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MR-guidance in clinical reality: current treatment challenges and future perspectives

Corradini, S. ; Alongi, F. ; Andratschke, N. ; Belka, C. ; Boldrini, L. ; Cellini, F. ; Debus, J. ; Guckenberger, M. ; Hörner-Rieber, J. ; Lagerwaard, F. J. ; Mazzola, R. ; Palacios, M. A. ; Philippens, M. E. P. ; Raaijmakers, C. P. J. ; Terhaard, C. H. J. ; Valentini, V. ; Niyazi, M.

In: Radiation Oncology, 14 (2019), Nr. 92. pp. 1-12. ISSN 1748-717X

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Download (1MB) | Lizenz: Creative Commons LizenzvertragMR-guidance in clinical reality: current treatment challenges and future perspectives by Corradini, S. ; Alongi, F. ; Andratschke, N. ; Belka, C. ; Boldrini, L. ; Cellini, F. ; Debus, J. ; Guckenberger, M. ; Hörner-Rieber, J. ; Lagerwaard, F. J. ; Mazzola, R. ; Palacios, M. A. ; Philippens, M. E. P. ; Raaijmakers, C. P. J. ; Terhaard, C. H. J. ; Valentini, V. ; Niyazi, M. underlies the terms of Creative Commons Attribution 4.0

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Abstract

Magnetic Resonance-guided radiotherapy (MRgRT) marks the beginning of a new era. MR is a versatile and suitable imaging modality for radiotherapy, as it enables direct visualization of the tumor and the surrounding organs at risk. Moreover, MRgRT provides real-time imaging to characterize and eventually track anatomical motion. Nevertheless, the successful translation of new technologies into clinical practice remains challenging. To date, the initial availability of next-generation hybrid MR-linac (MRL) systems is still limited and therefore, the focus of the present preview was on the initial applicability in current clinical practice and on future perspectives of this new technology for different treatment sites. MRgRT can be considered a groundbreaking new technology that is capable of creating new perspectives towards an individualized, patient-oriented planning and treatment approach, especially due to the ability to use daily online adaptation strategies. Furthermore, MRL systems overcome the limitations of conventional image-guided radiotherapy, especially in soft tissue, where target and organs at risk need accurate definition. Nevertheless, some concerns remain regarding the additional time needed to re-optimize dose distributions online, the reliability of the gating and tracking procedures and the interpretation of functional MR imaging markers and their potential changes during the course of treatment. Due to its continuous technological improvement and rapid clinical large-scale application in several anatomical settings, further studies may confirm the potential disruptive role of MRgRT in the evolving oncological environment.

Item Type: Article
Journal or Publication Title: Radiation Oncology
Volume: 14
Number: 92
Publisher: BioMed Central
Place of Publication: London
Date Deposited: 06 Aug 2019 15:17
Date: 2019
ISSN: 1748-717X
Page Range: pp. 1-12
Faculties / Institutes: Service facilities > German Cancer Research Center (DKFZ)
Medizinische Fakultät Heidelberg > Radiologische Universitätsklinik
Subjects: 610 Medical sciences Medicine
Uncontrolled Keywords: MR-guided radiotherapy, Image-guided, radiotherapy, MR-IGRT, MR-Linac, adaptive radiotherapy, Interfraction variability, Intra-fraction fraction variability, MRI, outcome
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