Flattening filter free (FFF) beams are now commonly available with new standard linear accelerators. These beams have recognised clinical advantages in certain circumstances, most notably the reduced beam-on times for high dose per fraction stereotactic treatments. Therefore FFF techniques are quickly being introduced into clinical use. The purpose of this report is to provide practical implementation advice and references for centres implementing FFF beams clinically. In particular UK-specific guidance is given for reference dosimetry and radiation protection.

The mineral content of bone can be quantified by recording a 31P NMR spectrum while the bone is stationary. The quantity of mineral in the bone is determined from the spectrum with a reference standard by comparison of relative peak areas. The phosphate of bone mineral is readily distinguished from inorganic phosphate and phosphorylated metabolites dissolved in cytosol and from the head groups of phospholipids in membranes. The technical feasibility of constructing a cost-effective instrument for analysis of bone mineral content in the extremities is demonstrated. The possible utility of such a noninvasive assay for detecting osteoporosis and for monitoring the progress of treatment is discussed.

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