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The CNAO Foundation
No profit organisation (Foundation) created with the financial law 2001 to build the National Center for Hadrontherapy designed by TERA Foundation
Fondazione Policlinico Ospedale Maggiore - Milano Fondazione Istituto Neurologico C. Besta - Milano Fondazione Istituto Nazionale dei Tumori - Milano Istituto Europeo di Oncologia - Milano Fondazione Policlinico San Matteo - Pavia Fondazione TERA - Novara
Istituto Nazionale di Fisica Nucleare Università di Milano Politecnico di Milano Università di Pavia Comune di Pavia
Origins - History
1990 – U. Amaldi and G. Tosi have the idea of promoting hadrontherapy in Italy 1992 – TERA Foundation is founded 1993 – ATER experiment at INFN 1996 – PIMMS starts 2000 – 2001 the CNAO foundation is created within the Financial Law 2003 – CNAO gets the project and hires the design group
Aim of the Center
AIM OF THE PROJECT To treat deep tumours : •With ion beams in the range 1 ≤ Z ≤ 6 •With active scanning •In approximately 3 min/field •Synchrotron with slow extraction! •Everything safe, proven and/or redundant
When there’s a tumor…
When a body hides a tumor, this needs to be killed. It's a dirty WORK but somebody's gotta do it…
Energy and Efficacy Administered dose 1 Gy = 1 J / 1Kg (typical dose in radiotherapy 35 X 2 Gy) How many cells do I kill? Potential energy (1 m fall = 10 Gy) Heat (fever 38° = 4185 Gy) Ionizing radiation (little energy. many damages) .
and superoxide. O2− . ionization distribution is relevant . Poison for the cell!) The target is DNA.Radiation damage Ionization breaks chemical bonds Free radicals creation (mainly hydroxyl radical. OH−.
Comparison of the depth dose profiles 110 100 90 80 70 Dose [%] 60 50 40 30 20 10 0 0 50 100 150 200 250 300 Carbon ions Inverse dose profile Electrons Photons I ≈ I 0 ⋅ e −μ ⋅ x Depth [mm] .
8 0.Longitudinal .2 0 0 2 4 6 8 10 12 14 16 18 20 Depth [cm] .Spread Out Bragg Peak 1.2 1 Dose [relative units] 0.4 0.6 0.
Macroscopic advantage of hadrons Photons Protons X rays protons Rapid fall-off .
Microscopic advantage of C ions 4 RBE 3 2 1 1 10 100 LET 10 – 20 keV/mm = 100 – 200 MeV/cm = 20 – 40 eV/(2 nm) .
Transverse .Beam delivery .
Scanning beam .
Dose conformation active vs passive Pencil beam Passive system “horns” in healthy tissue Scanned beam .
Controlling and leading charged particles .
Lorentz Force F = q (E + v × B) N C V/m m/s T V E ~ 3 MV/m = 3 106 V/m (dielectric rigidity of dry air) B~1T V < 3 108 m/s Magnetic fields are used to transport charged particles F B .
Magnets Dipoles to bend the trajectory Quadrupoles for focusing .
The CNAO accelerator and lines .
Synchrotron with slow extraction HEBT ECR Sources LINAC Range 3-27 g/cm2 Slow extraction RF Cavity .
LEBT Resolution needed 30 (C and O) H3 Source Monitoring LEBT Chopper .
Sources currents and emittances H3+. 1.4mA (design =450 uA) Emittance measured after spectrometer C4+. 230 uA (design = 150 uA) 21 .
35 m.CNAO RFQ Internal structure Beam input 217 MHz Four-rod like type Energy range = 8 – 400 keV/u Electrode length = 1. Electrode voltage = 70 kV RF power loss (pulse): about 100 kW Low duty cycle: around 0.1% Beam output 22 .
Stripping foils (carbon) C4+ H3+ C6+ p 24 .
offsetting the beam position and angle at the injection point for emittance dilution changing the injected current (movable grids) changing the injected beam momentum spread (debuncher) . 3. 2.MEBT Layout 1.
Intensity degrader 4 transmission levels: 100%. 50%. 10% Keep overall emittance unchanged . 20%.
Multiturn injection Incoming beam Septum The bumper creates an orbit bump collapsing in tens of turns Closed orbit Bumper Bumper First injection – 08-10 First multiturn injection – 08-10 .
Multi turn injection Protons = 1.2) BDI ~30 μs bump duration BDI IMS .6 (Ex/Elinac=3.3) Carbon = 2.9 (Ex/Elinac=2.
1 s LINAC ~20000 μs ~30 μs LINAC quads 1 pulse every 2-3 s LEBT Chopper Debuncher 1 pulse every 2-3 s Injection bumpers .Injection in time ~500 μs 1 pulse every 0.
