Aspects of Industrialization of Accelerators for Particle Therapy ICABU, November 11, 2013, Daejeon

Transcription

1 Aspects of Industrialization of Accelerators for Particle Therapy ICABU, November 11, 2013, Daejeon Introduction Why Particle Therapy? PT Milestones What is meant by Industrialization Examples Protons-only: IBA NC Cyclotron; ACCEL/ Varian Medical SC Cyclotron; Mevion Ion Therapy Machines Siemens synchrotron; IBA cyclotron design Industrialization and Commercialization Perspectives References & Thanks to Y. Jongen, IBA; J. Timmer, Varian; L. Bouchet, Mevion; U. Weber, Rhön-Kliniken DK-Ing Consult Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

2 DK-Ing Consult Why Particles? Particles: Precise does delivery Less side effects 18 MV Photons N o Beam Direction Siemens Web Page

3 DK-Ing Consult Milestones towards Industrialization of Accelerators for Particle Therapy The possible use of the Bragg peak of high energy ions in the radiotherapy of cancer was suggested by Robert R. Wilson in First patient treatment in Berkeley Lab.; parasitic use of an accelerator Mid 1980 first dedicated hospital_based proton facilities become feasible and are built in the 1990`s, e.g. Loma Linda, MGH Mid 1990`s - Market demand for P and C 12 facilities starts and development of turn-key facilities Industrialization since late 1990`s Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

4 2006 The Harvard Synchrocyclotron Upgraded in the 50`s and 60`s Several thousand patients treated until 2002

5 What is meant by Industrialization of Accelerators for Particle Therapy DK-Ing Consult Not Mass Production Not one-time delivery of accelerator components for a facility Instead: Development and supply of a turn-key PT system according to industry QM standards to private and public customers Suppliers mostly started from a key component business, e.g. cyclotrons or superconducting magnets This talk will not give a complete overview of existing or planned PT facilities Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

6 DK-Ing Consult Proton-only Machines Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

7 DK-Ing Consult Example 1 - IBA - Ion Beam Applications S.A., Belgium Spin-off from Cyclotron department of Univ. Louvain-la-Neuve Had built smaller cyclotrons for PET and other accelerators for Ion Beam Applic`s Won MGH worldwide Tender in 1993 Today claiming that IBA has pioneered proton therapy. With proven efficacy in more than 50,000 patients worldwide Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

8 IBA PT-Machine Concepts & Developments DK-Ing Consult From Cyclotron w/resistive Cu-coils to SC Cyclotrons From Beam Scattering needing patient specific devices to universal Scanning Cyclo 235: P+ Photos von IBA Maschinen SC Carbon- Cyclo 400 SC Syncro- Cyclotron for single room Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,2013 8

9 2006 IBA 230 MeV resistive isochronous cyclotron Built > 20 times so far Diam. > 4,5 m Weight > 200 tons Coil power cons. > 200 kw

10 Example 2 - ACCEL Instruments / Varian Medical Systems DK-Ing Consult ACCEL = MBO from Siemens/Interatom for Accelerator & Magnet Technology What made ACCEL engage in Proton Therapy? We knew a lot about Superconducting Magnets We knew about Accelerator Designs (mainly Synchrotrons) We had Access to Partners for a cooperative development for Cyclotrons: CAL first, later NSCL,PSI Key Features: Superconducting Cyclotron & Scanning for IMPT ACCEL was bought by Varian Medical Systems in early 2007 Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

11 ACCEL- History in Superconducting Magnets & Accelerators DK-Ing Consult Fabr. first Start SC Magnet Tech Fabr. of Foundation SERSE SECRAL Industrial Applic., e.g. CGMs; SC Cyclotron Resonators Accelerator Designs first WLS of ACCEL Ion Sources Fab&Assbly of LHC Main Quadrupoles - HERA Quads CGMs DetectorMagnets Mini-Gap Undus /5 1986/8 1992/3 1993/ / : 2009 Year Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

12 ACCEL industrialized design and built 400 LHC SC Quadrupoles for CERN; Year Order Vol. 60 mio.$ A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004

13 Cyclotron - Design Started from `93 NSCL Proposal for a manufacturing Prototype superconducting Cyclotron for advanced Cancer Treatment Close collaboration with external experts: First step to Industrialization on a component level by extensive use of 3D-FEM codes for magnetic and RF-structure designs instead of manual approaches; precise coil winding instead of wild winding reduced and simplified refrigeration system (easy maintenance) Closed-Cycle LHe operation by compact, industrial cryocoolers instead of LHe-Refrigerator A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004

14 Design: RF-Structures Central Region: Started with electrostatic and rough model (Relax 3D) Refinement of electrostatic design with TOSCA 3D Exchange of data between 3D-CAD and TOSCA for iterations, providing input for NC-milling machines 3D-CAD 3D E-Static TOSCA Model See ICABU Industrial Exhibition: NC milling machine A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004

15 LHe-Supply Vessel w/4 Cryocoolers 250 MeV Superconducting Proton Cyclotron Zero-boil-off design; first successful tests Dec Room-temp. access to mid-plane Compressors (6x) for cryocoolers RPTC, 5 - room facility Shield Cooler (2x) A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004

16 Superconducting Cyclotrons in Varian`s optimised workshop Based on design proposal from National Superconducting Cyclotron Laboratory, Michigan, MeV Protons internal ion source pill-box design allowing fast and easy access by automatic jacking system of pole caps. low temperature superconducting coils enclosed in cryostat. All other parts are warm. Trim rods at two radii for beam centering and excitation of precession for extraction, no normal conducting coil for internal field Four Dees, second harmonic operation 16 VARIAN PARTICLE THERAPY

