Why SMART ?
For 40% of people with cancer, radiation therapy is effective in shrinking and destroying the tumour or cancer cells. This treatment effectiveness is second after surgery at 49% and ahead of chemotherapy at 11%. SMART treatments are shifting the paradigm by delivering therapy on an MRI guided Linac from Viewray called MRIdian, a combination of a state-of-the-art, 6MV Linear accelerator with a low field magnetic resonance imaging (MRI) scanner. The combination allows users to track the movements of a tumour as they occur in real-time, switching the beam off when the tumour moves or important healthy tissue enters the radiation path and back on again automatically when it is appropriate to begin re-treating. In effect “Taking the Blindfold Off” and ensuring the dose is being delivered to the disease site.
The MRIdian now allows clinicians to deliver higher doses in fewer fractions with less complications due to confidence in the latest conformal and adaptive techniques.
SMART is novel, but not niche; over 45 different disease sites have been treated with this technique effectively, meaning more patients could benefit from SMART treatments than any other type of radiotherapy modality.
Other RT vendors have tried to come up with ways to improve the targeting of a radiation beam by approximating the tumour location with external markers or implanted fiducials—methods that may be invasive or may expose the patient to additional ionizing radiation from imaging devices. Even with these methods, it still isn’t possible to see what’s going on inside the patient during the treatment.
A Revolution of Targeting in Treatment
ViewRay’s MRI guided RT system is designed to solve this problem. Using a unique combination of MR imaging and radiation therapy delivery technologies, the MRIdian and MRIdian Linac systems provide continuous soft-tissue imaging while the treatment beam is on—along with the tools to refine the target and re-optimize the dose while the patient is on the treatment table.
The MRIdian® system supports advanced radiation therapy techniques such as image-guided radiation therapy (IGRT) and stereotactic radiation therapy and radiosurgery (SRT and SRS), as well as 3D conformal and intensity-modulated radiation therapy (IMRT). With its MRI capabilities, the system is intended to provide stereotactic radiosurgery and precision radiation therapy for lesions, tumours, and conditions anywhere in the body where radiation treatment is indicated.
MRIdian design specifically enables the treatment of organs that are likely to move significantly during therapy, as lung tumours move when patients breathe. The ability to see soft tissue and adjust to its motion in real time can help assure clinicians that they are delivering the intended dose of radiation and avoiding normal tissues and critical structures, such as the spinal cord. Along with lung cancer, ViewRay technology may be beneficial in head and neck, prostate, breast, bladder, and other types of cancer where tumour and organ motion can affect treatments.
For more information click here: www.viewray.com/treatment
Training and Research
Training and Research-please contact firstname.lastname@example.org for more information on our training and research programs
Compelling Early Pancreatic Cancer Data with ViewRay’s MRIdian System Presented at ESTRO 36
Presentations Also Highlighted Speed and Benefit of On-Table Adaptive Therapy in Routine Clinical Use
ViewRay have announced highlights from ESTRO 36, the annual meeting of the European Society for Radiotherapy and Oncology, which featured broad clinical experience with the company’s MRIdian System, including compelling early data on its use in pancreatic cancer.
A presentation by Sasa Mutic, Ph.D., from Washington University School of Medicine in St. Louis, highlighted early retrospective multi-institutional data on pancreatic cancer treatments with MRIdian at University of California, Los Angeles (UCLA) Health System; University of Wisconsin Carbone Cancer Center; VU University Medical Center; and Washington University School of Medicine. The study compared SBRT treatments with and without on-table adaptive dose reshaping and found that delivering a higher biological dose, enabled by MRI-guided on-table adaptive radiotherapy, may lead to improved survival in locally advanced pancreatic cancer.
A second clinical presentation on pancreatic cancer treatment with MRIdian was given by Anna Bruynzeel, M.D., Ph.D., from VU University Medical Center, focusing on their single-institutional experience. Early results illustrated MRIdian’s ability to deliver high doses with low toxicity, despite the proximity of the duodenum, through the use of daily plan adaptation and real-time tracking.
Following the promising data presented at ESTRO, ViewRay plans to support a multi-institutional single-arm prospective clinical trial in unresectable pancreatic cancer to demonstrate the benefits of MRIdian’s daily on-table adaptive SBRT and real-time tissue tracking capabilities, with a focus on toxicity, local control and overall survival outcomes.
