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Planning using MRI for anal and rectal cancer radiotherapy treatment

ABSTRACT: Background and study aims Almost half of cancer patients undergo radiotherapy as part of their treatment. Currently radiotherapy treatment planning involves using a CT scan to maximise radiation to the cancer whilst minimising radiation dose to healthy tissue. For many cancers the extent of the tumour is seen much better on Magnetic Resonance Imaging (MRI). This study will assess whether MRI can replace CT for radiotherapy planning for ano-rectal cancers. Who can participate? Adult patients (> 18 years) undergoing radiotherapy at Leeds Teaching Hospitals NHS Trust or the Northern Centre for Cancer Care (NHS) for anal and rectal cancers. What does the study involve? Patients who are already receiving radiotherapy as part of their treatment undergoing radiotherapy in Leeds Cancer Centre will be invited to participate in an imaging study where an additional MRI scan is obtained after informed consent have been taken. This study will have no impact on the participant’s treatment. The MRI scan will be used to compare the new method of treatment planning with the current method used routinely in patient care.

DISEASE(S): Colorectal Cancer

PROVIDER: 2424449 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: Cohort: 10 patients with histologically proven squamous cell carcinoma (SCC) of the anus, presenting to Austin Health for chemo-radiotherapy from June 2015. Observation: for up to 3 years post-radiotherapy. Interventions additional to standard procedures for purpose of study are administered by qualified health professionals and include: Pre-radiotherapy imaging: During standard MRI imaging session – non-standard diffusion weighted MRI (dwMRI) and dynamic contrast enhanced (DCE) MRI scans within Radiology facility. During standard CT simulation session – additional CT scan in prone position within Austin Radiation Oncology. Post-Radiotherapy - 3-4 weeks post completion of radiotherapy - non-standard timepoint for these scans MRI session – including dwMRI and DCE MRI scans within Radiology facility. PET session - PET imaging within Austin Nuclear & Molecular Imaging department. A number of imaging scans are required to map disease for targeting of radiotherapy (RT), including CT, PET and MRI. Each provides slightly different information about the position, shape and composition of the disease that is used by a Radiation Oncologist to define where to target the radiation and how much radiation to deliver. We aim to add an extra, non-standard MRI imaging sequence called a diffusion weighted (dwMRI) scan, to understand the characteristics of the disease and how its use may change the size or shape of the target area so as to ensure complete treatment coverage and improved outcomes from treatment. Additionally, the use of contrast with MRI, dynamic contrast enhanced MRI (DCEMRI) has been shown in other cancer sites to help better identify and show the disease and to show response to treatment, and we wish to verify this in anal Primary outcome(s): Identify the differences in radiotherapy target volume definition on standard (CT, T1/T2 MRI and PET) versus non-standard imaging modalities (dwMRI & DCE-MRI).[2 years post-radiotherapy] Study Design: Purpose: Treatment; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group

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Planning using MRI for anal and rectal cancer radiotherapy treatment

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