SU-F-J-150: Development of An End-To-End Chain Test for the First-In-Man MR-Guided Treatments with the MRI Linear Accelerator by Using the Alderson Phantom.

The Alderson phantom is a human shaped quality assurance tool that has been used for over 30 years in radiotherapy. The phantom can provide integrated tests of the entire chain of treatment planning and delivery. The purpose of this research was to investigate if this phantom can be used to chain test a treatment on the MRI linear accelerator (MRL) which is currently being developed at the UMC Utrecht, in collaboration with Elekta and Philips. The latter was demonstrated by chain testing the future First-in-Man treatments with this system.An Alderson phantom was used to chain test an entire treatment with the MRL. First, a CT was acquired of the phantom with additional markers that are both visible on MR and CT. A treatment plan for treating bone metastases in the sacrum was made. The phantom was consecutively placed in the MRL. For MRI imaging, an 3D volume was acquired. The initially developed treatment plan was then simulated on the new MRI dataset. For simulation, both the MR and CT data was used by registering them together. Before treatment delivery a MV image was acquired and compared with a DRR that was calculated form the MR/CT registration data. Finally, the treatment was delivered. Figure 1 shows both the T1 weighted MR-image of the phantom and the CT that was registered to the MR image. Figure 2 shows both the calculated and measured MV image that was acquired by the MV panel. Figure 3 shows the dose distribution that was simulated. The total elapsed time for the entire procedure excluding irradiation was 13:35 minutes.The Alderson Phantom yields sufficient MR contrast and can be used for full MR guided radiotherapy treatment chain testing. As a result, we are able to perform an end-to-end chain test of the future First-in-Man treatments.