Physica Medica-European Journal of Medical Physics最新文献_第5页

Impact of radiotherapy plan complexity on dosimetric measurement verification: A technical evaluation of two O-ring detector systems 放疗计划复杂性对剂量测量验证的影响：两种o型环探测器系统的技术评估

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-13 DOI: 10.1016/j.ejmp.2025.105679

Zhengwen Shen , Xin Yang , Huanli Luo , Bin Feng , Liyuan Chen , Lixin Chen , Fu Jin

Background and purpose

The measurement verification is an essential process of radiotherapy pre-treatment patient-specific quality assurance. The impact of plan complexity on measurement verification needs to be investigated.

Methods and materials

Sixty clinical radiotherapy plans were retrospectively analyzed using two types of O-ring detector arrays, ArcCHECK and ArcMap, to implement the measurement verification. Forty-three complexity indexes were calculated to comprehensively quantify plan characteristics. Spearman’s correlation analysis statistically evaluated the correlations between complexity indexes and gamma passing rates (GPRs).

Results

ArcMap achieved higher GPRs compared with ArcCHECK. Higher correlation coefficients |r| were achieved with the criteria of gamma analysis were tightened. At the 2 %/1 mm criteria, complexity indexes characterizing leaf motion, notably A_4-5 (proportion of leaf accelerations ranged 4–5 cm/s², |r|=0.72), S_1.2-1.6 (proportion of leaf speed ranged 1.2–1.6 cm/s, |r|=0.71), maximum leaf acceleration (LA_max, |r|=0.70) and leaf sequence variability (LSV, |r|=0.68) exhibited stronger GPRs correlations for ArcMap. Conversely, indexes related to beam area, including cross axis score (CAS, |r|=0.64), aperture area variability (AAV, |r|=0.57), small aperture score 5 mm (SAS₅, |r|=0.56) and converted aperture metric (CAM, |r|=0.56) demonstrated stronger correlations for ArcCHECK.

Conclusions

The impact of radiotherapy plan complexity on measurement verification displayed detector dependency, with detector size, spatial resolution, and geometric configuration critically influencing GPR-complexity correlations.

背景与目的测量验证是放射治疗前患者特异性质量保证的重要过程。计划复杂性对测量验证的影响需要研究。方法与材料采用ArcCHECK和ArcMap两种o型环形探测器阵列对60例临床放疗方案进行回顾性分析，进行测量验证。计算43项复杂性指标，综合量化方案特征。Spearman相关分析统计评估复杂性指数与伽马通过率（GPRs）之间的相关性。结果与ArcCHECK相比，sarcmap获得了更高的GPRs。随着伽玛分析标准的收紧，获得了较高的相关系数|和|。在2% /1 mm标准下，表征叶片运动的复杂性指数，特别是a1 -5（叶片加速度比例范围为4-5 cm/s2， |r|=0.72）、S1.2-1.6（叶片速度比例范围为1.2-1.6 cm/s, |r|=0.71）、最大叶片加速度（LAmax, |r|=0.70）和叶片序列变异（LSV, |r|=0.68）在ArcMap中表现出较强的GPRs相关性。相反，与光束面积相关的指标，包括交叉轴评分（CAS, |r|=0.64）、孔径面积变异性（AAV, |r|=0.57）、小孔径评分5 mm （SAS5, |r|=0.56）和转换孔径度量（CAM, |r|=0.56）与ArcCHECK的相关性更强。结论放疗计划复杂性对测量验证的影响表现为探测器依赖性，探测器尺寸、空间分辨率和几何构型对gpr -复杂性相关性有重要影响。

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引用次数: 0

Assessing stray neutron dose variability across Monte Carlo codes in a proton therapy scenario 在质子治疗方案中，通过蒙特卡罗代码评估杂散中子剂量变异性

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-10 DOI: 10.1016/j.ejmp.2025.105686

