The First Low-Field MRI-Guided Radiation Therapy Hybrid Integrated System: MRIdian

Combining a linear accelerator with an MRI scanner allows visualization of patient anatomy and radiation therapy simultaneously. The presence of a magnetic field poses dosimetric and delivery concerns requiring specific guidelines related to acceptance testing, commissioning, and QA of the MR-Linac systems. Advanced dose calculation algorithms need to be considered for MR-Linac treatment planning systems due to the impact of the magnetic field on the treatment beam. Other challenges such as personnel training, MRI safety, IT, and the economics of acquiring an MR-Linac need to be elucidated. This chapter aims to address the technical aspect of these challenges for the MRIdian 0.35 T MR-Linac.