Physica Medica-European Journal of Medical Physics最新文献

{"title":"Patient-specific organ dose and in-vivo image quality assessment in clinical CT","authors":"Wanyi Fu ,&nbsp;Shobhit Sharma ,&nbsp;Justin Solomon ,&nbsp;Francesco Ria ,&nbsp;Hananiel Setiawan ,&nbsp;Aiping Ding ,&nbsp;William P. Segars ,&nbsp;Ehsan Samei","doi":"10.1016/j.ejmp.2025.105017","DOIUrl":"10.1016/j.ejmp.2025.105017","url":null,"abstract":"<div><h3>Purpose</h3><div>To develop and characterize individualized dose and quality measures at organ level compared to their generic counterparts across a clinical CT dataset.</div></div><div><h3>Materials and methods</h3><div>The study included 9801 chest-abdomen-pelvis and abdomen-pelvis CT exams (7,763 patients, mean age, 56 ± 17 years; 4113 women) representing 20 unique protocols. For each exam, patient-specific organ dose of all radiosensitive organs was estimated using a validated method by generating personalized computational phantoms and Monte Carlo simulations. Effective dose (<span><math><mrow><msub><mi>E</mi><mrow><mi>OD</mi></mrow></msub></mrow></math></span>) was calculated by weighted sum of the organ doses. Liver dose, <span><math><mrow><mi>O</mi><msub><mi>D</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span>, noise in the liver, <span><math><mrow><msub><mi>N</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span>, and observer model detectability, <span><math><mrow><mi>d</mi><mo>′</mo></mrow></math></span>, were assessed within the liver as examples of individualized, organ-based image assessment measurements. The organ-based measurements (<span><math><mrow><mi>O</mi><msub><mi>D</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span>, <span><math><mrow><msub><mi>E</mi><mrow><mi>OD</mi></mrow></msub></mrow></math></span>, and <span><math><mrow><msub><mi>N</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span>) were compared to their generic counterparts: ssize-specific ddose estimates (SSDE), effective dose based on dose length product (<span><math><mrow><msub><mi>E</mi><mrow><mi>DLP</mi></mrow></msub></mrow></math></span>), and whole-body noise (<span><math><mrow><msub><mi>N</mi><mrow><mi>global</mi></mrow></msub></mrow></math></span>), respectively.</div></div><div><h3>Results</h3><div>Generic dose values were substantially higher than individualized estimates for SSDE vs. <span><math><mrow><mi>O</mi><msub><mi>D</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span> (median of all exams: 51.2 %, p &lt; 0.001) and <span><math><mrow><msub><mi>E</mi><mrow><mi>DLP</mi></mrow></msub></mrow></math></span> vs. <span><math><mrow><msub><mrow><mi>ED</mi></mrow><mrow><mi>OD</mi></mrow></msub></mrow></math></span> (median: 41.0 %, p &lt; 0.001). <span><math><mrow><msub><mi>N</mi><mrow><mi>global</mi></mrow></msub></mrow></math></span> was generally lower than <span><math><mrow><msub><mi>N</mi><mrow><mi>liver</mi></mrow></msub></mrow></math></span> (median: −7.2 %, p &lt; 0.001). The correlation relationships of <span><math><mrow><msub><mi>E</mi><mrow><mi>OD</mi></mrow></msub></mrow></math></span> and <span><math><mrow><mi>d</mi><mo>′</mo></mrow></math></span> were substantially varied (<span><math><mrow><msup><mrow><mi>R</mi></mrow><mn>2</mn></msup></mrow></math></span> range: 0–0.5) for different patient sizes and scan parameters.</div></div><div><h3>Conclusions</h3><div>Demonstrated across a population of exam","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105017"},"PeriodicalIF":3.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480457","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":"The current practice of volumetric modulated arc therapy for breast cancer in Europe – A survey by the EFOMP VMAT breast working group","authors":"T. Koivumäki ,&nbsp;A. Clivio ,&nbsp;P. Doolan ,&nbsp;M. Essers ,&nbsp;M. Fusella ,&nbsp;M. Jäckel ,&nbsp;E. Laugaard Lorenzen ,&nbsp;M. Lizondo ,&nbsp;C. Noblet","doi":"10.1016/j.ejmp.2025.105028","DOIUrl":"10.1016/j.ejmp.2025.105028","url":null,"abstract":"<div><h3>Introduction</h3><div>VMAT is used in the treatment of breast cancer with a wide variety of approaches. The objective of this study is to identify and share the most common indications, techniques, and practices for the use of VMAT for breast irradiation.