MR- and CT-Guided Adaptive Radiotherapy in Cancer Care

Adaptive radiotherapy is changing how cancer treatment is delivered by allowing radiation plans to be adjusted to the patient’s anatomy at the time of treatment. Advances in magnetic resonance and computed tomography guidance have made it increasingly feasible to account for daily changes in tumor position, organ motion, and normal tissue configuration, with the goal of improving precision, safety, and personalization. As MR-guided and CT-guided adaptive approaches move from early adoption into broader clinical use, the field is generating important evidence on workflow design, treatment efficiency, quality assurance, disease-site applicability, and patient benefit.

This Research Topic aims to bring together clinical, technical, and translational research on MR- and CT-guided adaptive radiotherapy in cancer care. We are particularly interested in studies that clarify where adaptive treatment adds the most value, how these workflows can be implemented safely and efficiently, and how image guidance can support better decision-making during treatment delivery. By covering both MR-guided and CT-guided adaptive strategies, this collection seeks to provide a broader and more practical view of how adaptive radiotherapy is being integrated across oncology. The goal is to support clinicians, physicists, radiation therapists, and researchers working to refine adaptive treatment pathways and expand evidence-based use in routine practice.

To capture the breadth and depth of current research, we welcome articles including but not limited to the following topics:
• Clinical implementation of MR- and CT-guided adaptive radiotherapy, including workflow design, staffing models, training, and operational efficiency.
• Site-specific adaptive treatment strategies for cancers such as prostate, pancreas, liver, gynecologic, breast, head and neck, central nervous system, and oligometastatic disease.
• Online adaptation methods, contouring, registration, motion management, gating, and treatment decision-making during image-guided delivery.
• Dosimetry, quality assurance, safety, reproducibility, and technical validation with clear clinical or translational relevance
• Automation, artificial intelligence, and digital tools that improve consistency, speed, and scalability in adaptive radiotherapy.
• Clinical outcomes, toxicity, patient-reported outcomes, comparative effectiveness, and real-world evidence for adaptive care pathways.

By bringing these studies together, this Research Topic will help define the current state and future direction of image-guided adaptive radiotherapy in oncology. We invite contributions that advance practical implementation, clinical impact, and multidisciplinary collaboration. Real-world studies, original research, clinical studies, technical reports, methods papers, reviews, mini reviews, case reports, and perspectives are all welcomed, and we invite authors to submit work that strengthens both evidence generation and adoption in cancer care.

Please note: manuscripts consisting solely of bioinformatics, computational analysis, or predictions of public databases which are not accompanied by validation (independent clinical or patient cohort, or biological validation in vitro or in vivo, which are not based on public databases) are not suitable for publication in this journal.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Clinical Trial
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Review
• Systematic Review
• Technology and Code

Keywords: Adaptive Radiotherapy, MR-Guided Radiotherapy, CT-Guided Radiotherapy, Online Adaptation, Cancer Care, Treatment Workflow, Quality Assurance, Clinical Outcomes, Motion Management, Artificial Intelligence

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.