BLOOMINGTON, IN, United States

Procure Treatment Centers, Inc.

www.procure.com
BLOOMINGTON, IN, United States
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Zheng Y.,Procure Treatment Centers, Inc.
Medical Physics | Year: 2013

Purpose: Accurate calculation of proton dose and penetration range is critical in proton therapy. However, in‐vivo studies on dose and range verification are very limited, and there is no consensus on the appropriate amount of range uncertainty. The purpose of this study is to verify the proton dose and range and evaluate the range uncertainty using in‐vivo measurement of patients under proton therapy. Methods: Gafchromic EBT2 films were used in the study. The film was calibrated using proton beams, and its energy dependence was measured for various proton energy beams. Water phantom and animal tissues were first used to test the application of EBT2 on dose and range verification before the in‐vivo dosimetry study. Several patients, such as lung and brain cases, were carefully selected for in‐vivo film measurement. For example, we measured a lung case with tumor located posterior, and the EBT2 film was placed immediately under the patient to measure the dose in the distal falloff region from an anterior‐posterior beam. The measured plane dose was compared to the calculated dose from the treatment plan, which was created using the XiO treatment planning system (TPS). The dose difference at the distal falloff region was used to evaluate the range difference between measurement and planning. Results: The EBT2 film showed a minimal energy dependence and was able to measure proton range accurately, within 1 mm in a phantom setting. Preliminary data for a lung treatment indicate a less than 3 mm range difference between EBT2‐measured range and the TPS‐calculated one. More studies for various disease sites are in progress. Conclusions: Our animal tissue and in‐vivo study shows that the measured and calculated proton ranges are within 2% plus 2 mm for most cases. Further in‐vivo studies are needed to confirm our findings and evaluate range uncertainties at different facilities. © 2013, American Association of Physicists in Medicine. All rights reserved.


Tasson A.,Procure Treatment Centers, Inc.
Medical Physics | Year: 2012

Purpose: To compare the range of the protons measured in the treatment room to the range predicted by Xio. Methods: Depth dose curves were measured using a multi layer ionization chamber for various ranges and modulations. Ranges and modulations were increased in one centimeter increments. The depth dose curves were then analyzed and the measured range was determined. The range is defined as the point where the distal edge of the depth dose curve is equal to 90% of the average value of the dose across the spread out bragg peak. The measured range was then compared to the range predicted by the treatment planning system. The treatment planning system used was Xio. Results: The maximum deviation was found to be 1.6 mm, with the majority of range/modulation combinations falling under 1 mm. Conclusions: The difference in range being modeled by the treatment planning system compared to the range measured in the teatment rooms is acceptable, and an uncertainty of 1.5mm is used for treatment planning. © 2012, American Association of Physicists in Medicine. All rights reserved.


Zheng Y.,Proton Therapy | Liu Y.,INTEGRIS Cancer Institute | Zeidan O.,Proton Therapy | Schreuder A.N.,Procure Treatment Centers, Inc. | Keole S.,Proton Therapy
Medical Physics | Year: 2012

