{"id":"https://openalex.org/W7223250014","doi":"https://doi.org/10.3390/cancers18213425","title":"Learning Curve Analysis of Alpha DaRT Implantation for Cutaneous Malignancies: A Single-Surgeon Experience","display_name":"Learning Curve Analysis of Alpha DaRT Implantation for Cutaneous Malignancies: A Single-Surgeon Experience","publication_year":2026,"publication_date":"2026-10-22","ids":{"openalex":"https://openalex.org/W7223250014","doi":"https://doi.org/10.3390/cancers18213425"},"language":"en","primary_location":{"id":"doi:10.3390/cancers18213425","doi":"https://doi.org/10.3390/cancers18213425","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18213425","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.3390/cancers18213425","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5085626941","display_name":"Tomer Charas","orcid":"https://orcid.org/0000-0002-3559-860X","observed_orcids":["https://orcid.org/0000-0002-3559-860X"]},"institutions":[{"id":"https://openalex.org/I2801301638","display_name":"Rambam Health Care Campus","ror":"https://ror.org/01fm87m50","country_code":"IL","type":"healthcare","lineage":["https://openalex.org/I2801301638"]}],"countries":["IL"],"is_corresponding":true,"raw_author_name":"Tomer Charas","raw_affiliation_strings":["Radiation Oncology Department, Rambam Health Care Campus, Haifa 3109601, Israel"],"raw_orcid":"https://orcid.org/0000-0002-3559-860X","affiliations":[{"raw_affiliation_string":"Radiation Oncology Department, Rambam Health Care Campus, Haifa 3109601, Israel","institution_ids":["https://openalex.org/I2801301638"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5062506790","display_name":"Yotam Shkedy","orcid":"https://orcid.org/0000-0002-7907-4963","observed_orcids":["https://orcid.org/0000-0002-7907-4963"]},"institutions":[{"id":"https://openalex.org/I4405259026","display_name":"Health New Zealand","ror":"https://ror.org/01jvwvd85","country_code":"NZ","type":"healthcare","lineage":["https://openalex.org/I4405259026"]}],"countries":["NZ"],"is_corresponding":false,"raw_author_name":"Yotam Shkedy","raw_affiliation_strings":["ORL and Audiology Department, Counties Manukau, Te Whatu Ora/Health New Zealand, Auckland 2104, New Zealand"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"ORL and Audiology Department, Counties Manukau, Te Whatu Ora/Health New Zealand, Auckland 2104, New Zealand","institution_ids":["https://openalex.org/I4405259026"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5085626941"],"corresponding_institution_ids":["https://openalex.org/I2801301638"],"apc_list":{"value":2900,"currency":"CHF","value_usd":3499},"apc_paid":{"value":2900,"currency":"CHF","value_usd":3499},"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.83988178,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"21","first_page":"3425","last_page":"3425"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11306","display_name":"Nonmelanoma Skin Cancer Studies","score":0.8363999724388123,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11306","display_name":"Nonmelanoma Skin Cancer Studies","score":0.8363999724388123,"subfield":{"id":"https://openalex.org/subfields/2708","display_name":"Dermatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10358","display_name":"Advanced Radiotherapy Techniques","score":0.04270000010728836,"subfield":{"id":"https://openalex.org/subfields/3108","display_name":"Radiation"},"field":{"id":"https://openalex.org/fields/31","display_name":"Physics and Astronomy"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T13123","display_name":"Advances in Oncology and Radiotherapy","score":0.01759999990463257,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/interstitial-radiotherapy","display_name":"interstitial radiotherapy","score":0.7639999985694885},{"id":"https://openalex.org/keywords/learning-curve","display_name":"learning curve","score":0.8840000033378601},{"id":"https://openalex.org/keywords/skin-cancer","display_name":"skin cancer","score":0.7480000257492065},{"id":"https://openalex.org/keywords/basal-cell-carcinoma","display_name":"basal cell carcinoma","score":0.9120000004768372},{"id":"https://openalex.org/keywords/squamous-cell-carcinoma","display_name":"squamous cell carcinoma","score":0.996999979019165},{"id":"https://openalex.org/keywords/procedural-efficiency","display_name":"procedural efficiency","score":0.7630000114440918},{"id":"https://openalex.org/keywords/procedure-time","display_name":"procedure