Physica Medica-European Journal of Medical Physics最新文献

{"title":"Imaging-aided diagnosis and treatment based on artificial intelligence for pulmonary nodules: A review","authors":"Huanlong Gao ,&nbsp;Jintao Li ,&nbsp;Yansong Wu ,&nbsp;Zijian Tang ,&nbsp;Xuelei He ,&nbsp;Fengjun Zhao ,&nbsp;Yanwei Chen ,&nbsp;Xiaowei He","doi":"10.1016/j.ejmp.2025.105050","DOIUrl":"10.1016/j.ejmp.2025.105050","url":null,"abstract":"<div><h3>Background:</h3><div>Pulmonary nodules are critical indicators for the early detection of lung cancer; however, their diagnosis and management pose significant challenges due to the variability in nodule characteristics, reader fatigue, and limited clinical expertise, often leading to diagnostic errors. The rapid advancement of artificial intelligence (AI) presents promising solutions to address these issues.</div></div><div><h3>Methods:</h3><div>This review compares traditional rule-based methods, handcrafted feature-based machine learning, radiomics, deep learning, and hybrid models incorporating Transformers or attention mechanisms. It systematically compares their methodologies, clinical applications (diagnosis, treatment, prognosis), and dataset usage to evaluate performance, applicability, and limitations in pulmonary nodule management.</div></div><div><h3>Results:</h3><div>AI advances have significantly improved pulmonary nodule management, with transformer-based models achieving leading accuracy in segmentation, classification, and subtyping. The fusion of multimodal imaging CT, PET, and MRI further enhances diagnostic precision. Additionally, AI aids treatment planning and prognosis prediction by integrating radiomics with clinical data. Despite these advances, challenges remain, including domain shift, high computational demands, limited interpretability, and variability across multi-center datasets.</div></div><div><h3>Conclusion:</h3><div>Artificial intelligence (AI) has transformative potential in improving the diagnosis and treatment of lung nodules, especially in improving the accuracy of lung cancer treatment and patient prognosis, where significant progress has been made.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105050"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144679525","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":"Automated radiation dose monitoring software packages: impact on computed tomography (CT) dose management and optimisation, implementation challenges, and practical considerations: a systematic review","authors":"Mohammed Alanazi ,&nbsp;Peter Kench ,&nbsp;Seyedamir Tavakoli-Taba ,&nbsp;Ernest Ekpo","doi":"10.1016/j.ejmp.2025.105056","DOIUrl":"10.1016/j.ejmp.2025.105056","url":null,"abstract":"<div><h3>Introduction</h3><div>Radiation Dose Monitoring Software (DMS) packages are increasingly used clinically to automatically monitor radiation doses, but their impact on computed tomography (CT) dose optimisation and the implementation challenges have not been systematically assessed.</div></div><div><h3>Aim</h3><div>This review aims to assess DMS tools effectiveness in managing and optimising CT radiation doses and identify the main challenges involved in their implementation.</div></div><div><h3>Methods</h3><div>Relevant articles published until August 2024 were identified via Medline, Scopus, CINAHL, Embase, and Web of Science databases. Reference lists were reviewed for additional studies. The selection process followed PRISMA guidelines. Articles were included if they assessed CT dose optimisation or management using DMS packages and were published in English.</div></div><div><h3>Results</h3><div>The search initially identified 1,293 articles. After screening and eligibility assessment, 49 eligible articles were met the inclusion criteria and included in the final analysis. DMS tools were found to play a crucial role in automating the monitoring and management of CT radiation doses and reducing manual effort and errors. DMS packages enabled CT dose benchmarking against diagnostic reference levels, inter-hospital and scanner comparisons, dose calculations, cumulative dose tracking, and radiation level monitoring over time. The use of DMS packages helped healthcare institutions to optimise radiation doses and improve patient safety. However, available data shows that effective implementation requires skilled users, standardised protocol naming, and regular data verification.