MRIdian Viewray Experience

Posted by bens1 @bens1, Feb 2, 2023

Making a decision related to which radiation machine one uses seems to be something that does not get a lot of discussion by urologists and radiation oncologists in terms of the differences, other than their success with the machine they use. I chose the MRIdian Viewray. There are multiple choices with different capability and toxicity risks.

I had my first treatment, out of 5, on January 31. I had spaceoar gel inserted. The machine is both a radiation and MRI built into one unit. They can see healthy tissue and the cancer in real time and adjust accordingly using the machines dynamic mapping capability, if necessary. They used 2 mm margins based on a recent randomized trial called Mirage. The machine turns off automatically if your internals move and the radiation goes outside the mapped out area. No pain or real side effects after the first treatment. Second treatment is on Friday. My prostate cancer is contained within the prostate and I am almost 70 with Gleason 3+4 on one core and 3+3 on another. Psa was 10.2.

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

Thanks for posting.. I have a consultation with a RO specifically about using the ViewRay MRIdian for my treatment of prostate cancer as well.. I have been researching this as well. I have already met with providers who use the Varian Trubeam/Edge or the Cyberknife as alternatives.. This consultation will be my last before deciding There is some debate whether the use of SpaceOar is necessary when using MRIdian… The other benefit could be avoiding the placement of markers that the other systems require… Please keep posting your progress as you get the remaining treatments… We are on the same page in terms of choosing a treatment regimen that best lessens probability of side effects.. Thanks and best of luck..

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bens1… where was this? Very interesting advance in technology! I had proton done three years ago at Mayo with very similar numbers to yours.

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Did this at UCLA with Dr. Kishan. So far no SE. Only time will tell when I get scans and PSA tested after off ADT.

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Good news. I am starting my treatment on Feb. 14 at Hoag Hospital, Irvine using the same equipment. I will follow up with results later.

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@dale1k

Thanks for posting.. I have a consultation with a RO specifically about using the ViewRay MRIdian for my treatment of prostate cancer as well.. I have been researching this as well. I have already met with providers who use the Varian Trubeam/Edge or the Cyberknife as alternatives.. This consultation will be my last before deciding There is some debate whether the use of SpaceOar is necessary when using MRIdian… The other benefit could be avoiding the placement of markers that the other systems require… Please keep posting your progress as you get the remaining treatments… We are on the same page in terms of choosing a treatment regimen that best lessens probability of side effects.. Thanks and best of luck..

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I had my second treatment with the MRIdian this morning. They adjusted the mapping a little in real time to account for some organ movements from last time, i.e. bladder filled a little differently than last time and bowel was not exactly the same. Same experience as the first a few days ago. I prepped with 30 Oz of water this time instead of 40 Oz as my bladder showed that it was too filled to be completely comfortable for the whole time.

At this location near Orlando (Ocoee), there is another photon based radiation machine (NOT the MRIdian) that is used for others that is not as accurate but the doctors take the position that the trials show the same outcomes. It was suggested that insurance and what the doctor recommends are key to which machine you end up with. Availability and what the doctor has been successful with are also an issue...or a bias. In downtown Orlando, they also have the Prooton machine.

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@docwatson

bens1… where was this? Very interesting advance in technology! I had proton done three years ago at Mayo with very similar numbers to yours.

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docwatson:

This was in Ocoee, Fl which is near Orlando. Here is a link to the MRIdian Viewray treatment centers:
https://viewray.com/mridian-treatment-centers/

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@dale1k

Thanks for posting.. I have a consultation with a RO specifically about using the ViewRay MRIdian for my treatment of prostate cancer as well.. I have been researching this as well. I have already met with providers who use the Varian Trubeam/Edge or the Cyberknife as alternatives.. This consultation will be my last before deciding There is some debate whether the use of SpaceOar is necessary when using MRIdian… The other benefit could be avoiding the placement of markers that the other systems require… Please keep posting your progress as you get the remaining treatments… We are on the same page in terms of choosing a treatment regimen that best lessens probability of side effects.. Thanks and best of luck..

