MR Linac referrals

We accept referrals from GPs and specialists to our statewide MR Linac service.

Not every cancer type or non-malignant tumour will benefit from the MR Linac. For this reason, all patients considered for treatment on the MR Linac will be discussed by a team of expert doctors in a Victorian statewide multidisciplinary meeting (MDM).

Clinical indications

A team of clinical experts have determined the clinical indications that will most benefit from the MR Linac. These will be progressively implemented.

In summary, they are:

• Oligometastases where surrounding critical organs-at-risk limit the ability for Stereotactic Body Radiotherapy (SBRT) target doses to be delivered safely.
• Locally advanced pancreatic cancers where stereotactic image guided radiotherapy is limited by the proximity of adjacent critical organs- at- risk proximity.
• Liver metastases where stereotactic image guided radiotherapy is limited by organs at risk proximity and other treatment modalities are not feasible.
• Primary liver carcinoma and cholangiocarcinoma where image guided radiotherapy is limited by organs at risk proximity and other treatment modalities are not feasible.
• Re-irradiation of head and neck tumours.
• Primary prostate cancer not suitable for current fiducial-based image guidance technique.
• Re-irradiation of recurrent dominant prostate cancer nodule.
• Highly mobile (>1cm) early stage non-small cell lung cancer and lung metastases.
  Ultra-central tumours (primary and metastases) within the thorax, abutting organs-at-risk where conventional stereotactic treatment is not feasible, due to limited conventional imaging tissue plane clarity.
• Re-irradiation of locally recurrent primary lung cancers or lung metastases
• Radical (Boost Dose) cervix carcinoma treatment where brachytherapy is not feasible.
• Recurrent endometrial carcinoma where surrounding organs at risk (bowel) limits radical radiotherapy.
• Radical dose escalated radiotherapy for rectal cancer where surgical management is not possible.
• Kidney SBRT where surrounding organs at risk or motion limit conventional image guided treatments.
• Adrenal SBRT where surrounding organs at risk or motion limit conventional image guided treatments.
• Pelvic re-irradiation where other modalities may not be feasible and dose delivery is limited by critical organs at risk.
• Paraspinal tumours where reliable localisation of primary and organs at risk such as spinal cord will allow for safe dose delivery.

Other scenarios can be considered on a case-by-case basis.