4D radiation dosimetry using a highly radiation-sensitive polymer gel dosimeter with real-time quantitative MRI readout is presented as a technique to acquire the accumulated radiation dose distribution during image guided radiotherapy (IGRT) in an MRI-Linac. Optimized T2 weighted TSE scans are converted to quantitative R2 maps and subsequently to radiation dose maps. A further increase in temporal resolution using a keyhole imaging approach is proposed. The potential use of real-time 4D radiation dosimetry for safeguarding image guided radiotherapy (IGRT) of moving and deforming targets in an MRI-Linac will be discussed.
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