BioMedical Engineering OnLine最新文献

{"title":"Preliminary development and validation of a textile-based pressure-sensing system for lower-limb prosthetic sockets.","authors":"Thierry Dugas, Calvin C Ngan, Jan Andrysek","doi":"10.1186/s12938-026-01521-w","DOIUrl":"10.1186/s12938-026-01521-w","url":null,"abstract":"<p><strong>Background: </strong>The socket is an essential component of prostheses and critical to the mobility, quality of life, and independence of individuals with lower-limb loss. A poor-fitting socket can lead to residual limb health issues, gait abnormalities, and prosthesis abandonment. To mitigate these risks, prosthetists routinely evaluate socket fit, but current assessments rely largely on subjective measures, which may not consistently ensure optimal outcomes. The use of pressure sensors at the limb-socket interface could enhance these evaluations, yet challenges with practicality and wearability have limited their clinical adoption. To address these gaps, we developed and evaluated a prosthetic sock with integrated textile-based pressure-sensing cells.</p><p><strong>Results: </strong>Individual cells were first loaded to evaluate sensitivity, repeatability, and drift. Then, a surrogate residual limb was fabricated from silicone and 3D-printed components to assess performance at the limb-socket interface. The sensitivity test demonstrated the ability to detect load changes equivalent to 5% of the maximum load throughout the full range, while the repeatability evaluation resulted in an intraclass correlation coefficient of 0.998 (0.996-1.000) and a percentage coefficient of variation (CV) below 2%. The average drift over 10 min was 3.03 ± 0.44%. When loading the residual limb in the neutral standing position, three out of four sock cells tested at the limb-socket interface showed percentage CVs below 10%. Finally, all cells tested detected changes in socket pressure distribution under simulated gait events when applying a load of 600 N.</p><p><strong>Conclusions: </strong>These results were similar to commonly used off-the-shelf pressure sensors, and the sock performance is, therefore, promising. However, further development is required, including form factor improvements, implementation of shear-sensing capabilities, calibration, and validation with prosthesis users.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"30"},"PeriodicalIF":4.6,"publicationDate":"2026-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12914962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Recent advances in potential drug nanocarriers for CNS disorders: a review.","authors":"Tenpattinam Shanmugam Saraswathi, Mohan Mothilal, Sarad Pawar Naik Bukke, Chandrashekar Thalluri, Ananda Kumar Chettupalli","doi":"10.1186/s12938-026-01523-8","DOIUrl":"10.1186/s12938-026-01523-8","url":null,"abstract":"","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":"25 1","pages":"13"},"PeriodicalIF":2.9,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12831303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteogenesis-synchronized degradation of Mg²⁺-doped calcium sulfate whisker bone grafts for critical-sized bone defect repair.","authors":"Chengyong Li, Zhi Shi, Xin Li, Yong Yang, Lei Zhang, Tingting Yan, Hongchang Yang","doi":"10.1186/s12938-026-01519-4","DOIUrl":"10.1186/s12938-026-01519-4","url":null,"abstract":"<p><strong>Background: </strong>Bone defects remain a major clinical challenge in orthopedic and reconstructive surgery. However, conventional inorganic ceramic biomaterials are limited by many problems, such as poor plasticity, limited osteogenic potential, and uncontrolled degradation kinetics, resulting in failing to keep pace with new bones' healing. Harmonizing biomaterial degradation with osteogenesis thus remains a crucial problem to be addressed in bone tissue engineering.</p><p><strong>Methods: </strong>In this study, Mg²⁺-doped calcium sulfate whiskers (MCSW) are synthesized by adopting a high-temperature autoclave method and are fabricated into bone grafting via die-casting molding. Their physicochemical properties, including surface morphology, solution diffusion behavior, mechanical performance, elemental distribution, and Mg²⁺ release kinetics, are systematically characterized. Biocompatibility and in vitro osteoinductive potential are evaluated through assaying cell viability and analyzing osteogenic differentiation. Furthermore, the bone grafting is implanted into critical-sized calvarial defect models in Sprague-Dawley rats, and their bones' regenerative efficacy is assessed by micro-computed tomography (micro-CT) and histological staining.