Zhong, J. orcid.org/0000-0001-5325-3739, Kobus, M. orcid.org/0000-0002-1290-0626, Maitre, P. et al. (9 more authors) (2023) MRI-guided Pelvic Radiation Therapy: A Primer for Radiologists. RadioGraphics, 43 (11). ARTN e230052. ISSN 0271-5333
Abstract
MRI–guided radiation therapy for treating pelvic tumors offers superior soft-tissue contrast, improved organ motion visualization, and the potential to image tumor phenotypic characteristics with real-time online adaptation of treatment plans to potentially decrease toxic effects and improve oncologic outcomes.
Radiation therapy (RT) is a core pillar of oncologic treatment, and half of all patients with cancer receive this therapy as a curative or palliative treatment. The recent integration of MRI into the RT workflow has led to the advent of MRI-guided RT (MRIgRT). Using MRI rather than CT has clear advantages for guiding RT to pelvic tumors, including superior soft-tissue contrast, improved organ motion visualization, and the potential to image tumor phenotypic characteristics to identify the most aggressive or treatment-resistant areas, which can be targeted with a more focal higher radiation dose. Radiologists should be familiar with the potential uses of MRI in planning pelvic RT; the various RT techniques used, such as brachytherapy and external beam RT; and the impact of MRIgRT on treatment paradigms. Current clinical experience with and the evidence base for MRIgRT in the settings of prostate, cervical, and bladder cancer are discussed, and examples of treated cases are illustrated. In addition, the benefits of MRIgRT, such as real-time online adaptation of RT (during treatment) and interfraction and/or intrafraction adaptation to organ motion, as well as how MRIgRT can decrease toxic effects and improve oncologic outcomes, are highlighted. MRIgRT is particularly beneficial for treating mobile pelvic structures, and real-time adaptive RT for tumors can be achieved by using advanced MRI-guided linear accelerator systems to spare organs at risk. Future opportunities for development of biologically driven adapted RT with use of functional MRI sequences and radiogenomic approaches also are outlined.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | This item is protected by copyright. This is an author produced version of an article published in RadioGraphics. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Neck; Humans; Neoplasms; Magnetic Resonance Imaging; Radiotherapy Planning, Computer-Assisted; Male; Radiotherapy, Image-Guided; Radiologists |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Biomedical Imaging Science Dept (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Medical Research (LIMR) > Division of Oncology The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 04 Jun 2024 12:17 |
Last Modified: | 04 Jun 2024 12:17 |
Published Version: | https://pubs.rsna.org/doi/10.1148/rg.230052 |
Status: | Published |
Publisher: | Radiological Society of North America (RSNA) |
Identification Number: | 10.1148/rg.230052 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:213087 |