Feasibility of celiac axis delineation and treatment on combined magnetic resonance imaging and linear accelerator systems

Trials have been performed on irradiating celiac plexus for pancreatic cancer pain management. Images from a combined magnetic resonance imaging and linear accelerator system (MR-linac) for ten patients were assessed for delineation of celiac ganglia, aiming for smaller target volumes and reducing treatment risks <i>versus</i> standard linac-based treatments. MRI-linacs showed superior soft tissue contrast, enabling increased dose to ganglia while irradiating smaller target volumes <i>versus</i> regular linacs (median: 0.8 cm³ vs. 32.2 cm³, p < 0.05 for ten pairs of plans). While further studies are needed, MR-linac treatments could improve targeting precision, minimize dose to organs-at-risk and enhance effectiveness in palliative care.