ArticleJournal of applied clinical medical physics2023
Evaluation of a workflow for cone-beam CT-guided online adaptive palliative radiotherapy planned using diagnostic CT scans.
Article in Journal of applied clinical medical physics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed.
- Development of CBCT-Guided Online Adaptive Radiotherapy.Cancers · 2026Review
- Development of a cost-effective end-to-end commissioning test for simulation-omitted direct-to-unit adaptive radiotherapy.Physics and imaging in radiation oncology · 2026Article
- Benefits of daily online plan adaptation with reduced margins in neoadjuvant chemoradiotherapy for esophageal cancer.Physics and imaging in radiation oncology · 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
- Simulation-free palliative radiotherapy using diagnostic CT scans- is less more? A systematic review.Clinical and translational radiation oncology · 2026Review
- Nasopharyngeal cancer adaptive radiotherapy with CBCT-derived synthetic CT: deep learning-based auto-segmentation precision and dose calculation consistency on a C-Arm linac.Radiation oncology (London, England) · 2025Article
- Simulation-free cone beam CT-based online adaptive radiotherapy for metastatic spinal cord compression.Acta oncologica (Stockholm, Sweden) · 2025Article
- Adaptive-driven CT simulation-free multi-fraction SBRT radiotherapy: Initial clinical experience.Journal of applied clinical medical physics · 2025Article
- Improving efficiency in lung SAbR planning using integrated tools for X-ray based adaptive radiotherapy.Journal of applied clinical medical physics · 2025Article
- Article
- Simulation-free magnetic resonance-guided radiation therapy of prostate cancer.Physics and imaging in radiation oncology · 2024Article
- Palliative radiotherapy of soft tissue tumoral masses based on diagnostic instead of planning computed tomography scans.Physics and imaging in radiation oncology · 2024Article
- The feasibility of CT simulation-free adaptive radiation therapy.Journal of applied clinical medical physics · 2024Article
- Adaptive-Driven CT Simulation-Free Soft Tissue Stereotactic Body Radiation Therapy: A Single-Patient Case Report.Cureus · 2024Article
- Technical feasibility of novel immunostimulatory low-dose radiation for polymetastatic disease with CBCT-based online adaptive and conventional approaches.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
- Improved Dosimetry and Plan Quality for Accelerated Partial Breast Irradiation Using Online Adaptive Radiation Therapy: A Single Institutional Study.Advances in radiation oncology · 2024Article
- Evaluation of the clinical feasibility of cone-beam computed tomography guided online adaption for simulation-free palliative radiotherapy.Physics and imaging in radiation oncology · 2023Article
- Evaluation of a workflow for cone-beam CT-guided online adaptive palliative radiotherapy planned using diagnostic CT scans.Journal of applied clinical medical physics · 2023Article
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Authors and funding
6 authors.
Funding
Abstract
purposeSingle-visit radiotherapy (RT) is beneficial for patients requiring pain control and can limit interruptions to systemic treatments. However, the requirement for a dedicated planning CT (pCT)-scan can result in treatment delays. We developed a workflow involving preplanning on available diagnostic CT (dCT) imaging, followed by online plan adaption using a cone-beam CT (CBCT)-scan prior to RT-delivery, in order to account for any changes in anatomy and target position.
methodsPatients previously treated with palliative RT for bone metastases were selected from our hospital database. Patient dCT-images were deformed to treatment CBCTs in the Ethos platform (Varian Medical Systems) and a synthetic CT (sCT) generated. Treatment quality was analyzed by comparing a coverage of the V95% of the planning/clinical target volume and different organ-at-risk (OAR) doses between adapted and initial clinical treatment plans. Doses were recalculated on the CBCT and sCT in a separate treatment planning system. Adapted plan doses were measured on-couch using an anthropomorphic phantom with a Gafchromic EBT3 dosimetric film and compared to dose calculations.
resultsAll adapted treatment plans met the clinical goals for target and OARs and outperformed the original treatment plans calculated on the (daily) sCT. Differences in V95% of the target volume coverage between the initial and adapted treatments were <0.2%. Dose recalculations on CBCT and sCT were comparable, and the average gamma pass rate (3%/2 mm) of dosimetric measurements was 98.8%.
conclusionsOnline daily adaptive RT using dCTs instead of a dedicated pCT is feasible using the Ethos platform. This workflow has now been implemented clinically.
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