IL SINCROTRONE DEL CNAO

Marco Pullia

The CNAO Foundation

No profit organisation (Foundation) created with the financial law 2001 to build the National Center for Hadrontherapy designed by TERA Foundation

Founders:
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

Institutional Participants:
Istituto Nazionale di Fisica Nucleare Universit di Milano Politecnico di Milano Universit di Pavia Comune di Pavia

Participants:
Fondazione Cariplo

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 theres a tumor

When a body hides a tumor, this needs to be killed. It's a dirty WORK but somebody's gotta do it

WORK= ENERGY

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)

Radiation damage
Ionization breaks chemical bonds Free radicals creation (mainly hydroxyl radical, OH, and superoxide, O2 . Poison for the cell!) The target is DNA, ionization distribution is relevant

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 x

Depth [mm]

Longitudinal - Spread Out Bragg Peak

1.2 1

Dose [relative units]

0.8

0.6

0.4

0.2

0 0 2 4 6 8 10 12 14 16 18 20

Depth [cm]

Macroscopic advantage of hadrons

Photons Protons

X rays

protons

Rapid fall-off

Microscopic advantage of C ions

4

RBE
3

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

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)

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CNAO RFQ

Internal structure Beam input

217 MHz Four-rod like type Energy range = 8 400 keV/u Electrode length = 1.35 m, Electrode voltage = 70 kV RF power loss (pulse): about 100 kW Low duty cycle: around 0.1%

Beam output

22

LINAC

Stripping foils (carbon)

C4+ H3+

C6+ p

24

MEBT Layout
1. 2. 3. 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)

Intensity degrader

4 transmission levels: 100%, 50%, 20%, 10% Keep overall emittance unchanged

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 = 1.9 (Ex/Elinac=2.3) Carbon = 2.6 (Ex/Elinac=3.2)
BDI

~30 s bump duration

BDI

IMS

Injection in time
~500 s 1 pulse every 0.1 s LINAC ~20000 s ~30 s LINAC quads

1 pulse every 2-3 s

LEBT Chopper Debuncher

1 pulse every 2-3 s

Injection bumpers

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. Biscari - LNF, INFN

Stop betatron

Hysteresis cycle
Bmax

Closed orbit during the cycle

acceleration Extraction Bumps

Rf off = debunching 1sec Pick-Up data acquisition with NI-PXI Chassis, data visualization with LabView

Extraction
We need to distribute the beam on the tumor The beam in the machine is a bunch shorter than 1 s (0.000001 s) Its like we had an apple to distribute on a trail 100 m long

Slow extraction
Peeling the beam
Beam Electrostatic septum

Betatron core
Pushes the beam against the resonance = 2.46 Wb Magnetic screen needed

Empty bucket
E
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 s. 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): 0.2 mm Beam position precision (at different energies): 0.3 mm

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, proven and/or redundant

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

Beam delivery scanning control

Box 1

Box 2

1 Integral chamber: Beam Intensity measure every 1 s 2 Strip chambers (X and Y): Beam position measure every 100 s, with 100 m of precision

1 Integral chamber: Beam Intensity measure every 1 s 1 Pixel chamber: Beam position and dimension measure every 100 s/1 ms, with 200 m of precision

Scanning - fast control

NI PXI Chassis

Monitor
(DAQ)

Timing System
(slow and fast)

Interlock Syste, Local Control Room

Courtesy of Marco Donetti

Control System

Scanning Magnets

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)

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, vertical line, treatment time, beam size, ...)

National collaborations
TERA Foundation: final design and high tech specifications INFN: co-direction HT, technical issues, radiobiology, research, formation University of Milan: medical coordination and formation University of Pavia: technical issues, radiobiology, formation University of Catania: medical physics The Technical-Scientific Collaborations University of Florence: medical physics University of Turin: interface beam-patient, TPS Polytechnic of Milan: patient positioning, radioprotection, authorisations European Institute of Oncology: medical activities, authorisations San Matteo Foundation: medical activities, logistics Town of Pavia: land and authorisations Province of Pavia: logistics and authorisation

International collaborations
CERN (Geneva): technical issues, PIMMS heritage GSI (Darmstadt): linac and special components LPSC (Grenoble): optics, betatron, low-level RF, 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, radiobiology, formation HIT (Heidelberg): research activities

Thats all,folks
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Thank you for your attention

M. Pullia - Improving ion gantries - PTCOG 48