CNAO: Stato della costruzione - INFN Sezione di Roma

IL CENTRO NAZIONALE DI ADROTERAPIA ONCOLOGICA
C N A O
STATO DELLA COSTRUZIONE
by
C. Sanelli
27 Maggio 2005
27th May 2005
1

The CNAO (National Centre for Oncological Hadrontherapy) will be an
hospital based facility, sited in Pavia, devoted to:
treatments of tumours with hadron beams
advanced research in clinical and radiobiological fields
Mandate from the Ministry of Health: CNAO has to be a centre of
excellence in radiation therapy
27th May 2005
2

A brief history of CNAO:
Advisory Committees and Commissions
The CNAO project (initiated by TERA in 1992) has been (and is) submitted to the
following reviews:
Year 1995: First National Oncological Commission by Ministry of Health
Years 1996-1999: Project Advisory Committee (PIMMS/CERN) - Technical
Year 2001: Second National Oncological Commission by Ministry of Health
Year 2003 - ongoing: CNAO Foundation Scientific Committee
Year 2003 - ongoing: International Advisory Committee
CNAO Foundation has been created at the beginning of 2001
21st November 2001, the Board has been established
27th May 2005
3

Council Board:
E. Borloni
- Ospedale Maggiore (Milan)
G. Arbosti
- Istituto Neurologico C. Besta (Milan)
G. Azzaretti
- Policlinico San Matteo (Pavia)
C. Ciani
- Istituto Europeo di Oncologia (Milan)
U. Amaldi
- Fondazione TERA (Novara)
A. Mattiussi
- Istituto Nazionale dei Tumori (Milan)
E. Iarocci
- Istituto Nazionale di Fisica Nucleare (Rome)
G. Coggi
- Università di Milano (Milan)
A. Pedotti
- Politecnico di Milano (Milan)
G. Goggi
- Università di Pavia
CNAO Foundation
President
Vice-president
L. Lamberti
Scientific Committee :
E. Solcia
- Policlinico San Matteo
F. Bonino
- Ospedale Maggiore
G. Cascinelli
- Istituto Nazionale dei Tumori
F. Cognetti
- Istituto Regina Elena
F. Cornelio - Istituto Neurologico C. Besta
L. Magno
- Dip. Oncologia Prov. Brescia
R. Orecchia
- Università di Milano e Fondazione TERA
D. Schiffer
- Ospedale Molinette
U. Veronesi
- Istituto Europeo di Oncologia
D. Scannicchio
- Università di Pavia
General Secretary
Scientific Director
R. Orecchia – (Università di Milano)
L. Zambianchi – (Policlinico
S. Matteo di Pavia)
M. Campiotti (President), G. Minniti e A. Petrucci
27th May 2005
Medical Director
Health Director
Financial Reviewers
4

CNAO ORGANISATION
COUNCIL
PRESIDENT
SCIENTIFIC COMMITTEE
ADVISORY BOARD
PRESIDENT OFFICE
GENERAL SECRETARY
MEDICAL DIRECTOR OFFICE MANAGER TECHNICAL COORDINATION
Prof. R. Orecchia – Medical Director (Università di Milano)
Dott. L. Zambianchi - Health Director (San Matteo di Pavia)
Dott. G. Fortuna (INFN) and Dott. S. Rossi – Co-Directors of the Technical part
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5

Technical group of CNAO Foundation:
25 persons (physicists, engineers and technicians) TECHNICAL ORGANISATION
TECHNICAL DIRECTION
S. Rossi+G. Fortuna
(G. Brianti)
Technical coordination
F. Gerardi e S. Gallo
Optics and parameters
M. Pullia e M.Tiberti
(LPSC)
Technical office
A. Franchellucci, P. Greco, M. Nodari
Secretariat
V. Mutti, L. Zucca
Buildings and plants
High Technology
Electrical plants
(INFN/LNF,UniPv)
Conventional Magnets
C. Priano, L. Vuffray
(INFN/LNF)
Power Supplies and Cabling
I. De Cesaris
(INFN/LNF)
Technical Committee: (N. 15 -
Tasksresponsibles+ Co-directors)
Restricted Steering Committee:
S. Rossi + G. Fortuna + C. Sanelli
Fluids
(INFN/LNF)
Mechanical plants
(INFN/LNF)
Radioprotection and safety
A. Ferrari e M. Ferrarini
(INFN/LNF,PoliMi)
Final Design and Work Direction
Calvi-Tekne (Inarcheck)
Special Magnets
(CERN, UniPv)
Betatron core
(UniPv,LPSC)
Sources, Linac
(INFN/LNL,INFN/LNS)
Nozzle assembly
M. Donetti
(INFN/To)
Vacuum System
V. Chimenti e L. Lanzavecchia
(INFN/LNF)
Beam Diagnostics
J.Bosser,M.Caldara,A.Parravicini
(CERN)
Control System
L.Casalegno,M.Pezzetta,S.Toncelli
(INFN/Mi,LPSC)
RF
G. Primadei
(INFN/Mi,LPSC)
27th May 2005
Patient positioning
(PoliMi)
Installation and Alignment
(INFN/LNF) 6

