IONS, ELECTRONS, AND IONIZING RADIATIONS
CHAPTER 1 BASIC RADIATION PHYSICS 11 INTRODUCTION 111 FUNDAMENTAL PHYSICAL CONSTANTS (ROUNDED OFF TO FOUR SIGNIFICANT FIGURES) 112 IMPORTANT DERIVED PHYSICAL CONSTANTS AND RELATIONSHIPS 113 PHYSICAL QUANTITIES AND UNITS 114 CLASSIFICATION OF FORCES IN NATURE 115 CLASSIFICATION OF FUNDAMENTAL PARTICLES 116 CLASSIFICATION OF RADIATION 117 CLASSIFICATION OF IONIZING PHOTON RADIATION 118 EINSTEIN’S RELATIVISTIC MASS, ENERGY AND MOMENTUM RELATIONSHIPS 119 RADIATION QUANTITIES AND UNITS 12 ATOMIC AND NUCLEAR STRUCTURE 121 BASIC DEFINITIONS FOR ATOMIC STRUCTURE 122 RUTHERFORD’S MODEL OF THE ATOM 123 BOHR’S MODEL OF THE HYDROGEN ATOM 124 MULTIELECTRON ATOMS 125 NUCLEAR STRUCTURE 126 NUCLEAR REACTIONS 127 RADIOACTIVITY 128 ACTIVATION OF NUCLIDES 129 MODES OF RADIOACTIVE DECAY 13 ELECTRON INTERACTIONS 131 ELECTRON–ORBITAL ELECTRON INTERACTIONS 132 ELECTRON–NUCLEUS INTERACTIONS 133 STOPPING POWER 134 MASS SCATTERING POWER 14 PHOTON INTERACTIONS 141 TYPES OF INDIRECTLY IONIZING PHOTON RADIATION 142 PHOTON BEAM ATTENUATION 143 TYPES OF PHOTON INTERACTION 144 PHOTOELECTRIC EFFECT 145 COHERENT (RAYLEIGH) SCATTERING 146 COMPTON EFFECT (INCOHERENT SCATTERING) 147 PAIR PRODUCTION 148 PHOTONUCLEAR REACTIONS 149 CONTRIBUTIONS TO ATTENUATION COEFFICIENTS 1410 RELATIVE PREDOMINANCE OF INDIVIDUAL EFFECTS 1411 EFFECTS FOLLOWING PHOTON INTERACTIONS 1412 SUMMARY OF PHOTON INTERACTIONS 1413 EXAMPLE OF PHOTON ATTENUATION 1414 PRODUCTION OF VACANCIES IN ATOMIC SHELLS BIBLIOGRAPHY CHAPTER 2 DOSIMETRIC PRINCIPLES, QUANTITIES AND UNITS 21 INTRODUCTION 22 PHOTON FLUENCE AND ENERGY FLUENCE 23 KERMA 24 CEMA 25 ABSORBED DOSE 26 STOPPING POWER 27 RELATIONSHIPS BETWEEN VARIOUS DOSIMETRIC QUANTITIES 271 ENERGY FLUENCE AND KERMA (PHOTONS) 272 FLUENCE AND DOSE (ELECTRONS) 273 KERMA AND DOSE (CHARGED PARTICLE EQUILIBRIUM) 274 COLLISION KERMA AND EXPOSURE 28 CAVITY THEORY 281 BRAGG–GRAY CAVITY THEORY 282 SPENCER–ATTIX CAVITY THEORY 283 CONSIDERATIONS IN THE APPLICATION OF CAVITY THEORY TO IONIZATION CHAMBER CALIBRATION AND DOSIMETRY PROTOCOLS 284 LARGE CAVITIES IN PHOTON BEAMS 285 BURLIN CAVITY THEORY FOR PHOTON BEAMS 286 STOPPING POWER RATIOS CHAPTER 3 RADIATION DOSIMETERS 31 INTRODUCTION 32 PROPERTIES OF DOSIMETERS 321 ACCURACY AND PRECISION 3211 TYPE A STANDARD UNCERTAINTIES 3212 TYPE B STANDARD UNCERTAINTIES 3213 COMBINED AND EXPANDED UNCERTAINTIES 322 LINEARITY 323 DOSE RATE DEPENDENCE 324 ENERGY DEPENDENCE 325 DIRECTIONAL DEPENDENCE 326 SPATIAL RESOLUTION AND PHYSICAL SIZE 327 READOUT CONVENIENCE 328 CONVENIENCE OF USE 33 IONIZATION CHAMBER DOSIMETRY SYSTEMS 331 CHAMBERS AND ELECTROMETERS 332 CYLINDRICAL (THIMBLE TYPE) IONIZATION CHAMBERS 333 PARALLEL-PLATE (PLANE-PARALLEL) IONIZATION CHAMBERS 334 BRACHYTHERAPY CHAMBERS 335 EXTRAPOLATION CHAMBERS 34 FILM DOSIMETRY 341 RADIOGRAPHIC FILM 342 RADIOCHROMIC FILM 35 LUMINESCENCE DOSIMETRY 351 THERMOLUMINESCENCE 352 THERMOLUMINESCENT DOSIMETER SYSTEMS 353 OPTICALLY STIMULATED LUMINESCENCE SYSTEMS 36 SEMICONDUCTOR DOSIMETRY 361 SILICON DIODE DOSIMETRY SYSTEMS 362 MOSFET DOSIMETRY SYSTEMS 37 OTHER DOSIMETRY SYSTEMS 371 ALANINE/ELECTRON PARAMAGNETIC RESONANCE DOSIMETRY SYSTEM 372 PLASTIC SCINTILLATOR DOSIMETRY SYSTEM 373 DIAMOND DOSIMETERS 374 GEL DOSIMETRY SYSTEMS 38 PRIMARY STANDARDS 381 PRIMARY STANDARD FOR AIR KERMA IN AIR 382 PRIMARY STANDARDS FOR ABSORBED DOSE TO WATER 383 IONOMETRIC STANDARD FOR ABSORBED DOSE TO WATER 384 CHEMICAL DOSIMETRY STANDARD FOR ABSORBED DOSE TO WATER 385 CALORIMETRIC STANDARD FOR ABSORBED DOSE TO