ES2671028T3 - Cancer treatment apparatus with multiaxial charged particles - Google Patents

Abstract

An apparatus that uses charged particles for irradiation of a tumor of a patient (1430), comprising a synchrotron (130) configured to provide control of an energy and intensity of an extracted beam, in which the control of energy and Intensity control occurs during extraction, comprising the synchrotron (130): a beam extraction path, comprising the path sequentially: a radiofrequency cavity system (1210) comprising a first pair of sheets (1212, 1214) ; an extraction foil (1230) that is approximately thirty to one hundred micrometers thick and essentially consists of atoms that have six or less protons; a second pair of sheets (1214, 1216); and an extraction magnet (292); in which the synchrotron (130) is configured to control an acceleration period to accelerate the charged particles, and a synchronization of the charged particles that hit the extraction foil (1230) in the acceleration period to control the energy of the extracted beam , in which the radiofrequency cavity system (1210) is configured to apply a radiofrequency through the first pair of sheets (1212, 1214) to alter a trajectory of the charged particles through the extraction lamella (1230) producing particles charged with reduced energy, and wherein the second pair of sheets (1214, 1216) is arranged so that the particles charged with reduced energy pass through the second pair of sheets (1214, 1216), the second pair of sheets being (1214, 1216) configured to have a direct current voltage of at least five hundred volts applied by the second pair of sheets (1214, 1216) for extr aer particles charged with reduced energy through the extraction magnet (292) outside the synchrotron (130), and in which the synchrotron (130) is configured to provide feedback control of the intensity of the extracted beam, to control the radio frequency cavity system (1210), using a feedback generated by a current generated by the charged particles that are transmitted through the extraction foil (1230) as an indicator of the intensity of the charged particles.

Description

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Cancer treatment apparatus with multiaxial charged particles DESCRIPTION

Background of the invention Field of the invention

This invention relates generally to the treatment of solid tumors. More particularly, the invention relates to an apparatus for controlling irradiated beams of charged particles in the treatment of cancer.

Description of the prior art

Cancer

A tumor is an abnormal mass of tissue. The tumors are benign or malignant. A benign tumor grows locally, but does not spread to other parts of the body. Benign tumors cause problems due to their spread, as they press and displace normal tissues. Benign tumors are dangerous in confined places such as the skull. A malignant tumor is able to invade other regions of the body. Metastasis is the spread of cancer by invading normal tissue and spreading to distant tissues.

Cancer treatment

There are several different forms of radiation therapy for cancer treatment, including: brachytherapy, traditional electromagnetic X-ray radiation therapy and proton therapy. Proton therapy systems typically include: a beam generator, an accelerator and a beam transport system to move the resulting accelerated protons to a plurality of treatment rooms where protons are delivered to a tumor in a patient's body .

Proton therapy works by targeting energy ionizing particles, such as protons accelerated with a particle accelerator, to a target tumor. These particles damage the DNA of the cells and eventually cause their death. Cancer cells, due to their high division speed and reduced ability to repair damaged DNA, are particularly vulnerable to attack on their DNA.

Cancer treatment with charged particles

The patents related to the present invention are summarized herein.

Proton beam therapy system

F. Cole, et al. from the Loma Linda University Medical Center "Multi-Station Proton Beam Therapy System", US Patent No. 4,870,287 (September 26, 1989) describe a proton beam therapy system for selectively generating and transporting proton beams from a source and an individual proton accelerator to a treatment room selected from a plurality of patient treatment rooms.

Accelerator / Synchrotron

S. Peggs, et al. "Rapid Cycling Medical Synchrotron and Beam Delivery System," U.S. Patent No. 7,432,516 (October 7, 2008) describes a synchrotron having combined function magnets and a radio frequency (RF) cavity accelerator. Combined function magnets work to deflect, in the first place, the particle beam along an orbital path and, secondly, to focus the particle beam. The RF cavity accelerator is a ferrite-loaded cavity adapted for high-speed frequency oscillations for acceleration of fast-cycling particles.

H. Tanaka, et al. "Charged Particle Accelerator", US Patent No. 7,259,529 (August 21, 2007) describes a charged particle accelerator that has a two-period acceleration process with a fixed magnetic field applied in the first period and a Second period of synchronized acceleration to provide compact and high-power acceleration of charged particles.

T. Haberer, et al. "Ion Beam Therapy System and a Method for Operating the System", US Patent No. 6,683,318 (January 27, 2004) describes an ion beam therapy system and method for operating the system. The ion beam system uses a gantry that has a vertical deflection system and a horizontal deflection system located before a last diverter magnet that results in a parallel scanning mode that results from a focus effect on the edge.

V. Kulish, et al. "Inductional Undulative EH-Accelerator", US Patent No. 6,433,494 (August 13

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2002) describe an undulating inductive EH accelerator for the acceleration of charged particle beams. The device consists of an electromagnetic ripple system, whose drive system for electromagnets is manufactured in the form of a radio frequency oscillator (Rf) that operates in the frequency range of approximately 100 KHz to 10 GHz.

K. Saito, et al. "Radio-Frequency Accelerating System and Ring Type Accelerator Provided with the Same", US Patent No. 5,917,293 (June 29, 1999) describe a radio frequency acceleration system having a frame antenna coupled to a group of magnetic core and impedance adjustment means connected to the frame antenna. A relatively low voltage is applied to the impedance adjustment means, allowing a small construction of the adjustment means.

J. Hirota, et al. "Ion Beam Accelerating Device Having Separately Excited Magnetic Cores", US Patent No. 5,661,366 (August 26, 1997) describe an ion beam acceleration device having a plurality of high magnetic field inducing units frequency and magnetic cores.

J. Hirota, et al. "Acceleration Device for Charged Particles," U.S. Patent No. 5,168,241 (December 1, 1992) describes an acceleration cavity that has a high frequency power supply and a loop driver that operates under a control that They combine to control a constant coupling and / or tuning that allows the transmission of power more efficiently to the particles.

Extraction

T. Nakanishi, et al. "Method of Operating the Particle Beam Radiation Therapy System", US Patent No. 7,122,978 (October 17, 2006) describes a charged particle beam accelerator having an RF-KO unit to increase the amplitude of the betatron oscillation of a bundle of charged particles within a stable resonance region and a quadrupole electromagnet extraction unit to vary a stable resonance region. The RF-KO unit is operated within a frequency range in which the circulating beam does not go beyond a stable resonance region boundary and the quadrupole extraction electromagnet is operated with the synchronization required for the extraction of the make.

T. Haberer, et al. "Method and Device for Controlling a Beam Extraction Raster Scan Irradiation Device for Heavy lons or Protons", US Patent No. 7,091,478 (August 15, 2006) describe a method for controlling beam extraction in terms of energy of the beam, beam focus, and beam intensity for each accelerator cycle.

K. Hiramoto, et al. "Accelerator and Medical System and Operating Method of the Same," U.S. Patent No. 6,472,834 (October 29, 2002) discloses a cyclic type accelerator having a deflection electromagnet and four-pole electromagnets for circulating a beam of charged particles, a multipolar electromagnet to generate a betatron oscillation resonance stability limit, and a high frequency source to apply a high frequency electromagnetic field to the beam to move the beam outside the stability limit. The high frequency source generates a sum signal of a plurality of alternating current (AC) signals whose instantaneous frequencies change with respect to time, and whose average values of instantaneous frequencies with respect to time are different. The system applies the sum signal using electrodes to the beam.

K. Hiramoto, et al. "Synchrotron Type Accelerator and Medical Treatment System Employing the Same", US Patent No. 6,087,670 (July 11, 2000) and K. Hiramoto, et al. "Synchrotron Type Accelerator and Medical Treatment System Employing the Same", US Patent No. 6,008,499 (December 28, 1999) describe a synchrotron accelerator having a high frequency application unit arranged in a circulation orbit for apply a high frequency electromagnetic field to a beam of circulating charged particles and to increase the amplitude of betatron oscillation of the particle beam to a level above a resonance stability limit. Additionally, for ejection of the beam, four-pole divergence electromagnets are arranged: (1) downstream with respect to a first deflector; (2) upstream with respect to a deflection electromagnet; (3) downstream with respect to the deflection electromagnet; and (4) upstream with respect to a second deflector.

K. Hiramoto, et al. "Circular Accelerator and Method and Apparatus for Extracting Charged-Particle Beam in Circular Accelerator", US Patent No. 5,363,008 (November 8, 1994) describe a circular accelerator for extracting a bundle of charged particles that is arranged to : (1) increase the displacement of a beam by the resonance effect of betatron oscillation; (2) to increase the amplitude of betatron oscillation of the particles, which have an initial betatron oscillation within a stability limit for resonance; and (3) to exceed the resonance stability limit thereby removing particles that exceed the resonance stability limit.

K. Hiramoto, et al. "Method of Extracting Charged Particles from Accelerator, and Accelerator Capable Carrying Out the Method, by Shifting Particle Orbit", US Patent No. 5,285,166 (February 8, 1994) describes a method of extracting a particle beam loaded An equilibrium orbit of charged particles maintained by a diverter magnet and magnets having multipolar components greater than six-fold components is displaced by a constituent element of the accelerator different from these magnets to change the tuning of the charged particles.

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Transport / scan control

K. Matsuda, et al. "Particle Beam Irradiation Apparatus, Treatment Planning Unit, and Particle Beam Irradiation Method", US Patent No. 7,227,161 (June 5, 2007); K. Matsuda, et al. "Particle Beam Irradiation Treatment Planning Unit, and Particle Beam Irradiation Method", US Patent No. 7,122,811 (October 17, 2006); and K. Matsuda, et al. "Particle Beam Irradiation Apparatus, Treatment Planning Unit, and Particle Beam Irradiation Method" (September 5, 2006) each describes a particle beam irradiation apparatus having a scanning controller that stops the output of a beam of ions, change the irradiation position by controlling scanning electromagnets, and restart the treatment based on treatment planning information.

T. Norimine, et al. "Particle Therapy System Apparatus", United States patents numbers: 7,060,997 (June 13, 2006); T. Norimine, et al. "Particle Therapy System Apparatus", 6,936,832 (August 30, 2005); and T. Norimine, et al. "Particle Therapy System Apparatus", 6,774,383 (August 10, 2004) each describes a particle therapy system having a first addressing magnet and a second addressing magnet arranged in the path of a beam of charged particles afterwards. of a synchrotron that are controlled by first and second beam position monitors.

K. Moriyama, et al. "Particle Beam Therapy System", US Patent No. 7,012,267 (March 14, 2006) describes a manual input to a "ready" signal indicating that preparations for transporting the ion beam have been completed to a patient

H. Harada, et al. "Irradiation Apparatus and Irradiation Method", US Patent No. 6,984,835 (January 10, 2006) describes an irradiation method that has a large irradiation field capable of uniform dose distribution, without reinforcing the yield of an irradiation field device, using a position controller having an overlapping area formed by a plurality of irradiations through the use of a multilayer collimator. The system provides a flat and uniform dose distribution over an entire surface of a target.

H. Akiyama, et al. "Charged Particle Beam Irradiation Equipment Having Scanning Electromagnet Power Supplies", US Patent No. 6,903,351 (June 7, 2005); H. Akiyama, et al. "Charged Particle Beam Irradiation Equipment Having Scanning Electromagnet Power Supplies", US Patent No. 6,900,436 (May 31, 2005); and H. Akiyama, et al. "Charged Particle Beam Irradiation Equipment Having Scanning Electromagnet Power Supplies", US Patent No. 6,881,970 (April 19, 2005) all describe a power source for applying a voltage to a scanning electromagnet to deflect a beam of charged particles and a second power supply without a pulsatile component to control the scanning electromagnet more precisely allowing uniform irradiation of the irradiation object.

K. Amemiya, et al. "Accelerator System and Medical Accelerator Facility", US Pat. No. 6,800,866 (October 5, 2004) describes an accelerator system having a wide range of ion beam control current capable of operating with low consumption of energy and that has a long maintenance interval.

A. Dolinskii, et al. "Gantry with an Ion-Optical System," U.S. Patent No. 6,476,403 (November 5, 2002) describes a gantry for an ion-optical system comprising an ion source and three diverter magnets to deflect a ion beam around an axis of rotation. A plurality of quadrupoles are provided along the beam path to create a fully achromatic beam transport and an ion beam with different emittances in the horizontal and vertical planes. In addition, two scanning magnets are provided between the second and third diverter magnets to direct the beam.

H. Akiyama, et al. "Charged Particle Beam Irradiation Apparatus", US Patent No. 6,218,675 (April 17, 2001) discloses an apparatus for irradiating charged particle beams to irradiate a target with a charged particle beam including a plurality of scanning electromagnets and a quadrupole electromagnet between two of the plurality of scanning electromagnets.

K. Matsuda, et al. "Charged Particle Beam Irradiation System and Method Thereof, US Patent No. 6,087,672 (July 11, 2000) describes a irradiation system of charged particle beams having a crest filter with protective elements to protect a part of the bundle of charged particles in an area corresponding to a thin region in the target.

P. Young, et al. "Raster Scan Control System for a Charged-Particle Beam", US Patent No. 5,017,789 (May 21, 1991) describes a raster scan control system for use with a particle beam delivery system charged which includes a nozzle through which a beam of charged particles passes. The nozzle includes a programmable frame generator and scanning scan electromagnets both fast and slow that cooperate to generate a scanning magnetic field that directs the beam along a desired frame scan pattern on a target.

Energy / beam intensity

M. Yanagisawa, et al. "Charged Particle Therapy System, Range Modulation Wheel Device, and Method of Installing Range Modulation Wheel Device", US Patent No. 7,355,189 (April 8, 2008) and

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Yanagisawa, et al. "Charged Particle Therapy System, Range Modulation Wheel Device, and Method of Installing Range Modulation Wheel Device", US Patent No. 7,053,389 (May 30, 2008) both describe a particle therapy system having a wheel of scope modulation. The ion beam passes through the scope modulation wheel resulting in a plurality of energy levels corresponding to a plurality of stepped thicknesses of the scope modulation wheel.

M. Yanagisawa, et al. "Particle Beam Irradiation System and Method of Adjusting Irradiation Apparatus", US Patent No. 7,297,967 (November 20, 2007); M. Yanagisawa, et al. "Particle Beam Irradiation System and Method of Adjusting Irradiation Apparatus", US Patent No. 7,071,479 (July 4, 2006); M. Yanagisawa, et al. "Particle Beam Irradiation System and Method of Adjusting Irradiation Apparatus", US Patent No. 7,026,636 (April 11, 2006); and M. Yanagisawa, et al. "Particle Beam Irradiation System and Method of Adjusting Irradiation Apparatus", US Patent No. 6,777,700 (August 17, 2004) all discloses a dispersion device, a range adjustment device and a spike extension device . The dispersion device and the scope adjustment device combine with each other and move along the axis of a beam. The extension device moves independently along the axis to adjust the degree of dispersion of the ion beam. The combined device increases the degree of uniformity of radiation dose distribution to diseased tissue.

A. Sliski, et al. "Programmable Particle Scatterer for Radiation Therapy Beam Formation", US Patent No. 7,208,748 (April 24, 2007) describes a programmable path length of a fluid disposed in a particle beam to modulate the dispersion angle and the range of the beam in a predetermined way. The disperser / modulator of the charged particle beam scope comprises a fluid reservoir having opposite walls in the path of a particle beam and a driving mechanism to adjust the distance between the walls of the fluid reservoir under the control of a programmable controller to create a predetermined extended Bragg peak at a predetermined depth in a tissue. The dispersion and modulation of the beam are continuously and dynamically adjusted during the treatment of a tumor to deposit a dose in a predetermined target three-dimensional volume.

M. Tadokoro, et al. "Particle Therapy System", United States Patent No. 7,247,869 (July 24, 2007) and United States Patent No. 7,154,108 (December 26, 2006) each describe a particle therapy system able to measure the energy of a beam of charged particles during irradiation of cancerous tissue. The system includes a beam passage between a pair of collimators, an energy detector and a signal processing unit.

G. Kraft, et al. "Ion Beam Scanner System and Operating Method", US Patent No. 6,891,177 (May 10, 2005) describes an ion beam scanning system that has a mechanical alignment system for the target volume to be scanned. allowing the modulation of the ion beam depth by means of a linear motor and the transverse displacement of energy absorption means resulting in scaled depth exploration of volume elements of a target volume.

G. Hartmann, et al. "Method for Operating an Ion Beam Therapy System by Monitoring the Distribution of the Radiation Dose," U.S. Patent No. 6,736,831 (May 18, 2004) describes a method for operating a beam therapy system. ions that have a grid scanner that radiates and explores an area surrounding an isocenter. Both the depth dose distribution and the cross-dose distribution of the grid scanner device at various positions in the isocenter region are measured and evaluated.

Y. Jongen "Method for Treating a Target Volume with a Particle Beam and Device Implementing Same", US Patent No. 6,717,162 (April 6, 2004) describes a method of production, from a particle beam , of a narrow point directed towards a target volume, characterized in that the scanning speed of the point and the intensity of the particle beam are modified simultaneously.

G. Kraft, et al. "Device for Irradiating a Tumor Tissue", US Patent No. 6,710,362 (March 23, 2004) describes a method and an apparatus for irradiation of a tumor tissue, where the apparatus has an ion-driven braking device. Electromagnetically in the path of the proton beam for adaptation based on the depth of the proton beam that adjusts both the direction of the ion beam and the scope of the ion beam.

K. Matsuda, et al. "Charged Particle Beam Irradiation Apparatus", US Patent No. 6,617,598 (September 9, 2003) describes a beam irradiation apparatus of charged particles that increases the width in a depth direction of a Bragg peak by passing the Bragg peak through an enlargement device containing three ion beam components that have different energies produced according to the difference between past positions of each of the filter elements.

H. Stelzer, et al. "Ionization Chamber for Ion Beams and Method for Monitoring the Intensity of an Ion Beam", US Patent No. 6,437,513 (August 20, 2002) describes an ionization chamber for an ion beam and a monitoring method of the intensity of an ion therapy beam. The ionization chamber includes a chamber housing, a beam entry window, a beam exit window and a chamber volume filled with counting gas.

H. Akiyama, et al. "Charged-Particle Beam Irradiation Method and System", US Patent No. 6,433,349 (August 13, 2002) and H. Akiyama, et al. "Charged-Particle Beam Irradiation Method and System", US Patent No. 6,265,837 (July 24, 2001) both describe a system of irradiation of charged particle beams that includes a charger for charging particle energy and a controller of

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intensity to control a beam intensity of charged particles.

Y. Pu "Charged Particle Beam Irradiation Apparatus and Method of Irradiation with Charged Particle Beam", US Patent No. 6,034,377 (March 7, 2000) describes a irradiated apparatus of charged particle beams having a degrader of energy comprising: (1) a cylindrical member having a length; and (2) a wall thickness distribution in a circumferential direction around an axis of rotation, where the wall thickness determines the energy degradation of the irradiation beam.

Portico

T. Yamashita, et al. "Rotating Irradiation Apparatus", US Patent No. 7,381,979 (June 3, 2008) describe a rotary gantry having a front ring and a rear ring, each ring having radial support devices, where the support devices Radials have linear guides. The system has push support devices to limit the movement of the rotary body in the direction of the rotational axis of the rotary body.

T. Yamashita, et al. "Rotating Gantry of Particle Beam Therapy System" US Patent No. 7,372,053 (May 13, 2008) describes a rotary gantry supported by a pneumatic braking system that allows rapid movement, braking and stopping of the gantry during treatment irradiation

M. Yanagisawa, et al. "Medical Charged Particle Irradiation Apparatus", US Patent No. 6,992,312 (January 31, 2006); M. Yanagisawa, et al. "Medical Charged Particle Irradiation Apparatus", US Patent No. 6,979,832 (December 27, 2005); and M. Yanagisawa, et al. "Medical Charged Particle Irradiation Apparatus", US Patent No. 6,953,943 (October 11, 2005) all discloses an apparatus capable of irradiation from upward and horizontal directions. The gantry is rotating around a rotation axis where the irradiation field forming device is eccentrically arranged, so that an irradiation axis passes through a different position of the rotation axis.

H. Kaercher, et al. "Isokinetic Gantry Arrangement for the Isocentric Guidance of a Particle Beam And a Method for Constructing Same," U.S. Patent No. 6,897,451 (May 24, 2005) describes an isokinetic gantry type arrangement for the isocentric guidance of a particle beam that can be rotated around a horizontal longitudinal axis.

G. Kraft, et al. "Ion Beam System for Irradiating Tumor Tissues", US Pat. No. 6,730,921 (May 4, 2004) describe an ion beam system for irradiating tumor tissues at various irradiation angles in relation to a patient's couch arranged horizontally, where the patient's stretcher is rotating around a central axis and has a lifting mechanism. The system has a central ion beam deviation of up to ± 15 degrees with respect to a horizontal direction.

M. Pavlovic, et al. "Gantry System and Method for Operating Same," U.S. Patent No. 6,635,882 (October 21, 2003) describes a gantry system for adjusting and aligning an ion beam on a target from a determinable effective treatment angle. freely. The ion beam is aligned on a target at adjustable angles of 0 to 360 degrees around the axis of rotation of the gantry and at an angle of 45 to 90 degrees displaced from the axis of rotation of the gantry producing an irradiation cone when it has rotated a full turn around the axis of rotation of the porch.

Mobile patient

N. Rigney, et al. "Patient Alignment System with External Measurement and Object Coordination for Radiation Therapy System", US Patent No. 7,199,382 (April 3, 2007) describe a patient alignment system for a radiation therapy system that includes multiple devices for external measurements that obtain position measurements of mobile components of the radiotherapy system. The alignment system uses external measurements to provide corrective placement feedback to more precisely match the patient with the radiation beam.

Y. Muramatsu, et al. "Medical Particle Irradiation Apparatus", US Patent No. 7,030,396 (April 18, 2006); Y. Muramatsu, et al. "Medical Particle Irradiation Apparatus", US Patent No. 6,903,356 (June 7, 2005); and Y. Muramatsu, et al. "Medical Particle Irradiation Apparatus", US Patent No. 6,803,591 (October 12, 2004) all describes a medical particle irradiation apparatus having a rotary gantry, an annular frame located within the gantry so that it can rotate with respect to the rotary gantry, an anti-correlation mechanism to prevent the frame from rotating with the gantry, and a flexible movable floor coupled with the frame such that it moves freely with a substantially level bottom while the gantry rotates .

