S m u m m a m ry y Ta T lk of o the h Wo W r o ksho h p Accelerators for IBT Linz-MediConsult U e e L i L nz n Forschungszentrum Jülich

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1 Accelerators for IBT

2 general requirements for IBT accelerators high reliability fast morning start-up ease of operation low operation cost ease of maintenance low maintenance cost low follow-up costs

3 accelerator types cyclotron synchrotron isochronous synchrocyclotron slow-cycling rapid-cycling NC vs SC FFAG non-scaling scaling

4 cyclotrons: isochronous IBA-C230: FHBPTC, UFPTI, UPHS and 17 other locations Compact isochronous cyclotron 235 MeV proton energy 300 na beam current, quasi-continuous Typical efficiency : 55 % Approx. weight: 220 T Diameter: 4.3 m normal conducting Conventional magnet coil: T RF Frequency: 106 MHz Dee voltage: 55 to 150 kv peak Data: D. Bertrand

5 cyclotron: isochronous Varian 250: PSI, RPTC Particle Energy Outer diameter Height Weight Extracted current RF power Magnetic field H 250 MeV 3.1 m 1.6 m <90 t (max)800 na 115 kw 2.4 (<4) T Design: H. Blosser, MSU superconducting Data: H. Röcken

6 IBA C400: ARCHADE? cyclotron: isochronous Particle H-Ne Energy (MeV/u) 400 (H:250) Outer diameter (m) 6.3 Height (m) Weight (t) Extracted current (na) 8 RF power (kw) 2x100 Magnetic field 2.5 (4.5) T superconducting Data: D. Bertrand

7 IBA S2C2 cyclotrons: synchrocyclotron super conducting Compact: Ø 2.5 m, height 2 m, weight <50 t Reliable: NbTi cryogen free coil, Repeatable: Standard high quality laminated steel Operable: Operator-free system, remote diagnostics 20 na average beam current at 230 MeV for PBS; Extraction efficiency >50% at 230 MeV 1 khz beam pulse repetition rate for PBS Data: D. Bertrand Still River Monarch250 Design: T. Antaya, MIT Ø 1.7 m, weight 20 t, 9 T, Nb3Sn coil, >10 na at 250 MeV

8 220º gantry Summary Talk of the Workshop one room facility 180º gantry L: 27 m, H: 13 m (scheduled for 2014) Data: D. Bertrand L: 14 m, H: 14 m (scheduled for 2011)

9 synchrotron: slow cycling LLUMC H Fermi Labs HIMAC He-Ar Hitachi, Toshiba U Tsukuba H Hitachi PTC-H H Hitachi HIT H-O GSI Marburg, NRoCK, H, C Siemens Shanghai H, C Siemens GHMC C Mitsubishi CNAO H-C CERN

10 GHMC 66.0m 38.4m C MeV/u max 1.3 x 10 9 pps Synchrotron Extraction RF Cavity 1/3 size and price of HIMAC ECR C 4+ RFQ APF-IH C 4+ Foil C 6+ 4 MeV/u Injector Data: T. Kanai

11 Ion type Energy Maximum range SOBP Maximum aperture Lateral field shaping Beam intensity Summary Talk of the Workshop Dose rate Beam delivery modes slow cycling synchrotron: GHMC Carbon only MeV/u 25 cm 2 14 cm (with ridge filters) 15 cm x 15 cm Single radius wobbling Spiral wobbling 1.3 x 10 9 pps (3 sec nozzle 5 GyE/min for φ15 cm 10 cm SOBP Respiration gating Layer Stacking Established extraction method yielding high stability in time, position, and size Data: T. Kanai

12 Data: P. Urschütz

13 Shanghai Cancer Center: Synchrotron w 4 treatment rooms (Siemens) Data: Zh. Zhang

14 Siemens Synchrotron produces proton MeV and carbon MeV/u slow extraction of beam over 1-10 s Shift from carbon to proton: in <1 min. Data: Zh. Zhang

15 Siemens Synchrotron produces proton MeV and carbon MeV/u slow extraction of beam over 1-10 s Shift from carbon to proton: in <1 min. COSY Jülich

16 Data: P. Urschütz

17 4 May 2011 Data: Zh. Zhang

18 Welcome to Shanghai Wish Erice Meeting Success!!! Forschungszentrum Zh. Zhang Jülich

19 synchrotron: rapid cycling Pros Compact construction (1-turn injection) good intensity control variable energy operation proven technology for physics applications (KEK, ISIS, J-PARC, RAL) Not yet realized for IBT Cons rapid frequency sweeps high RF voltage (16 kv for H and 100 kv for C) Eddy currents too costly? RCMS by BNL

