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Development and validation of a novel pulse optimization and beam control system for conventional and ultra high dose‐per‐pulse (FLASH) irradiation.

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Title: Development and validation of a novel pulse optimization and beam control system for conventional and ultra high dose‐per‐pulse (FLASH) irradiation.
Authors: Connell, Luke1,2 (AUTHOR), Esplen, Nolan1 (AUTHOR), Lim, Rebecca1,2 (AUTHOR), Baikalov, Alex1 (AUTHOR), Coupey, Nicholas1 (AUTHOR), Nguyen, Chinh1 (AUTHOR), Schüler, Emil1,2 (AUTHOR) eschueler@mdanderson.org
Source: Medical Physics. Jun2026, Vol. 53 Issue 6, p1-12. 12p.
Subjects: Linear accelerators, Radiation doses, Radiotherapy
Abstract: Background: FLASH radiotherapy requires precise control and minimal variation of dose per pulse (DPP). However, clinical linear accelerators and their beam control systems are designed to ensure accuracy of the temporally integrated dose and do not control for transient variations in DPP during radiation delivery. Purpose: We introduce a robust external beam control system (EBCS) with radiofrequency optimization and beam monitoring that addresses this need. This system was designed to precisely control the output of FLASH‐capable electron linear accelerators within a clinical range of energies (6–20 MeV) and to monitor the output by using a beam current transformer. Methods: An EBCS, using either an internal transmission ion chamber or a multistage beam current transformer, was implemented to support delivery of conventional DPPs and ultrahigh DPPs (UH‐DPPs) on a modified clinical linear accelerator. The EBCS was interfaced with the accelerator's gating system, and beam output and stability were maximized by optimizing the accelerating radiofrequency power efficiency through voltage inputs (VEXT) to the automatic frequency control interface while the beam was held. The EBCS performance was tested by characterizing the beam‐off latency; beam output stability within and between pulsed deliveries; sensitivity to deviations from optimization solutions; and beam current transformer linearity from conventional DPPs to UH‐DPPs. Results: The measured beam‐off latency of the system was 56.7 µs (± 4.9 µs). The radiofrequency optimization was shown to reduce the DPP variability within the first five pulses from 26.7% to less than 0.5% for both conventional DPPs and UH‐DPPs. Total output was reduced by up to 20% when VEXT voltage inputs varied from the optimal solution by more than ± 10%. Conclusion: We developed an EBCS capable of delivering reproducible doses and implemented it on a modified clinical linear accelerator. Through real time readout of the beam current transformer signal and automatic radiofrequency optimization, the uncertainty in DPP within and between each delivery was reduced to < 0.5%, offering unprecedented precision and accuracy. [ABSTRACT FROM AUTHOR]
Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Label: Title
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  Data: Development and validation of a novel pulse optimization and beam control system for conventional and ultra high dose‐per‐pulse (FLASH) irradiation.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Connell%2C+Luke%22&quot;&gt;Connell, Luke&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Esplen%2C+Nolan%22&quot;&gt;Esplen, Nolan&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Lim%2C+Rebecca%22&quot;&gt;Lim, Rebecca&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Baikalov%2C+Alex%22&quot;&gt;Baikalov, Alex&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Coupey%2C+Nicholas%22&quot;&gt;Coupey, Nicholas&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Nguyen%2C+Chinh%22&quot;&gt;Nguyen, Chinh&lt;/searchLink&gt;&lt;relatesTo&gt;1&lt;/relatesTo&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sch&#252;ler%2C+Emil%22&quot;&gt;Sch&#252;ler, Emil&lt;/searchLink&gt;&lt;relatesTo&gt;1,2&lt;/relatesTo&gt; (AUTHOR)&lt;i&gt; eschueler@mdanderson.org&lt;/i&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Medical+Physics%22&quot;&gt;Medical Physics&lt;/searchLink&gt;. Jun2026, Vol. 53 Issue 6, p1-12. 12p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Linear+accelerators%22&quot;&gt;Linear accelerators&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Radiation+doses%22&quot;&gt;Radiation doses&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Radiotherapy%22&quot;&gt;Radiotherapy&lt;/searchLink&gt;
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  Label: Abstract
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  Data: Background: FLASH radiotherapy requires precise control and minimal variation of dose per pulse (DPP). However, clinical linear accelerators and their beam control systems are designed to ensure accuracy of the temporally integrated dose and do not control for transient variations in DPP during radiation delivery. Purpose: We introduce a robust external beam control system (EBCS) with radiofrequency optimization and beam monitoring that addresses this need. This system was designed to precisely control the output of FLASH‐capable electron linear accelerators within a clinical range of energies (6–20 MeV) and to monitor the output by using a beam current transformer. Methods: An EBCS, using either an internal transmission ion chamber or a multistage beam current transformer, was implemented to support delivery of conventional DPPs and ultrahigh DPPs (UH‐DPPs) on a modified clinical linear accelerator. The EBCS was interfaced with the accelerator&#39;s gating system, and beam output and stability were maximized by optimizing the accelerating radiofrequency power efficiency through voltage inputs (VEXT) to the automatic frequency control interface while the beam was held. The EBCS performance was tested by characterizing the beam‐off latency; beam output stability within and between pulsed deliveries; sensitivity to deviations from optimization solutions; and beam current transformer linearity from conventional DPPs to UH‐DPPs. Results: The measured beam‐off latency of the system was 56.7 &#181;s (&#177; 4.9 &#181;s). The radiofrequency optimization was shown to reduce the DPP variability within the first five pulses from 26.7% to less than 0.5% for both conventional DPPs and UH‐DPPs. Total output was reduced by up to 20% when VEXT voltage inputs varied from the optimal solution by more than &#177; 10%. Conclusion: We developed an EBCS capable of delivering reproducible doses and implemented it on a modified clinical linear accelerator. Through real time readout of the beam current transformer signal and automatic radiofrequency optimization, the uncertainty in DPP within and between each delivery was reduced to &lt; 0.5%, offering unprecedented precision and accuracy. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of Medical Physics is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1002/mp.70522
    Languages:
      – Code: eng
        Text: English
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        PageCount: 12
        StartPage: 1
    Subjects:
      – SubjectFull: Linear accelerators
        Type: general
      – SubjectFull: Radiation doses
        Type: general
      – SubjectFull: Radiotherapy
        Type: general
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      – TitleFull: Development and validation of a novel pulse optimization and beam control system for conventional and ultra high dose‐per‐pulse (FLASH) irradiation.
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            – D: 01
              M: 06
              Text: Jun2026
              Type: published
              Y: 2026
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