Search Results (228)

Background/Objectives: This study aims to present a structured clinical workflow for offline adaptive Biology-guided Radiotherapy (BgRT) using the RefleXion X1 PET-linac system, addressing challenges introduced by inter-treatment anatomical and biological changes. Methods: We propose a decision tree offline adaptation framework based on real-time assessments of Activity Concentration (AC), Normalized Target Signal (NTS), and bounded dose-volume histogram (bDVH%) metrics. Three offline strategies were developed: (1) preemptive adaptation for minor changes, (2) partial re-simulation for moderate changes, and (3) full re-simulation for major anatomical or metabolic alterations. Two clinical cases demonstrating strategies 1 and 2 are presented. Results: The preemptive adaptation strategy was applied in a case with early tumor shrinkage, maintaining delivery parameters within acceptable limits while updating contours and dose distribution. In the partial re-Simulation case, significant changes in PET signal necessitated a same-day PET functional modeling session and plan re-optimization, effectively restoring safe deliverability. Both cases showed reduced target volumes and improved OAR sparing without additional patient visits or tracer injections. Conclusions: Offline adaptive workflows for BgRT provide practical solutions to address inter-fractional changes in tumor structure and function. These strategies can help maintain the safety and accuracy of BgRT delivery and support clinical adoption of PET-guided radiotherapy, paving the way for future online adaptive capabilities. Full article

To evaluate the characteristics of Smith–Purcell radiation, we modified a surface current model to consider the geometrical shading effect of a grating, which was ignored in the original one, and compared it with measurements for a grating with a shallow blaze angle. According to the numerical calculations based on the surface current model with and without the shading effect, it was found that the azimuthal angular distribution, polarization components and the variation in radiation intensity with the blaze angle of the grating are predicted to show significantly different behaviors under our experimental conditions. Generating the coherent Smith–Purcell radiation using the very short electron bunch in the test accelerator, t-ACTS at the Research Center for Accelerator and Radioisotope Science, Tohoku University, we measured polarization and the angular distribution of radiation for the gratings with different blaze angles. This study supports the validity of the modified surface current model with the shading effect and will provide new insights into the evaluation of the characteristics of Smith–Purcell radiation. Full article

NAC (NAM, ATAF1/2, CUC1/2) is a plant-specific transcription factor (TF) family that plays important roles in various physiological and biochemical processes of plants. However, the NAC gene family in Lagerstroemia indica and its role in anthocyanin metabolism are still unexplored. In our study, a total of 167 NACs were identified in the L. indica genome via genome-wide analysis and bioinformatics techniques. Amino acid sequence analysis showed that all 167 NAC proteins contained a conserved NAM domain. This domain primarily comprised random coils, extended strands, and alpha helices. Most NACs were found on the nucleus and dispersed over 23 of the 24 plant chromosomes. Based on phylogenetic analysis, the NACs can be categorized into ten subgroups. Furthermore, the promoter homeotropic elements predicted the cis-acting elements in the promoters of these genes related to hormones, development, environmental stress response, and other related responses, demonstrating the diverse regulatory mechanisms underlying gene functions. In addition, a co-expression network was established through RNA sequencing. This network helped identify seven key LiNACs, genes related to anthocyanin expression (CHS) and transcription factors (MYB and bHLH). To identify potential anthocyanin regulatory factors present in L. indica petals, protein interaction prediction was performed, which revealed that LiNACs might participate in anthocyanin regulation by interacting with other proteins, such as MYB, ABF, ABI, bZIP, MYC, etc. Our results provided novel insights and could help in the functional identification of LiNACs in L. indica and the regulation of anthocyanin synthesis. Full article

High-current electron beams can significantly enhance the productivity of variety of applications including medical radioisotope (RI) production and wastewater purification. High-power superconducting radio frequency (SRF) linacs are capable of producing such high-current electron beams due to the key advantage to operate in continuous wave (CW) mode. However, this requires an injector capable of generating electron bunches with high repetition rate and in CW mode, while minimizing beam losses to avoid damage to SRF cavities due to quenching. RF gating to the grid of a thermionic electron gun is a promising solution, as it ensures CW bunch generation at the repetition rate same as the fundamental or sub-harmonics of the accelerating RF frequency, with minimal beam loss. This paper presents detailed beam dynamics simulations demonstrating that an RF-gated gun operating at 1.3 GHz can generate bunches with 148 ps full width with 8.96 pC charge. Full article

