Non-invasive Reversible Software-based Electron FLASH Irradiation Configuration of a Linear Accelerator in Clinical Use

Configuring clinical linear accelerators (linacs) for ultra-high dose rate (UHDR) electron experiments typically requires invasive hardware manipulation and/or irreversible manufacturer modifications, limiting broader implementation. We present an independently developed UHDR electron configuration of a clinical TrueBeam linac that allows reversible switching between preclinical UHDR and conventional (CONV) modes using only non-invasive software settings. UHDR mode was achieved via service mode software with RF and beam current settings typical of a photon beam, the photon target and monitor chamber retracted, and a clinically unused low-energy scattering foil inserted. An external AC current transformer (ACCT) for beam monitoring, anatomy-specific collimator, and sample holder were mounted on the accessory tray, with external ion chamber in solid water for exit dose monitoring. Percent depth dose (PDD) was measured for UHDR and CONV beams. Dose-per-pulse (DPP) was varied by adjusting gun voltage and quantified with radiochromic film at different source-to-surface distances (SSD). Beam profiles assessed dose uniformity and usable field size. Dose calibration was established between film, ACCT, and ion chamber, and day-to-day reproducibility was tested. PDD confirmed similar energies for UHDR (12.8MeV) and CONV (11.9MeV) beams with matching profiles through mouse thickness. Maximum DPP exceeded 0.5Gy, reaching ~1.5Gy for collimated in vivo setups and ~0.7Gy at extended SSD for tissue culture. Field flatness and symmetry were maintained, supporting organ-specific irradiations and up to 5cm fields for culture. Calibration showed strong linearity across detectors, and output variation was<4%. We demonstrated accurate, reproducible UHDR delivery on a widely available clinical linac with no invasive hardware manipulation, enabling preclinical FLASH research on a clinical treatment machine.