Physics and Imaging in Radiation Oncology最新文献

{"title":"Uncertainty estimation in female pelvic synthetic computed tomography generated from iterative reconstructed cone-beam computed tomography","authors":"Yvonne J.M. de Hond,&nbsp;Paul M.A. van Haaren,&nbsp;Rob H.N. Tijssen,&nbsp;Coen W. Hurkmans","doi":"10.1016/j.phro.2025.100743","DOIUrl":"10.1016/j.phro.2025.100743","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Iterative reconstruction (IR) can be used to improve cone-beam computed tomography (CBCT) image quality and from such iterative reconstructed (iCBCT) images, synthetic CT (sCT) images can be generated to enable accurate dose calculations. The aim of this study was to evaluate the uncertainty in generating sCT from iCBCT using vendor-supplied software for online adaptive radiotherapy.</div></div><div><h3>Materials and Methods</h3><div>Projection data from 20 female pelvic CBCTs were used to reconstruct iCBCT images. The process was repeated with 128 different IR parameter combinations. From these iCBCTs, sCTs were generated. Voxel value variation in the 128 iCBCT and 128 sCT images per patient was quantified by the standard deviation (STD). Additional sub-analysis was performed per parameter category.</div></div><div><h3>Results</h3><div>Generated sCTs had significantly higher maximum STD-values, median of 438 HU, compared to input iCBCT, median of 198 HU, indicating limited robustness to parameter changes. The highest STD-values of sCTs were within bone and soft-tissue compared to air. Variations in sCT numbers were parameter dependent. Scatter correction produced the highest variance in sCTs (median: 358 HU) despite no visible changes in iCBCTs, whereas total variation regularization resulted in the lowest variance in sCTs (median: 233 HU) despite increased iCBCT blurriness.</div></div><div><h3>Conclusions</h3><div>Variations in iCBCT reconstruction parameters affected the CT number representation in the sCT. The sCT variance depended on the parameter category, with subtle iCBCT changes leading to significant density alterations in sCT. Therefore, it is recommended to evaluate both iCBCT and sCT generation, especially when updating software or settings.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100743"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143561888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Added value of non-rigid image registration for intrafraction dose accumulation in magnetic resonance imaging-guided prostate radiotherapy","authors":"Georgios Tsekas,&nbsp;Cornel Zachiu,&nbsp;Gijsbert H. Bol,&nbsp;Johannes C.J. de Boer,&nbsp;Bas W. Raaymakers","doi":"10.1016/j.phro.2025.100711","DOIUrl":"10.1016/j.phro.2025.100711","url":null,"abstract":"<div><div>This work investigates potential advantages of non-rigid versus rigid image registration for intrafraction dose reconstruction in hypofractionated prostate radiotherapy. The data of 15 patients were analyzed using 3D cine magnetic resonance imaging (MRI) in combination with machine log files and the accumulated dose distributions were compared to the planned ones. Both image registration methods resulted in comparable results for the majority ( <span><math><mo>∼</mo></math></span> 95%) of patient fractions. However, better image alignment was reported for the non-rigid method compared to rigid in cases of transient gas pockets, indicating better image registration quality in the presence of large intrafraction deformations.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100711"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143379453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose-volume parameter evaluation of a sub-fractionation workflow for adaptive radiotherapy of prostate cancer patients on a 1.5 T magnetic resonance imaging radiotherapy system","authors":"Georgios Tsekas,&nbsp;Cornel Zachiu,&nbsp;Gijsbert H. Bol,&nbsp;Jochem R.N. van der Voort van Zyp,&nbsp;Sandrine M.G. van de Pol,&nbsp;Johannes C.J. de Boer,&nbsp;Bas W. Raaymakers","doi":"10.1016/j.phro.2025.100706","DOIUrl":"10.1016/j.phro.2025.100706","url":null,"abstract":"<div><h3>Background and purpose:</h3><div>This study focuses on evaluating a sub-fractionation workflow for intrafraction motion mitigation of prostate cancer patients on a 1.5 T magnetic resonance imaging radiotherapy system.</div></div><div><h3>Materials and methods:</h3><div>The investigated workflow consisted of two sub-fractions where intrafraction drift correction steps were applied based on a daily reference plan. However, the daily contours were only rigidly shifted to match the intrafraction anatomies and therefore the clinical dosimetric constraints might be violated. In this work, daily contours were deformed to match the intrafraction anatomies and the online plans were re-calculated for a total of 15 patients. The deformed prostate contours were inspected by radiation oncologists and corrections were performed when necessary. Finally, a dose-volume parameter evaluation was performed on a sub-fraction level using the clinical plan parameters.