Direct-to-Treatment Adaptive Radiation Therapy: Live Planning of Spine Metastases Using Novel Cone Beam Computed Tomography.
Journal:
International journal of radiation oncology, biology, physics
Published Date:
Mar 9, 2025
Abstract
PURPOSE: Cone beam computed tomography (CBCT)-based online adaptive radiation therapy is carried out using a synthetic CT (sCT) created through deformable registration between the patient-specific fan-beam CT, fan-beam computed tomography (FBCT), and daily CBCT. Ethos 2.0 allows for plan calculation directly on HyperSight CBCT and uses artificial intelligence-informed tools for daily contouring without the use of a priori information. This breaks an important link between daily adaptive sessions and initial reference plan preparation. This study explores adaptive radiation therapy for spine metastases without prior patient-specific imaging or treatment planning. We hypothesize that adaptive plans can be created when patient-specific positioning and anatomy is incorporated only once the patient has arrived at the treatment unit.