ArticleJournal of applied clinical medical physics2026
Probabilistic quality assurance of biopsy DVH thresholds in HDR prostate brachytherapy under localization uncertainty.
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.
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Abstract
backgroundMR-US guided biopsies support biologic correlation in HDR prostate brachytherapy, but steep dose gradients and millimeter-scale localization uncertainty limit the validity of nominal biopsy doses. PURPOSE: To assess how localization uncertainty affects the robustness of biopsy DVH dose thresholds in HDR prostate brachytherapy and to quantify the nominal dose margins corresponding to 95% pass probabilities.
methodsTwenty-seven biopsies from 15 HDR monotherapy patients were reconstructed as sets of
resultsThe pooled voxel-dose and dose-gradient distributions were broad, positively skewed, and consistent with log-normal models. Nominal voxel-level doses tended to be higher than localization-perturbed samples, with mean absolute per-trial
conclusionsLocalization uncertainty causes nominal biopsy DVH metrics to systematically overestimate Monte Carlo-propagated doses. The reported 95% margins should be interpreted as biopsy-scale robustness buffers under the stated uncertainty model, not as clinically prescriptive focal-boost increments. Dose decorrelated over distances of order
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