Maite Romero-Expósito , Luka Pasariček , Nicolas Arbor , Hrvoje Brkić , Anna Cimmino , David Horváth , Villads Lundsteen Jacobsen , Benoit Lefebvre , Liliana Stolarczyk , Marija Majer , Roberto Versaci , Marijke De Saint-Hubert

Background and purpose

Monte Carlo (MC) simulations are widely used in proton therapy dosimetry, but neutron dose estimates vary significantly across different MC codes, nuclear models, and cross-section libraries. This study provides an overview of the expected differences in neutron fluence and dose equivalent calculations across five MC codes (PHITS, MCNP, FLUKA, GATE, and TOPAS) for a clinically-relevant proton beam model in a reference phantom.

Methods

A spread-out Bragg peak (SOBP) proton beam was simulated in a water phantom. Neutron fluence spectra and dose equivalents were evaluated at multiple out-of-field positions using each code’s default nuclear models and cross-section libraries. Additional simulations explored the impact of alternative cross-section libraries (JENDL-5, JEFF-3.3, TENDL-2021) and nuclear models.

Results

While proton dose distributions were consistent across codes (spatial variations < 2 mm), neutron fluences differed by up to 130 %, and dose equivalents varied by 88 % depending on nuclear data. Proton cross-sections had a greater influence on neutron spectra than neutron cross-sections. Codes using the same nuclear data libraries produced comparable results, highlighting cross-section selection as a key source of variability.

Conclusion

These results provide MC users with a reference for expected differences in neutron dose calculations. While default MC settings offer reasonable internal consistency, the observed variability underscores the need for benchmarking against experimental data to ensure accurate neutron dose predictions in proton therapy.

背景和目的蒙特卡罗（MC）模拟广泛应用于质子治疗剂量测定，但中子剂量估算在不同的MC代码、核模型和截面文库之间存在显著差异。本研究概述了参考幻影中与临床相关的质子束模型在五个MC代码（PHITS， MCNP， FLUKA， GATE和TOPAS）中中子通量和剂量当量计算的预期差异。方法在水模中模拟扩散布拉格峰（SOBP）质子束。使用每个代码的默认核模型和截面库在多个场外位置评估中子通量谱和剂量当量。其他模拟探讨了不同截面文库（JENDL-5、JEFF-3.3、TENDL-2021）和核模型的影响。结果虽然质子剂量分布在不同的核数据中是一致的（空间变化约2mm），但中子的影响差异高达130%，剂量当量差异高达88%。质子截面比中子截面对中子能谱的影响更大。使用相同核数据库的代码产生了可比较的结果，突出显示横截面选择是可变性的关键来源。结论这些结果为MC用户计算中子剂量的预期差异提供了参考。虽然默认的MC设置提供了合理的内部一致性，但观察到的可变性强调了需要对实验数据进行基准测试，以确保质子治疗中准确的中子剂量预测。

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引用次数: 0

Simultaneous attenuation and scatter correction of PET data in the image: quantitative and clinical assessment of image-to-image deep learning models 图像中PET数据的同时衰减和散点校正：图像到图像深度学习模型的定量和临床评估

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-06 DOI: 10.1016/j.ejmp.2025.105683

Avishan Elkayee Dehno , Pardis Ghafarian , Hossein Arabi , Mohammad Reza Ay

Background

Positron Emission Tomography (PET) non-invasively assesses body metabolism but requires correction for photon attenuation and scatter.

Purpose

This study aims to convert non-attenuation scatter corrected (NASC) brain PET/CT images to measured attenuation and scatter corrected (MASC) images using deep learning algorithms.

Methods

In this study, brain PET/CT (¹⁸F-FDG) images of 125 patients diagnosed with epilepsy disorder were used. Two convolutional neural networks, UNET and CGAN, were implemented to take 2D-NASC inputs and generate MASC images. For a precise evaluation, segmentation of 83 brain regions and the calculation of 19 radiomic features for each region were performed, and paired sample t-test was conducted for each region to determine significant differences between the predicted and ground-truth images. Clinical evaluation was performed by nuclear medicine physicians.