The base of success: COLLABORATIONS
THE SUCCESS OF CNAO IS BASED ON THE COLLABORATION WITH MANY ISTITUTIONS
NATIONAL
INFN: co-direction of the technical realisation and involvment/responsibility in many technical issues (15)
Town of Pavia: land and authorisations
University of Milan: medical coordination
Polytechnic of Milan: patient positioning, radioprotection and authorisations
University of Pavia: electrical plants, special power supplies and betatron
INTERNATIONAL
CERN: special magnets and diagnostics (+ PIMMS heritage)
GSI: linac and special components
LPSC (Etoile): optics, betatron, low-level RF, control system
European Project that required CNAO collaboration:
MED-AUSTRON – signed collaboration agreement last 19th March
Asclepios – CAEN (agreement in progress)
Etoile – Lyon (site selected by France Governement)
27th May 2005
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Partecipanti Istituzionali:
Istituto Nazionale di Fisica Nucleare – In data 12 Novembre 2003
Accordi di collaborazione
Stipulata convenzione quadro e definiti gli accordi attuativi
Co-responsabilità del Progetto (G. Fortuna)
27th May 2005
8

Obiettivi di INFN-LNF
• Magneti Convenzionali (C. Sanelli)
• Alimentatori Magneti Convenzionali e Cablaggi (M. Incurvati)
• Sistema da Vuoto (A. Clozza)
• Installazione e Allineamento (F. Sgamma)
• Impianti Elettrici Speciali (R. Ricci)
• Impianti a Fluido (L. Pellegrino)
• Radioprotezione e Autorizzazioni (A. Esposito)
27th May 2005
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Altri Obiettivi con INFN
• Cavità RF INFN - Mi (C. De Martinis)
• Monitoraggio dei Fasci INFN - To (R. Cirio)
• Magneti Verticali INFN - Ge (P. Fabbricatore)
• Radiobiologia INFN - LNL (R. Cherubini)
• LINAC
INFN – LNL (C. Roncolato)
• Dosimetria INFN – LNS (Da definire)
• Sorgenti INFN – LNS (G. Ciavola)
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Time and Industrial Plan
High Tech: tenders, contracts and construction
Building and plants: construction under way
27th May 2005
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A clooser look to CNAO...
SITEPLAN TERRITORIAL CONTEXT
Project area
Historical center
Rivers
Medical centers and
hospitals
Main street
Strade principali distr.
High-way
Railway
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Area of
37’000 mq
Policlinico
S. MATTEO
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15

One experimental room
Three treatment rooms (3H+1V)
CNAO – Phase 1
Approved by
CNAO Board
27th May 2005
16

CNAO – Phase 2
+ 2 gantries for ions (?)
future upgrade with minimum
impact on routine operation
27th May 2005
17

Phase 1- Sections
Section A-A’
B
Section B-B’
A A’
B’
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18

Site ground investigation
27th May 2005
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Alta Tecnologia ... a tutta velocità
2004: 11 Bandi gara europei completati
2 Trattative private
16 Ordini all’industria
= 30 Ditte (18 Italiane) lavorano attualmente per il CNAO
2005: Completamento degli ordini e anno soprattutto di costruzione
2006: Installazione dei componenti (attività già in preparazione)
2007: Prove di funzionamento
27th May 2005
20

