The American Association of Physicists in Medicine (AAPM) International Council (IC), in collaboration with Help Ukraine Group (HUG) and the Ukrainian Association of Medical Physicists (UAMP), developed a novel hybrid year-long training course to assist Ukrainian medical physicists in transitioning from Co-60 to intensity-modulated radiation therapy during the war. To create a comprehensive curriculum for the course, AAPM IC committees, HUG, and UAMP conducted a needs assessment survey. Based on the survey results, the course was divided into three parts: foundational knowledge and linear accelerator commissioning (Part 1), treatment planning and quality assurance (QA) program (Part 2), and practical sessions on linear accelerator commissioning, QA, and treatment planning (Part 3). Part 1 and 2 featured 50 1.5-2 hour virtual lectures, with prelecture and postlecture assignments, delivered online with interactive questions, and artificial intelligence-driven synchronous subtitling in Ukrainian, while Part 3 included four 3-day practical sessions in Ukrainian at two clinical sites using equipment from two different vendors. A total of 131 medical physicists and students enrolled in Part 1 and 2, including almost all practicing medical physicists in Ukraine. Part 1 and Part 2 lectures were endorsed by AAPM and accredited by Commission on Accreditation of Medical Physics Education Programs. Average examination scores increased from 51.2% to 82.5% (Part 1) and 53.3% to 89.4% (Part 2). Satisfaction scores averaged 9.3 ± 0.9 of 10, with 96.3% recommending the course and 70% claiming changing practices. Practical sessions (Part 3) involved 62 participants, with examination scores improving from 57.8% to 80.5%. The average satisfaction for Part 3 was 9.8 ± 0.7 of 10. This collaborative training initiative demonstrates a concerted effort to support, educate, and expand the medical physics community in Ukraine during wartime. It can serve as a model for similar initiatives in other low- and middle-income countries/upper middle-income countries.
Medical physicists are essential healthcare professionals who bridge the gap between technology and patient care, particularly in radiation oncology and medical imaging. With the profession expanding its clinical and global roles, the need for competencies beyond technical expertise-such as communication, leadership, and cultural awareness-is increasingly evident. These competencies, commonly referred to as soft skills, are critical for patient-centered care but remain insufficiently integrated into formal education and training pathways. The aim of the present work was to identify soft skills relevant to medical physics practice and investigate where in a career they are acquired and used. This paper presents the views of a group of medical physicists affiliated with leading organizations in medical physics education and professional development. The group conducted a comprehensive analysis of the role and relevance of soft skills in clinical practice, academic settings, and international training programs. Their discussions led to the identification, classification, and mapping of essential soft skills across different career stages and professional roles within the field. The findings aim to inform curriculum development, professional standards, and capacity-building initiatives in medical physics worldwide. A framework of core soft skills was developed and categorized into seven domains: professionalism, leadership, cultural/political awareness, communication, adaptability, emotional intelligence, and ethical reasoning. These skills were mapped to various career stages of medical physicists, from university coursework to clinical practice and international expert missions. The analysis demonstrated that soft skills are dynamic, teachable, and essential across academic, clinical, and global contexts. The study also reviewed current gaps and opportunities in integrating soft skills into medical physics curricula, clinical residency programs, and continuing professional development. To meet the evolving demands of healthcare, soft skills may need to be embedded in the education, training, and professional development of medical physicists. These skills enhance interdisciplinary collaboration, patient engagement, and leadership capacity, positioning medical physicists as integral members of the healthcare team. Academic institutions, professional societies, and global organizations are encouraged to work together to define, teach, and assess these competencies in ways that are practical and culturally adaptable.
