Magnetic resonance imaging in precision radiation therapy for lung cancer.
Van Es, C
AffiliationThe Institute of Cancer Research and The Royal Marsden Hospital NHS Foundation Trust, London, UK
MetadataShow full item record
AbstractRadiotherapy remains the cornerstone of curative treatment for inoperable locally advanced lung cancer, given concomitantly with platinum-based chemotherapy. With poor overall survival, research efforts continue to explore whether integration of advanced radiation techniques will assist safe treatment intensification with the potential for improving outcomes. One advance is the integration of magnetic resonance imaging (MRI) in the treatment pathway, providing anatomical and functional information with excellent soft tissue contrast without exposure of the patient to radiation. MRI may complement or improve the diagnostic staging accuracy of F-18 fluorodeoxyglucose position emission tomography and computerized tomography imaging, particularly in assessing local tumour invasion and is also effective for identification of nodal and distant metastatic disease. Incorporating anatomical MRI sequences into lung radiotherapy treatment planning is a novel application and may improve target volume and organs at risk delineation reproducibility. Furthermore, functional MRI may facilitate dose painting for heterogeneous target volumes and prediction of normal tissue toxicity to guide adaptive strategies. MRI sequences are rapidly developing and although the issue of intra-thoracic motion has historically hindered the quality of MRI due to the effect of motion, progress is being made in this field. Four-dimensional MRI has the potential to complement or supersede 4D CT and 4D F-18-FDG PET, by providing superior spatial resolution. A number of MR-guided radiotherapy delivery units are now available, combining a radiotherapy delivery machine (linear accelerator or cobalt-60 unit) with MRI at varying magnetic field strengths. This novel hybrid technology is evolving with many technical challenges to overcome. It is anticipated that the clinical benefits of MR-guided radiotherapy will be derived from the ability to adapt treatment on the fly for each fraction and in real-time, using 'beam-on' imaging. The lung tumour site group of the Atlantic MR-Linac consortium is working to generate a challenging MR-guided adaptive workflow for multi-institution treatment intensification trials in this patient group.
CitationMagnetic resonance imaging in precision radiation therapy for lung cancer. 2017, 6 (6):689-707 Transl Lung Cancer Res
JournalTranslational Lung Cancer Research
- Automated computer quantification of breast cancer in small-animal models using PET-guided MR image co-segmentation.
- Authors: Bagci U, Kramer-Marek G, Mollura DJ
- Issue date: 2013 Jul 5
- Advances in 4D medical imaging and 4D radiation therapy.
- Authors: Li G, Citrin D, Camphausen K, Mueller B, Burman C, Mychalczak B, Miller RW, Song Y
- Issue date: 2008 Feb
- MR-guidance--a clinical study to evaluate a shuttle- based MR-linac connection to provide MR-guided radiotherapy.
- Authors: Bostel T, Nicolay NH, Grossmann JG, Mohr A, Delorme S, Echner G, Häring P, Debus J, Sterzing F
- Issue date: 2014 Jan 9
- Functional MRI for radiotherapy dose painting.
- Authors: van der Heide UA, Houweling AC, Groenendaal G, Beets-Tan RG, Lambin P
- Issue date: 2012 Nov
- Radiotherapy of high-grade gliomas: current standards and new concepts, innovations in imaging and radiotherapy, and new therapeutic approaches.
- Authors: Dhermain F
- Issue date: 2014 Jan