Data-Driven Margin Determination for Online Adaptive Radiotherapy Using Batch Automated Planning

Intrafraction Motion and Margin Assessment for Ethos Online Adaptive Radiotherapy Treatments of the Prostate and Seminal Vesicles

“…Due to the amount of data already presented we have decided not to present results for OARs in this study; however, given the reduction in dose to the body it stands to reason that OAR doses should also reduce considerably, as has been found by several other authors. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

“… 9 For example, interfraction motion no longer needs to be accounted for as a new plan is generated each day, whereas intrafraction motion may increase due to the longer treatment times, and contouring uncertainty may be considered a random rather than systematic error necessitating a much smaller margin. OART has the potential to result in both greater target coverage and less dose to organs at risk (OARs) both with 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 and without 19 , 20 margin reductions, although the largest benefits reported with OART come from margin reductions. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

“…OART has the potential to result in both greater target coverage and less dose to organs at risk (OARs) both with 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 and without 19 , 20 margin reductions, although the largest benefits reported with OART come from margin reductions. 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 …”

Review and recommendations on deformable image registration uncertainties for radiotherapy applications

“…Ray at al. evaluated the use of automatic deformed CTVs compared to physician defined CTVs and proposed a framework to determine PTV margins based on automatic deformed CTVs for adaptive planning (Ray et al 2020 ). Nash et al showed that even large geometrical structure differences rarely had a statistically significant impact on OAR dose-volume-histograms (DVH) parameters and concluded that DIR propagated structures are suitable for dose evaluation (Nash et al 2022 ).…”

A margin recipe for the management of intra-fraction target motion in radiotherapy

“…Moreover, there currently is no relation known between an intervention strategy and the resulting margin reduction. Published margins for online adaptive radiotherapy are determined using heuristic estimates, but lack an underlying framework to systematically assess the impact of motion management strategies [15] , [16] . Therefore, an open question remains how to determine the margin upon introducing (online) motion management.…”