Scripps Proton Therapy Center Monthly Update - October 2012

October was an exciting month of starting to move into the Center.

Building

In October, the Center received their certificate of occupancy. This allowed key administrative personnel to move into the facilities. At this time, the computer, phone and security systems are also being put into place. Most of the touches of the office furnishings have been delivered and installed into the offices, lobby and community spaces.

Technology

Varian has been working on the treatment rooms and was able to deliver a beam to the treatment rooms thereby moving one step closer to getting the system live. While Varian continues to configure and tune the beam properties, a highly time intensive task, they are also focused on the critical systems supporting the proton beam.

The collaboration of the mechanical components in the treatment rooms also continues. The interaction of the robotic components in the treatment room is exceedingly complex and requires the equipment itself to be calibrated to a high level of precision. This means that measurements must be taken with a laser tracker from hundreds of points in space for each discrete component, and these all must be correlated to allow these mechanical components to function simultaneously in a safe and predictable manner.

Additionally, Varian has been spending time testing the communications between the user console for the proton therapy equipment and the control systems of the PT equipment itself.   This is the system that allows for the clinical users to operate the devices within the treatment room, and to do the imaging and beam delivery required daily in patient treatment.   This equipment has been designed to be very close to Varian’s proven TrueBeam (linear accelerator) user-interface.    This will provide efficiency when bringing new staff on board who already have experience with Varian’s TrueBeam system.

Varian continues to focus on testing each system component. This began with physical components, like magnets, power supplies, cooling lines, and other mechanical components. That work is mostly complete, and Varian has continued on to focus primarily on the myriad of control systems needed to manage the components of the PT system. The user interface is an example of this. In addition to beam tuning activities, Varian has spent a good portion of time checking all of the software needed to run this system, and getting local inspections and other certifications as necessary.

Scripps Proton Therapy Center Monthly Update - September 2012

The Scripps Proton Therapy Center continues to make excellent progress towards the goal of treating patients in 2013.

Technology

Varian made great progress in the month of September.  Varian was able to bring the first gantry treatment room on line and beam was successfully transported to the room. 

Varian still has a lot of work ahead of them to tune the size and shape of the proton beam in the treatment room.  This must be done all along the beamline, between the cyclotron and the nozzle (work that is ongoing from prior months), then it must be checked at isocenter for all beam angles and energies available. 

Varian will continue to work through October on tuning the beam at the isocenter and making sure the system can reliably create proton beams of the appropriate size and energy at any position that the clinicians may need. They will also continue work on the robot calibration, as well as brining other systems online.  

Building

The building is beginning to get the polish and warmth that appeals to both the staff and the future patients. As of September, the furniture was starting to come into some of the spaces (including the waiting rooms as seen in the site photos) and the treatment wings. Haskell continues to work on the spaces and the vegetation on the outside of the building is being put in.

Inside the treatment rooms, all major components are installed.  Flooring and finishes are coming to completion, and with the exception of the covers for the portions of the equipment that is exposed to the patient space, the rooms are very close to looking completed. 

Varian has been working in the treatment rooms to do the high precision calibration of the patient treatment robots.  This is a time consuming process where laser trackers are used to map out the robots motions in 3D space, so that the computer control system can properly and safely move the robot with a patient on it.  Once completed there will be five major components that will be capable of movement independently, that will be able to be controlled and move in concert (gantry, patient robot, nozzle, floor, and imaging system).   

Scripps Proton Therapy Center Monthly Update - August 2012

The Scripps Proton Therapy Center is beginning to get the look and feel of a fully operational center as the summer of 2012 comes to an end.

Technology

Varian continues to keep up the good work on commissioning the beamline. Varian is focused on making sure that the beam properties at each individual measurement device are as precise as possible. This complicated process is supported by an expert team at Varian.

As the major beam-generation components of the system (RF Amplifier and Cyclotron) go into the sixth month of use, the systems have proved to be remarkably stable and robust.  These systems are extraordinarily complex, and the process of pre-testing these components prior to shipment has helped them avoid any excessive downtime at this early, and critical, phase of the project.  

Varian will continue to focus on tuning and transporting the proton beam into treatment rooms in the coming month, as well as working to test and validate the various safety systems associated with the proton therapy system as a whole.   This includes door switches, emergency off switches, and other monitoring and safety devices.   These components are critical to the safe and effective operation of the proton therapy system.  

Building

The patient treatment room construction and outfitting is progressing well.  Haskell has almost completed the interiors of these rooms as of the end of August.   Varian has the patient positioning robots installed, and is set to go through the calibration process in the coming months.   The flooring systems in the gantry treatment rooms are almost complete as well.

