{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T11:28:22Z","timestamp":1790508502883,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":11,"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"}],"funder":[{"DOI":"10.13039\/100011950","name":"ITEA","doi-asserted-by":"publisher","award":["#20052"],"award-info":[{"award-number":["#20052"]}],"id":[{"id":"10.13039\/100011950","id-type":"DOI","asserted-by":"publisher"}]}],"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>Stereotactic arrhythmia radioablation (STAR) has emerged as a salvage treatment for patients with ventricular tachycardia, and the MR\u2010linacs offer MRI\u2010guidance during such treatment. However, available workflows on MR\u2010linacs are not yet optimized and characterized dedicatedly to perform heart radiotherapy due to a lack of realistic MRI\u2010compatible cardiac phantoms suitable for real\u2010time dosimetry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This work introduces a newly designed, deformable, and MRI\u2010compatible cardiac phantom with real\u2010time and multi\u2010point dosimetric capabilities, characterizes its MRI properties and mechanical behavior, and showcases its use for MR\u2010linac end\u2010to\u2010end workflow\u00a0testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cardiac phantom (IBA QUASAR, London, Ontario, Canada) is composed of a deformable heart model \u2014 representing the left and right ventricles \u2014 with integrated Plastic Scintillation Detectors (Medscint, Quebec, Quebec, Canada) (PSDs), a section\u00a0filled with contrast solution, and a piston compatible with the motor of the QUASAR\n                      <jats:sup>TM<\/jats:sup>\n                      MRI\n                      <jats:sup>4D<\/jats:sup>\n                      motion phantom. We determined its T1 and T2 values by acquiring gold standard inversion recovery and spin echo sequences. We evaluated its 2D deformation and mechanical behavior by performing an MRI\u2010based analysis inspired by dynamic mechanical analysis. We evaluated its 3D deformation and mechanical behavior by acquiring 3D scans at different motor positions, and by applying deformable image registration. We evaluated the reliability of the PSD measurements by testing the repeatability, linearity, and dose rate dependency of their measured dose on a 1.5 T Unity MR\u2010linac (Elekta AB, Stockholm, Sweden). We evaluated the dosimetric impact of motion and motion mitigation on the dose measured by the PSDs by delivering a STAR plan in different cases: static, motion (cardiorespiratory or cardiac motion), and motion with gating (MR\u2010linac clinical workflow).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      On average, T1 values were T1\n                      <jats:sub>constrast_solution<\/jats:sub>\n                      = 1130  44 ms, T1\n                      <jats:sub>left_ventricle's_wall<\/jats:sub>\n                      = 763  76 ms, and T1\n                      <jats:sub>right_ventricle's_wall<\/jats:sub>\n                      = 775  69 ms, and T2 values were T2\n                      <jats:sub>constrast_solution<\/jats:sub>\n                      = 155  16 ms, T2\n                      <jats:sub>left_ventricle's_wall<\/jats:sub>\n                      = 49  12 ms, and T2\n                      <jats:sub>right_ventricle's_wall<\/jats:sub>\n                      = 185  35 ms. For the 2D deformation, no phase lag of deformation (i.e., ventricular area) with respect to the piston motion and no hysteresis behavior were observed. For the 2D and 3D deformation, linear relationships between piston positions and ventricular areas or volumes of interest were observed (\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 0.99 and\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 1.0, respectively). For the 3D deformation, negligible differences between volumes before and after PSDs integration were obtained (largest absolute percentage difference of 1.1%). The maximum deformation of the heart model was 5 mm. For the dosimetric capabilities, the reliability of the PSD measurements was shown (repeatability: coefficient of variation 0.31%, linearity:\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 1.0, dose rate dependency: coefficient of variation 0.72%). Dose rates measured by the PSDs over time during STAR delivery were fluctuating in phase with the motion pattern. Percentage errors on cumulative doses with respect to static cases when cardiorespiratory or cardiac motion were applied were, respectively, up to \u221228.6% and \u22120.7% in motion cases, and up to \u22123.1% and 0.8% in gating\u00a0cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This deformable and MRI\u2010compatible cardiac phantom has good MRI contrast, and its heart model exhibits elastic behavior. Its integrated PSDs offer real\u2010time and multi\u2010point dose measurements, and their reliability was demonstrated. We successfully showed that this cardiac phantom enables end\u2010to\u2010end testing for heart radiotherapy on\u00a0MR\u2010linacs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mp.70313","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T04:05:42Z","timestamp":1770955542000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of a deformable beating cardiac phantom with real\u2010time dosimetric capabilities for validation of MRI\u2010guided heart radiotherapy"],"prefix":"10.1002","volume":"53","author":[{"given":"Manon M. N.","family":"Aubert","sequence":"first","affiliation":[{"name":"Department of Radiotherapy University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prescilla","family":"Uijtewaal","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalin I.","family":"Penev","sequence":"additional","affiliation":[{"name":"IBA QUASAR London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoan","family":"LeChasseur","sequence":"additional","affiliation":[{"name":"Medscint Qu\u00e9bec City Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Hartman","sequence":"additional","affiliation":[{"name":"IBA QUASAR London Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurie J. M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paris","family":"Tzitzimpasis","sequence":"additional","affiliation":[{"name":"Department of Radiotherapy University Medical Center Utrecht Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim T. 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