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@ARTICLE{Hoffmans:154497,
      author       = {D. Hoffmans and N. I. Niebuhr$^*$ and O. Bohoudi and A.
                      Pfaffenberger$^*$ and M. A. Palacios},
      title        = {{A}n end-to-end test for {MR}-guided online adaptive
                      radiotherapy.},
      journal      = {Physics in medicine and biology},
      volume       = {65},
      number       = {12},
      issn         = {1361-6560},
      address      = {Bristol},
      publisher    = {IOP Publ.},
      reportid     = {DKFZ-2020-00819},
      pages        = {Article number 125012},
      year         = {2020},
      note         = {Volume 65, Issue 12, 21 June 2020, Article number 125012},
      abstract     = {In the evolving field of adaptive MR guided radiotherapy,
                      the need for dedicated procedures for acceptance and quality
                      assurance is increasing. Research has been devoted to MR
                      compatible dosimeters and phantoms, but to date no
                      end-to-end test has been presented that covers an MRgRT
                      workflow. Such an end-to-end test should comprise each step
                      of the workflow and include all associated uncertainties.
                      The purpose of this study was to investigate the usability
                      of an anthropomorphic deformable and multimodal pelvis
                      (ADAM-pelvis) phantom in combination with film dosimetry for
                      end-to-end testing of an MRgRT adaptive workflow. The
                      ADAM-pelvis phantom included surrogates for muscle tissue,
                      adipose and bone, as well as deformable silicone organs
                      mimicking a prostate patient. At the interfaces of the
                      critical structures (bladder and rectum), small pieces of
                      GafChromic EBT3 films were placed to measure delivered dose.
                      Pre-treatment MR imaging of the phantom was used to
                      delineate the prostate, rectum and bladder and to generate a
                      treatment plan to deliver 2 Gy to the prostate. Electron
                      density (ED) map from CT imaging was used for dose
                      calculation after deformable image registration (DIR) to the
                      pre-treatment MR scan. At each fraction, bladder- and rectum
                      filling was varied and a new adapted plan was generated.
                      Dose calculation was performed using both a DIR-based ED map
                      and a CT-based ED map after acquisition of a new CT scan of
                      the phantom at each fraction. Dose calculations were
                      performed taking into account the magnetic field. A good
                      agreement between measured and calculated dose was found
                      using both, the CT-derived and the DIR-based ED map $(2.0\%$
                      and $2.8\%$ dose difference, respectively). The gamma index
                      pass-rate $(3\%$ / 2 mm) varied from $96.4\%$ to $100\%.The$
                      ADAM-pelvis phantom was suitable for end-to-end testing in
                      MR-guided radiotherapy and a very good agreement with the
                      calculated dose was achieved.},
      cin          = {E040},
      ddc          = {530},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Imaging and radiooncology (POF3-315)},
      pid          = {G:(DE-HGF)POF3-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32294637},
      doi          = {10.1088/1361-6560/ab8955},
      url          = {https://inrepo02.dkfz.de/record/154497},
}