Particle Therapy with the Varian / ACCEL 250 MeV S.C. Proton Cyclotron

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Particle Therapy with the Varian / ACCEL 250 MeV S.C. Proton Cyclotron 1st Workshop HADRON BEAM THERAPY OF CANCER ERICE SICILY, 24 APRIL - 1 MAY 2009 D. W. Krischel, A.E. Geisler, J.H. Timmer, Volker Schirrmeister (Varian Medical Systems) References: M.J. Schippers (PSI)

ACCEL History towards Accelerators for Medical Applications Fab first Start SC Magnet Tech Layout of PTS Foundation SERSE Hexapole Reevaluate Contracts PSI Cyclotron Resonators - Accelerator Designs MGH Boston of ACCEL PTS Options PSI&RPTC Assembly of RPTC - HERA Quads, DetectorMagnets (Cycl.+Syn.) LHC Main Quads 1980 1984/5 1992/3 1993/4 1997 2001/2 2004 2007 Year

Site for Cyclotron Assembly 400 LHC SC- Quadrupoles CERN Order Volume ~50Mio.$

System Overview / Cyclotron D&D in 2001 started from the `93 NSCL Proposal for a manufacturing Prototype superconducting Cyclotron for advanced Cancer Treatment with no inhouse cyclotron expertise at that time, only experiences in ( nearly ) all different technologies needed (s/c magnets, RF, Linacs,... ) Extensive use of 3D-FEM codes for magnetic, electrostatic, RF, heat load calculations, no mock-ups Close collaborations with various experts of different institutions:

... some design parameters and customer specifications Beam - Energy 250 MeV - Emittance of extracted beam 3π / 5π mm mrad - Momentum spread Δp/p ± 0.2% - Extraction efficiency > 80% - Fast intensity modulation ΔI / I > 90% in 100 μs (beam switch off) with 1 khz max. repetition rate Iron yoke - Outer diameter 3.2 m - Weight 90 t Magnet - Central field 2.4 T - Max. field at the coil < 4 T - Operating current 160 A - Rated power cryocoolers 40 kw RF-System -Frequency 72.8 MHz (2 nd harmonic) - Number of Dees 4 - Voltage Source to Puller / @ extraction radius 80 kv / 130 kv - RF-Power ~120 kw

System Overview / Design Goals Purpose: medical cyclotron serving as the source for proton therapy Features serve design goals: extensive, detailed modeling to optimize the system (RF, electrostatics, magnetics, neutron heating, mech. stress analysis, tracking ) superconducting magnet trimming: only trim rods at two radii, (centering, extraction bump) + main coil, no trom coils two adjustable (radius and width) slits with current read out vertical deflector two extraction deflectors with moderate voltages internal cold cathode ion source reliability, reduced need and effort for maintenance large, constant gap, compact, high extraction efficiency, low activation, low dose for maintenace personnel, fast morning startup simple, not heat load, passive, reliable Beam control and valuable fast beam diagnostics for (QA) Fast control of beam current, needed for adv. scanning Reliable, low maintenance effort simple, proven design, designed after Harper. Medical Cyclotron

Magnet Technology for a Medical Proton Cyclotron: Advantages by using Superconducting Magnet Coils: No Ohmic losses Less Rated Power needed and reduced Electrical Consumption: (40 kw for Cryosystem instead of >200 kw power supply) No heat introduced into iron yoke Machine will stay powered overnight reduces time to switch on the machine in the morning Reduced size and weight (less activated material) Superconducting: 90 t and 3 m diameter Make use of achievable high fields in larger volume to increase gap size over full radius Reduced Non-Linearities Improved Extraction Efficiency >80% meaning less activation)

LHe-Supply Vessel w/4 Cryocoolers 250 MeV Superconducting Proton Cyclotron System Overview Compressors 4x for cryocoolers 2x for shield coolers Shield Cooler (2x) Superconducting Coil

View of 3D-TOSCA Modell

Design: Magnet First magnetic design with saturated iron approximation codes; Fast iteration steps Refinement of magnetic design with TOSCA 3D model using saturated iron approximation to determine the changes for hill shape etc.

