%0 Journal Article
%T Real-time motion management in MRI-guided radiotherapy: Current status and AI-enabled prospects.
%A Lombardo E
%A Dhont J
%A Page D
%A Garibaldi C
%A Künzel LA
%A Hurkmans C
%A Tijssen RHN
%A Paganelli C
%A Liu PZY
%A Keall PJ
%A Riboldi M
%A Kurz C
%A Landry G
%A Cusumano D
%A Fusella M
%A Placidi L
%J Radiother Oncol
%V 190
%N 0
%D 2024 Jan 26
%M 37898437
%F 6.901
%R 10.1016/j.radonc.2023.109970
%X MRI-guided radiotherapy (MRIgRT) is a highly complex treatment modality, allowing adaptation to anatomical changes occurring from one treatment day to the other (inter-fractional), but also to motion occurring during a treatment fraction (intra-fractional). In this vision paper, we describe the different steps of intra-fractional motion management during MRIgRT, from imaging to beam adaptation, and the solutions currently available both clinically and at a research level. Furthermore, considering the latest developments in the literature, a workflow is foreseen in which motion-induced over- and/or under-dosage is compensated in 3D, with minimal impact to the radiotherapy treatment time. Considering the time constraints of real-time adaptation, a particular focus is put on artificial intelligence (AI) solutions as a fast and accurate alternative to conventional algorithms.