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              <text>Synthetic CTs enable voxel-by-voxel mass density representation while reducing artefacts, a significant advancement for accurate dose calculations in adaptive radiotherapy. This study evaluates two synthetic algorithms—corrected CBCT (corrCBCT) and virtual CT (vCT) —against conventional CBCT with bulk density assignment. Analysing dosimetric outcomes in patients with varying anatomical changes, it was found that while the vCT offers improved mass density representation, there is no significant difference in dose distributions between the vCT and corrCBCT. The execution of hybrid registrations was critical, significantly impacting the anatomical accuracy of the vCT image. Despite differences in mass density representations between the vCT and corrCBCT, using a corrCBCT is recommended in adaptive radiotherapy to ensure current anatomical accuracy.</text>
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