1,5 Tesla MR-Linac

MR-Linac is an MR technology used in the field of radiation oncology, which provides clear imaging of tumour tissue with a special measurement and targeting. With MR Linac Unity 1.5 Tesla, which we prefer in many of our patients in need of radiotherapy at Liv Hospital Ulus Hospital, we reduce the treatment sessions of our patients by protecting the surrounding tissues. MR-Linac Unity treatment, which is specially planned for the person, has the feature of distinguishing tumor tissue from normal tissues. With its privileged aspects such as sensitive imaging technology and tissue visualization, it can be applied to regions such as heart, kidney, stomach and spinal cord, where the beam position is difficult, especially to tumours located in the brain, neck and abdomen.

Generally, in radiotherapy, the dose is administered with the sum of lower daily amounts. The number of treatment days, which can last up to 30 sessions in classical linacs, can be reduced in suitable patients in treatment with MR-Linak. According to criteria such as the patient's condition, tumor size, structure, mobility and proximity to sensitive organs, treatment can be applied to the patient at specified intervals. In the treatment, which generally lasts 3 or 5 sessions, the device monitors all the changes in the patient and offers treatment according to new situations. One session varies between 20-50 minutes, depending on the condition of the patient and the tumor.

Radiation Oncology Clinic, in cooperation with all other disciplines dealing with oncology, uses the high-tech MR-Linak in the following tumor types.

• Brain tumors
• Head and neck cancers
• Pancreatic cancer
• Colorectal cancer
• Pelvic tumors
• Cervical cancer
• Intrauterine cancer
• Liver – biliary tract tumors and metastases
• Adrenal gland cancer and metastases
• Kidney tumors
•    Lung cancer
•    Gastric cancer
• Esophageal-esophageal tumors
•    Prostate cancer
• Breast cancer
• Soft tissue sarcoma
• Vaginal cancer
• Bladder cancer
• Abdominal masses
 

In radiotherapy, it is aimed to protect the normal tissues and organs around the tumor while the tumor is destroyed by applying a high dose of radiation to the tumor. High treatment efficacy and fewer side effects are expected. The effectiveness of the treatment is determined by imaging the tumor with computed tomography before and after the treatment. However, it can be difficult to view the tissues and soft tissues in the abdomen, especially with tomography. With MRI, these tissues can be imaged with high resolution. MR-Linak provides treatment by imaging the tumor area and normal tissues more clearly. Before and during the treatment, the tumor and surrounding normal tissues are followed. Radiation doses suitable for the current position of the tumor and its surroundings are calculated and applied to the patient correctly (online adaptive 4-dimensional therapy).

With 1.5 Tesla MR-Linak Unity technology, the doctor can see the tumor tissue more clearly and adjusts the treatment radiation dose according to the daily changes of your organs. While applying the required dose to the existing tumor, the effectiveness of the treatment increases as it can safely deliver radiation to the surrounding tissues. This treatment, which protects normal tissues better, reduces the number of sessions and creates a comfort zone for the patient.

First, the patient's tomography and MRI are taken on the treatment device, and a treatment plan is made for the patient. After the patient lies on the device, the location of tumor and normal tissues is determined during the MRI. The daily dose distribution is recalculated according to the current position. It detects not only predictable movements of tumor and normal tissues such as breathing, but also unpredictable movements such as bowel movements. When the treatment does not progress as planned because it is controlled by continuous MRI, a new treatment is planned.

For successful treatment and pinpointing in MR-Linak, the target tissue must be visualized very clearly. MRI is performed for this imaging. Sound attenuating headphones are used to prevent patients from being disturbed by the MR sound. Patients who wish can listen to the music they brought with them during these experiences.

It is the treatment performed by directing the entire treatment in accordance with the target. Thanks to MR images, accuracy during point shooting is at the highest level. In tumors close to healthy tissues, their clear observation allows for the best preservation of these tissues. During this application, which is one of the most effective radiotherapy methods, even if the location of the tumor changes when the patient breathes, the beams given to the tumor make a clear focus and ensure the destruction of the tumor with a full hit. Again, "Dynamic MR Changes" that occur in the tumor of the patient whose radiotherapy continues, provides an idea about the response of the tumor to treatment.

All these processes and stages are performed while the patients are lying on the device and ready for treatment. The soft stretcher increases the comfort of the patient. The short and wide shooting space of the device reduces patient anxiety and fear. Technology that reduces acoustic noise is used. However, sound attenuating headphones are available for patients who are bothered by sound.

