Nanoscale Colloquium

The Australian MRI-Linac program: Transforming cancer treatment through real-time anatomic and functional image guided adaptive radiotherapy.

Abstract: Radiation therapy is used to treat 40% of cancer patients in Australia. A significant problem with current radiation therapy is that, due to patients’ musculo-skeletal, respiratory, cardiac, gastro-intestinal and genito-urinary systems cancers move during radiotherapy. Consequently, even though the patients’ anatomy is known prior to treatment, radiation beams can be off-target during treatment, missing the cancer and instead striking healthy tissue. This mistargeting results in reduced tumour control and increased treatment-related toxicity.

To solve this problem, we are building an integrated MRI-linear accelerator ‘MRI-linac’ in which the cancer will be able to be imaged as it is moving. Patient treatments will be adapted in real-time so that the radiation is always targeting the cancer rather than healthy organs. We estimate, with evidence-based justification, that MRI-linac treatments will demonstrate measurable increases in overall survival and measureable decreases in toxic side-effects.

There are three broad themes of the Australian MRI-Linac program focusing on (1) the ongoing development of the MRI-linac system, (2) the basic scientific and translation studies based around the MRI-linac, and (3) investigations into physiologic targeting capabilities to identify and deliver higher radiation doses to the most treatment-resistant cancer sub-volumes.

Acknowledgements: NHMRC Program Grant 1036078.