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Brief Report
Peer-Review Record

MR-LINAC-Guided Adaptive Radiotherapy for Gastric MALT: Two Case Reports and a Literature Review

Radiation 2022, 2(3), 259-267; https://doi.org/10.3390/radiation2030019
by Yajun Song 1,2, Zhenjiang Li 3, Huadong Wang 1,3, Yun Zhang 2,* and Jinbo Yue 2,4,*
Reviewer 1:
Ryoichi Yoshimura
Reviewer 2:
Keun-Yeong Jeong
Radiation 2022, 2(3), 259-267; https://doi.org/10.3390/radiation2030019
Submission received: 25 May 2022 / Revised: 7 July 2022 / Accepted: 11 July 2022 / Published: 13 July 2022
(This article belongs to the Special Issue Innovative Approaches for Medical Imaging and Radiation Therapy)

Round 1

Reviewer 1 Report

This is a case report of gastric MALT lymphoma that underwent MR-guided daily adaptive radiotherapy based on the daily automated segmentation using the novel AI technique.

This is interesting and shows the usefulness of MR-LINIAC system for gastric MALT lymphoma.

There are a few comments

#1. In discussion, authors described about the reduction of OAR toxicity in MRI-guided therapy. Can researchers show in Case 1 how much the organs around the stomach, such as the liver, left kidney, and spinal cord, were daily irradiated, and compare them to the dose in the CT simulation?

#2. Is a presentation of Case #2 necessary in this report?

Author Response

Please see the attached file.

Author Response File: Author Response.pdf

Reviewer 2 Report

Magnetic resonance imaging-guided linear accelerator (MR-LINAC) is known to be useful in treating cancers in the whole body, using magnetic resonance imaging in combination with radiation therapy. The application of radiotherapy (RT) for the treatment of gastric mucosa-associated lymphoid tissue (MALT) lymphoma is not a novel area, but it is interesting to try MR-LINAC to enhance the accuracy of RT. Even so, the following issues need to be supplemented.

1. MR-LINAC is a routinely used treatment for soft tissue tumors. It should be clearly described the theoretical (clinical) background of trying MR-LINAC to treat MALT lymphoma. In one specific example, what clinical benefit is it intended to achieve? 

2. Cases from two patients were provided. It is recommended that their demographic and etiological information be compiled in a separate table.

3. The regimens of anticancer drugs prescribed in combination with RT should be specified (therapeutic dosage, usage, route, and so on).

4. Piece of physical information was not provided for the MRI and irradiator.

5. Methods of analysis for acquisition images were not specified.

6. The clinical outcome following MR-LINAC should be specified in detail.

Author Response

Please see the attachment.

Author Response File: Author Response.pdf

Round 2

Reviewer 1 Report

This manuscript has been revised in response to reviewer comments.

I have no further comments.

Reviewer 2 Report

There are great efforts to improve the quality of the manuscript. No additional concern to raise.

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