Clinical Applications of Magnetic Resonance-Guided Radiotherapy: A Narrative Review

Abstract

Magnetic resonance-guided radiotherapy (MRgRT) represents a promising new image guidance technology for radiation treatment delivery combining an onboard MRI scanner with radiation delivery technology. By enabling real-time low-field or high-field MRI acquisition, it facilitates improved soft tissue delineation, adaptive treatment, and motion management. Now that MRgRT has been available for nearly a decade, research has shown the technology can be used to effectively shrink treatment margins to either decrease toxicity (in breast, prostate cancer, and pancreatic cancer) or facilitate dose-escalation and improved oncologic outcomes (in pancreatic and liver cancer), as well as enabling indications that require clear soft tissue delineation and gating (lung and cardiac ablation). In doing so, the use of MRgRT has the potential to significantly improve the outcomes and quality of life of the patients it treats. The present narrative review aims to describe the rationale for MRgRT, the current and forthcoming state of technology, existing studies, and future directions for the advancement of MRgRT, including associated challenges.

MR-LINAC, a New Partner in Radiation Oncology: Current Landscape

“…Another emerging field in RT is the treatment of ventricular tachycardia with SBRT. The hypothesis is that ionizing radiation produces a homogenization of the scar tissue that is responsible for some of these tachycardias [105]. In 2017, Cuculich et al [106] published their experience with five patients treated with single-fraction SBRT (25 Gy), with a 99.9% reduction in tachycardia episodes in the following 46 months.…”