HIMAC

NIRS

Cancer Treatment by Charged Particles

- Carbon Ion Radiotherapy – Part 2

HIMAC

NIRS

Takeshi Murakami Research Center of Charged Particle Therapy

National Institute of Radiological Sciences

2012.07.04-5

HIMAC

NIRS

Medical application of accelerators

Requirements

1. Stable, reliable, easy operation and maintenance

• Ion source, injector, main ring, irradiation system etc.

(same way as water from a faucet…)

2. Precise irradiation system

• Patient positioning

• Respiration motion compensation

3. Small inexpensive facility!

• accelerators

• Irradiation system

Satisfied!

???

HIMAC

NIRS

Design Consideration for Compact Facility

What Ion Species? Carbon!

1. Scanning or Broadbeam?

2. How high the Energy ?

3. How large the Irradiation-Field Size?

4. How high the Intensity?

5. Consequently, how large the Facility?

Based on experience at HIMAC, the specification is determined!!

HIMAC

NIRS

How high a beam energy should be?

Residual range of 250 mm covers almost all treatments at HIMAC.

Required energy: 400 MeV/n, with an additional range of 25 mm required for the scatterer etc.

0

100

200

300

400

500

600

700

800

900

～20 80～100 160～180 240～260

Residual Range (mm)

Head&Neck

Brain

Lacrimal gland

Esophagus

Lung

Linver

Pancreas

Bone&SoftTissu

Prostate

Uterus

Digestive duct

Others

HIMAC

NIRS

How large a field size should be?

The field of 200 mm in diameter is large enough to cover almost all treatments in HIMAC.

0

100

200

300

400

500

600

700

800

900

～10 60～70 120～130 180～190

Field Diameter (mm)

Head&Neck

Brain

Lacrimal gland

Esophagus

Lung

Linver

Pancreas

Bone&SoftTissu

Prostate

Uterus

Digestive duct

Others

0

100

200

300

400

500

600

700

800

900

10～20 60～70 110～120

SOBP Size (mm)

Head&Neck

Brain

Lacrimal gland

Esophagus

Lung

Linver

Pancreas

Bone&SoftTissu

Prostate

Uterus

Digestive duct

Others

The SOBP with a depth of 150 mm covers treatments more than 95%.

HIMAC

NIRS

Specification of the Compact Carbon-Therapy Facility

1. Ion species: high LET (100keV/μm) charged particle - Carbon

2. Range: Max. 25cm in water

3. Maximum irradiation area: 15cm square

4. Dose rate: 5Gy/min/l 1.2×109pps (C ions)

5. Irradiation direction : horizontal, vertical

6. Treatment rooms: 3 (H&V, H, V)

7. Irradiation technique: gating & layer stacking irradiation

1. Accelerator systems and Irradiation systems : High reliability, stability, reproducibility, easy operation, easy maintenance and absolute safety

2. The other requirements : - Precise beam delivering - Easy beam tuning in a short time within a few minutes - Accurate dose measurement and control - Fail-safe system

Furthermore how can

we reduce the size?

Optimize for

Carbon beams

HIMAC

NIRS

Compact Therapy Facility

Train Detailed design and R&D was

completed in FY ’05. Its size is

downsized to 1/3 compared with

HIMAC.

HIMAC

NIRS

Compact Injector Linac Cascade

An ECR ion source employs permanent magnets. The injector linac cascade consists of RFQ and APF-IH linac. The RFQ accelerates C4+ ions from 10 to 600 keV/n. The IH linac accelerates them to 4 MeV/n. The operation frequency is 200 MHz for both linacs.

