A formalism for reference dosimetry in photon beams in the presence of a magnetic field

Fano cavity test and investigation of the response of the Roos chamber irradiated by proton beams in perpendicular magnetic fields up to 1 T

Objective. The aim of this work is to investigate the response of the Roos chamber (type 34001) irradiated by clinical proton beams in magnetic fields.Approach. At first, a Fano test was implemented in Monte Carlo software package GATE version 9.2 (based on Geant4 version 11.0.2) using a cylindrical slab geometry in a magnetic field up to 1 T. In accordance to an experimental setup (Fuchset al2021), the magnetic field correction factorskQB⃗of the Roos chamber were determined at different energies up to 252 MeV and magnetic field strengths up to 1 T, by separately simulating the ratios of chamber signalsMQ/MQB⃗,without and with magnetic field, and the dose-conversion factorsDw,QB⃗/Dw,Qin a small cylinder of water, with and without magnetic field. Additionally, detailed simulations were carried out to understand the observed magnetic field dependence.Main results. The Fano test was passed with deviations smaller than 0.25% between 0 and 1 T. The ratios of the chamber signals show both energy and magnetic field dependence. The maximum deviation of the dose-conversion factors from unity of 0.22% was observed at the lowest investigated proton energy of 97.4 MeV andB⃗= 1 T. The resultingkQB⃗factors increase initially with the applied magnetic field and decrease again after reaching a maximum at around 0.5 T; except for the lowest 97.4 MeV beam that show no observable magnetic field dependence. The deviation from unity of the factors is also larger for higher proton energies, where the maximum lies at 1.0035(5), 1.0054(7) and 1.0069(7) for initial energies ofE0= 152, 223.4 and 252 MeV, respectively.Significance. Detailed Monte Carlo studies showed that the observed effect can be mainly attributed to the differences in the transport of electrons produced both outside and inside of the air cavity in the presence of a magnetic field.

MR compatible detectors assessment for a 0.35 T MR-linac commissioning

PURPOSE

To assess a large panel of MR compatible detectors on the full range of measurements required for a 0.35 T MR-linac commissioning by using a specific statistical method represented as a continuum of comparison with the Monte Carlo (MC) TPS calculations. This study also describes the commissioning tests and the secondary MC dose calculation validation.

MATERIAL AND METHODS

Plans were created on the Viewray TPS to generate MC reference data. Absolute dose points, PDD, profiles and output factors were extracted and compared to measurements performed with ten different detectors: PTW 31010, 31021, 31022, Markus 34045 and Exradin A28 MR ionization chambers, SN Edge shielded diode, PTW 60019 microdiamond, PTW 60023 unshielded diode, EBT3 radiochromic films and LiF µcubes. Three commissioning steps consisted in comparison between calculated and measured dose: the beam model validation, the output calibration verification in four different phantoms and the commissioning tests recommended by the IAEA-TECDOC-1583.

MAIN RESULTS

The symmetry for the high resolution detectors was higher than the TPS data of about 1%. The angular responses of the PTW 60023 and the SN Edge were - 6.6 and - 11.9% compared to the PTW 31010 at 60°. The X/Y-left and the Y-right penumbras measured by the high resolution detectors were in good agreement with the TPS values except for the PTW 60023 for large field sizes. For the 0.84 × 0.83 cm2 field size, the mean deviation to the TPS of the uncorrected OF was - 1.7 ± 1.6% against - 4.0 ± 0.6% for the corrected OF whereas we found - 4.8 ± 0.8% for passive dosimeters. The mean absolute dose deviations to the TPS in different phantoms were 0 ± 0.4%, - 1.2 ± 0.6% and 0.5 ± 1.1% for the PTW 31010, PTW 31021 and Exradin A28 MR respectively.

CONCLUSIONS

The magnetic field effects on the measurements are considerably reduced at low magnetic field. The PTW 31010 ionization chamber can be used with confidence in different phantoms for commissioning and QA tests requiring absolute dose verifications. For relative measurements, the PTW 60019 presented the best agreement for the full range of field size. For the profile assessment, shielded diodes had a behaviour similar to the PTW 60019 and 60023 while the ionization chambers were the most suitable detectors for the symmetry. The output correction factors published by the IAEA TRS 483 seem to be applicable at low magnetic field pending the publication of new MR specific values.

Proton dosimetry in a magnetic field: Measurement and calculation of magnetic field correction factors for a plane-parallel ionization chamber

BACKGROUND

The combination of magnetic resonance imaging and proton therapy offers the potential to improve cancer treatment. The magnetic field (MF)-dependent change in the dosage of ionization chambers in magnetic resonance imaging-integrated proton therapy (MRiPT) is considered by the correction factork B ⃗ , M , Q $k_{\vec{B},M,Q}$ , which needs to be determined experimentally or computed via Monte Carlo (MC) simulations.

PURPOSE

In this study,k B ⃗ , M , Q $k_{\vec{B},M,Q}$ was both measured and simulated with high accuracy for a plane-parallel ionization chamber at different clinical relevant proton energies and MF strengths.

MATERIAL AND METHODS

The dose-response of the Advanced Markus chamber (TM34045, PTW, Freiburg, Germany) irradiated with homogeneous 10 × $\times$ 10 cm2 $^2$ quasi mono-energetic fields, using 103.3, 128.4, 153.1, 223.1, and 252.7 MeV proton beams was measured in a water phantom placed in the MF of an electromagnet with MF strengths of 0.32, 0.5, and 1 T. The detector was positioned at a depth of 2 g/cm2 $^2$ in water, with chamber electrodes parallel to the MF lines and perpendicular to the proton beam incidence direction. The measurements were compared with TOPAS MC simulations utilizing COMSOL-calculated 0.32, 0.5, and 1 T MF maps of the electromagnet.k B ⃗ , M , Q $k_{\vec{B},M,Q}$ was calculated for the measurements for all energies and MF strengths based on the equation:k B ⃗ , M , Q = M Q M Q B ⃗ $k_{\vec{B},M,Q}=\frac{M_\mathrm{Q}}{M_\mathrm{Q}^{\vec{B}}}$ , whereM Q B ⃗ $M_\mathrm{Q}^{\vec{B}}$ andM Q $M_\mathrm{Q}$ were the temperature and air-pressure corrected detector readings with and without the MF, respectively. MC-based correction factors were determined ask B ⃗ , M , Q = D det D det B ⃗ $k_{\vec{B},M,Q}=\frac{D_\mathrm{det}}{D_\mathrm{det}^{\vec{B}}}$ , whereD det B ⃗ $D_\mathrm{det}^{\vec{B}}$ andD det $D_\mathrm{det}$ were the doses deposited in the air cavity of the ionization chamber model with and without the MF, respectively. Furthermore, MF effects on the chamber dosimetry are studied using MC simulations, examining the impact on the absorbed dose-to-water (D W $D_{W}$ ) and the shift in depth of the Bragg peak.

RESULTS

The detector showed a reduced dose-response for all measured energies and MF strengths, resulting in experimentally determinedk B ⃗ , M , Q $k_{\vec{B},M,Q}$ values larger than unity. For all energies and MF strengths examined,k B ⃗ , M , Q $k_{\vec{B},M,Q}$ ranged between 1.0065 and 1.0205. The dependence on the energy and the MF strength was found to be non-linear with a maximum at 1 T and 252.7 MeV. The MC simulatedk B ⃗ , M , Q $k_{\vec{B},M,Q}$ values agreed with the experimentally determined correction factors within their standard deviations with a maximum difference of 0.6%. The MC calculated impact onD W $D_{W}$ was smaller 0.2 %.

CONCLUSION

For the first time, measurements and simulations were compared for proton dosimetry within MFs using an Advanced Markus chamber. Good agreement ofk B ⃗ , M , Q $k_{\vec{B},M,Q}$ was found between experimentally determined and MC calculated values. The performed benchmarking of the MC code allows for calculatingk B ⃗ , M , Q $k_{\vec{B},M,Q}$ for various ionization chamber models, MF strengths and proton energies to generate the data needed for a proton dosimetry protocol within MFs and is, therefore, a step towards MRiPT.

Experimental characterization of four ionization chamber types in magnetic fields including intra-type variation

Background and purpose

For dosimetry in magnetic resonance (MR) guided radiotherapy, assessing the magnetic field correction factors of air-vented ionization chambers is crucial. Novel MR-optimized chambers reduce MR-imaging artefacts, enhancing their quality assurance utility. This study aimed to characterize two new MR-optimized ionization chambers with sensitive volumes of 0.07 and 0.016 cm3 regarding magnetic field correction factors and intra-type variation and compare them to their conventional counterparts.

