Addressing respiratory gating latency for accurate pulse delivery in preclinical electron FLASH irradiation on a clinical linear accelerator.

BACKGROUND: Clinical linear accelerators are an accessible platform for preclinical research on the biological effects of ultra rapid electron irradiation (FLASH). However, they are not inherently designed for the accurate pulse control required for experiments using a small number of relatively high-dose pulses, and available methods for beam control such as respiratory gating can be error prone owing to system latency. Here we experimentally characterize the temporal latency of the respiratory gating system for controlling beam-on and beam-off at the individual linac pulse level. METHODS AND MATERIALS: We used programmable controller boards and a relay circuit to monitor and control delivery of specific numbers of pulses through the built-in monitor chamber and respiratory gating system of a Varian Trilogy linac. We implemented two methods an adaptive method using only the delivered pulse signal, and a synchronization method additionally using the linac internal pulse-timing signal and characterized their performance for standard and customized pulse sequences. RESULTS: Characterizing the latency parameters permitted choosing optimal timing parameters that maximized the rate of successfully delivering the desired number of pulses using both adaptive and synchronization methods. CONCLUSIONS: We demonstrated that accounting for latency and/or using the ability to read the prior information on expected pulse timing can provide high accuracy in delivering specified numbers of pulses. This reliability is critical for accurate dose delivery in preclinical FLASH research of single fraction and especially fractionated dosing regimens. The ability to generate custom pulse sequences enables more detailed exploration of the temporal dependence of biological FLASH effects.