The Physics of Radiation Therapy

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ISBN: 9780683045024 | 0683045024
Cover: Hardcover
Copyright: 1/1/1994

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Summary

Supplemental Materials

University of Minnesota, Minneapolis. New edition of a text on clinical radiation oncology physics, for residents and clinical physicists. Previous edition 1984. Illustrated. DNLM: Health Physics.

Preface to the Second Edition

vii

Preface to the First Edition

Structure of Matter

The Atom

(1)

The Nucleus

(1)

Atomic Mass and Energy Units

(2)

Distribution of Orbital Electrons

(1)

Atomic Energy Levels

(1)

Nuclear Forces

(1)

Nuclear Energy Levels

(1)

Particle Radiation

(1)

Electromagnetic Radiation

(3)

Wave Model

(1)

Quantum Model

(2)

Nuclear Transformations

Radioactivity

(1)

Decay Constant

(1)

Activity

(1)

The Half Life and the Mean Life

(3)

Radioactive Series

(1)

Radioactive Equilibrium

(4)

Modes of Radioactive Decay

(4)

α Particle Decay

(1)

β Particle Decay

(1)

Negatron Emission

(1)

Positron Emission

(1)

Electron Capture

(1)

Internal Conversion

(1)

Isomeric Transition

(1)

Nuclear Reactions

(5)

The α,p Reaction

(1)

The α,n Reaction

(1)

Proton Bombardment

(1)

Deuteron Bombardment

(1)

Neutron Bombardment

(1)

Photodisintegration

(1)

Fission

(1)

Fusion

(1)

Activation of Nuclides

(1)

Nuclear Reactors

(1)

Production of X-Rays

The X-Ray Tube

(3)

The Anode

(2)

The Cathode

(1)

Basic X-Ray Circuit

(1)

Voltage Rectification

(2)

Physics of X-Ray Production

(3)

Bremsstrahlung

(1)

Characteristic X-Rays

(1)

X-Ray Energy Spectra

(2)

Operating Characteristics

(2)

Clinical Radiation Generators

Kilovoltage Units

(4)

Grenz-Ray Therapy

(1)

Contact Therapy

(2)

Superficial Therapy

(1)

Orthovoltage Therapy or Deep Therapy

(1)

Supervoltage Therapy

(1)

Resonant Transformer Units

(1)

Megavoltage Therapy

(1)

Van de Graaff Generator

(2)

Linear Accelerator

(7)

The Magnetron

(2)

The Kylstron

(1)

The Linac X-Ray Beam

(1)

The Electron Beam

(1)

Treatment Head

(1)

Target and Flattening Filter

(1)

Beam Collimation and Monitoring

(1)

Gantry

(1)

Betatron

(1)

Microtron

(1)

Cyclotron

(1)

Machines Using Radionuclides

(5)

Cobalt-60 Unit

(1)

Source

(1)

Source Housing

(1)

Beam Collimation and Penumbra

(2)

Heavy Particle Beams

(5)

Neutrons

(1)

D-T Generator

(1)

Cyclotron

(1)

Protons and Heavy Ions

(1)

Negative Pions

(3)

Interactions of Ionizing Radiation

Ionization

(1)

Photon Beam Description

(1)

Photon Beam Attenuation

(4)

Coefficients

(2)

Attenuation Coefficient

(1)

Energy Transfer Coefficient

(1)

Energy Absorption Coefficient

(1)

Interactions of Photons with Matter

(1)

Coherent Scattering

(1)

Photoelectric Effect

(2)

Compton Effect

(5)

Special Cases of Compton Effect

(1)

Direct Hit

(1)

Grazing Hit

(1)

90° Photon Scatter

(2)

Dependence of Compton Effect on Energy and Atomic Number

(2)

Pair Production

(1)

Annihilation Radiation

(1)

Variation of Pair Production with Energy and Atomic Number

(1)

Relative Importance of Various Types of Interactions

(3)

Interactions of Charged Particles

(1)

Heavy Charged Particles

(1)