To evaluate adoption patterns and attitudes toward generative AI-particularly large language models (LLMs) such as ChatGPT-among medical physicists in Indonesia. A cross-sectional online survey was conducted in October 2025 among 165 Indonesian medical physicists. The questionnaire captured demographics, awareness and use of LLMs, professional use cases, perceived productivity benefits, verification behaviors, concerns, and views on future integration. Descriptive statistics were used for analysis. LLM awareness was nearly universal (95%), and 96% had used an LLM. Most respondents (72%) used LLMs at least several times per week. Common applications included literature search and summarization (67%), solving technical or clinical questions (58%), drafting professional communications (46%), preparing teaching materials (41%), and assisting scientific writing (39%). Perceived benefits were strong: over 85% reported increased perceived efficiency, with 61% noting significant productivity gains and none reporting decreased productivity. Trust remained moderate; only 11% expressed high confidence in LLM accuracy, and the majority routinely verified important outputs. Key concerns included potential inaccuracies or hallucinations (63%), overreliance (59%), limited domain understanding (59%), ethical or plagiarism risks (55%), and data privacy (44%). Despite these concerns, 94% expected a positive future impact of LLMs on the profession, 79% supported incorporating AI/LLM competencies into training, and 92% would recommend LLM use to colleagues, albeit with caution. Indonesian medical physicists have rapidly integrated generative AI into research, education, and problem-solving activities, reporting perceived efficiency gains while maintaining critical oversight. Their optimism underscores the need for guidance and training to ensure responsible, effective use of AI tools in medical physics. Cautions should be made on ethical issues of an overuse/abuse of generative AI especially among early-career or in-training medical physicists.
Equitable access to high-quality cancer care depends on scalable, sustainable training initiatives, particularly in radiation oncology. This study evaluated whether gains in treatment planning competency, confidence, and knowledge among medical physicists were maintained 2 years after a virtual volumetric modulated arc therapy/intensity modulated radiation therapy (VMAT/IMRT) training course. Medical physicists who completed a 15-week virtual training in 2022 were reassessed 2 years later via remote submission of a head and neck VMAT/IMRT plan, a multiple-choice knowledge test, and a confidence survey. Plan quality was assessed using automated scorecards (25 points) and expert rubrics (14 points), whereas knowledge and confidence were measured via surveys. Wilcoxon signed-rank tests compared pre, post, and follow-up outcomes. Effect sizes were calculated using Cohen's d. Nineteen of the 40 invited participants who had completed the prior postcourse assignment (47.5%) were enrolled in the follow-up study, representing 15 countries across four continents. Seventeen participants had complete data, defined as submitting pre, post, and follow-up responses for both objective and subjective assessments. Objective scores improved from 10.5/25 (±8.1) pretraining to 16.4/25 (±6.8) posttraining and 18.6/25 (±6.4) at follow-up (P = .011 and P = .001), with no significant change from posttraining to follow-up (P = .26). Subjective scores declined posttraining (11.1/14 ± 5.9 to 8.5/14 ± 3.0; P = .021) but rebounded at follow-up (10.8/14 ± 3.4; P = .037), with no difference from baseline (P = .96). Among 18 participants with complete survey data, confidence improved from 3.18 ± 1.26 at baseline to 4.14 ± 0.95 posttraining and was sustained at 4.12 ± 0.74 at follow-up, with a significant improvement from baseline to follow-up (P = .0023). Knowledge increased from 65.3% ± 29.9 at baseline to 83.3% ± 17.1 posttraining and was sustained at 80.6% ± 20.2 at follow-up, with a significant improvement from baseline to follow-up (P = .026). Remote VMAT/IMRT training led to lasting improvements in treatment planning, confidence, and knowledge, with objective scores continuing to rise over time. These findings support remote education as a sustainable model for building radiation therapy capacity in low- and middle-income countries.
The optimization process is an important part of image-based diagnostics and treatments, requiring collaboration among medical physicists, radiologists, physicians, radiographers, nurses, engineers, and vendors. However, such teamwork can be challenging in some departments. In spring 2024, questionnaires were sent to Swedish medical physicists working with radiology, interventional radiology, or surgery facilities using radiological equipment. The surveys included modality-specific questions about optimization processes. The aim was to explore differences in optimization processes between modalities and departments, identify common challenges, and understand factors facilitating effective optimization. Results showed variations in optimization processes across different modalities, where successful optimization processes were harder to achieve for stationary fluoroscopy systems and mobile fluoroscopy systems than for the other modalities. Common challenges included limited time and lack of knowledge about image quality issues, while close collaboration, continuous meetings with focus on optimization, and good communication were mentioned as important factors for obtaining successful optimization processes.