WATER 39 SUMMARY OF SOME COMMONLY USED DOSIMETRIC SYSTEMS CHAPTER 4 RADIATION MONITORING INSTRUMENTS 41 INTRODUCTION 42 OPERATIONAL QUANTITIES FOR RADIATION MONITORING 43 AREA SURVEY METERS 431 IONIZATION CHAMBERS 432 PROPORTIONAL COUNTERS 433 NEUTRON AREA SURVEY METERS 434 GEIGER–MÜLLER COUNTERS 435 SCINTILLATOR DETECTORS 436 SEMICONDUCTOR DETECTORS 437 COMMONLY AVAILABLE FEATURES OF AREA SURVEY METERS 438 CALIBRATION OF SURVEY METERS 439 PROPERTIES OF SURVEY METERS 4391 SENSITIVITY 4392 ENERGY DEPENDENCE 4393 DIRECTIONAL DEPENDENCE 4394 DOSE EQUIVALENT RANGE 4395 RESPONSE TIME 4396 OVERLOAD CHARACTERISTICS 4397 LONG TERM STABILITY 4398 DISCRIMINATION BETWEEN DIFFERENT TYPES OF RADIATION 4399 UNCERTAINTIES IN AREA SURVEY MEASUREMENTS 44 INDIVIDUAL MONITORING 441 FILM BADGE 442 THERMOLUMINESCENCE DOSIMETRY BADGE 443 RADIOPHOTOLUMINESCENT GLASS DOSIMETRY SYSTEMS 444 OPTICALLY STIMULATED LUMINESCENCE SYSTEMS 445 DIRECT READING PERSONAL MONITORS 446 CALIBRATION OF PERSONAL DOSIMETERS 447 PROPERTIES OF PERSONAL MONITORS 4471 SENSITIVITY 4472 ENERGY DEPENDENCE 4473 UNCERTAINTIES IN PERSONAL MONITORING MEASUREMENTS 4474 EQUIVALENT DOSE RANGE 4475 DIRECTIONAL DEPENDENCE 4476 DISCRIMINATION BETWEEN DIFFERENT TYPES OF RADIATION CHAPTER 5 TREATMENT MACHINES FOR EXTERNAL BEAM RADIOTHERAPY 51 INTRODUCTION 52 X RAY BEAMS AND X RAY UNITS 521 CHARACTERISTIC X RAYS 522 BREMSSTRAHLUNG (CONTINUOUS) X RAYS 523 X RAY TARGETS 524 CLINICAL X RAY BEAMS 525 X RAY BEAM QUALITY SPECIFIERS 526 X RAY MACHINES FOR RADIOTHERAPY 53 GAMMA RAY BEAMS AND GAMMA RAY UNITS 531 BASIC PROPERTIES OF GAMMA RAYS 532 TELETHERAPY MACHINES 533 TELETHERAPY SOURCES 534 TELETHERAPY SOURCE HOUSING 535 DOSE DELIVERY WITH TELETHERAPY MACHINES 536 COLLIMATOR AND PENUMBRA 54 PARTICLE ACCELERATORS 541 BETATRON 542 CYCLOTRON 543 MICROTRON 55 LINACS 551 LINAC GENERATIONS 552 SAFETY OF LINAC INSTALLATIONS 553 COMPONENTS OF MODERN LINACS 554 CONFIGURATION OF MODERN LINACS 555 INJECTION SYSTEM 556 RADIOFREQUENCY POWER GENERATION SYSTEM 557 ACCELERATING WAVEGUIDE 558 MICROWAVE POWER TRANSMISSION 559 AUXILIARY SYSTEM 5510 ELECTRON BEAM TRANSPORT 5511 LINAC TREATMENT HEAD 5512 PRODUCTION OF CLINICAL PHOTON BEAMS IN A LINAC 5513 BEAM COLLIMATION 5514 PRODUCTION OF CLINICAL ELECTRON BEAMS IN A LINAC 5515 DOSE MONITORING SYSTEM 56 RADIOTHERAPY WITH PROTONS, NEUTRONS AND HEAVY IONS 57 SHIELDING CONSIDERATIONS 58 COBALT-60 TELETHERAPY UNITS VERSUS LINACS 59 SIMULATORS AND COMPUTED TOMOGRAPHY SIMULATORS 591 RADIOTHERAPY SIMULATOR 592 COMPUTED TOMOGRAPHY SIMULATOR 510 TRAINING REQUIREMENTS CHAPTER 6 EXTERNAL PHOTON BEAMS: PHYSICAL ASPECTS 61 INTRODUCTION 62 QUANTITIES USED IN DESCRIBING A PHOTON BEAM 621 PHOTON FLUENCE AND PHOTON FLUENCE RATE 622 ENERGY FLUENCE AND ENERGY FLUENCE RATE 623 AIR KERMA IN AIR 624 EXPOSURE IN AIR 625 DOSE TO SMALL MASS OF MEDIUM IN AIR 63 PHOTON BEAM SOURCES 64 INVERSE SQUARE LAW 65 PENETRATION OF PHOTON BEAMS INTO A PHANTOM OR PATIENT 651 SURFACE DOSE 652 BUILDUP REGION 653 DEPTH OF DOSE MAXIMUM ZMAX 654 EXIT DOSE 66 RADIATION TREATMENT PARAMETERS 661 RADIATION BEAM FIELD SIZE 662 COLLIMATOR FACTOR 663 PEAK SCATTER FACTOR 664 RELATIVE DOSE FACTOR 67 CENTRAL AXIS DEPTH DOSES IN WATER: SOURCE TO SURFACE DISTANCE SET-UP 671 PERCENTAGE DEPTH DOSE 672 SCATTER FUNCTION 68 CENTRAL AXIS DEPTH DOSES IN WATER: SOURCE TO AXIS DISTANCE SET-UP 681 TISSUE–AIR RATIO 682 RELATIONSHIP BETWEEN TAR(D, AQ, HN) AND PDD(D, A, F, HN) 683 SCATTER–AIR RATIO 684 RELATIONSHIP BETWEEN SAR(D, AQ, HN) AND S(Z, A, F, HN) 685 TISSUE–PHANTOM RATIO