H. Nonaka, et al. "Rotating Radiation Chamber for Radiation Therapy", US Patent No. 5,993,373 (November 30, 1999) describes a horizontal mobile floor consisting of a series of multiple plates that are freely and flexibly connected, where the floor mobile moves in sync with the rotation of a radiation beam irradiation section.

Breathing

K. Matsuda "Radioactive Beam Irradiation Method and Apparatus Taking Movement of the Irradiation Area Into Consideration", US Patent No. 5,538,494 (July 23, 1996) describes a method and apparatus that

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It allows irradiation even in the case of a changing position of the diseased part due to physical activity, such as breathing and heartbeat. Initially, a change of position of a diseased body part and physical activity of the patient are measured concurrently and a relationship between the two is defined as a function. Radiation therapy is performed according to the function.

Patient placement

Y. Nagamine, et al. "Patient Positioning Device and Patient Positioning Method", US Patent No. 7,212,609 (May 1, 2007) and Y. Nagamine, et al. "Patient Positioning Device and Patient Positioning Method", US Patent No. 7,212,608 (May 1, 2007) describe a patient placement system comparing a comparison area of a reference radiographic image and a radiographic image current of a current patient location using pattern unification.

D. Miller, et al. "Modular Patient Support System", US Patent No. 7,173,265 (February 6, 2007) describes a radiation treatment system that has a patient support system that includes a modularly expandable patient module and at least one immobilization device, such as a cradle of moldable foam.

K. Kato, et al. "Multi-Leaf Collimator and Medical System Including Accelerator", US Patent No. 6,931,100 (August 16, 2005); K. Kato, et al. "Multi-Leaf Collimator and Medical System Including Accelerator", US Patent No. 6,823,045 (November 23, 2004); K. Kato, et al. "Multi-Leaf Collimator and Medical System Including Accelerator", US Patent No. 6,819,743 (November 16, 2004); and K. Kato, et al. "Multi-Leaf Collimator and Medical System Including Accelerator", US Patent No. 6,792,078 (September 14, 2004) all discloses a laminar plate system used to shorten a patient's placement time for irradiation therapy . The driving force of the motor is transmitted to a plurality of laminar plates at the same time through a pinion gear. The system also uses upper and lower pneumatic cylinders and upper and lower guides to position a patient.

Computer control

A. Beloussov et al. "Configuration Management and Retrieval System for Proton Beam Therapy System", US Patent No. 7,368,740 (May 6, 2008); A. Beloussov et al. "Configuration Management and Retrieval System for Proton Beam Therapy System", US Patent No. 7,084,410 (August 1, 2006); and A. Beloussov et al. "Configuration Management and Retrieval System for Proton Beam Therapy System", US Patent No. 6,822,244 (November 23, 2004) all describe a proton beam system controlled by multiprocessor software having configurable treatment parameters that are easily modified by an authorized user to prepare the software-controlled system for various modes of operation to ensure that data and configuration parameters are accessible if individual point failures occur in the database.

J. Hirota et al. "Automatically Operated Accelerator Using Obtained Operating Patterns", US Patent No. 5,698,954 (December 16, 1997) describes a main controller for determining the amount of control and control timing of each component of an accelerator body with the controls coming from an operating pattern.

Imaging

P. Adamee, et al. "Charged Particle Beam Apparatus and Method for Operating the Same", US Patent No. 7,274,018 (September 25, 2007) and P. Adamee, et al. "Charged Particle Beam Apparatus and Method for Operating the Same", US Patent No. 7,045,781 (May 16, 2006) describe a charged particle beam apparatus configured for serial and / or parallel imaging of a object.

K. Hiramoto, et al. "Ion Beam Therapy System and its Couch Positioning System", US Patent No. 7,193,227 (March 20, 2007) describe an ion beam therapy system that has a radiographic imaging system that moves along with A rotating porch.

C. Maurer, et al. "Apparatus and Method for Registration of Images to Physical Space Using a Weighted Combination of Points and Surfaces", US Patent No. 6,560,354 (May 6, 2003) described a process of recorded radiographic computed tomography for physical measurements taken in the patient's body, where different parts of the body are given different weights. Weights are used in an iterative recording process to determine a transformation process of a rigid body, where the transformation function is used to assist surgical or stereotactic procedures.

M. Blair, et al. "Proton Beam Digital Imaging System," U.S. Patent No. 5,825,845 (October 20, 1998) describes a proton beam digital imaging system that has an X-ray source that is mobile inside the line. of the treatment beam that can produce an x-ray beam through a region of the body. By comparing the relative positions of the center of the beam in the patient orientation image and the isocenter in the master prescription image with respect to selected reference points, the amount and direction of movement of the patient to make the best one determined correspondence of

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center of the beam with the target isocenter.

S. Nishihara, et al. "Therapeutic Apparatus", US Patent No. 5,039,867 (August 13, 1991) describes a method and apparatus for placing a therapeutic beam in which a first distance is determined based on a first image, a second distance based on a second image, and the patient is moved to an irradiation position with therapy beam based on the first and second distances.

Additional prior art related to the present invention is described in the following publications:

• BIOPHYSICS GROUP Y COL, "Design, Construction and First Experiments of a Magnetic Scanning System for Therapy. Radiobiological Experiments on the Radiobiological Action of Carbon, Oxygen and Neon", GSI REPORT, GESELLSCHAFT FÜR SCHWERIONENFORSCHUNG MBH., DARMSTADT, GERMANY, (19910601 ), vol. GSI-91-18, ISSN 0171-4546, pages 1-31, XP009121701;

• Document US 2003/164459 A1;

• Document US 5,538,494 A;

• Document US 3,412,337 A;

• AMALDI U AND COL, "A Hospital-Based Hadrontherapy Complex", PROCEEDINGS OF EPAC 94, LONDON, ENGLAND, (19940627), pages 49-51, XP002552288;

• NODA KY COL, "Slow beam extraction by a transverse RF field with AM and FM", NUCLEAR INSTRUMENTS & METHODS IN PHYSICS RESEARCH, SECTION - ACCELERATORS, SPECTROMETERS, DETECTORS AND ASSOCIATED EQUIPMENT, ELSEVIER, AMSTERDAM, NETHERLANDS, (19960521), vol. A374, ISSN 0168-9002, pages 269-277, XP002552289;

• US 6,335,535 B1;

• YULIN LI, "A Thin Beryllium Injection Window for CESR-C", PROCEEDINGS PAC03, PORTLAND, OREGON, USA. UU., (20030512), pages 2264-2266, XP002568010;

• BRYANT (ED) P, Proton-Ion Medical Machine Study (PIMMS) Part II, PROTON-ION MEDICAL MACHINE STUDY. PIMMS, EUROPEAN ORGANIZATION FOR NUCLEAR RESEARCH CERN - PS DIVISION, GENEVA, SWITZERLAND, PAGES 23, 228, 289-290, (20000727), ISBN 9789290831662, XP002551811;

• ARIMOTO Y Y COL, "A Study of the PRISM-FFAG Magnet", PROCEEDINGS OF CYCLOTRON 2004 CONFERENCE, TOKYO, JAPAN, (20041018), pages 243-245, XP002551810;

• SAITO K Y COL, "RF Accelerating System for a Compact Ion Synchrotron", PROCEEDINGS OF 2001 PAC, CHICAGO EE. UU., (20010618), pages 966-968, XP002568009;

• KIM K R Y COL, "50 MeV Proton Beam Test Facility for Low Flux Beam Utilization Studies of PEFP", PROCEEDINGS OF APAC 2004, POHANG, KOREA, (20051031), pages 441-443, XP002568008 [Y] 25.51.

There is a need for control of the particle beam of cancerous tumors in the technique of controlling the irradiation beam of charged particles. More particularly, there is a need in the art for a separate control of various dimensions of the charged particle beam to produce a timely, precise and accurate tumor irradiation.

Summary of the invention

The invention comprises a multiaxial controlled charged particle irradiation beam system, for use in radiation therapy of cancerous tumors.

Description of the figures

Figure 1 illustrates component connections of a particle beam therapy system;

Figure 2 illustrates a charged particle therapy system;

Figure 3 illustrates an ion beam generation system;

Figure 4 illustrates straight and curved sections of a synchrotron;

Figure 5 illustrates deflector magnets of a synchrotron;

Figure 6 provides a perspective view of a diverter magnet;

Figure 7 illustrates a cross-sectional view of a diverter magnet;

Figure 8 illustrates a cross-sectional view of a diverter magnet;

Figure 9 illustrates a magnetic tuning section of a synchrotron;

Figures 10A and B illustrate an RF accelerator and an RF accelerator subsystem, respectively;

Figure 11 illustrates a magnetic field control system;

Figure 12 illustrates a system for extracting and controlling the intensity of charged particles;

Figure 13 illustrates a system for verifying the position of a proton beam;

Figure 14 illustrates a patient positioning system from: (A) a front view and (B) a top view;

Figure 15 provides distributions of the x-ray dose and proton beam;

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Figures 16A-E illustrate the controlled depth of focus irradiation;

Figures 17A-E illustrate multi-field irradiation;

Figure 18 illustrates improvement of dose efficiency through the use of multi-field irradiation; Figures 19A-C and Figure 19E illustrate distal irradiation of a tumor from variable rotational directions and Figure 19D illustrates integrated radiation resulting from distal radiation;

Figure 20 provides two methods of multi-field irradiation implementation;

Figure 21 illustrates multidimensional scanning of a point scanning system with a charged particle beam operating on: (A) a 2-D section or (B) a 3-D volume of a tumor;

Figure 22 illustrates an electron cannon source used to generate X-rays coupled with a particle beam therapy system;

Figure 23 illustrates an X-ray source near the path of a particle beam;

Figure 24 illustrates a semivertical patient placement system;

Figure 25 illustrates breathing monitoring;

Figure 26 provides a method of coordinating the collection of radiographs with the patient's breathing.

Figure 27 illustrates a patient positioning, immobilization and repositioning system;

Figure 28 shows acceleration of the particle field synchronized with the breathing cycle of a patient; Y

Figure 29 illustrates acceleration synchronization of the adjustable particle field.

Detailed description of the invention

The invention comprises a multiaxial controlled charged particle irradiation beam system, for use in radiation therapy of cancerous tumors.

The multiaxial control includes separate control of one or more horizontal or x-axis positions, vertical or y-axis position, energy control and intensity control of the irradiated beam of charged particles. Optionally, the separate control is independent control. Optionally, the beam of charged particles is further controlled in terms of synchronization. Synchronization is coordinated with the patient's breathing and / or the patient's rotational placement. Combined, the system allows irradiation of multiaxial and multicamp charged particles of tumors, producing precise and accurate irradiation dosages to a tumor with harmful proximal distal energy distribution around the tumor. The invention uses a radio frequency (RF) cavity system to induce the oscillation of the betatron of a flow of charged particles. Modulation of sufficient amplitude of the flow of charged particles causes the flow of charged particles to hit a material, such as a lamella. The lamella decreases the energy of the flow of charged particles, which decreases a radius of curvature of the flow of charged particles in the synchrotron sufficiently to allow a physical separation of the flow of charged particles of reduced energy from the flow of charged original particles. The flow of physically separated charged particles is then removed from the system by the use of an applied field and a baffle.

In another embodiment, the system comprises controlling the intensity of an acceleration, extraction and / or addressing apparatus of a bundle of charged particles used in conjunction with radiation therapy with bundles of particles loaded with cancerous tumors. Particularly, the intensity of a flow of charged particles of a synchrotron is described in combination with rotating magnets, focusing magnets on the edge, concentration magnetic field magnets, winding and control coils, and synchrotron extraction elements. The system reduces the overall size of the synchrotron, provides a closely controlled proton beam, directly reduces the size of the required magnetic fields, directly reduces the required operating power, and allows continuous acceleration of protons in a synchrotron even during an extraction process. of synchrotron protons.

In yet another embodiment, a multi-field imaging and cancer treatment apparatus with charged multi-field particles is used that coordinates with the patient's breathing through the use of feedback sensors used to monitor and / or control the patient's breathing. Optionally, the respiration monitoring system uses thermal and / or force sensors to determine where a patient is in a breathing cycle in combination with a feedback signal control provided to the patient to inform the patient when control of the breath is required. breathing. Preferably, multi-field imaging, such as radiographic imaging, and charged particle therapy are performed in a patient in a partially immobilized and relocatable position. The supply of X-rays and / or protons is synchronized with the patient's breathing by controlling the injection, acceleration, extraction and / or addressing apparatus of charged particle beams.

In yet another exemplary embodiment, the system refers to a combined rotation / weft method, called cancer therapy with multi-laden particles. The system uses a source of fixed orientation protons with respect to a rotary patient to give irradiation of the tumor from multiple directions. The system combines irradiation of the tumor by layers from many directions with irradiation of energy protons

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controlled to supply maximum proton beam energy within a selected tumor volume or irradiated section. Optionally, the tumor volume selected for irradiation from a given angle is a distal part of the tumor. In this way, the energy of the access Bragg peak extends circumferentially around the tumor minimizing damage to healthy tissue and the proton energy of the peak is efficiently, accurately and accurately delivered to the tumor.

In yet another exemplary embodiment, a method and apparatus for efficient delivery of a dose of radiation to a tumor is described. Preferably, the radiation is delivered through an entry point into the tumor and the energy of the Bragg peak is directed to a distal or distant side of the tumor from an access point. The energy supply of the Bragg peak to the distal side of the tumor from the access point is repeated from multiple rotational directions. The intensity of the beam is proportional to the efficiency of radiation dose delivery. The multi-field irradiation process with energy levels that go to the far side of the tumor from each direction of irradiation provides a uniform and efficient supply of a radiation dose of charged particles to the tumor. Preferably, the therapy with charged particles is synchronized with the patient's breathing by controlling methods and apparatus for injection, acceleration, extraction and / or addressing of bundles of charged particles.

Used in combination with the invention, novel design features of a cancer treatment system with charged particle beams are described. Particularly, a negative ion beam source with novel characteristics in the negative ion source, the ion source vacuum system, the ion beam focusing lens, and tandem accelerator is described. Additionally, rotating magnets, focusing magnets on the edge, concentration magnets of the magnetic field, winding and correction coils, incident surfaces on flat magnetic fields, and extraction elements that minimize the overall size of the synchrotron are described, provide a tightly controlled proton beam, directly reduce the size of the required magnetic fields, directly reduce the required operating power, and allow continuous acceleration of protons in a synchrotron even during a proton extraction process from the synchrotron. The ion beam source system and the synchrotron are preferably integrated by computer with a patient imaging system and a patient interface that includes breathing monitoring sensors and patient positioning elements. In addition, the intensity control of a method and apparatus of acceleration, extraction and / or addressing of charged particle beams used together with radiation therapy with particle beams loaded with cancerous tumors is described. More particularly, the control of the intensity, energy and synchronization of a flow of charged particles of a synchrotron is described. Synchrotron control elements allow tight control of the bundle of charged particles, which complements the close control of patient placement to give efficient treatment of a solid tumor with reduced tissue damage to surrounding healthy tissue. In addition, the system reduces the overall size of the synchrotron, provides a closely controlled proton beam, directly reduces the size of required magnetic fields, directly reduces the required operating power, and allows continuous acceleration of protons in a synchrotron even during a process of Synchrotron proton extraction. All these systems are preferably used together with a radiographic system capable of collecting radiographs of a patient in (1) a placement system for proton treatment and (2) at a specified time in the patient's breathing cycle. Combined, the systems enable efficient, accurate and precise non-invasive tumor treatment with minimal damage to surrounding healthy tissue.

Cyclotron / Synchrotron

A cyclotron uses a constant magnetic field and an electric field applied at a constant frequency. One of the two fields is modified in a synchro-cyclotron. Both fields are modified in a synchrotron. Therefore, a synchrotron is a particular type of cyclic particle accelerator in which a magnetic field is used to spin the particles to circulate and an electric field is used to accelerate the particles. The synchrotone carefully synchronizes the applied fields with the moving particle beam.

By increasing the fields appropriately as the particles gain energy, the trajectory of the charged particles can remain constant as they are accelerated. This allows the vacuum container for particles to be a thin and large bull. It is actually easier to use some straight sections between the diverting magnets and some curved sections that give the bull the shape of a polygon with round corners. In this way, a large effective radius path is constructed using simple straight and curved pipe segments, unlike the disk-shaped chamber of cyclotron-type devices. The shape also allows and requires the use of multiple magnets to deflect the particle beam.

The maximum energy that a cyclic accelerator can impart is normally limited by the intensity of the magnetic fields and the minimum radius / maximum curvature of the particle's path. In a cyclotron, the maximum radius is quite limited since the particles begin in the center and form a spiral outwards, therefore, this complete path must be a vacuum chamber shaped like a self-supporting disk. Since the radius is limited, the power of the machine is limited by the intensity of the magnetic field. In the case of an ordinary electromagnet, the field strength is limited by the saturation of the core because, when all

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Magnetic domains are aligned, the field cannot be increased more in practical terms. The arrangement of the pair of individual magnets also limits the economic size of the device.

Synchrotrons overcome these limitations, using a narrow beam pipe surrounded by much smaller magnets with a more precise focus. The ability of this device to accelerate particles is limited by the fact that the particles must be charged to accelerate at all, but particles charged under acceleration emit photons, thereby losing energy. The energy of the limiting beam is reached when the energy lost by the lateral acceleration required to maintain the trajectory of the beam in a circle is equal to the energy added in each cycle. The most powerful accelerators are built by using large radius paths and by using more numerous and more powerful microwave cavities to accelerate the particle beam between the corners. Lighter particles, such as electrons, lose a larger fraction of their energy when they spin. In practical terms, the energy of the electron / positron accelerators is limited by this loss of radiation, while this does not play a significant role in the dynamics of the proton or ion accelerators. The energy of those is strictly limited by the strength of the magnets and the cost.

THERAPY WITH MAKES OF LOADED PARTICLES

Throughout this document, a therapy system with charged particle beams, such as a proton beam, hydrogen ion beam or carbon ion beam, is described. Here, the charged particle beam therapy system is described using a proton beam. However, the aspects taught and described in terms of a proton beam are not intended to be limited to those of a proton beam and are illustrative of a system of charged particle beams. Any system of charged particle beams is also applicable to the techniques described herein.

Referring now to Figure 1, a system 100 of charged particle beams is illustrated. The bundle of charged particles preferably comprises a series of subsystems including any of: a main controller 110; an injection system 120; a synchrotron 130 which normally includes: (1) an accelerator system 132 and (2) an extraction system 134; a scanning / addressing / supply system 140; a patient interface module 150; a display system 160; and / or an imaging system 170.

In one embodiment, one or more of the subsystems is stored in a client. The client is a computer platform configured to act as a client device, for example, a personal computer, a digital media player, a personal digital assistant, etc. The client comprises a processor that is coupled to a series of external or internal input devices, for example, a mouse, a keyboard, a display device, etc. The processor is also coupled to an output device, for example, a computer monitor for displaying information. In one embodiment, the main controller 110 is the processor. In another embodiment, the main controller 110 is a set of instructions stored in memory that are carried out by the processor.

The client includes a computer-readable storage medium, that is, a memory. The memory includes, but is not limited to, an electronic, optical, magnetic or other storage or transmission device capable of being coupled to a processor, for example, such as a processor in communication with a touch input device, with readable instructions By computer. Other examples of suitable media include, for example, flash drive, CD-ROM, read-only memory (ROM), random access memory (RAM), application-specific integrated circuit (ASIC), DVD, magnetic disk, chip memory, etc. The processor executes a set of computer executable program code instructions stored in memory. The instructions may comprise code of any computer programming language, including, for example, C, C ++, C #, Visual Basic, Java and JavaScript.

An exemplary method of using the system 100 of charged particle beams is provided. The main controller 110 controls one or more of the subsystems to accurately and accurately deliver protons to a patient's tumor. For example, the main controller 110 obtains an image, such as a part of a body and / or a tumor, of the imaging system 170. The main controller 110 also obtains position and / or synchronization information of the interface module 150 of the patient. The main controller 110 optionally then controls the injection system 120 to inject a proton into a synchrotron 130. The synchrotron typically contains at least one accelerator system 132 and an extraction system 134. The main controller preferably controls the proton beam within the system. accelerator, such as controlling the speed, trajectory and synchronization of the proton beam. The main controller then controls the extraction of a proton beam from the accelerator through the extraction system 134. For example, the controller controls the timing, energy and / or intensity of the extracted beam. The controller 110 also preferably controls the proton beam addressing through the scanning / addressing / delivery system 140 to the patient interface module 150. One or more components of the patient interface module 150 are preferably controlled by the main controller 110. In addition, the display elements of the display system 160 are preferably controlled by the main controller 110. Displays, such as patient screens

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visualization, are normally provided to one or more operators and / or to one or more patients. In one embodiment, the main controller 110 synchronizes the supply of the proton beam from all systems, so that protons are delivered in an optimal therapeutic manner to the patient.

In this document, the main controller 110 refers to a single system that controls the system 100 of charged particle beams, a single controller that controls a plurality of subsystems that control the system 100 of charged particle beams, or a plurality of individual controllers that control one or more subsystems of the system 100 of charged particle beams.

Synchrotron

In this document, the term synchrotron is used to refer to a system that keeps the beam of charged particles in a circulation path; however, cyclotrons are used as an alternative, despite their inherent limitations of energy control, intensity and extraction. In addition, the bundle of charged particles is mentioned herein circulating along a circulation path around a central point of the synchrotron. The circulation path is called an orbit path as an alternative; however, the orbit path does not refer to a perfect circle or ellipse, instead it refers to the cycling of protons around a central point or region.

