{"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":1789740115479,"version":"4.0.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":15,"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>Low\u2010dose\u2010rate prostate seed brachytherapy (BT) is an established guideline\u2010conformal treatment option for low\u2010risk prostate cancer. Precise seed placement is essential for achieving adequate dose coverage while minimizing exposure of surrounding healthy tissue. MRI guidance offers superior soft\u2010tissue contrast for target visualization, but technical challenges remain for accurate transrectal seed implantation under in\u2010bore conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>The Remote Control Manipulator (RCM) is an MRI\u2010compatible robotic guidance system originally designed for in\u2010bore transrectal targeted prostate biopsies. This work investigates its feasibility for MRI\u2010guided transrectal targeted focal prostate seed BT. We demonstrate the intervention workflow and quantify seed placement accuracy in a preclinical phantom experiment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The proposed intervention workflow defines the setup steps, interaction of the treatment planning system (TPS) with the robot's navigation software, MR\u2010imaging as well as seed\u2010 and needle\u2010guide registration. We performed and analyzed the total workflow in an anthropomorphic pelvis phantom. Seed positions corresponding to the initial treatment plan, the expected positions after needle\u2010guide alignment, and the final released seed positions were assessed in detail. Their geometric displacement was decomposed into contributions from robotic alignment, seed release, and registration uncertainty. Dosimetric consequences were evaluated using the target's V\n                      <jats:sub>100%<\/jats:sub>\n                      dose coverage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Robotic alignment produced a mean expected seed displacement of 0.6\u00a0\u00b1\u00a00.2\u00a0mm. Total deviation from planned to released seed positions was 2.6\u00a0\u00b1\u00a00.9\u00a0mm, with 0.7\u00a0\u00b1\u00a00.4\u00a0mm along\u2010trajectory displacement. MRI\u2010only seed registration differed from CT\u2010verified reconstruction by 2.8\u00a0\u00b1\u00a01.4\u00a0mm. After two released needles, V\n                      <jats:sub>100%<\/jats:sub>\n                      declined from 100% to 92.9% using MRI\u2010only data and to 85.7% using CT\u2010verified seed positions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The workflow was successfully executed and demonstrated sub\u2010millimeter robotic targeting precision. Seed displacement during release and limited MRI\u2010only seed localization remain dominant sources of error impacting dose coverage. Active needle guidance during imaging and improved MRI\u2010only seed reconstruction could enable monitoring the live dose distribution and adaptive trajectory correction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70747","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T04:39:48Z","timestamp":1786941588000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Flexible intervention workflow for MRI guided robotic prostate seed brachytherapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Philipp","family":"Aumueller","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology University Medical Centre Mannheim, University Heidelberg  Mannheim Germany"},{"name":"Research Campus M<sup>2<\/sup>OLIE University Medical Centre Mannheim, University Heidelberg  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam 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Mannheim, University Heidelberg  Mannheim Germany"},{"name":"DKFZ\u2010Hector Cancer Institute at the University Medical Center Mannheim  Mannheim Germany"},{"name":"Mannheim Institute for Intelligent Systems in Medicine (MIISM)  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"Fleckenstein","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Medical Centre Mannheim, University Heidelberg  Mannheim Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sven","family":"Clausen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University Medical Centre Mannheim, University Heidelberg  Mannheim Germany"},{"name":"Research Campus M<sup>2<\/sup>OLIE University Medical Centre Mannheim, University Heidelberg  Mannheim 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