</p><p><strong>Results: </strong>MCSW exhibits many characteristics, including a rough surface, solution-dependent degradation behavior, appropriate mechanical strength, as well as sustained and controlled Mg²⁺ release, presenting favorable physicochemical properties with tunable degradation, which shows it is suitable for applying to bone tissue engineering. In vitro studies demonstrate excellent biocompatibility, supporting the survival, proliferation, and osteogenic differentiation of BMSCs, as proved by enhanced alkaline phosphatase (ALP) activity and calcium mineral deposition. More importantly, the in vivo degradation rate of MCSW is well synchronized with osteogenesis, resulting in effective bone regeneration and satisfactory repair of critical-sized defects.</p><p><strong>Conclusion: </strong>This Mg²⁺-doping strategy for calcium sulfate whiskers provides a novel and effective approach to enhance osteogenic activity and achieve tunable degradation in bone tissue engineering biomaterials, thereby showing strong potential for future clinical application.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"28"},"PeriodicalIF":4.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12910739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing the feature of knee hyperextension in stroke patients based on transformer-long-short-term memory model.","authors":"Aoli Shen, Xinpeng Chen, Qing Xia, Yifang Wang, Hanlin Xu","doi":"10.1186/s12938-026-01513-w","DOIUrl":"10.1186/s12938-026-01513-w","url":null,"abstract":"<p><strong>Background: </strong>Recognizing knee hyperextension during gait in stroke patients is clinically challenging and involves cumbersome, costly procedures. This study proposes a simplified strategy based on a transformer-long-short-term memory (transformer-LSTM) approach for knee hyperextension recognition via surface electromyography (sEMG) data.</p><p><strong>Aim: </strong>This study proposes an algorithmic model to streamline knee hyperextension screening in stroke patients and reduce associated screening costs.</p><p><strong>Methods: </strong>Using an open-source gait database of 50 stroke patients, co-contraction index (CCI) values-derived from Biceps Femoris (BF)/Rectus Femoris (RF), Tibialis Anterior (TA)/Gastrocnemius (GAS), and their combinations-were input into the model. Performance was evaluated using accuracy, F1 scores, Receiver Operating Characteristic (ROC) curves, and loss function convergence.</p><p><strong>Results: </strong>The transformer-LSTM achieved a recognition accuracy of 83.38% (F1: 0.8335), outperforming linear regression (36.78%, F1: 0.3405), support vector machines (38.65%, F1: 0.3185), convolutional neural networks (72.56%, F1: 0.7259), gated recurrent units (70.94%, F1: 0.7103), long-short-term memory (76.86%, F1: 0.7687), and transformer (75.76%, F1: 0.7678). The transformer-LSTM demonstrated the fastest loss function convergence and an ROC Area Under Curve of 0.99.</p><p><strong>Conclusions: </strong>The transformer-LSTM provides superior recognition rates (83.38%) and offers a robust solution for screening knee hyperextension in stroke patients, highlighting its potential for clinical application.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"29"},"PeriodicalIF":4.6,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of CT target scan-based radiomics and clinical features for patients with chronic obstructive pulmonary disease combined with malignant pulmonary nodules.","authors":"Fang Liu, Mingjing Yuan, Jun Luo, Rong Luo","doi":"10.1186/s12938-026-01509-6","DOIUrl":"10.1186/s12938-026-01509-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to evaluate the predictive value of CT target scan-based radiomics and clinical features in patients with chronic obstructive pulmonary disease (COPD) who also present with malignant pulmonary nodules.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 104 patients diagnosed with COPD and pulmonary nodules, treated at our hospital between September 2022 and September 2024. The cohort was stratified into a benign group (n = 48) and a malignant group (n = 66) based on the definitive pathological examination results. All participants underwent spiral CT target scanning. Univariate and multivariate logistic regression analyses were employed to identify influencing factors. In addition, a receiver operating characteristic (ROC) curve was constructed to assess the predictive value.