17 ProBeam TM Compact Innovate Without Limits ACCEL Munich Varian CA 17 VARIAN PARTICLE THERAPY

18 ProBeam TM Compact Innovate Without Limits Next steps to Industrialization Series fab: Pre-assembled beamline on girders; Optimised Cyclotron Workshop 18 VARIAN PARTICLE THERAPY

19 Installation at RPTC 2004/5 - A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004

20 Installation at Paul-Scherrer-Institut fairly crowded A. Geisler, ACCEL Instruments GmbH, 18A3, Cyclotrons 2004, October 2004 Courtesy of PSI

21 Installation of fully pre-assembled California 21 VARIAN PARTICLE THERAPY

22 Dynamic Peak TM Scanning Scattering versus Scanning From Scattering to Scanning Today Scanning is available from Industry Reduced cost Shorter treatment times Continuous IMPT does request stability s<2% / Ref. PSI 22 VARIAN PARTICLE THERAPY

23 Dr. Detlef Krischel, BGL Huge Gantry in multi-room facility for 250 MeV Protons RPTC Gantry and Patient Table Beam axis within 0.5 mm radius during volume Acceptance around Isocenter Tests

24 Industry response to market demands for PT w/reduced investment cost 4 to 6 room facilities require financing investments in the order of 100 to 150 Mio. (~140 to 210 Bill. Won) Planning, building, commissioning ~ 5 years even for available technology High amounts of liability obligations for many years; disliked by industry many project initiatives failed Smaller facilities requested to become achievable also for smaller hospitals, geographically decentralized Companies developed dedicated single room accelerators& compact gantries DK-Ing Consult Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

25 2006 Compact Cyclotron + Compact Gantry 25

26 2006 Compact Synchro-Cyclotron S2C2 - First extracted beam observed end of August

27 Varian`s ProBeam Single Room Eclipse & ARIA Integration S. C. Isochronous Cyclotron Dynamic Peak TM Scanning Big Bore Beam Line 2D Orthogonal & CBCT 27 VARIAN PARTICLE THERAPY

28 Example 3: Still River/ Mevion Dedicated foundation by former MGH people; basic cyclotron design by MIT, Boston 1946 Harvard (700 tons) Synchrocyclotron 1996 IBA/Sumitomo (220 tons) Isochronous Cyclotron 2004 Varian/Accel (90 tons) Isochronous Cyclotron Under Development IBA (50 tons) 2012 Synchrocyclotron Mevion Medical Systems (<20 tons) Synchrocyclotron mounted on Gantry

29 Mevion SC synchrocyclotron prototype Very compact by 9 Tesla high field Nb3Sn magnet mounted on gantry Ref. Schippers, PTCOG 2009

30 MEVION S250 Proton Therapy More than 10x weight reduction of proton source allow equipment to be placed in a smaller room with proton source mounted on gantry Just like a conventional radiation therapy linac... 30

31 DK-Ing Consult 2. Accelerators for (Protons and) Heavy Ions up to Carbon It is not simply scaling up! Carbon accelerators so far are synchrotrons with a much different beam time-structure This strongly impacts treatment modes and irradiation times Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

32 Titel RHÖN-KLINIKUM AG Partikel-Therapie Beam extraction, spill shape of 220 MeV protons, extraction time: 8sec (max.) Allows for voxel/or spot scanning, but not continuous IMPT; needs periodic extraction and refill of accelerator

33 RHÖN-KLINIKUM AG Titel Partikel-Therapie Example 4 - Proton / Carbon Ion Synchrotron@ Rhön-Clinics Marburg, Germany: Siemens productizing a GSI pilot plant, following HIT Heidelberg Diameter ~20 m 12 Dipoles w/10 t each Extraction Septa E max = 430MeV/u = 0.75 c Up to 10 s extraction time per spill Interruption of extraction is possible electrostatic Septum HF- cavity Injection Septum

34 LINAC Titel The Accelerator (Marburg) RHÖN-KLINIKUM AG Partikel-Therapie Ion Sources Synchrotron HE Beamline

35 2006 IBA Carbon Therapy System C400 IBA Product offering: BIG Isochronous SC Cyclotron using experience from proton-only machines not built yet!

36 DK-Ing Consult KIRAMS: Isochronous Cyclotron for Carbon More similar to proton-only accelerators and their beam properties KIRAM`s project KHIMA will be an important step to confirm feasibility of big cyclotrons for ion therapy Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

37 DK-Ing Consult Industrialization and Commercialization After ~ 15 years Industry can deliver Proton-only facilities on-time and on budget according to Medical Product Laws, e.g. FDA, and other industrial QA standards and typical economical contractual conditions Carbon machines are still under development, some drawbacks happened (Siemens closed down this business!) However: Requested patient numbers for economically viable outcome were estimated to be > 2000/y for a 4 room facility given the reimbursement rates of k / patient PTCOG patient statistics shows / y maximum!!! Steady Commercialization of PT Facilities must still be confirmed over the next few years by continuous demand from the market and economical success for suppliers and operating institutions Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

38 DK-Ing Consult Perspectives Workflow optimization to increase patient numbers Standardizing accelerator layouts allowing series fabrication as far as possible together with Education programs and intense collaboration between universities, accelerator labs, and industry will provide basis for continuous innovative industrialization and successful commercialization Dr. Detlef Krischel; ICABU, DAEJEON, Nov 11,

39 DK-Ing Consult Thank you for your Attention! SCAN (20 x 20 cm) of Albert Einstein produced by GSI rasterscan-system with 430 MeV/u C 12 beam of 1,7 mm width (FWHM). (direct Irradiation of x-ray film, no other Absorbers