Physica Medica-European Journal of Medical Physics最新文献

{"title":"Optimization of microcalcification cluster detection in wide-angle flying focal spot digital breast tomosynthesis and synthetic mammography: A virtual imaging study","authors":"Katrien Houbrechts ,&nbsp;Astrid Van Camp ,&nbsp;Lesley Cockmartin ,&nbsp;Liesbeth Vancoillie ,&nbsp;Nicholas Marshall ,&nbsp;Hilde Bosmans","doi":"10.1016/j.ejmp.2025.105676","DOIUrl":"10.1016/j.ejmp.2025.105676","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the impact of angular range and dose distribution on microcalcification cluster detection in digital breast tomosynthesis (DBT) and synthetic mammography (SM) of a clinical wide-angle DBT system with flying focal spot (FFS), through virtual imaging techniques.</div></div><div><h3>Approach</h3><div>DBT projection sets were acquired from ten patients at twice the automatic exposure controlled (AEC) dose. Noise was added to each projection to create four projection sets: (1) 25 projections at AEC dose (“AEC”), (2) 25 projections with a convex dose distribution (“convex”), (3) 25 projections with increased dose in the central three projections (“peak 3”), and (4) 19 projections covering a 40° angular range instead of the standard 50° (“40 degrees”). Total scan dose and angular spacing were maintained constant across all setups. Microcalcification clusters were simulated within these projection sets, followed by a human observer detection study with DBT and SM patches. Performance was analysed using jackknife-alternative free-response receiver operating characteristic (JAFROC) analysis.</div></div><div><h3>Results</h3><div>For DBT, the area under the curve (AUC) was 0.89 ± 0.03 (AEC), 0.91 ± 0.03 (convex), 0.88 ± 0.03 (peak 3), and 0.91 ± 0.04 (40 degrees). For SM, AUC values were lower: 0.73 ± 0.04, 0.74 ± 0.02, 0.73 ± 0.04, and 0.74 ± 0.02, respectively. No significant improvements were observed compared to the AEC setup for either modality.</div></div><div><h3>Conclusions</h3><div>Increasing the dose to the central projections or reducing the angular range from 50° to 40° did not significantly affect calcification detection in DBT or SM compared to the standard AEC setup for an FFS system.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105676"},"PeriodicalIF":2.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of DICOM extraction and Structuration Toolkit (DEST) for automated extraction and structuration of radiotherapy data for large-scale analysis","authors":"Ibrahima Diallo ,&nbsp;Mamadou Hady Balde ,&nbsp;Duyen Do ,&nbsp;Véronique Letort ,&nbsp;Thomas Ménard ,&nbsp;Sarah Lemler ,&nbsp;Guillaume Auzac ,&nbsp;Anne Beaudré ,&nbsp;Eric Deutsch ,&nbsp;Nicolas Meillan ,&nbsp;Thomas Sarrade ,&nbsp;Anne-Laure Martin ,&nbsp;Catherine Gaudin ,&nbsp;Dominique Delmas ,&nbsp;Antonio Di Meglio ,&nbsp;Ines Vaz-Luis ,&nbsp;Charlotte Robert ,&nbsp;Florent de Vathaire ,&nbsp;Sofia Rivera ,&nbsp;Rodrigue S. Allodji","doi":"10.1016/j.ejmp.2025.105215","DOIUrl":"10.1016/j.ejmp.2025.105215","url":null,"abstract":"<div><h3>Purpose</h3><div>Converting radiotherapy (RT) data from DICOM-RT into datasets suitable for statistical modelling remains challenging. We developed the DICOM Extraction and Structuration Toolkit (DEST), an automated solution that streamlines data extraction and ensures compatibility with statistical software. The reliability of DEST was also assessed by comparing its outputs with those from treatment planning systems (TPS) in study of cardiopulmonary dose-volume histograms (DVH) after radiotherapy (RT) for localised breast cancer.</div></div><div><h3>Methods</h3><div>DEST comprises two main modules: a data extraction module and a viewer/analysis module. It processes DICOM-RT objects, including RT structure sets, RT plans, and RT dose files. Extractions are performed per treatment for predefined patient lists, after which structured data is consolidated. A 3D visualisation module verifies dose distributions for selected regions of interest, ensuring consistency and accuracy.