The multi-wire proportional chamber conceived in by the CERN physicist Georges Charpak not only opened a new era for particle physics and earned its inventor the Nobel Prize in Physics but also found important applications in biology, radiology, and nuclear medicine 2 , 3. After these individual efforts, CERN witnessed the first collaborative endeavors in medical applications in the 90s.
In the same years, both the Medipix 7 and Crystal Clear 8 collaborations began exploring possible medical applications of technologies developed for the LHC detectors hybrid silicon pixel detectors and scintillating crystals, respectively. The Crystal Clear Collaboration developed various PET scanners with variable geometry suitable for both small and large animals. One of them became commercially available to customers worldwide.
Emerging interest in theranostics, i. Over 1, radioisotope beams of more than 70 chemical elements have been made available for fundamental and applied research, including in the medical field. A particular achievement was the demonstration of the efficiency of Terbium, one of the lightest alpha emitters, for treatment at the level of single cancer cells 9. These efforts had considerable success, and the CERN researchers have also been playing key roles in various international multidisciplinary collaborations and networks in specific fields such as medical imaging, hadron therapy, radioisotopes, data analytics and handling, medical simulations.
But a profound shift in the global approach of the laboratory to the whole issue of knowledge transfer to healthcare was needed. The challenge and aim for the CMA Office is to ensure that state-of-the-art technologies and know-how developed at CERN are used or modified to provide clinical applications that are valuable for the medical community. At the same time, resources for this program should be allocated without compromising particle physics research, which is the core mission of CERN.
This process requires the input and guidance of external experts from various disciplines. In keeping with the tried and tested CERN practice, an advisory committee composed of external experts was formed. The committee, called the International Strategy Committee ISC , comprises specialists from a wide range of medical fields as well as from medical physics.
As a first step, the CMA Office identified the key medical physics activities that were already ongoing or were just starting. They included a variety of topics: tools for data handling and data analytics, detectors for medical imaging, radiation dosimetry instruments and techniques, novel accelerators for optimized cancer treatment, facilities for researching new radioisotopes or for biomedical studies, and the vast realm of non-cancer applications.
The ultimate scientific goal of the CMA program is to provide more reliable, more efficient, and more cost-effective treatment options, as well as to ensure early diagnosis of serious illnesses. The idea of using accelerated beams of protons for cancer treatment was proposed by a visionary physicist and founder of Fermilab, Robert Wilson in Protons and light ions have unique physical properties.
They penetrate a patient with minimal lateral diffusion, depositing most of their energy at the end of their range in the so-called Bragg peak , effectively sparing healthy tissue on their way to the tumor.
In addition, they can be focused into narrow pencil beams allowing a precise radiation dose profile and tumor conformed treatment. At the time, the accelerators available were not powerful enough to treat deep-seated tumors. Advancement in accelerator technology coupled with improved medical imaging and computing made proton therapy a viable option for routine medical applications in the s.
However, it is only since the s that patients started being treated in clinical settings. Since protons are hadrons, proton therapy is also referred to as hadron therapy.
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The use of ions increases target conformity on the basis of physics principles, i. In this respect, carbon ions have a smaller lateral penumbra than protons, which may allow a better protection of normal tissue. Also, carbon ions have a higher linear energy transfer LET compared to protons and photons, which directly correlates with a higher relative biological effectiveness RBE. LET of carbon ion beams increases steadily as they pass through the body, reaching a maximum in the Bragg peak region: this property is an obvious therapeutic advantage when treating deep-seated tumors.
Carbon ions are also more efficient in hypoxic tumors, which are resistant to both photon and proton radiation. The lower acute or late toxicity of carbon ions compared to protons leads to an enhanced quality of life both during and after cancer treatment With the growing interest in particle therapy, the first dual ion protons and carbon ions clinical facility in Europe, established in Heidelberg, Germany, started treating patients at the end of The third dual ion center in Europe at MedAustron in Wiener Neustadt, Austria, is expected to start treating patients in At present, efforts in hadron therapy are focused on establishing a facility to provide ion beams for research.
The study group was later joined by Onkologie Czech Republic. Proton Ion Medical Machine Study aimed at producing a synchrotron design optimized for treating cancer patients with protons and carbon ions. The proposed design was detailed in two reports issued in Except the initial design study, CERN has also contributed to the realization of the CNAO and MedAustron treatment centers, in particular with expertise in accelerators and magnets, and with training of personnel.
Collisions and Collaboration
Both projects have been accomplished through networks of national and international collaborations. This was reiterated by a wide multidisciplinary scientific community at the Physics for Health workshop, where CERN was asked to take a lead on this initiative. Again, the broad positive feedback from the medical and radiobiological communities was received OPEN-Access MEDical Facility intends to provide suitable ion beams for a multitude of interdisciplinary studies, including radiation biology, nuclear physics models for medicine, detectors and instrumentation for dosimetry, diagnostics, and imaging.
OPENMED will complement a few existing or planned beam lines for this kind of multidisciplinary research, providing ample beam time without the constraints of a clinical setting.
Ideally, all centers hosting research beam lines should form a pan-European collaborative network that will allocate beam time to researchers in an effective and concerted way. Research at OPENMED will make a significant contribution to the progress of medical physics, biomedical research, medical simulations, and the development of innovative detectors and beam instrumentation. Medical and radiobiological collaborators will be able to investigate the biological impact of different ion beams at various energies on tumor cells and biological materials, and then to optimize radiation therapy for different types of cancer.
The research will be carried out on cell cultures and tissues, and it is not foreseen to conduct live animal or human experiments. They were fragmented in time and were performed with different beam qualities and cell systems.
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All of them need to be systematically reexplored in one single setting, under standardized dosimetry and laboratory conditions, in larger panels of biologically well-characterized human cancer and normal tissue cell systems. The ultimate gain would be a comprehensive model that can individualize therapy, incorporating clinical, biological and physics inputs. Also, it is imperative to develop state-of-the-art instrumentation and methods to bring the performance of hadron therapy to the level of the most advanced photon therapy techniques.
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OPEN-Access MEDical Facility will offer ample opportunities for testing novel radiation detectors, medical instrumentation, optimized delivery of the therapeutic beam to patients, diagnostics, and dosimetry. The experimental verification and improvement of biological simulation models will also be possible, along with the studies of complex processes such as nuclear fragmentation. These activities would complement other work elsewhere, and contribute to boost the impact of particle physics research on healthcare Hadron therapy is the epitome of a multidisciplinary and transnational venture: its full development requires the competences of physicists, physicians, radiobiologists, engineers, and IT experts, as well as collaboration between research and industrial partners.
ENLIGHT was established to co-ordinate European efforts in using ion beams for radiation therapy and to catalyze collaboration and co-operation among the different disciplines involved Despite the end of EC funding in , the following year the network members decided to maintain ENLIGHT alive, with the primary mandate to develop strategies to obtain the necessary funding for hadron therapy research, and to establish and implement common standards and protocols for treating patients.
They are guided around the accelerator ring by a strong magnetic field maintained by superconducting electromagnets.
Collisions and Collaboration. The Organization of Learning in the ATLAS Experiment at the LHC
The electromagnets are built from coils of special electric cable that operates in a superconducting state, efficiently conducting electricity without resistance or loss of energy. For this reason, much of the accelerator is connected to a distribution system of liquid helium, which cools the magnets, as well as to other supply services. Thousands of magnets of different varieties and sizes are used to direct the beams around the accelerator.
These include dipole magnets 15 metres in length which bend the beams, and quadrupole magnets, each 5—7 metres long, which focus the beams.
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