LAUSR

Abstract Purpose Real‐time magnetic resonance guided radiation therapy (MRgRT) uses 2D cine imaging for target tracking. This work evaluates the percent image uniformity (PIU) and spatial integrity of cine images in the presence of multileaf collimator (MLC) and gantry motion in order to simulate sliding window and volumetric modulated arc therapy (VMAT) conditions. Methods Percent image uniformity and spatial integrity of cine images were measured (1) during MLC motion, (2) as a function of static gantry position, and (3) during gantry rotation. PIU was calculated according to the ACR MRI Quality Control Manual. Spatial integrity was evaluated by measuring the geometric distortion of 16 measured marker positions (10 cm or 15.225 cm from isocenter). Results The PIU of cine images did not vary by more than 1% from static linac conditions during MLC motion and did not vary by more than 3% during gantry rotation. Banding artifacts were present during gantry rotation. The geometric distortion in the cine images was less than 0.88 mm for all points measured throughout MLC motion. For all static gantry positions, the geometric distortion was less than 0.88 mm at 10 cm from isocenter and less than 1.4 mm at 15.225 cm from isocenter. During gantry rotation, the geometric distortion remained less than 0.92 mm at 10 cm from isocenter and less than 1.60 mm at 15.225 cm from isocenter. Conclusion During MLC motion, cine images maintained adequate PIU, and the geometric distortion of points within 15.225 cm from isocenter was less than the 1 mm threshold necessary for real‐time target tracking and gating. During gantry rotation, PIU was negatively affected by banding artifacts, and spatial integrity was only maintained within 10 cm from isocenter. Future work should investigate the effects imaging artifacts have on real‐time target tracking during MRgRT.