MR-Linac program
Verification of high treatment quality across cancer sites Over the past year, our MR-Linac teams have undertaken extensive reviews of patient outcomes across multiple cancer sites. One study focused on men who had undergone prostate surgery and later required radiation therapy. Forty-seven patients were treated using MR-guided adaptive radiation therapy, with some also receiving a targeted radiation boost enabled by advanced imaging. The review showed that treatment was safe and well tolerated, with generally mild, temporary side effects. Importantly, the targeted boost did not increase complication rates, and prostate-specific antigen (PSA) levels dropped significantly in most patients, an indicator of good disease control. 12 A second project evaluated patients receiving stereotactic radiation therapy for prostate cancer, a highly precise, short-course treatment. Clinicians were able to safely deliver escalate doses to the primary target while protecting surrounding organs. Side effects were again generally mild, and PSA reductions indicate a robust treatment response.
MR-Linac teams contribute to advancing imaging innovation in radiation therapy
Subsequent investigation by our teams measured the apparent diffusion coefficient in prostate patients. This study 15 showed a measurable change between the start and end of treatment, indicating biological response to radiation therapy. These early findings move us closer to future treatment pathways informed by individual bio-sensitivity.
Outcome evaluations also extended to pancreatic cancer. Findings confirmed that MR-guided adaptive radiation therapy can be delivered safely, achieving target doses while keeping toxicity low. These results highlight evolving improvements in radiation therapy delivering meaningful progress in treatment areas previously constrained by toxicity limitations. 13 Collectively, these results demonstrate the ability to deliver personalised, targeted and well-tolerated MR-guided radiation therapy. GenesisCare joins the international phase III trial, ULTRAS The MR-linac teams in Sydney and Perth are pleased to have opened the ULTRAS international phase III clinical trial this year. ULTRAS is evaluating treatment of liver metastases on MR-Linac systems in a single, high-dose treatment session. Building on promising outcomes from a previous phase II study, this trial will assess the safety and efficacy of this innovative approach across multiple centres internationally.
The integration of MR imaging during treatment in MR-Linac systems allows access to sophisticated imaging techniques that have been found to be diagnostically important in recent years. One such technique – diffusion- weighted imaging – measures a biological property of tissue, the apparent diffusion coefficient (ADC), a biomarker reflecting tissue microstructure and cancer-related changes. In a study published this year 14 , our researchers measured the apparent diffusion coefficient using three MR-Linac systems across Australia. Both models and a healthy volunteer were scanned to test accuracy and consistency across sites. Results showed that most measurements met international quality standards, with excellent repeatability in controlled model tests and acceptable variability in patient imaging. These findings confirm that MR-Linac systems can generate high quality imaging biomarkers, without increasing burden for patients. Establishing this reliability paves the way for large, multi- centre clinical trials that use MRI biomarkers to personalise cancer care.
Streamlining prostate radiation therapy
Stereotactic treatment for prostate cancer can currently be offered as a course of five treatment sessions, but emerging evidence suggests that giving the same treatment in just two sessions may be feasible. Our team modelled how adaptive MR‑guided radiation therapy could safely deliver this ultra-short course treatment. The simulations showed that MR‑guided radiation therapy could deliver high doses to the tumour while keeping doses to surrounding organs within safe limits. These findings suggest that ultra‑short, two‑session prostate radiation therapy could be delivered safely with MR‑guided radiation therapy systems. This work paves the way for GenesisCare to join the DESTINATION-2 international clinical trial which will evaluate clinical delivery of the two-session approach.
WA ULTRAS team following successful enrolment of the first patient
MR-Linac team successes at CINSW Cancer Summit Conference, 2025
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