A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.

A monolithic silicon small-field array detector is proposed for relative dosimetry applications in hybrid MRI-linac systems. The detector has high sampling resolution, with 512 active elements arranged with 2 mm pitch over a 46 mm×46 mm detection area. Experimental measurements were performed in a custom-designed permanent magnet device that is compatible with a standard clinical linear accelerator. It can be configured in both inline and perpendicular magnetic-field-to-photonbeam orientations and produces magnetic field strengths 0.95 T and 1.20 T, respectively. Monte Carlo simulation data, obtained using the GEANT4 toolkit, are presented to supplement experimental data. Beam profiles show agreement to EBT3 film within 0.5 mm for FWHM and penumbral width measurement of small square fields (width ranging from 0.75 cm to 2.25 cm), in both inline and perpendicular magnetic field orientations. The detector can be used to accurately resolve normalised beam profiles in magnetic fields. The impact of electron return effects (ERE) in a small air gap surrounding the detector was also quantified. For the perpendicular orientation, a reduced profile intensity was observed for an increasing air gap width above the detector (10% at 2 mm) due to ERE. In the inline orientation, a very small increase in response relative to the zero field case was observed with an air gap above the detector (2% at 2 mm). Calibration of the device in a magnetic field will therefore be necessary; the zero field calibration is non-transferable. The MagicPlate-512 provides a high-resolution real time alternative to accurately measure normalised beam profiles in magnetic fields, and is expected to be a suitable array detector for use in magnetic field environments typical of MRI-linacs.

Purpose The fringe field of the Australian MRI‐linac causes contaminant electrons to be focused along the central axis resulting in a high surface dose. This work aims to characterize this effect using Gafchromic film and high‐resolution detectors, MOSkinTM and microDiamond. The secondary aim is to investigate the influence of the inline magnetic field on the relative dose response of these detectors. Methods The Australian MRI‐linac has the unique feature that the linac is mounted on rails allowing for measurements to be performed at different magnetic field strengths while maintaining a constant source‐to‐surface distance (SSD). Percentage depth doses (PDD) were collected at SSD 1.82 m in a solid water phantom positioned in a low magnetic field region and then at isocenter of the MRI where the magnetic field is 1 T. Measurements for a range of field sizes were taken with the MOSkinTM, microDiamond, and Gafchromic® EBT3 film. The detectors’ relative responses at 1 T were compared to the near 0 T PDD beyond the region of electron contamination, that is, 20 mm depth. The near surface measurements inside the MRI bore were compared among the different detectors. Results Skin dose in the MRI, as measured with the MOSkinTM, was 104.5% for 2.1 × 1.9 cm2, 185.6% for 6.1 × 5.8 cm2, 369.1% for 11.8 × 11.5 cm2, and 711.1% for 23.5 × 23 cm2. The detector measurements beyond the electron contamination region showed agreement between the relative response at 1 T and near 0 T. Film was in agreement with both detectors in this region further demonstrating their relative response is unaffected by the magnetic field. Conclusions Experimental characterization of the high electron contamination at the surface was performed for a range of field sizes. The relative response of MOSkinTM and microDiamond detectors, beyond the electron contamination region, were confirmed to be unaffected by the 1‐T inline magnetic field.

Purpose Dose deposition measurements for parallel MRI‐linacs have previously only shown comparisons between 0 T and a single available magnetic field. The Australian MRI‐Linac consists of a magnet coupled with a dual energy linear accelerator and a 120 leaf Multi‐Leaf Collimator with the radiation beam parallel to the magnetic field. Two different magnets, with field strengths of 1 and 1.5 T, were used during prototyping. This work aims to characterize the impact of the magnetic field at 1 and 1.5 T on dose deposition, possible by comparing dosimetry measured at both magnetic field strengths to measurements without the magnetic field. Methods Dose deposition measurements focused on a comparison of beam quality (TPR20/10), PDD, profiles at various depths, surface doses, and field size output factors. Measurements were acquired at 0, 1, and 1.5 T. Beam quality was measured using an ion chamber in solid water at isocenter with appropriate TPR20/10 buildup. PDDs and profiles were acquired via EBT3 film placed in solid water either parallel or perpendicular to the radiation beam. Films at surface were used to determine surface dose. Output factors were measured in solid water using an ion chamber at isocenter with 10 cm solid water buildup. Results Beam quality was within ±0.5% of the 0 T value for the 1 and 1.5 T magnetic field strengths. PDDs and profiles showed agreement for the three magnetic field strengths at depths beyond 20 mm. Deposited dose increased at shallower depths due to electron focusing. Output factors showed agreement within 1%. Conclusion Dose deposition at depth for a parallel MRI‐linac was not significantly impacted by either a 1 or 1.5 T magnetic field. PDDs and profiles at shallow depths and surface dose measurements showed significant differences between 0, 1, and 1.5 T due to electron focusing.

This experimental work has demonstrated how strong inline magnetic fields act to enhance the dose to lower density mediums such as lung tissue. Clinically, such scenarios will arise in inline MRI-linac systems for treatment of small lung tumours.

