ArticleJournal of applied clinical medical physics2024
Feasibility of Ethos adaptive treatments of lung tumors and associated quality assurance.
Article in Journal of applied clinical medical physics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- 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
- In-vivo dosimetry using electronic portal imaging in online-adaptive radiotherapy for rectal 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
- Automated target misalignment correction for cone beam computed tomography-based online adaptive radiotherapy of locally advanced lung cancer patients.Physics and imaging in radiation oncology · 2025Article
- Localization accuracy of 6-second CBCT for lung IGRT with various breathing patterns.Journal of applied clinical medical physics · 2025Article
- Are treatment plans optimized on the basis of acuros XB dose calculation robust against anatomic changes during online adaptive radiotherapy for lung cancer regarding dose homogeneity?Radiation oncology (London, England) · 2025Article
- Assessing Dosimetric Benefits of Cone Beam Computed Tomography-Guided Online Adaptive Radiation Treatment Frequencies for Lung Cancer.Advances in radiation oncology · 2025Article
- Innovative approaches in precision radiation oncology: advanced imaging technologies and challenges which shape the future of radiation therapy.Frontiers in medicine · 2025Review
- Updates in Management of Unresectable Stage III Non Small Cell Lung Cancer: A Radiation Oncology Perspective.Cancers · 2024Review
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- Feasibility of Ethos adaptive treatments of lung tumors and associated quality assurance.Journal of applied clinical medical physics · 2024Article
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Authors and funding
6 authors.
Funding
Abstract
motivationOnline adaptive radiotherapy with Ethos is based on the anatomy determined from daily cone beam computed tomography (CBCT) images. Dose optimization and computation are performed on the density map of a synthetic CT (sCT), a deformable registration of the initial planning CT (pCT) onto the current CBCT. Large density changes as present in the lung region are challenging the system.
methodsTreatment plans for Ethos were created and delivered for 1, 2, and 3 cm diameter lung lesions in an anthropomorphic phantom, combining different insets in the pCT and during adaptive and non-adaptive treatment sessions. Primary and secondary dose calculations as well as back-projected dose from portal images were evaluated.
resultsDensity changes due to changed insets were not considered in the sCTs. This resulted in errors in the dose; for example, -15.9% of the mean dose for a plan when changing from a 3 cm inset in the pCT to 1 cm at the time of treatment. Secondary dose calculation is based on the sCT and could therefore not reveal these dose errors. However, dose calculation on the CBCT, either as a recalculation in the treatment planning system or as pre-treatment quality assurance (QA) before the treatment, indicated the differences. EPID in-vivo QA also reported discrepancies between calculated and delivered dose distributions.
conclusionsAn incorrect density distribution in the sCT has an impact on the dose calculation accuracy in the adaptive treatment workflow with the Ethos system. Additional quality checks of the sCT can detect such errors.
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