Physica Medica-European Journal of Medical Physics最新文献

{"title":"National survey of SRS and SRT practices in Malaysian radiotherapy centres: A medical physics perspective","authors":"Vorakit Epin,&nbsp;Aik Hao Ng,&nbsp;Zulaikha Jamalludin,&nbsp;Ngie Min Ung","doi":"10.1016/j.ejmp.2025.105086","DOIUrl":"10.1016/j.ejmp.2025.105086","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT) are advanced non-surgical procedures delivering high-dose radiation with precision to small target volumes. This study aims to investigate the current clinical practices of SRS/SRT among Malaysian radiotherapy centres, with a specific focus on the medical physics aspects.</div></div><div><h3>Methods</h3><div>A web-based survey was conducted using Google Forms, targeting Malaysian radiotherapy centres. The survey gathers data on medical physics practices in SRS/SRT. Questions included aspects such as the centre’s experience, treatment planning, treatment delivery, equipment used, and quality assurance (QA).</div></div><div><h3>Results</h3><div>A total of 34 responses were received, representing 34 out of 41 radiotherapy centres in Malaysia (83% response rate). The results indicated that practices at some centres, particularly in areas such as treatment simulation and treatment planning, deviate from established guidelines and recommendations. Additionally, several issues were identified, including a shortage of medical physicists, insufficient annual caseloads, inadequate training opportunities for physicists, and limited availability of treatment modalities for SRS.</div></div><div><h3>Conclusions</h3><div>This study presents the first national survey of SRS/SRT practices in Malaysia, highlighting notable variations in clinical practice and several challenges faced by radiotherapy centres. These findings underscore the need for national standardisation of SRS practices and the development of common guidelines. The data presented may serve as a benchmark for centres to evaluate and optimise their local protocols and as a reference for centres planning to implement SRS services.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105086"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144889636","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":"Dosimetric and temporal evaluation of dynamic collimation with multi-leaf collimator in scanned proton therapy: A planning study","authors":"Yushi Wakisaka ,&nbsp;Yuki Tominaga ,&nbsp;Keith M Furutani ,&nbsp;Teiji Nishio","doi":"10.1016/j.ejmp.2025.105088","DOIUrl":"10.1016/j.ejmp.2025.105088","url":null,"abstract":"<div><h3>Purpose</h3><div>The MELTHEA V proton therapy system incorporates a beam nozzle capable of both passive scattering and active scanning, featuring a multi-leaf collimator (MLC). This study evaluates the dosimetric and temporal efficiency of dynamic collimation using the universal MLC with the scanning method.</div></div><div><h3>Methods</h3><div>Three MLC configurations were defined: (1) nMLC – no MLC use; (2) sMLC – static leaf positioning across all energy layers; and (3) dMLC – dynamic leaf positioning changing with each energy layer. Since the treatment planning system does not support dMLC natively, it was implemented via scripting. First, various MLC margins were evaluated through phantom simulations. Then, using a representative margin, treatment plans for nine liver cancer cases were assessed for each MLC configuration. Irradiation delay time was simulated considering monitor units, dose rates, and the time characteristics of the irradiation system.</div></div><div><h3>Results</h3><div>Phantom simulations demonstrated that an MLC margin of 0.5σ (with σ representing the in-medium spot size) effectively reduced the surrounding dose while preserving target coverage. For liver cancer cases, the average conformity index at the 50 % isodose line for nMLC, sMLC, and dMLC was 3.27 ± 0.60, 2.61 ± 0.28, and 2.28 ± 0.24, respectively. The mean doses in a 10-mm ring surrounding the target were 54.9 ± 2.5, 48.3 ± 3.9, and 41.4 ± 3.8 Gy, respectively. The average irradiation delay time of the dMLC was 8.4 %.</div></div><div><h3>Conclusion</h3><div>The dMLC demonstrated enhanced dosimetric performance compared to nMLC and sMLC, with minimal irradiation time delays, making it suitable for clinical liver cancer treatment.