Pingyu Xiang, Xiangyu Mi, Hongye Zhang, Fei Wang, Xiong Yang, Yue Wang, Rong Xiong, Song Liu, Haojian Lu
{"title":"Enhancing Shape Sensing of Slender Medical Continuum Robot Using Carbon Nanotube Piezoresistive Fiber Bandage.","authors":"Pingyu Xiang, Xiangyu Mi, Hongye Zhang, Fei Wang, Xiong Yang, Yue Wang, Rong Xiong, Song Liu, Haojian Lu","doi":"10.34133/cbsystems.0622","DOIUrl":"10.34133/cbsystems.0622","url":null,"abstract":"<p><p>Slender medical continuum robots with flexibility and highly redundant degrees of freedom are widely used in various minimally invasive surgery. However, when interacting with anatomical structures, the continuum robot adopts diverse shapes, posing challenges for operation and control. To achieve real-time intraoperative shape sensing and provide online guidance for manipulation, most existing methods rely on optical fibers embedded within the robot, which often require specialized robot designs and come with high costs. Here, we present a novel approach utilizing thin and flexible carbon nanotube piezoresistive fibers as a bandage, helically integrated on the surface of existing slender medical continuum robots for shape sensing. The spatial configuration of the robot is effectively inferred by downsampling the resistance changes along the robot's body and applying a learning-based method. The results demonstrate that the proposed helically arranged carbon nanotube piezoresistive fibers, combined with a data-driven approach, are capable of reconstructing the robot's spatial shape. In vitro and ex vivo experiments on animal tissues further highlight its promising potential for enhancing the shape-sensing ability of existing medical continuum robots.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0622"},"PeriodicalIF":18.1,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13291483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148335144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bowen Zhang, Zemeng Chen, Weiguang Li, Louzhe Xu, Songqi Yang, Felix Wang, Kai Yan, Xunbin Wei, Ting Li
{"title":"Frequency-Specific Transcranial Photobiomodulation Elicits Complementary Glial Mechanisms for Neurovascular Protection and Amyloid Clearance in Alzheimer Disease.","authors":"Bowen Zhang, Zemeng Chen, Weiguang Li, Louzhe Xu, Songqi Yang, Felix Wang, Kai Yan, Xunbin Wei, Ting Li","doi":"10.34133/cbsystems.0551","DOIUrl":"10.34133/cbsystems.0551","url":null,"abstract":"<p><p>Alzheimer disease (AD), a devastating neurodegenerative disorder, is pathologically defined by amyloid-β (Aβ) deposition and neurofibrillary tangles. Critically, concomitant cerebrovascular dysfunction compromises neuronal homeostasis and significantly accelerates AD progression by impairing the neurovascular unit. However, effective strategies to modulate this complex neurovascular pathology remain unclear. Here, we applied transcranial photobiomodulation (tPBM) with continuous-wave (CW) and 40-Hz pulsed light to target neurovascular pathology in 5xFAD mice. The results showed that both tPBM modalities comparably ameliorated cognitive dysfunction through distinct glial-mediated mechanisms. Specifically, CW light primarily enhanced astrocyte-vascular coupling, which ameliorated vascular dysfunction and protected synapses. In contrast, 40-Hz light predominantly drove spatial redistribution of microglia toward Aβ plaques, thereby enhancing localized amyloid clearance. These findings reveal complementary pathways for tPBM in AD intervention, highlighting that CW and 40-Hz light offer modality-specific therapeutic advantages: The former targets cerebrovascular dysfunction, while the latter addresses Aβ plaque deposition. Collectively, our study provides critical mechanistic insights for optimizing tPBM protocols, establishing a foundation for more precise and comprehensive AD interventions.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0551"},"PeriodicalIF":18.1,"publicationDate":"2026-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lei Zhou, Yingjie Tan, Weigang Lv, Kening Lin, Feifeng Li, Wen Ouyang, Di Zhang
