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Future of medical physics: Real-time MRI-guided proton therapy: Real-time

Journal Article


Abstract


  • With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), atten-tion is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidan ce for proton beam therapy is expected to offer acompelling improvement to the current treatment workflow which is warranted arguably more thanfor x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomesare similar to that of the most advanced IMRT treatments, despite being a fundamentally superiorparticle for cancer treatment.In this Future of Medical Physics article, we describe the various software and hardware aspects ofpotential MRPT systems and the corresponding treatment workflow. Significant software develop-ments, particularly focused around adaptive MRI-based planning will be required. The magneticinteraction between the MRI and the proton beamline components will be a key area of focus. Forexample, the modeling and potential redesign of a magnetically compatible gantry to allow for beamdelivery from multiple angles towards a patient located within the bore of an MRI scanner. Further tothis, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringefield will require modeling, testing, and potential further development to ensure that the highly tar-geted radiotherapy is maintained.Looking forward we envisage a clear and accelerated path for hardware development, leveragingfrom lessons learnt from MRXT development. Within few years, simple prototype systems will likelyexist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestoneswill be key in the development of a more efficient, more accurate, and more successful form of pro-ton beam therapy for many common cancer sites

Authors


  •   Oborn, Brad M.
  •   Dowdell, Stephen (external author)
  •   Metcalfe, Peter E.
  •   Crozier, Stuart (external author)
  •   Mohan, Radhe (external author)
  •   Keall, Paul J. (external author)

Publication Date


  • 2017

Citation


  • Oborn, B. M., Dowdell, S., Metcalfe, P. E., Crozier, S., Mohan, R. & Keall, P. J. (2017). Future of medical physics: Real-time MRI-guided proton therapy: Real-time. Medical Physics, 44 (8), e77-e90.

Scopus Eid


  • 2-s2.0-85021704283

Has Global Citation Frequency


Start Page


  • e77

End Page


  • e90

Volume


  • 44

Issue


  • 8

Place Of Publication


  • United States

Abstract


  • With the recent clinical implementation of real-time MRI-guided x-ray beam therapy (MRXT), atten-tion is turning to the concept of combining real-time MRI guidance with proton beam therapy; MRI-guided proton beam therapy (MRPT). MRI guidan ce for proton beam therapy is expected to offer acompelling improvement to the current treatment workflow which is warranted arguably more thanfor x-ray beam therapy. This argument is born out of the fact that proton therapy toxicity outcomesare similar to that of the most advanced IMRT treatments, despite being a fundamentally superiorparticle for cancer treatment.In this Future of Medical Physics article, we describe the various software and hardware aspects ofpotential MRPT systems and the corresponding treatment workflow. Significant software develop-ments, particularly focused around adaptive MRI-based planning will be required. The magneticinteraction between the MRI and the proton beamline components will be a key area of focus. Forexample, the modeling and potential redesign of a magnetically compatible gantry to allow for beamdelivery from multiple angles towards a patient located within the bore of an MRI scanner. Further tothis, the accuracy of pencil beam scanning and beam monitoring in the presence of an MRI fringefield will require modeling, testing, and potential further development to ensure that the highly tar-geted radiotherapy is maintained.Looking forward we envisage a clear and accelerated path for hardware development, leveragingfrom lessons learnt from MRXT development. Within few years, simple prototype systems will likelyexist, and in a decade, we could envisage coupled systems with integrated gantries. Such milestoneswill be key in the development of a more efficient, more accurate, and more successful form of pro-ton beam therapy for many common cancer sites

Authors


  •   Oborn, Brad M.
  •   Dowdell, Stephen (external author)
  •   Metcalfe, Peter E.
  •   Crozier, Stuart (external author)
  •   Mohan, Radhe (external author)
  •   Keall, Paul J. (external author)

Publication Date


  • 2017

Citation


  • Oborn, B. M., Dowdell, S., Metcalfe, P. E., Crozier, S., Mohan, R. & Keall, P. J. (2017). Future of medical physics: Real-time MRI-guided proton therapy: Real-time. Medical Physics, 44 (8), e77-e90.

Scopus Eid


  • 2-s2.0-85021704283

Has Global Citation Frequency


Start Page


  • e77

End Page


  • e90

Volume


  • 44

Issue


  • 8

Place Of Publication


  • United States