ACPSEM position paper: the safety of magnetic resonance imaging linear accelerators

• Published in: Australasian physical & engineering sciences in medicine Vol. 46; no. 1; pp. 19 - 43
• Main Authors: Cook, Nick, Shelton, Nikki, Gibson, Stephen, Barnes, Peter, Alinaghi-Zadeh, Reza, Jameson, Michael G.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.03.2023; Springer Nature B.V
• Subjects: ACPSEM Position Paper; Australia; Biological and Medical Physics; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Biophysics; Documents; Hazards; Health services; Humans; Linear accelerators; Magnetic Fields; Magnetic resonance imaging; Magnetic Resonance Imaging - adverse effects; Medical and Radiation Physics; Medical imaging; Particle Accelerators; Radiation; Radiation therapy; Safety; Workforce; Australia; Training; Guidance; Linear accelerator; Safety; Magnetic resonance imaging; Adaptive radiation therapy
• ISSN: 2662-4729; 0158-9938; 2662-4737; 2662-4737; 1879-5447
• DOI: 10.1007/s13246-023-01224-9

Magnetic Resonance Imaging linear-accelerator (MRI-linac) equipment has recently been introduced to multiple centres in Australia and New Zealand. MRI equipment creates hazards for staff, patients and others in the MR environment; these hazards must be well understood, and risks managed by a system of environmental controls, written procedures and a trained workforce. While MRI-linac hazards are similar to the diagnostic paradigm, the equipment, workforce and environment are sufficiently different that additional safety guidance is warranted. In 2019 the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) formed the Magnetic Resonance Imaging Linear-Accelerator Working Group (MRILWG) to support the safe clinical introduction and optimal use of MR-guided radiation therapy treatment units. This Position Paper is intended to provide safety guidance and education for Medical Physicists and others planning for and working with MRI-linac technology. This document summarises MRI-linac hazards and describes particular effects which arise from the combination of strong magnetic fields with an external radiation treatment beam. This document also provides guidance on safety governance and training, and recommends a system of hazard management tailored to the MRI-linac environment, ancillary equipment, and workforce.