IntroductionLow- and middle-income countries (LMICs) like Nigeria face rising cancer incidence and mortality, with late-stage presentation and limited resources. Only eight government-funded radiotherapy centres serve a population of 223.8 million-far below the estimated 280 radiotherapy machines required. To increase patient throughput we evaluated integration of AI auto-contouring tools to expedite treatment planning, specifically target and organ-at-risk delineation.Materials and MethodsWe performed an observational, survey-based study of radiation oncology staff at our Cancer Centre. Participants were consultant and resident oncologists and medical physicists. The survey compared time spent using AI auto-contouring versus manual contouring and collected perceptions of impact, benefits, and limitations.ResultsThirty-one staff responded: 20 (64.5%) oncologists and 11 (35.5%) medical physicists. Experience with AI varied (33% ≤ 6 months; 13% ≈2 years). Respondents reported increased confidence in planning: 11 (35%) moderate, 12 (39%) moderate-high, and 8 (26%) high. Common limitations were licence availability (20, 64.5%) and technical expertise (19, 61.3%). Most respondents (20, 65%) would recommend the tool. The principal benefit was improved workflow efficiency (25, 81%). AI-assisted planning significantly reduced planning time for most tumour sites; sites with complex anatomy showed no time benefit, reflecting the need for intensive manual correction.ConclusionDeployment of AI auto-contouring at a Nigerian cancer centre reduced planning time for most sites and improved clinician confidence, but complex anatomical regions still require detailed manual oversight and additional AI training. AI tools can increase throughput in LMIC radiotherapy services, though licensing, infrastructure, and training barriers exist and must be addressed to ensure safe implementation. Future work should include multi-centre validation, formal inter-rater reliability assessment, and prospective patient-level outcome evaluation and cost-effectiveness analyses.
This study evaluates the impact of international observerships organized by Help Ukraine Group (HUG) on professional development, knowledge transfer, and clinical practice improvement in radiation oncology in Ukraine. A total of 50 observerships were facilitated for Ukrainian medical professionals at 14 institutions across the USA, Canada, Europe, and Australia from 2022 to 2024, including 31 radiation oncologists and medical physicists. A survey assessed their impact on oncology care, focusing on knowledge gained, lessons learned, and challenges in implementing new techniques. The primary outcome was the success score, defined as a composite score of implementing new procedures, initiating improvement projects, and knowledge dissemination efforts. Descriptive and comparative analyses examined satisfaction and success outcomes. A total of 43 respondents participated in the survey (response rate 86.0%). Twenty-eight of the responders were radiation oncology professionals (67.8% radiation oncologists, 32.1% medical physicists). The median observership duration for radiation oncology professionals was four weeks, with 96.4% also attending a professional conference. Overall satisfaction was high (mean 9.5 out of 10, median 10.0, IQR 9.0-10.0) while the success score was substantial (mean 6.1 out of 10, median 7.0, IQR 5.0-8.0). Time since certification influenced success, with ≥10 years' experience associated with higher success scores (7.4 vs. 4.7, p=0.01). Importantly, 100% of respondents learned new procedures, 89.3% reported shifts in their clinical perspective, and 60.7% successfully implemented new techniques. Subsequent knowledge dissemination in Ukraine was substantial: 82.1% provided informal training, 60.7% delivered institutional or national presentations, 39.3% incorporated materials into lectures, and 10.7% engaged in all activities. Continued mentorship with host institutions was reported by 82.1%. Amid the war, international observerships advanced clinical practice, education, and procedures in Ukraine, demonstrating the resilience of its medical community and providing a model that other LMICs/UMICs can follow.