PurposeTo report on experimental results of a high spatial resolution silicon‐based detector exposed to therapeutic quality proton beams in a 0.95 T transverse magnetic field. These experimental results are important for the development of accurate and novel dosimetry methods in future potential real‐time MRI‐guided proton therapy systems.MethodsA permanent magnet device was utilized to generate a 0.95 T magnetic field over a 4 × 20 × 15 cm3 volume. Within this volume, a high‐resolution silicon diode array detector was positioned inside a PMMA phantom of 4 × 15 × 12 cm3. This detector contains two orthogonal strips containing 505 sensitive volumes spaced at 0.2 mm apart. Proton beams collimated to a circle of 10 mm diameter with nominal energies of 90 MeV, 110 MeV, and 125 MeV were incident on the detector from an edge‐on orientation. This allows for a measurement of the Bragg peak at 0.2 mm spatial resolution in both the depth and lateral profile directions. The impact of the magnetic field on the proton beams, that is, a small deflection was also investigated. A Geant4 Monte Carlo simulation was performed of the experimental setup to aid in interpretation of the results.ResultsThe nominal Bragg peak for each proton energy was successfully observed with a 0.2 mm spatial resolution in the 0.95 T transverse magnetic field in both a depth and lateral profiles. The proton beam deflection (at 0.95 T) was a consistent 2 ±0.5 mm at the center of the magnetic volume for each beam energy. However, a pristine Bragg peak was not observed for each energy. This was caused by the detector packaging having small air gaps between layers of the phantom material surrounding the diode array. These air gaps act to degrade the shape of the Bragg peak, and further to this, the nonwater equivalent silicon chip acts to separate the Bragg peak into multiple peaks depending on the proton path taken. Overall, a promising performance of the silicon detector array was observed, however, with a qualitative assessment rather than a robust quantitative dosimetric evaluation at this stage of development.ConclusionsFor the first time, a high‐resolution silicon‐based radiation detector has been used to measure proton beam Bragg peak deflections in a phantom due to a strong magnetic field. Future efforts are required to optimize the detector packaging to strengthen the robustness of the dosimetric quantities obtained from the detector. Such high‐resolution silicon diode arrays may be useful in future efforts in MRI‐guided proton therapy research.

A back-projection algorithm in the presence of an extra attenuating medium: towards EPID dosimetry for the MR-Linac I Torres-Xirau, I Olaciregui-Ruiz, R A Rozendaal et al. Abstract. The Australian MRI-Linac consists of a fixed horizontal photon beam combined with a MRI. Commissioning required PDD and profiles measured in a horizontal set-up using a combination of water tank measurements and gafchromic film. To validate the methodology, measurements were performed comparing PDD and profiles measured with the gantry angle set to 0 and 90° on a conventional linac. Results showed agreement to within 2.0% for PDD measured using both film and the water tank at gantry 90° relative to PDD acquired using gantry 0°. Profiles acquired using a water tank at both gantry 0 and 90° showed agreement in FWHM to within 1 mm. The agreement for both PDD and profiles measured at gantry 90° relative to gantry 0° curves indicates that the methodology described can be used to acquire the necessary beam data for horizontal beam lines and in particular, commissioning the Australian MRI-linac.

Purpose: Longitudinal magnetic fields narrow beam penumbra and tighten lateral spread of secondary electrons in air cavities, including lung tissue. Gafchromic â EBT3 film was used to investigate differences between penumbra in solid water and solid lung, without a magnetic field (0 T) and with two field strengths (0.9 and 1.5 T). Methods: The first prototype of the Australian MRI-linac consisted of a 1.5 T Siemens Sonata MRI and Varian industrial linatron (nominal 4 MV). The second prototype replaced the Sonata with a 1.0 T Agilent split-bore magnet. Measurements were completed at 0.9 T to maintain the same source-to-surface distance between set-ups. Gammex-rmi â solid water with 50 mm of CIRS solid lung inserted as a lung cavity was positioned inside each magnet. This was compared to the same set-up with solid water only, where film measurements were completed at solid water equivalent depths corresponding to entrance interface/mid/exit interface positions of solid lung from the first set-up. Multileaf collimator (MLC)-defined field sizes were set to 3 9 3 cm 2 and 10 9 10 cm 2 . The 80%-20% penumbral width was determined. Results: Under 1.5 T conditions, penumbra narrowing occurred up to 4.4 AE 0.1 mm compared to 0 T. As expected, the effect was less for 0.9 T, which resulted in a maximum narrowing of 2.5 AE 0.1 mm. Exit profile penumbra were more affected than entrance penumbra by up to 2.6 AE 0.2 mm. The 1.5 T field brought the solid water and lung penumbral widths more into alignment by a maximum difference of 0.4 AE 0.1 mm. Conclusions:The trimming of penumbral widths due to magnetic fields in solid water and lung was demonstrated and compared to 0 T. The 0.9 and 1.5 T field trimmed the penumbra by up to 2.5 AE 0.1 mm and 4.4 AE 0.1 mm respectively.