Johns and Cunningham's The Physics of Radiology

Name: Johns and Cunningham's The Physics of Radiology
Brand: Charles C Thomas Publisher, Ltd.
Price: 483.99 EUR
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Eva Bezak Alun H. Beddoe Marcu G. Loredana Martin Ebert Roger Price(Author)

Charles C Thomas Publisher, Ltd.

1st Edition

Published on 1. March 2021

1384 pages

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Content

Intro
THE PHYSICS OF RADIOLOGY
PREFACE
ACKNOWLEDGMENTS
CONTENTS
Chapter 1 BASIC CONCEPTS
Chapter 2 THE FUNDAMENTALS OF NUCLEAR PHYSICS
Chapter 3 INTERACTION OF IONISING RADIATION WITH MATTER
Chapter 4 THE PRODUCTION AND PROPERTIES OF KILOVOLTAGE X-RAY BEAMS
Chapter 5 HIGH-ENERGY MACHINES
Chapter 6 RADIOISOTOPES FOR MEDICAL IMAGING & RADIOTHERAPY
Chapter 7 RADIATION DOSIMETRY: THE MEASUREMENT OF IONIZING RADIATION
Chapter 8 MEASUREMENT OF RADIATION: INSTRUMENTATION
Chapter 9 BASIC RADIOBIOLOGY
Chapter 10 CLINICAL RADIOBIOLOGY
Chapter 11 DIAGNOSTIC RADIOLOGY
Chapter 12 DIAGNOSTIC NUCLEAR MEDICINE
Chapter 13 CHARACTERISTICS OF RADIOTHERAPY PHOTON BEAMS
Chapter 14 THE INTERACTION OF PHOTON BEAMS WITH A SCATTERING MEDIUM
Chapter 15 EXTERNAL PHOTON BEAM DOSE CALCULATION
Chapter 16 PHOTON BEAM TREATMENT: DOSE PRESCRIPTION AND REPORTING
Chapter 17 PHOTON BEAM TREATMENT: PLANNING AND DELIVERY
Chapter 18 EXTERNAL ELECTRON BEAMS
Chapter 19 RADIOTHERAPY WITH NEUTRONS, PROTONS AND HEAVY IONS
Chapter 20 BRACHYTHERAPY
Chapter 21 MOLECULAR RADIOTHERAPY
Chapter 22 RADIATION PROTECTION
THE PHYSICS OF RADIOLOGY
Chapter 1 BASIC CONCEPTS
1.1 INTRODUCTION
1.2 QUANTITIES AND UNITS
1.2.1 Mechanical Quantities and Units
1.2.2 Electrical Quantities and Units
1.2.3 Radiation Quantities and Units
1.2.4 Prefixes
1.3 ATOMS, NUCLEI AND ELEMENTARY PARTICLES
1.4 ELECTRONIC STRUCTURE
1.5 ATOMIC AND NUCLEAR ENERGY LEVELS
1.5.1 Atomic Energy Levels
1.5.2 Nuclear Energy Levels
1.6 ELECTROMAGNETIC RADIATION AND THE ELECTROMAGNETIC SPECTRUM
1.6.1 The Quantum Nature of Radiation
1.6.2 The EM Spectrum
1.7 RADIATION OF ENERGY FROM ATOMIC ELECTRONS
1.8 MASS, ENERGY AND VELOCITY - SPECIAL RELATIVITY
1.8.1 Mass and Energy
1.8.2 Mass and Velocity
1.9 THE EXPONENTIAL FUNCTION AND ITS IMPORTANCE IN RADIATION PHYSICS
1.9.1 Growth of Cells in a Cell Colony
1.9.2 Exponential Killing of Cells
1.9.3 Decay of Radioactive Isotopes
1.9.4 Exponential Attenuation
1.9.5 Summary of Exponential Behaviour
PROBLEMS
REFERENCE
Chapter 2 THE FUNDAMENTALS OF NUCLEAR PHYSICS
2.1 NATURAL RADIOACTIVITY
2.2 ARTIFICIAL RADIOACTIVITY
2.3 ACTIVITY
2.3.1 Exponential Decay of Some Commonly Used Isotopes
2.4 CHARTS OF ISOTOPES
2.5 ALPHA DECAY
2.6 BETA DECAY
2.7 BETA MINUS (b-) DECAY
2.8 BETA PLUS (b+) DECAY
2.9 ELECTRON CAPTURE
2.10 GAMMA DECAY
2.11 INTERNAL CONVERSION
2.12 AUGER ELECTRONS
2.13 ISOMERIC TRANSITIONS
2.14 ENERGY ABSORPTION FROM RADIOACTIVE ISOTOPES
2.15 DECAY SERIES
2.16 GROWTH OF RADIOACTIVE DAUGHTER
2.17 NUCLEAR FISSION
2.18 NUCLEAR FUSION
2.19 NUCLEAR REACTIONS
2.20 INTERACTION CROSS-SECTIONS
2.21 ACTIVATION
2.22 ACTIVITY PRODUCED BY NEUTRON IRRADIATION
SUMMARY
PROBLEMS
REFERENCES
Chapter 3 INTERACTION OF IONIZING RADIATION WITH MATTER
3.1 ABSORPTION OF ENERGY
3.2 ATTENUATION, LINEAR ATTENUATION COEFFICIENT AND HALF-VALUE LAYER
3.2.1 Half-Value Layer
3.2.2 Narrow and Broad Beams
3.3 MASS, ELECTRONIC AND ATOMIC ATTENUATION COEFFICIENTS
3.4 ENERGY TRANSFER AND ABSORPTION
3.4.1 Energy Transfer Coefficient
3.4.2 Energy Absorption Coefficient
3.5 PHOTON INTERACTION PROCESSES
3.5.1 Coherent (Classical) Scattering
3.5.2 Photoelectric Absorption
Variation of the Photoelectric Process with Photon Energy
Variation of the Photoelectric Process with Atomic Number
Photoelectric Transfer and Absorption Coefficients in Low Z Materials
Photoelectric Transfer Effect in Higher Z Materials
Summary of Photoelectric Interaction Process
3.5.3 Compton Interaction Process
Compton Cross Sections
Mean Energy Transferred in the Compton Process
Compton Energy Transfer Coefficient
Compton Coefficients Including the Effects of Binding Energy
Summary of the Compton Process
3.5.4 Pair Production Process
Fate of the Positron
Triplet Production
Variation of Pair Production with Energy and Atomic Number
Energy Transfer and Energy Transfer Coefficients for Pair Production
Summary for Pair (and Triplet) Production
3.5.5 Total Attenuation, Energy Transfer and Absorption Coefficients
Total Attenuation Coefficient
