{Reference Type}: Journal Article
{Title}: Real-time motion management in MRI-guided radiotherapy: Current status and AI-enabled prospects.
{Author}: Lombardo E;Dhont J;Page D;Garibaldi C;Künzel LA;Hurkmans C;Tijssen RHN;Paganelli C;Liu PZY;Keall PJ;Riboldi M;Kurz C;Landry G;Cusumano D;Fusella M;Placidi L;
{Journal}: Radiother Oncol
{Volume}: 190
{Issue}: 0
{Year}: 2024 Jan 26
{Factor}: 6.901
{DOI}: 10.1016/j.radonc.2023.109970
{Abstract}: 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.