First-in-human technique translation of oxygen-enhanced MRI to an MR Linac system in patients with head and neck cancer
Michael J. Dubec, David L. Buckley, Michael Berks, Abigael Clough, John Gaffney, Anubhav Datta, Damien J. McHugh, Núria Porta, Ross A. Little, Susan Cheung, Christina J. Hague, C. Eccles, Peter Hoskin, Robert G. Bristow, Julian C. Matthews, Marcel van Herk, Ananya Choudhury, Geoff J.M. Parker, Andrew McPartlin, James P.B. O’Connor
Abstract
BACKGROUND AND PURPOSE: Tumour hypoxia is prognostic in head and neck cancer (HNC), associated with poor loco-regional control, poor survival and treatment resistance. The advent of hybrid MRI - radiotherapy linear accelerator or 'MR Linac' systems - could permit imaging for treatment adaptation based on hypoxic status. We sought to develop oxygen-enhanced MRI (OE-MRI) in HNC and translate the technique onto an MR Linac system. MATERIALS AND METHODS: ) between air and oxygen gas breathing phases. We compared results from 1.5 T diagnostic MR and MR Linac systems. RESULTS: magnitude and time-course trends were similar on both systems. CONCLUSION: We demonstrate first-in-human translation of volumetric, dynamic OE-MRI onto an MR Linac system, yielding repeatable hypoxia biomarkers. Data were equivalent on the diagnostic MR and MR Linac systems. OE-MRI has potential to guide future clinical trials of biology guided adaptive radiotherapy.