Article
Medicine, General & Internal
David A. P. Dunkerley, Daniel E. Hyer, Jeffrey E. Snyder, Joel J. St-Aubin, Carryn M. Anderson, Joseph M. Caster, Mark C. Smith, John M. Buatti, Sridhar Yaddanapudi
Summary: MRgART provides benefits for cancer patients through enhanced imaging technology during treatment, but also faces challenges. This paper presents an institution's experience in developing a MRgART program and provides considerations for treating patients at different anatomical sites.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
M. P. W. Intven, S. R. de Mol van Otterloo, S. Mook, P. A. H. Doornaert, E. N. de Groot-van Breugel, G. G. Sikkes, M. E. Willemsen-Bosman, H. M. van Zijp, R. H. N. Tijssen
Summary: This study evaluates the feasibility and implementation of MR-guided radiotherapy for rectal cancer on a 1.5T MR-linac. Results show that daily online adaptation of the CTV can reduce margins effectively and achieve good treatment outcomes. The treatment process takes about 48 minutes per fraction.
RADIOTHERAPY AND ONCOLOGY
(2021)
Article
Oncology
T. N. van de Lindt, M. E. Nowee, T. Janssen, C. Schneider, P. Remeijer, V. W. J. van Pelt, A. Betgen, E. P. M. Jansen, J. J. Sonke
Summary: This study aimed to test the technical feasibility of 4D-MRI guided liver SBRT and investigate target motion and coverage during treatment. The results showed that 4D-MRI guided SBRT was feasible in treating liver metastases, but the occurrence of midposition drifts highlighted the need for motion management strategies to enhance treatment precision.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Oncology
Dennis Winkel, Anita M. Werensteijn-Honingh, Wietse S. C. Eppinga, Martijn P. W. Intven, Jochem Hes, Louk M. W. Snoeren, Sanne A. Visser, Gijsbert H. Bol, Bas W. Raaymakers, Ina M. Jurgenliemk-Schulz, Petra S. Kroon
Summary: The study investigated the dosimetric feasibility and plan quality of hypofractionated radiotherapy for patients with lymph node oligometastases using the 1.5T MR-linac system. The results showed that hypofractionated treatment is feasible based on dose criteria and plan quality metrics, but it is important to consider the location of the target relative to critical structures when choosing the fractionation scheme. Meeting all dose criteria in the pre-treatment situation does not guarantee the same outcome during online treatment.
RADIOTHERAPY AND ONCOLOGY
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Ke Zhang, Yuan Tian, Minghui Li, Kuo Men, Jianrong Dai
Summary: This study evaluated the performance of an MLC system on the Elekta Unity MR-linac under high magnetic field, showing comparable T&G effect, low radiation leakage, high positioning reproducibility, and good RF shielding. Attention is needed for the positional change of the leaf side penumbra.
Article
Oncology
Jihong Wang, Travis Salzillo, Yongying Jiang, Yuri Mackeyev, Clifton David Fuller, Caroline Chung, Seungtaek Choi, Neil Hughes, Yao Ding, Jinzhong Yang, Sastry Vedam, Sunil Krishnan
Summary: This study focused on analyzing the molecular stability of MRI contrast agents when exposed to high energy photons and secondary electrons in a 1.5T MR-Linac system. The results showed no significant changes in chemical composition or displacement of gadolinium ions from their chelates in samples irradiated with 7 MV photons at clinical doses. Additionally, there was no significant correlation observed between concentrations of irradiated MRI contrast agents and radiation dose.
RADIOTHERAPY AND ONCOLOGY
(2021)
Article
Engineering, Biomedical
Can Wu, Victor Murray, Syed S. Siddiq, Neelam Tyagi, Marsha Reyngold, Christopher Crane, Ricardo Otazo
Summary: This study developed a real-time 4D MRI technique using MR signature matching (MRSIGMA) for volumetric motion imaging in patients with pancreatic cancer on a 1.5T MR-Linac system. Two consecutive MRI scans were performed and the results showed that MRSIGMA had high accuracy and low uncertainty in real-time motion tracking.
