Accumulated dose implications from systematic dose-rate transients in gated treatments with Viewray MRIdian accelerators

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  • M. F. Klavsen
  • C. Ankjærgaard
  • K. Boye
  • C. P. Behrens
  • Vogelius, Ivan
  • S. Ehrbar
  • M. Baumgartl
  • C. Rippke
  • C. Buchele
  • C. K. Renkamp
  • G. V. Santurio
  • C. E. Andersen
The combination of magnetic resonance (MR) imaging and linear accelerators (linacs) into MR-Linacs enables continuous MR imaging and advanced gated treatments of patients. Previously, a dose-rate transient (∼8% reduced dose rate during the initial 0.5 s of each beam) was identified for a Viewray MRIdian MR-Linac (Klavsen et al 2022 Radiation Measurement 106759). Here, the dose-rate transient is studied in more detail at four linacs of the same type at different hospitals. The implications of dose-rate transients were examined for gated treatments. The dose-rate transients were investigated using dose-per pulse measurements with organic plastic scintillators in three experiments: (i) A gated treatment with the scintillator placed in a moving target in a dynamic phantom, (ii) a gated treatment with the same dynamic conditions but with the scintillator placed in a stationary target, and (iii) measurements in a water-equivalent material to examine beam quality deviations at a dose-per-pulse basis. Gated treatments (i) compared with non-gated treatments with a static target in the same setup showed a broadening of accumulated dose profiles due to motion (dose smearing). The linac with the largest dose-rate transient had a reduced accumulated dose of up to (3.1 ± 0.65) % in the center of the PTV due to the combined dose smearing and dose-rate transient effect. Dose-rate transients were found to vary between different machines. Two MR-Linacs showed initial dose-rate transients that could not be identified from conventional linearity tests. The source of the transients includes an initial change in photon fluence rate and an initial change in x-ray beam quality. For gated treatments, this caused a reduction of more than 1% dose delivered at the central part of the beam for the studied, cyclic-motion treatment plan. Quality assurance of this effect should be considered when gated treatment with the Viewray MRIdian is implemented clinically.
OriginalsprogEngelsk
Artikelnummer065001
TidsskriftBiomedical Physics and Engineering Express
Vol/bind9
Udgave nummer6
Antal sider15
DOI
StatusUdgivet - 2023

Bibliografisk note

Funding Information:
This work was supported by the Danish Comprehensive Cancer Center (DCCC) for Radiotherapy and the MRgRT-DOS project that has received funding from the EMPIR programme (19NRM01) co-financed by the Participating States and from the European Union’s Horizon 2020 research and innovation programme.

Publisher Copyright:
© 2023 The Author(s). Published by IOP Publishing Ltd.

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