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Review
. 2024 Jan 8;16(2):270.
doi: 10.3390/cancers16020270.

MR-LINAC, a New Partner in Radiation Oncology: Current Landscape

Abrahams Ocanto  1   2 , Lisselott Torres  1   2 , Miguel Montijano  1   2 , Diego Rincón  1   2 , Castalia Fernández  1   2 , Beatriz Sevilla  1   2 , Daniela Gonsalves  1   2 , Macarena Teja  1   2 , Marcos Guijarro  1   2 , Luis Glaría  1 , Raúl Hernánz  1 , Juan Zafra-Martin  3   4 , Noelia Sanmamed  5 , Amar Kishan  6 , Filippo Alongi  7   8 , Drew Moghanaki  9 , Himanshu Nagar  10 , Felipe Couñago  1   2   11
Affiliations
Review

MR-LINAC, a New Partner in Radiation Oncology: Current Landscape

Abrahams Ocanto et al. Cancers (Basel). .

Abstract

Technological advances in radiation oncology are oriented towards improving treatment precision and tumor control. Among these advances, magnetic-resonance-image-guided radiation therapy (MRgRT) stands out, with technological advances to deliver targeted treatments adapted to a tumor's anatomy on the day while minimizing incidental exposure to organs at risk, offering an unprecedented therapeutic advantage compared to X-ray-based IGRT delivery systems. This new technology changes the traditional workflow in radiation oncology and requires an evolution in team coordination to administer more precise treatments. Once implemented, it paves the way for newer indication for radiation therapy to safely deliver higher doses than ever before, with better preservation of healthy tissues to optimize patient outcomes. In this narrative review, we assess the technical aspects of the novel linear accelerators that can deliver MRgRT and summarize the available published experience to date, focusing on oncological results and future challenges.

Keywords: adaptative radiotherapy; image guidance; radiotherapy; stereotactic body radiotherapy.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
MR-LINAC prostate cancer treatment. Red line: Prostate. Yellow line: Margins of 2mm (A) Gating during SBRT, (B) Displacement of gland by intestinal gas.
Figure 2
Figure 2
MR-LINAC Liver metastases treatment. Red line: Liver Metastases. Yellow line: Margins of 3 mm (A) Gating during SBRT, (B) Displacement of tumor during respiration.
Figure 3
Figure 3
MR-LINAC Pancreatic cancer treatment. Red line: Pancreatic tumor. Yellow line: Margins of 3 mm (A) Gating during SBRT, (B) Displacement of tumor during respiration.
Figure 4
Figure 4
MR-LINAC of two metastases of lung cancer in adrenal glands. Red line: Adrenal glands with tumor. Yellow line: Margins of 3 mm (A) Gating during SBRT, (B) Displacement of two tumors during respiration.
See this image and copyright information in PMC

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