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The methodology presented can be used to improve the knowledge of instrument behavior in current applicators and aid the development of novel (3D\u2010printed) BT applicators.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>For the computer models, BT instruments were discretized in finite elements. Simulations were performed in SPACAR by formulating nodal contact force and motion input models and specifying the instruments\u2019 kinematic and dynamic properties. To evaluate the source cable model, simulated source paths in ring applicators were compared with manufacturer\u2010measured source paths. The impact of discrepancies on the dosimetry was estimated for standard plans. To validate needle models, simulated needle insertion forces in curved channels with varying curvature, torsion, and clearance, were compared with force measurements in dedicated 3D\u2010printed templates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Comparison of simulated with manufacturer\u2010measured source positions showed 0.5\u20131.2\u00a0mm median and\u00a0&lt;2.0\u00a0mm maximum differences, in all but one applicator geometry. The resulting maximum relative dose differences at the lateral surface and at 5\u00a0mm depth were 5.5% and 4.7%, respectively. Simulated insertion forces for BT needles in curved channels accurately resembled the forces experimentally obtained by including experimental uncertainties in the simulation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The models developed can accurately predict source positions and insertion forces in BT applicators. Insights from these models can aid novel applicator design with improved motion and force transmission of BT instruments, and contribute to the estimation of overall treatment precision. The methodology presented can be extended to study other applicator geometries, flexible instruments, and afterloading systems.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.16934","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T08:44:47Z","timestamp":1705394687000},"page":"3698-3710","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Multibody dynamic modeling of the behavior of flexible instruments used in cervical cancer brachytherapy"],"prefix":"10.1002","volume":"51","author":[{"given":"Robin","family":"Straathof","sequence":"first","affiliation":[{"name":"Department of BioMechanical Engineering Delft University of Technology  Delft the Netherlands"},{"name":"Department of Radiotherapy Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaap P.","family":"Meijaard","sequence":"additional","affiliation":[{"name":"Department of Precision and Microsystems Engineering Delft University of Technology  Delft the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharline M.","family":"van Vliet\u2010P\u00e9rez","sequence":"additional","affiliation":[{"name":"Department of BioMechanical Engineering Delft University of Technology  Delft the Netherlands"},{"name":"Department of Radiotherapy Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inger\u2010Karine K.","family":"Kolkman\u2010Deurloo","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Remi A.","family":"Nout","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy Erasmus MC Cancer Institute University Medical Center Rotterdam Rotterdam the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ben J. 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