Andreas Wetscherek

Keywords: Cross-organ: Cancer, Physics & Engineering: Interventional

Hybrid MR-Linac systems enable imaging of the soft-tissue anatomy at the time of radiation treatment. While staff numbers and durations of individual treatment fractions are currently higher than for treatments on standard linear accelerators, replanning on daily images can reduce the required hospital visits for some anatomies and clinical trials exploring safe dose escalation to overcome resistance become possible. Real-time guidance of the treatment beam with MRI and the use of MRI-derived biomarkers for response assessment and treatment adaptation are active research areas. To unleash the full potential of MR-Linacs, further advances in both MRI and treatment planning are required.

Jin Wei Kwek

Keywords: Cross-organ: Cancer, Contrast mechanisms: Thermometry, Body: Body

High-Intensity-Focused-Ultrasound (HIFU) can induce permanent tissue destruction by thermal ablation with coagulative necrosis. Integration with MRI provides spatial guidance with fine anatomic detail and high soft-tissue contrast. MR-thermometry provides a near real-time temperature map during sonication to track the treated focus spot and surrounding tissue. MR-guided HIFU with closed-loop feedback ensures deposition of a thermal dose sufficient to cause coagulative necrosis at the targeted area and also allows protection of crucial structures from overheating, improving safety and therapeutic outcome. We explore how MR-guided HIFU can enhance our therapeutic armamentarium for established applications and some proof of concept pilot studies.
 

Ali Pirasteh