An IPEM international survey of MRI use for external beam RT treatment planning
Speight, R. Tyyger, M. Schmidt, M. A. Liney, G. P. Johnstone, R. I. Eccles, Cynthia L Dubec, Michael George, B. Henry, A. Nyholm, T.
Speight, R.
Tyyger, M.
Schmidt, M. A.
Liney, G. P.
Johnstone, R. I.
Eccles, Cynthia L
Dubec, Michael
George, B.
Henry, A.
Nyholm, T.
Citations
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Abstract
Purpose or Objective
Despite growing interest in MRI, integration in external
beam radiotherapy (EBRT) treatment planning uptake
varies globally. In order to understand the current
international landscape of MRI in EBRT a survey has been
performed in 10 countries. This work reports on
differences and common themes identified.
Material and Methods
A survey was developed covering eight topics: MRI access;
MRI use; MRI to CT registration; commissioning/Quality
Assurance (QA); safety; workflow/staffing; education; and
future applications. The survey was distributed within 10
countries by a ‘local champion’ ensuring it reached all
radiotherapy centres.
Results
The survey had a median response rate of 77% per country
(184/442 in total). Response rates in individual countries
varied between those with high response rates (≥66% in the
UK/Denmark (DK)/Finland (FN)/Sweden (SE)/Netherlands
(NL)/Belgium (BE)/New Zealand (NZ)) and those with
response rates low enough that results cannot be
considered representative of the country (≤35% in Italy
(IT)/France (FR)/Australia (AU)).
MRI access was varied between countries, with FR and the
UK reporting the lowest rates (43% and 69% respectively).
In DK/SE >80% of centres reported having dedicated MRI scanners for EBRT, whereas in all other countries <25%
reported dedicated scanners for EBRT and were more
reliant on collaboration with radiology for MRI access.
Anatomical sites receiving MRI for EBRT varies
internationally and the most common are shown in table
1. Commissioning and QA of both image registration and
MRI scanners varied greatly, as did MRI sequences
performed, staffing models and training given to different
staff groups.
The most common barrier for increasing MRI scans for
radiotherapy across all centres (figure 1) was MRI access
and a lack of financial reimbursement, except DK/SE
where lack of clinical interest/local knowledge was the
main barrier.
It was reported that within 5 years a median of 29% (range
9-50%, absolute number 57) of centres per country are
planning for a new MRI scanner dedicated for EBRT A
limited number of sites in NL/DK/SE/FN/AU/BE currently
employ MRI-only EBRT planning; over the next 5 years MRIonly
EBRT planning is expected to be taken up in >50% of
centres in NL/SE/DK/FN but < 35% in UK/NZ/BE/FR/AU/IT.
MR-linac technology is being clinically employed in
DK/UK/NL and within 5 years expected uptake varies
between 63% in DK, 59% in NL and <35% in
UK/FN/SE/NZ/BE/AU/IT/FR.
Conclusion
The current international use of MRI for EBRT has been
surveyed in 10 countries. Variations in
practice/equipment/QA/staffing models have been
identified. These are likely due to differences in funding
as well as a lack of consensus or guidelines in the
literature. For most countries the lack of MRI access and
funding is the limiting factor on the number of patients
who benefit from MRI as part of their EBRT treatment
planning. Despite these challenges, significant interest
remains in increasing MRI-assisted EBRT planning over the
next 5 years.
Description
Date
2020
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Speight R, Tyyger M, Schmidt MA, Liney GP, Johnstone RI, Eccles CL, et al. PH-0406: An IPEM international survey of MRI use for external beam RT treatment planning. Radiotherapy and Oncology . 2020 Nov;152:S217–8.