Total Coefficient for Compounds or Mixtures
Total Energy Transfer and Absorption Coefficients
3.5.6 The Relative Importance of the Four Interaction Processes
Absorption of Photon Radiation by Biological Tissues
3.5.7 Conclusion
3.6 COHERENT (THOMSON AND RAYLEIGH) SCATTERING
3.6.1 Thomson Scattering
3.6.2 Rayleigh Scattering
3.7 COMPTON SCATTERING
3.7.1 Prediction of Energy-Angle Relationships in Compton Interactions
3.7.2 Probability of Compton Collision (Klein-Nishina Coefficients)
Total Coefficient for Compton Process
Scatter Coefficient for Compton Process
3.7.3 Kinetic Energy Transfer via Compton Process
Mean Energy of Compton Recoil Electrons
Energy Distribution of Compton Electrons
3.7.4 Effects of Binding Energy on Compton Scattering
3.8 PAIR AND TRIPLET PRODUCTION
3.8.1 Energy Distribution of Electrons and PositronsProduced in Pair Production Process
3.8.2 Energy Transfer in Pair Production
3.9 INTERACTIONS OF HEAVY CHARGED PARTICLES WITH MATTER
3.9.1 Ionization Stopping Power
3.9.2 Bragg Curves for Heavy Particles
3.10 INTERACTION OF ELECTRONS WITH MATTER
3.10.1 Ionization Stopping Power
3.10.2 Radiative Stopping Power
3.10.3 Range of Electrons and Bremsstrahlung Yield
Range of Electrons
Bremsstrahlung Yield
3.10.4 Electron Scattering
Electron-Nucleus Scattering
Electron-Electron Scattering
Multiple Scattering - the Fermi-Eyges Approach
Mass Angular Scattering Power
3.11 ELECTRON SPECTRA PRODUCED BY PHOTON INTERACTIONS IN A MEDIUM
3.11.1 Energy Distribution of Electrons Generated by 10 MeV Photons
Mean Energy Transferred
Energy Loss to Bremsstrahlung
Energy Absorption Coefficient
3.11.2 Energy Spectrum of Electrons Seen in the Medium
Electron Spectra Resulting from Monoenergetic Electrons
Electron Spectra Resulting from a Distribution of Initial Electron Energies
3.12 MEAN ELECTRON STOPPING POWER
3.12.1 Mean Stopping Power for Monoenergetic Electrons Set in Motion in Medium
3.12.2 Mean Stopping Powers for Polyenergetic Electrons Setin Motion in Medium by Monoenergetic Photons
3.12.3 Mean Stopping Powers for Electrons Set in Motionby a Spectrum of Photon Energies
3.12.4 Restricted Stopping Power and Linear Energy Transfer
PROBLEMS
REFERENCES
Chapter 4 THE PRODUCTION AND PROPERTIES OF KILOVOLTAGE X-RAY BEAMS
4.1 PRODUCTION OF X-RAYS
4.1.1 Basic Electron Interactions in an X-ray Target
4.1.2 Characteristic Radiation
4.1.3 Bremsstrahlung
Thin Target Radiation
Thick Target Radiation
4.1.4 Angular Distribution of X-rays
Thin Targets
Thick Targets
4.1.5 Measured X-Ray Spectra
4.2 X-RAY QUALITY
4.2.1 Measurement of HVL
4.2.2 Effects of Scatter on HVL Measurements
4.2.3 Effects of Detector on HVL Measurements
4.2.4 Filters for Radiation Therapy and Diagnostic Radiology
Radiation Therapy Filters
Diagnostic Radiology Filters
4.2.5 Equivalent Photon Energy
4.2.6 Further Notes on X-ray Spectra
Measurement of X-ray Spectra
Effects of Filters on X-ray Spectra
Effects of Special High-Z Filters
Types of Spectral Distribution
Spectral Distribution of Scattered Radiation
4.3 PRINCIPLES OF X-RAY TECHNOLOGY
4.3.1 The X-ray Tube and the Simplified Circuit
4.3.2 Self-Rectified X-ray Circuits
Alternating Currents and Voltages
Current Pulse in an X-ray Circuit
4.3.3 Rectification
Half-Wave and Full-Wave Rectification
4.3.4 Three-Phase Units
Secondaries Connected in a Delta Configuration
Three-Phase 12-Rectifier System
4.3.5 Anode and Cathode Structures
Diagnostic X-ray Tubes
X-ray Tubes for Radiotherapy
4.3.6 Ratings of Diagnostic Tubes
Focal Spot Loading
Anode Cooling
SUMMARY
PROBLEMS
REFERENCES
Chapter 5 HIGH-ENERGY MACHINES
5.1 INTRODUCTION
5.2 CONSIDERATIONS IN THE DESIGN OF HIGH-ENERGY BEAMS
5.3 BETATRONS
5.4 THE LINEAR ACCELERATOR (LINAC)
5.5 MEDICAL LINACS
5.5.1 Medical Linear Accelerators: Waveguideand Treatment Head (Additional Notes)
5.5.2 FFF Linacs
5.6 ISOTOPE MACHINES
5.7 COBALT 60 UNITS
5.8 SPECIAL MEDICAL ACCELERATORS
5.8.1 Tomotherapy
5.8.2 Gamma-knife
5.8.3 CyberKnife
5.8.4 MRI Linac
5.9 PARTICLES FOR RADIOTHERAPY
5.9.1 Medical Particle Accelerators
5.9.1.1 Beam Shaping
5.9.1.2 Other Charged Particles
5.9.2 Neutron Accelerators
5.9.3 Fast Neutron Therapy
SUMMARY
PROBLEMS
REFERENCES
Chapter 6 RADIOISOTOPES FOR MEDICAL IMAGING & RADIOTHERAPY
6.1 INTRODUCTION
6.2 STRUCTURE OF MATTER FROM AN ISOTOPIC PERSPECTIVE
6.3 "NEUTRON-RICH" & "PROTON-RICH" ISOTOPES
6.4 Q-VALUE, THRESHOLD ENERGY & STARTING ENERGY
Endoergic reactions.