Factory Tests: Magnetic Performance

Manufacturing: cold mass and coils

Mounting of cryostat into lower yoke

First successful Ramping of PSI Cyclotron Magnet, 12/2003

Performance Cryogenic System / cooling capacity Calc. of heat load in cold mass per 100 na stopped: PSI (Atchison) : 0.4-0.6 W KVI (Beijers, Brandenburg) : 0.3 W ACCEL : 0.58 W Δ = 0.9 W @ 250 na Calculation of heat load induced by neutrons produced by dumping protons into beam probe PHeater=3.7 W measured of heat load 0.36 W / 100 na stopped beam plhe=1040 mbar or 1.8 W / 500 na Acceptance test performed with only 3 of 4 cold heads in operation. comfortable margin

Factory Tests: Cryogenics Design current (160A) exceeded without any quench Large amount (> 4 W) of redundant cooling power Superconductor with high stability margin: Quench @ quench heater power > 4 W Proven conservative cryogenic design

Commissioning / Verification Isochronism: Smith Garren measurement Smith-Garren: Variation of main coil current Goal: Verification of magnetic field shimming Verification of energy gain per turn Result: excellent agreement between phase curve derived from measured field maps and Smith- Garren measurement

The 250 MeV Proton Cyclotron at ACCEL for cryogenic and magnetic factory tests magnetic measurement arm with search coil

Installation of the Cyclotron at RPTC

Commissioning Status PSI Cyclotron Sept. 04 (~ Tokyo-Conference) Courtesy of PSI

System Overview Time line PSI - Project learning curve Δt=10 months Δt=2 months Δt=2 ½ weeks Commissioning start at RPTC: Feb. 05 first beam at RPTC: Apr 19th Contract RPTC: spring 2002 contract Apr. 01 Start commissioning Cyclotron Conferences: East Lansing `01 Tokyo`04 Giardini Naxos `07 Dec. 04 first beam April1st, 05 Dec. 05 Mar. 06 Oct. 06 Feb. 07 acceptance test phase end of test phase Start of PROSCAN Integration 1st Patient Now: cyclotron routinely run by operators

Design: RF-Structures RF-Design Started with simple models for estimations/rough and fast optimization steps (e.g. acc. gap) NSCL Detailed 3D-Models of one sector (Microwave Studio, O(10 6 ) nodes) Simple 3D-Models full geometry (Microwave Studio) ACCEL Detailed full 3D-Model (using 3D-CAD data, Omega 3P) separate talk 18B3, H. Fitze, PSI PSI

Cyclotron Inner Region E-Fields, First proton turns Extensive 3D-Computations performed to optimize pattern of electical fields

Design: RF-Structures Central Region: Started with electrostatic and rough model (Relax 3D) Refinement of electrostatic design with TOSCA 3D Exchange of data between 3D-CAD and TOSCA for iterations, goals: Optimizing focusing, minimize electric fields, etc. 3D-CAD 3D E-Static TOSCA Model Good agreement: calculated and measured mode separation, Needed RF power = 110 kw (120 kw deduced from calculations + experience), extensive use of acurate and detailed modelling paid off: No problem with high electric fields in the inner region (200 kv/cm)

RF System Commissioning Good agreement: calculated and measured mode separation Needed power 110 kw (120 kw deduced from calculations + experience) extensive use of acurate and detailed modelling paid off: No problem with high electric fields in the inner region (200 kv/cm) number of spark events within specs talk M. Schippers (MOXCR04,Cyclotron Conf. 2007) Contact fingers in RF amplifier and Dee 3 exchanged

Medical Cyclotron Simulation Results Mode Separation: Desired mode is mode1 (push-pull mode) at 72.8 MHz Sufficient distance to mode 2? Excitation of higher order modes by harmonics? Tuning Resonance tuning: moving all 8 shorting plates identical Field balance tuning: moving each shorting plate individually slide 26 CST UGM 2007 / 13.09.2007

