NCT02973828

PRIMER: Development of Daily Online Magnetic Resonance Imaging for Magnetic Resonance Image Guided Radiotherapy

Recruiting now Last updated 6 May 2025

What this trial tests

trial testing Imaging in Adenocarcinoma in 173 participants. Currently enrolling.

Timeline

17 October 2017

Primary endpoint
31 December 2026

31 December 2026

Quick facts

Lead sponsor	Institute of Cancer Research, United Kingdom
Status	Recruiting now
Study type	OBSERVATIONAL
Enrollment	173
Start date	17 October 2017
Primary completion	31 December 2026
Estimated completion	31 December 2026
Sites	1 location across United Kingdom

Drugs / interventions tested

• Imaging

Conditions studied

• Adenocarcinoma — all drugs for Adenocarcinoma →

Sponsor

Institute of Cancer Research, United Kingdom

Who can join

3 and older, any sex, with Adenocarcinoma. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

In radiotherapy high-tech scans with x-rays (CT scans) are taken before and during treatment to locate the tumour and ensure the radiation is hitting the target.

These x-rays expose patients to additional radiation and the quality of these scans is often poor which makes it difficult to distinguish tumour from normal tissue and there may be uncertainty in the tumour position due to movement or shrinkage. To allow for these uncertainties a large margin around the tumour is also treated, but this means that large volumes of normal tissue also receive significant doses of radiation, which can result in early and late toxicity.

MRI (magnetic resonance imaging) is better than CT scanning at being able to tell the difference between tumour and normal tissues and does not expose patients to additional radiation. A new machine called an MR Linac (or magnetic resonance imaging-guided linear accelerator) integrates high quality MRI with a state-of-the-art radiotherapy machine and the Institute of Cancer Research (ICR)/The Royal Marsden Hospital (RMH) are currently installation a prototype, which will be one of the first in the world. This revolutionary technology has the potential to change the way radiotherapy is delivered. We hope the improved precision and accuracy in hitting the target will mean reductions in margins around tumours and that this will lead to higher cure rates with significantly fewer side effects. Studies are required to simulate treatment on the MR Linac before it can be used in routine clinical practice and to conduct these studies, we need to obtain MRI scans on volunteers and patients who are currently undergoing treatment. This study will involve imaging with MRI in healthy volunteers as well as in patient volunteers before and during their standard course of radiotherapy to allow us to develop MRI sequences derived on the MR Linac for MR Linac-based research focusing on clinical application and establishment into a MR-CT and MR only workflow, treatment adaptation and quality assurance.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

1. Online adaptive radiotherapy for head and neck cancers on the MR linear Accelerator: Introducing a novel modified Adapt-to-Shape approach.
   Gupta A, Dunlop A, Mitchell A, McQuaid D, et al · · 2022 · cited 27× · PMID 34849412 · DOI 10.1016/j.ctro.2021.11.001
2. Quantitative analysis of diffusion weighted imaging in rectal cancer during radiotherapy using a magnetic resonance imaging integrated linear accelerator.
   Ingle M, Blackledge M, White I, Wetscherek A, et al · · 2022 · cited 12× · PMID 35756883 · DOI 10.1016/j.phro.2022.06.003
3. MRIgRT head and neck anthropomorphic QA phantom: Design, development, reproducibility, and feasibility study.
   Steinmann A, Alvarez P, Lee H, Court L, et al · · 2020 · cited 11× · PMID 31808949 · DOI 10.1002/mp.13951
4. Magnetic resonance imaging sequence evaluation of an MR Linac system; early clinical experience.
   Eccles CL, Adair Smith G, Bower L, Hafeez S, et al · · 2019 · cited 10× · PMID 32095556 · DOI 10.1016/j.tipsro.2019.11.004
5. Treatment of Central Nervous System Tumors on Combination MR-Linear Accelerators: Review of Current Practice and Future Directions.
   Bryant JM, Doniparthi A, Weygand J, Cruz-Chamorro R, et al · · 2023 · cited 6× · PMID 37958374 · DOI 10.3390/cancers15215200
6. Accelerating 4D image reconstruction for magnetic resonance-guided radiotherapy.
   Lecoeur B, Barbone M, Gough J, Oelfke U, et al · · 2023 · cited 4× · PMID 37664799 · DOI 10.1016/j.phro.2023.100484
7. Measurement and Incorporation of Laryngeal Motion Using cine-MRI on an MR-Linear Accelerator to Generate Radiation Therapy Plans for Early-stage Squamous Cell Cancers of the Glottis.
   Gupta A, McQuaid D, Dunlop A, Barnes H, et al · · 2024 · cited 2× · PMID 38681895 · DOI 10.1016/j.adro.2024.101490
8. Geometric distortion caused by metallic femoral head prosthesis in prostate cancer imaging on an MR Linac: in-vivo measurements of spatial deformation.
   McDaid L, Clough A, Benson RK, Nelder C, et al · · 2024 · cited 2× · PMID 38407369 · DOI 10.1093/bjr/tqae044