National Institute of Radiological Sciences. Naoya Saotome

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1 National Institute of Radiological Sciences Naoya Saotome 1

2 Contents Introduction History and collaboration KCC i-rock Commissioning of commercial scanning system NIRS Gantry Commissioning of NIRS s Gantry with superconducting magnet 2017/2/23 Naoya Saotome(NIRS) 2

3 Contents Introduction History and collaboration KCC i-rock Commissioning of commercial scanning system NIRS Gantry Commissioning of NIRS s Gantry with superconducting magnet 2017/2/23 Naoya Saotome(NIRS) 3

4 OUR EVOLUTION 2008 Experimental port for scanning 2011 New treatment rooms with scanning 2015 Commercial machine with scanning 2017 Superconducting Gantry for carbon ion Iso-center RSF Main monitor SCN02 PRN SCN m SM-Y SM-X PH1 By courtesy of Toshiba 2017/2/23 Naoya Saotome(NIRS) 4

5 OUR RECENT PROGRESS Building construction start(12/12) Installation start (14/5) Accelerate 430MeV/u (15/1) Multiple-energy operation and scanning irradiation(15/2) Treatment start (15/12) Beam commissioning start(10/13) Treatment start(15/2) Installation start(15/1) Gantry Energy scanning Beam commissioning start (16/1) Treatment start (17/4,plan) KCC: Kanagawa Cancer Center NIRS: National Institute of Radiological Sciences 5

6 drawn by RF63_IDD_forGComi_ _Overflow NIRS OUR COLLABORATION RGF RSF SCMY SCMX SCN USING (TREATMENT) DESIGN IC DSN_M DSN_S NST FST DSN_P COLLABORATION National Institute of Radiological Sciences 2017/2/23 COMMISSIONING Amount of ionization [C] 0e+00 1e 07 2e 07 3e 07 4e LGRC_IDD_000_PM1m LGRC_IDD_008_PM1m LGRC_IDD_016_PM1m LGRC_IDD_024_PM1m LGRC_IDD_032_PM1m LGRC_IDD_040_PM1m Moter value [mm] 0e+00 1e 07 2e 07 3e 07 4e 07 DEVELOPENT Naoya Saotome(NIRS) 6

7 Contents Introduction History and collaboration KCC i-rock Commissioning of commercial scanning system NIRS Gantry Commissioning of NIRS s Gantry with superconducting magnet 2017/2/23 Naoya Saotome(NIRS) 7

Specification of KCC Combination of a compact dissemination treatment system and

available with respiratory-gated and rescanning technique item specification Ion

dose rate 2 Gy/L/min Beam intensity Irradiation type 1.

8 Specification of KCC Combination of a compact dissemination treatment system and pencil beam 3D scanning technique designed by NIRS Moving target treatment is available with respiratory-gated and rescanning technique item specification Ion C 6+ Energy MeV/u Max. field 220 x 220 mm 2 Max. dose rate 2 Gy/L/min Beam intensity Irradiation type 1.2x10 9 pps 3D Scanning 2017/2/23 Treatment rooms Horizontal: 2 rooms Horizontal and Vertical: 2 rooms Vender Toshiba Naoya Saotome(NIRS) 8

9 Building Construction 2017/2/23 Naoya Saotome(NIRS) 9

10 OUR RECENT PROGRESS Building construction start(12/12) Installation start (14/5) Accelerate 430MeV/u (15/1) Multiple-energy operation and scanning irradiation(15/2) Treatment start (15/12) KCC: Kanagawa Cancer Center NIRS: National Institute of Radiological Sciences 10

11 DARUMA CEREMONY 2017/2/23 Naoya Saotome(NIRS) 11

12 Commissioning of the irradiation system NON-scanned beam test Beam intensity Beam position Beam size Beam on/off response Scanned beam test Scanned beam position Field uniformity Complex field Dose monitor performance Position monitor performance Beam data collection for TPS Beam size Beam divergent Integral depth-dose Dose monitor unit Overall verification Interlock check Information transfer check Coordinate check End-to-End test Training for staff Beam matching 2017/2/23 Naoya Saotome(NIRS) 12