Synchrotron 7-250 MeV p 7-400 MeV/u C Active beam delivery: change slice energy Slow extraction .
Machine cycle 5s 1s Sync 5 min Extraction lines Injection lines 10 s Extracted beam .
32 Bmin Inj bumper on Multiturn Binj Rf trapping Acceleration Rf jump Rf off Start betatron Machine Cycle Bextr Start hysterestis 12/04/12 End cycle C.LNF. Biscari . INFN Stop betatron Hysteresis cycle Bmax .
data visualization with LabView .Closed orbit during the cycle acceleration Extraction Bumps Rf off = debunching 1sec Pick-Up data acquisition with NI-PXI Chassis.
Extraction We need to distribute the beam on the tumor The beam in the machine is a “bunch” shorter than 1 μs (0.000001 s) It’s like we had an apple to distribute on a trail 100 m long .
Slow extraction “Peeling” the beam Beam Electrostatic septum .
46 Wb Magnetic screen needed .Betatron core Pushes the beam against the resonance ΔΦ = 2.
Empty bucket ΔE Resonance line for low betatron amplitudes Amplitude Resonance region Sense of stack acceleration Resonance line for high betatron amplitudes PHASE .
Air core quadrupole .
Ripple compensation Sampling frequency 10 kHz 100 ms No compensation FeedBack vs FeedForward Empty bucket Empty bucket Empty bucket + air core quad .
Chopper Fast turn on/off for the beam Intrinsically safe Allows beam qualification The chopper stops (and starts) the beam within 200 μs. Used for irradiation of separated parts of slices and for synchronization with breathing. .
Chopped beam .
Beam position requirement .
Beam position at HEBT end Beam position repeatability (at the same energy): 0.3 mm .2 mm Beam position precision (at different energies): 0.
proven and/or redundant .Control system Remember slide #1 AIM OF THE PROJECT To treat deep tumours : •With ion beams in the range 1 ≤ Z ≤ 6 •With active scanning •In approximately 3 min/field Synchrotron with slow extraction! Everything safe.
Control system Cutting edge clinical research center Lots of distributed intelligence and memory on peripheral devices in order to make them autonomous and produce limited data traffic Long-term maintenance and evolution perspective suggest the use of COTS and commercial platforms 250 devices. including NI PXI and NI CompactRIO. almost exclusively with real-time operating system .
with 200 μm of precision . with 100 μm of precision 1 Integral chamber: • Beam Intensity measure every 1 μs 1 Pixel chamber: • Beam position and dimension measure every 100 μs/1 ms.Beam delivery – scanning control Box 1 Box 2 1 Integral chamber: • Beam Intensity measure every 1 μs 2 Strip chambers (X and Y): • Beam position measure every 100 μs.
Scanning . Local Control Room Courtesy of Marco Donetti Control System Scanning Magnets .fast control NI PXI Chassis Monitor (DAQ) Timing System (slow and fast) Interlock Syste.
Dose delivery Giordanengo et al.NIM A613 ..
Artistic use of the beam Radiochromic film 150° Italian Unification Anniversary .
Treatment room .
Milestones MARCH 2005 “first milestone” SEPTEMBER 2010 FIRST BEAM ACCELERATED IN THE SYNCHROTRON OCTOBER 2010 FIRST BRAGG PEAK MEASURED IN TREATMENT ROOM .
Start of medical activities First patient with Proton beam September 22. 2011) .
treatment time. . beam size. vertical line.) ...Conclusions The machine construction is finished Treatments with protons have started Treatments with carbon have started The first protocols will be soon approved There is still a lot of space to improve performances (treatment rooms.
National collaborations TERA Foundation: final design and high tech specifications INFN: co-direction HT. logistics Town of Pavia: land and authorisations Province of Pavia: logistics and authorisation . TPS Polytechnic of Milan: patient positioning. research. radioprotection. formation University of Catania: medical physics The Technical-Scientific Collaborations University of Florence: medical physics University of Turin: interface beam-patient. radiobiology. authorisations European Institute of Oncology: medical activities. radiobiology. formation University of Milan: medical coordination and formation University of Pavia: technical issues. authorisations San Matteo Foundation: medical activities. technical issues.
low-level RF.International collaborations CERN (Geneva): technical issues. control system The Technical-Scientific Collaborations Med-Austron (Vienna): technical collaboration for MA centre Roffo Institute (Buenos Aires): medical and research activities NIRS (Chiba): medical activities. betatron. PIMMS heritage GSI (Darmstadt): linac and special components LPSC (Grenoble): optics. formation HIT (Heidelberg): research activities . radiobiology.
Improving ion gantries .PTCOG 48 .folks 56 Thank you for your attention M.That’s all. Pullia .
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