WIR SCHAFFEN WISSEN HEUTE FR MORGEN Marco Schippers

WIR SCHAFFEN WISSEN – HEUTE FÜR MORGEN Marco Schippers : : Paul Scherrer Institut Accelerators for Proton Therapy: What is so special? SPS meeting, Lausanne, 31. 8. 2018

The boost in particle therapy more mostly in labs hospital based Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 2

X-rays vs. Protons Proton beams from 3 directions X-ray beams (IMRT ) from 7 directions Protons X-rays heart lung Spinal cord pictures: Medaustron Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 3

Dose delivery technique: Scanning Spread-out Bragg peak tumour spread-out Bragg peak Tumor rear edge Maximum Energy Bragg-peak Tumor thickness ge Ran tumor energy modulation Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 4

Accelerators for Proton therapy Cyclotron Synchrotron

Proton therapy facility t a p cyclotron t n ie gantries beam transport Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 6

Treatment room as seen from patient side X-ray treatment room: Accelerator + beam Acceleators for Proton th: what is so special? Proton treatment room Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 7

Acc. Lab Hospital Operators Radiologist operates Technicians CE/FDA-certification: PROCEDURES Experienced workshops ……. and NO quick changes More improvised actions Local technicians: only small repairs Service by equipment company Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 8

Service of the equipment 6 -8 weeks 1 week SERVICE Full treatment STOP new treatments Full treatment Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 9

Service of the equipment 6 -8 weeks new treatments 1 week SERVICE STOP Full treatment Full treatment nt Full treatment Full treatment Effectively: a loss of 8 -10 weeks Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 10

Service of the equipment So… no long services => • well scheduled short services • know what to do • easy access • many prepared spare parts Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 11

Main operational aspects • Dose application within 1 -2 %: REPRODUCIBILITY • «just retune and do a test» : NOT allowed ! • Operation by medical staff Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 12

Safety Availability At Psi: Separate interlock systems: all components technically OK Area access & area dose: Doors closed, dose rate < µSv/h Patient safety: More special for treatments Machine interlocks: Dose delivery as planned Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 13

Hierarchy of Interlock signals Patient safety system at PSI: STOP Kick beam into dump Machine interlocks STOP Blocker in line Area access & area dose STOP RF off Patient safety STOP Ion Source off Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 14

Hierarchy of Interlock signals Patient safety system at PSI: STOP Kick beam into dump Machine interlocks R E DU N DA N CY Area access & area dose STOP Blocker in line STOP RF off Patient safety STOP Ion Source off Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 15

Redundancy measurement Ala r lev m el BEAM off stop rm Ala interlock system stop el Redundancy Patient safety lev Redundancy stop Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 16

Operation: non-accelerator experts What has happened ? AM ERGONOMIC display of: NO BE Status Instructions Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 17

SUMMARY Unique Aspects of Accelerators for Medical Application: What is so special? • Technics: • Operation: dedicated, but not on the limit of technology …. but… Reliable, Reproducible, Reliable, Reproducible by non-accelerator experts strictly according procedures NO long shut downs • Control and safety: VERY DEDICATED and SPECIAL : Reliable & Redundant, but not too sensitive Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 18

…. Motivation …. first scanning gantry : PSI, 1996 Thank you !! Gantry: Eros Pedroni Tumours in kids: Beate Timmermann, Gudrun Goitein Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 19

Acceleators for Proton th: what is so special? Marco Schippers SPS, Lausanne, 31. 8. 2018 Page 20