Purpose: Magnetic resonance guided teletherapy systems aspire to image the patient concurrently with the radiation delivery. Thus, the radiofrequency (RF) coils used for magnetic resonance imaging, placed on or close to patient skin and in close proximity to the treatment volume, would be irradiated leading to modifications of radiation dose to the skin and in the buildup region. The purpose of this work is to measure and assess these dose modifications due to standard off-the-shelf RF coil materials.
Methods: A typical surface coil was approximated as layered sheets of polycarbonate, copper tape, and Teflon to emulate the base, conductor, and cover, respectively. A separate investigation used additional coil materials, such as copper pipe, plastic coil housing, a typical coil padding material, and a thin copper conductor. The materials were placed in the path of a 6 MV photon beam at various distances from polystyrene phantoms in which the surface and buildup doses were measured. The experiments were performed on a clinical Varian linac with no magnetic field and with a 0.21 T electromagnet producing a magnetic field parallel to the beam central axis. The authors repeated similar experiments in the presence of a 0.22 T magnetic field oriented perpendicular to the beam central axis using an earlier linac-MR prototype, with a biplanar permanent magnet. The radiation detectors used for the measurements were two different parallel plate ion chambers and GAFChromic films.
Results: A typical open beam surface dose of 20% (relative to open beam Dmax) was increased to 63% by the coil padding material and to >74% by all other materials when placed in direct contact with the phantom, irrespective of magnetic field presence or orientation. Without a magnetic field, the surface dose decreased as the test materials were moved away from the phantom surface toward the radiation source, reaching between 30% and 40% at 10 cm gap between the phantom and the test materials. In the presence of the transverse magnetic field, the surface dose reduction was more rapid reaching a dose level of 30%-40% with only 3-4 cm gap. In the presence of the parallel magnetic field, as expected, the surface dose did not decrease considerably as the gap between the phantom surface and test materials was increased; the surface dose remained >60% at 10 cm gap for all tested materials except for the thin copper conductor.
Conclusions: As expected, placing coil materials in direct contact with the phantom surface increases the surface dose considerably. The surface dose is reduced by creating a gap between the coil materials and phantom surface. This dose reduction happens more rapidly in the presence of a transverse magnetic field. However, the surface dose stays relatively large irrespective of the gap in the presence of a parallel magnetic field. Thus, the standard, off-the-shelf RF coils should be used with caution in integrated linac-MR systems, especially those using a parallel magnetic field orientation in which case the RF coils will probably need to be reconfigured to create open ports for the radiation beam.