Functional Requirements for IMRT

Timothy J. Waldron, M.S.

OR: Accelerator Fundamentals: Role and Impact on IMRT

Short Review of Basic Concepts
Accelerating Structures Electron Injection Energy Control Dose Rate/Beam Control

Implementation of First Generation IMRT Systems

Elekta Siemens Varian

Accelerating Structures: Traveling-Wave

Implementation of Second Generation IMRT

Tomotherapy

Circular transmission waveguide Tube and Washer slow wave structure decreases phase velocity of the RF to a useful level (< c). Washer spacing greater at proximal end, constant at distal end -electron transit time decreases, then is essentially constant as energy approaches c.

Accelerating Structures: Traveling-Wave

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Accelerating Structures: Traveling-Wave

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Packets of RF energy are injected at proximal end and extracted at distal end. Instantaneously, half of structure electric field is zero, no acceleration occurs. Electric field amplitude decreases along length of accelerator due to resistive losses.

Electrons are captured and accelerated by the differential electric field components of RF waves. Electrons accelerated downstream travel with RF wave groups. Output electron energy spectrum is primarily dependent upon RF frequency.

Accelerating Structures: Standing-Wave

Accelerating Structures: Standing-Wave

Series of coupled circular resonant cavities. Alternating zero field cavities propagate RF only, and so may be on or off of beam axis. Most proximal cavity (buncher) may be larger, but generally all accelerating cavities same size.

RF is injected at any point, not extracted per se. SW structure is a highly resonant shorted transmission line, RF propagates/reflects. After fill time, electric fields in structure establish standing wave pattern of apparently stationary nodes and modes of uniform amplitude.

Accelerating Structures: Standing-Wave

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Accelerating Structures: Energy Control

TW Accelerators
Accelerator length (power limited) RF Frequency

Electron transit time approximately 1/2 RF wave time constant. Electrons see constant repelling electric field upstream and attracting electric field downstream. Resonant structure operates over narrow frequency range.

SW Accelerators
RF Power/cavity. Number of cavities (length). Several techniques in use.

Energy Control: Acceleration Per Cavity

Energy Control: Length of Accelerator/# of Cavities (1)

E1

A1

E1

E2 < E1 A2 = A1/2 E2 < E1

Energy Control: Length of Accelerator/# of Cavities (2)

Electron Injection
Gun/Injector Functions
Controllable source of electrons to be accelerated (Thermionic emission). Provide initial velocity to electrons for capture by oscillating electric fields.

Energy Switch out

E1

Energy Switch in

E2 < E1

Both Diode and Triode designs are currently in use.

Diode Electron Gun

FOCUSING (V0 - HV) ACCELERATING STRUCTURE

Triode Electron Gun (gridded)

GRID (+ inj. on/ - inj. off) FOCUSING ( - HV) ACCELERATING STRUCTURE

FILAMENT

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FILAMENT

CATHODE (-HV)

CATHODE (- V0 - HV)

Triode Electron Gun (gridded)

GRID (- inj. off) FOCUSING ( - HV) ACCELERATING STRUCTURE

Triode Electron Gun (gridded)

GRID (+ inj. on) FOCUSING ( - HV) ACCELERATING STRUCTURE

FILAMENT

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FILAMENT

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CATHODE (- V0 - HV)

CATHODE (- V0 - HV)

Basic Beam Parameters

Amplitudes -RF
RF Power level determines available work to accelerate electrons. RF Work in accelerator is shared between accelerating electrons and resistive heating of structure. Resistive heating/cooling of accelerator impacts frequency characteristics. Initial beam-on may incorporate a run-up period for RF system to stabilize frequency.

Basic Beam Parameters

Amplitudes -Gun Current
Governs fluence or dose per pulse. Increasing gun/injector current loads RF, result is decrease in average energy as available work is exceeded. Increased cathode/filament temperature increases emission (potential gun current). Increasing cathode voltage increases gun current. Backheating occurs as cathodedriven current further increases temperature.

Dose Rate, Beam Control

Beam Pulse = Coincident RF + Injection
Options depend upon gun/accelerator type.

Dose Rate, Beam Control

Run-up time
At initial beam on, the time necessary for RF in accelerator to stabilize, and re-stabilize as beam is loaded with electrons. Depends strongly upon gun and accelerator design.

Control Options via:

Coincidence/anti-coincidence of gun + RF to control single beam pulse production. Control repetition frequency of coincident RF + gun to control pulse rate Control fluence per pulse via gun current to control dose rate. Calibration may be affected (recombination).

Intra-segment time
Time required for beam production to restabilize after beam suppression between IMRT segments. Linac and control system each contribute some component.