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105088"},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887189","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":"Radiobiological effect of delivery time in treatments of multiple brain metastases with robotic radiosurgery","authors":"David Sevillano ,&nbsp;Petar Ivaylov ,&nbsp;Eva Fernández-Lizarbe ,&nbsp;Juan David García ,&nbsp;Mercedes Martín ,&nbsp;Rafael Morís ,&nbsp;Belén Capuz ,&nbsp;Rafael Colmenares ,&nbsp;Miguel Cámara ,&nbsp;Rubén Chillida ,&nbsp;Carlos Rodríguez-Manzaneque ,&nbsp;Juan Trujillo ,&nbsp;María José Béjar ,&nbsp;Daniel Prieto ,&nbsp;Feliciano García-Vicente","doi":"10.1016/j.ejmp.2025.105087","DOIUrl":"10.1016/j.ejmp.2025.105087","url":null,"abstract":"<div><h3>Purpose</h3><div>To analyze the dose effect of the delivery time in CyberKnife Stereotactic Radiosurgery treatments. A prediction tool and methods to minimize this effect are presented.</div></div><div><h3>Methods</h3><div>Eighty CyberKnife plans of multiple brain metastases (BMs) were analyzed. The Microdosimetric Kinetic Model was used to assess the biological effectiveness of each treatment at each BM. Results were obtained in terms of relative dose (RD) between delivered and planned treatments.</div><div>A prediction algorithm of RD was developed by predicting beam delivery times of not yet delivered plans. Two strategies to optimize treatments in terms of biological effectiveness were proposed: beam reordering and treatment splitting.</div></div><div><h3>Results</h3><div>An average RD of 92.3 % (SD = 2.6 %) was obtained for our patient population. Differences between treated and predicted RD were −0.12 % (SD = 0.6 %). Beam reordering improved RD by a mean value of 5.5 % (SD = 3.3 %) with 17.3 % mean increase in overall treatment time.</div><div>Splitted treatments yielded a mean increase of 5.8 % in RD with a time increase of 35 %, while healthy brain was equally spared if treatments were delivered in different days. For those five treatments, an 8.0 % increase in RD and a 20 % increase in treatment time were obtained with reordered beams.</div></div><div><h3>Conclusions</h3><div>The effect of treatment time on the dose delivered to BMs in SRS with CyberKnife should be taken into consideration, especially when a large number of BMs are involved. This effect can be predicted and minimized by reordering beams at the cost of increasing overall treatment time.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105087"},"PeriodicalIF":2.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887188","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":"Temporal footprint reduction via neural network denoising in 177Lu radioligand therapy","authors":"Max Celio Nzatsi ,&nbsp;Nicolas Varmenot ,&nbsp;David Sarrut ,&nbsp;Grégory Delpon ,&nbsp;Michel Cherel ,&nbsp;Caroline Rousseau ,&nbsp;Ludovic Ferrer","doi":"10.1016/j.ejmp.2025.105071","DOIUrl":"10.1016/j.ejmp.2025.105071","url":null,"abstract":"<div><h3>Background</h3><div>Internal vectorised therapies, particularly with [177Lu]-labelled agents, are increasingly used for metastatic prostate cancer and neuroendocrine tumours. However, routine dosimetry for organs-at-risk and tumours remains limited due to the complexity and time requirements of current protocols.</div></div><div><h3>Method</h3><div>We developed a Generative Adversarial Network (GAN) to transform rapid 6 s SPECT projections into synthetic 30 s-equivalent projections. SPECT data from twenty patients and phantom acquisitions were collected at multiple time-points.</div></div><div><h3>Results</h3><div>The GAN accurately predicted 30 s projections, enabling estimation of time-integrated activities in kidneys and liver with maximum errors below 6 % and 1 %, respectively, compared to standard acquisitions. For tumours and phantom spheres, results were more variable. On phantom data, GAN-inferred reconstructions showed lower biases for spheres of 20, 8, and 1 mL (8.2 %, 6.9 %, and 21.7 %) compared to direct 6 s acquisitions (12.4 %, 20.4 %, and 24.0 %). However, in patient lesions, 37 segmented tumours showed higher median discrepancies in cumulated activity for the GAN (15.4 %) than for the 6 s approach (4.1 %).</div></div><div><h3>Conclusion</h3><div>Our preliminary results indicate that the GAN can provide reliable dosimetry for organs-at-risk, but further optimisation is needed for small lesion quantification. This approach could reduce SPECT acquisition time from 45 to 9 min for standard three-bed studies, potentially facilitating wider adoption of dosimetry in nuclear medicine and addressing challenges related to toxicity and cumulative absorbed doses in personalised radiopharmaceutical therapy.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105071"},"PeriodicalIF":2.