Modern radiotherapy: First MR linac in Lithuania

Background / Objective MRI-guided radiation therapy represents a promising shift in cancer treatment, offering real-time imaging capabilities for improved target localization and treatment delivery. MR-linac simulation, positioning, and planning also have some differences compared to linear accelarators, which will be discussed. Working with MR-linac we have the opportunity for MR-guided hypofractionated radiotherapy. This abstract aims to provide a review of advancements in MRI-guided radiotherapy, including technological developments, clinical applications, and our first experience. Methods A systematic literature review was conducted to identify relevant studies and articles on MRI-guided radiotherapy. Data were summarized to key findings related to technical specifications, treatment planning, clinical outcomes, and MRI-guided radiotherapy safety considerations. Results The review highlights significant advancements in MRI-guided radiotherapy technology, including the integration of MRI scanners with linear accelerators, real-time adaptive planning, and magnetic resonance-based motion management. Clinical studies demonstrate the potential of MRI-guided radiotherapy in improving tumor control and sparing healthy tissues, particularly in challenging anatomical sites such as the prostate, liver, and pancreas. Safety considerations, including magnetic field interactions and quality assurance protocols are also discussed to ensure the safe and effective performance of MRI-guided radiation therapy in clinical practice. Workflow and MR-guided hypofractionated radiotherapy were discussed from personal experience. Conclusions MRI-guided radiation therapy represents a promising approach to increase the precision and accuracy of radiation treatment delivery while minimizing toxicity to surrounding normal tissues.