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Publications

Journal Article Review Ahead of print

PubMed: 42933262 DOI: 10.1016/j.canrad.2026.104888

Magnetic resonance imaging and radiotherapy: Precision begins with imaging.

Cancer Radiother 30(5-6):104888

Authors: Pierrick Gouel, Damien Autret, Aurélie Tournier, Ariane Lapierre, Jérémy Baude, Anaïs Barateau, Stéphane Dufreneix, Isabelle Fitton, Paul Rétif, Vincent Marchesi, Caroline Moreau-Noblet

Affiliations

  • Centre Henri-Becquerel, Rouen, France; Laboratoire AIMS-QuantIF, université de Rouen, Rouen, France.
  • Département de physique médicale, Institut de cancérologie de l'Ouest, Angers, France.
  • Institut universitaire du cancer de Toulouse - Oncopole Claudius-Regaud, Toulouse, France.
  • Department of Radiation Oncology, centre hospitalier universitaire Lyon Sud, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite, France; Université de Lyon, Lyon, France.
  • Inserm UMR 1231, Unicancer, département de radiothérapie, unité Xrain, centre Georges-François-Leclerc, université Bourgogne Europe, Dijon, France.
  • Centre de lutte contre le cancer Eugène-Marquis, Inserm, LTSI - UMR 1099, université de Rennes, Rennes, France.
  • Département de physique médicale, Institut de cancérologie de l'Ouest, Angers, France.
  • Service de radiologie, hôpital européen Georges-Pompidou, Assistance publique-hôpitaux de Paris, Paris, France.
  • Medical Physics Unit, centre hospitalier régional de Metz-Thionville, Metz, France; CNRS, Centre de recherche en automatique de Nancy (CRAN), université de Lorraine, Nancy, France.
  • Service de physique médicale, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
  • Department of Medical Physics, clinique mutualiste de l'Estuaire, cité Sanitaire, Saint-Nazaire, France.

Abstract

Magnetic resonance imaging has played an increasingly important role in radiotherapy, both before and during treatment. Before irradiation, its excellent soft-tissue contrast has provided a major advantage over simulation computed tomography by improving the visualization of tumour volumes and organs at risk, and by reducing delineation uncertainties, particularly in high-precision treatments such as stereotactic radiotherapy. Beyond morphological information, magnetic resonance imaging has also provided access to functional and quantitative data, such as diffusion-weighted imaging, apparent diffusion coefficient maps, perfusion and T1/T2 mapping, which may contribute to the biological characterization of tissues and to the early assessment of treatment response. During irradiation, onboard magnetic resonance imaging has helped overcome some of the limitations of cone beam computed tomography, owing to improved soft-tissue visualization, motion monitoring, and adaptation of the treatment plan to inter- or intrafraction anatomical variations. The development of magnetic resonance-only workflows, based on synthetic computed tomography generation, could also reduce dependence on planning computed tomography. However, these benefits have imposed specific requirements: acquisition under treatment-position conditions, geometric distortion control, reproducibility of quantitative acquisitions, accurate computed tomography-magnetic resonance imaging registration, and rigorous validation. Their implementation requires harmonization of practices, strengthened coordination between imaging and radiotherapy, and official recommendations, or even a dedicated regulatory framework.

MeSH

Radiotherapy, Tomography, Magnetic Resonance Imaging, Therapeutics, Tissues