{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T18:28:49Z","timestamp":1767896929586,"version":"3.49.0"},"reference-count":102,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Oesophageal cancer remains a significant global health burden with poor survival outcomes despite multimodal treatment. Recent advances in magnetic resonance imaging (MRI) have opened opportunities to improve radiotherapy delivery. This review examines the role of MRI and MR-guided radiotherapy (MRgRT) in oesophageal cancer, focusing on applications in staging, treatment planning, and response assessment, with particular emphasis on magnetic resonance linear accelerator (MR-Linac)-based delivery. Compared to computed tomography (CT), MRI offers superior soft-tissue contrast, enabling more accurate tumour delineation and the potential for reduced treatment margins. Real-time MR imaging during treatment can facilitate motion management, while daily adaptive planning can accommodate anatomical changes throughout the treatment course. Functional MRI sequences, including diffusion-weighted and dynamic contrast-enhanced imaging, offer quantitative data for treatment response monitoring. Early clinical and dosimetric studies demonstrate that MRgRT can significantly reduce radiation dose to critical organs while maintaining target coverage. However, clinical evidence for MRgRT in oesophageal cancer is limited to small early-phase studies, with no phase II\/III trials demonstrating improvements in survival, toxicity, or patient-reported outcomes. Long-term clinical benefits and cost-effectiveness remain unproven, highlighting the need for prospective outcome-focused studies to define the role for MRgRT within multimodality treatment pathways.<\/jats:p>","DOI":"10.3390\/curroncol33010034","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T12:56:55Z","timestamp":1767877015000},"page":"34","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MR-Guided Radiotherapy in Oesophageal Cancer: From Principles to Practice\u2014A Narrative Review"],"prefix":"10.3390","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1021-9079","authenticated-orcid":false,"given":"Su Chen","family":"Fong","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Austin Hospital, Heidelberg, VIC 3084, Australia"},{"name":"Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia"},{"name":"Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eddie","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Radiology and Molecular Imaging Therapy, Austin Health, Heidelberg, VIC 3084, Australia"},{"name":"Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Liu","sequence":"additional","affiliation":[{"name":"Upper Gastrointestinal Surgery Unit, Division of Surgery, Anaesthesia and Procedural Medicine, Austin Health, Heidelberg, VIC 3084, Australia"},{"name":"Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia"},{"name":"Victorian Interventional Research and Trials Unit, Department of Surgery, University of Melbourne, Austin Precinct, Heidelberg, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niall C.","family":"Tebbutt","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia"},{"name":"Department of Medical Oncology, Austin Health, Heidelberg, VIC 3084, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard","family":"Khor","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Austin Hospital, Heidelberg, VIC 3084, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trevor","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia"},{"name":"Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Pathology, Austin Health, Heidelberg, VIC 3084, Australia"},{"name":"Olivia Newton-John Cancer Wellness and Research Institute, Heidelberg, VIC 3084, Australia"},{"name":"School of Cancer Medicine, La Trobe University, Bundoora, VIC 3086, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4970-9710","authenticated-orcid":false,"given":"Sergio","family":"Uribe","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sweet Ping","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Austin Hospital, Heidelberg, VIC 3084, Australia"},{"name":"Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC 3800, Australia"},{"name":"Department of Surgery, University of Melbourne, Melbourne, VIC 3010, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1007\/s12328-020-01237-x","article-title":"Epidemiology of esophageal cancer: Update in global trends, etiology and risk factors","volume":"13","author":"Uhlenhopp","year":"2020","journal-title":"Clin. 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