Physica Medica-European Journal of Medical Physics最新文献

{"title":"The accuracy of surface imaging in detecting secondary patient motion caused by pitch and roll corrections in pelvic radiotherapy","authors":"Annele Heikkilä ,&nbsp;Eeva Boman ,&nbsp;Antti Aula ,&nbsp;Marko Laaksomaa ,&nbsp;Tuomas Koivumäki ,&nbsp;Michiel Postema","doi":"10.1016/j.ejmp.2025.105097","DOIUrl":"10.1016/j.ejmp.2025.105097","url":null,"abstract":"<div><h3>Background and objective:</h3><div>Correction of rotational setup errors by tilting the treatment couch improves target dose accuracy and prevents healthy tissue overdosage in external beam radiotherapy. However, couch tilts may cause secondary patient motion. This study aimed to quantify the secondary motion caused by pitch and roll corrections and to evaluate the feasibility of surface imaging for detecting the secondary motion in pelvic radiotherapy.</div></div><div><h3>Methods:</h3><div>Setup cone-beam computed tomography images and surface imaging data of 337 fractions of 22 patients were retrospectively collected. The secondary motion was quantified by the residual setup deviations observed in verification cone-beam computed tomography images acquired in 91 fractions with <span><math><mrow><mo>&gt;</mo><mn>1</mn><mo>°</mo></mrow></math></span> pitch or roll corrections. The secondary motion observed in the surface imaging data was compared to that observed in the cone-beam computed tomography images in 73 fractions.</div></div><div><h3>Results:</h3><div>Average residual errors of 0.7 mm/1<span><math><mo>°</mo></math></span> (<span><math><mrow><mi>R</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>95</mn></mrow></math></span>) and –1.3 mm/1<span><math><mo>°</mo></math></span> (<span><math><mrow><mi>R</mi><mo>=</mo><mo>−</mo><mn>0</mn><mo>.</mo><mn>87</mn></mrow></math></span>) were observed in longitudinal and lateral directions after pitch and roll corrections, respectively. The 95% limits of agreement between surface imaging and cone-beam tomography imaging residual errors were (–2.2, 1.5) mm in longitudinal direction and (–1.3, 1.1) mm in lateral direction.</div></div><div><h3>Conclusion:</h3><div>Pelvic radiotherapy patients seemed to have shifted downwards on the treatment couch during couch tilts. The secondary motion could be accurately detected by surface imaging, although respiratory motion reduced the accuracy in longitudinal direction.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"138 ","pages":"Article 105097"},"PeriodicalIF":2.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145020143","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":"Corrigendum to \"Ultra-high dose rate dosimetry for pre-clinical experiments with mm-small proton fields\" [Phys. Med. 104 (2022) 101-111].","authors":"M Togno, K P Nesteruk, R Schäfer, S Psoroulas, D Meer, M Grossmann, J B Christensen, E G Yukihara, A J Lomax, S Safai","doi":"10.1016/j.ejmp.2025.105100","DOIUrl":"https://doi.org/10.1016/j.ejmp.2025.105100","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":" ","pages":"105100"},"PeriodicalIF":2.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031336","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":"Supporting patient-specific quality assurance with fast Monte Carlo at CCB proton therapy center","authors":"Wiktor Komenda ,&nbsp;Natalia Mojżeszek ,&nbsp;Marta Bałamut ,&nbsp;Jan Gajewski ,&nbsp;Hubert Jabłoński ,&nbsp;Damian Kabat ,&nbsp;Renata Kopeć ,&nbsp;Dawid Krzempek ,&nbsp;Paweł Rogalski ,&nbsp;Marzena Rydygier ,&nbsp;Anna Spaleniak ,&nbsp;Paulina Stasica-Dudek ,&nbsp;Antoni Ruciński","doi":"10.1016/j.ejmp.2025.105085","DOIUrl":"10.1016/j.ejmp.2025.105085","url":null,"abstract":"<div><h3>Purpose</h3><div>Experimental patient-specific quality assurance (PSQA) in proton therapy is a labor-intensive process requiring physical access to treatment rooms, beam time, and significant human resources. With the increasing complexity of treatment plans and the implementation of adaptive therapy, the need for efficient alternatives is pressing. Simulation-based techniques are proposed as a replacement or enhancement for experimental ones. This study presents a data-driven approach to simulation-based PSQA criteria selection and validation.</div></div><div><h3>Methods</h3><div>The FRED Monte Carlo code was used to simulate PSQA for 293 patients (Gantry 1) and 296 patients (Gantry 2), divided into training and verification subsets. The training dataset guided criteria selection for simulation-based PSQA. The gamma index (GI) was analysed with criteria of 3 %/2 mm, 2 %/2 mm, 1.75 %/2 mm, 1.5 %/2 mm and 1.25 %/2 mm and compared to experimental PSQA through Spearman’s rank test. Both GI criteria and passing rate thresholds were tested to maximize consistency between experimental and simulation-based PSQA and to minimize the likelihood of false-positive errors. We validated the selected criterion on the verification subset.