The UK’s first MR Linac scan

The UK’s first healthy volunteer has been scanned on the pioneering MR Linac imaging machine at The Royal Marsden and The Institute of Cancer Research (ICR)

09 November 2017

The Evening Standard's Health Editor and Chief News Correspondent Ross Lydall volunteered to join The Royal Marsden and the ICR’s PRIMER study. The study is open to healthy volunteers to test the MR imaging protocols to assess the visibility and value of MR sequences.

How does it work? 

The Magnetic Resonance Linear Accelerator (MR Linac) combines two technologies – an MR 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.

The location of tumours and organs within the body changes, for example a tumour in the lung will move up and down as a person breathes, and a tumour in the prostate might move from day to day depending on what the person has eaten, or how full their bladder is - as seen in the scans below, which shows how the bladder can change over the course of a 40-minute scan. 

 

Constant monitoring of the patient during treatment will enable the most precise targeting of the tumour and help avoid healthy tissue. 

The PRIMER study is the first step to treating cancer patients on the MR Linac at The Royal Marsden and the ICR. Researchers will use the information from the scans to help decide the best ways to use the imagine capabilities of the MR Linac. The volunteers’ scans will be used to assess and optimize the quality of the images acquired on the new machine. This will help design and plan treatments with the new MR Linac in the future.

Ross Lydall said:

“It was an honour to be the first healthy volunteer and amazing to be immersed in technology like this and understand how my images will help research and develop the technology.

“I am happy to have helped people with cancer who may need this machine as a part of their treatment in the future.

“I felt like the astronaut Tim Peake getting ready to go into the MR Linac. At first being closed in the tunnel was a little alarming but my head was stuck out so that was reassuring and gave me the feeling of space.”

Professor Robert Huddart , Principle Investigator for the PRIMER study, said:

“Although a patient may lie perfectly still, the inside of their body, including the tumour, may move and even change shape. Changes of a few millmetres might not seem a lot but it significant is when you’re aiming to be as accurate as possible.

“Aiming at a moving target presents a real challenge in radiotherapy because we only want to hit the tumour and avoid the healthy tissue. The MR Linac has been designed to overcome this challenge and really could be a game-changer in radiotherapy.

“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, and many patients may need fewer doses in total. If our trials are successful, we will be able to deliver a much more effective treatment for cancer patients that will hopefully have fewer side effects.”

The installation of the MR Linac was made possible by a £10m grant from the Medical Research Council to the ICR, with additional support from The Royal Marsden Cancer Charity.

Meet the team 

Cynthia Eccles

“I am the MR Linac Lead Research Radiographer, and have been testing end-to-end workflows, developing imaging and research protocols, as well as safe standard operating procedures, and providing education to core staff in preparation for clinical use.”

Trina Herbert 

“My role as a Senior Therapy Radiographer has evolved as a result of this project. I have worked closely with Diagnostic MRI radiographers and undertaken post graduate education in order to learn a new discipline.

Dr Simeon Nill

“I am Head of Translational Radiotherapy Physics, and am coordinating the commissioning of the MR Linac and leading the radiotherapy physics implementation of the system.”

Dr Ian Hanson

“I am a clinical scientist working on the fundamental physics and engineering of the MR Linac. I am working on the measurements and procedures that will allow us to deliver the highly precise treatments the MR Linac is capable of in a safe and effective way.”

Erica Scurr

“I am the lead MRI Superintendent Radiographer and have been working with my radiotherapy colleagues to promote MRI education, to support MRI training for Radiotherapy Radiographers in a new modality, ensure parity of safe practices between MRI departments, and support the development of MRI in radiotherapy planning.”

Helen McNair

“As the lead research radiographer I have been closely involved in developing the research protocols to investigate the potential benefits of the MR Linac. I have also undergone additional training in MR safety and Imaging.”