices between scanners were statistically significant (p-value &lt;0.05) for all age categories. Pearson correlation coefficients demonstrated a weak correlation between radiation dose and the image quality total score across all scanners.</div></div><div><h3>Conclusion</h3><div>Significant dose variability was observed among scanners, with only a weak association between radiation dose and image quality. Examinations at a specialized pediatric facility resulted in higher radiation doses compared to general hospitals in the province. The derived LDRLs provide a useful benchmark for optimizing pediatric head CT and standardizing imaging across hospitals.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105750"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT- DImQ: An open-access platform for image quality assessment of CT systems- application to CT values and noise characterization in 3D-printed anthropomorphic thorax phantoms","authors":"Ainur Kazhybekova ,&nbsp;Peter McHale ,&nbsp;J.M. den Harder ,&nbsp;Irene Hernandez-Giron","doi":"10.1016/j.ejmp.2025.105692","DOIUrl":"10.1016/j.ejmp.2025.105692","url":null,"abstract":"<div><h3>Purpose</h3><div>To present an open access platform for CT image quality assessment combined with anthropomorphic phantoms. To promote the accessibility of anthropomorphic phantoms, including 3D-printed affordable ones, in regular QC analysis of CT images reconstructed with filtered back projection (FBP), iterative (IR) and Deep-Learning (DLR) reconstruction algorithms.</div></div><div><h3>Methods</h3><div>The Python-based platform CT-DImQ enables the advanced evaluation of CT values distribution through histogram analysis and noise characterization (noise maps and noise power spectrum (NPS)). The interactive GUIs allow the user to perform the CT data analysis adapting the output to their own requirements. The use case for CT-DImQ was CT anthropomorphic phantom data (thorax phantom with 3D-printed TPU lung vessel trees and PA-12 nodules) obtained under clinical conditions and two dose levels reconstructed with FBP, IR and DLR.</div></div><div><h3>Results</h3><div>Histograms showed in general an underestimation of CT-values for the 3D printed materials and a overestimation for Teflon (spine surrogate), in DLR images, while air and PMMA-soft tissue were the same as with IR and FBP. Noise maps showed a strong noise reduction in uniform phantom parts, and to a lesser extent in vessel and nodules edges. NPS showed noise reduction with increasing dose, especially with FBP and iterative reconstruction, and differences in the noise reduction frequency dependence among reconstruction methods, which was corroborated visually by the more uniform appearance of vessels and nodules in DLR images.</div></div><div><h3>Conclusion</h3><div>CT-DImQ combined with anthropomorphic phantoms represents a step towards advanced image quality evaluation in CT, closer to the clinical reality with patients and able to evaluate advanced reconstruction methods trained with patient data.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105692"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146144720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for the dosimetry of patients undergoing therapy with radiopharmaceuticals that include 177Lu","authors":"Pablo Mínguez Gabiña ,&nbsp;Nuria Carrasco Vela ,&nbsp;Leticia Irazola Rosales ,&nbsp;Josep María Martí-Climent ,&nbsp;Luis Carlos Martínez Gómez ,&nbsp;Teresa Monserrat Fuertes ,&nbsp;Carlos Montes Fuentes ,&nbsp;Alfredo Montes Uruen ,&nbsp;Raquel Barquero Sanz","doi":"10.1016/j.ejmp.2026.105752","DOIUrl":"10.1016/j.ejmp.2026.105752","url":null,"abstract":"<div><div>Currently the two radiopharmaceuticals approved by the AEMPS that include ¹⁷⁷Lu are [¹⁷⁷Lu]Lu-DOTA-TATE for the treatment of neuroendocrine tumours and [¹⁷⁷Lu]Lu-PSMA-617 for the treatment of mCRPC. The RD601/2019 states that for all medical exposure of patients for radiotherapeutic purposes, exposures of target volumes shall be individually planned and their delivery appropriately verified taking into account that doses to non-target volumes and tissues shall be as low as reasonably achievable and consistent with the intended radiotherapeutic purpose of the exposure. However, for both radiopharmaceuticals the treatment is performed by administering cycles of 7.4 GBq of the radiopharmaceutical — 4 cycles for [¹⁷⁷Lu]Lu-DOTA-TATE and 6 cycles for [¹⁷⁷Lu]Lu-PSMA-617. This implies that treatments are not planned in advance, but can at least be verified by dosimetry. The purpose of the present document is to provide recommendations for the dosimetry of patients in treatments with the aforementioned radiopharmaceuticals.