An Uncertainty-Guided Digital Twin Framework for Online Adaptive Proton Therapy in Head and Neck Cancer: A Feasibility Study
Objective: Head and neck (HN) proton therapy spans six to seven weeks of anatomical change, while offline replanning takes about a week. We present an uncertainty-guided digital twin (UGDT) framework that forecasts treatment-day anatomy before treatment and evaluate whether it generates online adaptive proton therapy (APT) plans of clinical quality. Approach: A library of 302 longitudinal deformations from 88 previously treated HN patients was transported onto each new patient's treatment planning CT (TPCT) using two-step multi-atlas deformable image registration (DIR) built on a pretrained CT foundation model, generating about 284 predicted CTs (pdCTs) with contours per patient. Dispersi...
| Authors | Yizhou Wu, Ryan J. Sanford, Huiqiao Xie et al. |
|---|---|
| Primary category | physics.med-ph |
| Published | 30 September 2026 |
| Last updated at source | 30 September 2026 |
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