Results

The mean Peak Signal-to-Noise Ratio (PSNR), Structural Similarity Index Measure (SSIM), and Root Mean Square Error (RMSE) were 41.55 ± 3.55 (dB), 0.997 ± 0.002, and 294.8 ± 131.0 (Bq/ml) for the CGAN model, and 40.70 ± 3.84 (dB), 0.996 ± 0.003, and 327.6 ± 163.8 (Bq/ml) for the UNET model, respectively. Among 1,577 paired values of radiomic features in different brain regions of test set, only 126 (CGAN) and 156 (UNET) values showed significant differences from the corresponding MASC values, indicating that the majority of radiomic features were well preserved while still highlighting subtle textural variations. In clinical evaluation, the UNET and CGAN models demonstrated strong performance in visual quality assessment.

Conclusion

Direct attenuation and scatter correction using both convolutional deep networks is a promising approach for brain PET images, when CT is not available.

背景：正电子发射断层扫描（PET）无创评估人体代谢，但需要校正光子衰减和散射。本研究旨在利用深度学习算法将非衰减散射校正（NASC）脑PET/CT图像转换为测量的衰减和散射校正（MASC）图像。方法对125例癫痫患者进行脑PET/CT （18F-FDG）扫描。采用UNET和CGAN两种卷积神经网络获取2D-NASC输入并生成MASC图像。为了精确评估，对83个脑区域进行分割，并计算每个区域的19个放射学特征，并对每个区域进行配对样本t检验，以确定预测图像与真实图像之间的显着差异。临床评价由核医学医师进行。结果CGAN模型的平均峰值信噪比（PSNR）、结构相似指数（SSIM）和均方根误差（RMSE）分别为41.55±3.55 （dB）、0.997±0.002和294.8±131.0 (Bq/ml)， UNET模型的平均峰值信噪比（PSNR）、结构相似指数（SSIM）和均方根误差（RMSE）分别为40.70±3.84 （dB）、0.996±0.003和327.6±163.8 （Bq/ml）。在测试集不同脑区放射组学特征的1577个配对值中，只有126个（CGAN）和156个（UNET）值与相应的MASC值存在显著差异，表明大多数放射组学特征得到了很好的保留，但仍突出了细微的纹理变化。在临床评价中，UNET和CGAN模型在视觉质量评价中表现出较强的性能。结论在CT不可用的情况下，使用卷积深度网络对脑PET图像进行直接衰减和散射校正是一种很有前途的方法。

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引用次数: 0

AIFM young group focus on the medical physics residents in Italy: A survey results AIFM青年群体关注意大利医学物理居民：一项调查结果。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105678

Pasqualina Gallo , Roberta Castriconi , Agnese Chendi , Ilaria Cupparo , Lorenzo Lasagni , Mariaconcetta Longo , Nicola Maffei , Sara Parabicoli , Cristina Lenardi , Carlo Cavedon , Marco Maria Jacopo Felisi

Purpose

The young working group of the Italian Association of Medical and Health Physics (AIFM) launched a survey to provide an overview of training and professional experiences of Medical Physics residents, in view of the upcoming ministerial regulations.

Methods

A 72-questions online survey was developed to collect data on demographic, educational backgrounds, internship experiences, University programs of the Post-Graduate Specialization School in Medical Physics and perspectives on AIFM initiatives. The survey was administered to 174 Medical Physics residents via mailing lists and social media between July to September 2024.

Results

The response rate was 60 %. Most respondents (73 %) were under 30 years, with a balanced gender distribution. Nearly 85 % first encountered Medical Physics during studies, primarily through introductory courses.

