For longitudinal linac-MR systems only a small increase in the entrance skin dose is predicted, due to the rapid decay of the realistic magnetic fringe fields. For transverse linac-MR systems, changes to the entrance skin dose are small for most scenarios. For the same geometry, on the exit side a fairly large increase is observed for perpendicular beams, but significantly drops for large oblique angles of incidence. The observed effects on skin dose are not expected to limit the application of linac-MR systems in either the longitudinal or transverse configuration.

The magnetic fields of linac-MR systems modify the path of contaminant electrons in photon beams, which alters patient entrance skin dose. Also, the increased SSD of linac-MR systems reduces the maximum achievable dose rate. To accurately quantify the changes in entrance skin dose, the authors use EGSnrc Monte Carlo calculations that incorporate 3D magnetic field of the Alberta 0.5 T longitudinal linac-MR system. The Varian 600C linac head geometry assembled on the MRI components is used in the BEAMnrc simulations for 6 MV and 10 MV beam models and skin doses are calculated at an average depth of 70 μm using DOSXYZnrc. 3D modeling shows that magnetic fringe fields decay rapidly and are small at the linac head. SSDs between 100 and 120 cm result in skin-dose increases of between ~6%-19% and ~1%-9% for the 6 and 10 MV beams, respectively. For 6 MV, skin dose increases from ~10.5% to ~1.5% for field-size increases of 5  ×  5 cm(2) to 20  ×  20 cm(2). For 10 MV, skin dose increases by ~6% for a 5  ×  5 cm(2) field, and decreases by ~1.5% for a 20  ×  20 cm(2) field. Furthermore, the proposed reshaped flattening filter increases the dose rate from the current 355 MU min(-1) to 529 MU min(-1) (6 MV) or 604 MU min(-1) (10 MV), while the skin-dose increases by only an additional ~2.6% (all percent increases in skin dose are relative to D max). This study suggests that there is minimal increase in the entrance skin dose and minimal/no decrease in the dose rate of the Alberta longitudinal linac-MR system. The even lower skin dose increase at 10 MV offers further advantages in future designs of linac-MR prototypes.

The presence of RIC in MR RF coils leads to a loss of SNR which is directly related to the linac dose rate. The RIC related loss in SNR is likely to increase for systems that are able to provide larger than 250 MU∕min dose. Some of this SNR loss can be recovered through the use of a postprocessing algorithm, which removes the RIC artefact from the image k-space.

Purpose Real‐time magnetic resonance (MR) guidance is of interest to various groups globally because the superior soft tissue contrast MR images offer over other x‐ray‐based imaging modalities. Because of the precision required in proton therapy, proton therapy treatments rely heavily on image guidance. Integrating a magnetic resonance imaging (MRI) into a proton therapy treatment is a challenge. The charged particles (protons) used in proton therapy experience magnetic forces when travelling through the MRI magnetic fields. Given that it is desired that proton beams can be delivered with submillimeter accuracy, it is important that all potential sources of beam displacement are well modeled and understood. This study investigated the behavior of monoenergetic proton beams in the presence of a simulated set of realistic three‐dimensional (3D) vector magnetic gradient fields required for spatial localization during imaging. This deflecting source has not been previously investigated. Methods Three‐dimensional magnetic vector fields from a superconducting 0.5 T open bore MRI magnet model (previously developed in‐house) and 3D magnetic fields from an in‐house gradient coil model were applied to two types of computer simulations. In all simulations, monoenergetic proton pencil beams (from 80 to 250 MeV) were used. The initial directions of proton beams were varied. In all simulations, the orientation of the B0 field coincided with the positive z‐axis in the simulation geometry. The first type of simulation is based on an analytic magnetic force equation (analytic simulations) while the second type is a full Monte Carlo (MC) simulation. The analytic simulations were limited to propagating the proton beams in vacuum but could be rapidly calculated in a desktop computer while the MC simulations were calculated in a cluster computer. The proton beam locations and dose profiles at the central plane (z = 0 cm) with or without magnetic fields were extracted and used to quantify the effect of the presence of the different magnetic fields on the proton beam. Results The analytic simulations agree with MC results within 0.025 mm, thus acting as the verification of MC calculations. The presence of the B0 field caused the beam to follow a helical trajectory which resulted in angular offsets of 4.9o, 3.6o, and 2.8o for the 80, 150, and 250 MeV, respectively. Magnetic field deflections caused by a rapid MRI sequence (bSSFP, with maximum gradient strength of 40 mT/m) show a pattern of distortion which remained spatially invariant in the MR's field of view. For the 80 MeV beam, this pattern shows a maximum ranged in the y direction of 1.5 mm. The presence of the B0 field during the bSSFP simulations adds the same beam rotation to the observed during the B0 only simulations. Conclusion This investigation reveals that time‐varying gradient magnetic fields required for image generation can cause a small spread in the proton beams used in the study which are independent of the effects arising from the B0 field. Further, studies where cl...

