{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:35:36Z","timestamp":1788867336501,"version":"build-2803163510"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T00:00:00Z","timestamp":1687564800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T00:00:00Z","timestamp":1687564800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"JSPS KAKENHI","award":["22K07661"],"award-info":[{"award-number":["22K07661"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Jpn J Radiol"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The aim of this study was to develop a new workflow for 1.5-T magnetic resonance (MR)-guided on-line adaptive radiation therapy (MRgART) and assess its feasibility in achieving dose constraints.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>We retrospectively evaluated the clinical data of patients who underwent on-line adaptive radiation therapy using a 1.5-T MR linear accelerator (MR-Linac). The workflow in MRgART was established by reviewing the disease site, number of fractions, and re-planning procedures. Five cases of prostate cancer were selected to evaluate the feasibility of the new workflow with respect to achieving dose constraints.\n<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Between December 2021 and September 2022, 50 consecutive patients underwent MRgART using a 1.5-T MR-Linac. Of these, 20 had prostate cancer, 10 had hepatocellular carcinoma, 6 had pancreatic cancer, 5 had lymph node oligo-metastasis, 3 had renal cancer, 3 had bone metastasis, 2 had liver metastasis from colon cancer, and 1 had a mediastinal tumor. Among a total of 247 fractions, 235 (95%) were adapt-to-shape (ATS)-based re-planning. The median ATS re-planning time in all 50 cases was 17\u00a0min. In the feasibility study, all dose constraint sets were met in all 5 patients by ATS re-planning. Conversely, a total of 14 dose constraints in 5 patients could not be achieved by virtual plan without using adaptive re-planning. These dose constraints included the minimum dose received by the highest irradiated volume of 1\u00a0cc in the planning target volume and the maximum dose of the rectal\/bladder wall.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>A new workflow of 1.5-T MRgART was established and found to be feasible. Our evaluation of the dose constraint achievement demonstrated the effectiveness of the workflow.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11604-023-01457-4","type":"journal-article","created":{"date-parts":[[2023,6,24]],"date-time":"2023-06-24T11:46:34Z","timestamp":1687607194000},"page":"1316-1322","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A new workflow of the on-line 1.5-T MR-guided adaptive radiation therapy"],"prefix":"10.1007","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4606-5662","authenticated-orcid":false,"given":"Takashi","family":"Uno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masato","family":"Tsuneda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kota","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukio","family":"Fujita","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rintaro","family":"Harada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aki","family":"Kanazawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asuka","family":"Kodate","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukinao","family":"Abe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yohei","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho Watanabe","family":"Nemoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajime","family":"Yokota","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,24]]},"reference":[{"key":"1457_CR1","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/j.radonc.2007.10.034","volume":"86","author":"JJW Lagendijk","year":"2008","unstructured":"Lagendijk JJW, Raaymakers BW, Raaijmakers AJE, Overweg J, Brown KJ, Kerkhof EM, et al. MRI\/linac integration. Radiother Oncol. 2008;86:25\u20139.","journal-title":"Radiother Oncol"},{"key":"1457_CR2","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1016\/j.semradonc.2014.02.009","volume":"24","author":"JJA Lagendijk","year":"2014","unstructured":"Lagendijk JJA, Raaymakers BW, van Vulpen M. The magnetic resonance imaging-linac system. Semin Radiat Oncol. 