</p><p><strong>Results: </strong>In comparison with the benign group, the malignant group exhibited a greater aspect ratio, a higher proportion of patients over 45 years of age, and increased occurrences of mixed ground-glass opacities, calcification, spiculation sign, vascular convergence sign, and lobulation sign, along with a significant elevation in the CAT score (P < 0.05). The CAT score, density, spiculation sign, and lobulation sign emerged as independent risk factors for the presence of malignant pulmonary nodules in patients with COPD (P < 0.05). The aforementioned imaging factors were incorporated into a multivariate logistic regression model: Logit (P) = 10.490 + 0.917 × CAT score + 1.547 × density + 0.823 × spiculation sign + 0.736 × lobulation sign. The area under the curve (AUC) values for the CAT score, radiomics model, and combined model were 0.768, 0.826, and 0.909, respectively.</p><p><strong>Conclusions: </strong>Radiomics features derived from CT target scanning, when combined with clinical features, demonstrate promising potential for differentiating between benign and malignant pulmonary nodules in patients with COPD. This approach may indirectly reflect patients' pulmonary function and serve as a reference for the early diagnosis of COPD combined with lung cancer.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"25"},"PeriodicalIF":4.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the diabetic foot in patients with type 2 diabetes mellitus based on machine learning.","authors":"Haixiang Zhang, Weijian Fan, Peipei Li, Xiangzi Chen, Shiwu Yin","doi":"10.1186/s12938-025-01494-2","DOIUrl":"10.1186/s12938-025-01494-2","url":null,"abstract":"<p><strong>Background: </strong>Diabetic foot (DF) is a severe complication of type 2 diabetes mellitus (T2DM), contributing to significant morbidity and healthcare costs globally. Early prediction and intervention are critical for preventing amputations and improving patient outcomes. However, traditional statistical methods lack the capacity to handle high-dimensional clinical data and identify optimal predictive features. This study aimed to develop and validate machine learning models for DF risk prediction using feature selection strategies based on binary logistic regression and information theory.</p><p><strong>Methods: </strong>A retrospective cohort of 1,179 patients (95 DF cases, 1,084 T2DM controls) was analyzed using clinical and biochemical data from 2019 to 2025. Three data sets were constructed: (1) original features; (2) features selected via binary logistic regression (F1); and (3) features selected via information-theoretic global learning (F2). Six models-extreme learning machine (ELM), kernel extreme learning machine (KELM), and their variants trained on the three data sets-were evaluated using fivefold cross-validation. Performance metrics included area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and computational efficiency.</p><p><strong>Results: </strong>Age, blood-urea-nitrogen (BUN), homocysteine (Hcy), albumin (ALB), and fasting blood glucose (FBG) were identified as independent DF risk factors. The information theory-based KELM (IT-KELM) model achieved the highest AUC of 0.799 (sensitivity: 0.792 and specificity: 0.710) on F2, outperforming other models. Feature selection improved predictive accuracy while reducing computational time, with IT-KELM requiring 0.138 s for training and 0.0023 s for testing. The SHAP summary dot plot and bar chart revealed that the top five features contributing to the model were TP, RBC, ALB, BMI and HB.</p><p><strong>Conclusions: </strong>Integrating information theory with KELM enhances DF risk prediction by optimizing feature subsets and leveraging nonlinear kernel mapping. The IT-KELM model demonstrates robust diagnostic performance and clinical feasibility for early DF screening. Future multi-center studies are needed to validate generalizability and refine model interpretability in real-world settings. This approach provides a cost-effective tool for precision medicine in diabetes care.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"24"},"PeriodicalIF":4.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smartphone photogrammetry for prosthetics and orthotics: accuracy and reliability across upper-limb, lower-limb, and AFO casts.","authors":"Arthur Ellis, Vishal Pendse, Calvin C Ngan, Jan Andrysek","doi":"10.1186/s12938-026-01515-8","DOIUrl":"10.1186/s12938-026-01515-8","url":null,"abstract":"<p><strong>Background: </strong>Conventional shape capture in prosthetics and orthotics (P&O) relies on plaster casting of a positive mold, which is then hand-rectified to the desired shape. While effective under expert practice, this workflow is labor-intensive, equipment-dependent, and difficult to archive or share. Digital approaches using structured-light scanners address some of these limitations but remain costly and require dedicated training. This study evaluated whether smartphone photogrammetry can accurately and reliably capture prosthetic and orthotic cast geometries, and assessed its usability in comparison to a clinical structured-light scanner for integration into clinical workflows.