ArticlePhysics and imaging in radiation oncology2025
Workflow to detect exceeded dose constraints in pancreatic stereotactic body irradiation after intrafraction motion during magnetic resonance-guided adaptive radiotherapy using a deep learning-refined contour propagation tool.
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. Not yet cited in PubMed.
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Abstract
Introduction: The adapt-to-shape (ATS) process on the MR-Linac involves manual contour edits followed by treatment plan re-optimization on daily pre-beam MRIs. A verification image is acquired after plan optimization to assess the dose distribution with respect to intrafraction motion using the pre-beam contours. We introduce here a workflow to automatically detect organ motion of gastrointestinal structures that results in exceeded planned dose constraints. Materials and methods: The workflow first transferred the contours and dose distribution created on the daily pre-beam MRI to the verification MRI. A deep learning-refined contour propagation (DL-RCP) tool, trained on 79 images, improved the transferred contours and the dose to 0.03 cm Results: The Dice similarity coefficient and mean distance to agreement for the clinical/DL-refined contours were 0.56/0.71 and 9.08/5.08 mm, respectively. The workflow detected exceeded constraints with specificity 0.90, sensitivity 0.75, and accuracy 0.85. In one case, the duodenal D Conclusion: The proposed method detected exceeded dose constraints in gastrointestinal structures due to intrafraction motion during ATS planning for pancreatic treatments and can aid in the clinical decision to re-optimize the plan on the verification MR.
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