The ViewRay System: Magnetic Resonance–Guided and Controlled Radiotherapy

A description of the first commercially available magnetic resonance imaging (MRI)–guided radiation therapy (RT) system is provided. The system consists of a split 0.35-T MR scanner straddling 3 60Co heads mounted on a ring gantry, each head equipped with independent doubly focused multileaf collimators. The MR and RT systems share a common isocenter, enabling simultaneous and continuous MRI during RT delivery. An on-couch adaptive RT treatment-planning system and integrated MRI-guided RT control system allow for rapid adaptive planning and beam delivery control based on the visualization of soft tissues. Treatment of patients with this system commenced at Washington University in January 2014.