</div></div><div><h3>Methods</h3><div>The EFOMP VMAT Breast working group conducted an online questionnaire for European medical physicists via EFOMP national member organizations in February-March 2024. The questionnaire consisted of 56 questions in six categories: background of responders; treatment site specific approaches; dosimetric principles; treatment planning; quality assurance; and foundation of the VMAT breast technique used.</div></div><div><h3>Results</h3><div>A total of 314 responses were analyzed from various institutes across 31 countries, representing approximately 20 % of European radiotherapy centers. Of these, 73 % use VMAT for breast radiotherapy. Among the VMAT users, VMAT is most often used for more complex treatment sites, such as breast with lymph nodes and the internal mammary chain (56 % of responders). Most of these treatments are performed with C-arm linacs (77 %), using daily IGRT (&gt;80 % of institutes) with CBCT (&gt;50 %) as the preferred technique. Across all treatment sites, VMAT breast treatments are most often implemented with two arcs, an arc length of &gt;150°, 5 mm CTV-to-PTV margin and skin/auto flash of 10 mm.</div></div><div><h3>Conclusion</h3><div>This paper presents a comprehensive survey of VMAT breast radiotherapy in Europe. These data can serve as a useful reference point or starting guide for centers establishing VMAT protocols.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105028"},"PeriodicalIF":3.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144469994","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 characterisation of commercial optically stimulated luminescence and tin-filtered radiophotoluminescence glass dosimeters for accurate radiation dose measurement in general radiography","authors":"Sumalee Yabsantia ,&nbsp;Kosuke Matsubara ,&nbsp;Chirasak Khamfongkhruea ,&nbsp;Sawanee Suntiwong ,&nbsp;Nuntawat Udee ,&nbsp;Titipong Kaewlek ,&nbsp;Darrin Madtohed ,&nbsp;Nobpamadsiri Boonkrachang ,&nbsp;Pratchayakan Hompeng ,&nbsp;Thunyarat Chusin","doi":"10.1016/j.ejmp.2025.105030","DOIUrl":"10.1016/j.ejmp.2025.105030","url":null,"abstract":"<div><h3>Background</h3><div>Accurate radiation dose measurements rely on well-characterised dosimeter properties. This study investigated the characteristics of optically stimulated luminescence dosimeters (OSLD) and tin-filtered radiophotoluminescence glass dosimeters (RPLGD) in measuring incident air kerma (K_i), entrance surface air kerma (K_e), and absorbed dose (D) during general X-ray imaging.</div></div><div><h3>Methods</h3><div>We evaluated the radiation sensitivity and signal stability of OSLD and RPLGD. Their linear responses across doses from 0.5–7.0 mGy, energy dependence between 60 and 120 kVp, and variability in accumulated dose measurements were characterised using an ionisation chamber under K_i, K_e, and D measurement conditions.</div></div><div><h3>Results</h3><div>The sensitivity correction factors for OSLD and RPLGD ranged from 0.96 to 1.04 (CoV: 1.99 %) and 0.90–1.06 (CoV: 3.75 %), respectively. Signal depletion per reading was −0.40 ± 0.11 % for OSLD and −0.03 ± 0.04 % for RPLGD. Over 60 days, signal fading was −6.83 ± 0.40 % for OSLD and −2.70 ± 0.20 % for RPLGD. Both dosimeters showed excellent dose–response linearity (R² &gt; 0.995), with correction factors of 0.98–1.01 (CoV: 1.20 %) for OSLD and 1.01–1.05 (CoV: 1.95 %) for RPLGD. Beam quality correction factors ranged from 0.93 to 1.14 (CoV: 5.76 %) for OSLD and 0.87–1.07 (CoV: 5.36 %) for RPLGD, relative to 80 kVp calibration in K_i condition. Reproducibility of accumulated dose readings across nine fractions was within 2.32 % and 7.96 % for OSLD and RPLGD.</div></div><div><h3>Conclusions</h3><div>OSLD demonstrated superior uniformity and greater reproducibility in accumulated measurements of K_i, K_e, and D, whereas RPLGD exhibited enhanced signal stability. Both dosimeters displayed distinct characteristics, underscoring the importance of applying correction factors for accurate radiation dose measurement.