{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T03:02:24Z","timestamp":1789700544934,"version":"4.0.1"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01CA301448"],"award-info":[{"award-number":["R01CA301448"]}],"id":[{"id":"10.13039\/100000002","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":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Glioblastoma (GBM) patients have poor clinical prognoses, which may partially be explainable by correlations between radiation\u2010induced killing of circulating blood cells (CBCs) and worse clinical outcomes. Proton radiotherapy is currently delivered via intensity\u2010modulated proton therapy (IMPT), for which the target is irradiated from a few different angles. Spot\u2010scanning proton arc therapy (SPArc), for which the target is irradiated from arc trajectories, is associated with dosimetric benefits, and the first SPArc treatments of head\u2010and\u2010neck cancer patients have now been reported. However, since SPArc increases the low\u2010dose bath, concerns have been raised about potentially higher killing of CBC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This study aims to evaluate and compare blood vessel dose and dose\u2010averaged linear energy transfer (LET\n                      <jats:sub>d<\/jats:sub>\n                      ) distributions between IMPT and SPArc, with and without blood vessel sparing, in patients with GBM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      For 10 GBM patients, patient\u2010specific cerebrovasculature models were developed, and IMPT and SPArc treatment plans were created according to current clinical standards (IMPT\n                      <jats:sub>Conv<\/jats:sub>\n                      and SPArc\n                      <jats:sub>Conv<\/jats:sub>\n                      ) and with sparing of delineated blood vessels (IMPT\n                      <jats:sub>Sparing<\/jats:sub>\n                      and SPArc\n                      <jats:sub>Sparing<\/jats:sub>\n                      ) for every patient. Dose and LET\n                      <jats:sub>d<\/jats:sub>\n                      distributions were then compared across all treatment plans.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      While treatment plans maintained comparable target coverage, blood vessel sparing significantly reduced the mean dose to delineated blood vessels, with values of 6.5\u00a0\u00b1\u00a02.9\u00a0Gy(RBE) for IMPT\n                      <jats:sub>Conv<\/jats:sub>\n                      , 5.3\u00a0\u00b1\u00a02.3\u00a0Gy(RBE) for IMPT\n                      <jats:sub>Sparing<\/jats:sub>\n                      , 5.6\u00a0\u00b1\u00a02.2\u00a0Gy(RBE) for SPArc\n                      <jats:sub>Conv<\/jats:sub>\n                      , and 3.8\u00a0\u00b1\u00a01.6\u00a0Gy(RBE) for SPArc\n                      <jats:sub>Sparing<\/jats:sub>\n                      . The dose within the 10% of blood vessel volume receiving the highest dose (D\n                      <jats:sub>10%<\/jats:sub>\n                      ) was 29.5\u00a0\u00b1\u00a013.4\u00a0Gy(RBE) for IMPT\n                      <jats:sub>Conv<\/jats:sub>\n                      , 23.2\u00a0\u00b1\u00a011.0\u00a0Gy(RBE) for IMPT\n                      <jats:sub>Sparing<\/jats:sub>\n                      , 24.5\u00a0\u00b1\u00a012.6\u00a0Gy(RBE) for SPArc\n                      <jats:sub>Conv<\/jats:sub>\n                      , and 13.4\u00a0\u00b1\u00a08.7\u00a0Gy(RBE) for SPArc\n                      <jats:sub>Sparing<\/jats:sub>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Implementation of blood vessel sparing resulted in successful reductions in blood vessel dose metrics while preserving target coverage, and SPArc further reduced blood vessel dose metrics compared with IMPT, with the potential to reduce radiation\u2010induced lymphopenia and improve clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70780","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:59:38Z","timestamp":1789023578000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Reducing the dose delivered to major intracranial blood vessels in brain radiotherapy using spot\u2010scanning proton arc therapy"],"prefix":"10.1002","volume":"27","author":[{"given":"Peilin","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology William Beaumont University Hospital, Corewell Health  Royal Oak Michigan USA"},{"name":"Medical Physics, School of Medicine Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Tattenberg","sequence":"additional","affiliation":[{"name":"Laurentian University  Sudbury Ontario Canada"},{"name":"TRIUMF  Vancouver British Columbia Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoda","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology William Beaumont University Hospital, Corewell Health  Royal Oak Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology William Beaumont University Hospital, Corewell Health  Royal Oak Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuanfeng","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology William Beaumont University Hospital, Corewell Health  Royal Oak Michigan USA"},{"name":"Corewellhealth William Beaumont University Hospital  Royal Oak USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdelkhalek","family":"Hammi","sequence":"additional","affiliation":[{"name":"Technical University of Dortmund  Dortmund Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060\u2010011\u20100749\u20104"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571\u2010020\u201000447\u2010z"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201011\u20100774"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2015.0151"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.23217"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2015.04.005"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060\u2010019\u201003167\u20102"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.06.031"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11604\u2010023\u201001434\u2010x"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2022.10.019"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/52\/10\/009"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4801899"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152477"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.08.049"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijpt.2025.100749"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.17669"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110421"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2023.100480"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1201500"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/ad69f9"},{"key":"e_1_2_12_22_1","unstructured":"ShusharinaN BortfeldT.Glioma image segmentation for radiotherapy: rT targets barriers to cancer spread and organs at risk (GLIS\u2010RT). Published online 2021. doi:10.7937\/TCIA.T905\u2010ZQ20"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/acdcdc"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1088\/1361\u20106560\/ad144e"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010022\u201002055\u2010w"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/57\/11\/R99"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70341"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2024.104816"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70780","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70780","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70780","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T02:08:08Z","timestamp":1789697288000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70780"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/acm2.70780"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70780","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"2026-04-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70780"}}