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Review
. 2019 Jun;92(1098):20180670.
doi: 10.1259/bjr.20180670. Epub 2019 May 14.

Realizing the potential of magnetic resonance image guided radiotherapy in gynaecological and rectal cancer

Ingrid M White  1 , Erica Scurr  1 , Andreas Wetscherek  1 , Gina Brown  1 , Aslam Sohaib  1 , Simeon Nill  1 , Uwe Oelfke  1 , David Dearnaley  1 , Susan Lalondrelle  1 , Shreerang Bhide  1
Affiliations
Review

Realizing the potential of magnetic resonance image guided radiotherapy in gynaecological and rectal cancer

Ingrid M White et al. Br J Radiol. 2019 Jun.

Abstract

CT-based radiotherapy workflow is limited by poor soft tissue definition in the pelvis and reliance on rigid registration methods. Current image-guided radiotherapy and adaptive radiotherapy models therefore have limited ability to improve clinical outcomes. The advent of MRI-guided radiotherapy solutions provides the opportunity to overcome these limitations with the potential to deliver online real-time MRI-based plan adaptation on a daily basis, a true "plan of the day." This review describes the application of MRI guided radiotherapy in two pelvic tumour sites likely to benefit from this approach.

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Figures

Figure 1.
Figure 1.
Radiotherapy planning imaging in a male patient with T3N1 rectal cancer; (a) CT and (b) MRI. On MRI, the tumour (arrow) is easily differentiated from normal rectum, which is not possible on CT.
Figure 2.
Figure 2.
Radiotherapy planning imaging in Stage 2B cervix cancer (a) CT and (b) MRI. On MRI, the cervix tumour (arrow) is easily differentiated from normal bladder and rectum, which is not possible on CT.
Figure 3.
Figure 3.
Changes in clinical target volume position during cervix radiotherapy as seen on MRI at (a) week 0, (b) week 2, (c) week 3 and (d) week 4.
Figure 4.
Figure 4.
Changes in cervix tumour volume (arrow), as seen on weekly MRI during treatment at (a) week 0, (b) week 2, (c) week 3 and (d) week 4.
Figure 5.
Figure 5.
Changes in rectal tumour volume (arrow), as seen on weekly MRI during treatment at (a) week 0, (b) week 2, (c) week 3 and (d) week 4.
See this image and copyright information in PMC

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