S1955
Physics - Dose prediction/calculation, optimisation and applications for photon and electron planning
ESTRO 2026
considerable potential for visualizing complex three- dimensional anatomies. In standard Radiation Therapy planning, clinicians must interpret complex relationships between target volumes, critical organs- at-risks, and dose distributions on inherently limiting 2D screens. This study investigates whether immersive 3D visualization using XR can enhance users' spatial perception and provide a novel, clinically valuable perspective on treatment plan evaluation compared to standard 2D approaches. Material/Methods: We conducted a simulated clinical workflow study where three physicist and physician pairs (average experience 7.25 years) evaluated 5 treatment plans of varying complexity: acoustic neuroma, lung, prostate, and VMAT/SRS brain (Figure 1). Each pair collaboratively reviewed and discussed the plans using an XR environment while being in different locations. User feedback on the system's utility, ease of use, spatial visualization benefits, and clinical integration potential was systematically collected immediately after the session. Feedback included responses to a questionnaire comprising eight questions utilizing a Likert scale (Figure 2) and three open-ended free-text questions to capture qualitative insights.
arm skin tumors and exploiting the ElectronFlash machine developed by S. I. T. [3] to deliver UHDR irradiations. Results: The TPS is fully operational and can be routinely used to optimize the shaper aperture, generate dose maps and dose–volume histograms, and identify the optimal treatment plan. The planning workflow schematic is shown in Figure 2.
Figure 2: Schematic of the planning workflow, starting from image processing (1–3), followed by dose calculation (4), and ending with dose report and DVH generation.The full MC chain was validated using an anthropomorphic phantom to assess the precision of the attainable dose distribution in complex, multi- density geometries, comparing simulated and measured distributions. Conclusion: Within the CPFR clinical trial framework, a FLUKA MC- based TPS for FLASH-eRT has been developed and validated, achieving planning quality comparable to standard external beam radiotherapy systems in terms of performance and reliability.We thank Fondazione Pisa for funding CPFR with the grant “prog. n. 134/2021”. References: [1] http://www.fluka.org/fluka.php?id=aboutmm2=1.[2] https://cisup.unipi.it/electron-flash-therapy/.[3] https://www.soiort.com/. Keywords: FLASH-RT, Monte Carlo simulation, TPS Can Extended Reality lead to better 3D spatial perception in Radiation Therapy Planning? Aniol Serra Juhé 1 , Tobias Brandt 2 , Johann Brand 2 , Philipp Schubert 2 , Christopher Dürrbeck 2 , Charlotte Frei 2 , Daniel Höfler 2 , Juliane Szkitsak 2 , Christoph Bert 2 , Andreas Maier 1 , Stefanie Corradini 2 , Florian Putz 2 , Annette Schwarz 2 1 Pattern Recognition Lab, Friedrich-Alexander- Universität Erlangen-Nürnberg, Erlangen, Germany. 2 Department of Radiation Oncology, University Hospital Erlangen, Erlangen, Germany Purpose/Objective: Extended reality (XR) technologies, encompassing augmented, mixed and virtual reality, offer Proffered Paper 3835
Results: Participants overwhelmingly agreed that the 3D representation enhanced their spatial understanding of the dose distribution and spatial tumor spread (with
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