A survey was conducted across various institutes to assess the footprints of patient-specific quality assurance (PSQA) in radiation oncology practice in India. A multiple-choice pre-questionnaire was created to assess the practice of PSQA for intensity-modulated radiation therapy (IMRT) and volumetric modulated arc therapy (VMAT). A Google Form was used to conduct the online survey. The medical physicists at different radiotherapy institutions with at least one functioning teletherapy machine received a Google Form via email/social media with a link to a Google Form survey. The survey URL was shared with medical physicists with the understanding that participation would be voluntary. The present survey turnout was 63.5% and the leading respondents were from tier II cities with 43.5%. The 41.7% hospital was treating more than 750 cancer patients every year. The majority of hospitals (99.0%) have C-series linear accelerators (LINAC). Most commonly used photon energy for treatment was 6 MV (FF/FFF). The majority of users (94.44%) follow the gamma passing criteria of 3%/3 mm, and 91.6% users follow the gamma passing rate of >95%. The survey provided significant information on the current PSQA methods, instruments, and techniques used by different hospitals practicing IMRT and VMAT techniques. There was variation in the practice of PSQA, the equipment used, their methodology, and the analysis followed. The most common PSQA analysis followed was ±3% for ion chamber measurements and 3% dose difference and 3 mm distance to agreement for gamma-analysis. Additionally, limited use of a heterogeneous phantom for PSQA was observed in clinical settings.
Skin is filled with a rich network of sensory neurons, and consequently skin interaction with, and perception of the external environment, is a continual phenomenon experienced by all people in society. For medical devices such as prosthetics, the mechanical interaction between skin and the device is an essential aspect for device function, but it must be minimized to ensure continued skin health, which is inherently intertwined with biological processes. Numerous factors influence the interface properties of skin. For example, hydration, which influences skin morphology and composition, in turn influencing skin mechanics that may lead to tissue inflammation and skin injury. Here, we review the current state-of-the-art in skin medical device tribology with a particular focus on skin-prosthetic interactions. We split this article into traditional approaches to skin friction and a biology-first approach to skin friction, with a paradigm shift of skin as an engineered material. The field of tribology has historically been an interdisciplinary field comprising engineers, chemists and physicists, but future developments are needed in skin biology to drive meaningful change. We envisage that the integration of both clinical and biological perspectives will drive future innovations towards improved medical device interactions with the skin, when paired with engineering perspectives.
This study aims to assess the current prevalence, utilization patterns, and operational challenges of electronic portal imaging device (EPID)-based dosimetry systems in Indian radiotherapy centres. A multiple-choice survey was distributed through Google Forms to medical physicists in India. The four-section survey covered treatment techniques, EPID availability and dosimetry, alternative detectors, and future challenges. Responses were limited to one per institution, with follow-up reminders. A total of 237 responses were received with a response rate of 62.2%. Among these, 73% of institutions currently use EPID-based dosimetry systems. Of these users, 42.2% rely on EPID for daily quality assurance (QA), and 62.4% of institutions use EPID for more than 50% of their total QA workflow. The primary tasks performed using EPID systems include patient-specific QA (PSQA) for intensity modulated radiation therapy (100%), periodic machine QA (58.4%), PSQA for stereotactic radiation therapy/stereotactic body radiation therapy (48.6%), machine commissioning (18.5%), and in vivo dosimetry (10.4%). Among institutions not currently using EPID due to nonavailability, 89.1% expressed willingness to adopt it for PSQA in the future. Major challenges in implementing EPID dosimetry were software limitations (34.2%) and maintenance and calibration issues (35.0%). After adopting EPID dosimetry, 79.8% of institutions observed improvements compared to conventional detectors. In addition, 93.7% of institutions believed that EPID dosimetry implementation would reduce physicist workload through automated software and resource optimization. This study reveals the widespread use of EPID systems and highlights that implementation offers certain advantages. However, issues such as software limitations, high initial cost, and the need for affordable or free resources remain barriers to wider adoption.
For decades, magnetic resonance has been considered one of the most insightful and versatile families of analytical techniques available to chemists, physicists, and materials scientists [...].
