University Medical Center Utrecht, Utrecht, the Netherlands

Abstract

This chapter describes the development toward magnetic resonance imaging (MRI)-guided brachytherapy at University Medical Center Utrecht (UMC Utrecht) such as MRI-brachytherapy suite, the development of an MRI-compatible afterloader, MRI visualization of the Ir source, the development of a robotic prostate implant device, MRI-based gynecology, prostate and nasopharynx applications, and safety issues. For the treatment of patients with advanced cervix cancer, the workflow in the combined MRI-brachytherapy suite is now fully adapted to exploit MR imaging immediately before dose delivery. The potential of focal MRI-guided high-dose rate (HDR) brachytherapy in patients with localized prostate cancer is investigated in an Institutional Review Board (IRB) approved feasibility study. Since manual MRI-guided insertion of needles is not feasible due to limited access to the patient in MRI scanner bore, ultrasound (US)-guided insertion and use of MR information is applied. MRI guidance for brachytherapy has potential for different body sites. The chapter explores MRI for delivery of a boost dose using the Rotterdam nasopharynx applicator.