Adaptive radiation strategies require advanced software for image registration (including deformable registration) as well as dose summation. This session will cover how real time adaptive radiation therapy will require rapid treatment planning and novel quality assurance methods to ensure patient safety. The safe implementation of image registration and dose summation will be described and the use of adaptive radiotherapy in the daily clinical management of patients with cancer will be illustrated. The STAT RAD platform will be highlighted to demonstrate a real time adaptive radiation therapy workflow.