{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T22:17:09Z","timestamp":1783117029169,"version":"3.54.6"},"reference-count":38,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021202","name":"Digital Research Alliance of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021202","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004734","name":"Jewish General Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004734","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002784","name":"Canada Excellence Research Chairs","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002784","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","phiro.science","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Physics and Imaging in Radiation Oncology"],"published-print":{"date-parts":[[2026,5]]},"DOI":"10.1016\/j.phro.2026.100974","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T02:02:18Z","timestamp":1777600938000},"page":"100974","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["Trends in brachytherapy utilization in Canada from 2011 to 2020"],"prefix":"10.1016","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1407-488X","authenticated-orcid":false,"given":"Mirta","family":"Duman\u010di\u0107","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9969-1224","authenticated-orcid":false,"given":"Yujing","family":"Zou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-6065-5651","authenticated-orcid":false,"given":"Harry","family":"Glickman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara Ghassimi","family":"Kouraneh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9875-2600","authenticated-orcid":false,"given":"Piotr","family":"Pater","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Alexander","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge E. Alpuche","family":"Aviles","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda","family":"Cherpak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-2767-6515","authenticated-orcid":false,"given":"Kristin","family":"Marchant","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4718-907X","authenticated-orcid":false,"given":"Geetha","family":"Menon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7557-4912","authenticated-orcid":false,"given":"Daniel","family":"Morton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Olding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moti","family":"Paudel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2790-669X","authenticated-orcid":false,"given":"Alexandra","family":"Rink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3647-6858","authenticated-orcid":false,"given":"Ingrid","family":"Spadinger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6037-0615","authenticated-orcid":false,"given":"Shirin A.","family":"Enger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.phro.2026.100974_b1","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.brachy.2020.05.004","article-title":"Brachytherapy education and certification - a canadian approach","volume":"19","author":"Morton","year":"2020","journal-title":"Brachytherapy"},{"issue":"5","key":"10.1016\/j.phro.2026.100974_b2","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1016\/j.ijrobp.2016.11.055","article-title":"The practice of radiation oncology in Canada","volume":"97","author":"N.","year":"2017","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10131","key":"10.1016\/j.phro.2026.100974_b3","doi-asserted-by":"crossref","first-page":"1718","DOI":"10.1016\/S0140-6736(18)30181-8","article-title":"Canada\u2019s universal health-care system: achieving its potential","volume":"391","author":"D.","year":"2018","journal-title":"Lancet"},{"key":"10.1016\/j.phro.2026.100974_b4","series-title":"Search list of areas of focused competence (afc) programs","author":"Royal College of Physicians and Surgeons of Canada","year":"2024"},{"issue":"6","key":"10.1016\/j.phro.2026.100974_b5","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.brachy.2018.07.009","article-title":"Cost-effectiveness of prostate boost with high-dose-rate brachytherapy versus intensity-modulated radiation therapy in the treatment of intermediate-high risk prostate cancer","volume":"17","author":"Vu","year":"2018","journal-title":"Brachytherapy"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.semradonc.2019.08.007","article-title":"The cost-effectiveness and value proposition of brachytherapy","volume":"30","author":"Vu","year":"2020","journal-title":"Semin Radiat Oncol"},{"key":"10.1016\/j.phro.2026.100974_b7","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.1016\/j.brachy.2021.07.002","article-title":"Utilization of brachytherapy in Quebec, Canada","volume":"20","author":"Lecavalier-Barsoum","year":"2021","journal-title":"Brachytherapy"},{"key":"10.1016\/j.phro.2026.100974_b8","doi-asserted-by":"crossref","first-page":"1272","DOI":"10.1016\/j.ijrobp.2008.03.032","article-title":"Image-guided radiotherapy for cervix cancer: High-tech external beam therapy versus high-tech brachytherapy","volume":"71","author":"Georg","year":"2008","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.phro.2026.100974_b9","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1016\/j.ijrobp.2014.07.017","article-title":"National