6.4.1 Coulomb Barrier & Starting Energy
Exoergic reactions.
6.5 NOMENCLATURE
6.6 MICROSCOPIC NUCLEAR CROSS SECTION & EXCITATION FUNCTION
6.7 ION BEAM STOPPING POWER & RANGE
6.7.1 Beam Energy, Range & Straggling of Ion Beams
Beam Energy and Energy Straggling
Beam Range and Range Straggling
6.8 RADIOISOTOPIC YIELD
6.8.1 Saturation Activity and Yield
6.8.2 Productions Well Below the Saturation Activity
6.8.3 Thick Targets
6.9 ACCELERATORS FOR BIOMEDICAL RADIOISOTOPES PRODUCTION
Penning Ion Source
6.9.1 Electrostatic (DC) Accelerators
6.9.2 Radiofrequency (RF) Accelerators
Linacs.
Betatrons
6.9.3 The Isochronous Compact Negative-Ion "Medical" Cyclotron
Technology of a Compact Cyclotron for Radioisotopes Production
Components of a cyclotron.
Operation of a cyclotron.
Relativistic mass.
"Wandering orbit".
Optimization of Cyclotrons for Radioisotopes Production
Design features of routine production systems.
6.9.4 Targetry for the Production of Radioisotopes
Major components of a targetry system.
Solid Targetry
Gas Targetry
Production of 18F using gas targetry.
Liquid Targetry
Production of 18F using liquid targetry (example).
6.9.5 Measurement of the Beam Energy
Direct Methods
Time-of-flight methods.
Magnetic analyser methods.
Indirect Methods
Monitor Reactions
Beam current known.
Beam current unknown
Activity of only one monitor isotope required
6.9.6 Measurement of Beam Current
Direct Methods
Secondary electrons emission (SEE)
Indirect Methods
6.9.7 Determining an Excitation Function
Measuring the excitation function
6.9.8 Theoretical Calculations of Excitation Functions
Direct and Compound Reactions
Pre-equilibrium Reactions
Emission spectra.
Model Descriptions of Nuclear Reactions
Optical model and optical potential
Hauser-Feshbach (HF) model
Exciton model
Computational Algorithms
ALICE-IPPE
EMPIRE
TALYS
Comparison of Algorithms
6.10 NUCLEAR REACTOR PRODUCTION OF MEDICAL RADIOISOTOPES
Nuclear fission
Barrier energy (Eb)
Excitation energy (Q )
6.10.1 Radioisotopes Production Using Uranium Fission
Macroscopic reaction cross section.
Fission product activity
Energy release from fission
6.10.2 Operations of a Nuclear Reactor
Moderating material and chain reaction
Movable control elements ("rods")
Neutron reflector
Coolant.
The pressure vessel
The containment structure
Effective Reactivity and Critical Mass
Specialized Nuclear Reactors for High Neutron Fluxes
Excess reactivity
Target location
6.10.3 Production of Radioisotopes from Fission Products
Example: Production of 99Mo from 235U Fission
6.10.4 Production of Radioisotopes from Neutron Activation of a Target
Example: Production of 99Mo by Neutron Activation
6.11 RADIOACTIVE WASTE FROM ACCELERATORS & REACTORS
6.11.1 Radioactive Waste from Particle Accelerators
Activation of bunker walls
Activation of accelerator structural components.
Activation of the bunker air and its expulsion into the environment
6.11.2 Radioactive Waste from Research Nuclear Reactors
6.12 NUCLEAR MEDICINE WITHOUT NUCLEAR REACTORS?
6.12.1 Comparison of Accelerator- vs. Reactor-based Productions
Financial, environmental and social "footprints" of the installation.
Legacy of enriched uranium fuel
Production and storage of long lived intermediate level radioactive waste
Separation of radionuclides from target material.