Clinical Benefits of On-Table Adaptive Treatment
In a talk in ViewRay’s booth, Frank Lagerwaard, M.D. Ph.D. of VU University Medical Center highlighted the excellent image quality of MRIdian and reported that on-table adaptation takes an average of less than fifteen minutes. Dr. Lagerwaard discussed the benefits of on-table adaptive treatments in a variety of cancers including pancreas, liver, kidney, lung, and prostate.
“We decided, from the very beginning, to leverage the benefits of MR guidance and MRIdian‘s integrated workflow to perform daily on-table adaptive treatments while using real-time MR tracking for every fraction,” said Dr. Lagerwaard. “With MRI-guidance and the ability to shape the dose on-table, we’re personalizing each treatment to ensure that the highest biologically effective dose is reaching the tumor and nearby healthy tissue and critical organs are spared, in an effort to improve patient outcomes. In our experience, this approach shows great promise, particularly in the treatment of pancreatic cancer.”
At a symposium titled “MRI-Guided RT with MRIdian: Perspectives from Installation to Clinical Use”, more than 400 attendees heard about the clinical experience at the first two European MRIdian centers, Gemelli ART in Rome and VU University Medical Center in Amsterdam, who are using on-table adaptive treatments on a daily basis.
Video highlights of select MRIdian presentations at ESTRO are available on ViewRay’s website at www.viewray.com/estro_2017.htm
For more information on the radiotherapy treatment process go to www.viewray.com/treatment
For more information on the latest Linac based product www.viewray.com/linac-system
The British Institute of Radiology Webinar on MR Guided Radiotherapy;
The MRIdian System The one-hour webinar featured presentation from Professor Andy Beavis PhD, Head of Radiation Physics and East Yorks NHS Hospitals Trust, Hull, UK.
Radiosurgery Society® Webinar on the UCLA Experience with MRI-Guided Radiation Therapy
The one-hour webinar featured presentations from two expert users of the MRIdian® System at the University of California, Los Angeles. Participants learned about the advantages of delivering stereotactic body radiotherapy (SBRT) under MRI-guidance for abdominal tumors. The topic of MRI-guided delivery of partial breast irradiation was also a featured discussion on the webinar.
Radiosurgery Society® Webinar on MR-Guided Stereotactic Body Radiation Therapy
The one-hour webinar featured users of the MRIdian® System, discussing their clinical experience with the world’s first and only MRI-guided radiation therapy system that images and treats cancer patients simultaneously. The event drew nearly 200 participants interested in learning more about MR-guided stereotactic body radiotherapy (SBRT), the treatment of cancer using higher doses of radiation in a shorter course of therapy than traditional radiation therapy, delivered under MRI guidance to enable soft-tissue visualization and on-table adaptive treatments.
MR Guided Soft Tissue Tumor Tracking: How real-time visualization is changing Radiation Therapy
This one-hour webinar will feature expert users of the MRIdian® system – the world’s first and only MRI-guided radiation therapy system that images and treats patients simultaneously – discussing their clinical experience. From the University of Wisconsin School of Medicine, John Bayouth, Ph.D., Professor and Chief of Physics will present an overview of the technology from a physics perspective including real-time tumor tracking and QA considerations. His colleague Michael Bassetti, M.D., Ph.D, Assistant Professor of Radiation Oncology, will discuss the benefits of MR-guidance in radiation therapy, including clinical case examples using real time MR-tracking and areas of current research.
Siteman Cancer Center Webinar
Watch the Siteman Cancer Center at Barnes Jewish Hospital and Washington University School of Medicine Webinar to learn about the world’s first MRI-Guided Radiation Therapy Program.
Practical implementation of MR-guided RT: pancreatic SBRT as an example site
Anna Bruynzeel, MD PhD, Dept. of Radiation Oncology
VU University medical center Amsterdam, The Netherlands
Pre-conditions and hurdles in initiating a MR-guided (adaptive) radiation therapy programme: Lessons learned.
Dr Frank Lagerwaard Radiation Oncologist; MD, PhD
Radiation Oncologist at the VU University Medical Center in Amsterdam, the Netherlands
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