The TERA project for hadrontherapy and related R&D...

The TERA project for a tumor therapy center with

hadrons and related R&D activities

Roberto CirioINFN Torino

LAL Orsay, March 16 2001

Orsay, March 16 2001TERA project and R&D activities

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What is TERA ?

FoundationNot-for-profit created in 1992Recognised in 1994 by the Health Ministry

In 2001:18 full time employees 6 staff researcher (physicists and engineers)9 fellows3 administrative

TERA has 4 sections: Novara - Geneva (CH) - Milan and Genoa


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The goal of TERA

Purpose of the TERA Foundation is tointroduce in hospitals the tools needed to treat cancers with radiation (radiotherapy) using hadron beams


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Why hadrons(1)

They are densely ionizing

!!!!DNA damages are more probable


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Why hadrons(2)

Small:energy release before targetenergy release after targetlateral deviation


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Why hadrons(3)

Very high Biological Effect!!!!radio-resistant tumors


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Hadronsor

Photons(3)

Between the eyes

Abdomen

Brain

IMRT protons


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Patients treated with hadrons

33104 patients treated at January 2001

[J.Sisterson, Denton 1996 and Particles 1998,2000]

HCL25%

LLUMC17%

Moscow10%

PSI -eye10%

Berkeley8%

Orsay6% Nice

5% Others5%

St. Petersburg3%

Clatterbridge3%Chiba

2%

NAC1%

TRIUMF1%

PSI (SIN)Tsukuba


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Loma Linda University Medical Center (LLUMC)


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USA 2001

LOMA LINDA

UNIVERSITY CENTER

Los Angeles (1992)

protons (≤ 250 MeV) from synchrotron

3 gantries + 2 fixed beams

NORTHEAST PROTON THERAPY CENTER

NPTC of Mass General Hospital

Boston (2001)

protons (≤ 235 MeV)

cyclotron (IBA)

2 gantries + 2 fixed beams


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Japan 2001

KASHIWA CENTERChiba (1998)

protons (≤ 235 MeV)cyclotron (IBA – SHI)

2 Gantries + 1 hor. beam

HYOGO MED CENTREHyogo (2001)

protons (≤ 230 MeV) - He and C ions (≤ 320 MeV/u) Mitsubishi synchrotron

2 p gantries + 2 fixed p beam + 2 ion rooms

TSUKUBA CENTREIbaraki (2001)

protons (≤ 270 MeV) synchrotron (Hitachi)

2 gantries2 beam for research

WAKASA BAY PROJECTby Wakasa-Bay Energy Research Center

Fukui (2002)protons (≤ 200 MeV) synchrotron (Hitachi)

1 h beam + 1 v beam + 1 gantry

SHIZUOKA FACILITYShizuoka (2002)

protons cyclotron or synchrotron2 gantries + 1 h beam

HEAVY ION MEDICAL ACCELERATOR

HIMAC of NIRS (1995)He and C (≤ 430 MeV/u) 2 synchrotrons

2 h beams + 2 v beams


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CNAO and R&D related

Goal of the TERA foundation!!!!build a Centro Nazionale di Adroterapia Oncologica (CNAO)

CNAOs not available off-the-shelf!!!!design it and make R&D


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CNAO: perspective view

Ministry of Health

Italian Financial Law 2001

20 Millions Euro


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CNAO(-2)

Synchrotron

Treatment rooms


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What should CNAO do

Be a Center of Excellence in hadrontherapy, that is:

Protons and ionsFixed beams and gantriesActive scanning beam delivery systemPatient positioningDosimetry and beam controlResearch rooms (radiobiology,…)(Isotope production,BNCT,…)


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Where and Who will it be

Minister of health has signed the birth of CNAO on march 2nd 2001Will be at Mirasole, few km SW of MilanoIt is being created a Fondazione CNAO that gathers:

Fondazione TERA,NovaraIstituto Europeo di Oncologia,IRCCS,MilanoIstituto Nazionale Neurologico Besta,IRCCS, MilanoOspedale Maggiore, IRCCS, MilanoPoliclinico S.Matteo, IRCCS, Pavia


