ArticleJournal of applied clinical medical physics2022
Clinical commissioning of an adaptive radiotherapy platform: Results and recommendations.
Article in Journal of applied clinical medical physics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed.
- HyperSight CBCT dose calculation accuracy for adaptive head and neck radiotherapy: Results from a prospective clinical trial.Medical physics · 2026Trial
- HyperSight CBCT image quality and metal artifact reduction for adaptive head and neck radiotherapy: Results from a prospective clinical trial.Journal of applied clinical medical physics · 2025Trial
- Image-based evaluation of a commercial AI synthetic CT generator for brain and prostate MR-only radiotherapy.Journal of applied clinical medical physics · 2026Article
- Article
- First evaluation of in-patient dose calculation accuracy on a C-arm Linear Accelerator with advanced Cone-Beam computed tomography (CBCT) imaging.Physics and imaging in radiation oncology · 2026Article
- The role of cone beam CT in personalization of bladder cancer radiotherapy.Radiological physics and technology · 2026Article
- Quality assurance of online adaptive radiotherapy workflows using film dosimetry in a 3D printed thorax anthropomorphic phantom.Physics and imaging in radiation oncology · 2026Article
- Adaptive-driven CT simulation-free multi-fraction SBRT radiotherapy: Initial clinical experience.Journal of applied clinical medical physics · 2025Article
- Quantification and dosimetric impact of intra-fractional bladder changes during CBCT-guided online adaptive radiotherapy for pelvic cancer treatments.Journal of applied clinical medical physics · 2025Article
- Body contour adaptation for weight-loss and bolus for head and neck radiotherapy on Ethos version 2.0 and HyperSight: Synthetic CT versus direct calculation.Journal of applied clinical medical physics · 2025Article
- Assessing Dosimetric Benefits of Cone Beam Computed Tomography-Guided Online Adaptive Radiation Treatment Frequencies for Lung Cancer.Advances in radiation oncology · 2025Article
- Quality of density deformations in patient anatomy during synthetic CT guided online adaptive radiation therapy for pelvic cancer.Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Article
- Multi-institutional questionnaire-based survey on online adaptive radiotherapy performed using commercial systems in Japan in 2023.Radiological physics and technology · 2024Article
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- Article
- Re-evaluation of the prospective risk analysis for artificial-intelligence driven cone beam computed tomography-based online adaptive radiotherapy after one year of clinical experience.Zeitschrift fur medizinische Physik · 2024Article
- Adaptive-Driven CT Simulation-Free Soft Tissue Stereotactic Body Radiation Therapy: A Single-Patient Case Report.Cureus · 2024Article
- Feasibility of Ethos adaptive treatments of lung tumors and associated quality assurance.Journal of applied clinical medical physics · 2024Article
- Unlocking the adaptive advantage: correlation and machine learning classification to identify optimal online adaptive stereotactic partial breast candidates.Physics in medicine and biology · 2024Article
- Enhancing Safety in AI-Driven Cone Beam CT-based Online Adaptive Radiation Therapy: Development and Implementation of an Interdisciplinary Workflow.Advances in radiation oncology · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Online adaptive radiotherapy platforms present a unique challenge for commissioning as guidance is lacking and specialized adaptive equipment, such as deformable phantoms, are rare. We designed a novel adaptive commissioning process consisting of end-to-end tests using standard clinical resources. These tests were designed to simulate anatomical changes regularly observed at patient treatments. The test results will inform users of the magnitude of uncertainty from on-treatment changes during the adaptive workflow and the limitations of their systems. We implemented these tests for the cone-beam computed tomography (CT)-based Varian Ethos online adaptive platform. Many adaptive platforms perform online dose calculation on a synthetic CT (synCT). To assess the impact of the synCT generation and online dose calculation on dosimetric accuracy, we conducted end-to-end tests using commonly available equipment: a CIRS IMRT Thorax phantom, PinPoint ionization chamber, Gafchromic film, and bolus. Four clinical scenarios were evaluated: weight gain and weight loss were simulated by adding and removing bolus, internal target shifts were simulated by editing the CTV during the adaptive workflow to displace it, and changes in gas were simulated by removing and reinserting rods in varying phantom locations. The effect of overriding gas pockets during planning was also assessed. All point dose measurements agreed within 2.7% of the calculated dose, with one exception: a scenario simulating gas present in the planning CT, not overridden during planning, and dissipating at treatment. Relative film measurements passed gamma analysis (3%/3 mm criteria) for all scenarios. Our process validated the Ethos dose calculation for online adapted treatment plans. Based on our results, we made several recommendations for our clinical adaptive workflow. This commissioning process used commonly available equipment and, therefore, can be applied in other clinics for their respective online adaptive platforms.
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