Protons - Superior Dose Distribution

1. Experience, Expertise and a Commitment to Excellence™

2. 4 3 Relative Dose 2 1 60 0 30 20 10 Depth in Tissue (cm) Protons - Superior Dose Distribution • The Bragg Peak is representative of a delivery of a full, localized, and uniform dose of energy in the target Experience, Expertise and a Commitment to Excellence™

3. System Components • The Synchrotron Accelerator • The Beam Transport System • The Stationary Beam • Gantries (Isocentric Gantries) • Patient Alignment and Digital Imaging Systems • Facility Control System Experience, Expertise and a Commitment to Excellence™

4. Facility Layout The Loma Linda University Medical Center Proton Treatment Center • Stationary Beam: • Has two branches: • Eye Tumors • Head and Neck Tumors The Gantries: Resembling giant ferris wheels can rotate around the patient and direct the proton beam to a precise point. Each gantry weights about 90 tons and stands 3 stories tall. It supports the bending and focusing magnets to direct the beam. The Injector: Protons are stripped out of the nucleus of hydrogen atoms and sent to the accelerator. Steel-reinforced concrete walls are up to 15 feet thick. Synchrotron: (Accelerator) A ring of magnets, 20 ft. in diameter, through which protons circulate in a vacuum tube. Beam Transport System: Carries the beam from the accelerator to one of four treatment rooms. This system consists of several bending and focusing magnets which guide the beam around corners and focus it to the desired location. Experience, Expertise and a Commitment to Excellence™

5. Proton Accelerator Control System • Conforma 3000 Integrated Solution • Treatment Control System (TCS) • Accelerator Control System (ACS) • Treatment Workstation • Integrated and Automated • “The Brain” • Software & Electronics for Treatment Precision • Accelerate • Deliver • Control Experience, Expertise and a Commitment to Excellence™

6. Accelerator Control - Advantages • Automatic Beam Centering in Treatment Nozzle • Key to Active Beam Scanning • Rapid Beam Line Switching • <10 sec. • Accurate, Reproducible Beam Energy • Within 0.1 MeV • Patented Safety Systems • Ensure Beam is Delivered at the Right Place & Time Experience, Expertise and a Commitment to Excellence™

7. Gantry TreatmentRoom • Integrated and automated • Rotates >360o • Treatment from multiple “portals” or angles • Isocenter is contained within a sphere  to 1.0 mm in radius • Automated set up • Designed for functionality Experience, Expertise and a Commitment to Excellence™

8. Conforma 3000 Passive Scattering Beam Delivery System Range Modulation Wheel X-ray Tube Dose and Flatness Monitor(s) Second Scatterer First Scatterer Profile Monitor Compensator (Bolus) and Block (Aperture) Beam Movable Snout (cones) Experience, Expertise and a Commitment to Excellence™

9. Conforma 3000 Active Beam SystemIntensity Modulated Proton Therapy Redundant Dose Detectors Optional Compensator (Bolus) and Block (Aperture) Beam Movable Snout (cones) Scanning Magnets Radiographic Imaging Panels (2) • IMPT or Active Beam Scanning (ABS) • Supports Compensator-less treatments • Variable energy controls penetration depth • Capable of continuous (raster scanning) & discrete point based (“Spot” scanning) Experience, Expertise and a Commitment to Excellence™

10. Intensity Modulated Proton Therapy • Ability to Treat Complex Volumes & Multiple Target Areas • “Spot Scanning” Technique • Beam scans from the top down • Radiation deposited from side to side Experience, Expertise and a Commitment to Excellence™

11. Modular Design (4 gantry, 2 Stationary) Experience, Expertise and a Commitment to Excellence™

12. Treatment Planning Software Experience, Expertise and a Commitment to Excellence™

13. Contact Information Experience, Expertise and a Commitment to Excellence™