{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T17:01:26Z","timestamp":1784739686589,"version":"3.55.0"},"reference-count":47,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T00:00:00Z","timestamp":1721692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Medical Physics"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Cardiac applications in radiation therapy are rapidly expanding including magnetic resonance guided radiation therapy (MRgRT) for real\u2010time gating for targeting and avoidance near the heart or treating ventricular tachycardia (VT).<\/jats:p><\/jats:sec><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This work describes the development and implementation of a novel multi\u2010modality and magnetic resonance (MR)\u2010compatible cardiac phantom.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The patient\u2010informed 3D model was derived from manual contouring of a contrast\u2010enhanced Coronary Computed Tomography Angiography scan, exported as a Stereolithography model, then post\u2010processed to simulate female heart with an average volume. The model was 3D\u2010printed using Elastic50A to provide MR contrast to water background. Two rigid acrylic modules containing cardiac structures were designed and assembled, retrofitting to an MR\u2010safe programmable motor to supply cardiac and respiratory motion in superior\u2010inferior directions. One module contained a cavity for an ion chamber (IC), and the other was equipped with multiple interchangeable cavities for plastic scintillation detectors (PSDs). Images were acquired on a 0.35 T MR\u2010linac for validation of phantom geometry, motion, and simulated online treatment planning and delivery. Three motion profiles were prescribed: patient\u2010derived cardiac (sine waveform, 4.3\u00a0mm peak\u2010to\u2010peak, 60 beats\/min), respiratory (cos<jats:sup>4<\/jats:sup> waveform, 30\u00a0mm peak\u2010to\u2010peak, 12 breaths\/min), and a superposition of cardiac (sine waveform, 4\u00a0mm peak\u2010to\u2010peak, 70 beats\/min) and respiratory (cos<jats:sup>4<\/jats:sup> waveform, 24\u00a0mm peak\u2010to\u2010peak, 12 breaths\/min). The amplitude of the motion profiles was evaluated from sagittal cine images at eight frames\/s with a resolution of 2.4\u00a0mm \u00d7 2.4\u00a0mm. Gated dosimetry experiments were performed using the two module configurations for calculating dose relative to stationary. A CT\u2010based VT treatment plan was delivered twice under cone\u2010beam CT guidance and cumulative stationary doses to multi\u2010point PSDs were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No artifacts were observed on any images acquired during phantom operation. Phantom excursions measured 49.3\u00a0\u00b1\u00a025.8%\/66.9\u00a0\u00b1\u00a014.0%, 97.0\u00a0\u00b1\u00a02.2%\/96.4\u00a0\u00b1\u00a01.7%, and 90.4\u00a0\u00b1\u00a04.8%\/89.3\u00a0\u00b1\u00a03.5% of prescription for cardiac, respiratory, and cardio\u2010respiratory motion profiles for the 2\u2010chamber (PSD) and 12\u2010substructure (IC) phantom modules respectively. In the gated experiments, the cumulative dose was\u00a0&lt;2% from expected using the IC module. Real\u2010time dose measured for the PSDs at 10\u00a0Hz acquisition rate demonstrated the ability to detect the dosimetric consequences of cardiac, respiratory, and cardio\u2010respiratory motion when sampling of different locations during a single delivery, and the stability of our phantom dosimetric results over repeated cycles for the high dose and high gradient regions. For the VT delivery, high dose PSD was\u00a0&lt;1% from expected (5\u20136 cGy deviation of 5.9\u00a0Gy\/fraction) and high gradient\/low dose regions had deviations\u00a0&lt;3.6% (6.3 cGy less than expected 1.73\u00a0Gy\/fraction).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A novel multi\u2010modality modular heart phantom was designed, constructed, and used for gated radiotherapy experiments on a 0.35 T MR\u2010linac. Our phantom was capable of mimicking cardiac, cardio\u2010respiratory, and respiratory motion while performing dosimetric evaluations of gated procedures using IC and PSD configurations. Time\u2010resolved PSDs with small sensitive volumes appear promising for low\u2010amplitude\/high\u2010frequency motion and multi\u2010point data acquisition for advanced dosimetric capabilities. Illustrating VT planning and delivery further expands our phantom to address the unmet needs of cardiac applications in radiotherapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mp.17315","type":"journal-article","created":{"date-parts":[[2024,7,23]],"date-time":"2024-07-23T16:38:27Z","timestamp":1721752707000},"page":"7479-7491","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Development and first implementation of a novel multi\u2010modality cardiac motion and dosimetry phantom for radiotherapy applications"],"prefix":"10.1002","volume":"51","author":[{"given":"Kenneth W.","family":"Gregg","sequence":"first","affiliation":[{"name":"Department of Human Oncology University of Wisconsin\u2013Madison  Madison Wisconsin USA"},{"name":"Department of Medical Physics University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase","family":"Ruff","sequence":"additional","affiliation":[{"name":"Department of Human Oncology University of Wisconsin\u2013Madison  Madison Wisconsin USA"},{"name":"Department of Medical Physics University of Wisconsin\u2013Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Koenig","sequence":"additional","affiliation":[{"name":"Modus Medical Devices, Inc. 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