</div></div><div><h3>Results:</h3><div>Clinically acceptable coverage was reported for the target structures resulting in mean V_95% of 99.7 % and 97.8 % for the clinical target volume (CTV) and planning target volume (PTV) respectively. Sub-fractions with insufficient CTV dose can be explained by the presence of intrafraction rotations and deformations that were not taken into account during intrafraction corrections. Additionally, for no sub-fraction the dose to the organs-at-risk exceeded the clinical constraints.</div></div><div><h3>Conclusion:</h3><div>Given our results on the CTV coverage we can conclude that the sub-fractionation workflow met the dosimetric constraints for the hypofractionated treatment of the analyzed group of prostate cancer patients. A future dose accumulation study can provide further insights into the suitability of the clinical margins.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100706"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143372421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demonstration of motion-compensated volumetric modulated arc radiotherapy on an MR-linac","authors":"Pim T.S. Borman ,&nbsp;Prescilla Uijtewaal ,&nbsp;Jeffrey Snyder ,&nbsp;Bryan Allen ,&nbsp;Caiden K. Atienza ,&nbsp;Peter Woodhead ,&nbsp;Daniel E. Hyer ,&nbsp;Bas W. Raaymakers ,&nbsp;Martin F. Fast","doi":"10.1016/j.phro.2025.100729","DOIUrl":"10.1016/j.phro.2025.100729","url":null,"abstract":"<div><div>Intensity-modulated radiotherapy (IMRT) in combination with magnetic resonance imaging (MRI)-guided gated delivery represents the latest development in the treatment of abdominothoracic tumours on MR-linac. In contrast, volumetric-modulated arc therapy (VMAT) is typically used on conventional linacs due to its superior delivery efficiency and speed. Non-inferior VMAT plans were created in a research treatment planning system for eight lung cancer patients previously treated on an MR-linac. VMAT plans were delivered on a moving dosimeter using respiratory multi-leaf collimator (MLC) tracking. VMAT with MLC tracking achieved an average 2%/2 mm local gamma pass rate of 93% relative to planned dose with a delivery efficiency of 83%.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100729"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143428786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning combining imaging, dose and clinical data for predicting bowel toxicity after pelvic radiotherapy","authors":"Behnaz Elhaminia ,&nbsp;Alexandra Gilbert ,&nbsp;Andrew Scarsbrook ,&nbsp;John Lilley ,&nbsp;Ane Appelt ,&nbsp;Ali Gooya","doi":"10.1016/j.phro.2025.100710","DOIUrl":"10.1016/j.phro.2025.100710","url":null,"abstract":"<div><h3>Background and Purpose:</h3><div>A comprehensive understanding of radiotherapy toxicity requires analysis of multimodal data. However, it is challenging to develop a model that can analyse both 3D imaging and clinical data simultaneously. In this study, a deep learning model is proposed for simultaneously analysing computed tomography scans, dose distributions, and clinical metadata to predict toxicity, and identify the impact of clinical risk factors and anatomical regions.</div></div><div><h3>Materials and methods</h3><div>: A deep model based on multiple instance learning with feature-level fusion and attention was developed. The study used a dataset of 313 patients treated with 3D conformal radiation therapy and volumetric modulated arc therapy, with heterogeneous cohorts varying in dose, volume, fractionation, concomitant therapies, and follow-up periods. The dataset included 3D computed tomography scans, planned dose distributions to the bowel cavity, and patient clinical data. The model was trained on patient-reported data on late bowel toxicity.</div></div><div><h3>Results:</h3><div>Results showed that the network can identify potential risk factors and critical anatomical regions. Analysis of clinical data jointly with imaging and dose for bowel urgency and faecal incontinence improved performance (area under receiver operating characteristic curve [AUC] of 88% and 78%, respectively) while best performance for diarrhoea was when analysing clinical features alone (68% AUC).</div></div><div><h3>Conclusions:</h3><div>Results demonstrated that feature-level fusion along with attention enables the network to analyse multimodal data. This method also provides explanations for each input’s contribution to the final result and detects spatial associations of toxicity.