</div></div><div><h3>Conclusion</h3><div>DMS packages offer long-term solution to CT dose optimisation for patients and healthcare facilities. Implementing these tools will ensure accurate and consistent CT dose monitoring while supporting compliance with best practices.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105056"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670669","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":"Effective and organ doses assessment in neuroradiologic and hemodynamic procedures: comparison among three different simulation software","authors":"Francesca Calderoni ,&nbsp;Andrea D’Alessio ,&nbsp;Marco Maria Jacopo Felisi ,&nbsp;Klarisa Elena Szilagyi ,&nbsp;Cristina De Mattia ,&nbsp;Mariangela Piano ,&nbsp;Emanuela Piccaluga ,&nbsp;Alessandro Turra ,&nbsp;Marco Brambilla ,&nbsp;Paola Enrica Colombo","doi":"10.1016/j.ejmp.2025.105053","DOIUrl":"10.1016/j.ejmp.2025.105053","url":null,"abstract":"<div><h3>Introduction</h3><div>The goal of this work is to compare three different software for effective (ED) and organ (OD) dose estimation to analyze the reliability and investigate the main differences.</div></div><div><h3>Methods</h3><div>Both thirty neuroradiologic and hemodynamic procedures were analyzed retrospectively choosing a representative sample in terms of kerma-area product and complexity. Each procedure was simulated using NCIRF, VirtualDose-IR Batch Utility<!--> <!-->and PCXMC. The three software differ for computational method and phantom used and they also need different parameters from RDSR or experimental data to meet the requirements.<!--> <!-->Bland-Altman method was used to assess the agreement among software.</div></div><div><h3>Results</h3><div>Large variations in some ODs were observed for all the software, ranging from −70 % to 109 % for neuroradiology and −73 % to 92 % for hemodynamics. This variation is greatly reduced when considering ED, from −23 % to 19 % and from −12 % to 18 % respectively. Bland-Altman analysis showed a poor agreement in OD estimations, with mean differences from 0.8 to 92 mGy and variations up to 200 mGy. The variability in ED is less evident, with mean differences from 1.3 to 3.7 mSv for neuroradiology and from 0.6 mSv to 3.4 mSv for hemodynamics, although in individual cases these differences reached 7.6 mSv and 11 mSv respectively.</div></div><div><h3>Conclusions</h3><div>Differences principally arise from input parameters, models and phantoms which strongly affect ODs. Nevertheless, the overall EDs is confirmed to be a robust quantity with discrepancies lower than 4 mSv (20 %), showing differences comparable to uncertainties in radiological dosimetry and confirming its utility in population dose assessment.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105053"},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670670","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":"Proof of concepts of resting state fMRI implementation for presurgical planning in a large general hospital","authors":"Beatrice Macchi ,&nbsp;Marco Maria Jacopo Felisi ,&nbsp;Gaia Muti ,&nbsp;Davide Cicolari ,&nbsp;Marco Parisotto ,&nbsp;Luciana Gennari ,&nbsp;Ivana Sartori ,&nbsp;Paolo Arosio ,&nbsp;Mariangela Piano ,&nbsp;Paola Enrica Colombo ,&nbsp;Silvia Squarza","doi":"10.1016/j.ejmp.2025.105052","DOIUrl":"10.1016/j.ejmp.2025.105052","url":null,"abstract":"<div><h3>Purpose</h3><div>Task-based functional MRI (tb-fMRI) effectiveness as a support tool in brain mapping may be limited by patients’ poor cooperation. Resting-state fMRI (rs-fMRI) represents an alternative or complementary approach.</div><div>In this work, we developed and validated an analysis pipeline for rs-fMRI acquisitions, primarily aimed at language mapping in drug-resistant epileptic patients. The workflow relies on open-source software and semi-automatized solutions, ensuring easy clinical adoption.