Prior to 2024, scholarships during the training period for Medical Physics residents were not always guaranteed: universities, hospitals and regions offered support, but 25 % did not receive any contributions. Approximately 50 % relocated outside their home region to attend the Post-Graduate Specialization School.

Nearly 80 % expressed satisfaction with their programs, highlighting the quality of Medical Physics training in Italy. Over 80 % participated in courses and conferences (40 % as speakers) and approximately 65 % were involved in research projects (33 % publishing papers).

Conclusions

This survey provides an overview and identifies challenges encountered by Medical Physics residents within the AIFM community. Derived insights will guide future strategies and initiatives aimed at supporting and enhancing the training and professional development of young medical physicists.

目的：鉴于即将出台的部级条例，意大利医疗和保健物理学协会（AIFM）青年工作组发起了一项调查，概述医疗物理学住院医师的培训和专业经验。方法：采用72个问题的在线调查，收集人口统计、教育背景、实习经历、医学物理研究生专业学院的大学课程以及对AIFM倡议的看法。这项调查是在2024年7月至9月期间通过邮件列表和社交媒体对174名医学物理专业的居民进行的。结果：有效率为60%。大多数受访者（73%）年龄在30岁以下，性别分布均衡。近85%的学生在学习期间第一次接触医学物理学，主要是通过入门课程。在2024年之前，医学物理住院医师培训期间的奖学金并不总是有保证的：大学、医院和地区提供支持，但25%的人没有收到任何捐款。大约50%的人离开家乡到研究生专业学校学习。近80%的人对他们的课程表示满意，突出了意大利医学物理培训的质量。超过80%的人参加课程和会议（40%作为演讲者），大约65%的人参与研究项目（33%发表论文）。结论：这项调查提供了一个概述，并确定了AIFM社区内医学物理居民遇到的挑战。由此得出的见解将指导旨在支持和加强年轻医学物理学家的培训和专业发展的未来战略和举措。

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引用次数: 0

Corrigendum to “CAD-based Monte Carlo dose calculation system for evaluating geometrical effect of inserted materials in carbon-ion radiation therapy” [Phys. Med. 136 (2025) 105051] “基于cad的蒙特卡罗剂量计算系统用于评估碳离子放射治疗中插入材料的几何效应”的勘误表[物理学]。医学杂志。136(2025)105051]。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105214

Min Cheol Han, Yongdo Yun, Taeho Kim, Soorim Han, Changhwan Kim, Dong Wook Kim, Ho Lee, Hojin Kim, Chae-Seon Hong, Jin Sung Kim

引用次数: 0

Comparative effectiveness of advanced radiotherapy techniques for brain cancers: A systematic review with an emphasis on dosimetric variability 脑癌先进放射治疗技术的比较有效性：一项强调剂量学变异性的系统综述。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105682

Hamed Zamani , Mohsen Saeb , Shahram Monadi , Mostafa Alizade-Harakiyan , Ali Akhavan , Amin Khodaei , Mikaeil Molazadeh , Alireza Farajollahi

Background

Central nervous system (CNS) cancers pose a significant burden on global health. Radiotherapy remains central to treatment, yet optimal techniques for maximizing tumor control remain controversial due to dosimetric variability.

Methods

This systematic review evaluates the effectiveness of six advanced radiation techniques in clinical practice. Following PRISMA guidelines, we analyzed 61 studies from the Web of Science, PubMed, and Scopus, covering the period from 2018 to 2024, which reported on tumor coverage, dose conformity, and organ at risk (OAR) sparing.

