S2923
RTT- RTT operational practice and workflow innovations
ESTRO 2026
workflows. Prioritizing ART for these high-burden disease sites may optimize resource utilization, reduce treatment delays, and improve overall patient care within current system constraints. Keywords: Non-Adaptive, resource burden and optimization Digital Poster Highlight 2312 MR-Linac Treatment Times in Clinical Routine: A Multi Treatment Site Evaluation Lieke Meijers, Pim Borman, Eline de Groot-van Breugel, Louk Snoeren, Alexis Kotte, Reijer Rutgers, Roel Bouwmans, Martijn Intven, Bas Raaymakers Radiotherapy, UMC Utrecht, Utrecht, Netherlands Purpose/Objective: Magnetic Resonance-guided Radiotherapy (MRgRT) provides superior soft-tissue visualization and enables daily online adaptation. Despite these advantages, MR- Linac treatments are often perceived as excessively time-consuming, limiting patient throughput and clinical feasibility. Over recent years, workflow optimizations and growing team experience have substantially shortened MRgRT treatment durations. This study aimed to quantify the current treatment times across all treatment sites treated with MRgRT at our center. Material/Methods: Total time per fraction was defined as the interval between the start of the 3D MRI pre-scan and the end of radiation delivery, as extracted from the record- and-verify system. Fractions were grouped by treatment site and workflow type: adapt-to-position (ATP), adapt-to-shape (ATS), and ATS with minimal manual contour adaptations (ATS-Lite). Mean and median times were calculated and compared with the benchmark data reported by Westerhoff et al [1]. Results: In total, 5295 treatment fractions across 585 patients were analyzed (Figure 1 and Table 1). Median treatment times were 25.8 minutes for prostate ATS, 35.8 minutes for abdominal ATS sites (liver, pancreas, kidney and adrenal gland) and 12.2 minutes for a prostate ATP treatment. Outliers resulted mostly from treatment interruptions or technical faults. Compared to the workflow timings reported by Westerhoff et al., all workflows showed improved efficiency, particularly prostate ATS, following implementation of a deep-learning auto-contouring step.
Conclusion: MR-Linac treatment times at our institution are within a clinically feasible range to support routine implementation across multiple tumor sites and workflow types. The perception that MR-guided treatments are prohibitively time-consuming is no longer consistent with current clinical practice. References: [1] Westerhoff JM, Raaijmakers FJ, Daamen LA, de Groot-van Breugel EN, Meijers LTC, van der Voort van Zyp JRN, Verhoeff JJC, Mook S, Verkooijen HM, Intven MPW. Treatment time and learning curve analysis of 1.5 T MR-Linac workflows led by radiation oncologists or therapists. Clin Transl Radiat Oncol. 2025;51:100901. doi:10.1016/j.ctro.2024.100901. Keywords: MRgRT, Workflow efficiency
Digital Poster Highlight
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