Researchers at UCLA granted $2 million to progress MRI-directed radiation therapy for cancer patients, aiming to enhance treatment efficacy and reduce side effects.
MRI-guided radiotherapy is an advanced form of external beam radiotherapy that is revolutionizing the way cancer is treated. This innovative approach uses magnetic resonance imaging (MRI) to guide radiation delivery, offering a more precise and effective method compared to traditional X-ray-based imaging or computed tomography (CT) scans.
This technology allows for the delivery of intensity-modulated radiotherapy (IMRT) and stereotactic body radiotherapy (SBRT), techniques that enable the delivery of high doses of radiation to tumours while minimizing damage to healthy tissue.
One of the key advantages of MRI-guided radiotherapy is its superior soft tissue imaging and contrast. This means that doctors can see the tumour and surrounding tissues in greater detail, enabling them to make more informed decisions about treatment.
Adaptive radiotherapy, another significant development, allows for an increase in dose to the intended target and a decrease in dose outside the intended target. This is made possible by the on-board MRI in MRI-guided radiotherapy, which allows for real-time tracking of targets and the ability to perform adaptive radiotherapy.
Real-time tracking uses the on-board MRI to obtain images at a rate of four to eight frames per second to track the target in 'real-time' and perform a 'beam hold' if the target moves out of position.
The use of MRI-based imaging to guide radiation has been a technical challenge, but this has been overcome with the advent of specialty linear accelerators that have integrated MRI-based imaging (MRI-LINACs).
UCLA was a leader for the SMART trial, which evaluated adaptive, dose-escalated SBRT for pancreatic cancer. The results of the SCIMITAR trial showed the benefit of MRI-guided radiotherapy in the context of post-prostatectomy radiation. The MIRAGE trial demonstrated a dramatic reduction in side effects of prostate cancer SBRT with MRI-guided radiotherapy versus CT-guided radiotherapy.
Several ongoing and planned clinical trials are exploring the potential of MRI-guided radiotherapy for various cancer types. These include the VORTEX trial for prostate cancer, the MANTICORE trial for adaptive radiotherapy in prostate cancer, the MASAMUNE trial for post-prostatectomy SBRT, the HERA trial for post-operative treatment of gynecological malignancies, and the NOM-Rectal trial for short-course radiotherapy, without surgery, for rectal cancer.
The HEATWAVE trial is a study of 'triple precision' therapy for intermediate risk prostate cancer, while the MARS trial is a study of short-course radiotherapy for abdominopelvic sarcomas. The MASAMUNE trial is a study of adaptive radiotherapy in the setting of post-prostatectomy SBRT.
In conclusion, MRI-guided radiotherapy represents a significant step forward in cancer treatment. Its ability to deliver highly precise radiation while minimizing damage to healthy tissue offers hope for improved outcomes for cancer patients. As research continues, we can expect to see this technology play an increasingly important role in the fight against cancer.
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