A phantom based laser marking workflow to visually assess geometric image distortion in magnetic resonance guided radiotherapy.

Magnetic resonance (MR)-only workflows require quality assurance due to potential dosimetric impacts of using geometry distorted MR images in radiotherapy planning. MR-visible silicone-based fiducials were arranged in regular 3D structures to cover extended imaging volumes. The scanner's patient marking workflow with a 2-axes movable laser bridge allowed to visually check geometric distortions of each MR reconstructed fiducial against its true position in 3D space. A measurement resolution and uncertainty of the order of 0.5 mm in sagittal and coronal, and 1 mm in transversal direction was found. The proposed workflow required 1 min of evaluation time per fiducial position, and a 9 min 3D MR volume acquisition.