Developments in Particle Therapy using Nuclear Science and - - PowerPoint PPT Presentation

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Developments in Particle Therapy using Nuclear Science and - - PowerPoint PPT Presentation

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WIR SCHAFFEN WISSEN HEUTE FR MORGEN Marco Schippers, Paul Scherrer Institut, Villigen Developments in Particle Therapy using Nuclear Science and Technology Helsinki, NUSPRASEN workshop, November 26, 2019 Helsinki, Nov 2019 1

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WIR SCHAFFEN WISSEN – HEUTE FÜR MORGEN

Helsinki, Nov 2019 1

Developments in Particle Therapy using Nuclear Science and Technology

Marco Schippers, Paul Scherrer Institut, Villigen Helsinki, NUSPRASEN workshop, November 26, 2019

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NUSPRASEN-workshop Marco Schippers, PSI Helsinki, Nov 2019 2

  • Proton Therapy
  • Recent developments in dose delivery and p.th.-accelerators
  • Current major topics of research:

Treatment when organs are moving High intensity Proton range determination

3.3.2

OUTLINE

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NUSPRASEN-workshop Marco Schippers, PSI Helsinki, Nov 2019 3

X-rays

lung

heart

Spinal cord

Protons

lung

heart

Spinal cord

pictures: Medaustron

Proton beams

from 3 directions

X-ray beams

from 7 directions

Why Particle therapy?

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Proton therapy facility

accelerator

IBA

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Accelerators for Proton therapy

Cyclotron Synchrotron

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Recent Developments in dose delivery and accelerators

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Dose delivery techniques

Collimator Scatter syst.

Scatter technique: From nucl physics lab: Pencil Beam Scanning

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compact “Gantry-1” at PSI (1996)

4 m

Eros Pedroni

scanning proton pencil beam

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Typical Gantry ~1996…

Schär Engineering - Munich

Roberts Proton Therapy Center Philladelphia

10-12 m

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ProNova Toshiba, NIRS

NEW: gantries with SC magnets

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Proton SC Gantry (PSI)

Energy acceptance = ± 30%

 NO Magnetic Field change for tumors 15-30 cm

NEW: optics in SC gantry design

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Kicker

Vary depth: adjust beam energy

Degrader unit

All following magnets: 1% field change (5mm) in 50-80 ms (PSI) Steerer Q Q Q

graphite multi-wedge degrader  238-70 MeV

250 250 MeV Cyc yclotron

E- change ges with Cyclot

  • tron
  • n

Gaphite  Boron Carbide Less scattering less losses at low E

recent development:

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NUSPRASEN-workshop Marco Schippers, PSI Helsinki, Nov 2019 13

#

Energy is set per spill

1 spill: several spills

recent development: Energy adjustable during extraction

NIRS: Y. Iwata et al., MOPEA008, Proc. IPAC’10

E-change ges with Synchrot

  • tron
  • n

Vary depth: adjust beam energy

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cyclotrons in proton therapy

IBA (1996) , SHI Isochronous Cyclotron Varian (2005) Isochronous Cyclotron IBA (2018) Synchrocyclotron MEVION (2013) Synchrocyclotron

Pulsed beam: Limits speed in dose delivery

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AVO, ADAM: A. Degiovanni et al. 2016

In Production: Linac 230 MeV

Spin-off from TERA and CERN: Coupled Cavity Linac 230 MeV

E-change by: switching on/off power of cavity units

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Laser driven proton accelerator

thin foil, doped with hydrogen Laser light

  • +
  • +
  • +
  • -
  • -
  • +

++ + + + ++ + ++ + + +

Laser light creates plasma and pushes electrons out

Electric field from electrons pulls protons out of foil O OO O O O OO O OO O O O

  • now used:

6x1017 W/mm2 Pulsed at low rate

protons

C.M. Ma, Laser Physics, 2006, Vol. 16, No. 4, pp. 639

But: more research needed for:

  • 100x more power (for Ep)
  • MUCH higher pulse rate
  • better energy spectrum
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Current major topics of research

Treatment with moving organs High intensity + verification Range determination

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Possible solutions:

  • Gating
  • Adaptive scanning

(tumor tracking)

  • Fast (+ rescanning)
  • rgan / tumor motion

Organ motion

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Fast pencil beam scanning

0 time (ms) 10 intensity

  • Cont. scanning “TV” mode

kHz-Intensity modulation

7 s for a 1 liter volume.

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High intensity:

  • Reduces motion problems
  • FLASH irradiation: 0.03 Gy/s  40 Gy/s

To be modified:

  • Source / accelerator / beam transport
  • How to verify?

Current major topics of research

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CCD camera proton pencil beams Light emitting Screen

  • r ….gas scintillation

with a GEM beam delivery system

scanning beam monitor

Sjirk Boon (1996),

Advantages of gas scintillation: No quenching at low E Very fast (s)

Enrica Seravalli (2003)

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Particle range in tissue

Current major topics of research

Particle beams are sensitive to

  • CT Hounsfield number  Stopping Power accuracy
  • Organ motion
  • Change of patient’s anatomy

 Uncertainty in range in patients ~3% ….. but impossible to measure range directly  Various methods are in development

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Proton range in tissue

CT images: based on X- ray interaction.  Calibration to stopping power is needed  Range error from CT calibr ~1% CT - Hounsfield nr

Effect of: CT

protons: Range 2 cm less X-rays: Dose drops 11%

Effect of: 3 cm bone

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Protons create activation in tissue

11C 13N

Paans and Schippers, IEEE 40(1993)1041

Range measurements

CURRENT STATUS:

  • Need to know tissue constituents and predict PET signal
  • Compare measured signal with prediction
  •  accuracy ~3mm
  • but new developments are coming……

 Measure PET Activity!  3D activ.image Dose

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Range measurements

e.g.: Verburg et al., PMB 60(2015)1019

CURRENT STATUS:

  • Dependent on E selection
  • Know tissue constituents
  • Accuracy of range change: ~1mm

prompt  patient

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U.Scheider and E.Pedroni

  • Med. Phys. 22(1994), 353

Residual range  E-loss = Integrated stopping power along track

Proton radiography Range measurements

CURRENT STATUS:

  • Range accuracy: ~1%
  • Proton CT:  3D stopping power

Mumot et al, PMB (2010).

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  • Lower price (50%)

 (SC) Magnets + Acc.

  • Faster (x …100)

 Acc. + Nucl techn.

  • Motion detect., imaging

 Nucl. Techn.

  • Range detection

 Nucl. Techn.

What developments are needed and where can Nuclear Technology contribute?

Conclusions

But take care when implementing new developments:

  • Do not propose a solution looking for a problem
  • Proven idea  clinic takes 10-20 years
  • Long term (>20 yr) commitment: service / upgrades…
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Thank you for your attention

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