PHYSICS IN MEDICINE AND BIOLOGY
(2023)
Article
Engineering, Biomedical
G. Tsekas, G. H. Bol, B. W. Raaymakers
Summary: This work presents a robust deep learning-based framework for forward dose calculations in VMAT using a 1.5T MR-linac. A convolutional neural network is trained on dose data of individual multi-leaf-collimator VMAT segments and used to predict dose per segment in MR-linac-deliverable VMAT test plans. The method shows highly accurate dose predictions for a set of MR-linac-deliverable VMAT test plans and passes all clinical requirements for previously unseen IMRT patients, making it a promising solution for plan validation in IMRT and VMAT workflows.
PHYSICS IN MEDICINE AND BIOLOGY
(2022)
Article
Oncology
Francesco Cuccia, Michele Rigo, Vanessa Figlia, Niccolo Giaj-Levra, Rosario Mazzola, Luca Nicosia, Francesco Ricchetti, Giovanna Trapani, Antonio De Simone, Davide Gurrera, Stefania Naccarato, Gianluisa Sicignano, Ruggero Ruggieri, Filippo Alongi
Summary: This study reports the preliminary data of using 1.5T MR-Linacs for prostate or prostate bed re-irradiation. The study found that this treatment option has minimal toxicity and encouraging clinical outcomes.
FRONTIERS IN ONCOLOGY
(2022)
Article
Oncology
Shouliang Ding, Yongbao Li, Hongdong Liu, Rui Li, Bin Wang, Jun Zhang, Yan Chen, Xiaoyan Huang
Summary: This study evaluated the dosimetric qualities and usability of 1.5 T MR-Linac based intensity modulated radiotherapy (MRL-IMRT) compared to conventional linac IMRT plans for different clinical sites. Results showed that MRL-IMRT plans were clinically equivalent but had higher skin dose and shorter optimization time. Minor differences in plan quality between MR-Linac plans and current clinical practice were found due to machine characteristics, which should be considered in clinical practice.
TECHNOLOGY IN CANCER RESEARCH & TREATMENT
(2021)
Article
Radiology, Nuclear Medicine & Medical Imaging
Hassan Jassar, An Tai, Xinfeng Chen, Timothy D. D. Keiper, Eric Paulson, Fabienne Lathuiliere, Silvain Beriault, Francois Hebert, Laurence Savard, David T. T. Cooper, Sneha Cloake, X. Allen Li
Summary: This study develops and tests an improved real-time motion monitoring technique for accurate motion management during radiation therapy. The results show that the technique can achieve accurate motion monitoring on MR-Linac without using contrast agents or radio-opaque implants.
Article
Oncology
Alice Couwenberg, Uulke van der Heide, Tomas Janssen, Baukelien van Triest, Peter Remeijer, Corrie Marijnen, Jan-Jakob Sonke, Marlies Nowee
Summary: The master protocol trial design aims to improve efficiency in the development of innovations in radiation oncology. This article describes a master protocol for studying the feasibility of MR-guided adaptive radiotherapy techniques/software.
RADIOTHERAPY AND ONCOLOGY
(2022)
Article
Medicine, General & Internal
Daniel Wegener, Alexandra Thome, Frank Paulsen, Cihan Gani, Jessica Boldt, Sarah Butzer, Daniela Thorwarth, David Moennich, Marcel Nachbar, Arndt-Christian Muller, Daniel Zips, Simon Boeke
Summary: In this study, the feasibility and acute toxicity of using a 1.5 T MRI-linear accelerator hybrid for salvage radiotherapy of prostate cancer were investigated. The study demonstrated the feasibility of the technology and reported low rates of acute toxicity.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Radiology, Nuclear Medicine & Medical Imaging
Xuechun Liu, Chengqiang Li, Jian Zhu, Guanzhong Gong, Hongqiang Sun, Xu Li, Mengdi Sun, Zicheng Zhang, Baosheng Li, Yong Yin, Zhenjiang Li
Summary: The study verified the dosimetric accuracy of an MR-Linac system in treating a moving target and assessed the error with different motion patterns and adaptation methods. The adaptive treatment on the MR-Linac system investigated met the expected performance with tumor motions, showing acceptable clinical differences between measured and calculated doses under various motion patterns.