</div></div><div><h3>Methods</h3><div>Rs-fMRI data were acquired from 26 subjects (15 volunteers, 11 patients) using a 3 T-MRI scanner. The developed pipeline starts with preprocessing of raw data, subsequently analyzed through <em>Independent Component Analysis</em> (ICA), performed with MELODIC-FSL tool. Manual classification, semi-automated classifiers (FIX, ICA-AROMA) and a template matching procedure were employed to classify the ICA components and extract each patient rs-language network. Finally, verb-generation tb-fMRI and Diffusion Tensor Imaging were acquired to map language regions and reconstruct the arcuate fasciculus, respectively. The rs-language networks were validated evaluating the three acquisition modalities agreement.</div></div><div><h3>Results</h3><div>Trained FIX showed AUC = 0.95 and ICA-AROMA 97 % of classification accuracy, considering manual classification as ground truth. Manual classification identified one (46 %), two (31 %), or three (19 %) language-related components per subject. The manually selected language components were among the top three ranked by the template matching in 88 % of cases, 100 % considering the top five.</div><div>The Dice index between rs-fMRI and tb-fMRI language maps resulted 0.36 ± 0.13. Rs-language areas resulted qualitatively well-connected by the reconstructed arcuate fasciculus.</div></div><div><h3>Conclusion</h3><div>The developed pipeline confirmed strong potential for clinical applicability in a large general hospital, especially when tb-fMRI is infeasible.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105052"},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662069","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":"Intercomparison of personal and ambient neutron detectors used for radiation protection in a synchrotron-based proton therapy facility: experimental and Monte Carlo results","authors":"Evangelina Martínez-Francés ,&nbsp;Verónica Morán ,&nbsp;Ana M. Romero ,&nbsp;J. Pablo Cabello-García ,&nbsp;Alberto Viñals ,&nbsp;Javier Burguete ,&nbsp;Sergio Rivera ,&nbsp;Rafael Rodríguez ,&nbsp;Roberto Méndez ,&nbsp;Carles Domingo ,&nbsp;Josep M. Martí-Climent","doi":"10.1016/j.ejmp.2025.105044","DOIUrl":"10.1016/j.ejmp.2025.105044","url":null,"abstract":"<div><h3>Purpose</h3><div>This study evaluates ambient and personal neutron detectors in a synchrotron-based proton therapy facility, using experimental data and Monte Carlo (TOPAS) simulations. It aims to assess the interchangeability of detectors, characterize neutron doses in the treatment room, and provide radiological protection recommendations. <em>Method</em>: A 10 × 10 × 10 cm³ volume (energy range: 121–173 MeV) was irradiated on a 30 × 30 × 60 cm³ solid water phantom. Ambient dose equivalent (<em>H*</em>(10)) was measured using two extended-energy-range detectors (LUPIN-II, WENDI-II) at 20 positions. Personal dose equivalent (<em>H_p</em>(10)) was evaluated using five dosimeters (bubble detectors, DOPEN tracks, NeutrakT, MCP6/MCP7 TLDs, NRF51 EPD) at 14–20 positions. Bland-Altman analysis quantified agreement. TOPAS, a Monte Carlo code, was employed to calculate neutron spectra and to compare the results with experimental <em>H*</em>(10) values for its validation. <em>Results</em>: The WENDI-II and LUPIN-II detectors showed good agreement, with WENDI-II readings 14 % higher on average. Among personal dosimeters, DOPEN tracks exhibited the closest agreement with bubble detectors, with a bias of −33 %. In constrast, NeutrakT underperformed due to its high detection limit. TOPAS simulations aligned with experimental <em>H*</em>(10) trends, with differences ranging from 0 to 32 %, except for positions involving significant PMMA attenuation. Neutron spectra revealed angular and distance-dependent variations, with thermal neutrons dominating at larger distances. <em>Conclusions</em>: Both WENDI-II and LUPIN-II are suitable for environmental neutron monitoring in synchrotron-based facilities. DOPEN tracks emerged as the most reliable passive personal dosimeter for <em>H_p</em>(10). Monte Carlo simulations enhanced understanding of neutron field behavior and were validated, in terms of <em>H*</em>(10), by the experimental results. Recommendations for radiological protection include replicating accidental exposures with WENDI-II and LUPIN-II to estimate doses accurately.