This document gives guidance for multidisciplinary teams within institutions setting up and using an MRI-guided radiotherapy (RT) treatment planning service. It has been written by a multidisciplinary working group from the Institute of Physics and Engineering in Medicine (IPEM). Guidance has come from the experience of the institutions represented in the IPEM working group, in consultation with other institutions, and where appropriate references are given for any relevant legislation, other guidance documentation and information in the literature. Guidance is only given for MRI acquired for external beam RT treatment planning in a CT-based workflow, i.e. when MRI is acquired and registered to CT with the purpose of aiding delineation of target or organ at risk volumes. MRI use for treatment response assessment, MRI-only RT and other RT treatment types such as brachytherapy and gamma radiosurgery are not considered within the scope of this document. The aim was to produce guidance that will be useful for institutions who are setting up and using a dedicated MR scanner for RT (referred to as an MR-sim) and those who will have limited time on an MR scanner potentially managed outside of the RT department, often by radiology. Although not specifically covered in this document, there is an increase in the use of hybrid MRI-linac systems worldwide and brief comments are included to highlight any crossover with the early implementation of this technology. In this document, advice is given on introducing a RT workload onto a non-RT-dedicated MR scanner, as well as planning for installation of an MR scanner dedicated for RT. Next, practical guidance is given on the following, in the context of RT planning: training and education for all staff working in and around an MR scanner; RT patient set-up on an MR scanner; MRI sequence optimisation for RT purposes; commissioning and quality assurance (QA) to be performed on an MR scanner; and MRI to CT registration, including commissioning and QA.

本文件为机构内建立和使用 MRI 引导的放射治疗 (RT) 治疗计划服务的多学科团队提供指导。它由医学物理与工程研究所 (IPEM) 的一个多学科工作组编写。指南来自 IPEM 工作组所代表机构的经验，并与其他机构协商，并在适当的情况下提供了任何相关立法、其他指南文件和文献中的信息的参考。仅针对在基于 CT 的工作流程中为外部射束 RT 治疗计划获取的 MRI 提供指导，即当获取 MRI 并将其注册到 CT 以帮助描绘有风险的目标或器官体积时。MRI用于治疗反应评估，仅 MRI 的 RT 和其他 RT 治疗类型，如近距离放射治疗和伽马放射外科手术不在本文件的范围内。目的是为那些正在为 RT 设置和使用专用 MR 扫描仪（称为 MR-sim）的机构以及那些在可能在 RT 之外管理的 MR 扫描仪上时间有限的机构提供有用的指南科室，通常是放射科。尽管本文档中没有具体介绍，但全球混合 MRI-直线加速器系统的使用有所增加，并且包括简短的评论以强调与该技术的早期实施的任何交叉。在本文档中，建议将 RT 工作负载引入非 RT 专用 MR 扫描仪，以及计划安装专用于 RT 的 MR 扫描仪。下一个，在 RT 计划的背景下，提供了以下实用指导： 对在 MR 扫描仪内和周围工作的所有工作人员进行培训和教育；在 MR 扫描仪上设置 RT 患者；用于 RT 目的的 MRI 序列优化；对 MR 扫描仪进行调试和质量保证 (QA)；和 MRI 到 CT 注册，包括调试和 QA。