Review
Medicine, General & Internal
James W. Randall, Nikhil Rammohan, Indra J. Das, Poonam Yadav
Summary: Advances in image-guided radiotherapy, particularly the application of magnetic resonance imaging (MRI), have improved oncologic outcomes and reduced toxicity. The integration of MRI with a linear accelerator in the MR-Linac provides real-time imaging, motion management assessment, and online adaptive therapy, offering potential advantages in different clinical scenarios and enhancing the future role of these machines in clinical workflows.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Oncology
Lisanne V. van Dijk, Abdallah S. R. Mohamed, Sara Ahmed, Nafiul Nipu, G. Elisabeta Marai, Kareem Wahid, Nanna M. Sijtsema, Brandon Gunn, Adam S. Garden, Amy Moreno, Andrew J. Hope, Johannes A. Langendijk, Clifton D. Fuller
Summary: By utilizing "big-data," a personalized radiotherapy prediction model was developed to accurately stratify patients with head and neck cancer into high, intermediate, and low mortality risk groups, providing guidance for personalized radiotherapy.
EUROPEAN JOURNAL OF CANCER
(2023)
Article
Oncology
Volker Arndt, Daniela Doege, Stefan Froehling, Peter Albers, Hana Alguel, Ralf Bargou, Carsten Bokemeyer, Martin Bornhaeuser, Christian H. Brandts, Peter Brossart, Sara Yvonne Brucker, Tim H. Bruemmendorf, Hartmut Doehner, Norbert Gattermann, Michael Hallek, Volker Heinemann, Ulrich Keilholz, Thomas Kindler, Cornelia von Levetzow, Florian Lordick, Ulf Peter Neumann, Christoph Peters, Dirk Schadendorf, Stephan Stilgenbauer, Thomas Zander, Daniel Zips, Delia Braun, Thomas Seufferlein, Gerd Nettekoven, Michael Baumann
Summary: The capacities of German Comprehensive Cancer Centers (CCCs) in various aspects of oncology care were significantly affected during the first 2 years of the COVID-19 pandemic. Follow-up, psycho-oncologic care, and tumor surgery were particularly impacted, along with other areas of multidisciplinary oncological care. This study highlights the importance of developing strategies to prevent similar limitations in the future.
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY
(2023)
Article
Oncology
Mehdi Hemmati, Carly Barbon, Abdallah S. R. Mohamed, Lisanne van Dijk, Amy C. Moreno, Neil D. Gross, Ryan P. Goepfert, Stephen Y. Lai, Katherine A. Hutcheson, Andrew J. Schaefer, Clifton D. Fuller
Summary: The aim of this study was to analyze the outcomes of transoral robotic surgery (TORS) for oropharyngeal squamous cell cancer (OPSCC) patients. The results showed that TORS had inferior swallowing function compared to radiation therapy (RT), but remained the optimal therapy as compared to chemoradiation therapy (CRT) in certain cases. The study suggests that TORS with adjuvant therapy may result in more severe swallowing toxicity for OPSCC patients.
Article
Oncology
Monica Lo Russo, Marcel Nachbar, Aisling Barry, Shree Bhide, Amy Chang, William Hall, Martijn Intven, Corrie Marijnen, Femke Peters, Bruce Minsky, Paul B. Romesser, Reith Sarkar, Alex Tan, Simon Boeke, Daniel Wegener, Sarah Butzer, Jessica Boldt, Sergios Gatidis, Konstantin Nikolaou, Daniela Thorwarth, Daniel Zips, Cihan Gani
Summary: This study investigated the impact of rectal ultrasound gel filling on interobserver variability in the delineation of primary rectal tumor volumes. The study found that rectal ultrasound gel filling can improve interobserver agreement and may be a useful tool for future dose escalation strategies.
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
(2023)
Article
Health Care Sciences & Services
Alex Koong, Ulysses Grant Gardner, Jason Burton, Caleb Stewart, Petria Thompson, Clifton David Fuller, Ethan Bernard Ludmir, Michael Kevin Rooney
Summary: In this observational cohort study, the authors aimed to characterize the landscape of open access (OA) publishing in oncology and identify characteristics of oncology journals predictive of article processing charges (APCs). The results showed that oncology journals with more citable articles, a hybrid OA model, higher impact factors, and based in North America or Europe tend to have higher APCs.
JMIR FORMATIVE RESEARCH
(2023)
Article
Oncology
Siyer Roohani, Juergen Loskutov, Jens Heufelder, Felix Ehret, Lena Wedeken, Manuela Regenbrecht, Rica Sauer, Daniel Zips, Andrea Denker, Antonia M. Joussen, Christian R. A. Regenbrecht, David Kaul
Summary: A pilot study was conducted using patient-derived 3D cell cultures to investigate the effects of photon and proton radiation on different subtypes of localized high-grade soft tissue sarcoma (STS). The study found pronounced differences in radiosensitivity among different subtypes of STS, and showed that photon and proton radiation had similar dose-dependent cell-killing effectiveness in the 3D cell cultures.
