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Kill Cancer, Find Explosives, Catch a Smuggler
April 26, 2012   
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Agnieszka Syntfeld-Każuch, Ph.D., from the Radiation Detector Physics Division of the National Center for Nuclear Research in Warsaw, talks to Karolina Olszewska.

You are the project manager on Development of Specialized Systems to Use Ionizing Radiation Accelerators and Detectors in Medical Therapy and the Detection of Hazardous Materials and Toxic Waste. The goal of the project is to design innovative devices for use in radiotherapy and security systems. As far as medicine is concerned, how will the devices help cancer patients?

We have taken up the challenge to build three modern devices that use accelerators in cancer therapy. The project has major market potential, because the number of patients developing tumors keeps growing and while radiotherapy is efficient and economical, many countries lack the equipment. According to World Health Organization (WHO) recommendations, Poland should double the number of radiotherapy devices it has. The most developed countries have, in turn, double the number of radiotherapy systems recommended by the WHO. The Ministry of Health is planning to make radiotherapy more readily available by enlarging the existing network of radiotherapy centers and building regional centers. We are also expecting the demand for such devices to increase dramatically in developing countries, which have only just begun to use accelerators to treat tumors.

What is it that you want to deliver to physicians and patients in the near future?

The first device we have been working on is a mobile electron accelerator for intraoperative treatment. The accelerator emits electron beams that are targeted at the body part from which a tumor was removed, such as breasts in women. Electron radiation is crucial for oncology, because electrons ionize the matter which they penetrate and by doing so, they destroy cell structures. Just because a tumor has been removed does not mean all cancerous cells are gone and so by shooting electrons into the postoperative site, we seek to destroy as many cancerous cells as possible. We are able to do it by using an accelerator that generates a beam of electrons carrying energy with exactly the level that the treatment requires. Our device accelerates electron beams to energy levels ranging between 4 and 12 mega electronvolts (MeV), the range that is of interest to radiotherapists.

What are the new opportunities this device presents?

The HITEC Nuclear Equipment Division of the National Center for Nuclear Research has produced accelerators for medical use for many years. So far, however, they have been single-energy accelerators, that is, ones that emitted a single beam of electrons with a specific energy level. The new project further develops the technology to ensure a greater variety of applications. This time, the accelerators produce a wide range of electron energies. Depending on whether physicians are operating on, for example, a breast or the abdominal cavity, they need electron beams with different energies. We want to address this wide demand and this is the innovation in our project. The HITEC Nuclear Equipment Division has a comprehensive quality management system which conforms to all the norms. The first, key thing we will need to do to start technology deployment is compile a documentation package for each demonstrator model for devices developed in the course of the project, so the devices can be awarded the CE mark. The mark is the prerequisite for a product to be put on the market.

Once the project is completed and the demonstrator models are built, how much time will it take before physicians can use the equipment in hospitals?

The project ends in December 2013 and work on it began in December 2008. We are planning to fully cooperate with oncology centers in Poland and around the world. In order to deploy the technology, we will probably try to agree on some efficient system that differs from standard commercialization. Technology deployment is a way to provide a customer with devices to conduct tests, so you can work together with the customer to adjust the product and meet the customer’s expectations. Since we have planned to come up with competitive prices, the resulting medical equipment will also get a tremendous opportunity to make its way into the private medical services sector.

How can you be sure that the new device will be cheaper than others?

The production costs and the final price are never released to all potential buyers; it is a question of approaching customers individually. We do not have exact data on the costs which health centers will have to pay for our accelerators, but we can estimate the costs during individual talks with our customers. Apart from our institute, nobody else produces medical accelerators in Poland. We cannot really compare ourselves with large companies from abroad at this point, as they have been marketing such technical solutions on European and global markets for years. We can only ask the producers questions to get a rough idea of the price range for a given device and that is our point of reference. We know how much our devices take to manufacture and by using a certain margin we are aiming for, we can come forward with a price to negotiate with the customer.