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105044"},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662068","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":"Effect of arc length on the deep learning prediction of monitor units in lung stereotactic ablative radiation therapy treatment","authors":"Mathieu Gaudreault ,&nbsp;Lachlan McIntosh ,&nbsp;Katrina Woodford ,&nbsp;Jason Li ,&nbsp;Susan Harden ,&nbsp;Sandro Porceddu ,&nbsp;Vanessa Panettieri ,&nbsp;Nicholas Hardcastle","doi":"10.1016/j.ejmp.2025.105018","DOIUrl":"10.1016/j.ejmp.2025.105018","url":null,"abstract":"<div><h3>Introduction</h3><div>The dose magnitude required to fine-tune radiation in multi-lesion stereotactic ablative radiation therapy (SABR) treatment to the lung is driven by the monitor units (MU) per control point (CP). We investigate the arc length effect on the deep learning (DL) prediction of the MU per CP for automated lung lesions treatment planning.</div></div><div><h3>Methods</h3><div>Consecutive lung cancer patients treated at our institution between 01/2019 and 11/2024 were considered. Two models were trained, one on a homogeneous (same-nCP) and the other on a heterogeneous (diff-nCP) set of arc lengths with an equivalent number of samples. A third model was trained with an increased sample size of heterogeneous arc lengths (all-nCP). The predicted MU per CP were converted to meterset weights and MU per beam. The dosimetry achieved with predicted MU per CP was compared with the clinical dosimetry using gamma passing rates (γPR) and achieved clinical goals.</div></div><div><h3>Results</h3><div>In total, 60,720 samples from 295 treatments of 257 patients were included. The mean absolute percentage error between predicted and clinical meterset weights/MU per beam was less than 5.5 %/5.3 % with the all-nCP model and less than 8.3 %/7.1 % with the same-nCP and diff-nCP model. The median γPR(3 %, 2 mm) was 100 % with the all-nCP model and greater than 99.4 % with the same-nCP and diff-nCP models. All models provided the same or greater number of achieved clinical goals.</div></div><div><h3>Conclusions</h3><div>DL model trained with variable arc lengths allowed increased sample size and provided equivalent dosimetry in multi-lesion SABR treatment to the lung.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105018"},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662070","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":"Comparison of LEM and MKM based RBE-weighted doses from microdosimetric measurements with silicon 3D microdosimeter","authors":"Emanuele Maria Data ,&nbsp;James Vohradsky ,&nbsp;Benjamin James ,&nbsp;Vladimir Pan ,&nbsp;David Bolst ,&nbsp;Marco Donetti ,&nbsp;Silvia Molinelli ,&nbsp;Simona Giordanengo ,&nbsp;Anna Vignati ,&nbsp;Susanna Guatelli ,&nbsp;Marco Petasecca ,&nbsp;Michael Lerch ,&nbsp;Angela Kok ,&nbsp;Marco Povoli ,&nbsp;Michael Jackson ,&nbsp;Verity Ahern ,&nbsp;Anatoly Rosenfeld ,&nbsp;Linh T. Tran","doi":"10.1016/j.ejmp.2025.105042","DOIUrl":"10.1016/j.ejmp.2025.105042","url":null,"abstract":"<div><h3>Introduction:</h3><div>In carbon ion radiation therapy, the Local Effect Model (LEM) predicts higher value of Relative Biological Effectiveness (RBE) with respect to the Microdosimetric Kinetic Model (MKM) in most clinical situations. This work aims at comparing the MKM-based RBE-weighted dose calculated from experimental microdosimetric quantities against the RBE-weighted dose computed by a Treatment Planning System (TPS) using the LEM version I.</div></div><div><h3>Methods:</h3><div>The Silicon-On-Insulator (SOI) 3D mushroom microdosimeter, developed by the <em>Centre for Medical Radiation Physics</em> (CMRP), Wollongong (Australia), was placed in an RW3 phantom and was irradiated with carbon ions with different plans at the <em>Centro Nazionale di Adroterapia Oncologica</em> (CNAO), Pavia (Italy), acquiring microdosimetric spectra along the beam direction and calculating the corresponding <span><math><msub><mrow><mi>RBE</mi></mrow><mrow><mn>10</mn></mrow></msub></math></span> with the MKM model applied for Human Salivary Gland (HSG) cells.