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@ARTICLE{Otazo:166583,
author = {R. Otazo and P. Lambin and J.-P. Pignol and M. E. Ladd$^*$
and H.-P. Schlemmer$^*$ and M. Baumann$^*$ and H. Hricak},
title = {{MRI}-guided {R}adiation {T}herapy: {A}n {E}merging
{P}aradigm in {A}daptive {R}adiation {O}ncology.},
journal = {Radiology},
volume = {298},
number = {2},
issn = {1527-1315},
address = {Oak Brook, Ill.},
publisher = {Soc.},
reportid = {DKFZ-2020-03026},
pages = {248-260},
year = {2021},
note = {2021 Feb;298(2):248-260},
abstract = {Radiation therapy (RT) continues to be one of the mainstays
of cancer treatment. Considerable efforts have been recently
devoted to integrating MRI into clinical RT planning and
monitoring. This integration, known as MRI-guided RT, has
been motivated by the superior soft-tissue contrast, organ
motion visualization, and ability to monitor tumor and
tissue physiologic changes provided by MRI compared with CT.
Offline MRI is already used for treatment planning at many
institutions. Furthermore, MRI-guided linear accelerator
systems, allowing use of MRI during treatment, enable
improved adaptation to anatomic changes between RT fractions
compared with CT guidance. Efforts are underway to develop
real-time MRI-guided intrafraction adaptive RT of tumors
affected by motion and MRI-derived biomarkers to monitor
treatment response and potentially adapt treatment to
physiologic changes. These developments in MRI guidance
provide the basis for a paradigm change in treatment
planning, monitoring, and adaptation. Key challenges to
advancing MRI-guided RT include real-time volumetric
anatomic imaging, addressing image distortion because of
magnetic field inhomogeneities, reproducible quantitative
imaging across different MRI systems, and biologic
validation of quantitative imaging. This review describes
emerging innovations in offline and online MRI-guided RT,
exciting opportunities they offer for advancing research and
clinical care, hurdles to be overcome, and the need for
multidisciplinary collaboration.},
subtyp = {Review Article},
cin = {E020 / E220},
ddc = {610},
cid = {I:(DE-He78)E020-20160331 / I:(DE-He78)E220-20160331},
pnm = {315 - Bildgebung und Radioonkologie (POF4-315)},
pid = {G:(DE-HGF)POF4-315},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33350894},
doi = {10.1148/radiol.2020202747},
url = {https://inrepo02.dkfz.de/record/166583},
}