Authors: (including presenting author): :
OL Chan(1), I Yeung(2), PW Kwok(2), WY Tin(2), Polly Kung(2), HY Chan(2), TY Cheung(2), Venus Lee(2), L Xiao(2), KW Lee(1), WH Chong(1), KY Kwok(1)
Affiliation: :
(1) Department of Radiology & Nuclear Medicine
(2) Department of Clinical Oncology
Keyword 1: :
MR Simulator
Keyword 2: :
Patient Care Pathway
Keyword 3: :
Healthcare Accessibility
Keyword 4: :
Nasopharyngeal Carcinoma
Keyword 5: :
Radiotherapy
Introduction: :
The first magnetic resonance simulator (MR‑Sim) within the Hospital Authority was commissioned at Tuen Mun Hospital (TMH) in 2022. Since October 2022, the Department of Radiology & Nuclear Medicine and the Department of Clinical Oncology have jointly piloted a nasopharyngeal carcinoma (NPC) collaboration program utilizing the MR‑Sim. Under this program, dedicated slots in MR‑Sim were allocated for restaging MRI post-induction chemotherapy. Patients were scanned with radiotherapy immobilization cast in-situ on a flat tabletop MR couch with LAP laser guidance. This protocol enables the acquired images to serve both diagnostic and simulation purposes.
Objectives: :
To evaluate how the NPC collaboration program improves timeliness and accessibility of restaging MRI, treatment workflow efficiency and outcome for NPC patients undergoing induction chemotherapy followed by concurrent chemoradiotherapy.
Methodology: :
This retrospective review identified all NPC patients treated with three-cycle induction chemotherapy followed by concurrent chemoradiotherapy at TMH from October 2022 to September 2025 (MR-sim cohort). The date of restaging MRI, the date of initiation of concurrent chemoradiotherapy, and local recurrence data were retrieved from the electronic patient record (ePR). A historical comparison cohort (October 2019 to September 2022) was similarly reviewed.
Result & Outcome: :
Following the NPC collaboration (Oct 2022–Sept 2025), 96.3% (103/107) of patients underwent restaging MRI in designated slots. In the historical cohort, 98.6% (69/70) had scans arranged at private centers, with 21.7% (15/69) requiring rescheduling due to treatment interruptions or unacceptable late appointments. The interval from restaging MRI to the start of concurrent chemoradiotherapy was significantly shorter in the MR-sim cohort (8–29 days, median 21, IQR 16–23), than in the historical cohort (14–48 days, median 24, IQR 20–31; p=0.026). The 1-year local recurrence rate was low in both groups: 2.5% (2/80) in MR sim cohort versus 4.3% (3/70) in historical cohort (p=0.665). The NPC collaboration program enhanced patient access to timely restaging MRI through dedicated MR-Sim slots, streamlining logistics and care pathway. Restaging MRI performed with immobilization casts in-situ ensured consistent positioning, enabling superior image fusion, and accurate radiotherapy planning and treatment delivery. The reduced interval to initiation of chemoradiotherapy reflected greater workflow efficiency. This interdepartmental MR-Sim collaboration significantly enhanced the comprehensive care for NPC patients.
