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A clinically relevant increase in IPSS in the three months following MRgRT was observed in 25 patients. The V from DOSE and V from DOSE showed good correlation with IPSS increase with area under the curve (AUC) values ranging from 0.71 to 0.75. In contrast, baseline dosimetry showed a poor correlation with AUC values between 0.53 and 0.62. DOSE was superior to baseline dosimetry in predicting acute urinary symptoms. Because DOSE also showed good correlation, this can potentially be used to optimize MRgRT for the remaining fractions. DOS