Material and methods

Five chambers of each type were evaluated in a water phantom, using a clinical linear accelerator and an electromagnet, as well as a 1.5 T MR-linac system. The magnetic field correction factor k B → , Q , addressing the change of response caused by a magnetic field, was assessed together with its intra-type variation. MR-optimized and conventional chambers were compared using a Mann-Whitney U-Test.

Results

Considering 1.5 T and a perpendicular chamber orientation, we observed significant differences in the magnetic field-induced change in chamber reading between the two 0.016 cm3 chamber versions (p = 0.03). For a 7 MV beam, MR-optimized chambers (0.016/0.07 cm3) showed k B → , Q values of 1.0426(66) and 1.0463(44), compared to 1.0319(53) and 1.0480(41) of their conventional counterparts. In anti-parallel orientation, k B → , Q was 1.0012(69) and 0.9863(49) for the MR-optimized chambers. The average intra-type variation of k B → , Q over all chamber types was 0.3%.

Conclusion

Magnetic field correction factors were successfully determined for four ionization chamber types, including two new MR-optimized versions, allowing their use in MR-linac absolute dosimetry. Evaluation of the intra-type variation enabled the assessment of their contribution to the uncertainty of tabulated k B → , Q .

Dose-response dependencies of OSL dosimeters in conventional linacs and 1.5T MR-linacs: an experimental and Monte Carlo study

Objective. This work focuses on the optically stimulated luminescence dosimetry (OSLD) dose-response characterization, with emphasis on 1.5T MR-Linacs.Approach. Throughout this study, the nanoDots OSLDs (Landauer, USA) were considered. In groups of three, the mean OSLD response was measured in a conventional linac and an MR-Linac under various irradiation conditions to investigate (i) dose-response linearity with and without the 1.5T magnetic field, (ii) signal fading rate and its dependencies, (iii) beam quality, detector orientation and dose rate dependencies in a conventional linac, (iii) potential MR imaging related effects on OSLD response and (iv) detector orientation dependence in an MR-Linac. Monte Carlo calculations were performed to further quantify angular dependence after rotating the detector around its central axis parallel to the magnetic field, and determine the magnetic field correction factors,kB,Q,for all cardinal detector orientations.Main results. OSLD dose-response supralinearity in an MR-Linac setting was found to agree within uncertainties with the corresponding one in a conventional linac, for the axial detector orientation investigated. Signal fading rate does not depend on irradiation conditions for the range of 3-30 d considered. OSLD angular (orientation) dependence is more pronounced under the presence of a magnetic field. OSLDs irradiated with and without real-time T2w MR imaging enabled during irradiation yielded the same response within uncertainties.kB,Qvalues were determined for all three cardinal orientations. Corrections needed reached up to 6.4%. However, if OSLDs are calibrated in the axial orientation and then irradiated in an MR-Linac placed again in the axial orientation (perpendicular to the magnetic field), then simulations suggest thatkB,Qcan be considered unity within uncertainties, irrespective of the incident beam angle.Significance. This work contributes towards OSLD dose-response characterization and relevant correction factors availability. OSLDs are suitable for QA checks in MR-based beam gating applications andin vivodosimetry in MR-Linacs.

MR-guided ion therapy: Detector response in magnetic fields during carbon ion irradiation

BACKGROUND

Combining carbon ion therapy with on-bed MR imaging has the potential to bring particle therapy to a new level of precision. However, the introduction of magnetic fields brings challenges for dosimetry and quality assurance. For protons, a small, but significant change in detector response was shown in the presence of magnetic fields previously. For carbon ion beams, so far no such experiments have been performed.

PURPOSE

To investigate the influence of external magnetic fields on the response of air-filled ionization chambers.

METHODS

Four commercially available ionization chambers, three thimble type (Farmer, Semiflex, and PinPoint), and a plane parallel (Bragg peak) detector were investigated. Detectors were aligned in water such that their effective point of measurement was located at 2 cm depth. Irradiations were performed using10 × 10 cm 2 $10\times 10\nobreakspace \mathrm{cm}^2$ square fields for carbon ions of 186.1, 272.5, and 402.8 MeV/u employing magnetic field strengths of 0, 0.25, 0.5, and 1 T. In addition, the detector response for protons and carbon ions was compared taking into account the secondary electron spectra and employing protons of 252.7 MeV for comparison.

RESULTS

For all four detectors, a statistically significant change in detector response, dependent on the magnetic field strength, was found. The effect was more pronounced for higher energies. The highest effects were found at 0.5 T for the PinPoint detector with a change in detector response of 1.1%. The response of different detector types appeared to be related to the cavity diameter. For proton and carbon ion irradiation with similar secondary electron spectra, the change in detector response was larger for carbon ions compared to protons.

CONCLUSION

A small, but significant dependence of the detector response was found for carbon ion irradiation in a magnetic field. The effect was found to be larger for smaller cavity diameters and at medium magnetic field strengths. Changes in detector response were more pronounced for carbon ions compared to protons.

Monte Carlo simulation for proton dosimetry in magnetic fields: Fano test and magnetic field correction factorskBfor Farmer-type ionization chambers

Objective. In this contribution we present a special Fano test for charged particles in presence of magnetic fields in the MC code TOol for PArticle Simulation (TOPAS), as well as the determination of magnetic field correction factorskBfor Farmer-type ionization chambers using proton beams.Approach. Customized C++ extensions for TOPAS were implemented to model the special Fano tests in presence of magnetic fields for electrons and protons. The Geant4-specific transport parameters,DRoverRandfinalRange,were investigated to optimize passing rate and computation time. ThekBwas determined for the Farmer-type PTW 30013 ionization chamber, and 5 custom built ionization chambers with same geometry but varying inner radius, testing magnetic flux density ranging from 0 to 1.0 T and two proton beam energies of 157.43 and 221.05 MeV.Main results. Using the investigated parameters, TOPAS passed the Fano test within 0.39 ± 0.15% and 0.82 ± 0.42%, respectively for electrons and protons. The chamber response (kB,M,Q) gives a maximum at different magnetic flux densities depending of the chamber size, 1.0043 at 1.0 T for the smallest chamber and 1.0051 at 0.2 T for the largest chamber. The local dose differencecBremained ≤ 0.1% for both tested energies. The magnetic field correction factorkB, for the chamber PTW 30013, varied from 0.9946 to 1.0036 for both tested energies.Significance. The developed extension for the special Fano test in TOPAS MC code with the adjusted transport parameters, can accurately transport electron and proton particles in magnetic field. This makes TOPAS a valuable tool for the determination ofkB. The ionization chambers we tested showed thatkBremains small (≤0.72%). To the best of our knowledge, this is the first calculations ofkBfor proton beams. This work represents a significant step forward in the development of MRgPT and protocols for proton dosimetry in presence of magnetic field.

Experimental and Monte Carlo-based determination of magnetic field correction factors k B , Q $k_{B,Q}$ in high-energy photon fields for two ionization chambers

BACKGROUND

The integration of magnetic resonance tomography into clinical linear accelerators provides high-contrast, real-time imaging during treatment and facilitates online-adaptive workflows in radiation therapy treatments. The associated magnetic field also bends the trajectories of charged particles via the Lorentz force, which may alter the dose distribution in a patient or a phantom and affects the dose response of dosimetry detectors.

PURPOSE

To perform an experimental and Monte Carlo-based determination of correction factors k B , Q $k_{B,Q}$ , which correct the response of ion chambers in the presence of external magnetic fields in high-energy photon fields.

METHODS

The response variation of two different types of ion chambers (Sun Nuclear SNC125c and SNC600c) in strong external magnetic fields was investigated experimentally and by Monte Carlo simulations. The experimental data were acquired at the German National Metrology Institute, PTB, using a clinical linear accelerator with a nominal photon energy of 6 MV and an external electromagnet capable of generating magnetic flux densities of up to 1.5 T in opposite directions. The Monte Carlo simulation geometries corresponded to the experimental setup and additionally to the reference conditions of IAEA TRS-398. For the latter, the Monte Carlo simulations were performed with two different photon spectra: the 6 MV spectrum of the linear accelerator used for the experimental data acquisition and a 7 MV spectrum of a commercial MRI-linear accelerator. In each simulation geometry, three different orientations of the external magnetic field, the beam direction and the chamber orientation were investigated.