</div></div><div><h3>Results:</h3><div>A good agreement between experiment and Monte Carlo simulation was found, obtaining RBE₁₀ values ranging between 1.2 and 2.8. The prescribed LEM I-based RBE-weighted dose of 3.0 GyE in a cubic SOBP showed to be 33 % larger than the MKM-based RBE-weighted dose, consistently with other results found in literature.</div></div><div><h3>Conclusion:</h3><div>This work confirms the reliable use of the 3D SOI microdosimeters as a quality assurance tool for RBE prediction in particle therapy. In addition, the presented outcomes represents a validation through experimental measurements of previous works found in literature on the MKM and LEM RBE-weighted dose comparison based on TPS calculations and Monte Carlo simulations.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105042"},"PeriodicalIF":3.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653316","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 of an anthropomorphic phantom of the lower extremities for feasibility studies and verification of total-body irradiation","authors":"M. Wegner ,&nbsp;N.Alizadeh Azbari ,&nbsp;D. Krause ,&nbsp;E. Gargioni","doi":"10.1016/j.ejmp.2025.105045","DOIUrl":"10.1016/j.ejmp.2025.105045","url":null,"abstract":"<div><h3>Background</h3><div>Total-body irradiation (TBI) is a specialised radiotherapy treatment used alongside chemotherapy to prepare leukaemia patients for stem cell transplants. For commissioning and validation of conformal irradiation techniques, anatomically detailed phantoms of the whole body play an important role. This study aimed to create a cost-effective modular phantom of the lower extremities that can be combined with a commercial torso phantom, thus enabling the optimisation of TBI treatment planning and dose delivery.</div></div><div><h3>Methods</h3><div>We designed a modular leg phantom consisting of five key components: foot, calf, knee, thigh, and hip. Variants of knee and hip allow for both straight and angled leg positions. Inserts for dosimeters are integrated into the knee and hip joints, as well as within femur and fibula. To assess the phantom functionality in TBI, we analysed a currently used static-field technique and studied the feasibility of an intensity-modulated sweeping-beam technique.</div></div><div><h3>Results</h3><div>We employed 3D printing to create hollow structures of bones, pelvis, and legs, which we filled with surrogate materials representing soft tissue and bone marrow. We simulated cortical bone with a gypsum coating. The CT numbers of soft tissue and bone surrogates align accurately with literature data. The material properties remained stable even one-year post-manufacturing, ensuring long-term use of the phantom. First dose verification measurements for the static-field technique show an agreement with the prescribed dose within less than ±10 %.</div></div><div><h3>Conclusion</h3><div>The cost-effective modular phantom can be combined with a commercial torso phantom, allowing for the optimization and verification of various CT-based TBI techniques.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105045"},"PeriodicalIF":3.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633040","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":"Dosimetry audits in high dose rate brachytherapy: A survey on the current scenario in Europe","authors":"Laura Oliver-Cañamás ,&nbsp;Javier Vijande ,&nbsp;Cristian Candela-Juan ,&nbsp;Jose Perez-Calatayud","doi":"10.1016/j.ejmp.2025.105047","DOIUrl":"10.1016/j.ejmp.2025.105047","url":null,"abstract":"<div><h3>Introduction</h3><div>This work aims to study the current scenario of dosimetry audits in high dose rate (HDR) brachytherapy (BT) in Europe to evaluate whether there is a need to implement more services of this type and to define the characteristics that they should meet according to users.