</div></div><div><h3>Results</h3><div>DEST was successfully applied to 404 patients from the <em>“CANcer TOxicities – Radiation Therapy”</em> (CANTO-RT) cohort. In this initial implementation, DEST showed strong overall agreement with regard to TPS for heart and lung dose metrics, including mean doses and dose-volume measurements. Specifically, near-minimum dose, median dose, near-maximum dose and percentages of volume receiving at least 10 Gy (V<em>_10Gy</em>), 20 Gy (V<em>_20Gy</em>), 30 Gy (V<em>_30Gy</em>) and 40 Gy (V<em>_40Gy</em>) showed high consistency between DEST and TPS.</div></div><div><h3>Conclusions</h3><div>DEST enhances accessibility to dose-volume metrics and will facilitate advanced modelling of medical outcomes (efficiency and risk) at the voxel level. By providing streamlined access to voxel spatial coordinates and local dose information, DEST enables more sophisticated analyses, such as clustering and localized region selection, supporting deeper insights into dose–response relationships.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105215"},"PeriodicalIF":2.7,"publicationDate":"2025-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of domain shift sources and generalisability in AI-based prostate MRI autocontouring for radiotherapy","authors":"Maram Alqarni ,&nbsp;Emma-Louise Jones ,&nbsp;Vinod Mullassery ,&nbsp;Stephen Morris ,&nbsp;Jorge Mariscal Harana ,&nbsp;Esther Puyol Antón ,&nbsp;Sian Cooper ,&nbsp;Hema Verma ,&nbsp;Teresa Guerrero Urbano ,&nbsp;Andrew P. King","doi":"10.1016/j.ejmp.2025.105188","DOIUrl":"10.1016/j.ejmp.2025.105188","url":null,"abstract":"<div><h3>Aim</h3><div>Deep learning (DL) models have been widely proposed to automate MRI-based delineation, but their use is hindered by differences in image characteristics between training and evaluation datasets (i.e. domain shift). This paper aims to (i) analyse the impacts of different sources of domain shift and (ii) externally evaluate a model trained using heterogeneous public data and compare it with an in-house model.</div></div><div><h3>Methods</h3><div>The nnU-Net DL framework was trained for prostate autocontouring using axial T2-weighted (T2W) prostate MRIs from five public datasets. By controlling training set size, three sources of domain shift were evaluated: dataset, scanner vendor/field strength, and image acquisition/annotation protocol. 66 prostate MRIs were used for external evaluation and training/evaluation of an in-house model. The Dice Similarity Coefficient (DSC) and 95 % Hausdorff distance (HD) evaluated the model-produced contours.</div></div><div><h3>Results</h3><div>The performance gap (Δ) between intra/inter-domain evaluation showed that domain shift from scanner vendor/field strength (ΔDSC = 0.33, Δ95 % HD = 246.86 mm) and image acquisition/annotation protocols (ΔDSC = 0.20, Δ95 % HD = 14.70 mm) had greater impact than that from dataset (ΔDSC = 0.06, Δ95 % HD = 3.69 mm), although all were significant (p &lt; 0.05). External evaluation showed that the mixed-domain trained model performed well but was less robust than the in-house model (median (IQR) DSC/95 % HD = 0.87 (0.06)/3.75 (4.47)mm, 0.90 (0.03)/1.03 (1.29) mm, p &lt; 0.05, respectively).</div></div><div><h3>Conclusions</h3><div>We highlight for the first time the domain shift effect of image acquisition/annotation protocol, even with images acquired using the same scanner vendor/field strength. Understanding the effect of multiple sources of domain shift has enabled us to train a robust model that can be safely clinically deployed.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105188"},"PeriodicalIF":2.7,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward the use of Silicon Carbide based detector for protontherapy microdosimetry","authors":"G. Petringa ,&nbsp;C. Verona ,&nbsp;R. Catalano ,&nbsp;M. Guarrera ,&nbsp;A. Kurmanova ,&nbsp;L. Brighel ,&nbsp;A. Sciuto ,&nbsp;S. Tudisco ,&nbsp;G.A.P. Cirrone","doi":"10.1016/j.ejmp.2025.105675","DOIUrl":"10.1016/j.ejmp.2025.105675","url":null,"abstract":"<div><h3>Purpose:</h3><div>This study explores the potential of a Silicon Carbide (SiC)-based microdosimeter for use in proton therapy. Thanks to its high radiation hardness, minimal leakage current, and stable charge collection efficiency, SiC is proposed as an innovative solid-state material for measuring microdosimetric quantities and enhancing radiobiological modeling in hadrontherapy.