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105030"},"PeriodicalIF":3.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366514","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":"Integration of microdosimetry into treatment planning systems using look-up tables (LUT): A proof-of-concept","authors":"Jacopo Magini ,&nbsp;Pietro Pisciotta ,&nbsp;Mohammad Hussein ,&nbsp;Stefan Both ,&nbsp;Alexander Gerbershagen ,&nbsp;Erik Traneus ,&nbsp;Giuseppe Schettino ,&nbsp;Francesco Romano","doi":"10.1016/j.ejmp.2025.105031","DOIUrl":"10.1016/j.ejmp.2025.105031","url":null,"abstract":"<div><h3>Introduction</h3><div>Microdosimetry provides a statistical, measurable description of energy deposition at the sub-cellular level, directly linked to biological effectiveness. In recent years its application to proton therapy has shown promising improvements in the accuracy of radiobiological modelling. This paper introduces a novel approach for integrating microdosimetric quantities into the treatment planning process.</div></div><div><h3>Material and methods</h3><div>This study aims to demonstrate the feasibility of a method for incorporating microdosimetric quantities into TPS, through the creation of look-up tables (LUT) that account for the stochastic nature of energy deposition occurring during a proton treatment irradiation.</div></div><div><h3>Results</h3><div>This work provides a preliminary set of LUT that relate the kinetic energy of incoming protons to the first-order stochastic means obtained from the corresponding microdosimetric spectra to proton kinetic energy. Such LUT are pre-produced via Monte Carlo simulations with sub-micrometre precision and can be immediately implemented into commercial TPSs. The resulting quantities are validated against complete Monte Carlo simulations, showing an agreement within 1 keV/µm for <span><math><msub><mover><mrow><mi>y</mi></mrow><mrow><mo>¯</mo></mrow></mover><mi>F</mi></msub></math></span>, <span><math><msup><mrow><mi>y</mi></mrow><mrow><mo>∗</mo></mrow></msup></math></span>, and <span><math><msub><mover><mrow><mi>y</mi></mrow><mrow><mo>¯</mo></mrow></mover><mi>D</mi></msub></math></span> from the entrance region through the 20 % distal fall-off, and within 3 keV/µm at greater depths. Applying the MKM model to <span><math><msup><mrow><mi>y</mi></mrow><mrow><mo>∗</mo></mrow></msup></math></span>, this process enables a microdosimetric RBE prediction with an agreement exceeding 98.5 %.</div></div><div><h3>Conclusion</h3><div>This work represents a promising initial step toward the successful implementation of microdosimetry in routine clinical practice. Establishing a standardized approach will enhance consistency and comparability across institutions.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105031"},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338950","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":"Rapid and reversible adaptation of a clinical linear accelerator for electron FLASH radiotherapy","authors":"Frank Schneider ,&nbsp;Cornelius J. Bauer ,&nbsp;Ida D. Göbel ,&nbsp;Clarence King ,&nbsp;Maria Francesca Spadea ,&nbsp;Joao Seco ,&nbsp;Frank A. Giordano ,&nbsp;Jens Fleckenstein","doi":"10.1016/j.ejmp.2025.105032","DOIUrl":"10.1016/j.ejmp.2025.105032","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this work was to establish a procedure that allows the conversion of a standard clinical LINAC into a “FLASH” LINAC capable of delivering ultra-high dose rates above 40 Gy/s, with minimal, fully reversible modifications to the device. A dosimetric characterization of the resulting treatment beam is presented.