RESULTS

Good agreement was achieved between Monte Carlo simulations and measurements with the SNC125c and SNC600c ionization chambers, with a mean deviation of 0.3% and 0.6%, respectively. The magnitude of the correction factor k B , Q $k_{B,Q}$ strongly depends on the chamber volume and on the orientation of the chamber axis relative to the external magnetic field and the beam directions. It is greater for the SNC600c chamber with a volume of 0.6 cm³ than for the SNC125c chamber with a volume of 0.1 cm³ . When the magnetic field direction and the chamber axis coincide, and they are perpendicular to the beam direction, the ion chambers exhibit a calculated overresponse of less than 0.7(6)% (SNC600c) and 0.3(4)% (SNC125c) at 1.5 T and less than 0.3(0)% (SNC600c) and 0.1(3)% (SNC125c) for 0.35 T for nominal beam energies of 6 MV and 7 MV. This chamber orientation should be preferred, as k B , Q $k_{B,Q}$ may increase significantly in other chamber orientations. Due to the special geometry of the guard ring, no dead-volume effects have been observed in any orientation studied. The results show an intra-type variation of 0.17% and 0.07% standard uncertainty (k=1) for the SNC125c and SNC600c, respectively.

CONCLUSION

Magnetic field correction factors k B , Q $k_{B,Q}$ for two different ion chambers and for typical clinical photon beam qualities were presented and compared with the few data existing in the literature. The correction factors may be applied in clinical reference dosimetry for existing MRI-linear accelerators.

ACPSEM position paper: dosimetry for magnetic resonance imaging linear accelerators

Consistency and clear guidelines on dosimetry are essential for accurate and precise dosimetry, to ensure the best patient outcomes and to allow direct dose comparison across different centres. Magnetic Resonance Imaging Linac (MRI-linac) systems have recently been introduced to Australasian clinics. This report provides recommendations on reference dosimetry measurements for MRI-linacs on behalf of the Australiasian College of Physical Scientists and Engineers in Medicine (ACPSEM) MRI-linac working group. There are two configurations considered for MRI-linacs, perpendicular and parallel, referring to the relative direction of the magnetic field and radiation beam, with different impacts on dose deposition in a medium. These recommendations focus on ion chambers which are most commonly used in the clinic for reference dosimetry. Water phantoms must be MR safe or conditional and practical limitations on phantom set-up must be considered. Solid phantoms are not advised for reference dosimetry. For reference dosimetry, IAEA TRS-398 recommendations cannot be followed completely due to physical differences between conventional linac and MRI-linac systems. Manufacturers' advice on reference conditions should be followed. Beam quality specification of TPR_20,10 is recommended. The configuration of the central axis of the ion chamber relative to the magnetic field and radiation beam impacts the chamber response and must be considered carefully. Recommended corrections to delivered dose are [Formula: see text], a correction for beam quality and [Formula: see text], for the impact of the magnetic field on dosimeter response in the magnetic field. Literature based values for [Formula: see text] are given. It is important to note that this is a developing field and these recommendations should be used together with a review of current literature.

Dosimetry Effects Due to the Presence of Fe Nanoparticles for Potential Combination of Hyperthermic Cancer Treatment with MRI-Based Image-Guided Radiotherapy

Nanoparticles have proven to be biocompatible and suitable for many biomedical applications. Currently, hyperthermia cancer treatments based on Fe nanoparticle infusion excited by alternating magnetic fields are commonly used. In addition to this, MRI-based image-guided radiotherapy represents, nowadays, one of the most promising accurate radiotherapy modalities. Hence, assessing the feasibility of combining both techniques requires preliminary characterization of the corresponding dosimetry effects. The present work reports on a theoretical and numerical simulation feasibility study aimed at pointing out preliminary dosimetry issues. Spatial dose distributions incorporating magnetic nanoparticles in MRI-based image-guided radiotherapy have been obtained by Monte Carlo simulation approaches accounting for all relevant radiation interaction properties as well as charged particles coupling with strong external magnetic fields, which are representative of typical MRI-LINAC devices. Two main effects have been evidenced: local dose enhancement (up to 60% at local level) within the infused volume, and non-negligible changes in the dose distribution at the interfaces between different tissues, developing to over 70% for low-density anatomical cavities. Moreover, cellular uptakes up to 10% have been modeled by means of considering different Fe nanoparticle concentrations. A theoretical temperature-dependent model for the thermal enhancement ratio (TER) has been used to account for radiosensitization due to hyperthermia. The outcomes demonstrated the reliability of the Monte Carlo approach in accounting for strong magnetic fields and mass distributions from patient-specific anatomy CT scans to assess dose distributions in MRI-based image-guided radiotherapy combined with magnetic nanoparticles, while the hyperthermic radiosensitization provides further and synergic contributions.

Practical guidelines of online MR-guided adaptive radiotherapy

The first magnetic resonance (MR)-guided radiotherapy system in Japan was installed in May 2017. Implementation of online MR-guided adaptive radiotherapy (MRgART) began in February 2018. Online MRgART offers greater treatment accuracy owing to the high soft-tissue contrast in MR-images (MRI), compared to that in X-ray imaging. The Japanese Society for Magnetic Resonance in Medicine (JSMRM), Japan Society of Medical Physics (JSMP), Japan Radiological Society (JRS), Japanese Society of Radiological Technology (JSRT), and Japanese Society for Radiation Oncology (JASTRO) jointly established the comprehensive practical guidelines for online MRgART. These guidelines propose the essential requirements for clinical implementation of online MRgART with respect to equipment, personnel, institutional environment, practice guidance, and quality assurance/quality control (QA/QC). The minimum requirements for related equipment and QA/QC tools, recommendations for safe operation of MRI system, and the implementation system are described. The accuracy of monitor chamber and detector in dose measurements should be confirmed because of the presence of magnetic field. The ionization chamber should be MR-compatible. Non-MR-compatible devices should be used in an area that is not affected by the static magnetic field (outside the five Gauss line), and their operation should be checked to ensure that they do not affect the MR image quality. Dose verification should be performed using an independent dose verification system that has been confirmed to be reliable through commissioning. This guideline proposes the checklists to ensure the safety of online MRgART. Successful clinical implementation of online MRgART requires close collaboration between physician, radiological technologist, nurse, and medical physicist.

The impact of ion chamber components onkB,Qfor reference dosimetry in MRgRT

For reference dosimetry in MRgRT,k_B,Qis used to correct for the impact of the magnetic field on the chamber calibration coefficient. It has been demonstrated that for accurate simulation ofk_B,Qthe dead volume (DV) must be considered. This work goes one step further by analysing the contribution of secondary electrons generated in the various chamber components tok_B,Q. The Farmer-type chamber PTW 30013 geometry was modelled for two different DVs. Monte Carlo simulations were performed for a⁶⁰Co source and a 7 MV MRI-linac and the model was validated against measurements. Both parallel (α = 0° or 180°) and perpendicular (α = 90° or 270°) orientations of the chamber and the magnetic (B) field were considered, and severalB-field strengths between 0 T and 1.5 T. To study the dose contribution to the reduced volume (RV = cavity - DV) from the secondary electrons produced in certain components of the chamber the labelling of the particles was implemented in the PENELOPE user code PENMAIN. A separate model with each solid component of the chamber modelled as liquid water was used to investigate the impact of material choice onk_B,Q. Results show that simulatedk_B,Qvalues agree better with the measuredk_B,Qwhen the DV is considered. It is demonstrated that small components of the chamber impactk_B,Qconsiderably, since the contribution to the RV-dose from the bodies closer to the RV is higher than withoutB. Moreover, it is seen that the impact to the dose in the RV is reduced when the material of each component is modelled as liquid water. Therefore, chamber design and, to a lesser extent, choice of material affectk_B,Q, and an accurate geometrical model of the chamber components and its further validation are important for correct calculations ofk_B,Q.