AND TISSUE–MAXIMUM RATIO 686 RELATIONSHIP BETWEEN TMR(Z, AQ, HN) AND PDD(Z, A, F, HN) 687 SCATTER–MAXIMUM RATIO 69 OFF-AXIS RATIOS AND BEAM PROFILES 691 BEAM FLATNESS 692 BEAM SYMMETRY 610 ISODOSE DISTRIBUTIONS IN WATER PHANTOMS 611 SINGLE FIELD ISODOSE DISTRIBUTIONS IN PATIENTS 6111 CORRECTIONS FOR IRREGULAR CONTOURS AND OBLIQUE BEAM INCIDENCE 61111 EFFECTIVE SOURCE TO SURFACE DISTANCE METHOD 61112 TISSUE–AIR RATIO OR TISSUE–MAXIMUM RATIO METHOD 61113 ISODOSE SHIFT METHOD 6112 MISSING TISSUE COMPENSATION 61121 WEDGE FILTERS 61122 BOLUS 61123 COMPENSATORS 6113 CORRECTIONS FOR TISSUE INHOMOGENEITIES 6114 MODEL BASED ALGORITHMS 612 CLARKSON SEGMENTAL INTEGRATION 613 RELATIVE DOSE MEASUREMENTS WITH IONIZATION CHAMBERS 614 DELIVERY OF DOSE WITH A SINGLE EXTERNAL BEAM 615 EXAMPLE OF DOSE CALCULATION 616 SHUTTER CORRECTION TIME CHAPTER 7 CLINICAL TREATMENT PLANNING IN EXTERNAL PHOTON BEAM RADIOTHERAPY 71 INTRODUCTION 72 VOLUME DEFINITION 721 GROSS TUMOUR VOLUME 722 CLINICAL TARGET VOLUME 723 INTERNAL TARGET VOLUME 724 PLANNING TARGET VOLUME 725 ORGAN AT RISK 73 DOSE SPECIFICATION 74 PATIENT DATA ACQUISITION AND SIMULATION 741 NEED FOR PATIENT DATA 742 NATURE OF PATIENT DATA 7421 TWO DIMENSIONAL TREATMENT PLANNING 7422 THREE DIMENSIONAL TREATMENT PLANNING 743 TREATMENT SIMULATION 744 PATIENT TREATMENT POSITION AND IMMOBILIZATION DEVICES 745 PATIENT DATA REQUIREMENTS 746 CONVENTIONAL TREATMENT SIMULATION 7461 SIMULATORS 7462 LOCALIZATION OF THE TARGET VOLUME AND ORGANS AT RISK 7463 DETERMINATION OF THE TREATMENT BEAM GEOMETRY 7464 ACQUISITION OF PATIENT DATA 747 COMPUTED TOMOGRAPHY BASED CONVENTIONAL TREATMENT SIMULATION 7471 COMPUTED TOMOGRAPHY BASED PATIENT DATA ACQUISITION 7472 DETERMINATION OF THE TREATMENT BEAM GEOMETRY 748 COMPUTED TOMOGRAPHY BASED VIRTUAL SIMULATION 7481 COMPUTED TOMOGRAPHY SIMULATOR 7482 VIRTUAL SIMULATION 7483 DIGITALLY RECONSTRUCTED RADIOGRAPHS 7484 BEAM’S EYE VIEW 7485 VIRTUAL SIMULATION PROCEDURE 749 CONVENTIONAL SIMULATOR VERSUS COMPUTED TOMOGRAPHY SIMULATOR 7410 MAGNETIC RESONANCE IMAGING FOR TREATMENT PLANNING 7411 SUMMARY OF SIMULATION PROCEDURES 75 CLINICAL CONSIDERATIONS FOR PHOTON BEAMS 751 ISODOSE CURVES 752 WEDGE FILTERS 753 BOLUS 754 COMPENSATING FILTERS 755 CORRECTIONS FOR CONTOUR IRREGULARITIES 7551 ISODOSE SHIFT METHOD 7552 EFFECTIVE ATTENUATION COEFFICIENT METHOD 7553 TISSUE–AIR RATIO METHOD 756 CORRECTIONS FOR TISSUE INHOMOGENEITIES 7561 TISSUE–AIR RATIO METHOD 7562 BATHO POWER LAW METHOD 7563 EQUIVALENT TISSUE–AIR RATIO METHOD 7564 ISODOSE SHIFT METHOD 757 BEAM COMBINATIONS AND CLINICAL APPLICATION 7571 WEIGHTING AND NORMALIZATION 7572 FIXED SOURCE TO SURFACE DISTANCE VERSUS ISOCENTRIC TECHNIQUES 7573 PARALLEL OPPOSED BEAMS 7574 MULTIPLE COPLANAR BEAMS 7575 ROTATIONAL TECHNIQUES 7576 MULTIPLE NON-COPLANAR BEAMS 7577 FIELD MATCHING 76 TREATMENT PLAN EVALUATION 761 ISODOSE CURVES 762 ORTHOGONAL PLANES AND ISODOSE SURFACES 763 DOSE STATISTICS 764 DOSE–VOLUME HISTOGRAMS 7641 DIRECT DOSE–VOLUME HISTOGRAM 7642 CUMULATIVE DOSE–VOLUME HISTOGRAM 765 TREATMENT EVALUATION 7651 PORT FILMS 7652 ON-LINE PORTAL IMAGING 77 TREATMENT TIME AND MONITOR UNIT CALCULATIONS 771 TREATMENT TIME AND MONITOR UNIT CALCULATIONS FOR A FIXED SOURCE TO SURFACE DISTANCE SET-UP 772 MONITOR UNIT AND TREATMENT TIME CALCULATIONS FOR ISOCENTRIC SET-UPS 773 NORMALIZATION OF DOSE DISTRIBUTIONS 774 INCLUSION OF OUTPUT PARAMETERS IN THE DOSE DISTRIBUTION 775 TREATMENT TIME CALCULATION FOR ORTHOVOLTAGE AND COBALT-60 UNITS CHAPTER 8 ELECTRON BEAMS: PHYSICAL AND CLINICAL ASPECTS 81 