Developments in the design of proton and ion accelerators for medical use

Accelerators and medicine have been close companions since cyclotrons first made biological studies with particle beams possible in the 1930s. Later improvements, such as H-minus (H-) extraction, made cyclotrons the foremost, commercially-available producer of medical isotopes. Although the world's first hospital-based proton treatment centre, Loma Linda, uses a synchrotron, the cyclotron is now al so establishing a dominance in proton centres using passive beam spreading. However, two trends indicate a slightly different direction. The first is towards light ions and the second is towards 'penc il' beam scanning with active energy control. Together, these point to a new generation of synchrotrons with slow-beam-extraction systems that allow time for on-line dosimetry and provide very smooth spills. There are several variants for the slow extraction including the use of a betatron core and rf knockout. There are also methods for improving the spill quality such as rf channelling buckets a nd rf noise. The use of a synchrotron has the consequence of unequal emittances in the extracted beam, which affects the design of extraction lines, the rotational optics of gantries and the passive a nd active scanning systems.