Thinking big, building small

Technological advances are making proton therapy centers more scalable than ever.

When it comes to proton therapy centers, size, complexity and cost have been consistent barriers to entry. The slow but steady proliferation of proton therapy centers in the U.S. has been limited by their girth and expense, which has been dictated in part by the size and space requirements for the bulky proton technology itself; the cyclotron and the gantry primarily. For years we’ve known that for proton beam therapy centers to grow worldwide, they would need to be offered in a smaller, cheaper and faster form.

Recent technological advances make proton therapy centers more scalable than ever. Advances in superconducting magnet technology have decreased the physical size of proton technology. Manufacturers have reduced the circumference of their particle beam accelerators (cyclotrons) as well as the size of the gantries. Advances in power supply technologies suggest power supply rooms can be smaller, too.
“We see manufacturers starting to develop more compact gantries, which is usually the largest physical piece of proton operating system. Additionally, manufacturers are using superconducting type magnets and moving towards developing more compact equipment components, such as power supply and control cabinets, to further reduce their overall footprint requirement. The equipment technology continues to evolve to the benefit of the end user. The manufacturers are really moving in the right direction in terms of shrinking their physical requirements and energy use. The result is lower building and system operational costs,” says Michael Fahey, Managing Principal of Bard, Rao + Athanas Consulting Engineers, PC who regularly consults with VOA on proton therapy centers.
Several manufacturers have shrunk the major components and now offer compact proton beam accelerator systems. Mevion S250, IBA Proteus One, Varian ProBeam Compact Single-Room Proton Therapy System, ProNova SC360 and Hitachi PROBEAT-RT are among them. In our view, competition among manufacturers will continue the trend toward more compact technology.


On site coordination at Georgia Proton Center construction

VOA/BR+A’s experience in designing proton centers has led us to a certain level of comfort with the design considerations that promote further scalability of centers. We’ve found, for example, that the size requirements for the technology in the building can be reduced significantly. A continuing dialogue with the proton beam system manufacturer’s technical engineering team has yielded significant results. In terms of building size, we have been working with the manufacturers to help them better understand the opportunities they have when applying the building and safety codes that are appropriate to their technology. “We’re working with them to help them understand where they can further compress their spaces,” says Fahey. “They’re mostly international manufacturers and when they come to the States they are not as familiar with our codes. For example, defining allowable working clearances required around the equipment. When we educate them on where they can actually further compress areas, as allowed by codes, without compromising the function or serviceability to the equipment, they understand it and adapt accordingly.”

They recognize the value of what we bring to the table as design professionals. It’s not a coincidence that they come to us to redesign, not their equipment, but how it’s configured.

Manufacturers have been willing to reduce the size of their maintenance and technical areas. Where large overhead cranes may have been required in the past, we now have other design options for accessing maintenance and servicing. Informed by our practical experience relative to the actual use of proton beam facilities, VOA is pushing the logic of manufacturer’s requirements. Operationally, we’ve found that power and cooling requirements are often theoretical figures and higher than what is actually needed. We can reduce these requirements based on our experience with facilities in operation.

New York Proton Therapy Center, VOA

New York Proton Therapy Center

For many interested institutions, price and complexity have been barriers to joining the world of proton therapy. Enter the compact single-room solution. Smaller, more affordable, easier to install, simpler to operate and ultimately more realistic to finance, these one-room facilities are poised to increase accessibility to cancer patients around the world.

Manufacturers have optimized their systems and can now offer what used to be extensive equipment spread over four or five rooms in just a single room. That type of scale provides flexibility for hospitals to incorporate the technology and evaluate its benefits. It makes proton possible for adoption by small or remote hospitals. The business plan for larger, five-room centers will continue to require a hearty number of referrals and high rate of patient throughput to produce a return on investment. Scalability offers more potential options in terms of financial feasibility. I predict we will see growth in these one-room facilities, some of which will be integrated with academic medical settings or cancer centers. Smaller, cheaper, faster is closer than ever.

Download the complete Design Quarterly Winter 2015 – Trends in Proton Therapy Center Design now.

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