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Progress in the Application of Hadron Therapy (protons or ions)

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louismorrison
29 diapositives · 342 Views · Jan 03, 2020

Explore the advancements in particle therapy, with a focus on protons and ions, as seen in hospitals like Loma Linda. Learn about accelerators, treatment facilities, the unique benefits of X-rays, protons, and carbon ions, and the latest in accelerator technology. Discover how hadron therapy is changing cancer treatment for over 150,000 patients worldwide.

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  1. Progress in the Application of Hadron Therapy (protons or ions) Marco Schippers

  2. The boost in particle therapy more hospital based mostly in labs Loma Linda (Ca, USA) Particletherapygroup: until 2015 > 150.000 patientstreated www.ptcog.ch

  3. Contents • Introduction: particletherapy • Accelerators • Synchrotron • Cyclotron • Treatment facilities • Whatis so special?

  4. X-ray dose X-ray beams (IMRT ) from 7 directions X-rays heart lung Spinal cord

  5. Dose profile of protons Bragg peak Dose (a.u.) 0 2 4 6 8 10 12 14 16 18 Depth in tissue (cm)

  6. Protons heart lung Spinal cord X-rays vs. Protons Proton beams from 3 directions X-ray beams (IMRT ) from 7 directions X-rays heart lung Spinal cord pictures: Medaustron

  7. Biological effect of Carbon ions RBE>1: Less dose for same cell killing RBE= 1.1 RBE≈ 3 electron track (or energy) density at nm scale effects RBE ( this means: RBE≠ 1 )

  8. Pencil beam scanning intensity 0 time (ms) 10 Spot scanning: step&shoot Continuous scanning kHz-Intensity modulation allows fast target repainting: 15-30 scans / 2 min.

  9. e.g: Boston Florida Seoul Wanjie PSI München Orsay e.g.: Loma Linda Houston Tsukuba 3.5 m Present accelerator choice cyclotron synchrotron Protons in use, 3.5-5 m in use, 8-10 m Carbon ionsin design, 6 m in use, 25 m

  10. Synchrotron Heidelberg Hitachi Ltd Extracted beam Protons only: ( ~8 m) synchrotron Proton source + injector synchrotron Ions (p-C): ( ~25 m) Extracted beam Injector Ion sources

  11. 1-10 sec 0.5-1 sec Synchrotron beam structure in time Beam intensity Time  in development • “spill” time • fill ring with ~1011 particles • accelerate to desired energy • extract slowly during 1-10 sec • decelerate and dump unused particles

  12. 250 MeV (ACCEL/Varian,2005) SC coils: diam 3.5 m, 100 tons 230 MeV (IBA, SHI,1996) iam. 5 m, 200 tons Cyclotron

  13. E-adjustment with cyclotron 250 MeV cyclotron All following magnets: 1% field change in 50-80 ms At PSI: Graphite degrader 238-70 MeV

  14. Small cyclotron fRF time very strong magnetic field: Synchro-Cyclotron Bdecreases with radius  Tcircleincreases with radius. SO: decrease fRF with radius and extract Repeat 1000 x per sec 1 ms Each pulse: set intensity at source within ms (=> typ 10-30% accuracy) => Spot scanning requires >2 pulses per spot.

  15. Synchro-Cyclotron 8-10 T 250 MeV Synchro-cyclotron on a gantry First system installed in 2013

  16. Accelerator status (protons) cyclotron synchrotron small synchro- cyclotron linac Current Useability => Quality FFAG laser Dielectr. wall linac Plasma wake field Now Mañana Time until useable

  17. At cyclotron: degrader+ energy selection beam transport gantries Cyclotron or synchrotron Proton therapy: multi-room facility IBA

  18. Gantries 10-12 m IBA ~90 t Loma Linda (Optivus)

  19. PSI Gantry-2: fast 3D scanning PSI-”Gantry-2” Eros Pedroni David Meer

  20. Gantry for carbon-therapy HIT, Heidelberg

  21. NEW: SC gantries SC dipoles NIRS, Japan SC dipoles Scanning XY Pronova, Knoxville, USA

  22. PSI’s superconducting gantry design combined function, achromatic bending • Degrader mounted on the gantry • Momentum acceptance of approx. ±12.5 % • Treatment of the small tumors without change of the SC magnet field Collimators Degrader Scanning magnets Rotation axis Isocenter

  23. Acc.Lab Hospital What is so special? Operators Technicians Experienced workshops More improvised actions Radiologistoperates CE/FDA-certification: PROCEDURES Localtechnicians:onlysmallrepairs Service byequipmentcompany

  24. SafetyAvailability Separate interlock systems e.g. : Machineinterlocks: all componentstechnically OK More speciallyfortreatments Area access & area dose: Doors closed, dose rate < µSv/h Patient safety: Dose deliveryasplanned

  25. Redundancy measurement BEAM off Alarm level stop Redundancy Redundancy Patient safety interlock system stop stop Alarm level stop

  26. Operation: non-acceleratorexperts Whathashappened ? Strong needfor ERGONOMIC display of: Status Instructions NO BEAM

  27. Accelerators for Medical Application What is so special? • Technics: dedicated, but not on thelimitoftechnology ….but… • Reliable, Reproducible, Reliable, Reproducible • Operation:by non-acceleratorexperts • strictlyaccordingprocedures • Control andsafety: • VERY DEDICATED and SPECIAL : • Reliable & Redundant, but not too sensitive

  28. SUMMARY • Dose: • finite range • maximum dose at end of track • Apply the dose by Pencil Beam Scanning • Accelerators for Medical Application: • Cyclotron • Synchrotron • Medical applications: VERY Special Operation • Facilities: Gantry aims the beam from all directions • Recent development: SC magnets

  29. …. Motivation …. first scanning gantry : PSI, 1996 Thank you !! Gantry: Eros Pedroni Tumours in kids: Beate Timmermann, Gudrun Goitein