A REVIEW OF MAGNETIC RESONANCE IMAGING-GUIDED ADAPTIVE RADIATION THERAPY: CURRENT CHALLENGES

Abstract

Radiation Therapy (RT) is considered one of the most prevalent options for oncologic cancer treatment. However, due to changes in some patients' organs, size, shape, tumor position, or movement that may occur over the treatment period, adaptive radiotherapy (ART) was a new method introduced in 1997 (Yan et al., 1997). ART is used to correct these anatomical and functional variations by modifying plans during the treatment. Image-guided Radiotherapy (IGRT), as part of the ART process, is a technique used to detect these variations and adjust treatment plans accordingly (Sterzing et al., 2011). Currently, the IGRT technique uses onboard Cone-Beam Computed Tomography (CBCT), which is an effective technique. However, CBCT generates insufficient soft tissue contrast images to accurately distinguish between normal tissues and tumor fields. Therefore, a new method using Magnetic Resonance Imaging-Guided Adaptive Radiotherapy (MRgRT) was introduced to advance ART by providing real-time visualization of the cancer and the tissue around it (Acharya et al., 2016). To further identify and monitor anatomic motion, MRgRT offers real-time images (Chin et al., 2020). In this review, an investigation of previous studies and clinical trials was conducted to understand the challenges and limitations that can be faced by using MRgRT. The results of the study might suggest MRIgRT's potential function in enhancing radiation therapy.