Integrated MRI-guided radiotherapy - opportunities and challenges.
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Embargo End Date
ICR Authors
Authors
Keall, PJ
Brighi, C
Glide-Hurst, C
Liney, G
Liu, PZY
Lydiard, S
Paganelli, C
Pham, T
Shan, S
Tree, AC
van der Heide, UA
Waddington, DEJ
Whelan, B
Brighi, C
Glide-Hurst, C
Liney, G
Liu, PZY
Lydiard, S
Paganelli, C
Pham, T
Shan, S
Tree, AC
van der Heide, UA
Waddington, DEJ
Whelan, B
Document Type
Journal Article
Date
2022-04-19
Date Accepted
2022-03-31
Abstract
MRI can help to categorize tissues as malignant or non-malignant both anatomically and functionally, with a high level of spatial and temporal resolution. This non-invasive imaging modality has been integrated with radiotherapy in devices that can differentially target the most aggressive and resistant regions of tumours. The past decade has seen the clinical deployment of treatment devices that combine imaging with targeted irradiation, making the aspiration of integrated MRI-guided radiotherapy (MRIgRT) a reality. The two main clinical drivers for the adoption of MRIgRT are the ability to image anatomical changes that occur before and during treatment in order to adapt the treatment approach, and to image and target the biological features of each tumour. Using motion management and biological targeting, the radiation dose delivered to the tumour can be adjusted during treatment to improve the probability of tumour control, while simultaneously reducing the radiation delivered to non-malignant tissues, thereby reducing the risk of treatment-related toxicities. The benefits of this approach are expected to increase survival and quality of life. In this Review, we describe the current state of MRIgRT, and the opportunities and challenges of this new radiotherapy approach.
Citation
Nature reviews. Clinical oncology, 2022
Source Title
Publisher
Springer Science and Business Media LLC
ISSN
1759-4774
eISSN
1759-4782