{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T18:29:07Z","timestamp":1787682547204,"version":"build-2784847793"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"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":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Accurate and consistent delineation of target and normal structures is essential for safe and effective radiotherapy. Compared with manual or atlas\u2010based methods, deep learning\u2010based auto\u2010contouring has demonstrated improved efficiency and reduced interobserver variability. However, its performance can vary across anatomical regions and clinical contexts, and comprehensive multi\u2010site validation remains limited. Existing studies have tended to assess only geometric similarity or a single region, providing insufficient insight into real\u2010world usability and dosimetric influence. A systematic evaluation that integrates physician\u2010based quality assessment, quantitative geometric metrics, and plan\u2010level dosimetry across diverse anatomical sites is needed to support broader clinical implementation of deep learning\u2010based auto\u2010contouring for differentiation between target and normal structures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To perform the first practice\u2010oriented, cross\u2010anatomical evaluation of the SYNAPSE Radiotherapy system (v1.5) and to assess its qualitative usability, geometric agreement (Dice similarity coefficient [DSC], mean distance to agreement [MDA], and maximum Hausdorff distance [HD]), and plan\u2010level dosimetric impact across six anatomical sites.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed data for 120 patients across six sites, namely, the head, head and neck, thorax, abdomen, male pelvis, and female pelvis. Thirty organs at risk were auto\u2010segmented using the SYNAPSE Radiotherapy platform, and three board\u2010certified radiation oncologists graded the clinical usability of the platform on a 4\u2010point scale. Geometric agreement was quantified using the DSC, MDA, and maximum HD. Plan\u2010level dosimetric comparisons were performed for representative targets. Institutional review board approval was obtained (number 2017\u2010440).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 76.1% of auto\u2010contours were qualitatively judged to be clinically usable (score \u22653). Geometric thresholds were achieved for most structures (DSC\u00a0&gt;\u00a00.8 in 54.8%, MDA\u00a0&lt;\u00a02.5\u00a0mm in 71.5%, and maximum HD\u00a0&lt;\u00a012.5\u00a0mm in 50%), with only 8\/29 being major outliers. Auto\u2010contours tended to be larger than manual contours in 72% of cases. Dosimetrically, 88.1% of organs showed dose\u2010volume differences within \u00b15%, and dose constraint achievement rates were comparable between auto\u2010contours and manual contours (93.9% vs. 95.%). Median doses to planning target volumes (e.g., prostate and iliac nodes) were also consistent, indicating minimal clinical impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SYNAPSE Radiotherapy system showed high overall clinical usability with organ\u2010dependent variability. Our findings expand the platform\u2010specific evidence for the SYNAPSE Radiotherapy system by linking geometry to dosimetric impact and supporting clinical deployment with an organ\u2010specific quality assurance policy, while highlighting contexts in which targeted expert review remains necessary for safe clinical translation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70662","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:11:18Z","timestamp":1781586678000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cross\u2010anatomical evaluation of a deep\u2010learning auto\u2010contouring system: qualitative, geometric, and dosimetric validation"],"prefix":"10.1002","volume":"27","author":[{"given":"Sara","family":"Endo","sequence":"first","affiliation":[{"name":"Radiation Safety and Quality Assurance Division National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaki","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Fujisawa","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidehiro","family":"Hojo","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidenobu","family":"Tachibana","sequence":"additional","affiliation":[{"name":"Radiation Safety and Quality Assurance Division National Cancer Center Hospital East  Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.09.009"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2017.11.012"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010019\u20101392\u2010z"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmrs.618"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14090"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2023.101326"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14338"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70067"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1754\u20109485.2010.02192.x"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1076\u20106332(03)00671\u20108"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2009.2013851"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.12256"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70662","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70662","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70662","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T06:22:54Z","timestamp":1782627774000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70662"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/acm2.70662"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70662","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2026-02-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70662"}}