Advancements in Accelerator and Beam Delivery Technology

In this article, we review the development of accelerator and beam delivery technology for particle therapy. The working principles of accelerators, encompassing isochronous cyclotrons, synchrocyclotrons and synchrotrons, and recent advancements in other accelerator technology, are presented. For beam delivery technology, we focus on pencil beam scanning (PBS) for intensity modulated proton therapy (IMPT). In addition, we incorporate aspects of proton arc therapy, ultrahigh-dose rate FLASH therapy, and motion management for PBS beam delivery. Last, we have discussions on imaging guidance for particle therapy treatment delivery, upright patient positioning, and online adaptive therapy.