Purpose: Neutron exposure is of concern in proton therapy, and varies with beam delivery technique, nozzle design, and treatment conditions. Uniform scanning is an emerging treatment technique in proton therapy, but neutron exposure for this technique has not been fully studied. The purpose of this study is to investigate the neutron dose equivalent per therapeutic dose, HD, under various treatment conditions for uniform scanning beams employed at our proton therapy center. Methods: Using a wide energy neutron dose equivalent detector (SWENDI-II, ThermoScientific, MA), the authors measured HD at 50 cm lateral to the isocenter as a function of proton range, modulation width, beam scanning area, collimated field size, and snout position. They also studied the influence of other factors on neutron dose equivalent, such as aperture material, the presence of a compensator, and measurement locations. They measured HD for various treatment sites using patient-specific treatment parameters. Finally, they compared HD values for various beam delivery techniques at various facilities under similar conditions. Results: HD increased rapidly with proton range and modulation width, varying from about 0.2 mSvGy for a 5 cm range and 2 cm modulation width beam to 2.7 mSvGy for a 30 cm range and 30 cm modulation width beam when 18 × 18 cm2 uniform scanning beams were used. HD increased linearly with the beam scanning area, and decreased slowly with aperture size and snout retraction. The presence of a compensator reduced the HD slightly compared with that without a compensator present. Aperture material and compensator material also have an influence on neutron dose equivalent, but the influence is relatively small. HD varied from about 0.5 mSvGy for a brain tumor treatment to about 3.5 mSvGy for a pelvic case. Conclusions: This study presents HD as a function of various treatment parameters for uniform scanning proton beams. For similar treatment conditions, the HD value per uncollimated beam size for uniform scanning beams was slightly lower than that from a passive scattering beam and higher than that from a pencil beam scanning beam, within a factor of 2. Minimizing beam scanning area could effectively reduce neutron dose equivalent for uniform scanning beams, down to the level close to pencil beam scanning. © 2012 American Association of Physicists in Medicine.


Nichiporov D.,Indiana University | Hsi W.,Procure Treatment Centers, Inc. | Farr J.,Westdeutsches Protonentherapiezentrum
Medical Physics | Year: 2012

Purpose: To compare clinically relevant dosimetric characteristics of proton therapy fields produced by two uniform scanning systems that have a number of similar hardware components but employ different techniques of beam spreading. Methods: This work compares two technologically distinct systems implementing a method of uniform scanning and layer stacking that has been developed independently at Indiana University (IU) and by Ion Beam Applications, S. A. (IBA). Clinically relevant dosimetric characteristics of fields produced by these systems are studied, such as beam range control, peak-to-entrance ratio (PER), lateral penumbra, field flatness, effective source position, precision of dose delivery at different gantry angles, etc. Results: Under comparable conditions, both systems controlled beam range with an accuracy of 0.5 mm and a precision of 0.1 mm. Compared to IBA, the IU system produced pristine peaks with a slightly higher PER (3.23 and 3.45, respectively) and smaller, symmetrical, lateral in-air penumbra of 1 mm compared to about 1.9/2.4 mm in the inplane/crossplane (IP/CP) directions for IBA. Large field flatness results in the IP/CP directions were similar: 3.0/2.4 for IU and 2.9/2.4 for IBA. The IU system featured a longer virtual source-to-isocenter position, which was the same for the IP and CP directions (237 cm), as opposed to 212/192 cm (IP/CP) for IBA. Dose delivery precision at different gantry angles was higher in the IBA system (0.5) than in the IU system (1). Conclusions: Each of the two uniform scanning systems considered in this work shows some attractive performance characteristics while having other features that can be further improved. Overall, radiation field characteristics of both systems meet their clinical specifications and show comparable results. Most of the differences observed between the two systems are clinically insignificant. © 2012 American Association of Physicists in Medicine.


Patent
Procure Treatment Centers, Inc. | Date: 2013-07-08

A particle beam transport system used for particle radiation therapy is provided. A beam of particles exiting from an accelerator is transported at fixed energy for treatment of patients in one or more treatment rooms using permanent magnets. In one embodiment, the system includes a series of fixed-magnetic-field permanent magnets as beam focusing elements that transport the beam at fixed energy to a point where the constant energy beam can be modified for use independently in different treatment rooms. In some embodiments, the particle beam may be deflected using dipole or Lambertson magnets manufactured using permanent magnetic material. The system may also incorporate a matching section imposed as the beam exits the accelerator. The matching system includes diagnostic elements and feedback systems that verify the beam properties as it exits the accelerator, and modify it, if necessary, until the beam attains a desired energy value.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 205.92K | Year: 2012

