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However, the greatest challenge is to implement full pencil beam scanning, where scanning speeds 2 orders of magnitude faster than the existing state-of-the-art will be necessary, along with similar improvements in the speed and accuracy of associated dosimetry. Hybrid systems utilising 3D-printed patient specific range modulators present the most likely route to clinical delivery. However, to correctly adapt and develop existing technology to meet the challenges of FLASH, more pre-clinical studies are needed to properly establish the be