The landscape of lung radiotherapy (RT) has rapidly evolved over the past decade with modern RT and surgical techniques, systemic therapies, and expanding indications for RT. To date, 2 MRI-guided RT (MRgRT) units, 1 using a 0.35T magnet and 1 using a 1.5T magnet, are available for commercial use with more systems in the pipeline. MRgRT offers distinct advantages such as real-time target tracking, margin reduction, and on-table treatment adaptation, which may help overcome many of the common challenges associated with thoracic RT. Nonetheless, the use of MRI for image guidance and the current MRgRT units also have intrinsic limitations. In this review article, we will discuss clinical experiences to date, advantages, challenges, and future directions of MRgRT to the lung.

过去十年，随着现代放疗和外科技术、全身治疗以及放疗适应症的扩大，肺放疗 (RT) 的前景迅速发展。迄今为止，已有 2 台 MRI 引导 RT (MRgRT) 装置（1 台使用 0.35T 磁铁，1 台使用 1.5T 磁铁）可供商业使用，更多系统正在筹备中。 MRgRT 具有独特的优势，例如实时目标跟踪、余量减少和桌上治疗适应，这可能有助于克服与​​胸部 RT 相关的许多常见挑战。尽管如此，使用 MRI 进行图像引导和当前的 MRgRT 装置也存在固有的局限性。在这篇综述文章中，我们将讨论肺部 MRgRT 迄今为止的临床经验、优势、挑战和未来方向。