Results

Our analysis revealed several key findings: (1) Tomotherapy (TOMO) demonstrated optimal dose homogeneity (HI 0.024-0.3) for hippocampal-sparing applications; (2) Volumetric Modulated Arc Therapy (VMAT) provided superior target coverage (CI 1.16-3.0) with greater efficiency (294 MU vs. Intensity-Modulated Radiation Therapy (IMRT 572 MU)); (3) Proton Beam Therapy (PBT) excelled in pediatric cases, reducing hippocampal dose by 91 % (4.8 Gy vs. 52.5 Gy); (4) Image-Guided Radiation Therapy (IGRT) enabled significant spinal cord sparing, with a Dmax reduction of 15 % compared to non-IGRT, through precise margin matching; (5) CyberKnife (CK) achieved remarkable accuracy for small lesions (<3 cm), maintaining the optic nerve dose below 2.02 Gy, although the treatment time averaged 220 min for larger targets. This review identified significant variability in OAR exposure across modalities (0.02 to 66.8 Gy), particularly for sensitive structures such as the brainstem (2.41 to 55.62 Gy).

Conclusions

While all modalities achieve acceptable tumor control, VMAT and PBT may provide advantages for complex geometries and pediatric cases, respectively. Prospective trials are needed to establish evidence-based guidelines for selection.

背景：中枢神经系统（CNS）癌症对全球健康构成重大负担。放疗仍然是治疗的核心，但由于剂量的可变性，最大限度地控制肿瘤的最佳技术仍然存在争议。方法：系统评价六种先进放射技术在临床应用中的效果。根据PRISMA指南，我们分析了来自Web of Science， PubMed和Scopus的61项研究，涵盖2018年至2024年期间，报告了肿瘤覆盖率，剂量一致性和器官风险（OAR）保留。结果：我们的分析揭示了几个关键发现：(1)在保留海马的应用中，断层治疗（TOMO）表现出最佳的剂量均匀性（HI 0.024-0.3）；(2)体积调制弧线治疗（VMAT）提供了更好的靶覆盖率（CI 1.16-3.0）和更高的效率（294 MU vs调强放疗（IMRT） 572 MU）；(3)质子束治疗（PBT）在儿科病例中表现突出，海马剂量减少91% (4.8 Gy对52.5 Gy)；(4)图像引导放射治疗（IGRT）通过精确的边缘匹配，与非IGRT相比，Dmax减少了15%，显著节省了脊髓；(5)射波刀（CK）在小病变上取得了显著的准确性(结论：虽然所有的方式都能达到可接受的肿瘤控制，但VMAT和PBT可能分别在复杂几何形状和儿科病例上具有优势。需要前瞻性试验来建立以证据为基础的选择指南。

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引用次数: 0

A proposal for the establishment of national diagnostic reference level for FDG tumor hybrid imaging examinations in Bulgaria 保加利亚建立FDG肿瘤混合影像检查国家诊断参考水平的建议。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105680

Anna Zagorska , Philip Simeonov , Daniela Dogandjiiska , Hristo Hristov , Ivo Petrov , Nikolay Mutkurov , Iveta Batolska , Pavlina Mihaylova , Pavel Bochev , Shawkat Masso , Simeon Petrov , Svetoslav Shalamanov , Dessislava Kostova-Lefterova

Purpose

The purpose of this study was to survey and analyse the doses from FDG PET/CT tumour imaging examinations for the available PET/CT equipment in Bulgaria, to propose national DRLs and analyse the used CT protocols and their contribution to the total patient exposure.

Methods

Data was collected for equipment, patient and examination parameters: administered activity and CT exposure data. Effective dose from PET component was estimated using published conversion coefficients. The National Cancer Institute dosimetry system was used for effective doses assessment due to CT component. The typical values of administered activity and dose indexes were determined following the ICRP recommendations using the median value of the data presented for each hospital and compared to previous surveys.

Results

100 % of PET/CT departments in Bulgaria provided data for the available equipment and information about doses from FDG PET/CT for oncological imaging for group of at least 15 adult patients. The proposed DRLs were: AA: 175 MBq, AA.kg⁻¹: 2.3 MBq.kg⁻¹, CTDI_vol: 5.1 mGy and DLP: 523 mGy.cm. Analysis of the CT protocols identified different trends, outliers and proposed optimization strategies.

