1. Detector technologies: from particle physics to radiotherapy
B. Camanzi
STFC – RAL & University of Oxford

2. SEPnet RDI Kick-off Meeting 19/04/10
Outline
Why cancer
The detector challenges: dosimetry and imaging
Positron Emission Tomography (PET)
Time-Of-Flight PET
Future activities
Conclusions
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

3. The challenge of cancer in UK
Cancer is the leading cause of mortality in people under the age of in 4 people die of cancer overall.
293k people/year diagnosed with cancer, 155k people/year die from cancer.
Incidence of cancer is rising due to:
Population ageing
Rise in obesity levels
Change in lifestyle
Cancer 3rd largest NHS disease programme.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

4. Radiotherapy and cancer in UK
Radiotherapy given to 1/3 of cancer patients (10-15% of all population).
Overall cure rate = 40%. In some instances 90-95% (for ex. breast and stage 1 larynx cancers).
Radiotherapy often combined with other cancer treatments:
Surgery
Chemotherapy
Hormone treatments
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

5. Radiotherapy treatments
External beam radiotherapy:
X-ray beam
Electron beam
Proton/light ion beam
Internal radiotherapy:
Sealed sources (brachytherapy)
Radiopharmaceuticals
Binary radiotherapy:
Boron Neutron Capture Therapy (BNCT)
Photon Capture Therapy (PCT)
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

6. The technological challenges
The challenge of radiotherapy from the patient end Make sure that the right dose is delivered at the right place = improved dosimetry + improved imaging
The challenge of early diagnosis “See” smaller tumours = improved imaging
New advanced technologies desperately needed for dosimetry and imaging
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

7. How particle physics can help
"The significant advances achieved during the last decades in material properties, detector characteristics and high-quality electronic system played an ever-expanding role in different areas of science, such as high energy, nuclear physics and astrophysics. And had a reflective impact on the development and rapid progress of radiation detector technologies used in medical imaging."
“The requirements imposed by basic research in particle physics are pushing the limits of detector performance in many regards, the new challenging concepts born out in detector physics are outstanding and the technological advances driven by microelectronics and Moore's law promise an even more complex and sophisticated future.”
D. G. Darambara "State-of-the-art radiation detectors for medical imaging: demands and trends"
Nucl. Inst. And Meth. A 569 (2006)
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

8. SEPnet RDI Kick-off Meeting 19/04/10
In-vivo dosimetry
Radiation sensitive MOSFET transistors (RadFETs) used in particle physics experiments (BaBar, LHC, etc.) for real-time, online radiation monitoring.
Development of RadFET based miniaturised wireless dosimetry systems to be implanted in patient body at tumour site for real-time, online, in-vivo dosimetry.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

9. SEPnet RDI Kick-off Meeting 19/04/10
Imaging
Most medical imaging systems, CT, gamma cameras, SPECT, PET, use particle physics technologies: scintillating materials, photon detectors, CCDs, etc.
Courtesy Mike Partridge (RMH/ICR)
Collimator
Scintillator
Diode
CT scanner
Gamma camera (SPECT)
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

10. Positron Emission Tomography
511 keV g
18F labelled glucose given to patients: e+ annihilates in two back-to-back 511 keV g.
A ring of scintillating crystals and PMTs detects the g.
Courtesy Mike Partridge (RMH/ICR)
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

11. SEPnet RDI Kick-off Meeting 19/04/10
Conventional PET
Conventional PET scanner:
Coincidences formed within a very short time window
Straight line-of-response reconstructed
Position of annihilation calculated probabilistically
Courtesy Mike Partridge (RMH/ICR)
PET CT
PET + CT
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

12. Time-Of-Flight PET (TOF-PET)
TOF-PET scanner:
Time difference between signals from two crystals measured
Annihilation point along line-of-response directly calculated
Goal: 100 ps timing resolution (ideally 30 ps and below) = 3 cm spatial resolution (ideally sub-cm)
Advantages: higher sensitivity and specificity, improved S/N
Technology needed: fast scintillating materials and fast photon detectors
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

