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Pre-conceptual design of Energy Modulation Ion Therapy (EMIT)

Pre-conceptual design of Energy Modulation Ion Therapy (EMIT). YK Heng Represents EMIT group Institute of High Energy Physics April 30, 2008 @ USTC, Hefei. 主要人员. 总体设计 韦杰 / 方守贤 快循环同步加速器物理设计 焦毅 / 王生 基于直线加速器的注入器 傅世年 回旋加速注入器 唐靖宇

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Pre-conceptual design of Energy Modulation Ion Therapy (EMIT)

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  1. Pre-conceptual design of Energy Modulation Ion Therapy (EMIT) YK Heng Represents EMIT group Institute of High Energy Physics April 30, 2008 @ USTC, Hefei

  2. 主要人员 • 总体设计 韦杰/方守贤 • 快循环同步加速器物理设计 焦毅/王生 • 基于直线加速器的注入器 傅世年 • 回旋加速注入器 唐靖宇 • 环注入、引出、传输线及束流配送 唐靖宇 • 机械系统预制研究 屈化民 • 电气系统预研 张旌 • 旋转机架设计 屈化民/唐靖宇 • 治疗头设计 衡月昆/刘力 • 成像与定位系统 舒航 • 控制及安全联锁系统 上海光源 刘德康

  3. Outline • General introduction with proton/ion therapy • Clinical Requirements and EMIT advantages • Main pre-conceptual design: • Accelerator (Injector, Synchrotron, Delivery ) • Therapy (Gantry, Nozzle, positioning ) • Control and software (TCS, TPS, dose verification ) • Summary

  4. Part I General introduction with proton/ion therapy

  5. Comparison of irradiation therapy 常规放射治疗: 放射源(放射性同位素)产生γ射线: γ刀. 电子直线加速器：电子打靶产生 X 射线 新型放射治疗: 质子及重离子速器: 质子及重离子

  6. Dose and effects comparison • 第24届 (PTCOG)公布的质子治疗适应症主要有六大类: • (1)中枢神经; (2)眼部; (3)头颈部; (4)胸部; (5)腹部; (6)骨盆。 • 例如：T3-T4期前列腺癌症患者，用光子治疗的七年生存率是37%，用质子和X射线复合治疗上升到85%。 • 再如：日本筑波大学曾对122名原发肝细胞癌患者进行质子治疗，七年的局控率和生存率分别为94%和27%，质子治疗不会引起肝功能的有症状（symptomatic）变化。

  7. Demands and status • 20%人死于肿瘤，我国每年至少有240万发病的肿瘤病人，其中适应放疗的病人约为100万人 • 治疗费用：10~20万RMB • 装置费用：3亿~10亿RMB • 世界上,正式运行的约30台，正在建造中或计划建造的粒子治疗装置共有14台。 • 其中美国9台、日本8台、德国6台、法国4台、俄罗斯3台、意大利3台、瑞士3台、南非2台、英国1台、瑞典1台、加拿大1台、奥地利1台、韩国1台。 • 中国1~3台

  8. Part II Clinical Requirements and EMIT advantages

  9. Clinical Requirements P Energy Range in water (MeV) (cm) 100 3.50 126 10.00 155 13.35 186 20.00 200 21.15 225 29.00 250 33.90 • Range in patient：3.5～35g/cm^2 (beam 60~250MeV) • Range Adjustment precision：0.1g/cm^2 • @ 60MeV: 1Mev variation is relative to 1mm depth; • @ 220MeV: 1Mev variation is relative to 2.5mm depth • Average Dose rate：>2Gy/min (Scattering) >20Gy/min (Scanning) • Field size：20cmX20cm • Dose uniformity：±4% • Beam Positioning resolution at isocenter: ± 0.5mm

  10. Comparison of Accelerator technique Refer to RCMS (BNL)

  11. EMIT main parameters

  12. Energy Modulation AC advantages • AC can adjust precise energy: <1MeV, spread <0.2% • Beam intensity modulation: factor of ~ 100 • 7 by chopping the beam to different length (50 - 350 ns). • Another factor of 15 by source current adjustment & collimation • Typical Treatment of 50 mm x 50 mm x 50 mm volume: 1 – 4 minutes • Voxels of 5 mm x 5 mm x 5 mm • 100 pulses per layer with ~ 5 mm steps (~ 4 s per layer) • Energy adjustment (transport & gantry magnets) in 2 s • 10 layers of 1,000 scanning voxels in ~ 1 min. • Respiration synchronization: 3 – 4 times longer treatment time

  13. EMIT layout

  14. Part III Main pre-conceptual design: • Accelerator (Injector, Synchrotron, Delivery ) • Therapy (Gantry, Nozzle, positioning ) • Control and software (TCS, TPS, dose verification )

