Although magnetic resonance imaging (MRI) has become standard diagnostic workup for head and neck malignancies and is currently recommended by most radiological societies for pharyngeal and oral carcinomas, its utilization in radiotherapy has been heterogeneous during the last decades. However, few would argue that implementing MRI for annotation of target volumes and organs at risk provides several advantages, so that implementation of the modality for this purpose is widely accepted. Today, the term MR-guidance has received a much broader meaning, including MRI for adaptive treatments, MR-gating and tracking during radiotherapy application, MR-features as biomarkers and finally MR-only workflows. First studies on treatment of head and neck cancer on commercially available dedicated hybrid-platforms (MR-linacs), with distinct common features but also differences amongst them, have also been recently reported, as well as “biological adaptation” based on evaluation of early treatment response via functional MRI-sequences such as diffusion weighted ones. Yet, all of these approaches towards head and neck treatment remain at their infancy, especially when compared to other radiotherapy indications. Moreover, the lack of standardization for reporting MR-guided radiotherapy is a major obstacle both to further progress in the field and to conduct and compare clinical trials. Goals of this article is to present and explain all different aspects of MR-guidance for radiotherapy of head and neck cancer, summarize evidence, as well as possible advantages and challenges of the method and finally provide a comprehensive reporting guidance for use in clinical routine and trials.

尽管磁共振成像 (MRI) 已成为头颈部恶性肿瘤的标准诊断检查，并且目前被大多数放射学会推荐用于咽癌和口腔癌，但在过去几十年中，其在放射治疗中的应用一直存在差异。然而，很少有人会认为，实施 MRI 来注释目标体积和处于危险中的器官具有多种优势，因此为此目的实施的模式被广泛接受。如今，MR 指导一词已获得了更广泛的含义，包括用于适应性治疗的 MRI、放射治疗应用期间的 MR 门控和跟踪、作为生物标记的 MR 功能以及最终的仅 MR 工作流程。最近还报道了在商用专用混合平台（MR-linacs）上治疗头颈癌的第一项研究，这些研究具有明显的共同特征，但也存在差异，以及基于早期评估的“生物适应”通过功能性 MRI 序列（例如弥散加权序列）评估治疗反应。然而，所有这些头颈部治疗方法仍处于起步阶段，特别是与其他放射治疗适应症相比。此外，报告磁共振引导放射治疗缺乏标准化是该领域进一步进展以及进行和比较临床试验的主要障碍。本文的目标是介绍和解释 MR 指导头颈癌放射治疗的所有不同方面，总结证据以及该方法可能的优点和挑战，并最终提供用于临床常规和治疗的全面报告指南。试验。