Electrons

(1)

Interactions of Neutrons

(1)

Comparative Beam Characteristics

(3)

Measurement of Ionizing Radiation

Introduction

(1)

The Roentgen

(2)

Free-Air Ionization Chamber

(1)

Thimble Chambers

(5)

Chamber Wall

(1)

Effective Atomic Number

(1)

Chamber Calibration

100

(1)

Desirable Chamber Characteristics

101

(1)

Practical Thimble Chambers

102

(6)

Condenser Chambers

102

(2)

Chamber Sensitivity

104

(1)

Stem Effect

104

(2)

Farmer Chamber

106

(2)

Electrometers

108

(3)

String Electrometer

108

(1)

Other Electrometers

109

(1)

Operational Amplifiers

109

(2)

Special Chambers

111

(2)

Extrapolation Chamber

111

(1)

Parallel-Plate Chambers

111

(2)

Ion Collection

113

(1)

Saturation

113

(1)

Collection Efficiency

114

(1)

Chamber Polarity Effects

114

(2)

Environmental Conditions

116

(1)

Measurement of Exposure

117

(2)

Quality of X-Ray Beams

Half Value Layer

119

(1)

Filters

120

(2)

Measurement of Beam Quality Parameters

122

(6)

Half Value Layer

122

(1)

Peak Voltage

122

(1)

Direct Measurement

123

(1)

Voltage Divider

123

(1)

Sphere-Gap Method

123

(1)

Indirect Measurement

123

(1)

Fluorescence Method

123

(1)

Attenuation Method

124

(1)

Penetrameter

124

(2)

Effective Energy

126

(1)

Mean Energy

127

(1)

Measurement of Megavoltage Beam Energy

128

(1)

Measurement of Energy Spectrum

129

(2)

Measurement of Absorbed Dose

Radiation Absorbed Dose

131

(1)

Relationship Between Kerma, Exposure, and Absorbed Dose

132

(3)

Kerma

132

(1)

Exposure and Kerma

133

(1)

Absorbed Dose and Kerma

133

(2)

Calculation of Absorbed Dose from Exposure

135

(5)

Absorbed Dose to Air

135

(1)

Absorbed Dose to any Medium

135

(2)

Dose Calibration with Ion Chamber in Air

137

(1)

Dose Measurement from Exposure with Ion Chamber in a Medium

138

(2)

The Bragg-Gray Cavity Theory

140

(6)

Stopping Power

141

(1)

Chamber Volume

142

(3)

Effective Point of Measurement

145

(1)

Plane Parallel Chambers

145

(1)

Cylindrical Chambers

145

(1)

Calibration Protocol for Megavoltage Beams

146

(1)

Cavity-Gas Calibration Factor (Ngas)

146

(1)

Chamber as a Bragg-Gray Cavity

147

(13)

Photon Beams

148

(3)

Electron Beams

151

(1)

Dose Calibration Parameters

152

(1)

Chamber Calibration Factor, Nx

153

(1)

Cavity-Gas Calibration Factor, Ngas

153

(1)

W/e

154

(1)

Ion Recombination Correction: Aion, Pion

154

(1)

Wall-Correction Factors: Awall, βwall, Pwall

154

(2)

Replacement Correction Factor, Prepl

156

(1)

Calibration Phantom

157

(1)

Simplified Equations

158

(2)

Transfer of Absorbed Dose from One Medium to Another

160

(1)

Photon Beams

160

(1)

Electron Beams

161

(1)

Exposure from Radioactive Sources

161

(2)

Measurement of Absorbed Dose

163

(13)

Calorimetry

163

(1)

Chemical Dosimetry

164

(1)

Ferrous Sulfate (Fricke) Dosimeter

165

(1)

G Value

165

(2)

Solid State Methods

167

(1)

Thermoluminescence Dosimetry

167

(1)

Simplified Theory of TLD

168

(1)

Lithium Fluoride

169

(1)

Practical Considerations

170

(2)