Let me stress that as a research institute, we are not allowed to handle sales on our own. If things were marketed and sold, then the revenues would be returned to the project sponsor. To this end, special methods are developed to move technology out of institutes and to companies that sell the final technology and products. What I mean are spin-off companies, but as far as our institute is concerned, it is still too early for that to happen. It is not until we reach the target parameters with our demonstrators that we can start debating the right kind of commercialization for us to reach out to customers.

The National Center for Nuclear Research has a lot more to offer in this department...

We do have a far more advanced device, which is a multi-energy electron accelerator for highly specialized radiotherapy procedures. The accelerator is integrated with a diagnostic simulator. It is our largest project and most expensive product. Aside from beams of electrons, the accelerator will be able to generate gamma rays. It will be fitted with an imaging system which prior to the target irradiation will reveal, like an X-ray examination, the exact location of a tumor to indicate how the treatment plan should proceed. This means that physicians will also obtain comprehensive software for the accelerator. As they work with a computer, they will first obtain an image of the tumor to determine its location and size, and then they will program the right radiation dose, the key parameter, and finally, they will irradiate the tumor.

We have also been researching techniques to precisely irradiate neoplasms so as to ensure maximum protection for healthy tissues. The techniques include intensity-modulated radiation therapy (IMRT) and the image-guided radiation therapy (IGRT) system which verifies the location of tumors. The thing is, a tumor can be an irregularly shaped malformation. When you intervene in a patient’s body, you need to access the tumor from different sides and modulate the shape and intensity of the beam to destroy the tumor. Our accelerator can revolve around the patient, so that the location of the tumor can be followed on a screen and the shape and intensity of the beam can be modulated to make sure healthy tissues are unaffected.

A wonder device like that will not be easily affordable. What is left for smaller and less affluent health centers?

To those, we offer the photon needle, which is an attractive and reasonably priced low-energy electron accelerator with an X-ray tube. A special applicator shoots the photon radiation from the tube directly into the tumor area. The needle is also used to irradiate tissues after a breast tumor is removed, the goal being to destroy whatever cancerous cells are left after the procedure. This time, however, instead of an electron beam like in the accelerator I spoke about, this device uses low-energy X-rays. The photon needle is much smaller than the other device. While the accelerator can weigh more than a metric ton, the photon needle is a tube around 40 centimeters in length with X-rays beaming spherically out of one of the tube’s ends. The downside is that irradiation of the same destructive power takes much longer, up to 20-30 minutes. That causes discomfort to the patient, but the device has certain benefits as well. Many health centers cannot afford to buy huge and heavy equipment which admittedly needs much less time for irradiation. To begin with, hospitals need appropriate rooms for such equipment. These cannot be regular operating theaters, seeing how they are supposed to house a piece of equipment that weighs one metric ton. This necessitates a reinforced floor and thus an extra expense for the hospital. It is far cheaper and easier to buy the tiny accelerator that we call the photon needle. Mounted on a light and mobile dental manipulator, it weighs less than 20 kilograms and can be wheeled into any room at any time without any extra cost that the modernization of a room requires.

Tumors are not the only problem you tackle. What about devices used to combat terror and smuggling?

We are building, completely from scratch, two pieces of equipment used to protect national borders. Escalating terrorist threats necessitate increasingly sensitive methods to detect materials and technology which are of strategic importance and get smuggled across borders. The ever-growing cross-border traffic has to be addressed with more efficient detection methods. A single terrorist act can cause immense losses and so state-of-the-art detection systems should be launched at all container terminals, rail hubs and border crossings.

What is so inventive about the security systems you are working on?

The Radiation Detector Physics Division is very experienced in developing systems to detect the smuggling of hazardous materials. We were members of a European consortium that built a demonstrator model of a device to detect contraband at seaports. As a result, we were the only ones in Poland to start building a system employing an electron beam to detect explosives.

