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The PSIHO Project In-hospital installation of Dedicated Linac &

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1 The PSIHO Project In-hospital installation of Dedicated Linac &
Photoneutron Source In HOspital In-hospital installation of Dedicated Linac & New PhoNeS photoconverter Gianrossano GIANNINI Physics Dept. Trieste University and INFN Via Valerio 2, Trieste, 34127, Italy Financially supported by: National Institute for Nuclear Physics Ministery of Industry, Research and University Fondazione CRT Torino

2 PhoNeS Bianco prototype
At present GRAPHITE LEAD D2O POLYETHILENE Cavity: 20 x 20 x 10 cm3 PhoNeS Bianco prototype 50% boron carbide slabs 50% Epoxy resin slabs, thickness 2 mm Lead slabs, thickness 1 mm 60 cm MCNP-GN simulation Closed cavity configuration Two carbon fibre boxes filled with heavy water and a polyethylene slab to close Graphite: - 2 horizontal blocks, 15 x 30 x 60 cm3 - 2 vertical blocks, 15 x 30 x 30 cm3 Thermal neutron field of suitable intensity and energy spectral distribution for biological samples irradiation

3 Orbassano –Torino (Italy)
Universita’ degli Studi di Torino II Facolta’ di Medicina e Chirurgia ASO San Luigi Gonzaga Orbassano Torino Orbassano –Torino (Italy) The hospital was funded in 1818. Since 1970 is situated in the new location. It is leader in the treatment of lung diseases. BUNKER

4 Campioni di tessuti polmonari umani, in seguito a rimozione chirurgica
presso l’ospedale S. Luigi Orbassano di Torino dopo perfusione con boron-phenyl-alanine arricchita in 10B (10BPA) per 2 ore, Campioni ~10mm di spessore e ~ 1cm2 di area preparati su lastrine di CR-39

5 Convertitore fotoneutronico PhoNeS montato presso il linac Elekta SLIT 25 MV dell’Ospedale Le Molinette di Torino Campioni biologici su CR-39 due strati (37 x 13 x 1 mm3) esposti a neutroni termici nella cavita’ di PhoNeS

6 Electa SL25 25 MV 70000 M.U. @400 M.U./min 104 s ~ 3 hours PHONES ~1011 n/cm2

7 CR-39 ANALYSIS Histological samples on CR-39 detectors and corresponding image of samples after irradiation.

8 Image processing ImageJ. Cinema 4D. Surfer8. green>20ppm
blue>40ppm orange>60ppm red>80ppm Color-densitometry

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13 for hole area study and counting
Image-Pro Plus © Microscopic Image Automated Analysis for hole area study and counting

14 DETERMINATION OF BORON CONCENTRATION AT VARIOUS
TIMES AFTER PERFUSION WITH 10BPA μg/ml (Pavia) or ppm (Trieste/Como) Time, min

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16 Analisi di campioni biologici da tessuto umano trattato con perfusione ex-vivo con BPA per studiare diversi tipi di patologie tumorali (in particolare il mesotelioma) seguendo le indicazioni degli oncologi. Si prevede che nei prossimi decenni (2015) il mesotelioma polmonare (neoplasia della pleura polmonare) diventi uno dei tumori con il più alto tasso di incidenza a causa dell’uso industriale e civile dell’amianto negli ultimi anni. QUESTO ASPETTO E’ DI GRANDE INTERESSE PER LA COMPONENTE OSPEDALIERA. In Regione Piemonte si prevede un numero rilevante di pazienti affetti da tale patologia per la presenza di impianti industriali che utilizzavano o producevano eternit (“Eternit” di Casale Monferrato), e come dimostrato anche da recenti fatti di cronaca (Chivasso (TO), 22/07/08) Le regioni più colpite dal mesotelioma, il cosidetto “mal d’amianto”,sono: Liguria, Friuli Venezia Giulia, Piemonte e Lombardia

17 PhoNeS Bianco neutron spectrum
At present PhoNeS Bianco neutron spectrum

18 Dedicated Linac: advantages & goals
Possibility of full time use of the LINAC overcoming the restriction imposed by radiotherapy departments for the use of clinical accelerators: Time restriction (following the patients timetable) Impossibility to modify the machine parameters For photoneutron production it is not necessary to have an optimized gamma beam (g,n) treashold energy region Neutron photoproduction +1.5 times higher Removing filters (flattening and hardening filters) from the linac gantry Improving the linac duty cycle, (increasing beam current, repetiton rate, pulse duration, etc.) to obtain higher gamma fluence rate higher neutron photoproduction

