Health: Radiotherapy, the first prototype of a Compact Neutron Generator installed in Italy

The first patented prototype of a Compact Neutron Generator (CNG) for the treatment of advanced stage solid tumors with intraoperative neutron radiotherapy^[1] (nIORT) was installed at the ENEA Research Center in Brasimone (Bologna). Lightweight and self-shielded, it can be and installed on a mobile robotic arm and can generate a powerful radiation field, stronger than traditional forms of radiotherapy like X-rays, electrons or protons, and can be delivered directly to the exposed tumor during surgery.

The prototype is a cylinder 35 cm long, with a diameter of 18 cm, patented and designed ad hoc for single-shot intraoperative radiotherapy, which is completed in no more than 10 minutes and does not require several cycles of external treatments after surgery.

Designed by the US company Berkion Technology following the guidelines provided by the Italian company TheranostiCentre srl and numerical simulation calculations performed by Massimo Sarotto at the ENEA Nuclear Safety and Sustainability Division, the Compact Neutron Generator was created as part of a collaboration between ENEA and TheranostiCentre under the LINC-ER^[2] project funded by the Emilia-Romagna region.

“Thanks to the evolution of compact neutron generators, it’s possible to combine the technologies currently used in radiotherapy, like X-rays, electrons or protons, with neutrons, which have a higher radiobiological effect and are more effective in treating non-early stage solid tumors”, pointed out Antonietta Rizzo, head of the ENEA Laboratory of Nuclear Methods and Techniques for Safety, Monitoring and Traceability.

"These conclusions are based on accurate simulations and physical models created thanks to the ENEA CRESCO6 supercomputer", pointed out Giuseppe Ottaviano atthe ENEA Laboratory of Nuclear Methods and Techniques for Safety, Monitoring and Traceability. “This is the second most important computing infrastructure in the public sector in Italy – said Ottaviano –a national point of reference for research institutions and companies to conduct frontier studies in various fields, including health, energy, climate, environment, bioinformatics and safety”.

After the electromechanical tests of plasma ignition and the simulations of the radiation fields and shielding necessary to obtain the authorizations for its operation, which will take place by 2024, the Compact Neutron Generator is to be positioned in a dedicated bunker for the following stages: ignition of hydrogen plasma and then deuterium; experimental characterization of radiation fields by means of particle detectors and anthropomorphic phantom; chemical and biological test of materials adjuvant to intraoperative neutron radiotherapy, conducted in the ENEA Bologna Research Center, at the Nuclear Methods and Techniques Laboratory for Safety, Monitoring and Traceability of the Nuclear Safety and Sustainability Division.

“TheranostiCentre aims to carry out research projects concerning the use of compact neutron generators for medical use. Our strategy is to seek a partner company capable of accompanying the CNG up to the complete configuration of the entire device usable in the operating room”, explained Maurizio Martellini at TheranostiCentre. “The ongoing phases concern the construction of a second 'non-laboratory' prototype suitable for positioning in the operating room, on the basis of the tests performed by ENEA and the planning of in vivo tests at a European university clinic for a comparative study, in collaboration with TheranostiCentre, ENEA and the partner company”.