Modern dosimetry can meet historical accuracy requirements, but tighter geometric precision and particle-specific uncertainties increasingly determine treatment accuracy.
The pre-plateau modulation factor preserved plan quality while further reduction created idle delivery time without meaningful efficiency gain.
Skull-equivalent anatomy improved synthetic CT performance, but none of ten tested head phantoms satisfied all geometric, HU and dosimetric criteria.
A severity-weighted action-priority framework identified the same seven highest RT workflow risks while avoiding 23 additional traditional FMEA flags.
uTPS generated Halcyon VMAT plans with generally comparable dosimetry to Eclipse and greater than 97% gamma passing rates.
Substantial physician-dependent dose variation meant treatment-group assignment did not consistently reflect the dose actually delivered to regional nodes.
Across 40 Unity SBRT plans, OCTAVIUS 4D achieved 98.3% mean local gamma passing with sub-degree angular agreement.
A scoping review maps generative AI across imaging, documentation, QA and decision support while emphasizing major safety and governance gaps.
HD-TMAR improved metal-region PSNR from 25.5 to 35.5 dB in simulated half-detector CBCT while preserving dental anatomy.
Treatment-planning audit logs closely reproduced manual contour-edit timing and exposed major structure-specific differences in correction workload.
Behavioral and image-derived features explained 39% of interobserver contour uncertainty during manual brain tumor delineation.
Synthetic CT artifacts were common during brain MR-only implementation, highlighting workflow QA and patient-selection issues not captured by controlled validation.
AI synthetic CT preserved soft-tissue HU and geometry well, while bone, air interfaces and implanted devices remained important failure modes.
Alternative shielding materials reduced modeled linac vault area by 17–34% while remaining below the NCRP controlled-area dose goal.
The unshielded SunSILICON detector required only modest corrections in small fields, while the shielded version became unreliable below approximately 2 cm.