The UK’s first MR Linac, combining MRI and radiotherapy technology

The Royal Marsden has treated the first UK patient in the UK on the revolutionary new MR Linac, which tracks tumours in real-time for more accurate radiotherapy treatments. 

The Magnetic Resonance Linear Accelerator (MR Linac) combines two technologies – an MRI scanner and linear accelerator – to precisely locate tumours, tailor the shape of X-ray beams in real time and accurately deliver doses of radiation to moving tumours.

“This truly groundbreaking device is the first of its kind anywhere in the UK and has the potential to transform the care that cancer patients receive.”

Sadiq Khan, Mayor of London, at the official opening of the MR Linac

How it works

Combining the highly precise soft-tissue contrast of MRI scanning with precision radiotherapy in a single treatment technology has been one of the major challenges of modern radiotherapy research.

Trials of the system have shown that the MR Linac system can be calibrated to deliver X-rays accurately in the presence of the distorting magnetic field used to generate MRI images.

In doing so, researchers have overcome a key scientific challenge. It could be especially effective for cancers which move during radiotherapy or change position between scanning and treatment — for instance through breathing, bladder filling or bowel changes. Examples are lung, cervical, prostate, bowel and bladder cancer.

The scans below show how the position of the bladder (the white area in the centre of the scan) can change over the course of a 40 minute treatment.

The benefits of MR Linac technology

The pioneering kit could mean significant reduction in treatment times, side effects and inconvenience for patients.

Professor Robert Huddart, Consultant Clinical Oncologist said:

“By seeing the tumour as we aim the radiation at it better, we can be more confident of a direct hit. We should ultimately be able to attack the tumour with a higher dose of radiation each time, meaning we can treat some patients which are currently difficult to treat effectively.”

Dr Alison Tree, Consultant Clinical Oncologist, explains the impact for prostate cancer patients:

“Prostate cancer responds most effectively to large doses of radiation delivered over a short period. However, because the prostate lies close to the rectum, high doses risk damaging the rectum and increasing side effects.

“With MR Linac we can better target the prostate while avoiding the rectum, so we can safely deliver higher doses of radiation. Treatment time could be reduced to five days – or even just one, which will save time and money for patients and the NHS.”

A world-leader in clinical research The Royal Marsden and its academic partner, The Institute of Cancer Research (ICR), have been actively developing the technology for several years as part of an international consortium of seven leading centres initiated and coordinated by the company Elekta, which makes the MR Linac (also known as the Elekta Unity Systems), and MR partner Phillips.

As international leaders in the development of this technology, The Royal Marsden and ICR have the expertise to deliver these complex treatments safely and effectively.

In 2017, The Evening Standard's Health Editor and Chief News Correspondent Ross Lydall was the first healthy volunteer to be scanned on the MR Linac as part of The Royal Marsden and the ICR’s PRIMER study.

The Royal Marsden and ICR project has been funded by a £10 million grant from the Medical Research Council to the ICR, with additional support from and The Royal Marsden Cancer Charity.

Case study 

Barry Dolling, 65, from Selsdon, Surrey

“I was diagnosed with prostate cancer in April this year. I was told about the PRISM clinical trial on the new MR Linac when I was referred to The Royal Marsden for radiotherapy. I jumped at the chance to sign onto the trial as I believe the treatment will give me a better quality of life and minimal side effects in comparison to other treatments. 

I will be having 20 treatments on the MR Linac and am hoping to keep up with my swimming and golf. It was important to me to have treatment that had minimal side effects. It is nice to know that my treatment will help research treatments for cancer patients in the future.

I am lucky the timings worked out for me as the trial just opened at the time I would have been starting standard radiotherapy treatment. I was really excited when they told me I would be the first patient in UK. I feel very privileged.”

Referral

NHS patients can access MR Linac treatment through clinical trials at The Royal Marsden. Ask your GP or consultant for a referral to The Royal Marsden. Alternatively, patients can access the MR Linac privately. For more information about the MR Linac and the cost of treatment, contact our Central Referral and Information Line:

Call us: +44 (0)20 7811 8111 (Monday to Friday, 8am to 6pm, Saturday, 10am to 2pm)

Email us: privatepatients@rmh.nhs.uk