13 Beam intensity Extended FT + Multiple Energy Operation Extended FT + Intensity Modulation Operation 2017/2/23 Naoya Saotome(NIRS) 13

Screen monitor for spot Beam size and position Beam

adjusted within 10 percent from designed Beam size

14 Screen monitor for spot Beam size and position Beam shape was adjusted as round shape Beam size was adjusted within 10 percent from designed Beam size for each treatment port were matched Beam Size [mm] Energy [MeV/n] 2017/2/23 Naoya Saotome(NIRS) MeV 430MeV 1HC 2HC 2VC

15 Beam size and position Beam position stability was within +/-0.5mm Beam size stability was within +/-0.5mm from design Beam position (2VC) Beam size (2VC) /2/23 Naoya Saotome(NIRS) 15

Integral depth dose Concentric Ionization chamber IDD for 11 energy beams Beam energy/range was adjusted Residual range for each treatment port were matched Lateral distribution was used for TPS 3D

16 Integral depth dose Concentric Ionization chamber IDD for 11 energy beams Beam energy/range was adjusted Residual range for each treatment port were matched Lateral distribution was used for TPS 3D Water phantom Integral depth dose [A.U.] Depth in water[mm] beam modelling Dose of integral electrode [C] Depth [mm] BeamData_KCC _inaniwa2 RID06_PMMA _rangecheck 1HC_RID06 offset= 9.1,scallcor= _rangecheck 2HC_RID06 offset= 9.1,scallcor= _rangecheck 2VC_RID06 offset= 6.3,scallcor= /2/23 Naoya Saotome(NIRS) 16

17 Screen monitor for field Scanned beam position Scanned beam position for every beam energy was checked Beam shape was adjusted as round shape at any position The precision of the scanned beam position was verified within 0.5 mm. 430MeV/u +/-0.5mm ü 240x240mm 2 field ü 20 mm pitch +/-0.5mm 380MeV/u +/-0.5mm ü 240x240mm 2 field ü 20 mm pitch +/-0.5mm 2017/2/23 Naoya Saotome(NIRS) 17

18 Screen monitor for field Field uniformity Field uniformity for every beam energy was checked The flatness of the uniform field was verified within % 290MeV/u ± 1.5% ü 150x150mm 2 field ü 2mm pitch 2017/2/23 Naoya Saotome(NIRS) ± 1.5% 18

energy was checked The dose distribution was compared with plan

19 Position monitor system Complex field Beam intensity, dose, and beam position were modulated Complex field for every beam energy was checked The dose distribution was compared with plan and confirmed 2017/2/23 Naoya Saotome(NIRS) 19 Flanz et al., PTCOG2009

20 Treatment planning 3D dose distribution Rectangle shape irradiation fields were planned Dose distribution on the depth and lateral direction were compared with planned dose distribution Depth dose distribution Lateral dose distribution 3D Water phantom 2017/2/23 Naoya Saotome(NIRS) 20

21 Beam matching Beam size matching Beam Size [mm] Dose of integral electrode [C] MeV Dose [Gy] Dose [Gy] plan meas plan meas../data/1hc_ /la_pr003_111a.csv../data/2hc_ /la_pr003_111a.csv Lateral position [mm] 2017/2/23 Naoya Saotome(NIRS) 21 Depth [mm] BeamData_KCC _inaniwa2 RID06_PMMA _rangecheck 1HC_RID06 offset= 9.1,scallcor= _rangecheck 2HC_RID06 offset= 9.1,scallcor= _rangecheck 2VC_RID06 offset= 6.3,scallcor= 1 430MeV Energy [MeV/n] Range matching HC 2HC 2VC Room 1 Room 2 Sample patient field for Prostate and H&N were planned The plan were deliver and measured at each treatment rooms Beam size and range matching brought dose distribution matching Prostate Dose [Gy] Dose [Gy] H&N plan meas../data/1hc_ /la_hn005bh.csv plan meas../data/2hc_ /la_hn005bh.csv

5% 57 sec Lateral dose distribution Relative Dose [A.U.

