{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T07:48:08Z","timestamp":1791964088319,"version":"4.3.4"},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100015803","name":"BC Cancer Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100015803","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005247","name":"University of British Columbia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005247","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>MR\u2010US guided biopsies support biologic correlation in HDR prostate brachytherapy, but steep dose gradients and millimeter\u2010scale localization uncertainty limit the validity of nominal biopsy\u00a0doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess how localization uncertainty affects the robustness of biopsy DVH dose thresholds in HDR prostate brachytherapy and to quantify the nominal dose margins corresponding to 95% pass\u00a0probabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010seven biopsies from 15 HDR monotherapy patients were reconstructed as sets of  voxels and sampled on the clinical HDR dose lattice. Localization uncertainty was modeled with 10 000 Monte Carlo trials per biopsy using isotropic 3D Gaussian translations () plus an axial tissue\u2010deficit offset. For each voxel we computed nominal and Monte Carlo summaries of dose and dose gradient magnitude; for each biopsy we evaluated DVH metrics , , , and . For four robustness thresholds, Monte Carlo pass probabilities  were related to nominal distance\u2010from\u2010threshold using logistic models, and geometric, spatial, and radiomics predictors were tested as secondary\u00a0covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled voxel\u2010dose and dose\u2010gradient distributions were broad, positively skewed, and consistent with log\u2010normal models. Nominal voxel\u2010level doses tended to be higher than localization\u2010perturbed samples, with mean absolute per\u2010trial . Margin\u2010only logistic models captured most of the variability in pass probabilities; the nominal margins required for a 95% pass probability were  (),  (),  (), and 49 percentage points (). Adding geometric, spatial, or radiomics predictors altered these margins only modestly. Along biopsy cores, mean absolute dose differences between voxel pairs approached  at separations of \u2013, indicating decorrelation on that\u00a0scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Localization uncertainty causes nominal biopsy DVH metrics to systematically overestimate Monte Carlo\u2010propagated doses. The reported 95% margins should be interpreted as biopsy\u2010scale robustness buffers under the stated uncertainty model, not as clinically prescriptive focal\u2010boost increments. Dose decorrelated over distances of order \u2013 along biopsy cores, supporting spatially explicit, Monte Carlo\u2010based reporting when interpreting biopsy dosimetry in HDR prostate\u00a0brachytherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70660","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T06:50:58Z","timestamp":1784530258000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Probabilistic quality assurance of biopsy DVH thresholds in HDR prostate brachytherapy under localization uncertainty"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-8285-6512","authenticated-orcid":false,"given":"Matthew","family":"Muscat","sequence":"first","affiliation":[{"name":"Department of Computer Science, Mathematics, Physics and Statistics University of British Columbia Okanagan Kelowna British Columbia Canada"},{"name":"BC 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