MR-Linac (MRI-Guided Radiotherapy)

An MR-Linac joins a radiotherapy machine (linear accelerator) to an MRI scanner. It shows the tumour and nearby organs in soft-tissue detail immediately before, and during, each treatment, so the plan can be re-shaped every day to match your anatomy at that moment.

This allows tighter margins and higher doses per session for tumours that move or sit beside sensitive organs, such as those in the pancreas, liver, prostate and kidney. It is a way of delivering radiotherapy more precisely, not a different kind of radiation. For many cancers, long-term proof that it cures more patients than modern standard machines is still being gathered.

What MR-Linac (MRI-Guided Radiotherapy) involves

A radiation oncologist first confirms that radiotherapy is indicated and that MR guidance adds something for your tumour. You complete an MRI safety questionnaire. A planning session with MRI and usually CT is done in the treatment position, sometimes with simple immobilisation. At each treatment you lie on the couch inside the scanner bore. A fresh MRI is acquired, the team re-outlines the tumour and organs, and the software re-optimises the plan, which takes 15 to 30 minutes. During the beam, live MRI tracks the target, and the machine pauses automatically if it drifts out of the boundary, for example as you breathe. Some systems show you a screen so you can hold your breath in the right position.

Who is a good candidate for MR-Linac (MRI-Guided Radiotherapy)?

It is most useful where daily changes in position or shape would otherwise force larger safety margins.

• Localised prostate cancer treated in 5 sessions (stereotactic body radiotherapy)
• Inoperable or borderline pancreatic cancer close to the bowel and stomach
• Liver tumours and limited liver metastases
• Kidney tumours and adrenal metastases
• Small numbers of metastases (oligometastases) in lymph nodes or the abdomen
• Re-irradiation near a previously treated area, in selected cases

It is usually not the right choice if:

• MRI-incompatible implants such as many older pacemakers, some cochlear implants or metal fragments in the eye
• Severe claustrophobia or inability to lie still for 45 to 60 minutes
• Very large treatment fields, which exceed the machine's field size
• Tumours that are treated equally well on standard machines, such as most breast and many head and neck cases

Technique options

• 1.5 Tesla MR-Linac (Elekta Unity): High-field diagnostic-quality imaging with daily plan adaptation.
• 0.35 Tesla MR-Linac (ViewRay MRIdian): Lower field with automatic beam gating on live images; widely used for pancreas and lung-adjacent targets.
• Adapt-to-position versus adapt-to-shape: The quicker method shifts the plan to the day's position; the fuller method redraws organs and re-optimises, used when anatomy has changed.
• Conventional image-guided SBRT, CyberKnife or protons: Alternatives your oncologist may consider equivalent or better for your situation.

What happens during your treatment

Each session lasts 30 to 60 minutes, longer than standard radiotherapy, most of it imaging and re-planning. You feel nothing from the beam. The scanner is noisy, so headphones are provided. No anaesthetic is used and you go home straight afterwards.

Preparing for your trip

Courses are often short: 5 sessions over 1 to 2 weeks for prostate, pancreas or liver SBRT, though some schedules run to 20 sessions or more. Add 3 to 5 working days beforehand for consultation, planning scans and plan preparation. A typical stay is 2 to 3 weeks.

• Tell the doctor about medication, allergies, pregnancy or breastfeeding, and any history of cold sores, keloid scars or autoimmune disease
• Avoid alcohol, aspirin and anti-inflammatory painkillers for a few days beforehand if your own doctor agrees, to reduce bruising
• Arrive without make-up on the treatment area and avoid sunbeds and strong sun for two weeks before

Recovery and results

Side effects depend on the area treated and build up towards the end of the course and the fortnight after. Tiredness is common. Prostate treatment can cause urinary frequency and looser bowels for a few weeks. Upper abdominal treatment can cause nausea or indigestion. Response is assessed by blood markers and scans from about 3 months, under your oncologist at home, who should receive the full dose plan.

• Back to everyday activity: Usually able to continue light activity
• When results show: Assessed from about 3 months
• How long they last: Depends on cancer type and stage

Safety, risks and revision policy

Risks are those of radiotherapy to the region concerned. Greater precision aims to reduce them and cannot remove them.

• Fatigue during and after the course
• Bladder and bowel irritation after pelvic treatment, and erectile dysfunction developing over months to years
• Nausea, ulceration or, rarely, bleeding or narrowing of the stomach or duodenum after pancreatic or liver treatment
• Skin reaction, usually mild
• Late effects on nearby organs appearing months or years later
• A very small long-term risk of a radiation-induced second cancer
• Incomplete tumour control or recurrence

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of MR-Linac (MRI-Guided Radiotherapy) in Türkiye

Clinic-Y does not publish a single price for MR-Linac (MRI-Guided Radiotherapy), because the honest figure depends on your case. What moves it:

• Number of fractions and the complexity of daily adaptation
• Planning scans and any fiducial markers or rectal spacer
• Concurrent chemotherapy or hormone therapy
• Length of stay in the city during the course

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

Frequently Asked Questions