DESCRIPTION (provided by applicant): In recent years there has been increased interest throughout the world in the use of proton radiation therapy for treatment of cancer. Currently, there are only 9 operational centers in the US that treat a total of about 7,000 patients per year comprising less than 1% of all patients that receive radiation therapy. However, at least 30% of patients would benefit from treatment with proton beams. The capital and operating cost of extant systems is a major limiting factor. One attractive option being developed by at least two commercial suppliers is based on compact high field superconducting synchrocyclotron (SCSC) technology developed at MIT. The SCSC has many attractive features such as cost, size and ease of operation.However, it has one potential major drawback due to the very low duty cycle whereby beam pulses of about 10 ns in duration occur about 1000 times per second. Real-time detectors currently in clinical practice have several deficiencies for utilization withshort pulse beams such as delivered by a SCSC, A detector that can measure these small, short duration, beam spots in real-time and provide feedback is required. The overall goal for this SBIR project is to perform the research needed to develop an innovative detector that would be suitable for the above application. ProCure proposes a novel technique that takes advantage of the very short proton SCSC pulse to measure only the fast scintillation light from direct atomic excitations in Zenon within a narrow time gate of about 100ns following the proton pulse thus avoiding the problem of ion recombination that occur over a much longer time scale. We emphasize that this scheme, based on fast emitted light detection and fast electronics, will achieve linear response and no saturation when used with intense sub-microsecond beam pulses. In Phase I, the research team will concentrate on developing a working prototype detector and measuring its parameters. Based on the results of these studies in Phase II ProCurewill focus on the engineering and construction of full-scale 30 30 cm2 detectors as well as design of custom data acquisition electronics. This will be followed by the comprehensive testing required for FDA 510k approval, leading to a final marketable product. PUBLIC HEALTH RELEVANCE: Proton therapy provides the best possible option for using radiation to control and eliminate tumors with the least short and long term toxic side effects but its utilization is restricted by the size and cost of extant equipment. One attractive option being commercialized is based on compact high field superconducting synchrocyclotrons (SCSC) technology. However existing detectors used in clinical practice are not capable of monitoring the dose from such a machineand the novel detector proposes here by ProCure is required to do so and consequently help to bring this highly effective form of cancer treatment to the mainstream of radiation therapy in a more affordable option.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase I | Award Amount: 129.02K | Year: 2010

DESCRIPTION (provided by applicant): In comparison to standard x-ray therapy, proton therapy allows an increased dose of radiation to a tumor and by reducing the amount of radiation to healthy tissue. As a result, it provides the best possible option for using radiation to control and eliminate tumors with the least short and long term toxic side effects. Currently less than 1% of all radiation therapy patients receive proton therapy while the number of patients that would benefit substantially from their use with current protocols is estimated to be over 30%. The major barriers to greater utilization of proton therapy are the size and cost of the facilities. The layout of the current proton therapy treatment centers is dominated by the size of the iso-centric gantries that rotate the proton beam dose delivery system around the patient. ProCure's focus for this project is to invent a new gantry concept using modern robotics and high temperature superconducting magnets that will greatly reduce the gantry size and mass, the power needed to operate it and consequently the contribution of these gantries to the facility cost. ProCure proposes to research new technology that would reduce the gantry mass by an order of magnitude and cost by a factor of three. Phase I research will allow ProCure to determine the optimal design and components needed for a compact and low cost gantry based on novel beam scanning concepts and the use of high temperature superconducting magnet technology for use in Intensity Modulated Proton Therapy. In the first 12 months of Phase II, ProCure will work on constructing prototype magnets for the selected gantry concept, build key temporary magnet supports and nozzle components and in the next six months of Phase II, ProCure will carry out experiments using a full scale system in the Proton Dosimetry Test Facility recently commissioned at the Indiana University Cyclotron Facility. In Phase III, ProCure will complete the tests of the magnetic and nozzle operation at IUCF and make initial submission to the FDA. ProCure will construct a first prototype of the full rotating mechanical support system for the gantry and install the full system for mechanical system tests. In parallel, ProCure will start the acquisition process for the first systems that will be installed. Finally, FDA complete system testing for full FDA 510k approval will be performed. PUBLIC HEALTH RELEVANCE: Proton therapy provides the best possible option for using radiation to control and eliminate tumors with the least short and long term toxic side effects; however, only less than 1% of all radiation therapy patients receive proton therapy. The major barriers to greater utilization of proton therapy are the size and cost of the facilities. ProCure's new proton beam delivery concept will greatly reduce the size and mass of the system and the power needed to operate it, and consequently, help to bring this highly effective form of cancer treatment to the mainstream of radiation therapy.