</div></div><div><h3>Methods:</h3><div>A custom SiC p–n junction diode with a 10 <span><math><mi>μ</mi></math></span>m epitaxial layer was fabricated and electrically characterized. Microdosimetric spectra were acquired under proton beams at 30, 70, and 150 MeV at various depths in water. The SiC detector’s performance was compared with benchmark microdosimeters, including a silicon-based MicroPlus probe and a single-crystal diamond device. Monte Carlo simulations were used to determine the water-equivalent thickness and to validate the measured spectra. Key microdosimetric quantities, such as frequency-mean and dose-mean lineal energy, were extracted and used to estimate the relative biological effectiveness (RBE) via the Microdosimetric Kinetic Model (MKM).</div></div><div><h3>Results:</h3><div>The SiC detector demonstrated full charge collection efficiency and an energy resolution of approximately 2% under alpha irradiation. The measured spectra showed depth-dependent trends consistent with LET variations. The microdosimetric parameters derived from SiC data were in good agreement with both reference detectors and simulations. RBE values estimated from SiC measurements accurately reflected experimental data for U87 glioblastoma cells.</div></div><div><h3>Conclusion:</h3><div>SiC-based detectors prove to be promising tools for microdosimetry in proton therapy. The consistency with reference systems and simulations supports their use in RBE estimation and biologically optimized treatment planning. Future work will target further miniaturization and application to heavier ions.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105675"},"PeriodicalIF":2.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145497564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of practice of image guided particle therapy for brain tumours: A site specific multi-institutional survey of the European particle therapy network","authors":"Iuliana Toma-Dasu ,&nbsp;Alexandru Dasu ,&nbsp;Dante Amelio ,&nbsp;Lorenzo Placidi ,&nbsp;Juliette Thariat ,&nbsp;Markus Stock ,&nbsp;Petra Trnková ,&nbsp;Daniëlle Eekers ,&nbsp;Anneleen Goedgebeur ,&nbsp;Morten Høyer ,&nbsp;Aswin Hoffmann ,&nbsp;Alessandra Bolsi","doi":"10.1016/j.ejmp.2025.105211","DOIUrl":"10.1016/j.ejmp.2025.105211","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the current practice patterns in image-guided proton therapy (IGPT) for brain tumours.</div></div><div><h3>Methods</h3><div>A multi-institutional survey was distributed to European particle therapy centres to analyse the current practice of IGPT for neuro-oncology. The survey was subsequently used for driving a DELPHI consensus analysis aiming at defining the minimum requirements and the optimal workflow.</div></div><div><h3>Results</h3><div>Seven centres participated in the survey on proton therapy for brain tumours. All reported access to pencil beam scanning and rotating gantries; one also used passive scattering. Supine positioning with standard immobilisation tools was common, while prone and paediatric-specific methods were rare. Multimodal imaging with CT and MRI was standard; PET use was limited and SPECT absent. Rigid registration between imaging modalities was widely used, though MR imaging in treatment position was uncommon. Verification practices varied. Six centres joined the DELPHI consensus, reaching agreement on minimum requirements for immobilisation, imaging for treatment planning, image registration and pre-treatment setup. Disagreement remained on robustness criteria, imaging frequency, and dose tracking, highlighting the need for unified clinical guidelines and workflow optimisation.