Experimental characterisation of the magnetic field correction factor,kB⃗,for Roos chambers in a parallel MRI-linac

Objective.Reference dosimetry on an MRI-linac requires a chamber specific magnetic field correction factor,kB⃗.This work aims to measure the correction factor for a parallel plate chamber on a parallel MRI-linac.Approach.kB⃗is defined as the ratio of the absorbed dose to water calibration coefficient in the presence of the magnetic field,ND,wB⃗relative to that under 0 T conditions,ND,w0T.kB⃗was measured via aND,wtransfer to a field chamber at each magnetic field strength from a chamber with knownND,wandkB⃗.This was achieved on the parallel MRI-linac by moving the measurement set-up between a high magnetic field strength region at the MRI-isocentre and a low magnetic field strength region at the end of the bore whilst maintaining consistent set-up and scatter conditions. Three PTW 34001 Roos chambers were investigated as well as a PTW 30013 Farmer used to validate methodology.Main Results.The beam quality used for the measurements ofkB⃗wasTPR_20/10 = 0.632. ThekB⃗for the PTW Farmer chamber at 1 T on a parallel MRI-linac was 0.993 ± 0.013 (k = 1). The averagekB⃗factor measured for the three Roos chambers on a 1 T parallel MRI-linac was 0.999 ± 0.014 (k = 1).Significance.The results presented are the first measurements ofkB⃗for a Roos chamber on a parallel MRI-linac. The Roos chamber results demonstrate the potential for the chamber as a reference dosimeter in parallel MRI-linacs.

Compact bunker shielding assessment for 1.5 T MR-Linac

This study evaluated the effect of the 1.5 T magnetic field of the magnetic resonance-guided linear accelerator (MR-Linac) on the radiation leakage doses penetrating the bunker radiation shielding wall. The evaluated 1.5 T MR-Linac Unity system has a bunker of the minimum recommended size. Unlike a conventional Linac, both primary beam transmission and secondary beam leakage were considered independently in the design and defined at the machine boundary away from the isocenter. Moreover, additional shielding was designed considering the numerous ducts between the treatment room and other rooms. The Linac shielding was evaluated by measuring the leakage doses at several locations. The intrinsic vibration and magnetic field were inspected at the proposed isocenter of the system. For verification, leakage doses were measured before and after applying the magnetic field. The intrinsic vibration and magnetic field readings were below the permitted limit. The leakage dose (0.05–12.2 µSv/week) also complied with internationally stipulated limits. The special shielding achieved a five-fold reduction in leakage dose. Applying the magnetic field increased the leakage dose by 0.12 to 4.56 µSv/week in several measurement points, although these values fall within experimental uncertainty. Thus, the effect of the magnetic field on the leakage dose could not be ascertained.

Commissioning measurements on an Elekta Unity MR-Linac

Magnetic resonance-guided radiotherapy technology is relatively new and commissioning publications, quality assurance (QA) protocols and commercial products are limited. This work provides guidance for implementation measurements that may be performed on the Elekta Unity MR-Linac (Elekta, Stockholm, Sweden). Adaptations of vendor supplied phantoms facilitated determination of gantry angle accuracy and linac isocentre, whereas in-house developed phantoms were used for end-to-end testing and anterior coil attenuation measurements. Third-party devices were used for measuring beam quality, reference dosimetry and during treatment plan commissioning; however, due to several challenges, variations on standard techniques were required. Gantry angle accuracy was within 0.1°, confirmed with pixel intensity profiles, and MV isocentre diameter was < 0.5 mm. Anterior coil attenuation was approximately 0.6%. Beam quality as determined by TPR_20,10 was 0.705 ± 0.001, in agreement with treatment planning system (TPS) calculations, and gamma comparison against the TPS for a 22.0 × 22.0 cm² field was above 95.0% (2.0%, 2.0 mm). Machine output was 1.000 ± 0.002 Gy per 100 MU, depth 5.0 cm. During treatment plan commissioning, sub-standard results indicated issues with machine behaviour. Once rectified, gamma comparisons were above 95.0% (2.0%, 2.0 mm). Centres which may not have access to specialized equipment can use in-house developed phantoms, or adapt those supplied by the vendor, to perform commissioning work and confirm operation of the MRL within published tolerances. The plan QA techniques used in this work can highlight issues with machine behaviour when appropriate gamma criteria are set.

Monte Carlo investigation of electron fluence perturbation in MRI-guided radiotherapy beams using six commercial radiation detectors

With the integration of treatments with MRI-linacs to the clinical workflow, the understanding and characterization of detector response in reference dosimetry in magnetic fields are required. The external magnetic field perturbs the electron fluence. The degree of perturbation depends on the irradiation conditions and on the detector type. The purpose of this study is to evaluate the magnetic field impact on the electron fluence spectra in several detectors to provide a deeper understanding of detector response in these conditions. Monte Carlo calculations of the electron fluence are performed in six detectors (solid-state: PTW60012 and PTW60019, ionization chambers: PTW30013, PTW31010, PTW31021, and PTW31022) in water and irradiated by a 7 MV FFF photon beam with a small and a reference field, at 0 and 1.5 T. Three chamber axis orientations are investigated: parallel or perpendicular (either the Lorentz force pointing towards the stem or the tip) to the magnetic field and always perpendicular to the photon beam. One orientation for the solid-state detector is studied: parallel to the photon beam and perpendicular to the magnetic field. Additionally, electron fluence spectra are calculated in modified detector geometries to identify the underlying physical mechanisms behind the fluence perturbations. The total electron fluence in the Farmer chamber varies up to 1.24% and 5.12% at 1.5 T, in the parallel and perpendicular orientation, respectively. The interplay between the gyration radius and the Farmer chamber cavity length significantly affects the electron fluence in the perpendicular orientation. For the small-cavity chambers, the maximal variation in total electron fluence is 0.19% in the parallel orientation for the reference field. Significant small-field effects occur in these chambers; the magnetic field reduces the total electron fluence (with respect to the no field case) between 9.86% and 14.50%, depending on the orientation. The magnetic field strongly impacted the solid-state detectors in both field sizes, probably due to the high-Z components and cavity density. The maximal reductions of total electron fluence are 15.06 ± 0.09% (silicon) and 16.00 ± 0.07% (microDiamond). This work provides insights into detector response in magnetic fields by illustrating the interplay between several factors causing dosimetric perturbation effects: (1) chamber and magnetic field orientation, (2) cavity size and shape, (3) extracameral components, (4) air gaps and their asymmetry, (5) electron energy. Low-energy electron trajectories are more susceptible to change in magnetic fields, and are associated with detector response perturbation. Detectors with higher density and high-Z extracameral components exhibit more significant perturbations in the presence of a magnetic field, regardless of field size.

Monte Carlo calculation of detector perturbation and quality correction factors in a 1.5 T magnetic resonance guided radiation therapy small photon beams

Objective.With future advances in magnetic resonance imaging-guided radiation therapy, small photon beams are expected to be included regularly in clinical treatments. This study provides physical insights on detector dose-response to multiple megavoltage photon beam sizes coupled to magnetic fields and determines optimal orientations for measurements.Approach.Monte Carlo simulations determine small-cavity detector (solid-state: PTW60012 and PTW60019, ionization chambers: PTW31010, PTW31021, and PTW31022) dose-responses in water to an Elekta Unity 7 MV FFF photon beam. Investigations are performed for field widths between 0.25 and 10 cm in four detector axis orientations with respect to the 1.5 T magnetic field and the photon beam. The magnetic field effect on the overall perturbation factor (P_MC) accounting for the extracameral components, atomic composition, and density is quantified in each orientation. The density (P_ρ) and volume averaging (P_vol) perturbation factors and quality correction factors (kQB,QfB,f) accounting for the magnetic field are also calculated in each orientation.Main results.Results show thatP_volremains the most significant perturbation both with and without magnetic fields. In most cases, the magnetic field effect onP_volis 1% or less. The magnetic field effect onP_ρis more significant on ionization chambers than on solid-state detectors. This effect increases up to 1.564 ± 0.001 with decreasing field size for chambers. On the contrary, the magnetic field effect on the extracameral perturbation factor is higher on solid-state detectors than on ionization chambers. For chambers, the magnetic field effect onP_MCis only significant for field widths <1 cm, while, for solid-state detectors, this effect exhibits different trends with orientation, indicating that the beam incident angle and geometry play a crucial role.Significance.Solid-state detectors' dose-response is strongly affected by the magnetic field in all orientations. The magnetic field impact on ionization chamber response increases with decreasing field size. In general, ionization chambers yieldkQB,QfB,fcloser to unity, especially in orientations where the chamber axis is parallel to the magnetic field.

