Monitoring lung tumour volume on daily cone beam CT; is it achievable in a real-world setting?

Delineating the gross tumour volume (GTV) in non-small cell lung cancer (NSCLC) can be challenging due to anatomical complexities and imaging artefacts. This study evaluates a semi-automated workflow using commercial software for target volume (TV) delineation on cone-beam CT (CBCT) in patients undergoing radical radiotherapy. Seventy-six patients with 553 scans (n = 76 planning CT, n = 477 CBCT) were included. Auto-contours were adjusted by a senior Radiation Therapist and reviewed for accuracy. The majority (59.1 %) required only minor revisions, with median adjustment time of CBCT auto-contours of 83 (range 0-460) seconds. The findings support the feasibility of this approach, offering a pragmatic solution for adaptive radiotherapy workflows in NSCLC.