Medical Cyclotron Simulation Results Gap-Voltage distribution Voltage minimum at stem position Results used for beam dynamic calculations Design of Contact Springs Calculation of maximum current at contact spring position Verification of contact spring design voltage [kv] 140 120 100 80 60 40 Dee 1 entry Dee 1 exit 0 200 400 600 800 1000 radius [mm] slide 27 CST UGM 2007 / 13.09.2007

Fitted Dee Voltage (kv) RF System 90 88 86 84 Commissioning Spread in DEE voltages reduced from Δ=20kV to Δ=2kV with a X-ray detector DEE 1 DEE 2 DEE 3 DEE 4 number of RF trips strongly reduced problem with contact fingers eliminated BEFORE 82 Δ=2kV 80 115 120 125 130 135 140 RF Power (kw) AFTER

Commissioning / RF System Model is fitted to determine Dee voltage Online fitting side development Small low resolution X-ray detector Collimation from iron Easy calibration and exchange

RF-Stems, RF-Amplifier

Animation of Cyclotron Acceleration

System Performance Overview Purpose: medical cyclotron serving as the source for proton therapy Design Goals: High reliability Low activation Easy maintenance Suitable for advanced scanning techniques Fast morning start-up Easy to use

First Steps: Beam Centering and Beam Control

Performance Stability := ½ (I Max I Min) / < I > Ion Source Beam Current Measurements at RPTC: before: stability typically 30% acceptable beam quality for simple raster scanning at PSI (Gantry 1) and RPTC Now: clear evidence that ion source is capable of providing adequate beam quality for 2D-fast scanning Recently: After applying changes to the geometry of plasma chamber Fulfills requirements for PSI - Gantry 2 and RPTC after: stability: better 10%, reproducible

Commissioning / Beam Optimization Beam centering Bad Centering Beam current (na) 5 4 3 Measured beam current Measured turn separation 4 Turn separation (mm) beam measured with shadow finger probe on platform in inner region (commissioning probe) 2 1 0 240 260 280 300 Cyclotron radius (mm) 2 0 centering optimized with magnetic Trim Rods Beam current (na) 3 2 Good Centering Measured beam current Measured turn separation 4 Turn separation (mm) 2 1 0 0 240 260 280 300 Cyclotron radius (mm)

Intensity modulation 1. Ion Source For slow variations 2. Vertical deflector plates Variations up to 10kHz First results: Saw-tooth voltage Vertical beam profile visible Vertical position on external monitor is stable

Intensity control - Max intensity set by: Ion source + phase slits Roles of deflector plate: - decrease drift of intensity - set requested intensity within 5% Febr. 2007: start program to reach spec=> best:σ =3 % (see poster) Courtesy of M. Schippers, PSI

Diagnostics Radial probe viewer Commissioning Radial probe integral head Foils Profile monitors Beam Current (na) 120 60 0 300 600 Radius (mm) + Special developments: Commissioning probe probe head X-ray detector Phase probe (automation) platform platform

Vertical deflector in cycl. Center -beam on/off Beam on/off and stability Necessary for fast dynamic scanning (Gantry-2) Acceptance tests: repetition rate 1 khz beam off < 50 μsec intensity stability σ<5% (for Gantry-1 and München: ) Beam intensity On/off by means of Vertical deflector in center 40 μs 0.6 0.7 0.8 ms 0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 time (ms)

Extraction from cyclotron 80% Courtesy of M. Schippers, PSI Electrostatic extraction elements (ACCEL / Varian)

Commissioning / beam optimization Extraction efficiency one of the most important parameters / design goals low activation allows efficient maintenance high up-time specified: > 80% difficult to measure M. Schippers (MOXCR04) Now: routine at PSI: 85%, tuned by operators at RPTC: 80%, tuned by operators not being explored further

>80% extraction efficiency: Low dose to service staff inside cyclotron Mid plane, open cap 24 h after beam off, June 2007 (extracted beam integral 72 μa.h) : on pole, closed cap: mid plane, open pole cap: 400 μsv/h (40 mrem/h) 250 μsv/h (25 mrem/h) Courtesy of M. Schippers, PSI

