In online adaptive radiation therapy, in-room CBCT imaging data lacks the quality and accurate electron density information a planning X-ray computed tomography (CT) scan provides. Therefore, corrections of the in-room images must be performed to enable dose calculation and treatment adaptation. These procedures need to be
Accepted ArticleThis article is protected by copyright. All rights reserved evaluated carefully. So far, evaluations are only based on recalculation of the initial treatment plan on the new image data and disregard effects of the optimization itself.This study aims to fill this gap by proposing a measurement and reoptimization based approach to analyze image data for online adaptive proton therapy, where inaccuracies in the planning image data have a much larger effect on dose calculation and optimization compared to photon therapy.The measured results of this study showed a high agreement with the expectations from recalculations and reoptimization based on the treatment planning system only.
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