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105752"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146138158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guide for quality control and safety in clinical linear accelerators","authors":"P. Almendral Manzano ,&nbsp;E. Ambroa Rey ,&nbsp;C. Ferrer Gracia ,&nbsp;M. Martínez Albaladejo ,&nbsp;J. Pérez-Alija Fernández ,&nbsp;R. Tortosa Oliver ,&nbsp;M. Vilches Pacheco ,&nbsp;F. Lliso Valverde","doi":"10.1016/j.ejmp.2026.105747","DOIUrl":"10.1016/j.ejmp.2026.105747","url":null,"abstract":"<div><div>The main objective of this document has been to establish a guide for the design of the quality control programme in linear accelerators with isocentric assembly, incorporating the approaches of statistical process control and risk analysis. Throughout the text, it is emphasized that the guide is not prescriptive, and adaptation to the specific needs of each centre is encouraged.</div><div>A brief description of the recommended tests is presented. A set of fundamental parameters and complementary ones are suggested, taking into account the results obtained from a survey of SEFM members, as well as proposals from other scientific societies, manufacturer comments, and consensus from this working group. Frequency and tolerance recommendations are provided for representative accelerators as a reference.</div><div>This document presents a summarized version of the guide, which is accessible in Revista de Física Médica or on the website of the SEFM, providing a synthesis of the main recommendations.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105747"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146183544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithm-based gantry angle range determination in volumetric modulated arc therapy for liver stereotactic body radiation therapy","authors":"Hideharu Miura ,&nbsp;Minoru Nakao ,&nbsp;Masanori Ochi ,&nbsp;Shuichi Ozawa ,&nbsp;Soichiro Ishihara ,&nbsp;Masahiro Kenjo ,&nbsp;Masayuki Kagemoto","doi":"10.1016/j.ejmp.2026.105746","DOIUrl":"10.1016/j.ejmp.2026.105746","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop an algorithm-based method for determining optimal gantry angle ranges in volumetric modulated arc therapy (VMAT) for liver cancer by minimizing the beam path length through normal liver.</div></div><div><h3>Methods</h3><div>Fifteen consecutive patients with primary liver cancer who had undergone stereotactic body radiotherapy (SBRT) were analyzed. The algorithm calculated the shortest beam paths between the liver surface and the target center from DICOM-based contours to determine feasible gantry-angle ranges. For each patient, three VMAT plans were generated: (1) an automated gantry-angle plan using the proposed method, (2) an expert manual plan, and (3) a novice manual plan. Plans were compared in terms of selected gantry angle ranges, liver path length, dose-volume parameters, and monitor units (MUs). Gantry angle range agreement between plans was evaluated using the Jaccard similarity coefficient.</div></div><div><h3>Results</h3><div>The automated plan achieved a mean normal liver path length of 35.0 ± 14.4 mm, comparable to the expert plan (34.6 ± 15.0 mm) and shorter than the novice plan (39.3 ± 15.2 mm), with no significant differences among the three plans (p &gt; 0.05). The mean Jaccard similarity coefficients were 0.86 ± 0.10 (auto–expert) and 0.80 ± 0.12 (auto–novice), indicating closer agreement with expert plans. Dosimetric parameters and MUs were similar across all plans.</div></div><div><h3>Conclusions</h3><div>The algorithmic approach provides a simple, quantitative, and reproducible method for determining gantry-angle ranges in liver VMAT. It effectively reproduces expert planner decision-making, reduces variability between planners, and has the potential to standardize gantry angle determination and streamline treatment planning.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105746"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146159398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor control probability analysis in carbon-ion radiotherapy for prostate cancer considering the oxygen effect","authors":"Yushi Wakisaka ,&nbsp;Shuka Fukuda ,&nbsp;Toshiro Tsubouchi ,&nbsp;Noriaki Hamatani ,&nbsp;Masashi Yagi ,&nbsp;Mayu Nakata ,&nbsp;Yuki Tominaga ,&nbsp;Kazuhiko Hayashi ,&nbsp;Masaaki Takashina ,&nbsp;Kazumasa Minami ,&nbsp;Teiji Nishio ,&nbsp;Tatsuaki Kanai","doi":"10.1016/j.ejmp.2026.105744","DOIUrl":"10.1016/j.ejmp.2026.105744","url":null,"abstract":"<div><h3>Purpose</h3><div>Carbon ion radiotherapy (CIRT) is expected to be effective against hypoxic tumors due to its lower oxygen enhancement ratio (OER) compared to X-ray radiotherapy (XRT). OER is expected to have a significant impact on therapeutic efficacy, especially for prostate cancer, which has low oxygen partial pressure. This study aimed to derive OERs for photon and carbon-ion spread-out Bragg peak (SOBP) irradiation through cellular experiments and incorporate them into the tumor control probability (TCP) function to test consistency with clinical outcomes.