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Mevion ,Single Gantry Proton Therapy machine

Mevion ,Single Gantry Proton Therapy machine. 2012.12.28 醫學物理學會. 超導原理及迴旋加速器 原理 設備 組成架構 , 搭配軟硬體 介紹 設備空間 需求 輻射 防護規劃及相關法規 要求 Mevion 建議品保項目及相關配套設備 介紹 效益分析. A New Paradigm In Proton Therapy 新型質子治療設備. The MEVION S250 is approved by US FDA 510(k) clearance. About Mevion Medical Systems.

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Mevion ,Single Gantry Proton Therapy machine

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  1. Mevion ,Single Gantry Proton Therapy machine 2012.12.28 醫學物理學會

  2. 超導原理及迴旋加速器原理 • 設備組成架構, • 搭配軟硬體介紹 • 設備空間需求 • 輻射防護規劃及相關法規要求 • Mevion建議品保項目及相關配套設備介紹 • 效益分析

  3. A New Paradigm In Proton Therapy新型質子治療設備 The MEVION S250 is approved by US FDA 510(k) clearance.

  4. About Mevion Medical Systems • Dedicated to advancing the treatment of cancer, from 2004 • “High Energy Cancer Care™” • Primary commercial offices: Mevion USA (Boston), Mevion Asia (Tokyo) • 100+ Employees - highly experienced team in proton and radiation therapy • Mevion Proton Therapy Launch: • MEVION S250 is CE Mark and US FDA 510(k) approved • 3個系統已正在安裝中，另有六套系統將於2013年進行 • Includes 3 NCI designated comprehensive cancer centers • Other Leading Universities and private Health Centers • In N. America, Asia, and Europe

  5. Mevion Proton Therapy The MEVION S250 is Pending US FDA 510(k) clearance. 50

  6. The MEVION S250 Power Nb3Sn Modern superconducting material capable to carry more than 3,000 Amps TriNiobium Tin The TriNiobium Core 45 The MEVION S250 is Pending US FDA 510(k) clearance.

  7. 2012 2000 1996 1946 Harvard (700 tons) MGH (220 tons) Reinecker (90 tons) Mevion Medical Systems (<20 tons) The MEVION S250 is Pending US FDA 510(k) clearance. 50

  8. High Energy Proton Source • One-push button operation • Low power requirements • Simple service & high reliability 250 MeV Protons 6 ft diameter (1.8m) < 20 tons

  9. High Precision Gantry System • Patented gantry mounted source • First isoconcentric gantry system • High conformance geometries 190 degrees ± 0.1 deg & 0.5 mm accuracy

  10. Mevion Proton Therapy Workflow • Analogous to linac • Advanced IGRT with integrated image guided CT • Interface to hospital OIS - ARIA or MOSAIQ • No beam queuing or rationing • Optimized beam delivery system • Modern and upgradeable • Reduce risks of technology obsolescence

  11. Mevion Proton Therapy Couch • Robotic patient positioning, accurate to 0.5mm • Multi-dimensional image guidance - 270 degrees rotation & ±5 deg Roll/Pitch - Proton compatible top with Exact™ indexing

  12. MeviOS Control System • Operator Control System • Simple-to-use operator’s environment • Oncology information systems integration • ARIA • MOSAIQ • Treatment planning systems integration • Eclipse • Pinnacle - Under development • CMS - Under development

  13. MEVION S250 - Architectural Requirements Rooms can be grouped or individually sited, dependent on clinical and logistics optimization • Bunker size: 1,500 to 2,000 sq.ft. (~150 m2) • Full flexibility in siting - no room interdependence • Distributed sites possible with no additional cost • Rooms can be staged 40 - 45 ft 12 m - 14 m 40 - 45 ft - 12 m - 14 m

  14. QA in Proton Therapy • There are currently no task group recommendations for proton beam QA. Where relevant we follow guidelines from the following sources: • IAEA TRS 398 • ICRU 59 • ICRU 78 • TG 40 & TG 142 • There are no guidelines on delivery mode specific QA

  15. RPC Accreditation • ProCure-OKC and ProCure-CHI have recently completed the RPC proton credentialing requirements for the use of proton therapy in NCI-funded clinical trials • RPC recommendations from on-site dosimetry review visit include: • Increase frequency of measuring distal & lateral penumbra • Tracking data for SOBP widths • Implementing checks for range uniformity Daily ??

