{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T15:34:17Z","timestamp":1787758457439,"version":"build-2784847793"},"reference-count":32,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To study the impact of different optimization methods in dealing with metallic hip implant using intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A cohort of 16 patients having metallic implants was selected for the study. Three sets of IMRT and VMAT plans were generated. Set 1 IMRT (IM_Base), VMAT (VM_Base) without any restrictions on beam entry and exit, set 2 (IM_ENT and VM_ENT) optimizer restricts the beam entry and set 3 (IM_EXT+ENT), neither entry nor exit doses were allowed toward the metallic implant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      There was no significant difference in target (D\n                      <jats:sub>95%<\/jats:sub>\n                      ) and organ-at-risk doses between IM_Base and IM_ENT. There were significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002) improvements in planning target volume (PTV) V\n                      <jats:sub>95%<\/jats:sub>\n                      and homogeneity from IM_EXT+ENT to IM_ENT. There was no significant difference in plan quality between VM_Base and VM_ENT. There were significant (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005) improvements in PTV, V\n                      <jats:sub>95%,<\/jats:sub>\n                      homogeneity from VM_EXT+ENT to VM_ENT. V\n                      <jats:sub>40Gy<\/jats:sub>\n                      , V\n                      <jats:sub>30Gy<\/jats:sub>\n                      for bladder, rectum, bowel, and bowel maximum dose decreases significantly (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.005) in IM_ENT compared to IM_EXT+ENT, but not significant for VMAT plans. Similarly, there was a significant decrease in dose spill outside target (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) comparing 40%, 50%, 60%, and 70% dose spills for IM_ENT compared to IM_EXT+ENT, but variations among VMAT plans are insignificant. VMAT plans were always superior to IMRT plans for the same optimization methods.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The best approach is to plan hip prosthesis cases with blocked entry of radiation beam for IMRT and VMAT. The VMAT plans had more volumetric coverage, fewer hotspots, and lesser heterogeneity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jmp.jmp_14_22","type":"journal-article","created":{"date-parts":[[2022,11,8]],"date-time":"2022-11-08T04:08:29Z","timestamp":1667880509000},"page":"262-269","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":5,"title":["To Study the Impact of Different Optimization Methods on Intensity-Modulated Radiotherapy and Volumetric-Modulated Arc Therapy Plans for Hip Prosthesis Patients"],"prefix":"10.4103","volume":"47","author":[{"given":"Pawan Kumar","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak","family":"Tripathi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sukhvir","family":"Singh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manindra","family":"Bhushan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lalit","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kothanda","family":"Raman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soumitra","family":"Barik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gourav","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushil Kumar","family":"Shukla","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munish","family":"Gairola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-7-20240906","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1634\/theoncologist.11-10-1121","article-title":"Bone loss and fracture risk associated with cancer therapy","volume":"11","author":"Guise","year":"2006","journal-title":"Oncologist"},{"key":"R3-7-20240906","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1016\/S0022-5347(01)61639-2","article-title":"Bone mineral density in men treated with synthetic gonadotropin-releasing hormone agonists for prostatic carcinoma","volume":"161","author":"Maillefert","year":"1999","journal-title":"J Urol"},{"key":"R4-7-20240906","doi-asserted-by":"crossref","first-page":"1731","DOI":"10.31557\/APJCP.2020.21.6.1731","article-title":"Effect of hip prosthesis on photon beam characteristics in radiological physics","volume":"21","author":"Bhushan","year":"2020","journal-title":"Asian Pac J Cancer Prev"},{"key":"R5-7-20240906","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.1148\/rg.324115183","article-title":"CT of the hip prosthesis: Appearance of components, fixation, and complications","volume":"32","author":"Roth","year":"2012","journal-title":"Radiographics"},{"key":"R6-7-20240906","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1148\/rg.246045065","article-title":"Artifacts in CT: Recognition and avoidance","volume":"24","author":"Barrett","year":"2004","journal-title":"Radiographics"},{"key":"R7-7-20240906","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1109\/23.775600","article-title":"Metal streak artifacts in X-ray computed tomography: 4 simulation study","volume":"3","author":"De Man","year":"1999","journal-title":"IEEE Transactions on Nuclear Science"},{"key":"R8-7-20240906","first-page":"347","article-title":"Evaluation of metallic implant artifact on photon beam calculation algorithms using a CIRS thorax phantom","volume":"11","author":"Acquah","year":"2019","journal-title":"New Pub"},{"key":"R9-7-20240906","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1120\/jacmp.v16i5.5612","article-title":"High-density dental implants and radiotherapy planning: Evaluation of effects on dose distribution using pencil beam convolution algorithm and Monte Carlo method","volume":"16","author":"\u00c7atli","year":"2015","journal-title":"J Appl Clin Med Phys"},{"key":"R10-7-20240906","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/0958-3947(92)90018-B","article-title":"Radiotherapy treatment planning for prostate cancer in patients with prosthetic hips","volume":"17","author":"Schild","year":"1992","journal-title":"Med Dosim"},{"key":"R11-7-20240906","doi-asserted-by":"crossref","first-page":"1162","DOI":"10.1118\/1.1565113","article-title":"Dosimetric considerations for patients with HIP prostheses undergoing pelvic irradiation. 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