MR-linac: role of artificial intelligence and automation.

Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]
PMID:

Abstract

The integration of artificial intelligence (AI) into radiotherapy has advanced significantly during the past 5 years, especially in terms of automating key processes like organ at risk delineation and treatment planning. These innovations have enhanced consistency, accuracy, and efficiency in clinical practice. Magnetic resonance (MR)-guided linear accelerators (MR-linacs) have greatly improved treatment accuracy and real-time plan adaptation, particularly for tumors near radiosensitive organs. Despite these improvements, MR-guided radiotherapy (MRgRT) remains labor intensive and time consuming, highlighting the need for AI to streamline workflows and support rapid decision-making. Synthetic CTs from MR images and automated contouring and treatment planning will reduce manual processes, thus optimizing treatment times and expanding access to MR-linac technology. AI-driven quality assurance will ensure patient safety by predicting machine errors and validating treatment delivery. Advances in intrafractional motion management will increase the accuracy of treatment, and the integration of imaging biomarkers for outcome prediction and early toxicity assessment will enable more precise and effective treatment strategies.

Authors

  • Serena Psoroulas
    Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
  • Alina Paunoiu
    Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
  • Stefanie Corradini
    Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
  • Juliane Hörner-Rieber
    Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.
  • Stephanie Tanadini-Lang
    Department of Radiation Oncology, University Hospital Zurich, Zurich, Switzerland.