Pub Date : 2025-10-01Epub Date: 2025-09-29DOI: 10.1016/j.radmp.2025.09.009
Yuan Sun , Fei Tuo , Wuhui Lin , Qiang Zhou , Baolu Yang
Radionuclide identification using NaI(Tl) gamma-ray spectroscopy is critical in nuclear security, environmental monitoring, and medicine. While cost-effective and efficient, NaI(Tl) detectors are limited by low energy resolution, spectral noise, and environmental variability. This systematic review evaluates how machine learning (ML) advancements address these limitations. Our analysis reveals that deep learning models—particularly convolutional neural networks (CNNs), hybrid architectures, and other advanced Deep Networks—excel in analyzing low-resolution spectra, achieving over 95% accuracy even under complex conditions (e.g., shielding effects, low-count spectra). Hybrid models which integrate CNNs with traditional algorithms demonstrate superior robustness and explainability. Nevertheless, traditional ML methods (e.g., SVMs) remain valuable for limited datasets or real-time applications. Despite these methodological advances, the field continues to face overarching challenges including data scarcity, model generalization, and explainability, necessitating standardized datasets and physics-informed ML frameworks. ML bridges the performance gap between NaI(Tl) and high-resolution detectors, enabling portable, automated solutions. Future research should prioritize hybrid models, dataset standardization, and optimization for field deployment, enhancing nuclear safety and environmental monitoring capabilities.
{"title":"Machine learning application in NaI(Tl) gamma-ray spectroscopy for radionuclide identification: A systematic review","authors":"Yuan Sun , Fei Tuo , Wuhui Lin , Qiang Zhou , Baolu Yang","doi":"10.1016/j.radmp.2025.09.009","DOIUrl":"10.1016/j.radmp.2025.09.009","url":null,"abstract":"<div><div>Radionuclide identification using NaI(Tl) gamma-ray spectroscopy is critical in nuclear security, environmental monitoring, and medicine. While cost-effective and efficient, NaI(Tl) detectors are limited by low energy resolution, spectral noise, and environmental variability. This systematic review evaluates how machine learning (ML) advancements address these limitations. Our analysis reveals that deep learning models—particularly convolutional neural networks (CNNs), hybrid architectures, and other advanced Deep Networks—excel in analyzing low-resolution spectra, achieving over 95% accuracy even under complex conditions (e.g., shielding effects, low-count spectra). Hybrid models which integrate CNNs with traditional algorithms demonstrate superior robustness and explainability. Nevertheless, traditional ML methods (e.g., SVMs) remain valuable for limited datasets or real-time applications. Despite these methodological advances, the field continues to face overarching challenges including data scarcity, model generalization, and explainability, necessitating standardized datasets and physics-informed ML frameworks. ML bridges the performance gap between NaI(Tl) and high-resolution detectors, enabling portable, automated solutions. Future research should prioritize hybrid models, dataset standardization, and optimization for field deployment, enhancing nuclear safety and environmental monitoring capabilities.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 5","pages":"Pages 251-258"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Radiation-induced skin injury (RISI) poses a significant clinical challenge in radiotherapy, characterized by acute inflammatory responses progressing to chronic fibrosis. Central to its pathogenesis is the dynamic interplay between immune cells and cytokine-mediated cascades following DNA double-strand breaks (DSBs) and oxidative stress induced by. This process triggers localized immune activation, radiation-damaged structural cells release DAMPs, triggering resident Langerhans cells and dermal dendritic cells to initiate antigen presentation and cytokine cascades; subsequently, activated macrophages and DCs recruit neutrophils and monocytes, driving acute inflammation that critically determines tissue fate toward regenerative repair or pathological fibrosis. Meanwhile, ultraviolet (UV) radiation primarily drives immunosuppression and photoaging. This review systematically delineates the dual regulatory roles of diverse immune populations—including T lymphocyte subsets, mast cells, and eosinophils—through comprehensive cytokine profiling. We highlight how temporal shifts in immune phenotypes orchestrate inflammation resolution versus fibrotic transformation. By integrating these insights, we provide a mechanistic framework of immune cells and related cytokines for RISI progression.
