Nuclear Physics European Collaboration Committee (NuPECC)

Nuclear Physics for Medicine

European Science Foundation (ESF)

The European Science Foundation (ESF) was established in 1974 to provide a common platform for its Member Organisations to advance European research collaboration and explore new directions for research. It is an independent organisation, owned by 66 Member Organisations, which are research funding organisations, research performing organisations and academies from 29 countries. ESF promotes collaboration in research itself, in funding of research and in science policy activities at the European level. Currently ESF is reducing its research programmes while developing new activities to serve the science community, including peer review and evaluation services.

www.esf.org

The European Science Foundation hosts six Expert Boards and Committees: The European Space Sciences Committee (ESSC) The Nuclear Physics European Collaboration

Committee (NuPECC) The European Marine Board (EMB) The European Polar Board (EPB) The Committee on Radio Astronomy Frequencies

(CRAF) The Materials Science and Engineering Expert

Committee (MatSEEC)

In the statutory review of the Expert Boards and Committees conducted in 2011, the Review Panel concluded unanimously that all Boards and Committees provide multidisciplinary scientific services in the European and in some cases global framework that are indispensable for Europes scientific landscape, and therefore confirmed the need for their continuation.The largely autonomous Expert Boards and Committees are vitally important to provide in-depth and focused scientific expertise, targeted scientific and policy advice, and to initiate strategic developments in areas of research, infrastructure, environment and society in Europe.

Nuclear Physics European Collaboration Committee (NuPECC)

NuPECC is an Expert Committee of the European Science Foundation. The aim of NuPECC is to strengthen collaboration in nuclear science by promoting nuclear physics, and its trans-disciplinary use and application, in collaborative ventures between European research groups, and particularly those from countries linked to the European Science Foundation (ESF). NuPECC encourages the optimal use of a network of complementary facilities across Europe, provides a forum for discussing the provision of future facilities and instrumentation, and advises and makes recommendations to the ESF and other bodies on the development, organisation, and support of European nuclear research, particularly on new projects. The Committee is supported by its subscribing institutions which are, in general, member organisations of the ESF involved in nuclear science and research or research facilities.

www.nupecc.org

Nuclear Physics for Medicine edited by: Faial Azaiez, Angela Bracco, Jan Dobe, Ari Jokinen, Gabriele-Elisabeth Krner, Adam Maj, Alexander Murphy and Piet Van Duppen

For further information contact:

Professor Angela Bracco NuPECC ChairUniversit degli Studi di MilanoDipartimento di Fisica and INFN sez. MilanoVia Celoria 16 20133 Milano ItalyTel: +39 02 50317252Email: bracco@mi.infn.it

Dr Gabriele-Elisabeth Krner NuPECC Scientific Secretaryc/o Physik-Department E12Technische Universitt Mnchen85748 Garching GermanyTel: +49 172 89 15 011 / +49 89 2891 2293Email: sissy.koerner@ph.tum.de

http://www.nupecc.org/index.php?display=staff/contacts

Cover pictures: Top: Nuclei consist of protons (red) and neutrons (blue), which are each made up of three elementary quarks held together by gluons.Below: (left) Advanced approaches to high intensity laser-driven ion acceleration, see page 123. (Right) Image of an FDG-injected rat heart obtained in a small PET scanner for molecular imaging, see page 69.

ISBN: 978-2-36873-008-9

Contents

Foreword 3

Introduction 5

Chapter I Hadrontherapy 9

1. Introduction 11

2. Facilities in operation and planned 14

3. Accelerators 18

4. Beam delivery 24

5. Dosimetry 27

6. Moving targets 30

7. Radiobiology 33

8. Modelling 37

9. Treatment planning 41

10. Boron neutron capture therapy 46

11. Clinical programme update in particle therapy 53

12. Outlook 56

Chapter II Medical Imaging 59

1. Introduction 61

2. From nuclear to molecular imaging 63

3. New challenges 70

4. Interfaces 84

5. Outlook 92

Chapter III Radioisotope Production 95

Introduction 97

1. Properties of radioisotopes for nuclear medicine 98

2. Production methods and facilities 111

3. Examples and specific topics 128

Annexes 145

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3Nuclear physics is a coin that has two sides: basic research and applications. Without basic research there would be little to be applied; applications resulting from basic research contribute to the wealth and health of society.