19 Experimental set-up for biological trials
At present Experimental set-up for biological trials e-Linac Elekta 25 MeV max dose rate 400 UM/min PhoNeS Bianco (weight ~ 400 kg – assembling time ~ 1.5 ore) Thermal neutron fluence rate ~ 1E7 n cm-2s-1 Biologiacl samples: primary lung carcinoma UM total: 70000; Total fluence: ~ 1E11 ncm-2; Irradiation Time: ~ 3 hrs BIOLOGICAL SAMPLES INSIDE THE CAVITY The irradiation has been carried out at Radiotherapy Department of San Giovanni Battista Molinette Hospital (Turin, Italy)

20 LINAC ELEKTA PRECISE 18 MV DEDICATED LINAC
FUTURE LINAC ELEKTA PRECISE 18 MV DEDICATED LINAC (#) (#) as in 25MV Dose Rate: 400 UM/min Average Beam Energy: 20,39 MeV Effective pulse duration: 2,8 micros Peak beam current: 50 mA Repetition Rate: 200 Hz Electron current on target: 1,75E14 e-/s Neutron photoproduction 4 times higher

21 PhoNeS Optimized Prototype
FUTURE PhoNeS Optimized Prototype GRAPHITE LEAD HEAVY WATER POLYETHILENE IRRADIATION CAVITY An optimized geometrical configuration of the various components has been designed. The high-Z core for neutron production and the low-Z moderating structures are suitably shaped.

22 Neutron photoproduction 15 times higher
PhoNeS Optimized Neutron photoproduction 15 times higher by using PhoNeS optimized prototype and dedicated LINAC PhoNeS Bianco

23 PhoNeS Bianco vs PhoNeS Optimized Prototype
PhoNeS Prototypes Neutron Beam Parameter PhoNeS Bianco PhoNeS Optimized Thermal Neutron Fluence Rate 1.01E7 cm-2s-1 (78%) 1.50E8 cm-2s-1 (73%) Epithermal Neutron Fluence Rate 2.18E6 cm-2s-1 (18%) 4.08E7 cm-2s-1 (20%) FastNeutron Fluence Rate 5.88E5 cm-2s-1 (4%) 1.43E7 cm-2s-1 (7%) Biological samples irradiation time 3 hrs (1E11 ncm-2) 12 min

24 BUNKER INSTALLATION SITE
ASU San Luigi Gonzaga Orbassano (TO) CORRIDOR CONTROL ROOM BUNKER Already built and actually not used for radiotherapy. Proposed by San Luigi Gonzaga hospital for PhoNeS BNCT studies

25 Dedicated Linac: ACTIONS
ITEM ACTION Disassembly Assembly Transport PROVIDED BY ELEKTA COMPANY financial support by INFN?, bank foundation? Beam Modification (removing filters, beam upgrade, electrical wiring) Magnetron replacement and assistance IF NECESSARY Waveguide 20-year Elekta warranty Cooling system It is NOT necessary a dedicated cooling system (e.g. Chiller) (temperature of water should be 12 to 20°C, and must be not less than 12°C; Elekta specifications) Technical assistance Partialy covered by INFN-TO technical staff Elekta intervention if necessary Adaptation of San Luigi Gonzaga bunker Provided by Hospital

26 Conclusion 12 min.  total thermal neutron fluence rate of 1E11 cm-2
A dedicated LINAC and an optimized PhoNeS prototype could provide an increase of neutron photoproduction of: about +1.5 times by removing filters (flattening and hardening) about +4 times by increasing LINAC beam power about +2.5 times by using PhoNeS optimized prototype for a total of about 15 times higher in neutron photoproduction 12 min.  total thermal neutron fluence rate of 1E11 cm-2 FIRST IN-HOSPITAL NEUTRON SOURCE FOR BNCT RESEARCH! (available to the worldwide BNCT scientific community)