Conclusion

NDLRs for half body hybrid FDG PET/CT for both PET and CT were proposed. A tendency of a general decrease in AA was observed, compared to previous survey. The large variation in CT dose indexes highlighted the need for optimisation.

目的：本研究的目的是调查和分析保加利亚现有PET/CT设备中FDG PET/CT肿瘤成像检查的剂量，提出国家drl并分析使用的CT方案及其对患者总暴露量的贡献。方法：收集设备、患者和检查参数的数据：给药活动和CT暴露数据。利用已公布的转换系数估计PET组分的有效剂量。使用美国国家癌症研究所剂量测定系统进行CT成分的有效剂量评估。给药活度和剂量指数的典型值是根据ICRP的建议确定的，使用每家医院提供的数据的中位数，并与以前的调查进行比较。结果：保加利亚100%的PET/CT科室提供了至少15名成年患者的可用设备数据和FDG PET/CT肿瘤成像剂量信息。建议的drl为：AA: 175 MBq， AA。kg-1: 2.3 MBq。kg-1, CTDIvol: 5.1 mGy, DLP: 523 mGy.cm。通过对CT协议的分析，确定了不同的趋势、异常值并提出了优化策略。结论：对PET和CT均提出了半体混合dfdg PET/CT的NDLRs。与以前的调查相比，观察到AA普遍下降的趋势。CT剂量指标的巨大变化突出了优化的必要性。

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引用次数: 0

Improvements of lateral penumbra at various depth regions in proton pencil beam scanning with a multileaf collimator: Dose verifications and plan comparisons 多叶准直器对质子铅笔束扫描不同深度区域侧半影的改进：剂量验证和方案比较。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105684

Yuki Tominaga , Yushi Wakisaka , Takahiro Kato , Keisuke Yasui , Ryohei Kato , Masaya Ichihara , Masashi Tomida , Motoharu Sasaki , Masataka Oita , Teiji Nishio

Purpose

In scanned proton therapy, the current consensus is that the effective range of the collimator’s contribution to lateral penumbra improvement is up to approximately 150 mm depth. We characterized the penumbra variations for scanned proton beams with or without a new type of multileaf collimator (MLC) under various air gaps, depth, and with or without range shifter (RS).

Methods

Eighty-six uniform dose plans were created (38 RS-negative and 48 RS-positive plans) for nine box targets of 60 × 60 × 54 mm³ at 0–280 mm depths in water. They were created with or without MLC, with 50–300 mm air gaps. The penumbra and average doses of MLC-positive and MLC-negative plans at the organs at risk (OAR) region of each box plan were compared. Besides, several plan doses were validated by measurements with penumbra (with an average of 80–20 % dose point widths for both side profiles) differences and 2D gamma analysis.

Results

The MLC-positive plans reduced the penumbra and mean OAR doses by 1.0–5.1 mm and 3.3–13.5 %, respectively, compared to MLC-negative plans even at >150 mm depths. The penumbra differences in measurements were <±1.5 mm for all plans. The mean gamma scores at 2 %/2 mm were 97.9 ± 2.3 % and 97.4 ± 3.1 % for the MLC-negative and MLC-positive plans, respectively.

Conclusions

The MLC-positive beams improved the penumbra and reduced the OAR dose in every depth region and air gap. We have shown that PBS with MLCs can be useful at more than 150 mm regions, depending on the machine.