20 synchrotrons: rapid-cycling Data: S. Peggs

21 FFAG Accelerator Magnetic Fixed Modulated Type Field Variation Frequency Frequency FFAG alternating + IsoC alternating + SynchroC uniform + * First prototype realized in 2000 (KEK)

22 FFAG: scaling vs non-scaling Scaling: B field follows a scaling law as a function of radius - rk (k a constant;) present-day scaling FFAGs: Y. Mori, Kyoto University Research Reactor Institute geometrically similar orbits Nonscaling: Linear (quadrupole) gradient; beam parameters generally vary significantly with energy (EMMA FFAG, Daresbury Laboratory, first nonscaling FFAG) Nonlinear-gradient; beam parameters such as machine tune can be fixed (as in a synchrotron, PAMELA and a new generation of constant-tune, CW FFAGs) compressed orbits Data: C. Johnstone

23 FFAG: Bringing the Community a Step Forward? Advantages of the FFAG : Simplicity of fixed magnetic fields rather than pulsed operation 12 C 6+ Potential for variable energy extraction Strong focusing allows synchrotron-like straights p 3.5 m Goal: lower operational overhead and system simplicity of the cyclotron Data: C. Johnstone

24 FFAG: PAMELA Particle Accelerator for MEdicaL Application Particle physics EMMA ν-factory, muon source, proton driver Medical PAMELA Particle therapy, BNCT, X-ray source Energy (PAMELA) ADSR, Nucl. Transmutation Particle therapy FFAG FFAG ADSR ν-factory CONFORM (Construction of a Non-scaling FFAG for Oncology, Research and Medicine) aims to develop the Non-scaling FFAG as a versatile accelerator. (Project HP: Data: T. Yokoi/J. Pozimski

25 polygonal Summary Talk of the Workshop RACCAM - new layout rectangular This results in : - Smaller overall surface : 3400 m 2 versus 4200 m 2 - A reduction of non-productive surface (e.g., beam transport) - Cost of building reduced : 16 M versus 18 M - Reduced walking distances and flux, both for personnel and patients - Reduced operationnal costs Note: An X-ray radiotherapy center for Toulouse has been proposed by AGC in a bid in 2009, based on this cylindrical layout Data: F. Méot

26 agony of choice Which medical accelerator to choose?

27 agony of choice Which medical accelerator to choose? For MDs the IBT part upstream of the patient is a black box

28 accelerator vs facility costs total facility costs cost of equipment cost of accelerator Varian MEuro MEuro 7-10 MEuro Data: IBA For a multiroom PT facility, the accelerator is NOT the size- and cost-determining factor!

29 Which accelerator to choose? Why do most PT centers use cyclotrons? Why do most IBT centers use synchrotrons? Why do industrial suppliers take the challenge of SC? Antagonism between preference of clients for proven technology and desire of developers for innovation

30 which accelerator to choose? Simplicity, reliability, lower cost and size IBA: i cyclotron, nc Smallest possible footprint and weight, less power consumption Varian: i cyclotron, sc Simple, robust, low voltage, low cost, compact,... T. Antaya, synchrocyclotron, sc Simple, robust, small magnets, light gantry, flexible S. Peggs, RCMS Smaller, simpler, significantly cheaper than synchrotron CONFORM Project: FFAG

31 the benchmark for a new IBT system yr LC 100% 5-yr LC 33.9% 70.4 GyE/16 f./4 wks (0006, n=25) LogRank p< or 57.6 GyE (9602, n=16).2 Sarcomas of the H & N TIME 観察期間 IN ( 月 MONTH ) Data: H. Tsujii

32 clinical operation with various IBT systems Institution Acc 1st pt pt # 12/2010 PTC-H SCS May UFPTI icycl Aug comparable patient numbers with different approaches

33 Which accelerator to choose? Health services have to be economical: accelerator design unconstrained by financial and/or space limitations is not instrumental Balance size of accelerator with special features, e.g., single room vs. tomography option Balance facility cost with patient population, patient share, e.g., max. range vs. 3rd or 4th level care unit

34 efficiency and sustainability reducing weight reducing power consumption reducing neutron activation extending running time and service life saving raw materials/resources give numbers on sustainability!

