Radiotherapy (RT) uses high-energy radiation generated by a medical linear accelerator (LINAC) to kill cancer. It is used to treat over 1/2 of all cancer patients. Online image guidance, i.e. to image the patient at the treatment position plays an important role for RT. It helps to accurately align the tumor with the radiation beam, to allow us making necessary changes on treatment plans based on patient anatomy at the treatment time, and to see tumor motions during treatment for treatment safety and accuracy. Online image guidance requires the combination of a certain imaging device with a LINAC. Current CT-based image guidance systems suffer from problems such as low image quality and high...

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Radiotherapy (RT) uses high-energy radiation generated by a medical linear accelerator (LINAC) to kill cancer. It is used to treat over 1/2 of all cancer patients. Online image guidance, i.e. to image the patient at the treatment position plays an important role for RT. It helps to accurately align the tumor with the radiation beam, to allow us making necessary changes on treatment plans based on patient anatomy at the treatment time, and to see tumor motions during treatment for treatment safety and accuracy. Online image guidance requires the combination of a certain imaging device with a LINAC. Current CT-based image guidance systems suffer from problems such as low image quality and high x-ray radiation. Recently, two commercial systems combining MRI with LINAC have been developed. Clinical studies have showed that MR-guided RT can substantial improve treatment outcome even in some of the most challenging RT cases such as inoperable advanced stage pancreatic cancer. However, the bulky system design, high development cost, and sale price (~$8-10 Million) of these MR-LINACs severely limited the wide adoption of MR-guided RT and prohibited the demonstrated clinical benefits from reaching all patient populations. To address this problem, the research team at UT Southwestern Medical Center proposes developing a customized compact non-conventional MRI scanner that can be installed on existing LINACs, which realizes MR-guided RT at a much reduced cost. This project will develop the MRI scanner on a representative LINAC and test its feasibility for MR-guided RT. Given the large availability of LINACs worldwide (total ~16k), our strategy will make the clinically beneficial MR-guided RT accessible to much more patient population than current commercial MR-LINAC systems, and therefore generate more significant impacts on cancer treatment. We also expect substantial commercial impacts.

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