CENTRAL AXIS DEPTH DOSE DISTRIBUTIONS IN WATER 811 GENERAL SHAPE OF THE DEPTH DOSE CURVE 812 ELECTRON INTERACTIONS WITH AN ABSORBING MEDIUM 813 INVERSE SQUARE LAW (VIRTUAL SOURCE POSITION) 814 RANGE CONCEPT 815 BUILDUP REGION (DEPTHS BETWEEN THE SURFACE AND Z (IE 0 £ Z £ ZMAX )) 816 DOSE DISTRIBUTION BEYOND ZMAX (Z > ZMAX) MAX 82 DOSIMETRIC PARAMETERS OF ELECTRON BEAMS 821 ELECTRON BEAM ENERGY SPECIFICATION 822 TYPICAL DEPTH DOSE PARAMETERS AS A FUNCTION OF ENERGY 823 PERCENTAGE DEPTH DOSE 8231 PERCENTAGE DEPTH DOSES FOR SMALL ELECTRON FIELD SIZES 8232 PERCENTAGE DEPTH DOSES FOR OBLIQUE BEAM INCIDENCE 824 OUTPUT FACTORS 825 THERAPEUTIC RANGE R90 826 PROFILES AND OFF-AXIS RATIOS 827 FLATNESS AND SYMMETRY 83 CLINICAL CONSIDERATIONS IN ELECTRON BEAM THERAPY 831 DOSE SPECIFICATION AND REPORTING 832 SMALL FIELD SIZES 833 ISODOSE CURVES 834 FIELD SHAPING 8341 ELECTRON APPLICATORS 8342 SHIELDING AND CUT-OUTS 8343 INTERNAL SHIELDING 8344 EXTENDED SOURCE TO SURFACE DISTANCE TREATMENTS 835 IRREGULAR SURFACE CORRECTION 836 BOLUS 837 INHOMOGENEITY CORRECTIONS 8371 COEFFICIENT OF EQUIVALENT THICKNESS 8372 SCATTER PERTURBATION (EDGE) EFFECTS 838 ELECTRON BEAM COMBINATIONS 8381 MATCHED (ABUTTED) ELECTRON FIELDS 8382 MATCHED PHOTON AND ELECTRON FIELDS 839 ELECTRON ARC THERAPY 8310 ELECTRON THERAPY TREATMENT PLANNING CHAPTER 9 CALIBRATION OF PHOTON AND ELECTRON BEAMS 91 INTRODUCTION 911 CALORIMETRY 912 FRICKE DOSIMETRY 913 IONIZATION CHAMBER DOSIMETRY 914 MEAN ENERGY EXPENDED IN AIR PER ION PAIR FORMED 915 REFERENCE DOSIMETRY WITH IONIZATION CHAMBERS 9151 STANDARD FREE AIR IONIZATION CHAMBERS 9152 CAVITY IONIZATION CHAMBERS 9153 PHANTOM EMBEDDED EXTRAPOLATION CHAMBERS 916 CLINICAL BEAM CALIBRATION AND MEASUREMENT CHAIN 917 DOSIMETRY PROTOCOLS 92 IONIZATION CHAMBER BASED DOSIMETRY SYSTEMS 921 IONIZATION CHAMBERS 922 ELECTROMETER AND POWER SUPPLY 923 PHANTOMS 93 CHAMBER SIGNAL CORRECTION FOR INFLUENCE QUANTITIES 931 AIR TEMPERATURE, PRESSURE AND HUMIDITY EFFECTS: KT,P 932 CHAMBER POLARITY EFFECTS: POLARITY CORRECTION FACTOR KPOL 933 CHAMBER VOLTAGE EFFECTS: RECOMBINATION CORRECTION FACTOR KSAT 934 CHAMBER LEAKAGE CURRENTS 935 CHAMBER STEM EFFECTS 94 DETERMINATION OF ABSORBED DOSE USING CALIBRATED IONIZATION CHAMBERS 941 AIR KERMA BASED PROTOCOLS 942 ABSORBED DOSE TO WATER BASED PROTOCOLS 95 STOPPING POWER RATIOS 951 STOPPING POWER RATIOS FOR ELECTRON BEAMS 952 STOPPING POWER RATIOS FOR PHOTON BEAMS 96 MASS–ENERGY ABSORPTION COEFFICIENT RATIOS 97 PERTURBATION CORRECTION FACTORS 971 DISPLACEMENT PERTURBATION FACTOR PDIS AND EFFECTIVE POINT OF MEASUREMENT 972 CHAMBER WALL PERTURBATION FACTOR PWALL 973 CENTRAL ELECTRODE PERTURBATION PCEL 974 CAVITY OR FLUENCE PERTURBATION CORRECTION PCAV 98 BEAM QUALITY SPECIFICATION 981 BEAM QUALITY SPECIFICATION FOR KILOVOLTAGE PHOTON BEAMS 982 BEAM QUALITY SPECIFICATION FOR MEGAVOLTAGE PHOTON BEAMS 983 BEAM QUALITY SPECIFICATION FOR MEGAVOLTAGE ELECTRON BEAMS 99 CALIBRATION OF MEGAVOLTAGE PHOTON AND ELECTRON BEAMS: PRACTICAL ASPECTS 991 CALIBRATION OF MEGAVOLTAGE PHOTON BEAMS BASED ON THE AIR KERMA IN AIR CALIBRATION COEFFICIENT NK,CO 992 CALIBRATION OF MEGAVOLTAGE PHOTON BEAMS BASED ON THE DOSE TO WATER CALIBRATION COEFFICIENT ND,W,CO 993 CALIBRATION OF MEGAVOLTAGE ELECTRON BEAMS BASED ON THE AIR KERMA IN AIR CALIBRATION COEFFICIENT NK,CO 994 CALIBRATION OF HIGH ENERGY ELECTRON BEAMS BASED ON THE DOSE TO WATER CALIBRATION COEFFICIENT ND,W,CO 910 KILOVOLTAGE DOSIMETRY 9101 SPECIFIC FEATURES OF KILOVOLTAGE BEAMS 9102 AIR KERMA BASED IN-PHANTOM CALIBRATION METHOD (MEDIUM