Traceable reference dosimetry in MRI guided radiotherapy using alanine: calibration and magnetic field correction factors of ionisation chambers

Magnetic resonance imaging (MRI)-guided radiotherapy (RT) (MRIgRT) falls outside the scope of existing high energy photon therapy dosimetry protocols, because those protocols do not consider the effects of the magnetic field on detector response and on absorbed dose to water. The aim of this study is to evaluate and demonstrate the traceable measurement of absorbed dose in MRIgRT systems using alanine, made possible by the characterisation of alanine sensitivity to magnetic fields reported previously by Billaset al(2020Phys. Med. Biol.65115001), in a way which is compatible with existing standards and calibrations available for conventional RT. In this study, alanine is used to transfer absorbed dose to water to MRIgRT systems from a conventional linac. This offers an alternative route for the traceable measurement of absorbed dose to water, one which is independent of the transfer using ionisation chambers. The alanine dosimetry is analysed in combination with measurements with several Farmer-type chambers, PTW 30013 and IBA FC65-G, at six different centres and two different MRIgRT systems (Elekta Unity™ and ViewRay MRIdian™). The results are analysed in terms of the magnetic field correction factors, and in terms of the absorbed dose calibration coefficients for the chambers, determined at each centre. This approach to reference dosimetry in MRIgRT produces good consistency in the results, across the centres visited, at the level of 0.4% (standard deviation). Farmer-type ionisation chamber magnetic field correction factors were determined directly, by comparing calibrations in some MRIgRT systems with and without the magnetic field ramped up, and indirectly, by comparing calibrations in all the MRIgRT systems with calibrations in a conventional linac. Calibration coefficients in the MRIgRT systems were obtained with a standard uncertainty of 1.1% (Elekta Unity™) and 0.9% (ViewRay MRIdian™), for three different chamber orientations with respect to the magnetic field. The values obtained for the magnetic field correction factor in this investigation are consistent with those presented in the summary by de Pooteret al(2021Phys. Med. Biol.6605TR02), and would tend to support the adoption of a magnetic field correction factor which depends on the chamber type, PTW 30013 or IBA FC65-G.

The dose response of PTW microDiamond and microSilicon in transverse magnetic field under small field conditions

The aim of the present work is to investigate the behavior of two diode-type detectors (PTW microDiamond 60019 and PTW microSilicon 60023) in transverse magnetic field under small field conditions. A formalism based on TRS 483 has been proposed serving as the framework for the application of these high-resolution detectors under these conditions. Measurements were performed at the National Metrology Institute of Germany (PTB, Braunschweig) using a research clinical linear accelerator facility. Quadratic fields corresponding to equivalent square field sizesSbetween 0.63 and 4.27 cm at the depth of measurement were used. The magnetic field strength was varied up to 1.4 T. Experimental results have been complemented with Monte Carlo simulations up to 1.5 T. Detailed simulations were performed to quantify the small field perturbation effects and the influence of detector components on the dose response. The does response of both detectors decreases by up to 10% at 1.5 T in the largest field size investigated. InS = 0.63 cm, this reduction at 1.5 T is only about half of that observed in field sizesS > 2 cm for both detectors. The results of the Monte Carlo simulations show agreement better than 1% for all investigated conditions. Due to normalization at the machine specific reference field, the resulting small field output correction factors for both detectors in magnetic fieldkQclin,QmsrBare smaller than those in the magnetic field-free case, where correction up to 6.2% at 1.5 T is required for the microSilicon in the smallest field size investigated. The volume-averaging effect of both detectors was shown to be nearly independent of the magnetic field. The influence of the enhanced-density components within the detectors has been identified as the major contributors to their behaviors in magnetic field. Nevertheless, the effect becomes weaker with decreasing field size that may be partially attributed to the deficiency of low energy secondary electrons originated from distant locations in small fields.

Acceptance procedure for the linear accelerator component of the 1.5 T MRI-linac

Purpose

To develop and implement an acceptance procedure for the new Elekta Unity 1.5 T MRI‐linac.

Methods

Tests were adopted and, where necessary adapted, from AAPM TG106 and TG142, IEC 60976 and NCS 9 and NCS 22 guidelines. Adaptations were necessary because of the atypical maximum field size (57.4 × 22 cm), FFF beam, the non‐rotating collimator, the absence of a light field, the presence of the 1.5 T magnetic field, restricted access to equipment within the bore, fixed vertical and lateral table position, and the need for MR image to MV treatment alignment. The performance specifications were set for stereotactic body radiotherapy (SBRT).

Results

The new procedure was performed similarly to that of a conventional kilovoltage x‐ray (kV) image guided radiation therapy (IGRT) linac. Results were acquired for the first Unity system.

Conclusions

A comprehensive set of tests was developed, described and implemented for the MRI‐linac. The MRI‐linac met safety requirements for patients and operators. The system delivered radiation very accurately with, for example a gantry rotation locus of isocenter of radius 0.38 mm and an average MLC absolute positional error of 0.29 mm, consistent with use for SBRT. Specifications for clinical introduction were met.

The role of the construction and sensitive volume of compact ionization chambers on the magnetic field-dependent dose response

PURPOSE

The magnetic-field correction factors k B , Q of compact air-filled ionization chambers have been investigated experimentally and using Monte Carlo simulations up to 1.5 T. The role of the nonsensitive region within the air cavity and influence of the chamber construction on its dose response have been elucidated.

MATERIALS AND METHODS

The PTW Semiflex 3D 31021, PinPoint 3D 31022, and Sun Nuclear Cooperation SNC125c chambers were studied. The k B , Q factors were measured at the experimental facility of the German National Metrology Institute (PTB) up to 1.4 T using a 6 MV photon beam. The chambers were positioned with the chamber axis perpendicular to the beam axis (radial); and parallel to the beam axis (axial). In both cases, the magnetic field was directed perpendicular to both the beam axis and chamber axis. Additionally, the sensitive volumes of these chambers have been experimentally determined using a focused proton microbeam and finite element method. Beside the simulations of k B , Q factors, detailed Monte Carlo technique has been applied to analyse the secondary electron fluence within the air cavity, that is, the number of secondary electrons and the average path length as a function of the magnetic field strength.

RESULTS

A nonsensitive volume within the air cavity adjacent to the chamber stem for the PTW chambers has been identified from the microbeam measurements and FEM calculations. The dose response of the three investigated ionization chambers does not deviate by more than 4% from the field-free case within the range of magnetic fields studied in this work for both the radial and axial orientations. The simulated k B , Q for the fully guarded PTW chambers deviate by up to 6% if their sensitive volumes are not correctly considered during the simulations. After the implementation of the sensitive volume derived from the microbeam measurements, an agreement of better than 1% between the experimental and Monte Carlo k B , Q factors for all three chambers can be achieved. Detailed analysis reveals that the stem of the PTW chambers could give rise to a shielding effect reducing the number of secondary electrons entering the air cavity in the presence of magnetic field. However, the magnetic field dependence of their path length within the air cavity is shown to be weaker than for the SNC125c chamber, where the length of the air cavity is larger than its diameter. For this chamber it is shown that the number of electrons and their path lengths in the cavity depend stronger on the magnetic field.

DISCUSSION AND CONCLUSION

For clinical measurements up to 1.5 T, the required k B , Q corrections of the three chambers could be kept within 3% in both the investigated chamber orientations. The results reiterate the importance of considering the sensitive volume of fully guarded chambers, even for the investigated compact chambers, in the Monte Carlo simulations of chamber response in magnetic field. The resulting magnetic field-dependent dose response has been demonstrated to depend on the chamber construction, such as the ratio between length and the diameter of the air cavity as well as the design of the chamber stem.

MR-guided proton therapy: Impact of magnetic fields on the detector response

PURPOSE

To investigate the response of detectors for proton dosimetry in the presence of magnetic fields.

MATERIAL AND METHODS

Four ionization chambers (ICs), two thimble-type and two plane-parallel-type, and a diamond detector were investigated. All detectors were irradiated with homogeneous single-energy-layer fields, using 252.7 MeV proton beams. A Farmer IC was additionally irradiated in the same geometrical configuration, but with a lower nominal energy of 97.4 MeV. The beams were subjected to magnetic field strengths of 0, 0.25, 0.5, 0.75, and 1 T produced by a research dipole magnet placed at the room's isocenter. Detectors were positioned at 2 cm water equivalent depth, with their stem perpendicular to both the magnetic field lines and the proton beam's central axis, in the direction of the Lorentz force. Normality and two sample statistical Student's t tests were performed to assess the influence of the magnetic field on the detectors' responses.

RESULTS

For all detectors, a small but significant magnetic field-dependent change of their response was found. Observed differences compared to the no magnetic field case ranged from +0.5% to -0.7%. The magnetic field dependence was found to be nonlinear and highest between 0.25 and 0.5 T for 252.7 MeV proton beams. A different variation of the Farmer chamber response with magnetic field strength was observed for irradiations using lower energy (97.4 MeV) protons. The largest magnetic field effects were observed for plane-parallel ionization chambers.

