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. 2021 May:1:29-39.
doi: 10.1016/j.yao.2021.02.003. Epub 2021 May 19.

MRI-Guided Radiation Therapy

Sangjune Laurence Lee  1   2 , William A Hall  3 , Zachary S Morris  1 , Leslie Christensen  4 , Michael Bassetti  1
Affiliations

MRI-Guided Radiation Therapy

Sangjune Laurence Lee et al. Adv Oncol. 2021 May.
No abstract available

Keywords: MR guidance; MR linear accelerator; MR-guided radiation therapy; MR-linac; MRIgRT; Plan adaptation; Real-time imaging.

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Figures

FIG. 1
FIG. 1
Axial views of SABR dose distribution for an oligometastatic lesion in left lower lung close to the stomach at (A) initial MRI simulation, (B) day of treatment before plan adaptation, and (C) after plan adaptation to avoid overdosing the stomach (arrow) (D) DVH demonstrating an increase in dose to the planning target volume (PTV) after re-optimization. See Video 1 for sagittal cine of tumor tracking. Pink = Planning target volume, red = stomach. DVH, Dose volume histogram; SABR, stereotactic ablative radiotherapy.
FIG. 2
FIG. 2
Hypothesized imaging biomarker “threshold” goal (arrow) for a radiation treatment dosing. Imaging response during treatment could be closely correlated with a validated imaging biomarker and clinical/pathologic end-point. (Adapted from Hall WA, Paulson ES, van der Heide UA, et al. The transformation of radiation oncology using real-time magnetic resonance guidance: A review. Eur. J. Cancer. 2019;122:42–52.; with permission. (Figure 3 in original).)
FIG. 3
FIG. 3
Illustration of the electron return effect, for left whole breast irradiation by means of 2 tangential fields. The edges of the photon beams are depicted by the blue lines. (Left) In the absence of a magnetic field, secondary electrons leave the breast at the tissue-air interface. (Right) With a magnetic field, secondary electrons return to the breast, increasing the skin dose. (From van Heijst T, den Hartogh M, J W Lagendijk J, et al. MR-guided breast radiotherapy: Feasibility and magnetic-field impact on skin dose. Phys. Med. Biol. 2013;58:5917–5930 © Institute of Physics and Engineering in Medicine. Reproduced by permission of IOP Publishing. All rights reserved.)
FIG. 4
FIG. 4
Coronal CT slice of a patient with lung cancer. Dose distribution of (A) respiratory gated treatment in which the tumor is tracked and (B) conventional free-breathing treatment with larger treatment margins. (C) Dose difference between the tracked treatment versus the conventional treatment. (From Menten MJ, Fast MF, Nill S, et al. Lung stereotactic body radiotherapy with an MR-linac – Quantifying the impact of the magnetic field and real-time tumor tracking. Radiother. Oncol. 2016;119:461–466.; with permission. (Figure 4 in original).)
FIG. 5
FIG. 5
(Left) Axial and (right) coronal views of a patient a few hours after ingesting iron-fortified breakfast cereal causing susceptibility artifact. (From Green O, Henke LE, Parikh P, et al. Practical Implications of Ferromagnetic Artifacts in Low-field MRI-guided Radiotherapy. Cureus. 2018;10:e2359.; with permission. (Figure 2 in original).)
See this image and copyright information in PMC

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