The integration of medical linear accelerators (linac) with magnetic resonance imaging (MRI) systems is advancing the current state of image-guided radiotherapy. The MRI in these integrated units will provide real-time, accurate tumor locations for radiotherapy treatment, thus decreasing geometric margins around tumors and reducing normal tissue damage. In the real-time operation of these integrated systems, the radiofrequency (RF) coils of MRI will be irradiated with radiation pulses from the linac. The effect of pulsed radiation on MRI radio frequency (RF) coils is not known and must be studied. The instantaneous radiation induced current (RIC) in two different MRI RF coils were measured and presented. The frequency spectra of the induced currents were calculated. Some basic characterization of the RIC was also done: isolation of the RF coil component responsible for RIC, dependence of RIC on dose rate, and effect of wax buildup placed on coil on RIC. Both the time and frequency characteristics of the RIC were seen to vary with the MRI RF coil used. The copper windings of the RF coils were isolated as the main source of RIC. A linear dependence on dose rate was seen. The RIC was decreased with wax buildup, suggesting an electronic disequilibrium as the cause of RIC. This study shows a measurable RIC present in MRI RF coils. This unwanted current could be possibly detrimental to the signal to noise ratio in MRI and produce image artifacts.

There is a great deal of interest in image-guided radiotherapy (IGRT), and to advance the state of IGRT, an integrated linear accelerator-magnetic resonance (linac-MR) system has been proposed. Knowledge of the radiofrequency (RF) emissions near a linac is important for the design of appropriate RF shielding to facilitate the successful integration of these two devices. The frequency spectra of both electric and magnetic fields of RF emission are measured using commercially available measurement probes near the treatment couch in three clinical linac vaults with distinct physical layouts. The magnitude spectrum of the RF power emitted from these three linacs is then estimated. The electric field spectrum was also measured at several distances from the linac modulator in order to assess the effects of variations in spatial location in the treatment vault. A large fraction of RF power is emitted at frequencies below 5 MHz. However, the measured RF power at the Larmor frequency (8.5 MHz) of the proposed 0.2 T MR in the linac-MR (0.4-14.6 μW m −2 ) is still large enough to cause artifacts in MR images. Magnetron-based linacs generally emit much larger RF power than klystron-based linacs. In the frequency range of 1-50 MHz, only slight variation in the measured electric field is observed as a function of measurement position. This study suggests that the RF emissions are strong enough to cause image artifacts in MRI systems.

Currently several groups are actively researching the integration of a megavoltage teletherapy unit with magnetic resonance (MR) imaging for real-time image-guided radiotherapy. The use of a multileaf collimator (MLC) for intensity-modulated radiotherapy for linac-MR units must be investigated. The MLC itself will likely reside in the fringe field of the MR and the motors will produce radio frequency (RF) noise. The RF noise power spectral density from a Varian 52-leaf MLC motor, a Varian Millennium MLC motor and a brushless fan motor has been measured as a function of the applied magnetic field using a near field probe set. For the Varian 52-leaf MLC system, the RF noise produced by 13 of 52 motors is studied as a function of distance from the MLC. Data are reported in the frequency range suitable for 0.2-1.5 T linac-MR systems. Below 40 MHz the Millennium MLC motor tested showed more noise than the Varian 52-leaf motor or the brushless fan motor. The brushless motor showed a small dependence on the applied magnetic field. Images of a phantom were taken by the prototype linac-MR system with the MLC placed in close proximity to the magnet. Several orientations of the MLC in both shielded and non-shielded configurations were studied. For the case of a non-shielded MLC and associated cables, the signal-to-noise ratio (SNR) was reduced when 13 of 52 MLC leaves were moved during imaging. When the MLC and associated cables were shielded, the measured SNR of the images with 13 MLC leaves moving was experimentally the same as the SNR of the stationary MLC image. When the MLC and cables are shielded, subtraction images acquired with and without MLC motion contains no systematic signal. This study illustrates that the small RF noise produced by functioning MLC motors can be effectively shielded to avoid SNR degradation. A functioning MLC can be incorporated into a linac-MR unit.

The real-time operation of a linac-MRI system will require proper radio frequency (RF) shielding such that the MRI images can be acquired without extraneous RF noise from the linac. We report on the steps taken to successfully shield the linac from the MRI such that the two devices can operate independently of one another. RF power density levels are reported internally and externally to the RF cage which houses the linac and MRI. The shielding effectiveness of the RF cage has been measured in the frequency range 1-50 MHz and is presented. Lastly MRI images of two phantoms are presented during linac operation. This work illustrates that the accelerating structure of a linac and an MRI can be housed within the same RF cage. The 6 MV linac can be operated to produce radiation with no measurable degradation in image quality due to RF effects.