CONCLUSION

Small magnetic field-dependent changes in the detector response were identified, which should be corrected for dosimetric applications.

Reference dosimetry in MRI-linacs: evaluation of available protocols and data to establish a Code of Practice

With the rapid increase in clinical treatments with MRI-linacs, a consistent, harmonized and sustainable ground for reference dosimetry in MRI-linacs is needed. Specific for reference dosimetry in MRI-linacs is the presence of a strong magnetic field. Therefore, existing Code of Practices (CoPs) are inadequate. In recent years, a vast amount of papers have been published in relation to this topic. The purpose of this review paper is twofold: to give an overview and evaluate the existing literature for reference dosimetry in MRI-linacs and to discuss whether the literature and datasets are adequate and complete to serve as a basis for the development of a new or to extend existing CoPs. This review is prefaced with an overview of existing MRI-linac facilities. Then an introduction on the physics of radiation transport in magnetic fields is given. The main part of the review is devoted to the evaluation of the literature with respect to the following subjects: • beam characteristics of MRI-linac facilities; • formalisms for reference dosimetry in MRI-linacs; • characteristics of ionization chambers in the presence of magnetic fields; • ionization chamber beam quality correction factors; and • ionization chamber magnetic field correction factors. The review is completed with a discussion as to whether the existing literature is adequate to serve as basis for a CoP. In addition, it highlights subjects for future research on this topic.

End-to-end validation of the geometric dose delivery performance of MR linac adaptive radiotherapy

The clinical introduction of hybrid magnetic resonance (MR) guided radiotherapy (RT) delivery systems has led to the need to validate the end-to-end dose delivery performance on such machines. In the current study, an MR visible phantom was developed and used to test the spatial deviation between planned and delivered dose at two 1.5 T MR linear accelerator (MR linac) systems, including pre-treatment imaging, dose planning, online imaging, image registration, plan adaptation, and dose delivery. The phantom consisted of 3D printed plastic and MR visible silicone rubber. It was designed to minimise air gaps close to the radiochromic film used as a dosimeter. Furthermore, the phantom was designed to allow submillimetre, reproducible positioning of the film in the phantom. At both MR linac systems, 54 complete adaptive, MR guided RT workflow sessions were performed. To test the dose delivery performance of the MR linac systems in various adaptive RT (ART) scenarios, the sessions comprised a range of systematic positional shifts of the phantom and imaging or plan adaptation conditions. In each workflow session, the positional translation between the film and the adaptive planned dose was determined. The results showed that the accuracy of the MR linac systems was between 0.1 and 0.9 mm depending on direction. The highest mean deviance observed was in the posterior-anterior direction, and the direction of the error was consistent between centres. The precision of the systems was related to whether the workflow utilized the internal image registration algorithm of the MR linac. Workflows using the internal registration algorithm led to a worse precision (0.2-0.7 mm) compared to workflows where the algorithm was decoupled (0.2 mm). In summary, the spatial deviation between planned and delivered dose of MR-guided ART at the two MR linac systems was well below 1 mm and thus acceptable for clinical use.

Monte Carlo modeling of the influence of strong magnetic fields on the stem-effect in plastic scintillation detectors used in radiotherapy dosimetry

PURPOSE

To investigate the impact of strong magnetic fields on the stem-effect in plastic scintillation detectors (PSDs) using Monte Carlo methods.

METHODS

Prior to building the light guide model, the properties of the Čerenkov process in GEANT4 were investigated by simulating depth-dose and depth-Čerenkov emission profiles in water as functions of Čerenkov process input parameters. In addition, profile simulations were performed for magnetic field strengths ranging from 0 T to 1.5 T. A PMMA light guide was constructed in GEANT4 using data from the manufacturer and literature. Simulations were performed with the model as functions of depth and fiber-beam angle where the simulated stem-effect spectrum and the Čerenkov light ratio (CLR) were scored and compared to measured data in the literature. The light guide optical properties were iteratively adjusted until agreement between the simulated and measured data was achieved. Simulations were performed with the validated model as functions of depth and magnetic field strength and the simulated data were compared to measured data in the literature. The model was also used to evaluate the sensitivity of the CLR to the various optical properties of the light guide in different irradiation conditions.

RESULTS

No significant changes in the depth-dose or depth-Čerenkov emission profiles were observed with step-size restrictions imposed by the Čerenkov process input parameters, which was attributed to the condensed history algorithm and transport parameters used in this work. Similar changes in the depth-dose and depth-Čerenkov emission profiles were observed with increasing magnetic field strength, which indicates the Čerenkov process is not adversely impacted by the presence of the magnetic field. Following optimization of the light guide optical properties, agreement within two standard deviations was observed between the simulated and measured optical data for all validation geometries considered. Agreement within one standard deviation was observed between the simulated and measured data for all depths and field strengths ≥0 T whereas discrepancies were observed for magnetic field strengths <-0.35 T. These significant differences were attributed to insufficient measurement data for this irradiation configuration during model validation. Of the light guide optical properties investigated, the fluorescence signal had the greatest impact on the CLR sensitivity to the magnetic field.

CONCLUSIONS

No significant change in the Čerenkov emission per dose in water was observed for magnetic field strengths up to 1.5 T. The nominal fiber fluorescence signal was found to have a significant impact on the CLR sensitivity to varying irradiation conditions where changes up to 11.7% were observed whereas the mirror reflectivity and fiber attenuation had a modest impact with maximum CLR changes of 2.6% and 1.2% relative to 0 T, respectively. The results of this work suggest light guides with low fiber fluorescence should be used with PSDs for dosimetry measurements in magnetic fields to minimize the impact of the magnetic field on the CLR correction.

Experimental determination of magnetic field correction factors for ionization chambers in parallel and perpendicular orientations

Magnetic field correction factors are needed for absolute dosimetry in magnetic resonance (MR)-linacs. Currently experimental data for magnetic field correction factors, especially for small volume ionization chambers, are largely lacking. The purpose of this work is to establish, independent methods for the experimental determination of magnetic field correction factors [Formula: see text] in an orientation in which the ionization chamber is parallel to the magnetic field. The aim is to confirm previous experiments on the determination of Farmer type ionization chamber correction factors and to gather information about the usability of small-volume ionization chambers for absolute dosimetry in MR-linacs. The first approach to determine [Formula: see text] is based on a cross-calibration of measurements using a conventional linac with an electromagnet and an MR-linac. The absolute influence of the magnetic field in perpendicular orientation is quantified with the help of the conventional linac and the electromagnet. The correction factors for the parallel orientation are then derived by combining these measurements with relative measurements in the MR-linac. The second technique utilizes alanine electron paramagnetic resonance dosimetry. The alanine system as well as several ionization chambers were directly calibrated with the German primary standard for absorbed dose to water. Magnetic field correction factors for the ionization chambers were determined by a cross-calibration with the alanine in an MR-linac. Important quantities like [Formula: see text] for Farmer type ionization chambers in parallel orientation and the change of the dose to water due the magnetic field [Formula: see text] have been confirmed. In addition, magnetic field correction factors have been determined for small volume ionization chambers in parallel orientation. The electromagnet-based measurements of [Formula: see text] for [Formula: see text] MR-linacs and parallel ionization chamber orientations resulted in 0.9926(22), 0.9935(31) and 0.9841(27) for the PTW 30013, the PTW 31010 and the PTW 31021, respectively. The measurements based on the second technique resulted in values for [Formula: see text] of 0.9901(72), 0.9955(72), and 0.9885(71). Both methods show excellent accuracy and reproducibility and are therefore suitable for the determination of magnetic field correction factors. Small-volume ionization chambers showed a variation in the resulting values for [Formula: see text] and should be cross-calibrated instead of using tabulated values for correction factors.

Direct determination of [Formula: see text] for cylindrical ionization chambers in a 6 MV 0.35 T MR-linac

To ensure accurate reference dosimetry with ionization chambers in magnetic resonance linear accelerators (MR-linacs), the influence of the magnetic field on the response of the ionization chambers must be considered. The most direct method considering the influence of magnetic fields in dosimetry is to apply an appropriate absorbed-dose-to-water primary standard. At PTB, a new water calorimeter has been designed which is capable to determine D_w,Q in an MR-linac. The new device allows the direct calibration of ionization chambers in terms of absorbed dose to water for MR-linac irradiation conditions. Hence, the correction factors [Formula: see text] can be determined which replace the current radiation-quality dependent correction factors [Formula: see text] for dosimetry in the presence of magnetic fields. In cooperation with Heidelberg University Hospital,[Formula: see text] factors were measured at the 6 MV 0.35 T Viewray MR-linac for different cylindrical ionization chambers with sensitive volumes ranging from 0.015 cm³ to 0.65 cm³. The chambers were placed both perpendicular and parallel in respect to the magnetic field. Standard uncertainties of about 0.5% were achieved.