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dale1k:
Your welcome. I decided to do the Spaceoar after speaking with reps from the company and my brother had it done at Cornell Weill in NYC. I liked the idea of the extra half inch protection between the rectum and the prostate. My RO put the Fiducial markers in as well, which I had no problem with (as they were already "there") both from the benefit perhaps to mapping but also as backup if technology breaks down, a discussion I have not followed up with.
Orlando Health just changed their policy regarding margins on the MRIdian, about a week ago, from 3 mm to 2 mm (hopefully minimizing even more, any side effects) because of the Mirage randomized study:
https://www.prnewswire.com/news-releases/mirage-phase-iii-randomized-controlled-trial-demonstrates-superiority-of-mridian-mri-guidance-in-stereotactic-body-radiotherapy-sbrt-for-localized-prostate-cancer-301660815.html

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@bens1

dale1k:
Your welcome. I decided to do the Spaceoar after speaking with reps from the company and my brother had it done at Cornell Weill in NYC. I liked the idea of the extra half inch protection between the rectum and the prostate. My RO put the Fiducial markers in as well, which I had no problem with (as they were already "there") both from the benefit perhaps to mapping but also as backup if technology breaks down, a discussion I have not followed up with.
Orlando Health just changed their policy regarding margins on the MRIdian, about a week ago, from 3 mm to 2 mm (hopefully minimizing even more, any side effects) because of the Mirage randomized study:
https://www.prnewswire.com/news-releases/mirage-phase-iii-randomized-controlled-trial-demonstrates-superiority-of-mridian-mri-guidance-in-stereotactic-body-radiotherapy-sbrt-for-localized-prostate-cancer-301660815.html

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Thanks for the update and additional information.. So how much time have the treatments lasted..?? I’m thinking holding in that amount of water for more than a half hour could be challenging… I’ve got many questions I’ll be asking the RO in terms of process, placement of fiducial markers, SpaceOar, etc.. My appointment isn’t until February 13th… I appreciate your sharing your experience as many of us are seeking as much information as we can before we go thru the treatment process as well… Best to you…

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@dale1k

Thanks for the update and additional information.. So how much time have the treatments lasted..?? I’m thinking holding in that amount of water for more than a half hour could be challenging… I’ve got many questions I’ll be asking the RO in terms of process, placement of fiducial markers, SpaceOar, etc.. My appointment isn’t until February 13th… I appreciate your sharing your experience as many of us are seeking as much information as we can before we go thru the treatment process as well… Best to you…

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dale1K
The radiation part is about 15-20 minutes but by the time they get you settled, adjust the mapping for any changes and make sure your bladder fills enough, it was about an hour and a half. For the second session on Friday, they had me drink 30 oz of water in 15 minutes, one hour before my treatment. I was comfortable holding that amount (vs the 40 oz the first session) but, as you indicated, not every person will be. No other prep for the radiation except clothing or what has come to be known for me as my radiation sweats...no zippers, no metal at all, otherwise you are naked at the bottom or underwear with warm blankets. I would also add, for me, by last night I was more restricted urinating than when I finished in the morning. I started taking cranberry pills (UTI concept my RO suggested) to help though my RO had preemptively prescribed Flomax which I am hoping I don't have to take not for any other reason other than its one more pill and once on it, you have to phase it out.

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Thanks for the additional update… So you have 3 more sessions to go… I hope the problem with urination restriction gets resolved… I realize that there is a high probability that something will be impacted when I eventually start my treatments… After all, we are radiating a very sensitive/important area of our body… I just hope it doesn’t stop me from remaining active as I ride my bike daily unless the weather prohibits me from doing so… Also, like you, I don’t want to take any more pills than I already have to.. If it cures/stops the cancer from progressing, it will be worth it…

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