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An MR-linac is a radiation machine with an MRI scanner built in, so images taken during setup let the plan be re-optimised in minutes to that day's anatomy. It allows tighter margins and higher doses in pancreatic and prostate cancer, but treatment is slow and costly, and whether daily adaptation improves cure rates rather than only toxicity is unproven.
An MR-linac integrates an MRI scanner into the treatment machine, acquiring images during setup and delivery so the plan can be re-optimised in minutes to the anatomy of that day. Elekta Unity and ViewRay MRIdian enable daily online adaptation and gating on soft-tissue targets such as pancreas, prostate, and liver, allowing tighter margins and dose escalation in pancreas. The MIRAGE trial showed reduced toxicity in prostate SBRT with MR guidance. Biology-guided radiotherapy (RefleXion, PET-guided) is a parallel approach that tracks the tumour's metabolic signal instead. Slow throughput and cost are the practical limits, and whether daily adaptation improves cure rates rather than only toxicity is still being tested. The simple version is a radiation machine with an MRI inside it.
Integrated MRI acquires images during setup and delivery; plan re-optimised in minutes.
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Query for this technology: (TITLE:"MR-linac" OR ABSTRACT:"MR-linac" OR TITLE:"MR-guided radiotherapy" OR ABSTRACT:"MR-guided radiotherapy" OR TITLE:"adaptive radiotherapy" OR ABSTRACT:"adaptive radiotherapy"). Results are unfiltered search hits about MR-guided adaptive radiotherapy, not a curated reading list.
Shares Respiratory motion management (4D-CT, gating, breath-hold, tracking), Ring-gantry linacs (Halcyon, Ethos), University of Wisconsin Carbone Cancer Center, Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony).
Shares Coverage-with-evidence registries for MR-guided and adaptive radiotherapy, Ring-gantry linacs (Halcyon, Ethos), AI auto-contouring and adaptive planning, Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony).
Shares A regulatory pathway for new radiotherapy techniques modelled on drug development, A translation fund for academic surgical devices and radiotherapy technology, American Society for Radiation Oncology, Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW).
Shares Adaptive radiotherapy (online replanning), Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW), Radiotherapy treatment planning and QA software, Elekta.
Shares Amar U. Kishan, CROSSFIRE, ViewRay (MRIdian), A regulatory pathway for new radiotherapy techniques modelled on drug development.
Shares Respiratory motion management (4D-CT, gating, breath-hold, tracking), Ring-gantry linacs (Halcyon, Ethos), Radiotherapy QA phantoms and dosimeters (Sun Nuclear, IBA Dosimetry, PTW), Elekta.
Shares Respiratory gating and tumour tracking systems (RPM, ABC, Calypso, Synchrony), In-room imaging for radiotherapy (cone-beam CT, ExacTrac, CT-on-rails, HyperSight), Linac, proton system and brachytherapy machine manufacturing, Radiotherapy.
Shares Core-funded radiotherapy trials infrastructure with central quality assurance, The Christie NHS Foundation Trust, The Royal Marsden, Surgery and radiotherapy cure most, get least.
Open-source projects that implement or serve this technology, from OnCo's own catalogue: licence and last activity as the repository reported them on the day of the fetch. Listing is not endorsement; check the licence before reuse and the validation before clinical use.
Code from the SynthRAD challenge on synthesising CT from MRI and CBCT for MR-only and adaptive radiotherapy.