{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:00:33Z","timestamp":1790312433501,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japan mHDR Research Fund"},{"name":"National Cancer Center Research and Development Fund","award":["2025\u2013A\u201312"],"award-info":[{"award-number":["2025\u2013A\u201312"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study investigated the feasibility and reproducibility of inverse planning (IP) in gynecologic high-dose-rate brachytherapy (BT) across ten institutions (five IP and five manual). Two pre-defined cases (high-risk clinical target volume, CTVHR: 62.8 and 27.4\u00a0cm3) included the organs at risk (OARs), a tandem, ovoids, and 8 and 3 interstitial needles, respectively. Each institution generated BT plans according to its policy, assuming 30\u00a0Gy\/15 fractions of whole-pelvis irradiation and 20\u00a0Gy\/10 fractions of central shielding. Plans were evaluated using dose\u2013volume histogram (DVH) parameters. Dwell-time distributions were compared with conventional Manchester-based pear-shaped plans to identify deviations (e.g. needle dominance and high-dose characteristics) that may not be captured by DVH alone. Institutional interviews assessed clinical acceptability and optimization strategies. All plans were considered clinically acceptable, with no significant differences between IP and non-IP groups in CTVHR \u00a0D90% and OARs ${{D}}_{{2}\\ {\\mathrm{cm}}^{{3}}}$. IP institutions used institution-specific strategies to preserve uterine dose conformity, including fixing dwell times for selected applicators and applying optimization constraints based on Manchester-derived contours, delineated ovoids or delineated uterine structures. Overall, IP plans were comparable to non-IP plans for CTVHR \u00a0D90%, CTVHR \u00a0V100% (cm3) and OARs ${{D}}_{{2}\\ {\\mathrm{cm}}^{{3}}}$. In contrast, differences in dose distribution around the uterine fundus and the wide range of the body V100% (cm3) suggested varying institutional strategies for fundus dose. These findings highlight the need for planning QA that incorporates dwell-time review in addition to DVH parameters, and provide a foundation for optimizing and standardizing IP in gynecologic BT to improve planning reproducibility and patient outcomes.<\/jats:p>","DOI":"10.1093\/jrr\/rrag084","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T11:12:16Z","timestamp":1788520336000},"source":"Crossref","is-referenced-by-count":0,"title":["Current practices and challenges in inverse planning for gynecologic brachytherapy: insights from a multi-institutional study"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9491-787X","authenticated-orcid":false,"given":"Hiroyuki","family":"Okamoto","sequence":"first","affiliation":[{"name":"Section of Radiation Safety and Quality Assurance, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayaka","family":"Nagao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, National Cancer Center Hospital , 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045 ,","place":["Japan"]},{"name":"Department of Radiation Oncology, The Jikei University School of Medicine , 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo 105-8461 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Morimoto","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Osaka International Cancer Institute , 3-1-69 Otemae, Chuo-ku, Osaka 541-8567 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setsuo","family":"Tamenaga","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Osaka International Cancer Institute , 3-1-69 Otemae, Chuo-ku, Osaka 541-8567 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Osaka International Cancer Institute , 3-1-69 Otemae, Chuo-ku, Osaka 541-8567 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mie University Hospital , 2-174 Edobashi, Tsu, Mie 514-8507 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Ii","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ise Red Cross Hospital , 1-471-2 Funae, Ise, Mie 516-8512 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Clinical Department of Radiation Oncology, Tottori University Hospital , 36-1 Nishi-cho, Yonago, Tottori 683-8504 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromi","family":"Sakaguchi","sequence":"additional","affiliation":[{"name":"Clinical Department of Radiation Oncology, Tottori University Hospital , 36-1 Nishi-cho, Yonago, Tottori 683-8504 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Radiology, Graduate School of Medical and Dental sciences, Kagoshima University , 8-35-1 Sakuragaoka, Kagoshima 890-8544 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshifumi","family":"Oku","sequence":"additional","affiliation":[{"name":"Division of Radiology, Department of Clinical Technology, Kagoshima University Hospital , 8-35-1 Sakuragaoka, Kagoshima 890-8520 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiji","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University , 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0660-9987","authenticated-orcid":false,"given":"Naoya","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9486-1922","authenticated-orcid":false,"given":"Noriyuki","family":"Okonogi","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9848-9251","authenticated-orcid":false,"given":"Jun","family":"Takatsu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Iijima","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Juntendo University Graduate School of Medicine , 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutoshi","family":"Murata","sequence":"additional","affiliation":[{"name":"QST Hospital, National Institutes for Quantum Science and Technology , 4-9-1 Anagawa, Inage-ku, Chiba-shi, Chiba 263-0024 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"Ushijima","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Saitama Cancer Center , 780 Komuro, Ina-machi, Kitaadachi-gun, Saitama 362-0806 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4011-622X","authenticated-orcid":false,"given":"Ken","family":"Ando","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Gunma University Graduate School of Medicine , 3-39-15 Showa-machi, Maebashi, Gunma 371-8511 ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6703-3144","authenticated-orcid":false,"given":"Tatsuya","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Gunma University Graduate School of Medicine , 3-39-15 Showa-machi, Maebashi, Gunma 371-8511 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