This study presents the design and development of electromagnetic dipole magnets for use as beam dumps and spectrometers in the MIR and THz free-electron laser (FEL) beamlines at the PBP-CMU Electron Linac Laboratory (PCELL). The magnets were optimized to achieve a 60-degree bending angle for electron beams with energies up to 30 MeV, without requiring water cooling. Using CST EM Studio for 3D magnetic field simulations and ASTRA for particle tracking, the THz dipole (with 414 turns) and MIR dipole (with 600 turns) generated magnetic fields of 0.1739 T and 0.2588 T, respectively, while both operating at currents below 10 A. Performance analysis confirmed effective beam deflection, with the THz dipole showing that it was capable of handling beam energies up to 20 MeV and the MIR dipole could handle up to 30 MeV. The energy measurement at the spectrometer screen position was simulated, taking into account transverse beam size, fringe fields, and space charge effects, using ASTRA. The energy resolution, defined as the ratio of energy uncertainty to the mean energy, was evaluated for selected cases. For beam energies of 16 MeV and 25 MeV, resolutions of 0.2% and 0.5% were achieved with transverse beam sizes of 1 mm and 4 mm, respectively. All evaluated cases maintained energy resolutions below 1%, confirming the spectrometer’s suitability for high-precision beam diagnostics. Furthermore, the relationship between the initial and measured energy spread errors, taking into account a camera resolution of 0.1 mm/pixel, was evaluated. Simulations across various beam energies (10–16 MeV for the THz dipole and 20–25 MeV for the MIR dipole) confirmed that the measurement error in energy spread decreases with smaller RMS transverse beam sizes. This trend was consistent across all tested energies and magnet configurations. To ensure accurate energy spread measurements, a small initial beam size is recommended. Specifically, for beams with a narrow initial energy spread, a transverse beam size below 1 mm is essential. Full article

The generation of high-quality mid-infrared free-electron laser (MIR-FEL) radiation depends critically on precise control of electron beam parameters, including energy, energy spread, transverse emittance, bunch charge, and bunch length. At the PBP-CMU Electron Linac Laboratory (PCELL), effective beam diagnostics are essential for optimizing FEL performance. However, dedicated systems for direct measurement of transverse emittance and bunch length at the undulator entrance have been lacking. This paper addresses this gap by presenting the design, simulation, and analysis of diagnostic stations for accurate characterization of these parameters. A two-quadrupole emittance measurement system was developed, enabling independent control of beam-focusing in both transverse planes. An analytical model was formulated specifically for this configuration to enhance emittance reconstruction accuracy. Systematic error analysis was conducted using ASTRA beam dynamics simulations, incorporating 3D field maps from CST Studio Suite and fully including space-charge effects. Results show that transverse emittance values as low as 0.15 mm·mrad can be measured with less than 20% error when the initial RMS beam size is under 2 mm. Additionally, quadrupole misalignment effects were quantified, showing that alignment within ±0.95 mm limits systematic errors to below 33.3%. For bunch length measurements, a transition radiation (TR) station coupled with a Michelson interferometer was designed. Spectral and interferometric simulations reveal that transverse beam size and beam splitter properties significantly affect measurement accuracy. A 6% error due to transverse size was identified, while Kapton beam splitters introduced additional systematic distortions. In contrast, a 6 mm-thick silicon beam splitter enabled accurate, correction-free measurements. The finite size of the radiator was also found to suppress low-frequency components, resulting in up to 10.6% underestimation of bunch length. This work provides a practical and comprehensive diagnostic framework that accounts for multiple error sources in both transverse emittance and bunch length measurements. These findings contribute valuable insight for the beam diagnostics community and support improved control of beam quality in MIR FEL systems. Full article

