ArticleThe British journal of radiology2025
Simulation-free radiotherapy on the MR-linac in prostate cancer.
Article in The British journal of radiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe radiotherapy (RT) pathway faces bottlenecks. The Rapid Adaptive and Cost-Effective Radiotherapy (RACE) study evaluates the feasibility of using diagnostic MRI (dMRI) scans for planning prostate MRI-guided adaptive RT (MRIgART).
methodsWe audited prostate cancer patients treated with 5-fraction (#) stereotactic body radiotherapy (SBRT) between March 2023 and January 2024, assessing dMRI for RT planning suitability. Planning suitability required a T2-weighted sequence for target/organs at risk (OAR) delineation and a large field-of-view (LFOV). Scans were classified as RT plan suitable or as having specific issues (incomplete body coverage or slice thickness >10 mm). Workflow analysis from RT referral to first fraction estimated potential time savings with simulation-free RT (SFRT). Case studies illustrated identified issues and proposed solutions.
resultsdMRIs were available for 93% of patients, with scans originating from various hospitals and conducted on 1.5 Tesla (T) or 3 T MRI scanners. Ideal image characteristics for RT planning were met in 38% of MRIs. Issues such as cropped field of view (FOV) and low slice resolution were identified, but proposed solutions could increase the number of patients with suitable scans to 87%.
conclusionsThe findings suggest that with appropriate technical solutions, most dMRI scans can be adapted for RT planning purposes. ADVANCES IN KNOWLEDGE: The study highlights the potential of SFRT to reduce treatment delays and improve cost-effectiveness.
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