ENERGIES) 9103 AIR KERMA BASED BACKSCATTER METHOD (LOW AND MEDIUM PHOTON ENERGIES) 9104 AIR KERMA IN AIR BASED CALIBRATION METHOD FOR VERY LOW ENERGIES 9105 ABSORBED DOSE TO WATER BASED CALIBRATION METHOD 911 ERROR AND UNCERTAINTY ANALYSIS FOR IONIZATION CHAMBER MEASUREMENTS 9111 ERRORS AND UNCERTAINTIES 9112 CLASSIFICATION OF UNCERTAINTIES 9113 UNCERTAINTIES IN THE CALIBRATION CHAIN CHAPTER 10 ACCEPTANCE TESTS AND COMMISSIONING MEASUREMENTS 101 INTRODUCTION 102 MEASUREMENT EQUIPMENT 1021 RADIATION SURVEY EQUIPMENT 1022 IONOMETRIC DOSIMETRY EQUIPMENT 1023 FILM 1024 DIODES 1025 PHANTOMS 10251 RADIATION FIELD ANALYSER AND WATER PHANTOM 10252 PLASTIC PHANTOMS 103 ACCEPTANCE TESTS 1031 SAFETY CHECKS 10311 INTERLOCKS, WARNING LIGHTS AND PATIENT MONITORING EQUIPMENT 10312 RADIATION SURVEY 10313 COLLIMATOR AND HEAD LEAKAGE 1032 MECHANICAL CHECKS 10321 COLLIMATOR AXIS OF ROTATION 10322 PHOTON COLLIMATOR JAW MOTION 10323 CONGRUENCE OF LIGHT AND RADIATION FIELD 10324 GANTRY AXIS OF ROTATION 10325 PATIENT TREATMENT TABLE AXIS OF ROTATION 10326 RADIATION ISOCENTRE 10327 OPTICAL DISTANCE INDICATOR 10328 GANTRY ANGLE INDICATORS 10329 COLLIMATOR FIELD SIZE INDICATORS 103210 PATIENT TREATMENT TABLE MOTIONS 1033 DOSIMETRY MEASUREMENTS 10331 PHOTON ENERGY 10332 PHOTON BEAM UNIFORMITY 10333 PHOTON PENUMBRA 10334 ELECTRON ENERGY 10335 ELECTRON BEAM BREMSSTRAHLUNG CONTAMINATION 10336 ELECTRON BEAM UNIFORMITY 10337 ELECTRON PENUMBRA 10338 MONITOR CHARACTERISTICS 10339 ARC THERAPY 104 COMMISSIONING 1041 PHOTON BEAM MEASUREMENTS 10411 CENTRAL AXIS PERCENTAGE DEPTH DOSES 10412 OUTPUT FACTORS 10413 BLOCKING TRAY FACTORS 10414 MULTILEAF COLLIMATORS 10415 CENTRAL AXIS WEDGE TRANSMISSION FACTORS 10416 DYNAMIC WEDGE 10417 TRANSVERSE BEAM PROFILES/OFF-AXIS ENERGY CHANGES 10418 ENTRANCE DOSE AND INTERFACE DOSIMETRY 10419 VIRTUAL SOURCE POSITION 1042 ELECTRON BEAM MEASUREMENTS 10421 CENTRAL AXIS PERCENTAGE DEPTH DOSE 10422 OUTPUT FACTORS 10423 TRANSVERSE BEAM PROFILES 10424 VIRTUAL SOURCE POSITION 105 TIME REQUIRED FOR COMMISSIONING CHAPTER 11 COMPUTERIZED TREATMENT PLANNING SYSTEMS FOR EXTERNAL PHOTON BEAM RADIOTHERAPY 111 INTRODUCTION 112 SYSTEM HARDWARE 1121 TREATMENT PLANNING SYSTEM HARDWARE 1122 TREATMENT PLANNING SYSTEM CONFIGURATIONS 113 SYSTEM SOFTWARE AND CALCULATION ALGORITHMS 1131 CALCULATION ALGORITHMS 1132 BEAM MODIFIERS 11321 PHOTON BEAM MODIFIERS 11322 ELECTRON BEAM MODIFIERS 1133 HETEROGENEITY CORRECTIONS 1134 IMAGE DISPLAY AND DOSE–VOLUME HISTOGRAMS 1135 OPTIMIZATION AND MONITOR UNIT CALCULATIONS 1136 RECORD AND VERIFY SYSTEMS 1137 BIOLOGICAL MODELLING 114 DATA ACQUISITION AND ENTRY 1141 MACHINE DATA 1142 BEAM DATA ACQUISITION AND ENTRY 1143 PATIENT DATA 115 COMMISSIONING AND QUALITY ASSURANCE 1151 ERRORS 1152 VERIFICATION 1153 SPOT CHECKS 1154 NORMALIZATION AND BEAM WEIGHTING 1155 DOSE–VOLUME HISTOGRAMS AND OPTIMIZATION 1156 TRAINING AND DOCUMENTATION 1157 SCHEDULED QUALITY ASSURANCE 116 SPECIAL CONSIDERATIONS CHAPTER 12 QUALITY ASSURANCE OF EXTERNAL BEAM RADIOTHERAPY 121 INTRODUCTION 1211 DEFINITIONS 12111 QUALITY ASSURANCE 12112 QUALITY ASSURANCE IN RADIOTHERAPY 12113 QUALITY CONTROL 12114 QUALITY STANDARDS 1212 NEED FOR QUALITY ASSURANCE IN RADIOTHERAPY 1213 REQUIREMENTS ON ACCURACY IN RADIOTHERAPY 1214 ACCIDENTS IN RADIOTHERAPY 122 MANAGING A QUALITY ASSURANCE PROGRAMME 1221 MULTIDISCIPLINARY RADIOTHERAPY TEAM 1222 QUALITY SYSTEM/COMPREHENSIVE QUALITY ASSURANCE PROGRAMME 123 QUALITY ASSURANCE PROGRAMME FOR EQUIPMENT 1231 STRUCTURE OF AN EQUIPMENT QUALITY ASSURANCE PROGRAMME 12311 