Film Dosimetry

172

(4)

Dose Distribution and Scatter Analysis

Phantoms

176

(3)

Depth Dose Distribution

179

(1)

Percentage Depth Dose

179

(9)

Dependence on Beam Quality and Depth

180

(1)

Initial Dose Buildup

180

(2)

Effect of Field Size and Shape

182

(3)

Dependence on Source-Surface Distance

185

(3)

Tissue-Air Ratio

188

(8)

Effect of Distance

188

(1)

Variance with Energy, Depth, and Field Size

189

(1)

Backscatter Factor

190

(1)

Relationship between TAR and Percent Depth Dose

190

(2)

Conversion of Percent Depth Dose from One SSD to Another-the TAR Method

192

(3)

Calculation of Dose in Rotation Therapy

195

(1)

Scatter-Air Ratio

196

(4)

Dose Calculation in Irregular Fields-Clarkson's Method

197

(3)

A System of Dosimetric Calculations

Dose Calculation Parameters

200

(6)

Collimator Scatter Factor

201

(1)

Phantom Scatter Factor

201

(2)

Tissue-Phantom and Tissue-Maximum Ratios

203

(1)

Properties of TMR

204

(2)

Scatter-Maximum Ratio

206

(1)

Practical Applications

206

(10)

Accelerator Calculations

206

(1)

SSD Technique

206

(2)

Isocentric Technique

208

(1)

Cobalt-60 Calculations

209

(1)

Irregular Fields

210

(1)

SSD Variations within the Field

211

(1)

Computer Program

212

(1)

Asymmetric Fields

212

(4)

Other Practical Methods of Calculating Depth Dose Distribution

216

(6)

Irregular Fields

216

(1)

Point Off Axis

216

(2)

Point outside the Field

218

(1)

Point under the Block

219

(3)

Appendix to Chapter

222

(4)

Derivation of Sp

222

(1)

Derivation of TMR

222

(1)

Derivation of SMR

223

(3)

Treatment Planning I: Isodose Distributions

Isodose Chart

226

(3)

Measurement of Isodose Curves

229

(2)

Sources of Isodose Charts

230

(1)

Parameters of Isodose Curves

231

(3)

Beam Quality

231

(1)

Source Size, SSD, and SDD-The Penumbra Effect

231

(2)

Collimation and Flattening Filter

233

(1)

Field Size

233

(1)

Wedge Filters

234

(5)

Wedge Isodose Angle

235

(1)

Wedge Transmission Factor

236

(1)

Wedge Systems

236

(1)

Effect on Beam Quality

236

(2)

Design of Wedge Filters

238

(1)

Combination of Radiation Fields

239

(6)

Parallel Opposed Fields

240

(1)

Patient Thickness versus Dose Uniformity

241

(1)

Edge Effect (Lateral Tissue Damage)

242

(1)

Integral Dose

243

(1)

Multiple Fields

244

(1)

Isocentric Techniques

245

(5)

Stationary Beams

247

(1)

Rotation Therapy

247

(3)

Wedge Field Techniques

250

(4)

Uniformity of Dose Distribution

252

(1)

Open and Wedged Field Combinations

253

(1)

Tumor Dose Specification for External Photon Beams

254

(6)

Terminology

255

(1)

Target Volume

255

(1)

Treatment Volume

255

(1)

Irradiated Volume

255

(1)

Maximum Target Dose

255

(1)

Minimum Target Dose

256

(1)

Mean Target Dose

256

(1)

Median Target Dose

256

(1)

Modal Target Dose

256

(1)

Hot Spots

257

(1)

Specification of Target Dose

257

(1)

Stationary Photon Beams

257

(1)

Rotation Therapy

257

(1)

Additional Information

258

(2)

Treatment Planning II: Patient Data, Corrections, and Setup

Acquisition of Patient Data

260

(15)

Body Contours

260

(2)

Internal Structures

262

(1)

Transverse Tomography

262

(1)

Computed Tomography

263

(5)

