1. OPENMED CDR Status G. Roy, CMASC Meeting, April 27, 2016 Ghislain Roy April 27 th, 2016

2. Historical Perspective Physics For Health Meeting: 20102010 Major published papers 1. Feasibility study for a biomedical experimental facility based on LEIR at CERN, Abler D, Garonna A, Carli C, Dosanjh M, Peach K, J Radiat Res. 2013 Jul; 54 Suppl 1 Feasibility study for a biomedical experimental facility based on LEIR at CERN 2. A possible biomedical facility at the European Organization for Nuclear Research (CERN), Dosanjh M, Jones B, Myers S, Br J Radiol. 2013 May; 86(1025) A possible biomedical facility at the European Organization for Nuclear Research (CERN) 3. A community call for a dedicated radiobiological research facility to support particle beam cancer therapy, Holzscheiter MH, Bassler N, Dosanjh M, Sorensen BS, Overgaard J, Radiother Oncol. 2012 Oct;105(1) A community call for a dedicated radiobiological research facility to support particle beam cancer therapy Workshop “Possible Medical Facility at CERN”: 2012“Possible Medical Facility at CERN” ICTR-PHE Conferences: 2012, 2014, 2016201220142016 ”Divonne Meetings” : 2012, 2014, 2016 G. Roy, CMASC Meeting, April 27, 2016 All yield a consistent message : OPENMED is an essential initiative for the biomedical community!

3. Biomedical Motivation & Justification External document motivating and justifying OPENMED Complement to the OPENMED CDR Research program at OPENMED Defined by the user community Research program listed with priorities, based on merit Ideally, research that is difficult or impossible to do at other facilities, or complementary to other facilities At least 3 years worth of concrete research program Potential impact in the biomedical field and on clinical protocols; i.e. Impact to Society Imagery, TPS, ion species, dosage (RBE), dose delivery… G. Roy, CMASC Meeting, April 27, 2016

4. OPENMED facility outline LEIR Exp. Area Light Ion Linac Linac 3 G. Roy, CMASC Meeting, April 27, 2016 Linac 4

5. OPENMED facility outline Transfer lines - from Linac3 - to the PS New ejection channel Injection line Ejection line for PS transfer LEIR shielding wall PS shielding wall New transfer line to experiment Slow Extraction, Beamlines, Experimental area, Dump, Shielding, Ancillaries… G. Roy, CMASC Meeting, April 27, 2016

6. Transfer Lines to Experimental Area Design of beam transfer lines to the biomedical experimental area - common extraction transfer line - 2 (or 3) final beam lines  vertical beam line (going upwards, 70 MeV/u)  horizontal beam line (440 MeV/u for clean cell work)  horizontal beam line (440 MeV/u for more technical work) G. Roy, CMASC Meeting, April 27, 2016 Wide beam 50x50 mm 2 1-2% homogeneity (w/o collimation ?) Beam interception as upstream as possible Pencil beam with multispot scanning (both lines ?)

7. Requirements / Parameters H, He, Li, Be, B, C, N, O with new light ion linac Heavier ions from Linac 3 (?) Single source if rapid ion change Two sources would allow mixed irradiation Energies down to 50 MeV/u Energies up to 440 MeV/u (after PC upgrade) Higher energies (?) Cycle time of 2.4s minimum (2 basic periods) Slow extraction ; O(10 9 -10 10 ) ions per spill Energy change at synchrotron, and/or range shifter G. Roy, CMASC Meeting, April 27, 2016

8. Work on CDR in 2015 Draft structure Identification of some stakeholders, and first initial discussions Decision on new source front end and light ion linac Proposal to reuse Linac 2 housing after Linac 4 connection Established communication channels to outside (HIT, MedAustron, CNAO, PSI, INFN, CEA/CNRS…) Discussed concrete collaboration proposals (HIT, CNAO, INFN, CEA/CNRS…) Requirements chapter in good draft form, currently under review by community Technical studies started at CERN and progressing… (Source, Linac, Beamlines, RP, Experimental Area…) G. Roy, CMASC Meeting, April 27, 2016

