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Prototypes for dynamic IMBT have been proposed for prostate, cervical, and rectal\u00a0cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>We considered two shielded applicators for IMBT rectal cancer treatment and investigated how rotational uncertainties in the shield angle and translational uncertainties in the source position affect plan evaluation\u00a0criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The effect of rotational errors of ,  and , and translational errors of 1, 2 and 3\u00a0mm on evaluation criteria were investigated for shields with  and  emission windows. Further, a robust optimization approach based on quadratic penalties that includes scenarios with errors was proposed. The extent to which dosimetric effects of positional errors can be mitigated with this model was evaluated compared to a quadratic penalty model without scenarios with errors. A retrospective rectal cancer data set of ten patients was included in this study. Treatment planning was performed using the Monte Carlo\u2010based treatment planning system,\u00a0RapidBrachyMCTPS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For the largest investigated rotational error of , the clinical target volume\u00a0 remained, on average, within  of the result without error, while the contralateral healthy rectal wall experienced an increase in the mean , , and  of , , and  for the  shield and of 32%, 9%, and 2% for the  shield. For translational errors of \u00a0mm, there were increases in dosimetric indices for both the superior (sup) and inferior (inf) dose spill regions. Specifically, for the  shield, the , , and  increased by , , and , respectively, for the sup region, and by , , and , respectively, for the inf region. Similar results were obtained with the  shield. Overall, the robust and traditional models had similar results. However, the number of active dwell positions obtained with the robust model was larger, and the longest dwell time was shorter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We have quantified the effect of rotational shield and translational source errors of various magnitudes on evaluation criteria for rectal IMBT. The robust optimization approach was generally not able to mitigate positional errors. However, it resulted in more homogeneous dwell times, which can be beneficial in conventional high\u2010dose\u2010rate brachytherapy to avoid hot spots around specific dwell\u00a0positions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.17800","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T08:48:22Z","timestamp":1743497302000},"page":"3528-3540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Dosimetric impact of positional uncertainties and a robust optimization approach for rectal intensity\u2010modulated brachytherapy"],"prefix":"10.1002","volume":"52","author":[{"given":"Bj\u00f6rn","family":"Mor\u00e9n","sequence":"first","affiliation":[{"name":"Medical Physics Unit Department of Oncology McGill University Montreal Qu\u00e9bec Canada"},{"name":"Department of Mathematics Link\u00f6ping University Link\u00f6ping Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alana","family":"Thibodeau\u2010Antonacci","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Department of Oncology McGill University Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5501-618X","authenticated-orcid":false,"given":"Jonathan","family":"Kalinowski","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Department of Oncology McGill University Montreal Qu\u00e9bec Canada"},{"name":"Lady Davis Institute for Medical Research Jewish General Hospital Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin A.","family":"Enger","sequence":"additional","affiliation":[{"name":"Medical Physics Unit Department of Oncology McGill University Montreal Qu\u00e9bec Canada"},{"name":"Lady Davis Institute for Medical Research Jewish General Hospital Montreal Qu\u00e9bec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"Global Cancer Observatory \u2010 World Health Organization\/International Agency for Research on Cancer.Cancer Today. 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