Clinical experience of MR-only radiotherapy for prostate cancer

More than 47,500 men are diagnosed with prostate cancer each year in the UK. More than 30% of them will receive radiotherapy as part of their primary cancer treatment. Accurate radiotherapy depends on high quality imaging to localise the cancer and design the radiation treatment. Conventionally, prostate radiotherapy is planned using CT imaging. However, CT […]More than 47,500 men are diagnosed with prostate cancer each year in the UK. More than 30% of them will receive radiotherapy as part of their primary cancer treatment. Accurate radiotherapy depends on high quality imaging to localise the cancer and design the radiation treatment. Conventionally, prostate radiotherapy is planned using CT imaging. However, CT suffers from poor soft tissue contrast, which can make distinguishing the prostate boundaries difficult. MR imaging has superior soft tissue contrast and has demonstrated reduced variability in prostate target delineation. However, MR images, unlike CT, cannot be used directly for radiotherapy dose calculations, which are essential in the radiotherapy planning process. Acquiring both MR and CT scans and registering them together for radiotherapy planning combines accurate MR-based target delineation with CT-based radiotherapy dose calculations and on-treatment verification. This approach, however, has downsides including uncertainty in the MR-CT registration due to different bladder and bowel filling between the two images, as well as increased resource burden on patient and hospital.

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