2014;24:207\u20139.","journal-title":"Semin Radiat Oncol"},{"key":"1457_CR3","doi-asserted-by":"publisher","first-page":"085015","DOI":"10.1088\/1361-6560\/aab566","volume":"63","author":"SJ Woodings","year":"2018","unstructured":"Woodings SJ, Bluemink JJ, de Vries JHW, Niatsetski Y, van Veelen B, Schillings J, et al. Beam characterisation of the 1.5 T MRI-linac. Phys Med Biol. 2018;63:085015.","journal-title":"Phys Med Biol."},{"key":"1457_CR4","doi-asserted-by":"publisher","first-page":"L41","DOI":"10.1088\/1361-6560\/aa9517","volume":"62","author":"BW Raaymakers","year":"2017","unstructured":"Raaymakers BW, J\u00fcrgenliemk-Schulz IM, Bol GH, Glitzner M, Kotte ANTJ, van Asselen B, et al. First patients treated with a 1.5 T MRI-Linac: clinical proof of concept of a high-precision, high-field MRI guided radiotherapy treatment. Phys Med Biol. 2017;62:L41-50.","journal-title":"Phys Med Biol"},{"key":"1457_CR5","first-page":"54","volume":"18","author":"D Winkel","year":"2019","unstructured":"Winkel D, Bol GH, Kroon PS, van Asselen B, Hackett SS, Werensteijn-Honingh A, et al. Adaptive radiotherapy: the Elekta Unity MR-Linac concept. Clin Trans Radiat Oncol. 2019;18:54\u20139.","journal-title":"Clin Trans Radiat Oncol"},{"key":"1457_CR6","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1093\/jrr\/rrab100","volume":"63","author":"H Okamoto","year":"2022","unstructured":"Okamoto H, Igaki H, Chiba T, Shibuya K, Sakasai T, Jingu K, et al. Practical guidelines of online MR-guided adaptive radiotherapy. J Radiat Res. 2022;63:730\u201340.","journal-title":"J Radiat Res"},{"key":"1457_CR7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.radonc.2019.01.024","volume":"134","author":"AM Werensteijn-Honingh","year":"2019","unstructured":"Werensteijn-Honingh AM, Kroon PS, Winkel D, Aalbers EM, van Asselen B, Bol GH, et al. Feasibility of stereotactic radiotherapy using a 1.5 T MR-Linac: multi-fraction treatment of pelvic lymph node oligometastases. Radiother Oncol. 2019;134:50\u20134.","journal-title":"Radiother Oncol."},{"key":"1457_CR8","doi-asserted-by":"publisher","first-page":"1352","DOI":"10.1080\/0284186X.2019.1627417","volume":"58","author":"AS Bertelsen","year":"2019","unstructured":"Bertelsen AS, Schytte T, M\u00f8ller PK, Mahmood F, Riis HL, Gottlieb KL, et al. First clinical experiences with a high field 1.5 T MR linac. Acta Oncol. 2019;58:1352\u20137.","journal-title":"Acta Oncol."},{"key":"1457_CR9","first-page":"35","volume":"23","author":"A Dunlop","year":"2020","unstructured":"Dunlop A, Mitchell A, Tree A, Barnes H, Bower L, Chick J, et al. Daily adaptive radiotherapy for patients with prostate cancer using a high field MR-Linac: initial clinical experiences and assessment of delivered doses compared to a C-arm linac. Clin Transl Radiat Oncol. 2020;23:35\u201342.","journal-title":"Clin Transl Radiat Oncol"},{"key":"1457_CR10","first-page":"72","volume":"23","author":"ES Paulson","year":"2020","unstructured":"Paulson ES, Ahunbay E, Chen X, Mickevicius NJ, Chen GP, Schultz C, et al. 4D-MRI driven MR-guided online adaptive radiotherapy for abdominal stereotactic body radiation therapy on a high field MR-Linac: implementation and initial clinical experience. Clin Transl Radiat Oncol. 2020;23:72\u20139.","journal-title":"Clin Transl Radiat Oncol"},{"key":"1457_CR11","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1016\/j.radonc.2020.09.024","volume":"154","author":"MPW Intven","year":"2021","unstructured":"Intven MPW, de Mol van Otterloo SR, Mook S, Doornaert PAH, de Groot-van Breugel EN, Sikkes GG, et al. Online adaptive MR-guided radiotherapy for rectal cancer; feasibility of the workflow on a 1.5T MR-Linac: clinical implementation and initial experience. Radiother Oncol. 2021;154:172\u20138.","journal-title":"Radiother Oncol."},{"key":"1457_CR12","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1016\/j.radonc.2021.03.025","volume":"159","author":"S Corradini","year":"2021","unstructured":"Corradini S, Alongi F, Andratschke N, Azria D, Bohoudi O, Boldrini L, et al. ESTRO-ACROP recommendations on the clinical implementation of hybrid MR-Linac systems in radiation oncology. Radiother Oncol. 