Referring now to Figure 2, an exemplary exemplary embodiment of a version of the system 100 of charged particle beams is provided. The number, position and described type of the components are illustrative and not limiting in nature. In the illustrated embodiment, an injector system 210 or ion source or source of charged particle beams generates protons. Protons are supplied inside a vacuum tube that runs inside, through, and out of the synchrotron. The generated protons are supplied along an initial path 262. Focus magnets 230, such as quadrupole magnets or quadrupole injection magnets, are used to focus the path of the proton beam. A quadrupole magnet is a focus magnet. An injector deflecting magnet 232 deflects the proton beam towards the plane of the synchrotron 130. Focused protons having an initial energy are introduced into an injector magnet 240, which is preferably an injection Lamberson magnet. Normally, the initial trajectory 262 of the beam is along an axis outside, as previously, a plane of synchronization of the synchrotron 130. The injector diverter magnet 232 and the injector magnet 240 combine to move the protons into the synchrotron. 130. Main deflector magnets 250 or dipole magnets or circulation magnets are used to rotate the protons along a circulation path 264 of the beam. A dipole magnet is a diverter magnet. The main diverting magnets 250 divert the initial path 262 of the beam to a circulation path 264 of the beam. In this example, the main diverter magnets 250 or circulation magnets are represented as four sets of four magnets to maintain the beam's trajectory 264 in a steady beam's circulation path. However, any number of magnets or sets of magnets are optionally used to move the protons around a single orbit in the circulation process. The protons pass through an accelerator 270. The accelerator accelerates the protons in the circulation path 264 of the beam. As the protons are accelerated, the fields applied by the magnets increase. Particularly, the speed of the protons achieved by the accelerator 270 is synchronized with magnetic fields of the main diverter magnets 250 or circulation magnets to maintain a stable circulation of the protons around a central point or region 280 of the synchrotron. At points separated in time, the combination of accelerator 270 / main diverter magnet 250 is used to accelerate and / or decelerate the circulating protons while maintaining the protons in the path or orbit of circulation. An extraction element of the inflector / deflector system 290 is used in combination with a Lamberson 292 extraction magnet to remove protons from its circulation path 264 from the beam within the synchrotron 130. An example of a deflector component is a Lamberson magnet. Normally, the deflector moves the protons from the circulation plane to the axis outside the circulation plane, such as above the circulation plane. The extracted protons are directed and / or preferably focused using an extraction diverting magnet 237 and extraction focusing magnets 235, such as quadrupole magnets along a transport path 268 in the scanning / addressing / supply system 140. Two Components of a scanning system 140 or addressing system typically include a first axis control 142, such as a vertical control, and a second axis control 144, such as a horizontal control. In one embodiment, the first control of the axis 142 allows approximately 100 mm of vertical scanning of the proton beam 268 and the second control of the axis 144 allows approximately 700 mm of horizontal exploration of the proton beam 268. A nozzle system 146 is used for Obtain images of the proton beam and / or as a vacuum barrier between the low pressure beam path of the synchrotron and the atmosphere. Protons with control are supplied to the patient interface module 150 and to a tumor of a patient. All the elements listed above are optional and can be used in various permutations and combinations.

Ion Beam Generation System

An ion beam generation system generates a negative ion beam, such as a beam of hydrogen anions or H-; preferably focus the negative ion beam; convert the negative ion beam into a beam of

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positive ions, such as a proton beam or H +; and injects the positive ion beam into synchrotron 130. Parts of the ion beam path are preferably in partial vacuum. Each of these systems is described further below.

Referring now to Figure 3, an exemplary ion beam generation system 300 is illustrated. As illustrated, the ion beam generation system 300 has four main elements: a negative ion source 310, a first partial vacuum system 330, an optional ion beam focusing system 350, and a tandem accelerator 390.

Even with reference to Figure 3, the negative ion source 310 preferably includes an input port 312 for injection of gaseous hydrogen into a high temperature plasma chamber 314. In one embodiment, the plasma chamber includes a magnetic material. 316, which provides a magnetic field barrier 317 between the high temperature plasma chamber 314 and a low temperature plasma region on the opposite side of the magnetic field barrier. An extraction pulse is applied to a negative ion extraction electrode 318 to drag the negative ion beam to a negative ion beam path 319, which advances through the first partial vacuum system 330, through the system 350 ion beam approach, and inside the tandem throttle 390.

Even with reference to Figure 3, the first partial vacuum system 330 is a closed system that runs from the inlet port 312 of gaseous hydrogen to the lamella 395 of the tandem accelerator 390. The lamella 395 is directly or indirectly sealed to the edges of the vacuum tube 320 providing a higher pressure, such as about 10-5 torr, which will be maintained on the side of the first partial vacuum system 330 of the lamella 395 and a lower pressure, such as about 10-7 torr, which will remain on the synchrotron side of the lamella 390. By pumping only the first partial vacuum system 330 and running only the ion beam source vacuum semi-continuously based on sensor readings, the life of the pump It works semi-continuously. Sensor readings are described further below.

Even with reference to FIG. 3, the first partial vacuum system 330 preferably includes: a first pump 332, such as a continuously operating pump and / or a turbomolecular pump; a large containment volume 334; and a semi-continuous operating pump 336. Preferably, a pump controller 340 receives a signal from a pressure sensor 342 that monitors the pressure in the large containment volume 334. After a signal representative of a sufficient pressure in the large containment volume 334, the pump controller 340 directs an actuator 345 to open a valve 346 between the large containment volume and the semi-continuously operated pump 336 and instructs the pump to run semicontinuously to turn on and pump residual gases out of the vacuum line 320 around the flow of charged particles into the atmosphere. In this way, the life of the semi-continuous pump is extended by running only semi-continuously as necessary. In one example, the semi-continuous pump 336 operates for several minutes every few hours, such as 5 minutes every 4 hours, thereby extending a pump with a service life of approximately 2,000 hours to approximately 96,000 hours.

In addition, by isolating the inlet gas from the synchrotron vacuum system, the synchrotron vacuum pumps, such as turbomolecular pumps, can operate over a longer lifespan, since the synchrotron vacuum pumps have fewer molecules. of gas to treat. For example, the inlet gas is primarily hydrogen gas but may contain impurities, such as nitrogen and carbon dioxide. Isolating the inlet gases in the negative ion source system 310, the partial vacuum system 330, the ion beam focusing system 350 and the negative ion beam side of the tandem accelerator 390, the vacuum pumps of the Synchrotron can operate at lower pressures with longer lifespan, which increases the efficiency of the synchrotron 130.

Even with reference to Figure 3, the ion beam focusing system 350 includes two or more electrodes where one electrode of each pair of electrodes partially obstructs the path of the ion beam with conductive paths 372, such as a conductive mesh. In the illustrated example, three sections of the ion beam focusing system are illustrated, a two-electrode ion focus section 360, a first three electrode ion focus section 370, and a second ion focus section 380 of three electrodes. In a given pair of electrodes, electric field lines, which run between the conductive mesh of a first electrode and a second electrode, provide inward forces that focus on the negative ion beam. Multiple of said pairs of electrodes provide multiple focus regions of negative ion beams. Preferably, the focus section 360 of two electrode ions, the first focus section 370 of three electrode ions, and the second focus section 380 of three electrode ions are placed after the negative ion source and before the accelerator in tandem and / or cover a space of approximately 0.5, 1 or 2 meters along the path of the ion beam. Ion beam focusing systems are described further below.

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Even with reference to Figure 3, the tandem accelerator 390 preferably includes a foil 395, such as a carbon foil. The negative ions in the path 319 of negative ion beams are converted into positive ions, such as protons, and the initial path 262 of the ion beams results. The lamella 395 is preferably sealed directly or indirectly to the edges of the vacuum tube 320 providing a greater pressure, such as about 10-5 torr, which will be maintained on the side of the lamella 395 which has the path 319 of ion beams negative and a lower pressure, such as about 10-7 torr, which will be maintained on the side of the lamella 390 which has the path 262 of proton ion beams. Having the lamella 395 that physically separates the vacuum chamber 320 into two pressure regions allows a system that has fewer and / or smaller pumps to maintain the lower pressure system in the synchrotron 130 as the hydrogen in the inlet and its waste is extracted in a contained and isolated space separated by the first partial vacuum system 330.

Referring again to Figure 1, another exemplary method of using the system 100 of charged particle beams is provided. The main controller 110, or one or more subcontrollers, controls one or more of the subsystems to accurately and accurately deliver protons to a patient's tumor. For example, the main controller sends a message to the patient that indicates when or how to breathe. The main controller 110 obtains a sensor reading from the patient interface module, such as a breathing temperature sensor or a force reading indicative of where the subject is in a breathing cycle. The main controller collects an image, such as a part of a body and / or a tumor, of the imaging system 170. The main controller 110 also obtains position and / or synchronization information from the patient interface module 150. The main controller 110 optionally then controls the injection system 120 to inject gaseous hydrogen into a source 310 of negative ion beams and controls the synchronization of the negative ion extraction from the source 310 of negative ion beams. Optionally, the main controller controls the ion beam focus using the ion beam focus lens system 350; acceleration of the proton beam with tandem accelerator 390; and / or injection of the proton into the synchrotron 130. The synchrotron normally contains at least one accelerator system 132 and an extraction system 134. The synchrotron preferably contains one or more of: rotating magnets, focusing magnets on the edge, magnets of concentration of the magnetic field, winding and correction coils and incident surfaces on flat magnetic fields, some of which contain elements under control by the main controller 110. The main controller preferably controls the proton beam within the accelerator system, such as controlling the speed, trajectory and / or synchronization of the proton beam. The main controller then controls the extraction of a proton beam from the accelerator through the extraction system 134. For example, the controller controls the timing, energy and / or intensity of the extracted beam. The controller 110 also preferably controls the addressing of the proton beam through the addressing / supply system 140 to the patient interface module 150. One or more components of the patient interface module 150 are preferably controlled by the main controller 110, such as the vertical position of the patient, the rotational position of the patient, and the positioning / stabilization / control elements of the patient's chair. In addition, display elements of the display system 160 are preferably controlled by the main controller 110. Displays, such as display screens, are normally provided to one or more operators and / or one or more patients. In one embodiment, the main controller 110 synchronizes the supply of the proton beam from all systems, so that protons are delivered in an optimal therapeutic manner to the patient.

Circulation system

A synchrotron 130 preferably comprises a combination of straight sections 410 and rotation sections 420 of the ion beam. Therefore, the path of circulation of the protons is not circular in a synchrotron, but instead is a polygon with rounded corners.

In an illustrative embodiment, the synchrotron 130, which has also been called an accelerator system, has four straight elements and four turning sections. Examples of straight sections 410 include: the inflector 240, the accelerator 270, the extraction system 290 and the deflector 292. Along with the four straight sections there are four turning sections 420 of the ion beam, which are also called magnet sections or turn sections. The turning sections are described further below.

With reference now to Figure 4, an exemplary synchrotron is illustrated. In this example, the protons supplied along the initial trajectory of the proton beam 262 are inflected in the path of circulation of the beam with the inflator 240 and after acceleration are extracted by means of a deflector 292 to a transport path 268 of you do In this example, the synchrotron 130 comprises four straight sections 410 and four diverting or turning sections 420, where each of the four turning sections uses one or more magnets to rotate the proton beam about ninety degrees. As described further below, the ability to narrowly separate the rotating sections and to effectively rotate the proton beam results in shorter straight sections. Shorter straight sections allow a synchrotron design without the use of quadrupoles of

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focus on the movement path of the synchrotron beam. The elimination of the focus quadroles of the proton beam circulation path results in a more compact design. In this example, the illustrated synchrotron has a diameter of approximately five meters versus cross-sectional diameters of eight meters and larger for systems using a quadrupole focusing magnet in the path of the proton beam.

Referring now to Figure 5, an additional description of the first section 420 diverter or turn is provided. Each of the turning sections preferably comprises multiple magnets, such as about 2, 4, 6, 8, 10 or 12 magnets. In this example, four turn magnets 510, 520, 530, 540 are used in the first turn section 420 to illustrate key principles, which are the same regardless of the number of magnets in a turn section 420. A turn magnet 510 it is a particular type of diverter magnet or main circulation 250.

In physics, Lorentz's force is the force at a point charge due to electromagnetic fields. The Lorentz force is given by equation 1 in terms of magnetic fields with the terms of the field of choice not included.

F = q (v X B) ec. one

In equation 1, F is the force in Newtons; B is the magnetic field in Teslas; and v is the instantaneous velocity of the particles in meters per second.

Referring now to Figure 6, an example of a single magnet turning or turning section 510 is expanded. The turning section includes a gap 610 through which protons circulate. The recess 610 is preferably a flat recess, which allows a magnetic field through the recess 610 that is more uniform, regular and intense. A magnetic field enters the hole 610 through an incident surface of the magnetic field and leaves the hole 610 through a protruding surface of the magnetic field. The gap 610 runs in a vacuum tube between two magnet halves. The hole 610 is controlled by at least two parameters: (1) the hole 610 is kept as large as possible to minimize proton loss and (2) the hole 610 is kept as small as possible to minimize magnet sizes and Associated requirements of size and power of magnet power supplies. The flat nature of the hole 610 allows a compressed and more uniform magnetic field through the hole 610. An example of a hole dimension is to accommodate a vertical proton beam size of about 2 cm with a horizontal beam size of about 5 6 cm

As described above, a larger hole size requires a larger power supply. For example, if the size of the hole 610 is doubled in vertical size, then the requirements of the power supply increase by approximately a factor of 4. The flatness of the hole 610 is also important. For example, the flat nature of the recess 610 allows an increase in the energy of the extracted protons from about 250 to about 330 MeV. More particularly, if the gap 610 has an extremely flat surface, then the limits of a magnetic field of an iron magnet are attainable. An exemplary precision of the flat surface of the gap 610 is a polish of less than about 5 micrometers and preferably with a polish of about 1 to 3 micrometers. The irregularity in the surface results in imperfections in the applied magnetic field. The flat polished surface extends the irregularity of the applied magnetic field.

Even with reference to Figure 6, the charged particle beam moves through the gap 610 with an instantaneous velocity, v. a first magnetic coil 620 and a second magnetic coil 630 run above and below the gap 610, respectively. The current flowing through the coils 620, 630 results in a magnetic field, B, which runs through the rotating section 510 of the individual magnet. In this example, the magnetic field, B, runs upward, which results in a force, F, pushing the beam of charged particles inward toward a central point of the synchrotron, which rotates the beam of charged particles in an arc.

Even with reference to FIG. 6, a part of a second deviating or rotating section 520 of optional magnet is illustrated. Coils 620, 630 normally have return elements 640, 650 or turns at the end of a magnet, such as at the end of the first rotation section 510 of magnet. The 640, 650 turns take up space. The space reduces the percentage of the trajectory around a synchrotron orbit that is covered by the rotating magnets. This leads to parts of the circulation path where the protons are not rotated and / or focused and allows parts of the circulation path where the proton path is blurred. In this way, the space results in a larger synchrotron. Therefore, the space between magnet rotating sections 660 is preferably minimized. The second turning magnet is used to illustrate that the coils 620, 630 optionally run along a plurality of magnets, such as 2, 3, 4, 5, 6 or more magnets. The coils 620, 630 that run through multiple rotating section magnets allow two rotating section magnets to be placed spatially closer to each other due to the withdrawal of the steric limitation of the turns, which reduces and / or

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Minimizes the 660 gap between two rotating section magnets.

With reference now to FIGS. 7 and 8, two cross sections rotated 90 degrees illustrative of deviating or rotating sections 510 of individual magnet are presented. Referring now to Figure 8, the magnet assembly has a first magnet 810 and a second magnet 820. A coil-induced magnetic field, described below, runs between the first magnet 810 to the second magnet 820 through the gap 610 Magnetic return fields run through a first regulator coil 812 of the scan and a second regulator coil 822 of the scan. The combined cross-sectional area of the return scanning regulating coils approximates roughly the cross-sectional area of the first magnet 810 or the second magnet 820. The charged particles run through the vacuum tube in the recess 610. Such as illustrated, the protons run in figure 8 through the gap 610 and the magnetic field, illustrated as vector B, applies a force F to the protons, which pushes the protons towards the center of the synchrotron, which is outside of page on the right in figure 8. The magnetic field is created using curls. A first coil constitutes a first winding coil 850 and a second wire coil constitutes a second winding coil 860. Insulation or concentration gaps 830, 840, such as air voids, isolate the regulating coils of the exploration based on hollow iron 610. The hollow 610 is approximately flat to produce a uniform magnetic field through the hollow 610, as described above.

Again still to Figure 7, the ends of a deviating magnet or of individual rotation are preferably beveled. Almost perpendicular or right-angled edges of a rotating magnet 510 are represented by dashed lines 774, 784. Dashed lines 774, 784 intersect at a point 790 beyond the center of the synchrotron 280. Preferably, the edge of the rotating magnet it is beveled at angles alpha, a, and beta, p, which are angles formed by a first line 772, 782 that goes from an edge of the rotating magnet 510 and the center 280 and a second line 774, 784 that goes from it edge of the turning magnet and intersection point 790. The alpha angle is used to describe the effect and the description of the alpha angle is applied to the beta angle, but the alpha angle is optionally different from the beta angle. The alpha angle provides a focus effect on the edge. Beveling the edge of the rotating magnet 510 at the alpha angle focuses the proton beam.

Multiple spin magnets provide multiple magnet edges that each have focus effects on the edge in the synchrotron 130. If only one spin magnet is used, then the beam is only focused once for the alpha angle or twice for the alpha angle and the beta angle. However, using smaller turn magnets, more turn magnets fit into the turn sections 420 of the synchrotron 130. For example, if four magnets are used in a turn section 420 of the synchrotron, then for a single turn section there is eight possible focusing effect surfaces on the edge, two edges per magnet. The eight focusing surfaces produce a smaller cross section beam size. This allows the use of a smaller 610 gap.

The use of multiple edge focusing effects on the rotating magnets results in not only a smaller 610 gap, but also the use of smaller magnets and smaller power supplies. F or a synchrotron 130 having four rotating sections 420 where each rotating section has four rotating magnets and each rotating magnet has two focusing edges, there are a total of thirty-two focusing edges for each orbit of the protons in the synchrotron circulation path 130. Similarly, if 2, 6 or 8 magnets are used in a given turning section, or if 2, 3, 5 or 6 turning sections are used, then the number of focusing surfaces in the edge expands or contracts according to equation 2.

M FE

TFE - NTS * ------- * ^ - ec. 2

NTS M

where TFE is the number of total focusing edges, NTS is the number of turning sections, M is the number of magnets, and FE is the number of focusing edges. Naturally, not all magnets are necessarily beveled and some magnets are optionally beveled only at one edge.

The inventors have determined that multiple smaller magnets have benefits compared to fewer larger magnets. For example, the use of 16 small magnets produces 32 focusing edges while the use of 4 larger magnets produces only 8 focusing edges. The use of a synchrotron that has more focus edges results in a synchrotron circulation path constructed without the use of quadrupole focusing magnets. All prior art synchrotrons use quadrupoles in the synchrotron's flow path. In addition, the use of quadrupoles in the circulation path requires additional straight sections in the synchrotron circulation path. Thus, the use of quadrupoles in the circulation path of a synchrotron results in synchrotrons having diameters, beam path lengths, and / or larger circumferences.

In various embodiments of the system described herein, the synchrotron has any combination.

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from:

- at least 4 and preferably 6, 8, 10, or more focusing edges on the edge by 90 degrees of rotation of the beam of particles charged in a synchrotron having four rotation sections;

- at least about 16 and preferably about 24, 32, or more focusing edges on the orbit edge of the bundle of charged particles in the synchrotron;

- only 4 turning sections where each of the turning sections includes at least 4 and preferably 8 focusing edges on the edge;

- an equal number of straight sections and turn sections;

- exactly 4 turning sections;

- at least 4 focusing edges on the edge per rotation section;

- no quadrupoles in the synchrotron circulation path;

- a rectangular polygon configuration of rounded corners;

- a circumference of less than 60 meters;

- a circumference of less than 60 meters and 32 focusing surfaces on the edge; I

- any of approximately 8, 16, 24 or 32 non-quadrupole magnets per synchrotron circulation path, where non-quadrupole magnets include focusing edges on the edge.

Referring again to Figure 8, the incident magnetic field surface 870 of the first magnet 810 is further described. Figure 8 is not to scale and is illustrative in nature. Local imperfections or irregularity in the quality of the finish of the incident surface 870 results in inhomogeneities or imperfections in the magnetic field applied to the gap 610. Preferably, the incident surface 870 is flat, such as within a finishing polish of approximately zero to three micrometers, or less preferably at about a ten micrometer finishing polish.

Even with reference to Figure 8, additional magnet elements are described. The first magnet 810 preferably contains an initial cross-sectional distance 890 of the iron-based core. The contours of the magnetic field are made up of magnets 810, 820 and coils 812, 822 regulating the scan. The iron-based core tapers to a second cross-sectional distance 892. The magnetic field in the magnet preferably remains in the iron-based core as opposed to the gaps 830, 840. As the cross-sectional distance decreases From the initial cross-section distance 890 to the final cross-section distance 892, the magnetic field is concentrated. Changing the shape of the magnet from the longest distance 890 to the shortest distance 892 acts as an amplifier. The magnetic field concentration is illustrated by representing an initial density of magnetic field vectors 894 in the initial cross section 890 to a concentrated density of magnetic field vectors 896 in the final cross section 892. The concentration of the magnetic field due to the geometry of the rotating magnets result in less winding coils 850, 860 being required and a smaller power supply to the coils is also required.

In one example, the initial cross-section distance 890 is approximately fifteen centimeters and the final cross-section distance 892 is approximately ten centimeters. Using the numbers provided, the concentration of the magnetic field is approximately 15/10 or 1.5 times on the incident surface 870 of the gap 610, although the relationship is not linear. Taper 842 has a slope, such as about 20, 40 or 60 degrees. The concentration of the magnetic field, as in 1.5 times, causes a corresponding decrease in the energy consumption requirements of the magnets.