{"title":"Deep Generative Model of Macrophage Immune Response for Hepato-intestinal Tumor Therapy Optimization.","authors":"Lei Zhou, Yingjie Tan, Weigang Lv, Kening Lin, Feifeng Li, Wen Ouyang, Di Zhang","doi":"10.34133/cbsystems.0559","DOIUrl":"10.34133/cbsystems.0559","url":null,"abstract":"<p><p>Digestive tract cancers, including hepatobiliary and gastrointestinal malignancies, remain a major oncological burden globally. Immunotherapy efficacy rates are low, with only 15% to 30% of patients experiencing responses following treatment. Tumor-associated macrophages, which change phenotype between a pro-inflammatory and an immunosuppressive state, play a key role in determining the response to therapy, and current static biomarkers are inadequate for capturing the spatial-temporal changes associated with the immune response. We developed a bioinspired digital twin platform integrating variational representation learning with causal sequence modeling. The platform incorporates heterogeneous biological data (1.2 million single-cell transcriptomes, spatial immunophenotyping, and clinical trajectories) from 2,847 individuals across 5 digestive cancer types. Graph-based attention mechanisms encode intercellular interactions, while transformer-based temporal modules simulate immunological state transitions. A model-predictive optimization layer identifies patient-specific interventions maximizing repolarization potential. The biomimetic model predicted the outcome of therapy response better than conventional biomarker models did (area under the receiver operating characteristic curve: 0.847 compared to 0.692 with a statistically significant difference at <i>P</i> below 0.001). In an exploratory, nonrandomized analysis of discordant cases (<i>n</i> = 156) where model and physician recommendations differed, model-guided treatment was associated with higher response rates (47.4% versus 28.2%) and longer median progression-free survival (9.8 months versus 6.0 months; <i>P</i> = 0.003); however, selection bias cannot be excluded. This study provides preliminary evidence for the feasibility of a computational framework for immunotherapy optimization; prospective randomized trials are required to establish clinical utility.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0559"},"PeriodicalIF":18.1,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13505573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Text Sequence Stimulation for High-Speed and Comfortable SSVEP-BCI.","authors":"Xiaoyang Li, Shaojie Zhang, Yonghao Song, Shangen Zhang, Xiaogang Chen, Yijun Wang, Xiaorong Gao","doi":"10.34133/cbsystems.0612","DOIUrl":"10.34133/cbsystems.0612","url":null,"abstract":"<p><p>Steady-state visual evoked potential brain-computer interfaces offer a high-speed communication channel. However, traditional steady-state visual evoked potential paradigms often rely on strong flickering visual stimulation, which can lead to substantial visual fatigue. Moreover, the electroencephalography responses evoked by brightness flicker are spatially constrained and are primarily associated with occipital visual processing. This study presents a novel text sequence stimulation paradigm that combines periodic visual stimulation with orthographic information and elicits distinct occipital and occipitotemporal scalp response patterns relative to conventional brightness flicker. Frequency-sweep experiments were conducted to investigate the temporal, spatial, and spectral characteristics of the evoked responses. A comparison experiment further showed that text sequence stimulation is less sensitive to variations in stimulus size and luminance than conventional brightness flicker. Based on these findings, a 40-target speller was developed and validated through online experiments. The proposed paradigm achieved an information transfer rate of 235.12 ± 30.12 bits/min while significantly improving user comfort, as confirmed by questionnaire evaluations. These results suggest that text sequence stimulation offers a practical design direction for high-speed and more comfortable visual brain-computer interface.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0612"},"PeriodicalIF":18.1,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13266052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148267289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jiajun He, Zhixin Xia, Lipeng Liao, Xu Li, Xuhao Wu, Jie Shen, Qinglong Wang, Ben Wang