</p><p><strong>Results: </strong>A clinical-grade structured-light scanner (EinScan H2) served as the reference and demonstrated small volumetric and dimensional errors, at 0.21 ± 0.15% and 0.35 ± 0.18 mm, with intraclass correlation coefficients (ICCs) greater than 0.9999. Relative to this reference, across 12 cast models (upper limb, lower limb, and ankle-foot orthosis), smartphone photogrammetry achieved a volumetric error of 0.89 ± 0.68% and a dimensional error of 0.89 ± 0.51 mm; the mean surface point-to-point distance was 0.24 ± 0.19 mm. Reliability across operators was near-perfect (ICCs ≥ 0.9997). Usability data showed approximately 62 photographs and 88 s per capture for photogrammetry (about 12 min cloud processing) versus 34 s capture (about 85 s desktop processing) for the reference scanner. Photogrammetry scored higher on the System Usability Scale (79 versus 58).</p><p><strong>Conclusions: </strong>On casts, smartphone photogrammetry produced accurate and reliable meshes with favorable perceived usability and minimal hardware demands. These findings support its integration into digital workflows in P&O, particularly for scanning rectified positive casts and other stable geometries. Further multi-site evaluations on live limbs should determine acceptable capture-time thresholds and effective stabilization strategies to ensure clinical feasibility in routine practice.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"27"},"PeriodicalIF":4.6,"publicationDate":"2026-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12908380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standing balance therapy through portable and low-cost visual feedback training.","authors":"Mohammad Shushtari, William Pei, Derrick Lim, Kei Masani","doi":"10.1186/s12938-025-01507-0","DOIUrl":"10.1186/s12938-025-01507-0","url":null,"abstract":"<p><p>Individuals with incomplete spinal cord injury (iSCI) often fall due to decreased sensorimotor integration. Functional electrical stimulation (FES) therapy combined with visual feedback balance training (VFBT), termed FES+VFBT, can effectively improve standing balance in iSCI populations. Although promising, the need for force plates (FP), which are expensive and bulky, limits the translation of these methods to clinical and home settings. In this work, we propose a solution by replacing FP with Wii Balance Board (WBB), allowing for more accessible FES+VFBT at a lower cost in both clinical and community settings. Our investigations on ten non-injured participants reveal that WBB-based estimated center of mass (COM) has low prediction error and high correlation in both anteroposterior (RMSE: 4.13 ± 0.69 mm, r: 0.94 ± 0.02) and mediolateral directions (RMSE: 6.25 ± 1.80 mm, r: 0.92 ± 0.04) with ground FP-estimated COM, resulting in similar stimulation patterns obtained with the WBB-based approach, indicating that the WBB-based FES+VFBT system could yield a more accessible therapeutic strategy for balance rehabilitation in iSCI.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"26"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12903637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smart patches for healthcare industry: a review of emerging technologies, challenges, and developmental opportunities.","authors":"K Umapathi, L Priya, Hady Habib Fayek","doi":"10.1186/s12938-025-01485-3","DOIUrl":"10.1186/s12938-025-01485-3","url":null,"abstract":"<p><strong>Background: </strong>Smart patch healthcare devices are emerging as a distinct user interface in decoding the bidirectional interaction of the five sense organs. Powered by recent advancements in nano-materials, and artificial intelligence predictions, smart patches could understand the immune response of the body by analysing the biofluids, microenvironment and analytes in the five sense organs. These eminent potentials in smart patches, inspired the necessity for a review. Thus, this review aims to bring in to the limelight the current progress in smart patch technologies, highlighting their functions, opportunities and challenges in healthcare applications.</p><p><strong>Methods: </strong>A comprehensive review of literature was conducted focusing on smart patches designed for skin, ocular, cochlear, oral, and nasal applications. Further, the review is structured emphasising details on materials used, fabrication methods adapted, sensing mechanisms employed, enabling technologies such as artificial intelligence and Internet of Things.