Three-Dimensional Treatment Planning

268

(1)

Magnetic Resonance Imaging

269

(3)

Ultrasound

272

(3)

Treatment Simulation

275

(2)

Treatment Verification

277

(4)

Port Films

277

(1)

Electronic Portal Imaging

278

(3)

Corrections for Contour Irregularities

281

(5)

Effective SSD Method

281

(2)

Tissue-Air (or Tissue-Maximum) Ratio Method

283

(1)

Isodose Shift Method

283

(3)

Corrections far Tissue Inhomogeneities

286

(13)

Corrections for Beam Attenuation and Scattering

287

(1)

Tissue-Air Ratio Method

287

(1)

Power Law Tissue-Air Ratio Method

287

(1)

Equivalent Tissue-Air Ratio Method

288

(1)

Isodose Shift Method

289

(1)

Typical Correction Factors

289

(2)

Absorbed Dose within an Inhomogeneity

291

(1)

Bone Mineral

291

(2)

Bone-Tissue Interface

293

(1)

Soft Tissue in Bone

293

(1)

Soft Tissue Surrounding Bone

294

(4)

Lung Tissue

298

(1)

Air Cavity

299

(1)

Tissue Compensation

299

(8)

Design of Compensators

300

(4)

Two-Dimensional Compensators

304

(1)

Three-Dimensional Compensators

305

(1)

Moire Camera

305

(1)

Magnetic Digitizer

305

(1)

CT-Based Compensator Systems

305

(1)

Compensating Wedges

306

(1)

Other Applications

306

(1)

Compensator Setup

307

(1)

Patient Positioning

307

(8)

General Guidelines

307

(3)

The XYZ Method of Isocenter Setup

310

(1)

Simulation Procedure

310

(1)

Treatment Setup

310

(5)

Treatment Planning III: Field Shaping, Skin Dose, and Field Separation

Field Blocks

315

(8)

Block Thickness

316

(1)

Block Divergence

316

(1)

Field Shaping

317

(1)

Custom Blocking

317

(3)

Independent Jaws

320

(1)

Multileaf Collimators

320

(3)

Skin Dose

323

(9)

Electron Contamination of Photon Beams

323

(1)

Measurement of Dose Distribution in the Build-Up Region

323

(1)

Skin Sparing as a Function of Photon Energy

324

(1)

Effect of Absorber-Skin Distance

325

(1)

Effect of Field Size

326

(1)

Electron Filters

327

(2)

Skin Sparing at Oblique Incidence

329

(3)

Separation of Adjacent Fields

332

(14)

Methods of Field Separation

332

(2)

Geometric

334

(5)

Dosimetric

339

(1)

Orthogonal Field Junctions

339

(1)

Craniospinal Fields

339

(1)

Technique A

340

(1)

Technique B

341

(2)

Guidelines for Field Matching

343

(3)

Electron Beam Therapy

Electron Interactions

346

(4)

Rate of Energy Loss

347

(1)

Collisional Losses (Ionization and Excitation)

348

(1)

Radiation Losses (Bremsstrahlung)

348

(1)

Polarization

348

(1)

Stopping Power

348

(1)

Absorbed Dose

349

(1)

Electron Scattering

349

(1)

Energy Specification and Measurement

350

(2)

Most Probable Energy

351

(1)

Mean Energy

352

(1)

Energy at Depth

352

(1)

Determination of Absorbed Dose

352

(9)

Output Calibration

353

(1)

Ion Chamber

353

(1)

Phantom

353

(1)

Reference Depth and Field Size

354

(1)

Chamber Voltage

354

(1)

Effects of Chamber Polarity

354

(1)

Perturbation or Replacement Correction

354

(1)

Displacement Correction

355

(1)

Absorbed Dose Calculation

355

(1)

Depth Dose Distribution

356

(1)

Ionization Chambers

356

(1)

Silicon Diodes

356

(1)

Film

356

(4)

Phantoms

360

(1)

Characteristics of Clinical Electron Beams

361

(14)