Decommissioning of spent facilities
6.12.2 Which "Reactor" Radioisotopes Could be Produced in an Accelerator?
Production of "Reactor" Isotopes by Neutron Spallation
Production of "Reactor" Isotopes by Cyclotron
6.12.3 Accelerator-based Production of 99mTc: A Possible Paradigm Shift?
6.13 RADIOISOTOPIC GENERATORS
6.13.1 The 99Mo/99mTc Generator
6.13.2 Secular & Transient Equilibria in Radioisotopic Generators
Secular Equilibrium
Transient Equilibrium
Other Aspects: Multiple Decay Chains and In Vivo Generators
In vivo generator
6.14 ADVANCED TECHNOLOGIES FOR RADIOISOTOPES PRODUCTION
6.14.1 The Future of Cyclotrons
6.14.2 Particle Acceleration using Laser-generated EM Fields
Application to Protons
6.15 RADIONUCLIDES FOR RADIOPHARMACEUTICALS SYNTHESES
6.15.1 The Concepts of Radiopharmaceutical & Radiotracer
Investigating the efficacy and safety of a radiopharmaceutical
Action of a diagnostic radiopharmaceutical (radiotracer): (radio)pharmacokinetics
Action of a therapeutic radiopharmaceutical: (radio)pharmacodynamics
6.15.2 Specific Activity
Specific activity: general definition
Carrier-free specific activity (Scf)
No-carrier-added (NCA) specific activity (Snca)
Carrier-added specific activity (Sca).
Effective specific activity (Seff)
6.15.3 Common Diagnostic Radioisotopes in Nuclear Medicine
6.15.4 Common Therapy Radioisotopes in Nuclear Medicine
6.15.5 Production of Emerging Targeting-therapy Isotopes
Copper-67
Scandiun-47.
Astatine-211
Actinium-225 and bismuth-213
6.16 DESIGN OF A "FIT-FOR-PURPOSE" RADIOPHARMACEUTICAL
6.16.1 Definition of a Radiopharmaceutical
6.16.2 Target-seeking Mechanisms of Radiopharmaceuticals
Structural Levels of Tumor Target Recognition
Targeting gross anatomic features of tumor
Targeting tumor microvasculature: EPR effect
Targeting biomolecular structures with "free" radioisotopes
Targeting biomolecular structures with radiolabelled complexes
Targeting of signature molecular targets on the cell surface
6.16.3 Optimal Choice of Radioisotope for Constructing a Radiopharmaceutical
Half-life
Accessibility.
Specific activity
Conjugation chemistry
Suitable ionizing radiation emission
Negligible unwanted radiations
6.16.4 Properties of the Ideal Radiopharmaceutical
Efficient radiolabelling
Labelling specificity
Protection of binding affinity
Stability in vitro and in vivo
Target specificity
Specific activity
Routes and rapidity of accretion and excretion
6.16.5 Pharmacokinetics of Radiolabelled Antibodies & their Constructs
Antibody structure
Antibody pharmacokinetics
Minibody pharmacokinetics
Diabody pharmacokinetics
6.16.6 Mapping or Modifying Cellular Processes using Radiopharmaceuticals
Ligands (First Messengers)
Ligands.
Lipophilic (freely diffusing) ligands
Water-soluble (lipophobic) ligands
Extracellular-matrix associated ligands
Membrane-bound ligands
Cell-signalling Receptors, Transporter Proteins and Ion Channels
Cell-signalling receptors
Transporter proteins and ion channels
Second Messengers
6.17 SYNTHESIS & QA/QC OF A RADIOPHARMACEUTICAL
6.17.1 Production of [18F ]FDG as an Archetypal Radiopharmaceutical
6.17.2 QA Programme & QC Tests for [18F ]FDG: Radionuclidic Purity
Quality assurance
Quality control
Experimental Photopeak Spectrum from Positron Annihilation
Full energy peak (FEP)
Compton edge
Compton backscatter peak
Compton continuum
Range of Compton events
Spectral features of multiple FEPs
Germanium characteristic escape X-rays
Bremsstrahlung
Characteristic X-rays from lead shielding
Features above the FEP
Contaminating Radionuclides in Radioisotope Production
SUMMARY
PROBLEMS
REFERENCES
Chapter 7 RADIATION DOSIMETRY: THE MEASUREMENT OF IONIZING RADIATION
7.1 THE DESCRIPTION OF A RADIATION BEAM
7.2 QUANTITIES DEFINED IN RADIATION MEASUREMENT:KERMA, ABSORBED DOSE, TERMA, AND EXPOSURE
7.2.1 Kerma
7.2.2 Absorbed Dose
7.2.3 Terma
7.2.4 Exposure
7.3 ELECTRONIC EQUILIBRIUM
7.4 THE BRAGG-GRAY CAVITY
7.4.1 Dose to a Small Gas-filled Cavity
7.4.2 Dose to the Cavity Wall
Effects of Restricted Stopping Power on Mass Stopping Power Ratios
Conclusion
Spencer-Attix Cavity Theory
7.5 MEASUREMENT OF ABSORBED DOSE USING AN ABSOLUTE ION CHAMBER
7.5.1 Perturbation Correction Factors
7.5.2 Temperature and Pressure Correction Factors
7.6 ION CHAMBERS
7.6.1 Standard Air Chamber
7.6.2 Practical Ion Chambers
The Effects of Wall Thickness on Ion Chamber Response
7.6.3 Effective Atomic Number
