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HEALTHCARE TECHNOLOGY


equipment installed in the treatment room provides up-to-date location of the tumour for proper alignment with the beam therapy. The beam generation can be located remotely or within the same volume of space as the treatment room depending on the selected system. Because there are so many common


spaces in a clinic, it is possible to share common spaces with other departments or divisions with similar needs. This could result in cost efficiencies and improved utilisation of spaces. However, having a fully independent


clinic from other hospital spaces would allow for autonomous operation for other healthcare areas in the case of an outbreak that might make sharing spaces with other divisions or departments undesirable. The recent COVID-19 pandemic has resulted in careful evaluation of clinic configuration to allow continuous operation throughout such an occurrence. Originally, proton therapy centers


required large real estate commitments and significant expenditure which led to a limited number of facilities available for treating patients that would benefit greatly from this technology. Single room proton therapy centers


were developed in response to this market limitation and made it possible for a healthcare organisation to construct and operate a proton therapy centre with a considerably smaller initial cost and real estate commitment. Additionally, healthcare organisations


have been able to develop proton therapy clinics in locations closer to the patients. Many are located at hospitals, including major cancer centres, and stand-alone treatment clinics are also becoming more common. This benefits patients as it reduces the travel hardships including cost, anxiety from unfamiliar surroundings, and time away from support. Single room proton therapy facilities


vary in size depending on the manufacturer and type selected. There are standard single-room and


compact single room options. Generally, a compact single-room system is 30 per cent less floor area and over 40 per less volume than a standard single room solution. Space constraints, particularly on congested sites, make the compact system an attractive option. Table 1


Table 1. General system characteristics. Mevion


Gantry type Accelerator


180˚+ Synchro-cyclotron


Lobby.


provides some general characteristics of several manufacturers.


Overall challenges The technical challenges of designing a proton therapy treatment centre include coordination of all the services and provisions for reliable operations. As systems become more compact, space available for routing critical utilities becomes less generous. High-density concrete aggregate


makes up the roughly 1.5 m thick walls surrounding the equipment and treatment room. All services that enter the vault must be carefully coordinated for pre- planning of pathways to set sleeves in the proper locations in the high-density concrete walls. Once the pours are complete, it is


very difficult, and expensive, to create new paths and should be avoided. The coordination of the pathways also has a significant impact on the beam generation equipment as the manufacturer will determine specific cable lengths to connect all the components. The voltage drops are calculated to


determine equipment calibration for precise operation; changes to the length could impact the function of the equipment. Backup systems for all


IBA 220˚


Cone Beam – CT Rail mounted ceiling Nozzle mount Multiroom capable Modular expansion


capability 50 IFHE DIGEST 2021


Varian 360˚


Synchro-cyclotron Cyclotron


services must be ready for instant initiation to preserve operations and protect the equipment. Provisions for maintenance and


component failure need to be included for reliable, continuous operation. This article references specific design issues encountered for the world’s first compact proton therapy system, Kling Proton Therapy Center at Siteman Cancer Center at Barnes-Jewish Hospital located in St. Louis, Missouri, USA. The initial compact single-room


installation was completed in 2013 and a second treatment room was completed in 2020. The newest installation is the MEVION S250i proton therapy system with technological advancements in pencil beam scanning, ceiling mounted cone beam CT, and diagnostic CT on-rail system. These features provide state-of- the-art image guided proton therapy (IGPT).


Electrical systems Power and communications are critical to the successful operation of a proton therapy centre. The proton therapy centre requires four levels of electrical system distribution (ups, generator, normal, mechanical equipment) to support the proton therapy and imaging equipment.


Hitachi 360˚


Protom 180˚+


Synchrotron Synchrotron


Nozzle mount Nozzle mount Ceiling mounted robot 3


3 3


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