Evidence map›Paper›PMID 40881550›Full record

ArticleCureus2025

A Beam Orientation Quality Assurance Framework for Gyroscopic Stereotactic Radiosurgery Systems.

Alec Zheng, Timothy Kong, Ajay Zheng, Xiang Kong, Xiaodong Wu, Aizik Wolf

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Article
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

6 authors.

Alec ZhengMiami Neuroscience Center, Larkin Community Hospital, Miami, USA.
Timothy KongMiami Neuroscience Center, Larkin Community Hospital, Miami, USA.
Ajay ZhengMedical Physics, New York Proton Center, New York, USA.
Xiang KongMedical Physics, Executive Medical Physics Associates, Miami, USA.
Xiaodong WuMiami Neuroscience Center, Larkin Community Hospital, Miami, USA.
Aizik WolfMiami Neuroscience Center, Larkin Community Hospital, Miami, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Gyroscopic stereotactic radiosurgery (SRS) systems, such as ZAP-X, enable precise, isocentric beam delivery with high conformality and minimal exposure to surrounding tissues. While standard quality assurance (QA) protocols verify beam centricity and overall targeting accuracy, they are not specifically designed to assess the consistency of beam entry angles, which can vary in systems employing gimbaled delivery. These angular variations, though often less consequential at the target, may have significant dosimetric implications for peripheral critical structures. To address this, we developed a practical quality assurance framework using the ArcCHECK cylindrical diode array for periodic beam orientation monitoring. The system comprises 1,386 diodes arranged cylindrically (21 cm diameter), providing a density of 221 diodes per 10×10 cm². Although the array's resolution limits direct dose distribution comparisons, its sensitivity to angular deviations leverages the steep dose fall-off typical in SRS beams. A calibration protocol was established using a 44-beam QA plan with collimators of varying sizes. Sensitivity to beam rotation was quantified as the percentage of diode failures per degree of angular deviation. The 10 mm collimator demonstrated optimal performance, with sensitivity reaching 37.7% per degree, owing to the match between its penumbra and the 1 cm diode spacing. Daily QA measurements confirmed high reproducibility and sensitivity, with a deliberately introduced 0.8° error accurately detected and quantified. This framework, validated through controlled tests, offers a reliable and efficient method to track beam orientation consistency without requiring additional hardware or major workflow changes. While the study serves as a proof of principle within a single institution, broader adoption and multicenter validation could support its standardization. Ultimately, the integration of angular QA enhances treatment fidelity in gyroscopic SRS, ensuring both mechanical precision and patient safety.

Indexed as

angular deviationbeam orientationdiode arrayquality assurance (qa)zap gyroscopic radiosurgery

Identifiers

PMID40881550
PMCPMC12386560

What OpenQuestion 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 OpenQuestion graph.