Stereotactic MR-guided Adaptive Radiotherapy for Pancreatic Cancers on a 1.5 Tesla MR-linac system

Ablative SBRT to pancreatic cancers on MRI-Linac is a novel and rapidly evolving technology allowing real-time visualization of tumor and nearby organs-at-risk (OAR). Reliable identification of pancreas tumors on MR-Linac has direct impact on radiotherapy planning and outcome. A novel workflow was clinically implemented for pancreas stereotactic body radiotherapy on Elekta Unity MR-Linac. Compared to T2W images, pancreas tumors on T1W images, were superiorly visible for accurate delineation during the entire treatment course. This study is the first to determine the impact of an optimized MR sequence for pancreas tumors and OARs during multi-fractionate MR-guided radiotherapy on 1.5T Elekta MR-Linac.