7.7 MEASUREMENTS OF ABSORBED DOSE USING AN IONIZATION CHAMBER
7.7.1 Absorbed Dose Measurement Using an Exposure Calibration Factor, Nx
7.7.2 Absorbed Dose Measurement Using an Absorbed Dose Calibration Factor, ND
7.7.3 Absorbed Dose Measurement above 3 MeV
7.7.4 Absorbed Dose Measurement with Electron Beams
Electron Absorbed Doses for Thimble Chambers with Exposure Calibration Factors
7.7.5 Calibration Protocols at Radiation Metrology Laboratories
7.8 CALIBRATION PROTOCOLS
7.8.1 IAEA Protocol
7.8.2 IPEM (IPSM) Protocol
7.8.3 AAPM Protocol (TG-51)
7.8.4 Other Protocols
7.8.5 Kilovoltage Calibration Protocols
Absolute dosimetry of very low-energy X-rays (IPEMB only)
Absolute Dosimetry of Low-Energy X-rays
Absolute Dosimetry of Medium Energy X-rays
7.8.6 Electron Calibration Protocols
7.9 ABSORBED DOSE AT INTERFACES BETWEEN DIFFERENT MATERIALS
7.9.1 Kilovoltage Energies
7.9.2 Megavoltage Energies
7.10 THEORETICAL DOSIMETRY (MONTE CARLO CALCULATIONS)
7.10.1 Boltzmann Radiation Transport Equation
7.10.2 The Monte Carlo Procedure
Variance Reduction
The Random Walk
7.10.3 Monte Carlo Codes in Radiotherapy
EGSnrc Monte Carlo code
BEAMnrc user code
DOSXYZnrc user code
PROBLEMS
REFERENCES
Chapter 8 MEASUREMENT OF RADIATION: INSTRUMENTATION
8.1 INTRODUCTION
8.2 SATURATION IN ION CHAMBERS
Mobility
Recombination Coefficient
8.3 CALCULATION OF EFFICIENCY OF ION COLLECTION - PULSED RADIATION
Pulsed Radiation
8.4 CALCULATION OF THE EFFICIENCY OF ION COLLECTION - CONTINUOUS RADIATION
Cylindrical and Spherical Chambers
8.5 OPERATIONAL AMPLIFIERS
8.6 PRACTICAL DEVICES FOR MEASURING RADIATION
Guarded Construction
Condenser Chambers
Townsend Balance
8.7 TYPES OF ION CHAMBERS
8.8 SOLID STATE DETECTORS
8.8.1 Properties and Uses of the Diode Detector
8.8.2. Metal Oxide Semiconductor Field Effect Transistors (MOSFETs)
8.8.3 Diamond Detectors
8.9 THERMOLUMINESCENT DOSIMETRY (TLD)
8.9.1 Use of TLDs in neutron dosimetry
8.9.2 Optically Stimulated Luminescence
8.10 CHEMICAL DOSIMETRY
8.10.1 Gel dosimetry in radiation therapy
8.11 FILM AS A DOSIMETER
8.12 DIRECT MEASUREMENT OF ABSORBED DOSE - THE CALORIMETER
SUMMARY
PROBLEMS
REFERENCES
Chapter 9 BASIC RADIOBIOLOGY
9.1 INTRODUCTION
9.2 INITIAL EVENT-THE PASSAGE OF THE CHARGED PARTICLES
9.2.1 Efficiency of Radiation Damage
9.2.2 Linear Energy Transfer (LET)
9.3 IMMEDIATE RADIOCHEMICAL EFFECTS
9.3.1 Production of Solvated Electrons and Radicals
9.3.2 Dependence of Radiation Damage on LET
9.4 ASSAYS FOR PROLIFERATIVE CAPACITY-SURVIVAL CURVES
9.5 MATHEMATICAL ASPECTS OF SURVIVAL CURVES
9.5.1 Single-Hit Survival Curve
9.5.2 Multi-Target Single-Hit Survival Curve
9.5.3 Calculations Using the Survival Curves
9.5.4 Other Types of Survival Curves. The Linear Quadratic Model
9.6 STATISTICAL NATURE OF RADIATION DAMAGE
9.7 RADIATION-INDUCED CELLULAR EFFECTS
9.7.1 The Cell Cycle
9.7.2 Repairable and Unrepairable Cellular Damage
9.7.3 Bystander Effects and Adaptive Response
9.8 NORMAL AND TUMOR CELLS-THERAPEUTIC RATIO
9.8.1 Tumor Control Probability Models
Spatial Models of Dose, Tumor Heterogeneity and Response to Treatment
9.8.2 NTCP Models: Functional Subunits and Dose-Volume Effects
The Lyman-Kutcher-Burman Model
Functional Subunits
Volume Effects
The Relative Seriality Model
Spatial Models of Normal Tissue Complication Probability
9.9. RELATIVE BIOLOGICAL EFFECTIVENESS
9.9.1 RBE as a Function of LET
9.9.2 RBE as a Function of Dose
9.9.3 RBE as a Function of Dose per Fraction
9.10 THE OXYGEN EFFECT
9.10.1 The Oxygen Enhancement Ratio (OER)
9.10.2 OER as a Function of LET
SUMMARY
PROBLEMS
REFERENCES
Chapter 10 CLINICAL RADIOBIOLOGY
10.1 INTRODUCTION
10.2 TUMOR GROWTH CHARACTERISTICS
10.3 CELL CYCLE AND RADIOSENSITIVITY
10.4 THE Rs OF RADIOBIOLOGY
10.4.1 Repair
Survival Curves for Fractionated Treatment
10.4.2 Repopulation
10.4.3 Redistribution of Cells Along the Cell Cycle
10.4.4 Reoxygenation
10.4.5 Radiosensitivity
10.5 FRACTIONATION IN RADIOTHERAPY AND THE LQ MODEL
10.5.1 Incomplete Repair Model
10.5.2 The Extended LQ Model for Proliferative Tumors
10.5.3 The LQ Model and Reoxygenation
10.5.4 The Effect of Fractionation on Early and Late Responding Tissues
10.5.5 Choice of Fractionation Based on the Rs of Radiobiology
A. Altered Fractionation
B. Fractionation in Specialized Treatments
10.6 NORMAL TISSUE REACTIONS
10.6.1 The Skin
10.6.2 The Hematopoietic System
