Session 4 Summary Ugo Amaldi Ken Peach (Co-chairs) Geneva, 29 th - - PowerPoint PPT Presentation

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Session 4 Summary Ugo Amaldi Ken Peach (Co-chairs) Geneva, 29 th - - PowerPoint PPT Presentation

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Session 4 Summary Ugo Amaldi Ken Peach (Co-chairs) Geneva, 29 th February 2012 http://www.ptcri.ox.ac.uk Ken.Peach@ptcri.ox.ac.uk Programme Ken Peach ICTR-PHE 2012 Session 4 Summary 29 th February 2012 2 Novel Techniques in Proton

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http://www.ptcri.ox.ac.uk Ken.Peach@ptcri.ox.ac.uk

Session 4 Summary

Ugo Amaldi Ken Peach (Co-chairs) Geneva, 29th February 2012

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 2

Programme

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 3

Novel Techniques in Proton Therapy

  • Why do we need new techniques?

– Improved clinical outcomes

  • Better tumour control
  • Reduced side effects

– Improved patient experience

  • Reduced treatment times
  • Fewer complications
  • Improved quality of life

– Better “value for money”

  • Reduced cost of treatment
  • Reduced cost of treating late effects

Marco Schippers/PSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 4

How or What to Improve?

Marco Schippers/PSI

& cost

s

Two

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Novel Techniques in Proton Therapy

Marco Schippers, ICTR-PHE 2012, Geneva, February 28, 2012 5

…and One Low:

  • Low Price

=> Reduction

  • f size

The Five High’s:

  • Higher quality
  • Higher accuracy
  • Higher flexibility
  • Higher intensity
  • Higher energy

Need for novel techniques in proton therapy: Do not treat tomorrow’s patients with yesterday’s proton technology !

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 6

Comments

  • 1. The more we know

the more we need to know … and the more accurately we need to know it

  • 2. We do not know

how close we are to the optimum treatment

and so

we do not know the scope for improvement

We need novel technologies

to realise the potential of Ion Beam Therapy

probably ….

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 7

THE ACCELERATOR

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 8

The Accelerator options

Marco Schippers/PSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 9

Today’s technology can be improved

  • Cyclotrons
  • Synchrotrons

Marco Schippers/PSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 10

Examples

David Meer Christian Hilbes Silvan Zenklusen (PSI)

30 20 10 Proton beam deflection in water

Marco Schippers/PSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 11

New developments

  • Old ideas,

new implementations

Marco Schippers/PSI Degiovanni/TERA

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 12

New ideas

  • Laser plasma accelerators

– ultrashort bunches same as conventional bunches

  • only dose matters

at the cell level! in vivo???

Laschinsky/Oncoray

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 13

New beams

  • Very High Energy Electrons
  • Dose distributions

?

Seitz/Glasgow

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 14

ACCELERATOR TO PATIENT

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Can we make it better?

— As usual we want everything and its

  • pposite at the same time…
  • Small aperture final magnet to lower power

consumption, but scanning upstream

  • Small radius, but space around isocenter
  • Light magnets, but possibly non

superconducting

  • Maximum performance, but cheap
  • …
  • M. Pullia – Carbon ion gantries – ICTR-PHE 2012

15

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 16

Delivering to the patient

  • Beam Transport & Gantries

Pullia/CNAO Large aperture dipole: weight and power consumption Large gantry radius and large room size

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 17

The “Reisenrad” gantry

Pullia/CNAO

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 18

Organ motion in radiotherapy

Gas Prostate

Gut motion

Scale: minutes

Heart beat

Scale: seconds

  • A. Constantinescu

Friday, 9:30h

  • A. Rucinski

Friday, 16:12h

Bert/GSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 19

Mitigation Techniques

Bert/GSI

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Novel Techniques in Proton Therapy

Marco Schippers, ICTR-PHE 2012, Geneva, February 28, 2012 20

Possible solutions:

  • Gating
  • Adaptive scanning

(tumor tracking)

  • Fast rescanning
  • rgan / tumor motion

Organ motion

Schippers/PSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 21

Organ Motion Summary

Bert/GSI

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 22

Novel dosimetry

General purpose device for low currents (nA) and high currents (µA) continuous and pulsed beams based on a sensing fibre moved through the beam

  • S. Braccini et al., 2012 JINST 7 T02001 and arXiv:1110.1583

Braccini/Bern

H- at 2 MeV, pulsed at repetition rate 50 Hz, average current 0.8 µA, cross section at the detector ≈1 cm2 (circular)

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 23

IN THE PATIENT

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 24

Optimising treatment planning

Radio-resistant tumors

(e.g. hypoxic tumors)

need

higher doses

for

same effect

  • xygen enhancement ratio (OER)

Reduces total dose to normal tissue? Sellner/MPI Heidelberg

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 25

Fragmentation - incidental harm

12C (400 MeV/u) on water

Bragg-Peak Dose over the Bragg Peak : p ~ 1-2 % C ~ 15 % Ne ~ 30 %

TPC MUSIC IV TOF WALL Neutron detector Interaction region ALADIN MAGNET

Beam Beam

Patera/Rome & INFN

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 26

What is the “best” ion?

Total energy deposited per beam kinetic energy Chin/CERN

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 27

“Escapes” may be useful

  • But the challenge is to make them useful

Chin/CERN

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 28

Simulation: how much detail?

  • The body is not water!

– Beam interacts with atoms

  • 1010-1011 cells

– Beam interacts with DNA

Chin/CERN Karamitros/Bordeaux

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 29

GEANT4-DNA: tracking + radiation biology

Karamitros/Bordeaux

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 30

GENAT4 challenges & solutions

Karamitros/Bordeaux

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 31

Some results …

Karamitros/Bordeaux

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 32

SUMMARY OF THE SUMMARY

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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 33

Novel Techniques in Proton Therapy

  • Why do we need new techniques?

– Improved clinical outcomes

  • Better tumour control
  • Reduced side effects

– Improved patient experience

  • Reduced treatment times
  • Fewer complications
  • Improved quality of life

– Better “value for money”

  • Reduced cost of treatment
  • Reduced cost of treating late effects
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Ken Peach ICTR-PHE 2012 Session 4 Summary 29th February 2012 34

Novel Technologies

  • Optimum approached asymptotically

– The first 80% is “easy” – The next 16% “needs thought”

  • The last 4% “is difficult”
  • How near are to the optimum?

– Probably still quite far away – Need new ideas, better technologies

  • Lots more ideas on the posters

– and room for much more

  • Thanks to all contributors!