Central Axis Depth Dose Curves

361

(4)

Isodose Curves

365

(1)

Field Flatness and Symmetry

366

(1)

Beam Collimation

367

(2)

Field Size Dependence

369

(2)

Electron Source

371

(3)

X-Ray Contamination

374

(1)

Treatment Planning

375

(15)

Choice of Energy and Field Size

375

(1)

Corrections for Air Gaps and Beam Obliquity

375

(7)

Tissue Inhomogeneities

382

(1)

Bone

382

(1)

Lung

382

(1)

Small Inhomogeneities

383

(4)

Use of Bolus and Absorbers

387

(1)

Problems of Adjacent Fields

387

(3)

Field Shaping

390

(9)

External Shielding

390

(1)

Measurement of Transmission Curves

391

(1)

Effect of Blocking on Dose Rate

392

(2)

Internal Shielding

394

(5)

Electron Arc Therapy

399

(5)

Calibration of Arc Therapy Beam

400

(1)

Treatment Planning

401

(1)

Beam Energy

401

(1)

Scanning Field Width

402

(1)

Location of Isocenter

402

(1)

Field Shaping

403

(1)

Isodose Distribution

404

(1)

Total Skin Irradiation

404

(1)

Translational Technique

404

(1)

Large Field Technique

405

(4)

Field Flatness

405

(1)

X-Ray Contamination

405

(2)

Field Arrangement

407

(1)

Dose Distribution

407

(2)

Modified Stanford Technique

409

(9)

Dual Field Angle

409

(2)

Calibration

411

(1)

In Vivo Dosimetry

412

(6)

Brachytherapy

Radioactive Sources

418

(10)

Radium

418

(1)

Decay

418

(1)

Source Construction

419

(1)

Source Specification

419

(1)

Exposure Rate Constant

420

(1)

Radon Hazard

421

(1)

Cesium-137

422

(1)

Cobalt-60

423

(1)

Iridium-192

423

(1)

Gold-198

424

(1)

Iodine-125

424

(1)

Palladium-103

425

(3)

Calibration of Brachytherapy Sources

428

(6)

Specification of Source Strength

428

(1)

Activity

428

(1)

Exposure Rate at a Specified Distance

428

(1)

Equivalent Mass of Radium

428

(1)

Apparent Activity

429

(1)

Air Kerma Strength

429

(1)

Milligram Radium Equivalent

430

(1)

Apparent Activity

430

(1)

Exposure Rate Calibration

431

(1)

Open-Air Measurements

432

(1)

Well-Type Ion Chambers

432

(2)

Calculation of Dose Distributions

434

(11)

Exposure Rate

434

(3)

Effect of Inverse Square Law

437

(1)

Absorbed Dose in Tissue

438

(2)

Modular Dose Calculation Models

440

(2)

Isodose Curves

442

(3)

Systems of Implant Dosimetry

445

(9)

The Paterson-Parker System

445

(1)

Planar Implant

445

(1)

Volume Implants

446

(1)

Paterson-Parker Tables

447

(1)

Determination of Implant Area or Volume

448

(1)

Orthogonal Radiographs

448

(2)

The Quimby System

450

(1)

The Memorial System

450

(1)

The Paris System

451

(1)

Computer System

451

(3)

Computer Dosimetry

454

(3)

Localization of Sources

455

(1)

Orthogonal Imaging Method

455

(1)

Stereo-Shift Method

455

(2)

Dose Computation

457

(1)

Implantation Techniques

457

(3)

Surface Molds

457

(1)

Interstitial Therapy

458

(1)

Intracavitary Therapy

459

(1)

Uterine Cervix

459

(1)

Uterine Corpus

460

(1)

Dose Specification: Cancer of the Cervix

460

(8)

Milligram-Hours

461

(1)

The Manchester System

461

(2)

Dose to Bladder and Rectum

463

(1)

The ICRU System

463

(2)

Absorbed Dose at Reference Points

465

(2)

Commentary

467

(1)

