Elekta Unity MR-Linac. a breakthrough innovation that simultaneously generates magnetic resonance images (MRI) and delivers radiation

[Scout4answers]

anyone heard of this?

“It may also be an effective option for recurrent or previously treated tumors that we can’t treat with standard therapies.” — Dr. Tom Colonias

Real-Time Tumor Targeting: Police Officer First to Have New Radiotherapy Technology

January 14, 2022

Partner | Cancer Centers | <b>Allegheny Health Network</b>

A 59-year-old police officer with prostate cancer was treated with the Elekta Unity MR-Linac, a breakthrough innovation that simultaneously generates magnetic resonance images and delivers radiation directly to the tumors.

figure image

Russell Fuhrer, MD

Andrew “AC” Jones has long been a leader with a passion to serve others.

As a Pittsburgh Bureau of Police officer for the last 27 years, AC had dedicated his career to building relationships and trust in the community. He spent much of his career as a patrol officer in the North Side, getting to know residents to help make neighborhoods safer.

So when AC was diagnosed with prostate cancer last year, true to form, he volunteered to be the first patient treated with a new radiotherapy technology at the AHN Cancer Institute.

“I said, ‘Sign me up.’ Whatever it takes, and maybe it will help other people down the line.”

Last June, the 59-year-old was treated with the Elekta Unity MR-Linac. It’s a breakthrough innovation that simultaneously generates magnetic resonance images (MRI) and delivers radiation directly to the tumors. The AHN Cancer Institute is one of the few facilities in the country and the first in Pennsylvania to have the MR-Linac.

“We can see the tumor in real time as a patient moves and breathes, and we can adapt the radiation dose right there during the treatment,” said Russell Fuhrer, MD, system director for AHN Radiation Oncology. “Then each time a patient comes for treatment, we begin with all new MRIs for the most accurate radiation delivery”.

Now Cancer Can’t Hide

Unity MR-Linac is a hybrid technology that integrates an MRI scanner with a linear accelerator. It gives oncologists and physicists a sharp and well-defined view of the shape, size, and position of a tumor, so they can target the cancer with pinpoint precision.

“This technology lets us treat the cancer so precisely for each patient,” Dr. Fuhrer said. “We’ve never had such accuracy before in radiation oncology, so this is very exciting that patients could possibly experience fewer treatments, minimal side effects, and better outcomes.”

“We’ve never had such accuracy before in radiation oncology.” — Dr. Russell Fuhrer

AC had just five treatments over 10 days. He was tired after the first treatment and didn’t make it to work at the City of Pittsburgh Warrant Office that day. But he bounced back and was ready to go after the next four treatments.

“I do what I got to do and keep on living. The whole staff at Allegheny, they kept me upbeat and positive, and they were so good to me,” AC said. “Dr. Fuhrer and all of them have been a godsend.”

Dr. Fuhrer said it’s too early to say if AC is cancer-free, but added that the goal is to cure him without surgery.

“Men with prostate cancer typically have several treatment options,” Dr. Fuhrer explained. “Improving the precision and shortening the number of visits of radiotherapy with the Unity MR-Linac makes it a good option for more men.”

AC praised his three grown daughters, Meagan, Monica, and Paige, his siblings, friends, and colleagues for supporting him and keeping him optimistic through his cancer battle.

“The day I rang the bell down there, I got very emotional. It really is a blessing, and to have all of these people who support you, it’s something else.”

International Collaboration

The AHN Cancer Institute is part of an international research consortium to address how the MR-Linac could be used to improve patient survival and quality of life. The University of Texas MD Anderson Cancer Center and Memorial Sloan Kettering Cancer Center are two other U.S. facilities involved.

Patients with prostate, liver, pancreatic, and metastatic tumors are candidates for the Unity treatment. AHN physicians will also study treating head and neck, lung, breast, and gastrointestinal cancers.

“It may also be an effective option for recurrent or previously treated tumors that we can’t treat with standard therapies,” said Tom Colonias, MD, AHN director of Thoracic Malignancies in Radiation Oncology. “We will study how best to use the MR-Linac for these challenging cases.”

“It may also be an effective option for recurrent or previously treated tumors that we can’t treat with standard therapies.” — Dr. Tom Colonias

[Tall_Allen]

Similar to Viewray MRIdian. Clinical trials will determine if there is any real patient benefit. But having no fiducial placement is nice.

[londoncyclist48]

Dumb question but I thought they could see inside you with the latest equipment? When I got off the table last June, they would make comments like "oh, your bladder was full which was good". And the name of that machine seems very familiar. I was treated at the Royal Marsden in London and was assured by the doctor that the new radiotherapy machines are highly accurate. Maybe this one goes one step further? You also have CyberKnife. Personally, I can't recommend radiotherapy highly enough. So glad I was offered it over surgery. At first, I was very disappointed that I was not suitable for an RP due to metastasis but I'm so glad I wasn't offered it because I would have accepted it. The side effects sound horrendous. Radiotherapy is painless and stress free. It halved my PSA and apparently goes on working for two years. I'm not a doctor but I think RP will increasingly not be offered to patients due to the side effects and the new technology available in radiotherapy.

[Tall_Allen in reply to londoncyclist48]

You are right. They normally use CT imaging or stereoscopic X-rays and fiducials. When fiducials are out of alignment with the planning CT, the machine automatically stops and realigns them. This one uses MRI and gating. Gating means that the contours of specific organs (instead of fiducials) have to fall within a given margin for treatment to continue. Does it make a measurable difference? That is TBD.

[cesces]

I saw that.

I assume there is only one benefit.

If you connect the imaging, in real time, to the device delivering the radiation, you should get very very precise targeting.

You deliver more radiation to where you want, and less to where you don't want it.

[MommyMod]

We’ve heard of it from the gentleman here. Actually, my husband is currently treated at University of Tübingen where this treatment has been offered. We’ve not got a chance to ask his doctor, the chief urologist, about it since they decided to hold off his radiation treatment. I’ll note it down and ask him next time.

[Justfor_]

It has been under my radar for some years now. I am a retired engineer and put more faith on machines designed by akin professionals than claims of super-competences by fancy ROs. One thing though, I have to loose some weight as I am currently at the max usable limit of the machine's bore diameter, that is ~40 cm.

[Javelin18]

My SBRT treatment at UCLA used the ViewRay for precise targeting and higher dosage than traditional IMRT.

uclahealth.org/radonc/ViewRay

When I was inside the machine I could hear the pulses of the MRI. The technology was first used for lung cancer, so they could precisely target the tumor while the patient is breathing

[lokibear0803]

I spoke to my MO about this at our monthly visit yesterday. We agreed that, at least in my case, it still amounts to whack-a-mole with unfavorable risk/benefit: I do have some small mets identified on PSMA, in areas that have been previously radiated…so while with MR-Linac, the risk is reduced if we re-radiate, there is still non-zero risk of things like fistula, etc. And whack-a-mole does not address the micro-mets that I likely have elsewhere, so it has — again, speaking solely for my situation — an unacceptable risk/benefit.

[swwags]

GTTown went through this. Perhaps he can weigh inhealthunlocked.com/advanced...