Pets‑Care‑Adapt: A Quantitative Adaptive and Pulsar Translational Platform Integrating Veterinary and Clinical Oncology
Abstract
Purpose
Adaptive radiotherapy (ART) and personalized ultra‑fractionated stereotactic adaptive radiotherapy (PULSAR) require longitudinal anatomical modeling, deformable image registration (DIR), and dose recalculation and accumulation. While these capabilities are well established in human radiotherapy, they remain largely unavailable in veterinary practice. This work presents a quantitative translational platform designed to support ART and PULSAR workflows in veterinary radiotherapy while maintaining compatibility with clinical treatment planning systems.
Methods
We developed PETS‑CARE‑AdaPT, an integrated platform that standardizes veterinary imaging and treatment data and enables longitudinal anatomical and dosimetric analysis. Imaging and treatment plans were archived using DICOM‑compliant formats with standardized structure nomenclature. Template‑guided AI segmentation adapted from human models were used to generate organ‑at‑risk and target contours. For longitudinal assessment, region‑of‑interest–constrained DIR (RC‑DIR) was implemented to improve registration stability in the presence of tumor regression and large anatomical deformation. Delivered dose was recalculated on longitudinal imaging using a Monte Carlo (MC)–based dose engine, and dose deformation was applied to accumulate dose. The workflow was evaluated on nine veterinary patients, including three thoracic, two pelvic, and four head‑and‑neck cases.
Results
Automated segmentation performed best in thoracic cases, particularly for prone positioning. Significant challenges were observed due to inter‑animal variability in anatomy, body proportions, and treatment setup. Nonstandard positioning and differences in skeletal and muscular flexibility relative to humans increased DIR complexity and impacted dose mapping. RC‑DIR improved robustness of tumor tracking across time points, enabling consistent dose warping and cumulative dose assessment compared with unconstrained DIR approaches.
Conclusion
PETS‑CARE‑AdaPT provides the first integrated platform for quantitative segmentation, deformable tumor tracking, MC dose recalculation, and deformable dose accumulation in veterinary radiotherapy. The platform establishes a robust dosimetric foundation for ART and PULSAR workflows in companion animals and enables standardized translational studies aligned with modern clinical radiotherapy practice.