High-resolution entry and exit surface dosimetry in a 1.5 T MR-linac

The magnetic field of a transverse MR-linac alters electron trajectories as the photon beam transits through materials, causing lower doses at flat entry surfaces and increased doses at flat beam-exiting surfaces. This study investigated the response of a MOSFET detector, known as the MO Skin ™, for high-resolution surface and near-surface percentage depth dose measurements on an Elekta Unity. Simulations with Geant4 and the Monaco treatment planning system (TPS), and EBT-3 film measurements, were also performed for comparison. Measured MO Skin ™ entry surface doses, relative to D max , were (9.9 ± 0.2)%, (10.1 ± 0.3)%, (11.3 ± 0.6)%, (12.9 ± 1.0)%, and (13.4 ± 1.0)% for 1 × 1 cm 2 , 3 × 3 cm 2 , 5 × 5 cm 2 , 10 × 10 cm 2 , and 22 × 22 cm 2 fields, respectively. For the investigated fields, the maximum percent differences of Geant4, TPS, and film doses extrapolated and interpolated to a depth suitable for skin dose assessment at the beam entry, relative to MO Skin ™ measurements at an equivalent depth were 1.0%, 2.8%, and 14.3%, respectively, and at a WED of 199.67 mm at the beam exit, 3.2%, 3.7% and 5.7%, respectively. The largest measured increase in exit dose, due to the electron return effect, was 15.4% for the 10 × 10 cm 2 field size using the MO Skin ™ and 17.9% for the 22 × 22 cm 2 field size, using Geant4 calculations. The results presented in the study validate the suitability of the MO Skin ™ detector for transverse MR-linac surface dosimetry.