ArticlePhysics and imaging in radiation oncology2026
Impact of intra- and interfractional motion on the dose distribution and urinary adverse events for magnetic resonance-guided prostate cancer radiotherapy.
Article in Physics and imaging in radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Dynamic modulated arc therapy (DMAT): A time-aware, modulation-steered optimization framework for next-generation radiotherapy delivery.Journal of applied clinical medical physics · 2026Article
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10 authors.
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Abstract
Purpose: To evaluate the impact of intra- and interfractional motion on dose distribution and clinical outcome in prostate magnetic resonance (MR)-guided adaptive radiotherapy. Methods: Seventy-six patients were treated with five-fraction stereotactic radiotherapy on a 1.5 T MR linear accelerator. Cine MR images were acquired during treatment and exported to a motion monitoring research package, to generate motion traces in the anterior-posterior (AP), superior-inferior (SI) and left-right (LR) directions. Planned dose distributions were shifted according to motion trace to reconstruct intrafraction motion-blurred dose. Intrafraction motion-blurred doses were deformably registered to fraction one motion-blurred dose to obtain interfraction accumulated dose. The impact of motion on prostate, bladder, rectal and urethral dose-volume parameters were assessed. Correlation between patients experiencing prolonged motion > 3 mm and urinary adverse events was evaluated. Results: The average intrafraction prostate motion was -0.0 ± 0.2 mm (LR), 0.3 ± 0.5 mm (AP), and -0.3 ± 0.6 mm (SI). Intrafraction motions were associated with dose-volume parameter deviations up to 2.5 Gy. During 24 months of follow-up, 3 patients experienced ≥ Grade 2 acute adverse events, and 4 patients reported ≥ Grade 2 long term adverse events evaluated with common terminology criteria for adverse events. All patients with clinically significant urinary adverse events experienced prolonged large intrafraction motion > 3 mm. Interfraction accumulated motion-blurred dose demonstrated substantial interpatient variabilities for bladder, rectum and urethra. Conclusion: Prolonged intrafraction motion > 3 mm may result in dose difference and clinically significant urinary adverse events. However, combined intra- and interfraction motion might average out fraction-specific variations.
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