Detector-specific correction factors for small-field photon dosimetry in magnetic resonance-guided radiation therapy: A systematic review and meta-analysis
Abstract
Background: Accurate small-field (SF) dosimetry is essential for Magnetic Resonance-guided Radiation Therapy (MRgRT), particularly for stereotactic treatments. The static magnetic field (B-field) alters detector response, necessitating detector-specific correction factors kB,Qf,f$k_{B,Q}^{f,f}$ to ensure dosimetric accuracy. While numerous studies have reported such factors, the published data shows considerable variability, creating uncertainty for clinical practice.
Purpose: This study was undertaken to (1) systematically review the literature on SF photon dosimetry in MRgRT and (2) perform a meta-analysis to pool quantitative data and investigate the sources of this variability.
Methods: A systematic search of four databases was conducted following PRISMA 2020 guidelines. A qualitative synthesis was performed on all included studies (n = 86). A random-effects meta-analysis was performed on studies providing correction factors (beam quality correction factor, kmsr; field output correction factor, kclin) or uncorrected output factors (FOF) for fields ≤ 4 × 4 cm2 with associated uncertainties (n = 13 studies, 441 data points). Heterogeneity (I2) was quantified, and subgroup analyses (B-field, detector model, and orientation) and meta-regression (field size) were used to investigate its sources.
Results: The qualitative review identified key themes in foundational physics, detector-specific characteristics, and clinical quality assurance. The meta-analysis revealed extremely…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 86 participants or records.
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