10.6.3 The Gastrointestinal System
10.6.4 The Spinal Cord
10.7 ISOEFFECT CURVES AND ISOEFFECTIVE DOSES IN RADIOTHERAPY
10.7.1 Historical Perspective of Power-law Models
Nominal Standard Dose
Time Dose and Fractionation Factors (TDF)
10.7.2 Isoeffective Doses in Radiotherapy
10.8 THE OXYGEN EFFECT IN CLINICAL SETTINGS
10.8.1 High LET Radiation and the Oxygen Effect
10.8.2 Radiosensitizers and Anti-Angiogenic Agents
10.9 RADIOBIOLOGICAL RATIONALE FOR COMBINED TREATMENT MODALITIES
10.9.1 Chemotherapy
The Role and Action of Chemotherapeutic Agents
Models in Chemotherapy
10.9.2 Hyperthermia
10.9.3 Enhancement of TR Through Combined Treatment Modalities
10.10 SURVIVAL OF PATIENTS
Statistical errors
SUMMARY
PROBLEMS
REFERENCES
Chapter 11 DIAGNOSTIC RADIOLOGY
11.1 INTRODUCTION
11.2 THE X-RAY IMAGING CHAIN AS AN INFORMATION PROCESSING SYSTEM
The imaging chain
Links of the imaging chain
11.2.1 Analyzing an Imaging Chain: Projection Digital Radiography
X-ray source
Tube port, beam filters and collimation
Air gap and diverging beam
Target tissue ± contrast-enhancing agent
Scatter rejection grid
2D DR detector
Signal processing and image display
Visual and cognitive processing
11.3 X-RAY PHOTON ABSORPTION & ATTENUATION COEFFICIENTS
11.4 DIGITAL FLAT-PANEL X-RAY DETECTORS
Computed radiography (CR)
11.4.1 Active Matrix Arrays as X-ray Image Detectors
Direct-conversion
Indirect-conversion
11.4.2 Physical Principles of X-ray Flat-panel Detector Materials
Direct Conversion
Indirect Conversion
Structured scintillators
Unstructured Scintillators
11.5 FLAT-PANEL DETECTOR PERFORMANCE CHARACTERISTICS
Physical Determinants of a Detector's Performance
Quantum detection efficiency (QDE).
Dynamic range
Fill Factor
Response uniformity
Sensitivity
11.6 DETERMINANTS OF IMAGE QUALITY & THEIR ASSESSMENT
Determinants of Image Quality
11.6.1 Spatial Resolution: The Modulation Transfer Function (MTF)
The Point, Line, and Edge Spread Functions
Point Spread Function (PSF)
Line Spread Function (LSF)
Edge Spread Function (ESF)
Mathematical Representations of Spatial Response Functions
The Modulation Transfer Function
Spatial frequency: "lp mm-1" vs. "cycles mm-1".
11.6.2 Contrast Resolution
Subject (target) contrast
Detector contrast
Displayed (presentation) contrast
Adjusting for Human Visual Perception
Just noticeable differences ( JND)
P-values, standardized display system (SDS).
DICOM GSDF
Color imaging
Low- and high-contrast resolution measurements
11.6.3 Sources of Noise in Radiographic Imaging
Beam-quality noise
Anatomical noise
Quantum noise
Detector resolution noise
Electronic noise
Detector structural offset/gain noise
Summing random noise contributions
11.6.4 Signal-to-noise Ratio
Minimum Patient Dose Burden for a Given Image Noise Level
11.6.5 Measuring Noise in the Displayed Image: Contrast-to-noise Ratio and SNR
Contrast-to-noise Ratio
Signal-to-noise Ratio
11.6.6 Random and Non-random Noise: The Noise Power Spectrum (NPS)
Structured image noise: simple "square-wave" example
Aliasing and under-sampling
Noise power ("Wiener") spectrum
11.6.7 Scatter Rejection Grids: Effects on Image Noise
Scatter rejection grid
Grid construction
Scatter Rejection Grid Descriptors
Grid ratio
Primary transmission (Tp).
Bucky factor (BF).
Focal distance and range
Grid frequency (fG).
Contrast improvement factor (K ).
Image Artifacts from Grids: Aliasing
11.7 DETECTIVE QUANTUM EFFICIENCY (DQE)
Determinants of DQE
Direct-Conversion Detector
Indirect-Conversion Detector
Noise Equivalent Quanta (NEQ ).
11.8 EXAMPLE OF PROJECTION RADIOGRAPHY: DIGITAL MAMMOGRAPHY
Conventional DM.
Enhancing tumor detection
Iodine contrast enhancement
11.8.1 Single- and Dual-energy Contrast-enhanced Digital Imaging
Temporal subtraction (TS) CEDM
Dual-energy subtraction CEDM (CESM)
11.8.2 Logarithmic Subtraction of Images
Subtracting TS CEDM images
Subtracting dual-energy CEDM images
Comparison of CEDM Techniques
CEDM: Example of a Combined Serial-parallel Imaging Chain
11.9 EXAMPLE OF PROJECTION RADIOGRAPHY: FLUOROSCOPY & FLUOROGRAPHY
11.9.1 Introduction
11.9.2 Components of a Fluoroscopic System
X-rays detection, signal conversion, and amplification
Conversion stages and their efficiencies
Nomenclature
11.9.3 Performance of a Fluoroscopic System
XII overall efficiency: the conversion factor
XII gain factors
Contrast ratio (CR).
Spatial resolution
Temporal resolution
Noise.
