Literature DB >> 34643065

Early experience with MR-guided adaptive radiotherapy using a 1.5 T MR-Linac: First 6 months of operation using adapt to shape workflow.

Jeremiah de Leon1, David Crawford1, Zoë Moutrie1, Stacy Alvares1, Louise Hogan1, Claire Pagulayan1, Urszula Jelen1, Conrad Loo1, Jack D Aylward1,2,3, Kieran Condon1, Nicolle Dunkerley1, Monique Y Heinke1, Sandy Sampaio1, Kathy Simon1, Tania Twentyman1, Michael G Jameson1,4.   

Abstract

INTRODUCTION: The magnetic resonance linear accelerator (MRL) offers improved soft tissue visualization to guide daily adaptive radiotherapy treatment. This manuscript aims to report initial experience using a 1.5 T MRL in the first 6 months of operation, including training, workflows, timings and dosimetric accuracy.
METHODS: All staff received training in MRI safety and MRL workflows. Initial sites chosen for treatment were stereotactic and hypofractionated prostate, thoraco-abdomino-pelvic metastasis, prostate bed and bladder. The Adapt To Shape (ATS) workflow was chosen to be the focus of treatment as it is the most robust solution for daily adaptive radiotherapy. A workflow was created addressing patient suitability, simulation, planning, treatment and peer review. Treatment times were recorded breaking down into the various stages of treatment.
RESULTS: A total of 37 patients were treated and 317 fractions delivered (of which 313 were delivered using an ATS workflow) in our initial 6 months. Average treatment times over the entire period were 50 and 38 min for stereotactic and non-stereotactic treatments respectively. Average treatment times reduced each month. The average difference between reference planned and ionization chamber measured dose was 0.0 ± 1.4%.
CONCLUSION: The MRL was successfully established in an Australian setting. A focus on training and creating a detailed workflow from patient selection, review and treatment are paramount to establishing new treatment programmes.
© 2021 The Royal Australian and New Zealand College of Radiologists.

Entities:  

Keywords:  MR-Linac; MRL; adaptive radiatiotherapy; radiotherapy; technology implementation

Mesh:

Year:  2021        PMID: 34643065     DOI: 10.1111/1754-9485.13336

Source DB:  PubMed          Journal:  J Med Imaging Radiat Oncol        ISSN: 1754-9477            Impact factor:   1.735


  3 in total

1.  Magnetic resonance imaging-guided radiotherapy for intermediate- and high-risk prostate cancer: Trade-off between planning target volume margin and online plan adaption.

Authors:  Shyama U Tetar; Anna M E Bruynzeel; Lisa Verweij; Omar Bohoudi; Berend J Slotman; Tezontl Rosario; Miguel A Palacios; Frank J Lagerwaard
Journal:  Phys Imaging Radiat Oncol       Date:  2022-07-03

2.  Commissioning measurements on an Elekta Unity MR-Linac.

Authors:  Marcus Powers; John Baines; Robert Crane; Chantelle Fisher; Stephen Gibson; Linda Marsh; Bronwyn Oar; Ariadne Shoobridge; Emily Simpson-Page; Marchant Van der Walt; Glenn de Vine
Journal:  Phys Eng Sci Med       Date:  2022-03-02

3.  Clinical utility of a 1.5 T magnetic resonance imaging-guided linear accelerator during conventionally fractionated and hypofractionated prostate cancer radiotherapy.

Authors:  Gorkem Turkkan; Nazli Bilici; Huseyin Sertel; Yavuz Keskus; Sercan Alkaya; Busra Tavli; Muge Ozkirim; Merdan Fayda
Journal:  Front Oncol       Date:  2022-08-16       Impact factor: 5.738

  3 in total

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