</div></div><div><h3>Conclusion</h3><div>There is generally agreement across European proton centres, but variability remained in key components of treatment planning, verification and workflow optimisation, including the frequency and modality of control imaging, plan robustness criteria, and treatment position imaging protocols. These differences reflect both local resource availability and the absence of harmonised guidelines. The minimal requirements for image guidance in brain proton therapy achieved good consensus level and will be very useful for new centres.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105211"},"PeriodicalIF":2.7,"publicationDate":"2025-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing the use of prospective risk assessment through training","authors":"Elizabeth Claridge Mackonis ,&nbsp;Anna Ralston ,&nbsp;Johnson Yuen ,&nbsp;Nicholas Hardcastle ,&nbsp;Annette Haworth","doi":"10.1016/j.ejmp.2025.105213","DOIUrl":"10.1016/j.ejmp.2025.105213","url":null,"abstract":"<div><h3>Purpose</h3><div>Whilst a formal prospective risk assessment is an important part of risk management in the implementation of new techniques and technologies, a lack of time and practical knowledge can prevent its use. Here we present an innovative training program aiming to increase the knowledge and practical skills of radiation oncology professionals in using prospective risk assessment.</div></div><div><h3>Methods</h3><div>The training program explained the need for prospective risk assessment and provided practical experience in the use of an easy-to-use prospective risk assessment and project management tool. Participants were surveyed before the training and 12-months post-training to determine current risk assessment processes and whether the training affected participants views and behaviours in this area.</div></div><div><h3>Results</h3><div>A time-efficient training program in prospective risk assessment was created and successful delivered to multi-disciplinary groups from 12 radiation therapy providers. In the 12-months post-training, the number of centres completing prospective risk assessments increased from 8% to 30%. The training removed many of the perceived barriers, with insufficient time remaining the largest barrier.</div></div><div><h3>Conclusions</h3><div>The training was found to be useful and applicable by all respondents. Future work needs to focus on how to expand the reach of the training program while maintaining its success, and how to ensure prospective risk assessments are seen as an essential part of implementation of new techniques and technologies in radiation therapy centres.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"140 ","pages":"Article 105213"},"PeriodicalIF":2.7,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145442562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Ultra-high dose rate dosimetry for pre-clinical experiments with mm-small proton fields” [Phys. Med. 104 (2022) 101–111]","authors":"M. Togno ,&nbsp;K.P. Nesteruk ,&nbsp;R. Schäfer ,&nbsp;S. Psoroulas ,&nbsp;D. Meer ,&nbsp;M. Grossmann ,&nbsp;J.B. Christensen ,&nbsp;E.G. Yukihara ,&nbsp;A.J. Lomax ,&nbsp;S. Safai","doi":"10.1016/j.ejmp.2025.105100","DOIUrl":"10.1016/j.ejmp.2025.105100","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"139 ","pages":"Article 105100"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the accuracy of SPECT/CT LSF estimations in SIRT therapies using Monte Carlo simulations with virtual 4D anthropomorphic phantoms","authors":"Niamh McArdle ,&nbsp;Jackie McCavana ,&nbsp;Darragh McCague ,&nbsp;Seán Cournane ,&nbsp;Luis León Vintró","doi":"10.1016/j.ejmp.2025.105196","DOIUrl":"10.1016/j.ejmp.2025.105196","url":null,"abstract":"<div><h3>Purpose</h3><div>Recent publications advocate the use of SPECT/CT for LSF estimation for more accurate lung dose estimations in Selective Internal Radiation Therapy (SIRT) treatments. These studies have been limited to patient studies where the ground truth is not known or to a small number of phantom studies of a single body size. This research aimed to investigate the accuracy of LSF estimation derived using a Monte Carlo SPECT/CT model incorporating 4D virtual phantoms of varying BMIs.