22 Treatment planning 2Gy/L/min 2Gy of physical dose to 10x10x10cm 3 cubic target was planned The dose homogeneity was better than 2.5% 57 sec Lateral dose distribution Relative Dose [A.U.] mm 10mm 10mm +/-2.5% 102.5% 97.5% Lateral Position [mm] 2017/2/23 Naoya Saotome(NIRS) 22

23 DARUMA CELEMONY 2017/2/23 23

24 Contents Introduction History and collaboration KCC i-rock Commissioning of commercial scanning system NIRS Gantry Commissioning of NIRS s Gantry with superconducting magnet 2017/2/23 Naoya Saotome(NIRS) 24

25 ADVANTAGES OF GANTRY 2017/2/23 Naoya Saotome(NIRS) 25

26 Specification of NIRS s Gantry Function combined superconducting magnets were employed Moving target treatment is available with respiratory-gated and rescanning technique item specification Ion C 6+ Energy MeV/u Max. field 200 x 200 mm 2 Irradiation type Rotating angle Magnet type Beam orbit radius Length 3D Scanning +/- 180 degree Superconducting magnet 5.45 m 13 m 2017/2/23 Weight 300 ton Naoya Saotome(NIRS) Vender Toshiba 27

27 Construction and installation 2017/2/23 Naoya Saotome(NIRS) 28

28 installation Gantry room Treatment room 2017/2/23 Naoya Saotome(NIRS) 29

29 Commissioning of the Gantry NON-scanned beam test Beam data collection for TPS Beam intensity Beam size Beam position Beam divergent Beam sizegantry angle dependence Integral check depth-dose Beam on/off response Beam position Dose monitor unit Scanned beam test Beam size Dose output Scanned beam position Scanned beam position Field uniformity Complex field Dose monitor performance Position monitor performance Overall verification Interlock check Information transfer check Coordinate check End-to-End test Training for staff Beam matching 2017/2/23 Naoya Saotome(NIRS) 30

30 Angle dependence of the beam size Angular dependence of a beam size and shape at the isocenter (E=430 MeV/u) 180 deg 135 deg 90 deg 67.5 deg 45 deg 22.5 deg 0 deg -45deg -90deg -135deg 2017/2/23 Naoya Saotome(NIRS) 31

Angle dependence of the beam size Screen monitor for spot The accuracy of the beam size and beam position for every gantry angle were checked The measurement was performed with sequence (15min for

31 Angle dependence of the beam size Screen monitor for spot The accuracy of the beam size and beam position for every gantry angle were checked The measurement was performed with sequence (15min for 200Energy) Angle dependent of the beam size is less than 10% 4 Measurement sequence Lateral Beam Spread (1 ) [mm] Degree Energy [MeV/u] Naoya Saotome(NIRS) 32

32 Beam size Beam tuning was made for various beam energies E=430~55.6 MeV/u MeV/u 387 MeV/u 292 MeV/u 2.5 σx σy 238 MeV/u 174 MeV/u 55.6 MeV/u 1σ beam size at Iso [mm] E [MeV/u] 2017/2/23 Naoya Saotome(NIRS) 33

Angle dependence of the beam position Digital

accuracy for each gantry angle was confirmed

33 Angle dependence of the beam position Digital starshout device The accuracy of the isocenter position and gantry angles are checked using digital starshout device Beam position accuracy for each gantry angle was confirmed within +/- 0.5mm. 3D Water phantom Naoya Saotome(NIRS) 34

34 Concentric Ionization chamber Integral Dose Distribution Beam energy/range was adjusted Lateral distribution was used for TPS beam modelling Low energy _GRC_ LGRC_IDD_144_AL1cm Rad symbol means 'Over Flow' (integral) High energy 3D Water phantom Amount of ionization [C] 0e+00 2e 07 4e 07 6e LGRC_IDD_144_AL1cm LGRC_IDD_152_AL1cm LGRC_IDD_160_AL1cm LGRC_IDD_168_AL1cm LGRC_IDD_176_AL1cm LGRC_IDD_184_AL1cm Moter value [mm] 0e+00 2e 07 4e 07 6e 07 drawn by RF63_IDD_forGComi_ _Overflow Amount of ionization [C] 0e+00 1e 07 2e 07 3e 07 4e LGRC_IDD_000_PM1m LGRC_IDD_008_PM1m LGRC_IDD_016_PM1m LGRC_IDD_024_PM1m LGRC_IDD_032_PM1m LGRC_IDD_040_PM1m Moter value [mm] 0e+00 1e 07 2e 07 3e 07 4e 07 drawn by RF63_IDD_forGComi_ _Overflow 2017/2/23 Naoya Saotome(NIRS) 35

00 0.75 0.50 430 MeV/u 290 MeV/u 89 MeV/u Dose [%] 0.25 0.00-0.25-0.50-0.