  16. Proton QA Equipment

  17. Proton QA Equipment • making use of what is commercially available for photon therapy QA

  18. We are constantly changing and improving QA equipment

  19. 1D Arrays

  20. 1D Arrays -How do they compare for PDD measurements? V.S

  21. Zebra PDDs

  22. Monthly Range Trend

  23. 2D Arrays

  24. Use of IC Profiler for Flatness & Symmetry

  25. Monthly Flatness Trend

  26. ProCure Morning QA Device rf Daily QA 3 Irradiation area ProCure Machine Shop

  27. How to check on Imaging & PPS correction at the same time? • Orthogonal imaging can be used to image the array and implanted fiducials in the Lucite phantom and compare to reference images. • The goal is to prove that the robotic couch moves to the same location everyday based on image fusion correction vector of the fiducials.

  28. Imaging QA: Comparing DRR with X-ray Image

  29. Temporal tracking of PPS correction vector

  30. Morning QA Procedure • One setup, One device, One beam and this is what it can do • Output consistency • Range consistency • Symmetry consistency • Laser isocentric accuracy • Imaging vs mechanical alignment • In-room laser check

  31. Morning QA Trends

  32. 3D Dosimetry

  33. Capturing 3D Dose in Polymer Gels UFPTI, Jacksonville An example of a pristine beam: R = 28 cm Irregular Aperture 3.5 cm

  34. More about 3D Polymer Gel Dosimetry • Response is independent of delivery mode (PB, US, DS) • Requires a lot of maintenance and strict QC workflow procedures for consistency Zeidan et al, MP, 37 (5), (2010) Su et al, PMB, 649 (57), (2012)

  35. Conclusions & Future Directions • Proton Therapy Systems are complex and requires specialized equipment to measure various parameters of the beam delivery • For sake of consistency & efficiency it is imperative to make use of commercially available 1D & 2D arrays and adapt them to check routinely for • Beam parameters (R,M, Symmetry, Flatness, Output) • Imaging System • Positioning System • With increasing interest in proton therapy & identifying the right set of QA equipment we should take active role in accelerating the development of QA standards for proton therapy and tolerance limits for each delivery mode

  36. MEVION S250 - Architectural Requirements Rooms can be grouped or individually sited, dependent on clinical and logistics optimization • Bunker size: 1,500 to 2,000 sq.ft. (~150 m2) • Full flexibility in siting - no room interdependence • Distributed sites possible with no additional cost • Rooms can be staged 40 - 45 ft 12 m - 14 m 40 - 45 ft - 12 m - 14 m

  37. MEVION S250 - Operational Costs • Utilities: Electrical only • Standby: 50 kW • Beam on: 100 kW • Annual Cost: $50,000 to $75,000 (@ $0.1 / kW-h) • Staffing: similar to modern IGRT - NO Accelerator scientist or engineers required • Physics: 1 FTE • Dosimetrist: 1 to 2 FTE (function of clinical load) • Therapists: 2 needed to operate the machine • Maintenance/Service: Platinum level • Quarterly maintenance requirements with no daily maintenance required: 48/72 hours • 95% uptime guarantee

  38. MEVION S250 - Patient Throughput • Patient Throughput similar to conventional RT • Patient volume is similar to conventional RT: • 4 patients per hours for normal case load • Available facility time is 8 to16+ hours per day, 5 - 6 days per wk • MEVION S250 high throughput via • Dedicated beam for each room - no beam queuing or rationing • Quarterly only maintenance • Clinical optimization with conventional workflow • Smaller routine equipment

  39. Patient Throughput Each MEVION S250 treatment room has its own proton source No. of Patients/Day Waiting Time Per Beam MEVION S250 1 Accelerator Multiple Rooms 1 Accelerator Multiple Rooms 3 MEVION S250 treatment room support up to 50 more patients per day No Beam Queuing No Beam Rationing MEVION S250 Throughput modeling for a proton therapy centre AH Aitkenhead, CG Rowbottom, RI MacKay - The Christie - UK

  40. Mevion Proton Therapy Implementation • Simple construction requirements: Like a linac • Experienced team in radiation and proton therapy providing support all along the development of the project • Full Project Management support • Project Site Manager: Site preparation support for planning and construction: review of drawings and verification conformance • Installation Project Manager: during system installation • Clinical Project Manager: Training expert for the Facility clinical team and will support the clinical startup of the facility.

  41. MEVION S250 Project Sequencing MEVION S250 proton therapy projects can be managed like any conventional radiation therapy project Simpler vault requirements combined with routine equipment located in one single vault greatly reduce the time of design and construction of the facility and the installation and facility startup

  42. A New Paradigm in Proton Therapy Modern, Advanced, and Affordable Proton Therapy One proton source per room supporting IMPT or scattering beam delivery • A Standalone Medical Device • No Dedicated Technical Staff Needed • Simple Maintenance, High Uptime • Minimized Capital Outlays and Project Risks • Rooms Can Be Phased, Lowering Risk • Half Per Room Cost of Traditional Centers • Easy Integration Into Existing Facilities

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