Elenco ditte che lavorano per il CNAO
DITTA
OGGETTO
DITTE ITALIANE
1 Ansaldo Superconduttori (Genova) Magneti convenzionali sincrotrone
2 Alintel (Pieve di Cento -- Bologna) Alimentatori RF
3 C&D elettronica (Bergamo) Componenti elettronici per il sistema di controllo
4 Calvi-Tekne-Inarcheck (Pavia - Milano) Progettazione Definitiva Edifici e Impianti e Direzione Lavori
5 CECOM (Guidonia - Roma) Camere da vuoto del sincrotrone
6 CINEL srl (Vigonza - PD) Apparecchiatura per misure magnetiche dei dipoli
7 CMB (Casalpalocco - Roma) 1. Flange / 2. Sistema di raffreddamento prototipo FC
8 DEC SpA (Bari) Costruzione Edifici e Impianti
9 EEI (Vicenza) Alimentatori dei multipoli del sincrotrone
10 INNOVACTION (Pianopoli - Catanzaro) Driver amplifier
11 Morgan - Wesgo (Casalpusterlengo - Lodi) Controlled resistivity alumina e metallizzazione aggiuntiva
12 OCEM (San Giorgio di Piano - Bologna) 1. Alimentatore dipoli, sext.res, corr. / 2. Ripristino, collaudo e upgrade alimentatore per RF
13 Robot Italy (Frascati - Roma) Componenti elettronici per il sistema di controllo
14 RS Components (Cinisello Balsamo - Milano) Componenti elettronici per diagnostica e laboratorio CERN
15 Sidea Srl-BlueSof (Milano-Torino) Sistema di supervisione e controllo
16 Stiavelli Irio SpA (Capalle - Campi Bisenzio - Firenze) Elettroventilatori per RF
17 VARIAN (Leinì - Torino) Pompe da vuoto per il sincrotrone
18 VLT (Colleferro - Roma) 1. Isolatori ceramici / 2. Prove di applicazione di isolante su flange DN 100
DITTE STRANIERE
19 COMVAT (Haag - Svizzera) Soffietti
20 DANFYSIK (Jyllinge - Danimarca) 1. Quadrupoli linac / 2. Magneti speciali
21 Dynalloy (Costa Mesa - California) Componenti elettronici per il sistema di controllo
22 Eckelmann (Wiesbaden - Germania) Sistema di controllo Linac
23 EVAC ( Buchs - Svizzera) Catene
24 JAEGER (Eppstein - Germania) Alimentatori Linac
25 NTG (Gelnhausen - Germania) Struttura RFQ
26 PINK (Wertheim -. Germania) Struttura IH
27 SigmaPhi (Vannes - Francia) Correttore
28 Stesalit AG (Zuillwil - Svizzera) Vetronite per strumentazione di misura dei dipoli
29 Vacuumschmelze (Hanau - Gemania) Vitrovac
30 THALES (Velizy - Francia) 1. Electron Tubes / 2. RF del linac
27th May 2005
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The synchrotron
The heart of CNAO
Linac
HE lines
Treatment rooms
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Table 1 – Clinical performance specifications for the CNA.
1 Beam particle species p, He 2+ , Li 3+ , Be 4+ , B 5+ , C 6+ , O 8+
2 Beam particle switching time ≤ 10 min
3 Beam range
1.0 g/cm 2 to 27 g/cm 2 in one treatment room
3.1 g/cm 2 to 27 g/cm 2 in two treatment rooms
Up to 20 g/cm 2 for O 8+ ions
4 Bragg peak modulation steps 0.1 g/cm 2
5 Range adjustment 0.1 g/cm 2
6 Adjustment/modulation accuracy ≤± 0.025 g/cm 2
7 Average dose rate 2 Gy/min (for treatment volumes of 1000 cm 3 )
8 Delivery dose precision ≤± 2.5%
9 Beam axis height (above floor)
150 cm (head and neck beam line)
120 cm (elsewhere)
10 Beam size 1 4 to 10 mm FWHM for each direction
independently
11 Beam size step 1 1 mm
12 Beam size accuracy 1 ≤± 0.25 mm
13 Beam position step 1 0.8 mm
14 Beam position accuracy 1 ≤± 0.2 mm
15 Field size 1 5 mm to 34 mm (diameter for ocular treatments)
2×2 cm 2 to 20×20 cm 2 (for H and V fixed beams)
16 Field position accuracy 1 ≤± 0.5 mm
17 Field dimensions step 1 1 mm
18 Field size accuracy 1 ≤± 0.5 mm
19 Field homogeneity 2 (orthogonal) R t ≤ 105%
20 Field homogeneity 3 (longitudinal) R l ≤ 111%
21 Field symmetry 2 ≤ 105%
22 Lateral penumbra 2 < 2 mm for each side
(80%-20%)
(at the phantom entrance surface)
23 Distal dose fall-off 3 (80%-20%) < 2 mm (in addition to intrinsic distal fall-off)
24 Source to surface distance (SSD) > 3 m
25 Coincidence of H and V beam axis ≤± 0.2 mm
1 At isocentre or, for fixed beam, at normal treatment distance.
At patient surface. 27th May 2005
3 Measured in water phantom.
Starting point...
THE PATIENT
Deep hadrontherapy
Optimised dose distribution
Beam quality (active scanning)
23