</div></div><div><h3>Methods</h3><div>To derive the OER for photons and the OERs at three depths (proximal, center, and distal) within the carbon-ion SOBP, the dose-dependent survival rate of the prostate cancer cell line PC3 was measured under both aerobic and hypoxic conditions. TCP functions incorporating dose-dependent OERs based on clinical prescription doses were fitted to clinical outcomes of prostate cancer treated with XRT and CIRT to test the clinical relevance of the obtained OERs.</div></div><div><h3>Results</h3><div>The OERs at 10% survival for PC3 cells were 2.12 ± 0.68 for photons, and 1.70 ± 0.13, 1.65 ± 0.19, and 1.56 ± 0.13 at the proximal, center, and distal depths of the carbon-ion SOBP, respectively. The TCP functions calculated using dose-dependent OERs were not inconsistent with the clinical outcomes for both XRT and CIRT, supporting the clinical relevance of the OERs derived from cell experiments.</div></div><div><h3>Conclusion</h3><div>The carbon-ion SOBP used in prostate cancer treatment has a lower OER than photons, suggesting its potential effectiveness against hypoxic tumors.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105744"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146167898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized survival models for choosing irradiated tumor burden on combined radiotherapy and immune checkpoint inhibitors in stage IV NSCLC patients","authors":"Yeseul Kim ,&nbsp;Joongyo Lee ,&nbsp;Ibrahim Chamseddine ,&nbsp;Clemens Grassberger ,&nbsp;Hong In Yoon ,&nbsp;Kyung Hwan Kim ,&nbsp;Yeona Cho ,&nbsp;Wonmo Sung","doi":"10.1016/j.ejmp.2026.105751","DOIUrl":"10.1016/j.ejmp.2026.105751","url":null,"abstract":"<div><h3>Purpose</h3><div>To assess the effects of irradiated tumor burden (ITB) and key prognostic factors for patients with advanced non-small cell lung cancer (NSCLC) who received a combination treatment of radiotherapy (RT) and immune checkpoint inhibitors (ICI).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 79 patients with stage 4 NSCLC treated with ICI after RT. The linear and non-linear prediction models were trained to predict individual risk-based on the optimal parameter set selected from 14 clinical features including patient, tumor, treatment, and immunologic factors. We introduced a new prognostic factor, ITB, as the volume fraction of tumor that irradiated to investigate the impact of radiotherapy for the combination treatment. ITB’s correlation with clinical variables was examined using log-rank survival tests and Pearson correlation maps.</div></div><div><h3>Results</h3><div>Overall survival (OS) prediction indicates the non-linear random survival forest (RSF) model surpassed both the Cox linear model and gradient boosting model (RSF c-index = 0.78 90 %CI [0.77–0.80], Cox c-index = 0.75 90 %CI [0.74–0.76], GBM c-index = 0.77 90 %CI [0.76–0.78]; <em>t</em>-test P &lt; 0.001 between RSF and Cox). Major prognostic factors for the final OS models are ITB, metastasis extent, and RT-induced lymphopenia. Patients with an ITB over 50 % exhibited improved outcomes (Median OS: 15.8 vs 7.9 months, p &lt; 0.001; median progression-free survival (PFS): 12.5 vs 7.4 months, p &lt; 0.001). ITB demonstrated independent predictive power, as no linear correlation with other variables was evident.</div></div><div><h3>Conclusion</h3><div>Our findings endorse RT followed by ICI as a favorable protocol for advanced NSCLC, advocating for ITB’s integration into future RT-ICI trial designs due to its significant prognostic implication.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105751"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient exposure in paediatric Interventional Cardiology: a multicenter inter-comparison of clinical practices in Italy","authors":"Francesca De Monte ,&nbsp;Angelo Giannone ,&nbsp;Andrea Bettinelli ,&nbsp;Giuseppe Annoni ,&nbsp;Gianfranco Butera ,&nbsp;Vittorio Cannatà ,&nbsp;Martino Cheli ,&nbsp;Davide Ciucci ,&nbsp;Andrea Donti ,&nbsp;Marco Favetta ,&nbsp;Roberto Formigari ,&nbsp;Chiara Fraccaro ,&nbsp;Gianpiero Gaio ,&nbsp;Mario Giordano ,&nbsp;Fabrizio Levrero ,&nbsp;Giovanni Meliota ,&nbsp;Danilo Montefoschi ,&nbsp;Federico Palmacci ,&nbsp;Veronica Rossetti ,&nbsp;Maria Giovanna Russo ,&nbsp;Marta Paiusco","doi":"10.1016/j.ejmp.2026.105754","DOIUrl":"10.1016/j.ejmp.2026.105754","url":null,"abstract":"<div><h3>Purpose</h3><div>This multicenter study aims to assess compliance with Image Gently Alliance dose optimization principles in paediatric Interventional Cardiology (IC) and to examine inter-center variability in patient radiation exposure.