Evidence map›Paper›PMID 41094662›Full record

ArticleRadiation oncology (London, England)2025

Advanced HyperSight™ imaging for patients with adaptive SBRT of prostate cancer: a longitudinal analysis of tissue demarcation.

Ralf Schmidt, Thanh Nguyen, Alicia S Bicu, Paula Cvachovec, Victor Siefert, Miriam Eckl, Marvin Willam, Matthias F Froelich, Stefan O Schoenberg, Michael Ehmann and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiation oncology (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing 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

6 citing papers in PubMed.

  1. Review
  2. HyperSightRadiation oncology (London, England) · 2026
    Article
  3. Article
  4. Article
  5. 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

16 authors.

Ralf SchmidtDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Thanh NguyenDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Alicia S BicuDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Paula CvachovecDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Victor SiefertDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Miriam EcklDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Marvin WillamDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Matthias F FroelichDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Stefan O SchoenbergDepartment of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Michael EhmannDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Daniel BuergyDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Sven ClausenDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Jens FleckensteinDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Frank A GiordanoDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Judit Boda-HeggemannDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
Constantin DreherDepartment of Radiation Oncology, University Medical Center Mannheim, Medical Faculty Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. constantin.dreher@medma.uni-heidelberg.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCone-beam computed tomography (CBCT)-based adaptive radiotherapy (ART) at the Ethos® linear accelerator (eLinac) allows for daily anatomical and dosimetric adjustments and relies on robust image quality. This study evaluated the longitudinal image quality of the novel HyperSightTM-CBCT (hCBCT) compared to planning CT (pCT), using phantoms and data of prostate cancer patients undergoing adaptive stereotactic body radiotherapy (SBRT). Building on this, the longitudinal contour sharpness of the organs in fractional hCBCT and their usability for ART workflow across fractions was evaluated.

methodsBetween December 2023 and May 2024, 26 prostate cancer patients receiving ART at the eLinac with hCBCT technology were enrolled. Phantom studies assessed pCT and hCBCT image quality. Patient based analyses of all 156 imaging scans (pCT and each of the fractional hCBCT) analyzed, longitudinally examined firstly image quality, secondly contour sharpness of prostate, seminal vesicles, and rectal wall, and thirdly confidence to delineate the structures for the ART workflow. Time required for the ART based parameters were recorded. Quantitative metrics included CT number changes in the fat adjacent to the prostate and seminal vesicles. Friedman’s test with Bonferroni correction, Spearman and Intraclass Correlation Coefficient (ICC) were used for statistics.

resultshCBCT scans showed robust image quality parameters in the phantom and patient based analysis across fractions. Inter-observer agreement was moderate, with lower rating score for resident compared to the experienced radiation oncologist (p < 0.001). Patient based analysis showed no significant differences of the contour sharpness of the prostate and seminal vesicles between pCT and initial hCBCT scan, but contour sharpness ratings declined across treatment fractions. Confidence for the delineation of prostate and seminal vesicles during ART was significantly decreased at later fractions (each padj<0.05) and this correlated significantly with longer assessment times (padj≤0.05). The CT attenuation of the fat tissue adjacent to the prostate and seminal vesicles significantly increased across the fractions (padj<0.05).

conclusionsHigh-quality imaging for adaptive SBRT in prostate cancer is provided by hCBCT, which offers equivalent tissue visualization compared to pCT. Fraction-dependent decreases in contour sharpness can be detected using longitudinal hCBCT imaging. These decreases are likely related to treatment-induced tissue changes and may impact ART workflow. The rating of the observed effects may potentially be influenced by the observer’s experience.

Indexed as

Cone-Beam Computed TomographyProstatic NeoplasmsRadiosurgeryRadiotherapy, Image-GuidedRadiotherapy Planning, Computer-AssistedAgedHumansLongitudinal StudiesMaleOrgans at RiskPhantoms, ImagingRadiotherapy DosageRadiotherapy, Intensity-ModulatedAdaptive radiotherapyEthosHyperSightTM-CBCTProstate cancerStereotactic radiotherapy

Identifiers

PMID41094662
PMCPMC12529831

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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.