The many types of ionizing radiation include neutrons, but since neutrons carry a neutral electric charge, the ionizing effect is not direct. It might seem the particles pass through our bodies without any consequences, but in reality, they have an indirect effect on matter. What is worse, protection against neutrons is more difficult than against other kinds of radiation. A wall of lead which suffices to shield ourselves from electrons and gamma and X-rays is no longer enough as far as neutrons are concerned. Neutrons penetrate everything and we are only able to detect them with technologically more advanced measuring devices.

How can this type of radiation be put into use without exposing users to any risks, then?

The public is afraid of what neutrons can do. We want to operate in sectors where risks of negative effects that a device might have on human health are much lower than those related to terrorist attacks involving, for example, explosives. We have been in talks with the Central Investigation Bureau (CB¦), customs officers, and the Border Guard. Once a demonstrator model is there, we want to approach the military with an offer. Future users of this device are somewhat concerned about neutrons being so close, but we want the device to be used away from its operator. When there are reasons to believe that explosives have been planted somewhere or are being smuggled, the device will approach the suspicious-looking object, but the operator will remain at least 50 meters away.

Our neutron-based system is a unique one. Due to the concerns that neutrons raise among the public, we want the device to be used as second-line inspection, in extraordinary situations. X-ray screening devices installed at border crossings work with impressive irradiation speeds, which is particularly important to prevent traffic jams from forming during checks at road border crossings. This why we will first screen vehicles and cargo containers with X-ray devices. If there is suspicion that unwanted materials such as explosives are inside, our mobile system will ride up to the suspicious vehicle and use neutrons to activate the substances, prompting them to emit distinctive gamma rays.

And what about substances and objects other than explosives?

Those will be detected by the other device we have been working on, a system to scan cargo of large dimensions. It will detect contraband toxic waste and substances along with goods and technology of strategic importance, including illegal drugs, cigarettes and products which can be used for both civilian and military purposes. Devices of this kind are used in Poland to screen different objects using X-rays. Gates and trace detection portal machines have been mounted at border crossings for years and small X-ray scanners are also installed at airports. We are aiming to X-ray large objects such as 18-wheelers, trucks and containers. The innovative side of this idea is the use of X-ray beams carrying two different levels of energy, which will allow for better identification of materials inside a container, a semi-trailer or a truck. The resulting radiograph will identify the contents, detect explosives and identify a wide range of other contraband products.

As part of the project, we also want to test a method to activate fissile materials so the device also becomes sensitive to nuclear substances. We have been searching for extra functionalities to become more competitive, because X-ray radiography devices have been marketed in Poland by a Chinese company. Our goal is to come up with a price and fit the device with features that extend far beyond simple X-ray radiography. You need to remember that detection of fissile materials is still in research phase in Poland and it takes years for an idea to morph into a product out on the market.

The project has obtained a grant under the European Union’s Innovative Economy Operational Program. What exactly are the funds being spent on?

The money has allowed us to buy equipment for our labs, develop new technology and buy materials to build models of accelerators. We are now starting to buy and make the demonstrator models we have been aiming for. The result will be a qualitative change in research services provided by the National Center for Nuclear Research and the center will be also able to enhance its research potential. Newly opened and modernized labs and research and measurement stations will enable us to build high-end devices.

The project team is made up of around 100 people. New people are being hired, including scientists and engineers, and the project also involves university students and administration staff. All are employees of the National Center for Nuclear Research, which was established in 2011 through a merger of the Institute for Nuclear Studies in ¦wierk and the Institute of Atomic Energy. The project funds also provide salaries for the employees.

An important part in the project is played by the National Center for Research and Development, which disburses funds within the Innovative Economy program and sees to it that the funds are spent rationally. How are you doing in this department?

We have obtained a grant of zl.79 million via the National Center for Research and Development. The funds are for eligible expenses and research and so it is only natural that we have to account for every dime we spend. We receive all the help we need from the National Center for Research and Development and each question we ask is promptly answered. Sometimes we need to discuss the way we spend the money in order to clarify what is an eligible expense and what is not. For each debatable issue, we are given a helpful explanation.
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