</div></div><div><h3>Results</h3><div>The analysis identified the 1.75 %/2<!--> <!-->mm GI criterion with a 95 % passing rate as optimal. Validation on an independent verification dataset of 2816 planes showed high consistency between simulation-based and experimental PSQA: 97.5 % agreement for Gantry 1 and 98.6 % for Gantry 2. False positives were eliminated for Gantry 1 and reduced to 0.5 % for Gantry 2.</div></div><div><h3>Conclusion</h3><div>The proposed approach demonstrates its potential to streamline PSQA workflows, maintain clinical accuracy, and enable the integration of simulation-based PSQA into routine practice.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"138 ","pages":"Article 105085"},"PeriodicalIF":2.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144989989","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":"Robustness evaluation of an artificial intelligence-based automatic contouring software in daily routine practice.","authors":"Jimmy Fontaine, Maud Suszko, Francesca di Franco, Agathe Leroux, Emilie Bonnet, Mathieu Bosset, Julien Langrand-Escure, Sébastien Clippe, Bertrand Fleury, Jean-Baptiste Guy","doi":"10.1016/j.ejmp.2025.105065","DOIUrl":"10.1016/j.ejmp.2025.105065","url":null,"abstract":"<p><strong>Purpose: </strong>AI-based automatic contouring streamlines radiotherapy by reducing contouring time but requires rigorous validation and ongoing daily monitoring. This study assessed how software updates affect contouring accuracy and examined how image quality variations influence AI performance.</p><p><strong>Methods: </strong>Two patient cohorts were analyzed. The software updates cohort (40 CT scans: 20 thorax, 10 pelvis, 10 H&N) compared six versions of Limbus AI contouring software. The image quality cohort (20 patients: H&N, pelvis, brain, thorax) analyzed 12 reconstructions per patient using Standard, iDose, and IMR algorithms, with simulated noise and spatial resolution (SR) degradations. AI performance was assessed using Volumetric Dice Similarity Coefficient (vDSC) and 95 % Hausdorff Distance (HD95%) with Wilcoxon tests for significance.</p><p><strong>Results: </strong>In the software updates cohort, vDSC improved for re-trained structures across versions (mean DSC ≥ 0.75), with breast contour vDSC decreasing by 1 % between v1.5 and v1.8B3 (p > 0.05). Median HD95% values were consistently <4 mm, <5 mm, and <12 mm for H&N, pelvis, and thorax contours, respectively (p > 0.05). In the image quality cohort, no significant differences were observed between Standard, iDose, and IMR algorithms. However, noise and SR degradation significantly reduced performance: vDSC ≥ 0.9 dropped from 89 % at 2 % noise to 30 % at 20 %, and from 87 % to 70 % as SR degradation increased (p < 0.001).</p><p><strong>Conclusion: </strong>AI contouring accuracy improved with software updates and showed robustness to minor reconstruction variations, but it was sensitive to noise and SR degradation. Continuous validation and quality control of AI-generated contours are essential. Future studies should include a broader range of anatomical regions and larger cohorts.</p>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"105065"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805351","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":"Radiological assessment of Cerrobend and tungsten carbide as aperture materials in proton therapy","authors":"Jia Wei Law ,&nbsp;Alexandre Santos ,&nbsp;Scott Penfold","doi":"10.1016/j.ejmp.2025.105084","DOIUrl":"10.1016/j.ejmp.2025.105084","url":null,"abstract":"<div><h3>Background</h3><div>The use of patient-specific apertures in pencil beam scanning (PBS) proton therapy improves target conformity but increases secondary neutron production and induces aperture activation. While brass is commonly used for apertures, Cerrobend and tungsten carbide may offer cost-effective alternatives.</div></div><div><h3>Purpose</h3><div>This study evaluates the viability of Cerrobend and tungsten carbide for PBS apertures by examining secondary neutron production and activation using Tool for Particle Simulation (TOPAS). Comparisons were made with brass and also nickel and tungsten alloy, which are materials proposed for dynamic collimation systems (DCS).</div></div><div><h3>Methods</h3><div>TOPAS was used to simulate the irradiation of 230 MeV proton beams on fully closed apertures, with neutron fluence and dose scored in water phantom. Custom scorers recorded isotopes formed in apertures, with residual activity calculated using phase space files and Python scripts.