</div></div><div><h3>Material and Methods</h3><div>Leading centers in Italy were involved. An operational survey,developed in agreement with the Image Gently recommendations, was administered to investigate clinical practices and identify any deviations from established guidelines.Data from 2841 procedures were collected. Dosimetric data (PKA, Ka,r, fluoroscopy time) from centers were compared and analyzed alongside the questionnaire responses.Inter-center differences were assessed using the Kruskal-Wallis test (p &lt; 0.05).</div></div><div><h3>Results</h3><div>Despite adherence to recommendations,the questionnaire identified deviations correlated with exposure,including failure to remove the anti-scatter grid for patients &lt; 20 kg, excessive magnification,and extensive cine-acquisition. Statistically significant inter-center differences in dose were observed. Centre A shows a significant reduction in patient dose for almost all procedure types. As an example, for angioplasty, centre A showed a lower median value (P_KA = 3.5 Gy·cm²), less than half that of C (P_KA = 9.2 Gy·cm²), D (P_KA = 10.3 Gy·cm²) and E (P_KA = 10.0 Gy·cm²). Centre E exhibited higher doses for most procedures: a median P_KA = 5.6 Gy·cm² in diagnostic catheterizations compared to a range of 1.6–4.6 Gy·cm² in the other centres, and a median P_KA = 3.2 Gy·cm² for Patent Ductus Arteriosus closure compared to 0.7–1.4 Gy·cm². These results can be attributed to an outdated equipment.</div></div><div><h3>Conclusions</h3><div>Investigating clinical practices in a multicenter context is crucial for harmonizing operations and ensuring dose monitoring. Identifying differences in practices, equipment, and image quality that affect patient dose is essential for enhancing patient safety.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105754"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146198293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized organ dose assessment from CT imaging during proton therapy for classical Hodgkin lymphoma patients","authors":"Angeliki Gkavonatsiou ,&nbsp;Maite Romero-Expósito ,&nbsp;Karin M Andersson ,&nbsp;Mona Azizi ,&nbsp;Christina Goldkuhl ,&nbsp;Daniel Molin ,&nbsp;Alexandru Dasu","doi":"10.1016/j.ejmp.2026.105748","DOIUrl":"10.1016/j.ejmp.2026.105748","url":null,"abstract":"<div><h3>Background/Purpose</h3><div>Proton therapy (PT) improves treatment precision for classical Hodgkin lymphoma (cHL), with computed tomography (CT) being essential for treatment planning and verification. This study evaluates the individual organ doses from CT imaging in these patients treated with PT using free-breathing (FB) or deep inspirational breath hold (DIBH) techniques.</div></div><div><h3>Material/Methods</h3><div>A cohort of 38 patients treated at the Skandion Clinic was studied. Organ doses from each planning and verification scan were estimated using VirtualDose software, based on CT parameters extracted from DICOM data. The impact of different imaging protocols (standard dose [SD], low dose [LD], and 4DCT) was assessed for patients with target in mediastinum, and neck and upper thorax.</div></div><div><h3>Results</h3><div>Significant variations were observed in the number of CT scans (median 9, range 3–12) and the protocols used among patients. Organ doses were further influenced by the extent of the scanning volume and the scanning technique. SD protocols in the mediastinum set resulted in median dose per scan to the lungs around 21 mGy (males and females), while LD protocol reduced these doses by up to 87%. The most exposed organs can receive a total dose of several hundred mGy.</div></div><div><h3>Conclusion</h3><div>Large inter-patient variations highlight the need for personalized CT dose calculations. Although in-field and near-field organs may receive relatively high doses from imaging, these remain significantly lower than the prescribed dose, less than 2%. Nevertheless, organ doses and their associated risks for long-term survivors of cHL could be further minimized by implementing low-dose CT protocols whenever feasible.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"143 ","pages":"Article 105748"},"PeriodicalIF":2.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146116686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}