MR-linac delivers first treatment at GenesisCare Oxford

The UK’s first ViewRay MRIdian MR-linac has gone live at GenesisCare Oxford and delivered its first fully online-adaptive treatments to patients in December.

Working non-stop for two months meant that the project team completed the fastest installation and commissioning of a MRIdian linac so far and met the go-live date.

Senior radiographer Tejal Patel explained that this is the first MRIdian linac in the global GenesisCare network. “The treatment team of doctors, physicists, dosimetrists and radiographers undertook extensive training at centres around the world. Clinical commissioning required the development of new treatment documentation, which went through a rigorous peer-review process by internal and external subject matter experts.

“The roll-out went smoothly, with the first patients completing their 5# SABR prostate treatment regimes in December. Further SABR treatment indications were introduced throughout January, including lung, liver and pancreas.”

MRI provides exquisite soft tissue contrast not only to confirm patient positioning, but also to enable accurate online daily adaptation of the treatment plan. Additionally, real-time MR images are acquired during treatment delivery to assess intra-fraction tumour motion and provide automated beam gating.

For tumours in the abdomen and thorax, breath-hold techniques are required to ensure correct tumour positioning and OAR sparing . An in-room monitor allows the patient to track their breathing cycle and coach themselves into the correct breath-hold position and hold for a duration that they feel comfortable with.

Abdominal tumour tracking (yellow contour tracking the tumour and red contour depicting the boundary for the gating).

GenesisCare plans to introduce a network of several MR-linacs throughout the UK, as well as further machines across its worldwide network. GenesisCare Oxford will become a reference site for MRIdian training for future teams. It is working in partnership with the University of Oxford to conduct research in the area of MR-guided treatment and build an evidence base for future practice.

Picture: MR-linac team members Donna Hughes, Versha Dhanda, Ben George, Tejal Patel and Ali Friis.

Published on pages 1 and 2 of the February 2020 issue of RAD Magazine.