35 Dose output Dose output for every gantry angle was checked using famer type ionization chamber Angle dependence of the dose output was less than 0.5% MeV/u 290 MeV/u 89 MeV/u Dose [%] Ganrty Angle [degree] 2017/2/23 Naoya Saotome(NIRS) 36

Screen monitor for field Scanned Beam Position (-)Distortion correction

Beam shape was adjusted as round shape at any position and any gantry

correction was verified within 0.5 mm. (+)Distortion correction 1.5 1 0.

36 Screen monitor for field Scanned Beam Position (-)Distortion correction Scanned beam position for every beam energy and gantry angle was checked Beam shape was adjusted as round shape at any position and any gantry angle The precision of the scanned beam position after the distortion correction was verified within 0.5 mm. (+)Distortion correction FB-ON FB-OFF /2/23 Naoya Saotome(NIRS) 37

37 3D Water phantom 3D dose distribution Rectangle shape irradiation fields were planned Dose distribution on the depth and lateral direction were compared with planned dose distribution Depth dose distribution../result/nirsg_ /dd_al1c_d1rec90todd_al1c_d5rec90_g02.pdf Lateral dose distribution../result/nirsg_ /la_al1c_d2rec30tola_al1c_d2rec90_g02.pdf Pin-point chamber array Dose [Gy] plan s1_plan s2_plan s3_plan s4_plan s5_plan Range in water [mm] Dose [Gy] plan s1 s2 s3 s4 s5 Lateral position [mm] /result/NIRSG_ /dd_AL1c_d1rec30todd_AL1c_d5rec30_g02.pdf../result/NIRSG_ /la_AL1c_d1rec30tola_AL1c_d1rec90_g02.pdf Dose [Gy] plan s1_plan s2_plan s3_plan s4_plan s5_plan Range in water [mm] plan s1 s2 s3 s4 s5 Lateral position [mm] 2017/2/23 Naoya Saotome(NIRS) 38 Dose [Gy]

3D Water phantom 3D dose distribution Rectangle shape irradiation fields were planned Dose distribution on the depth and lateral direction were compared with planned dose distribution Lateral dose

csv Pin-point chamber array Dose [Gy] Dose [Gy] 0.0 0.4 0.8 0.2 0.3 0.4 0.5 0.6 plan meas Lateral position [mm] 100 50 0 50 100 plan meas 100 50 0 50 100 Lateral position [mm] Dose [Gy] Dose [Gy] 0.

38 3D Water phantom 3D dose distribution Rectangle shape irradiation fields were planned Dose distribution on the depth and lateral direction were compared with planned dose distribution Lateral dose distribution../data/nirsg_ /la_al1c_920070_2_pro_d3mm_0.csv../data/nirsg_ /la_al1c_924016_1_pro_d29mm_0.csv../data/nirsg_ /la_al1c_926108_1_hn_ 11175mm.csv Pin-point chamber array Dose [Gy] Dose [Gy] plan meas Lateral position [mm] plan meas Lateral position [mm] Dose [Gy] Dose [Gy] plan meas plan meas Lateral position [mm] Lateral position [mm] Dose [Gy] Dose [Gy] plan meas Lateral position [mm] plan meas Lateral position [mm] 2017/2/23 Naoya Saotome(NIRS) 39

39 SUMMARY Fast scanning system dedicated for moving target was succeeded at NIRS Commercial system which is combination of a compact dissemination treatment system and pencil beam 3D scanning technique was constructed at KCC Treatment using superconducting rotating-gantry will be started in near future 2017/2/23 Naoya Saotome(NIRS) 40

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