Hadron Therapy: A Physicists View E. Cisbani Italian National - - PowerPoint PPT Presentation

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Hadron Therapy: A Physicists View E. Cisbani Italian National - - PowerPoint PPT Presentation

Sep 10, 2023 169 likes •282 views

Hadron Therapy: A Physicists View E. Cisbani Italian National Institute of Health E. Cisbani VIC 20/Sep/2017 2 From service to value for-money Hadron-therapy (proton and ions) has intrinsic physical properties to precisely

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SLIDE 1

Hadron Therapy: A Physicist’s View

  • E. Cisbani

Italian National Institute

  • f Health
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SLIDE 2

Hadron Therapy

  • Hadron-therapy (proton and ions)

 has intrinsic physical properties to precisely target

the tumors, reducing side effects

 has remarkable biological effects on tumor cells  is relatively expensive

  • Continuously growing

– technologies development – improved physics and biological knowledge – extended cost/benefit and clinical outcomes analyses

From service to value for-money

2 VIC ‐ 20/Sep/2017

  • E. Cisbani
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SLIDE 3

Clinical outcomes depend

  • n how well we know and

control the physics and the biological processes involved in the hadron therapy and how we make them happen

Physics-Biology-Clinics Interplay

3

Physics Biology

VIC ‐ 20/Sep/2017

Machine

  • Design and construction
  • Daily quality checks

Patient Preparation

  • CT (PET) imaging
  • Positioning/Alignment
  • Immobilization
  • Treatment Planning

Treatment

  • Continuous

monitoring

  • Stop at

prescribed dose

Assessment

  • On‐line /

Offline imaging

  • E. Cisbani
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SLIDE 4

Hadron-therapy facility

4

CNAO Layout

(Circular) Accelerator Beam Trasport Beam/Dose Delivery Treatment Room Patient positioning and verification

Treatment planning

Adapted from Bohlen et al. 2013

Control System Patient Data Management

Beam Physics Characterization

Quality Assessment …

Costs (keuro) Capital Oper./year Fraction Treatment Carbon+Proton 140000 37000 1.1 10‐30 Proton 95000 25000 0.7 12‐39 Photon 23000 10000 0.2 4‐18

VIC ‐ 20/Sep/2017

Costs analysis from

  • A. Peeters et al.,
  • Rad. & Onc.

95 (2010) 45‐53 Surgery: 14‐57 kUSD Pharmacologic: 1‐120 kUSD Note: cost/treatment strongly depends on tumor and modality

  • E. Cisbani
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SLIDE 5

New acceleration technologies: Linear Accelerator, Superconducting, FFAG, Laser Acceleration, Dielectric Wall Accelerator

Current developments directions

5

Reducing system costs

Smaller weight Lower power needs Smaller size Simpler procedures

Improved assess‐ ment Optimal dose delivery Accurate quality assurance Improved planning

Dielectric Wall Accelerator Caporaso et al. (2009) Artistic view

A dream device (single room facility)

VIC ‐ 20/Sep/2017

  • E. Cisbani
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SLIDE 6

TOP—IMPLART project

 Compact and lightweight  Radiation clean, reduced shielding  Power efficient  Very Modular: customizable according to needs; can be in operation during its construction  Performances: all physics properties (energy, intensity, direction, …) of the particle beam can be varied quickly and actively offering improved precision and larger flexibility on dose delivery to the patient (e.g. optimal intrafraction motion control)  Only single ion type can be accelerated  Never used before for therapy (but physical modality similar to photon therapy)

Linear Accelerator for Proton Therapy

6 VIC ‐ 20/Sep/2017

Estimated Capital costs: 40‐70 MEuro

  • E. Cisbani
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SLIDE 7

LinAc for Proton Therapy becoming real

7

Already in operation for:

  • Beam and diagnostics characterization
  • Radiobiology studies
  • Cultural heritage analyses
  • New development (e.g LiF dosimetry)
  • Radioprotection optimization studies

Already in operation for:

  • Beam and diagnostics characterization
  • Radiobiology studies
  • Cultural heritage analyses
  • New development (e.g LiF dosimetry)
  • Radioprotection optimization studies

Status: Energy: 35 MeV (150 MeV in 3 years) Current/Pulse: 30 uA

TOP‐IMPLART facility Projects on LinAc for PT: LIGHT, Erha, TOP‐IMPLART

VIC ‐ 20/Sep/2017

Current development total costs: 6 Meuro

  • E. Cisbani
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SLIDE 8

Robust Treatment Planning

Physics Processes

  • Tracking particles in

heterogeneous matter

Biological Effects

  • Tumor and Normal

Tissue Biological / Personalized Response

Planning System

  • Decision support (AI)
  • MonteCarlo methods
  • Computing Power

Imaging of the patient Radiobiology data Anatomic and Functional Imaging of the patient Detailed and validated accelerator description nuclear physics data Accurate (few %) and extended low energy nuclear physics data

8

The optimal exploitation of a very accurate equipment needs to tackle all details of the involved processes and a carefull plan

VIC ‐ 20/Sep/2017

  • R. Grün et al., Med. Phys. 2013
  • F. Tommasino et al. Cancers, 2015

GPU: from games to crucial applications

  • E. Cisbani
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SLIDE 9

System System

Accelerator Accelerator Diagnostic Devices Diagnostic Devices Redundancy and Safety Redundancy and Safety

Planning Planning

Quality Control Quality Control Imaging Imaging Modeling Modeling MonteCarlo (computing) MonteCarlo (computing)

Treatment Treatment

Delivery modality Delivery modality Delivery control Delivery control Intra‐fractional Motion control Intra‐fractional Motion control

Assessment Assessment

Online Dose Delivered Verification Online Dose Delivered Verification Montecarlo validation Montecarlo validation

Nuclear Science and Technologies

9 VIC ‐ 20/Sep/2017

play a major role in many key aspects of hadron radiation therapies and their improvements are substantial for the ultimate benefit of the patients

  • E. Cisbani
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SLIDE 10

10 VIC ‐ 20/Sep/2017

Thank You

  • E. Cisbani