Evidence map›Paper›PMID 35278717›Full record

ArticlePractical radiation oncology

Clinical Implementation and Initial Experience With a 1.5 Tesla MR-Linac for MR-Guided Radiation Therapy for Gynecologic Cancer: An R-IDEAL Stage 1 and 2a First in Humans Feasibility Study of New Technology Implementation.

David S Lakomy, Jinzhong Yang, Sastry Vedam, Jihong Wang, Belinda Lee, Angela Sobremonte, Pamela Castillo, Neil Hughes, Mustefa Mohammedsaid, Anuja Jhingran and 4 more

Open access · greenAbstract read
In one paragraph

Article in Practical radiation oncology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
2.1field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 9 citations in OpenAlex.

  1. Stereotactic body radiation therapy (SBRT) with MRI-Linac in oligometastatic gynaecological cancer patients: a systematic review.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 1 country.

David S LakomyDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas; Dartmouth Geisel School of Medicine, Hanover, New Hampshire.
Jinzhong YangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Sastry VedamDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Jihong WangDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Belinda LeeDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Angela SobremonteDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Pamela CastilloDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Neil HughesDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Mustefa MohammedsaidDepartment of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Anuja JhingranDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Ann H KloppDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Seungtaek ChoiDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
C David FullerDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Lilie L LinDepartment of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas. Electronic address: lllin@mdanderson.org.
The University of Texas MD Anderson Cancer Center · USDartmouth College · US

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Fabien Delerue · 1985 to 2026
$290.8M
Flexible Hybrid Cloud Infrastructure for Seamless Management of HuBMAP Resources, Including Consortium-Wide and External EngagementOT2OD026675 · OD · CARNEGIE-MELLON UNIVERSITY · PI BLOOD, PHILIP D., SILVERSTEIN, JONATHAN C. · 2018 to 2021
$8.9M
Development of functional magnetic resonance imaging-guided adaptive radiotherapy for head and neck cancer patients using novel MR-Linac deviceR01DE028290 · NIDCR · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI CHRISTODOULEAS, JOHN PAUL, FULLER, CLIFTON DAVID · 2019 to 2023
$4.3M
Breast Cancer PARP PET Imaging AIP to Support FDA Approval & CommercializationR01CA258717 · NCI · UNIVERSITY OF PENNSYLVANIA · PI LIN, LILIE LEMING, MANKOFF, DAVID A. · 2021 to 2025
$2.9M
Longitudinal Spatial-Nonspatial Decision Support for Competing Outcomes in Head and Neck Cancer TherapyR01CA258827 · NCI · UNIVERSITY OF ILLINOIS AT CHICAGO · PI CANAHUATE, GUADALUPE, FULLER, CLIFTON DAVID · 2021 to 2025
$2.9M
SCH: Personalized Rescheduling of Adaptive Radiation Therapy for Head & Neck CancerR01CA257814 · NCI · RICE UNIVERSITY · PI FULLER, CLIFTON DAVID, SCHAEFER, ANDREW J · 2021 to 2024
$1.8M
imaging Radiation-Associated Dysphagia (iRAD)R01CA218148 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI FULLER, CLIFTON DAVID, HUTCHESON, KATHERINE ARNOLD · 2017 to 2019
$810k
A novel PARP inhibitor PET tracer for breast cancerR01CA249329 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI LIN, LILIE LEMING, PIWNICA-WORMS, DAVID · 2021 to 2023
$748k
Fellow and Resident Radiation Oncology iNtensive Training in Imaging and Informatics to Empower Research Careers (FRONTI2ER)R25EB025787 · NIBIB · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI DAS, PRAJNAN, FULLER, CLIFTON DAVID · 2018 to 2022
$535k
A System for Xerostomia Risk Classification after Head & Neck Cancer RadiotherapyR43CA254559 · NCI · ONCOSPACE, INC. · PI LAKSHMINARAYANAN, PRANAV · 2021 to 2021
$521k
NCI NIH HHS P30 CA016672NCI NIH HHS R01 CA218148NCI NIH HHS R01 CA249329NCI NIH HHS R01 CA257814NCI NIH HHS R01 CA258717NCI NIH HHS R01 CA258827NCI NIH HHS R43 CA254559NIBIB NIH HHS R25 EB025787NIDCR NIH HHS R01 DE028290NIH HHS OT2 OD026675
6 · The paper itself

Abstract

purposeMagnetic resonance imaging-guided linear accelerator systems (MR-linacs) can facilitate the daily adaptation of radiation therapy plans. Here, we report our early clinical experience using a MR-linac for adaptive radiation therapy of gynecologic malignancies. METHODS AND MATERIALS: Treatments were planned with an Elekta Monaco v5.4.01 and delivered by a 1.5 Tesla Elekta Unity MR-linac. The system offers a choice of daily adaptation based on either position (ATP) or shape (ATS) of the tumor and surrounding normal structures. The ATS approach has the option of manually editing the contours of tumors and surrounding normal structures before the plan is adapted. Here, we documented the duration of each treatment fraction; set-up variability (assessed by isocenter shifts in each plan) between fractions; and, for quality assurance, calculated the percentage of plans meeting the γ-criterion of 3%/3-mm distance to agreement. Deformable accumulated dose calculations were used to compare accumulated versus planned dose for patient treated with exclusively ATP fractions.

resultsOf the 10 patients treated with 90 fractions on the MR-linac, most received boost doses to recurrence in nodes or isolated tumors. Each treatment fraction lasted a median 32 minutes; fractions were shorter with ATP than with ATS (30 min vs 42 min, P < .0001). The γ criterion for all fraction plans exceeded >90% (median, 99.9%; range, 92.4%-100%; ie, all plans passed quality assurance testing). The average extent of isocenter shift was <0.5 cm in each axis. The accumulated dose to the gross tumor volume was within 5% of the reference plan for all ATP cases. Accumulated doses for lesions in the pelvic periphery were within <1% of the reference plan as opposed to -1.6% to -4.4% for central pelvic tumors.

conclusionsThe MR-linac is a reliable and clinically feasible tool for treating patients with gynecologic cancer.

Indexed as

Genital Neoplasms, FemaleRadiotherapy Planning, Computer-AssistedAdenosine TriphosphateFeasibility StudiesFemaleHumansMagnetic Resonance ImagingParticle AcceleratorsRadiotherapy DosageTechnologyAdenosine Triphosphate

Identifiers

PMID35278717
PMCPMC9233002
OpenAlexW4220813188

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.