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Computed tomography (CT)-based, non-adaptive PI met all organ-at-risk (OAR) constraints based on anatomy from initial CT simulation (2a). Application of PI to the daily MR-image set of a patient with a pancreatic tumor (blue colorwash) resulted in violation of hard duodenal constraints (2b). Daily adaptive planning achieved resolution of the OAR constraint violation to the duodenum (marked with arrows) while preserving target volume coverage (2c).