{"title":"Unveiling the role of immune response and related cytokines in radiation-induced skin injury: orchestrate inflammation to repair or fibrosis","authors":"Jiacheng Li, Yiting Tang, Peijing Chen, Zhenhua Ding, Meijuan Zhou","doi":"10.1016/j.radmp.2025.09.005","DOIUrl":"10.1016/j.radmp.2025.09.005","url":null,"abstract":"<div><div>Radiation-induced skin injury (RISI) poses a significant clinical challenge in radiotherapy, characterized by acute inflammatory responses progressing to chronic fibrosis. Central to its pathogenesis is the dynamic interplay between immune cells and cytokine-mediated cascades following DNA double-strand breaks (DSBs) and oxidative stress induced by. This process triggers localized immune activation, radiation-damaged structural cells release DAMPs, triggering resident Langerhans cells and dermal dendritic cells to initiate antigen presentation and cytokine cascades; subsequently, activated macrophages and DCs recruit neutrophils and monocytes, driving acute inflammation that critically determines tissue fate toward regenerative repair or pathological fibrosis. Meanwhile, ultraviolet (UV) radiation primarily drives immunosuppression and photoaging. This review systematically delineates the dual regulatory roles of diverse immune populations—including T lymphocyte subsets, mast cells, and eosinophils—through comprehensive cytokine profiling. We highlight how temporal shifts in immune phenotypes orchestrate inflammation resolution versus fibrotic transformation. By integrating these insights, we provide a mechanistic framework of immune cells and related cytokines for RISI progression.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 5","pages":"Pages 242-250"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Radiation Medicine and Protection – contributions to the UN SDGs","authors":"Jing Chen , Qiuju Guo , Shinji Tokonami , Weihai Zhuo","doi":"10.1016/j.radmp.2025.09.001","DOIUrl":"10.1016/j.radmp.2025.09.001","url":null,"abstract":"","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 5","pages":"Page 241"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-01Epub Date: 2025-09-22DOI: 10.1016/j.radmp.2025.09.007
Shovi Furaeli Sawe
Objective
To assess the excess life time cancer risk (ELCR) due to radon exposure in small scale Tanzanite mines in Northern Tanzania.
Methods
Radon concentrations were measured using the solid state nuclear track detectors (SSNTD) type CR-39. Three to six CR-39 detectors were placed in the underground working environment of each mine for a period of four months then removed and sent to Niton laboratory in Italy for processing and determination of radon concentrations. The obtained radon concentrations were used to estimate exposure to radon progenies, excess relative risk (ERR) of developing lung cancer, total lung cancer risk (TCR) and excess lifetime cancer risk (ELCR) using standard equations.
Results
The radon levels in 58% of the assessed mines were below the action level of 300 Bq/m3 recommended by the International Commission on Radiological Protection (ICRP) while 42% were above this limit. The estimated mean exposure to radon and its progenies ranged from 0.08 to 1.18 WLM corresponding to annual effective doses of 0.8 and 11.8 mSv/year, for the minimum and maximum values respectively. These values are below the annual limit of 20 mSv for occupational exposure recommended by the ICRP. The ELCR estimated using simplified linear model from BEIR IV report ranged from 0 to 0.03% which is below the U.S. EPA action level of 1.3% due to radon exposure of 148 Bq/m3.
Conclusion
The ELCR due to exposure to radon in the assessed mines is negligible. However, follow up studies are recommended as the depths of the mines increase especially in the mines were radon concentrations exceeded the action level.