APF IH-DTL

HIMAC

NIRS

Development of ECR source

Compact ECR ion source with all permanent magnets

1. Mirror magnetic field was copied from NIRS-ECR

2. Traveling-Wave-Tube amp. was chosen for fixed magnetic field

3. Enough insulation for carbon ion production

• Diameter 300mm

• Mirror field 0.87, 0.25, 0.59 T

• Permanent magnet NdFeB

• Max. surface field 1.1 T

• Microwave 8 - 10 GHz, 300 W

M. Muramatsu will contribute in ICIS05!

HIMAC

NIRS

Beam Test of Compact Injector

RFQ APF-IH

ECR

Analyzer

0

50

100

150

200

250

300

350

400

450

29.5 30 30.5 31 31.5 32 32.5 33

Pick-up voltage for IH-DTL (V)

FCN

2 (

eμ

A)

0

10

20

30

40

50

60

70

80

90

100

Tra

nsm

issi

on

(%

)

FC2

Transmission (%)

Kinetic energy distribution for 12

C4+

0

5

10

15

20

25

30

35

40

45

3.97 3.98 3.99 4 4.01 4.02 4.03

E (MeV/u)

dI/

dE (

arb

. u

nits)

0.44m

HIMAC

NIRS

Synchrotron

SXD

SXD

SXFr1

SXF

BMPf2

BMP1

SXDr1

BMP2

SM1 SM2

QD

ESD

BMPf1

BMP3

V-CR 6

H-CR 6

SXFr2

SXF

SXDr2

RF-KO

RF-Cavity

QF

H-CR 1

H-CR 2

H-CR 3

H-CR 5

V-CR 1

V-CR 2

V-CR 3

V-CR 4

H-CR 4

V-CR 5

ESI

BM

SM

QDS1

QDS2

DCCT

SPRN

FCN

Injection

Extraction

SXD

5m0

Lattice Type FODO

Maximum intensity of C6+ 1.2×109 pps

Cell number 6

Long straight section 3.0m×6

Circumference 61.5m

Injection energy 4 MeV/u

Extraction energy 140 - 400 MeV/u

Revolution frequency 0.450 - 3.483 MHz

Emittance and Δp/p

of injection beam

10 π mm mrad

±0.2%

Acceptance

(after COD correction) 240/30 π mm mrad

Momentum acceptance ±0.4%

Qx /Qy 1.68-1.72/1.23

Maximum β function 11.5/13.4

transition gamma 1.72

ξx/ξy -0.5/-1.5

Shorten the straight line.

Specification

HIMAC

NIRS

Compact RF Cavity

Comparison between HIMAC cavity

HIMAC New cavity

Frequency [MHz] 1 ~ 8 0.4 ~ 7

Voltage [kV] 6 4.5

Power [kW] 15 8

Cavity size [cm] 277×89 150×140

Size of PS etc Amp. with Tetrode

70×40×60

250×150×250

70×70×90

Bias PS

100×100×200

Transister Amp.

60×85×220

Un-tuned RF cavity with Co-based MA

HIMAC

NIRS

Gunma University Heavy-Ion Medical Center

HIMAC

NIRS

Adjacent to Shin-Tosu Station

HIMAT

Shin-Tosu

To Fukuoka

To Kumamoto, Kagoshima

SAGA-HIMAT

To Saga, Nagasaki

Shin-Kansen Railway

near to Tosu high way junction Fukuoka

Tosu

HIMAC

NIRS

Facilities in Japan

Hyogo

(2001)

Chiba

(1994) Heavy ion

Heavy ion (under construction)

Proton

Proton (under construction)

Other plans (not funded)

Gunma

(2010)

Kanagawa

(2014)

Tosu

(2013)

HIMAC

NIRS

Heavy ion radiotherapy worldwide

Chiba

Gunma

Hyogo

Lanzhou

Busan

Darmstadt

Lyon

Wiener Neustadt

Pavia

Heidelberg

Rochester

Kanagawa Tosu

Shanghai

Heavy ion

Heavy ion (under construction)

Proton

Proton (under construction)

Heavy ion (planning)

Penang

Taipei

HIMAC

NIRS

Quick change of the target

840cc 69cc

(a) (b)

Change of target position and shape @PSI Large change of target size and shape

during the treatment process

Change the treatment planning, and bolus, collimator

-> 4-5 days are necessary for machining, transport, inspection

HIMAC

NIRS

Motivation of New Treatment Facility

1 day!

1 day treatment is possible

Adaptive Cancer Treatment

diagnosis and treatment in a short period

HIMAC

NIRS

scatterer

Patient collimator Bolus Ridge filter

Broad beam

Scanning

Wobbling magnets

Scanning magnets

range shifter

Irradiation Methods

HIMAC

NIRS

Comparison of scanning and broad beam method

Broad beam: matured

technology!