First-Generation IMRT Implementations

Existing Radiotherapy delivery systems adapted/modified for IMRT. System Overview, Overall Control Architecture, Beam Control, IMRTspecific parameters for:
Elekta SL-25/Precise Siemens Primus/Oncor Varian 21EX/Millenium

Elekta SL-25/Precise
Travelling-Wave accelerator Diode (nongridded) Injector/Gun Energy Control via RF frequency and beam loading 80-leaf MLC replaces upper jaws

Elekta/Precise Control System Architecture -Overall

CONTROL AREA 16 -HT & RF MULTIBUS 2 Display (NT) Processor BACKPLANE Remote Terminal Unit (RTU) x2 High Voltage Microwav eHardwar e/Circuits

Control Area -Redundant, 1/2 shown

Eurocard Cardrack/Backplane Remote Terminal Unit (RTU) 1 of 2 -A or B Multiplexer Terminal Unit (MTU) Relay Output Card (ROC) Aux PSU PCB DC Power Supply

Elekta Control Architecture I/O

Treatment Terminal

Debug Terminal

Control Processor (RMX)

CONTROL AREA 12 -Radiation Head Control Mode Remote Selection Terminal BeamUnit Modifier Controls/ (RTU) x2 Circuits FULL-DUPLEX SERIAL BUS IN DAISY-CHAIN CONFIGURATION CONTROL AREA 72 -Interface Cabinet Remote Terminal Unit (RTU) x2 Interface & Motor Controls Hardware/ Circuits

1/2 Serial Link to Control System

Analog Input PCB (12 Bit 10V AD)

Digital Input Encoder (DIE) 32 Inputs 8 Outputs via FPLAs DIE #2 (ICCA B only)

Analog Output 8 bit DA 8 channels

Control Area Specific Circuit Boards (Dosimetry in RHCA, HV Supply Control in HTCA)

Other Machine Hardware

Signal Conditioning Card (SCC)

Analog Output 12 bit DA 8 channels

Elekta Control System: MLC

MULTIBUS 2 CCD Camera BACKPLANE

Elekta Beam Control

Diode gun and TW accelerator: Each microwave pulse synchronized with an injection pulse and intended to produce beam. Run-up 8-10 seconds, as cathode temp stabilizes and RF system tunes to proper frequency. Dose rate is controlled by adjusting the machine Pulse Repetition Frequency (PRF). For a nominal dose rate of 700 MU/minute, the SL-25 is pulsed at 400 PPS. Nominal output is approximately 0.03 MU/pulse.

Control Processor (RMX)

Video Digitizer Card

MLC Head Electronics

Head Control RTU (Area 12)

FULL-DUPLEX SERIAL BUS IN DAISY-CHAIN CONFIGURATION

Elekta/Precise Beam Control (IMRT)

Intra-segment state is achieved by setting gun filament to standby value and suppressing triggers to modulator and injection. Magnetron uses a solenoid linear actuator to drive the magnetron tuning plunger instead of a rotary gear/chain arrangement. Faster tuning reduces intra-segment time to 2-4 seconds. Reduced dose rates are selected by varying frequency of filament voltage (cathode temperature) at the nominal system PRF.

Siemens Primus/Oncor
Standing-Wave Accelerator Triode (gridded) Gun Injector Energy control via RF-power-per cavity/beam loading. 58 or 82-leaf double-focussed MLC replaces lower jaws.

Siemens Control System Architecture -Overall

Function Controller 0 MOTORS
Console PC w/ Serial Interface Processor

Siemens Control System: MLC

Function High Speed Serial Comm Function Controller Comm Chain

Function Controller 1 DOSE 1

Function Controller 2 DOSE 2

Controller 3 BEAM

Console PC w/ Serial Interface Processor

Function
FULL-DUPLEX SERIAL BUS DAISY-CHAIN CONFIGURATION

Function Controller 6 INTER -LOCKS

Function Controller 5 LIGHTS BMSHLD

Function Controller 4 HAND CONTROL

Leaf Bank B Drives + Feedback X 29

Leaf Bank A Drives + Feedback X 29 Multiplexer I/O Hardware Lines to Motors and I/L Controllers

Controller 7 I/O

Siemens Beam Control

Triode gun, SW accelerator. An injection pulse is produced in coincidence with each RF pulse. Dose rate is controlled by adjusting PRF of system. Dose rate servo takes input from Dose Channel 2, adjusts PRF to maintain specified rate. Run up 3-6 seconds, gun pulse is dephased/non-coincident with RF.

Siemens Beam Control (IMRT)

Machine enters a PAUSE state while beam shaping components are moved. PAUSE is achieved by de-phasing injection and RF so they are non-coincident. RF power may be reduced during PAUSE to suppress dark current by adjusting PFN to IPFN (80% of nominal) value. Intrasegment time is <1 second for linac, additional time for control system.

