Physics and Imaging in Radiation Oncology · Published 2026-06-18 · DOI 10.1016/j.phro.2026.101024
Federico Mastroleo, Mariana Borras-Osorio, Shiv P. Patel, David M. Routman, Doug J. Moseley, Satomi Shiraishi, Andrew Y.K. Foong, Mark R. Waddle
Digital twin research in radiation oncology has expanded rapidly across multiple domains, yet the field lacks definitional consensus and validated translational frameworks. A systematic search (PubMed, Scopus and Web of Science – September 2025) identified 903 records and six original studies met inclusion criteria. Appraisal of the available original studies revealed three recurring translational barriers: misuse of the term “digital twin” for virtual humans or patient-specific predictive models; overreliance on internal or in-silico validation; and limited benchmarking against clinically established alternatives. Progress toward clinical translation requires disciplined nomenclature, real-patient external validation, head-to-head benchmarking, explicit attention to data-pipeline and regulatory pathways.
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Mastroleo, F., Borras-Osorio, M., Patel, S., et al. (2026). Translational barriers to digital twins in radiation oncology. Physics and Imaging in Radiation Oncology. https://doi.org/10.1016/j.phro.2026.101024