ART2Dose: A comprehensive dose verification platform for online adaptive radiotherapy

Area of Science:

• Medical Physics
• Radiation Oncology
• Radiotherapy Technology

Background:

• Online adaptive radiotherapy (ART) requires rapid, accurate dose verification.
• Current commercial software limitations hinder efficient secondary dose checks in time-sensitive online ART workflows.
• Independent verification of volumetric dose distribution is critical for adaptive plan accuracy.

Purpose of the Study:

• To introduce ART2Dose, an efficient online quality assurance (QA) platform for online ART.
• To evaluate the performance of ART2Dose on Ethos and Unity treatment delivery systems.
• To assess the platform's integration into clinical QA workflows.

Main Methods:

• Developed ART2Dose, a secondary dose verification software with an integrated workflow (database, calculation server, report generator, web portal).
• Compared ART2Dose with Mobius3D in pre-clinical evaluations for 40 adaptive plans.
• Conducted retrospective analysis of 1302 cone-beam CT guided adaptive radiotherapy (CTgART) and 1278 MR image-guided adaptive radiotherapy (MRgART) fractions.

Main Results:

• ART2Dose demonstrated comparable or superior gamma passing rates to Mobius3D.
• Pre-treatment check time was reduced by 3-4 minutes per plan.
• Retrospective analysis showed average gamma passing rates of 99.61% for CTgART and 97.75% for MRgART.
• Average calculation times were ~1 min for CTgART and ~2 min for MRgART.

Conclusions:

• ART2Dose significantly enhances the online ART workflow through streamlined implementation.
• The platform offers reliable and efficient online QA, reducing clinical time pressure.
• ART2Dose minimizes labor-intensive tasks, improving overall efficiency in adaptive radiotherapy.