MRL QA

Question 1

Adapt to Plan (ATP)

Answer 1

Each treatment fraction starts with the acquisition of an online MRI. The pre-treatment dataset, contours and plan, together with the online MRI are used as input to adapt the plan for that specific session

Question 2

Adapt to Shape (ATS)

Answer 2

ATS allows for plan adaptation based on the new patient anatomy and the plan is optimized on the daily MRI and adapted contours.

Question 3

MRL Challenges

Answer 3

• New treatment modality
  
  • Daily adaptive treatments
  • Unique system(limited integration with other linac systems)
• Knowledge and skill gaps
• Radiation behaviour in a magnetic field
• Limited commercial QA solutions
• Limited training courses from 3rd parties
• Unique and new workflows
  
  • New protocols (department and published) need to be established
• Machine design
  
  • Unique beam energy
  • Ring gantry (vs conventional C-arm)
  • Full integration with the imaging system
  • No light field
  • Limitedboresize
  • Presence of MR system (safety concerns and equipment restrictions)
  • Comprehensive laser system not included as default (only a sagittal laser)
  • Limited couch motion (SUP-INF on Unity only and fixed during treatment)