Article
Oncology
Rolf D. Issels, Stefan Boeck, Uwe Pelzer, Ulrich Mansmann, Pirus Ghadjar, Lars H. Lindner, Markus Albertsmeier, Martin K. Angele, Michael Schmidt, Yujun Xu, Marcus Bahra, Johann Pratschke, Michael Schoenberg, Wolfgang E. Thasler, Christoph Salat, Oliver J. Stoetzer, Wolfram T. Knoefel, Dirk Graf, Rudiger Wessalowski, Verena Keitel-Anselmino, Alfred Koenigsrainer, Michael Bitzer, Daniel Zips, Michael Bamberg, Rainer Fietkau, Oliver Ott, Maciej Kawecki, Lucian Wyrwicz, Piotr Rutkowski, Markus Rentsch, Juliana Ababei, Peter Reichardt, Marco Rigamonti, Bernhard Weber, Sultan Abdel-Rahman, Katharina Tschoep-Lechner, Karl-Walter Jauch, Christiane J. Bruns, Helmut Oettle, Michael von Bergwelt-Baildon, Volker Heinemann, Jens Werner
Summary: In this randomized controlled trial, the addition of cisplatin to gemcitabine with regional hyperthermia did not significantly improve disease-free survival in resected pancreatic ductal adenocarcinoma, but it showed a difference in post-recurrence survival and a trend for improved overall survival.
EUROPEAN JOURNAL OF CANCER
(2023)
Article
Otorhinolaryngology
Houda Bahig, Hanna Y. Y. Ehab, Adam S. S. Garden, Sweet Ping Ng, Steven J. J. Frank, Theresa Nguyen, Gary B. B. Gunn, David I. I. Rosenthal, Clifton D. D. Fuller, Renata Ferrarotto, Diana Bell, Shirley Su, Jack Phan
Summary: This study retrospectively analyzed the long-term outcomes of patients with sinonasal tumors treated with modern radiotherapy. The results showed favorable disease control rate and acceptable toxicity profile in patients treated with modern radiotherapy.
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
(2023)
Article
Oncology
Sebastian Regnery, Chiara de Colle, Chukwuka Eze, Stefanie Corradini, Christian Thieke, Oliver Sedlaczek, Heinz-Peter Schlemmer, Julien Dinkel, Ferdinand Seith, Annette Kopp-Schneider, Clarissa Gillmann, C. Katharina Renkamp, Guillaume Landry, Daniela Thorwarth, Daniel Zips, Claus Belka, Oliver Jaekel, Juergen Debus, Juliane Hoerner-Rieber
Summary: This study aims to explore the clinical feasibility of MR-guided online adaptive radiotherapy for locally-advanced non-small-cell lung cancer (LA-NSCLC). The study will be conducted at three German university hospitals, with 30 patients receiving MR-guided online adaptive radiotherapy along with chemotherapy. The primary endpoints are successful completion of online adapted fractions and on-table time.
RADIATION ONCOLOGY
(2023)
Article
Oncology
C. De-Colle, A. Kirby, N. Russell, S. F. Shaitelman, A. Currey, E. Donovan, E. Hahn, K. Hang, C. N. Anandadas, F. Mahmood, E. L. Lorenzen, D. van den Bongard, M. L. Groot Koerkamp, A. C. Houweling, M. Nachbar, D. Thorwarth, D. Zips
Summary: Research in the field of local and locoregional breast cancer radiotherapy aims to optimize treatment outcomes and minimize treatment-related toxicities. Adaptive radiotherapy (ART) takes into account anatomical variations in the target area and organs at risk (OARs) during treatment, resulting in re-optimized treatment plans. This review examines the use of MR-guided and CT-guided ART in different clinical scenarios for breast cancer patients and discusses their advantages and challenges.