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144867021","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":"Development and simulation of a SPECT real time dose monitoring system for BNCT: response at the LENA reactor","authors":"L. Santini ,&nbsp;T. Ferri ,&nbsp;L. Grisoni ,&nbsp;A. Caracciolo ,&nbsp;D. Bortot ,&nbsp;G. Borghi ,&nbsp;A. Pola ,&nbsp;S. Agosteo ,&nbsp;V. Pascali ,&nbsp;N. Protti ,&nbsp;D.Ramos Lòpez ,&nbsp;N. Ferrara ,&nbsp;D. Mazzucconi","doi":"10.1016/j.ejmp.2025.105070","DOIUrl":"10.1016/j.ejmp.2025.105070","url":null,"abstract":"<div><h3>Background</h3><div>Boron Neutron Capture Therapy (BNCT) selectively targets tumor cells while sparing healthy ones, by exploiting neutron capture on boron-10, which accumulates to the cancerous cells. To ensure that the therapy is properly tuned, real-time dose monitoring during treatment plays a fundamental role. A Single Photon Emission Computed Tomography (SPECT) imaging system relying on the 478 keV gamma ray emitted by the neutron capture reaction, can, in principle, detect the boron distribution and allow the 3D reconstruction of the dose inside the patient. However, neutron interactions with all the other elements present in tissues and structures introduce background signals, complicating dose evaluation.</div></div><div><h3>Methods</h3><div>In this study, FLUKA Monte Carlo simulations were applied to a BNCT-SPECT oriented detector to simulate the image reconstruction process. The simulations were conducted by irradiating the system at the LENA (Laboratorio Energia Nucleare Applicata) in Pavia and compared with experimental data. Moreover, a proof-of-concept study on a SPECT acquisition have been performed on different borated samples.</div></div><div><h3>Results</h3><div>The experimental and simulated results are in good agreement for both image acquisition and detected counting rates. The simulated projections, reconstructed with an appropriated iterative algorithm, show that the presented system is capable of distinguishing two separated vials containing boron-10.</div></div><div><h3>Conclusion</h3><div>This study show that the presented system holds a good promise for enhancing the precision of dose monitoring and localization during clinical BNCT treatments. For this reason, the system will be deployed in real BNCT facilities to evaluate and validate its performance under clinical conditions.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105070"},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144852409","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":"Using HistoQC to predict disagreement on human epidermal growth factor receptor 2 (HER2) assessment","authors":"Laura Verzellesi ,&nbsp;Moira Ragazzi ,&nbsp;Andrea Botti ,&nbsp;Giacomo Santandrea ,&nbsp;Andrew Janowczyk ,&nbsp;Luca Bottazzi ,&nbsp;Alessandra Bisagni ,&nbsp;Ione Tamagnini ,&nbsp;Giorgio Gardini ,&nbsp;Saverio Coiro ,&nbsp;Elisa Gasparini ,&nbsp;Mauro Iori","doi":"10.1016/j.ejmp.2025.105066","DOIUrl":"10.1016/j.ejmp.2025.105066","url":null,"abstract":"<div><h3>Background</h3><div>The human epidermal growth factor receptor 2 (HER2) gene is a significant prognostic and predictive factor for breast cancer therapy response. HER2 assessment is critical for targeted therapy eligibility, but interobserver reproducibility is a well-known issue in HER2 evaluation.</div></div><div><h3>Purpose</h3><div>The goal of our study is to create a machine learning (ML) system able to detect whole slide images (WSIs) that might cause discrepancies among observers.</div></div><div><h3>Methods</h3><div>We collected 132 pathology slides with double-blind HER2 evaluation and defined the agreement between observers as a binary classification: 0 for disagreement and 1 for agreement. We utilized HistoQC software to analyze and characterize the pathology slides based on a series of quality-related features. HistoQC-derived quality metrics were used to train a machine learning model (XGBoost) to predict interobserver disagreement. The dataset was randomly split into training and testing at proportions of 60%/40%, respectively.</div></div><div><h3>Results</h3><div>Our model demonstrated a mean AUC of 0.86 (standard deviation, SD = 0.09) across five cross-validation runs on the training set, highlighting its predictive reliability. The AUC on the testing set was 0.81 (confidence interval, CI = [0.82–0.94]), emphasizing the model’s precision in predicting whether an unseen WSI would lead to discordance.</div></div><div><h3>Conclusions</h3><div>Our study presents a machine learning model built to identify potential diagnostic disagreements in HER2 pathology evaluations. The results demonstrate a correlation between the quality of pathology slides and diagnostic outcomes. Upon proper validation, our tool could be integrated among the existing quality assurance systems used in anatomic pathology departments to improve HER2 diagnostic process.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105066"},"PeriodicalIF":2.