Adaptive radiotherapy · London
MR-Linac adaptive radiotherapy - private in London.
A 1.5T MRI scanner integrated with a linear accelerator, delivering daily online adaptive radiotherapy for prostate, pancreas, liver, lung and other MR-visible targets. Elekta Unity and ViewRay MRIdian centres in London and the UK.
Why patients choose us
- 01
A named MR-Linac clinical oncologist, in a UK Unity or MRIdian centre
Not a generic radiotherapy list. A consultant with a high MR-guided adaptive case volume, in a centre that runs an Elekta Unity or ViewRay MRIdian programme.
- 02
The right modality for your tumour
MR-Linac is not always the answer. For some sites CyberKnife, standard SBRT, brachytherapy or proton is the better call. We say so, before you commit.
- 03
Independent, and free
We are paid by no clinic, so the modality recommendation is impartial and costs you nothing.
What MR-Linac is
A linear accelerator with a 1.5T MRI scanner built around it.
The Elekta Unity is a 7MV linac integrated with a diagnostic-grade 1.5T MRI. The ViewRay MRIdian pairs a 0.35T MRI with a linac and cine-gating. Both deliver radiotherapy while the tumour and surrounding organs are watched in real time on MRI.
Real-time MRI, not CT
Soft-tissue targets (prostate, pancreas, liver) are seen directly, without ionising imaging dose and without needing invasive fiducial markers.
Daily online adaptation
Before every fraction the plan is re-optimised to today's bowel gas, bladder filling and tumour position. Yesterday's anatomy is not tomorrow's.
Reduced PTV margins
Because the target is imaged with millimetre precision, the planning target volume margin drops from 5 to 10mm to 2 to 3mm. Less normal tissue in the high-dose zone.
Indicative pricing
What a private MR-Linac course costs in London.
Indicative all-inclusive ranges across our partner UK centres, covering planning, delivery and consultant follow-up. Send the scans and we quote firm figures across two or three options.
In short
A 5-fraction MR-Linac SBRT course in our network: £18,000-£28,000 typical, £22,000-£38,000 for complex indications.
| Indication | Indicative range | Per-fraction time | Course length |
|---|---|---|---|
| Second-opinion review of scans and pathology | £350–£650 | 30–45 min | 48 hours |
| Prostate SBRT, 5-fraction Unity | £18,000–£24,000 | 45–60 min per fraction | 1–2 weeks |
| Pancreatic SBRT, 5-fraction MRIdian or Unity | £24,000–£32,000 | 60–75 min per fraction | 1–2 weeks |
| Liver oligometastasis SBRT, 3–5 fractions | £20,000–£28,000 | 45–60 min per fraction | 1–2 weeks |
| Lung mobile-tumour SBRT, 5-fraction | £20,000–£28,000 | 45–60 min per fraction | 1–2 weeks |
| Complex re-irradiation or dose-escalation course | £22,000–£38,000 | 60–75 min per fraction | 2 weeks |
Prices vary by centre, by which consultant clinical oncologist leads your care, and by tumour site and complexity. Firm quotes are returned within one working day of receiving the scans and pathology.
The adaptive workflow
From referral to response imaging - what happens, in order.
One consultant, one MDT, one team from first message to response imaging. Daily plan re-optimisation is what makes MR-Linac different.
Phase 1 · Before your course
Referral, MDT, planning
Phase 2 · On treatment
1 to 2 weeks of daily fractions
Phase 3 · After
Follow-up and imaging
- 01
Before
You send us the scans and pathology
A short, confidential form. Diagnosis, staging MRI or CT, PSMA or FDG-PET if done, and any prior radiotherapy history.
- 02
Before
We come back with a modality recommendation
Within one working day: whether MR-Linac Unity or MRIdian fits, or whether CyberKnife, standard SBRT or brachytherapy is the better call. Indicative price. An honest read either way.
- 03
Before
Planning MRI and CT simulation
A planning MRI on the Unity (or MRIdian) plus a planning CT for electron density. Fiducials are not usually needed. Bladder and rectal filling protocol explained.