MR-Linak Unity can be used in patients who can enter a 1.5 Tesla MR device and need radiotherapy. With its fine-detail imaging capabilities, MR-Linak Unity provides a clear image that separates tumor tissue from normal tissue for radiation therapy planning and treatment administration. In addition, it allows excellent soft tissue visualization in tumors located in the brain, neck and abdomen, while tracking the tumor and normal tissues with precision throughout the treatment with its real-time imaging features.

• Tumor and normal tissues look better. Not only predictable movements of tumor and normal tissues such as breathing are detected, but also unpredictable movements such as bowel movements.
• Daily Adaptive (Adaptive) treatment is paved with the treatment plan made from the beginning according to the current position of the tumor and normal tissues that is redefined every treatment day.
• During the implementation of the adaptive treatment, which is calculated according to the positions on each treatment day, the patient's position is constantly checked with MR images obtained simultaneously (Position control during treatment).
• “Dynamic MR Changes” in the tumor of the patient whose radiotherapy is still continuing, allows us to have an idea about the response of the tumor to the treatment (The only FDA-approved MR-Linak UNITY in this regard)

First of all, sharper and clearer imaging is possible. You can apply very high doses of radiation to tumor tissue. Surrounding normal tissues and organs can be better protected. The treatment time is also shortened. While the tumor tissue is affected in a short time, a very rapid response to treatment can be obtained. Radiation can be given to recurrent tumors.

We prefer it in patients who can enter the MRI device and need radiotherapy. MR-Linac Unity, 1.5 Tesla;

• It is a technology that can be applied to many patients who are suspicious of being treated.
• With this technology, which distinquins tumour tissues from bony structures and blood vessels, it is possible to see soft tissues clearly.
• It is an ideal treatment method especially for tumours that involve the organs that become active during breathing, such as the upper abdomen and lungs. It can also be preferred in the heart, stomach, kidney, brain and spinal cord regions where irradiation is difficult.
• Mobile tumours can be seen clearly in all treatments.
• It has the ability to protect organs, healthy tissues and blood vessels.
• It makes it possible to give more effective radiation to the tumour.
• It is a technology that can reduce the number of sessions of patients depending on the dose level to be preferred.
• It is possible to understand whether the patient's tumour is moving or not. In this way, tumour mobility can be monitored and followed when the patient holds or releases their breath.

Today, 6/7 of many cancer types have soft tissue anatomy. This feature makes it difficult to visualize the tumour area and causes a decrease in the effectiveness of the treatment. With MR Linac Unity, 1.5 Tesla, we aim to increase the life comfort of our patients by achieving successful results in many types of metastatic cancer, intra-abdominal, lung, prostate, pancreatic and liver tumours. Detailed listing of areas where <b>MR-Linac Unity, 1.5 Tesla</b> is used;

• Pancreatic cancers that cannot be operated or are limitedly suitable for operation
• Pelvic tumours
• Colon cancer
• Uterine and cervical cancers
• Rectal cancers unsuitable for surgery
• Adrenal and gland cancers, metastases
• Gastric cancer
• Lung and liver cancers
• Prostate cancer
• Breast cancer
• Bladder cancers
• Vaginal cancer
• Soft tissue sarcoma
• Fallopian tube cancer
• Liver HCC
• Early stage breast cancer
• Abdominal tumours
• Venter tumours

Under the Ministry of Health of the United States of America, which can respond to treatment in tumours such as head-neck, brain, liver, rectum, used in the field of radiotherapy; The only MR technology approved by the FDA is MR-Linac Unity, 1.5 Tesla. This technology is a very important guide in planning the treatment to be applied after radiotherapy in all tumour types and especially in brain tumours.

Treatment varies according to the movement and shape of the tumour. Although there is no limitation in the number of sessions, we can say that average of 4-6 sessions. MR-Linac has the ability to treat tumours with higher doses than other technologies. The average treatment duration of one day varies between 20 and 60 minutes.

Treatment with MR-Linac technology is planned in 3 stages;

• The scanning phase is the follow-up of the patient's anatomical changes with daily MRI scanning.
• The planning stage is the creation of the treatment by taking into account the changes in the environment in order to make it suitable for the patient again.
• The treatment phase is performed simultaneously with targeting, which is displayed regularly throughout the radiation process