The Inova Schar Cancer Institute is a full-service cancer treatment center and includes the Inova Mather Proton Therapy Center which is the first proton treatment center in Northern Virginia, revolutionizing cancer care with cutting-edge technology. The treatment with pencil beam scanning targets malignant cells while leaving healthy ones unharmed, sparing adjacent healthy tissue. 

The Inova Hospital System made the decision to embark on implementing this new proton treatment within its Inova Center for Personalized Health Campus as part of a strategic initiative to broaden the hospital’s ability to provide leading-edge patient care and bring top-quality cancer treatment closer to home. The two-room IBA Proteus Plus proton therapy solution demanded its own dedicated space, an additional facility adjacent to the existing hospital building to ensure its safe and accurate operation. 

From the outset, this project demanded extensive use of planning tools and BIM technology to navigate piping in a 16-foot thick concrete wall surrounding the proton machine. All in all, this project represents proactive use of ground-breaking technology and a steep learning curve – with no margin for error. 

BIM Expertise, A Significant Asset

The Inova Mather Proton Therapy project consisted of a highly complex set of tasks that demanded creativity, expertise, and a strong project management infrastructure from the outset. BIM expertise and fabrication tools were essential to developing the strategy and approach necessary to address these challenges. Additionally, BIM was particularly valuable in this instance to ensure safe and accurate housing for the new proton treatment machine to operate at top functionality. As there was no margin for error once the concrete walls were poured, pre-fab and BIM made all the difference in creating the precise plans needed to be sure this was done right, the first time. 

Key challenges of the Inova Mather Proton Therapy project follow. 

Varying levels of complexity. From start to finish. 

Design elements dictated by equipment. The size and nature of the 250-ton cyclotron proton machine itself required a new 2-story facility built as an addition to the existing hospital structure. The safe operation of the machine required the construction of a 16-foot thick reinforced concrete wall surrounding it with our piping and other utilities to be embedded inside.

No option for re-work. The rebar within the 16-foot thick concrete walls had to be laid with the piping embedded precisely and attention to detail and our Quality Control process by our VDC team ensured this was done right, the first time because with this there are no second chances.

Tight time constraints and a steep learning curve. The team was largely learning together throughout, as this proton technology is so new and innovative that very few contractors have previous projects from which to draw experience.  

A Multi-Leveled Solution to Address Complex Tasks 

The pioneering nature of the proton therapy technology, coupled with an intense construction process that did not just require accuracy, but unwavering precision, required a multi-leveled approach to execute this project. In addition to massive amounts of tradespeople and activity happening throughout, BIM technology played a critical role in the solution developed to address key challenges, on-time and on-budget. 

Varying levels of complexity – from start to finish. The large task list and level of complexity this project demanded required seamless coordination of activity and resources. The proton technology itself is so cutting-edge and the majority of tradespeople on the job had not seen or worked with the proton unit prior to this project. To get a sense for what was involved, the team traveled to Florida to see one in action before beginning work, which added exponential value to the work quality. The data and background gathered here – in combination with the BIM technology used to plot key steps and sequences – enabled top quality in workmanship throughout the project. 

Design elements dictated by equipment. An unconventional element of this project was that the design plans for the new building were directly dependent on the proton equipment’s needs. This began with determining the optimal placement for the machine within the concrete walls and plans for how the pipe and fittings would be laid around it. Due to the radiation produced by the machine, the pipe penetrations into the new therapy room facility had to include a z-bend as a safety measure to prevent radiation from passing through the pipes themselves. The project team placed the pipe fittings virtually into the wall model and used this approach to plot the actual sequence of the installation and order of steps to achieve it successfully, the first time. Surveyors with robotic stations were mobilized at the BIM stage to map out all pipe support locations and checkpoints and to ensure the model created was executed to 100% accuracy before moving forward.

No option for re-work. Deployment of cutting-edge BIM technology allowed the project team to strategically map precise locations of piping and fittings ahead of time. BIM was also used to create the model for the rebar placement to ensure pinpoint accuracy, essential to the concrete pouring of the walls surrounding the Proteus Plus unit. Quality control played a vital role as well in ensuring the project was done right the first time. Double and triple-checking took place in the field in order to be absolutely certain everything was correct before the concrete pouring took place.

Tight time constraints and a steep learning curve. The project team’s in-house Pre-fabrication team played a key role in bringing the expert skills needed to conduct the stainless-steel welding this job required. This provided the project with Process Chilled Water pipe and fittings in prefabricated assemblies produced in a clean, safe and controlled environment providing for the highest quality of craftsmanship and just in time delivery.   

Top Outcomes Through the Robust Power, Unmatched Necessity of BIM Technology 

The Inova Mather Proton Therapy project involved numerous complexities on a massive scale. No safety incidents were reported despite a number of risky, challenging activities having to take place, including tradespeople standing on plywood as the 16-foot thick concrete walls were being poured, to walk acrossa the rebar itself to coordinate piping sequencing precisely. This, in addition to a safety challenge, required top attention and expertise from each member of the field team in order to ensure that the pipes were laid, and concrete poured to the exact specifications in order for the project to be executed successfully. 

These factors, coupled with the fact that from start to finish, this project demanded a level of coordination and rebar precision with the piping installation and concrete wall pouring that the project team had never encountered previously, makes its successful and timely completion a significant achievement. The Inova Mather Proton Therapy Center opened on schedule and treated its first patient on March 9, 2020. 

From beginning to end, the Inova Mather Proton Therapy project – and the other projects completed at the Inova Center for Personalized Health, is a testament to the robust power, and unmatched necessity the BIM process plays in successful completion of a particularly challenging job. Shapiro & Duncan’s level of BIM expertise surpasses that of most competitors, and this, coupled with the optimal mix of high-quality technical team members and field tradespeople to execute key tasks with the precision and attention to detail this life changing project demanded.