Journal of Medical Physics (Jun 2024)

Commissioning of the First MRlinac in Latin America

  • Rojas-López José Alejandro,
  • Cabrera-Santiago Alexis,
  • González Souto Xesús

DOI
https://doi.org/10.4103/jmp.jmp_6_24
Journal volume & issue
Vol. 49, no. 2
pp. 213 – 224

Abstract

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Purpose: To show the workflow for the commissioning of a MRlinac, and some proposed tests; off-axis targets, output factors for small fields, dose in inhomogeneities, and multileaf collimator quality assurance (MLC QA). Methods: The tests were performed based on TG-142, TG-119, ICRU 97, TRS-398, and TRS-483 recommendations as well as national regulations for radiation protection and safety. Results: The imaging tests are in agreement with the protocols. The radiation isocenter was 0.34 mm, and for off-axis targets location was up to 0.88 mm. The dose profiles measured and calculated in treatment planning system (TPS) passed in all cases the gamma analysis of 2%/2 mm (global dose differences). The output factors of fields larger than 2 cm × 2 cm are in agreement with the model of the MRlinac in the TPS. However, for smaller fields, their differences are higher than 10%. Picket fence test for different gantry angles showed a maximum leaf deviation up to 0.2 mm. Displacements observed in treatment couch adding weight (50 kg) are lower than 1 mm. Cryostat, bridge, and couch attenuation was up to 1.2%, 10%, and 24%, respectively. Conclusion: The implemented tests confirm that the studied MRlinac agrees with the standards reported in the literature and that the strict tolerances established as a baseline should allow a smoother implementation of stereotactic treatments in this machine.

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