{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:01:55Z","timestamp":1789740115485,"version":"4.0.1"},"reference-count":17,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"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":[[2026,8]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Surface\u2010guided radiation therapy (SGRT) has been increasingly adopted in modern radiotherapy, enabling radiation\u2010dose\u2010free, marker\u2010free patient positioning with high accuracy. A novel SGRT system, LUNA 3D (LAP, L\u00fcneburg, Germany), featuring a browser\u2010based interface, GPU\u2010accelerated surface reconstruction, high frame rates, large field\u2010of\u2010view and virtual laser projection capabilities, has been commissioned and implemented clinically.<\/jats:p>\n <\/jats:sec>\n \n Purpose<\/jats:title>\n This study reports comprehensive commissioning procedures and the associated results for the LUNA 3D system and evaluates its clinical impact on patient positioning accuracy for breast and pelvic cancer treatments.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Commissioning tests were performed, including thermal drift, reproducibility, translational and rotational shift accuracy, camera occlusion assessment during gantry rotation, radiographic verification against cone\u2010beam computed tomography (CBCT), and End\u2010to\u2010End dosimetric testing. Test results were compared using two reference surfaces: one captured by LUNA 3D (SGRT\u2010reference) and the other derived from the CT external structure (SIM\u2010reference). A clinical evaluation was conducted to compare CBCT\u2010derived positioning corrections from 192 breast and 259 pelvic treatment datasets acquired in the periods before and after the clinical implementation of LUNA 3D, employing Welch's two\u2010sample t\u2010test and Cohen's\n d<\/jats:italic>\n effect size.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The thermal drift within the operating temperature range is \u22640.4\u00a0mm for all three axes. Across the reproducibility and translational\/rotational shift tests, maximum deviations were \u22640.3\u00a0mm translational and \u22640.2\u00b0 rotational with the SGRT\u2010reference, and \u22640.8\u00a0mm translational and \u22640.2\u00b0 rotational with the SIM\u2010reference, the latter attributable to the difference introduced by the CT\u2010derived reference surface. Radiographic verification showed agreement within 1.0\u00a0mm between LUNA 3D and CBCT corrections for both reference surfaces. End\u2010to\u2010End testing yielded CBCT residuals of 0.9\u20131.3\u00a0mm with 1.2% dosimetric deviation. All evaluated performance metrics are compared to the ESTRO\u2010ACROP and AAPM TG\u2010302 guidelines' tolerances. Clinical implementation resulted in significant positioning improvements: for breast treatments, 3D translational vector decreased 28.7% from 7.00\u00a0\u00b1\u00a04.35\u00a0mm to 4.99\u00a0\u00b1\u00a02.75\u00a0mm (\n p<\/jats:italic>\n \u00a0<\u00a00.001, Cohen's\n d<\/jats:italic>\n \u00a0=\u00a00.54); for pelvic treatments, 3D rotational vector decreased 24.0% from 2.31\u00a0\u00b1\u00a00.96\u00b0 to 1.76\u00a0\u00b1\u00a00.67\u00b0 (\n p<\/jats:italic>\n \u00a0<\u00a00.001, Cohen's\n d<\/jats:italic>\n \u00a0=\u00a00.66).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n LUNA 3D was successfully commissioned, meeting international SGRT guidelines. Clinical implementation produced statistically significant and clinically meaningful improvements in patient positioning accuracy with anatomical site\u2010specific benefits. These findings establish LUNA 3D as a reliable SGRT technology that enhances positioning accuracy in routine clinical practice.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/acm2.70707","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T12:54:09Z","timestamp":1786020849000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Commissioning and clinical positioning assessment of a novel surface\u2010guided radiation therapy (SGRT) system at a C\u2010Arm linear accelerator"],"prefix":"10.1002","volume":"27","author":[{"given":"Hui Khee","family":"Looe","sequence":"first","affiliation":[{"name":"University Clinic for Medical Radiation Physics Clinic for Radiation Therapy, Medical Campus Pius Hospital Carl von Ossietzky University Oldenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas Felix Hendrik","family":"Bartner","sequence":"additional","affiliation":[{"name":"University Clinic for Medical Radiation Physics Clinic for Radiation Therapy, Medical Campus Pius Hospital Carl von Ossietzky University Oldenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bj\u00f6rn","family":"Poppe","sequence":"additional","affiliation":[{"name":"University Clinic for Medical Radiation Physics Clinic for Radiation Therapy, Medical Campus Pius Hospital Carl von Ossietzky University Oldenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay C.","family":"Willborn","sequence":"additional","affiliation":[{"name":"University Clinic for Medical Radiation Physics Clinic for Radiation Therapy, Medical Campus Pius Hospital Carl von Ossietzky University Oldenburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.05.026"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010020\u201001629\u2010w"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14510"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tipsro.2022.03.001"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2023.07.003"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.4103\/jcrt.JCRT_1147_21"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010023\u201044320\u20102"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15532"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13006"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1088\/2057\u20101976\/ac3e37"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3190392"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70138"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpt.2026.101303"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jrras.2025.101290"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.10.017"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radi.2020.02.008"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010023\u201002250\u20103"}],"container-title":["Journal 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