Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group
Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential to be used for the personalised treatment of cancer patients. However, large-scale data are missing to validate their added value in clinical practice. Integrated MRI-guided radiotherapy (MRIgRT) systems, such as h...
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| Veröffentlicht in: | European journal of cancer (1990) 2021-08, Vol.153, p.64-71 |
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| creator | van Houdt, Petra J. Saeed, Hina Thorwarth, Daniela Fuller, Clifton D. Hall, William A. McDonald, Brigid A. Shukla-Dave, Amita Kooreman, Ernst S. Philippens, Marielle E.P. van Lier, Astrid L.H.M.W. Keesman, Rick Mahmood, Faisal Coolens, Catherine Stanescu, Teodor Wang, Jihong Tyagi, Neelam Wetscherek, Andreas van der Heide, Uulke A. |
| description | Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential to be used for the personalised treatment of cancer patients. However, large-scale data are missing to validate their added value in clinical practice. Integrated MRI-guided radiotherapy (MRIgRT) systems, such as hybrid MRI-linear accelerators, have the unique advantage that MR images can be acquired during every treatment session. This means that high-frequency imaging of QIBs becomes feasible with reduced patient burden, logistical challenges, and costs compared to extra scan sessions. A wealth of valuable data will be collected before and during treatment, creating new opportunities to advance QIB research at large. The aim of this paper is to present a roadmap towards the clinical use of QIBs on MRIgRT systems. The most important need is to gather and understand how the QIBs collected during MRIgRT correlate with clinical outcomes. As the integrated MRI scanner differs from traditional MRI scanners, technical validation is an important aspect of this roadmap. We propose to integrate technical validation with clinical trials by the addition of a quality assurance procedure at the start of a trial, the acquisition of in vivo test-retest data to assess the repeatability, as well as a comparison between QIBs from MRIgRT systems and diagnostic MRI systems to assess the reproducibility. These data can be collected with limited extra time for the patient. With integration of technical validation in clinical trials, the results of these trials derived on MRIgRT systems will also be applicable for measurements on other MRI systems.
•Daily imaging is feasible on integrated MRI-guided radiotherapy (MRIgRT) systems.•This will advance quantitative imaging biomarker (QIB) research in oncology.•QIBs have the potential to personalise radiotherapy treatment.•This paper presents a roadmap towards clinical use of QIBs on MRIgRT systems.•Technical validation should be integrated in clinical trials on MRIgRT systems. |
| doi_str_mv | 10.1016/j.ejca.2021.04.041 |
| format | Article |
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•Daily imaging is feasible on integrated MRI-guided radiotherapy (MRIgRT) systems.•This will advance quantitative imaging biomarker (QIB) research in oncology.•QIBs have the potential to personalise radiotherapy treatment.•This paper presents a roadmap towards clinical use of QIBs on MRIgRT systems.•Technical validation should be integrated in clinical trials on MRIgRT systems.</description><identifier>ISSN: 0959-8049</identifier><identifier>EISSN: 1879-0852</identifier><identifier>DOI: 10.1016/j.ejca.2021.04.041</identifier><identifier>PMID: 34144436</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Accelerators ; Biomarkers ; Biomarkers - metabolism ; Biomedical materials ; Clinical trials ; Consortia ; Humans ; Hybrid systems ; Image acquisition ; Image-guided ; In vivo methods and tests ; Integration ; Linear accelerators ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medical imaging ; Multicentre study ; Patients ; Quality assurance ; Radiation Oncology - methods ; Radiation therapy ; Radiotherapy ; Radiotherapy, Image-Guided - methods ; Reproducibility ; Scanners</subject><ispartof>European journal of cancer (1990), 2021-08, Vol.153, p.64-71</ispartof><rights>2021 Elsevier Ltd</rights><rights>Copyright © 2021 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. Aug 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c483t-f9766e46018bebd6f6d86e0f675490c7d4e359ec96a5302e7ef6f93e12ba192b3</citedby><cites>FETCH-LOGICAL-c483t-f9766e46018bebd6f6d86e0f675490c7d4e359ec96a5302e7ef6f93e12ba192b3</cites><orcidid>0000-0003-4799-2193 ; 0000-0002-7270-7967 ; 0000-0003-4443-7741 ; 0000-0003-0205-3459 ; 0000-0003-0073-7443 ; 0000-0003-4230-1330 ; 0000-0001-7751-3494 ; 0000-0003-1433-9315 ; 0000-0002-0551-7266 ; 0000-0003-4321-5506</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0959804921003129$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34144436$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Houdt, Petra J.