EQUIPMENT SPECIFICATION 12312 ACCEPTANCE 12313 COMMISSIONING 12314 QUALITY CONTROL 1232 UNCERTAINTIES, TOLERANCES AND ACTION LEVELS TELETHERAPY MACHINES 1234 QUALITY ASSURANCE PROGRAMME FOR LINACS 1235 QUALITY ASSURANCE PROGRAMME FOR TREATMENT SIMULATORS 1236 QUALITY ASSURANCE PROGRAMME FOR COMPUTED TOMOGRAPHY SCANNERS AND COMPUTED TOMOGRAPHY SIMULATION 1237 QUALITY ASSURANCE PROGRAMME FOR TREATMENT PLANNING SYSTEMS 1238 QUALITY ASSURANCE PROGRAMME FOR TEST EQUIPMENT 124 TREATMENT DELIVERY 1241 PATIENT CHARTS 1242 PORTAL IMAGING 12421 PORTAL IMAGING TECHNIQUES 12422 FUTURE DEVELOPMENTS IN PORTAL IMAGING 1243 IN VIVO DOSE MEASUREMENTS 12431 IN VIVO DOSE MEASUREMENT TECHNIQUES 12432 USE OF ELECTRONIC PORTAL IMAGING SYSTEMS FOR IN VIVO DOSIMETRY 1244 RECORD AND VERIFY SYSTEMS 125 QUALITY AUDIT 1251 DEFINITION 1252 PRACTICAL QUALITY AUDIT MODALITIES 12521 POSTAL AUDIT WITH MAILED DOSIMETERS 12522 QUALITY AUDIT VISITS 1253 WHAT SHOULD BE REVIEWED IN A QUALITY AUDIT VISIT? CHAPTER 13 BRACHYTHERAPY: PHYSICAL AND CLINICAL ASPECTS 131 INTRODUCTION 132 PHOTON SOURCE CHARACTERISTICS 1321 PRACTICAL CONSIDERATIONS 1322 PHYSICAL CHARACTERISTICS OF SOME PHOTON EMITTING BRACHYTHERAPY SOURCES 1323 MECHANICAL SOURCE CHARACTERISTICS 1324 SOURCE SPECIFICATION 13241 SPECIFICATION OF G RAY SOURCES 13242 SPECIFICATION OF B RAY SOURCES 133 CLINICAL USE AND DOSIMETRY SYSTEMS 1331 GYNAECOLOGY 13311 TYPES OF SOURCE 13312 DOSE SPECIFICATION 13313 SOURCE ARRANGEMENT 13314 APPLICATORS 13315 RECTAL AND BLADDER DOSE MONITORING 1332 INTERSTITIAL BRACHYTHERAPY 13321 PATTERSON–PARKER SYSTEM 13322 QUIMBY SYSTEM 13323 PARIS SYSTEM 1333 REMOTE AFTERLOADING SYSTEMS 1334 PERMANENT PROSTATE IMPLANTS 13341 CHOICE OF RADIONUCLIDE FOR PROSTATE IMPLANTS 13342 PLANNING TECHNIQUE: ULTRASOUND OR COMPUTED TOMOGRAPHY 13343 PREPLANNING, SEED PLACEMENT AND DOSE DISTRIBUTIONS 13344 POST-IMPLANT DOSE DISTRIBUTIONS AND EVALUATION 1335 EYE PLAQUES 1336 INTRAVASCULAR BRACHYTHERAPY 134 DOSE SPECIFICATION AND REPORTING 1341 INTRACAVITARY TREATMENTS 1342 INTERSTITIAL TREATMENTS 135 DOSE DISTRIBUTIONS AROUND SOURCES 1351 AAPM TG 43 ALGORITHM 1352 OTHER CALCULATION METHODS FOR POINT SOURCES 1353 LINEAR SOURCES 13531 UNFILTERED LINE SOURCE IN AIR 13532 FILTERED LINE SOURCE IN AIR 13533 FILTERED LINE SOURCE IN WATER 136 DOSE CALCULATION PROCEDURES 1361 MANUAL DOSE CALCULATIONS 13611 MANUAL SUMMATION OF DOSES 13612 PRECALCULATED DOSE DISTRIBUTIONS (ATLASES) 1362 COMPUTERIZED TREATMENT PLANNING 13621 SOURCE LOCALIZATION 13622 DOSE CALCULATION 13623 DOSE DISTRIBUTION DISPLAY 13624 OPTIMIZATION OF DOSE DISTRIBUTION 1363 CALCULATION OF TREATMENT TIME 13631 USE OF PATTERSON–PARKER TABLES 13632 CHOICE OF REFERENCE POINTS 13633 DECAY CORRECTIONS 137 COMMISSIONING OF BRACHYTHERAPY COMPUTER TREATMENT PLANNING SYSTEMS 1371 CHECK OF THE RECONSTRUCTION PROCEDURE 1372 CHECK OF CONSISTENCY BETWEEN QUANTITIES AND UNITS 1373 COMPUTER VERSUS MANUAL DOSE CALCULATION FOR A SINGLE SOURCE 1374 CHECK OF DECAY CORRECTIONS 138 SOURCE COMMISSIONING 1381 WIPE TESTS 1382 AUTORADIOGRAPHY AND UNIFORMITY CHECKS OF ACTIVITY 1383 CALIBRATION CHAIN 139 QUALITY ASSURANCE 1391 CONSTANCY CHECK OF A CALIBRATED DOSIMETER 1392 REGULAR CHECKS OF SOURCES AND APPLICATORS 13921 MECHANICAL PROPERTIES 13922 SOURCE STRENGTH 13923 WIPE TESTS 1393 CHECKS OF SOURCE POSITIONING WITH AFTERLOADING DEVICES 1394 RADIATION MONITORING AROUND PATIENTS 1395 QUALITY MANAGEMENT PROGRAMME 1310 BRACHYTHERAPY VERSUS EXTERNAL BEAM RADIOTHERAPY CHAPTER 14 BASIC RADIOBIOLOGY 141 INTRODUCTION 142 CLASSIFICATION