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MR-Guided Radiotherapy Demonstrates High Accuracy for Intracranial Stereotactic Radiosurgery

By MedImaging International staff writers
Posted on 04 Oct 2023

In the past, MR-guided radiotherapy (MRgRT) has shown enhanced capabilities for visualizing soft tissue and the usefulness of online adaptive radiotherapy for treating malignancies in the abdomen, chest, and pelvis compared to CT-based image-guided radiotherapy (IGRT). However, the application of MRgRT in treating intracranial cancers and especially in stereotactic radiosurgery (SRS) hasn't been extensively reported. Now, a new study has shown promising outcomes when using intracranial SRS for an MRgRT system.

The study, led by radiation oncology physicists at Miami Cancer Institute, part of Baptist Health South Florida (Coral Gables, FL, USA), demonstrated positive accuracy through an end-to-end hidden target test to quantify the imaging, planning, and delivery coincidence of an MR Linac system, ViewRay MRIdian. For their study, the team developed an in-house MR head phantom to simulate SRS procedures for brain tumors. Specifically, they simulated intracranial spherical targets, an irregularly shaped target, and a target abutting the brainstem. Their findings showed that the treatment could be delivered with up to 99% accuracy.

Following the successful demonstration of the ViewRay MRIdian's ability to deliver treatment within a 1 mm setup margin, this innovative technique is now being used to treat brain cancer patients at the Miami Cancer Institute. Using the onboard MR image guidance of the MR Linac system, the team has observed that a patient's tumor size could change during a short 3-fraction radiosurgery course. Remarkably, it is possible to visualize daily changes in tumor volume even during the short 3-fraction treatment period.

“This work enables the utilization of novel MR-guided radiotherapy technology for intracranial SRS, which has not been used with MR Linac systems,” said Nema Bassiri, Ph.D., radiation oncology physicist with Miami Cancer Institute. “In the future, we will see more studies that investigate the benefit of using MRIdian for stereotactic radiosurgery. This study will help advance the community by providing a blueprint to implement MR-guided SRS program for anyone who is interested in utilizing this treatment technique.”

“This research will help us better understand how these tumors change (including tumor progression), and the role of adaptive radiotherapy which adjusts the radiation to account for these changes to enable more precision,” said Kathryn Mittauer, Ph.D., lead physicist for the MR-guided radiation therapy program with Miami Cancer Institute. “In the field of radiation oncology, this is revolutionary as we assess the frequency of these anatomical changes and how this will inform us for even other radiation choices.”

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70 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

71 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

72 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

73 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (24.795532226562): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (41.007995605469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

82 (26.941299438477): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

83 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

84 (60.081481933594): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

88 (27.179718017578): SELECT show_live FROM jos_com_show_setting LIMIT 1

89 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

90 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (65.088272094727): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

99 (47.922134399414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

100 (56.982040405273): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

101 (49.829483032227): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

102 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

103 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

104 (365.9725189209): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

105 (328.06396484375): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

106 (309.94415283203): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294798830 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (562.90626525879): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

108 (342.84591674805): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

109 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

110 (40.054321289062): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

111 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

112 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

113 (60.081481933594): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

114 (35.04753112793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

115 (228.8818359375): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

116 (!!!!! 19947.052001953): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

117 (186.92016601562): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

118 (130.89179992676): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

119 (401.97372436523): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798835 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798835 AND type='deeppockets_item' AND published='1' LIMIT 1

120 (!!!!! 386600.97122192): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

121 (169.03877258301): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

122 (345.94535827637): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

123 (53.167343139648): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

124 (230.07392883301): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

125 (41.007995605469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

126 (180.00602722168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

127 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

128 (272.98927307129): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

129 (202.89421081543): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

130 (120.87821960449): SELECT name FROM jos_deeppockets WHERE id=212

131 (33.855438232422): SELECT name FROM jos_deeppockets WHERE id=212

132 (471.11511230469): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

133 (384.09233093262): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

134 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

135 (41.007995605469): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

136 (!!!!! 16308.069229126): TRUNCATE TABLE jos_trademed_module

137 (168.0850982666): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

138 (!!!!! 2858.1619262695): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294798835 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

139 (365.9725189209): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

140 (72.002410888672): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

141 (46.968460083008): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

142 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

143 (!!!!! 1079.0824890137): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

144 (53.167343139648): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

145 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

146 (51.021575927734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294798835 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294798835 AND type='deeppockets_item' AND published='1' LIMIT 1

147 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

148 (27.894973754883): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=0 or channel_id is null)

149 (34.093856811523): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

150 (108.95729064941): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

151 (37.908554077148): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294798835 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294798835 AND published='1' LIMIT 1

152 (136.13700866699): select jos_twitters.link from jos_twitters where cat=10

153 (28.848648071289): select jos_facebook.link from jos_facebook where cat=10

154 (28.133392333984): select jos_google_plus.link from jos_google_plus where cat=10

155 (25.98762512207): select jos_linkedin.link from jos_linkedin where cat=10

156 (316.14303588867): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

157 (!!!!! 3796.1006164551): insert into jos_banners_delta values (14615,'2025-04-29 22:43:13','18.190.239.193','view'),(14202,'2025-04-29 22:43:13','18.190.239.193','view'),(14203,'2025-04-29 22:43:13','18.190.239.193','view')

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