{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T06:54:32Z","timestamp":1772607272934,"version":"3.50.1"},"reference-count":12,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,12,20]],"date-time":"2024-12-20T00:00:00Z","timestamp":1734652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>This study assesses a novel, automated dose accumulation process during MR\u2010guided online adaptive radiotherapy (MRgART) for prostate cancer, focusing on inter\u2010fractional anatomical changes and discrepancies between delivered and planned doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective analysis was conducted on seven prostate cancer patients treated with a five\u2010fraction stereotactic body radiation therapy (SBRT), using a 0.35T MRIdian MR\u2010LINAC system. Daily plans were adapted when dose thresholds were exceeded. Planning MRI (pMRI) and daily MRIs (dMRIs) were imported into MIM software for automated and manual dose accumulation procedures. Rigid and deformable image registrations were followed by dose accumulation to compare delivered and planned doses. Manual and automated image registrations were compared by calculating the Hausdorff distance (HD), Jaccard, and DICE metrics.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Moderate discrepancies in dosimetric parameters for the planning target volume (PTV) were observed between auto\u2010accumulated and planned doses, such as  and , with average differences of \u00a0Gy and \u00a0Gy, respectively. Volume differences of  and  indicated that auto\u2010accumulated doses consistently had lower numbers compared to planned doses, with mean discrepancies of  and , respectively. Organs at risk (OAR) dosimetric parameters exhibited higher dose volumes in auto\u2010accumulated doses, with moderate differences (planned [cc] vs. auto\u2010accumulated [cc]) observed in parameters such as urethra PRV  at , rectum  at  and rectum  at . The comparison between manually and auto\u2010accumulated doses revealed negligible variations, as also indicated by strong concordance in geometric indices and <jats:italic>t<\/jats:italic>\u2010test <jats:italic>p<\/jats:italic>\u2010values above 0.7.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The automated workflow, developed in collaboration with MIM Software Inc., demonstrates high accuracy compared to manual accumulation. The moderate differences observed between planned and accumulated doses emphasize the need for\u00a0accurate dose accumulation for adaptive plans.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acm2.14594","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T06:56:46Z","timestamp":1734764206000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Automated daily dose accumulation workflow for treatment quality assurance during online adaptive radiotherapy with a 0.35T MR\u2010linac"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3855-5373","authenticated-orcid":false,"given":"Mojtaba","family":"Behzadipour","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tianjun","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6571-2258","authenticated-orcid":false,"given":"Rabten K.","family":"Datsang","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brandon","family":"Lee","sequence":"additional","affiliation":[{"name":"Clinical Science MIM Software Inc.  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dane","family":"Pittock","sequence":"additional","affiliation":[{"name":"Clinical Science MIM Software Inc.  Cleveland Ohio USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Weiss","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-3196-2368","authenticated-orcid":false,"given":"William Y.","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,12,20]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2012.10.040"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2007.07.2345"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1086258"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/tcr.2017.03.30"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.07.034"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1088\/0031\u20109155\/60\/19\/7485"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2020.06.005"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.12.009"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2019.12.010"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctro.2018.04.005"},{"key":"e_1_2_9_12_1","unstructured":"Piper: VoxAlign deformation engine\u2014Google Scholar. 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