CLINICAL AND TRANSLATIONAL RADIATION ONCOLOGY
(2023)
Article
Computer Science, Software Engineering
A. Wentzel, C. Floricel, G. Canahuate, M. A. Naser, A. S. Mohamed, C. D. Fuller, L. van Dijk, G. E. Marai
Summary: In this study, we developed a modeling system called DASS to support the development and validation of predictive models for estimating long-term toxicities related to radiotherapy doses in head and neck cancer patients. DASS incorporates human-in-the-loop visual steering, spatial data, and explainable AI to augment domain knowledge with automatic data mining. We demonstrated DASS by developing two practical clinical stratification models and received feedback from domain experts.
COMPUTER GRAPHICS FORUM
(2023)
Article
Otorhinolaryngology
Kevin J. Contrera, Jack Phan, Steven G. Waguespack, Mohammed Aldehaim, Xin Wang, Tze Yee Lim, Dianna B. Roberts, C. David Fuller, Michael T. Spiotto, Shaan M. Raza, Franco DeMonte, Ehab Y. Hanna, Shirley Y. Su
Summary: This study investigated the prevalence of pituitary dysfunction in adults who underwent anterior skull base radiation. The results showed that 46% of patients had abnormal pituitary hormone levels, with 12% requiring treatment for symptomatic abnormalities. The most common abnormalities were hyperprolactinemia, central hypothyroidism, and central hypogonadism. The study also found a dose-dependent association between hormonal dysfunction and radiation.
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK
(2023)
Article
Oncology
Haidara Almansour, Fritz Schick, Marcel Nachbar, Saif Afat, Victor Fritz, Daniela Thorwarth, Daniel Zips, Felix Bertram, Arndt-Christian Mueller, Konstantin Nikolaou, Ahmed E. Othman, Daniel Wegener
Summary: This study investigated the dynamics of lesion ADC in patients with prostate cancer undergoing MR-guided radiation therapy on a 1.5T MR-Linac. The results showed a significant increase in lesion ADC during radiotherapy, suggesting that lesion ADC can be used as a biomarker for evaluating treatment response. However, the absolute ADC values calculated by the algorithm of the MR-Linac manufacturer showed systematic deviations from values obtained on a diagnostic 3T MRI system.
RADIOLOGY AND ONCOLOGY
(2023)
Article
Oncology
Mirjam Renovanz, Sylvia C. Kurz, Johannes Rieger, Bianca Walter, Hannes Becker, Hanni Hille, Paula Bombach, David Rieger, Lucia Grosse, Lara Haeusser, Marco Skardelly, Daniel J. Merk, Frank Paulsen, Elgin Hoffmann, Cihan Gani, Manuela Neumann, Rudi Beschorner, Olaf Riess, Cristiana Roggia, Christopher Schroeder, Stephan Ossowski, Sorin Armeanu-Ebinger, Axel Gschwind, Saskia Biskup, Martin Schulze, Falko Fend, Stephan Singer, Lars Zender, Claudia Lengerke, Sara Yvonne Brucker, Tobias Engler, Andrea Forschner, Arnulf Stenzl, Oliver Kohlbacher, Sven Nahnsen, Gisela Gabernet, Sven Fillinger, Benjamin Bender, Ulrike Ernemann, Oeznur Oener, Janina Beha, Holly Sundberg Malek, Yvonne Moeller, Kristina Ruhm, Marcos Tatagiba, Jens Schittenhelm, Michael Bitzer, Nisar Malek, Daniel Zips, Ghazaleh Tabatabai
Summary: This study investigates the feasibility and clinical utility of molecular profiling and targeted therapy in patients with advanced tumors in the nervous system. The results show that 93.1% of patients can receive biomarker-guided therapy recommendations, with treatment initiated in 22.6% of cases and a progression-free survival ratio >1.3 observed in 31.3% of patients. These findings support the clinical efficacy of biomarker-guided therapies in neuro-oncology patients and have implications for future clinical trials and care.
NEURO-ONCOLOGY ADVANCES
(2023)
Article
Computer Science, Interdisciplinary Applications
Temitayo Ajayi, Seyedmohammadhossein Hosseinian, Andrew J. Schaefer, Clifton D. Fuller
Summary: This paper presents a mixed-integer program for optimizing combination chemotherapy. The model incorporates various important operational constraints and controls treatment toxicity and white blood cell count for dose adjustments. Chance constraints are proposed to address the uncertainty of tumor heterogeneity and ensure reaching an operable tumor size with a high probability in a neoadjuvant setting.
INFORMS JOURNAL ON COMPUTING
(2023)