Small-cavity chamber dose response in megavoltage photon beams coupled to magnetic fields

In MRgRT, dosimetry measurements are performed in the presence of magnetic fields. For high-resolution measurements, small-cavity ionization chambers are required. While Monte Carlo simulations are essential to determine dosimetry correction factors, models of small-chambers require careful validation with experimental measurements. The aim of this study is to characterize small-cavity chamber response coupled to magnetic fields. Small-cavity chambers (PTW31010, PTW31016, PTW31021 and PTW3022) are irradiated by a 6 MV photon beam for 9 magnetic field strengths between -1.5 T and +1.5 T. The chamber axis is orientated either parallel or perpendicular to the irradiation beam, with the magnetic field always perpendicular to the beam. MC simulations are performed in EGSnrc. The sensitive volume of the chambers is reduced to account for the inefficiency adjacent to the guard electrode (dead volume) based on COMSOL calculations of electric potentials. The magnetic field affects the chamber response by up to 4.1% and 4.5% in the parallel and perpendicular orientations, respectively, compared to no magnetic field. The maximal difference in dose response between experiments and simulations is up to 6.1% and 4.5% for parallel and perpendicular orientation, respectively. When the dead volume is removed, which accounts for the 15%-23% of the nominal volume, the difference, in most cases, is within the stated uncertainties. Nevertheless, for a particular chamber, the reduced nominal volume barely improved the agreement between the experimental and calculated relative response (4.53% to 4.13%). This disagreement may be due to the imperfect chamber geometry model, as was found from microCT images. A detailed uncertainty analysis is presented. The characterization of small-cavity ion chamber response coupled to magnetic fields is complex. Small differences between real and model chamber geometry that normally would be insignificant become an issue in the presence of magnetic fields. Accurate characterization of the nominal volume is essential for small-cavity ion chamber modelling.

Influence of beam quality on reference dosimetry correction factors in magnetic resonance guided radiation therapy

Correction factors for reference dosimetry in magnetic resonance (MR) imaging-guided radiation therapy (k B → , M , Q ) are often determined in setups that combine a conventional 6 MV linac with an electromagnet. This study investigated whether results based on these measurements were applicable for a 7 MV MR-linac using Monte Carlo simulations. For a Farmer-type ionization chamber,k B → , M , Q was assessed for different tissue-phantom ratios (TPR 20 , 10 ).k B → , M , Q differed by 0.0029 ( 43 ) betweenTPR 20 , 10 = 0.6790 ( 23 ) (6 MV linac) andTPR 20 , 10 = 0.7028 ( 14 ) (7 MV MR-linac) at 1.5 T . The agreement was best in an orientation in which the secondary electrons were deflected to the stem of the ionization chamber.

Characterization of an inorganic scintillator for small-field dosimetry in MR-guided radiotherapy

INTRODUCTION

Aim of this study is to dosimetrically characterize a new inorganic scintillator designed for magnetic resonance-guided radiotherapy (MRgRT) in the presence of 0.35 tesla magnetic field (B).

METHODS

The detector was characterized in terms of signal to noise ratio (SNR), reproducibility, dose linearity, angular response, and dependence by energy, field size, and B orientation using a 6 MV magnetic resonance (MR)-Linac and a water tank. Field size dependence was investigated by measuring the output factor (OF) at 1.5 cm. The results were compared with those measured using other detectors (ion chamber and synthetic diamond) and those calculated using a Monte Carlo (MC) algorithm. Energy dependence was investigated by acquiring a percentage depth dose (PDD) curve at two field sizes (3.32 × 3.32 and 9.96 × 9.96 cm² ) and repeating the OF measurements at 5 and 10 cm depths.

RESULTS

The mean SNR was 116.3 ± 0.6. Detector repeatability was within 1%, angular dependence was <2% and its response variation based on the orientation with respect to the B lines was <1%. The detector has a temporal resolution of 10 Hz and it showed a linear response (R²  = 1) in the dose range investigated. All the OF values measured at 1.5 cm depth using the scintillator are in accordance within 1% with those measured with other detectors and are calculated using the MC algorithm. PDD values are in accordance with MC algorithm only for 3.32 × 3.32 cm² field. Numerical models can be applied to compensate for energy dependence in case of larger fields.

CONCLUSION

The inorganic scintillator in the present form can represent a valuable detector for small-field dosimetry and periodic quality controls at MR-Linacs such as dose stability, OFs, and dose linearity. In particular, the detector can be effectively used for small-field dosimetry at 1.5 cm depth and for PDD measurements if the field dimension of 3.32 × 3.32 cm² is not exceeded.

Influence of 0.35 T magnetic field on the response of EBT3 and EBT-XD radiochromic films

PURPOSE

To investigate the inconsistency of recent literature on the effect of magnetic field on the response of radiochromic films, we studied the influence of 0.35 T magnetic field on dosimetric response of EBT3 and EBT-XD Gafchromic^TM films.

METHODS

Two different models of radiochromic films, EBT3 and EBT-XD, were investigated. Pieces of films samples from two different batches for each model were irradiated at different dose levels ranging from 1 to 20 Gy using 6 MV flattening filter free (FFF) x-rays generated by a clinical MR-guided radiotherapy system (B = 0.35 T). Film samples from the same batch were irradiated at corresponding dose levels using 6 MV FFF beam from a conventional linac (B = 0) for comparison. The net optical density was measured 48 h postirradiation using a flatbed scanner. The absorbance spectra were also measured over 500-700 nm wavelength range using a fiber-coupled spectrometer with 2.5 nm resolution. To study the effect of fractionated dose delivery to EBT3 (/EBT-XD) films, 8 (/16) Gy dose was delivered in four 2 (/4) Gy fractions with 24 h interval between fractions.

RESULTS

No significant difference was found in the net optical density and net absorbance of the films irradiated with or without the presence of magnetic field. No dependency on the orientation of the film during irradiation with respect to the magnetic field was observed. The fractionated dose delivery resulted in the same optical density as delivering the whole dose in a single fraction.

CONCLUSIONS

The 0.35 T magnetic field employed in the ViewRay^® MR-guided radiotherapy system did not show any significant influence on the response of EBT3 and EBT-XD Gafchromic^TM films.

Alanine dosimetry in strong magnetic fields: use as a transfer standard in MRI-guided radiotherapy

Reference dosimetry in the presence of a strong magnetic field is challenging. Ionisation chambers have shown to be strongly affected by magnetic fields. There is a need for robust and stable detectors in MRI-guided radiotherapy (MRIgRT). This study investigates the behaviour of the alanine dosimeter in magnetic fields and assesses its suitability to act as a reference detector in MRIgRT. Alanine pellets were loaded in a waterproof holder, placed in an electromagnet and irradiated by 60Co and 6 MV and 8 MV linac beams over a range of magnetic flux densities. Monte Carlo simulations were performed to calculate the absorbed dose, to water and to alanine, with and without magnetic fields. Combining measurements with simulations, the effect of magnetic fields on alanine response was quantified and a correction factor for the presence of magnetic fields on alanine was determined. This study finds that the response of alanine to ionising radiation is modified when the irradiation is in the presence of a magnetic field. The effect is energy independent and may increase the alanine/electron paramagnetic resonance (EPR) signal by 0.2% at 0.35 T and 0.7% at 1.5 T. In alanine dosimetry for MRIgRT, this effect, if left uncorrected, would lead to an overestimate of dose. Accordingly, a correction factor, [Formula: see text], is defined. Values are obtained for this correction as a function of magnetic flux density, with a standard uncertainty which depends on the magnetic field and is 0.6% or less. The strong magnetic field has a measurable effect on alanine dosimetry. For alanine which is used to measure absorbed dose to water in a strong magnetic field, but which has been calibrated in the absence of a magnetic field, a small correction to the reported dose is required. With the inclusion of this correction, alanine/EPR is a suitable reference dosimeter for measurements in MRIgRT.

