Cross-fraction anatomical priors boost organ-at-risk segmentation in online MR-guided radiotherapy

AdaptSeg, using cross-fraction priors, boosted abdominal OAR segmentation mean DSC by 4.1% (HD95 −43%, ASSD −39%) vs. best single-fraction method, with inference <1.6s—fast enough for online MR-guided adaptive radiotherapy.

• For highly deformable organs, small bowel DSC increased from 77.8% to 84.8% (p<0.001) and colon HD95 dropped from 23.13 to 8.74 mm (p<0.001).
• The method requires no per-patient retraining and fits within the 50–90 min online adaptive treatment window.

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