9. Requirements Chapter Good draft available Thanks to ISC working group and direct contacts with clinical centres (CNAO, MedAustron, PSI, HIT…) Editorial team: B. Jones, S. Schuh, D. Nicosia, G. Roy Requirements vs. Feasibility Baseline: phantoms, 2D & 3D cells, NO animals Gradually increasing circulation for more comments and improvement. G. Roy, CMASC Meeting, April 27, 2016

10. CDR Timeline G. Roy, CMASC Meeting, April 27, 2016 End Sept ‘16 Draft of selected chapters End March ‘17 CDR Final Draft Ready End June ‘17 CDR Published 5/166/167/168/169/1610/1611/1612/161/172/17 3/17 4/175/176/17 Parallel editing of all chapters Concentrate on selected parts Final drafting of all chapters CDR publishing Beg Dec ’16 Contri- bution to CMA Paper Beg Dec ‘16 CMA Paper

11. CDR Outline Requirements / Beam Parameters Ion Source Frontend & LINAC Injection Transfer Line LEIR Beam Dynamics Beam Extraction Transfer Lines to Experimental Area Biomedical Experimental Area Safety Radiation Protection Controls Vacuum Integration and General Services Installation Planning Cost Estimate (M+P) Maintenance and Operations (M+P) Risk Assessment G. Roy, CMASC Meeting, April 27, 2016

12. CDR Outline (Sept 2016) Requirements / Beam Parameters Ion Source Frontend & LINAC Injection Transfer Line LEIR Beam Dynamics Beam Extraction Transfer Lines to Experimental Area Biomedical Experimental Area Safety Radiation Protection Controls Vacuum Integration and General Services Installation Planning Cost Estimate (M+P) Maintenance and Operations (M+P) Risk Assessment G. Roy, CMASC Meeting, April 27, 2016

13. kick-off meetings 20 groups concerned BE: ABP, ICS, RF, BI, OP, ASR EN: HE, STI, EA, EL, MME, ACE, CV TE: EPC, VSC, ABT, MSC HSE: GS, RP SMB: SE - Conceptual study w/ minimal resources - 50-70 pages - addressed to wide audience - Coherent set of parameters, based on Requirements - Enough details to outline potential difficulties and required R&D - No detailed R&D before further decision by CERN management - List and define all necessary interfaces - Simple & robust facility design, minimize M&O cost - Commercially available equipment or useful collaborations G. Roy, CMASC Meeting, April 27, 2016

14. Concerns @ CDR kickoff Need to see commitment from biomedical community. Motivation and Justification Operability of OPENMED in conjunction with other CERN programmes Installation planning and date of availability of facility staging… Very short timeline, Resources are tight minimal level of investment, rough cost estimates, based on experienced engineering evaluation Feasibility study more than CDR G. Roy, CMASC Meeting, April 27, 2016

15. Deliverables Most important parts available at end 2016 Requirements – Beamlines – Experimental Area Integration & General Services, Installation Planning, Cost Estimate, Maintenance & Operations, Risk Assessment Conceptual Design Report published June 2017 G. Roy, CMASC Meeting, April 27, 2016

17. Spare Slides

18. Research Reduction of uncertainties in dose calculation and delivery Dosimetric tools Imaging tools Particle range Treatment planning tools (MC, RBE, LET, painting) Motion mitigation Big data

19. Research RBE or alternative Mechanisms of action Combination (ions and therapies) Radiogenomics Different ions (optimal) Hypoxia Immunogenic and off target effects Normal tissue Adverse effects Carcinogenesis Biomarkers Animal models

20. Facility Helium to silicon ions Horizontal and vertical beams, possibly a gantry. Pencil beams with raster scanning capability. Capable of accelerating light ions up to 500 MeV/u Depth 0.05 to 30 cm (at least 5cm) 1 mm precision large field 20x20 cm to 50 x 50 scattered horizontal and vertical 2 Gy/min 10x10x10cm homogeneity better than 3% Operations and maintenance Absolute dosimetry and international national standard

