title: Modelling the throughput capacity of a single-accelerator multitreatment room proton therapy centre.
abstract: OBJECTIVE
  We describe a model for evaluating the throughput capacity of a single-accelerator multitreatment room proton therapy centre with the aims of (1) providing quantitative estimates of the throughput and waiting times and (2) providing insight into the sensitivity of the system to various physical parameters.
  
  
  METHODS
  A Monte Carlo approach was used to compute various statistics about the modelled centre, including the throughput capacity, fraction times for different groups of patients and beam waiting times. A method of quantifying the saturation level is also demonstrated.
  
  
  RESULTS
  Benchmarking against the MD Anderson Cancer Center showed good agreement between the modelled (140 ± 4 fractions per day) and reported (133 ± 35 fractions per day) throughputs. A sensitivity analysis of that system studied the impact of beam switch time, the number of treatment rooms, patient set-up times and the potential benefit of having a second accelerator. Finally, scenarios relevant to a potential UK facility were studied, finding that a centre with the same four-room, single-accelerator configuration as the MD Anderson Cancer Center but handling a more complex UK-type caseload would have a throughput reduced by approximately 19%, but still be capable of treating in excess of 100 fractions per 16-h treatment day.
  
  
  CONCLUSIONS
  The model provides a useful tool to aid in understanding the operating dynamics of a proton therapy facility, and for investigating potential scenarios for prospective centres.
  
  
  CONCLUSIONS
  The model helps to identify which technical specifications should be targeted for future improvements.
authors.affiliation: Christie Medical Physics and Engineering, The Christie NHS Foundation Trust, Manchester, UK. adam.aitkenhead@christie.nhs.uk
authors.forename: A H
authors.initials: AH
authors.lastname: Aitkenhead
authors.forename: D
authors.initials: D
authors.lastname: Bugg
authors.forename: C G
authors.initials: CG
authors.lastname: Rowbottom
authors.forename: E
authors.initials: E
authors.lastname: Smith
authors.forename: R I
authors.initials: RI
authors.lastname: Mackay
mesh_terms: D019985:Benchmarking / Q000592:standards; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D008962:Models, Theoretical; D009010:Monte Carlo Method; D009369:Neoplasms / Q000532:radiotherapy; D061766:Proton Therapy / Q000706:statistics & numerical data*; D014850:Waiting Lists; D016526:Workload