cancer data base analysis of radiation therapy consolidation modality for cervical cancer: The impact of new technological advancements","volume":"90","author":"Gill","year":"2014","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b10","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.ijrobp.2023.11.007","article-title":"Updated trends in the utilization of brachytherapy in cervical cancer in the united states: A surveillance, epidemiology, and end-results study","volume":"119","author":"Han","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"9","key":"10.1016\/j.phro.2026.100974_b11","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1001\/jama.2018.0587","article-title":"Radical prostatectomy, external beam radiotherapy, or external beam radiotherapy with brachytherapy boost and disease progression and mortality in patients with gleason score 9\u201310 prostate cancer","volume":"319","author":"Kishan","year":"2018","journal-title":"J Am Med Assoc"},{"issue":"109632","key":"10.1016\/j.phro.2026.100974_b12","article-title":"Brachytherapy boost improves survival and decreases risk of developing distant metastases compared to external beam radiotherapy alone in intermediate and high risk group prostate cancer patients","volume":"183","author":"Miszczyk","year":"2023","journal-title":"Radiother Oncol"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b13","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ijrobp.2013.05.033","article-title":"Trends in the utilization of brachytherapy in cervical cancer in the United States","volume":"87","author":"Han","year":"2013","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.phro.2026.100974_b14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.brachy.2013.08.005","article-title":"Declining use of brachytherapy for the treatment of prostate cancer","volume":"13","author":"Mahmood","year":"2014","journal-title":"Brachytherapy"},{"issue":"9","key":"10.1016\/j.phro.2026.100974_b15","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1200\/JCO.2014.59.8128","article-title":"Brachytherapy: Where has it gone?","volume":"33","author":"Petereit","year":"2015","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.phro.2026.100974_b16","doi-asserted-by":"crossref","first-page":"701","DOI":"10.1016\/j.brachy.2016.05.001","article-title":"The decreased use of brachytherapy boost for intermediate and high-risk prostate cancer despite evidence supporting its effectiveness","volume":"15","author":"Orio","year":"2016","journal-title":"Brachytherapy"},{"key":"10.1016\/j.phro.2026.100974_b17","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1016\/j.brachy.2019.07.001","article-title":"How might financial pressures have impacted brachytherapy? a proposed narrative to explain the declines in cervical and prostate brachytherapy utilization","volume":"18","author":"Schad","year":"2019","journal-title":"Brachytherapy"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b18","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1016\/j.brachy.2022.10.004","article-title":"Underutilization of brachytherapy for cervical cancer in the united states","volume":"22","author":"Williamson","year":"2023","journal-title":"Brachytherapy"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b19","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1016\/j.ijrobp.2023.11.036","article-title":"Updated trends in cervical cancer brachytherapy utilization and disparities in the united states from 2004 to 2020","volume":"119","author":"Colson-Fearon","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"6","key":"10.1016\/j.phro.2026.100974_b20","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1016\/j.brachy.2013.08.008","article-title":"Brachytherapy practice across Canada: A survey of workforce and barriers","volume":"12","author":"Rose","year":"2013","journal-title":"Brachytherapy"},{"key":"10.1016\/j.phro.2026.100974_b21","series-title":"Surveyhero [internet platform]","year":"2025"},{"key":"10.1016\/j.phro.2026.100974_b22","series-title":"R: A language and environment for statistical computing","author":"R Core Team","year":"2021"},{"key":"10.1016\/j.phro.2026.100974_b23","series-title":"Statistics Canada, table 13\u201310-0111-01: Number and rates of new cases of primary cancer, by cancer type, age group and sex","year":"2020"},{"issue":"5","key":"10.1016\/j.phro.2026.100974_b24","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/j.ijrobp.2020.11.023","article-title":"Impact of high-dose-rate and low-dose-rate brachytherapy boost on toxicity, functional and cancer outcomes in patients receiving external beam radiation therapy for prostate cancer: A national population-based study","volume":"109","author":"Parry","year":"2021","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"5","key":"10.1016\/j.phro.2026.100974_b25","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1016\/j.brachy.2022.04.006","article-title":"Combined brachytherapy and ultra-hypofractionated radiotherapy for intermediate-risk prostate cancer: Comparison of toxicity outcomes using