Medical physics challenges in clinical MR-guided radiotherapy

The integration of magnetic resonance imaging (MRI) for guidance in external beam radiotherapy has faced significant research and development efforts in recent years. The current availability of linear accelerators with an embedded MRI unit, providing volumetric imaging at excellent soft tissue contrast, is expected to provide novel possibilities in the implementation of image-guided adaptive radiotherapy (IGART) protocols. This study reviews open medical physics issues in MR-guided radiotherapy (MRgRT) implementation, with a focus on current approaches and on the potential for innovation in IGART.Daily imaging in MRgRT provides the ability to visualize the static anatomy, to capture internal tumor motion and to extract quantitative image features for treatment verification and monitoring. Those capabilities enable the use of treatment adaptation, with potential benefits in terms of personalized medicine. The use of online MRI requires dedicated efforts to perform accurate dose measurements and calculations, due to the presence of magnetic fields. Likewise, MRgRT requires dedicated quality assurance (QA) protocols for safe clinical implementation.Reaction to anatomical changes in MRgRT, as visualized on daily images, demands for treatment adaptation concepts, with stringent requirements in terms of fast and accurate validation before the treatment fraction can be delivered. This entails specific challenges in terms of treatment workflow optimization, QA, and verification of the expected delivered dose while the patient is in treatment position. Those challenges require specialized medical physics developments towards the aim of fully exploiting MRI capabilities. Conversely, the use of MRgRT allows for higher confidence in tumor targeting and organs-at-risk (OAR) sparing.The systematic use of MRgRT brings the possibility of leveraging IGART methods for the optimization of tumor targeting and quantitative treatment verification. Although several challenges exist, the intrinsic benefits of MRgRT will provide a deeper understanding of dose delivery effects on an individual basis, with the potential for further treatment personalization.

Dosimetric Optimization and Commissioning of a High Field Inline MRI-Linac

Purpose: Unique characteristics of MRI-linac systems and mutual interactions between their components pose specific challenges for their commissioning and quality assurance. The Australian MRI-linac is a prototype system which explores the inline orientation, with radiation beam parallel to the main magnetic field. The aim of this work was to commission the radiation-related aspects of this system for its application in clinical treatments.

Methods: Physical alignment of the radiation beam to the magnetic field was fine-tuned and magnetic shielding of the radiation head was designed to achieve optimal beam characteristics. These steps were guided by investigative measurements of the beam properties. Subsequently, machine performance was benchmarked against the requirements of the IEC60976/77 standards. Finally, the geometric and dosimetric data was acquired, following the AAPM Task Group 106 recommendations, to characterize the beam for modeling in the treatment planning system and with Monte Carlo simulations. The magnetic field effects on the dose deposition and on the detector response have been taken into account and issues specific to the inline design have been highlighted.

Results: Alignment of the radiation beam axis and the imaging isocentre within 2 mm tolerance was obtained. The system was commissioned at two source-to-isocentre distances (SIDs): 2.4 and 1.8 m. Reproducibility and proportionality of the dose monitoring system met IEC criteria at the larger SID but slightly exceeded it at the shorter SID. Profile symmetry remained under 103% for the fields up to ~34 × 34 and 21 × 21 cm² at the larger and shorter SID, respectively. No penumbra asymmetry, characteristic for transverse systems, was observed. The electron focusing effect, which results in high entrance doses on central axis, was quantified and methods to minimize it have been investigated.

Conclusion: Methods were developed and employed to investigate and quantify the dosimetric properties of an inline MRI-Linac system. The Australian MRI-linac system has been fine-tuned in terms of beam properties and commissioned, constituting a key step toward the application of inline MRI-linacs for patient treatments.

Absolute dosimetry of a 1.5 T MR-guided accelerator-based high-energy photon beam in water and solid phantoms using Aerrow

PURPOSE

In this work, the fabrication, operation, and evaluation of a probe-format graphite calorimeter - herein referred to as Aerrow - as an absolute clinical dosimeter of high-energy photon beams while in the presence of a B = 1.5 T magnetic field is described. Comparable to a cylindrical ionization chamber (IC) in terms of utility and usability, Aerrow has been developed for the purpose of accurately measuring absorbed dose to water in the clinic with a minimum disruption to the existing clinical workflow. To our knowledge, this is the first reported application of graphite calorimetry to magnetic resonance imaging (MRI)-guided radiotherapy.

METHODS

Based on a previously numerically optimized and experimentally validated design, an Aerrow prototype capable of isothermal operation was constructed in-house. Graphite-to-water dose conversions as well as magnetic field perturbation factors were calculated using Monte Carlo, while heat transfer and mass impurity corrections and uncertainties were assessed analytically. Reference dose measurements were performed in the absence and presence of a B = 1.5 T magnetic field using Aerrow in the 7 MV FFF photon beam of an Elekta MRI-linac and were directly compared to the results obtained using two calibrated reference-class IC types. The feasibility of performing solid phantom-based dosimetry with Aerrow and the possible influence of clearance gaps is also investigated by performing reference-type dosimetry measurements for multiple rotational positions of the detector and comparing the results to those obtained in water.

RESULTS

In the absence of the B-field, as well as in the parallel orientation while in the presence of the B-field, the absorbed dose to water measured using Aerrow was found to agree within combined uncertainties with those derived from TG-51 using calibrated reference-class ICs. Statistically significant differences on the order of (2-4)%, however, were observed when measuring absorbed dose to water using the ICs in the perpendicular orientation in the presence of the B-field. Aerrow had a peak-to-peak response of about 0.5% when rotated within the solid phantom regardless of whether the B-field was present or not.

CONCLUSIONS

This work describes the successful use of Aerrow as a straightforward means of measuring absolute dose to water for large high-energy photon fields in the presence of a 1.5 T B-field to a greater accuracy than currently achievable with ICs. The detector-phantom air gap does not appear to significantly influence the response of Aerrow in absolute terms, nor does it contribute to its rotational dependence. This work suggests that the accurate use of solid phantoms for absolute point dose measurement is possible with Aerrow.

Technical Note: Consistency of PTW30013 and FC65-G ion chamber magnetic field correction factors

Purpose

Reference dosimetry in a strong magnetic field is made more complex due to (a) the change in dose deposition and (b) the change in sensitivity of the detector. Potentially it is also influenced by thin air layers, interfaces between media, relative orientations of field, chamber and radiation, and minor variations in ion chamber stem or electrode construction. The PTW30013 and IBA FC65‐G detectors are waterproof Farmer‐type ion chambers that are suitable for reference dosimetry. The magnetic field correction factors have previously been determined for these chamber types. The aim of this study was to assess the chamber‐to‐chamber variation and determine whether generic chamber type‐specific magnetic field correction factors can be applied for each of the PTW30013 and FC65‐G type ion chambers when they are oriented anti‐parallel (ǁ) to, or perpendicular (⊥) to, the magnetic field.

Methods

The experiment was conducted with 12 PTW30013 and 13 FC65‐G chambers. The magnetic field correction factors were measured using a practical method. In this study each chamber was cross‐calibrated against the local standard chamber twice; with and without magnetic field. Measurements with 1.5 T magnetic field were performed with the 7 MV FFF beam of the MRI‐linac. Measurements without magnetic field (0 T) were performed with the 6 MV conventional beam of an Elekta Agility linac. A prototype MR‐compatible PTW MP1 phantom was used along with a prototype holder that facilitated measurements with the chamber aligned 90° counter‐clockwise (⊥) and 180° (ǁ) to the direction of the magnetic field. A monitor chamber was also mounted on the holder and all measurements were normalized so that the effect of variations in the output of each linac was minimized. Measurements with the local standard chamber were repeated during the experiment to quantify the experimental uncertainty. Recombination was measured in the 6 MV beam. Beam quality correction factors were applied. Differences in recombination and beam quality between beams are constant within each chamber type. By comparing the results for the two cross calibrations the magnetic field correction factors can be determined for each chamber, and the variation within the chamber‐type determined.

Results

The magnetic field correction factors within both PTW30013 and FC65‐G chamber‐types were found to be very consistent, with observed standard deviations for the PTW30013 of 0.19% (ǁ) and 0.13% (⊥), and for the FC65‐G of 0.15% (ǁ) and 0.17% (⊥). These variations are comparable with the standard uncertainty (k = 1) of 0.24%.

Conclusion

The consistency of the results for the PTW30013 and FC65‐G chambers implies that it is not necessary to derive a new factor for every new PTW30013 or FC65‐G chamber. Values for each chamber‐type (with careful attention to beam energy, magnetic field strength and beam‐field‐chamber orientations) can be applied from the literature.