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Stavros Melemenidis¹, Dixin Chen¹, Cody Jensen¹

¹Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California.

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|May 19, 2026

Summary

This study presents a non-invasive method to configure clinical linear accelerators for ultra-high dose rate (UHDR) electron experiments. This software-based approach allows switching between UHDR and conventional modes, enabling preclinical FLASH research without hardware modifications.

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Area of Science:

Medical Physics
Radiation Oncology
Preclinical Research

Background:

Clinical linear accelerators (linacs) require invasive modifications for ultra-high dose rate (UHDR) electron experiments, limiting accessibility.
This study introduces a reversible, non-invasive UHDR electron configuration for a clinical TrueBeam linac.

Purpose of the Study:

To enable preclinical FLASH research using a standard clinical linac.
To develop a software-based method for switching between UHDR and conventional (CONV) clinical modes without internal hardware changes.

Main Methods:

Utilized built-in service mode software to configure UHDR settings.
Retracted photon target/monitor chambers, loaded an electron scattering foil, and used an external current transformer for beam control.
Measured dose profiles using radiochromic films and assessed dose-per-pulse (DPP) and output variation.

Main Results:

Achieved UHDR electron beams with energies comparable to CONV electron beams (e.g., 9.2-12.6 MeV vs. 8.4-11.7 MeV).
Confirmed stable field flatness and symmetry for both UHDR and CONV modes, suitable for in vivo and in vitro irradiations.
Demonstrated reproducible dose delivery with day-to-day output variation averaging <3% for UHDR (FLASH) and <1% for CONV.

Conclusions:

Successfully demonstrated accurate and reproducible UHDR electron delivery via a non-invasive, software-based method.
This approach facilitates preclinical FLASH research on clinical linacs, overcoming previous hardware limitations.