A Method to Determine the Coincidence of MRI-Guided Linac Radiation and Magnetic Isocenters.

Abstract

To assure accurate treatment delivery on any image-guided radiotherapy system, the relative positions and walkout of the imaging and radiation isocenters must be periodically verified and kept within specified tolerances. In this work, we first validated the multiaxis ion chamber array as a tool for finding the radiation isocenter position of a magnetic resonance–guided linear accelerator. The treatment couch with the array on it was shifted in 0.2-mm increments and the reported beam center position was plotted against that shift and fitted to a straight line, in both X and Y directions. From the goodness-of-fit and intercepts of the regression lines, the accuracy and precision were conservatively estimated at 0.2 and 0.1 mm, respectively. This holds true whether the array is irradiated from the front or from the back, which allows efficient collecting the data from the 4 cardinal gantry angles with just 2 array positions. The average isocenter position agreed to within at most 0.4 mm along any cardinal axis with the linac vendor’s film-based procedure, and the maximum walkout radii were 0.32 mm and 0.53 mm, respectively. The magnetic resonance imaging isocenter walkout as a function of gantry angle was studied with 2 different phantoms, one employing a single fiducial at the center and another extracting the rigid displacement values from the distortion map fit of 523 fiducials dispersed over a large volume. The results were close between the 2 phantoms and demonstrated variation in the magnetic resonance imaging isocenter location as high as 1.3 mm along a single axis in the transverse plane. Verification of the magnetic resonance imaging isocenter location versus the gantry angle should be a part of quality assurance for magnetic resonance-guided linear accelerators.