UW Health Among First to Offer MRI-Guided Radiotherapy

Madison, Wisconsin - Dennis Bricco, 58, is among the first in the world to benefit from new radiotherapy technology, now available at UW Health. Created by ViewRay, the system uses real-time magnetic resonance imaging (MRI) to guide the radiotherapy instead of CT scans that picture the tumor before treatment begins.


"For the first time we are able to see a patient's tumors and internal organs in real time, as we are treating the patient," says radiation oncologist Michael Bassetti, MD.


During the course of his treatment for metastatic colorectal cancer, Dennis has undergone surgery, cryoablation, and other procedures.


"After multiple invasive treatments to his liver, a precise, non-invasive option is exactly what Dennis needed," says medical oncologist Sam Lubner, MD.


Clinicians at UW Health are using this technology for complex patients like Dennis who have tumors that move as they are being treated. These types of tumors are typically found in the lung, liver, GI tract and thorax.


The real time technology allows clinicians to clearly see the target tumor and closely monitor the radiation dose location. The system scans the patient's anatomy and adjusts for motion in real time, delivering radiation only when the tumor is located exactly where it should be. If the tumor moves beyond the pre-defined area, the beam automatically pauses, resuming when the target moves back into the area.


"One of the key advantages is that this technology allows us to 'view and gate' the radiation delivery in real time, so we are less likely to expose normal tissues while delivering full dose to the tumor," says Paul Harari, MD, Chair of the Department of Human Oncology.


The system can quickly compare the pre-treatment MRI image to the planning image and predict the dose to be delivered. Clinicians can then determine whether organ motion or other changes in the patient's anatomy might result in sub-optimal treatment. The plan can be adapted to re-optimize the dose in several minutes.


The continuous imaging throughout the treatment allows the shape of the beam to be adapted as needed to deliver the prescribed treatment. Over the course of therapy, if the patient loses weight, the tumor changes shape or the patient's anatomy shifts from day to day – physicians can adjust the radiation treatment to these changes.


This technology is currently available at only three institutions: UW Health, UCLA and Barnes-Jewish Hospital in St. Louis.


Dr. Bassetti says the UW Health team is developing clinical protocols to track data from patients like Dennis to compare their outcomes with conventional non-MRI based treatments.


Date Published: 01/07/2015

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