Scanning Broad beam

Dose distribution excellent good

Moving target No Yes

Irradiation time long short

Dose control Elaborate Easy

Bolus, collimator No Yes

Beam position < 0.2mm ~ 2 mm

Beam size Control No control

Intensity Low High

long treatment time

no moving target

sensitive to the device error

scanning

New scanning system must be

developed.

HIMAC

NIRS

100 120 140 160 180 200

-40

-20

0

20

40

Non-gating Gating

Gating with rescanning (8 times)

100 120 140 160 180 200

-40

-20

0

20

40

100 120 140 160 180 200

-40

-20

0

20

40

0

0.1

0.2

0.3

0.4

0.4

0.5

0.6

0.7

0.8

0.9

1.0

1.1

1.1

Motion：7mm in gate

Simulation of moving tumor irradiation

Irradiation on Moving Tumors

In order to avoid hot/cold spot due to

target motion, we decided to employ

“gating method” with rescanning.

Example:

Φ40mm

spherical target

stts 2,3/cos3.317.1)( 4

HIMAC

NIRS

R&S of Fast Scanning System

New control system

HIMAC SB course

Scanning

R&D port

1. Fast scanning system

2. Respiratory motion

HIMAC

NIRS

Fast Scanning

SMx

SMy

Beam

0.0

0.20.4

0.6

0.8

1.0

-50

0

50

0.0

0.2

0.4

0.6

0.8

1.0

0 200

-50

0

50

Example: B&ST

@Extended FT

HIMAC

NIRS

Operation pattern of synchrotron

0 200 400 600 800 1000 1200 1400 1600 1800 20000

10

20

30

40

50

60

nu

m.

of

po

rt

PTV (cc)

Manipulate synchrotron

1 spill （2×1010 particles） corresponds to 15

GyE on 300cc target!

-> Most of the treatments require 1 spill !

time

time

Fixed period

Extension of the flat-top

First half of 2006

300cc injection

acceleration

extraction

extraction

acceleration

injection

HIMAC

NIRS

Extension of the flat-top

0 10 20 30 40 50

0

2

4

-2

-1

0

1

2

0

1

2

3

4

Inte

nsity

Time (s)

Be

am

po

sitio

n (

mm

)

Horizontal

Vertical

Be

am

siz

e (

mm

)

Horizontal

Vertical

Size Position Intensity

Position, size , intensitｙ -> stable?

HIMAC

NIRS

Scanning with extended Flat-Top

SMx

SMy

Beam

Syn. BM

Fluorescent screen

plan 1. Treatment planning for fast scanning ⇒ ×5

2. Modification of acc. operation ⇒ ×2

3. Fast scanning magnet ⇒ ×10

We can save the dead time of synchrotron operation.

HIMAC

NIRS

11-steps Energy Operation

1400

1200

1000

800

600

400

200

0300025002000150010005000

1150

1100

1050

1000200019001800170016001500

40ms

150ms

40ms

t (ms)

I(B

M)

(A)

11-step Energy: 430, 400, 380, 350, 320, 290, 260, 230, 200, 170 and 140

Tune: (Qh, Qv) = (3.68, 3.11)

HIMAC

NIRS

New Particle Therapy Research Facilities

○3D Scanning with Gating (H&V): 2 rooms

○Rotating Gantry : 1 room

Iso-center0 1 2m

SMxQM SMy

Monitors

RGF

RSF

Wall

PRN1 PRN2

9.0 m3D Scanning

New treatment facility

HIMAC building

Hospital

Research Building for Charged Particle Therapy

HIMAC

NIRS

Rotating Capsule

28 - 32GyE (1 fraction)

03/4 ~ 06/3 54 – 79.2GyE (9 fraction)

97/9 ~ 00/12

52.8 - 60GyE (4 fraction)

00/12 ~ 03/11

59.4 – 95.4GyE (18 fraction)

94/10 ~ 97/8

× burden on patients

× complicated treatment planning due to deformation

of organs

HIMAC

NIRS

Rotating Gantry with Super-Conducting Magnets

-10

0

10

20

30

40

50

Beta

an

d d

isp

ers

ion

fu

ncti

on

(m

)

x

y

Dx

-10

0

10

20

30

40

50

Beta

an

d d

isp

ers

ion

fu

ncti

on

(m

)

