Highlights
- •Daily imaging is feasible on integrated MRI-guided radiotherapy (MRIgRT) systems.
- •This will advance quantitative imaging biomarker (QIB) research in oncology.
- •QIBs have the potential to personalise radiotherapy treatment.
- •This paper presents a roadmap towards clinical use of QIBs on MRIgRT systems.
- •Technical validation should be integrated in clinical trials on MRIgRT systems.
Abstract
Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential
to be used for the personalised treatment of cancer patients. However, large-scale
data are missing to validate their added value in clinical practice. Integrated MRI-guided
radiotherapy (MRIgRT) systems, such as hybrid MRI-linear accelerators, have the unique
advantage that MR images can be acquired during every treatment session. This means
that high-frequency imaging of QIBs becomes feasible with reduced patient burden,
logistical challenges, and costs compared to extra scan sessions. A wealth of valuable
data will be collected before and during treatment, creating new opportunities to
advance QIB research at large. The aim of this paper is to present a roadmap towards
the clinical use of QIBs on MRIgRT systems. The most important need is to gather and
understand how the QIBs collected during MRIgRT correlate with clinical outcomes.
As the integrated MRI scanner differs from traditional MRI scanners, technical validation
is an important aspect of this roadmap. We propose to integrate technical validation
with clinical trials by the addition of a quality assurance procedure at the start
of a trial, the acquisition of in vivo test-retest data to assess the repeatability, as well as a comparison between QIBs
from MRIgRT systems and diagnostic MRI systems to assess the reproducibility. These
data can be collected with limited extra time for the patient. With integration of
technical validation in clinical trials, the results of these trials derived on MRIgRT
systems will also be applicable for measurements on other MRI systems.
Keywords
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Article info
Publication history
Published online: June 15, 2021
Accepted:
April 27,
2021
Received:
April 23,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