time","score":0.8679999709129333},{"id":"https://openalex.org/keywords/surgeon-experience","display_name":"surgeon experience","score":0.6600000262260437},{"id":"https://openalex.org/keywords/tumor-volume","display_name":"tumor volume","score":0.6470000147819519}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.7131999731063843},{"id":"https://openalex.org/C2779417484","wikidata":"https://www.wikidata.org/wiki/Q406009","display_name":"Dart","level":2,"score":0.583299994468689},{"id":"https://openalex.org/C2989005","wikidata":"https://www.wikidata.org/wiki/Q214963","display_name":"Nuclear medicine","level":1,"score":0.5806000232696533},{"id":"https://openalex.org/C34585555","wikidata":"https://www.wikidata.org/wiki/Q1368723","display_name":"Learning curve","level":2,"score":0.5546000003814697},{"id":"https://openalex.org/C509974204","wikidata":"https://www.wikidata.org/wiki/Q180507","display_name":"Radiation therapy","level":2,"score":0.44589999318122864},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.4023999869823456},{"id":"https://openalex.org/C112758219","wikidata":"https://www.wikidata.org/wiki/Q16038819","display_name":"Duration (music)","level":2,"score":0.39089998602867126},{"id":"https://openalex.org/C76318530","wikidata":"https://www.wikidata.org/wiki/Q16833590","display_name":"Area under the curve","level":2,"score":0.3865000009536743},{"id":"https://openalex.org/C64943373","wikidata":"https://www.wikidata.org/wiki/Q2651003","display_name":"Alpha (finance)","level":4,"score":0.382099986076355},{"id":"https://openalex.org/C2776805002","wikidata":"https://www.wikidata.org/wiki/Q614984","display_name":"Fluoroscopy","level":2,"score":0.37059998512268066},{"id":"https://openalex.org/C2781156865","wikidata":"https://www.wikidata.org/wiki/Q827023","display_name":"Lesion","level":2,"score":0.3635999858379364},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.31540000438690186},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3095000088214874},{"id":"https://openalex.org/C118663420","wikidata":"https://www.wikidata.org/wiki/Q3614983","display_name":"DART ion source","level":5,"score":0.30160000920295715},{"id":"https://openalex.org/C203092338","wikidata":"https://www.wikidata.org/wiki/Q1340863","display_name":"Clinical endpoint","level":3,"score":0.2865999937057495},{"id":"https://openalex.org/C141341695","wikidata":"https://www.wikidata.org/wiki/Q2368661","display_name":"Surrogate endpoint","level":2,"score":0.2854999899864197},{"id":"https://openalex.org/C2779466056","wikidata":"https://www.wikidata.org/wiki/Q107630651","display_name":"Time point","level":2,"score":0.27140000462532043},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.26269999146461487},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.25769999623298645}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.3390/cancers18213425","doi":"https://doi.org/10.3390/cancers18213425","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18213425","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.3390/cancers18213425","doi":"https://doi.org/10.3390/cancers18213425","is_oa":true,"landing_page_url":"https://doi.org/10.3390/cancers18213425","pdf_url":null,"source":{"id":"https://openalex.org/S168415115","display_name":"Cancers","issn_l":"2072-6694","issn":["2072-6694"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","norway-1","poland-140","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310310987","host_organization_name":"Multidisciplinary Digital Publishing Institute","host_organization_lineage":["https://openalex.org/P4310310987"],"host_organization_lineage_names":["Multidisciplinary Digital Publishing Institute"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cancers","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9537000060081482,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[],"awards":[],"funders":[{"id":"https://openalex.org/F4320319302","display_name":"AlphaTau