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@ARTICLE{BakhtiariMoghaddam:305619,
      author       = {A. Bakhtiari Moghaddam$^*$ and A. Runz$^*$ and R. F.
                      Augusto$^*$ and G. Echner$^*$ and W. Johnen$^*$ and R.
                      Gabriel$^*$ and P. Haering$^*$ and C. Lang$^*$ and S.
                      Seeber$^*$ and C. Murillo$^*$ and B. Ackermann and R.
                      Pestana and C. Beyer and F. Weykamp$^*$ and M. Jochim$^*$
                      and A. Qubala and V. Batista and O. Jäkel$^*$ and C.
                      Karger$^*$},
      title        = {{A} dynamic anthropomorphic phantom for end-to-end testing
                      in image- and surface-guided adaptive radiotherapy.},
      journal      = {Medical physics},
      volume       = {52},
      number       = {11},
      issn         = {0094-2405},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DKFZ-2025-02267},
      pages        = {e70107},
      year         = {2025},
      note         = {#EA:E040#LA:E040#},
      abstract     = {Respiratory and digestive motion can compromise the
                      accuracy of radiotherapy (RT), affecting tumor targeting and
                      healthy tissue sparing. Current phantoms often fail to
                      replicate complex organ movements and lack compatibility
                      with advanced imaging modalities like magnetic resonance
                      imaging (MRI) and 4D computed tomography (4DCT), limiting
                      their utility in adaptive radiotherapy. The BRaVIDA
                      (Breathing Radiotherapy Visual monitoring, Imaging, and
                      Dosimetric Anthropomorphic) phantom addresses these
                      limitations by simulating realistic organ motion during
                      breathing and digestion. Its MRI compatibility allows for
                      comprehensive testing in adaptive radiotherapy workflows,
                      improving motion management and treatment precision for both
                      photon and ion beam therapies.This study introduces the
                      BRaVIDA (Breathing Radiotherapy Visual monitoring, Imaging,
                      and Dosimetric Anthropomorphic) phantom, a novel
                      anthropomorphic phantom designed to simulate respiratory
                      motion and support end-to-end testing in adaptive
                      radiotherapy. The aim is to improve motion management,
                      imaging accuracy, and dosimetric validation for radiotherapy
                      treatments.The BRaVIDA phantom is designed with realistic
                      anatomical structures of the thorax and abdomen and may be
                      equipped with dosimeters. It simulates respiratory and
                      digestive motion using an in-house developed hydraulic
                      system. The phantom was imaged by CT and MRI, using
                      different protocols (CT, MRI, 4DCT, and 4DMRI) to evaluate
                      image contrast and motion parameters. Dosimetric properties
                      were assessed by measuring the relative electron density
                      (RED) and the stopping power ratio (SPR) of ion beams and
                      the results were compared with the values of the treatment
                      planning system (TPS).The phantom demonstrated realistic
                      image contrast in CT and MRI, with anthropomorphic
                      characteristics similar to human tissues. Motion amplitudes
                      for various organ models (pancreas, stomach, liver) were
                      successfully measured using 4DCT and 4DMRI. Dosimetric
                      testing showed that the RED and SPR values of BRaVIDA align
                      closely with TPS reference values. Deviations in photon
                      attenuation were below $1.5\%$ for all phantom
                      materials.BRaVIDA presents a versatile, MRI-compatible
                      phantom exhibiting anthropomorphic image contrast, inter-
                      and intrafractional motion as well as radiation attenuation
                      in photon beams, and equipping the phantom with detectors
                      allows for full end-to-end-tests in adaptive image- and
                      surface-guided photon RT workflows without further
                      adaptions. For ion beams, the SPR values in the TPS have to
                      be adapted to the measured data to assure correct range
                      calculation in the phantom. The phantom presents a valuable
                      and accurate tool for clinical and research applications in
                      adaptive RT.},
      keywords     = {Phantoms, Imaging / Radiotherapy, Image-Guided:
                      instrumentation / Humans / Magnetic Resonance Imaging /
                      Respiration / Movement / Radiometry / adaptive radiotherapy
                      (Other) / anthropomorphic phantom (Other) / end to end test
                      (Other)},
      cin          = {E040 / E073 / E050 / E010},
      ddc          = {610},
      cid          = {I:(DE-He78)E040-20160331 / I:(DE-He78)E073-20160331 /
                      I:(DE-He78)E050-20160331 / I:(DE-He78)E010-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:41185391},
      doi          = {10.1002/mp.70107},
      url          = {https://inrepo02.dkfz.de/record/305619},
}