{"title":"Preliminary assessment of excess life time cancer risk due to radon exposure in small scale Tanzanite mines in Tanzania","authors":"Shovi Furaeli Sawe","doi":"10.1016/j.radmp.2025.09.007","DOIUrl":"10.1016/j.radmp.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the excess life time cancer risk (ELCR) due to radon exposure in small scale Tanzanite mines in Northern Tanzania.</div></div><div><h3>Methods</h3><div>Radon concentrations were measured using the solid state nuclear track detectors (SSNTD) type CR-39. Three to six CR-39 detectors were placed in the underground working environment of each mine for a period of four months then removed and sent to Niton laboratory in Italy for processing and determination of radon concentrations. The obtained radon concentrations were used to estimate exposure to radon progenies, excess relative risk (ERR) of developing lung cancer, total lung cancer risk (TCR) and excess lifetime cancer risk (ELCR) using standard equations.</div></div><div><h3>Results</h3><div>The radon levels in 58% of the assessed mines were below the action level of 300 Bq/m<sup>3</sup> recommended by the International Commission on Radiological Protection (ICRP) while 42% were above this limit. The estimated mean exposure to radon and its progenies ranged from 0.08 to 1.18 WLM corresponding to annual effective doses of 0.8 and 11.8 mSv/year, for the minimum and maximum values respectively. These values are below the annual limit of 20 mSv for occupational exposure recommended by the ICRP. The ELCR estimated using simplified linear model from BEIR IV report ranged from 0 to 0.03% which is below the U.S. EPA action level of 1.3% due to radon exposure of 148 Bq/m<sup>3</sup>.</div></div><div><h3>Conclusion</h3><div>The ELCR due to exposure to radon in the assessed mines is negligible. However, follow up studies are recommended as the depths of the mines increase especially in the mines were radon concentrations exceeded the action level.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 5","pages":"Pages 297-300"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To evaluate the dosimetric parameters and radiobiological effects in both irradiated and non-irradiated bystander cells of early- and late-responding normal tissues using three radiotherapy (RT) techniques: Three-dimensional conformal RT (3D-CRT), Volumetric modulated arc therapy (VMAT), and Helical Tomotherapy (HT).
Methods
HaCaT cells, representing early-responding normal tissue with a high α/β ratio, and BEAS-2B cells, representing late-responding normal tissue characterized by a low α/β ratio, were irradiated with a 2 Gy across three RT techniques. A water phantom was utilized for treatment planning to maintain uniform target coverage and ensure dosimetric comparability among all RT modalities. Various radiobiological endpoints were analyzed to assess cell responses in both irradiated and bystander cells.
Results
Although the dosimetric parameters (D95% ≈ 2.0 Gy, D2% ≈ 2.1 Gy, Dmean ≈ 2.0 Gy, HI = 0.04–0.35, beam-on time = 27–254 s, MU rate = 270–1936) were broadly comparable across the three RT techniques, the biological responses differed depending on cell type and irradiation method. HT irradiation induced the most pronounced cellular damage in HaCaT cells, with the survival fraction (SF) reduced to 0.31 ± 0.09 in irradiated cells and cell viability of (93.5 ± 3.7) % in bystander cells. In contrast, for BEAS-2B cells, VMAT predominantly affected irradiated cells (SF: 0.36 ± 0.04), whereas bystander responses were more evident following HT irradiation [cell viability: (95.0 ± 6.3) %]. These observations likely reflect an interplay between biological variables (such as, cellular phenotype, DNA repair capability, and cell cycle distribution), and physical parameters, including beam delivery characteristics, beam on time and MU rate.
Conclusion
These findings may help inform decision-making by radiation oncologists and support the development of individualized RT approaches aimed at maximizing treatment efficacy while minimizing long-term toxicity.
{"title":"Normal cell responses to 3D-CRT, VMAT, and helical tomotherapy: A comparative study","authors":"Rinwarat Phumsankhot , Phanwadee Kasetthamrongrat , Aphidet Duangya , Anirut Watcharawipha , Wannapha Nobnop , Narongchai Autsavapromporn","doi":"10.1016/j.radmp.2025.09.002","DOIUrl":"10.1016/j.radmp.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the dosimetric parameters and radiobiological effects in both irradiated and non-irradiated bystander cells of early- and late-responding normal tissues using three radiotherapy (RT) techniques: Three-dimensional conformal RT (3D-CRT), Volumetric modulated arc therapy (VMAT), and Helical Tomotherapy (HT).</div></div><div><h3>Methods</h3><div>HaCaT cells, representing early-responding normal tissue with a high α/β ratio, and BEAS-2B cells, representing late-responding normal tissue characterized by a low α/β ratio, were irradiated with a 2 Gy across three RT techniques. A water phantom was utilized for treatment planning to maintain uniform target coverage and ensure dosimetric comparability among all RT modalities. Various radiobiological endpoints were analyzed to assess cell responses in both irradiated and bystander cells.