This study aimed to investigate the strength of the correlation between organ doses and four computed tomography (CT) dose metrics, and to explore a method for rapidly estimating organ doses in patients undergoing chest-abdominal-pelvic (CAP) CT examinations. We retrospectively collected DICOM images of 43 patients who underwent CAP CT examinations. These images were imported into Archer-CT for organ segmentation and dose calculation. Then, regarding the six radiosensitive organs (spinal cord, lung, oesophagus, stomach, liver, and bladder) that were included in the study, various radiation dose metrics were calculated based on size-specific dose estimate (SSDE) derived from equivalent water diameters (Dw), i.e. SSDEcentrebased onDwin the centre of the scan range, the SSDEmeanbased on the mean SSDEs of all slices, and the organ-specific SSDEorganfor various organs, as prescribed in American Association of Physicists in Medicine Report 220. Subsequently, correlation analyses were applied to evaluate the relationship between the organ doses and each radiation dose metric and to derive conversion factors for rapid estimation of organ doses. The ranked linear correlations of the four dose metrics with each organ dose were as follows, in descending order: SSDEorgan, SSDEmean, CTDIvol, and SSDEcentre. The strongest and weakest correlations were found between organ dose to liver and SSDELiver(R2= 0.88),and between organ dose to the bladder and SSDEBladder(R2= 0.62) respectively, while theR2of the rest of the organ doses to SSDEorganwas around 0.8. The conversion coefficients for estimating organ doses based on SSDEorganfor the spinal cord, lung, oesophagus, liver, stomach, and bladder were 0.75, 1.24, 0.89, 1.17, 1.18, and 0.83, respectively. Higher correlations were observed between organ doses and SSDEorganfor organs involved in this study during CAP CT examinations. Thus, SSDEorgancan be used to simplify and estimate the individualised organ dose for CAP CT examinations.
To gauge the views of UK nuclear medicine staff on a skin contamination incident of 500 mSv from Tc-99m and Ra-223 (an alpha source). An anonymous questionnaire asked staff their concerns on anxiety, erythema, and skin cancer. Also, aspects of removal from open-source work. The same question set was used for Tc-99m and Ra-223. Replies were grouped as 37 RPAs, 121 other physicists, 78 technologists/radiographers, and 31 radiopharmacy staff. Scores encompassed 1-10 for all staff groups for questions on 'anxiety', 'erythema', and 'skin cancer'. However all staff groups scored significantly higher for Ra-223 than for Tc-99m. The majority of staff in all groups expected to be removed from open-source work, with timescales up to a year. Many staff indicated they would prefer not to be taken out of work (56% for a Tc-99m incident and 47% for a Ra-223 incident). But, a high proportion of staff wanted to have significant time off (≥3 months). In practice, there is no risk of erythema and the skin cancer risk is extremely low. This applies to Tc-99m and to Ra-223. Also, the IRR2017 allow for someone who receives an overexposure to continue to work, with modified dose limits and agreement from the appointed doctor. All staff groups need to have a clearer understanding of the risks and implications of receiving this level of skin dose. The high anxiety levels indicate that return to work needs careful communication that it is because of low risks and within the legal framework.
The aim of this study is to investigate how well veterinary institutions have adopted to the structure naming conventions provided by the American Association of Physicists in Medicine (AAPM) Task Group 263 (TG-263). The TG-263 standard nomenclature has been suggested as a means of reducing the uncertainty in structure definitions in radiation oncology. Our interest is in understanding whether these recommendations have been adopted in the veterinary radiation oncology setting. This study includes a convenience sample survey of five veterinary institutions across the United States, each with 38-102 total structure names defined across their templates. The data were examined in two steps: an automated check that flagged forbidden characters, spaces, and exceeding length, and a manual review for abbreviations (e.g., L/R), uniqueness, and mapping to the TG-263 structure spreadsheet and SNOMED (Systematized Nomenclature of Medicine) Veterinary Extension. Each structure was classified as compliant, having one error, multiple errors, or uniquely defined by the institution. The results were analyzed by determining the percentages of each category per institution. Our results suggest wide variability with a mean compliance of 55.2% and a standard deviation of 35.2%, which suggests no clear trend.
