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Abstract This study evaluated segmentation accuracy, efficiency, and radiomic feature stability for manual (MD), artificial intelligence-based (AI), and hybrid (MD + AI) contouring of pelvic organs on planning CT (pCT) and HyperSight cone-beam CT (hCBCT) for adaptive radiotherapy. Dice similarity and 95th percentile Hausdorff distance (HD95) quantified segmentation agreement, while radiomic feature stability was assessed using the concordance correlation coefficient (CCC).
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