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Observational Study
. 2020 Aug;196(8):691-698.
doi: 10.1007/s00066-020-01578-z. Epub 2020 Jan 30.

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

Sebastian Klüter  1   2   3 , Sonja Katayama  1   2   3 , C Katharina Spindeldreier  1   2   3 , Stefan A Koerber  1   2   3 , Gerald Major  1   2   3 , Markus Alber  1   2   3 , Sati Akbaba  1   2   3 , Jürgen Debus  1   2   3   4   5 , Juliane Hörner-Rieber  6   7   8   9
Affiliations
Observational Study

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

Sebastian Klüter et al. Strahlenther Onkol. 2020 Aug.

Abstract

Purpose: Magnetic resonance-guided radiotherapy (MRgRT) has recently been introduced in our institution. As MRgRT requires high patient compliance compared to conventional techniques and can be associated with prolonged treatment times, feasibility and patient tolerance were prospectively assessed using patient-reported outcome questionnaires (PRO-Q).

Materials and methods: Forty-three patients were enrolled in a prospective observational study and treated with MRgRT on a low-field hybrid Magnetic Resonance Linear Accelerator system (MR-Linac) between April 2018 and April 2019. For assistance in gated breath-hold delivery using cine-MRI, a video feedback system was installed. PRO-Qs consisted of questions on MR-related complaints and also assessed aspects of active patient participation.

Results: The most commonly treated anatomic sites were nodal metastases and liver lesions. The mean treatment time was 34 min with a mean beam-on time of 2:17 min. Gated stereotactic body radiotherapy (SBRT) was applied in 47% of all patients. Overall, patients scored MRgRT as positive or at least tolerable in the PRO‑Q. Almost two thirds of patients (65%) complained about at least one item of the PRO‑Q (score ≥4), mainly concerning coldness, paresthesia, and uncomfortable positioning. All patients reported high levels of satisfaction with their active role using the video feedback system in breath-hold delivery.

Conclusion: MRgRT was successfully implemented in our clinic and well tolerated by all patients, despite MR-related complaints and complaints about uncomfortable immobilization. Prospective clinical studies are in development for further evaluation of MRgRT and for quantification of the benefit of MR-guided on-table adaptive radiotherapy.

Keywords: Gating; Implementation; MR-Linac; MR-guided; Patient acceptance; Patient-reported outcomes.

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Conflict of interest statement

S. Klüter, S. Katayama, and J. Hörner-Rieber have received speaker fees and travel reimbursement from ViewRay Inc. (Oakwood, USA). J. Debus has a research agreement with ViewRay Inc. and is member of the Scientific Advisory Board of ViewRay Inc. (Oakwood, USA). C. K. Spindeldreier, S. A. Koerber, G. Major, M. Alber, and S. Akbaba declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
In-room screen used for live visual patient feedback during gated treatments
See this image and copyright information in PMC

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