21. 3: Ion source Define source characteristics (intensity, charge state) from irradiation requirements Identify range of light ions that can be produced with intensity & charge states Sources under consideration: - Pantechnik Supernanogan - AISHA (LNS Catania) Install & characterize a test source - Intensity and charge states - Fast switching of ion species - Operability G. Roy, ISC meeting Sep 18, 201521 Collaboration opportunity with INFN LNS Interest at CNAO D. Kuchler, V. Toivanen

22. 4: Frontend and LINAC Design the frontend for optimal matching between source and LINAC - Design of source output shaping - Design of new beamline elements (RFQ) Design of a new light ion LINAC5 - q/m ratio ? - final design with source characterization input Opportunity to reuse LINAC2 area G. Roy, ISC meeting Sep 18, 201522 A. Lombardi, J-B. Lallement Interest from CNAO

23. 5: Injection Transfer Line Design of the transfer line between LINAC5 and LEIR - Preserve existing lines LINAC3 to LEIR (heavy ions) LINAC4 to PSB (protons) - Minimum of new elements Issues for integration and planning G. Roy, ISC meeting Sep 18, 201523

24. 6: LEIR Beam Dynamics Beam dynamics studies to verify LEIR for use with full range of light ions at energies up to 440 MeV and as low as 20 MeV Study of LEIR beam optics Impact of magnet saturation after magnet power supply upgrade Study effect of electron cooling and/or solenoid on light ions operation Fast ion switching in LEIR from operational point of view Beam dump etc. G. Roy, ISC meeting Sep 18, 201524

25. 7: Beam Extraction Study and design beam extraction mechanism and specification of required equipment Review applicability of extraction via RF knock-out (better beam quality) & required hardware Review quad. driven slow extraction preliminary design and parameters (intensity fluctuations) Impact of electron cooler on slow extraction G. Roy, ISC meeting Sep 18, 201525 Collaboration opportunity with HIT, positive experience

26. 8: Transfer Lines to Experimental Area Design of beam transfer lines to the biomedical experimental area - common extraction transfer line - 2 or 3 final beam lines  vertical beam line (going upwards, 70 MeV/u)  horizontal beam line (440 MeV/u for clean cell work)  horizontal beam line (440 MeV/u for more technical work) G. Roy, ISC meeting Sep 18, 201526 Collaboration with University of Huddersfield, UK D. Abler, T. Amin, R. Barlow, S. Ghithan

27. 9: Biomedical Experimental Area Design of the biomedical experimental area providing common instrumentation & sample/detector mounts, access & area control. - Biomedical laboratory for experimental preparation (fridges, incubators) - Provision for cell imaging - Design of user access to the irradiation areas and integration of the area - Beam delivery design to experiments - Beam Instrumentation - Provision for an X-ray irradiation control - Provision of generic sample mount – possible robotic placement system - Provision of local experimental control G. Roy, ISC meeting Sep 18, 201527 Collaboration with University of Oxford, UK B. Jones, B. Vojnovic

28. 10: Radiation Protection Study all aspects of radioprotection for the OPENMED facility and necessary shielding implementation - necessity of a shielding roof over LEIR for light ion operation ? - Shielding requirements for the transfer lines - Beam dump in end user station - Impact of stray radiation from PS on OPENMED - Neutron and gamma at the end user station - Provide FLUKA simulations for nuclear safety & beam characteristics - Study dosimetry requirements in the enduser station - Access control requirements for the enduser station G. Roy, ISC meeting Sep 18, 201528 Ambient Dose-Eq Rate [μSv/h] Collaboration with University of Huddersfield, UK S. Damjanovic, R. Rata, R. Barlow

29. 12, 13: Controls & Operation Full integration of OPENMED controls into CERN accelerator controls Local control for the enduser stations (beam on/off…) Manpower requirements Infrastructure requirements (local or remote) Integration in CERN beam planning Independence of LINAC3 and LINAC5 Requirements from HEP community for Heavy Ions from LEIR G. Roy, ISC meeting Sep 18, 201529