Compared with computed tomography (CT), magnetic resonance imaging (MRI) traditionally plays a very limited role in lung cancer management, although there is plenty of room for improvement in the current CT-based workflow, for example, in structures such as the brachial plexus and chest wall invasion, which are difficult to visualize with CT alone. Furthermore, in the treatment of high-risk tumors such as ultracentral lung cancer, treatment-associated toxicity currently still outweighs its benefits. The advent of MR-Linac, an MRI-guided radiotherapy (RT) that combines MRI with a linear accelerator, could potentially address these limitations. Compared with CT-based technologies, MR-Linac could offer superior soft tissue visualization, daily adaptive capability, real-time target tracking, and an early assessment of treatment response. Clinically, it could be especially advantageous in the treatment of central/ultracentral lung cancer, early-stage lung cancer, and locally advanced lung cancer. Increasing demands for stereotactic body radiotherapy (SBRT) for lung cancer have led to MR-Linac adoption in some cancer centers. In this review, a broad overview of the latest research on imaging-guided radiotherapy (IGRT) with MR-Linac for lung cancer management is provided, and development pertaining to artificial intelligence is also highlighted. New avenues of research are also discussed.
与计算机断层扫描（CT）相比，磁共振成像（MRI）在肺癌管理中传统上作用非常有限，尽管当前基于CT的工作流程仍有很大的改进空间，例如在臂丛神经和胸壁侵犯等结构上，仅靠CT难以清晰显示。此外，在治疗超中央型肺癌等高危肿瘤时，治疗相关毒性目前仍超过其益处。MR-Linac的出现——一种将MRI与直线加速器相结合的MRI引导放射治疗（RT）——可能有望解决这些局限性。与基于CT的技术相比，MR-Linac可提供更优的软组织可视化、每日自适应能力、实时靶区追踪以及治疗反应的早期评估。在临床上，它在治疗中央型/超中央型肺癌、早期肺癌和局部晚期肺癌方面可能尤其具有优势。对肺癌立体定向体部放疗（SBRT）日益增长的需求，已促使一些癌症中心采用MR-Linac。本综述广泛概述了使用MR-Linac进行影像引导放射治疗（IGRT）在肺癌管理中的最新研究，并重点强调了与人工智能相关的发展。同时，也讨论了新的研究方向。
肿瘤(癌症)患者之家