2018
DOI: 10.1016/j.clon.2018.08.001
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Adaptive Radiotherapy Enabled by MRI Guidance

Abstract: Adaptive radiotherapy (ART) strategies systematically monitor variations in target and neighbouring structures to inform treatment-plan modification during radiotherapy. This is necessary because a single plan designed before treatment is insufficient to capture the actual dose delivered to the target and adjacent critical structures during the course of radiotherapy. Magnetic resonance imaging (MRI) provides superior soft-tissue image contrast over current standard X-ray-based technologies without additional … Show more

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Cited by 106 publications
(95 citation statements)
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“…A number of authors have reported on on-table adaption of treatment plans using MRgRT devices [11,[33][34][35][36][37] and also on assessing which patients benefit most from adaptive MRgRT [35,[38][39][40][41][42][43][44]. In the presented study, no online treatment plan adaptions were performed.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…A number of authors have reported on on-table adaption of treatment plans using MRgRT devices [11,[33][34][35][36][37] and also on assessing which patients benefit most from adaptive MRgRT [35,[38][39][40][41][42][43][44]. In the presented study, no online treatment plan adaptions were performed.…”
Section: Discussionmentioning
confidence: 99%
“…Head-to-head comparative studies of CT-guided and MR-guided adaptive radiotherapy applying standard doses and fractionation might not be sufficient, as MR-guided adaptive radiotherapy allows for high-dose radiotherapy under circumstances in which treatment would not have been possible with conventional techniques [34]. Further well-designed clinical trials will be necessary to fully demonstrate the true potential of MR-guided adaptive radiotherapy.…”
Section: Discussionmentioning
confidence: 99%
“…MRI provides superior soft tissue contrast compared to standard onboard X-ray based imaging without the additional ionising radiation risk [7]. When combined with online adaptive replanning capabilities, MRgRT offers opportunity to adapt the plan at each fraction to the anatomical changes seen [8,9].…”
Section: Introductionmentioning
confidence: 99%
“…The use of such systems is expected to allow online image acquisitions just before and during treatment. This aims at quantifying inter-and intra-fraction anatomo-pathological changes by means of imaging, which could be used to accurately deliver the planned dose based on the current changing anatomy or to entirely create a new plan, thus performing adaptive treatments (Verellen et al 2008, Hunt et al 2018.…”
Section: Mri For Organ Motion Management In Treatment Deliverymentioning
confidence: 99%
“…For treatment planning, the superior soft-tissue contrast of MRI can decrease organ delineation uncertainties (Schmidt and Payne 2015), whilst the dose-free nature of MRI enables multiple and extended acquisitions, accounting for cycleto-cycle breathing variations (Kauczor and Plathow 2006, Biederer et al 2010, Jaffray 2012. During treatment, the new generation of in-room MRI / X-ray treatment unit systems (Ménard and van der Heide 2014, Keall, Barton and Crozier 2014, Fallone 2014, Lagendijk et al 2014, Jaffray et al 2014, Mutic and Dempsey 2014 allows direct imaging and both inter-and intra-fraction treatment adaptation strategies (Bainbridge et al 2017a, Hunt et al 2018. The recent clinical application of hybrid MRI and treatment unit systems (Olsen, Green and Kashani 2014, Kashani and Olsen 2018 represents an important milestone in external beam radiotherapy, and this technology is expected to provide improved clinical outcomes and reduce toxicities as well as efficient workflows.…”
Section: Introductionmentioning
confidence: 99%