Image artifacts
11.9.4 Digital Fluorography and Digital Subtraction Angiography (DSA)
Digital subtraction angiography (DSA).
11.9.5 Fluoroscopy and Fluorography in Oncology
Biopsy needle guidance
Visualization of tumor vasculature
Correcting for respiratory motion
11.10 COMPUTED TOMOGRAPHY (CT)
11.10.1 Introduction
11.10.2 Physical Principles and Technologies of Single Slice CT
Coordinate system for the scanning bed: tomographic imaging modalities
The Basics: First-generation CT Configuration
CT image representation: "CT numbers".
Second-generation CT: Multiple Narrow Discrete Beams
Third-generation CT: Elimination of Translational Motion
Scanning speed
Detector stability and response
Scatter.
Spatial resolution.
Dose efficiency.
Fourth-generation CT Scanners: Source-only Rotation
Dynamic calibration of detectors
Spatial resolution
Ring diameter and number of detectors
Scatter.
Multiple-row Detector CT (MDCT)
11.10.3 Slip-ring Technology and Helical ("Spiral") CT
Pitch
11.10.4 Multiple-row Detector CT (MDCT)
Optimization of image quality in MDCT
11.10.5 Image Reconstruction Techniques
Analytical Reconstruction: Filtered Back-projection (FBP)
Projection function (p).
Fourier slice theorem
Summary (without the math).
Advantages and limitations of FBP
Convolution of reconstruction kernel with the image data.
Application to CT Images
Iterative Reconstruction (IR)
Algebraic Reconstruction Technique
General IR Techniques including statistical algorithms
Reducing radiation dose
11.10.6 Cone-beam Computed Tomography (CBCT)
Current Cone-beam Imaging Technologies
Image Dose and Optimization
11.10.7 Four-dimensional CT (4DCT) Imaging
Slow CT
Prospective CT
Retrospective CT
Application of 4DCT Datasets
11.10.8 Assessing Doses and Upper Dose Limits of CT Scan Protocols
CT Dose Index, Dose Length Product and Diagnostic Reference Levels
CT Dose Index (CTDI)
CTDI100
CTDIw
Multiple scan average dose (MSAD).
Volume CTDI (CTDIvol).
nCTDIvol
Dose Length Product (DLP).
Estimating effective dose from CT dose assessment.
Diagnostic Reference Levels (DRLs) and Facility Reference Levels (FRLs).
Dose reduction using iterative reconstruction (IR).
11.10.9 Measurements of Image Quality in CT
CT High-contrast Resolution
CT Low-contrast Resolution
Image Optimization to Enhance Visual Perception
11.10.10 Artifacts of CT Images and their Minimization
"Poisson" Noise Artifacts
Reducing noise artifacts
Beam Hardening Artifacts
Reducing beam hardening artifacts
Scatter Artifacts
Reducing scattering artifacts
Metal Artifacts
Reducing metal artifacts
Ring, Motion, Cone-beam, Windmill, and Other Artifacts
11.11 ULTRASOUND IN MEDICAL IMAGING
11.11.1 Introduction
Biomedical Imaging Capabilities of US
11.11.2 Key Physical Concepts in US
Net pressure (P) and its wavefront
Phase velocity and group velocity (c and cg).
Amplitudes (P0 and x0).
Power (W ).
Intensity (I ).
Duty factor (DF )
Dwell time (td).
Spatial path length (SPL).
11.11.3 US as a Linear Travelling Wave
Acoustic (Characteristic) Impedance
Behavior of US at an Interface
Non-linear Effects
Reflection, Refraction and Transmission
11.11.4 Attenuation of US in Tissues
Sound intensity and attenuation in dB
11.11.5 Generation of US: Single Transducer
Components of a Single US Transducer Probe
Piezoelectric element
Shape of transducer element
Acoustic matching
Damping
Radiative zones of a single disc-like transducer element
Side lobes
Grating lobes
11.11.6 Generation of US: Transducer Arrays
Linear and curved sequential arrays
Phased Arrays
Enhanced 1D and 2D arrays
Beam Steering and Focusing
Minimum Beam Lateral Width (Dx) and Focal Zone (fd )
11.11.7 Functions of the Receiver
Preamplification and ADC
General RF amplification
Time gain compensation (TGC).
Signal compression
Rectification, demodulation and smoothing
Data-storage and digital display
11.11.8 Types of US Diagnostic Scans
A-Mode, B-Mode and M-Mode
A (Amplitude)-mode
B (Brightness)-mode
M (Motion)-mode
Two-dimensional Mode
Linear sequential array
Linear phased array
Beam focusing
Three-dimensional Mode
11.11.9 Basics of Doppler Imaging
Continuous wave (CW) Doppler
Pulsed Doppler
Multiplexed scans
Doppler flow map (color Doppler)
Power Doppler
Harmonic imaging
Image enhancement using contrast media: molecular US imaging
11.11.10 Axial Spatial Resolution
11.11.11 Lateral and Elevational Spatial Resolutions
Lateral resolution
Elevational resolution
11.11.12 Temporal Resolution
11.11.13 Biological Effects and Safety: Choice of Beam Parameters
Thermal Effects: "Thermal Index" (TI)
Thermal index
Cavitation Effects: "Mechanical Index" (MI)
Mechanical index
Model for beam attenuation
Other mechanical effects: radiation force and acoustic streaming
Choice of Beam Central Frequency
Diagnostic.
Therapeutic.
11.11.14 Applications of US Imaging to Cancer Diagnosis and Management
11.11.15 Artifacts in US Imaging
Beam behavior physical assumptions
Types of US Image Artifacts
Beam physical characteristics
mass would be assigned erroneously.Reflection, refraction and multiple paths
Beam attenuation anomalies.
