News • MR-Linac measures oxygen levels

One step closer to targeted real time treatment of hypoxic cancers

Imaging researchers have taken a major step towards their ultimate goal of identifying cancers that are starved of oxygen so that altered treatment can be used to target them more effectively.

Data from the three oxygen-enhanced (OE)-MRI feasibility patients, showing the post-contrast T1w image for anatomical reference (left column), along with the ΔR1 map derived from the single visit (middle column) and the mean ΔR1 time-course obtained from the contoured tumour (right column). Vertical dashed lines on the time-course indicate the timepoints at which the gas was switched between air to oxygen (timepoint 26) and oxygen to air (timepoint 71).

Image source: Dubec et al., Radiotherapy & Oncology 2023 (CC BY 4.0)

The study led by researchers from The University of Manchester, working with scientists at the Institute of Cancer Research, University College London and The University of Leeds, is published in the journal Radiotherapy and Oncology. Funded mainly by the Medical Research Council, the breakthrough was achieved by combining two cutting edge technologies: the research team adapted an MRI scanner that also delivers radiotherapy - called MR-Linac - to be able to also measure oxygen levels in tumours. 

Researchers have known since the 1950s that when tumours are starved of oxygen they are difficult to treat effectively, a problem which is particularly true when doctors give radiotherapy. Despite this knowledge, patients with cancer do not get routine tests to evaluate tumour oxygen levels because no single test has been developed that is precise, accurate, cost effective and readily available. 

The 11 patients with head and neck cancer in the study, treated at The ChristieNHS Foundation Trust in Manchester, were successfully scanned on the MR-Linac machine and, for the first time, maps of oxygen levels were obtained. However, the technology is relevant to most cancers. The patients first breathed room air through a mask and then pure oxygen to bathe the tumour with the gas. Parts of the cancer that had good levels of oxygen responded differently to those that were oxygen depleted, so the technique - called 'oxygen-enhanced MRI' - revealed which parts of the tumour were oxygen starved and likely to be resistant to radiotherapy.

This imaging lets us see inside tumours and helps us understand why some people with cancer need an extra boost to get effective treatment

James O’Connor

Lead author Professor James O’Connor is a clinician scientist at The University of Manchester, The Christie and The Institute of Cancer Research. He said: “Though it’s clear more work needs to be done, we’re very excited about the potential this technology has to enable daily monitoring of tumour oxygen and we hope to be at a point soon when the technology will guide cancer doctors in how they can best deliver radiotherapy. This imaging lets us see inside tumours and helps us understand why some people with cancer need an extra boost to get effective treatment. This is an important step towards the goal of changing treatment based on imaging biology.” 

First author Michael Dubec from The University of Manchester and The Christie said: “The MR-Linac is an exciting technology that combines highly precise imaging and radiotherapy delivery that allows for real-time imaging. We are tremendously excited about what is the first application in humans of 'oxygen-enhanced MRI', developed as a result of a multi-disciplinary team working across the country which has exciting implications on patient outcomes.” 

Source: University of Manchester


Read all latest stories

Related articles


News • Possible biological explanation found

Why are dense breasts associated with increased cancer risk?

The risk of developing breast cancer is higher in breasts with high density. But why is that? Researchers at Linköping University have shown major biological differences that promote cancer growth.


News • Water exchange detection

New MRI-based method measures tumor malignancy

An Italian research team has introduced a new MRI-based method for assessing water water exchange to estimate the degree of malignancy and the success of treatments in tumors.


News • Radiation and immunotherapy

Promising combination therapy against "cold" breast cancer tumors

US researchers have discovered that radiation therapy combined with two types of immunotherapy can control tumors in preclinical models of triple negative breast cancer.

Related products

Subscribe to Newsletter