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A Visit to CNAO:

A Visit to CNAO:. The Italian Carbon Therapy Facility. History. May 1991 – Amaldi & Tosi, “For a center of teletherapy with hadrons” 1992 – financing for a study by INFN 1992 – TERA Foundation formed 1992 – 2002 – three different designs completed

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A Visit to CNAO:

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  1. A Visit to CNAO: The Italian Carbon Therapy Facility

  2. History • May 1991 – Amaldi & Tosi, “For a center of teletherapy with hadrons” • 1992 – financing for a study by INFN • 1992 – TERA Foundation formed • 1992 – 2002 – three different designs completed • 1995 – 2000 – Proton Ion Medical Machine Study (PIMMS) by CERN

  3. History continued • May 2000 – decision to construct CNAO • 2001 – CNAO Foundation formed • 2005 construction starts • Feb. 15, 2010 – construction complete • Sep. 22, 2011 – first proton patient • Nov. 13, 2012 – first carbon patient • Note: Italy, Austria, and France all planned to use the CNAO design

  4. Source & Linac • Same as HIT • 2 permanent magnet ECR sources • 400 keV/u 4-rod type RFQ • 20 MV IH-type drift tube linac (IH-DTL)

  5. CNAO vs HIT ~ 25 m ~21 m Synchrotron circumference 65 m Synchrotron circumference 78 m

  6. Extraction, etc. • Use amplitude momentum extraction, 5/3 resonance • Event driven, i.e resp. gating • Right now only one event - completion of a plane • Indefinite flattop, spill 200 msec – 10 sec • Presently, 1 sec spill • Rep rate design 3 sec • Presently 5 sec

  7. Daily schedule • Treat 4 days/week with carbon • (5 days/week with protons) • Up to 12 hours per day • Mid – 8 AM, QA • Make adjustments ~ 1/month • QA & TP on some weekends also

  8. Patient positioning • Couch platform rides on air cushion • IR optical tracking and lasers • Later may use x-rays or CT • Some pre-positioning outside of room • Therapists don’t like to make patients wait • Alignment and Prep takes a long time

  9. Cont. • Use the Japanese protocols • Use couch tilt like Japan

  10. Scanning • Active scanning • Beam monitors drive the scanning system • 5 msec to treat each voxel • 10 μsec to move between voxels • Beam does not stop • 3 mm voxel pitch • Beam size 4 - 10 mm • Beam abort in 200 μsec

  11. What would you do differently? • Would not outsource the control system • Lost too much control and ability to adjust to evolution of the design

  12. Other concern • Need a second accelerator • Once in treatment, time is scarce for studies • Reluctance to make changes once treatment is stable

  13. What can the US (Fermilab) do? • Varian has not entered even the proton market • Siemens has withdrawn from ions and even has abandoned two proton centers under construction • Ions are too expensive right now

  14. In my view • Ion market will be small • An opening for a national lab to develop a national resource: • Choose a technology • Something that will provide a significant cost savings • Develop it • Provide a prototype for initial development • Allow for continued development to allow for upgrades to be proven before deployment to operational facilities

  15. Thank you

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