{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T09:58:56Z","timestamp":1790330336224,"version":"4.1.0"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patient-specific quality assurance (QA) in radiotherapy is traditionally performed using measurement-based systems that require dedicated hardware, machine time, and manpower. Although software-based QA approaches have emerged as efficient alternatives, their comparative accessibility and operational performance remain insufficiently investigated. This study evaluated conventional and software-based QA methodologies using integrated dosimetric, temporal, and economic metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A total of 90 clinically approved treatment plans, including head-and-neck, pelvis, and lung volumetric modulated arc therapy\/stereotactic body radiotherapy cases, were retrospectively analysed. All plans were generated in Eclipse TPS v15.6 and evaluated using ArcCHECK phantom-based QA, electronic portal imaging device (EPID)-based QA, and log file-based QA. Gamma analysis was performed using 3%\/2 mm criteria with a 10% dose threshold. Workflow time and relative cost burden were recorded for each method. Three composite indices were defined: QA Cost Efficiency Index (QCEI), QA Efficiency Index (QEI), and QA Accessibility Index (QAI). Statistical comparisons were performed using paired analysis with Bonferroni correction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      All QA methods achieved clinically acceptable gamma passing rates. Log file-based QA demonstrated the highest median gamma passing rate; however, the absolute differences between methodologies were small, and all approaches exceeded the predefined clinical acceptance criterion (\u226595%). ArcCHECK showed the greatest workflow time and cost burden, whereas log file-based QA demonstrated the highest QCEI, QEI, and QAI values. EPID-based QA showed intermediate performance. All pairwise differences in accessibility metrics were statistically significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Software-based QA approaches significantly improved operational efficiency and accessibility while maintaining clinically acceptable dosimetric agreement. However, further prospective, multi-institutional validation of the proposed accessibility framework is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmp.jmp_115_26","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T13:01:42Z","timestamp":1790168502000},"page":"637-645","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Gamma Analysis: An Accessibility-oriented Framework for Comparative Evaluation of Patient-specific Radiotherapy Quality Assurance"],"prefix":"10.4103","volume":"51","author":[{"family":"Vikram","sequence":"first","affiliation":[{"name":"Department of Physics, GLA University, Mathura, Uttar Pradesh, India"},{"name":"Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj Pal","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Physics, GLA University, Mathura, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manindra","family":"Bhushan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Division of Medical Physics, Rajiv Gandhi Cancer Institute and Research Center, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"R1-20260925","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1118\/1.598248","article-title":"A technique for the quantitative evaluation of dose distributions","volume":"25","author":"Low","year":"1998","journal-title":"Med Phys"},{"key":"R2-20260925","first-page":"e53","article-title":"Tolerance limits and methodologies for IMRT measurement-based verification QA: Recommendations of AAPM Task Group No","volume":"45","author":"Miften","year":"2018","journal-title":"218. 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