MR guided radiotherapy in Heidelberg

• Applicant: Professor Dr. Jürgen Debus
• Subject Area: Nuclear Medicine, Radiotherapy, Radiobiology
• Term: from 2016 to 2021
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 281540677

Magnetic resonance guided Radiotherapy (MRgRT) has the potential to revolutionize the delivery of radiation therapy. In a consortium of applicants with expertise in the areas of MR physics, radiation physics, computer science, diagnostic radiology, radiation oncology and medical oncology we aim to implement and develop the method of MR-guided radiotherapy and bring it into clinical application. The MRgRT platform will also be open for integration of external user groups. The applicants have a long tradition of successful developments and pioneering of new technologies in radiotherapy like Intensity Modulated Radiotherapy (IMRT) and Stereotactic Body Radiotherapy (SBRT). The department of Radiation Oncology has treated 4056 new patients in 2014.Based on fundamental, translational and clinical research strategies we plan to investigate the potential of magnetic resonance guided radiotherapy. We will establish 6 major research areas, which will be carried by experienced groups in the following fields: 1) MR sequence testing and development for optimal inter- and intrafractional imaging. 2) New adaptation strategies including ultrafast registration, re-planning, motion tracking and dose accumulation. 3) Clinical evaluation of MRgRT within clinical trials with comparison to standard CT guided RT and offline shuttle-based MRgRT. 4) A dosimetry and quality assurance program assuring the implementation of a completely new workflow and its concordance to regulatory requirements. 5) Investigation of the possibilities of MR-guided proton and ion therapy based on the developments in the photon area. 6) Socioeconomic analysis of this time consuming and costly technique that accompanies all clinical applications.Through this program, new extraordinary treatment options shall be developed and explored. This is supposed to enable a clear assessment of the trade-off of high investment and maintenance on one side and patient benefit on the other side. We plan to identify patient groups that gain the most improvements in terms of toxicity, quality of life and survival.With MRgRT the most individualized and personalized method of radiotherapy could be started in Heidelberg very soon after approval of this program. A bunker for MRgRT is available at the University hospital which has been approved as suitable and ready for installation by both manufacturers of the available systems. In principle, the proposed projects can be performed with both machines. For scientific reasons we have a preference for a 1.5T MR-linac system.All necessary staff to operate the treatment machine and to successfully perform the research projects is available. Additionally, a new professorship on image-guided radiotherapy is currently being recruited and will be assigned to this project.

• DFG Programme: Major Instrumentation Initiatives
• Major Instrumentation: MRgRT
• Instrumentation Group: 3250 Beschleuniger (Medizin)
• Co-Investigators: Professor Dr. Stefan Delorme; Professorin Dr. Sabine Heiland; Professor Dr. Klaus Herfarth; Professor Dr. Dirk Jäger; Professor Dr. Oliver Jäkel; Professor Dr. Christian Peter Karger; Professor Dr. Mark E. Ladd; Dr. Katja Lindel; Dr. Asja Pfaffenberger; Professor Dr. Heinz-Peter Schlemmer; Dr. Gabriele Sroka-Pérez; Privatdozent Dr. Florian Sterzing