{"title":"Micro/Nanorobotic Systems for Imaging-Guided Closed-Loop Thrombus Recanalization.","authors":"Jiajun He, Zhixin Xia, Lipeng Liao, Xu Li, Xuhao Wu, Jie Shen, Qinglong Wang, Ben Wang","doi":"10.34133/cbsystems.0592","DOIUrl":"10.34133/cbsystems.0592","url":null,"abstract":"<p><p>How can we reopen blocked blood vessels quickly and safely when a clot forms in stroke, heart attack, deep-vein thrombosis, or pulmonary embolism? Current care relies on clot-dissolving drugs given through the bloodstream and catheter-based procedures that mechanically retrieve thrombi and/or deliver drugs locally. These methods can be lifesaving, but they are limited by residual distal microvascular obstruction, reduced efficacy against dense or lysis-resistant clots, and procedure-related complications such as hemorrhage and downstream embolization. This review compares 2 complementary technology paths: \"tethered\" catheter systems designed for rapid and operator-controlled reopening of large vessels, and \"untethered\" micro/nanoscale systems, including injectable carrier-based platforms and actively actuated micro/nanorobots, that can be actuated and guided by magnetic, ultrasound, or light energy to seek, penetrate, and disrupt clots at the microscale. Across reported studies, rationally engineered nanocarriers can improve clot targeting and local retention of thrombolytic payloads, while externally powered microrobots and microswarms enable active mixing and mechanical assistance, often reducing treatment time and lowering required drug doses in preclinical models. We further summarize imaging and tracking strategies that ensure feedback control of device position, energy delivery, and treatment endpoints. Finally, we discuss key translational barriers, including robust navigation under complex hemodynamics, reliable stopping and clearance, standardized safety windows, and seamless integration into established interventional workflows, thereby outlining actionable priorities that can steer this field toward clinical therapies.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0592"},"PeriodicalIF":18.1,"publicationDate":"2026-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kazuki Kai, Le Duc Long, Qifeng Lin, Hirotaka Sato
{"title":"Fully Implanted Miniature Radio Controller Boosts Cyborg Insect Mobility in Challenging Terrains.","authors":"Kazuki Kai, Le Duc Long, Qifeng Lin, Hirotaka Sato","doi":"10.34133/cbsystems.0589","DOIUrl":"10.34133/cbsystems.0589","url":null,"abstract":"<p><p>Cyborg insect is a living insect equipped with electronic devices for allowing remote control of their movement. Due to their small size and locomotor capability, cyborg insects have potential advantages for application in cluttered environments where human cannot operate. Past studies have proposed various cyborg insects using different insect species and custom-made controllers equipped with sensors for desirable tasks. Those cyborg insects were usually equipped with the electronic devices on the back, leading to the loss of useful body shape of the platform organism. Although the body shape of animals is known to contribute to effective locomotion in their living environments, it has been unexamined how the arrangement of electronics to cyborg insect affects its locomotion. Here, we developed a miniature wireless controller that is fully implantable to small insects and demonstrated that the implantation of electronic device enhances traversal performance of the cyborg cockroach. The developed wireless controller was 10 mm in width, 10 mm in length, and 3 mm in height. It served sub-1 GHz communication and electrical signal output for maneuvering locomotion of cockroach. The cockroach with the implant maintained the innate tendency and traversal performance in gap negotiation comparable to intact animals, whereas the cyborg cockroach with the electronics mounted on the back exhibited degraded performance. The automatic stimulation algorithm successfully navigated the cockroach with the implant to the target with a success rate of 90.9%. The proposed technique will boost the capability of cyborg insects in challenging terrains in real scenarios.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0589"},"PeriodicalIF":18.1,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199645/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sifan Cao, Jingfan Fan, Long Shao, Qing Sun, Tao Xu, Danni Ai, Tianyu Fu, Deqiang Xiao, Hong Song, Tao Zhang, Jian Yang