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828690","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":"Technical note: A PBS source model based independent dose calculation frame on TOPAS MC","authors":"Xuying Shang ,&nbsp;Yaoying Liu ,&nbsp;Xiaoyun Le ,&nbsp;Zishen Wang ,&nbsp;Xiaoqing Sun ,&nbsp;Chunfeng Fang ,&nbsp;Baolin Qu ,&nbsp;Yue Zou ,&nbsp;Wei Zhao ,&nbsp;Gaolong Zhang ,&nbsp;Shouping Xu","doi":"10.1016/j.ejmp.2025.105074","DOIUrl":"10.1016/j.ejmp.2025.105074","url":null,"abstract":"<div><h3>Purpose</h3><div>We endeavor to present a comprehensive methodology for establishing a versatile Monte Carlo (MC) dose calculation platform that operates independently of the treatment planning system (TPS, e.g., RayStation).</div></div><div><h3>Methods</h3><div>We assumed the source emission plane was at the nozzle exit. To align with the measured data, we optimized the phase space parameters (spot size, angular spread, correlation, energy spread, and nominal energy) and the beam source model’s absolute dose (the number of protons per MU) in the source emission plane. Additionally, we devised a method that automatically converts patient plans into executable MC scripts capable of running in the TOPAS MC software.</div></div><div><h3>Results</h3><div>Our efforts successfully established a library encompassing the source model parameters. The disparities between the measured and simulated beam spot sizes were all below 0.3 mm. Moreover, the differences in the depth-dose curve’s distal falloff (R₉₀) were less than 0.1 mm, and the mean point-to-point dose differences were less than 0.7 %. Remarkably, the 3D gamma passing rates (GPRs) for three spread-out Bragg peaks (SOBPs, 3 mm/3% criteria) were 100 %. Furthermore, when comparing TOPAS and TPS MCs for 23 pencil beam scanning (PBS) patient plans, the mean 3D GPRs for 2 mm/2% and 3 mm/3% criteria were 99.96 % and 100 %, respectively.</div></div><div><h3>Conclusion</h3><div>We have successfully developed a comprehensive MC framework for PBS, employing a well-defined beam source model. The method we presented for building the PBS MC framework holds potential to build a dose verification tool and for scientific research.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105074"},"PeriodicalIF":2.7,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144841181","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":"4-Dimensional Computed Tomography Angiography for capturing cardiac cycle-induced volume change of intracranial aneurysms","authors":"Lotte B. Stam ,&nbsp;Sabine M.L. Linden ,&nbsp;René Aquarius ,&nbsp;Alessa Hering ,&nbsp;Luuk J. Oostveen ,&nbsp;Frederick J.A. Meijer ,&nbsp;Hieronymus D. Boogaarts","doi":"10.1016/j.ejmp.2025.105073","DOIUrl":"10.1016/j.ejmp.2025.105073","url":null,"abstract":"<div><h3>Background</h3><div>Several studies suggest 4-Dimensional Computed Tomography Angiography (4D CTA) to assess wall motion of intracranial aneurysms as an indicator of stability. However, capturing cardiac cycle-related motion may exceed limits of imaging techniques. The goal is to evaluate consistency of aneurysm volume change across three consecutive cardiac cycles.</div></div><div><h3>Methods</h3><div>Eighteen adult patients with unruptured and untreated intracranial aneurysms were recruited at Radboud University Medical Center. Three cardiac cycles were captured on a wide detector CT system, using electrocardiogram-gated 4D CTA. To reduce the impact of movements, a rigid-body registration was employed. Aneurysms were manually segmented and a deformable registration algorithm was used to determine volume change. The amplitude of absolute volume change, relative volume change, derived mean diameter were determined. The Pearson correlation was calculated as a measure of volume change pattern similarity across cardiac cycles.</div></div><div><h3>Results</h3><div>Three of eighteen subjects were excluded because of technical difficulties, resulting in fifteen subjects with seventeen aneurysms. Among the remaining aneurysms, the mean absolute maximum volume change was 13.7 ± 26.5 mm3, the mean relative maximum volume change was 3.49 ± 1.45 %, and the mean averaged maximum diameter change per cardiac cycle was 0.068 ± 0.025 mm. In two aneurysms, the volume change pattern was consistent across cardiac cycles, and a fall-and-rise pattern was observed.</div></div><div><h3>Conclusion</h3><div>This study indicates low consistency in intracranial aneurysm volume change patterns across cardiac cycles, questioning the feasibility of current CT scanners in capturing volume changes. Future research should focus on higher-resolution imaging on alternative metrics like shape changes, to improve assessment of aneurysm wall motion.