I present an analysis of the changes to intra-scientific communication in postwar American physics. In particular, I focus on a case study of the technical typists who worked for the American Institute of Physics (AIP) journals, especially the Physical Review (PR), c. 1962-1977. I argue PR became a trading zone amidst the page-charge crisis, and analyze the networks of physicists, typists, editors, and copy-editors that emerged to resolve this threat to community-level objectivity. Challenging the picture of typist as "automaton", I identify the skills and technical knowledge needed to perform manuscript transcription, and offer an account of the material culture of intra-scientific communication to situate the typists' epistemic role in the broader context of "Big Science" changes to postwar physics. I claim this is a case of an epistemic contribution that has been instrumentalized, akin to human computers and human scanners. However, unlike other cases of instrumentalization, technical typists were not directly involved in the production or critique of scientific data. Rather, their novel contributions occurred in the new field of mathematical typesetting that emerged from this trading zone. Thus, I seek to differentiate the material culture of scientific experiments from the material culture of intra-scientific communication. I see this project as an extension of Galison's trading zone framework, recognizing that there are many more material objects besides those of the laboratory that are created in the scientific process.
This report summarizes the establishment and implementation of the first dedicated pediatric radiation oncology program in Nigeria. The program was developed to improve clinical outcomes, increase professional capacity, and advance regional research and protocol development. Key considerations included professional development and capacity building, promoting multidisciplinary communication and practice, and incorporating technology for improved communication and data management. Regional and international collaborations were instrumental in addressing these considerations and ensuring the program's success. The program encountered challenges, including difficulties in recruiting team members, high rates of treatment abandonment, gaps in clinical and pathological information, as well as inadequacies in diagnostic testing capabilities. This pioneering pediatric radiation oncology unit in Nigeria was established with a multidisciplinary team comprising radiation oncologists, medical physicists, radiation therapy technologists, nurses, trainee medical doctors, and a dedicated research associate. The facility is equipped with 3 linear accelerators capable of delivering advanced conformal 3-dimensional radiation therapy such as intensity modulated (IMRT) and volumetric modulated arc radiation therpay (VMAT). Within a 4-year duration, the program received 210 pediatric referrals, of which 55.7% proceeded to undergo radiation treatment. Innovative, context-specific, feasible, and sustainable solutions were necessary to address the unique challenges of the region. This report details the establishment process, achievements, and strategies employed to overcome common barriers in commencing a pediatric radiation program in sub-Saharan Africa, in order to serve as a replicable model for advancing pediatric radiation oncology practice in regions with similar health care and socioeconomic contexts.
Access to radiotherapy (RT) remains a challenge even in high-income countries such as the Kingdom of Saudi Arabia (KSA). This study aims to examine how key structural indicators such as staffing and equipment availability, distribution, and capacity affect access to care and the quality of RT services in Saudi Arabia. A mixed-methods design using a descriptive cross-sectional approach was employed. A survey was distributed electronically to supervisors and managers of 20 RT units in the KSA between September 24 and October 23, 2025. The qualitative phase explored the perspectives of radiation therapists (RTTs) and medical physicists, whereas the quantitative phase examined variables such as staff numbers and distribution, patient volumes, equipment availability, treatment waiting times, and overall facility capacity between January and December 2024. The survey response rate was 85% (n =20). Public facilities treated the highest caseloads but had fewer linear accelerators per patient, higher clinician workloads, and longer waiting times, with radical treatment often exceeding 14 days and, in some cases, extending beyond 42 days. The mixed centers had the highest machine capacity and advanced technologies. Training opportunities were limited, particularly in the public sector, where most departments rated staffing and operational efficiency inadequate. Equipment procurement presented a challenge with 65% of centers (majority in the public sector), expressing tendering delays severely or critically affected their ability to provide care. These findings support the development of a strategic framework to strengthen RT capacity and reduce sector-based disparities. Outsourcing initiatives among different facility types have already been initiated. Ultimately, these results may support policy development and resource planning to promote more equitable cancer care delivery in the country.