Modern medicine benefits tremendously from nuclear physics, both for diagnosis and for therapy. Therefore NuPECC initiated this report Nuclear Physics for Medicine, with its three main sections: hadrontherapy, medical imaging and radioisotope production topics that are actively and widely pursued in Europe and abroad.

Following the successful model of previous NuPECC reports, conveners were engaged by NuPECC members and Working Groups were set up for the three topics. NuPECC members and in particular NuPECC liaisons have followed and discussed thoroughly the various steps necessary to prepare this report. The draft reports were published on the NuPECC website and discussed at an open meeting in Paris on 18 November 2013. The input received from the community was incorporated, resulting in the report now at hand.

We wish you enjoyable reading!

Forewordlll

Gabriele-Elisabeth KrnerNuPECC Scientific Secretary

Angela Bracco NuPECC Chair

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5The present report is one of the initiatives launched by NuPECC after the successful publi-cation of its latest Long Range Plan Perspectives for Nuclear Physics in Europe in 2010 (see www.nupecc.org/pub/lrp10/lrp2010_final_hires.pdf). Thus it represents a contribution towards fulfill-ing the mission of this expert committee of the European Science Foundation.

While most nuclear physics phenomena are far beyond our daily experience there is a great vari-ety of related techniques and applications such as those in medicine which have considerable impact on society.

The development of nuclear physics since the f irst discovery of the atomic nucleus by Rutherford in the early 20th century has been intimately tied to the development of new detec-tion techniques, accelerators and to theoretical and simulation frameworks. A large number of these have found, and will increasingly find, applications in daily life, well outside the realm of nuclear physics and indeed of physics itself. Nuclear physics methods find increased applica-tions within trans-disciplinary areas as diverse as energy, nuclear waste processing and transmuta-tion, climate change containment, life sciences and cancer therapy, environment and space, secu-rity and monitoring, materials science, cultural heritage, arts and archaeology. Comprehensive surveys on the impact of nuclear physics were issued by NuPECC in 1994 and in 2003 with two reports on Impacts and Applications of Nuclear Physics in Europe see www.nupecc.org/pub/impact_applications_1994.pdf and www.nupecc.org/pub/impact_applications_interac-tions_2002.pdf, respectively. Since then nuclear physics has progressed and new ideas have

emerged leading to developments of technologi-cal interest.

In the last Long Range Plan of NuPECC, issued in 2010, suggesting directions and a strat-egy in the field, one important recommendation concerns applications. In particular it was stated that further development of the nuclear physics skills base has to be pursued in view of current and future needs and these include of course the life sciences. One important question in this con-nection is: how can nuclear physics techniques improve medical diagnostics and contribute to cancer therapy? It is on this specific question that we have decided to focus and thus to issue this report prepared by a group of distinguished expert researchers, who have contributed a great deal and at a high level, to answer to these key questions.

It is important to stress that laboratories with focus on research in accelerator-based nuclear physics and on the related accelerator, detector, and isotope-production technology contribute (always indirectly but very often directly) to devel-opments in nuclear medicine. Indeed not only can the best suited isotopes used for medical imaging and treatment be produced and developed with those accelerators, but the techniques used by nuclear physicists to peer inside the nucleus can be used to image and trace these agents inside the body to study human health and diseases.

In a multidisciplinary vision, the knowledge of nuclear physics provides fundamental support to the requests of many specialist physicians, such as oncologists, radiologists, radiotherapists, and nuclear medicine specialists, looking to guar-antee early detection of disease and to select the most appropriate therapeutic strategies.

Introductionlll

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driven by the use of hadrons (particles subject to the strong force) such as protons and atomic nuclei (ions). This frontier in radiation therapy, recognised and pursued worldwide, is illustrated to