Evidence map›Paper›PMID 39715307›Full record

ArticleJournal of applied clinical medical physics2025

Development of an automated CBCT-based simulation-free platform for expedited palliative radiotherapy on a conventional linear accelerator.

Riley C Tegtmeier, Edward L Clouser, Quan Chen, Courtney R Buckey, Suzanne J Chungbin, Christopher J Kutyreff, Jose S Aguilar, Amber L Labbe, Brooke L Horning, William G Rule and 2 more

Abstract read
In one paragraph

Article in Journal of applied clinical medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Riley C TegtmeierDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.ORCID https://orcid.org/0000-0002-8339-7845
Edward L ClouserDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Quan ChenDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Courtney R BuckeyDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Suzanne J ChungbinDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Christopher J KutyreffDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Jose S AguilarDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Amber L LabbeDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Brooke L HorningDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
William G RuleDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Sujay A VoraDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.
Yi RongDepartment of Radiation Oncology, Mayo Clinic Arizona, Phoenix, Arizona, USA.ORCID https://orcid.org/0000-0002-2620-1893

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConventional approaches for emergent or expedited palliative radiotherapy (RT) involve the application of cumbersome vendor-provided solutions and/or multiple patient appointments to complete the RT workflow within a compressed timeframe. PURPOSE: This report delineates the clinical development of an in-house, semi-automated Cone-beam computed tomography (CBCT)-based simulation-free platform for expedited palliative RT on conventional linacs, intended to supplant existing techniques employed at this institution.

methodsThe internal software, termed SimFree Wizard (SFW), was engineered utilizing a C#-based application programming interface integrated within the treatment planning system (TPS). Generated scripts were compiled as stand-alone executables, with a graphical user interface (GUI) customized via an integrated development environment. The platform was conceived as a framework for accelerated CBCT-based RT, bypassing the requirement for standard simulation imaging. SFW employs full automation where feasible to minimize user intervention, supplemented by graphical instructions for tasks requiring manual execution. During development, relevant temporal metrics from 10 end-to-end tests for palliative spine RT were quantified. User feedback was solicited via a simple questionnaire assessing the overall platform usability. Automated in-house secondary verification software was developed for validation of the TPS-calculated monitor units (MUs).

resultsThe mean duration for workflow execution was 41:42 ± 3:18 [mm:ss] (range ∼37-46 min). SFW satisfactorily generated simple, multi-field CBCT-based 3D treatment plans within seconds following delineation of the desired treatment area. User feedback indicated enhanced usability compared to previously employed solutions. Validation of the secondary verification software demonstrated accurate results for palliative spine RT and other simple cases wherein the dose calculation point resides in a predominantly homogenous medium.

conclusionA novel in-house solution for expedited CBCT-based RT was successfully developed, facilitating completion of the entire workflow within approximately 1-hour or less for simple palliative/emergent scenarios. Overall, this application is expected to improve the quality and safety of palliative RT while greatly reducing workflow duration, thereby improving access to palliative care.

Indexed as

Cone-Beam Computed TomographyImage Processing, Computer-AssistedPalliative CareParticle AcceleratorsRadiotherapy Planning, Computer-AssistedSoftwareHumansOrgans at RiskRadiotherapy DosageRadiotherapy, Intensity-ModulatedUser-Computer InterfaceWorkflowCBCTexpedited radiotherapypalliative radiotherapySFRTsimulation‐free radiotherapy

Identifiers

PMID39715307
PMCPMC11969108

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.