Tanny, Sean; Dona Lemus, Olga M; Wancura, Joshua; Sperling, Nicholas; Webster, Matthew; Jung, Hyunuk; Zhou, Yuwei; Li, Fiona; Yoon, Jihyung; Podgorsak, Alexander; Zheng, Dandan
description
CBCT-guided online-adaptive radiotherapy (oART) systems have been made possible by using artificial intelligence and automation to substantially reduce treatment planning time during on-couch adaptive sessions. Evaluating plans generated during an adaptive session presents significant challenges to the clinical team as the planning process gets compressed into a shorter window than offline planning. We identified MU variations up to 30% difference between the adaptive plan and the reference plan in several oART sessions that caused the clinical team to question the accuracy of the oART dose calculation. We investigated the cause of MU variation and the overall accuracy of the dose delivered when MU variations appear unnecessarily large.