</creatorcontrib><creatorcontrib>Saeed, Hina</creatorcontrib><creatorcontrib>Thorwarth, Daniela</creatorcontrib><creatorcontrib>Fuller, Clifton D.</creatorcontrib><creatorcontrib>Hall, William A.</creatorcontrib><creatorcontrib>McDonald, Brigid A.</creatorcontrib><creatorcontrib>Shukla-Dave, Amita</creatorcontrib><creatorcontrib>Kooreman, Ernst S.</creatorcontrib><creatorcontrib>Philippens, Marielle E.P.</creatorcontrib><creatorcontrib>van Lier, Astrid L.H.M.W.</creatorcontrib><creatorcontrib>Keesman, Rick</creatorcontrib><creatorcontrib>Mahmood, Faisal</creatorcontrib><creatorcontrib>Coolens, Catherine</creatorcontrib><creatorcontrib>Stanescu, Teodor</creatorcontrib><creatorcontrib>Wang, Jihong</creatorcontrib><creatorcontrib>Tyagi, Neelam</creatorcontrib><creatorcontrib>Wetscherek, Andreas</creatorcontrib><creatorcontrib>van der Heide, Uulke A.</creatorcontrib><title>Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group</title><title>European journal of cancer (1990)</title><addtitle>Eur J Cancer</addtitle><description>Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential to be used for the personalised treatment of cancer patients. However, large-scale data are missing to validate their added value in clinical practice. Integrated MRI-guided radiotherapy (MRIgRT) systems, such as hybrid MRI-linear accelerators, have the unique advantage that MR images can be acquired during every treatment session. This means that high-frequency imaging of QIBs becomes feasible with reduced patient burden, logistical challenges, and costs compared to extra scan sessions. A wealth of valuable data will be collected before and during treatment, creating new opportunities to advance QIB research at large. The aim of this paper is to present a roadmap towards the clinical use of QIBs on MRIgRT systems. The most important need is to gather and understand how the QIBs collected during MRIgRT correlate with clinical outcomes. As the integrated MRI scanner differs from traditional MRI scanners, technical validation is an important aspect of this roadmap. We propose to integrate technical validation with clinical trials by the addition of a quality assurance procedure at the start of a trial, the acquisition of in vivo test-retest data to assess the repeatability, as well as a comparison between QIBs from MRIgRT systems and diagnostic MRI systems to assess the reproducibility. These data can be collected with limited extra time for the patient. With integration of technical validation in clinical trials, the results of these trials derived on MRIgRT systems will also be applicable for measurements on other MRI systems.
•Daily imaging is feasible on integrated MRI-guided radiotherapy (MRIgRT) systems.•This will advance quantitative imaging biomarker (QIB) research in oncology.•QIBs have the potential to personalise radiotherapy treatment.•This paper presents a roadmap towards clinical use of QIBs on MRIgRT systems.•Technical validation should be integrated in clinical trials on MRIgRT systems.</description><subject>Accelerators</subject><subject>Biomarkers</subject><subject>Biomarkers - metabolism</subject><subject>Biomedical materials</subject><subject>Clinical trials</subject><subject>Consortia</subject><subject>Humans</subject><subject>Hybrid systems</subject><subject>Image acquisition</subject><subject>Image-guided</subject><subject>In vivo methods and tests</subject><subject>Integration</subject><subject>Linear accelerators</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medical imaging</subject><subject>Multicentre study</subject><subject>Patients</subject><subject>Quality assurance</subject><subject>Radiation Oncology - methods</subject><subject>Radiation therapy</subject><subject>Radiotherapy</subject><subject>Radiotherapy, Image-Guided - methods</subject><subject>Reproducibility</subject><subject>Scanners</subject><issn>0959-8049</issn><issn>1879-0852</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9klGL1DAQx4so3nr6BXyQgC--dE2aNG1FBF30XFgRRPExpOl0b_baZC9JF-4L-rlMb_cO9UEIhMn85s9_JpNlzxldMsrk690SdkYvC1qwJRXpsAfZgtVVk9O6LB5mC9qUTV5T0ZxlT0LYUUqrWtDH2RkXTAjB5SL7tbYRtl5HdJa4nlxP2kaMKT4AwVFv0W5Ji27U_gp8IGiJGdCi0QOJHvUQSO88-fIt307YQUe87tDFS_B6f_OGrJw1sI9Toue8TtEtP05DRAM2eiAhTh1C0vFuJKlyFtug1WauDs5HnEayPln5cGeF_HT-an658G7aP80e9ckLPDvd59mPTx-_rz7nm68X69X7TW5EzWPeN5WUICRldQttJ3vZ1RJoL6tSNNRUnQBeNmAaqUtOC6igl33DgRWtZk3R8vPs3VF3P7UjdLcd6EHtfRqVv1FOo_o7Y_FSbd1B1VxQzlgSeHUS8O56ghDViMHAMGgLbgqqKAUXZVlzmtCX_6A7N3mb2kuUFKySJRWJKo6U8S4ED_29GUbVvCZqp-Y1UfOaKCrSmV28-LON-5K7vUjA2yMAaZgHBK-CQUi_16EHE1Xn8H_6vwFgJtQr</recordid><startdate>20210801</startdate><enddate>20210801</enddate><creator>van Houdt, Petra J.</creator><creator>Saeed, Hina</creator><creator>Thorwarth, Daniela</creator><creator>Fuller, Clifton D.</creator><creator>Hall, William A.</creator><creator>McDonald, Brigid A.</creator><creator>Shukla-Dave, Amita</creator><creator>Kooreman, Ernst S.</creator><creator>Philippens, Marielle E.P.</creator><creator>van Lier, Astrid L.H.M.W.</creator><creator>Keesman, Rick</creator><creator>Mahmood, Faisal</creator><creator>Coolens, Catherine</creator><creator>Stanescu, Teodor</creator><creator>Wang, Jihong</creator><creator>Tyagi, Neelam</creator><creator>Wetscherek, Andreas</creator><creator>van der Heide, Uulke A.</creator><general>Elsevier Ltd</general><general>Elsevier Science Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4799-2193</orcidid><orcidid>https://orcid.org/0000-0002-7270-7967</orcidid><orcidid>https://orcid.org/0000-0003-4443-7741</orcidid><orcidid>https://orcid.org/0000-0003-0205-3459</orcidid><orcidid>https://orcid.org/0000-0003-0073-7443</orcidid><orcidid>https://orcid.org/0000-0003-4230-1330</orcidid><orcidid>https://orcid.org/0000-0001-7751-3494</orcidid><orcidid>https://orcid.org/0000-0003-1433-9315</orcidid><orcidid>https://orcid.org/0000-0002-0551-7266</orcidid><orcidid>https://orcid.org/0000-0003-4321-5506</orcidid></search><sort><creationdate>20210801</creationdate><title>Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group</title><author>van Houdt, Petra J. ; Saeed, Hina ; Thorwarth, Daniela ; Fuller, Clifton D. ; Hall, William A. ; McDonald, Brigid A. ; Shukla-Dave, Amita ; Kooreman, Ernst S. ; Philippens, Marielle E.P. ; van Lier, Astrid L.H.M.W. ; Keesman, Rick ; Mahmood, Faisal ; Coolens, Catherine ; Stanescu, Teodor ; Wang, Jihong ; Tyagi, Neelam ; Wetscherek, Andreas ; van der Heide, Uulke A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c483t-f9766e46018bebd6f6d86e0f675490c7d4e359ec96a5302e7ef6f93e12ba192b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Accelerators</topic><topic>Biomarkers</topic><topic>Biomarkers - metabolism</topic><topic>Biomedical materials</topic><topic>Clinical trials</topic><topic>Consortia</topic><topic>Humans</topic><topic>Hybrid systems</topic><topic>Image acquisition</topic><topic>Image-guided</topic><topic>In vivo methods and tests</topic><topic>Integration</topic><topic>Linear accelerators</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medical imaging</topic><topic>Multicentre study</topic><topic>Patients</topic><topic>Quality assurance</topic><topic>Radiation Oncology - methods</topic><topic>Radiation therapy</topic><topic>Radiotherapy</topic><topic>Radiotherapy, Image-Guided - methods</topic><topic>Reproducibility</topic><topic>Scanners</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Houdt, Petra J.</creatorcontrib><creatorcontrib>Saeed, Hina</creatorcontrib><creatorcontrib>Thorwarth, Daniela</creatorcontrib><creatorcontrib>Fuller, Clifton D.</creatorcontrib><creatorcontrib>Hall, William A.</creatorcontrib><creatorcontrib>McDonald, Brigid A.</creatorcontrib><creatorcontrib>Shukla-Dave, Amita</creatorcontrib><creatorcontrib>Kooreman, Ernst S.</creatorcontrib><creatorcontrib>Philippens, Marielle E.P.</creatorcontrib><creatorcontrib>van Lier, Astrid L.H.M.W.</creatorcontrib><creatorcontrib>Keesman, Rick</creatorcontrib><creatorcontrib>Mahmood, Faisal</creatorcontrib><creatorcontrib>Coolens, Catherine</creatorcontrib><creatorcontrib>Stanescu, Teodor</creatorcontrib><creatorcontrib>Wang, Jihong</creatorcontrib><creatorcontrib>Tyagi, Neelam</creatorcontrib><creatorcontrib>Wetscherek, Andreas</creatorcontrib><creatorcontrib>van der Heide, Uulke A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of cancer (1990)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Houdt, Petra J.