ERHA SYSTEM

Enhanced Radiotherapy with HAdrons

What is ERHA SYSTEM
p-Linac
Robotic Patient Positioning System
TPS – Treatment Planning System
Implementation times

ERHA, the proton therapy made in Italy

ERHA (Enhanced Radiotherapy with Hadrons) is the innovative proton therapy system developed by LinearBeam for the treatment of tumors.

This is a different and definitely more advanced technology than proton accelerators currently on the market as:

  • it is the first in the world to have a p-Linac specifically designed for clinical use, which is able to replace extremely expensive cyclotrons or synchrotrons

  • it requires an area of less than 100sqm. and is therefore easy to set up at most hospital sites

  • each component is installed by a single company and managed by a single integrated software

  • it can be equipped with more adjoining treatment rooms with a gradually higher energy release

  • the system is completed within merely 30 months from the beginning of the implementation works. From the 9th month, an experimental radiobiological room will be available and from the 18th month, it will be possible to carry out pediatric, orbital and ocular treatments

Example One The three components of ERHA 1 Proton linear accelerator (p-Linac) the p-Linac has a more advanced acceleration technology than a cyclotron and therefore combines many of the technical advantages of a synchrotron with greater cost-efficiency in management 2 Robotic patient positioning platform The robotic platform allows the patient to be positioned at the fixed proton beam 3 Integrated control software (TPS) this software allows for the creation of treatment plans with a real-time assessment of the effects caused by the proton beam on cells and tissue

p-Linac, a linear approach

In order to treat tumors with protons, an accelerator is required i.e., a device that increases the speed and therefore the energy of the protons. Current existing systems use two different types of accelerators – cyclotrons or synchrotrons – which nowadays are deemed as a mature technology.

Cyclotrons represent the oldest technology and are still widely used worldwide.

Synchrotrons are a more advanced type of technology, yet they have a significant bulkiness and are also expensive.  

The ERHA system on the other hand uses a p-Linac i.e., a linear acceleration system that can be easily placed in a container of about 24 m. in length and only 4 m. in width. Furthermore, the p-Linac has a more advanced technology than a cyclotron and combines many of the advantages of a synchrotron with greater cost-efficiency.

Spot size Energy modulation Intensity modulation
Cyclotron
Synchrotron
Linac
Comparison between LINAC and other particle accelerators used for ProtonTherapy

The advantages of the linear accelerator

  • Modular installation

  • Best beam optics

  • Intensity modulation (IMPT)

  • Energy modulation

  • Low radiation and low activation

  • Fast warm-up

Robotic Patient Positioning System

The robotic platform allows the patient to be positioned according to the treatment plan.

The ITEL patent on the “Robotic patient positioning system in relation to at least one source of particles” ensures positioning with an accuracy level of less than 0.2 mm on the target, by using a stereoscopic 3D vision system and a dedicated CT.

The advantages of the robotic system:

  • Significant cost reduction compared to the traditional Gantry

  • Space reduction

  • Fixed beam

  • TPS fully integrated with the positioning system

TPS – Treatment Planning System

The Monte Carlo treatment plan module is able to track every single particle and reproduce every interaction with healthy tissue and cells during the path to lesion.

This is the most realistic method and allows calculating the effective dose also in difficult cases, when the calculation of dose delivered to the patient could only be carried out through the traditional way of water equivalent (pencil beam).

Both the treatment planning system for proton beams with radiobiological calculation and the full Monte Carlo technique run on MOM (Monte Carlo Optimized Mainframe).

This ensures a reasonable running time for each plan, thanks to the distributed computing and code optimization.

Software characteristics

  • Radiobiological evaluation of proton beams on cells and tissue crossed

  • 2-step-optimization: fast and full

  • Active scanning support

  • Monte Carlo algorithm

  • Cloud support for distributed architectures and GPU calculation

  • Support for active scanning

  • Optimization process according to the type of accelerator

Slide We know that time
is precious
The ERHA system can be active from as early as the 9th month from the beginning of the implementation works, and be fully operational within merely 30 months.

Slide FIRST 9 MONTHS Radiobiological experimental room The healthcare workers may be able to start the training on proton treatment as early as the 9th month from the beginning of the implementation works. info p-Linac Eye and research
treatment room
p-Linac 65 MeV 12 m
Slide Full LINAC up to 65 MeV Radiobiological experimental room Pulsed machine up to 400 Hz (0,2% Duty Cycle)
Intesity modulated current Iavg 1-10 nA
Fixed Energy 65 MeV ± 0,4 MeV
ε(rms,n) = 1,2 π mm mrad
Spotsize: σx=1,4mm, σy=1,6mm
Number of protons for pulse 3x10⁶ - 3x10⁸
Electrical power: 60 kW max, 6 kW standby
Warm up from stanby < 1 hr
Low secondary radiations, activation
Back

Slide 18 MONTHS Eye and pediatric treatment room From as early as the 18th month, it will be possible to use a room for pediatric treatments or treatments of the visual system Info Eye and pediatric
treatment room
Radiobiological
experimental room
p-Linac p-Linac 160 MeV 18 m
Slide Full LINAC up to 160 MeV Eye and pediatric treatment room Pulsed machine up to 400 Hz (0,2% Duty Cycle)
Intesity modulated current Iavg 1-5 nA
Energy modulated 65-160 MeV ± 0,4 MeV (spread <0,75% over 100MeV )
ε(rms,n) = 1,2 π mm mrad
Spotsize: σx=1,4mm, σy=1,6mm
2 Gy/min FOV 25x25 cm² at 17 cm depth
Number of protons for pulse 3x10⁶ - 3x10⁸
Electrical power: 120 kW max, 8 kW standby
Warm up from stanby < 1 hr
Low secondary radiations, activation
Back

Slide 30 MONTHS Deep tumor treatment room Implementation of a room for deep tumor treatment Deep tumor
treatment room
Info Eye and pediatric treatment room Radiobiological experimental room p-Linac p-Linac 230 MeV 24 m
Slide Full LINAC up to 230 MeV Deep tumor treatment room Pulsed machine up to 400 Hz (0,2% Duty Cycle)
Intesity modulated current Iavg 1-5 nA
Energy modulated 65-230 MeV ± 0,4 MeV (spread <0,75% over 100MeV )
ε(rms,n) = 1,2 π mm mrad
Spotsize: σx=1,4mm, σy=1,6mm
2 Gy/min FOV 25x25 cm² at 32 cm depth
Number of protons for pulse 3x10⁶ - 3x10⁸
Electrical power: 180 kW max, 10 kW standby
Warm up from stanby < 1 hr
Low secondary radiations, activation
Back protonterapia

5 reasons to choose ERHA, the Enhanced Radiotherapy with Hadrons

linearbeam

Lower price compared to existing systems

linearbeam

Respect for the environment: our system has almost negligible both instant and induced radiations, it avoids the need for large amounts of concrete shielding and it reduces problems of decommissioning and disposal of radioactive waste at the end of its life (20-30 years)

linearbeam

Small footprint: our structure extends mostly in length and requires a surface area of less than 100sqm. Therefore, it has very little impact compared to existing PT structures

linearbeam

Easy to set up in a shielded corridor, a warehouse or a parking lot, as it requires only a small flat surface

linearbeam

Ease of management by operators: the number of devices is reduced and control is achieved by a single software interface

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