ArticleJournal of applied clinical medical physics2026
Impact of Monaco sequencing parameters on monitor units, plan quality, and optimization time for Elekta Unity liver SBRT plans.
Article in Journal of applied clinical medical physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMagnetic resonance-guided radiation therapy (MRgRT) using the Elekta Unity MR-linac offers significant advantages for liver stereotactic body radiation therapy (SBRT). However, the Unity is limited by a low dose rate and the lack of volumetric-modulated arc therapy (VMAT), resulting in prolonged treatment times. Reducing monitor units per fraction (MU/Fx) by optimizing Monaco sequencing parameters may improve treatment efficiency. PURPOSE: To evaluate the impact of Monaco sequencing parameters on MU/Fx, plan quality, and optimization time for Unity liver SBRT.
methodsTen liver SBRT patients previously treated on the Unity were replanned. For each patient, 33 plans were generated by varying one of five sequencing parameters: maximum number of segments per plan, minimum MU per segment, minimum segment width (MSW), minimum segment area (MSA), and fluence smoothing (FS). The MU/Fx, optimization time, and estimated delivery time were recorded for each plan. Dosimetric and hotspot constraint compliance and the RTOG 0915 conformality index (CI) and gradient index (RI) were used to assess plan quality.
resultsReducing the maximum number of segments to no fewer than 30 and increasing the MSA produced the largest reductions in MU/Fx (3.4%-50.8% and 3.7%-43.2%, respectively) for all patients' clinically acceptable plans. Using a high FS yielded modest MU/Fx reductions (3.0%-17.6%) in eight patients. Minimum MU per segment and MSW showed negligible effects on MU/Fx among clinically acceptable plans. MSWs of 1.5 cm or greater resulted in degraded plan quality or clinically unacceptable plans. For the five patients with the largest planning target volumes (PTVs), optimization time decreased with fewer segments (1.1%-416%) and with increased MSA (22.5%-48.1%). Across all patients, optimization time decreased with increasing minimum MU per segment (3.0%-47.2%). Estimated delivery time strongly correlated with MU/Fx (R
conclusionsAdjusting Monaco sequencing parameters-particularly lowering the maximum number of segments, increasing the MSA, or using a high FS-can reduce MU/Fx and treatment time while maintaining acceptable plan quality on a patient-specific basis.
Indexed as
Identifiers
What Socratic holds
Registered trials
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.