OF RADIATIONS IN RADIOBIOLOGY 143 CELL CYCLE AND CELL DEATH 144 IRRADIATION OF CELLS 1441 DIRECT ACTION IN CELL DAMAGE BY RADIATION 1442 INDIRECT ACTION IN CELL DAMAGE BY RADIATION 1443 FATE OF IRRADIATED CELLS 145 TYPE OF RADIATION DAMAGE 1451 TIMESCALE 1452 CLASSIFICATION OF RADIATION DAMAGE 1453 SOMATIC AND GENETIC EFFECTS 1454 STOCHASTIC AND DETERMINISTIC (NON-STOCHASTIC) EFFECTS 1455 ACUTE VERSUS LATE TISSUE OR ORGAN EFFECTS 1456 TOTAL BODY RADIATION RESPONSE 1457 FOETAL IRRADIATION 146 CELL SURVIVAL CURVES 147 DOSE RESPONSE CURVES 148 MEASUREMENT OF RADIATION DAMAGE IN TISSUE 149 NORMAL AND TUMOUR CELLS: THERAPEUTIC RATIO 1410 OXYGEN EFFECT 1411 RELATIVE BIOLOGICAL EFFECTIVENESS 1412 DOSE RATE AND FRACTIONATION 1413 RADIOPROTECTORS AND RADIOSENSITIZERS CHAPTER 15 SPECIAL PROCEDURES AND TECHNIQUES IN RADIOTHERAPY 151 INTRODUCTION 152 STEREOTACTIC IRRADIATION 1521 PHYSICAL AND CLINICAL REQUIREMENTS FOR RADIOSURGERY 1522 DISEASES TREATED WITH STEREOTACTIC IRRADIATION 1523 EQUIPMENT USED FOR STEREOTACTIC RADIOSURGERY 1524 HISTORICAL DEVELOPMENT 1525 RADIOSURGICAL TECHNIQUES 15251 GAMMA KNIFE 15252 LINAC BASED RADIOSURGERY 15253 MINIATURE LINAC ON ROBOTIC ARM 1526 UNCERTAINTY IN RADIOSURGICAL DOSE DELIVERY 1527 DOSE PRESCRIPTION AND DOSE FRACTIONATION 1528 COMMISSIONING OF RADIOSURGICAL EQUIPMENT 1529 QUALITY ASSURANCE IN RADIOSURGERY 15210 GAMMA KNIFE VERSUS LINAC BASED RADIOSURGERY 15211 FRAMELESS STEREOTAXY 153 TOTAL BODY IRRADIATION 1531 CLINICAL TOTAL BODY IRRADIATION CATEGORIES 1532 DISEASES TREATED WITH TOTAL BODY IRRADIATION 1533 TECHNICAL ASPECTS OF TOTAL BODY IRRADIATION 1534 TOTAL BODY IRRADIATION TECHNIQUES 1535 DOSE PRESCRIPTION POINT 1536 COMMISSIONING OF TOTAL BODY IRRADIATION PROCEDURE 1537 TEST OF TOTAL BODY IRRADIATION DOSIMETRY PROTOCOL 1538 QUALITY ASSURANCE IN TOTAL BODY IRRADIATION 154 TOTAL SKIN ELECTRON IRRADIATION 1541 PHYSICAL AND CLINICAL REQUIREMENTS FOR TOTAL SKIN ELECTRON IRRADIATION 1542 CURRENT TOTAL SKIN ELECTRON IRRADIATION TECHNIQUES 1543 SELECTION OF TOTAL SKIN ELECTRON IRRADIATION TECHNIQUE 1544 DOSE CALIBRATION POINT 1545 SKIN DOSE RATE AT THE DOSE PRESCRIPTION POINT 1546 COMMISSIONING OF THE TOTAL SKIN ELECTRON IRRADIATION PROCEDURE 1547 MEASUREMENT OF CLINICAL TOTAL SKIN ELECTRON IRRADIATION DOSE DISTRIBUTIONS 1548 QUALITY ASSURANCE IN TOTAL SKIN ELECTRON IRRADIATION 155 INTRAOPERATIVE RADIOTHERAPY 1551 PHYSICAL AND CLINICAL REQUIREMENTS FOR INTRAOPERATIVE RADIOTHERAPY 1552 INTRAOPERATIVE RADIOTHERAPY RADIATION MODALITIES AND TECHNIQUES 1553 COMMISSIONING OF AN INTRAOPERATIVE RADIOTHERAPY PROGRAMME 1554 QUALITY ASSURANCE IN INTRAOPERATIVE RADIOTHERAPY 156 ENDOCAVITARY RECTAL IRRADIATION 1561 PHYSICAL AND CLINICAL REQUIREMENTS FOR ENDORECTAL IRRADIATION 1562 ENDORECTAL TREATMENT TECHNIQUE 1563 QUALITY ASSURANCE IN ENDORECTAL TREATMENTS 157 CONFORMAL RADIOTHERAPY 1571 BASIC ASPECTS OF CONFORMAL RADIOTHERAPY 1572 MULTILEAF COLLIMATORS 1573 ACCEPTANCE TESTING OF MULTILEAF COLLIMATORS 1574 COMMISSIONING OF MULTILEAF COLLIMATORS 1575 QUALITY ASSURANCE PROGRAMME FOR MULTILEAF COLLIMATORS 1576 INTENSITY MODULATED RADIOTHERAPY 1577 COMMISSIONING OF INTENSITY MODULATED RADIOTHERAPY SYSTEMS 1578 QUALITY ASSURANCE FOR INTENSITY MODULATED RADIOTHERAPY SYSTEMS 1579 DOSE VERIFICATION FOR INTENSITY MODULATED RADIOTHERAPY TREATMENT PLANS 158 IMAGE GUIDED RADIOTHERAPY 1581 CONE BEAM COMPUTED TOMOGRAPHY 1582 COMPUTED TOMOGRAPHY PRIMATOM 1583 TOMOTHERAPY 1584 BAT SYSTEM 1585 EXACTRAC ULTRASONIC MODULE 1586 CYBERKNIFE 159 ADAPTIVE RADIOTHERAPY 1510 