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Clinical Implementation of MR-IGRT

B Raaymakers1*, P Yadav2*, D Hyer3*, A Sethi4*, (1) University Medical Center Utrecht, Utrecht,NL, (2) School of Medicine and Public Health UW-Madison, Madison, WI, (3) University of Iowa, Iowa City, IA, (4) Loyola University Medical Center, Maywood, IL

Presentations

10:30 AM Tools of the Trade: MR linacs & Image optimization for MRgART - B Raaymakers, Presenting Author
11:00 AM State of the ART 1: Low Field MRgART - P Yadav, Presenting Author
11:30 AM State of the ART 2: High Field MRgART - D Hyer, Presenting Author
12:00 PM Proof is in the Plan: Pros and Cons of MRgART - A Sethi, Presenting Author

SU-AB-TRACK 7-0 (Sunday, 7/25/2021) 10:30 AM - 12:30 PM [Eastern Time (GMT-4)]



During the course of treatment, a patient treatment plan may be compromised by anatomical changes resulting from weight loss, soft-tissue deformation, organ filling/emptying, peristalsis etc. This often requires plan adjustment or full-re-planning (adaptive radiation therapy). MR Guided Adaptive RT (MRgART) is a novel treatment paradigm to address dose variations due to above changes. Therapeutic ratio for many treatment sites can be improved with MRgART, but at the added expense of time investment with the patient on the table. The adaptive workflow introduces several new steps to the treatment process, such as, deformable image registration, contouring, plan optimization, QA and tumor tracking. Clinical implementation of MRgART will be discussed with a focus on resource utilization. We will also propose guidelines for clinical workflow enhancements in imaging, treatment planning and delivery. Importance of comprehensive system QA (end-to-end test) will be discussed along with QA thresholds and consistency checks for each step in the process chain. Finally, interesting clinical cases will be presented to emphasize efficient planning techniques for daily plan adaptation and improved clinical workflow.

Learning Objectives:

1. Present fundamentals of MR imaging in the IGRT environment while highlighting features unique to hybrid MR linacs.
2. Share clinical experiences of performing MRgART on low & high Tesla MR linacs.
3. Present clinical examples that emphasize smart plan adaptation and associated benefits.

Funding Support, Disclosures, and Conflict of Interest: Research Funding Support/Speaker's Bureau, ViewRay, Inc. Speaker's Bureau, Standard Imaging, Inc.

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