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@ARTICLE{Elter:177720,
      author       = {A. Elter$^*$ and C. Rippke and W. Johnen$^*$ and P.
                      Mann$^*$ and E. Hellwich$^*$ and A. Schwahofer$^*$ and S.
                      Dorsch$^*$ and C. Buchele and S. Klüter and C. Karger$^*$},
      title        = {{E}nd-to-end test for fractionated online adaptive
                      {MR}-guided radiotherapy using a deformable anthropomorphic
                      pelvis phantom.},
      journal      = {Physics in medicine and biology},
      volume       = {66},
      issn         = {0031-9155},
      address      = {Bristol},
      publisher    = {IOP Publ.},
      reportid     = {DKFZ-2021-02761},
      pages        = {245021},
      year         = {2021},
      note         = {#EA:E040#LA:E040# / 66 245021},
      abstract     = {In MR-guided radiotherapy (MRgRT) for prostate cancer
                      treatments inter-fractional anatomy changes such as bladder
                      and rectum fillings may be corrected by an online adaption
                      of the treatment plan. To clinically implement such complex
                      treatment procedures, however, specific end-to-end tests are
                      required that are able to validate the overall accuracy of
                      all treatment steps from pre-treatment imaging to dose
                      delivery.In this study, an end-to-end test of a fractionated
                      and online adapted MRgRT prostate irradiation was performed
                      using the so-called ADAM-PETer phantom. The phantom was
                      adapted to perform 3D polymer gel (PG) dosimetry in the
                      prostate and rectum. Furthermore, thermoluminescence
                      detectors (TLDs) were placed at the center and on the
                      surface of the prostate for additional dose measurements as
                      well as for an external dose renormalization of the PG. For
                      the end-to-end test, a total of five online adapted
                      irradiations were applied in sequence with different bladder
                      and rectum fillings, respectively.A good agreement of
                      measured and planned dose was found represented by high
                      γ-index passing rates (3 $\%⁄$ 3 mm criterion) of the PG
                      evaluation of 98.9 $\%$ in the prostate and 93.7 $\%$ in the
                      rectum. TLDs used for PG renormalization at the center of
                      the prostate showed a deviation of -2.3 $\%.The$ presented
                      end-to-end test, which allows for 3D dose verification in
                      the prostate and rectum, demonstrates the feasibility and
                      accuracy of fractionated and online-adapted prostate
                      irradiations in presence of inter-fractional anatomy
                      changes. Such tests are of high clinical importance for the
                      commissioning of new image-guided treatment procedures such
                      as online adaptive MRgRT.},
      keywords     = {3D gel dosimetry (PAGAT) (Other) / Magnetic
                      resonance-guided (adaptive) radiotherapy (MRgRT) (Other) /
                      deformable anthropomorphic pelvis phantom (Other) /
                      end-to-end test (Other) / fractionated treatment (Other) /
                      inter-fractional motion (Other) / thermoluminescence
                      detectors (TLD) (Other)},
      cin          = {E040},
      ddc          = {530},
      cid          = {I:(DE-He78)E040-20160331},
      pnm          = {315 - Bildgebung und Radioonkologie (POF4-315)},
      pid          = {G:(DE-HGF)POF4-315},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34845991},
      doi          = {10.1088/1361-6560/ac3e0c},
      url          = {https://inrepo02.dkfz.de/record/177720},
}