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The new radiotherapy high field, 1.5 Tesla MRI-guided linear accelerator (MR-Linac) is being clinically introduced. Sensing and evaluating opportunities and barriers at an early stage will facilitate its eventual scale-up. This study investigates the opportunities and barriers to the implementation of MR-Linac into prostate cancer care based on 43 semi-structured interviews with Dutch oncology care professionals, hospital and division directors, patients, payers and industry. The analysis was guided by the Non-adoption, Abandonment, Scale-up, Spread, and Sustainability framework of new medical technologies and services. Opportunities included: the acquirement of ( 1 ) advanced MRI-guided radiotherapy technology with ( 2 ) the potential for improved patient outcomes and ( 3 ) economic benefits, as well as ( 4 ) professional development and ( 5 ) a higher hospital quality profile. Barriers included: ( 1 ) technical complexities, ( 2 ) substantial staffing and structural investments, ( 3 ) the current lack of empirical evidence of clinical benefits, ( 4 ) professional silos, and ( 5 ) the presence of patient referral patterns. While our study confirms the expected technical and clinical prospects from the literature, it also reveals economic, organizational, and socio-political challenges.

Problems and Promises of Introducing the Magnetic Resonance Imaging Linear Accelerator Into Routine Care: The Case of Prostate Cancer