Abstract
Radiotherapy is an integral component of head/neck squamous cell carcinomas (HNSCCs) treatment, and technological developments including advances in image-guided radiotherapy over the past decades have offered improvements in the technical treatment of these cancers. Integration of magnetic resonance imaging (MRI) into image guidance through the development of MR-guided radiotherapy (MRgRT) offers further potential for refinement of the techniques by which HNSCCs are treated. This article provides an overview of the literature supporting the current use of MRgRT for HNSCC, challenges with its use, and developing research areas.
Highlights
The delivery of radiotherapy (RT) for cancer treatment was revolutionized in the1990s with the development of computed tomography (CT)-based three-dimensional RT planning and image-guided RT (IGRT)
Modern approaches to RT for head and neck squamous cell carcinomas (HNSCCs) include salivary-sparing [1,2] and pharyngeal constrictor-sparing [3,4] approaches, which require more conformal dose distributions made possible by the improvement in technology used to delivery radiotherapy
Two machines are Food and Drug Administration (FDA) approved and commercially available—one with a 0.35 Tesla (T) Magnetic resonance imaging (MRI) (ViewRay MRIdian) and and commercially available—one with a 0.35 Tesla (T) MRI (ViewRay MRIdian) and one with a 1.5 T MRI (Elekta Unity). These machines show promise in improving IGRT, with a 1.5 T MRI (Elekta Unity). These machines show promise in improving IGRT, with their better delineation of soft tissue relative to cone beam computed tomography (CBCT); significant work is ne their better delineation of soft tissue relative to CBCT; significant work is needed to further the clinical use of MR-guided radiotherapy (MRgRT) for HNSCC
Summary
The delivery of radiotherapy (RT) for cancer treatment was revolutionized in the. 1990s with the development of computed tomography (CT)-based three-dimensional RT planning and image-guided RT (IGRT). 1990s with the development of computed tomography (CT)-based three-dimensional RT planning and image-guided RT (IGRT). This allowed for better targeting of tumors and areas at risk while sparing nearby normal tissues. The development of cone beam computed tomography (CBCT) around 2000 ushered in an era of further precision in RT, allowing for dose escalation aiming to eradicate tumors while sparing nearby tissues. Modern approaches to RT for HNSCC include salivary-sparing [1,2] and pharyngeal constrictor-sparing [3,4] approaches, which require more conformal dose distributions made possible by the improvement in technology used to delivery radiotherapy. Integration of CBCT into RT has allowed for better visualization of changes seen during the course of treatment for HNSCC, which typically lasts 6–7 weeks.
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