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Book Review
A Primer on Theory and Operation of Linear
Accelerators in Radiation Therapy
Title: A Primer on Theory and Operation of Linear Accelerators in Radiation Therapy
Edition: Third Edition, 2018
Editor: James Lamb
Series Editors: C. J. Karzmark and Robert J. Morton
Series: Imaging in Medical Diagnosis and Therapy
Published: Medical Physics Publishing
Pages: Hardback, 41 pages, 42 black/white illustrations
ISBN No: 978‑1‑930524‑96‑5
Year: 2018
The Medical Physics Publishing has brought another good
book entitled “A Primer on Theory and Operation of Linear
Accelerators in Radiation Therapy” written by C. J. Karzmark
and Robert J. Morton, which was edited by James Lamb.
Since the application of mega voltage radiation for therapeutic
treatments came in vogue, the medical linear accelerators
have placed a vital role and this book has enlisted a simple
theoretical operational aspects. This book has fifteen sections
as detailed below.
1. Introduction
2. Energy designation in accelerators
3. An elementary linear accelerator
4. A comparison of linac with diagnostic X‑ray generators
5. Major linac modules and components
6. Microwave power sources
a. Microwave cavities
b. The klystron
c. The magnetron.
7. The wave guide and circulator
8. Accelerator structures
a. Traveling‑wave accelerator structures
b. Standing‑wave accelerator structures.
9. Multiple X‑ray energy mode accelerators
a. Traveling‑wave accelerator structures
b. Standing‑wave accelerator structures.
10. Bending magnet
11. Treatment head
12. Image‑guided radiotherapy
13. Physiologic beam gating
14. Functional block diagram and auxiliary systems
15. Operational review.
The introduction sections starts with the brief description
of linac with illustration of schematic diagram, principles,
and functional and application aspects in treatment of deep
seated tumors. The energy designation and description of an
elementary linac operating with battery to alternating voltage
applications is systematically narrated with appropriate figures
298 © 2019 Journal of Medical Physics | Published by Wolters Kluwer - Medknow
in sections two and three. Basic comparison of medical
linac with diagnostic X‑ray generators is nicely explained
in section four. The major medical linac models and their
major components with schematic diagram were elaborated in
section five. The functional aspects of microwave power source
with principle and operation of klystron and magnetron was
described in a systematic manner in section six. Conveyance
of generated microwave power from klystron (or magnetron)
through a circular wave guide is narrated in section seven.
In sections eight and nine, the typical methodology of
accelerating structures  (standing and travelling wave) with
their functionality aspects and mode of multiple X‑ray energy
mode acceleration is excellently described with elaborative
figures. The role of bending magnet in bringing the electrons
to a focal position is described in section ten. Brief description
of components of treatment head for photon and electron mode
followed by the description and importance of multi‑leaf
collimator in facilitating the modern therapy techniques such
as three‑dimensional conformal and intensity‑modulated
radiotherapy was well discussed in chapter  11. The role of
image guidance and common techniques that are following
in modern radiotherapy applications followed by motion
management is simply narrated in chapters 12 and 13. Typical
narration of auxiliary system which is essential for operation
of linac is discussed with a block diagram in chapter  14.
Chapter  15, the operational review, mentions the essential
sequential steps from starting the treatment plan to till
execution with linac and is well narrated.
Overall, the book has brought out the theoretical aspects of
operation of a linac with elaborative schematic diagrams and
figures which help in understanding them easily. I  strongly
recommend having this book to all students, teachers, clinical
medical physicists, and research students.
Challapalli Srinivas
Department of Radiotherapy and Oncology, Kasturba Medical College Hospital
(An Associated Teaching Hospital of Manipal Academy of Higher Education:
A Deemed to be University), Mangalore, Karnataka, India
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Srinivas: A primer on theory and operation of linear accelerators in radiation therapy

Address for correspondence: Dr. Challapalli Srinivas,

Department of Radiotherapy and Oncology, Kasturba Medical College
Hospital (An Associated Teaching Hospital of Manipal Academy of Higher
Education: A Deemed to be University), Attavar, Mangalore ‑ 575 001,
Karnataka, India.
E-mail: challapalli.srinivas@manipal.edu
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DOI:
10.4103/jmp.JMP_68_19

How to cite this article: Srinivas C. A primer on theory and operation of

linear accelerators in radiation therapy. J Med Phys 2019;44:298-9.

Journal of Medical Physics  ¦  Volume 44  ¦  Issue 4  ¦  October-December 2019 299