Development of patient‐controlled respiratory gating system based on visual guidance for magnetic‐resonance image‐guided radiation therapy

Kim, Jung In; Lee, Han Young; Wu, Hong Gyun; Chie, Eui Kyu; Kang, Hyun-Cheol; Park, Jong Min

doi:10.1002/mp.12447

Cited by 20 publications

(14 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During gated delivery, patients were provided with visual guidance via an in-room screen displaying the live sagittal cine-MR image with an overlay of gating target and boundary, thus enabling them to steer their repeated breath-holds to the right position. This idea was adopted from other published in-room screen solutions for MRgRT [17,20]. Patients were able to observe this monitor during the whole treatment with the help of a mirror fixed to the bore (see Fig.…”

Section: Treatmentmentioning

confidence: 99%

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

et al. 2020

View full text Add to dashboard Cite

Purpose Magnetic resonance-guided radiotherapy (MRgRT) has recently been introduced in our institution. As MRgRT requires high patient compliance compared to conventional techniques and can be associated with prolonged treatment times, feasibility and patient tolerance were prospectively assessed using patient-reported outcome questionnaires (PRO-Q). Materials and methods Forty-three patients were enrolled in a prospective observational study and treated with MRgRT on a low-field hybrid Magnetic Resonance Linear Accelerator system (MR-Linac) between April 2018 and April 2019. For assistance in gated breath-hold delivery using cine-MRI, a video feedback system was installed. PRO-Qs consisted of questions on MR-related complaints and also assessed aspects of active patient participation. Results The most commonly treated anatomic sites were nodal metastases and liver lesions. The mean treatment time was 34 min with a mean beam-on time of 2:17 min. Gated stereotactic body radiotherapy (SBRT) was applied in 47% of all patients. Overall, patients scored MRgRT as positive or at least tolerable in the PRO-Q. Almost two thirds of patients (65%) complained about at least one item of the PRO-Q (score ≥4), mainly concerning coldness, paresthesia, and uncomfortable positioning. All patients reported high levels of satisfaction with their active role using the video feedback system in breath-hold delivery. Conclusion MRgRT was successfully implemented in our clinic and well tolerated by all patients, despite MR-related complaints and complaints about uncomfortable immobilization. Prospective clinical studies are in development for further evaluation of MRgRT and for quantification of the benefit of MR-guided on-table adaptive radiotherapy.

show abstract

Section: Treatmentmentioning

confidence: 99%

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

et al. 2020

View full text Add to dashboard Cite

show abstract

“…In order to visually guide patients especially for repeated breath-holds, some authors have reported on in-room screens or projectors [28], [29]. During RT delivery, the patients can thereby see their live cine MR images including projections of target and margin, and thus actively control their breathing.…”

Section: Treatment Planning and Deliverymentioning

confidence: 99%

Technical design and concept of a 0.35 T MR-Linac

Klüter

2019

Clinical and Translational Radiation Oncology

245

288

View full text Add to dashboard Cite

The integration of magnetic resonance (MR) imaging and linear accelerators into hybrid treatment systems has made MR-guided radiation therapy a clinical reality. This work summarizes the technical design of a 0.35 T MR-Linac and corresponding clinical concepts. The system facilitates 3D-conformal as well as IMRT treatments with 6MV photons. Daily MR imaging provides superior soft-tissue contrast for patient setup and also enables on-table adaption of treatment plans, which is fully integrated into the treatment workflow of the system. Automated beam gating during delivery is facilitated by cine MR imaging and structure tracking. Combining different novel features compared to conventional image-guided radiotherapy, this technology offers the potential for margin reduction as well as dose escalation.

show abstract

“…In this setting, the breath-hold technique has proven to be a safe and effective way to reduce tumor motion, resulting in an average intrafractional movement of <1 mm in all directions and an average cranio-caudal interfractional reproducibility of <4 mm ( 79 , 80 ). Some authors reported on the implementation of an additional visual feedback for the breath-hold procedure using in-room screens or projectors ( 81 , 82 ). This allows patients to see their live cine MR images including projections of target and gating boundary and, thus actively control their breathing.…”

Section: Motion Management For Liver Mrgrtmentioning

confidence: 99%

MR-Guided Radiotherapy for Liver Malignancies

et al. 2021

View full text Add to dashboard Cite

MR guided radiotherapy represents one of the most promising recent technological innovations in the field. The possibility to better visualize therapy volumes, coupled with the innovative online adaptive radiotherapy and motion management approaches, paves the way to more efficient treatment delivery and may be translated in better clinical outcomes both in terms of response and reduced toxicity. The aim of this review is to present the existing evidence about MRgRT applications for liver malignancies, discussing the potential clinical advantages and the current pitfalls of this new technology.

show abstract

Development of patient‐controlled respiratory gating system based on visual guidance for magnetic‐resonance image‐guided radiation therapy

Abstract: The developed system could improve treatment efficiency when performing respiratory-gated MR-IGRT. The VG-PC gating system could be applied to any kind of bore-type radiotherapy machine.

Cited by 20 publications

References 20 publications

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

First prospective clinical evaluation of feasibility and patient acceptance of magnetic resonance-guided radiotherapy in Germany

Technical design and concept of a 0.35 T MR-Linac

MR-Guided Radiotherapy for Liver Malignancies

Contact Info

Product

Resources

About