目的：在扫描质子治疗中，目前的共识是准直器对外侧半影改善的有效范围可达约150 mm深度。研究了在不同的气隙、不同的深度、不同的距离移位器（RS）的情况下，带或不带新型多叶准直器（MLC）的扫描质子束的半影变化。方法：在0 ~ 280 mm深的水中，对9个盒靶60 × 60 × 54 mm3，建立86个均匀剂量计划（38个rs阴性计划和48个rs阳性计划）。它们有或没有MLC，有50-300 毫米的气隙。比较各箱体方案中mlc阳性和mlc阴性方案在危险器官（OAR）区域的半暗区和平均剂量。此外，通过测量半影（两侧剖面的平均剂量点宽度为80- 20% %）差异和二维伽马分析验证了几个计划剂量。结果：与mlc阴性计划相比，即使在 >150 mm深度，mlc阳性计划也分别减少了1.0-5.1 mm和3.3-13.5 %的半影和平均OAR剂量。结论：mlc阳性光束改善了半影，降低了各深度区和气隙的OAR剂量。我们已经证明，PBS与MLCs可以在超过150 mm的区域使用，具体取决于机器。

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引用次数: 0

Considerations on dose constraints in interventional cardiology – first approach to establishing dose constraints 介入性心脏病学中剂量限制的思考——建立剂量限制的第一步。

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-12-01 DOI: 10.1016/j.ejmp.2025.105685

Joanna Domienik-Andrzejewska , Mateusz Mirowski , Anja Almen , Eleftheria Carinou , Peter Covens , Anita Dowling , Dario Faj , Merce Ginjaume , Izabela Milcewicz-Mika , Una O’Connor , Lara Struelens

Various aspects related to establishing dose constraints (DCs) in interventional cardiology (IC) based on their features as defined in the recommendations of Publication 103 by the ICRP and the Basic Safety Standard Directive are presented. Preliminary DC values are proposed for the personal dose equivalent at 10 mm and 3 mm depth (H_p(10) and H_p(3) respectively).

The methodology was based on the analysis of dose distributions and third quartile doses. Two data sources were used a) doses from monitoring of occupational exposure in IC facilities and b) annual doses calculated based on EURALOC project survey responses from interventional cardiologists (ICs).

DCs are set to be constraints on the annual doses of ICs in a single workplace and values ranging from 0.4 to 2.0 mSv for H_p(10) and 6.0 to 10.0 mSv for H_p(3) were derived for this study. Higher DC values for Hp(3) are considered inappropriate, as they may risk exceeding the 20 mSv eye lens dose limit, particularly for physicians working across multiple sites.

Since the use of DCs is an optimization tool for the occupational exposure due to individual sources within a workplace, the final selection of the DC values is refined by assessing the use of radiation protection measures.

The proposed ranges of DCs facilitates optimization and better compliance with regulatory limits by ensuring that for all workplaces all sources of exposure are accounted for, leading to a more comprehensive radiation protection programme. The findings highlight the need for further research to refine the methodology of DC determination.

根据ICRP和基本安全标准指令第103号出版物中所定义的特点，介绍了与在介入心脏病学（IC）中建立剂量限制（dc）相关的各个方面。提出了10毫米和3毫米深度的个人剂量当量的初步直流值（分别为Hp（10）和Hp(3)）。该方法基于剂量分布和第三个四分位数剂量的分析。使用了两个数据来源：a)来自IC设施中职业性暴露监测的剂量；b)根据EURALOC介入性心脏病专家（IC）项目调查答复计算的年剂量。dc被设定为对单个工作场所的ic年剂量的限制，并为本研究推导出Hp（10）的0.4至2.0 mSv和Hp(3)的6.0至10.0 mSv的值。较高的Hp(3) DC值被认为是不合适的，因为它们可能有超过20毫西弗的眼镜片剂量限制的风险，特别是对于在多个地点工作的医生。由于直流电压的使用是工作场所内单个源的职业照射的优化工具，因此直流电压值的最终选择是通过评估辐射防护措施的使用情况来改进的。拟议的辐射防护范围有助于优化和更好地遵守管制限制，确保所有工作场所的所有照射源都得到考虑，从而制定更全面的辐射防护方案。研究结果强调需要进一步研究以完善DC测定方法。