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100710"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143437654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gross tumor volume confidence maps prediction for soft tissue sarcomas from multi-modality medical images using a diffusion model","authors":"Yafei Dong ,&nbsp;Thibault Marin ,&nbsp;Yue Zhuo ,&nbsp;Elie Najem ,&nbsp;Maryam Moteabbed ,&nbsp;Fangxu Xing ,&nbsp;Arnaud Beddok ,&nbsp;Rita Maria Lahoud ,&nbsp;Laura Rozenblum ,&nbsp;Zhiyuan Ding ,&nbsp;Xiaofeng Liu ,&nbsp;Kira Grogg ,&nbsp;Jonghye Woo ,&nbsp;Yen-Lin E. Chen ,&nbsp;Ruth Lim ,&nbsp;Chao Ma ,&nbsp;Georges El Fakhri","doi":"10.1016/j.phro.2025.100734","DOIUrl":"10.1016/j.phro.2025.100734","url":null,"abstract":"<div><h3>Background and purpose:</h3><div>Accurate delineation of the gross tumor volume (GTV) is essential for radiotherapy of soft tissue sarcomas. However, manual GTV delineation from multi-modality images is time-consuming. Furthermore, GTV delineation is subject to inter- and intra-reader variability, which reduces the reproducibility of treatment planning. To address these issues, this work aims to develop a highly accurate automatic delineation technique modeling reader variability for soft tissue sarcomas using deep learning.</div></div><div><h3>Materials and methods:</h3><div>We employed a publicly available soft tissue sarcoma dataset consisting of Fluorodeoxyglucose Positron Emission Tomography (FDG-PET), X-ray Computed Tomography (CT), and pre-contrast T1-weighted Magnetic Resonance Imaging (MRI) scans for 51 patients, of which 49 were selected for analysis. The GTVs were delineated by six experienced readers, each reader performing GTV contouring multiple times for every patient. The confidence maps were calculated by averaging the labels provided by all readers, resulting in values ranging from 0 to 1. We developed and trained a diffusion model-based neural network to predict confidence maps of GTV for soft tissue sarcomas from multi-modality medical images.</div></div><div><h3>Results:</h3><div>Quantitative analysis showed that the proposed diffusion model performed competitively with U-Net-based models, frequently ranking first or second across five evaluation metrics: Dice Index, Hausdorff Distance, Recall, Precision, and Brier Score. Additionally, experiments evaluating the impact of different imaging modalities demonstrated that incorporating multi-modality image inputs provided improved performance compared to single-modality and dual-modality inputs.</div></div><div><h3>Conclusion:</h3><div>The proposed diffusion model is capable of predicting accurate confidence maps of GTV for soft tissue sarcomas from multi-modality inputs.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100734"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143547973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New guidelines and recommendations to advance treatment planning in proton therapy","authors":"Barbara Knäusl,&nbsp;Anne Vestergaard,&nbsp;Marco Schwarz,&nbsp;Ludvig P. Muren","doi":"10.1016/j.phro.2024.100695","DOIUrl":"10.1016/j.phro.2024.100695","url":null,"abstract":"","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100695"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11764265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of automated online adaptive proton therapy to reduce margins for oesophageal cancer","authors":"Pascal Herbst ,&nbsp;Camille Draguet ,&nbsp;Ana M. Barragán-Montero ,&nbsp;Elena Borderías Villarroel ,&nbsp;Macarena Chocan Vera ,&nbsp;Pieter Populaire ,&nbsp;Karin Haustermans ,&nbsp;Edmond Sterpin","doi":"10.1016/j.phro.2025.100712","DOIUrl":"10.1016/j.phro.2025.100712","url":null,"abstract":"<div><h3>Background and purpose:</h3><div>Proton therapy for oesophageal cancer is administered over multiple fractions, based on a single pre-treatment image. However, anatomical changes can lead to the deterioration of the treatment plan, necessitating manual replanning. To keep this within limits, increased residual margins are employed. This study aimed to evaluate the proposed automated Online Adaptive Proton Therapy (OAPT) strategies on their capability to reduce the need for manual replanning, while also exploring the possibility of margin reduction.</div></div><div><h3>Materials and methods:</h3><div>Two automated OAPT methods were examined: Automated Dose Restoration (ADR) and Automated Full Adaptation (AFA). ADR makes use of dose restoration, restoring the original dose map based on the patient’s altered anatomy. AFA adapts the contours used for plan optimization by applying a deformation field, not only correcting for density changes, but also for the relative location of organs. A comparative analysis of OAPT strategies, evaluating <span><math><msub><mrow><mi>D</mi></mrow><mrow><mtext>98%</mtext></mrow></msub></math></span> tumour coverage on 17 patients, was conducted.</div></div><div><h3>Results:</h3><div>The nominal results of non-adapted plans with 7 mm residual margins required manual replanning for 18% of the patients. ADR reduced this to 6%, while AFA eliminated the need for manual replanning. With 2 mm margins, 47% of cases required manual replanning. ADR reduced this to 18%, and AFA further reduced it to 11%.</div></div><div><h3>Conclusions:</h3><div>The proposed OAPT strategies offered a marked improvement compared to a non-adaptive approach. ADR and AFA significantly reduced the necessity for manual replanning and facilitated the reduction of residual margins, enhancing dose conformity and reducing treatment toxicity.