Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck…

Cohort studyJournal of applied clinical medical physics· Aug 2026

Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck cancer.

Jessica Lye, Kartik Kumar, Benjamin Harris … Sweet Ping Ng

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Head & Neck SurgeryCohort studyClinical practiceQ2IF 2.8

Synthetic CT predicted need for radiotherapy replanning with 92% sensitivity and specificity.

Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck cancer.

Jessica Lye … Sweet Ping Ng

Journal of applied clinical medical physics · Aug 2026 · Q2 in General Medicine

Background

Anatomical changes over the many weeks of radiotherapy for Head and Neck cancer patients can compromise the original treatment plan, potentially increase the risk of side effects and impact outcomes.

Purpose

This work presents an automated approach to evidence-based assessment of treatment plan robustness to anatomy changes.

Methods

A retrospective study was undertaken using 12 H&N patients who had a replanning CT during their treatment.

n = 12 H&N patients

Results

synthetic CT correctly flagged replanning need in most cases, few errors

Sensitivity

92%

Specificity

92%

More results

The average Dice Similarity Coefficient (Dice Similarity Coefficient) was > 80% for all contours, except for the sub-mandibular (> 75%) and excluding cochlea.

The average mean distance-to-agreement (mean distance-to-agreement) was < 2 mm, and all MDAs were < 3 mm.

More results

The average DVH differences were within 1%, and all dose differences were within 3%.

The total gamma passing rates were > 95%.

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Conclusion · 1 of 2

By quantifying the impact of anatomical changes on dose distributions, the Directed Adaptive Radiotherapy process helps determine whether a patient would benefit from adaptive replanning.

Conclusion · 2 of 2

The Directed Adaptive Radiotherapy method improves efficiency by reducing unnecessary imaging and replanning when the treatment remains robust against anatomy changes.

Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck cancer.

Evaluating synthetic CT from deformable registration in directed adaptive radiotherapy for head and neck cancer.

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