</div></div><div><h3>Methods</h3><div>A LINAC was modified to emit a 10 MeV electron FLASH beam. Modifications included the integration of a pulse control unit which consisted out of a scintillation detector and a transistor circuit. Beam parameters were optimized to maximize dose output. Beam characterization measurements were performed with different detectors in water: ionization chamber, diamond detector, radiographic films and scintillation detector. The resulting doses per pulse (DPP) and dose rates at different source-surface-distances (SSD) as well as the output reproducibility were determined. The beam was characterized with depth dose curves and lateral profiles.</div></div><div><h3>Results</h3><div>Conversion of a LINAC to FLASH mode was feasible in less than 30 min. Output was between DPP_SSD=56cm = 1.69 ± 0.02 Gy and DPP_SSD=100cm = 0.53 ± 0.01 Gy or dose rates between 676 ± 8 Gy/s and 213 ± 4 Gy/s. Reproducibility of DPP was better than 0.8 %. FLASH depth dose curves showed a higher range (R80 = 39.8 mm vs. 34.6 mm) and lateral beam profiles had a reduced flatness (from 5.5 % to 12.7 %) at SSD = 56 cm.</div></div><div><h3>Conclusion</h3><div>We present a fully reversible conversion method requiring minimal modifications to a LINAC to produce electron FLASH beams. The achieved DPP and mean dose rates demonstrated high reproducibility, meeting criteria for FLASH applications, and markedly simplifying access to this technology for broader implementation.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105032"},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338949","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":"An effective time reduction strategy in whole-body SPECT/CT studies using novel acquire during step mode without compromising diagnostic image quality","authors":"Timothy Melhuish ,&nbsp;Amit Nautiyal ,&nbsp;Sofia Michopoulou","doi":"10.1016/j.ejmp.2025.105033","DOIUrl":"10.1016/j.ejmp.2025.105033","url":null,"abstract":"<div><h3>Purpose</h3><div>WB-SPECT/CT can provide valuable insight into metastatic disease, assist in diagnosing numerous conditions, and enable volumetric dosimetry. Various approaches have made whole-body (WB) SPECT/CT less feasible in routine practice as it takes impractically long acquisition times. We aim to determine whether acquire during step (ADS) technology can be used for WB SPECT/CT studies to minimise acquisition time without compromising diagnostic quality.</div></div><div><h3>Design</h3><div>Two different phantom studies were performed using ^99mTc and ¹⁷⁷Lu. An initial comparison of step-and-shoot (SSM) and ADS SPECT acquisition mode with full-time, half-time, and quarter-time was carried out. The recovery coefficients were calculated for different spheres and background regions to check the quantitative accuracy of SSM and ADS modes with different acquisition times. The xSPECT quantification tool was used to obtain the SUVs in the VOI.</div></div><div><h3>Result</h3><div>The SPECT scan time with full-time ADS was 3.5 min quicker for each bed compared to full-time SSD. The ADS mode saved 15%-of acquisition time compared to the SSM mode. For both ^99mTc and ¹⁷⁷Lu, no statistical difference in recovery coefficients was noted between different acquisition times in SSM and ADS mode. No significant changes were noted in the background SUV between SSM and ADS for ^99mTc and ¹⁷⁷Lu isotopes.</div></div><div><h3>Conclusion</h3><div>A 15%-time reduction could be achieved using ADS technology in our SPECT/CT scans without any change in quantitative accuracy. We also found that time can be reduced further, and scans can be acquired faster by implementing a half-time or quarter-time ADS in routine practice without compromising quantitative accuracy. The improvements in WB SPECT acquisition time could reduce motion artefact, especially for patients with pain and improve the accuracy of disease diagnosis and personalised dosimetry.