The British journal of radiology | 2019
Guidance on the use of MRI for treatment planning in radiotherapy clinical trials.
Abstract
The aim of this article is to propose meaningful guidance covering the technical and safety issues involved when designing or conducting radiotherapy (RT) clinical trials that use magnetic resonance imaging (MRI) for treatment planning. The complexity of imaging requirements will depend on the trial aims, design and MRI methods used.The use of MRI within the radiotherapy pathway is becoming more prevalent and clinically appropriate as access to MRI increases, treatment planning systems (TPS) become more versatile and potential indications for MRI-planning in RT are documented. Novel MRI-planning opportunities are often initiated and validated within clinical trials.The guidance in this document is intended to assist researchers designing radiotherapy clinical trials involving MRI to provide sufficient information about the appropriate methods used for image acquisition, post-processing and quality assurance (QA) to complete MRI to consistent standards at participating sites. It has been produced in collaboration with the National Radiotherapy Trials Quality Assurance Group (RTTQA).As the use of MRI in radiotherapy is developed, it is highly recommended for researchers writing clinical trial protocols to include imaging guidance as part of their clinical trial documentation covering the trial-specific requirements for MRI procedures. Many of the considerations and recommendations in this guidance may well apply to MR-guided treatment machines, where clinical trials will be crucial. Similarly, many of these recommendations will apply to the general use of MRI in radiotherapy, outside of clinical trials.This document contains a large number of recommendations, not all of which will be relevant to any particular trial. Designers of radiotherapy clinical trials must therefore take this into account. They must also use their own judgement as to the appropriate compromise between accessibility of the trial and its technical rigour.