Grant
Agency: Department of Health and Human Services | Branch: | Program: SBIR | Phase: Phase II | Award Amount: 1.00M | Year: 2011

DESCRIPTION (provided by applicant): In comparison to standard x-ray therapy, proton therapy allows an increased dose of radiation to a tumor and by reducing the amount of radiation to healthy tissue. As a result, it provides the best possible option for using radiation to control and eliminate tumors with the least short and long term toxic side effects. Currently less than 1% of all radiation therapy patients receive proton therapy while the number of patients that would benefit substantially from their use with current protocols is estimated to be over 30%. The major barriers to greater utilization of proton therapy are the size and cost of the facilities. The layout of the current proton therapy treatment centers is dominated by the size of the iso-centric gantries that rotate the proton beam dose delivery system around the patient. ProCure's focus for this project is to invent a new gantry concept using modern robotics and high temperature superconducting magnets that will greatly reduce the gantry sizeand mass, the power needed to operate it and consequently the contribution of these gantries to the facility cost. ProCure proposes to research new technology that would reduce the gantry mass by an order of magnitude and cost by a factor of three. PhaseI research will allow ProCure to determine the optimal design and components needed for a compact and low cost gantry based on novel beam scanning concepts and the use of high temperature superconducting magnet technology for use in Intensity Modulated Proton Therapy. In the first 12 months of Phase II, ProCure will work on constructing prototype magnets for the selected gantry concept, build key temporary magnet supports and nozzle components and in the next six months of Phase II, ProCure will carry out experiments using a full scale system in the Proton Dosimetry Test Facility recently commissioned at the Indiana University Cyclotron Facility. In Phase III, ProCure will complete the tests of the magnetic and nozzle operation at IUCF and make initial submission to the FDA. ProCure will construct a first prototype of the full rotating mechanical support system for the gantry and install the full system for mechanical system tests. In parallel, ProCure will start the acquisition process for the first systemsthat will be installed. Finally, FDA complete system testing for full FDA 510k approval will be performed. PUBLIC HEALTH RELEVANCE: Proton therapy provides the best possible option for using radiation to control and eliminate tumors with the leastshort and long term toxic side effects; however, only less than 1% of all radiation therapy patients receive proton therapy. The major barriers to greater utilization of proton therapy are the size and cost of the facilities. ProCure's new proton beam delivery concept will greatly reduce the size and mass of the system and the power needed to operate it, and consequently, help to bring this highly effective form of cancer treatment to the mainstream of radiation therapy.


News Article | February 1, 2011
Site: www.finsmes.com

The funding will support the continued development and expansion of ProCure’s network of proton therapy centers. The financing follows two significant investments totalling over $70m led by McClendon Venture Company, LLC (MVC). Founded in 2005 in Bloomington, Ind., and currently led by CEO Hadley Ford, ProCure has developed a network of proton therapy centers in cities across the United States (Oklahoma City, Chicago, Detroit and South Florida, and under construction in Somerset, N.J. and Seattle, Wash.). Proton therapy is an advanced form of radiation treatment and an important alternative to standard X-ray radiation for many patients with cancer and for some non-cancerous tumors. It has been shown to be beneficial in the treatment of a broad range of tumor types including brain, central nervous system, gastrointestinal, head and neck, lung and prostate as well as sarcomas and many pediatric cancers.


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