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105033"},"PeriodicalIF":3.3,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338948","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":"Exploring plan quality: using plan complexity to quantitatively analyse the tradeoff between clinical suitability and dosimetric accuracy","authors":"S. Cavinato ,&nbsp;A.G. Amico ,&nbsp;A. Bettinelli ,&nbsp;P. Caricato ,&nbsp;P. Ceroni ,&nbsp;B. El Khouzai ,&nbsp;F. Guida ,&nbsp;M. Paiusco ,&nbsp;C. Paronetto ,&nbsp;N. Pivato ,&nbsp;M.A. Rossato ,&nbsp;S. Sapignoli ,&nbsp;M. Sepulcri ,&nbsp;A. Scaggion","doi":"10.1016/j.ejmp.2025.105026","DOIUrl":"10.1016/j.ejmp.2025.105026","url":null,"abstract":"<div><h3>Purpose</h3><div>This study investigates how controlling the complexity of Volumetric Modulated Arc Therapy (VMAT) plans can quantitatively balance clinical suitability and dosimetric accuracy.</div></div><div><h3>Materials and Methods</h3><div>Thirty clinical cases treated with VMAT plans were re-optimized to limit plan complexity to varying degrees using Monitor Units (MU) objective and the Aperture Shape Controller (ASC) in the Eclipse TPS. The resulting plans were evaluated based on surrogate measures of plan complexity (single and aggregate complexity metrics), dosimetric accuracy (γ-index passing rate), and clinical suitability (Adjusted Plan Quality Metric).</div></div><div><h3>Results</h3><div>Stricter MU limits and higher ASC penalties resulted in beam’s-eye-view regularization and reduced leaf travel while increasing modulation of gantry speed and dose rate. Limiting plan complexity enhanced dosimetric accuracy, as shown by a higher γ-index passing rate. However, this was accompanied by a moderate reduction in clinical suitability, reflected by a lower Adjusted Plan Quality Metric (APQM%), with variations across treatment sites. Complexity metrics related to MLC apertures were the most significant indicators for characterizing dosimetric accuracy and clinical suitability. An aggregate complexity score was established, demonstrating a monotonic relationship with both dosimetric accuracy and clinical suitability, enabling the assessment of their trade-off.</div></div><div><h3>Conclusion</h3><div>By defining appropriate proxies, clinical suitability and deliverability can be quantitatively balanced through managing plan complexity in VMAT plans. While tailored to this study’s clinical routine, the method holds potential for standardizing plan quality assessment and improving VMAT treatment outcomes across diverse clinical settings. Insights gained could contribute to greater consistency and effectiveness in evaluating the overall plan quality in radiation therapy.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"136 ","pages":"Article 105026"},"PeriodicalIF":3.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330225","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)00137-1","DOIUrl":"10.1016/S1120-1797(25)00137-1","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"135 ","pages":"Article 105027"},"PeriodicalIF":3.3,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298378","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":"Clinical implementation of a secondary dose calculation system for patient-specific quality assurance of complex VMAT and SBRT treatments","authors":"Edoardo Mastella ,&nbsp;Klarisa E. Szilagyi ,&nbsp;Sara Fabbri ,&nbsp;Eleonora De Guglielmo ,&nbsp;Luigi Manco ,&nbsp;Eleonora Farina ,&nbsp;Melchiore Giganti ,&nbsp;Antonio Stefanelli ,&nbsp;Alessandro Turra","doi":"10.1016/j.ejmp.2025.105025","DOIUrl":"10.1016/j.ejmp.2025.105025","url":null,"abstract":"<div><h3>Purpose</h3><div>Advanced radiotherapy techniques require robust patient-specific quality assurance (PSQA). This study validated a secondary calculation software for plan dose verification, evaluating accuracy across different treatment sites, beam qualities, and plan complexities.</div></div><div><h3>Methods</h3><div>Data from two beam-matched VersaHD linacs were used to commission RadCalc-V7.3.2.0. 33 end-to-end tests in homogeneous and anthropomorphic phantoms compared RadCalc Monte Carlo (RC-MC) and Collapsed Cone Convolution Superposition (RC-CCCS) algorithms with Pinnacle³ TPS, using gamma analysis (1.5 %/2mm) and ionization chamber measurements. 140 clinical VMAT plans of varying complexities, including 35 head and neck (H&amp;N) and 65 SBRT treatments, were evaluated using gamma analysis (3 %/2mm) and relevant DVH metrics for PTV (D98%, D2%). RadCalc calculations were compared with pre-treatment Octavius 4D measurements.