Scripps Proton Therapy Center Monthly Update - July 2012

As the summer heat picked up in San Diego through July, so did the pace of Varian’s progress at the Scripps Proton Therapy Center.  

Varian continued their optimization work on the cyclotron, continuing to strive for a level of efficiency that will allow the cyclotron to operate with virtually no re-optimization for years to come.   The cyclotron was complete to a level, which allowed Varian to commence their beamline work in earnest. Varian has been able to extract beam from the cyclotron for some time, but now is doing so on a more regular basis so they are now able  to calibrate the various magnets and diagnostic devices that are arrayed along the beamline.   These devices help to maintain the size, shape, position and intensity of the beam as it travels between the cyclotron and the patient to deliver treatment.  Varian has made good progress on validating these devices and expects to be able to transport the beam all the way into one of the gantry treatment rooms in August.  

While the team has been working on the beamline, they have also been making strides on other projects.   Varian has performed mechanical functionality checks on the vast majority of elements in the beam transport system and performed basic calibration on the power supplies that drive each magnet along the beamline. The Scripps treatment rooms have also been coming along nicely.  Both Haskell and Varian are working in these rooms, installing the room finishes and system components.  They are starting to look ready for patients.  

Outside of finishes, Varian is completing the mechanical flooring systems and installing the patient positioning robots.   These systems will provide a safe and high precision environment for the patients to be transported to the treatment position.  In August, the team will begin more intensive work on the motion control systems that coordinate the movements of the gantry, floor, patient positioning robot, and imaging systems.   All of these components need to be able to move in concert with each other to protect staff and patients.

Much of the team’s future work will be focused on the precise set up of the elements for transporting and maintaining the properties of the beam into the treatment rooms. This is a very complex process, as Varian must mathematically model what the beam is expected to do, then must set the beamline elements appropriately based on this prediction, run the beam through the system, measure the outcome, and finally compare it to their predictions.   This iterative process, oversimplified here, is one of the core tasks remaining to allow the Center to be made available for safe, reliable, consistent patient treatments. 

Scripps Proton Therapy Center Monthly Update - June 2012

June was a busy month for the Center and Varian.   Varian was able to complete the centering of the beam in the cyclotron, and has only optimization tasks remaining here.   This means the cyclotron is very close to its final operating parameters, and in the month of July will be able to function at its most efficient state, where the vast majority of the protons created are able to be successfully extracted and sent for patient treatment.   To give some context, similar technologies typically will only extract around 50-60% of the protons created from the cyclotron for patient treatment.   This means that you can’t treat as quickly, and the cyclotron itself gets radioactive more quickly, making it harder to maintain over the long haul. 

Varian also received and installed many of the final large components necessary to complete the Gantry treatment rooms.   Each gantry, being close to 3 stories tall, with the patients being treated in the center, must have a specialized floor system to allow patients and clinicians to walk into the treatment volume.   This system must be moveable and retractable, making it a very complex piece of mechanical engineering.   Varian installed these systems in June, and worked to get them operational.   Now the only major component remaining to complete the treatment rooms is the robotic patient positioning device itself.   Each of the five treatment rooms will have one of these robots, which is capable of positioning a person within a millimeter of where they need to be in space.   The rotational gantries are so impressive because of their sheer size (over 200 tons!), the number of major mechanical systems (8 major systems), and the fact that all of these systems combined function with a mechanical precision of less than 1 millimeter!  This also explains why the assembly and calibration of these components is such a difficult job.

The building itself is quickly approaching completion.   The shielding block is complete, and Haskell is working on the finishes throughout the building, making it become the world-class medical center it was designed to be.   The last major work that has to be done to the building to accommodate the proton equipment is the finishing of the treatment rooms themselves.   Haskell is putting in special framing and fixtures that will allow Varian to come in during the fall/winter timeframe with very specific interior panels to give the space a modern, clean, comforting appearance. 

Varian has also been moving into and finishing their technical spaces in the building.   Varian completed the main control room, the “bridge” of the PT technology, in June.   They have also been moving into their storage spaces and offices in the facility.  

Cabling and safety system work continues, with Varian getting this work closer and closer to completion.   As Varian move the beam from the cyclotron to the treatment rooms, this work will need to be completed in order to not delay their process.   Varian remains aware of this and continues to make good progress on this complex and demanding installation and calibration work.

July will bring more focus on beam movement through the energy selection system, and down the beamline and towards treatment rooms.   The energy selection system allows the physicians to choose a discreet energy to help treat patients more effectively.   For the proton system, energy is a 1 to 1 correlation with depth in the patient of the protons, so if you can very precisely control and change energies, you can treat tumors at any depth in a patient.   This is vital to the highest quality patient care.

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