{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T00:31:12Z","timestamp":1791937872148,"version":"4.3.4"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":2,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Abdominal compression (AC) using a belt\u2010based system is widely employed in radiation therapy to limit respiration\u2010induced target motion for abdominal and hepatic malignancies. While AC has demonstrated efficacy in reducing intrafraction motion amplitude, the interfractional anatomical consequences of daily compression belt (CB) placement variability remain poorly characterized. A clearer understanding of this variability is necessary to determine whether online adaptive radiotherapy (oART) is required to maintain dosimetric robustness throughout the treatment course.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study aims to quantify interfractional anatomical variability associated with CB use in a clinical MR\u2010guided radiotherapy cohort and to compare these findings against a matched cohort of non\u2010compressed abdominal patients to determine the clinical significance of CB\u2010induced setup variability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Daily treatment MR images were retrospectively collected from 17 CB patients and 17 matched non\u2010CB controls treated on an MR\u2010Linac. External contours were delineated at the center of the planning target volume (PTV) and at the region of maximum compression for CB patients. Interfractional variability was assessed using cross\u2010sectional area (CSA), Dice Similarity Coefficient (DSC), Mean Distance to Agreement (MDA), and Hausdorff Distance (HD). Interfractional organ displacement of the liver and kidneys was quantified via rigid registration. Linear mixed\u2010effects models (LMEMs) evaluated the association between patient demographics\u2014including age, BMI, sex, subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT)\u2014and interfractional variability metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Interfractional DSC over the PTV region was significantly lower in the CB cohort compared with non\u2010CB controls (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01 and\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03 for comparisons to fraction one and sequential fraction comparisons, respectively), and MDA was significantly elevated in the CB cohort (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). No significant difference in CSA variability was observed between cohorts. In the maximum compression region, median HD was 1.6\u00a0cm relative to fraction one, with no significant correlation between compression\u2010region and PTV\u2010region CSA variability (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.99). Older age, male sex, and higher BMI were associated with improved belt\u2010contact shape reproducibility (all\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05), though these demographic effects did not translate to PTV\u2010region stability. LMEM analysis revealed that fixed demographic effects explained only a small fraction of PTV variability (R\n                      <jats:sup>2<\/jats:sup>\n                      <jats:sub>m<\/jats:sub>\n                      \u00a0=\u00a00.06\u20130.29), with the remainder attributable to patient\u2010specific random effects. Interfractional organ displacement ranged from 5.91 to 9.15\u00a0mm across organs and cohorts, with no statistically significant difference between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CB use introduces measurable but modest increases in interfractional anatomical variability at the PTV level compared with standard abdominal setups. Compression\u2010site variability does not propagate directly to the treatment target, and patient demographics alone are insufficient to predict CB\u2010induced setup variability. Daily MR\u2010based image guidance and selective adaptive replanning remain the appropriate management strategy for patients treated with abdominal compression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acm2.70783","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T13:04:51Z","timestamp":1788440691000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Evaluation of inter\u2010fractional anatomical variations due to compression belt placement reproducibility using MR\u2010guided radiotherapy treatment fraction images"],"prefix":"10.1002","volume":"27","author":[{"given":"Olivia","family":"Shay","sequence":"first","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Solis","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Aire","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krystal","family":"Kirby","sequence":"additional","affiliation":[{"name":"Department of Physics and Astronomy Louisiana State University  Baton Rouge Louisiana USA"},{"name":"Department of Radiation Oncology Mary Bird Perkins Cancer Center  Baton Rouge Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1118\/1.597396"},{"key":"e_1_2_11_3_1","unstructured":"ICRU ICRU Report 62. 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