</div></div><div><h3>Results</h3><div>Although the dosimetric parameters (<em>D</em><sub>95</sub><sub>%</sub> ≈ 2.0 Gy, <em>D</em><sub>2</sub> <sub>%</sub> ≈ 2.1 Gy, <em>D</em><sub>mean</sub> ≈ 2.0 Gy, HI = 0.04–0.35, beam-on time = 27–254 s, MU rate = 270–1936) were broadly comparable across the three RT techniques, the biological responses differed depending on cell type and irradiation method. HT irradiation induced the most pronounced cellular damage in HaCaT cells, with the survival fraction (<em>SF</em>) reduced to 0.31 ± 0.09 in irradiated cells and cell viability of (93.5 ± 3.7) % in bystander cells. In contrast, for BEAS-2B cells, VMAT predominantly affected irradiated cells (<em>SF</em>: 0.36 ± 0.04), whereas bystander responses were more evident following HT irradiation [cell viability: (95.0 ± 6.3) %]. These observations likely reflect an interplay between biological variables (such as, cellular phenotype, DNA repair capability, and cell cycle distribution), and physical parameters, including beam delivery characteristics, beam on time and MU rate.</div></div><div><h3>Conclusion</h3><div>These findings may help inform decision-making by radiation oncologists and support the development of individualized RT approaches aimed at maximizing treatment efficacy while minimizing long-term toxicity.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 5","pages":"Pages 259-266"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145340614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01Epub Date: 2025-07-03DOI: 10.1016/j.radmp.2025.06.006
Jing Chen
We are surrounded by various hazards and threats to the health of people, animals and the environment. Therefore, the protection work is multifaceted and needs to consider all potential hazards, and balance all potential impacts to the extent practicable. Whilst separated sectorial protections have proved capable of delivering adequate levels of protection for various risks we are facing, it is crucially important that protective activities of various sectors and disciplines be better integrated into a more holistic and reasonably optimized protection strategy – One Protection. Even though the holistic approach has been in practice for decades, more has to be done for better integration with the aim to achieve net health and societal benefits “as optimal as reasonably achievable” (AOARA). In this paper, radiological protection is taken as an example to discuss challenges when sector-specific protective activities are not well integrated and lack prioritization and optimization. It demonstrates the need for better integrated and reasonably optimized protective practices to achieve the objectives of One World One Health and the UN Sustainable Development Goals (SDGs).
{"title":"The need to implement better integrated and reasonably optimized protection strategy – One Protection","authors":"Jing Chen","doi":"10.1016/j.radmp.2025.06.006","DOIUrl":"10.1016/j.radmp.2025.06.006","url":null,"abstract":"<div><div>We are surrounded by various hazards and threats to the health of people, animals and the environment. Therefore, the protection work is multifaceted and needs to consider all potential hazards, and balance all potential impacts to the extent practicable. Whilst separated sectorial protections have proved capable of delivering adequate levels of protection for various risks we are facing, it is crucially important that protective activities of various sectors and disciplines be better integrated into a more holistic and reasonably optimized protection strategy – One Protection. Even though the holistic approach has been in practice for decades, more has to be done for better integration with the aim to achieve net health and societal benefits “as optimal as reasonably achievable” (AOARA). In this paper, radiological protection is taken as an example to discuss challenges when sector-specific protective activities are not well integrated and lack prioritization and optimization. It demonstrates the need for better integrated and reasonably optimized protective practices to achieve the objectives of One World One Health and the UN Sustainable Development Goals (SDGs).</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 4","pages":"Pages 183-186"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01Epub Date: 2025-07-18DOI: 10.1016/j.radmp.2025.07.002
Yuqi Yang , Fang-Fang Yin
This study presents a unified framework, systematically shows a detailed visual representation and emphasizes the understanding via various key factors throughout physical-chemical-biological stages underlying the irradiation process in FLASH radiotherapy (FLASH-RT) from the review of previous published studies. To develop this framework, we pay close attention to the time scale of irradiation process, to incorporated methodologies from current hypotheses documented by in vitro and vivo studies. Concurrently, the framework illustrates the potential differences in tumor and normal cells induced by FLASH-RT. This synthesis of the literature reveals the potential research points in existing hypotheses which lack of consideration on the entire responses and interactions of each stage from initial physical to biological process. Our interpretation provides both a structured overview and a conceptual explanation, facilitating current understanding and further investigation that could be validated in future experimental settings in FLASH-RT research.
