First clinical experiences with a high field 1.5 T MR linac

Anders S. Bertelsen*, Tine Schytte, Pia K. Møller, Faisal Mahmood, Hans L. Riis, Karina L. Gottlieb, Søren N. Agergaard, Lars Dysager, Olfred Hansen, Janne Gornitzka, Elisabeth Veldhuizen, Dean B. ODwyer, Rasmus L. Christiansen, Morten Nielsen, Henrik R. Jensen, Carsten Brink, Uffe Bernchou

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Purpose: A 1.5 T MR Linac (MRL) has recently become available. MRL treatment workflows (WF) include online plan adaptation based on daily MR images (MRI). This study reports initial clinical experiences after five months of use in terms of patient compliance, cases, WF timings, and dosimetric accuracy. Method and materials: Two different WF were used dependent on the clinical situation of the day; Adapt To Position WF (ATP) where the reference plan position is adjusted rigidly to match the position of the targets and the OARs, and Adapt To Shape WF (ATS), where a new plan is created to match the anatomy of the day, using deformable image registration. Both WFs included three 3D MRI scans for plan adaptation, verification before beam on, and validation during IMRT delivery. Patient compliance and WF timings were recorded. Accuracy in dose delivery was assessed using a cylindrical diode phantom. Results: Nineteen patients have completed their treatment receiving a total of 176 fractions. Cases vary from prostate treatments (60Gy/20F) to SBRT treatments of lymph nodes (45 Gy/3F) and castration by ovarian irradiation (15 Gy/3F). The median session time (patient in to patient out) for 127 ATPs was 26 (21–78) min, four fractions lasted more than 45 min due to additional plan adaptation. For the 49 ATSs a median time of 12 (1–24) min was used for contouring resulting in a total median session time of 42 (29–91) min. Three SBRT fractions lasted more than an hour. The time on the MRL couch was well tolerated by the patients. The median gamma pass rate (2 mm,2% global max) for the adapted plans was 99.2 (93.4–100)%, showing good agreement between planned and delivered dose. Conclusion: MRL treatments, including daily MRIs, plan adaptation, and accurate dose delivery, are possible within a clinically acceptable timeframe and well tolerated by the patients.

OriginalsprogEngelsk
TidsskriftActa Oncologica
Vol/bind58
Udgave nummer10
Sider (fra-til)1352-1357
ISSN0284-186X
DOI
StatusUdgivet - okt. 2019

Fingeraftryk

Workflow
Prostate
Lymph Nodes

Citer dette

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title = "First clinical experiences with a high field 1.5 T MR linac",
abstract = "Purpose: A 1.5 T MR Linac (MRL) has recently become available. MRL treatment workflows (WF) include online plan adaptation based on daily MR images (MRI). This study reports initial clinical experiences after five months of use in terms of patient compliance, cases, WF timings, and dosimetric accuracy. Method and materials: Two different WF were used dependent on the clinical situation of the day; Adapt To Position WF (ATP) where the reference plan position is adjusted rigidly to match the position of the targets and the OARs, and Adapt To Shape WF (ATS), where a new plan is created to match the anatomy of the day, using deformable image registration. Both WFs included three 3D MRI scans for plan adaptation, verification before beam on, and validation during IMRT delivery. Patient compliance and WF timings were recorded. Accuracy in dose delivery was assessed using a cylindrical diode phantom. Results: Nineteen patients have completed their treatment receiving a total of 176 fractions. Cases vary from prostate treatments (60Gy/20F) to SBRT treatments of lymph nodes (45 Gy/3F) and castration by ovarian irradiation (15 Gy/3F). The median session time (patient in to patient out) for 127 ATPs was 26 (21–78) min, four fractions lasted more than 45 min due to additional plan adaptation. For the 49 ATSs a median time of 12 (1–24) min was used for contouring resulting in a total median session time of 42 (29–91) min. Three SBRT fractions lasted more than an hour. The time on the MRL couch was well tolerated by the patients. The median gamma pass rate (2 mm,2{\%} global max) for the adapted plans was 99.2 (93.4–100){\%}, showing good agreement between planned and delivered dose. Conclusion: MRL treatments, including daily MRIs, plan adaptation, and accurate dose delivery, are possible within a clinically acceptable timeframe and well tolerated by the patients.",
author = "Bertelsen, {Anders S.} and Tine Schytte and M{\o}ller, {Pia K.} and Faisal Mahmood and Riis, {Hans L.} and Gottlieb, {Karina L.} and Agergaard, {S{\o}ren N.} and Lars Dysager and Olfred Hansen and Janne Gornitzka and Elisabeth Veldhuizen and ODwyer, {Dean B.} and Christiansen, {Rasmus L.} and Morten Nielsen and Jensen, {Henrik R.} and Carsten Brink and Uffe Bernchou",
year = "2019",
month = "10",
doi = "10.1080/0284186X.2019.1627417",
language = "English",
volume = "58",
pages = "1352--1357",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Taylor & Francis",
number = "10",

}

First clinical experiences with a high field 1.5 T MR linac. / Bertelsen, Anders S.; Schytte, Tine; Møller, Pia K.; Mahmood, Faisal; Riis, Hans L.; Gottlieb, Karina L.; Agergaard, Søren N.; Dysager, Lars; Hansen, Olfred; Gornitzka, Janne; Veldhuizen, Elisabeth; ODwyer, Dean B.; Christiansen, Rasmus L.; Nielsen, Morten; Jensen, Henrik R.; Brink, Carsten; Bernchou, Uffe.

