TY - JOUR
T1 - Clinical adoption patterns of 0.35 Tesla MR-guided radiation therapy in Europe and Asia
AU - Slotman, Berend J
AU - Clark, Mary Ann
AU - Özyar, Enis
AU - Kim, Myungsoo
AU - Itami, Jun
AU - Tallet, Agnès
AU - Debus, Jürgen
AU - Pfeffer, Raphael
AU - Gentile, PierCarlo
AU - Hama, Yukihiro
AU - Andratschke, Nicolaus
AU - Riou, Olivier
AU - Camilleri, Philip
AU - Belka, Claus
AU - Quivrin, Magali
AU - Kim, BoKyong
AU - Pedersen, Anders
AU - van Overeem Felter, Mette
AU - Kim, Young Il
AU - Kim, Jin Ho
AU - Fuss, Martin
AU - Valentini, Vincenzo
N1 - © 2022. The Author(s).
PY - 2022/8/22
Y1 - 2022/8/22
N2 - BACKGROUND: Magnetic resonance-guided radiotherapy (MRgRT) utilization is rapidly expanding, driven by advanced capabilities including better soft tissue imaging, continuous intrafraction target visualization, automatic triggered beam delivery, and the availability of on-table adaptive replanning. Our objective was to describe patterns of 0.35 Tesla (T)-MRgRT utilization in Europe and Asia among early adopters of this novel technology.METHODS: Anonymized administrative data from all 0.35T-MRgRT treatment systems in Europe and Asia were extracted for patients who completed treatment from 2015 to 2020. Detailed treatment information was analyzed for all MR-linear accelerators (linac) and -cobalt systems.RESULTS: From 2015 through the end of 2020, there were 5796 completed treatment courses delivered in 46,389 individual fractions. 23.5% of fractions were adapted. Ultra-hypofractionated (UHfx) dose schedules (1-5 fractions) were delivered for 63.5% of courses, with 57.8% of UHfx fractions adapted on-table. The most commonly treated tumor types were prostate (23.5%), liver (14.5%), lung (12.3%), pancreas (11.2%), and breast (8.0%), with increasing compound annual growth rates (CAGRs) in numbers of courses from 2015 through 2020 (pancreas: 157.1%; prostate: 120.9%; lung: 136.0%; liver: 134.2%).CONCLUSIONS: This is the first comprehensive study reporting patterns of utilization among early adopters of a 0.35T-MRgRT system in Europe and Asia. Intrafraction MR image-guidance, advanced motion management, and increasing adoption of on-table adaptive RT have accelerated a transition to UHfx regimens. MRgRT has been predominantly used to treat tumors in the upper abdomen, pelvis and lungs, and increasingly with adaptive replanning, which is a radical departure from legacy radiotherapy practices.
AB - BACKGROUND: Magnetic resonance-guided radiotherapy (MRgRT) utilization is rapidly expanding, driven by advanced capabilities including better soft tissue imaging, continuous intrafraction target visualization, automatic triggered beam delivery, and the availability of on-table adaptive replanning. Our objective was to describe patterns of 0.35 Tesla (T)-MRgRT utilization in Europe and Asia among early adopters of this novel technology.METHODS: Anonymized administrative data from all 0.35T-MRgRT treatment systems in Europe and Asia were extracted for patients who completed treatment from 2015 to 2020. Detailed treatment information was analyzed for all MR-linear accelerators (linac) and -cobalt systems.RESULTS: From 2015 through the end of 2020, there were 5796 completed treatment courses delivered in 46,389 individual fractions. 23.5% of fractions were adapted. Ultra-hypofractionated (UHfx) dose schedules (1-5 fractions) were delivered for 63.5% of courses, with 57.8% of UHfx fractions adapted on-table. The most commonly treated tumor types were prostate (23.5%), liver (14.5%), lung (12.3%), pancreas (11.2%), and breast (8.0%), with increasing compound annual growth rates (CAGRs) in numbers of courses from 2015 through 2020 (pancreas: 157.1%; prostate: 120.9%; lung: 136.0%; liver: 134.2%).CONCLUSIONS: This is the first comprehensive study reporting patterns of utilization among early adopters of a 0.35T-MRgRT system in Europe and Asia. Intrafraction MR image-guidance, advanced motion management, and increasing adoption of on-table adaptive RT have accelerated a transition to UHfx regimens. MRgRT has been predominantly used to treat tumors in the upper abdomen, pelvis and lungs, and increasingly with adaptive replanning, which is a radical departure from legacy radiotherapy practices.
KW - Humans
KW - Magnetic Resonance Imaging/methods
KW - Male
KW - Particle Accelerators
KW - Radiosurgery/methods
KW - Radiotherapy Dosage
KW - Radiotherapy Planning, Computer-Assisted/methods
KW - Radiotherapy, Image-Guided/methods
KW - Radiotherapy, Intensity-Modulated/methods
UR - http://www.scopus.com/inward/record.url?scp=85136237961&partnerID=8YFLogxK
U2 - 10.1186/s13014-022-02114-2
DO - 10.1186/s13014-022-02114-2
M3 - Journal article
C2 - 35996192
SN - 1748-717X
VL - 17
SP - 1
EP - 9
JO - Radiation Oncology
JF - Radiation Oncology
IS - 1
M1 - 146
ER -