Rapid Switching of a C-Series Linear Accelerator Between Conventional and Ultrahigh-Dose-Rate Research Mode With Beamline Modifications and Output Stabilization

Purpose In this study, a decommissioned C-series linear accelerator (linac) was configured to enable rapid and reliable conversion between the production of conventional electron beams and an Ultrahigh-dose-rate (UHDR) electron beamline to the treatment room isocenter for FLASH radiation therapy. Efforts to tune the beam resulted in a consistent, stable UHDR beamline. Methods and Materials The linac was configured to allow for efficient switching between conventional and modified electron output modes within two minutes. Additions to the air system allow for retraction of the X-ray target from the beamline when the 10MV photon mode is selected. With the carousel set to an empty port, this grants access to the higher current pristine electron beam normally used to produce clinical photon fields. Monitoring signals related to the automatic frequency control (AFC) system allows for tuning of the waveguide while the machine is in a hold state so a stable beam is produced from the initial pulse. A pulse counting system implemented on a FPGA-based controller platform controls the delivery to a desired number of pulses. Beam profiles were measured with Gafchromic film. Pulse-by-pulse dosimetry was measured using a custom electrometer designed around the EdgeTM diode. Results This method reliably produces a stable UHDR electron beam. Open field measurements of the 16cm (FWHM) gaussian beam saw average dose rates of 432Gy/s at treatment isocenter. Pulse overshoots were limited and ramp up was eliminated. Over the last year, there have been no recorded incidents that resulted in machine downtime due to the UHDR conversions. Conclusion Stable 10MeV UHDR beams were generated to produce an average dose rate of 432Gy/s at the treatment room isocenter. With a reliable pulse-counting beam control system, consistent doses can be delivered for FLASH experiments with the ability to accommodate a wide range of field sizes, source-to-surface distances, and other experimental apparatus that may be relevant for future clinical translation.