</div></div><div><h3>Methods</h3><div>Six 4D virtual XCAT phantoms were used to model patients of varying BMIs. SPECT acquisitions were simulated and assessed using the SIMIND Monte Carlo modelling framework. LSF estimates derived from SPECT imaging were evaluated and subsequently compared to corrected planar LSF estimates.</div></div><div><h3>Results</h3><div>SPECT LSF estimates which incorporated scatter correction and with a CT based attenuation correction were shown to be the most accurate. Moreover, the SPECT LSF estimates were shown to be comparable with planar LSF estimation with incorporated scatter correction.</div></div><div><h3>Conclusion</h3><div>Given that the LSF estimate is a critical input in calculating the absorbed dose to the target volume in SIRT treatments, errors in its estimation can propagate through the dosimetric workflow. This work showed that both the SPECT/CT and the planar LSF estimation with scatter correction methods can significantly improve the LSF accuracy, over the current geometric mean method, and are easily implementable into the clinical workflow.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"139 ","pages":"Article 105196"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to “Evaluation of cumulative radiation burden and associated risk in smouldering multiple myeloma patients monitored using recurrent whole-body low-dose CT imaging”. [Phys. Med. 138 (2025) 105173]","authors":"Pascaline Wangechi Abissi ,&nbsp;Georgia Lymperopoulou ,&nbsp;Vasileios-Petros Agrokostas ,&nbsp;Vassilis Koutoulidis ,&nbsp;Panagiotis Grigoropoulos ,&nbsp;Maria Gavriatopoulou ,&nbsp;Evangelos Terpos ,&nbsp;Lia Angela Moulopoulos ,&nbsp;Martin Fiebich ,&nbsp;Ioannis Seimenis","doi":"10.1016/j.ejmp.2025.105212","DOIUrl":"10.1016/j.ejmp.2025.105212","url":null,"abstract":"","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"139 ","pages":"Article 105212"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Insights, robustness and practical considerations of global noise level measurement in chest CT","authors":"Kwinten Torfs ,&nbsp;Dimitar Petrov ,&nbsp;Louise D’hondt ,&nbsp;Tim Busselot ,&nbsp;Janne Vignero ,&nbsp;Walter De Wever ,&nbsp;Annemiek Snoeckx ,&nbsp;Klaus Bacher ,&nbsp;Hilde Bosmans","doi":"10.1016/j.ejmp.2025.105207","DOIUrl":"10.1016/j.ejmp.2025.105207","url":null,"abstract":"<div><h3>Background</h3><div>Accuracy of global noise level (GNL) has been benchmarked predominantly for soft tissue. This work extends the use of GNL to lung tissue and investigates the effect of patient, protocol and method parameters on the robustness of the algorithm.</div></div><div><h3>Procedures</h3><div>Optimal GNL algorithm parameters for lung tissue were established after comparing manual measurements in one hundred patient images. Automatic determination of patient-specific GNL was performed from all chest CT slices with outlier verifications and lung tissue area estimation. Accuracy of GNL mean and variation were assessed with increasing number of included slices to convert GNLs into a stack-overarching parameter. Finally, GNL in soft and lung tissue were compared in identical patient images.</div></div><div><h3>Main findings</h3><div>Optimal GNL parameters for lung tissue were: 4 mm x 4 mm sliding window, Hounsfield units below −590 HU, and 1 HU histogram bin width. In chest CT slices with a lung tissue area above 40 cm², 99.8 % of GNL calculations were clinically relevant. A 95 % accurate mean lung GNL required minimally 17 equidistant slices. Finally, lung GNL in thicker slices was higher than soft tissue GNL, but the reverse was observed in thin slices.</div></div><div><h3>Conclusion</h3><div>This study provides insight into important practical considerations on the calculation and subsequent use of GNL for monitoring and image quality evaluation.</div></div>","PeriodicalId":56092,"journal":{"name":"Physica Medica-European Journal of Medical Physics","volume":"139 ","pages":"Article 105207"},"PeriodicalIF":2.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}