Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Dec 9:10:616291.
doi: 10.3389/fonc.2020.616291. eCollection 2020.

MR-Guided Radiotherapy for Prostate Cancer

Boris R Tocco  1 , Amar U Kishan  2 , Ting Martin Ma  2 , Linda G W Kerkmeijer  3 , Alison C Tree  1   4
Affiliations
Review

MR-Guided Radiotherapy for Prostate Cancer

Boris R Tocco et al. Front Oncol. .

Abstract

External beam radiotherapy remains the primary treatment modality for localized prostate cancer. The radiobiology of prostate carcinoma lends itself to hypofractionation, with recent studies showing good outcomes with shorter treatment schedules. However, the ability to accurately deliver hypofractionated treatment is limited by current image-guided techniques. Magnetic resonance imaging is the main diagnostic tool for localized prostate cancer and its use in the therapeutic setting offers anatomical information to improve organ delineation. MR-guided radiotherapy, with daily re-planning, has shown early promise in the accurate delivery of radiotherapy. In this article, we discuss the shortcomings of current image-guidance strategies and the potential benefits and limitations of MR-guided treatment for prostate cancer. We also recount present experiences of MR-linac workflow and the opportunities afforded by this technology.

Keywords: MR-guided radiotherapy; MR-linac; image-guided radiotherapy; online adaptive radiotherapy; prostate cancer.

PubMed Disclaimer

Conflict of interest statement

AT receives institutional research funding from Elekta, Varian, and Accuray and has received honoraria/travel grants from Elekta. AK received research funding and honoraria from ViewRay, Inc., as well as honoraria and consulting fees from Varian Medical Systems, Inc. and consulting fees from Intelligent Automation, Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Axial image of the prostate (T2 2 min scan) from the Unity.
Figure 2
Figure 2
Axial, sagittal, and coronal images of a prostate plan on the MRIdian (isodoses: Red = 40 Gy, Orange = 36 Gy, Yellow = 24 Gy, Green = 20 Gy).
Figure 3
Figure 3
Example workflow for the Unity.
Figure 4
Figure 4
Example workflow for the MRIdian.
See this image and copyright information in PMC

References

    1. European Comission Estimates of cancer incidence and mortality in 2020, for all countries. Eur Com (2020). Available at: https://ecis.jrc.ec.europa.eu/explorer.php?$0-1$1-All$2-All$4-1,2$3-0$6-...
    1. Dearnaley DP, Griffin C, Syndikus I, Khoo V, Birtle AJ, Choudhury A, et al. Eight-year outcomes of a phase III randomized trial of conventional versus hypofractionated high-dose intensity modulated radiotherapy for prostate cancer (CRUK/06/016): Update from the CHHiP Trial. J Clin Oncol (2020) 38:325. 10.1200/JCO.2020.38.6_suppl.325 - DOI
    1. Lee WR, Dignam JJ, Amin MB, Bruner DW, Low D, Swanson GP, et al. Randomized Phase III Noninferiority Study Comparing Two Radiotherapy Fractionation Schedules in Patients With Low-Risk Prostate Cancer. J Clin Oncol (2016) 34:2325–32. 10.1200/JCO.2016.67.0448 - DOI - PMC - PubMed
    1. Catton CN, Lukka H, Gu CS, Martin JM, Supiot S, Chung PWM, et al. Randomized trial of a hypofractionated radiation regimen for the treatment of localized prostate cancer. J Clin Oncol (2017) 35:1884–90. 10.1200/JCO.2016.71.7397 - DOI - PubMed
    1. Mohler JL, Antonarakis ES, Armstrong AJ, D’Amico AV, Davis BJ, Dorff T, et al. Prostate Cancer, Version 2.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw (2019) 17:479–505. 10.6004/jnccn.2019.0023 - DOI - PubMed

LinkOut - more resources