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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Radiation Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1441227
This article is part of the Research Topic Recent Developments in Pancreatic Cancer Radiotherapy - Vol II View all articles

Clinical experience with adaptive MRI guided pancreatic SBRT and the use of abdominal compression to reduce treatment volume

Provisionally accepted
William Ferris William Ferris Benjamin George Benjamin George Kristin Plichta Kristin Plichta Joseph Caster Joseph Caster Daniel Hyer Daniel Hyer Blake Smith Blake Smith Joel St-Aubin Joel St-Aubin *
  • The University of Iowa, Iowa City, United States

The final, formatted version of the article will be published soon.

    Introduction: This work presents a method to treat Stereotactic Body Radiation Therapy (SBRT) for pancreatic cancer on an MR-linac, using daily adaptation, real-time motion monitoring, and abdominal compression. Methods: The motion management and treatment planning process involves an MRI simulation with cine and 3D images, a computed tomography (CT) simulation with a breathhold CT and a 4DCT, pre-treatment verification and planning magnetic resonance imaging (MRI), and intrafraction MRI cine images. Results: The results from 26 patients were included in this work. Our motion management process results in consistent motion analyzed on the CT simulation, MRI simulation, and each treatment fraction. The liver dome was found to be an overestimate of tumor superior/inferior (SI) motion for most patients. Adding compression reduced SI liver dome motion by 6.2 mm on average. Clinical outcomes are similar to those observed in the literature. Conclusions: In this work we demonstrate how pancreatic SBRT can be successfully treated on an MR-linac using abdominal compression. This allows for an increased duty cycle compared to gating and/or breathhold techniques.

    Keywords: MR-linac, unity, compression, Adaptive, SBRT, Pancreatic Cancer

    Received: 30 May 2024; Accepted: 22 Jul 2024.

    Copyright: © 2024 Ferris, George, Plichta, Caster, Hyer, Smith and St-Aubin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Joel St-Aubin, The University of Iowa, Iowa City, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.