{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T23:53:45Z","timestamp":1791244425553,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"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":["Medical Physics"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upright patient positioning may provide anatomical advantages and more cost\u2010effective proton therapy using a fixed beamline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To characterize image quality, imaging dose, and dose calculation accuracy for an upright CT scanner with a six\u2010degree\u2010of\u2010freedom patient positioning system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      CT imaging dose (CTDI\n                      <jats:sub>vol<\/jats:sub>\n                      ) was measured at 120 kVp for head and thorax protocols. Image quality was evaluated using an ACR\u2010464 phantom. Mean CT number accuracy was assessed within inserts of known material, and uniformity as the difference in values at the center and periphery of uniform phantoms. High\u2010contrast resolution was assessed by visible line pairs and modulation transfer function (MTF). Low\u2010contrast performance was quantified by contrast\u2010to\u2010noise\u2010ratio (CNR). Spatial integrity was evaluated between fiducials 100\u00a0mm apart. Hounsfield unit to mass density and stopping\u2010power\u2010ratio calibrations were performed. Proton and photon plans were optimized on upright CT scans of a thorax phantom in heterogeneous and homogeneous regions. Dose was forward computed on a registered recumbent CT scan and agreement evaluated using 3D gamma analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CTDI\n                      <jats:sub>vol<\/jats:sub>\n                      was 23.5\u00a0\u00b1\u00a00.02 mGy for the 16\u00a0cm head and 10.1\u00a0\u00b1\u00a00.01 mGy for the 32\u00a0cm body phantoms. Mean CT numbers (HU) were within the expected range for water (1.7) and acrylic (120.8). CT numbers were slightly [5\u201327 HU] out\u2010of\u2010range for air (\u2212950.4), polyethylene (\u221278.8), and bone (823.0). Image uniformity was 20.2 HU and 35.0 HU for 20 and 48\u00a0cm diameter phantoms, respectively. Eight high\u2010contrast line pairs were visualized. The MTF equaled 4.4\u00a0cm\n                      <jats:sup>\u22121<\/jats:sup>\n                      at 50% and 7.1\u00a0cm\n                      <jats:sup>\u22121<\/jats:sup>\n                      at 10%. The median CNR was 0.93, below the \u22651.0 tolerance. Spatial integrity was \u22640.36\u00a0mm. Gamma pass rates were \u226599.8% for photon and \u226590.6% for proton plans with 1%\/1\u00a0mm criteria, and \u226598.0% for all plans with 3%\/2\u00a0mm criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Upright CT image quality and dose calculation accuracy are acceptable for photon and proton radiotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70312","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T14:45:08Z","timestamp":1770993908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Technical assessment of a novel vertical CT system for upright radiotherapy simulation and treatment planning"],"prefix":"10.1002","volume":"53","author":[{"given":"Jordan M.","family":"Slagowski","sequence":"first","affiliation":[{"name":"Department of Human Oncology University of Wisconsin \u2013 Madison  Madison Wisconsin USA"},{"name":"Department of Medical Physics University of Wisconsin \u2013 Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuhao","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Human Oncology University of Wisconsin \u2013 Madison  Madison Wisconsin USA"},{"name":"Department of Medical Physics University of Wisconsin \u2013 Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica R.","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Human Oncology University of Wisconsin \u2013 Madison  Madison Wisconsin USA"},{"name":"Department of Medical Physics University of Wisconsin \u2013 Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John W.","family":"Hayes","sequence":"additional","affiliation":[{"name":"Leo Cancer Care, Inc.  Middleton Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carson A.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Leo Cancer Care, Inc.  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