{"title":"Robot-Assisted Osteotomy and Reconstruction with AR Guidance in Maxillofacial Reconstructive Surgery.","authors":"Sifan Cao, Jingfan Fan, Long Shao, Qing Sun, Tao Xu, Danni Ai, Tianyu Fu, Deqiang Xiao, Hong Song, Tao Zhang, Jian Yang","doi":"10.34133/cbsystems.0590","DOIUrl":"10.34133/cbsystems.0590","url":null,"abstract":"<p><p>The treatment of maxillofacial tumors requires coordinated resection and reconstruction. Conventional template-guided open osteotomy techniques may increase the risk of tissue injury. Additionally, the accuracy of titanium plate-based reconstruction is limited by the lack of standardized positional criteria, thereby potentially affecting alignment consistency. To address these challenges, we propose a maxillofacial tumor treatment system termed RAMRS, comprising 2 modules: robot-assisted osteotomy and augmented reality-guided reconstruction (ARR). Within therobot-assisted osteotomy module, a hand-eye calibration framework is used to support robotic arm positioning, while preoperative CT-to-patient spatial alignment is achieved through an optical probe-mediated registration method, supporting robot-assisted osteotomy according to the preoperative plan. The ARR module incorporates a rotating-caliper-based calibration compensation framework to reduce marker registration errors caused by manual instability or fiducial marker deformation. Subsequently, quick-response markers are used to achieve spatial alignment between the preoperative 3-dimensional model and the intraoperative defective mandible, and the virtual mandibular model is projected onto a display visible to the surgeon, thereby providing intuitive intraoperative guidance. Validation experiments were conducted on cadaveric and ex vivo specimens. The results demonstrated favorable accuracy in osteotomy and reconstruction alignment in the evaluated experiments, while the ARR module achieved low 2-dimensional fusion error for augmented reality visualization. These findings support the feasibility of the proposed workflow in preclinical settings.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0590"},"PeriodicalIF":18.1,"publicationDate":"2026-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13195182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Peiyao Jiao, Yilin Song, Jin Shan, Yu Liu, Qianli Jia, Qi Li, Ying Wang, Yan Luo, Pengfei Zhao, Juntao Liu, Zhenchang Wang, Mixia Wang, Xinxia Cai
{"title":"A Dual-Mode Wireless Microsystem for Monitoring Dopamine and Spike Changes with Dexmedetomidine.","authors":"Peiyao Jiao, Yilin Song, Jin Shan, Yu Liu, Qianli Jia, Qi Li, Ying Wang, Yan Luo, Pengfei Zhao, Juntao Liu, Zhenchang Wang, Mixia Wang, Xinxia Cai","doi":"10.34133/cbsystems.0566","DOIUrl":"10.34133/cbsystems.0566","url":null,"abstract":"<p><p>To understand how cortical circuits respond to pharmacological regulation, tools that can simultaneously detect electrophysiological and electrochemical signals in vivo are needed. However, most existing methods target only a single modality or depend on tethered recording systems that constrain movement and limit the ability to monitor coordinated neural processes. To address these challenges, we developed a dual-mode wireless microsystem that enables simultaneous recording of spikes, local field potentials (LFPs), and dopamine (DA)-related electrochemical signals on microelectrode arrays. The platform integrates a PtNPs/PEDOT:PSS/rGO/Nafion-modified electrochemical site for sensitive and selective detection of DA, as well as independent electrophysiological and electrochemical acquisition pathways that support stable long-distance wireless transmission of dual-mode signals. In vitro tests demonstrated that the platform can stably detect DA within a certain range and exhibits reliable wireless transmission performance. Using this platform, we recorded simultaneous electrophysiological and dopaminergic signals from the prelimbic cortex under different doses of dexmedetomidine. The results showed that increasing drug dose led to a significant reduction in spike firing rate and high-frequency LFP power, accompanied by dose-dependent elevations in DA-related amperometric response. These combined measurements showed simultaneous dose-dependent changes in electrophysiological activity and the DA-related electrochemical signal under dexmedetomidine. This dual-mode wireless microsystem provides a practical tool for neuroscience experiments requiring the integration of electrophysiology and neurochemistry.