This study aims to evaluate statistical low-contrast detectability (SLCD) at multiple confidence levels (CLs) in computed tomography (CT) images and to determine the smallest detectable object sizes compared with human observers (HO). SLCD was calculated on a homogeneous region of the CT images using grids of varying cell sizes. For each grid, mean CT numbers were calculated and the standard deviation was used to derive the minimum detectable contrast (MDC) as a function of CL via the separation distance between object and background distributions. CLs from 95% to 99.99% were evaluated. The target sizes (smallest object sizes detected) were compared with visual assessment performed by 30 experienced medical physicists. The evaluation was carried out on the low-contrast module (module #2) of the ACR CT phantom scanned by GE Revolution EVO 128 slice CT scanner in various tube currents (80-200 mA), tube voltage (80-140 kV), and field of view (170-230 cm). At 95% CL, SLCD estimated target sizes were approximately half of those identified by HO. Increasing CL produced larger SLCD target sizes, where 99.99% CL yielded target sizes comparable to HO results across all parameter variations. SLCD outcomes depend strongly on the selected CL. To align with human performance at 6 HU, using ∼99.99% CL is recommended. This has implications for quality control (QC) and protocol optimization where statistical methods substitute for human reads.
Quantum annealing leverages the properties of interacting quantum spin systems to solve computational problems, typically optimisation problems. Current hardware now has capabilities that can be used to solve condensed matter physics problems, too. In thistopical review, we provide an overview of quantum annealing aimed at condensed matter physicists, to show the mutual benefits of working together to understand and improve how quantum annealers work, and to use them to advance condensed matter physics.
Considering the limitations of current homogeneity index (HI) in multi-target plans, we have redefined the volume (V)PTV in the formula for calculating the HI value of target volumes. This redefinition could provide a reference for clinical applications. Since the three widely used HI formulas may not fully capture dose homogeneity in multi-target treatment plans, we have redefined the VPTV in the calculation formulas, which may allow for a better assessment of HI for the multi-target radiotherapy plans. Fifteen clinically treated breast cancer (BC) with conserving surgery patients and fifteen nasopharyngeal carcinoma (NPC) patients were chosen. We calculated the VPTV with the name of VPTVpro and the HIpro1, HIpro2, HIpro3. A paired, two-tailed non-parametric Wilcoxon signed-rank test was utilized to compare VPTVori and VPTVpro, HIori1 and HIpro1, HIori2 and HIpro2, HIori3 and HIpro3. The correlations between HIori1 and HIpro1, HIori2 and HIpro2, HIori3 and HIpro3 were also analyzed. We conducted a questionnaire survey among a panel of six senior radiation oncologists and physicists to validate the clinical applicability of this study. For Planning Target Volume (PTV) of BC and PTV1 of NPC, the VPTVpro were significantly smaller than the VPTVori and HIpro were significantly lower than HIori. The correlation coefficient values of HIori1-HIpro1, HIori2-HIpro2, and HIori3-HIpro3 showed variations, though all demonstrated positive correlations with statistically significant p-values <0.01. The results for these two target volumes revealed a consistent pattern: the HIori1-HIpro1 pair exhibited the highest correlation coefficient values, while HIori2-HIpro2 consistently showed the lowest values. Meanwhile, clinical validation by the expert panel found that the VPTVpro and HIpro in this study do not affect clinical plan selection. All experts agreed that, compared to VPTVori and HIori, VPTVpro and HIpro better align with their clinical practice for evaluating multi-target radiotherapy plans. The VPTVpro calculation subtracts the overlapping high-dose target volume from the low-dose target volume. This adjustment is intended to enable a more accurate assessment of dose HI specifically within the low-dose target. Additionally, the VPTVpro is also applicable for HI calculation in single-target volume. We suggest using the VPTVpro to calculate the HI of the target for multi-target plans such as BC with conserving surgery and NPC. Meanwhile, we recommend employing formula 1 for the calculation of HI among the three formulas.