Instrumentation & Measurement Magazine 24-9 - 62

Fig. 2. The main elements that comprise the DDS. (a) The cabinet with the control electronics; (b) The two beam monitors.
The DDS comprises two main parts: the beam monitors,
placed on the beam path adjacent to the patient (Fig. 1 and
Fig. 2b), and the control unit, where the electronics and data
acquisition system are housed. The beam monitors include
two types of large area transmission ionization chambers,
used to measure beam position and intensity, while the control
unit includes a crate equipped with a controller and
programmable cards to execute the control and monitor
programs.
The CNAO DDS was designed to deliver treatments where
the tumor and the surrounding tissues remain static during the
course of treatment; however, today, the treatment of moving
organs has become of vital importance and remains as the most
significant challenge within the particle therapy community.
In an effort to tackle this challenge, a collaboration has been
established between CNAO and the German Ion Research
Center (GSI) in Darmstadt, Germany in order to implement
a new version of DDS with new strategies for motion mitigation
and for on-line evaluation of the delivered treatment. In
this work, we describe present and future technologies of the
CNAO DDS.
Introduction
Protons and heavier ions have emerged as a valuable radiation
therapy for several indications. In Europe, more than 30 clinical
particle therapy facilities are now in operation, while just
five centers were available 10 years ago [1].
62
The advantages of particles arise from their energy deposition
characteristics. As particles traverse through matter,
they slow down and their energy loss per unit track length increases.
This leads to a large peak of dose deposition at end of
its range, called the Bragg peak. This leads to a significantly
more conformal dose distribution in comparison to conventional
photon therapy. In particular, the low dose volume is
reduced drastically, as most particle irradiations achieve a conformal
target dose with 2 to 3 field angles only.
Heavier particles such as carbon ions also offer a higher
ionization density and therefore offer the potential to overcome
radioresistance in certain tumor types. Certain tumor
entities and locations benefit strongly from the characteristics
of particles, for example, ocular melanoma or craniospinal axis
irradiations. Tumors located in complex anatomies such as the
base of the skull can be treated more easily with the increased
conformity of particle beams.
Particles can be delivered with the pencil beam scanning
(PBS) technique. Since being pioneered at two European particle
therapy facilities [2]-[4], it has become the preferred
method for ion beam delivery used worldwide. PBS involves
delivering layers of narrow ion beams to shape the dose
volume, allowing for sparing adjacent organs at risk and maximizing
the treatment outcomes of ion beams. In comparison to
the previous standard for passively scattered particle beams,
active scanning permits conformal dose shaping in beam
range also proximal to the target. Moreover, the simultaneous
IEEE Instrumentation & Measurement Magazine
December 2021

Instrumentation & Measurement Magazine 24-9

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