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Direct-to-treatment MRI-guided prostate radiotherapy using a generic patient-agnostic reference plan.

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Technical innovations & patient support in radiation oncology 2026 Vol.37() p. 100370
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Tsekas G, Wiersema L, Conijn S, Sundaram J, van der Heide UA, Janssen T

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[BACKGROUND] Background and Purpose: Offline plan preparation is a time-consuming step in MRI-guided radiotherapy (MRIgRT).

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APA Tsekas G, Wiersema L, et al. (2026). Direct-to-treatment MRI-guided prostate radiotherapy using a generic patient-agnostic reference plan.. Technical innovations & patient support in radiation oncology, 37, 100370. https://doi.org/10.1016/j.tipsro.2025.100370
MLA Tsekas G, et al.. "Direct-to-treatment MRI-guided prostate radiotherapy using a generic patient-agnostic reference plan.." Technical innovations & patient support in radiation oncology, vol. 37, 2026, pp. 100370.
PMID 41626419 ↗

Abstract

[BACKGROUND] Background and Purpose: Offline plan preparation is a time-consuming step in MRI-guided radiotherapy (MRIgRT). This work explores the use of a patient-agnostic reference plan and delineations for direct-to-treatment (DtT) MRI-guided prostate RT, without any patient-specific treatment preparations.

[MATERIAL AND METHODS] The data of ten prostate cancer patients were used to simulate a (DtT) workflow: During fraction 1, patient-specific contour adaptations were performed and a treatment plan was created, which was used for the rest of the fractions. The DtT treatment plans were evaluated against the clinical RT plans using the clinical delineations.

[RESULTS] All DtT plans reached sufficient PTV coverage (V > 99%), while resulting in comparable OAR dose distributions to the clinical plans.

[CONCLUSION] Our DtT workflow resulted in adequate PTV coverage at the cost of small increase to the dose of some organs-at-risk and a high overall efficiency gain.

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