Background/Objectives: Non-ablative stereotactic body radiation therapy (SBRT) is commonly employed for locally advanced pancreatic cancer (LAPC) using computed tomography-guided radiotherapy (CTgRT) without online adaptive radiation therapy (oART). The safe delivery of ablative SBRT has been demonstrated using stereotactic magnetic resonance-guided online adaptive radiation therapy (SMART). We performed an in silico comparison of non-adapted CTgRT versus SMART to better understand the potential benefit of oART for ablative pancreatic SBRT. Methods: We retrospectively evaluated original and daily adapted SMART plans that were previously delivered for 20 consecutive LAPC cases (120 total plans across all patients) treated on a 0.35 T MR-linac prescribed to 50 Gy (gross disease) and 33 Gy (elective sites) simultaneously in five fractions. Six comparative CTgRT plans for each patient (one original, five daily treatment) were retrospectively generated with the same prescribed dose and planning parameters as the SMART plans assuming no oART availability. The impact of daily anatomic changes on CTgRT and SMART plans without oART was evaluated across each treatment day MRI scan acquired for SMART. Results: Ninety percent of cases involved the pancreatic head. No statistically significant differences were seen between CTgRT and SMART with respect to target coverage. Nearly all (96%) fractions planned on either CT or MRI platforms exceeded at least one GI organ at risk (OAR) constraint without oART. Significant differences favoring SMART over non-adaptive CTgRT were observed for the duodenum V35 Gy ≤ 0.5 cc (34.2 vs. 41.9 Gy, p = 0.0035) and duodenum V40 Gy ≤ 0.03 cc (37 vs. 52.5 Gy, p = 0.0006) constraints. Stomach V40 Gy trended towards significance favoring SMART (37 vs. 40.3 Gy, p = 0.057) while no significant differences were seen. Conclusions: This is the first study that quantifies the frequency and extent of GI OAR constraint violations that would occur during ablative five-fraction SBRT using SMART vs. CTgRT. GI OAR constraint violations are expected for most fractions without oART whereas all constraints can be achieved with oART. As such, these data suggest that oART should be required for ablative five-fraction pancreatic SBRT. Full article

Purpose/Objective: The clinical implementation of MR-guided radiotherapy on MR-linacs (MRL) hasrapidly increased in recent years. The advantages represented by the MR-based daily online plan adaptation and real-time monitoring have been exploited for different tumor sites. Nevertheless, some concerns remain, mainly related to the longer treatment time and limited patient eligibility. We report here the experience of our center, where a 1.5T MRL was clinically implemented in 2019 and, since then, more than 1200 patients have been treated. Material and Methods: The first 1000 patients treated at the MRL in our department were selected. Technical information such as treatment time and adaptive technic have been prospectively recorded, while toxicity data were retrospectively collected. Results: Between October 2019 and June 2024, 1000 patients for a total of 1061 treatment courses were included. Prostate and prostate bed were irradiated in 57.1% and 10.2% of the cases, respectively, including regional pelvic lymphnodes in 4.7%. Other frequent treated sites were lymph node metastases, pancreas and liver. The most frequent prescribed doses were 36.25 Gy (31%), 35 Gy (28.3%) and 30 Gy (9.4%) in five fractions. On a total of 9076 administered fractions, 80.8% were performed with adapt-to-shape and 19.2% with adapt-to-position method. The mean in-room time was 38 min (range, 18–103), with 74.4% of patients completing the session within 40 min. Acute grade (G) 3 toxicity was recorded in 1.6% of the cases, while, on a total of 858 patients available for late toxicity, G3 was recorded in 0.3% of the cases, with no >G3. Conclusions: Our real-world experience of an early-adopter center confirms that MRL treatments are feasible for different tumor entities in several anatomical sites. We showed that most of the patients could be treated within 40 min and showed low toxicity rates. Protocols for dose escalation and margin reduction, by adopting new comprehensive motion monitoring strategies, are under development. Full article

This study investigates the magnetic fields produced by a three-solenoid system configuration using both traditional numerical solvers and fractional integral methods. We focus on the role of mesh resolution in influencing simulation accuracy, examining coils with dimensions 80 mm × 160 mm and a radius of 15.5 mm, each carrying a current of 200 A. Magnetic field behavior is analyzed along a line parallel to the central axis at a distance equal to half the solenoid’s radius. The fractional integral formulation employed provides a refined understanding of field variations, especially in off-axis regions. Comparisons with the Poisson solver highlight consistency across methods and suggest pathways for further optimization. The results support the potential of fractional approaches in advancing electromagnetic field modeling, particularly in accelerator and beamline applications. Full article