RESPIRATORY GATED RADIOTHERAPY 1511 POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY SCANNERS AND POSITRON EMISSION TOMOGRAPHY/COMPUTED TOMOGRAPHY IMAGE FUSION CHAPTER 16 RADIATION PROTECTION AND SAFETY IN RADIOTHERAPY 161 INTRODUCTION 162 RADIATION EFFECTS 1621 DETERMINISTIC EFFECTS 1622 STOCHASTIC EFFECTS 1623 EFFECTS ON THE EMBRYO AND FOETUS 163 INTERNATIONAL CONSENSUS AND RADIATION SAFETY STANDARDS 164 TYPES OF RADIATION EXPOSURE 165 QUANTITIES AND UNITS USED IN RADIATION PROTECTION 1651 PHYSICAL QUANTITIES 1652 RADIATION PROTECTION QUANTITIES 16521 ORGAN DOSE 16522 EQUIVALENT DOSE 16523 EFFECTIVE DOSE 16524 COMMITTED DOSE 16525 COLLECTIVE DOSE 1653 OPERATIONAL QUANTITIES 16531 AMBIENT DOSE EQUIVALENT 16532 DIRECTIONAL DOSE EQUIVALENT 16533 PERSONAL DOSE EQUIVALENT 166 BASIC FRAMEWORK OF RADIATION PROTECTION 167 GOVERNMENTAL REGULATION AND NATIONAL INFRASTRUCTURE 168 SCOPE OF THE BASIC SAFETY STANDARDS 169 RESPONSIBILITIES FOR IMPLEMENTATION OF BASIC SAFETY STANDARDS REQUIREMENTS 1610 SAFETY IN THE DESIGN OF RADIATION SOURCES AND EQUIPMENT 16101 EQUIPMENT 16102 SEALED SOURCES 16103 SAFETY IN THE DESIGN OF FACILITIES AND ANCILLARY EQUIPMENT 161031 MANUAL BRACHYTHERAPY 161032 REMOTE CONTROL BRACHYTHERAPY AND EXTERNAL BEAM RADIOTHERAPY 1611 SAFETY ASSOCIATED WITH ACCEPTANCE TESTS, COMMISSIONING AND OPERATION 16111 SAFE OPERATION OF EXTERNAL BEAM RADIOTHERAPY 16112 SAFE OPERATION OF BRACHYTHERAPY 161121 SAFE OPERATION OF MANUAL BRACHYTHERAPY 161122 SAFE OPERATION OF REMOTE CONTROL AFTERLOADING BRACHYTHERAPY 1612 SECURITY OF SOURCES 1613 OCCUPATIONAL EXPOSURE 16131 RESPONSIBILITIES AND CONDITIONS OF SERVICE 16132 USE OF DOSE CONSTRAINTS IN RADIOTHERAPY 16133 INVESTIGATION LEVELS FOR STAFF EXPOSURE IN RADIOTHERAPY 16134 PREGNANT WORKERS 16135 CLASSIFICATION OF AREAS 16136 LOCAL RULES AND SUPERVISION 16137 PROTECTIVE EQUIPMENT AND TOOLS 16138 INDIVIDUAL MONITORING AND EXPOSURE ASSESSMENT 16139 MONITORING OF THE WORKPLACE 161310 HEALTH SURVEILLANCE 161311 RECORDS 1614 MEDICAL EXPOSURE 16141 RESPONSIBILITIES FOR MEDICAL EXPOSURE 16142 JUSTIFICATION OF MEDICAL EXPOSURE 16143 OPTIMIZATION OF EXPOSURE AND PROTECTION 16144 CALIBRATION OF RADIOTHERAPY SOURCES AND MACHINES 16145 CLINICAL DOSIMETRY 16146 QUALITY ASSURANCE FOR MEDICAL EXPOSURE 16147 CONSTRAINTS FOR COMFORTERS AND VISITORS 16148 DISCHARGE OF PATIENTS 16149 INVESTIGATION OF ACCIDENTAL MEDICAL EXPOSURE 1615 PUBLIC EXPOSURE 16151 RESPONSIBILITIES 16152 ACCESS CONTROL FOR VISITORS 16153 RADIOACTIVE WASTE AND SOURCES NO LONGER IN USE 16154 MONITORING OF PUBLIC EXPOSURE 1616 POTENTIAL EXPOSURE AND EMERGENCY PLANS 16161 POTENTIAL EXPOSURE AND SAFETY ASSESSMENT 16162 MITIGATION OF CONSEQUENCES: EMERGENCY PLANS 161621 LOST SOURCE 161622 STUCK SOURCE 161623 CONTAMINATION 161624 OFF-SITE ACCIDENTS 161625 PATIENT ACCIDENTAL EXPOSURE 1617 GENERAL SHIELDING CALCULATIONS 16171 STEP ONE: DESIGN DOSE IN OCCUPIED AREAS (ANNUAL DOSE AND WEEKLY DOSE) 16172 STEP TWO: CALCULATION OF THE RADIATION FIELD (AIR KERMA IN AIR) IN THE OCCUPIED AREA WITHOUT SHIELDING 16173 STEP THREE: ATTENUATION BY SHIELDING BARRIERS 1618 TYPICAL LINAC INSTALLATION 16181 WORKLOAD 16182 CALCULATION OF THE PRIMARY BARRIER TRANSMISSION FACTOR 16183 CALCULATION OF THE SCATTER BARRIER TRANSMISSION FACTOR 16184 CALCULATION OF THE LEAKAGE BARRIER TRANSMISSION FACTOR 16185 DETERMINATION OF BARRIER THICKNESS 16186 CONSIDERATION OF NEUTRON PRODUCTION IN A HIGH ENERGY LINAC 16187 DOOR OF A LINAC ROOM 16188 OTHER CONSIDERATIONS 1619 SHIELDING DESIGN FOR BRACHYTHERAPY FACILITIES