Trial reportRadiation oncology (London, England)2021
Operating procedures, risk management and challenges during implementation of adaptive and non-adaptive MR-guided radiotherapy: 1-year single-center experience.
Trial report in Radiation oncology (London, England), 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Failure modes and effects analysis for clinical implementation of online adaptive radiotherapy: A systematic review.Journal of applied clinical medical physics · 2026Pooled it
- Cross-fraction prior learning for scalable organ-at-risk segmentation in abdominal MR-guided radiotherapy.Medical physics · 2026Article
- Implementation of an FMEA-guided quality-improvement workflow is associated with improved setup accuracy in lung stereotactic body radiotherapy.Frontiers in oncology · 2026Article
- Long-term patient experience with online MR-guided radiotherapy: adaptive versus non-adaptive workflow.Frontiers in oncology · 2026Article
- Article
- Process failure mode and effects analysis for external beam radiotherapy: Introducing a literature-based template and a novel action priority.Zeitschrift fur medizinische Physik · 2024Article
- Re-evaluation of the prospective risk analysis for artificial-intelligence driven cone beam computed tomography-based online adaptive radiotherapy after one year of clinical experience.Zeitschrift fur medizinische Physik · 2024Article
- Impact of daily plan adaptation on accumulated doses in ultra-hypofractionated magnetic resonance-guided radiation therapy of prostate cancer.Physics and imaging in radiation oncology · 2024Article
- Leaf-individual calibration for a double stack multileaf collimator in photon radiotherapy.Physics and imaging in radiation oncology · 2023Article
- Interobserver variation of clinical oncologists compared to therapeutic radiographers (RTT) prostate contours on T2 weighted MRI.Technical innovations & patient support in radiation oncology · 2023Article
- Risk analysis of the Unity 1.5 T MR-Linac adapt-to-position workflow.Journal of applied clinical medical physics · 2023Article
- Evaluation of therapeutic radiographer contouring for magnetic resonance image guided online adaptive prostate radiotherapy.Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology · 2023Article
- Dosimetric benefits of adaptive radiation therapy for patients with stage III non-small cell lung cancer.Radiation oncology (London, England) · 2023Article
- Quality assurance for on-table adaptive magnetic resonance guided radiation therapy: A software tool to complement secondary dose calculation and failure modes discovered in clinical routine.Journal of applied clinical medical physics · 2022Article
- Magnetic-Field-Induced Secondary-Electron Effects in MR-Guided Radiotherapy: From Dosimetric Mechanisms to Workflow-Based Clinical Risk Management.Technology in cancer research & treatmentReview
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundMain purpose was to describe procedures and identify challenges in the implementation process of adaptive and non-adaptive MR-guided radiotherapy (MRgRT), especially new risks in workflow due to the new technique. We herein report the single center experience for the implementation of (MRgRT) and present an overview on our treatment practice.
methodsDescriptive statistics were used to summarize clinical and technical characteristics of treatment and patient characteristics including sites treated between April 2019 and end of March 2020 after ethical approval. A risk analysis was performed to identify risks of the online adaptive workflow.
resultsA summary of the processes on the MR-Linac including workflows, quality assurance and possible pitfalls is presented. 111 patients with 124 courses were treated during the first year of MR-guided radiotherapy. The most commonly treated site was the abdomen (42% of all treatment courses). 73% of the courses were daily online adapted and a high number of treatment courses (75%) were treated with stereotactic body irradiation. Only 4/382 fractions could not be treated due to a failing online adaptive quality assurance. In the risk analysis for errors, the two risks with the highest risk priority number were both in the contouring category, making it the most critical step in the workflow.
conclusionAlthough challenging, establishment of MRgRT as a routinely used technique at our department was successful for all sites and daily o-ART was feasible from the first day on. However, ongoing research and reports will have to inform us on the optimal indications for MRgRT because careful patient selection is necessary as it continues to be a time-consuming treatment technique with restricted availability. After risk analysis, the most critical workflow category was the contouring process, which resembles the need of experienced staff and safety check paths.
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