</div></div><div><h3>Results</h3><div>Nickel yielded the lowest secondary neutron dose among all tested materials. The ambient dose equivalent from neutrons produced by tungsten carbide and Cerrobend were 10 % lower and 28 % higher compared to brass, respectively. Over a 6-week treatment course with 5-fractions per week, Cerrobend and tungsten carbide showed similar and 1.4 times higher activation than brass, respectively. The residual activity of Cerrobend and tungsten carbide fell below brass 30 and 130 days post-treatment, respectively. Nickel’s initial activity was 25 % of brass but residual activity remained three times higher after one year.</div></div><div><h3>Conclusions</h3><div>Brass remains the optimal aperture material, but tungsten carbide and Cerrobend could be viable alternatives for PBS proton therapy. Nickel’s high residual activity could pose challenges for DCS.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105084"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144932423","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":"Galileo Galilei award","authors":"","doi":"10.1016/j.ejmp.2025.105075","DOIUrl":"10.1016/j.ejmp.2025.105075","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105075"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010442","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":"Dose escalation in pediatric pelvic Ewing's Sarcoma: Insights from a national treatment planning exercise.","authors":"G Beldjoudi, F Goudjil, C Lafond, S Raucoules, C Moignier, D Maneval, C Bartau, G Hangard, D Trauchessec, V Anthonipillai, W Gehin, T Lacornerie, L Claude, L Ollivier","doi":"10.1016/j.ejmp.2025.105063","DOIUrl":"10.1016/j.ejmp.2025.105063","url":null,"abstract":"<p><strong>Purpose: </strong>The Inter Ewing-1 trial investigates dose escalation in definitive radiotherapy (randomization 54 Gy versus 64.8 Gy). Prior to the trial's initiation, the French Pediatric Radiotherapy Group conducted a national treatment planning exercise to assess dosimetric discrepancies associated with this dose escalation.</p><p><strong>Methods and materials: </strong>A non-operated pelvic pediatric case of Ewing's sarcoma was selected. CT-scan and delineated structures were distributed to accredited participants for pediatric radio- and/or proton-therapy. Treatment planning included a simultaneous integrated boost: 54 Gy in 30 fractions (1.80 Gy/fraction) for the pre-chemotherapy tumor volume, and 63.9 Gy (2.13 Gy/fraction) for the post-chemotherapy volume. Dose constraints for organs-at-risk and target coverage were provided. All treatment plans were collected, analyzed for deviations and compared. Data were projected in a 21-dimensional(D) space and reduced to 2-D for visual representation.</p><p><strong>Results and discussion: </strong>Eleven French centers submitted 14 plans (10 photon/4 proton plans). One photon plan exhibited one major and two minor deviations on organ-at-risk constraints. All photon plans presented a minor deviation regarding the constraint D0.1 cc Testis. No significant difference was observed between photons and protons for target coverage or for sparing most critical organs; however, protons showed significant advantages in DmeanBowel (9.9+/-1.1 Gy (photons) vs 3.5+/-0.4 Gy (protons), p < 0.01), and DmeanAnalCanal (3.8+/-0.7 Gy (photons) vs 2.2+/-0.9 Gy (protons), p < 0.01). Data projection revealed 3 clusters: one for protons, one for photons and one with two photon outliers.</p><p><strong>Conclusion: </strong>This initiative provided valuable insights into the Ewing-1 protocol, demonstrating treatment planning homogeneity among centers along with successful adherence to dose escalation constraints, with protons offering additional benefits as lower integral doses to critical organs.</p>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"105063"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812737","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":"Virtual radiotherapy plan quality education: Perspectives from a global setting","authors":"Caroline M. Colbert ,&nbsp;Emily Kruse ,&nbsp;Dustin Jacqmin ,&nbsp;Jose Carlos Pichardo ,&nbsp;Chunhao Wang ,&nbsp;Leah K. Schubert ,&nbsp;Stephanie Bennett ,&nbsp;Mu-Han Lin ,&nbsp;Lindsey Olsen ,&nbsp;Benjamin Li ,&nbsp;Minsun Kim","doi":"10.1016/j.ejmp.2025.105069","DOIUrl":"10.1016/j.ejmp.2025.105069","url":null,"abstract":"<div><h3>Purpose</h3><div>Evaluation of treatment plan quality is a critical element of training for radiotherapy professionals. With the increased adoption of intensity modulated radiotherapy internationally, this training is crucial to address patient care inequity. We aim to evaluate learning outcomes from a 14-session remote training course targeting critical elements of plan quality with advanced modalities.