0 5 10 15 20 25 30

-10

0

10

20

30

40

50

Beta

an

d d

isp

ers

ion

fu

ncti

on

(m

)

s (m)

(c)

(b)

(a)• 3D scanning

• Field size： 150 mm

• Max SOBP： 150 mm

•Max energy： 400 MeV/u

• respiratory mot.： OK

• ～250 ton

HIMAC

NIRS

New Particle Therapy Research Facilities

HIMAC

NIRS

New Particle Therapy Research Facilities 1F

HIMAC

NIRS

New Particle Therapy Research Facilities 1F

HIMAC

NIRS

New Particle Therapy Research Facilities 1F

HIMAC

NIRS

New Treatment Couch, Robotic Arm

HIMAC

NIRS

Requirements for the therapy at HIMAC

- Ion species: high LET (100keV/mm) charged particles

He, C, Ne, Si

- Range: 30cm in soft tissue 430MeV/u (C)

800MeV/u(Si)

- Maximum irradiation area: 22cm in diameter

- Dose rate: 5GyE/min 2×109pps

- Beam direction: horizontal, vertical, etc...

-> “large accelerator”, being rare in the world

HIMAC

NIRS

Weekly Schedule

–Monday

•Maintenance

–Weekdays

(Daytime)

•Therapy

–Weekdays (Night)

and Weekends

•Experiments

Mon Tue Wed Thu Fri Sat Sun

Upper Ring

Lower Ring

Linac

Application Therapy Biology Physics or others

Maintenance (No Beams)

HIMAC

NIRS

Specifications of the HIMAC facility

Ion source PIG, 10GHz-ECR, and

18GHz-ECR

8 keV/nucleon

Ion species: p to Xe

Injector RFQ linac (0.6 m f x 7.3 m long) 800 keV/ nucleon

Alvarez linac (2.2 m f x 24 m

long)

6 MeV/ nucleon

Main accelerator Synchrotron (42 m ) 2 rings 100 - 800 MeV / nucleon

repetition rate: 3.3 seconds

Irradiation rooms 3 treatment rooms

4 experiment rooms

Time Sharing Acceleration +

Pulse Magnets

General-physics experiment

room

Secondary beam experiment

room

Biology experiment room

Medium-energy experiment

room

2 experiment rooms

He to Ar

HIMAC

NIRS

Cut-away view of HIMAC

HIMAC

(Heavy Ion Medical Accelerator in Chiba)

Clinical trials using

carbon beams

130m

3 ion

sources

Pulse operation

Time sharing

acceleration

Two identical

rings

HIMAC

NIRS

Experiment rooms (HIMAC B2F)

Secondary beam

experiment room

Medium-energy

experiment room

General-physics

experiment room

HIMAC

NIRS

General-Physics Experiment Room

PH2

HIMAC

NIRS

Biology experiment room (HIMAC 2F)

Biology experiment room

HIMAC

NIRS

Biology Experiment Room

samples

HIMAC

NIRS

Time Sharing Acceleration

Injector

Upper

Ring

Lower

Ring

C Ar Xe

MEXP

Direct use

3.3sec

HIMAC

NIRS

The hours of operation, FY2011

0

1000

2000

3000

4000

5000

6000H

our

s in

FY20

11

Linac

Upper Ring

Lower Ring

HIMAC

NIRS

Beam Time for Physics and Biology

Cumulative time

0.0

1000.0

2000.0

3000.0

4000.0

5000.0

6000.0

1994 1997 2000 2003 2006 2009

Hours

in o

pera

tion

Year

Biology

Physics

HIMAC

NIRS

Number of proposals in each year

0

20

40

60

80

100

120

140

160

1994 1996 1998 2000 2002 2004 2006 2008 2011

Number of accepted

proposals

Year

Medical

Biology

Physics

HIMAC

NIRS

Number of Participants in the Basic Science Programs

0

100

200

300

400

500

600

700

800

1990 1995 2000 2005 2010 2015

Num

ber

of P

artici

pant

s

Outside users

Foreigners

Inside users