In collaboration with:
Conventional magnets
Prototype of a quarter of
a synchrotron
Quadrupole (N. 25)
27th May 2005
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Synchrotron Dipole
Contract signed on 9 June 2004 with:
ANSALDO SUPERCONDUTTORI
In collaboration with:
27th May 2005
25

Synchrotron Dipole
In collaboration with:
27th May 2005
26

Synchrotron Dipole
In collaboration with:
27th May 2005
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Synchrotron Dipole
In collaboration with:
27th May 2005
28

Synchrotron Quadrupole and Sextupole
In collaboration with:
27th May 2005
29

Synchrotron Vertical Steering
In collaboration with:
27th May 2005
30

In collaboration with:
Synchrotron Horizontal Steering
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In collaboration with:
Synchrotron Vertical Steering
B (G)
Z
200
180
160
X
s
140
120
100
-60,30
0,0
80
-60,-30
60
40
20
0
-200000 0 200000 400000 600000 800000
27th May 2005
s (µm)
32

In collaboration with:
Synchrotron Horizontal Steering
Z
X
s
450
400
350
300
250
200
-60,30
0,0
-60,-30
150
100
50
0
-200000 0 200000 400000 600000 800000
27th May 2005
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Synchrotron Magnets
• Under Construction by
ANSALDO Superconduttori
N. 21 Dipole Magnets (Synchrotron+HEBT)
N. 2 Dipole Magnets with Hole (HEBT)
N. 2 Half Dipole Magnets(HEBT)
N. 25 Quadrupoles
N. 5 Sextupole (1.5 mm)
N. 2 Resonance Sextupole
N. 11 Horizontal Correctors
N. 9 Vertical Correctors
27th May 2005
34

HEBT and MEBT Magnets
• Under Construction by:
ANSALDO Superconduttori
N.1 Switching Dipole (HEBT)
N. 38 Quadrupoles (HEBT)
N. 19 Corrector Magnets (HEBT)
N. 2 Dipole Magnets (MEBT)
N. 10 Quadrupoles (MEBT)
N. 8 Corrector Magnets (MEBT)
27th May 2005
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Linear Accelerator
Example of a similar structure realised at GSI
Contract signed
15th July 2004
Sub-contracts with firms:
Thales
Pink
Danfysik
Sigmaphy
Jaeger
NTG
Eckelmann
27th May 2005
36

In collaboration with:
Vacuum System
6 cm
14 cm
Contract signed
16th September 2004
With
CECOM (Roma)
Object: 70 m of vacuum chamber
Thin dipole chamber
27th May 2005
37

CNA/PS
In collaboration with:
Contract signed
19th October 2004 with:
OCEM
S. Gorgio di Piano (Bo)
In collaboration with
Bologna University
27th May 2005
38

Synchrotron Dipole Power Supply
Dipole Magnetic Field Cycles
27th May 2005
Vout = ± 1600 V
Iout = 3000 A
39

Synchrotron Power Supplies
Under Construction by OCEM (S. Giorgio di Piano – Bo)
‣ DIPOLES: ±1600V – 3000A – 10ppm – Number 1
‣ QUADRUPOLES: ± 150V – 600A – 10ppm – Number 3+1
‣ STANDARD SEXTUPOLES: ± 45V – 600A – 200ppm – Number 2+1
‣ RESONANCE SEXTUPOLE: ± 40(400)V – 600A – 6000ppm – Number 1+1
‣ HORIZ. CORRECTORS: ± 15V – 30A – 500ppm – Number 10+1
‣ VERT. CORRECTORS: ± 15V – 30A – 500ppm – Number 8
4 TENDERS AND 29 POWER SUPPLIES
Under Construction by EEI (Vi)
27th May 2005
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HEBT and MEBT Power Supplies
European Tender under way
‣ HEBT DIPOLES: ±110 V – 3000A – 100 ppm – Number 10+1
‣ MEBT DIPOLE: ±35 V – 300A – 100 ppm – Number 2+1
‣ HEBT QUADRUPOLES: ± 65V – 350A – 100 ppm – Number 37+1
‣ MEBT QUADRUPOLES: ± 20V – 150A – 100 ppm – Number 9+1
‣ HEBT COMB. STEERERS: ± 30V – ± 150A – 1000 ppm – Number 36+2
‣ MEBT COMB. STEERERS: ± 15V – ± 60A – 1000 ppm – Number 14+2
1 TENDER (3 issues) and 116 POWER SUPPLIES
27th May 2005
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RF Cavity
Acquired at the end of 2003
Completion plan in 2 years
LPSC+CERN for low-level
Milan
Task in the agreement
INFN-CNAO (23 July 2004)
27th May 2005
42

