Session Item

The pairing of magnetic resonance imaging (MRI) technology with the linear accelerator is an important recent innovation. The MR-Linac allows visualisation of anatomical and functional changes during radiotherapy (RT) and adapts the treatment to achieve optimal therapy. While the MR-Linac offers the promise of high precision treatment, it is important to evaluate this novel technology to understand the clinical outcomes achieved in the short and long term. Analysis of Data to Advance Personalised Therapy with MR-Linac (ADAPT-MRL) is a multi-site, multinational, observational cohort registry designed to collect data on the use of MR-Linac for RT and patient outcomes. The registry will provide a linked repository of technical and clinical data that will form a platform for prospective studies and technology assessment.

Ethics approval was granted by St Vincent’s Hospital Human Research Ethics Committee. Figure 1 shows the design of the ADAPT-MRL registry. This registry aims to include an estimated 10,000 eligible participants across Australia and other countries over a 7- to 10-year period. Participants will undergo treatment and assessments in accordance with standard practice. Toxicity and survival outcomes will be assessed at baseline, during treatment, and with 3 monthly follow-up until 24 months, patient reported outcome measures will also be collected. Participants with a variety of cancers will be included.

Figure 1: Design of the ADAPT-MRL registry

In 2020, the ADAPT-MRL registry was established in coordination with investigators of The MOMENTUM Study [1], another multi-institutional observational registry of MR-Linac treatments, to enable efficient data aggregation and coordinated sub-studies. Since then, 79 patients have consented to participate in the registry and 41 patients have completed 3-month follow-up. 

Data obtained from the ADAPT-MRL registry is expected to provide evidence on the safety and efficacy of the MR-Linac, a new technical innovation in radiation oncology. We expect this registry will generate data that will be used to optimise treatment techniques, MR-Linac software algorithms, evaluate participants’ outcomes and toxicities and to create a repository of adapted plans, anatomical and functional MR sequences linked to participants’ outcomes.

[1] Sophie R, Christodouleas JP, Blezer EL, Akhiat H, Brown K, Choudhury A, Eggert D, Erickson BA, Faivre-Finn C, Fuller CD, Goldwein J. The MOMENTUM Study: An international registry for the evidence-based introduction of MR-guided adaptive therapy. Frontiers in Oncology. 2020;10.