MRI linac at U Virginia or Philadelphia and my Florida experience

Posted by erbill @erbill, Jun 22 1:05pm

wondering if anyone has had sbrt with mri linac in Philadelphia or at university of Virginia. mridian or elekta unity? Were you pleased with the RO? spaceoar?
my experience lately is that even though a facilities website indicates they use the mridian viewray on prostate cancer doesn't mean they are.
i have had appointments at both moffit and Orlando health and found out the machines were taken off line recently. they don't want to pay the exhorbitant maintenance contract.

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

brianjarvis | @brianjarvis | Jun 22 4:44pm

The reason that “….a facilities website indicates they use the mridian viewray on prostate cancer doesn't mean they are….” is that ViewRay, the maker of the MRIdian MRI-guided radiation therapy system, filed for Chapter 11 bankruptcy on July 16, 2023.

chippydoo | @chippydoo | Jun 23 8:05am

I've heard good things about UVa prostate cancer care from a couple of guys that I know.

trchar | @trchar | Jun 23 10:25am

I had proton at Orlando health it was extremely successful spacer was inserted prior with no issues. Have not had any bowl problem at all, a bit of frequent need to urinate but totally manageable. Good luck with whatever you choose.

erbill | @erbill | Jun 23 10:27am

In reply to @chippydoo "I've heard good things about UVa prostate cancer care from a couple of guys that I..." + (show)

thanks
UVA is listed as NCI cancer institute

erbill | @erbill | Jun 23 10:52am

In reply to @brianjarvis "The reason that “….a facilities website indicates they use the mridian viewray on prostate cancer doesn't..." + (show)

cancer centers are still using the meridian device despite the bankruptcy filing. there have been issues with facilities continuing the maintenance contract with the former employee group.

the hope for patients is that image guided sbrt will continue to develop.
for instance my urologist at moffit said they are one of a few centers that combine the psma pet scan with the mri guided fusion biopsy.
perhaps technology may develop for image guided sbrt.
additionally the viewray mridian uses.35T mri while the elekta unity has a 1.5T mri.

brianjarvis | @brianjarvis | Jun 23 11:52am

In reply to @erbill "cancer centers are still using the meridian device despite the bankruptcy filing. there have been issues..." + (show)

Yes, some are and some aren’t. There was an article in a radiation oncology magazine about the possibility that some cancer centers that had been using it, might not be able to continue: https://www.oncologysystems.com/blog/the-collapse-of-viewray/

It’s worth asking when considering a facility where it’s still listed as being used.

bens1 | @bens1 | Jun 24 6:17am

@erbill and @brianjarvis : I was treated with the MRIdian in February 2023 at the Orlando Health cancer center. Yes Viewray went bankrupt but service contracts for $1m/year were available through another company that hired some of the original people from Viewray. Orlando Cancer center has indicated that they are not satisfied with the service they get for $1m and are going to switch to the Elekta Unity but that takes about a year. In the meantime, they are still using it for Prostate cancer but it seems that they try to prioritize what kind of cancer they use it for and organ movement is one criteria for that decision. I ran into that type of prioritization with Moffitt when I was looking for treatment at facilities that had the MRIdian and in Moffitts case, I was told by an executive radiologist that if I wanted the adaptive dynamic capability of the machine, to go elsewhere so I did.

The Elekta unity has some similar functions to the MRIdian, gating and adaptive functionality, but I am not familiar with other features , other than a higher Tesla, that gives it an advantage over the MRIdian.

beachguy | @beachguy | Jun 25 6:24pm

In reply to @bens1 "@erbill and @brianjarvis : I was treated with the MRIdian in February 2023 at the Orlando..." + (show)

I wondered the same regarding the magnet strength of the MRIdian and this what found when I was going for my 5 treatments….. The ViewRay MRIdian system uses a 0.35 Tesla (T) magnet to achieve high-quality images and specific advantages for radiation therapy.
Here's why ViewRay opted for this field strength:
Optimal field strength for radiation therapy: The 0.35 T magnet allows the system to avoid image artifacts and distortions in the dose distribution that can occur with high field strength magnets.
Geometrically precise images: This low field strength leads to geometrically precise images, without susceptibility distortions or chemical-shift artifacts.
Accurate dose distributions: The precise images enable accurate dose distributions for treatment.
Reduced tissue heating: The lower radiofrequency (RF) excitation frequency at 0.35 T minimizes RF induced tissue heating, allowing for uninterrupted MR imaging during treatment.
Split superconducting magnet design: The split superconducting magnet at 0.35 T allows for an unobstructed beam path, addressing technical complexities of combining an MRI with a linear accelerator.
Reduced magnetic susceptibility artifact: This low field strength reduces artifacts caused by spinal hardware and other materials, improving visualization of targets and organs at risk (OARs).
In essence, the 0.35 T magnet on the MRIdian is chosen to optimize image quality and treatment delivery in the context of MR-guided radiation therapy.

beachguy | @beachguy | Jun 25 6:37pm

I had my MRIdian treatments in Philly at TJUH. My experience was great no complaints. My RO used the Barrigel and not the SpaceOAR. Both my RO and the Nuclear Physicist were happy to answer all my questions about planning and show me on the control system how my radiation was directed and placed for all my individual beams. The technicians for the MRIdian that cared for me during my treatments were awesome.