Linear Accelerator: What Is This Equipment Used For?

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Linear Accelerator
A medical linear accelerator (LINAC)
customizes high energy x-rays or electrons to
conform to a tumor's shape and destroy cancer
cells while sparing surrounding normal tissue.
It features several built-in safety measures to
ensure that it will deliver the dose as
prescribed and is routinely checked by a
medical physicist to ensure it is working
properly.
If you're scheduled for radiation therapy using

a LINAC, your radiation oncologist will
collaborate with a radiation dosimetrist and a
medical physicist to develop a treatment plan
for you. They will double-check this plan
before treatment begins and implement quality
assurance procedures to ensure that each
treatment is delivered in the exact same
manner.
What is this equipment used for?

A medical linear accelerator (LINAC) is the device most commonly used for external beam radiation
treatments for patients with cancer. It delivers high-energy x-rays or electrons to the region of the patient's
tumor. These treatments can be designed in such a way that they destroy the cancer cells while sparing
the surrounding normal tissue. The LINAC is used to treat all body sites, using conventional techniques,
Intensity-Modulated Radiation Therapy (IMRT), Volumetric Modulated Arc Therapy (VMAT), Image
Guided Radiation Therapy (IGRT), Stereotactic Radiosurgery (SRS) and Stereotactic Body Radio
Therapy (SBRT).
How does the equipment work?

The linear accelerator uses microwave technology (similar to that used for radar) to accelerate electrons in
a part of the accelerator called the "wave guide," then allows these electrons to collide with a heavy metal
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Copyright© 2019, RadiologyInfo.org Reviewed: Feb-20-2019
a part of the accelerator called the "wave guide," then allows these electrons to collide with a heavy metal
target to produce high-energy x-rays. These high energy x-rays are shaped as they exit the machine to
conform to the shape of the patient's tumor and the customized beam is directed to the patient's tumor.
The beam is usually shaped by a multileaf collimator that is incorporated into the head of the machine.
The patient lies on a moveable treatment couch and lasers are used to make sure the patient is in the
proper position. The treatment couch can move in many directions including up, down, right, left, in and
out. The beam comes out of a part of the accelerator called a gantry,which can be rotated around the
patient. Radiation can be delivered to the tumor from many angles by rotating the gantry and moving the
treatment couch.
Who operates this equipment?

The patient's radiation oncologist prescribes the appropriate treatment volume and dosage. The medical
physicist and the dosimetrist determine how to deliver the prescribed dose and calculate the amount of
time it will take the accelerator to deliver that dose. Radiation therapists operate the linear accelerator and
give patients their daily radiation treatments.
How is safety ensured?

Patient safety is very important and is assured in several ways.
Before treatment is delivered to the patient, a treatment plan is developed and approved by the radiation
oncologist in collaboration with the radiation dosimetrist and medical physicist. The plan is
double-checked before treatment is given and quality-assurance procedures are performed to ensure that
the treatment will be delivered as planned.
Quality assurance of the linear accelerator is very important. There are several systems built into the
accelerator so that it will not deliver a higher dose than the radiation oncologist has prescribed. Each
morning before any patient is treated, the radiation therapist performs checks on the machine to make
sure that the radiation intensity is uniform across the beam and that it is working properly. In addition,
the medical physicist conducts more detailed monthly and annual checks of the linear accelerator.
Modern linear accelerators also have internal checking systems that do not allow the machine to be turned
on unless all the prescribed treatment requirements are met.
During treatment, the radiation therapist continuously observes the patient using a closed-circuit
television monitor. There is also a microphone in the treatment room so that the patient can speak to the
therapist if needed. Port films (x-rays taken with the treatment beam) or other imaging tools such as cone
beam CT are checked regularly to make sure that the beam position doesn't vary from the original plan.
Safety of the staff operating the linear accelerator is also important. The linear accelerator sits in a room
with lead and concrete walls so that the high-energy x-rays are shielded and no one outside of the room is
exposed to the x-rays. The radiation therapist must turn on the accelerator from outside the treatment
room. Because the accelerator only emits radiation when it is actually turned on, the risk of accidental
exposure is extremely low.

exposure is extremely low.
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This material is copyrighted by either the Radiological Society of North America (RSNA), 820 Jorie Boulevard, Oak
Brook, IL 60523-2251 or the American College of Radiology (ACR), 1891 Preston White Drive, Reston, VA
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Copyright ® 2019 Radiological Society of North America, Inc.


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If you're scheduled for radiation therapy using

What is this equipment used for?

How does the equipment work?

Linear Accelerator Page 1 of 3

Who operates this equipment?

How is safety ensured?

Linear Accelerator Page 2 of 3

Copyright ® 2019 Radiological Society of North America, Inc.

Linear Accelerator Page 3 of 3

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