- 04
On treatment
Arrival for fraction one
Arrival, a chat with the radiographers and consultant. You lie on the couch inside the 1.5T bore. Total in-room time is 45 to 60 minutes per fraction.
- 05
On treatment
Online adaptive replanning
A daily MRI is acquired. The plan is re-optimised in 20 to 40 minutes to today's anatomy, margins are re-drawn, and dose is delivered while the tumour is watched in real time.
- 06
On treatment
Home the same day
A short debrief, written aftercare, and home the same day. Five fractions across one to two weeks for most SBRT indications.
- 07
After
Follow-up and response imaging
Consultant review at 4 to 6 weeks, then response imaging at 3 months (MRI or PSMA-PET as indicated). Long-term surveillance handed back to your referring team.
Typical end-to-end: 2-3 weeks from enquiry to first fraction. Per fraction: 45-60 min. Response imaging: 3 months.
Indications
When MR-Linac is the right step - and when it is not.
The tumour sites where MR-guided online adaptive radiotherapy earns its cost, plus the situations where a standard linac or a different modality is the better call.
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Prostate SBRT (5-fraction ultra-hypofractionation)
MRI-visible prostate treated in five fractions across one to two weeks. PTV margins reduced to 2 to 3mm with daily adaptation.
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Pancreatic SBRT with dose escalation
Locally advanced or borderline resectable pancreatic cancer. Daily adaptation to bowel and stomach position allows 50Gy in 5 fractions without exceeding OAR tolerance.
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Liver oligometastases
One to three liver deposits treated in 3 to 5 fractions with real-time MRI tracking of the lesion, no fiducials needed.
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Lung mobile tumours
Peripheral or central lung tumours with respiratory motion, treated with cine-MRI gating rather than fiducial or 4D-CT surrogates.
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Oesophageal, gastric, cervical, kidney
Selected soft-tissue targets where daily anatomy changes (bowel gas, gastric filling, bladder) make a standard linac plan suboptimal.
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MR-visible soft tissue targets
Any tumour that is clearly visible on MRI but poorly seen on cone-beam CT is a candidate for MR-guided adaptive delivery.
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Re-irradiation of previously treated volumes
Where cumulative OAR dose is the limiting factor, daily adaptation lets us shave the margin and re-treat safely in selected cases.
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Not for: bone-only mets, whole-brain, palliative flash
Simple palliative bone or brain fractions are better delivered on a standard linac. MR-Linac is reserved for cases where adaptation earns its cost.
Technology and modality comparison
MR-Linac, CyberKnife, standard SBRT, proton - the honest comparison.
MR-Linac is online-adaptive with soft-tissue MRI guidance and no fiducials. CyberKnife tracks fiducials in real time. Standard SBRT uses cone-beam CT. Proton is dose-shape not adaptation. We pick the right tool.
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Elekta Unity 1.5T MR-Linac
The first-generation MR-Linac in UK private practice. High-field 1.5T diagnostic-grade MRI integrated with a 7MV linac. Adapt-to-shape and adapt-to-position workflows.
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ViewRay MRIdian 0.35T MR-Linac
Lower-field 0.35T MRI paired with a linac, with real-time cine-MRI gating. Strong pancreatic and abdominal SBRT programme (SMART trial platform).
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Adapt-to-position (ATP)
The reference plan is shifted and re-weighted to today's anatomy. Faster (15 to 25 minutes) but keeps the reference contours.
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Adapt-to-shape (ATS)
Contours are re-drawn on today's MRI and the plan is fully re-optimised. Slower (30 to 45 minutes) but the gold standard for changing anatomy.
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Real-time cine-MRI gating
The beam is automatically held when the tumour drifts outside a gating window. Standard on MRIdian, in development on Unity.
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CyberKnife SBRT
Robotic linac with real-time fiducial tracking. Excellent for prostate and small intracranial or spinal targets. No MRI in-room, no online replan.
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Standard linac SBRT (CBCT-guided)
Modern Varian Halcyon or TrueBeam SBRT with cone-beam CT. Faster and cheaper, less soft-tissue detail, no online plan adaptation.