2021;159:146\u201354.","journal-title":"Radiother Oncol"},{"key":"1457_CR13","doi-asserted-by":"publisher","first-page":"716","DOI":"10.3390\/cancers14030716","volume":"14","author":"T Stanescu","year":"2022","unstructured":"Stanescu T, Shessel A, Carpino-Rocca C, Taylor E, Semeniuk O, Li W, et al. MRI-guided online adaptive stereotactic body radiation therapy of liver and pancreas tumors on an MR-LINAC system. Cancers. 2022;14:716.","journal-title":"Cancers"},{"key":"1457_CR14","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.3390\/jcm11061662","volume":"11","author":"DAP Dunkerley","year":"2022","unstructured":"Dunkerley DAP, Hyer DE, Snyder JE, St-Aubin JJ, Anderson CM, Caster JM, et al. Clinical implementational and site-specific workflows for a 1.5T MR-Linac. J Clin Med. 2022;11:1662.","journal-title":"J Clin Med."},{"key":"1457_CR15","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1093\/jrr\/rrac072","volume":"64","author":"M Tsuneda","year":"2023","unstructured":"Tsuneda M, Abe K, Fujita Y, Ikeda Y, Furuyama Y, Uno T. Elekta Unity MR-Linac commissioning: mechanical and dosimetry tests. J Radiat Res. 2023;64:73\u201384.","journal-title":"J Radiat Res"},{"key":"1457_CR16","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1016\/j.ijrobp.2018.12.045","volume":"104","author":"MJ Zelefsky","year":"2019","unstructured":"Zelefsky MJ, Kollmeier M, McBride S, Varghese M, Mychalczak B, Gewanter R, et al. Five-year outcomes of a phase 1 dose-escalation study using stereotactic body radiosurgery for patients with low-risk and intermediate-risk prostate cancer. Int J Radiat Oncol Biol Phys. 2019;104:42\u20139.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1457_CR17","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1016\/j.ijrobp.2016.08.036","volume":"96","author":"L Henke","year":"2016","unstructured":"Henke L, Kashani R, Yang D, Zhao T, Green O, Olsen L, et al. Simulated online adaptive magnetic resonance-guided stereotactic body radiation therapy for the treatment of oligometastatic disease of the abdomen and central thorax: characterization of potential advantages. Int J Radiat Oncol Biol Phys. 2016;96:1078\u201386.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1457_CR18","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1016\/j.ijrobp.2021.07.003","volume":"111","author":"SR de Mol van Otterloo","year":"2021","unstructured":"de Mol van Otterloo SR, Christodouleas JP, Blezer ELA, Akhiat H, Brown K, Choudhury A, et al. Patterns of care, tolerability, and safety of the first cohort of patients treated on a novel high-field MR-Linac within the MOMENTUM Study: initial results from a prospective multi-institutional registry. Int J Radiat Oncol Biol Phys. 2021;111:867\u201375.","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"1457_CR19","doi-asserted-by":"publisher","first-page":"628155","DOI":"10.3389\/fonc.2021.628155","volume":"11","author":"WA Hall","year":"2021","unstructured":"Hall WA, Small C, Paulson E, Koay EJ, Crane C, Intven M, et al. Magnetic resonance guided radiation therapy for pancreatic adenocarcinoma, advantages, challenges, current approaches, and future directions. Front Oncol. 2021;11:628155.","journal-title":"Front Oncol"}],"container-title":["Japanese Journal of Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-023-01457-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11604-023-01457-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11604-023-01457-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T04:16:28Z","timestamp":1698639388000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11604-023-01457-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,24]]},"references-count":19,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["1457"],"URL":"https:\/\/doi.org\/10.1007\/s11604-023-01457-4","relation":{},"ISSN":["1867-1071","1867-108X"],"issn-type":[{"value":"1867-1071","type":"print"},{"value":"1867-108X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,24]]},"assertion":[{"value":"28 March 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 June 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The three authors (MT, KA, and YF) belong to an endowed chair sponsored by Elekta Corporation. The other authors have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and\/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Faculty of Medicine, Chiba University (approval no. M10434).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}