# Acceptance testing of a 0.35 T MR‐Linac: procedures, QA baseline, and system limitations

## TL;DR

This paper details the acceptance testing of a 0.35T MR-Linac system, highlighting its performance, limitations, and recommendations for clinical use.

## Contribution

The paper provides a detailed QA baseline and identifies specific system limitations for the 0.35T MR-Linac.

## Key findings

- The acceptance test outcomes met manufacturer specifications but revealed issues like high couch attenuation.
- Magnetic field homogeneity varied with gantry angles, affecting MRI performance.
- Discrepancies were found between TPS calculations and measurements for very small field output factors.

## Abstract

This study describes and evaluates the acceptance procedure for a ViewRay (VR) MRIdian 0.35T MR‐Linac, emphasizing key challenges, limitations, and recommendations to enhance clinical performance and accuracy.

A comprehensive acceptance test was conducted at a single institution, following the manufacturer's protocols and aligned with established acceptance guidelines. Specific tools and phantoms were used to assess three primary components: mechanical, dosimetric, and Magnetic Resonance Imaging (MRI).

Overall, the test outcomes satisfied the manufacturer's specifications. However, certain issues were identified: high couch attenuation at specific gantry angles (leading to their exclusion from treatment), variations in magnetic field homogeneity at different gantry angles, and discrepancies between TPS calculations and measurements for field output factors smaller than 0.83 cm × 0.83 cm.

This work provides a detailed account of the acceptance testing procedure and establishes a QA baseline for 0.35T MR‐Linac systems. In doing so, it also identifies key system limitations, such as couch attenuation, magnetic field inhomogeneity, and small‐field output discrepancies, underscoring the need for careful gantry angle selection, field homogeneity optimization, and meticulous validation of very small fields.