Cancer patients to benefit from Royal Marsden's new £10m MRI machine

Evening Standard reporter Ross Lydall tries out the all new MR Linac scanner
Ross Lydall @RossLydall9 November 2017

Thousands of cancer patients a year are to be offered “game-changing” treatment at a London hospital using one of the world’s most advanced radiotherapy machines.

The Royal Marsden will be the first hospital in Britain to use a £10 million MR Linac, which delivers precision blasts of radiotherapy to 3mm accuracy while scanning patients in “real time” to ensure the tumour is targeted.

Doctors hope this could lead to major advances in treatment and survival rates for prostate, breast, lung and pancreatic cancer - the deadliest of all major cancers.

Professor Robert Huddart, consultant oncologist at the Royal Marsden and Institute of Cancer Research, said the machine was able to deliver higher bursts of radiation at greater precision than other equipment — treating the tumour more effectively without the risk of damaging healthy tissue.

This could mean prostate cancer might require only several treatments while breast tumours could be eradicated in a single session. “We hope it will be for many, many patients a game-changer,” he told the Standard.

The giant machine is built in a bunker dug into the Sutton campus shared by the Marsden and The Institute of Cancer Research (ICR). It was funded by the Medical Research Council after a £230 million investment in UK science announced by the Treasury in 2014.

Just don't get an itch...

Evening Standard reporter Ross Lydall tried out the machine

“You’re not claustrophobic, are you?” asked Professor Robert Huddart. For the first time I felt uneasy about being entombed in a  radiotherapy machine for up to an hour.

I had been given the chance to be the first healthy volunteer to test the Marsden’s MR Linac. I’d taken some convincing. What if they found something?

Clad in scrubs, with earplugs and ear defenders protecting me from the grinding noise of the imaging magnets, I was slid backwards into the tunnel. I closed my eyes and tried to stay focused, wondering if this is what life is like for astronaut Tim Peake. “Try to stay still,” advised lead research radiographer Helen McNair. The magnets whirred and beeped. After 10 minutes came the urge to scratch my upper lip. After 30 minutes my feet cramped.

It was painless and thankfully nothing was detected. For patients, this machine could be the difference between life and death.

A second machine is being installed at The Christie hospital in Manchester. The Marsden will be the first to treat patients, starting by next summer.

Magnetic fields created by the Linac’s MRI scanner detect signals sent out by the body’s water molecules to create detailed images of internal organs.

This locates the tumour and enables the radiation beams to be “tailored” to the target. Lung tumours move as a patient breathes, while tumours in the kidney, bladder and prostate can move even during a 30-minute scan, for example as the patient’s bladder fills. Unlike CT scans, there is no radiation.

Professor Uwe Oelfke, head of physics at the Marsden and ICR, said the Linac used “adaptive radiation therapy” to provide maximum benefit to patients. He said: “The fresher the images, the more valuable they are. It’s almost like eating fruit: the fresher, the better.”

Healthy volunteers are helping radio-graphers test the Linac’s imaging capabilities. Cancer patients will join tests by the end of the year. Prostate patients are expected to the first to be treated with “eight or nine” cancer types eventually targeted, including cervical, abdominal, bladder and rectal. The plan is to treat 20 to 25 “intermediate” or “high-risk” patients a day.

The machines are also being trialled at five sites in Europe, Canada and the US, where early work suggests success with pancreatic cancer.

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