Even with reference to Figure 8, the first magnet 810 preferably contains an initial cross-sectional distance 890 of the iron-based core. The contours of the magnetic field are made up of magnets 810, 820 and coils 812, 822 regulating the scan. In this example, the core is tapered to a second cross-sectional distance 892 with a smaller tit angle, 0. As described above, the magnetic field in the magnet preferably remains in the iron-based core in opposition to the gaps 830, 840. As the cross-sectional distance decreases from the initial cross-sectional distance 890 to the final cross-sectional distance 892, the magnetic field is concentrated. The smallest angle, theta, results in greater amplification of the magnetic field ranging from the longest distance 890 to the shortest distance 892. The concentration of the magnetic field is illustrated by representing an initial density of magnetic field vectors 894 in the section. initial cross-section 890 to a concentrated density of magnetic field vectors 896 in the final cross-section 892. The concentration of the magnetic field due to the geometry of the rotating magnets results in less winding coils 850, 860 being required and also that a smaller power supply to the winding coils 850, 860 is required.

Even with reference to Figure 8, optional correction coils 852, 862 are illustrated which are used to correct the force of one or more turning magnets. The correction coils 852, 862 supplement the winding coils 850, 860. The correction coils 852, 862 have correction coil power supplies that are separate from winding coil power supplies used with the winding coils 850,

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860. Correction coil power supplies typically operate at a fraction of the required power compared to winding coil power supplies, such as approximately 1, 2, 3, 5, 7 or 10 percent of the power and more preferably about 1 or 2 percent of the power used with the winding coils 850, 860. The smaller operating power applied to the correction coils 852, 862 allows more precise and / or precise control of the coils of correction. Correction coils are used to adjust an imperfection in the rotating magnets 510, 520, 530, 540. Optionally, separate correction coils are used for each rotating magnet allowing individual tuning of the magnetic field for each rotating magnet, which relaxes the quality requirements in the manufacture of each rotating magnet.

Referring now to Figure 9, an example of winding coils and correction coils around a plurality of rotating magnets 510, 520, 530, 540 in a rotating section 420 of ion beams is illustrated. One or more high-precision magnetic field sensors are placed in the synchrotron and used to measure the magnetic field at or near the path of the proton beam. For example, magnetic sensors 950 are optionally placed between rotating magnets and / or within a rotating magnet, such as in or near the gap 610 or in or near the core or the magnet scanning regulating coil. The sensors are part of a feedback system to the correction coils. In this way, the system preferably stabilizes the magnetic field in the synchrotron elements instead of stabilizing the current applied to the magnets. The stabilization of the magnetic field allows the synchrotron to reach a new energy level quickly. This allows the system to be controlled to an energy level selected by an operator or an algorithm with each pulse of the synchrotron and / or with each breath of the patient.

The winding and / or correction coils correct 1, 2, 3 or 4 rotating magnets, and preferably correct a magnetic field generated by two rotating magnets. A winding or correction coil covering multiple magnets reduces the space between the magnets since less winding or correction coil ends are required, which take up space.

Referring now to Figure 10A and Figure 10B, accelerator system 270 is further described, such as a radio frequency (RF) accelerator system. The accelerator includes a series of coils 1010-1019, such as iron or ferrite coils, each circumferentially enclosing the vacuum system 320 through which the proton beam 264 passes to the synchrotron 130. Referring now to Figure 10B , the first coil 1010 is further described. A standard wire loop 1030 completes at least one turn around the first coil 1010. The loop joins a microcircuit 1020. Referring again to Figure 10A, an RF synthesizer 1040, which is preferably connected to the main controller 110 , provides a low voltage RF signal that is synchronized with the period of proton circulation in path 264 of the proton beam. The RF synthesizer 1040, the microcircuit 1020, the loop 1030 and the coil 1010 are combined to provide an acceleration voltage to the protons in the path 264 of the proton beam. For example, RF synthesizer 1040 sends a signal to microcircuit 1020, which amplifies the low voltage RF signal and produces an acceleration voltage, such as approximately 10 volts. The actual acceleration voltage for a single microcircuit / loop / coil combination is approximately 5, 10, 15 or 20 volts, but is preferably approximately 10 volts. Preferably, the RF amplifier microcircuit and the acceleration coil are integrated.

Even with reference to Figure 10A, the integrated RF amplifier and acceleration coil microcircuit presented in Figure 10B are repeated, as illustrated as the set of coils 1011-1019 surrounding the vacuum tube 320. For example, the RF synthesizer 1040, under the direction of the main controller 130, sends an RF signal to the microcircuits 1020-1029 connected to the coils 1010-1019, respectively. Each of the microcircuit / loop / coil combinations generates a proton acceleration voltage, such as approximately 10 volts each. Therefore, a set of five coil combinations generates approximately 50 volts for proton acceleration. Preferably, about 5 to 20 microcircuit / loop / coil combinations are used and more preferably about 9 or 10 microcircuit / loop / coil combinations are used in the accelerator system 270.

As an additional clarifying example, the RF synthesizer 1040 sends an RF signal, with a period equal to a period of circulation of a proton around the synchrotron 130, to a set of ten combinations of microcircuit / loop / coil, which gives as result approximately 100 volts for acceleration of the protons in the path 264 of the proton beam. The 100 volts are generated in a frequency range, such as about 1 MHz for a low energy proton beam up to about 15 MHz for a high energy proton beam. The RF signal is optionally set to an integer multiple of a proton circulation period around the synchrotron circulation path. Each of the microcircuit / loop / coil combinations is optionally independently controlled in terms of voltage and acceleration frequency.

The integration of the RF amplifier microcircuit and the acceleration coil, in each microcircuit / loop / coil combination, results in three considerable advantages. First, for synchrotrons, the

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Prior art does not use microcircuits integrated with the acceleration coils, but uses a set of long wires to provide power to a corresponding set of coils. Long cables have an impedance / resistance, which is problematic for high frequency RF control. As a result, the prior art system is not operable at high frequencies, such as above about 10 MHz. The integrated RF amplifier / acceleration coil microcircuit system is operable at more than about 10 MHz and even 15 MHz where The resistance and / or impedance of the long cables in prior art systems results in poor control or a failure in the acceleration of protons. Second, the long cable system, which operates at lower frequencies, costs about $ 50,000 and the integrated microcircuit system costs about $ 1000, which is 50 times less expensive. Third, the microcircuit / loop / coil combinations together with the RF amplifier system result in a compact, low power consumption design that allows the production and use of a proton cancer treatment system in a small space , as described above, and in a cost effective manner.

Referring now to Figure 11, an example is used to clarify the control of the magnetic field using a feedback loop 1100 to change supply times and / or periods of supply of the proton pulse. In one case, a respiratory sensor 1110 detects the subject's breathing cycle. The respiratory sensor sends the information to an algorithm in a magnetic field controller 1120, usually by the patient interface module 150 and / or by the main controller 110 or a subcomponent thereof. The algorithm predicts and / or measures when the subject is at a particular point in the breathing cycle, such as at the end of an inspiration. Magnetic field sensors 1130 are used as input to the magnetic field controller, which controls a power supply of magnet 1140 for a given magnetic field 1150, such as within a first rotation magnet 510 of a synchrotron 130. The feedback loop Control is used in this way to tune the synchrotron to a selected energy level and supply protons with the desired energy at a point in the selected time, such as at the end of the inspiration. More particularly, the main controller injects protons into the synchrotron and accelerates the protons in a way that combined with the extraction supplies the protons to the tumor at a selected point in the breathing cycle. The intensity of the proton beam is also selectable and controllable by the main controller in this phase. The feedback control to the correction coils allows the rapid selection of the synchrotron energy levels that are linked to the patient's breathing cycle. This system contrasts sharply with a system where the current is stabilized and the synchrotron supplies pulses with a period, such as 10 or 20 cycles per second with a fixed period. Optionally, the feedback or the design of the magnetic field coupled with the correction coils allows the extraction cycle to coincide with the patient's variable respiratory rate.

Traditional extraction systems do not allow this control, since magnets have memories in terms of both magnitude and sine wave amplitude. Therefore, in a traditional system, to change the frequency, slow changes in the current must be used. However, with the use of the feedback circuit using the magnetic field sensors, the frequency and energy level of the synchrotron are quickly adjusted. In addition, this process is aided by the use of a new extraction system that allows the acceleration of protons during the extraction process, described below.

Example III

Referring again to Figure 9, an example of a winding coil 930 covering two rotating magnets 510, 520 is provided. Optionally, a first winding coil 940 covers a magnet or a second winding coil 920 covers a plurality of magnets 510, 520. As described above, this system reduces the space between the turning section that allows more magnetic field to be applied per turning radius. A first correction coil 910 is illustrated which is used to correct the magnetic field for the first rotation magnet 510. A second correction coil 920 is used which is used to correct the magnetic field for a winding coil 930 around two magnets. rotation. Individual correction coils are preferred for each rotation magnet and individual correction coils produce the most precise and / or exact magnetic field in each rotation section. Particularly, the individual correction coil 910 is used to compensate imperfections in the individual magnet of a given rotation section. Therefore, with a series of magnetic field sensors, corresponding magnetic fields are individually adjustable in a series of feedback loops, by means of a magnetic field monitoring system, since an independent coil is used for each rotation section. Alternatively, a multi-magnet correction coil is used to correct the magnetic field for a plurality of rotating section magnets.

Flat hollow surface

Although the surface of the gap is described in terms of the first rotating magnet 510, the description applies to each of the rotating magnets in the synchrotron. Similarly, although the surface of the gap 610 is described in terms of the incident surface 670 of the magnetic field, the description additionally applies to the projecting surface 680 of the magnetic field.

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The incident surface 870 of the magnetic field of the first magnet 810 is preferably approximately flat, such as up to within a finishing polish of about zero to three micrometers or less preferably up to about a finishing polishing of ten micrometers. Being very flat, the polished surface extends the irregularity of the magnetic field applied by the hole 610. The very flat surface, such as a finish of approximately 0, 1, 2, 4, 6, 8, 10, 15 or 20 micrometers, It allows for a smaller hole size, a smaller applied magnetic field, smaller power supplies, and a narrower control of the cross-sectional area of the proton beam. The projecting surface 880 of the magnetic field is also preferably flat.

Proton Beam Extraction

Referring now to Figure 12, an exemplary proton extraction process from the synchrotron 130 is illustrated. For clarity, Figure 12 removes elements depicted in Figure 2, such as the rotating magnets, which allows for greater clarity. of presentation of the trajectory of the proton beam as a function of time. Generally, protons are extracted from synchrotron 130 by slowing down the protons. As described above, the protons were initially accelerated in a flow path 264, which is maintained with a plurality of main diverter magnets 250. The flow path is referred to herein as an original center beam line 264 The protons move cyclically repeatedly around a central point in the synchrotron 280. The path of the protons passes through a radiofrequency (RF) cavity system 1210. To initiate extraction, an RF field is applied through a first sheet 1212 and a second sheet 1214, in the RF cavity system 1210. The first sheet 1212 and the second sheet 1214 are referred to herein as a first pair of sheets.

In the proton extraction process, an RF voltage is applied across the first pair of sheets, where the first sheet 1212 of the first pair of sheets is on one side of the circulation path 264 of the proton beam and the second sheet 1214 of the first pair of sheets is on an opposite side of the circulation path 264 of the proton beam. The applied Rf field applies energy to the beam of circulating charged particles. The applied RF field alters the orbit or trajectory of the beam's circulation slightly from the protons from the original central beam line 264 to an altered beam circulation path 265. After a second pass of the protons through the cavity system of RF, the RF field further moves the protons out of the original proton beam line 264. For example, if the original beam line is considered a circular path, then the altered beam line is slightly elliptical. The applied RF field is synchronized to apply outward or inward motion to a given band of protons that circulates in the synchrotron accelerator. Each orbit of the protons is slightly further off the axis compared to the original beam's circulation path 264. Successive passes of the protons through the RF cavity system are increasingly pushed relative to the original center beam line 264 altering the direction and / or intensity of the RF field with each successive pass of the proton beam through the RF field.

The RF voltage is frequency modulated at a frequency approximately equal to the period of a proton in a cycle around the synchrotron during a turn or at a frequency that is an integral multiplier of the period of a proton in a cycle around the synchrotron. The frequency RF modulated voltage applied excites the oscillation of a betatron. For example, oscillation is a sine wave movement of protons. The process of synchronizing the RF field to a given proton beam within the rF cavity system is repeated thousands of times with each successive pass of the protons that move approximately one more micrometer out of the original center beam line 264. For clarity, the approximately 1000 changing beam paths with each successive path of a given proton band across the rF field are illustrated as the altered beam path 265.

With a sufficient sine wave betatron amplitude, the altered beam circulation path 265 touches a material 1230, such as a lamella or a lamella leaf. The lamella is preferably a light material, such as beryllium, a lithium hydride, a carbon sheet or a low nuclear charge material. A low nuclear charge material is a material composed of atoms that essentially consist of atoms that have six or less protons. The lamella is preferably about 10 to 150 micrometers thick, is more preferably 30 to 100 micrometers thick, and is even more preferably 40-60 micrometers thick. In one example, the lamella is beryllium with a thickness of approximately 50 micrometers. When the protons pass through the lamella, the energy of the protons is lost and the speed of the protons is reduced. Normally, a current is also generated, described below. Protons that move at a slower speed travel in the synchrotron with a reduced radius of curvature 266 compared to the original center beam line 264 or the altered circulation path 265. The path with reduced radius of curvature 266 is also called in this document a path that has a smaller path diameter or a path that has protons with reduced energy. The reduced radius of curvature 266 is typically about two millimeters less than a radius of curvature of the last proton pass along the path of the altered proton beam 265.

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The thickness of the material 1230 is optionally adjusted to create a change in the radius of curvature, such as approximately 1 ^, 1, 2, 3 or 4 mm less than the last pass of the protons 265 or the original radius of curvature 264. The Protons that move with the smallest radius of curvature move between a second pair of sheets. In one case, the second pair of sheets is physically different and / or separated from the first pair of sheets. In a second case, one of the first pair of sheets is also a member of the second pair of sheets. For example, the second pair of sheets is the second sheet 1214 and a third sheet 1216 in the RF cavity system 1210. A high voltage DC signal, such as about 1 to 5 kV, is then applied through the second pair of sheets, which directs the protons out of the synchrotron through an extraction magnet 292, such as a magnet Lamberson extraction, on a transport path 268.

The control of the acceleration of the beam path of particles loaded in the synchrotron with the accelerator and / or applied fields of the rotating magnets in combination with the extraction system described above allows the intensity control of the extracted proton beam to be controlled, where the intensity is a flow of protons per unit of time or the number of protons extracted as a function of time. For example, when a current is measured beyond a threshold, the modulation of the RF field in the RF cavity system is terminated or restarted to establish a subsequent cycle of proton beam extraction. This process is repeated to produce many cycles of proton beam extraction from the synchrotron accelerator.

Since the extraction system does not depend on any change in the properties of the magnetic field, it allows the synchrotron to continue operating in acceleration or deceleration mode during the extraction process. In other words, the extraction process does not interfere with the acceleration of the synchrotron. In stark contrast, traditional extraction systems introduce a new magnetic field, such as through a hexapol, during the extraction process. More particularly, traditional synchrotrons have a magnet, such as a hexapolar magnet, which is deactivated during an acceleration stage. During the extraction phase, the hexapolar magnetic field is introduced into the synchrotron's circulation path. The introduction of the magnetic field requires two different modes, an acceleration mode and an extraction mode, which are mutually exclusive in time.

Control of the intensity of the beam of charged particles

The control of the applied field, such as a radiofrequency (RF) field, the frequency and the magnitude in the RF cavity system 1210 allows control of the intensity of the extracted proton beam, where the intensity is the flow of extracted protons per unit of time or the number of protons extracted as a function of time.

Even with reference to Figure 12, when the protons in the proton beam hit the material 1230, electrons are released resulting in a current. The resulting current is converted into a voltage and used as part of an ion beam intensity monitoring system or as part of an ion beam feedback loop to control the beam intensity. The voltage is optionally measured and sent to the main controller 110 or a controller subsystem. More particularly, when protons in the trajectory of the charged particle beam pass through material 1230, some of the protons lose a small fraction of their energy, such as about a tenth of a percentage, which results in a secondary electron. . That is, the protons in the bundle of charged particles push some electrons when they pass through material 1230 giving electrons enough energy to cause secondary emission. The resulting electron flow results in a current or signal that is proportional to the number of protons that pass through the target material 1230. The resulting current is preferably converted to voltage and amplified. The resulting signal is called a measured intensity signal.

The amplified signal or measured intensity signal resulting from the protons passing through the material 1230 is preferably used in the control of the intensity of the extracted protons. For example, the measured intensity signal is compared with an objective signal, which is predetermined in a 1260 irradiation plan of the tumor. In one example, the tumor plan 1260 contains the target or target energy and intensity of the proton beam supplied as a function of the x position, the y position, the time, and / or the rotational position of the patient. The difference between the measured and planned intensity signal for the target signal is calculated. The difference is used as a control for the RF generator. Therefore, the measured current flow resulting from the protons passing through the material 1230 is used as a control in the RF generator to increase or reduce the number of protons that experience betatron oscillation and that hit the material 1230. Therefore, the stress determined outside the material 1230 is used as a measure of the orbital path and is used as a feedback control to control the RF cavity system. As an alternative, the measured intensity signal is not used in the feedback control and is only used as a monitor for the intensity of the extracted protons.

As described above, the photons that hit the material 1230 are a stage in the extraction of the protons from the synchrotron 130. Therefore, the measured intensity signal is used to change the number of protons per unit of time that they are extracted, what is called proton beam intensity. Beam intensity

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Protons is, therefore, under algorithmic control. In addition, the intensity of the proton beam is controlled separately from the speed of the protons in the synchrotron 130. Therefore, the intensity of the extracted protons and the energy of the extracted protons are independently variable.

For example, protons initially move along an equilibrium path in synchrotron 130. An RF field is used to excite protons in a betatron oscillation. In one case, the frequency of the orbit of the protons is approximately 10 MHz. In one example, in approximately one millisecond or after approximately 10,000 orbits, the first protons hit an outer edge of the target material 130. The specific frequency depends on the orbit period After hitting the material 130, the protons push electrons through the lamella to produce a current. The current is converted into voltage and amplified to produce a signal of measured intensity. The measured intensity signal is used as a feedback input to control the magnitude of RF applied, the RF frequency or the RF field. Preferably, the measured intensity signal is compared with a target signal and a measurement of the difference between the measured intensity signal and the target signal is used to adjust the RF field applied in the RF cavity system 1210 in the monitoring system. extraction to control the intensity of the protons in the extraction stage. Said again, the signal resulting from the protons that strike and / or pass through the material 130 is used as an input in the modulation of the RF field. An increase in the magnitude of the RF modulation results in the protons hitting the lamella or material 130 before. By increasing the RF, more protons are pushed into the lamella, which results in an increased intensity, or more protons per unit of time, of protons extracted from the synchrotron 130.

In another example, a detector 1250 external to the synchrotron 130 is used to determine the flow of protons extracted from the synchrotron and a signal from the external detector is used to alter the RF field or RF modulation in the RF cavity system 1210 . In this context, the external detector generates an external signal, which is used in a manner similar to the measured intensity signal, described in the preceding paragraphs. Particularly, the measured intensity signal is compared with a desired signal from the irradiation plan 1260 in a feedback intensity controller 1240, which adjusts the RF field between the first plate 1212 and the second plate 1214 in the extraction process, described above.

In yet another example, when a current from the material 130 resulting from protons passing through or hitting the material is measured beyond a threshold, the modulation of the RF field in the RF cavity system is terminated or It restarts to establish a subsequent cycle of proton beam extraction. This process is repeated to produce many cycles of proton beam extraction from the synchrotron accelerator.

In yet another embodiment, the modulation of the intensity of the extracted proton beam is controlled by the main controller 110. The main controller 110 optionally and / or additionally controls the timing of the extraction of the charged particle beam and the energy of the beam of protons removed.

The benefits of the system include a multidimensional scanning system. Particularly, the system allows independence in: (1) energy of the extracted protons and (2) intensity of the extracted protons. That is, the energy of the extracted protons is controlled by an energy control system and an intensity control system controls the intensity of the extracted protons. The energy control system and the intensity control system are optionally independently controlled. Preferably, the main controller 110 controls the energy control system and the main controller simultaneously controls the intensity control system to produce a beam of protons extracted with controlled energy and controlled intensity where the controlled energy and the controlled intensity are variable independently. Thus, the irradiation point that hits the tumor is under the independent control of:

- weather;

- Energy;

- intensity;

- position on the x-axis, where the x-axis represents the horizontal movement of the proton beam with respect to the patient, and

- position on the y-axis, where the y-axis represents vertical movement of the proton beam with respect to the patient.

In addition, the patient is optionally rotated independently with respect to a translational axis of the proton beam at the same time. The system is capable of pulse to pulse energy variability. Additionally, the system is able to dynamically modulate energy during a pulse, which allows a true three-dimensional exploration of the proton beam with modulation of energy and / or intensity.

Referring now to Figure 13, a system 1300 for verifying the position of a proton beam is described. A nozzle 1310 provides an outlet for the second vacuum system at reduced pressure that starts at the lamella 395 of the tandem accelerator 390 and runs through the synchrotron 130 to a lamella

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1320 of the nozzle covering the end of the nozzle 1310. The nozzle expands in cross-sectional area along the z axis of the path 268 of the proton beam to allow the proton beam 268 to be explored along the x and y axes by the vertical control element 142 and the horizontal control element 144, respectively. The lamella 1320 of the nozzle is preferably mechanically supported by the outer edges of an outlet port of the nozzle 1310. An example of a lamella 1320 of the nozzle is a sheet approximately 0.1 inches thick of the foil of foil . Generally, the nozzle lamella separates the atmospheric pressures on the patient side of the nozzle lamella 1320 from the low pressure region, such as the region of approximately 10-5 to 10-7 torr, on the synchrotron side 130 of the lamella 1320 of the nozzle. The low pressure region is maintained to reduce the dispersion of the proton beam 264, 268.

