{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:02:18Z","timestamp":1790863338244,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T00:00:00Z","timestamp":1762473600000},"content-version":"vor","delay-in-days":6,"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":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and purpose<\/jats:title>\n                    <jats:p>Safe delivery of prostate stereotactic body radiotherapy (SBRT) relies on precise target localization. Without access to real\u2010time intrafraction motion management, careful optimization of IGRT protocols is necessary to safeguard treatment accuracy and patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An IGRT workflow is proposed that incorporates surface\u2010monitoring (SGRT) to complement cone\u2010beam CT (CBCT) imaging. The study evaluates 23 consecutive SBRT prostate patients who were treated on a prospective registry study. Each patient received pre\u2010 and mid\u2010treatment and a subset received post\u2010treatment CBCTs. The frequency and magnitude of SGRT triggered beam interruptions as well as treatment times were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median number of CBCTs acquired per fraction was four and the median treatment time was 23 min (IQR 19\u201327). SGRT detected intra\u2010fraction surface\u2010based motion beyond a combined 4\u00a0mm vector isocenter tolerance in 62% of all fractions treated, with a maximum motion of 15\u00a0mm. On average\u00a0&lt;\u00a02 beam interruptions were triggered by SGRT per treatment fraction. There was no statistically significant correlation between overall treatment time and SGRT\u2010triggered beam interruptions (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.048,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.645). There was a weak but statistically relevant correlation of overall treatment time with the maximum detected motion (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a00.23,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.026). SGRT detected five fractions where the patients had persistently moved outside the SGRT tolerance, and for three of these (60%), a CBCT verified that the target was out of tolerance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>SGRT is a valuable tool that complements CBCT\u2010based IGRT. An SGRT motion vector tolerance of 4\u00a0mm provides a pragmatic compromise between detecting patient motion and treatment efficiency. Overall, persistent patient motion during treatment was infrequent in this cohort, however, SGRT was able to detect several cases where the internal target was outside of the tolerance highlighting that patient monitoring with SGRT can contribute to improved quality and safety for prostate SBRT.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70339","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:26:11Z","timestamp":1762521971000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["A hybrid IGRT workflow using SGRT and CBCT for prostate SBRT: Feasibility, efficiency, and safety"],"prefix":"10.1002","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4350-2222","authenticated-orcid":false,"given":"Juergen","family":"Meyer","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Fred Hutchinson Cancer Center University of 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