Varian 21-EX
Standing-Wave Accelerator Triode Gun Injector Energy control via RFpower-per cavity/beam loading, energy switch for low-X. 120 leaf Tertiary MLC with rounded leaf ends.

Varian Control Architecture Overall

STD BUS BACKPLANE

Linear Accelerator
Hardware and Inroom circuits

Comm Console PC Processor

Control Timer

Clinical Keyboard

Control Processor

Input / Output

Signal Conditioning Backplane Signal processing / scaling and distribution

Varian Cardrack Machine parameter control and interlock circuits

Common RAM

Varian Control System: MLC

Console Electronics
MLC Workstation PC

Varian Beam Control

Injection pulse is coincident with RF to produce a beam pulse, or delayed to not produce. Gun is pulsed continuously for constant temp/emission. Dark current is suppressed by ionic vacuum pumping in gun region, and a solenoid that encloses the accelerator. Microwave system and injector are pulsed at constant 360 PPS in lowX and 180 PPS in highX. Nominal max dose rate is 600 MU/min, the dose per pulse is approximately 0.03 and 0.06 MU/pulse for lowX and highX, respectively. Run-up is approximately 500 mSec.

Control Timer Hardware Interface Lines: Beam Holdoff MLC I/L

Comm Processor

Carriage A
Leaf Drive/ Feedback I/O

Carriage B
Leaf Drive/ Feedback I/O

RS232 Serial Comm

Signal Conditioning I/O

X 60

X 60

MLC Controller

Full-Duplex Optic Fiber Link X 2

RS-422 Serial Comm

Varian Beam Control (2)

Dose rate is controlled by selecting injector pulses to be coincident or not out of a 6pulse train. In the highest dose rate all 6 pulses are coincident. Dose rate servo delays pulses as needed to achieve specified rate over a 50 mSec sampling cycle (control window). Resolution of the dosimetry subsystem is 0.01 MU, but the overall resolution is 1 beam pulse (0.03 MU in lowX or 0.06 MU in highX mode).

Varian Beam Control (IMRT)

In IMRT, the Dynamic Beam Delivery servo auguments the dose rate servo: Injection pulses are delayed/coincident to produce beam or not based on a control window. The control window and beam holdoff are now a function of the status of the modulating/beam-shaping device (MLC position, gantry angle, jaw position or gating). Intrasegment time is 50-60 mSec. 50 mSec. from control system, 0-10 mSec. for linac.

Second-Generation IMRT Implementation

Radiotherapy delivery system designed specifically for IMRT delivery. System Overview, Overall Control Architecture, Beam Control, IMRTspecific parameters.

Tomotherapy Hi-Art
Helical Tomotherapy Standing-Wave Accelerator (Single photon) Triode (gridded) Gun Injector 64 Leaf Interlaced Binary MLC MVCT Detector Array

The Geometry of TomoTherapy

6 MV Linac

Binary MLC

Hi-Art Control Architecture Overall

LINAC GANTRY ANGLE HARDWARE SYNC COUCH

85 cm Gantry Aperture Approximately 85 cm 40 cm MVCT FOV

5 mm X 6.1 mm X 6.1 mm Minimum Voxel size at Isocenter

Approximately 50 cm 5 - 40 mm Selectable Slice Thickness

MLC/JAWS

STC
Operator Workstation/ Console

DETECTOR ARRAY

OBC SLIP RINGS DRS

64 MLC Beamlets - 6.25 mm average width at isocenter Courtesy of Tomotherapy, Inc.

MVCT Detector System Continuous Rotation

To External Data Server

Hi-Art Interlock Sub-system

LINAC HARDWARE I/L GANTRY HIGH VOLTAGE ENABLE DOOR I/L OBC STC

Hi-Art Beam Control (IMRT)

Triode gun, SW accelerator. An injection pulse is produced in coincidence with each RF pulse. Dose rate is controlled by adjusting PRF of system. Run up 3-6 seconds, gun pulse is dephased/non-coincident with RF.

S.W. SAFETY TASK

Operator Workstation /Status Console

COMMUNICATIONS

COUCH

Hi-Art Beam Control (IMRT)

Beam delivery is hardware-synchronized pulseby-pulse to gantry rotation (rather than MU delivery). Ionometric dosimetry system functions to maintain constant dose rate of 1000 cGy/min at a nominal PRF of 300 PPS, or approximately 3.33 cGy/pulse. Traditional flattening filter unnecessary, resulting in factor of 1-3 increase in dose rate.

Heartfelt Thanks
Frank Spitz of Thomas Jefferson University Hospital for education on Elekta systems. George Aleman of MD Anderson Cancer Center for review and details on Siemens digital control system. Jim Bilich of Siemens Medical Systems Calvin J. Huntzinger of Varian Medical Systems David C.Murray of Tomotherapy Inc.

Thank you!