Medical College of Wisconsin
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Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group. Eur J Cancer 2021 Aug;153:64-71

Date

06/19/2021

Pubmed ID

34144436

Pubmed Central ID

PMC8340311

DOI

10.1016/j.ejca.2021.04.041

Scopus ID

2-s2.0-85107945729 (requires institutional sign-in at Scopus site)   46 Citations

Abstract

Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential to be used for the personalised treatment of cancer patients. However, large-scale data are missing to validate their added value in clinical practice. Integrated MRI-guided radiotherapy (MRIgRT) systems, such as hybrid MRI-linear accelerators, have the unique advantage that MR images can be acquired during every treatment session. This means that high-frequency imaging of QIBs becomes feasible with reduced patient burden, logistical challenges, and costs compared to extra scan sessions. A wealth of valuable data will be collected before and during treatment, creating new opportunities to advance QIB research at large. The aim of this paper is to present a roadmap towards the clinical use of QIBs on MRIgRT systems. The most important need is to gather and understand how the QIBs collected during MRIgRT correlate with clinical outcomes. As the integrated MRI scanner differs from traditional MRI scanners, technical validation is an important aspect of this roadmap. We propose to integrate technical validation with clinical trials by the addition of a quality assurance procedure at the start of a trial, the acquisition of in vivo test-retest data to assess the repeatability, as well as a comparison between QIBs from MRIgRT systems and diagnostic MRI systems to assess the reproducibility. These data can be collected with limited extra time for the patient. With integration of technical validation in clinical trials, the results of these trials derived on MRIgRT systems will also be applicable for measurements on other MRI systems.

Author List

van Houdt PJ, Saeed H, Thorwarth D, Fuller CD, Hall WA, McDonald BA, Shukla-Dave A, Kooreman ES, Philippens MEP, van Lier ALHMW, Keesman R, Mahmood F, Coolens C, Stanescu T, Wang J, Tyagi N, Wetscherek A, van der Heide UA

Author

William Adrian Hall MD Chair, Professor in the Radiation Oncology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Biomarkers
Humans
Magnetic Resonance Imaging
Radiation Oncology
Radiotherapy, Image-Guided