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Practical guidelines of online MR-guided adaptive radiotherapy
Hiroyuki Okamoto1, Hiroshi Igaki2, Takahito Chiba1
1Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, 104-0045, Japan.
Journal of Radiation Research
|August 10, 2022
Summary
Japan established guidelines for online MR-guided adaptive radiotherapy (MRgART) to enhance cancer treatment accuracy. These guidelines cover equipment, personnel, and safety protocols for MRgART implementation.
Area of Science:
- Medical Physics
- Radiation Oncology
- Radiotherapy Technology
Background:
- The first MR-guided radiotherapy system in Japan was installed in 2017, with online MR-guided adaptive radiotherapy (MRgART) implementation starting in 2018.
- Online MRgART leverages MRI's superior soft-tissue contrast over X-ray imaging for improved treatment accuracy.
Purpose of the Study:
- To establish comprehensive practical guidelines for the clinical implementation of online MRgART in Japan.
- To define essential requirements for equipment, personnel, institutional environment, practice guidance, and quality assurance/control (QA/QC).
Main Methods:
- Joint establishment of guidelines by leading Japanese medical societies (JSMRM, JSMP, JRS, JSRT, JASTRO).
- Detailed recommendations for equipment (including MR-compatibility), personnel training, and safe operation of MRI systems.
- Emphasis on QA/QC, including dose measurement accuracy in magnetic fields and independent dose verification systems.
Main Results:
- The guidelines outline minimum requirements for equipment and QA/QC tools.
- Recommendations are provided for safe MRI operation and ensuring non-MR-compatible devices do not compromise image quality.
- Checklists are proposed to ensure the safety of online MRgART procedures.
Conclusions:
- Successful clinical implementation of online MRgART necessitates adherence to established guidelines.
- Close interdisciplinary collaboration among physicians, radiological technologists, nurses, and medical physicists is crucial for safe and effective MRgART.
