ArticlePhysics and imaging in radiation oncology2025
A simplified online adaptive workflow for long-course magnetic resonance-guided radiotherapy in esophageal cancer.
Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Deep learning-enhanced image registration for accelerating daily adaptive magnetic resonance imaging-guided prostate 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
- MR-Guided Radiotherapy in Oesophageal Cancer: From Principles to Practice-A Narrative Review.Current oncology (Toronto, Ont.) · 2026Review
- Feasibility of reusing online-generated treatment plans for adaptive radiotherapy in prostate cancer.Physics and imaging in radiation oncology · 2026Article
- Recent innovations in offline and online Magnetic Resonance Imaging guided radiation oncology.Physics and imaging in radiation oncology · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background and Purpose: Online adaptive magnetic resonance-guided radiotherapy (MRgRT) enables high-precision radiotherapy for esophageal cancer patients but is less feasible due to long on-table times in combination with long-course treatment. In this study, we conducted an in-silico assessment of a simplified online adaptive workflow, Adapt-To-Shape-lite (ATS-lite), in which deformable propagated contours are not modified, and assessed its feasibility. Materials and Methods: The ATS-lite workflow was simulated for all fractions of nine esophageal cancer patients who had previously received full online adaptive MRgRT with manual contour corrections if needed. The deformable propagated contours were not adjusted. A dose of 41.4 Gy in 23 fractions was prescribed. Intra- and interfraction dose accumulation were performed to evaluate target coverage per fraction and across the entire treatment. For individual fractions, coverage of the manually corrected clinical target volume (CTV) was considered adequate if V95% > 98 % and V90% > 99.5 %. Feasibility was assessed by recording treatment times in the first patients treated with ATS-lite. Results: The ATS-lite workflow provided adequate target coverage over the entire treatment for all patients, with sufficient coverage in 90% of the 177 fractions analyzed. Closer inspection revealed that inadequate target coverage in individual fractions was primarily attributed to enlargement of the manually corrected CTV, rather than poor contour propagation in the ATS-lite workflow. In seven patients, the ATS-lite workflow achieved a median time per fraction of 23 min. Conclusions: The ATS-lite workflow provides adequate target coverage and is feasible for online adaptive MRgRT in long-course esophageal cancer treatments.
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