Future electron accelerators and free electron lasers: Potentials in clinical medicine

Studies of the biological and technical prerequisites for the clinical use of monoenergetic X-rays, and their specific absorption in heavy elements are conducted, with a view towards plans for stereotactic photon activation radiosurgery. The primary aim is the controlled eradication of target structures in the brain for the treatment of functional brain disorders or small brain tumours, with monochromatic synchrotron X-rays. The specific cell-killing action is based on DNA-breakage caused by short-range Auger and Coster-Kronig electrons produced by heavy atoms upon K-shell absorption of their characteristic X-rays. To this end, iodine or heavy metals would have to be deposited, in or close to nuclear DNA in target cells by means of suitable molecular vehicles. Practically useful concepts for clinically useful monoenergetic X-ray facilities and beam-lines are being developed. In this paper attention is focussed on the possible use of laser Compton backscattering for the production of clinically useful monochromatic X-ray beams suitable for irradiation of very small targets in the brain through the intact skull. Particularly relevant, in the present context are prospects for introducing free electron laser technology to improve the calculated parameters of X-ray beams designed for stereotactic photon activation radiosurgery with monochromatic photons in the energy interval 30–100 keV. Constructive initiatives would be welcome!