</au><au>Saeed, Hina</au><au>Thorwarth, Daniela</au><au>Fuller, Clifton D.</au><au>Hall, William A.</au><au>McDonald, Brigid A.</au><au>Shukla-Dave, Amita</au><au>Kooreman, Ernst S.</au><au>Philippens, Marielle E.P.</au><au>van Lier, Astrid L.H.M.W.</au><au>Keesman, Rick</au><au>Mahmood, Faisal</au><au>Coolens, Catherine</au><au>Stanescu, Teodor</au><au>Wang, Jihong</au><au>Tyagi, Neelam</au><au>Wetscherek, Andreas</au><au>van der Heide, Uulke A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group</atitle><jtitle>European journal of cancer (1990)</jtitle><addtitle>Eur J Cancer</addtitle><date>2021-08-01</date><risdate>2021</risdate><volume>153</volume><spage>64</spage><epage>71</epage><pages>64-71</pages><issn>0959-8049</issn><eissn>1879-0852</eissn><abstract>Quantitative imaging biomarkers (QIBs) derived from MRI techniques have the potential to be used for the personalised treatment of cancer patients. However, large-scale data are missing to validate their added value in clinical practice. Integrated MRI-guided radiotherapy (MRIgRT) systems, such as hybrid MRI-linear accelerators, have the unique advantage that MR images can be acquired during every treatment session. This means that high-frequency imaging of QIBs becomes feasible with reduced patient burden, logistical challenges, and costs compared to extra scan sessions. A wealth of valuable data will be collected before and during treatment, creating new opportunities to advance QIB research at large. The aim of this paper is to present a roadmap towards the clinical use of QIBs on MRIgRT systems. The most important need is to gather and understand how the QIBs collected during MRIgRT correlate with clinical outcomes. As the integrated MRI scanner differs from traditional MRI scanners, technical validation is an important aspect of this roadmap. We propose to integrate technical validation with clinical trials by the addition of a quality assurance procedure at the start of a trial, the acquisition of in vivo test-retest data to assess the repeatability, as well as a comparison between QIBs from MRIgRT systems and diagnostic MRI systems to assess the reproducibility. These data can be collected with limited extra time for the patient. With integration of technical validation in clinical trials, the results of these trials derived on MRIgRT systems will also be applicable for measurements on other MRI systems.
•Daily imaging is feasible on integrated MRI-guided radiotherapy (MRIgRT) systems.•This will advance quantitative imaging biomarker (QIB) research in oncology.•QIBs have the potential to personalise radiotherapy treatment.•This paper presents a roadmap towards clinical use of QIBs on MRIgRT systems.•Technical validation should be integrated in clinical trials on MRIgRT systems.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>34144436</pmid><doi>10.1016/j.ejca.2021.04.041</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4799-2193</orcidid><orcidid>https://orcid.org/0000-0002-7270-7967</orcidid><orcidid>https://orcid.org/0000-0003-4443-7741</orcidid><orcidid>https://orcid.org/0000-0003-0205-3459</orcidid><orcidid>https://orcid.org/0000-0003-0073-7443</orcidid><orcidid>https://orcid.org/0000-0003-4230-1330</orcidid><orcidid>https://orcid.org/0000-0001-7751-3494</orcidid><orcidid>https://orcid.org/0000-0003-1433-9315</orcidid><orcidid>https://orcid.org/0000-0002-0551-7266</orcidid><orcidid>https://orcid.org/0000-0003-4321-5506</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | European journal of cancer (1990), 2021-08, Vol.153, p.64-71 |
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| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Accelerators Biomarkers Biomarkers - metabolism Biomedical materials Clinical trials Consortia Humans Hybrid systems Image acquisition Image-guided In vivo methods and tests Integration Linear accelerators Magnetic resonance imaging Magnetic Resonance Imaging - methods Medical imaging Multicentre study Patients Quality assurance Radiation Oncology - methods Radiation therapy Radiotherapy Radiotherapy, Image-Guided - methods Reproducibility Scanners |
| title | Integration of quantitative imaging biomarkers in clinical trials for MR-guided radiotherapy: Conceptual guidance for multicentre studies from the MR-Linac Consortium Imaging Biomarker Working Group |
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