35 the ideal medical accelerator Marco Pullia

36 the Blue Book U. Linz (ed) Ion Beam Therapy Ion Beam Therapy Fundamentals - Technology - Applications Series: Biological & Medical Physics Expected publication date: 10/2011

37 I Ion Beam Therapy in Perspective 1 From X-Rays to Ion Beams - A Short History of Radiation Therapy James M. Slater 2 The Place of Ion Beams in Clinical Applications Paul J. Kim, Helen A. Shih 3 Socio-Economic Aspects of Ion Beam II Therapy Andre Konski Physical and Biological Aspects 4 Physical and Biological Rationale for Using Ions in Therapy 5 Early and Late Responses to Ion Irradiation Reinhard Schulte, Ted Ling 6 The Impact of Radiation Quality on Cure III Rate John Gueulette, Reinhard Gahbauer, Dan Jones, Jacobus Slabbert, Andrˇ Wambersie Models and Preclinical Studies 7 Monte Carlo Methods for Dose Summary Talk of the Workshop the Blue Book: content I Calculations Katia Parodi 8 Modeling Heavy Ion Radiation Effects Thilo Elssser 9 Preclinical Radiobiology and Predictive Assays Eleanor A. Blakely, Polly Y. Chang IV Clinical Results and Indications 10 Treatment of Ocular Lesions Andrzej Kacperek 11 Clinical Indications for Carbon Ion Radiotherapy and Radiation Therapy with Other Heavier Ions Stephanie E. Combs 12 Skull Base Tumors Daniela Schulz-Ertner 13 Proton Therapy for Thoracoabdominal Tumors Hideyuki Sakurai, Toshiyuki Okumura, Shinji Sugahara, Hidetsugu Nakayama, Koichi Tokuuye 14 Carbon Ion Radiotherapy for Peripheral Stage I Non-Small Cell Lung Cancer Tadashi Kamada, Naoyoshi Yamamoto, Masayuki Baba 15 Ion Beam Therapy for Gynecological Tumors Tatsuya Ohno, Shingo Kato 16 Is Prostate Cancer a Good Candidate for Ion Beam Therapy? Carl J. Rossi, Jr. 17 Rationale for Proton Therapy in Pediatric Malignancies Shiao Y. Woo 18 Tolerance of Normal Tissues to Ion Beam Therapy Jean-Louis Habrand, Jean Datchary, Pascal Pommier, Stˇph anie Bolle, Lo c Feuvret, Ismael Ghorbel, Remi Dendale 19 Design and Implementation of Clinical V Trials of Ion Beam Therapy James D. Cox Medical Accelerators and Beam Line Design 20 Design Criteria for Medical Accelerators Hartmut Eickhoff, Udo Weinrich, Jose Alonso

38 the Blue Book: content II 21 Shielding and Radioprotection in Ion Beam Therapy Facilities Andrew J. Wroe, Steven Rightnar 22 Commercial Ion Beam Therapy Systems Yves Jongen 23 Advantages and Challenges of Superconducting Accelerators Detlef Krischel VI Beam Preparation and Control 24 All-in-One: An Atempt to Integrate the Full Potential of Proton Pencil Beam Scanning in a New Gantry System Eros Pedroni 25 Beam Spreading Devices Jay Flanz 26 Dosimetry Techniques for Ion Beams Giacomo Cuttone 27 Control and Safety Systems for Ion Beam Therapy Systems Hiroshi Akiyama, Kazuo Tomida 28 Considerations for Effective Quality Assurance Program for Proton Therapy Michael Gillin VII Patient Positioning and Treatment Planning 29 Imaging and Tumor Localization Oliver Jkel 30 Treatment Planning for Ion Beam Therapy Oliver Jkel 31 Online Irradiation Control by Means of PET Fine Fiedler, Daniela Kunath, Marlen Priegnitz, Wolfgang Enghardt 32 Compensation of Target Motion Christoph Bert, Eike Rietzel 33 Industrial Robots for Patient Support Andres Sommer VIIIŹIndividual Facilities and Management Issues 34 Twenty Years of Proton Radiation Therapy Center Jerry D. Slater at Loma Linda University Medical 35 The Francis H. Burr Proton Therapy Center Jay Flanz, Hanne Kooy, Thomas F. DeLaney 36 HIMAC - A New Start for Heavy Ions Tadashi Kamada, Hirohiko Tsujii 37 A National Action Plan in Japan - From Experimental Studies to Highly Advanced Medical Technology Koji Noda 38 Operational and Training Issues Related to Facility Start-Up Nancy P. Mendenhall, Zuofeng Li IX Future Developments 39 The Single-Room Ion Beam Facility Kenneth P. Gall 40 Smaller - Lighter - Cheaper: New Technological Concepts in Proton Therapy John Cameron, Niek Schreuder 41 New Facilities - Plans and Proposals Ramona Mayer, Stanislav Vatnitsky 42 Future Directions in Ion Beam Therapy Daniel Habermehl, Stephanie Combs, Jrgen Debus