In collaboration with:
Special Magnets
Università
di Pavia
Chopper dipole
Under construction by DANFYSIK (DK)
Electrostatic Extraction Septum
27th May 2005
43

In collaboration with:
Università
di Pavia
Special Magnets
Under construction by DANFYSIK (DK)
Injection and
Extraction Section
Models
27th May 2005
44

Prototype of a pixel chamber
Beam Monitoring
Realised by:
Torino
Task approved in INFN-CNAO
agreement (23 July 2004)
27th May 2005
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Realised by:
Task approved in INFN-
CNAO agreement
(23 July 2004)
Last magnets of the HEBT lines
27th May 2005
46

Beam diagnostics
Started realisation: PU + Schottky
By CECOM (Roma)
Pick Up
27th May 2005
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Computed Aided Positioning in Hadrontherapy
PoliMi
Respiration gating
TVC
Gantry
27th May 2005
Couch
48

Controls Domain
Level 1
Supervisory Processes
Presentation Layer
Several
WS
Virtual Instruments
(LabView like)
for maintenance
The Challange
is to guarantee:
To scopes, TV monitors
or digital viewers
Signals
Acquisition
and
Distribution
System
Signals Analyser
Equipment
Component
Level 2
CSRS Protocols on Ethernet
or the crate bus
Level 3
Equipment
Component
Equipment
Component
Equipment
Component
Equipment
Component
Equipment
Component
Once per
cycle per
station
1 SERVER
or embedded in VME/PXI
Data Management Layer
Once
per cycle
or off line
Equipment Server Layer
Many
VME/PXI
RT processes run once per cycle
TCP/IP on
Giga Ethernet
CPU
Equipment
Component
asap
Once
per cycle
or off line
Cycle
Decoder
Equipment
Component
Equipment
Component
Timing
Triggers
Cycle
Code
Repository
Master Timing
RF Train
B Train
- Safety
- Efficiency
- Reliability
- Maintainability
Adequate for an
hospital based
facility
Digital or Analogue Signals Digital Signals
Digitiser
Level 4
Equipment
Controller
CSDRS Protocols on
Ethernet or FieldBus
Equipment
Controller
Manufacturer
Protocols on FieldBus
or point to point
Once per
cycle
(max 1000
scalar data)
or off line
Many VME/PXI/
PLC
Equipment Electronics Layer
RT processes can run
many times per cycle
Many times
per cycle
Equipment
Controller
CPU
Front End Electronics (signal conditioning)
Once per
cycle
(max 1000
scalar data)
or off line
Cycle
Decoder
Timing
Many times
per cycle
Off Off Line means e.g. end of
of
treatment or or before starting
treatment sessions
Cycle
Code
Triggers
Equipment
Electronics Domain
Under realization by:
SIDEA s.r.l. (Mi)
27th May 2005
SubSystems Domain (e.g. Beam Diagnostics)
Detectors and Actuators
49

Tappe nella realizzazione degli edifici
30 Aprile 2003 Completamento del progetto preliminare
5 Dicembre 2003 Chiusura del bando per progetto definitivo e direzione
30 Marzo 2004 Completamento progetto definitivo
22 Luglio 2004 Approvazione del progetto definitivo da parte della
Conferenza dei Servizi – Permesso a costruire
9 Febbraio 2005 Ordine della stazione elettrica di trasformazione (ENEL)
16 Febbraio 2005 Chiusura del bando di costruzione e firma del contratto.
Durata della costruzione dell’edificio: 18 mesi - fine 2006
21 Febbraio 2005 Presa di possesso dell’area per l’edificazione
18 Maggio 2005 Consegna progetto esecutivo
15 Giugno 2005 Inizio attività edilizie
28 Febbraio 2006 Consegna area Alta tecnologia
27th May 2005
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Attività AMBULATORIALE
Funzionamento
80% trattamenti con ioni e 20% con protoni – tempi liberi per ricerca e sviluppo
Durata seduta: ca. 20-30 minuti di cui 2-3 minuti per l’irraggiamento
Anno di funzionamento 1 2 3
Turni di lavoro per i trattamenti 1 2 2
regime
Ore giornaliere di funzionamento 7 13 13
Giorni di funzionamento / settimana 5 5 5
Settimane equivalenti / anno 44 44 44
Giorni equivalenti / anno 220 220 220
Pazienti che si trattano / anno 850 2200 3400
Numero sedute effettuate all’anno 4835 12160 18738
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