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100712"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143387668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of 2D anti-scatter grid implementation in a gantry-mounted cone beam computed tomography system for proton therapy","authors":"Uttam Pyakurel ,&nbsp;Yawei Zhang ,&nbsp;Ryan Sabounchi ,&nbsp;Farhang Bayat ,&nbsp;Sébastien Brousmiche ,&nbsp;Curtis Bryant ,&nbsp;Nancy Mendenhall ,&nbsp;Perry Johnson ,&nbsp;Cem Altunbas","doi":"10.1016/j.phro.2025.100730","DOIUrl":"10.1016/j.phro.2025.100730","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Robust scatter mitigation by 2D anti-scatter grids (2D-ASG) in proton therapy cone beam computed tomography (CBCT) may improve target visualization and computed tomography (CT) number fidelity, allowing online dose verifications and plan adaptations. However, grid artifact-free implementation of 2D-ASG depends on the CBCT system characteristics. Thus, we investigated the feasibility of 2D-ASG implementation in a proton therapy gantry-mounted CBCT system and evaluated its impact on image quality.</div></div><div><h3>Materials and methods</h3><div>A prototype 2D-ASG and a grid support platform were developed for a proton therapy CBCT system with a 340 cm source to imager distance. The effect of gantry flex on 2D-ASG’s wall shadows and scan-to-scan reproducibility of 2D-ASG’s wall shadows were evaluated. Experiments were conducted to assess 2D-ASG’s wall shadow suppression and the effect of 2D-ASG on image quality.</div></div><div><h3>Results</h3><div>While maximum displacement in 2D-ASG wall shadows was 103 µm during gantry rotation, the drift from baseline over 3 months was 8 µm and 1 µm in the transverse and axial directions. 2D-ASG shadows were successfully suppressed in CBCT images. With 2D-ASG, maximum Hounsfield Unit (HU) nonuniformity decreased from 134 to 45 HU, contrast-to-noise ratio (CNR) increased by a factor of 2.5, and HU errors were reduced from 34 % to 5 %.</div></div><div><h3>Conclusions</h3><div>Proton therapy gantry flex was highly reproducible and did not noticeably affect 2D-ASG wall shadow suppression in CBCT images, supporting its feasibility in proton therapy CBCT system. Improved CT accuracy and artifact reduction with 2D-ASG could enhance CBCT-based proton therapy dose calculations.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100730"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards faster plan adaptation for proton arc therapy using initial treatment plan information","authors":"Benjamin Roberfroid ,&nbsp;Margerie Huet-Dastarac ,&nbsp;Elena Borderías-Villarroel ,&nbsp;Rodin Koffeing ,&nbsp;John A. Lee ,&nbsp;Ana M. Barragán-Montero ,&nbsp;Edmond Sterpin","doi":"10.1016/j.phro.2025.100705","DOIUrl":"10.1016/j.phro.2025.100705","url":null,"abstract":"<div><h3>Background and Purpose</h3><div>Proton arc therapy (PAT) is an emerging modality delivering continuously rotating proton beams. Current PAT planning approaches are time-consuming, making them unsuitable for online adaptation. This study proposes an accelerated workflow for adapting PAT plans.</div></div><div><h3>Materials and Methods</h3><div>The proposed workflow transfers spots from initial computed tomography (CT) to the CT of the day, updates energy layers considering the initial pattern, and re-optimizes selected transferred spots based on their initial weights and impact on the objective function.</div><div>A retrospective study was conducted on five head and neck patients who underwent plan adaptation on a repeated CT. PAT plans were generated with two different methods on the repeated CT: <em>reference</em>, created de novo, and <em>smart-adapted</em>, generated with the proposed adaptive workflow. Robust optimization was performed for all plans.</div></div><div><h3>Results</h3><div><em>Smart-adapted</em> plans achieved similar mean dose to organs at risk as the <em>reference</em>: the largest median increase of mean dose was 1.9 Gy to the mandible; the median of maximum dose to spinal cord was 0.5 Gy lower for the <em>smart-adapted</em> plans. The median target coverage, i.e. D₉₈, to primary tumor and nodes of <em>smart-adapted</em> plans decreased by 0.2 and 0.4 Gy for the nominal case, and 0.4 and 0.6 Gy for the worst-case scenario; all <em>smart-adapted</em> plans met clinical objectives. The smart-adaptation method reduced average planning time from 19184 s to 5626 s, a 3.4-fold improvement.</div></div><div><h3>Conclusions</h3><div><em>Smart-adapted</em> plans achieve similar plan quality to the reference method, while significantly reducing plan generation time for new patient anatomy.</div></div>","PeriodicalId":36850,"journal":{"name":"Physics and Imaging in Radiation Oncology","volume":"33 ","pages":"Article 100705"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143270412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}