{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T20:50:11Z","timestamp":1793134211174,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007091","name":"RefleXion Medical","doi-asserted-by":"publisher","award":["SRA202302-0018"],"award-info":[{"award-number":["SRA202302-0018"]}],"id":[{"id":"10.13039\/100007091","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Technol Cancer Res Treat"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>\n                      SCINTIX\n                      <jats:sup>\u00ae<\/jats:sup>\n                      therapy, a form of biology-guided radiotherapy using real-time positron emission tomography (PET) imaging on the RefleXion\n                      <jats:sup>\u00ae<\/jats:sup>\n                      X1 platform, recently received FDA clearance for FDG-guided treatment of lung and bone tumors. This study evaluates the feasibility and dosimetric quality of Biology-Guided Radiotherapy (BgRT) plans for FDG-avid lesions in anatomical sites beyond current indications using processed diagnostic PET (dPET) images.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eleven previously treated FDG-avid lesions in ten patients (sites: liver, head and neck, pancreas, kidney, pelvic\/abdominal nodes) were retrospectively analyzed. dPET images were processed to emulate RefleXion X1 PET characteristics. BgRT plans were generated using a non-clinical version of the RefleXion treatment planning system, delivering stereotactic body radiation therapy-level doses (48Gy\/3fx for liver, 40Gy\/5fx for other sites). Plan deliverability was evaluated based on normalized target signal (NTS &gt;2.7) and activity concentration (AC\u2009&gt;\u20095\u2005kBq\/ml). Plans were categorized based on the presence of dose-limiting organs at risk (OAR) constraints. Dosimetric parameters were assessed according to institutional standards. Statistical analyses examined relationships between dPET standardized uptake value (SUV), PET-derived parameters, planning target volume (PTV) characteristics, and plan complexity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>BgRT plans were successfully generated for all lesions. All met the NTS threshold (mean\u2009=\u20099.3); 72.7% met the AC goal (mean\u2009=\u200912.1\u2005kBq\/ml). Among cases with dPET SUV\u2009&gt;\u20096, 87.5% met AC criterion, supporting this threshold as a reasonable selection criterion. Plans without dose-limiting OARs (n\u2009=\u20096) achieved higher PTV coverage (V100%=94.4%, conformity index (CI)\u2009=\u20091.08) compared to plans with OAR constraints (n\u2009=\u20095, V100%=78.0%, CI\u2009=\u20091.4). All plans were deemed clinically acceptable despite observed heterogeneity within target regions. MLC modulation intensity correlated strongly with target volume (r\u2009=\u20090.907) and superior-inferior extent (r\u2009=\u20090.896) rather than OAR proximity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BgRT planning using processed dPET is feasible for non-lung\/bone FDG-avid lesions. SUV\u2009&gt;\u20096 may serve as a reasonable threshold, though feasibility is affected by tumor location, FDG background, and nearby critical structures. Findings support clinical potential of SCINTIX expansion into new anatomical sites.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15330338251365334","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T08:19:27Z","timestamp":1754900367000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Expanding SCINTIX Biology-Guided Radiotherapy Beyond Lung and Bone: A Planning Feasibility and Dosimetric Study on the RefleXion X1 System"],"prefix":"10.1177","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0666-5404","authenticated-orcid":false,"given":"Haozhao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Medical Artificial Intelligence and Automation Laboratory, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant","family":"Gibbard","sequence":"additional","affiliation":[{"name":"RefleXion Medical, Hayward, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Medical Artificial Intelligence and Automation Laboratory, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas I.","family":"Banks","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Medical Artificial Intelligence and Automation Laboratory, The University of Texas Southwestern Medical Center, Dallas, TX, 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tu","family":"Dan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahed N.","family":"Badiyan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Westover","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Sher","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, The University of Texas Southwestern Medical Center, Dallas, TX, 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