MOMENTUM stands for Multiple Outcome Evaluation of Radiotherapy Using the MR-Linac – a machine that combines imaging (MR) and treatment (RT) to precisely locate and irradiate tumours. The study is observational and uses the data of enrolled patients to track the effectiveness and benefits of using the state-of-the art MR-Linac machine, ELEKTA Unity.
Each patient enrolled in the study is asked to give informed consent so that they know what is being done with their treatment data. In addition to their data being tracked and stored in the MOMENTUM database, the patients are also questioned on their quality of life. In time, all of this information will help to define how different types of tumours can and should be treated. It will also identify which patients benefit the most from the MR-Linac approach.
To find out more about the study and the significance of reaching this 500-patient milestone, we spoke to Dr. Helena Verkooijen, Professor of Evaluation of Image-Guided Treatment at the University Medical Center (UMC) Utrecht and the Principal Investigator of MOMENTUM.
Q: What is unique about the MOMENTUM study?
A: The project provides an opportunity to learn from every patient treated on MR-Linac. What’s really unique about MOMENTUM is that from day one, we were able to start collecting information on consenting patients. This has ensured that evaluations and the implementation of new techniques can happen without delay. The informed consent part of MOMENTUM is really important and is pretty exceptional for such a data registry, especially considering the new GDPR rules in the EU.
It’s also quite rare in these types of studies for patients to be in control of what data is captured and for which purposes it is used. This helps to build trust between patients and the research community. Another benefit of informed consent is that we can link MOMENTUM data with other registries – this broadens the possibilities of what can be done with the data.
Dr. Helena Verkooijen
The patient is really in control of what data we use and how we use it.
Q: What is the latest status?
A: On Friday 6 March, we reached the 500-patient milestone. These are patients from across all seven centres involved in the project. Thanks to having so many leading organisations on board – covering Europe and North America – we know that the majority of patients treated on MR-Linac are captured within the MOMENTUM data registry. As such, this is one of the first techniques implemented that allows for reliable statements to be made about the use of the machine and the toxicity of treatment. By collecting information from day one, no valuable data has been lost regarding the safety and effectiveness of the technique.
Q: What are the key deliverables?
A: The creation of a large clinical data registry that provides valuable insight into the outcomes of MR-Linac treatment. The next step is to conduct trials to compare MR-Linac treatments with standard treatments to see which is better. The technical data repository allows us to improve the technique, helping to generate images more quickly and make the workflow more efficient. This will have important implications for the amount of time the patient is in the machine, as well as hospital time and resources. The technical data also allows for the consideration of new scanning techniques, which look at the functionality of the tumour to more precisely identify treatment areas.
Q: What advice do you have for researchers who plan to start such a study?
A: While collaboration can be challenging (it costs time and energy), it is definitely worth it. Working with a professional partnership manager such as Lygature to form the MOMENTUM Consortium was one of the best decisions we made. I would say, just do it, start! We have the obligation as healthcare professionals to put in all the effort we can to show which innovations are beneficial to patients, and which do more harm than good. To do this, you really need to collect all the information you can. But do it right, get the consent of your patients. In the end, this will open up a lot more opportunities for your research. You can start small, but you have to do it.
Dr. Helena Verkooijen
We have an obligation as healthcare providers to show that new technologies that are theoretically very useful, are in practice actually beneficial for patients.
MOMENTUM is a cross-Atlantic collaboration coordinated by UMC Utrecht and involves seven world-class oncology centres – two in the Netherlands, two in the UK, two in the US and one in Canada.
Every patient treated on an MR-Linac machine is approached by research assistants and asked if their treatment data (both clinical and technical) can be stored and used. In terms of the clinical data, they are asked what they are treated for as well as the exact details of treatment and outcomes (side effects and tumour recurrence). The technical registry collects all of the technical data generated during treatment and can be used for different purposes, for example to improve the machine and to expand upon deep learning (artificial intelligence) techniques for streamlining treatment logistics and monitoring and predicting treatment response.
Those who are interested, can download the MOMENTUM package, which includes the data dictionary, the standard operating procedures, and the clinical protocol.