I: Acta Oncologica, Bind 58, Nr. 10, 10.2019, s. 1352-1357.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - First clinical experiences with a high field 1.5 T MR linac

AU - Bertelsen, Anders S.

AU - Schytte, Tine

AU - Møller, Pia K.

AU - Mahmood, Faisal

AU - Riis, Hans L.

AU - Gottlieb, Karina L.

AU - Agergaard, Søren N.

AU - Dysager, Lars

AU - Hansen, Olfred

AU - Gornitzka, Janne

AU - Veldhuizen, Elisabeth

AU - ODwyer, Dean B.

AU - Christiansen, Rasmus L.

AU - Nielsen, Morten

AU - Jensen, Henrik R.

AU - Brink, Carsten

AU - Bernchou, Uffe

PY - 2019/10

Y1 - 2019/10

N2 - Purpose: A 1.5 T MR Linac (MRL) has recently become available. MRL treatment workflows (WF) include online plan adaptation based on daily MR images (MRI). This study reports initial clinical experiences after five months of use in terms of patient compliance, cases, WF timings, and dosimetric accuracy. Method and materials: Two different WF were used dependent on the clinical situation of the day; Adapt To Position WF (ATP) where the reference plan position is adjusted rigidly to match the position of the targets and the OARs, and Adapt To Shape WF (ATS), where a new plan is created to match the anatomy of the day, using deformable image registration. Both WFs included three 3D MRI scans for plan adaptation, verification before beam on, and validation during IMRT delivery. Patient compliance and WF timings were recorded. Accuracy in dose delivery was assessed using a cylindrical diode phantom. Results: Nineteen patients have completed their treatment receiving a total of 176 fractions. Cases vary from prostate treatments (60Gy/20F) to SBRT treatments of lymph nodes (45 Gy/3F) and castration by ovarian irradiation (15 Gy/3F). The median session time (patient in to patient out) for 127 ATPs was 26 (21–78) min, four fractions lasted more than 45 min due to additional plan adaptation. For the 49 ATSs a median time of 12 (1–24) min was used for contouring resulting in a total median session time of 42 (29–91) min. Three SBRT fractions lasted more than an hour. The time on the MRL couch was well tolerated by the patients. The median gamma pass rate (2 mm,2% global max) for the adapted plans was 99.2 (93.4–100)%, showing good agreement between planned and delivered dose. Conclusion: MRL treatments, including daily MRIs, plan adaptation, and accurate dose delivery, are possible within a clinically acceptable timeframe and well tolerated by the patients.

AB - Purpose: A 1.5 T MR Linac (MRL) has recently become available. MRL treatment workflows (WF) include online plan adaptation based on daily MR images (MRI). This study reports initial clinical experiences after five months of use in terms of patient compliance, cases, WF timings, and dosimetric accuracy. Method and materials: Two different WF were used dependent on the clinical situation of the day; Adapt To Position WF (ATP) where the reference plan position is adjusted rigidly to match the position of the targets and the OARs, and Adapt To Shape WF (ATS), where a new plan is created to match the anatomy of the day, using deformable image registration. Both WFs included three 3D MRI scans for plan adaptation, verification before beam on, and validation during IMRT delivery. Patient compliance and WF timings were recorded. Accuracy in dose delivery was assessed using a cylindrical diode phantom. Results: Nineteen patients have completed their treatment receiving a total of 176 fractions. Cases vary from prostate treatments (60Gy/20F) to SBRT treatments of lymph nodes (45 Gy/3F) and castration by ovarian irradiation (15 Gy/3F). The median session time (patient in to patient out) for 127 ATPs was 26 (21–78) min, four fractions lasted more than 45 min due to additional plan adaptation. For the 49 ATSs a median time of 12 (1–24) min was used for contouring resulting in a total median session time of 42 (29–91) min. Three SBRT fractions lasted more than an hour. The time on the MRL couch was well tolerated by the patients. The median gamma pass rate (2 mm,2% global max) for the adapted plans was 99.2 (93.4–100)%, showing good agreement between planned and delivered dose. Conclusion: MRL treatments, including daily MRIs, plan adaptation, and accurate dose delivery, are possible within a clinically acceptable timeframe and well tolerated by the patients.

U2 - 10.1080/0284186X.2019.1627417

DO - 10.1080/0284186X.2019.1627417

M3 - Journal article

C2 - 31241387

AN - SCOPUS:85068112036

VL - 58

SP - 1352

EP - 1357

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 10

ER -