Extraction efficiency Rextr R=30cm 140 probe signal (%) 120 100 80 60 40 20 Simulations of probe efficiency Measurement of current on probe: Extr eff= 80.6% 0 30 40 50 60 70 80 90 Radius in cyclotron (cm) Electrostatic extraction elements R=30 cm: 100% Routinely: 80-83%

Performance Automation / daily work: switch on the beam from overnight shutdown: - two button process on control system panel beam within 8 min - isochronism is maintained by an automated phase control loop beam within spec and machine ready for daily QA-checks within 10 min ( = additional 2 min ) perform calibration (beam current) and daily QA checks

Automation: Performance Transition Overnight Shutdown -> Beam On IMag = 158A IMag = f(irontemp) IMag = f(phase) PRF = 85kW UVD = 3.5kV H2-flow = 1.4sccm PRF = 110kW UEDx = 50kV ISarc = 250mA Ibeam within spec t=0min t=1min t=6min t=8min t=10min 1 2 1 calibration phase measurement 2 automatic phase control loop no operators routinely required (PSI specification): very close

Maintenance Performance relevant maintenance operations so far for internal components since 2005: Ion Source: every 2 weeks, exchange/cleaning of chimney and cathode, breaking of cyclotron vacuum not necessary RF-Window (cleaning) Jacking-System of the pole cap (greasing) vertical deflector (exchange, RPTC only) Regular maintenance of cold heads and shield coolers extraction deflectors: one set of deflectors and HV feed throughs installed for more than one year at PSI, similar at RPTC

Introduction ACCEL History Why Particle Therapy? System Technology Contents Cyclotron versus Synchrotron Magnet Technology: Advantage of Superconductivity The ACCEL 250 MeV Cyclotron - Overview Performance Ion Source (Animation!) RF-System Activation / Maintenance Automation / daily work Reliability Proton Therapy Facility and Application Scanning Requirements, Workflow, (New) Layouts, Conclusions

System Overview Varian/ACCEL Cyclotron installed at: Paul Scherrer Institut (PSI), Villigen, Switzerland dedicated cyclotron (COMET) for the PSI PROSCAN project intensification of R&D on proton therapy like intensity modulated proton therapy (IMPT) faster treatment, repainting of large volumes, etc. Cyclotron bunker at PSI, Villigen (courtesy of PSI) Rinecker Proton Therapy Center (RPTC) Munich, Germany As part of the delivery of complete proton therapy system identical to the PSI cyclotron Cyclotron bunker at RPTC, Munich

Proton Therapy Facilities beam/patient paths textfeld

Proton Therapy Facility RPTC, Munich I. S.C. cyclotron III. Gantry Rooms Eye Treatment Room II. Energy Selection System/ Beam Transfer Line ~90 m ~15 m

Beam-energy adjustment Degrader unit Q Q Q Steerer (Kicker) Carbon wedge degrader 238-70 MeV 5 mm ΔRange in 50 ms

Energy verification Specified: 250 +1-4 MeV PSI: 249.6 MeV RPTC: 250.2 MeV Commissioning / Verification Emittance verification horizontal (π mm mrad) vertical (π mm mrad) Specified (95% of particles): 3.0 5.0 PSI: 3.0 4.7

Energy measurement Ion chamber in water tank to measure proton range Range in water => E=250.4(1) MeV

Product Offering Turn Key Proton Therapy Facility SC Cyclotron Beam Transfer Line (Energy Selection Section w/ Degrader) Gantry for 360 Irradiation Scanning Nozzle Patient Couch Patient Position Verification Integrated Software Package ( TP, TCS, PIS, etc.) Building Interfacing

Conclusions PSI cyclotron has been commissioned successfully and has been accepted design and calculations were verified design goals fulfilled, in particular performance and reliability fulfill high demands on medical devices PSI cyclotron is fully operational, patient treatment has started RPTC patient treatment has started March 09

Perspectives: Industrialization of Fabrication of PT- Equipment, especially of sc Cyclotrons! Expansion to Ion Therapy? Expansion into smaller Synchro- Cyclotrons?

Thank you for your attention!