MRI-Guided Real-Time Adaptive Radiotherapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 15 November 2024 | Viewed by 1488

Special Issue Editor


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Guest Editor
1. Advanced Radiation Oncology Department, Cancer Care Center, IRCCS Sacro Cuore Don Calabria Hospital, 37024 Verona, Italy
2. Department of Medical, Surgical and Health Care Specialties, University of Brescia, 25121 Brescia, Italy
Interests: MRI-guided radiation therapy; stereotactic body radiotherapy; cancer

Special Issue Information

Dear Colleagues,

Radiation therapy is a crucial part of cancer treatment, where a multi-disciplinary approach is the standard of care. The advances in Radiation Oncology are continuous due to the innovations in engineering, imaging, physics, and technology, along with improvements in the knowledge of the radiobiology of cancer and healthy tissues.

Precision radiotherapy is the new paradigm of this non-invasive cancer treatment; over the last years, the concrete evolution in intensity-modulated adaptive radiotherapy was the clinical integration in the treatment room of online MRI with external beam radiotherapy. The advantages of MRI over CT-based images are well known and include higher soft tissue discrimination, the capability to monitor tumor motion, and the possibility of real-time treatment adaptation strategies. All these abilities allow operators to check and correct the inter- and intrafraction modifications in tumors, surrounding organs shape, and anatomical positioning. MRI-based physiologic information and biomarkers could potentially be utilized and integrated in an advanced-precision radiation therapy strategy: the outcome assessment using image texture represents the emerging world called "radiomics". The integration of MRI imaging capabilities with modern linear accelerators represents a paradigm shift in radiation therapy due to the opportunity to use the real-time anatomic and physiologic changes in tumors and surrounding critical organs to optimize the therapeutic ratio.

In this Special Issue, we will evaluate and report on all these aspects.

I look forward to receiving your contributions.

Prof. Dr. Filippo Alongi
Guest Editor

Manuscript Submission Information

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Keywords

  • radiotherapy
  • MRI-guided radiation therapy
  • stereotactic body radiotherapy
  • cancer
  • radiation oncology

Published Papers (2 papers)

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Research

16 pages, 555 KiB  
Article
Feasibility and Acute Toxicity of Hypo-Fractionated Radiotherapy on 0.35T MR-LINAC: The First Prospective Study in Spain
by Daniela Gonsalves, Abrahams Ocanto, Eduardo Meilan, Alberto Gomez, Jesus Dominguez, Lisselott Torres, Castalia Fernández Pascual, Macarena Teja, Miguel Montijano Linde, Marcos Guijarro, Daniel Rivas, Jose Begara, Jose Antonio González, Jon Andreescu, Esther Holgado, Diego Alcaraz, Escarlata López, Maia Dzhugashvli, Fernando Lopez-Campos, Filippo Alongi and Felipe Couñagoadd Show full author list remove Hide full author list
Cancers 2024, 16(9), 1685; https://doi.org/10.3390/cancers16091685 - 26 Apr 2024
Viewed by 245
Abstract
This observational, descriptive, longitudinal, and prospective basket-type study (Registry #5289) prospectively evaluated the feasibility and acute toxicity of hypo-fractionated radiotherapy on the first 0.35T MR-LINAC in Spain. A total of 37 patients were included between August and December 2023, primarily with prostate tumors [...] Read more.
This observational, descriptive, longitudinal, and prospective basket-type study (Registry #5289) prospectively evaluated the feasibility and acute toxicity of hypo-fractionated radiotherapy on the first 0.35T MR-LINAC in Spain. A total of 37 patients were included between August and December 2023, primarily with prostate tumors (59.46%), followed by pancreatic tumors (32.44%). Treatment regimens typically involved extreme hypo-fractionated radiotherapy, with precise dose delivery verified through quality assurance measures. Acute toxicity assessment at treatment completion revealed manageable cystitis, with one case persisting at the three-month follow-up. Gastrointestinal toxicity was minimal. For pancreatic tumors, daily adaptation of organ-at-risk (OAR) and gross tumor volume (GTV) was practiced, with median doses to OAR within acceptable limits. Three patients experienced gastrointestinal toxicity, mainly nausea. Overall, the study demonstrates the feasibility and safety of extreme hypo-fractionated radiotherapy on a 0.35T MR-LINAC, especially for challenging anatomical sites like prostate and pancreatic tumors. These findings support the feasibility of MR-LINAC-based radiotherapy in delivering precise treatments with minimal toxicity, highlighting its potential for optimizing cancer treatment strategies. Full article
(This article belongs to the Special Issue MRI-Guided Real-Time Adaptive Radiotherapy)
13 pages, 3520 KiB  
Article
Dose Calculation Accuracy of Beam Models in RadCalc for a 1.5 T MR-Linac
by Jiwon Sung, Yeonho Choi, Jun Won Kim and Ho Lee
Cancers 2024, 16(3), 526; https://doi.org/10.3390/cancers16030526 - 26 Jan 2024
Viewed by 751
Abstract
The purpose of this study is to evaluate RadCalc, an independent dose verification software, for patient-specific quality assurance (PSQA) in online adaptive planning with a magnetic resonance linear accelerator (MR-linac) of a 1.5 T. Version 7.1.4 of RadCalc to introduce the capability to [...] Read more.
The purpose of this study is to evaluate RadCalc, an independent dose verification software, for patient-specific quality assurance (PSQA) in online adaptive planning with a magnetic resonance linear accelerator (MR-linac) of a 1.5 T. Version 7.1.4 of RadCalc to introduce the capability to establish a beam model that incorporates MR field characteristics. A total of six models were established, with one using manufacturer-provided data and the others differing in percentage depth dose (PDD) data sources. Overall, two models utilized PDD data from the treatment planning system (TPS), and three used commissioned PDD data from gantry angles of 0° and 270°. Simple tests on a virtual water phantom assessed dose-calculation accuracy, revealing percentage differences ranging from −0.5% to −20.6%. Excluding models with significant differences, clinical tests on 575 adaptive plans (prostate, liver, and breast) showed percentage differences of −0.51%, 1.12%, and 4.10%, respectively. The doses calculated using RadCalc demonstrated similar trends to those of the PSQA-based measurements. The newly released version of RadCalc enables beam modeling that considers the characteristics of the 1.5 T magnetic field. The accuracy of the software in calculating doses at 1.5 T magnetic fields has been verified, thereby making it a reliable and effective tool for PSQA in adaptive plans. Full article
(This article belongs to the Special Issue MRI-Guided Real-Time Adaptive Radiotherapy)
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