Even with reference to Figure 13, the proton beam verification system 1300 is a system that allows real-time monitoring of the proton beam 268, 269 in real time without destruction of the proton beam. The proton beam verification system 1300 preferably includes a verification layer 1330 of the position of the proton beam, which is also referred to herein as a coating layer, luminescent, fluorescent, phosphorescent, radiant or viewing. The verification layer or coating layer 1330 is preferably a coating or thin layer substantially in contact with an internal surface of the lamella 1320 of the nozzle, where the internal surface is on the synchrotron side of the lamella 1320 of the nozzle. Less preferably, the verification layer or coating layer 1330 is substantially in contact with an external surface of the nozzle lamella 1320, where the external surface is on the patient's treatment side of the nozzle lamella 1320. Preferably, the lamella 1320 of the nozzle provides a substrate surface for coating by the coating layer, but optionally a separate support element of the coating layer, on which the coating 1330 is mounted, is placed anywhere in the 268 trajectory of the proton beam.

Even with reference to Figure 13, the coating 1330 produces a measurable spectroscopic response, spatially visible by the detector 1340, as a result of transmission by the proton beam 268. The coating 1330 is preferably a phosphorus, but is optionally any material that a detector where the material spectroscopically changes as a result of the path 268 of the proton beam that hits or is transmitted through the liner 1330 is visible or visible. A detector or camera 1340 views the lining layer 1330 and determines the current position of the proton beam 268 by the spectroscopic differences that result from protons passing through the coating layer. For example, the chamber 1340 views the coating surface 1330 as the proton beam 268 is being scanned by the horizontal beam 144 and vertical beam position control elements 142 during the treatment of the tumor 1420. The chamber 1340 views the current position of the proton beam 268 as measured by the spectroscopic response. The coating layer 1330 is preferably a phosphor or luminescent material that shines or emits photons for a short period of time, such as less than 5 seconds for an intensity of 50%, as a result of excitation by the proton beam 268. Optionally , a plurality of cameras or detectors 1340 are used, where each detector views all or a portion of the coating layer 1330. For example, two detectors 1340 are used where a first detector views a first half of the coating layer and the second detector visualizes a second half of the coating layer. Preferably, the detector 1340 is mounted on the nozzle 1310 to view the position of the proton beam after it passes through the controllers of the first axis and the second axis 142, 144. Preferably, the coating layer 1330 is placed in the trajectory 268 of the proton beam in one position before the protons hit patient 1430.

Even with reference to Figure 13, the main controller 130, connected to the output of the camera or detector 1340, compares the actual position of the proton beam 268 with the planned proton beam position and / or a calibration reference to determine if the actual position of the proton beam 268 is within tolerance. The 1300 proton beam verification system is preferably used in at least two phases, a calibration phase and a proton beam treatment phase. The calibration phase is used to correlate, depending on the position in x, and the brightness response, the position in x, and real of the proton beam at the patient interface. During the proton beam treatment phase, the position of the proton beam is monitored and compared with the calibration and / or treatment plan to verify the exact proton supply to the tumor 1420 and / or as an interruption safety indicator of the proton beam.

Patient placement

Referring now to Figure 14, the patient is preferably placed on or within a patient positioning system 1410 of the patient interface module 150. The patient positioning system 1410 is musa to move the patient and / or rotate the patient into an area where the proton beam can explore the tumor using a scanning system 140 or proton addressing system, described below. . Essentially, the patient positioning system 1410 performs wide movements of the patient to place the tumor near the center of a path 268 of the proton beam and the proton scanning or addressing system 140 performs fine movements of the momentary position of the beam 269 in the addressing of the tumor 1420. To illustrate, Figure 14 shows the momentary position of the proton beam

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269 and a range of explorable positions 1440 using the proton scanning or addressing system 140, where the explorable positions 1440 are around the tumor 1420 of the patient 1430. In this example, the explorable positions are scanned along the x and y axes; however, the scan is optionally performed simultaneously along the z axis as described below. This illustratively shows that the movement of the axis and the patient occurs on a scale of the body, such as an adjustment of approximately 1, 2, 3 or 4 feet, while the explorable region of the proton beam 268 covers a part of the body, such as a region of approximately 1, 2, 4, 6, 8, 10 or 12 inches. The patient placement system and its rotation and / or patient translation is combined with the proton addressing system to produce an accurate and / or accurate supply of the protons to the tumor.

Even with reference to Figure 14, the patient positioning system 1410 optionally includes a lower unit 1412 and an upper unit 1414, such as discs or a platform. Referring now to Figure 14A, the positioning unit 1410 of the patient is preferably adjustable in the axis and 1416 to allow vertical displacement of the patient with respect to the proton therapy beam 268. Preferably, the vertical movement of the positioning unit 1410 of the patient is approximately 10, 20, 30 or 50 centimeters per minute. Referring now to Fig. 14B, the positioning unit 1410 of the patient is also preferably rotary 1417 about a rotation axis, such as around the axis and running through the center of the lower unit 1412 or around an axis and which runs through tumor 1420, to allow rotational control and patient placement with respect to trajectory 268 of the proton beam. Preferably, the rotational movement of the positioning unit 1410 of the patient is approximately 360 degrees per minute. Optionally, the patient placement unit rotates approximately 45, 90 or 180 degrees. Optionally, the patient positioning unit 1410 rotates at a speed of approximately 45, 90, 180, 360, 720 or 1080 degrees per minute. The rotation of the positioning unit 1417 is illustrated around the axis of rotation at two different times, ti and t2. The protons are optionally administered to the tumor 1420 at n times, where each of the n moments represents different directions of the incident proton beam 269 thrashing the patient 1430 due to the rotation of the patient 1417 around the axis of rotation.

Any of the embodiments of the semi-vertical patient sitting, or lying down described below, are optionally vertically translatable along the y axis or rotating around the axis of rotation or y.

Preferably, the upper and lower units 1412, 1414 move together, so that they rotate at the same speeds and move into position at the same speeds. Optionally, the upper and lower units 1412, 1414 are independently adjustable along the axis and to allow a difference in the distance between the upper and lower units 1412, 1414. Motors, power supplies and mechanical assemblies for moving the upper and lower units. lower 1412, 1414 are preferably located outside the path 269 of the proton beam, such as below the lower unit 1412 and / or above the upper unit 1414. This is preferable since the patient positioning unit 1410 is preferably rotating around 360 degrees and the motors, power supplies and mechanical assemblies interfere with the protons if they are placed in the path 269 of the proton beam.

Efficiency of proton supply

Referring now to Figure 15, a common distribution of relative doses for irradiation with both X-rays and protons is presented. As shown, X-rays deposit their highest dose near the surface of the target tissue and then decrease exponentially based on tissue depth. The X-ray energy deposit near the surface is not ideal for tumors located deep inside the body, which is usually the case, since excessive damage is caused to the soft tissue layers surrounding the tumor 1420. The advantage of protons is that they deposit most of their energy near the end of the light path, since the loss of energy per unit path of the absorber traversed by a proton increases as the particle velocity decreases, giving rise to at an abrupt maximum of ionization near the end of the interval, referred to herein as the Bragg peak. In addition, since the flight path of the protons is variable by increasing or reducing their initial kinetic energy or initial velocity, then the peak corresponding to maximum energy is mobile within the tissue. Thus, the control of the z axis of the depth of penetration of the protons is allowed by the acceleration / extraction process, described above. As a result of the dose-distribution characteristics of protons, a radio-oncologist can optimize the dose to the tumor 1420 while minimizing the dose to surrounding normal tissues.

The energy profile of the Bragg peak shows that the protons supply their energy throughout the entire length of the body penetrated by the proton to a maximum penetration depth. As a result, energy is being supplied, in the distal part of the energy profile of the Bragg peak, to healthy tissue, bone, and other body constituents before the proton beam hits the tumor. It follows that, the shorter the path length in the body before the tumor, the greater the effectiveness of the proton supply efficiency, where the effectiveness of the proton supply is a measure of how much energy is supplied to the tumor regarding healthy parts of the patient. Examples of the efficiency of proton supply include: (1) a

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ratio of proton energy delivered to the tumor to proton energy delivered to non-tumor tissue; (2) proton path length in the tumor versus path length in the non-tumor tissue; and (3) damage to a tumor compared to damage to healthy parts of the body. Any of these measures is optionally weighted for damage to sensitive tissues, such as an element of the nervous system, heart, brain or other organ. To illustrate, for a patient in a lying position where the patient is turned on the axis and during treatment, a tumor near the heart would sometimes be treated with protons that traverse the head-to-heart path, leg-to-heart path or path from the hip to the heart, which are all ineffective compared to a patient in a sitting or semi-vertical position where protons are supplied through a path from the chest to the heart; path from the side of the body to the heart or path from the back to the shorter heart. Particularly, in comparison to a lying position, using a sitting or semi-vertical position of the patient, a shorter path is provided through the body to a tumor located in the torso or head, which results in a greater or better efficacy of the proton supply

Here, the efficiency of the proton supply is described separately from the temporal efficacy or the efficiency of use of the synchrotron, which is a fraction of the time that the charged particle beam apparatus is in operation.

Deep addressing

Referring now to Figs. 16 AE, scanning on the x-axis of the proton beam is illustrated while the energy on the z-axis of the proton beam undergoes controlled variation 1600 to allow irradiation of sections of the tumor 1420. For greater clarity of presentation, the exploration in the axis and simultaneous is not illustrated. In Figure 16A, irradiation is started with the momentary position of the proton beam 269 at the beginning of a first section. Referring now to Figure 16B, the momentary position of the proton beam is at the end of the first section. Importantly, during a given irradiation section, the energy of the proton beam is preferably controlled and changed continuously according to the tissue density in front of the tumor 1420. The variation of the energy of the proton beam to have in Tissue density counts thus allowing the beam stop point, or Bragg's peak, to remain within the tissue section. The variation of the energy of the proton beam during exploration is possible due to the acceleration / extraction techniques, described above, which allow the acceleration of the proton beam during extraction. Figures 16C, 16D and 16E show the momentary position of the proton beam in the middle of the second section, two thirds of the path through a third section, and after the end of irradiation from a given direction, respectively. Using this approach, a controlled, accurate and precise distribution of proton irradiation energy to the 1420 tumor, to a designated tumor subsection, or to a tumor layer is achieved. The efficiency of the deposition of energy from the proton to the tumor, as defined as the ratio of the irradiation energy of the proton delivered to the tumor with respect to the irradiation energy of the proton delivered to the healthy tissue is described further below.

Multi-field irradiation

It is desirable to maximize the efficiency of proton deposition in tumor 1420, as defined by maximizing the ratio of proton irradiation energy supplied to tumor 1420 with respect to proton irradiation energy delivered to healthy tissue. Irradiation from one, two or three directions in the body, such as rotating the body about 90 degrees between irradiation subsessions, results in the irradiation of protons from the distal part of the Bragg peak concentrating on one, two or three volumes of healthy tissue, respectively. It is desirable to further distribute the distal part of the energy of the Bragg peak evenly across the volume of healthy tissue surrounding the tumor 1420.

Multi-field irradiation is the irradiation of proton beams from a plurality of points of entry into the body. For example, patient 1430 is rotated and the radiation source point is kept constant. For example, as patient 1430 is rotated 360 degrees and proton therapy is applied from a multitude of angles resulting in distal radiation being circumferentially extended around the tumor producing improved proton irradiation efficiency. In one case, more than 3, 5, 10, 15, 20, 25, 30 or 35 positions are rotated to the body and proton irradiation occurs with each rotation position. The rotation of the patient for proton therapy or for radiographic imaging is preferably approximately 45, 90, 135, 180, 270 or 360 degrees. Patient rotation is preferably performed using patient positioning system 1410 and / or lower unit 1412 or disc, described above. The rotation of patient 1430 while maintaining the supply proton beam 268 in a relatively fixed orientation allows irradiation of the tumor 1420 from multiple directions without the use of a new collimator for each direction. In addition, since a new configuration is not required for each rotation position of the patient 1430, the system allows the tumor 1420 to be treated from multiple directions without re-seating or positioning the patient, thereby minimizing the time of tumor regeneration. 1420 and increasing the performance of cancer treatment of the patient 1430.

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The patient is optionally centered on the lower unit 1412 or the tumor 1420 is optionally centered on the lower unit 1412. If the patient is centered on the lower unit 1412, then the first control element 142 of the shaft and the second control element 144 of the axis are programmed to compensate for the variation of position outside the central axis of rotation of the tumor 1420.

Referring now to Figures 17 A-E, an example of 1700 multi-field irradiation is presented. In this example, five patient rotation positions are illustrated; however, the five rotation positions are discrete rotation positions of approximately thirty-six rotation positions, where the body is rotated approximately ten degrees with each position. Referring now to Figure 17A, a range of irradiation beam positions 269 from a first body rotation position is illustrated, illustrated as the patient 1430 facing the proton irradiation beam where a first healthy volume 1711 is irradiated by the input or distal part of the irradiation energy profile of the Bragg peak. With reference now to Figure 17B, patient 1430 is rotated approximately forty degrees and the irradiation is repeated. In the second position, the tumor 1420 again receives the mass of the irradiation energy and a second volume of healthy tissue 1712 receives the smallest input or distal part of the energy of the Bragg peak. With reference now to Figures 17 C-E, patient 1430 is rotated a total of approximately 90, 130 and 180 degrees, respectively. For each of the third, fourth and fifth rotation positions, tumor 1420 receives most of the irradiation energy and third 1713, fourth 1714 and fifth 1715 volumes of healthy tissue receive the smallest input or distal part of the energy of the Bragg peak, respectively Therefore, the rotation of the patient during proton therapy results in the distal energy of the proton energy delivered being distributed around the tumor 1420, such as in regions of one to five , while along a given axis, at least about 75, 80, 85, 90 or 95 percent of the energy is supplied to the tumor 1420.

For a given rotation position, all or part of the tumor is irradiated. For example, in one embodiment only a distal section or distal part of the tumor 1420 is irradiated with each rotation position, where the distal section is a section farther from the point of entry of the proton beam to the patient 1430. For example, the section distal is the dorsal side of the tumor when patient 1430 is facing the proton beam and the distal section is the ventral side of the tumor when patient 1430 is looking away from the proton beam.

With reference now to Figure 18, a second example of multi-field irradiation 1800 is presented where the source of protons is stationary and patient 1430 is rotated. For ease of presentation, the path 269 of the proton beam is illustrated as entering patient 1430 from varying sides at times ti, t2, t3, ..., tn, tn + 1. At first, t1, the distal end of the profile of Bragg's peak hits a first area 1810, A1. The patient is rotated and the trajectory of the proton beam is illustrated in a second moment, t2, where the distal end of the Bragg peak hits a second area 1820, A2. In a third moment, the distal end of the profile of Bragg's peak hits a third area 1830, A3. This process of rotation and irradiation is repeated n times, where n is a positive number greater than four and preferably greater than about 10, 20, 30, 100 or 300. At one time, the distal end of the Bragg peak profile it hits a ninth area 1840. As illustrated, in a ninth moment, tn, if patient 1430 is rotated further, the proton beam would strike a sensitive body constituent 1450, such as the spinal cord or eyes. The irradiation is preferably suspended until the sensitive constituent of the body has been rotated out of the path of the proton beam. Irradiation resumes at a time, tn + 1. After the sensitive constituent 1450 of the body has been rotated out of the path of the proton beam. At time tn + 1 the distal energy of the Bragg peak hits an area tn + 1 1450. In this way, the energy of the Bragg peak is always within the tumor, the distal region of the profile of the Bragg peak is distributed in healthy tissue around tumor 1420, and sensitive body constituents 1450 receive minimal or no irradiation of proton beams.

Efficiency of proton supply

Here, the efficacy of the delivery of charged particles or protons is the dose of radiation delivered to the tumor compared to the dose of radiation delivered to the patient's healthy regions.

A proton supply improvement method is described where the efficiency of the proton supply is improved, optimized or maximized. In general, multi-field irradiation is used to deliver protons to the tumor from a multitude of rotational directions. From each direction, the energy of the protons is adjusted to go to the distal part of the tumor, where the distal part of the tumor is the volume of the tumor farthest from the point of entry of the proton beam into the body.

For clarity, the process is described using an example where the outer edges of the tumor are initially irradiated using radiation applied distally through a multitude of rotational positions, such as through 360 degrees. This results in a smaller tumor remaining symbolic or calculated for irradiation. The process is repeated as many times as necessary in the smaller tumor. However, the presentation is for clarity. In practice, irradiation from a given rotational angle is

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performed once with the energy and intensity of the proton beam on the z axis being adjusted for the smallest internal tumors calculated during x and y axis scanning.

With reference now to Figure 19, the method of improving the supply of protons is further described. With reference now to Figure 19A, protons are delivered to the tumor 1420 of patient 1430 from a first direction at a first point in time. From the first rotational direction, proton beam 269 scans through the tumor. As the proton beam explores through the tumor, the energy of the proton beam is adjusted to allow the energy of the Bragg peak to be directed to the distal part of the tumor. Again, distal refers to the back of the tumor located farthest from where the charged particles enter the tumor. As illustrated, the proton beam explores along an x axis through the patient. This process allows the energy of the Bragg peak to be inside the tumor, that the middle area of the profile of the Bragg peak is in the middle and proximal part of the tumor, and that the small intensity input part of the Bragg peak hits tissue healthy. In this way, the maximum radiation dose is supplied to the tumor or the efficiency of the proton dose is maximized for the first rotational direction.

After irradiation from the first rotational position, the patient is rotated to a new rotational position. With reference now to Figure 19B, the proton beam scan is repeated. Again, the distal part of the tumor is the target with the adjustment of the energy of the proton beam to direct the energy of the Bragg peak to the distal part of the tumor. Naturally, the distal part of the tumor for the second rotational position is different from the distal part of the tumor for the first rotational position. With reference now to Figure 19C, the process of rotating the patient and then irradiating the new distal part of the tumor is further illustrated in a nth rotational position. Preferably, the process of rotating the patient and exploring along the x and y axis with the energy in the Z axis directed to the new distal part is repeated, such as with more than 5, 10, 20 or 30 rotational positions or with approximately 36 rotational positions.

For clarity, Figures 19A-C and Figure 19E show the proton beam as having moved, but in practice, the proton beam is stationary and the patient is rotated, such as through the use of rotating the lower unit 1412 of patient positioning system 1410. In addition, Figures 19A-C and Figure 19E show the proton beam exploring through the tumor along the x-axis. Although not illustrated for clarity, the proton beam explores further up and down the tumor along the axis and the patient. Combined, the distal part or volume of the tumor is irradiated along the x and y axes with adjustment of the energy level in the z axis of the proton beam. In one case, the tumor scans along the x axis and the scan is repeated along the x axis for multiple positions on the y axis. In another case, the tumor scans along the y-axis and the scan is repeated along the y-axis for multiple positions on the x-axis. In yet another case, the tumor explores by simultaneously adjusting the x and y axes so that the distal part of the tumor is the target. In all of these cases, the z-axis or proton beam energy is adjusted along the contour of the distal part of the tumor to direct the energy of the Bragg peak to the distal part of the tumor.

Referring now to Figure 19D, after going to the distal part of the tumor from multiple directions, such as through 360 degrees, the outer perimeter of the tumor has been intensely irradiated with the energy profile of the Bragg peak, the medium of the energy profile of the energy of the Bragg peak has been supplied along an internal edge of the perimeter of the strongly irradiated tumor, and smaller dosages from the input part of the Bragg energy profile are distributed throughout the tumor and in some healthy tissue The dosages supplied or the levels of accumulated radiation flow are illustrated in a cross-sectional area of the tumor 1420 using an isoline line diagram. After a first complete rotation of the patient, symbolically, the darkest regions of the tumor are almost completely irradiated and the regions of the tissue that have received less radiation are illustrated with a gray scale with the whitest parts having the lowest radiation dose .

Referring now to Figure 19E, after completing the multi-field irradiation with distal addressing, a smaller internal tumor is defined, where the internal tumor is already partially irradiated. The smallest internal tumor is indicated by the dashed line 1930. The previous process of tumor irradiation is repeated for the newly defined smaller tumor. Proton dosages to the outer or distal parts of the smaller tumor are adjusted to take into account the dosages supplied from other rotational positions. After irradiating the second tumor, an even smaller third tumor is defined. The process is repeated until the entire tumor radiates at the prescribed or defined dose.

As described at the beginning of this example, the patient is preferably only rotated to each rotational position once. In the example described above, after irradiation of the outer perimeter of the tumor, the patient is rotatably positioned, such as through 360 degrees, and the distal part of the newest smaller tumor is the target as described above. . However, the irradiation dose to be administered to the second smallest tumor and each subsequent smaller tumor is known a priori. Therefore, when at a given angle of rotation, the smaller tumor or multiple progressively smaller tumors are optionally target, so that the patient is only rotated once to multiple

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rotational irradiation positions.

The objective is to provide a treatment dose to each tumor position, preferably not to exceed the treatment dose to any tumor position, minimize the dose of radiation to healthy tissue, circumferentially distribute the radiation that hits the healthy tissue, and further minimize the dose of radiation entering sensitive areas. Since the Bragg energy profile is known, it is possible to calculate the optimal intensity and energy of the proton beam for each rotational position and for each scanning position on the x and y axis. This calculation results in that slightly less than the threshold radiation dose is delivered to the distal part of the tumor for each rotational position since the energy of the input dose from other positions carries the total dose energy for the target position to the target position. threshold delivery dose.

Referring again to Figure 19A and Figure 19C, the intensity of the proton beam is preferably adjusted to take into account the cross-sectional distance or density of healthy tissue. An example is used for clarity. Referring now to Figure 19A, when radiating from the first position where the healthy tissue has a small area 1910, the intensity of the proton beam preferably increases, since relatively less energy is supplied by the input portion of the Bragg profile. to healthy tissue. Referring now to Figure 19C, in contrast when irradiated from the ninth rotational position where the healthy tissue has a large cross-sectional area 1920, the intensity of the proton beam preferably decreases since a larger fraction of the proton dose is supplied to healthy tissue from this orientation.