{"title":"Understanding of FLASH radiotherapy through physical to biological interpretation","authors":"Yuqi Yang , Fang-Fang Yin","doi":"10.1016/j.radmp.2025.07.002","DOIUrl":"10.1016/j.radmp.2025.07.002","url":null,"abstract":"<div><div>This study presents a unified framework, systematically shows a detailed visual representation and emphasizes the understanding via various key factors throughout physical-chemical-biological stages underlying the irradiation process in FLASH radiotherapy (FLASH-RT) from the review of previous published studies. To develop this framework, we pay close attention to the time scale of irradiation process, to incorporated methodologies from current hypotheses documented by in <em>vitro</em> and <em>vivo</em> studies. Concurrently, the framework illustrates the potential differences in tumor and normal cells induced by FLASH-RT. This synthesis of the literature reveals the potential research points in existing hypotheses which lack of consideration on the entire responses and interactions of each stage from initial physical to biological process. Our interpretation provides both a structured overview and a conceptual explanation, facilitating current understanding and further investigation that could be validated in future experimental settings in FLASH-RT research.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 4","pages":"Pages 187-195"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To analyze the acceptance testing items of the CyberKnife® S7™ system and evaluate its technical performance and quality assurance (QA).
Methods
A comprehensive test was conducted on the CyberKnife® S7™ system, which is equipped with a linear accelerator, X-ray imaging, a fixed collimator, an Iris™ collimator, an InCise2™ multileaf collimator (MLC), iDMS® data management system, and the Accuray Precision® treatment planning system (TPS) and safety mechanisms. End-to-end (E2E) testing was conducted to assess the overall projection accuracy of the CyberKnife S7 system, with relevant parameters recorded. In addition, quality control during clinical application was analyzed, including the verification results of 72 patients obtained using SRS MapCHECK®.
Results
The 6 MV X-ray beam exhibited radiation quality and off-axis ratio curves within normal ranges, dose stability and linearity deviations both were below 1.0%. The transmission factors of the fixed and Iris collimators were <0.2%. Repeatability tests for the 5 mm and 60 mm apertures of the Iris collimator met acceptance criteria. The alignment deviation between the laser and radiation beam centers fell within the standard of <1 mm. The maximum leakage of the MLC complied with the ≤0.5% standard. All three criteria for the leaf positioning accuracy tests were satisfied. The maximum deviation in overall projection accuracy for the fixed, Iris, and MLC collimators was 0.90 mm. Across 83 automated quality assurance (AQA) tests, the average deviation was 0.42 mm. Regarding tracking methods, E2E testing for Xsight lung tracking using fixed and Iris collimators showed the maximum deviations, with averages of 0.59 mm and 0.74 mm, respectively. In contrast, the MLC system showed the highest deviation for Xsight spine tracking, with an average of 0.7 mm. Based on the 2%/2 mm γ analysis criteria with a threshold of 10%, the γ pass rate for quality control results of 72 patients was 97.65% ± 2.36%.
Conclusion
All acceptance testing results of the CyberKnife® S7™ system met the established standards, confirming its reliability and readiness for clinical deployment. Rigorous quality control during clinical application is importance to ensuring the system's ability to deliver precise and effective treatments. This will safeguard patient outcomes and advance the standardization of patients care in radiotherapy.
