{
  "abstract": "Background: Independent second checks for proton and carbon-ion pencil-beam scanning should assess the planned physical dose, the expected delivery sequence, and the model-dependent relative biological effectiveness (RBE)-weighted dose.\n\nObjective: The aim of this study was to design, implement, and assess a traceable second-check system that combines delivery-aware Monte Carlo transport with microdosimetric RBE calculation for both particle species.\n\nMethods: The system receives Digital Imaging and Communications in Medicine (DICOM) planning data, converts the discrete spot sequence into a predicted delivery sequence for dose-driven continuous scanning (DDCS), generates weighted particle histories, and performs independent TOPAS/Geant4 transport. It scores physical dose, dose-averaged linear energy transfer (LETd), and voxel-level microdosimetric quantities. For both beam types, the scored lineal-energy distribution is represented using abridged microdosimetry distribution methodology (AMDM) and processed with the Mayo Clinic Florida microdosimetric kinetic model (MCF MKM). The proton branch additionally produces a fixed-RBE-weighted dose using RBE = 1.1. No fixed-RBE model is used for carbon ions. Proton assessment included component tests, single-energy source, transport, and scoring checks at 70.0, 170.2, and 229.1 MeV, patient-level evaluations using de-identified plans, and operational timing. Carbon-ion assessment used a pre-existing Monte Carlo dataset to evaluate component-level handling and visualization of AMDM descriptors, the MCF MKM RBE factor, and RBE-weighted dose.\n\nResults: The integrated workflow completed plan receiving, delivery-sequence generation, particle transport, physical and biological dose calculation, comparison, and report generation. The proton case for which detailed quantitative end-to-end results were reported was classified as REVIEW REQUIRED because not all dosimetric comparison criteria were met. A pre-existing carbon-ion dataset was used to verify the component-level handling and separate presentation of physical dose, AMDM descriptors, RBE factor, and RBE-weighted dose. Predicted DDCS timing and the stationary-versus-moving irradiation components were not benchmarked against machine logs or measurements.\n\nConclusion: A common delivery-aware platform was implemented to support independent physical dose and microdosimetric RBE-weighted dose assessment for proton and carbon-ion treatments while retaining beam-specific dose conventions and biological model information. Further local commissioning and multicase validation are required before clinical use.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Radiation Oncology, Mayo Clinic Florida"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Jun Tan"
    },
    {
      "affs": [
        0
      ],
      "name": "Keith Furutani"
    },
    {
      "affs": [
        0
      ],
      "name": "Alessio Parisi"
    },
    {
      "affs": [
        0
      ],
      "name": "Shannon Hartzell"
    },
    {
      "affs": [
        0
      ],
      "name": "Chris Beltran"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/55fbm3ea684fb.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1949825",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727420/?tool=EBI",
  "id": "55fbm3ea684fb",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1949825/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Radiation Therapy and Dosimetry"
    ]
  ],
  "openalex": "W7223018574",
  "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1949825/pdf",
  "pmcid": "PMC13727420",
  "pmid": null,
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/55fbm3ea684fb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1949825",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1949825/full"
    },
    {
      "first_seen": "2026-11-04T15:20:46Z",
      "native_id": "PMC:PMC13727420",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727420"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2234-943X",
      "subfield": "oncology"
    }
  ],
  "title": "Design, implementation, and assessment of an independent second-check system for proton and carbon-ion pencil-beam scanning: delivery-aware Monte Carlo and microdosimetric RBE-weighted dose",
  "title_text": "Design, implementation, and assessment of an independent second-check system for proton and carbon-ion pencil-beam scanning: delivery-aware Monte Carlo and microdosimetric RBE-weighted dose",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T15:20:46Z",
  "url": "https://research.draconitic.com/paper/55fbm3ea684fb",
  "venue": "Frontiers in Oncology",
  "versions": []
}