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105073"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828688","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":"Radiation protection in proton therapy: Insights from a multi-institutional survey and experimental measurements within the SINFONIA project","authors":"Marijke De Saint-Hubert ,&nbsp;Maite Romero-Expósito ,&nbsp;Malgorzata Liszka ,&nbsp;Olivier Van Hoey ,&nbsp;Sita Pinasti ,&nbsp;Linda Eliasson ,&nbsp;Jan Lillhok ,&nbsp;Carles Domingo ,&nbsp;Lara Struelens ,&nbsp;Alexandru Dasu","doi":"10.1016/j.ejmp.2025.105049","DOIUrl":"10.1016/j.ejmp.2025.105049","url":null,"abstract":"<div><h3>Purpose:</h3><div>This study, part of the EU-funded SINFONIA project, addresses radiation protection concerns in daily PT practice to study potentially under- or overprotection of staff depending on their working environment and tasks.</div></div><div><h3>Methods:</h3><div>A multi-institutional survey was carried out, complemented by specific neutron dose measurements at a PT centre. Besides mono-energetic irradiations, clinical treatments for brain, thorax (Hodgkin’s lymphoma — HL) and pelvis (prostate), were investigated with and without range shifter (RS). The Thermo Fisher Scientific WENDI II and Berthold LB6411 ambient neutron monitors and two DIAMON neutron spectrometers were used for H*(10). Furthermore, BTI BD-PND bubble detectors, LANDAUER Neutrak dosimeters and Intercast CR-39 + plastic converters were also tested for Hp(10).</div></div><div><h3>Results:</h3><div>Initial survey results suggest no considerable risk for staff, with doses registering below 1 mSv/year. Further, site-specific measurements conducted at the Skandion facility, unveil annual staff doses ranging from 5–10 <span><math><mi>μ</mi></math></span>Sv in the staff control room. Accidental exposure scenarios on the other hand could reach up to 0.26 <span><math><mi>μ</mi></math></span>Sv/Gy in the gantry pit. Notably, H*(10) detectors demonstrated good performance, while H_p(10) dosimeters solely captured doses within the treatment room, yet remaining in agreement with reference values.</div></div><div><h3>Conclusion:</h3><div>Findings suggest a minimal neutron exposure risk for staff members within contemporary PT facilities.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105049"},"PeriodicalIF":2.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828689","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":"Diagnostic reference levels for dental cone-beam computed tomography: current state and way forward","authors":"Hugo Trindade ,&nbsp;Eneh Chibuzor Toivo Mark ,&nbsp;Mona Lisa Camilleri ,&nbsp;Eirini Tsaggari ,&nbsp;Paddy Gilligan ,&nbsp;Ruben Pauwels","doi":"10.1016/j.ejmp.2025.105072","DOIUrl":"10.1016/j.ejmp.2025.105072","url":null,"abstract":"<div><div>This study provides a comprehensive overview of Diagnostic Reference Levels (DRLs) for dental Cone Beam Computed Tomography (CBCT), addressing the current variability and challenges associated with their implementation. Data were collected through a survey conducted among members of the Dental Imaging Special Interest Group of the European Federation of Organizations for Medical Physics, encompassing 33 countries, not limited to Europe. The focus was on official DRL documentation issued by regulatory or authorized bodies and peer-reviewed publications based on data from more than ten CBCT units.</div><div>Official DRLs were identified in Finland, Germany, Ireland, Italy, Greece, the United Kingdom, Sweden, Japan, Switzerland, and Estonia. DRLs were analyzed using two primary classification schemes: by field of view (FOV) dimensions and by clinical application or indication. The application of differing methodologies across countries was a key finding. In the clinical application-based group DRLs ranged from 200 mGy·cm² for imaging a single jaw quadrant in Sweden to 1150 mGy·cm² for paranasal sinus imaging in Finland. The United Kingdom was the only country to establish pediatric-specific DRLs. For FOV-based DRLs, values ranged from 500 mGy·cm² for FOVs ≤ 25 cm², in Germany, to 1960 mGy·cm² for a &gt; 100 cm² FOVs, in Japan. The variability in exposure parameters and data reporting practices complicates cross-country comparisons.</div><div>To improve radiation safety, the harmonization of DRLs is essential. Increased international collaboration, the standardization of dose metrics, and enhanced training for dental professionals are critical steps toward the implementation of evidence-based DRLs and the optimization of CBCT practices worldwide.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"137 ","pages":"Article 105072"},"PeriodicalIF":2.7,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144826858","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}