ESTRO-ACROP recommendations on the clinical implementation of hybrid MR-linac systems in radiation oncology

Area of Science:

• Medical Physics
• Radiation Oncology
• Radiotherapy Technology

Background:

• Online magnetic resonance-guided radiotherapy (oMRgRT) integrates MR imaging with radiotherapy delivery.
• This technology allows for real-time imaging and adaptive treatment planning.

Purpose of the Study:

• To provide an overview of available oMRgRT systems.
• To offer guidance for the implementation of hybrid MR-linac systems.
• To highlight new challenges associated with integrating MR environments into radiotherapy practice.

Main Methods:

• Review of current oMRgRT systems and technologies.
• Discussion of best practices for implementation.
• Identification of potential issues and challenges in clinical practice.

Main Results:

• oMRgRT enables daily adaptive planning for improved targeting accuracy.
• Online imaging during treatment delivery enhances precision.
• Implementation requires addressing the unique challenges of the MR environment.

Conclusions:

• oMRgRT represents a significant advancement in image-guided radiation therapy.
• Successful implementation requires careful planning and exploration of new challenges.
• These recommendations aim to facilitate the adoption of hybrid MR-linac systems.