MEDICAL PHYSICS

Medicine progresses in part thanks to the developments in research conducted in other disciplines, including basic physics. The technologies developed for particle physics are actually successfully used both in diagnostics and in medical therapies, and for studying and producing new drugs. In particular, accelerator physics has proven to be crucial for developing oncological therapies, which are distinguished by very high precision and low impact on healthy tissues. One example is hadrontherapy, which treats thousands of patients in the world. Accelerator physics is also crucial for experimental techniques like BNCT (Boron Neutron Capture Therapy) and producing radiopharmaceuticals.
In Italy, we have one of the few centres in the world dedicated to hadrontherapy, which treats tumours using carbon ions as well as beams of protons. This is CNAO, the National Centre for Oncological Hadrontherapy in Pavia. The heart of CNAO consists of a particle accelerator built by INFN, which worked on the project with the divisions of Genoa, Milan, Pavia, and Turin and the National Laboratories of Frascati, Legnaro, and the South. INFN is still involved in important technological research and development projects. Hadrontherapy is a kind of radiotherapy that exploits the extreme precision ensured by using particle accelerators developed for basic research in physics. The tumour cells are irradiated with beams of protons or carbon ions (hadrons) emitted by a particle accelerator.With this method, you can hit tumours without damaging the surrounding tissue, enabling treatments of greater depth and precision compared to conventional systems. In conventional radiotherapy sessions, the tumour cells are actually bombarded with a beam of x-rays that “burns” the sick cells but also destroys the surrounding ones. In contrast, the hadrons fired by the accelerator beam release the greatest density of energy directly on the target, right where the tumour is located, saving the healthy tissues that surround it. Already, more than 4,800 patients have been treated since 2011.

In Catania, at INFN’s National Laboratories of the South, CATANA has been operating since 2002. This is the first proton therapy centre in Italy for treating ocular melanoma, which uses the Laboratories’ cyclotron. The University Hospital Polyclinic of the University of Catania also helps conduct the centre with its radiodiagnosis, oncological radiotherapy, and eye clinic facilities. Catana is the only centre for treating ocular melanoma operating inItaly, and one of very few in Europe. Since the start of its operations, more than 500 patients from various regions of Italy have been treated with a percentage success rate close to 95%. In addition, in Trent, INFN’s national TIFPA centre contributed decisively to founding the Trentino-Alto Adige Region proton therapy centre that opened in 2015, thanks to its expertise in the field of proton therapy machines.

CNAO, Centro Nazionale di Adroterapia Oncologica a Pavia (© CNAO)

CATANA, CATANA, Centro di Adroterapia e Applicazioni Nucleari Avanzate (© INFN)

At the INFN National Laboratories of Legnaro, in the province of Padua, a lot is invested indeveloping the SPES project. This will significantly contribute to research in the field of interdisciplinary physics, using a very new cyclotron, in which protons will be accelerated up to energies of 70 MeV. In particular, SPES will be used to develop new radiopharmaceuticals that are useful both for diagnosis and therapy and will help research in the BNCT (Boron Neutron Capture Therapy) field. This is an oncological therapy that is still experimental, which exploits the nuclear reaction between low-energy neutron beams with nuclei of Boron-10 to destroy tumour cells. It will be used to develop new radiopharmaceuticals that are useful to both diagnosis and therapy.

Imaging diagnostics also owes a lot to nuclear physics, which led to the development of Computed Tomography (CT) and one of the first practical applications of antimatter with Positron Emission Tomography (PET). In addition, the experience acquired in developing algorithms and software for analysing images was applied in automatic analysis programs for screening, especially in the oncological field. INFN is involved here through the Health Big Data project led by the Alliance Against Cancer (ACC), the national oncological network founded by the Ministry of Health in 2002, of which INFN is a member. Supercomputing is also crucial for developing customised medicine projects, like, for example, studying digital twins in the biomedical field.