By Dr. Hafsa Zameer
Abstract:
Background:
The integration of magnetic resonance imaging with linear
accelerator technology (MR-Linac) has transformed
radiotherapy practice by enabling superior soft-tissue
visualization and online adaptive planning. Compared with
conventional Linac systems, which rely on CT-based
simulation and cone-beam CT (CBCT) for setup verification,
the MR-Linac allows real-time imaging and plan modification
based on daily anatomical changes. This evolution has
significantly influenced the workflow and clinical
responsibilities of radiation therapists.
Objective:
To compare the conventional Linac and MR-Linac workflows
from a radiation therapist’s perspective, highlighting
differences in imaging, treatment adaptation, and professional
responsibilities.
Method:
A descriptive workflow comparison was conducted, outlining
each treatment phase—from simulation to treatment delivery.
Key differences were analyzed regarding image acquisition,
patient positioning, plan verification, adaptation, and quality
assurance.
Results:
Conventional Linac workflows follow an offline planning
process with fixed treatment plans and limited daily variation.
MR-Linac workflows incorporate daily MR imaging, online
contour review, adaptive plan optimization, and real-time
motion monitoring. These steps increase treatment time but
enhance target precision and organ-at-risk sparing. Radiation
therapists have expanded roles in MR image assessment,
adaptive decision support, MR safety, and patient
communication.
Conclusions:
The MR-Linac introduces a dynamic, adaptive workflow that
elevates treatment precision and expands the radiation
therapist’s role. As frontline professionals, therapists are integral to the success of MR-guided adaptive radiotherapy,
requiring ongoing training, multidisciplinary collaboration,
and workflow refinement to ensure safe and efficient clinical
implementation.