{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:50:39Z","timestamp":1791352239087,"version":"4.3.1"},"reference-count":14,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:00:00Z","timestamp":1791244800000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"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":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>An accurate assessment of the radiotherapy plans requires an accurate dose to the target and efficient confinement of the doses. However, present indices do not completely cover these aspects in a single framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To develop a unified, dimensionless metric that integrates geometric conformity and dosimetric efficiency for evaluating stereotactic and fractionated radiotherapy plans aims to reduce QA workload by providing a rapid, quantitative estimate of plan acceptability, allowing early prediction of treatment plan performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, the Nabaa Efficiency Index  is introduced and defined as the product of the Conformity Index (CI) and a Dose\u2010Efficiency Ratio (DER), evaluated at 50% and 90% isodose levels (, ). We analyzed theoretical behavior against normalized dose\u2013volume ratios and compared  with established indices of conformity, homogeneity, and the Paddick efficiency index . Clinical validation used 100 plans (50 Gamma Knife, 50 VMAT\u2010SRS). Statistics included ANOVA, correlations, ROC\/AUC, and decision\u2010curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      and  were monotonic, bounded, and dimensionless.  distinguished gradient\/halo efficiency between stereotactic and linac plans (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001).  most strongly reflected prescription\u2010dose conformity (pooled AUC\u00a0=\u00a00.94) and outperformed the Paddick Efficiency Index  in discrimination and interpretability.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>unifies geometric and dosimetric assessment across modalities. Its simplicity, physical interpretability, and software\u2010ready formulation support integration into automated QA and treatment\u2010planning pipelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70805","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T05:08:31Z","timestamp":1791349711000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Introducing a novel prediction index for treatment quality of gamma knife and stereotactic\u2010based radiotherapy: Nabaa Efficiency Index (\u03b7Nabaa)"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0506-6271","authenticated-orcid":false,"given":"Nabaa Mohammed","family":"Alsiraj","sequence":"first","affiliation":[{"name":"Programme of Diagnostic Imaging and Radiotherapy Faculty of Health Sciences Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"},{"name":"Gamma Knife Center Ghazi Alhariri Hospital for Specialist Neurosurgeries, Ministry of Health  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1960-7331","authenticated-orcid":false,"given":"Haydar Hamza","family":"Alabedi","sequence":"additional","affiliation":[{"name":"Surgery Department College of Medicine, Baghdad University  Baghdad Iraq"},{"name":"Surgery Department College of Medicine University of Warith Al\u2010Anbiyaa  Karbala Iraq"},{"name":"Warith International Cancer Institute  Karbala Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-525X","authenticated-orcid":false,"given":"Mustafa Salih","family":"Almusawi","sequence":"additional","affiliation":[{"name":"Medical Physics Department Faculty of Medical Sciences Jabir Ibn Hayyan Medical University  Al\u2010Kufa Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moneer K.","family":"Faraj","sequence":"additional","affiliation":[{"name":"Surgery Department College of Medicine, Baghdad University  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3864-9978","authenticated-orcid":false,"given":"Rozilawati","family":"Ahmad","sequence":"additional","affiliation":[{"name":"Programme of Diagnostic Imaging and Radiotherapy Faculty of Health Sciences Universiti Kebangsaan Malaysia  Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3423-6591","authenticated-orcid":false,"given":"Sura Abdulkareem Madlool","family":"Alzuabidi","sequence":"additional","affiliation":[{"name":"Al Amal National Hospital for Oncology, Medical Complex  Baghdad Iraq"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20201289"},{"issue":"3","key":"e_1_2_12_3_1","doi-asserted-by":"crossref","first-page":"219","DOI":"10.3171\/jns.2000.93.supplement_3.0219","article-title":"A simple scoring ratio to index the conformity of radiosurgical treatment plans","volume":"93","author":"Paddick I","year":"2000","journal-title":"J 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