Evidence map›Paper›PMID 42155735›Full record

ArticleInternational journal of radiation oncology, biology, physics2026

Noninvasive Reversible Software-Based Electron FLASH Irradiation Configuration of a Linear Accelerator in Clinical Use.

Stavros Melemenidis, Dixin Chen, Cody Jensen, Joseph B Schulz, Murat Surucu, Amy S Yu, Edward E Graves, Mengying Shi, Michael Reilly, Peter G Maxim and 4 more

Abstract read
In one paragraph

Article in International journal of radiation oncology, biology, physics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Stavros MelemenidisDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Dixin ChenDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: dixin@stanford.edu.
Cody JensenDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Joseph B SchulzDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Murat SurucuDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Amy S YuDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Edward E GravesDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
Mengying ShiDepartment of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California.
Michael ReillyDepartment of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California.
Peter G MaximDepartment of Radiation Oncology, Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, California.
Andrew CurrellAccelerator Service, Department of Medical Physics, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Billy W LooDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: bwloo@stanford.edu.
Lawrie SkinnerDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: lawries@stanford.edu.
M Ramish AshrafDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, California. Electronic address: ramish.ashraf@stanford.edu.

Funding

Project 4: Mechanistic Basics of FLASH Effect: Role of O2P01CA244091 · NCI · UNIVERSITY OF CALIFORNIA-IRVINE · PI LIMOLI, CHARLES · 2020 to 2024
$9.6M
Research Supplements to Promote Diversity in Health-Related Research: Preclinical optimization of ultra-high dose rate (FLASH) radiotherapy parameters for translational relevanceR01CA266673 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI SCHUELER, EMIL · 2022 to 2025
$3.5M
NCI NIH HHS P01 CA244091NCI NIH HHS R01 CA266673
6 · The paper itself

Abstract

backgroundConfiguring clinical linear accelerators (linacs) for ultra-high-dose-rate (UHDR) electron experiments typically requires invasive hardware manipulation and/or irreversible modifications, limiting broader implementation. This work reports a reversible and noninvasive UHDR electron configuration of a clinical TrueBeam linac that enables switching between preclinical UHDR and conventional (CONV) clinical treatment modes through software settings, without accessing the linac interior. METHODS AND MATERIALS: Built-in service mode software was used to configure the UHDR mode with settings typical of a standard megavoltage photon beam. Using service mode, the photon target and monitor chambers were retracted. An unused low-energy electron scattering foil was loaded. An external AC current transformer for beam control and monitoring was mounted on the accessory tray, with an ionization chamber placed downstream in solid water to monitor exit dose. Dose profiles were measured for UHDR and CONV beams with radiochromic films for open field, in vivo, and in vitro setups. Dose per pulse was varied by adjusting the gun voltage and quantified. Day-to-day output variation was assessed to evaluate dose reproducibility.

resultsPercent depth-dose measurements confirmed similar energy between UHDR (9.2 and 12.6 MeV) and CONV electron beams (8.4 and 11.7 MeV), with matching profiles throughout the typical thickness of a mouse or cell culture media. Maximum dose per pulse reached 1.5 Gy/pulse and 0.7 Gy/pulse for in vivo and in vitro setups at 64 and 82 cm source-to-surface distances, respectively. Field flatness and symmetry were maintained between UHDR and CONV, supporting organ-specific in vivo irradiation and a maximum of 5 × 5-cm

conclusionAccurate and reproducible UHDR electron delivery was demonstrated without invasive hardware manipulation, enabling preclinical FLASH research on a clinical linac.

Indexed as

ElectronsParticle AcceleratorsSoftwareAnimalsEquipment DesignMicePhotonsRadiotherapy Dosage

Identifiers

PMID42155735
PMCPMC13309057

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.