</div></div><div><h3>Material and methods</h3><div>A survey consisting of 30 multiple choice questions was designed and distributed among European centers. The estimated time to answer was less than 15 min. 74 HDR BT centers participated, having ¹⁹²Ir, ⁶⁰Co and/or electronic sources. Information about users’ opinions and experience with dosimetry audits in this field, center resources and quality assurance (QA) procedures was gathered.</div></div><div><h3>Results</h3><div>For 61 % of users, dosimetry audits in HDR BT should be recommended, but not mandatory, whereas 35 % suggested that they are necessary and should be compulsory. Only for 4 % of participants these audits are not necessary. In contrast, 86 % of users found that the current number of these services is inadequate and that more national and/or international services are needed. Most participants operate according to QA recommendations of published guidelines, with exceptions, such as the use of the Reference Air Kerma Rate provided by the manufacturer instead of the one measured by the home medical physicist.</div></div><div><h3>Conclusion</h3><div>The number of HDR BT dosimetry audits available to users is inadequate and there is a need to implement more national and/or international services of this type. Some technical aspects that an audit of this type should fulfill are outlined in this work.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105047"},"PeriodicalIF":3.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632852","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":"Treatment planning for in vivo multi-fraction, multi-port, multi-modal Synchrotron Radiotherapy","authors":"Micah J. Barnes ,&nbsp;Matthew Cameron ,&nbsp;Elette Engels ,&nbsp;Mitzi Klein ,&nbsp;Cristian Fernandez-Palomo ,&nbsp;Jeffrey C. Crosbie ,&nbsp;Liam Day ,&nbsp;Paolo Pellicioli ,&nbsp;Michael de Veer ,&nbsp;Robin L. Anderson ,&nbsp;Daniel Häusermann ,&nbsp;Valentin Djonov ,&nbsp;Olga A. Martin ,&nbsp;Michael Lerch","doi":"10.1016/j.ejmp.2025.105029","DOIUrl":"10.1016/j.ejmp.2025.105029","url":null,"abstract":"<div><h3>Background:</h3><div>Treatment planning systems (TPSs) for microbeam radiotherapy (MRT) have seen rapid development over the past few years, however very few TPSs are equipped to handle the growing complexity of in-vivo MRT studies. Current literature lacks sufficient detail for dosimetry, treatment planning, evaluation, and delivery to make meaningful links between dose and treatment outcomes. In a recent study, we investigated treatment outcomes in tumour-bearing mice through modifying temporal placement of MRT fields in a daily-fractionated synchrotron BB schedule. Here, we detail dosimetry, treatment planning, delivery, and evaluation to meaningfully correlate physical dose with observed treatment outcomes.</div></div><div><h3>Methods:</h3><div>The Eclipse TPS (Varian Medical Systems) was adapted to accumulate dose for fractionated mixed-modality treatments. Manual plan optimisation was used to meet dose prescriptions and constraints. Volumetric dose data for the primary tumour, organs-at-risk, and locoregional metastasis sites were calculated and compared to treatment outcomes.</div></div><div><h3>Results:</h3><div>Manual plan optimisation generally met treatment requirements but was limited by the delivery system’s physical limits. Dose accumulation for BB and MRT valleys was achieved, and MRT peaks were assessed separately. Tumour control was maintained in all mice, and all failed to treat out-of-field locoregional metastases. Mice receiving at least one MRT fraction had a <span><math><mo>&gt;</mo></math></span>32 % reduction in primary tumour volume. The temporal placement of MRT beams did not affect treatment outcomes or metastatic burden.</div></div><div><h3>Conclusion:</h3><div>This study represents the first detailed use of the Eclipse TPS for multi-fraction, multi-port, multi-modal synchrotron radiotherapy, providing insights into treatment outcomes and biological end-points in relation to physical dose.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105029"},"PeriodicalIF":3.3,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144623836","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}