In one example, for each rotational position and / or for each distance on the z axis inside the tumor, the efficacy of the proton dose delivery to the tumor is calculated. The intensity of the proton beam is made proportional to the calculated efficiency. Essentially, when the exploration direction is really good, the intensity increases and vice versa. For example, if the tumor is elongated, generally the efficacy of irradiating the distal part passing through the length of the tumor is greater than irradiating a distal region of the tumor passing through the

tumor with the energy distribution of Bragg. Generally, in the optimization algorithm:

- distal parts of the tumor are targets for each rotational position;

- the intensity of the proton beam is greater with the largest cross-sectional area of the tumor;

- the intensity is greater when the intermediate volume of healthy tissue is the smallest; Y

- intensity is minimized or trimmed to zero when the intermediate volume of healthy tissue includes sensitive tissue,

such as the spinal cord or eyes.

Using an exemplary algorithm, the efficiency of delivering the radiation dose to the tumor is maximized. More particularly, the ratio of radiation dose delivered to the tumor versus the dose of radiation delivered to surrounding healthy tissue approaches a maximum. In addition, the integrated supply of the radiation dose to each tumor volume on the x, y, and z axes as a result of irradiation from multiple directions of rotation is at or near the preferred dose level. Still further, the supply of the radiation dose to healthy tissue is distributed circumferentially around the tumor through the use of multi-field irradiation where radiation is supplied from a plurality of directions into the body, such as more than 5, 10, 20 or 30 addresses

Multi-field irradiation

In an example of multi-field irradiation, the particle therapy system with an annular synchrotron diameter of less than six meters includes the ability to:

- rotate the patient approximately 360 degrees;

- extract radiation in approximately 0.1 to 10 seconds;

- explore approximately 100 millimeters vertically;

- horizontally explore approximately 700 millimeters;

- vary the energy of the beam from approximately 30 to 330 MeV / second during irradiation;

- focus the proton beam of approximately 2 to 20 millimeters on the tumor; I

- complete the multi-field irradiation of a tumor in less than about 1, 2, 4 or 6 minutes as measured from the moment of initiation of the proton supply to the patient 1430.

With reference now to FIG. 20, two 2000 multi-field irradiation methods are described. In the first method, the main controller 110 rotationally places the patient 1430 in 2010 and subsequently radiates the tumor 1420 2020. The process is repeated until an irradiation plan Multicampo is complete. In the second method, the main controller 110 rotates and simultaneously radiates 2030 the tumor 1420 within the patient 1430 until the multicamp irradiation plan is complete. More particularly, irradiation of the proton beam occurs while patient 1430 is being rotated.

The three-dimensional point proton focal point scanning system, described herein, is preferably combined with a rotation / weft method. The method includes layered tumor irradiation

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from many directions. During a given irradiation section, the energy of the proton beam changes continuously according to the density of the tissue in front of the tumor so that the point of arrest of the beam, defined by the Bragg peak, always remains within the tumor and within the irradiated section. . The new method allows irradiation from many directions, referred to herein as multi-field irradiation, to reach the maximum effective dose at the tumor level while simultaneously significantly reducing the possible side effects on surrounding healthy tissues compared to existing methods. Essentially, the multi-field irradiation system distributes the dose distribution to tissue depths that have not yet reached the tumor.

Proton beam position control

Referring now to Figure 21, a system of beam delivery and tissue volume exploration is illustrated. Currently, the global radiotherapy community uses a dose field formation method using a brush beam scanning system. In stark contrast, Figure 21 illustrates a point scanning system or a tissue volume scanning system. In the tissue volume scanning system, the proton beam is controlled, in terms of transport and distribution, using an economical and accurate scanning system. The scanning system is an active system, where the beam is focused on a point focal point of approximately half, one, two or three millimeters in diameter. The focal point moves along two axes and at the same time alters the applied energy of the proton beam, which effectively changes the third dimension of the focal point. The system is applicable in combination with the rotation of the body described above, which preferably occurs between individual moments or cycles of proton delivery to the tumor. Optionally, the rotation of the body by the system described above occurs continuously and simultaneously with the supply of protons to the tumor.

For example, in the example illustrated in Figure 21A, the point moves horizontally, moves down an axis and vertical, and then returns along the horizontal axis. In this example, current is used to control a vertical scanning system that has at least one magnet. The applied current alters the magnetic field of the vertical scanning system to control the vertical deviation of the proton beam. Similarly, a horizontal scanning magnet system controls the horizontal deviation of the proton beam. The degree of transport along each axis is controlled to fit the cross section of the tumor at the given depth. Depth is controlled by changing the energy of the proton beam. For example, the energy of the proton beam is reduced, to define a new depth of penetration, and the scanning process is repeated along the horizontal and vertical axes that cover a new cross-sectional area of the tumor. Combined, the three control axes allow exploration or movement of the focal point of the proton beam over the entire volume of the cancerous tumor. The time at each point and the direction in the body for each point are controlled to produce the desired radiation in each subvolume of the cancerous volume while distributing energy that strikes outside the tumor.

The spot volume dimension of the focused beam is preferably closely controlled at a diameter of approximately 0.5, 1 or 2 millimeters, but as an alternative it is several centimeters in diameter. Preferred design controls allow two-way scanning with: (1) a vertical amplitude of approximately 100 mm amplitude and frequency up to approximately 200 Hz; and (2) a horizontal amplitude of approximately 700 mm amplitude and frequency up to approximately 1 Hz.

In Figure 21A, the proton beam is illustrated along a z axis controlled by the energy of the beam, the horizontal movement is along an x axis, and the vertical direction is along a y axis. The distance that protons move along the z axis into the tissue, in this example, is controlled by the proton's kinetic energy. This coordinate system is arbitrary and exemplary. Actual control of the proton beam is controlled in three-dimensional space using two scanning magnet systems and controlling the kinetic energy of the proton beam. The use of the extraction system, described above, allows different scanning patterns. Particularly, the system allows simultaneous adjustment of the x, y, and z axes in solid tumor irradiation. Said again, instead of exploring along an x, y plane, and then adjusting the energy of the protons, such as with a range modulation wheel, the system allows movement along the z axes while the x and / or y axes are adjusted simultaneously. Therefore, instead of irradiating sections of the tumor, the tumor is optionally irradiated in three simultaneous dimensions. For example, the tumor radiates around an outer border of the tumor in three dimensions. Next, the tumor radiates around an outer edge of an internal section of the tumor. This process is repeated until the entire tumor is irradiated. The irradiation of the outer edge is preferably coupled with the simultaneous rotation of the subject, such as around an axis and vertical. This system allows maximum efficiency of proton deposition in the tumor, as defined as the ratio between the energy of proton irradiation supplied to the tumor with respect to the energy of proton irradiation delivered to healthy tissue.

Combined, the system allows multiaxial control of the system of charged particle beams in a small space with low power supply. For example, the system uses multiple magnets where each magnet has the

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less a focus effect on the edge in each section of the synchrotron and / or multiple magnets that have geometry of the magnetic field of concentration, as described above. The multiple effects of focusing on the edge in the circulation path of the synchrotron beam combined with the concentration geometry of the magnets and the described extraction system produces a synchrotron that has:

- a small circumference system, such as less than about 50 meters;

- a hole of vertical proton beam size of approximately 2 cm;

- corresponding reduced power supply requirements associated with the reduced gap size;

- an extraction system that does not require a newly introduced magnetic field;

- acceleration or deceleration of protons during extraction; Y

- control of the energy in the z axis during extraction.

The result is a three-dimensional scanning system, control in x, y, and z axes, where the control in z axes resides in the synchrotron and where the energy of the z axes is controlled in a variable way during the extraction process within the synchrotron.

Referring now to Figure 21B, an example of a proton scanning or addressing system 140 used to direct the protons to the tumor with four-dimensional scanning control is provided, where the four-dimensional scanning is along the x, y, and z together with intensity control, as described above. A fifth axis is time. Normally, the charged particles that travel along the transport path 268 are directed through a first control element 142 of the axis, such as a vertical control, and a second control element 144 of the axis, such as a horizontal control and within a 1420 tumor. As described above, the extraction system also allows simultaneous variation on the z axis. In addition, as described above, the intensity or dose of the extracted beam is optionally controlled and modified simultaneously and independently. Thus, instead of irradiating a section of the tumor, as in Figure 21A, the four dimensions that define the point of targeting of the proton supply in the tumor are simultaneously variable. Simultaneous variation of the proton delivery point is illustrated in Figure 21B by the point delivery path 269. In the illustrated case, the protons are initially directed around an outer edge of the tumor and then directed around an internal radius of the tumor. Combined with the rotation of the subject on a vertical axis, a multi-field illumination process is used where a part of the tumor that is not yet irradiated preferably radiates to the additional distance of the tumor from the point of entry of the protons into the body. This produces the highest percentage of the proton supply, as defined by the Bragg peak, inside the tumor and minimizes damage to healthy peripheral tissue.

IMAGENOLOGY / RADIOGRAPHIC SYSTEM

In this document, a radiographic system is used to illustrate an imaging system. Synchronization

An x-ray is preferably collected (1) just before or (2) while treating a subject with proton therapy for a couple of reasons. First, the movement of the body, described above, changes the local position of the tumor in the body in relation to other body constituents. If the subject is taken an x-ray and then physically transferred to a proton treatment room, precise alignment of the proton beam with the tumor is problematic. Alignment of the proton beam with one or more radiographs is best performed at the time of proton delivery or in the seconds or minutes immediately before proton delivery and after placing the patient in a therapeutic body position, which is usually a position fixed or partially immobilized position. Second, the radiograph taken after patient placement is used to verify the alignment of the proton beam to a target position, such as a position of the tumor and / or internal organ.

Placement

An x-ray is preferably taken just before treating the subject to help the patient's placement. For placement purposes, an x-ray of a large body area is not needed. In one embodiment, an x-ray of only one local area is collected. When picking up an x-ray, the x-ray has an x-ray path. The proton beam has a proton beam path. Overlapping the X-ray path with the proton beam path is a method of aligning the proton beam with the tumor. However, this method involves placing the radiographic equipment on the path of the proton beam, taking the radiograph and then taking the radiographic equipment out of the beam path. This process takes time. The time elapsed while moving the radiographic equipment has a couple of harmful effects. First, during the time required to move the radiographic equipment, the body moves. The resulting movement decreases the precision and / or accuracy of the subsequent alignment of the proton beam with the tumor. Second, the time required to move the radiographic equipment is the time that the proton beam therapy system is not in use, which decreases the effectiveness

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Total proton beam therapy system.

X-ray source life

Preferably, the components in the particle beam therapy system require minimal or no maintenance during the life of the particle beam therapy system. For example, it is desirable to equip the proton beam therapy system with a radiographic system that has a long lifetime, such as a lifespan of approximately 20 years.

In a system, described below, electrons are used to create X-rays. Electrons are generated in a cathode where the cathode's life depends on temperature. Similarly to a bulb, where the filament is kept in equilibrium, the cathode temperature is maintained in equilibrium at temperatures of approximately 200, 500 or 1000 degrees Celsius. The reduction of the cathode temperature results in an increased lifespan of the cathode. Therefore, the cathode used to generate electrons is kept at a temperature as low as possible. However, if the cathode temperature is reduced, then electron emissions also decrease. To overcome the need for more electrons at lower temperatures, a large cathode is used and the generated electrons are concentrated. The process is analogous to the compression of electrons in an electron gun; However, in this context the compression techniques are adapted to be applied to the improvement of the useful life of an X-ray tube.

Referring now to Figure 22, an example of an X-ray generating device 2200 having an improved lifespan is provided. The electrons 2220 are generated at a cathode 2210, are focused with a control electrode 2212, and accelerated with a series of acceleration electrodes 2240. The accelerated electrons 2250 impact with a source 2248 generating X-rays resulting in X-rays generated which are then directed along a path 2370 of X-rays to the subject 1430. The concentration of electrons from a first diameter 2215 to a second diameter 2216 allows the cathode to operate at a reduced temperature and still produce the level Necessary amplification of electrons in the source 2248 of X-ray generation. In one example, the source of X-ray generation is the anode coupled with the cathode 2210 and / or the source of X-ray generation is substantially composed of tungsten.

Even with reference to Figure 22, a more detailed description of an exemplary X-ray generating device 2200 is described. An anode 2214 / cathode 2210 pair is used to generate electrons. Electrons 2220 are generated at cathode 2210 having a first diameter 2215, indicated d1. The control electrodes 2212 attract the generated electrons 2220. For example, if the cathode is maintained at approximately -150 kV and the control electrode is maintained at approximately -149 kV, then the generated electrons 2220 are attracted to the control electrodes 2212 And they focus. A series of acceleration electrodes 2240 are then used to accelerate electrons in a substantially parallel path 2250 with a smaller diameter 2116, which is indicated d2. For example, with the cathode maintained at -150 kV, a first, second, third and fourth acceleration electrodes 2242, 2244, 2246, 2248 are maintained at approximately -120, -90, -60 and -30 kV, respectively. If a finer body part is to be analyzed, then cathode 2210 is maintained at a smaller level, such as approximately -90 kV and the control electrode, first, second, third and fourth electrodes are adjusted, each, to lower levels Generally, the voltage difference from the cathode to the fourth electrode is smaller for a smaller negative voltage at the cathode and vice versa. The accelerated electrons 2250 are optionally passed through a magnetic lens 2260 for adjustment of the beam size, such as a cylindrical magnetic lens. Electrons are also optionally focused using 2270 quadrupole magnets, which focus in one direction and blur in another direction. Accelerated electrons 2250, which are now adjusted in beam size and focused hit a source 2248 of X-ray generation, such as tungsten, resulting in generated X-rays that pass through a blocker 2362 and continue along a 2270 X-ray path to the subject. The source 2248 of X-ray generation is optionally cooled with a cooling element 2249, such as water in contact or thermally connected to a rear side of the source 2248 of X-ray generation. The concentration of electrons from a first diameter 2215 at a second diameter 2216 it allows the cathode to operate at a reduced temperature and still produces the level of amplified electrons needed at the source 2248 of X-ray generation.

More generally, the 2200 x-ray generating device produces electrons that have initial vectors. One or more of the control electrode 2212, the acceleration electrodes 2240, the magnetic lens 2260 and the quadrupole magnets 2270 are combined to alter the initial electron vectors to parallel vectors with a reduced cross-sectional area having a substantially parallel path, called the 2250 accelerated electrons. The process allows the X-ray generating device 2200 to operate at a lower temperature. Particularly, instead of using a cathode that is the necessary electron beam size, a larger electrode is used and the resulting electrons 2220 are focused and / or concentrated on the required electron beam. Since the useful life is approximately the inverse of the current density, the concentration of the current density results in a longer useful life of the X-ray generating device. A specific example is provided for clarity. If the cathode has a radius of fifteen mm or d1 is of

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approximately 30 mm, then the area (n r2) is approximately 225 mm2 per pi. If the concentration of the electrons reaches a radius of five mm or d2 is approximately 10 mm, then the area (n r2) is approximately 25 mm2 per pi. The ratio of the two areas is approximately nine (225tc / 25tc). Therefore, there is approximately nine times less current density in the larger cathode compared to the traditional cathode that has a desired electron beam area. Therefore, the lifespan of the largest cathode approximates nine times the lifespan of the traditional cathode, although the actual current through the larger cathode and the traditional cathode is approximately the same. Preferably, the area of the cathode 2210 is approximately 2, 4, 6, 8, 10, 15, 20 or 25 times greater than that of the cross-sectional area of the substantially parallel electron beam 2150.

In another embodiment, the quadrupole magnets 2270 result in an oblong cross-sectional shape of the electron beam 2250. A projection of the oblong cross-sectional shape of the electron beam 2250 on the X48 generating source 2248 results in a X-ray beam having a small point in cross-sectional view, which is preferably substantially circular in cross-sectional shape, which is then passed through patient 1430. The small point is used to produce an x-ray having a Improved resolution in the patient.

With reference now to Figure 23, in one embodiment, an x-ray is generated near, but not in, the path of the proton beam. A combination 2300 of proton beam therapy system and a radiographic system is illustrated in Figure 23. The proton beam therapy system has a proton beam 268 in a transport system after the Lamberson 292 extraction magnet of the Synchrotron 130. The proton beam is directed by the scanning / addressing / delivery system 140 to a tumor 1420 of a patient 1430. The radiographic system 2305 includes a 2205 electron beam source that generates a 2250 electron beam. of electrons is directed to a 2248 source of x-ray generation, such as a piece of tungsten. Preferably, the tungsten X-ray source is located approximately 1, 2, 3, 5, 10, 15, 20 or 40 millimeters from the path 268 of the proton beam. When the electron beam 2250 hits the tungsten, X-rays are generated. In a case where X-rays are generated in all directions, the X-rays are preferably blocked with a port 2362 and selected for a path 2370 of the X-ray beam In a second case, the geometry of the electron beam 2250 and the source 2248 of X-ray generation produce generated X-rays 2270 that have a directionality, such as aligned with the proton beam 268. In any case, the path 2370 of the X-ray beam and the path 268 of the proton beam run substantially parallel as they move toward the tumor 1420. The distance between the path 2370 of the X-ray beam and the path 269 of the proton beam preferably decreases to almost zero and / or the trajectory 2370 of the x-ray beam and the trajectory 269 of the proton beam overlap at the moment they reach the tumor 1420. Simple geometry shows that this is the case given the long distance ia, of at least one meter, between the tungsten and the tumor 1420. The distance is illustrated as a gap 2380 in Figure 23. X-rays are detected in an X-ray detector 2390, which is used to form an image of the tumor 1420 and / or patient position 1430.

As a whole, the system generates an X-ray beam that is substantially on the same path as the proton therapy beam. The x-ray beam is generated by hitting a tungsten or equivalent material with an electron beam. The X-ray source is located close to the path of the proton beam. The geometry of the incident electrons, the geometry of the X-ray generation material and the geometry of the X-ray beam blocker 262 produce an X-ray beam that runs substantially in parallel with the proton beam or results in a trajectory of the X-ray beam that begins near the path of the proton beam and expands to cover and transmit through a cross-sectional area of the tumor to hit an X-ray matrix or film that allows imaging of the tumor from one direction and alignment of the proton therapy beam. The radiographic image is then used to control the trajectory of the charged particle beam to accurately and accurately target the tumor, and / or is used in the verification and validation of the system.

Having a source 2248 of X-ray generation that is close to the trajectory 268 of the proton beam allows an X-ray of the patient 1430 to be collected close at the time of the use of the proton beam for tumor therapy 1420, since the source 2248 X-ray generation does not need to be mechanically moved before proton therapy. For example, proton irradiation of tumor 1420 occurs within approximately 1, 5, 10, 20, 30 or 60 seconds of when the radiograph is collected.

Patient Immobilization

The exact and precise supply of a proton beam to a patient's tumor requires: (1) control of the placement of the proton beam and (2) control of the patient's placement. As described above, the proton beam is controlled using algorithms and magnetic fields up to a diameter of approximately 0.5, 1 or 2 millimeters. This section addresses the partial immobilization, restraint and / or alignment of the patient to ensure that the tightly controlled proton beam effectively strikes a target tumor and not the surrounding healthy tissue as a result of the patient's movement.

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In this section, a coordinate system of x, y, and z axes and a rotation axis are used to describe the orientation of the patient with respect to the proton beam. The z axis represents the displacement of the proton beam, such as the depth of the proton beam in the patient. When observing the patient along the z axis of the proton beam movement, the x axis refers to moving to the left or right in the patient and the axis and refers to the movement up or down of the patient. A first axis of rotation is the rotation of the patient around the y-axis, and is referred to herein as the axis of rotation, axis of rotation of the lower unit 1412 or axis of rotation and. In addition, the inclination is the rotation around the x axis, the oscillation is the rotation around the y axis, and the swing is the rotation around the z axis. In this coordinate system, the path 269 of the proton beam optionally runs in any direction. As an illustrative issue, the path of the proton beam that runs through a treatment room is described as a horizontal path through the treatment room.

In this section, a partial immobilization system 2400 of the patient 1430 is described. A semi-vertical partial immobilization system is used to illustrate key features, which are illustrative of features in a partial sitting immobilization system or a lying down system.

Vertical patient placement / immobilization

Referring now to Figure 24, the placement system 2400 of the semivertical patient is preferably used together with proton therapy of tumors in the torso. The patient's placement and / or immobilization system controls and / or restricts the patient's movement during proton beam therapy. In a first embodiment of partial immobilization, the patient is placed in a semi-vertical position in a proton beam therapy system. As illustrated, the patient is reclined at an alpha angle, a, about 45 degrees from the axis and, as defined by an axis that goes from the head to the patient's feet. More generally, the patient is optionally completely standing in a vertical position of zero degrees outside the axis and is in a semivertical alpha position that is reclined around 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60 or 65 degrees off the y axis, towards the z axis.

Patient placement restriction elements 2415 are used to keep the patient in a treatment position, including one or more of: a seat support 2420, a support 2430 for the back, a support 2440 for the head, a support 2450 for the arm, a 2460 support for the knee and a 2470 support for the foot. The restriction elements are optionally and independently rigid or semi-rigid. Examples of a semi-rigid material include a high or low density foam or a viscoelastic foam. For example, the foot support is preferably rigid and the back support is preferably semi-rigid, such as a high density foam material. One or more of the placement restriction elements 2415 are mobile and / or are under the control of a computer for rapid placement and / or immobilization of the patient. For example, the seat support 2420 is adjustable along an adjustment axis 2422 of the seat, which is preferably the y axis; the back support 2430 is adjustable along an axis 2432 of the back support, which is preferably dominated by movement in the z axis with an element in the y axis; the head support 2440 is adjustable along an axis 2442 of the head support, which is preferably dominated by movement in the z axis with an element in the y axis; the arm support 2450 is adjustable along an axis 2452 of the arm support, which is preferably dominated by movement in the z axis with an element in the y axis; the knee support 2460 is adjustable along an axis 2462 of the knee support, which is preferably dominated by movement in the axis and with an element in the z axis; and the foot support 2470 is adjustable along an axis 2472 of the foot support, which is preferably dominated by movement in the axis and with an element in the z axis.

If the patient is not facing the incoming proton beam, then the description of movements of the support elements along the axes changes, but the immobilization elements are the same.

An optional 2480 camera is used with the patient immobilization system. The camera views the patient / subject creating a video image. The image is provided to one or more operators of the charged particle beam system and allows operators a safety mechanism to determine if the subject has moved or wishes to complete the treatment procedure with proton therapy. Depending on the video image, operators can suspend or terminate the proton therapy procedure. For example, if the operator observes through the video image that the subject is moving, then the operator has the option to terminate or suspend the proton therapy procedure.