{"title":"Technical performance and quality assurance of the CyberKnife® S7™ system","authors":"Hanshun Gong, Shaojuan Wu, Jinglin Sun, Shanshan Gu, Pengfei Xu, Xiangkun Dai, Zhongjian Ju","doi":"10.1016/j.radmp.2025.06.001","DOIUrl":"10.1016/j.radmp.2025.06.001","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the acceptance testing items of the CyberKnife® S7™ system and evaluate its technical performance and quality assurance (QA).</div></div><div><h3>Methods</h3><div>A comprehensive test was conducted on the CyberKnife® S7™ system, which is equipped with a linear accelerator, X-ray imaging, a fixed collimator, an Iris™ collimator, an InCise2™ multileaf collimator (MLC), iDMS® data management system, and the Accuray Precision® treatment planning system (TPS) and safety mechanisms. End-to-end (E2E) testing was conducted to assess the overall projection accuracy of the CyberKnife S7 system, with relevant parameters recorded. In addition, quality control during clinical application was analyzed, including the verification results of 72 patients obtained using SRS MapCHECK®.</div></div><div><h3>Results</h3><div>The 6 MV X-ray beam exhibited radiation quality and off-axis ratio curves within normal ranges, dose stability and linearity deviations both were below 1.0%. The transmission factors of the fixed and Iris collimators were <0.2%. Repeatability tests for the 5 mm and 60 mm apertures of the Iris collimator met acceptance criteria. The alignment deviation between the laser and radiation beam centers fell within the standard of <1 mm. The maximum leakage of the MLC complied with the ≤0.5% standard. All three criteria for the leaf positioning accuracy tests were satisfied. The maximum deviation in overall projection accuracy for the fixed, Iris, and MLC collimators was 0.90 mm. Across 83 automated quality assurance (AQA) tests, the average deviation was 0.42 mm. Regarding tracking methods, E2E testing for Xsight lung tracking using fixed and Iris collimators showed the maximum deviations, with averages of 0.59 mm and 0.74 mm, respectively. In contrast, the MLC system showed the highest deviation for Xsight spine tracking, with an average of 0.7 mm. Based on the 2%/2 mm γ analysis criteria with a threshold of 10%, the γ pass rate for quality control results of 72 patients was 97.65% ± 2.36%.</div></div><div><h3>Conclusion</h3><div>All acceptance testing results of the CyberKnife® S7™ system met the established standards, confirming its reliability and readiness for clinical deployment. Rigorous quality control during clinical application is importance to ensuring the system's ability to deliver precise and effective treatments. This will safeguard patient outcomes and advance the standardization of patients care in radiotherapy.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 4","pages":"Pages 225-230"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01Epub Date: 2025-07-01DOI: 10.1016/j.radmp.2025.06.005
Cairong Hu , Yanming Cheng , Kai Wang , Kaiqiang Chen , Feibao Guo , Liwan Shi , Xiaobo Li , Xiuchun Zhang , Jinyong Lin
Objective
To perform a multicenter evaluation of planning quality and dosimetric accuracy for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), using both standardized American Association of Physicists in Medicine (AAPM) Task Group 119 (TG-119) test cases and complex real-world clinical scenarios. The goal is to comprehensively assess the overall implementation accuracy of IMRT systems across multiple institutions.
Methods
Four TG-119 test cases and five clinical cases—including nasopharyngeal carcinoma (T2/T4), esophageal carcinoma, breast carcinoma, and cervical carcinoma—were selected. Five radiotherapy centers in Fujian Province independently generated IMRT and VMAT plans using their respective treatment planning systems and linear accelerator models, adhering to the prescription guidelines from both TG-119 report and Fujian Cancer Hospital. Then the plan quality scores (QS) across multicenters were compared. Meanwhile the dosimetric delivery accuracy of these plans were evaluated through point dose measurements, 2D planar and 3D volumetric dose verification. Subsequently, inter-center comparisons were performed for point dose deviations (DD) and γ passing rates based on the 3%/2 mm criteria. Finally, confidence limits (CLs) were calculated for QS, DD and γ passing rates to quantify the consistency in plan quality and dosimetric performance.
Results
In TG-119 test cases, CL values of plan quality score, point dose deviation, 3D γ passing rate were 0.6, 0.037, 9.09 for IMRT, and 0.66, 0.032 and 8.20 for VMAT, respectively. In clinical cases, they were 2.74, 0.031 and 8.85 for IMRT, 2.86, 0.033 and 7.62 for VMAT, respectively. All results met established quality assurance (QA) thresholds, with increased variability observed in more complex clinical scenarios.
Conclusion
This multicenter study validated the clinical feasibility and dosimetric reliability of IMRT and VMAT systems by integrating standardized benchmarks with real-world clinical cases. The derived regional CL provide practical reference values for evaluating the performance of existing or newly implemented IMRT/VMAT systems, thereby supporting standardization and enhancing confidence in clinical application.