Medical","ror":"https://ror.org/02s1b4d31"}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":30,"referenced_works":["https://openalex.org/W2000500626","https://openalex.org/W2023276160","https://openalex.org/W2035536571","https://openalex.org/W2037531569","https://openalex.org/W2078428921","https://openalex.org/W2085487772","https://openalex.org/W2119677341","https://openalex.org/W2137247190","https://openalex.org/W2143450357","https://openalex.org/W2461512967","https://openalex.org/W2547536348","https://openalex.org/W2611163880","https://openalex.org/W2758978480","https://openalex.org/W2799448392","https://openalex.org/W2808924924","https://openalex.org/W2893963456","https://openalex.org/W2990334140","https://openalex.org/W2991102157","https://openalex.org/W3131543729","https://openalex.org/W4206959680","https://openalex.org/W4293778217","https://openalex.org/W4316194106","https://openalex.org/W4376131376","https://openalex.org/W4392094368","https://openalex.org/W4394919097","https://openalex.org/W4399984848","https://openalex.org/W4404534238","https://openalex.org/W4407758057","https://openalex.org/W7140208190","https://openalex.org/W7170041584"],"related_works":["https://openalex.org/W4307292959","https://openalex.org/W2972530953","https://openalex.org/W7223455692","https://openalex.org/W4205533766","https://openalex.org/W2951131253","https://openalex.org/W4376131376","https://openalex.org/W2610878680","https://openalex.org/W2950551916","https://openalex.org/W3082919342","https://openalex.org/W4236485577"],"abstract_inverted_index":{"Background/Objectives:":[0],"Diffusing":[1],"Alpha-emitters":[2],"Radiation":[3],"Therapy":[4],"(Alpha":[5],"DaRT)":[6],"is":[7,258],"a":[8,57,74,86,116,225],"novel":[9],"interstitial":[10],"radiotherapy":[11],"technique":[12],"that":[13,246],"delivers":[14],"high-linear":[15],"energy":[16],"transfer":[17],"alpha":[18],"radiation":[19],"directly":[20],"into":[21],"tumor":[22],"tissue.":[23],"As":[24],"with":[25,46,92,181,203,235],"any":[26],"new":[27],"procedural":[28,35,61,71,205,233,247],"oncology":[29],"intervention,":[30],"operator":[31],"experience":[32,123],"may":[33],"influence":[34],"efficiency":[36],"and":[37,95,130,148,160,214,256,267],"reproducibility.":[38],"This":[39],"study":[40],"evaluated":[41,134],"the":[42,101,177,191,262],"learning":[43,228],"curve":[44,229],"associated":[45,202],"Alpha":[47,80,140,221],"DaRT":[48,81,141,222],"implantation":[49,82,223],"for":[50,119],"cutaneous":[51],"malignancies":[52],"using":[53,70],"procedure":[54,104,128,158],"duration":[55,105,110,161,173,183,206],"as":[56,115],"surrogate":[58],"measure":[59],"of":[60,216,264],"efficiency.":[62],"Methods:":[63],"A":[64,151],"retrospective":[65],"learning-curve":[66,120],"analysis":[67],"was":[68,113,124,155,174,200],"conducted":[69],"data":[72],"from":[73,187],"prospective,":[75],"single-arm":[76],"clinical":[77],"trial":[78],"(NCT03889899).":[79],"procedures":[83,142],"performed":[84,144],"by":[85,126,232],"single":[87],"surgeon":[88],"in":[89,103,172,190],"24":[90],"patients":[91],"basal-cell":[93],"carcinoma":[94,97],"squamous-cell":[96],"were":[98,143,218],"analyzed.":[99],"Given":[100],"variability":[102],"due":[106],"to":[107,194,260],"lesion":[108,211],"size,":[109],"per":[111,184],"applicator":[112,185],"used":[114],"standardized":[117],"endpoint":[118],"assessment.":[121],"Surgeon":[122],"defined":[125],"sequential":[127,131],"number,":[129],"regression":[132],"analyses":[133],"changes":[135],"over":[136],"time.":[137],"Results:":[138],"Twenty-six":[139],"between":[145,157],"October":[146],"2020":[147],"February":[149],"2025.":[150],"moderate":[152],"negative":[153],"correlation":[154],"observed":[156,175,238],"number":[159,215],"(Spearman\u2019s":[162],"r":[163],"=":[164,167],"\u22120.57,":[165],"p":[166],"0.002).":[168],"The":[169],"greatest":[170],"reduction":[171],"after":[176,239],"first":[178],"five":[179,241],"procedures,":[180],"mean":[182],"decreasing":[186],"221":[188],"s":[189,196],"initial":[192,227],"cases":[193],"153":[195],"thereafter.":[197],"Tumor":[198],"volume":[199],"independently":[201],"longer":[204],"(p":[207],"<":[208],"0.001),":[209],"while":[210],"type,":[212],"location,":[213],"applicators":[217],"not.":[219],"Conclusions:":[220],"demonstrated":[224],"short":[226],"when":[230],"assessed":[231],"efficiency,":[234],"substantial":[236],"improvement":[237],"approximately":[240],"procedures.":[242],"These":[243],"findings":[244],"suggest":[245],"familiarity":[248],"develops":[249],"rapidly;":[250],"however,":[251],"validation":[252],"across":[253],"multiple":[254],"operators":[255],"institutions":[257],"needed":[259],"determine":[261],"generalizability":[263],"these":[265],"results":[266],"inform":[268],"future":[269],"training":[270],"standards.":[271]},"counts_by_year":[],"updated_date":"2026-11-01T11:40:01.658920","created_date":"2026-10-23T00:00:00"}