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Next steps of CNAO

Finalize financing with:Minister of health: 20 MEuroFondazione Cariplo (bank): 20 MEuroFondazione S.Paolo: 10 MEuroRegione Lombardia: 5 MEuroProvincia di Milano: 2.5 MEuroTotal: 57.5 MEuro

Elect the directorate of Fondazione CNAOOpen technical collaborations (INFN, CERN,…)

GOAL: start building January 2002treat first patient January 2006


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R&D:PIMMS


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R&D:PIMMS layout

Hadrontherapy center with no constraints


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R&D:Computer Aided Positioning (CAP)

Markers

Processingunit

Positiondetecting system

Controlroom

Bunker

Opto-electronicMotionAnalysis

2 TV cameras100 Hz sample5mm markers3D accuracy:340±±±±110 µµµµm


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R&D:Light Ion Gantry

4 T

Light weight

Gas cooled superconductor


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R&D:SEM for Low InterceptionMonitoring (SLIM)

vacuum chamber HVsecondary emission foil

beamHV

PROFILE MEASUREMENT

electron detector

CURRENT MEASUREMENT


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R&D:LInac BOoster (LIBO)

Couple a 3GHz linac to a cyclotron

Go from 70 MeV (eye) to 200 MeV (deep therapy) in 14 meters


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LIBO prototype

First module: 62 to 74 MeV

Prototype tested at CERN in December 2000: 30 MV/m


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R&D: Magic Cube

Goal:Check 3D dose distributionsBe fastHave reasonable space accuracy

How:Sampling calorimeterStrip segmented ionization chambersVLSI readout

Hope:Make a commercial device


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A chamber of the Magic Cube

N2 filled ionization chamber25x25 cm2 active area64 strips4 mm wide strips100µµµµm vetronite + 17µµµµm Cu electrodes1mm H2O-equivalent thickness


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Magic Cube at CPO


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A C-ion Bragg peak with the Magic Cube


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Commercial Magic Cube

A Company has taken the project2 Magic Cubes have been sold so far:

Loma Linda University Medical CenterIon Beam Application

Anybody may have one !


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Magic Cube promo


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R&D: TERA-VLSI chip

Recycling integrator architecture64 channels/chip80 fC minimum detectable charge3 µµµµA maximum input currentNo-dead time readout16—bit counters0.8 µµµµm AMS CMOSCommercially available


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Block diagram of TERA-VLSI


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A channel of TERA-VLSI


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Goal:Measure space point (not projections)Be faster Use as dosimeter or beam monitor

How:Pixel segmented ionization chambers (1024 pixels, 24x24 cm2 active area)VLSI readout

Hope:Can it be useful with photons ?

R&D: Pixel Ionization Chamber


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Exploded view of the Pixel Ionization Chamber


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Side view of the Pixel Ionization Chamber


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Fast data acquisition


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Pixel Ionization Chamber(photo 1)


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Uniform C-ion beam (GSI) 10x10 cm2

Inhomogeneity of response before calibration over the full 24X24 cm2:

2.6%


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16 C-ion (GSI) beam spots


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1204 C-ion (GSI) beam spots and comparison

Measured space resolution: 230 µµµµm


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Comparison with PSI proton beam transverse profile

PSI spot scanning proton beamComparison with their measurements


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Pixel chamber for photons ?

IMRT has difficulties with present dosimetersOur pixel ionization chamber is fast and thinWe have started a collaboration with IBA-Wellhofer-Scanditronix to have such a device


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Transverse profile with a 10x10 cm2, 6MV photon beam


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Variable field shapes and the Pixel Ionization Chamber


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Dynamic Multileaf Collimator and the Pixel Ionization Chamber


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Conclusions

Cancer treatment with hadrons is very effective in some pathologiesNumber of patients fully justifies a big dedicated centerCNAO will be built in MirasoleRelated R&D activities are well in progress

The TERA project for hadrontherapy and related R&D...

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