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0566"},"PeriodicalIF":18.1,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148018615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Articulated Untethered Magnetic Actuators for Multimodal and Cross-Scale Operations.","authors":"Zhixian Chen, Xiaoyu Zhao, Ying Liu, Shengli Mi","doi":"10.34133/cbsystems.0560","DOIUrl":"10.34133/cbsystems.0560","url":null,"abstract":"<p><p>Untethered magnetic actuators hold great promise for minimally invasive medicine, yet reconciling functional versatility with simple, reliable control remains a critical challenge. To address this, we introduce a modular design paradigm that employs revolute joints to interconnect discrete rigid modules. This strategy synergizes the mechanical robustness of rigid systems with the reconfigurability of soft robots, imparting additional degrees of freedom that enable complex, on-demand deformations. We demonstrate this approach through articulated prototypes capable of executing diverse locomotion strategies, including crawling and rolling, while leveraging on-demand mode switching to perform functional tasks such as cargo transportation, stirring and release. A critical advantage is that all locomotion and mode transitions are driven by a single, uniform magnetic field, thereby decoupling control from function and simplifying the system architecture. The robustness of the mechanism is confirmed through mathematical simulations and a dimensionless analysis that validates its feasibility across scales. The platform's versatility is ultimately demonstrated by its high-dexterity navigation through a tortuous vascular phantom and its successful execution of targeted cargo delivery within an ex vivo porcine stomach model. This work establishes a readily controllable and scalable framework for designing multifunctional magnetic robots, paving the way for high-precision operations within complex biological environments.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0560"},"PeriodicalIF":18.1,"publicationDate":"2026-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13184954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Real-Time AI-Based Radiotherapy Planning for Nasopharyngeal Carcinoma: Development and Validation.","authors":"Guangyu Wang, Xin Yang, Qianxi Ni, Junxiang Tang, Kailing Huang, Hailiang Guo, Xiaobo Jiang, Wenchao Diao, Hua Li, Yuxian Yang, Lecheng Jia, Yanfei Liu, Jiaxin Deng, Kang Zhang, Danyang Li, Xiaoyan Huang, Feng Jiang, Guanqun Zhou, Ying Sun","doi":"10.34133/cbsystems.0544","DOIUrl":"10.34133/cbsystems.0544","url":null,"abstract":"<p><p><b>Background:</b> Online all-in-one (AIO) radiotherapy workflows enable same-day treatment by integrating simulation, planning, and delivery into a single session. However, for anatomically complex tumors such as nasopharyngeal carcinoma (NPC), generating high-quality plans within strict time constraints remains a major barrier to clinical adoption. <b>Methods:</b> We developed a deep-learning-based automated planning model specifically tailored for real-time NPC planning in the online AIO workflow. The model was trained on 890 patients and iteratively refined through 4 versions, incorporating innovations such as quantile loss, priority-based constraint encoding, and hybrid central processing unit-graphics processing unit acceleration. Model performance was benchmarked in a 5-center retrospective study, including 125 patients from the model development center and 120 patients from 4 external centers. It was then prospectively validated in 242 consecutively treated patients with NPC using a CT-linear accelerator-based AIO platform. <b>Results:</b> In the 5-center retrospective evaluation, artificial intelligence (AI)-generated plans achieved superior or comparable dosimetric quality relative to expert manual plans, despite variations in imaging, contouring, and prescription practices. In prospective deployment, 95% of plans were clinically accepted after a single optimization cycle, with a mean generation time of 3.5 min. All plans met target coverage criteria and passed both secondary dose verification and in vivo electronic portal imaging device analysis. <b>Conclusion:</b> This study represents the largest prospective validation to date of AI-based treatment planning for NPC, demonstrating real-time feasibility, robust generalizability, and consistent clinical quality. Our development-to-deployment framework supports the scalable adoption of AI-driven precision planning and provides a transferable model for intelligent radiotherapy across disease sites.</p>","PeriodicalId":72764,"journal":{"name":"Cyborg and bionic systems (Washington, D.C.)","volume":"7 ","pages":"0544"},"PeriodicalIF":18.1,"publicationDate":"2026-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13181166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}