ESTRO-ACROP recommendations on the clinical implementation of hybrid MR-linac systems in radiation oncology

Stefanie Corradini; Filippo Alongi; Nicolaus Andratschke; David Azria; Omar Bohoudi; Luca Boldrini; Anna Bruynzeel; Juliane Hörner-Rieber; Ina Jürgenliemk-Schulz; Frank Lagerwaard; Helen McNair; Bas Raaymakers; Tine Schytte; Alison Tree; Vincenzo Valentini; Lotte Wilke; Daniel Zips; Claus Belka

doi:10.1016/j.radonc.2021.03.025

ESTRO-ACROP recommendations on the clinical implementation of hybrid MR-linac systems in radiation oncology

Radiother Oncol. 2021 Jun:159:146-154. doi: 10.1016/j.radonc.2021.03.025. Epub 2021 Mar 26.

Authors

Stefanie Corradini¹, Filippo Alongi², Nicolaus Andratschke³, David Azria⁴, Omar Bohoudi⁵, Luca Boldrini⁶, Anna Bruynzeel⁵, Juliane Hörner-Rieber⁷, Ina Jürgenliemk-Schulz⁸, Frank Lagerwaard⁵, Helen McNair⁹, Bas Raaymakers⁸, Tine Schytte¹⁰, Alison Tree⁹, Vincenzo Valentini⁶, Lotte Wilke³, Daniel Zips¹¹, Claus Belka¹²

Affiliations

¹ Department of Radiation Oncology, University Hospital, LMU Munich, Germany. Electronic address: stefanie.corradini@med.uni-muenchen.de.
² Department of Advanced Radiation Oncology, IRCCS Sacro Cuore Don Calabria Hospital, Negrar-Verona, Italy, University of Brescia, Italy.
³ Department of Radiation Oncology, University Hospital of Zurich, University of Zurich, Switzerland.
⁴ Department of Radiation Oncology, University Federation of Radiation Oncology Montpellier-Nîmes, ICM, Montpellier Cancer Institute, University of Montpellier, INSERM U1194, France.
⁵ Department of Radiation Oncology, Amsterdam University Medical Center, location de Boelelaan, The Netherlands.
⁶ Department of Bioimaging, Radiation Oncology and Hematology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Roma, Italy.
⁷ Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany, Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
⁸ Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.
⁹ The Royal Marsden NHS Foundation Trust and the Institute of Cancer Research, London, United Kingdom.
¹⁰ Department of Oncology, Odense University Hospital, Odense, Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
¹¹ Department of Radiation Oncology, University of Tübingen, Germany.
¹² Department of Radiation Oncology, University Hospital, LMU Munich, Germany.

PMID: 33775715
DOI: 10.1016/j.radonc.2021.03.025

Abstract

Online magnetic resonance-guided radiotherapy (oMRgRT) represents one of the most innovative applications of current image-guided radiation therapy (IGRT). The revolutionary concept of oMRgRT systems is the ability to acquire MR images for adaptive treatment planning and also online imaging during treatment delivery. The daily adaptive planning strategies allow to improve targeting accuracy while avoiding critical structures. This ESTRO-ACROP recommendation aims to provide an overview of available systems and guidance for best practice in the implementation phase of hybrid MR-linac systems. Unlike the implementation of other radiotherapy techniques, oMRgRT adds the MR environment to the daily practice of radiotherapy, which might be a new experience for many centers. New issues and challenges that need to be thoroughly explored before starting clinical treatments will be highlighted.

Keywords: Adaptation; Implementation; MR-Linac; MR-guided radiotherapy; Online adaptive; Radiotherapy.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Magnetic Resonance Imaging
Particle Accelerators
Radiation Oncology*
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Image-Guided*

Abstract

Publication types

MeSH terms

Grants and funding