Standard of Care (SOC) for locally advanced cervical cancer is represented by external beam radiation therapy concurrent with platinum-based chemotherapy and immunotherapy (cCIRT) followed by brachytherapy boost and immunotherapy maintenance. In some instances, it is impossible to perform brachytherapy due to patient and/or cancer issues. In these circumstances, an external beam boost could be delivered. Using a robotic arm LINAC, it is mandatory to use intramucosal implanted fiducials which are needed for tumour tracking. To avoid invasive procedures, we developed an original intravaginal 3D-printed universal device containing gold fiducials embedded within it. In this paper, we describe the step-by-step procedure that allowed us to obtain the utility model patent, including the in vivo test (feasibility, reproducibility, device compliance) on seven patients within the study protocol “STereotActic Radiotherapy Boost in locally Advanced Cervical carcinoma patientS” (STARBACS). Full article

Radiotherapy (RT) has undergone transformative advancements since its inception over a century ago. This review highlights the most promising and impactful innovations shaping the current and future landscape of RT. Key technological advances include adaptive radiotherapy (ART), which tailors treatment to daily anatomical changes using integrated imaging and artificial intelligence (AI), and advanced image guidance systems, such as MR-LINACs, PET-LINACs, and surface-guided radiotherapy (SGRT), which enhance targeting precision and minimize collateral damage. AI and data science further support RT through automation, improved segmentation, dose prediction, and treatment planning. Emerging biological and targeted therapies, including boron neutron capture therapy (BNCT), radioimmunotherapy, and theranostics, represent the convergence of molecular targeting and radiotherapy, offering personalized treatment strategies. Particle therapies, notably proton and heavy ion RT, exploit the Bragg peak for precise tumor targeting while reducing normal tissue exposure. FLASH RT, delivering ultra-high dose rates, demonstrates promise in sparing normal tissue while maintaining tumor control, though clinical validation is ongoing. Spatially fractionated RT (SFRT), stereotactic techniques and brachytherapy are evolving to treat challenging tumor types with enhanced conformality and efficacy. Innovations such as 3D printing, Auger therapy, and hyperthermia are also contributing to individualized and site-specific solutions. Across these modalities, the integration of imaging, AI, and novel physics and biology-driven approaches is redefining the possibilities of cancer treatment. This review underscores the multidisciplinary and translational nature of modern RT, where physics, engineering, biology, and informatics intersect to improve patient outcomes. While many approaches are in various stages of clinical adoption and investigation, their collective impact promises to redefine the therapeutic boundaries of radiation oncology in the coming decade. Full article

Background/Objectives: Radiotherapy for tumors of the central nervous system (CNS) could be improved by incorporating advanced imaging techniques into treatment planning and response assessment. The objective of this narrative review is to highlight the recent developments in magnetic resonance imaging (MRI) and positron emission tomography (PET) for applications in CNS radiotherapy. Methods: Recent articles were selected for discussion, covering the following topics: advanced imaging on MRI-linear accelerators for early response assessment in glioma; PET for guiding treatment planning and response assessment in glioma; and contrast-enhanced imaging and metabolic imaging for differentiating tumor progression and radiation necrosis for brain metastasis treatment. Where necessary, searches of scholarly databases (e.g., Google Scholar, PubMed) were used to find papers for each topic. The topics were chosen based on the perception of promise in advancing specific applications of CNS radiotherapy and not covered in detail elsewhere. This review is not intended to be comprehensive. Results: Advanced MRI sequences and PET could have a substantial impact on CNS radiotherapy. For gliomas, the tumor response to therapy could be assessed much earlier than using the conventional technique of measuring changes in tumor size. Using advanced imaging on combined imaging/therapy devices like MR-Linacs would enable response monitoring throughout radiotherapy. For brain metastases, radiation necrosis and tumor progression might be reliably differentiated with imaging techniques sensitive to perfusion or metabolism. However, the lack of level 1 evidence supporting specific uses for each imaging technique is an impediment to widespread use. Conclusions: Advanced MRI and PET have great promise to change the standard of care for CNS radiotherapy, but clinical trials validating specific applications are needed. Full article

