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Performance of a Vendor System for Systematic Offline Adaptive Breast Helical Radiotherapy.

Philippe Meyer^1,2, Claire Dossun¹, Georges Noel¹

¹Department of Radiation Therapy, Centre Paul Strauss, 3 Rue de la Porte de l'Hôpital, 67000 Strasbourg, France.

|May 13, 2026

Summary

This summary is machine-generated.

This study found that an offline adaptive radiotherapy system accurately monitors breast and lung structures during cancer treatment. However, caution is advised for nodal targets, heart, and esophagus dosimetry before clinical use.

Keywords:

adaptive radiotherapy (ART)breast cancer deformable registration (DIR)image-guided radiotherapy (IGRT)

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Area of Science:

Radiation oncology
Medical physics
Cancer treatment technology

Background:

Evaluating a commercial offline adaptive radiotherapy (ART) system for breast cancer treatment with nodal irradiation.
Utilizing helical tomotherapy for treatment delivery and monitoring.

Purpose of the Study:

To assess the performance and accuracy of an offline ART system in systematic monitoring during breast cancer radiotherapy.
To compare automated structure delineation with manual contours and evaluate dosimetric parameters.

Main Methods:

Thirty patients with invasive unilateral breast carcinoma undergoing helical tomotherapy were analyzed.
Three megavoltage CT scans per patient were processed using the PreciseART offline ART workflow.
Geometric accuracy (Dice Similarity Coefficient, Hausdorff distance) and dosimetric parameters (D2%, V95%, Dmean, V20Gy) were evaluated.

Main Results:

Median Dice Similarity Coefficients exceeded 0.9 for breast targets and major organs, with higher deviations for nodal targets and the esophagus.
Dosimetric differences were within 5% for most targets and the ipsilateral lung in over 90% of sessions.
Larger deviations were noted for nodal planning target volumes, heart mean dose, esophagus, and spinal canal.

Conclusions:

The offline ART system shows sufficient accuracy for automated monitoring of breast and lung structures.
Clinical implementation requires careful consideration of dosimetry for nodal targets, heart, and esophagus due to observed inconsistencies.