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引用次数: 0

Bladder surface-based analysis proves the advantages of online adaptive radiotherapy over plan of the day 基于膀胱表面的分析证明了在线适应性放疗优于日常计划

IF 2.7 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Physica Medica-European Journal of Medical Physics

Pub Date : 2025-11-22 DOI: 10.1016/j.ejmp.2025.105677

Sonia Sapignoli , Andrea Bettinelli , Paolo Caricato , Antonio Giuseppe Amico , Samuele Cavinato , Paola Ceroni , Federica Guida , Nicola Pivato , Chiara Paronetto , Badr Elkhouzai , Matteo Sepulcri , Marco Krengli , Marta Paiusco

Background

Radiotherapy delivery for bladder cancer is challenging due to inter- and intra-fraction anatomical variations. The literature shows that surface-based methods, such as cumulative Dose-Surface Histograms (cDSHs), are more appropriate than dose-volume histograms for evaluating dose distribution in hollow organs.

Purpose

To compare two adaptive radiotherapy approaches – Plan of the Day (POD) and online-Adaptive Radiotherapy (oART) – by focusing on target coverage, dose conformity, and healthy tissue sparing through surface-based methods.

Methods

Five patients with urothelial bladder cancer were selected. POD and oART treatment (9-field-IMRT plans, 55 Gy/20 fractions) were simulated using the Ethos™ Emulator.

The cDSHs were compared using the D98% and D50% metrics, describing the dose covering 98% and 50% of the PTV/CTV surface, respectively. The Surface Distance Histogram (SDH) was introduced and analysed through Full Width at Half Maximum and mode value. The Healthy Tissue Overdose volume Factor (HTOF) at 95% and 50% isodoses was calculated. Statistical comparisons included the Friedman test and the Canberra dissimilarity index.

Results

oART achieved superior PTV coverage, with a mean D98% consistently above 98% of the prescribed dose, whereas for POD, the mean D98% dropped below 90% for two patients. oART SDHs showed narrower bell shape with respect to POD, indicating higher dose conformity. oART improved healthy tissue sparing, reducing HTOF_95% by over 50% compared to POD. Inter- and intra-patient variability were lower for oART.

Conclusions

Surface analysis strengthens the notion that oART is advantageous in bladder cancer treatment, ensuring superior target coverage, enhanced dose conformity, and better healthy tissue sparing. The SDH findings suggest potential for reducing CTV-PTV margins.

背景：膀胱癌的放射治疗是具有挑战性的，这是由于肿瘤内部和内部的解剖变异。文献表明，基于表面的方法，如累积剂量-表面直方图（cDSHs），比剂量-体积直方图更适合评估空心器官的剂量分布。目的比较两种自适应放疗方法——每日计划（POD）和在线自适应放疗（oART）——通过基于表面的方法，重点关注目标覆盖、剂量一致性和健康组织保留。方法选择5例尿路上皮性膀胱癌患者。使用Ethos™模拟器模拟POD和oART治疗（9区imrt计划，55 Gy/20分数）。使用D98%和D50%指标对cDSHs进行比较，分别描述了覆盖98%和50% PTV/CTV表面的剂量。引入了表面距离直方图（SDH），并通过半最大值全宽度和模态值对其进行了分析。计算95%和50%等剂量时的健康组织过量体积因子（HTOF）。统计比较包括弗里德曼检验和堪培拉差异指数。结果art获得了更高的PTV覆盖率，平均D98%始终高于处方剂量的98%，而POD的平均D98%在两例患者中降至90%以下。oART sds相对于POD呈较窄的钟形，表明剂量符合性较高。与POD相比，oART改善了健康组织保留，将HTOF95%降低了50%以上。oART患者间和患者内部的变异性较低。结论表面分析加强了oART在膀胱癌治疗中的优势，确保了更好的靶标覆盖，增强了剂量一致性，更好地保留了健康组织。SDH的研究结果表明有可能降低CTV-PTV的边际。

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