</div></div><div><h3>Methods</h3><div>The virtual training course was delivered to over 500 radiotherapy professionals in North Africa. Attendees completed online pre- and post-course knowledge assessments, and surveys of their confidence in core competencies. Paired t-tests, general linear regression, and ANOVA were used to evaluate learning outcomes.</div></div><div><h3>Results</h3><div>On the pre-course knowledge assessment, attendees scored a mean of 3.97 ± 1.54 out of 10. After the course, remaining attendees’ scores increased to a mean of 4.88 ± 1.86 (p &lt; 0.001). Mean confidence scores increased from 2.28 ± 1.22 to 3.70 ± 0.76 out of 5. Confidence scores varied significantly with enrollees’ years of experience, clinical role, and involvement in treatment planning (p &lt; 0.05). However, pre-course knowledge scores only varied based on clinicians’ current involvement in advanced treatment planning (p &lt; 0.01). The improvement in knowledge score from baseline increased significantly with course attendance (p = 0.02).</div></div><div><h3>Conclusions</h3><div>This course produced positive overall learning outcomes, particularly with advanced treatment planning modalities. Attendees gained practical experience applying rigorous plan quality criteria. The study results support the crucial importance of continuing education and hands-on experience in the rapidly advancing technological environment of radiation oncology.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105069"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925573","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":"Aims & Scope & Editorial Board","authors":"","doi":"10.1016/S1120-1797(25)00212-1","DOIUrl":"10.1016/S1120-1797(25)00212-1","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105102"},"PeriodicalIF":2.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145010350","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":"Classification of computed tomography scans: a novel approach implementing an enforced random forest algorithm","authors":"Michelangelo Biondi ,&nbsp;Eleonora Bortoli ,&nbsp;Lorenzo Marini ,&nbsp;Rossella Avitabile ,&nbsp;Antonietta Bartoli ,&nbsp;Elena Busatti ,&nbsp;Antonio Tozzi ,&nbsp;Maria Cristina Cimmino ,&nbsp;Lucia Piccini ,&nbsp;Elisa Brinchi Giusti ,&nbsp;Andrea Guasti","doi":"10.1016/j.ejmp.2025.105080","DOIUrl":"10.1016/j.ejmp.2025.105080","url":null,"abstract":"<div><h3>Introduction</h3><div>Medical imaging faces critical challenges in radiation dose management and protocol standardisation. This study introduces a machine learning approach using a random forest algorithm to classify Computed Tomography (CT) scan protocols. By leveraging dose monitoring system data, we provide a data-driven solution for establishing Diagnostic Reference Levels while minimising computational resources.</div></div><div><h3>Materials and method</h3><div>We developed a classification workflow using a Random Forest Classifier to categorise CT scans into anatomical regions: head, thorax, abdomen, spine, and complex multi-region scans (thorax + abdomen and total body). The methodology featured an iterative “human-in-the-loop” refinement process involving data preprocessing, machine learning algorithm training, expert validation, and protocol classification. After training the initial model, we applied the methodology to a new, independent dataset.</div></div><div><h3>Results</h3><div>By analysing 52,982 CT scan records from 11 imaging devices across five hospitals, we train the classificator to distinguish multiple anatomical regions, categorising scans into head, thorax, abdomen, and spine. The final validation on the new database confirmed the model’s robustness, achieving a 97 % accuracy.</div></div><div><h3>Discussion</h3><div>This research introduces a novel medical imaging protocol classification approach by shifting from manual, time-consuming processes to a data-driven approach integrating a random forest algorithm.</div></div><div><h3>Conclusion</h3><div>Our study presents a transformative approach to CT scan protocol classification, demonstrating the potential of data-driven methodologies in medical imaging. We have created a framework for managing protocol classification and establishing DRL by integrating computational intelligence with clinical expertise. Future research will explore applying this methodology to other radiological procedures.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105080"},"PeriodicalIF":2.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907516","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}