</div></div><div><h3>Results</h3><div>Phantom studies showed excellent RadCalc-TPS agreement for homogeneous plans and lung SBRT with flattened beams (mean passing rates &gt; 98 %, mean measured dose differences &lt; 1 %). Larger discrepancies were observed in the anthropomorphic thorax phantom for FFF SBRT. For clinical plans, mean passing rates exceeded 98.5 %. Site-specific differences emerged: RC-MC performed better for H&amp;N, RC-CCCS for other sites. RadCalc calculated slightly less homogeneous dose distributions than Pinnacle³, but averaging RC-MC and RC-CCCS results in reduced DVH discrepancies (mean ΔD98% −1.1 ± 1.1 %, mean ΔD2% +1.1 ± 1.5 %). Octavius measurements may underestimate calculation discrepancies due to tissue inhomogeneities<strong>.</strong></div></div><div><h3>Conclusions</h3><div>RadCalc produced very consistent results with Pinnacle³ and can be integrated into our PSQA program for efficient 3D dose verification, reducing measurement workload while maintaining high standards of dosimetric accuracy. Using both RadCalc algorithms effectively reduced calculation uncertainties.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"135 ","pages":"Article 105025"},"PeriodicalIF":3.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271651","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":"Local DRL estimation and effective dose calculation in paediatric interventional cardiology using measurements and Monte Carlo simulations","authors":"Pedro Teles ,&nbsp;Raquel Costa ,&nbsp;Tiago Bettio ,&nbsp;Teresa Pinheiro ,&nbsp;Teresa Loupa ,&nbsp;Joana Santos ,&nbsp;Fátima Pinto ,&nbsp;Octávia Monteiro Gil ,&nbsp;Paolo Ferrari ,&nbsp;Maria Zankl","doi":"10.1016/j.ejmp.2025.105023","DOIUrl":"10.1016/j.ejmp.2025.105023","url":null,"abstract":"<div><h3>Background</h3><div>Paediatric patients with congenital heart disease benefit greatly from X-ray diagnostic and interventional procedures. However, multiple procedures lead to prolonged exposure to ionizing radiation (IR), raising concerns for secondary long-term health issues.</div></div><div><h3>Purpose</h3><div>This study aimed to establish local dose reference levels (LDRLs) for a National Reference Center for Congenital Cardiopathies (NRCCC) in Portugal. Additionally, it estimated effective and organ doses in paediatric patients undergoing coronary angiographies (CAs) using measurements and Monte Carlo simulations.</div></div><div><h3>Methods</h3><div>LDRLs were determined through statistical analysis of patient registry data from 120 patients recorded between 2022 and 2023. For effective dose estimation, personal dose equivalent values Hp(10) were measured with an anthropomorphic phantom (CIRS ATOM 705) and Raysafe dosimeters, used to validate Monte Carlo (MC) simulations, which were then employed with rescaled paediatric voxel phantoms (GsF Baby and Child), to estimate effective doses and dose conversion coefficients (DCCs) for representative patient anatomies across different age and weight groups.</div></div><div><h3>Results</h3><div>LDRLs for coronary angiographies at the NRCCC showed significant dose variability, indicating dose optimization opportunities. Monte Carlo simulations allowed for organ dose and effective dose calculations. Dose Conversion Coefficients were 1.107, 0.882, 0.719, and 0.524 mSv/Gy·cm² for newborn, 1 year-old, 5 year-old and 10 year-old groups respectively. A strong linear correlation between effective dose and air-kerma area product (KAP) was observed.</div></div><div><h3>Conclusions</h3><div>The study highlights the strong correlation between effective dose and KAP, offering a practical framework for estimating patient doses and enhancing radiation safety protocols in clinical practice.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"135 ","pages":"Article 105023"},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144254295","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}