a high-dose-rate (hdr) versus low-dose-rate (ldr) brachytherapy boost","volume":"21","author":"Kollmeier","year":"2022","journal-title":"Brachytherapy"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b26","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/j.ijrobp.2024.02.064","article-title":"A randomized trial comparing quality of life after low-dose rate or high-dose rate prostate brachytherapy boost with pelvic external beam radiation therapy","volume":"120","author":"Crook","year":"2024","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b27","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1016\/j.ijrobp.2025.03.053","article-title":"A randomized comparison of high-dose-rate and low-dose-rate prostate brachytherapy combined with external beam radiation therapy for unfavorable prostate cancer: Efficacy results after median follow-up of 74 months","volume":"123","author":"Crook","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"10.1016\/j.phro.2026.100974_b28","series-title":"Trends in prostate brachytherapy utilization in the united states and implications for resident training, practical radiation OncologyEpub ahead of print","author":"Isaac","year":"2025"},{"key":"10.1016\/j.phro.2026.100974_b29","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.ygyno.2024.10.014","article-title":"Trends in brachytherapy utilization for vaginal cancer in the united states from 2004 to 2021","volume":"191","author":"Colson-Fearon","year":"2024","journal-title":"Gynecol Oncol"},{"issue":"6","key":"10.1016\/j.phro.2026.100974_b30","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1016\/j.brachy.2019.10.006","article-title":"Resident experience in brachytherapy: An analysis of accreditation council for graduate medical education case logs for intracavitary and interstitial brachytherapy from 2007 to 2018","volume":"19","author":"Shinde","year":"2020","journal-title":"Brachytherapy"},{"issue":"6","key":"10.1016\/j.phro.2026.100974_b31","doi-asserted-by":"crossref","DOI":"10.1002\/acm2.70034","article-title":"A review of artificial intelligence in brachytherapy","volume":"26","author":"Chen","year":"2025","journal-title":"J Appl Clin Med Phys"},{"key":"10.1016\/j.phro.2026.100974_b32","series-title":"Breakthroughs in modern brachytherapy are transforming cancer care","author":"Fr\u00f6hlich","year":"2025"},{"key":"10.1016\/j.phro.2026.100974_b33","article-title":"Artificial intelligence in high-dose-rate brachytherapy treatment planning for cervical cancer: a review","volume":"15","author":"Shi","year":"2025","journal-title":"Front Oncol"},{"key":"10.1016\/j.phro.2026.100974_b34","article-title":"Evaluation of deep learning-based target auto-segmentation for magnetic resonance imaging-guided cervix brachytherapy","volume":"32","author":"Sim\u00f5es","year":"2024","journal-title":"Phys Imaging Radiat Oncol"},{"issue":"9","key":"10.1016\/j.phro.2026.100974_b35","doi-asserted-by":"crossref","DOI":"10.1002\/mp.18107","article-title":"Automatic catheter digitization in breast brachytherapy","volume":"52","author":"Quetin","year":"2025","journal-title":"Med Phys"},{"issue":"1","key":"10.1016\/j.phro.2026.100974_b36","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.ijrobp.2024.12.026","article-title":"Clinical application of deep learning-assisted needles reconstruction in prostate ultrasound brachytherapy","volume":"122","author":"Goulet","year":"2025","journal-title":"Int J Radiat Oncol Biol Phys"},{"issue":"10","key":"10.1016\/j.phro.2026.100974_b37","doi-asserted-by":"crossref","DOI":"10.1088\/1361-6560\/ad3dbd","article-title":"Deep learning for high-resolution dose prediction in high dose rate brachytherapy for breast cancer treatment","volume":"69","author":"Quetin","year":"2024","journal-title":"Phys Med Biol"},{"issue":"11","key":"10.1016\/j.phro.2026.100974_b38","doi-asserted-by":"crossref","DOI":"10.1088\/1361-6560\/ad4448","article-title":"Penalty weight tuning in high dose rate brachytherapy using multi-objective bayesian optimization","volume":"69","author":"Jafarzadeh","year":"2024","journal-title":"Phys Med Biol"}],"container-title":["Physics and Imaging in Radiation Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405631626000746?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S2405631626000746?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:26:00Z","timestamp":1783113960000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S2405631626000746"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":38,"alternative-id":["S2405631626000746"],"URL":"https:\/\/doi.org\/10.1016\/j.phro.2026.100974","relation":{},"ISSN":["2405-6316"],"issn-type":[{"value":"2405-6316","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Trends in brachytherapy utilization in Canada from 2011 to 2020","name":"articletitle","label":"Article Title"},{"value":"Physics and Imaging in Radiation Oncology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.phro.2026.100974","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Authors. Published by Elsevier B.V. on behalf of European Society of Radiotherapy & Oncology.","name":"copyright","label":"Copyright"}],"article-number":"100974"}}