{
  "abstract": "Purpose\n\nTo implement and preliminarily evaluate a practical digital acquisition-and-analysis workflow for routine laser-radiation field coincidence quality assurance (QA) on the CyberKnife M6 by integrating multileaf collimator (MLC) QA tool-based laser reference definition, QA StereoChecker (QASC)-based external digital image acquisition, and automated analysis with CKQA, an in-house CyberKnife QA software, and to compare this workflow with clinically realistic film-based alternatives.Methods\n\nMethods a and b were film-based measurements performed at the perch position. Method a used manual laser marking on film, whereas method b used the central metal marker of the MLC QA tool to define the laser reference. Method c used QASC as an external digital image-acquisition platform in combination with the MLC QA tool, and method d used film on the same QASC-based setup as a control. All methods were tested with 10 fixed collimators (5-40 mm). Images were analyzed using ImageJ and CKQA. Mean deviation, standard deviation, root mean square error (RMSE), and pairwise two-sided exact Wilcoxon signed-rank tests were used for exploratory comparisons.Results\n\nAll evaluated workflows achieved submillimeter mean deviations. Across both analysis approaches, the mean deviation ranked consistently in descending order: method a > method b > method d > method c. Under the present experimental conditions, method c yielded the lowest mean deviation and RMSE (0.116 mm and 0.155 mm with CKQA), whereas method a showed the largest deviations. Dataset-level exact Wilcoxon signed-rank tests showed that several comparisons involving method a were statistically significant, but statistically significant differences were not uniform across both ImageJ- and CKQA-based comparisons. For comparisons between analysis methods within each workflow, CKQA and ImageJ were not significantly different for methods a and b, whereas CKQA yielded significantly lower deviations than ImageJ for methods c and d (p < 0.05).Conclusions\n\nLaser-radiation field coincidence testing is an established CyberKnife QA procedure. The present study implemented and preliminarily evaluated a practical digital acquisition-and-analysis workflow for this routine task. The workflow combining MLC QA tool-based laser reference definition, QASC-based external digital image acquisition, and automated CKQA analysis provided a standardized and less operator-dependent procedure under the present experimental conditions. Its main value lies in reducing manual marking, film handling, scanning, and subjective image-analysis steps rather than in introducing a new physical measurement principle. In centers where QASC is not available, the film-based workflow using the MLC QA tool (method b) may serve as a practical alternative.",
  "abstract_shown": true,
  "affiliations": [
    "National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Shenzhen China.",
    "School of Computer Science and Artificial Intelligence Wuhan University of Technology Wuhan China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Linzheng Hu"
    },
    {
      "affs": [
        1
      ],
      "name": "Yongkang Zhao"
    },
    {
      "affs": [
        0
      ],
      "name": "Chunling Zheng"
    },
    {
      "affs": [
        0
      ],
      "name": "Jiajun Cai",
      "orcid": "0000-0002-4024-8380"
    },
    {
      "affs": [
        0
      ],
      "name": "Yajun Jia"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Tao"
    },
    {
      "affs": [
        0
      ],
      "name": "Yikun Liu"
    },
    {
      "affs": [
        0
      ],
      "name": "Yin Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Zhitao Dai",
      "orcid": "0000-0003-0554-689X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d1nyhys88231n.bib",
  "cited_by": 0,
  "doi": "10.1002/pro6.70103",
  "fulltext_url": "https://europepmc.org/articles/PMC13695332",
  "id": "d1nyhys88231n",
  "issns": [
    "2398-7324"
  ],
  "landing_url": "https://europepmc.org/article/MED/42927071",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "3108|Advanced Radiotherapy Techniques"
    ]
  ],
  "openalex": "W7223469310",
  "pdf_url": "https://europepmc.org/articles/PMC13695332?pdf=render",
  "pmcid": "PMC13695332",
  "pmid": "42927071",
  "published": "2026-10-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d1nyhys88231n.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42927071",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42927071"
    }
  ],
  "subjects": [
    {
      "field": "physics",
      "origin": "openalex:3108|Advanced Radiotherapy Techniques",
      "subfield": "applied-instrumentation"
    }
  ],
  "title": "Implementation and preliminary evaluation of a practical digital workflow for routine laser-radiation field coincidence quality assurance on the CyberKnife M6.",
  "title_text": "Implementation and preliminary evaluation of a practical digital workflow for routine laser-radiation field coincidence quality assurance on the CyberKnife M6.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/d1nyhys88231n",
  "venue": "Precision radiation oncology",
  "versions": []
}