A 2490 video viewer is provided to the patient. The video display optionally presents the patient with any of: operator instructions, system instructions, treatment status, or entertainment.

Motors for positioning the restriction elements 2415, the camera 2480, and the video display 2490 are preferably mounted above or below the path of the protons.

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Breathing control is optionally performed using the video display. As the patient breathes, the internal and external structures of the body move in both absolute and relative terms. For example, the outside of the thoracic cavity and internal organs both have absolute movements with breathing. In addition, the relative position of an internal organ with respect to another body component, such as an external region of the body, a bone, support structure or other organ, moves with each breath. Therefore, for a more exact and precise tumor orientation, the proton beam is preferably administered at a point a in time where the position of the internal structure or tumor is well defined, such as at the end of each inspiration. The video viewer is used to help coordinate the supply of the proton beam with the patient's breathing cycle. For example, the video viewer optionally visualizes the patient an order, such as a statement of holding his breath, a statement of inspiring, a countdown that indicates when it will be necessary to hold his breath or a countdown until breathing can resume.

The placement system 2400 of the semi-vertical patient and the positioning system of the sitting patient are preferably used for the treatment of tumors in the head or in the torso due to efficacy. The 2400 semi-vertical patient placement system, the sitting patient placement system, and the lying patient placement system are all usable for the treatment of tumors in the patient's limbs.

Elements of the support system

The placement restriction elements 2415 include all the elements used to position the patient, such as those described in the semi-vertical placement system 2400, the sitting placement system and the lying positioning system. Preferably, the positioning restriction elements or support system elements are aligned in positions that do not prevent or overlap with the path 269 of the proton beam. However, in some cases the placement restriction elements are in the path 269 of the proton beam for at least part of the patient's treatment time. For example, a positioning restriction element may reside on the path 269 of the proton beam for part of a period of time where the patient is rotated around the axis and during treatment. In cases or periods of time when the positioning restriction elements or the support system elements are in the path of the proton beam, then an upward adjustment of the energy of the proton beam that increases the energy of the proton beam is preferably applied. proton beam to displace the impedance of the proton beam placement restriction element. In one case, the energy of the proton beam is increased by a separate measure of the impedance of the placement restriction element determined during a reference scan of the placement restriction system element or set of reference scans of the restriction element of placement depending on the rotation around the y axis.

For greater clarity, placement restriction elements 2415 or support system elements are described herein with respect to semivertical placement system 2400; however, the descriptive placement elements and x, y, and z axes are adjustable to fit any coordinate system, to the sitting placement system, or to the lying placement system.

An example of a head support system is described to support, align and / or restrict the movement of a human head. The head support system preferably has several head support elements including any of: a support of the back of the head, an alignment element of the right part of the head, and an alignment element of the part left of the head. The support element of the back of the head is preferably curved to fit the head and is optionally adjustable along an axis of the head support, such as along the z axis. In addition, head restraints, such as the other patient placement restriction elements, are preferably made of a semi-rigid material, such as a low or high density foam, and have optional coverage, such as a plastic or leather. The alignment element of the right part of the head and the alignment element of the left part of the head or alignment elements of the head are mainly used to restrict the movement of the head in half. The head alignment elements are preferably padded and flat, but optionally have a radius of curvature to fit with the head side. The alignment elements of the right and left head are preferably respectively movable along translation axes to establish contact with the sides of the head. Restricted movement of the head during proton therapy is important when targeting and treating tumors in the head or neck. The head alignment elements and the support element of the back of the head are combined to restrict tilt, rotation or oscillation, balancing and / or head position in the x-axis coordinate system , and Z.

Referring now to Figure 25, another example of a head support system 2500 for positioning and / or restricting the movement of a human head 1402 during proton therapy of a solid tumor in the head or neck is described. In this system, the head is restricted using 1, 2, 3, 4, or more belts or belts, which are preferably connected or replaceably connected to a support element 2510 of the

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back of the head. In the illustrated example, a first belt 2520 pulls or positions the forehead relative to the support element 2510 of the head, such as running mainly along the z axis. Preferably, a second belt 2530 works together with the first belt 2520 to prevent the head from experiencing inclination, oscillation, swinging or movement in terms of translational movement in the x, y, and z axis coordinate system. The second belt 2530 is preferably attached or replaceably attached to the first belt 2520 on or around: (1) the forehead 2532; (2) or one or both sides of head 2534; and / or (3) in or around the support element 2510. A third belt 2540 preferably orients the chin of the subject with respect to the support element 2510 running dominant along the z axis. A fourth belt 2550 preferably runs along mainly the y and z axes to retain the chin with respect to the support element 2510 of the head and / or the path of the proton beam. The third strap 2540 is preferably attached to or is replaceably attached to the fourth strap 2550 during use on or around the patient's chin 2542. The second belt 2530 optionally connects 2536 to the fourth belt 2550 in or around the support element 2510. The four belts 2520, 2530, 2540, 2550 are illustrative in path and interconnection. Any of the straps optionally holds the head along different paths around the head and are connected to each other separately. Naturally, a given belt preferably extends around the head and not only on one side of the head. Any of the belts 2520, 2530, 2540 and 2550 are optionally used independently or in combinations and permutations with the other belts. The straps are optionally indirectly connected to each other through a support element, such as the support element 2510 of the head. The straps are optionally attached to the support element 2510 of the head using hook and loop technology, a buckle or fastener. Generally, the straps are combined to control the position, the movement from front to back of the head, the movement from side to side of the head, the inclination, the oscillation, the balancing and / or the translational position of the head.

The belts are preferably of known impedance for proton transmission allowing a calculation of peak energy release along the z axis. For example, the adjustment to the energy of the Bragg peak is made based on the tendency to slow down the belts for proton transport.

Computer control of the placement system

One or more of the components of the patient placement unit and / or one or more of the patient placement restriction elements are preferably under computer control, where the computer controls placement devices, such as by a series of engines. and driving mechanisms, to reproduce the patient reproducibly. For example, the patient is initially placed and restricted by the patient placement restriction elements. The position of each of the patient placement restriction elements is recorded and saved by the main controller 110, by a subcontroller or the main controller 110, or by a separate computer controller. Next, medical devices are used to locate the tumor 1420 in the patient 1430 while the patient is in the final treatment orientation. The imaging system 170 includes one or more of: Rm, radiographs, CT, proton beam tomography, and the like. Time passes optionally at this point where images of imaging system 170 are analyzed and a treatment plan with proton therapy is designed. The patient can leave the restriction system during this period of time, which can be minutes, hours or days. Upon return of the patient to the patient placement unit, the computer may return the patient placement restriction elements to the registered positions. This system allows a rapid repositioning of the patient to the position used during the imaging and the development of the treatment plan, which minimizes the patient setup time and maximizes the time that the system 100 of charged particle beams is used to cancer treatment

Patient placement

Preferably, patient 1430 is aligned on path 269 of the proton beam in a precise and accurate manner. Various placement systems are described. Patient placement systems are described using the lying placement system, but they are also applicable to semi-vertical and seated placement systems.

In a first placement system, the patient is placed in a known location with respect to the platform. For example, one or more of the positioning restriction elements places the patient in a precise and / or exact location on the platform. Optionally, a positioning restriction element connected or replaceably connected to the platform is used to place the patient on the platform. The placement restriction element or elements are used to position any position of the patient, such as a hand, limb, head or torso element.

In a second placement system, one or more placement restriction elements or support element, such as the platform, is aligned in front of an element in the patient's treatment room. Essentially a lock and key system is optionally used, where a lock fits with a key. The bolt elements and

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key are combined to locate the patient with respect to any of the x, y, and z positions, tilt, swing and swing. Essentially, the bolt is a first exact alignment element and the key is a second exact alignment element that fits in, adjacent to, or with the first exact alignment element to fix the patient's location and / or the location of the patient element. support with respect to trajectory 269 of the proton beam. Examples of an exact alignment element include any of a mechanical element, such as a mechanical stop, and an electrical connection indicating a relative position or contact.

In a third positioning system, the imaging system, described above, is used to determine where the patient is with respect to the path 269 of the proton beam or with respect to an imaging marker placed on a support element or structure. which holds the patient, as on the platform. When the imaging system is used, such as a radiographic imaging system, then the first placement system or placement restriction elements minimize patient movement once the imaging system determines the location of the subject. Similarly, when the imaging system is used, such as a radiographic imaging system, then the first placement system and / or the second placement system provide a rough position of the patient with respect to the path 269 of the proton beam and The imaging system subsequently determines a fine position of the patient with respect to the path 269 of the proton beam.

Synchronization of the radiographs with the patient's breathing

In one embodiment, radiographic images are collected in synchronization with the patient's breathing or inspiration. Synchronization improves the clarity of the radiographic image by eliminating the ambiguity of the position due to the relative movement of body constituents during a patient's breathing cycle.

In a second embodiment, a radiographic system is oriented to provide radiographic images of a patient in the same orientation as seen by a beam of proton therapy, is synchronized with the patient's breathing, is operable in a patient placed for proton therapy, and does not interfere in a treatment path with a proton beam. Preferably, the synchronized system is used in conjunction with a negative ion beam source, synchrotron, and / or directing the method apparatus to provide a radiography synchronized with the patient's breathing and performed immediately before and / or concurrently with irradiation of particle beam therapy to ensure the targeted and controlled supply of energy with respect to a patient's position that results in an efficient, accurate and / or accurate, non-invasive, in-vivo treatment of a solid cancerous tumor with minimization of the damage to surrounding healthy tissue in a patient using the proton beam position verification system.

An X-ray supply control algorithm is used to synchronize the supply of X-rays to the patient 1430 within a given period of each inspiration, such as at the beginning or end of an inspiration when the subject is holding his breath. For clarity of combined radiographic images, the patient is preferably both accurately positioned and precisely aligned with respect to the path 2370 of the X-ray beam. The X-ray supply control algorithm is preferably integrated with the module of breath control Thus, the X-ray supply control algorithm knows when the subject is breathing, where the subject is in the breathing cycle, and / or when the subject is holding the breath. In this way, the X-ray supply control algorithm supplies X-rays in a selected period of the breathing cycle. The accuracy and precision of alignment of the patient allow (1) a more accurate and precise location of the tumor 1420 with respect to other constituents of the body and (2) a more accurate and precise combination of X-rays in the generation of a three-dimensional radiographic image of patient 1430 and tumor 1420.

Referring now to Fig. 26, an example of generating a radiographic image 2600 of patient 1430 and tumor 1420 using the 2200 x-ray generating device or the three-dimensional x-ray generating device as a known function of time is provided of the patient's breathing cycle. In one embodiment, as a first stage, the main controller 110 orders, monitors and / or is informed about patient placement 2610. In a first example of positioning 2610 of the patient, an automated patient positioning system is used, under the control of the main controller 110, to align the patient 1430 with respect to the path 2370 of the X-ray beam. In a second example of Patient placement, the main controller 110 is informed by sensors or input by the human being that the patient 1430 is aligned. In a second stage, the patient's breathing is then monitored 2620, as described below. As a first example of breathing monitoring, a 2640 radiograph is collected at a known point in the patient's breathing cycle. In a second example of breathing monitoring, the patient's breathing cycle is controlled firstly in a third stage 2630 controlling the patient's breathing and then as a fourth stage an X-ray 2640 is collected at a controlled point in the patient breathing cycle Preferably, the positioning cycle 2610 of the patient, the monitoring 2620 of the patient's breathing, the control 2630 of the patient's breathing, and the collection of an X-ray 2640 is repeated with different positions of the patient. For example, patient 1430 is rotated around an axis 1417 and x-rays are collected as a function of rotation. In a fifth stage, a radiographic image is generated

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Three-dimensional 2650 of patient 1430, tumor 1420, and constituents of the body around the tumor using the collected radiographic images, such as with the three-dimensional X-ray generating device, which is a radiographic image produced while the patient is rotated 1430 while collect radiographs with a stationary radiographic system. The stages of monitoring and controlling the patient's breathing are described further below.

Patient Breath Monitoring

Preferably, the patient's breathing pattern is monitored 2620. When a subject or patient 1430 is breathing, many parts of the body move with each inspiration. For example, when a subject inspires the lungs they move as well as relative positions of organs within the body, such as the stomach, kidneys, liver, thoracic muscles, skin, heart and lungs. Generally, most or all parts of the torso move with each inspiration. In fact, the inventors have recognized that, in addition to the movement of the torso with each inspiration, there is also a diverse movement in the head and extremities with each inspiration. Movement should be considered when delivering a dose of protons to the body, since protons are preferably supplied to the tumor and not to the surrounding tissue. Therefore, the movement produces an ambiguity as to where the tumor resides with respect to the path of the beam. To partially overcome this concern, protons are supplied at the same point in each of a series of breathing cycles.

Initially 2620 determines a rhythmic pattern of breathing or inspiration of a subject. The cycle is observed or measured. For example, an X-ray beam operator or a proton beam operator can observe when a subject is breathing or between inspirations and can synchronize the proton delivery time to a given period of each inspiration. As an alternative, the subject is told to inhale, exhale and hold his breath and the protons are supplied during the ordered period of time.

Preferably, one or more sensors are used to determine the individual's breathing cycle. Two examples of a breathing monitoring system are provided: (1) a thermal monitoring system and (2) a force monitoring system.

A first example of the thermal respiration monitoring system is provided. In the thermal respiration monitoring system, a 2470 sensor is placed near the nose and / or mouth of the patient. Since the patient's jaw is optionally restricted, as described above, the thermal breathing monitoring system is preferably placed in the patient's nasal exhalation path. To avoid steric interference of the components of the thermal sensor system with proton therapy, the thermal respiration monitoring system is preferably used when treating a tumor not located in the head or neck, such as when treating a tumor in the torso or extremities In the thermal monitoring system, a first thermal resistance 2570 is used to monitor the patient's breathing cycle and / or the location in the patient's breathing cycle. Preferably, the first thermal resistance 2570 is placed near the patient's nose, so that when the patient exhales through his nose over the first thermal resistance 2570 heats the first thermal resistance 2570 indicating an exhalation. Preferably, a second thermal resistance 2560 functions as an ambient temperature sensor. The second thermal resistance 2560 is preferably placed outside the exhalation path of the patient but in the local environment of the same room as the first thermal resistance 2570. The generated signal, such as current from the thermal resistances 2570, is preferably converted into voltage and communicates with the main controller 110 or a subcontroller of the main controller. Preferably, the second thermal resistance is used to adjust the ambient temperature fluctuation that is part of a first thermal resistance 2570 signal, such as calculating a difference between thermal resistance values 2560, 2570 to produce a more accurate cycle reading. of patient breathing.

A second example of the breathing force / pressure monitoring system is provided. In the breathing force monitoring system, a sensor is placed on the torso. To avoid steric interference of the components of the force sensing system with proton therapy, the breathing force monitoring system is preferably used when treating a tumor located in the head, neck or extremities. In the force monitoring system, a belt or belt 2455 is placed around an area of the patient's torso that expands and contracts with each patient's breathing cycle. The belt 2455 is preferably tight around the patient's chest and is flexible. A force meter 2457 is attached to the belt and detects the patient's breathing pattern. The forces applied to the force meter 2457 correlate with periods of the breathing cycle. The signals from the force meter 2457 preferably communicate with the main controller 110 or a subcontroller of the main controller.

Breath control

Referring now to Figure 26, once the rhythmic pattern of the subject's breathing or inspiration is determined, a signal is optionally supplied to the subject to more accurately control the frequency

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respiratory 2630. For example, a 2490 display screen is placed in front of the subject indicating to the subject when to hold the breath and when to breathe. Normally, a breathing control module uses the input of one or more of the breathing sensors. For example, the entry is used to determine when the next exhalation should be completed. At the bottom of the inspiration, the control module displays a breath containment signal to the subject, such as on a monitor, through an oral signal, digitized and automatically generated voice command, or through a visual control signal . Preferably, a display monitor 2490 is placed in front of the subject and the monitor displays breathing orders for the subject. Normally, the subject is instructed to hold his breath for a short period of time, such as about ^, 1, 2, 3, 5 or 10 seconds. The period of time in which the breath is contained is preferably synchronized with the time of delivery of the proton beam to the tumor, which is approximately ^, 1, 2 or 3 seconds. Although the delivery of the protons at the end of the inspiration is preferred, the protons are optionally supplied at any point in the breathing cycle, such as when inhaled completely. The supply at the top of the inspiration or when the patient is instructed to inhale deeply and hold the breath through the breathing control module, is optionally done because, at the top of the inspiration, the thoracic cavity is more large and for some tumors the distance between the tumor and the surrounding tissue is maximized or the surrounding tissue is minimized as a result of the increase in volume. Therefore, the protons that hit the surrounding tissue are minimized. Optionally, the display screen tells the subject when they are about to ask you to hold your breath, such as with a countdown of 3, 2, 1, seconds, so that the subject is aware of the task they are about to perform

Synchronization of proton beam therapy with breathing

A proton supply control algorithm is used to synchronize the proton supply to the tumor within a given period of each inspiration, such as at the beginning or end of an inspiration when the subject is holding his breath. The proton supply control algorithm is preferably integrated with the breathing control module. Thus, the proton supply control algorithm knows when the subject is breathing, where the subject is in the breathing cycle, and / or when the subject is holding the breath. The proton supply control algorithm controls when the protons are injected and / or inflated into the synchrotron, when an RF signal is applied to induce an oscillation, as described above, and when a DC voltage is applied to extract protons from the synchrotron, as described above. Normally, the proton supply control algorithm initiates proton inflection and subsequent RF-induced oscillation before the subject is instructed to hold the breath or before the identified period of the selected breathing cycle for a supply time of protons In this way, the proton supply control algorithm can release protons in a selected period of the breathing cycle by simultaneously or almost simultaneously supplying the high DC voltage to the second pair of plates, described above, which results in the extraction of the synchrotron protons and the subsequent supply to the subject at the selected time point. Since the acceleration period of the protons in the synchrotron is constant or known for a desired energy level of the proton beam, the proton supply control algorithm is used to establish an AC RF signal that matches the cycle of breathing or directed breathing cycle of the subject.

DEVELOPMENT AND IMPLEMENTATION OF A TUMOR IRRADIATION PLAN

A series of stages are performed to design and execute a radiation treatment plan to treat a 1420 tumor in a 1430 patient. The stages include one or more of:

- place and immobilize the patient;

- record the patient's position;

- monitor the patient's breathing;

- control the patient's breathing;

- collect multi-field images of the patient to determine the location of the tumor with respect to body constituents

- develop a radiation treatment plan;

- reposition the patient;

- verify the location of the tumor; and

- irradiate the tumor.

In this section, a general description of the development of the irradiation plan and the subsequent implementation of the irradiation plan is initially presented, the individual steps are described in more detail and then a more detailed example of the process is described.

Referring now to Figure 27, a general description of a system for the development of an irradiation plan and the subsequent implementation of the irradiation plan 2700 is provided. Preferably, all the elements of the system 2700 for placement, monitoring of respiration, Imaging, and irradiation of tumors are under

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main controller control 110.

Initially, the volume containing a tumor of patient 1430 is placed and 2710 is immobilized in a controlled and reproducible position. The process of placement and immobilization 2710 of patient 1430 is preferably repeated 2712 until the position is accepted. The position is preferably digitally recorded 2715 and is used later in a computer-controlled repositioning stage of patient 2717 in the minutes or seconds before the implementation of irradiation element 2770 of the tumor treatment plan. The process of placing the patient in a reproducible manner and reproducibly aligning the patient 1430 to the controlled position is described further below.

After placement of patient 2710, the monitoring stages 2720 and preferably control 2730 of the patient's breathing cycle 1430 are preferably performed to produce a more precise placement of the tumor 1420 with respect to other body constituents, as described more above. Next, 2740 multicampo images of the tumor in the controlled, immobilized and reproducible position are collected. For example, multi-field radiographic images of tumor 1420 are collected using the X-ray source near the path of the proton beam, as described above. Multi-field images are optionally of three or more positions and / or collected while the patient is rotated, as described above.

At this point, patient 1430 remains in the treatment position or is allowed to move from the controlled treatment position while an oncologist processes the 2745 multicampo images and generates a 2750 tumor treatment plan using the multicampo images. Optionally, the tumor irradiation plan is implemented 2770 at this point in time.

Normally, at a subsequent visit to the treatment center, the patient 1430 is relocated 3817. Preferably, the patient's breathing cycle is monitored 2722 and / or 2732 is controlled again, such as by the use of thermal monitoring sensors. the breath, the breathing force monitoring sensor, and / or by orders sent to the display monitor 2490, described above. Once repositioned, 2760 verification images are collected, such as radiographic images of location verification from 1, 2 or 3 directions. For example, verification images are collected with the patient facing the proton beam and at rotation angles of 90, 180 and 270 degrees from this position. At this point, by comparing the verification images with the original multi-field images used in the generation of the treatment plan, the algorithm or preferably the oncologist determines if the tumor 1420 is sufficiently repositioned 2765 with respect to other parts of the body to allow the onset of irradiation of the tumor using the beam of charged particles. Essentially, the step of accepting the final position of patient 2765 is a safety feature used to verify that the tumor 1420 in patient 1430 has not moved or grown beyond established specifications. At this point, therapy with charged particle beams begins 2770. Preferably, the patient's breathing is monitored 2620 and / or 2630 is controlled, as described above, before the start of treatment 2770 with charged particle beams.

Optionally, simultaneous radiographic imaging 2790 of the tumor 1420 is performed during the proton beam multi-field irradiation procedure and the main controller 110 uses the radiographic images to adapt the real-time radiation treatment plan to account for small variations in movement of tumor 1420 within patient 1430.

Here, the monitoring stage 2720, 2722, 2620 and control 2730, 2732, 2630 of the patient's breathing is optional, but preferred. The stages of monitoring and controlling the patient's breathing are performed before and / or during the 2740 multi-field imaging stages, the 2760 position verification, and / or the 2770 tumor irradiation.

