{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:36:07Z","timestamp":1780468567257,"version":"3.54.1"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"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":[[2025,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Current radiotherapy machines intended to perform streamlined online adaptive therapy are designed to be standalone, which makes it challenging to integrate them with the rest of the clinic. This work describes the installation of a standalone CT\u2010guided online adaptive system, the Varian Ethos, in a busy clinic utilizing products from multiple vendors, including RayStation as the treatment planning system (TPS) and MOSAIQ as the oncology information system (OIS). The aim was to develop solutions that minimized workload increases for staff using redundant systems and to implement this new technology safely, with no increase in safety reports resulting from its integration into the clinic. The Ethos was delivered with a pre\u2010configured beam model, and a separate Ethos beam model was developed in RayStation 10A. Non\u2010adaptive treatments were planned in RayStation and transferred to Ethos for delivery. Although MOSAIQ 2.64 could not communicate with the Ethos, a machine characterization file was developed to allow manual recording of the treatment fields in MOSAIQ. Online adaptive therapy was performed using the Ethos TPS and OIS with documentation in MOSAIQ. Although dose calculations of the same plans differed by 1%\u20132% in the pelvis in RayStation compared to the Ethos TPS, dose computed in both systems passed measurement\u2010based QA, end\u2010to\u2010end testing, and clinical trial credentialing, so both systems were commissioned for clinical use. RayStation plans were successfully modified for delivery on Ethos, and at go\u2010live, all non\u2010adaptive planning was performed in RayStation and adaptive planning in Ethos. Ethos treatments were documented in MOSIAQ, which remained the OIS of record for all patients. Monitoring of error reports indicated some unique failure modes to the new technology, but the overall number of safety reports remained comparable to other systems. In conclusion, Ethos was successfully deployed for both non\u2010adaptive and online adaptive therapy in a multi\u2010vendor environment.<\/jats:p>","DOI":"10.1002\/acm2.70033","type":"journal-article","created":{"date-parts":[[2025,3,11]],"date-time":"2025-03-11T08:39:55Z","timestamp":1741682395000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Commissioning a standalone adaptive radiotherapy linac in a multi\u2010vendor environment"],"prefix":"10.1002","volume":"26","author":[{"given":"Sven","family":"Olberg","sequence":"first","affiliation":[{"name":"Division of Radiation Biophysics Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Radiation Oncology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"3rd","given":"David M.","family":"McClatchy","sequence":"additional","affiliation":[{"name":"Division of Radiation Biophysics Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Radiation Oncology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colleen","family":"Foote","sequence":"additional","affiliation":[{"name":"Division of Radiation Biophysics Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susu","family":"Yan","sequence":"additional","affiliation":[{"name":"Division of Radiation Biophysics Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Radiation Oncology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0531-6798","authenticated-orcid":false,"given":"Jennifer","family":"Pursley","sequence":"additional","affiliation":[{"name":"Division of Radiation Biophysics Department of Radiation Oncology Massachusetts General Hospital Boston Massachusetts USA"},{"name":"Department of Radiation Oncology Harvard Medical School Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,10]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semradonc.2019.02.004"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.10.021"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12568"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12881"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13961"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13723"},{"key":"e_1_2_10_8_1","doi-asserted-by":"crossref","unstructured":"PathakPK VashishtSK BabyS et\u00a0al.Commissioning and quality assurance of Halcyon\u2122 2.0 linear accelerator. Rep Pract Oncol Radiother.2021;26(3):433\u2010444. doi:10.5603\/RPOR.a2021.0065","DOI":"10.5603\/RPOR.a2021.0065"},{"issue":"2","key":"e_1_2_10_9_1","first-page":"77","article-title":"Making on\u2010line adaptive radiotherapy possible using artificial intelligence and machine learning for efficient daily re\u2010planning","volume":"8","author":"Archambault Y","year":"2020","journal-title":"Med Phys Intl Journal"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.3190392"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.4947547"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.13736"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.13116"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.14914"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.15833"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.12149"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.4236\/ijmpcero.2012.13011"},{"key":"e_1_2_10_18_1","unstructured":"Varian Medical Systems.(2024 July 22). Varian Announces Powerful Functionality Expanding Versatility and Connectivity for its Ethos Adaptive Radiotherapy System [Press release].https:\/\/www.varian.com\/about\u2010varian\/newsroom\/press\u2010releases\/varian\u2010announces\u2010powerful\u2010functionality\u2010expanding"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70033","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T12:34:09Z","timestamp":1743856449000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70033"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,10]]},"references-count":17,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/acm2.70033"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70033","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,10]]},"assertion":[{"value":"2024-11-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-03","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70033"}}