About this Research Topic
Radiotherapy is rapidly evolving due to advances in radiation delivery and image guidance. The improved targeting accuracy allowed for an increase in tumor dose (to an ablative approach for some indications) and a reduction in dose to surrounding healthy tissues. The integration of magnetic resonance imaging (MRI) with linear accelerators allows for a further paradigm shift in radiation oncology and radiotherapy research.
In this Research Topic, the possibilities and challenges when using online adaptive MR-guided radiotherapy will be described from a vendor-neutral and international perspective. The introduction of online adaptive MR-guided radiotherapy heavily influences the entire radiotherapy approach, from target definition and dose painting to fractionation and treatment planning, response prediction and responsibilities in the clinical workflow. The various MR-linac systems which are clinically available or in development will be described.
For several clinical indications, the clinical experience, evidence in the literature, advice on the introduction of MR-guided radiotherapy, open study protocols and future perspectives will be presented. The evidence-based introduction of complex new technology in radiation oncology requires a different approach than used in 'classical' medical oncology research and warrants international research collaboration. The future perspectives on the use of radiomics for radiotherapy and the potential benefit of combining radio-immunotherapy with online adaptive MR-guided radiotherapy will subsequently be discussed.
Keywords: MRI, external beam radiotherapy, MR-guided radiotherapy, adaptive, image-guided radiotherapy
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