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Proton beam therapy
Excellent dose distribution for paediatric, base-of-skull and re-irradiation cases. Not typically online-adaptive in UK NHS or private practice.
Where MR-Linac is available in the UK
A small panel of UK MR-Linac centres, we picked them.
The Royal Marsden ran the UK’s first Elekta Unity programme. GenesisCare Cromwell and University College London Hospital Private now run their own Unity platforms, and Christie Private Care runs a ViewRay MRIdian for pancreatic and abdominal SBRT.
Selection criteria
How we choose every MR-Linac consultant in our network.
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Consultant clinical oncologists with high MR-Linac case volumes on Unity or MRIdian
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UK centres running an accredited MR-guided adaptive radiotherapy programme
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MDT review with surgical, oncology, radiology and pathology input before every course
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Access to CyberKnife, standard SBRT, brachytherapy and proton pathways if MR-Linac is not the right call
The evidence base
Trials and registries behind MR-guided adaptive radiotherapy.
MR-Linac is a mature technology with a growing evidence base. We reference the trials and registries you can look up before making a decision.
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MOMENTUM registry
A multi-institutional international registry of MR-Linac patients tracking toxicity, quality of life and disease control across every treated site.
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HERMES prostate ultra-hypofractionation
Randomised trial comparing 5-fraction MR-Linac prostate SBRT with standard 20-fraction moderate hypofractionation. Non-inferior toxicity, similar early biochemical control.
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SMART pancreatic trial
Prospective multicentre study of 50Gy in 5 fractions to the pancreas on the MRIdian. Outstanding local control at 12 months with acceptable GI toxicity.
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MASTERPLAN pancreatic
A UK-led adaptive radiotherapy programme for pancreatic cancer, examining outcomes with online adaptation and MR guidance.
Side effects and safety
What to expect afterwards - by tumour site, honestly.
MR-Linac is a well-established therapeutic radiotherapy platform. Side effects depend on the tumour site, dose and prior treatment. The things worth planning are the MRI screening, the daily fraction time, and site-specific acute effects.
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Prostate: mild urinary and rectal symptoms
Frequency, urgency and mild proctitis peak at weeks 2 to 6 and settle by 3 months in most patients. Late toxicity is lower than with 20-fraction schedules in HERMES data.
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Pancreatic: mild nausea and fatigue
Nausea and fatigue during the fraction week are the commonest issues. Serious GI toxicity is uncommon with online adaptation and strict duodenal constraints.
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Liver: transient LFT rise
A transient rise in liver enzymes at 6 to 12 weeks is expected. Radiation-induced liver disease is rare when the mean liver dose is kept low.
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Lung: cough and mild pneumonitis
A dry cough during and after treatment is common. Symptomatic pneumonitis is uncommon in peripheral SBRT; central tumours carry a small airway toxicity risk.
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Claustrophobia inside the 1.5T bore
Each fraction is 45 to 60 minutes lying inside a diagnostic-grade MRI. We arrange a taster scan before you commit, and mild anxiolysis is available.
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Implants and prostheses screened first
MR safety screening happens before planning. Most hip replacements, coronary stents and dental work are fine; some pacemakers and cochlear implants are not.
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Bladder and rectal filling protocol
For pelvic treatments we ask for a comfortably full bladder and an empty rectum. Written instructions are provided before the planning scan.
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No fiducials for soft tissue targets
Because the tumour is seen directly on MRI, invasive fiducial marker placement is not usually needed for prostate, liver, pancreas or kidney.
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Red flags after discharge
New severe pain, heavy rectal bleeding, jaundice, breathlessness, fever or vomiting during or after treatment should be reported to the on-call oncology team the same day.
Reading your radiotherapy summary
Your MR-Linac summary in four parts. Read the last one first.
Whichever centre delivers your course, the end-of-treatment summary keeps to the same shape.
A quiet reminder
Radiotherapy language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the summary before your follow-up, just ask.
