{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:23:21Z","timestamp":1789010601260,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T00:00:00Z","timestamp":1708214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To elucidate the dosimetric errors caused by a model\u2010based algorithm in lung stereotactic body radiation therapy (SBRT) with Helical TomoTherapy (HT) using Monte Carlo (MC)\u2010based dose verification software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For 38 plans of lung SBRT, the dose calculation accuracy of a treatment planning system (TPS) of HT was compared with the results of DoseCHECK, the commercial MC\u2010based independent verification software. The following indices were extracted to evaluate the correlation of dosimetric errors: (1) target volume, (2) average computed tomography (CT) value of the planning target volume (PTV) margin, and (3) average CT value of surrounding 2\u2010mm area of the PTV (PTV ring). Receiver operating characteristic (ROC) analyses determined the threshold for 5% of differences in PTV D<jats:sub>95%<\/jats:sub>. Then, the 38 plans were classified into two groups using the cutoff values of ROC analysis for these three indices. Dosimetric differences between groups were statistically compared using the Mann\u2013Whitney <jats:italic>U<\/jats:italic> test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>TPS of HT overestimated by more than 5% in the PTV D<jats:sub>95%<\/jats:sub> in 16 of 38 plans. The PTV ring showed the strongest correlation with dosimetric differences. The cutoff value for the target volume, the PTV margin, and the PTV ring was 14.7 cc, \u2212754 HU, and \u2212708 HU, respectively. The area under the curve (AUC) for the target volume, the PTV margin, and the PTV ring were 0.835, 0.878, and 0.932, respectively. Dosimetric errors more than 5% were observed when the PTV volume was less than 15 cc or when the CT value around the target was less than \u2212700 HU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The TPS of HT might overestimate the PTV dose by more than 5% if any the three indices in this study were below threshold. Therefore, independent verification with an MC\u2010based algorithm should be strongly recommended for lung SBRT in HT.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14305","type":"journal-article","created":{"date-parts":[[2024,2,18]],"date-time":"2024-02-18T17:29:31Z","timestamp":1708277371000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Dosimetric evaluation in Helical TomoTherapy for lung SBRT using Monte Carlo\u2010based independent dose verification software"],"prefix":"10.1002","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-7918","authenticated-orcid":false,"given":"Takahiro","family":"Kosaka","sequence":"first","affiliation":[{"name":"Juntendo University Graduate School of Medicine  Bunkyo\u2010ku Tokyo Japan"},{"name":"Department of Radiology Juntendo University Urayasu Hospital  Urayasu\u2010shi Chiba 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