Evidence map›Paper›PMID 41185391›Full record

ArticleMedical physics2025

A dynamic anthropomorphic phantom for end-to-end testing in image- and surface-guided adaptive radiotherapy.

Anahita Bakhtiari Moghaddam, A Runz, R Figueiredo Augusto, G Echner, W Johnen, R Gabriel, P Haering, C Lang, S Seeber, C Murillo and 9 more

Abstract read
In one paragraph

Article in Medical physics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

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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

19 authors.

Anahita Bakhtiari MoghaddamFaculty of Medicine, University of Heidelberg, Heidelberg, Germany.
A RunzDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
R Figueiredo AugustoDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
G EchnerDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
W JohnenDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
R GabrielDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
P HaeringDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
C LangDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
S SeeberDivision of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
C MurilloDivision of Medical Physics in Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
B AckermannHeidelberg Ion Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany.
R PestanaHeidelberg Ion Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany.
C BeyerHeidelberg Ion Beam Therapy Center (HIT), University Hospital Heidelberg, Heidelberg, Germany.
F WeykampHeidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany.
M JochimDivision of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
A QubalaHeidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany.
V BatistaHeidelberg Institute for Radiation Oncology (HIRO), National Center for Radiation Research in Oncology (NCRO), Heidelberg, Germany.
O JäkelDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
C P KargerDivision of Medical Physics in Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRespiratory 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. PURPOSE: 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.

methodsThe 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).

resultsThe 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.

conclusionsBRaVIDA 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.

Indexed as

Phantoms, ImagingRadiotherapy, Image-GuidedHumansMagnetic Resonance ImagingMovementRadiometryRespirationadaptive radiotherapyanthropomorphic phantomend to end test

Identifiers

PMID41185391
PMCPMC12583891

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Registered trials

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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.