Remote Afterloading Units

468

(6)

Advantages

469

(1)

Disadvantages

470

(1)

HDR Versus LDR

470

(4)

Radiation Protection

Dose Equivalent

474

(1)

Effective Dose Equivalent

475

(1)

Risk Estimates

475

(1)

Background Radiation

476

(1)

Low-Level Radiation Effects

477

(1)

Effective Dose Equivalent Limits

478

(4)

Occupational and Public Dose Limits

479

(1)

Dose Limits for Pregnant Women

479

(2)

Negligible Individual Risk Level

481

(1)

Structural Shielding Design

482

(8)

Primary Radiation Barrier

483

(1)

Secondary Barrier for Scattered Radiation

484

(2)

Secondary Barrier for Leakage Radiation

486

(2)

Door Shielding

488

(1)

Protection against Neutrons

489

(1)

Protection against Radiation from Brachytherapy Sources

490

(2)

Storage

490

(1)

Source Preparation

491

(1)

Source Transportation

491

(1)

Leak Testing

491

(1)

Radiation Protection Surveys

492

(5)

Radiation Monitoring Instruments

492

(1)

Ionization Chamber

492

(1)

Geiger-Muller Counters

493

(1)

Neutron Detectors

494

(1)

Equipment Survey

495

(1)

Area Survey

496

(1)

Personnel Monitoring

497

(1)

NRC Regulations

497

(8)

License

497

(1)

Administrative Requirements

498

(1)

ALARA Program

498

(1)

Radiation Safety Officer

498

(1)

Radiation Safety Committee

498

(1)

Quality Management Program

498

(1)

Technical Requirements

499

(1)

Teletherapy

500

(2)

Training and Experience Requirements

502

(3)

Quality Assurance

Goals

505

(1)

Physics Staffing

505

(5)

Training

507

(1)

Qualifications

508

(1)

Roles and Responsibilities

508

(2)

Equipment

510

(3)

External Beam Units

510

(1)

Brachytherapy Sources

511

(1)

Simulator

512

(1)

Dosimetric Accuracy

513

(1)

Equipment Specifications

514

(1)

Acceptance Testing

515

(19)

Linear Accelerator

515

(1)

Radiation Survey

516

(1)

Jaw Symmetry

516

(1)

Coincidence

516

(1)

Collimator Axis, Light Beam Axis and Cross-Hairs

516

(1)

Light Beam with X-Ray Beam

516

(2)

Mechanical Isocenter

518

(1)

Collimator Rotation

518

(1)

Gantry Rotation

519

(1)

Radiation Isocenter

519

(1)

Collimator

519

(1)

Treatment Table

519

(3)

Gantry

522

(1)

Multiple Beam Alignment Check

522

(1)

X-Ray Beam Performance

523

(1)

Energy

523

(1)

Field Flatness

524

(2)

Field Symmetry

526

(1)

Electron Beam Performance

526

(1)

Energy

526

(1)

Flatness and Symmetry

526

(1)

Monitor Chambers

526

(1)

Wedges

526

(1)

Miscellaneous Checks

526

(1)

Simulator

527

(1)

Brachytherapy

527

(3)

Intracavitary Sources and Applicators

530

(1)

Source Identity

530

(1)

Source Uniformity and Symmetry

530

(1)

Source Calibration

530

(1)

Applicator Evaluation

530

(1)

Interstitial Sources

531

(1)

Remote Afterloaders

531

(1)

Source Positioning

532

(1)

Source Calibration

533

(1)

Commissioning

534

(3)

Linear Accelerator

535

(1)

Central Axis Depth Dose Tables

535

(1)

Isodose Curves

535

(1)

Monitor Unit Calculations

535

(1)

Treatment-Planning Computer System

535

(2)

Periodic Quality Assurance

537

Linear Accelerator

537

(2)

Cobalt-60 Unit

539

(1)

Simulator

540

Appendix

(1)

Index

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The Physics of Radiation Therapy

Summary

Table of Contents

Supplemental Materials