Technical feasibility and clinical evaluation of 4D-MRI guided liver SBRT on the MR-linac

Lindt, A van de; Nowee, B; Janssen, Tomas; Schneider, Christoph; Remeijer, P.; Pelt, V.W.J. Van; Betgen, A.; Jansen, E.P.M.; Sonke, J.J.

doi:10.1016/j.radonc.2022.01.009

Cited by 22 publications

(16 citation statements)

References 33 publications

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“…Over the last 20 years, various researchers have proposed numerous methods for 4D‐MRI, which have yielded promising results in both volunteers and patients 176 . It can provide valuable information for image‐guidance of RT including the tumor motion amplitude, tumor localization, treatment verification, and treatment monitoring 177,178 . Figure 2 demonstrates an example of 4D‐MRI in a patient with liver cancer.…”

Section: Methodsmentioning

confidence: 99%

“…176 It can provide valuable information for image-guidance of RT including the tumor motion amplitude, tumor localization, treatment verification, and treatment monitoring. 177,178 Prospective 4D-MRI can be achieved using realtime 3D acquisition or fast 2D acquisition with a respiratory triggering system to preselect respiratory amplitudes. [179][180][181][182][183][184][185][186] Compared with retrospective reconstruction methods, prospective reconstruction methods acquire images in pre-determined conditions, which makes them less susceptible to breathing irregularity.…”

Section: D-mrimentioning

confidence: 99%

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Multi‐parametric MRI for radiotherapy simulation

Wang

Yang

et al. 2023

Medical Physics

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Magnetic resonance imaging (MRI) has become an important imaging modality in the field of radiotherapy (RT) in the past decade, especially with the development of various novel MRI and image‐guidance techniques. In this review article, we will describe recent developments and discuss the applications of multi‐parametric MRI (mpMRI) in RT simulation. In this review, mpMRI refers to a general and loose definition which includes various multi‐contrast MRI techniques. Specifically, we will focus on the implementation, challenges, and future directions of mpMRI techniques for RT simulation.

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Section: Methodsmentioning

confidence: 99%

Section: D-mrimentioning

confidence: 99%

Multi‐parametric MRI for radiotherapy simulation

Wang

Yang

et al. 2023

Medical Physics

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“…For tumours with substantial motion, 3D MRI pre-beam and intra-fraction (real-time imaging) MRI monitoring of tumour motion is needed. Online pre-beam and intra-fraction 4D MRI has been successfully implemented in the clinical workflow for MRI-guided adaptive stereotactic radiotherapy delivered by MRI-Linac systems [77,78]. Gating experience from MRI-Linac systems has shown realtime tracking and gating capabilities using MRI is reliable and accurate with respect to spatial integrity and tracking accuracy [79].…”

Section: Mri-guided Proton Imaging and Delivery Requirements To Addre...mentioning

confidence: 99%

Magnetic resonance imaging (MRI) guided proton therapy: A review of the clinical challenges, potential benefits and pathway to implementation

Pham

Whelan

Oborn

et al. 2022

Radiotherapy and Oncology

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“…These technical advances have not only decreased the acute and long-term radiation-induced side effects but also allowed treatments that otherwise would result in intolerable normal tissue complications for the patients. State-of-the-art treatments such as gated stereotactic body radiation therapy (SBRT) liver treatment in an MR-linac workflow [1] and ventricular tachycardia radiotherapy, delivering single 25 Gy fraction during cardiobreathing motion [2], are notable results from the latest generation of technical and methodical developments. However, even with a perfect treatment technique using the current clinical accelerators, the tumour will still be surrounded by healthy tissue.…”

Section: Introductionmentioning

confidence: 99%

FLASH radiotherapy and the associated dosimetric challenges

Ceberg,

Mannerberg,

Konradsson

et al. 2023

J. Phys.: Conf. Ser.

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At Lund University and Skåne University Hospital in Lund, Sweden, we have, as the first clinic, modified a clinical Elekta Precise linear accelerator for convertible delivery of ultra-high dose rate (FLASH) irradiation. Whereas recently published reviews highlighted the need for standardised protocols for ultra-high dose rate beam dosimetry to be able to determine the true potential of FLASH irradiation, several dosimetry studies as well as in-vitro and in-vivo experiments have been carried out at our unit. Dosimetric procedures for verification of accurate dose delivery of FLASH irradiation to cell cultures, zebrafish embryos and small animals have been established using radiochromic films and thermo-luminescent dosimeters. Also, recently the first experience of electron FLASH radiotherapy (FLASH-RT) in canine patients in our clinical setting was published. Our research facilities also include a laboratory for 3D polymer gel manufacturing. Recently, we started investigating the feasibility of a NIPAM polymer gel dosimeter for ultra-high dose rate dosimetry. Furthermore, in the bunker of the modified Elekta linear accelerator, a Surface Guided Radiotherapy (SGRT) system is accessible. The Catalyst™ system (C-Rad Positioning, Uppsala, Sweden) provides optical surface imaging for patient setup, real-time motion monitoring and breathing adapted treatment. Aiming at treating patients using ultra-high dose rates, a real-time validation of the alignment between the beam and the target is crucial as the dose is delivered in a fraction of a second. Our research group has during the last decade investigated and developed SGRT workflows which improved patient setup and breathing adapted treatment for several cancer patient groups. Recently, we also started investigating the feasibility of a real-time motion monitoring system for surface guided FLASH-RT. Both FLASH related studies; 3D polymer gel dosimetry and surface guided FLASH-RT are to our knowledge the first of their kind. Following an introduction to the field of FLASH and the associated dosimetric challenges, we here aim to present the two ongoing studies including some preliminary results.

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Technical feasibility and clinical evaluation of 4D-MRI guided liver SBRT on the MR-linac

Cited by 22 publications

References 33 publications

Multi‐parametric MRI for radiotherapy simulation

Multi‐parametric MRI for radiotherapy simulation

Magnetic resonance imaging (MRI) guided proton therapy: A review of the clinical challenges, potential benefits and pathway to implementation

FLASH radiotherapy and the associated dosimetric challenges

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