Magnetic resonance linear accelerator technology and adaptive radiation therapy: An overview for clinicians
Radiation therapy (RT) continues to play an important role in the treatment of cancer. Adaptive RT (ART) is a novel method through which RT treatments are evolving. With the ART approach, computed tomography or magnetic resonance (MR) images are obtained as part of the treatment delivery process. Th...
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| Published in | CA: a cancer journal for clinicians Vol. 72; no. 1; pp. 34 - 56 |
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| Main Authors | , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Wiley Subscription Services, Inc
01.01.2022
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| Subjects | |
| Online Access | Get full text |
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| Summary: | Radiation therapy (RT) continues to play an important role in the treatment of cancer. Adaptive RT (ART) is a novel method through which RT treatments are evolving. With the ART approach, computed tomography or magnetic resonance (MR) images are obtained as part of the treatment delivery process. This enables the adaptation of the irradiated volume to account for changes in organ and/or tumor position, movement, size, or shape that may occur over the course of treatment. The advantages and challenges of ART maybe somewhat to oncologists and clinicians outside of the specialty of radiation oncology. ART is positioned to affect many different types of cancer. There is a wide spectrum of hypothesized benefits, from small toxicity improvements to meaningful gains in overall survival. The use and application of this novel technology should be understood by the oncologic community at large, such that it can be appropriately contextualized within the landscape of cancer therapies. Likewise, the need to test these advances is pressing. MR‐guided ART (MRgART) is an emerging, extended modality of ART that expands upon and further advances the capabilities of ART. MRgART presents unique opportunities to iteratively improve adaptive image guidance. However, although the MRgART adaptive process advances ART to previously unattained levels, it can be more expensive, time‐consuming, and complex. In this review, the authors present an overview for clinicians describing the process of ART and specifically MRgART. |
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| Bibliography: | The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The views expressed are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. DISCLOSURES William A. Hall is supported by the National Center for Advancing Translational Sciences, National Institutes of Health (NIH) (award KL2TR001438) and reports institutional grants and meeting support from Elekta AB outside the submitted work. Eric Paulson reports institutional research grants from Elekta AB and Siemens Healthineers; service as a committee member of the American Association for Physicists in Medicine; and in‐kind software support from Elekta AB and Siemens Healthineers outside the submitted work. X. Allen Li reports institutional grants from Elekta AB, Manteia Medical Technologies, and Siemens Healthineers; and honoraria from Elekta AB for an education lecture outside the submitted work. Beth Erickson serves as vice chair of the Education Council for American Society for Radiation Oncology (ASTRO), chair of the Annual ASTRO Refresher Course, and co‐chair of the American Brachytherapy Society GYN Brachytherapy School outside the submitted work. Christopher Schultz reports research grants from Elekta AB, Siemens Healthineers, Acuray, and Manteia Imaging Technologies; meeting expenses from Elekta AB; service on the Clinical Steering Committee Magnetic Resonance Linac Consortium for Elekta AB; and service as a member of the Magnetic Resonance‐Integrated Radiation Therapy Circle of Siemens Healthineers outside the submitted work. Alison Tree is supported by Cancer Research UK (C33589/A28284 and C7224/A28724) and the National Institute for Health Research Cancer Research Network; she reports financial support for a clinical trial (MOMENTUM) and occasional honoraria for lectures from Elekta AB outside the submitted work. Musaddiq Awan reports a grant from NIH R21 (CA256144‐01) funding for a phase 1 clinical trial of magnetic resonance‐guided radiation; honoraria from Elekta AB; and free drug support from Genentech for NIH R21 (CA256144‐01) funded trial of magnetic resonance‐guided radiation (ClinicalTrials.gov identifier NCT04477759) outside the submitted work. Brigid A. McDonald is supported by an NIH F31 fellowship (F31DE029093) and reports speaking honoraria from Elekta AB outside the submitted work. Travis Salzillo reports support from The University of Texas Health Science Center at Houston Center for Clinical and Translational Sciences TL1 Program (TL1 TR003169) outside the submitted work. Carri K. Glide‐Hurst reports grants from the NIH (R01CA204189 and R01HL153720) and GE Healthcare; and the receipt of equipment from Modus Medical Devices and GE Healthcare outside the submitted work. Amar U. Kishan reports research funding from ViewRay Technologies Inc and the ASTRO‐Prostate Cancer Foundation; consulting fees from ViewRay Technologies Inc, Varian Medical Systems Inc, and Intelligent Automation Inc; speaker's fees from ViewRay Technologies Inc and Varian Medical Systems Inc; service as a committee member of the American Society of Clinical Oncology and ASTRO; and owns stock in ViewRay Technologies Inc outside the submitted work. Clifton D. Fuller reports institutional funding from the NIH, National Institute of Dental and Craniofacial Research (NIDCR) Academic Industrial Partnership grant (R01DE028290); an NIH/National Cancer Institute (NCI) Cancer Center Support Grant (CCSG) Pilot Research Program Award to the University of Texas MD Anderson CCSG Radiation Oncology and Cancer Imaging Program (P30CA016672); the National Science Foundation (NSF)/NCI Smart Connected Health Program (R01CA257814); the NCI Early Stage Development of Technologies in Biomedical Computing, Informatics, and Big Data Science Program (R01CA214825); an NSF/NIH Joint Initiative on Quantitative Approaches to Biomedical Big Data Program (R01CA225190); an NIH National Institute of Biomedical Imaging and Bioengineering Research Education Programs for Residents and Clinical Fellows grant (R25EB025787); an NIDCR Establishing Outcome Measures for Clinical Studies of Oral and Craniofacial Diseases and Conditions award (R01DE025248); an NCI Parent Research Project grant (R01CA258827); the NIH NIDCR Exploratory/Developmental Research Grant Program (R21DE031082); a Small Business Innovation Research Grant Program subaward from Oncospace, Inc (R43CA254559); a Human BioMolecular Atlas Program Integration, Visualization, and Engagement Initiative (OT2OD026675) subaward; a Patient‐Centered Outcomes Research Institute (PCS‐1609‐36195) subaward from Princess Margaret Hospital; an NSF Division of Civil, Mechanical, and Manufacturing Innovation grant (NSF 1933369), and an Elekta AB Institutional research grant; speaker's fees from Elekta AB, the American Association for Physicists in Medicine, the University of Alabama‐Birmingham, ASTRO, the Radiological Society of North America, and the European Society for Radiation Oncology; honoraria from the American Society for Clinical Oncology and the NIH; US Patent Application No. 16/631,662, based on International Patent Application No. PCT/US2018/042364; service as committee member for The American Association for Physicists in Medicine, ASTRO, the Radiological Society of North America, and the American Society of Clinical Oncology; and the receipt of in‐kind software from Elekta AB outside the submitted work. Daniel Low had no disclosures. |
| ISSN: | 0007-9235 1542-4863 |
| DOI: | 10.3322/caac.21707 |