{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T14:01:53Z","timestamp":1789740113445,"version":"4.0.1"},"reference-count":39,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T00:00:00Z","timestamp":1785715200000},"content-version":"vor","delay-in-days":2,"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":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Synthetic CTs (sCT) were developed to provide electron density information for MR\u2010only treatment planning. Some AI\u2010based sCT generators have received FDA\u2010clearance and better capture tissue heterogeneity through voxel\u2010wise mappings to improve image guidance and dose calculation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To quantitatively characterize the image quality and geometric surrogate agreement of an FDA 510(k) cleared AI\u2010based synthetic CT generator (TheraPanacea) for brain and prostate MR\u2010only radiotherapy, using per\u2010structure volumetric analysis, Hounsfield unit (HU) assessment, and multi\u2010metric geometric evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Paired CT\/MR datasets from 20 brain and 20 prostate patients were retrospectively analyzed. sCTs were generated from T1w (brain) and T2w (pelvis) MR images acquired on the same day with identical immobilization. Auto\u2010contours from TheraPanacea and MIM Contour Prot\u00e9g\u00e9AI were compared against MIM Contour Prot\u00e9g\u00e9AI contours on the reference CT. Bone was segmented via a fixed\u2010threshold method. Evaluation metrics included contour volumes, cross\u2010contour HU comparisons, centroid offsets, overlap and surface\u2010based similarity metrics, and manual bony landmark measurements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Soft\u2010tissue mean HU differences were\u00a0&lt;50 HU across both cohorts. Central ROIs showed\u00a0&lt;20 HU deviations, apart from heterogeneous bone and air\u2010filled regions. Bony structures exhibited HU range compression in the sCT, where HU differences between the sCT and the reference CT differed by a maximum of 347\u00a0\u00b1\u00a014 HU in the femoral heads and 455\u00a0\u00b1\u00a050 HU in the sacrum. Global histograms confirmed HU range compression. Centroids shifted\u00a0&lt;\u00a02\u00a0mm for all contours (brain A\u2010P predominant, pelvis non\u2010systematic). Boundary metrics showed MDA\u00a0&lt;\u00a05\u00a0mm, and bony landmarks differed\u00a0&lt;\u00a01\u00a0mm between the reference CT and the sCT. Small structures in the brain had inconsistent auto\u2010segmentation, displaying different volumes and low Dice\/JI scores. Dental implants in the sCT produced localized MR\u2010like susceptibility artifacts. Within manual contoured implant ROIs, the mean HU values were underestimated by \u223c9,000 HU relative to CT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TheraPanacea sCT demonstrated acceptable soft\u2010tissue HU\u00a0(\u00b1\u00a050 HU) and geometric surrogate agreement\u00a0(&lt;\u00a02\u20135\u00a0mm) relative to CT, with larger errors in cortical bone, air interfaces, and implants. Site\u2010specific QA must verify bone HU compression, peripheral geometric agreement via landmark measures, and manually review small\/high\u2010contrast contours (optic nerves, cochleae, rectum). Institutional image and dosimetric validation, particularly with implanted devices, remains essential prior to clinical deployment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70725","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T03:41:41Z","timestamp":1785814901000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Image\u2010based evaluation of a commercial AI synthetic CT generator for brain and prostate MR\u2010only radiotherapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Morgan","family":"Aire","sequence":"first","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carson","family":"Matthews","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Duong","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Stathakis","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia","family":"Shay","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystal","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.72.860.10624344"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0167\u20108140(00)00159\u20106"},{"key":"e_1_2_10_4_1","unstructured":"Committee. 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