MRI-LINAC Adoption Expands as Centers Report Real-Time Precision Radiation Therapy
核心洞察
The University of New Mexico Comprehensive Cancer Center (搜索) has become the only facility in New Mexico offering an MRI-linear accelerator, one of roughly 100 worldwide.
UNM clinicians have treated 10 patients since April, including six with prostate cancer (搜索), three with pancreatic cancer (搜索) and one with rectal cancer (搜索).
RWJBarnabas Health (搜索) and Rutgers Cancer Institute (搜索) now operate two of New Jersey's three MR-Linac systems, at centers in New Brunswick and Livingston.
Radiation oncology programs are adopting MRI-guided linear accelerator technology to sharpen targeting and adapt treatment in real time, with two health systems detailing early clinical use and expanded patient access.
The University of New Mexico Comprehensive Cancer Center (搜索) is among approximately 100 treatment facilities worldwide—and the only one in New Mexico—to offer an MRI-linear accelerator (MRI-LINAC (搜索)), according to the center. The machine narrows the focus of radiation beams and is a key component of the center's recent expansion.
David Lee, MD, PhD, medical director of Radiation Oncology at the UNM Comprehensive Cancer Center, said the machine was installed in April and has since treated 10 cancer patients: six with prostate cancer (搜索), three with pancreatic cancer (搜索) and one with rectal cancer (搜索). Several more patients are already scheduled.
Real-Time Imaging and Adaptive Planning
The MR-Linac combines high-resolution magnetic resonance imaging with a linear accelerator, the device used to deliver radiation therapy, according to RWJBarnabas Health (搜索) and Rutgers Cancer Institute (搜索). Unlike conventional workflows that rely on imaging obtained before treatment, the system provides continuous, high-quality images of the tumor and surrounding healthy tissue during delivery.
That distinction matters because the body is not static. Breathing and digestion can shift organs and tumors, and a tumor may change in size, shape or position over a treatment course. This approach, known as adaptive radiation therapy, allows the plan to be personalized to a patient's anatomy at the time radiation is delivered.
At UNM, conventional treatment typically involves CT scans one to two weeks before radiation therapy, with oncologists planning treatment on a separate system. If changes occur between the initial scan and the scheduled session, a new CT scan may be required, potentially delaying care. Because MRI-LINAC (搜索) incorporates MRI, clinicians can image the tumor on the day of treatment and adjust the plan as needed.
"It allows us to see more clearly," Lee said. "It allows us to be much more precise and develop personalized therapy for our patients."
Motion Management and Tissue Sparing
Narrowing the treatment focus, even by a few millimeters, can reduce damage to surrounding tissues and organs. In prostate cancer (搜索), for example, changes in the bladder or bowel can shift the tumor's position. Traditionally, radiation oncologists account for this by treating a wider area around the tumor, which can expose more healthy tissue to radiation.
With MRI-LINAC (搜索), Lee said clinicians can monitor tumor movement during treatment. If the tumor moves outside the targeted area, the radiation beam automatically shuts off; once the tumor returns to the correct position, treatment resumes.
RWJBarnabas Health (搜索) lists greater precision, protection of healthy tissue, personalized treatment and potentially fewer treatment sessions among the potential benefits for appropriate patients. MR-Linac treatment is outpatient, requires no surgery or hospital stay, and carries no associated recovery or downtime from a procedure, according to the system. Sessions take slightly longer than traditional radiation appointments but offer increased precision and flexibility, per UNM.
Indications and Integration With Systemic Therapy
MRI-LINAC (搜索) is particularly useful for prostate cancer (搜索), according to UNM, and may also be used to treat cancers of the pancreas, liver and kidney, as well as limited metastatic disease (搜索). These cancers are often located near other organs and soft tissue, where minimizing radiation exposure to healthy structures is critical, Lee said.
For many early-stage prostate cancers, radiation therapy is an effective primary treatment option. Some patients may also receive chemotherapy or surgery in combination with radiation, with treatment decisions made collaboratively between patients and multidisciplinary teams. Lee noted that one of his patients with pancreatic cancer (搜索) is receiving chemotherapy and immunotherapy, with MRI-LINAC (搜索) therapy integrated between systemic treatments.
RWJBarnabas Health (搜索) emphasized that MR-Linac treatment is not necessary or appropriate for every patient; radiation oncologists consider the type, size and location of the cancer, as well as the overall treatment plan, when selecting a radiation approach. Its radiation oncology teams include physicians, nurses, radiation therapists, physicists and dosimetrists who develop individualized plans, and the length and number of sessions can vary from patient to patient.
Expanding Access
RWJBarnabas Health (搜索) and Rutgers Cancer Institute (搜索), New Jersey's only National Cancer Institute-designated Comprehensive Cancer Center, offer MR-Linac technology at the Jack & Sheryl Morris Cancer Center (搜索) in New Brunswick and the Melchiorre Cancer Center at Cooperman Barnabas Medical Center (搜索) in Livingston. The health system is home to two of New Jersey's three MR-Linac systems and is among a select group worldwide offering the technology.
The Livingston site is part of a new 137,000-square-foot outpatient cancer center serving as a northern destination for the organizations' integrated oncology services, bringing medical, surgical and radiation oncology together with advanced imaging, clinical research and supportive care.
"The MRI-LINAC (搜索) is a powerful armamentarium against cancer," Lee said. "It will allow us to deliver personalized, precision medicine and provide world-class care for our patients."