Ablative SBRT to liver malignancies on MRI-Linac is a novel and rapidly evolving technology allowing visualization of tumor and nearby organs at risk (OAR). Reliable identification of liver tumors has direct impact on radiotherapy planning and outcome. SPION agent Ferumoxytol® (Feraheme, AMAG Pharmaceuticals, Waltham, MA) was applied as MRI contrast during adaptive planning on Elekta Unity MR-Linac. Compared to the non-contrast images, liver tumors after Ferumoxytol® injection, were superiorly visible for accurate delineation during the entire treatment course. This study is the first to report the impact of SPION contrast agent on liver tumor visualization in a 1.5T Elekta MR-Linac.
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