- 01 Header
Diagnosis, staging and prior treatment
Tumour site, histology, stage, prior radiotherapy or surgery, and the specific MR-Linac indication (e.g. prostate SBRT 5#, pancreatic SMART).
- 02 Technique
Machine, dose and fractionation
Elekta Unity or ViewRay MRIdian, total dose in Gray, number of fractions, PTV margin, adapt-to-shape or adapt-to-position, and whether cine-MRI gating was used.
- 03 Findings
On-treatment adaptation and OAR sparing
How often the plan was re-optimised, any fractions replanned for anatomy change, and the maximum dose to bowel, rectum, bladder, duodenum or heart.
- 04 Impression
Response imaging and follow-up plan
Read this first: when response MRI or PSMA-PET is booked, expected acute side-effect timeline, and who your long-term surveillance clinician is.
Recognised by major UK insurers
Cover for MR-Linac varies by insurer and by indication - typically funded when medically indicated for approved SBRT sites. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about MR-Linac.
Quick answers on claustrophobia, implants, insurance cover, outpatient logistics, MDT review and re-irradiation.
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I am claustrophobic. Can I still have MR-Linac treatment?
Each fraction is 45 to 60 minutes lying inside a 1.5T (Unity) or 0.35T (MRIdian) MRI bore. We arrange a taster scan on the planning day so you know what to expect, and mild anxiolysis (a small dose of diazepam or lorazepam) is available. Severe claustrophobia can be a reason to choose CyberKnife or standard SBRT instead.
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I have a pacemaker or a hip replacement. Am I eligible?
MR safety screening is done before planning. Most modern hip replacements, coronary stents, spinal rods and dental work are compatible. Some older pacemakers, cochlear implants, aneurysm clips and drug pumps are not, and would push us toward CyberKnife or a standard linac. Send the implant card and we check for you.
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Will my insurance cover MR-Linac adaptive radiotherapy?
The major UK insurers (Bupa, AXA, Vitality, Aviva, WPA, Cigna, Healix) fund MR-Linac SBRT for approved indications, most commonly prostate, liver oligometastases and selected pancreatic cases. Cover for newer indications (kidney, cervix, gastric) is confirmed case by case. We verify cover in writing before booking.
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Is MR-Linac done as an outpatient or do I stay in?
It is an outpatient course. You come in for the planning MRI and CT, then five (or three) daily fractions across one to two weeks, and go home after each fraction. Overnight admission is not needed unless an unrelated medical issue requires it.
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Do I need to be discussed at an MDT first?
Yes. Every MR-Linac course we arrange is discussed at a specialist oncology MDT with surgical, radiology and pathology input before treatment starts. It is one of the reasons the recommendation is honest: sometimes MDT concludes surgery, brachytherapy or a different modality is the better option.
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Can MR-Linac be used to re-irradiate a previously treated area?
In selected cases, yes. Because daily adaptation lets us reduce the PTV margin and precisely track today's anatomy, cumulative OAR dose can sometimes be respected where it would not be on a standard linac. Re-irradiation always requires detailed prior-dose recovery, MDT discussion and a longer planning cycle.
Ready when you are
Send us your scans - we’ll come back within a working day.
A confidential form. Diagnosis, MRI or CT, PSMA or FDG-PET if you have one. We reply with a modality recommendation, a shortlist of MR-Linac consultants, and firm costs across two or three UK centres.
Related treatments and conditions
Looking for something else?
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Prostate SBRT (5-fraction)
Ultra-hypofractionated prostate radiotherapy.
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Oligometastasis SBRT
SBRT for 1-3 metastatic deposits.
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CyberKnife
Robotic linac with real-time fiducial tracking.
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Gamma Knife radiosurgery
Stereotactic radiosurgery for intracranial targets.
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Proton beam therapy
Charged-particle therapy for select paediatric and re-treatment cases.
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HDR prostate brachytherapy
High-dose-rate internal radiotherapy for prostate cancer.
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Prostate cancer
Diagnosis, staging and treatment options.
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Colorectal cancer
Diagnosis, staging and treatment pathways.
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