13. Fast scintillating materials
Decay time (ns)
Light yield (g/keV)
Density (g/cm3)
Latt at 511keV (cm)
LaBr3(Ce) BrilLanCeTM380 16 63
5.3
2.23
LYSO PreLudeTM420 41 32
7.1
1.20
LSO 40 27
7.4
1.14
BGO
300 9
1.04
GSO 60 8
6.7
1.43
BaF2
0.8
1.8
4.9
2.20
NaI(Tl)
250 38
3.7
2.91
BrilLanCeTM380 and PreLudeTM420 produced by Saint-Gobain Cristaux et Detecteurs
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

14. Photon detectors: SiPMs
Array of Silicon Photodiodes on common substrate each operating in Geiger mode
SiPMs have speed (sub ns) and high gain (106), small size and work in high magnetic fields (7T)
Hamamatsu Inc.
1x1 mm2
3x3 mm2
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

15. Tests on TOF-PET prototypes
LaBr3(Ce) and LYSO scintillating crystals from Saint-Gobain
SiPMs from Hamamatsu, SensL and Photonique
Various two-channel demonstrator systems tested at RAL and RMH
Timing resolution analysis still ongoing
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

16. SEPnet RDI Kick-off Meeting 19/04/10
Preliminary results
Best SiPMs: Hamamatsu (electrical problem with 11-25) and SensL.
Best timing resolutions measured:
20 ps for single SiPM
40 ps for pairs of SiPMs
Hamamatsu performance as function of pitch still under investigation.
Prototypes with Hamamatsu 3x3 mm2 best of all. SensL blind to LaBr3.
Best timing resolutions measured:
430 ps with 3x3x10 mm3 LYSO
790 ps with 3x3x30 mm3 LaBr3
Performance of prototypes with LaBr3 highly dependent from SiPM-crystal coupling.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

17. SEPnet RDI Kick-off Meeting 19/04/10
Where next
Preliminary results very encouraging. Need to investigate technology further: build a dual-head demonstrator system. Two planar heads with identical number of channels.
Use of fast scintillators can be expanded to other imaging systems (CT, SPECT, etc.).
Use of SiPMs opens up the possibility of designing a compact PET/MRI scanner.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

18. SEPnet RDI Kick-off Meeting 19/04/10
Future activities
Participation through Oxford to FP7 project ENVISION (European NoVel Imaging Systems for ION therapy).
Development of a technology roadmap for cancer care, to move toward a multi-modality approach to radiotherapy.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

19. SEPnet RDI Kick-off Meeting 19/04/10
ENVISION
Participation in WP2: development of TOF in-beam PET systems.
Oxford/STFC contributions:
Characterisation of scintillating materials (LYSO and LaBr3)
Characterisation of SiPMs
Construction and test of a TOF-PET dual-head demonstrator system
Simulations of component (crystals and SiPMs) and system performance
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

20. My vision: toward multi-modality
Multi-modality = bringing together the different forms of radiotherapy treatments:
Select best treatment depending on tumour type
Combine different treatments when appropriate
New advanced imaging and dosimetry systems of paramount importance → Technology roadmap
Roadmap to be developed in consultation with end-user groups, universities, etc.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

21. SEPnet RDI Kick-off Meeting 19/04/10
Conclusions
Cancer is a leading cause of mortality in UK. Its incidence is rising.
Radiotherapy is and will be given to a large number of patients.
Patients will benefit from a multi-modality approach to radiotherapy. This requires the development of new, advanced technologies.
Particle physics holds the key to the development of these technologies.
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10

22. SEPnet RDI Kick-off Meeting 19/04/10
Acknowledgements
Prof Ken Peach (John Adams Institute)
Dr Phil Evans and Dr Mike Partridge (Royal Marsden Hospital / Institute of Cancer Research)
Gareth Derbyshire (STFC Healthcare Futures Programme)
Dr John Matheson and Matt Wilson (STFC-RAL)
B. Camanzi
RAL & Oxford University
SEPnet RDI Kick-off Meeting 19/04/10