title: Review of potential improvements using MRI in the radiotherapy workflow.
abstract: The goal of modern radiotherapy is to deliver a lethal amount of dose to tissue volumes that contain a significant amount of tumour cells while sparing surrounding unaffected or healthy tissue. Online image guided radiotherapy with stereotactic ultrasound, fiducial-based planar X-ray imaging or helical/conebeam CT has dramatically improved the precision of radiotherapy, with moving targets still posing some methodical problems regarding positioning. Therefore, requirements for precise target delineation and identification of functional body structures to be spared by high doses become more evident. The identification of areas of relatively radioresistant cells or areas of high tumor cell density is currently under development. This review outlines the state of the art of MRI integration into treatment planning and its importance in follow up and the quantification of biological effects. Finally the current state of the art of online imaging for patient positioning will be outlined and indications will be given what the potential of integrated radiotherapy/online MRI systems is.
authors.affiliation: Department of Medical Physics, Azienda Ospedale Niguarda Ca' Granda, Milano, Italy. Electronic address: alberto.torresin@unimi.it.
authors.forename: Alberto
authors.initials: A
authors.lastname: Torresin
authors.affiliation: Department of Medical Physics, Azienda Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Brambilla
authors.affiliation: Department of Medical Physics, Azienda Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Angelo F
authors.initials: AF
authors.lastname: Monti
authors.affiliation: Department of Medical Physics, Azienda Ospedale Niguarda Ca' Granda, Milano, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Moscato
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, University Hospital of the RWTH Aachen, Germany; Department of Neuroradiology, University Medical Center Mannheim, Germany.
authors.forename: Marc A
authors.initials: MA
authors.lastname: Brockmann
authors.affiliation: Computer Assisted Clinical Medicine, University Medical Center Mannheim, Germany.
authors.forename: Lothar
authors.initials: L
authors.lastname: Schad
authors.affiliation: Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Germany.
authors.forename: Ulrike I
authors.initials: UI
authors.lastname: Attenberger
authors.affiliation: Department of Radiation Oncology, University Medical Center Mannheim, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Lohr
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D009369:Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D059351:Organ Sparing Treatments / Q000379:methods*; D011379:Prognosis; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D057188:Workflow
keywords: Bestrahlungsplanung; Integration; MRI; Online-Imaging; integration; online imaging; treatment planning