ArticlePhysics and imaging in radiation oncology2025
First experimental demonstration of magnetic resonance-guided multileaf collimator tracking for (ultra-)hypofractionated prostate radiotherapy.
Article in Physics and imaging in radiation oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Toxicity of rectal preparation strategies in ultra-hypofractionated SBRT for prostate cancer.Technical innovations & patient support in radiation oncology · 2026Article
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6 authors.
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Abstract
Background and purpose: (Ultra-)hypofractionated radiotherapy is an effective treatment for localized prostate cancer, but intrafraction motion can increase toxicity and/or reduce treatment efficacy. Therefore, motion management is essential. This study explores magnetic resonance imaging (MRI)-guided multileaf collimator (MLC) tracking for 2-fraction prostate radiotherapy on an MR-linac. Materials and methods: We compared two MRI-guided MLC centroid tracking workflows, each using a different motion manager to derive and stream target positions to our in-house MLC tracking software. The first workflow relies on interleaved 2D (2.5D) cine-MRI, introducing minimal latency. In contrast, the second workflow utilized 3D cine-MRI, which operates at a relatively lower imaging frequency that introduces more latency.For experimental validation, we used a motion phantom equipped with an integrated insert that combines film with plastic scintillation dosimetry. A 2x12 Gy 11-beam prostate intensity modulated radiotherapy plan was created for tracking deliveries. Results: The signal latency introduced by the motion managers was 0.6 s for 2.5D cine-MRI and 6.3 s for 3D cine-MRI. Despite this latency, MLC tracking effectively restored the planned dose, improving the 2%/2mm local gamma pass-rates from 21% (due to linear drift) to 89% (2.5D) and 91% (3D). Plastic scintillator measurements showed reduced dose deviations at the periphery of the clinical target volume from 13-64% (no tracking) to 0-11% (2.5D) and 2-26% (3D). Conclusion: Our experiments demonstrated the technical feasibility of 2.5D and 3D cine-MRI-based MLC tracking on an MR-linac for 2-fraction prostate radiotherapy, with both motion management strategies achieving comparable dosimetric improvements despite the difference in latency.
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