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1 | VARIAN PARTICLE THERAPY Varian Particle Therapy David E. Mellenberg, Ph.D. DABR

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Page 1: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

1 | VARIAN PARTICLE THERAPY

Varian Particle TherapyDavid E. Mellenberg, Ph.D. DABR

Page 2: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

2 | VARIAN PARTICLE THERAPY

>1100ProBeam™

PSI – Paul Scherrer Institute

Page 3: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

3 | VARIAN PARTICLE THERAPY

>1,500ProBeam™

Rinnecker Proton Therapy Center

Page 4: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

4 | VARIAN PARTICLE THERAPY

2ProBeam™

Scripps Proton Therapy Center

Page 5: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

5 | VARIAN PARTICLE THERAPY

ProBeam™ Key Features

2nd Generation IMPTPencil Beam 4 mm σDose Rate 2 Gy/L/Min

Dynamic PeakTM

Scanning

Page 6: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

6 | VARIAN PARTICLE THERAPY

ProBeam™ Key Features

Dynamic PeakTM

Scanning

Page 7: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

7 | VARIAN PARTICLE THERAPY

Dynamic Peak™ ScanningPrecision

80 100 120 140 160 180 200 220 2403,0

3,5

4,0

4,5

5,0

5,5

6,0

sigm

a (m

m)

Energy (MeV)

sigma-x sigma-y

4 mm

1 mm

Page 8: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

8 | VARIAN PARTICLE THERAPY

30 cm

40 c

m

-20

-15

-10

-5

0

5

10

15

20

-20 -10 0 10 20

Y (c

m)

X (cm)

Film Plan

Dong/Scripps

Large Field AccuracyScripps Proton Therapy Center

Page 9: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

9 | VARIAN PARTICLE THERAPY

Page 10: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

10 | VARIAN PARTICLE THERAPY

ProBeam™ Key Features

• On-board 2D & CBCT• Dedicated User Interface• I-Lab Development• TrueBeam Roadmap

Dynamic PeakTM

Imaging

Page 11: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

11 | VARIAN PARTICLE THERAPY

Dynamic Peak™ ImagingKey Features

Page 12: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

12 | VARIAN PARTICLE THERAPY

Dynamic PeakTM ImagingBiplanar Imaging Panels

CBCT Capable

Robotic

Image Analysis

Integrated Hardware

Integrated Software

Page 13: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

13 | VARIAN PARTICLE THERAPY

Dynamic Peak™ ImagingKey Features

Page 14: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

14 | VARIAN PARTICLE THERAPY

Dynamic Peak™ ImagingDeformable Registration

Page 15: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

15 | VARIAN PARTICLE THERAPY

ProBeam™ Key Features

TrueBeam™ ConsoleTherapy Hand PendantGuided WorkflowField Groups

Dynamic PeakTM

Workflow

Page 16: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

16 | VARIAN PARTICLE THERAPY

ProBeam™

Image Guided Proton Therapy

Page 17: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

17 | VARIAN PARTICLE THERAPY

Dynamic PeakTM WorkflowCommon User Interface – Guided Workflow

Console Pendant

Page 18: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

18 | VARIAN PARTICLE THERAPY

ProBeam™ Key Features

• Lessons learned conventional RT

• Multiple Strategies• Monitored Breath Hold,

Motion Scanning, Gating, Tracking, Triggered Imaging

Dynamic PeakTM

Motion Management

Page 19: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

19 | VARIAN PARTICLE THERAPY

Intra-fraction Motion

No MotionAmplitude under x mm

MotionAmplitude over x mm

Interplay EffectHot and cold spots

Also an issue for IMRTNot present with scattering

Position EffectMissing the target

Scanning DirectionLei Dong: solves 90% of issues

Ready to publish

RepaintingTony Lomax: 2 times layer

4D simulation

ITV TreatmentLarger margins around targetDominant strategy in photons

GatingSelecting part of the motion cycle

Vision RT Calypso Triggered Imaging

Auto Beam Hold

RPM

DeformationChange of tumor geometry

CBCTDetect deformation

Def- registration

Adaptive treatmentRe-plan, online or offline

After y fractions

Dynamic PeakTM Motion ManagementOverview

Page 20: Varian Particle Therapy - American Association of ... · 7 | VARIAN PARTICLE THERAPY Dynamic Peak™ Scanning Precision 80 100 120 140 160 180 200 220 240 3,0 3,5 4,0 4,5 5,0 5,5

20 | VARIAN PARTICLE THERAPY

Varian Medical SystemsVision