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BRIEF RESEARCH REPORT article
Front. Oncol.
Sec. Radiation Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1569428
This article is part of the Research Topic Implementation and Use of Motion Management Systems for Radiotherapy View all 3 articles
Real-time tracking of lung tumors using a 1.5T Elekta Unity MR-Linac: First clinical experiences
Provisionally accepted- University of Iowa Health Care, Iowa City, United States
There is a growing interest in the application of MRI-guided adaptive radiotherapy (MRIgART) to improve the treatment of lung tumors. Motion management plays a central role to better localize these tumors and minimize toxicities to surrounding healthy tissue. Elekta recently released their comprehensive motion management system for the Unity 1.5T MR-Linac, enabling real-time tracking and predictive gating using MR cine imaging during treatment. We report our first clinical experiences using this gating technology to treat patients with central lung tumors adjacent to critical structures on the Unity MR-Linac using both conventional and SBRT fractionations. A surrogate structure was tracked if the primary target could not be visualized. Beam gating was automatically performed if the system detected the target moving outside of the defined gating envelope, which was set as the planning target volume. Integrating this technology has profoundly impacted our MRIgART program; we have been able to treat challenging lung tumor patients with greater precision and have begun to reduce our PTV margins, leading to improved dose sparing of nearby critical structures.
Keywords: Adaptive, MRLinac, Gating, Lung, motion management
Received: 31 Jan 2025; Accepted: 19 Mar 2025.
Copyright: © 2025 Smith, Allen, Rusu, St-Aubin and Hyer. 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:
Blake Smith, University of Iowa Health Care, Iowa City, United States
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