{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:02:15Z","timestamp":1793642535278,"version":"4.5.1"},"reference-count":34,"publisher":"IOP Publishing","issue":"2","license":[{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T00:00:00Z","timestamp":1769731200000},"content-version":"tdm","delay-in-days":2,"URL":"https:\/\/iopscience.iop.org\/info\/page\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"crossref","award":["212855"],"award-info":[{"award-number":["212855"]}],"id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["iopscience.iop.org"],"crossmark-restriction":false},"short-container-title":["Phys. Med. Biol."],"published-print":{"date-parts":[[2026,1,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    <jats:italic>Objective.<\/jats:italic>\n                    Manual review of daily auto-generated contours remains a challenge for clinical implementation of online adaptive radiotherapy (OART). This study introduces a contour assessment tool for quality assurance (CAT-QA), an automatic workflow designed to flag organs-at-risk (OAR) contours requiring manual revision.\n                    <jats:italic>Approach.<\/jats:italic>\n                    CAT-QA applies sequential geometric and dosimetric tests to each auto-generated OAR contour to flag structures requiring review. The tool was retrospectively applied to ten head and neck (H&amp;N) patients (44 CTs with manual contours) treated with proton therapy, split into training and test sets. For each image, three treatment plans were created: one with manual contours (Gold), one with automatic OAR contours (Auto), and one combining auto-contours with manual ones for flagged OARs (CAT-QA plan). Generalizability was assessed on six abdominal patients (8 CTs) without retuning.\n                    <jats:italic>Main Results.<\/jats:italic>\n                    CAT-QA flagged 21% of OARs in H&amp;N and 27% in abdominal cases. No dose failures (&gt;5% of prescribed dose vs. Gold) were observed in H&amp;N. One abdominal OAR (1.4%) exceeded this threshold. In contrast, auto plans resulted in dose failures in 7.5% H&amp;N and 8.5% (abdomen). The higher flag rate observed in the abdomen was driven by a single failed auto-contouring case; excluding this outlier, the average flag rate was 20%, comparable to H&amp;N. CAT-QA runtime averaged &lt;2 min, supporting feasibility for integration into online workflows.\n                    <jats:italic>Significance.<\/jats:italic>\n                    CAT-QA shows promise for improving the safety and efficiency of auto-contouring in OART by flagging OARs that need manual review, with initial results suggesting generalizability across treatment sites.\n                  <\/jats:p>","DOI":"10.1088\/1361-6560\/ae39a0","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T22:53:27Z","timestamp":1768604007000},"page":"025022","update-policy":"https:\/\/doi.org\/10.1088\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Contour assessment tool for quality assurance (CAT-QA) to speed up online adaptive radiotherapy"],"prefix":"10.1088","volume":"71","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3926-4041","authenticated-orcid":true,"given":"Lisa Stefanie","family":"Fankhauser","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Giulia","family":"Toro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2874-3634","authenticated-orcid":true,"given":"Andreas Johan","family":"Smolders","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2702-0437","authenticated-orcid":true,"given":"Renato","family":"Bellotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony John","family":"Lomax","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2547-1269","authenticated-orcid":true,"given":"Francesca","family":"Albertini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"266","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"pmbae39a0bib1","doi-asserted-by":"publisher","DOI":"10.1088\/1361-6560\/AD7CBD","type":"journal-article","article-title":"First clinical implementation of a highly efficient daily online adapted proton therapy (DAPT) workflow","volume":"69","author":"Albertini","year":"2024","journal-title":"Phys. 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