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An MR-linac is a radiation machine with an MRI scanner built in, so images taken during setup let the plan be re-optimised in minutes to that day's anatomy. It allows tighter margins and higher doses in pancreatic and prostate cancer, but treatment is slow and costly, and whether daily adaptation improves cure rates rather than only toxicity is unproven.
An MR-linac integrates an MRI scanner into the treatment machine, acquiring images during setup and delivery so the plan can be re-optimised in minutes to the anatomy of that day. Elekta Unity and ViewRay MRIdian enable daily online adaptation and gating on soft-tissue targets such as pancreas, prostate, and liver, allowing tighter margins and dose escalation in pancreas. The MIRAGE trial showed reduced toxicity in prostate SBRT with MR guidance. Biology-guided radiotherapy (RefleXion, PET-guided) is a parallel approach that tracks the tumour's metabolic signal instead. Slow throughput and cost are the practical limits, and whether daily adaptation improves cure rates rather than only toxicity is still being tested. The simple version is a radiation machine with an MRI inside it.
Integrated MRI acquires images during setup and delivery; plan re-optimised in minutes.
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Query for this technology: (TITLE:"MR-linac" OR ABSTRACT:"MR-linac" OR TITLE:"MR-guided radiotherapy" OR ABSTRACT:"MR-guided radiotherapy" OR TITLE:"adaptive radiotherapy" OR ABSTRACT:"adaptive radiotherapy"). Results are unfiltered search hits about MR-guided adaptive radiotherapy, not a curated reading list.
Shares Amar U. Kishan, CROSSFIRE, ViewRay (MRIdian), A regulatory pathway for new radiotherapy techniques modelled on drug development and the tag precision.
Shares American Society for Radiation Oncology, European Society for Radiotherapy and Oncology, Siteman Cancer Center, Washington University, Linac, proton system and brachytherapy machine manufacturing and the tag precision.
Shares A translation fund for academic surgical devices and radiotherapy technology, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes, Surgery and radiotherapy cure most, get least and the tag precision.
Shares Biology-guided radiotherapy (RefleXion X1, SCINTIX), TUM Klinikum rechts der Isar / CCC München, UCLA Jonsson Comprehensive Cancer Center, Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes and the tag precision.
Shares Precision roadmap: margins measured in millimetres → tests that find a target → doses fitted to the person → precision that changes outcomes, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma and the tag precision.
Shares AI auto-contouring and adaptive planning, IMRT / IGRT (modern external beam) and the tag precision.
Shares Chris O'Brien Lifehouse, Champalimaud Foundation, Champalimaud Clinical Centre, Borderline resectable pancreatic ductal adenocarcinoma, Surgery and radiotherapy cure most, get least and the tag precision.
Shares Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma and the tag precision.
Open-source projects that implement or serve this technology, from OnCo's own catalogue: licence and last activity as the repository reported them on the day of the fetch. Listing is not endorsement; check the licence before reuse and the validation before clinical use.
Code from the SynthRAD challenge on synthesising CT from MRI and CBCT for MR-only and adaptive radiotherapy.
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