What is a cyclotron?

A cyclotron is a circular shaped particle accelerator that accelerates electrically charged particles to collide into other particles at a speed of 45,906,444 meters per second. This leads to the generation of so-called radionuclides, which are then linked to molecules. These radioactive compounds (radiopharmaceuticals) can be used to make detailed images of a variety of processes, structures and organs in patients, using a PET camera.

Why the name Translational Medicine?

Translational Medicine refers to Radboudumc’s focus on ‘translating’ the outcome of research that has first been performed in a laboratory into treatment for the patient. The cyclotron facility is considered an important missing link for the execution of such ‘translational’ research.

How much radioactive material will be produced by the cyclotron?

In the near future our daily production will be between three and seven batches of radiopharmaceuticals, based on carbon-11, nitrogen-13 and fluor-18. With one batch, between one to tens of patient doses can be manufactured.

What are the risks of a cyclotron facility?

These are comparable to the risks associated with other radiation processes in hospitals, such as linear accelerators. The cyclotron is located in a vault with thick concrete walls, covered under a meter of soil. Therefore, there is no radiation exposure outside of the facility. Employees of the facility working with the cyclotron are trained to work safely with this equipment and with the radioactive compounds produced. As defined in the “Kernenergiewet”, we have to follow the ALARA principle. ALARA is an acronym for "as low as (is) reasonably achievable," which means making every reasonable effort to keep exposures to ionizing radiation as far below the dose limits as practical.

Why has this cyclotron facility been constructed?

Manufacturing radioactive compounds in-house offers new opportunities for the treatment of patients. It is now possible to use short-living radionuclides. These have to reach the patient without any delay, often within minutes. Therefore, it is impossible to procure them from other suppliers. Having our own cyclotron facility also provides us with new research opportunities, e.g. for the diagnosis of cancer. Our own cyclotron makes us independent from external suppliers and allows us to obtain the required experimental compounds at any time. Hospitals in the vicinity of Radboudumc can also benefit from the new cyclotron facility.

Are the radioactive materials produced dangerous?

In the cyclotron only short-living radionuclides are being produced, like Carbon-11, Nitrogen-13 and Fluor-18. This means that these materials lose their radioactivity very rapidly. Of course, adequate precautionary measures are being taken when processing such radioactive materials, to ensure that employees and users are not exposed to unnecessary levels of radiation.

What is a PET-scan?

Positron emission tomography (PET) is an imaging technique in which very small quantities of a radioactive substance are used. Such a substance, e.g. radioactive glucose or water, is administered to a patient and sends out radiation as positrons. After annihilation, two 0.511 mega electron volts (MeV) photons are formed which can be detected by the PET scanner. In this way, the presence of (for instance) tumors can be determined with 18F-FDG (radioactive glucose) because cancer cells absorb more glucose than healthy cells.

How much radiation is a patient exposed to during a PET-scan?

The average effective received dose per PET-scan is 4,7 mSv (source: RIVM). mSv stands for millisievert and is a measure of the health effect of low levels of ionizing radiation on the human body. By comparison: the average annual dose to which a person is exposed is 2,4 mSv. A large part of this exposure is of natural origin, e.g. outer space or soil.

Is the radioactive material administered for a PET-scan harmful?

The amount of radioactive material administered for a scan is very small. Within 12 hours, all radioactivity has disappeared from the body. The amount of radiation is comparable to that of the radiation released for an X-ray or a CT-scan.

Can there be a ‘melt down’ in a cyclotron, with all negative consequences?

This is impossible. As soon as the cyclotron is switched off, the process stops and the creation of new radioactivity or a ‘melt-down’ cannot occur.

What are the costs associated with the construction of this facility?

The total investment is almost 12 million euro, of which nearly six million has been used for the reconstruction of an existing building. The cyclotron itself costs approximately 1,5 million euro. The remaining costs are to cover the procurement of equipment and for the validation and qualification of the facilities. The European Fund for Regional Development (EFRO) has invested approximately 8 million euro in this facility.

Is such a major investment justifiable, in this time of cost containment and budget constraints?

This new cyclotron facility creates many opportunities for new, advanced diagnostic methods and thereby helps to find better treatments for patients. Investigations that are stressful to the patient and unnecessary costs can be avoided. The cyclotron also enables scientists to use the latest research tools to obtain a better understanding of the cause of diseases for which until now treatment options are still lacking.

Does the cyclotron yield any radioactive waste?

When in use, the cyclotron creates small amounts of radioactive waste. This waste is temporarily stored, until the decay has made the material non-radioactive, or the waste is transported to a specialized waste handling company (COVRA).

What’s in it for the patient?

The availability of more radionuclides leads to a broader spectrum of diagnostic tools. The cyclotron also facilitates research that will yield better, more effective and efficient diagnoses and treatments.

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