</p><p><strong>Results: </strong>The review analysis revealed that smart patches play a multifaceted role in healthcare applications providing (i) continuous health monitoring, (ii) controlled drug delivery, (iii) supports tissue regeneration and (iv) enables modulation of nerve responses. Further, smart patch integration with Internet of Things (IoT) capabilities enables remote healthcare solutions which benefits both physician and patient communities equally. Despite these progresses, challenges remain in term of biocompatibility of the materials chosen, long-term use and stability of the patch, data security and large-scale manufacturing.</p><p><strong>Conclusion: </strong>Smart patches hold transformative potential in biomedical engineering by bridging biosensing, therapeutic, and digital healthcare domains. This article provides an in-depth review of the current advancements, identifying the existing challenges and emerging opportunities in the field of smart patch research, and thus could guide future research and development. With its broad scope, this review would act as a valuable resource for both researchers and healthcare innovators working towards next-generation biomedical devices.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"23"},"PeriodicalIF":4.6,"publicationDate":"2026-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145987982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Desargues cloud TPS: a cloud-based automatic radiation treatment planning system for IMRT.","authors":"Jian Guo, Songbing Qin, Chenlei Guo, Meng Zhu, Yin Zhou, He Wang, Xiaoting Xu, Wei Zhan, Long Chen, Jie Ni, Yu Tang, Jun Chen, Yi Shen, Haibo Chen, Kuo Men, Hui Liu, Yuning Pan, Jin Ye, Jian Huan, Juying Zhou","doi":"10.1186/s12938-026-01510-z","DOIUrl":"10.1186/s12938-026-01510-z","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a cloud-based automated treatment planning system for intensity-modulated radiation therapy and evaluate its efficacy and safety for tumors in various anatomical sites under general clinical scenarios.</p><p><strong>Results: </strong>All the plans from both groups satisfy the PTV prescription dose coverage requirement of at least 95% of the PTV volume. The mean HI of plan A group and plan B group is 0.084 and 0.081, respectively, with no statistically significant difference from those of plan C group. The mean CI, PQM, OOT and POT are 0.806, 77.55. 410 s and 185 s for plan A group, and 0.841, 76.87, 515.1 s and 271.1 s for plan B group, which were significantly superior than those of plan C group except for the CI of plan A group. There is no statistically significant difference between the dose accuracies of plan B and plan C groups.</p><p><strong>Conclusions: </strong>It is concluded that the overall efficacy and safety of the Desargues Cloud TPS are not significantly different to those of Varian Eclipse, while some efficacy indicators of plans generated from automatic planning without or with manual adjustments are even significantly superior to those of fully manual plans from Eclipse. The cloud-based automatic treatment planning additionally increase the efficiency of treatment planning process and facilitate the sharing of planning knowledge.</p><p><strong>Materials and methods: </strong>The cloud-based automatic radiation treatment planning system, Desargues Cloud TPS, was designed and developed based on browser/server mode, where all the computing intensive functions were deployed on the server and user interfaces were implemented on the web. The communication between the browser and the server was through the local area network (LAN) of a radiotherapy institution. The automatic treatment planning module adopted a hybrid of both knowledge-based planning (KBP) and protocol-based automatic iterative optimization (PB-AIO), consisting of three steps: beam angle optimization (BAO), beam fluence optimization (BFO) and machine parameter optimization (MPO). 53 patients from two institutions have been enrolled in a multi-center self-controlled clinical validation. For each patient, three IMRT plans were designed. The plan A and B were designed on Desargues Cloud TPS using automatic planning without and with manual adjustments, respectively. The plan C was designed on Varian Eclipse TPS using fully manual planning. The efficacy indicators were heterogeneous index, conformity index, plan quality metric, overall operation time and plan optimization time. The safety indicators were gamma indices of dose verification.</p>","PeriodicalId":8927,"journal":{"name":"BioMedical Engineering OnLine","volume":" ","pages":"22"},"PeriodicalIF":4.6,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12888112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145964957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}