case_images: PMC10800431_01
case_images: MRI urography demonstrating a lesion at the left renal pelvis size of 2.6 cm x 1.9 cm x 2.9 cm with restricted diffusion but no gross extraluminal extension (black arrow) and a 0.7-cm left para-aortic lymph node with prominent restricted diffusion but preserved hilar fat adjacent to the aforementioned lesion (white arrow).
case_images: fonc-13-1284417-g001.jpg
case_images: PMC10800431_01_fonc-13-1284417-g001.jpg
case_images: f1
case_images: Figure 1 ), but no bladder mass or gross mass at the surgical bed of the right nephrectomy is noted. Further computed tomography (CT) of the chest demonstrated multiple solid pulmonary nodules scattered at both lungs with a size up to 0.9 cm, which is likely pulmonary metastasis.
case_images: Pretreatment plan and all five daily adaptive plans showing gross tumor volume (red line), clinical target volume (blue line), and planning target volume (light green line) with left kidney (yellow line), spinal cord (dark pink line), duodenum (pink line), and small bowel (orange line).
case_images: fonc-13-1284417-g002.jpg
case_images: PMC10800431_01_fonc-13-1284417-g002.jpg
case_images: f2
case_images: Lastly, planning target volume (PTV) resulted from a summation of a 3-mm expansion of CTVp and CTVn excluding renal parenchyma ( Figure 2 ). All five fractions were delivered by using the ATP workflow, and the daily adaptive plan of each fraction was demonstrated in  Figure 2  with the pretreatment plan.
case_images: MRI at 3 months posttreatment illustrating the disappearance of a mass at the left renal pelvis with no restricted diffusion (black arrow) and a stable 0.7-cm left para-aortic lymph node with preserved hilar fat (white arrow).
case_images: fonc-13-1284417-g003.jpg
case_images: PMC10800431_01_fonc-13-1284417-g003.jpg
case_images: f3
case_images: MR imaging of the whole abdomen that was performed 3 months post-radiotherapy demonstrated the disappearance of the left renal pelvic mass without evidence of other gross mass lesions along the left ureter and an unchanged 0.7-cm left para-aortic lymph node with preserved hilar fat ( Figure 3 ).