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The development of the integrated MRI-guided radiotherapy systems (MRIgRT) is an engineering feat with growing adoption in hospitals over the past 6 years. Currently, there are 2 MRIgRT systems in development, and 2 systems that are commercially available [1–4]. ViewRay (Cleveland, OH) was the first to market with a 0.35-T MRI combined with a radioactive cobalt system in 2014 that has since been upgraded to linear accelerator–based photon radiation (MR-linac)[2, 5]. Elekta treated its first patient with the 1.5-T MR-linac system in 2017 [6].