{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T13:39:47Z","timestamp":1775914787067,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T00:00:00Z","timestamp":1766016000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fractionated stereotactic radiosurgery (fSRS) using LINAC\u2010based volumetric\u2010modulated arc therapy (VMAT) has become widely adopted and achieved favorable outcomes. However, this technique involves extremely small field sizes, making pre\u2010treatment quality assurance (QA) with high\u2010resolution detectors essential.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to evaluate the error detection sensitivity and utility of EPID using 3D in vivo dosimetry based on dose\u2010volume histogram (DVH) analysis for brain fSRS pre\u2010treatment QA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>VMAT plans were generated for spherical planning target volumes (PTVs) with diameters of 1\u20133\u00a0cm centered in SRS MapCHECK. A monitor unit (MU) output error was introduced in increments, and the leaf gap width was systematically opened and closed. Finally, multi\u2010leaf collimator (MLC) shift errors were applied. The error detection sensitivity was evaluated with these intentional errors. We compared this with the SRS MapCHECK 2D gamma analysis conventionally used in pre\u2010treatment QA. For in vivo dosimetry, 3D dose calculations were performed with PerFRACTION using cine\u2010mode electronic portal imaging device images and log files. DVH parameters such as D98%, D95%, D2%, and average doses of the PTV were compared between the base plan and the error plans. The 2D gamma analysis was performed using global gamma of 3%\/2\u00a0mm, 3%\/1\u00a0mm, 2%\/2\u00a0mm, 2%\/1\u00a0mm, and 1%\/1\u00a0mm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The 2D gamma analysis revealed no MU output errors for the 1\u00a0cm target across all criteria. The 2%\/1\u00a0mm criterion effectively detected errors in leaf gap width and MLC shifts in some cases. Conversely, all error types were detected by 3D in vivo dosimetry using D95% of the target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In pre\u2010treatment QA for brain fSRS, 3D in vivo dosimetry based on DVH analysis demonstrated superior error detection sensitivity compared to conventional 2D gamma analysis. Our results suggest that 3D in vivo dosimetry is a useful tool for pre\u2010treatment QA in brain fSRS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70417","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T07:14:37Z","timestamp":1766128477000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient\u2010specific quality assurance for extremely small field sizes using 3D in vivo dosimetry in fractionated stereotactic radiosurgery for brain metastases"],"prefix":"10.1002","volume":"27","author":[{"given":"Kenichi","family":"Jumonji","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Juntendo University Graduate School of Medicine  Bunkyo\u2010ku Tokyo Japan"},{"name":"Department of Radiology Tokyo Rosai Hospital  Ohta\u2010ku Tokyo 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