The stages of positioning of patient 2710 and repositioning of patient 2717 are described further below.

Acceleration of charged particles and coordinated respiratory rate

In yet another embodiment, the charged particle accelerator is synchronized with the patient's breathing cycle. More particularly, the efficiency of use of the synchrotron acceleration cycle is improved by adjusting the synchrotron acceleration cycle so that it correlates with a patient's breathing cycle. In this document, efficacy refers to the duty cycle, the percentage of acceleration cycles used to deliver charged particles to the tumor, and / or the fraction of time in which the charged particles are delivered to the tumor from the synchrotron. The system detects the patient's breathing and controls the synchronization of negative ion beam formation, the injection of charged particles into a synchrotron, the acceleration of the charged particles, and / or the extraction to produce supply of the particles to the tumor in a predetermined period of the patient's breathing cycle. Preferably, one or more magnetic fields in the synchrotron 130 are stabilized by the use of a feedback loop, which allows a rapid change in energy levels and / or the

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extraction time from one pulse to another. In addition, the feedback loop allows the acceleration / extraction control to be correlated with a changing respiratory rate of the patient. The independent control of the energy and intensity of the charged particle is maintained during synchronized irradiation therapy. Multi-field irradiation ensures efficient supply of energy from the Bragg peak to the tumor while distributing the input energy around the tumor.

In one example, a sensor, such as the first thermal sensor 2570 or the second thermal sensor 2560, is used to monitor a patient's breathing. A controller, such as the main controller 110, then controls the formation and supply of charged particles to produce a bundle of charged particles delivered at a given point or period of duration of the breathing cycle, which guarantees a precise and accurate supply of radiation to a tumor that moves during the breathing process. The optional charged particle therapy elements controlled by the controller include the injector system 120, accelerator 132 and / or extraction 134. The elements optionally controlled in the injector system 120 include: injection of hydrogen gas into a negative ion source 310, generation of a high energy plasma within the negative ion source, high energy plasma filtration with a magnetic field, extraction of a negative ion from the negative ion source, negative ion beam approach 319, and / or injection of a positive ion beam 262 resulting in the synchrotron 130. The elements optionally controlled in the throttle 132 include: accelerator coils, magnetic fields applied in rotating magnets, and / or current applied to correction coils in the synchrotron. Optionally controlled elements in the extraction system 134 include: radio frequency fields in an extraction element and / or fields applied in an extraction process. Using the breathing sensor to control the supply of the charged particle beam to the tumor during an established period of the breathing cycle, the delivery period of the charged particle to the tumor is adjustable at a variable respiratory rate. Thus, if the patient breathes faster, the bundle of charged particles is supplied to the tumor more frequently and if the patient breathes slower, then the beam of charged particles is delivered the tumor less frequently. Optionally, the bundle of charged particles is supplied to the tumor with each patient inspiration regardless of the patient's changing respiratory rate. This contrasts sharply with a system where the beam of charged particles supplies energy in a fixed time interval and the patient must adjust his respiratory rate to match the accelerator's energy supply period and if the patient's respiratory rate does not match the fixed accelerator period, then that accelerator cycle is not supplied to the tumor and the efficiency of acceleration use is reduced.

Normally, in an accelerator, the current stabilizes. A problem with the current stabilized accelerators is that the magnets used have memory in terms of both magnitude and sine wave amplitude. Therefore, in a traditional system, to change the frequency of circulation of the beam of charged particles in a synchrotron, slow changes in the current must be used. However, in a second example, the magnetic field that controls the circulation of charged particles around the synchrotron is stabilized. The magnetic field is stabilized by the use of: (1) magnetic field sensors that detect the magnetic field around the circulating charged particles and (2) a feedback loop through a main controller 110 that controls the magnetic field around the circulating charged particles. The feedback loop is optionally used as a feedback control for the first winding coil 850 and the second winding coil 860. However, preferably the feedback loop is used to control the correction coils 852, 862, described above. . With the use of the feedback loop described in this document using the magnetic field sensors, the frequency and energy level of the synchrotron are quickly adjustable and the problem is overcome. In addition, the use of the smaller correction coils 852, 862 allows rapid throttle adjustment compared to the use of the larger winding coils 850, 860, described above. More particularly, the feedback control allows an adjustment of the throttle energy from one pulse to another in the synchrotron 130.

In this section, the first example produced a supply of the charged particle beam during a particular period of the patient's breathing cycle even if the patient's breathing period is varying. In this section, the second example used a magnetic field sensor and a feedback loop to the correction coils 852, 862 to quickly adjust the throttle energy from one pulse to another. In a third example, the breathing sensor of the first example is combined with the magnetic field sensor of the second example to control both the timing of the supply of the charged particle beam from the accelerator and the energy of the particle beam charged from the accelerator. More particularly, the synchronization of the charged particle supply is controlled using the breathing sensor, as described above, and the energy of the charged particle beam is controlled using the magnetic field sensors and the feedback loop, such as It has been described above. Even more particularly, a magnetic field controller, such as the main controller 110, takes the input from the breathing sensor and uses the input as: (1) a magnetic field feedback control that controls the energy of the charged particles circulating and (2) as a feedback control to synchronize the accelerator pulse of charged particles with the patient's breathing cycle. This combination allows the delivery of the bundle of charged particles to the tumor with each patient inspiration, even if the patient's respiratory rate varies. In this way, the effectiveness of

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Accelerator increases since the cancer treatment system does not need to lose cycles when the patient's breathing is not in phase with the speed of generating charged particles of the synchrotron.

Referring now to Figure 28, the combined use of the breathing sensor and magnetic field sensor 2800 to deliver charged particles at variable energy and at varying time intervals is further described. The main controller 110 controls the injection system 120, the acceleration system 132 of charged particles, the extraction system 134, and the addressing / supply system 140. In this embodiment, a breathing monitoring system 2810 is used. Patient interface module 150 as an input to a magnetic field controller 2820. A second input to the magnetic field controller 2820 is a magnetic field sensor 2850. In one case, the respiratory frequencies from the breathing monitoring system 2810 are fed to the main controller 130, which controls the injection system 120 and / or components of the acceleration system 132 to produce a beam of charged particles in a chosen period. of the breathing cycle, as described above. In a second case, the respiration data from the respiration monitoring system is used as an input to the magnetic field controller 2820. The magnetic field controller also receives a feedback input from the 2850 magnetic field sensor. The magnetic field controller thus synchronizes the energy supply of charged particles to correlate with detected respiratory frequencies and supplies beam energy levels of charged particles that are rapidly adjustable with each accelerator pulse using the feedback loop through the 2850 magnetic field sensor.

Still with reference to Figure 28 and now additionally with reference to Figure 29, an additional example is used to clarify the control of the magnetic field using a feedback loop 2800 to change supply times and / or pulse delivery periods. of protons In one case, a respiratory sensor 2810 detects the patient's breathing cycle. The respiratory sensor sends the patient's breathing pattern or information to an algorithm in the magnetic field controller 2820, usually by the patient interface module 150 and / or by the main controller 110 or a subcomponent thereof. The algorithm predicts and / or measures when the patient is at a particular point in the breathing cycle, such as at the beginning or end of an inspiration. One or more sensors 2850 of the magnetic field are used as inputs to the controller 2820 of the magnetic field, which controls a magnet power supply for a given magnetic field, such as within a first turning magnet 420 of a synchrotron 130. The loop Control feedback is used in this way to tune the synchrotron to a selected energy level and to supply protons with the desired energy at a selected point in time, such as at a particular point in the breathing cycle. The selected point in the breathing cycle is optionally anywhere in the breathing cycle and / or for any duration during the breathing cycle. As illustrated in Figure 29, the selected period of time is at the top of an inspiration for a period of approximately 0.1, 0.5, 1 second. More particularly, the main controller 110 controls the injection of hydrogen into the injection system, the formation of the negative ion 310, controls the negative ion extraction from the negative ion source 310, controls the injection 120 of protons into the synchrotron 130, and / or controls the acceleration of protons in a way that, combined with extraction 134, releases protons 140 to the tumor at a selected point in the breathing cycle. The intensity of the proton beam is also selectable and controllable by the main controller 130 in this phase, as described above. The feedback control from the magnetic field controller 2820 is optionally for power or power supplies for one or both of the main diverter magnet 250, described above, or to the correction coils 852, 862 within the main diverter magnet 250. Having currents Applied smaller, correction coils 852, 862 are quickly adjustable to a newly selected acceleration frequency or corresponding charged particle energy level. Particularly, the magnetic field controller 2820 alters the fields applied to the main diverter magnets or correction coils that are linked to the patient's breathing cycle. This system contrasts sharply with a system where the current stabilizes and the synchrotron supplies pulses with a fixed period. Preferably, the feedback of the magnetic field design coupled with the correction coils allows the extraction cycle to coincide with the variable respiratory rate of the patient, such as when a first breathing period 2910, P1, is not equal to a second breathing period. 2920, P2.

Computer-controlled patient repositioning

One or more of the components of the patient placement unit and / or one or more of the patient placement restriction elements are preferably under the control of a computer. For example, the computer records or controls the position of the positioning elements 2415 of the patient, such as recording a series of positions of the motor connected to driving mechanisms that move the positioning elements 2415 of the patient. For example, the patient is initially placed 2710 and is restricted by the positioning restriction elements 2415 of the patient. The position of each of the patient placement restriction elements is recorded and saved by the main controller 110, by a subcontroller of the main controller 110, or by a separate computer controller. Next, imaging systems are used to locate the tumor 1420 in the patient 1430 while the patient is in the final treatment orientation. Preferably, when the patient is in the controlled position, multicampo imaging is performed, such as

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It is described in this document. The imaging system 170 includes one or more of: MRI, radiographs, CT, proton beam tomography, and the like. Time passes optionally at this point while images of imaging system 170 are analyzed and a treatment plan with proton therapy is designed. The patient optionally selects the restriction system during this period of time, which may be minutes, hours or days. During, and preferably after, the return of the patient and the initial placement of the patient to the patient placement unit, the computer returns the patient placement restriction elements to the registered positions. This system allows a rapid repositioning of the patient to the position used during imaging and the development of the treatment plan by irradiation of multicamp charged particles, which minimizes the patient placement configuration time and maximizes the time that the beam system 100 of charged particles is used for cancer treatment.

Reproduction of patient placement and immobilization

In one embodiment, using a patient positioning and immobilization system 2400, a region of the patient 1430 around the tumor 1420 is placed and immobilized reproducibly, such as with the motorized patient translation and rotation placement system and / or with the 1415 placement restriction elements of the patient. For example, one of the positioning systems described above 2400, such as (1) the semi-vertical partial immobilization system; (2) the sitting partial immobilization system; or (3) the lying positioning system is used in combination with the patient's translation and rotation system to position the tumor 1420 of the patient 1430 with respect to the path 268 of the proton beam. Preferably, the positioning and immobilization system 2400 controls the position of the tumor 1420 with respect to the path 268 of the proton beam, immobilizes the position of the tumor 1420, and facilitates the repositioning of the tumor 1420 with respect to the path 268 of the beam of protons after patient 1430 has moved away from path 268 of the proton beam, such as during the development of the 2750 irradiation treatment plan.

Preferably, tumor 1420 of patient 1430 is placed in terms of 3-D location and in terms of orientation attitude. In this document, the 3-D location is defined in terms of the x, y, and z axes, and the orientation attitude is the state of pitching, oscillation and balancing. Pitching is the rotation of a plane around the z axis, balancing is the rotation of a plane around the x axis, and the oscillation is the rotation of a plane around the y axis. The inclination is used to describe both pitch and roll. Preferably, the placement and immobilization system 2400 controls the location of the tumor 1420 with respect to the trajectory 268 of the proton beam in terms of at least three of and preferably in terms of four, five or six of: pitch, swing, swing , location on the x axis, location on the y axis, and location on the z axis.

Chair

The patient positioning and immobilization system 2400 is further described using an example of chair placement. For clarity, a case of placement and immobilization of a tumor in a shoulder is described using chair placement. Using the semi-vertical immobilization system, the patient is generally positioned using the seat support 2420, the knee support 2460 and / or the foot support 2470. To additionally place the shoulder, a motor in the 2430 support for the back pushes against the patient's torso. Additional support arm 2450 motors align the arm, such as pushing with a first force in one direction against the patient's elbow and the patient's wrist is placed using a second force in an opposite direction. This restricts arm movement, which helps to position the shoulder. Optionally, the head support is positioned to further restrict shoulder movement by applying tension to the neck. Combined, the positioning restriction elements 2415 of the patient control the position of the tumor 1420 of the patient 1430 in at least three dimensions and preferably control the position of the tumor 1420 in terms of all oscillating, balancing and nodding movement as well as in terms of position on the x axis, y and z. For example, the patient placement restriction elements position the tumor 1420 and restrict the movement of the tumor, such as preventing the patient from collapsing. Optionally, sensors in one or more of the patient's positioning restriction elements 2415 register an applied force. In one case, the seat support detects the weight and applies a force to support a fraction of the patient's weight, such as approximately 50, 60, 70 or 80 percent of the patient's weight. In a second case, a force applied to the neck, arm and / or leg is registered.

Generally, the patient's positioning and immobilization system 2400 eliminates degrees of freedom of movement of the patient 1430 to accurately and precisely position and control the position of the tumor 1420 with respect to path 2370 of the X-ray beam, path 268 of the proton beam, and / or the trajectory of an imaging beam. In addition, once the degrees of freedom are eliminated, the engine positions for each of the patient placement restriction elements are recorded and communicated digitally to the main controller 110. Once the patient moves from the system of 2400 immobilization, such as when the 2750 irradiation treatment plan is generated, the patient 1430 must be accurately repositioned before the irradiation plan is implemented. To achieve this, patient 1430 generally sits on the positioning device, such as the chair, and the main controller sends the engine position signals and

optionally the forces applied back to motors that control each of the patient restriction positioning elements 2415 and each of the patient positioning restriction elements 2415 are automatically moved back to their respective registered positions. Therefore, repositioning and reinmobilization of patient 1430 is achieved from a sitting position to fully controlled time 5 in less than about 10, 30, 60 or 120 seconds.

Using the computer-controlled and automated patient placement system, the patient is repositioned in the 2400 placement and immobilization system using the engine positions of the revoked patient placement restriction element 2415; patient 1430 is transferred and rotated using the patient's translation and rotation system with respect to the proton beam 268; and the proton beam 268 is scanned to its momentary position of the beam 269 by the main controller 110, which follows the irradiation treatment plan generated 2750.

Although the invention has been described herein with reference to certain preferred embodiments, a person skilled in the art will readily appreciate that other applications may replace those set forth herein without departing from the scope of the present invention. Therefore, the invention should only be limited by the claims included below.

Claims (13)

5 10 fifteen twenty 25 30 35 40 Four. Five fifty 55 60 1. An apparatus that uses charged particles for irradiation of a patient's tumor (1430), comprising a synchrotron (130) configured to provide control of an energy and intensity of an extracted beam, in which the control of energy and intensity control occurs during extraction, comprising the synchrotron (130): a beam extraction path, the path comprising sequentially: a radiofrequency cavity system (1210) comprising a first pair of sheets (1212, 1214); an extraction foil (1230) that is approximately thirty to one hundred micrometers thick and essentially consists of atoms that have six or less protons; a second pair of sheets (1214, 1216); and an extraction magnet (292); in which the synchrotron (130) is configured to control an acceleration period to accelerate the charged particles, and a synchronization of the charged particles that hit the extraction foil (1230) in the acceleration period to control the energy of the extracted beam , wherein the radiofrequency cavity system (1210) is configured to apply a radiofrequency through the first pair of sheets (1212, 1214) to alter a trajectory of the charged particles through the extraction lamella (1230) producing charged particles reduced energy, and wherein the second pair of sheets (1214, 1216) is arranged so that the charged particles of reduced energy pass through the second pair of sheets (1214, 1216), the second pair of sheets (1214, 1216) being configured to have a direct current voltage of at least five hundred volts applied by the second pair of sheets (1214, 1216) to extract the charged particles of reduced energy through the extraction magnet (292) out of the synchrotron (130), and wherein the synchrotron (130) is configured to provide feedback control of the intensity of the extracted beam, to control the radiofrequency cavity system (1210), using the feedback control a current generated by the charged particles that are transmitted through the extraction lamella (1230) as an indicator of the intensity of the charged particles. 2. The apparatus of claim 1, further comprising: a rotating platform (1412, 1414), wherein the rotating platform (1412, 1414) is configured to rotate approximately three hundred and sixty degrees during a period of irradiation, in which the energy and intensity control is configured to operate for at least ten rotational positions of the rotary platform (1412, 1414). 3. The apparatus of claim 2, further comprising: a breathing sensor configured to generate a breathing signal, the breathing signal corresponding to a patient's breathing cycle (1430), in which the synchronization control uses the breathing signal to synchronize the supply of the charged particles with a preset point in the breathing cycle, in which the control of energy and intensity also includes independent control of all of: a horizontal position of the charged particles; a vertical position of the charged particles; energy; Y the intensity, in which the control of energy and intensity is further configured to understand the supply of the charged particles at the predetermined point in the breathing cycle and in coordination with the rotation of the patient (1430) on the rotating platform ( 1412, 1414) during the at least ten rotating positions of the rotating platform (1412, 1414). 4. The apparatus of claim 1, wherein the control of the energy and intensity of the extracted beam is further configured to comprise separate control of all of: a position on the x-axis of the charged particles; a position on the axis and of the charged particles; energy; Y the intensity, in which the energy and intensity control is further configured to comprise the supply of the charged particles at a predetermined point in a patient breathing cycle (1430) in at least five rotational positions of a rotating platform (1412, 1414) holding the patient (1430). 5. The apparatus of claim 1, further comprising: 5 10 fifteen twenty 25 30 35 40 Four. Five fifty 55 60 a breathing sensor configured to generate a breathing signal, the breathing signal corresponding to a patient's breathing cycle (1430); a rotating platform (1412, 1414) that supports the patient (1430) during use, in which the rotating platform (1412, 1414) is configured to rotate at least one hundred and eighty degrees during a period of irradiation of the patient (1430), in which the synchronization of the energy and intensity control is configured to correlate with the breathing signal, and in which the control of energy and intensity is configured to supply the charged particles in more than four rotational positions of the rotating platform (1412, 1414). 6. The apparatus of claim 1, wherein the energy and intensity control is further configured to comprise synchronization control of the supply of charged particles, the synchronization control is configured to correlate with the patient's breathing , in which the synchronization control further comprises the control of any of: Injection of gaseous hydrogen in an ion beam generation system, in which there is a magnetic field barrier in the ion beam generation system between a high temperature plasma region and a low temperature plasma zone, the ion beam generation system configured to generate charged particles; an ion beam focusing system (350), comprising: metallic conductive paths (372) that run along a path of negative ion beams; and a focusing electrode (360, 370) circumferentially surrounding the path of negative ion beams, in which electric field lines run between the focusing electrode and the metallic conductive paths, in which negative ions in the ion beam negatives are focused by force vectors that run along the electric field lines during use, and in which the negative ion beam becomes the charged particles in a conversion foil; and the control of a magnetic field in a diverter magnet, the diverter magnet comprising: a tapered iron-based core (810, 812) adjacent to a recess (830, 840), the core comprising a surface polish of less than 10 micrometers of roughness; and a focus geometry comprising: a first cross-sectional distance of the iron-based core (810, 812) that forms a hollow edge (830, 840), a second cross-sectional distance of the iron-based core (810, 812) not in contact with the recess (830, 840), in which the second cross-sectional distance is at least fifty percent greater than the first distance of cross section. 7. The apparatus of claim 6, wherein the ion beam generation system further comprises a first vacuum chamber on a first side of the conversion foil and a second vacuum chamber on a second side of the foil conversion, the first vacuum chamber configured to operate at a different pressure from the second vacuum chamber. 8. The apparatus of claim 6, wherein the synchronization control controls synchronization with the patient's breathing for all of: negative ion generation; negative ion extraction and conversion into charged particles; acceleration of charged particles; extraction of charged particles; Y delivery position of the charged particles to the tumor. 9. The apparatus of claim 1, wherein the energy control further comprises the use of readings from a magnetic sensor (1130), the magnetic sensor (1130) close to a diverting magnet (250) in the synchrotron ( 130) further comprising a feedback system, in which the feedback system is configured to stabilize a magnetic field in the diverter magnet (250) using the input from the magnetic sensor (1130) to control a correction coil (852, 862) operating at less than ten percent of the power of a winding coil (860), both the correction coil (852, 862) and the winding coil (860) are wound around the diverter magnet (250). 5 10 fifteen twenty 25 30 35 10. The apparatus of claim 1, wherein the energy control further comprises controlling an accelerator system in the synchrotron (130), the accelerator system comprising: a set of at least ten coils (1010); a set of at least ten wire loops (1030); a set of at least ten microcircuits (1020), each of the microcircuits (1020) integrated in one of the loops (1030), in which each of the loops (1030) completes at least one turn around at least one of the coils (1010); Y a radiofrequency synthesizer (1040) that sends a low voltage signal to each of the microcircuits (1020), each of the microcircuits (1020) amplifying the low voltage signal producing an acceleration voltage. 11. The apparatus of claim 1, wherein the energy and intensity control is further configured to comprise: monitor both a horizontal position of the charged particles and a vertical position of the charged particles in a beam transport path using a liner on a foil, the foil comprising a vacuum barrier between the synchrotron (130) and the atmosphere, comprising the coating a layer that produces a luminescent, fluorescent or phosphorescent signal when hit by charged particles. 12. The apparatus of claim 1, wherein the control of energy and intensity is configured to increase intensity when directed to a distal part of the tumor, wherein the distal part of the tumor changes with the rotation of the patient (1430) on a platform that rotates at least ten different rotational positions in a period of less than one minute during irradiation of the tumor by the charged particles. 13. The apparatus of claim 1, wherein the energy and intensity control is further configured to comprise: control of the horizontal position of the charged particles; control of the vertical position of the charged particles; Y an X-ray input signal, in which the X-ray input signal comprises a signal generated by an X-ray source near the beam of charged particles, in which the X-ray input signal is used in: the adjustment of the horizontal position and the vertical position.