Purpose: Image-guided radiotherapy (IGRT) has been widely implemented in the treatment of prostate cancer, offering a number of advantages regarding the precision of dose delivery. This study provides an overview of factors, clinical and physical alike, that increase treatment accuracy in prostate cancer radiotherapy in the context of IGRT. The following aspects are explored based on recent literature: the radiotherapy technique used in conjunction with IGRT, the type and frequency of IGRT, the impact of radiotherapy technique/IGRT on target dosimetry and organs at risk, the influence of IGRT on planning target volume margins, the impact of treatment time on dosimetric outcome and clinical outcomes using IGRT repositioning or an online adaptive plan. Methods: A systematic search of the literature was conducted within Pubmed/Medline databases to find relevant studies. Of the 152 articles fulfilling the initial search criteria, 79 were selected for final analysis. Results: The frequency of image guidance, the treatment regimen and the radiation technique are important factors that contribute to the optimization and personalization of the treatment plan. The daily anatomy and volume of the bladder and rectum can vary considerably, which can significantly impact the dosimetric effects on these organs. When used in conjunction with volumetric modulated arc therapy, IGRT allows for shaping the dose distribution to avoid nearby critical structures such as the bladder and rectum. Conclusions: Precise tumor targeting via IGRT can result in fewer geometric uncertainties, thereby improving treatment outcome both in terms of superior target coverage and sparing organs at risk. Full article

Real-time tumor-tracked radiotherapy with a linear accelerator-magnetic resonance (linac-MR) hybrid system requires accurate tumor delineation at a fast MR imaging rate. Various autocontouring methods have been previously evaluated against “gold standard” manual contours by experts. However, manually drawn contours have inherent intra- and inter-observer variations. We aim to quantify these variations and evaluate our tumor-autocontouring algorithm against the manual contours. Ten liver, ten prostate, and ten lung cancer patients were scanned using a 3 tesla (T) magnetic resonance imaging (MRI) scanner with a 2D balanced steady-state free precession (bSSFP) sequence at 4 frames/s. Three experts manually contoured the tumor in two sessions. For autocontouring, an in-house built U-Net-based autocontouring algorithm was used, whose hyperparameters were optimized for each patient, expert, and session (PES). For evaluation, (A) Automatic vs. Manual and (B) Manual vs. Manual contour comparisons were performed. For (A) and (B), three types of comparisons were performed: (a) same expert same session, (b) same expert different session, and (c) different experts, using Dice coefficient (DC), centroid displacement (CD), and the Hausdorff distance (HD). For (A), the algorithm was trained using one expert’s contours and its autocontours were compared to contours from (a)–(c). For Automatic vs. Manual evaluations (Aa–Ac), DC = 0.91, 0.86, 0.78, CD = 1.3, 1.8, 2.7 mm, and HD = 3.1, 4.6, 7.0 mm averaged over 30 patients were achieved, respectively. For Manual vs. Manual evaluations (Ba–Bc), DC = 1.00, 0.85, 0.77, CD = 0.0, 2.1, 2.8 mm, and HD = 0.0, 4.9, 7.2 mm were achieved, respectively. We have quantified the intra- and inter-observer variations in manual contouring of liver, prostate, and lung patients. Our PES-specific optimized algorithm generated autocontours with agreement levels comparable to these manual variations, but with high efficiency (54 ms/autocontour vs. 9 s/manual contour). Full article

Monte Carlo simulation relies on pseudo-random number generators. In general, the quality of these generators can have a direct impact on simulation results. The GATE toolbox, widely adopted in radiotherapy, offers three generators from which users can choose: Mersenne Twister, Ranlux-64, and James-Random. In this study, we used these generators to simulate the head of a medical linear accelerator for 6 MV photons in order to assess their potential impact on the results obtained in radiotherapy simulation. Simulations were conducted for four different field openings. The simulations included a linac head model and a water phantom, all components of the head of the medical linear accelerator, and a water phantom placed at a distance of 100 cm from the electron source. Statistical analysis based on normal probability and Bland–Altman plots were used to compare dose distributions in the voxelized water phantom obtained by each generator. Experimental data (dose profiles, percentage dose at depth, and other dosimetric parameters) were measured using an appropriate quality assurance protocol for comparison with the different simulations. The evaluation of dosimetric criteria shows significant variations, particularly in the physical penumbra of the dose profile for large fields. The gamma index analysis highlights significant distinctions in generator performance. In all simulations, the average time of the primary particle generation rate, number of tracks, and steps in the simulation of different random number generators showed differences. The Mersenne Twister generator was distinguished by high performance in several aspects, particularly in terms of execution time, primary particle production, track and step production flow rate, and coming closer to the experimental results. Regarding computational time, the simulation using the Mersenne Twister generator was about 18% faster than the one using the James-Random generator and 27% faster than the simulation using the Ranlux-64 generator. This suggests that this generator is the most reliable for accurate and fast modeling of the medical linear accelerator head for 6 MV energy. Full article