{"title":"Multicenter dosimetric consistency evaluation of IMRT and VMAT techniques based on AAPM TG119 Report and clinical cases","authors":"Cairong Hu , Yanming Cheng , Kai Wang , Kaiqiang Chen , Feibao Guo , Liwan Shi , Xiaobo Li , Xiuchun Zhang , Jinyong Lin","doi":"10.1016/j.radmp.2025.06.005","DOIUrl":"10.1016/j.radmp.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>To perform a multicenter evaluation of planning quality and dosimetric accuracy for intensity-modulated radiotherapy (IMRT) and volumetric modulated arc therapy (VMAT), using both standardized American Association of Physicists in Medicine (AAPM) Task Group 119 (TG-119) test cases and complex real-world clinical scenarios. The goal is to comprehensively assess the overall implementation accuracy of IMRT systems across multiple institutions.</div></div><div><h3>Methods</h3><div>Four TG-119 test cases and five clinical cases—including nasopharyngeal carcinoma (T2/T4), esophageal carcinoma, breast carcinoma, and cervical carcinoma—were selected. Five radiotherapy centers in Fujian Province independently generated IMRT and VMAT plans using their respective treatment planning systems and linear accelerator models, adhering to the prescription guidelines from both TG-119 report and Fujian Cancer Hospital. Then the plan quality scores (QS) across multicenters were compared. Meanwhile the dosimetric delivery accuracy of these plans were evaluated through point dose measurements, 2D planar and 3D volumetric dose verification. Subsequently, inter-center comparisons were performed for point dose deviations (DD) and γ passing rates based on the 3%/2 mm criteria. Finally, confidence limits (CLs) were calculated for QS, DD and γ passing rates to quantify the consistency in plan quality and dosimetric performance.</div></div><div><h3>Results</h3><div>In TG-119 test cases, CL values of plan quality score, point dose deviation, 3D γ passing rate were 0.6, 0.037, 9.09 for IMRT, and 0.66, 0.032 and 8.20 for VMAT, respectively. In clinical cases, they were 2.74, 0.031 and 8.85 for IMRT, 2.86, 0.033 and 7.62 for VMAT, respectively. All results met established quality assurance (QA) thresholds, with increased variability observed in more complex clinical scenarios.</div></div><div><h3>Conclusion</h3><div>This multicenter study validated the clinical feasibility and dosimetric reliability of IMRT and VMAT systems by integrating standardized benchmarks with real-world clinical cases. The derived regional CL provide practical reference values for evaluating the performance of existing or newly implemented IMRT/VMAT systems, thereby supporting standardization and enhancing confidence in clinical application.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 4","pages":"Pages 218-224"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896598","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-08-01Epub Date: 2025-06-26DOI: 10.1016/j.radmp.2025.06.003
Ziyi Guan, Nanxi Yu, Ruhan Yi, Ling Gao
Radiation exposure from medical exposure, occupational exposure, or accidental incidents, increases significant risks to cardiovascular health. Small molecule metabolites have attracted widespread attention owing to the role in cardiovascular cell metabolism, immune response and inflammatory injury. This article reviews the classification and characteristics of small molecule metabolites and their multiple roles in radiation-induced cardiovascular inflammatory injury. This article explored the potential of small molecule metabolites as biomarkers in the diagnosis and prognosis of cardiovascular diseases, and the potential as therapeutic targets. Based on the relevant research in recent years, this article summarizes the relationship between small molecule metabolites and cardiovascular inflammatory injury, as well as the mechanisms on the cardiovascular system under radiation, aiming to understand the potential mechanism of small molecule metabolites in radiation-induced cardiovascular diseases to develop new prevention and treatment strategies.
{"title":"The role of small molecule metabolites in radiation-induced cardiovascular injury","authors":"Ziyi Guan, Nanxi Yu, Ruhan Yi, Ling Gao","doi":"10.1016/j.radmp.2025.06.003","DOIUrl":"10.1016/j.radmp.2025.06.003","url":null,"abstract":"<div><div>Radiation exposure from medical exposure, occupational exposure, or accidental incidents, increases significant risks to cardiovascular health. Small molecule metabolites have attracted widespread attention owing to the role in cardiovascular cell metabolism, immune response and inflammatory injury. This article reviews the classification and characteristics of small molecule metabolites and their multiple roles in radiation-induced cardiovascular inflammatory injury. This article explored the potential of small molecule metabolites as biomarkers in the diagnosis and prognosis of cardiovascular diseases, and the potential as therapeutic targets. Based on the relevant research in recent years, this article summarizes the relationship between small molecule metabolites and cardiovascular inflammatory injury, as well as the mechanisms on the cardiovascular system under radiation, aiming to understand the potential mechanism of small molecule metabolites in radiation-induced cardiovascular diseases to develop new prevention and treatment strategies.</div></div>","PeriodicalId":34051,"journal":{"name":"Radiation Medicine and Protection","volume":"6 4","pages":"Pages 205-209"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144896596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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