{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:44:02Z","timestamp":1793033042840,"version":"4.5.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aapm.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Applied Clin Med Phys"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Conventional cone\u2010beam computed tomography (CBCT) systems, while providing adequate visualization for positioning, have historically been limited by image truncation, scatter contamination, image noise, geometric artifacts, and unreliable CT number accuracy, which preclude their routine use for accurate dose calculation and re\u2010planning. Recent advances in CBCT detector technology and image reconstruction algorithms have led to the development of next\u2010generation CBCT platforms with improved image quality and CT number stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aimed to develop and evaluate an efficient daily adaptation workflow on a standard C\u2010arm linear accelerator by integrating HyperSight CBCT and plan adaptation in RayStation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Image quality metrics and CT number accuracy were evaluated and compared with those of an institutional CT simulator and conventional CBCT. Dose calculation accuracy was validated through measurement. The HyperSight CBCT adaptive workflow used both deformable image registration and rigid image registration for contour propagation, followed by manual revision when necessary. The adapted plan was iteratively optimized in RayStation by using the fine\u2010tune module. End\u2010to\u2010end test was done with a spine phantom and a pelvis phantom. Retrospective evaluation of four abdominal SBRT cases (12 fractions) compared estimated delivered and adapted plans with respect to target coverage, organs at risk (OARs) sparing, and monitor unit (MU) usage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Improved image quality and CT number accuracy compared to conventional CBCT were observed. The adaptation process required 13\u00a0\u00b1\u00a03 min per fraction from HyperSight\u2010CBCT acquisition to final plan evaluation, excluding time for contour revisions. Across all cases, adapted plans demonstrated improved dosimetric quality relative to delivered plans. Gross tumor volume V\n                      <jats:sub>100%<\/jats:sub>\n                      and planning target volume V\n                      <jats:sub>100%<\/jats:sub>\n                      were consistently higher in the adapted plans, with an average increase of 6.3% (\n                      <jats:italic>P\u00a0<\/jats:italic>\n                      =\u00a00.004). Doses to OARs, including the small bowel and ipsilateral kidney, were reduced or maintained. Adapted plan MU usage was comparable to reference plans, indicating no increase in treatment complexity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrating HyperSight CBCT with RayStation's streamlined plan adaptation capability provided dosimetric advantages. It improved target coverage and OAR sparing without increasing treatment complexity and represents a practical alternative to Ethos or MR\u2010Linac systems without the need for specialized delivery platforms.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70615","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T02:16:51Z","timestamp":1778638611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Simulated online adaptive radiotherapy on C\u2010arm linacs: Integrating high resolution cone\u2010beam CT into abdominal stereotactic body radiation therapy"],"prefix":"10.1002","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-2061-2758","authenticated-orcid":false,"given":"Shiqin","family":"Su","sequence":"first","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0741-7063","authenticated-orcid":false,"given":"Song","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hunter","family":"Mehrens","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-7130","authenticated-orcid":false,"given":"Kevin E.","family":"Casey","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2441-4457","authenticated-orcid":false,"given":"Zhiqian H.","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Comron J.","family":"Hassanzadeh","sequence":"additional","affiliation":[{"name":"Department of GU Radiation Oncology University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chad","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of GU Radiation Oncology University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phuoc Tho","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of GU Radiation Oncology University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Schofield","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Balter","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Young","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics University of Texas MD Anderson Cancer Center  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.68559"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.66943"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2023.10.014"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14337"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70023"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2025.100756"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70038"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.14438"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.phro.2024.100566"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13014\u2010025\u201002730\u20108"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.adro.2024.101681"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejmp.2025.105091"},{"key":"e_1_2_9_14_1","unstructured":"RaySearch Laboratories.RayStation 11B brings new features for adaptive workflows brachytherapy and radiation therapy with ions. Accessed August 22 2025.https:\/\/www.raysearchlabs.com\/media\/press\u2010releases\/2021\/raystation\u201011b\u2010brings\u2010new\u2010features\u2010for\u2010adaptive\u2010workflows\u2010brachytherapy\u2010and\u2010radiation\u2010therapy\u2010with\u2010ions\/"},{"key":"e_1_2_9_15_1","unstructured":"Varian Medical Systems.TrueBeam Instructions for Use P1055878\u2010008\u2010H. Published online November2025."},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.17325"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2024.110596"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/acm2.70245"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2024.02.007"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.canrad.2021.08.023"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.36401\/JIPO\u201023\u201029"}],"container-title":["Journal of Applied Clinical Medical Physics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70615","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acm2.70615","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acm2.70615","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T16:31:26Z","timestamp":1793032286000},"score":1,"resource":{"primary":{"URL":"https:\/\/aapm.onlinelibrary.wiley.com\/doi\/10.1002\/acm2.70615"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":20,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1002\/acm2.70615"],"URL":"https:\/\/doi.org\/10.1002\/acm2.70615","archive":["Portico"],"relation":{},"ISSN":["1526-9914","1526-9914"],"issn-type":[{"value":"1526-9914","type":"print"},{"value":"1526-9914","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"assertion":[{"value":"2025-12-02","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70615"}}