The Alberta Rotating Biplanar Linac-MR, a.k.a., Aurora-RT™

The Alberta biplanar rotating linac-MR is described with a discussion on its design objective of providing online MR guidance without hindering the advantages and workflow of conventional radiotherapy. Developments from various proof-of-concept prototypes to the current USA FDA-cleared device are described elucidating the system’s characteristics and advantages of easy installation, improved patient experience, ease of commissioning, QA and planning because of minimal electron-return effect, and providing highest contrast-to-noise ratio. Monte Carlo calculations and measurements are presented to validate these advantages, while the much larger patient bore (110 × 60 cm) with the rotating gantry and extensive lateral and vertical couch shifts of ±23 cm ensures that any target, even those offset, can be placed in 3D to the planned location. Image acquisitions and analyses are also discussed, and device specifications of SAD, MLC, output, etc. are provided.