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This study retrospectively evaluated imaging doses, scan lengths, and protocol adherence to support imaging optimization and reduce patient radiation exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>CT data from patients undergoing external beam radiotherapy and brachytherapy in the period 04\/2021 to 12\/2024 were retrieved from the institutional picture archiving and communication system (PACS). Imaging doses (volumetric CT dose index [CTDIvol] and dose length product [DLP]) were extracted from dose reports. Automated organ segmentation was used to assess standard operating procedures (SOPs) adherence by estimating anatomical scan length differences. Additional quality assurance checks assessed protocol and imaging consistency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Brain protocols exhibited the highest CTDIvol (73\u202f\u00b1\u200912\u202fmGy), while head and neck protocols had higher DLP values (3212\u202f\u00b1\u2009757\u202fmGy\u00b7cm). The lung 4D protocol showed a\u00a0higher effective dose (23\u202f\u00b1\u20099\u202fmSv) compared to the standard lung protocol. Notable anatomical scan length differences were observed at the lower boundary in the upper abdomen (120\u202f\u00b1\u200975\u202fmm) and spine (155\u202f\u00b1\u2009159\u202fmm), indicating opportunities for workflow improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Enhancing CT workflows for radiotherapy patients is important and feasible. Dose and scan length analyses suggest that revising institutional SOPs, optimizing X\u2011ray tube modulation, and refining scan length boundaries should be considered to achieve this goal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00066-025-02494-w","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T15:35:59Z","timestamp":1764344159000},"page":"272-282","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Automated quality assurance of imaging dose and protocol adherence in computed tomography radiotherapy planning using TotalSegmentator-based segmentation"],"prefix":"10.1007","volume":"202","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1994-9975","authenticated-orcid":false,"given":"Niklas A.","family":"Lackner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3842-1375","authenticated-orcid":false,"given":"Andre","family":"Karius","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Brandt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5806-6158","authenticated-orcid":false,"given":"Oliver J.","family":"Ott","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3966-2872","authenticated-orcid":false,"given":"Florian","family":"Putz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3871-7563","authenticated-orcid":false,"given":"Vratislav","family":"Strnad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2540-850X","authenticated-orcid":false,"given":"Matthias S.","family":"May","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rainer","family":"Fietkau","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8539-6600","authenticated-orcid":false,"given":"Christoph","family":"Bert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4603-492X","authenticated-orcid":false,"given":"Juliane","family":"Szkitsak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"issue":"6\u20137","key":"2494_CR1","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1016\/j.canrad.2011.04.003","volume":"15","author":"V Gregoire","year":"2011","unstructured":"Gregoire\u00a0V, Mackie\u00a0TR (2011) State of the art on dose prescription, reporting and recording in Intensity-Modulated Radiation Therapy (ICRU report No. 83). 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A.\u00a0Karius, T.\u00a0Brandt and O.J.\u00a0Ott declare that they have no competing interests. The Universit\u00e4tsklinikum Erlangen has research agreements with Siemens Healthineers AG, Germany & Vision RT Ltd, UK. None of these agreements represent a\u00a0conflict of interest relevant to this work.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}