  15. EMIT-p injector: IS + RFQ + DTL S.N. Fu

  16. EMIT-p rapid cycling synchrotron

  17. J.Y. Tang, J. Qiu, et al Transport and dispatch

  18. Gantry (BNL 2003 design) H.M. Qu

  19. C1 DM 1: SEM Sca.1 Sca.2: Double ring, 6 candidates Energyadjustment. DM2: TIC C2 C3:ML Bolus C4 DM3: 2D Schematic of Scattering Nozzle • Targets: • To make a large field, 1cm beam spot → 20cm therapy field • Energy modulation and spreading • Uniform dose distribution • Efficiently beam using • 2 scattering plates and 1 adjusting plates • 3 dosimeters • 5 collimators beam

  20. Scattering Nozzle: Dual-Ring Double Scattering (1) • Spreading Beam, Sca. Angle Principle: The bigger density and the smaller radiation length, The bigger. Sca. Angle: • 1st Scatter: Pb • 2nd Scatter: double rings, inner: Pb; outer: Al • Energy modulation :Energy lose in material: • 3rd, Energy modulation: Jagged plate The most possibility energy lose is proportional to thickness • Key results: • A: field radius, ~10cm • Beam efficiency: ~40% • Dose Uniform: ~3% • Total length: ~3m • Spreading field • uniform dose • Spreading energy • adjusting energy Range adjusting

  21. Compensator SIC Exit Window SEM Collimator Scanning guide Magnet Schematic of scanning Nozzle • 45°fixed beam,therapy bed can be rotated to make different fields. • X-Y section: spot scanning is realized by magnetic system • Step: 5mmX5mm,by scanning magnet, angle step:2.5 mrad • Spot size: <10mm,controlled by focusing magnet, overlap between spots to unify the field dose distribution • Positioning precision @ isocenter:± 0.5mm, Angle precision: 0.25 mrad • Range modulation (depth) : • Tumor in depth is divided layer by layer • Layer Step: 1mm~10mm, energy varied by AC control WC WC

  22. 3 dosimeters for Scanning Nozzle Refer to Lawrence Berkeley Laboratory • Wire Chamber (WC) : • Just out of beam delivery • Measure the beam profile,resolution: <0.5mm • Measure the total dose • Secondary Emission Monitor (SEM) : • Out of magnet, • used for large proton flux: <2X109 proton within ~50ns /pulse • Segmented IC • just out of the scanning guide. • used to measure the field dose distribution Compensator SIC Exit Window SEM Collimator Scanning guide WC Magnet

  23. Dose monitoring Controls and software D.K. Liu Dose safety monitoring network Hospital Information Systems Medical center Fabrication center CT, PET CT，MRI Pic. Arch. Comm. System Controls & Diagnostics Treatment planning Facility controls Safety interlock Beam diagnostics Treatment control Verification / quality assurance Rf, vacuum, power supply Position, loss, intensity Nozzle Positioning

  24. Summary • Proton/Ion therapy is a big opportunity and challenge • Rapid cycling synchrotron is the technology of choice for EMIT-p due to: • Relevance to flexible energy modulation and 3D point scanning for stereo-tactic therapy • Similarity with CSNS technology R&D • Roadmap: a continuous upgrade path • From fixed port to gantry • From scattering to spot scanning (position & energy scan) • From proton to carbon/proton dual facility • From 25 Hz to 50 Hz repetition rate; shorter treatment time • From demo to marketable production • Pre-conceptual design are finished.

  25. Thanks for your attention !

  26. 质子与碳离子作比较(1) • 在剂量分布和物理特性上碳重离子优于质子。碳离子和质子都具有Bragg峰物理特性，但凡原子系数越大，其Bragg峰宽度越狭，后沿下降越快，剂量分布越能集中在肿瘤部位上。 • 在生物特性上，碳离子能直接切断DNA双键功能，能直接杀死肿瘤细胞，质子只能切断DNA單键功能，质子难于有效治疗抗阻型和乏氧型癌细胞 • 在照射剂量的提升上，碳离子比质子有利 .

  27. 质子与碳离子作比较(2) • 碳离子12C在行程中会发生核分裂现象，将变成11C 或10C。在Bragg峰后形成一个小尾巴，往往对峰后的正常(或敏感)组织带来伤害，也会稍微增加横向散射和陰影 . • 由于碳离子重量过大，从而使被照射的肿瘤区，从微观上看始终存在某些癌细胞没有照射到的冷点。在今后有复发的可能。 • 质子共治疗了近5万名肿瘤患者，积累了大量丰富的临床经验，一般治疗有效率达到95% 以上，五年存活率高达80%。碳离子有治疗病例4千名左右。 • 质子治疗设备约需2-3亿元的投资，建造周期需2-3年之久。 但碳离子治疗所需的加速器及其相应的设备规模则更大，技术更为复杂，投资约为质子治疗的三倍之多。 It is unclear if carbon is better than protons, but the Japanese are sold on it. (The RBE is perhaps the most important aspect.) The Americans are going only for protons. by Andrew M. Sessler

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