Abstract and Learning Objectives

Software tools for image-based adaptive radiotherapy such as deformable image registration, contour propagation and dose mapping have progressed beyond the research setting and are now commercial products available as part of both treatment planning systems and stand-alone applications.  These software tools are used together to create clinical workflows to detect, track and evaluate changes in the patient and to accumulate dose.Deviations uncovered in this process are used to guide decisions about re-planning/adaptation with the goal of keeping the delivery of prescribed dose “on target" throughout the entire course of radiotherapy.

Since the output from one step of the adaptive process is used as an input for another, it is essential to understand and document the uncertainty associated with each of the step and how these uncertainties are propagated.This in turn requires an understanding how the underlying tools work. Unfortunately, important details about the algorithms used to implement these tools are scarce or incomplete, too often for competitive reasons. This is in contrast to the situation involving other basic treatment planning algorithms such as dose calculations, where the medical physics community essentiallyrequires vendors to provide complete details about their underlying theory and clinical implementation. Vendors must also be encouraged to “show their hand” when it comes the tools for adaptive radiotherapy. The goal of this session is to start this process by bringing vendors together for a series of “Texas style” competitions.

Learning objectives

- Understand the components of the image-based adaptive radiotherapy process

- Understand the how these components are implemented in various commercial systems

- Understand the pros and cons of each vendor implementation