27 Collaboration Hospitals Industries Institutes INFN Torino INFN Trieste
Università degli Studi di Torino Politecnico di Torino Università degli Studi di Trieste Università dell’ Insubria di Como Università degli Studi di Pavia Universita’ FedericoII di Napoli Universita’ La Cattolica di Roma Hospitals IRCC Candiolo (Torino) ASO Mauriziano Umberto I° (Torino) AOU San Luigi – Orbassano (Torino) AOU San Giovanni Battista (Torino) ASO Sant’Anna (Como) Ospedale Maggiore (Trieste) ST. JOHANNS HOSPITAL Salisburgo Industries SORDINA s.p.a. Saonara (PD) Elekta Company Tecnologie Avanzate s.r.l. ( Torino)

28 PSIHO Photoneutron Source In HOspital
TRIESTE: Gianrossano Giannini (100%, Resp.Loc., P.O.), ErikVallazza (20%, P.R.), Massimo Vascotto (20%, D.S.S.), A.Zanini (Resp.Naz., INFN Torino) Richieste finanziarie locali a Ts (kE) MI:9.0 ME:4.0 MC:6.0 TR:2.0 CA:8.0 TOT:29 Richieste servizi: Officina Meccanica :S.Reia (2m/u), D.Iugovaz (1m/u); Laboratorio Elettronica e Rivelatori : M.Bari (1m/u)

29 Torino-Trieste-Como project
In-Hospital installation of Dedicated Linac & PhoNeS Optimized Prototype Previous results Great interest by San Luigi Gonzaga hospital (Orbassano, Torino) for BNCT study on lung tumors (adenocarcinoma, mesothelioma) Availability by Elekta company in order to provide a decommisioned 18 MV Linac and to adapte for BNCT studies Possibility of installation in radiotheraoy dept. of San Luigi Gonzaga hospital with collaboration and assistance of radiotherapy staff. Applications in BNCT: analysis of 10B uptake in different lung cancer study of the behaviour and efficacy of different 10B carriers Multidisciplinary applications cultural heritage studies, neutron radiography, etc. Linac accelerators already exist in hospital radiotherapy departments well-known technology accepted by patients and medical staff Projects PHONES, NOE, NOE2 supported by INFN from 2005 to 2010 Encouraging results obtained during: feasibility study, first prototype test (PhoNeS Bianco), first biological trials on human lungs

30 Papers and Presentations at International Meetings
“A novel approach to BNCT with conventional radiotherapy accelerators.” Nuclear Instruments and Methods in Physics, Bevilacqua, R., et al., PhoNeS: Research A 572, “Comparison of different MC techniques to evaluate BNCT dose profiles in phantom exposed to various neutron fields.” Durisi et al Radiation Protection Dosimetry in press. Monte Carlo simulation of the photoneutron field in linac radiotherapy treatments with different collimation systems. Zanini, A., et al., Physics in Medicine and Biology, 49, 1-12. “Design of an epithermal column for BNCT based on DD fusion neutron facility”. Durisi E. et al. (2007). Nuclear Instruments and Methods in Physics, vol. 574; p , ISSN: “DoseMeasurements in the Thermal Column of the TAPIRO reactor.” Rosi G. et al. (2004). RADIATION PROTECTION DOSIMETRY, vol. 110; p “A Photoneutron Source for In-Hospital BNCT Treatment: feasibility study”. 12th International Congress on Neutron Capture Therapy 9-13 October 2006 Takamatsu, Kagawa, Japan. “A novel approach to the study of 10B uptake in human lung by ex-vivo BPA perfusion”. 13th International Congress on Neutron Capture Therapy, 2-7 November 2008 , Florence, Italy. "Characterization of a Thermal Cavity in the PhoNeS photo-neutron converter for BNCT research" - 13th International Congress on Neutron Capture Therapy 2-7 November 2008 Florence, Italy. “CR-39 neutron imaging of biological samples at clinical linac’s”. - 13th International Congress on Neutron Capture Therapy 2-7 November 2008 Florence, Italy. “Comparison of different MC techniques to evaluate BNCT dose profiles in phantom exposed to various neutron fields.” 13th International Congress on Neutron Capture Therapy, 2-7 November 2008 , Florence, Italy. “ 10B concentration analysis in primary human lung adenocarcinoma by Thermal Cavity of PhoNeS photo-neutron converter”. Young Researchers BNCT Meeting, 29 September – 2 October 2009, Mainz, Germany “ICP-MS analysis of 10B, in human cell lines and tissues, as support to the new Boron Neutron Autoradiography (PhotoNeutronSource project)”. Young Researchers BNCT Meeting, 29 September – 2 October 2009, Mainz, Germany


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