Beam velocity anomalies
11.12 MAGNETIC RESONANCE IMAGING (MRI)
11.12.1 Introduction: Historical Development of NMR and MRI
11.12.2 Magnetic Fields in Materials
Nuclear Paramagnetism
Volume Bulk Magnetization
When does N differ from Nw?
Magnetic Susceptibility: Paramagnetism and Diamagnetism
11.12.3 The Bloch Equations
11.12.4 Free Precession and Larmor Frequency
11.12.5 Relaxation of the Magnetic Moment
11.12.6 RF Excitation of the Magnetic Moment
Rotating Reference Frame and Effective Magnetic Field
Free precession as seen in the rotating frame
Equation of motion for magnetization in the rotating frame
11.12.7 RF Excitation and Magnetization Relaxation
Transverse Projection of the Magnetization: The "Spin Flip Angle"
The "90°" spin flip pulse
Why does M rotate and the "spin flip angle" achange?
Switching off the RF.
Extrinsic inhomogeneities in the static magnetic field: apparent relaxation time T2* .
11.12.8 T1, T2 & T*2 Relaxation Mechanisms and Proton Density
Molecular motion correlation times
Chemical Shift and J-coupling
Chemical shift of hydrogen nuclei (d).
J-coupling (NJA-B).
T1 Relaxation Mechanisms
Regime A.
Regime B.
Regime C.
T2 and T2* Relaxation Mechanisms
Proton Density
11.12.9 Optimizing MRI Image Contrast: MRI Sequences
The "180° Pulse" and Subsequent Mz Recovery: Mechanisms and Outcomes
11.12.10 SE and Fast SE Sequences: Highlighting T2 Effects
Readout signal strength
Fast ("Turbo") Spin Echo Sequences
"Fat signal" expression in T2-weighted conventional SE and FSE images
11.12.11 IR Sequence: Highlighting T1 Effects
Readout signal strength
11.12.12 GRE Sequence: Highlighting T2* and Acquisition Speed
Characteristics of the GRE Sequence
Highlighting T2* mechanisms: shorter TEs
Spin flip (or "spin tip") angle a &90°: shorter TR
11.12.13 Contrast-enhancing Variables of MRI Sequences: Summary
Choice of pulse sequence
Repetition time (TR).
Time of echo (TE).
Time of Inversion (TI).
The spin flip angle (a) and partial saturation.
Steady-state Partial Saturation
Flow-related (inflow) enhancement.
11.12.14 Spatial Localization of MR Signals Readout
Transaxial Slice Selection: Gz-Gradient
Voxel Selection Within a Slice: Phase and Frequency Encoding
Phase-encoding of spins along the y-axis
Frequency-encoding of spins along the x-axis
MR signals readout
Representation in k-space
Repeated phase encoding steps.
Meaning of k-space regions
Reconstruction of MR image
11.12.15 Symbolic Representations of Pulse Sequences: SE, GRE and EP
Pulse sequence notation
Echo planar (EP) imaging
Single-shot vs. multi-shot EP acquisitions: echo train length (ETL)
11.12.16 Artifacts of MR Images and Their Minimization
Artifacts caused by physiological processes
Artifacts arising from the underlying physics
Artifacts arising from MRI software or hardware
11.13 IMAGE REGISTRATION
SUMMARY
PROBLEMS
REFERENCES
Chapter 12 DIAGNOSTIC NUCLEAR MEDICINE
12.1 INTRODUCTION
12.1.1 Nuclear Medicine, Molecular Imaging & Molecular Medicine
12.2 THE GEIGER-MÜLLER COUNTER
Recombination region
Ionization chamber region.
Proportional counter region
Limited proportional region
Geiger-Mu¨ller region
Continuous discharge region
Gamma Counting
Beta & Alpha Counting
12.3 THE SCINTILLATION DETECTOR
Contributors to energy resolution
Intrinsic energy resolution
Effect of energy resolution on displayed spectra
Scintillation counter vs. Geiger counter
12.4 THE LIQUID SCINTILLATION COUNTER
Basic electronic circuit
12.5 THE SEMICONDUCTOR DETECTOR
12.6 STATISTICS OF RADIONUCLIDE DISINTEGRATION COUNTING
Poisson probability distribution
Standard deviation and probable error
Background counts
12.7 DEAD TIME & LOSS OF COUNTS
12.8 SAMPLE COUNTING: UPTAKE & VOLUME STUDIES
12.8.1 Example: Measurement of Thyroid Iodine Uptake
12.8.2 Example: Determination of Plasma Volume Using a Well Counter
12.9 IMAGING USING RADIONUCLIDES
12.9.1 Historical Development
Nuclear Medicine Legacy: Development of Bone Densitometry
12.9.2 The Scintillation ("Gamma") Camera
The patient as a macroscopic, diffuse radiation source
Collimator: photon scatter discrimination
Field of view (FOV).
Detector crystal and light guide ("light pipe").
Photomultiplier-tube (PMT) array
X-ray or g-ray detection
Photon energy discrimination
Compensation for scattering events
Spatial encoding
Assembling and processing the image
Anatomic (Structural) vs. Functional (Pharmacokinetic) Imaging
12.9.3 Scintillation Camera Physical Performance Characteristics
Spatial Resolution
Collimator spatial resolution
Intrinsic spatial resolution
System spatial resolution and line spread function (LSF).
Multiple-windows spatial registration
Efficiency
Collimator Geometric Efficiency
Intrinsic crystal efficiency
System efficiency
Contributors to system efficiency
Types of Collimators
Field Uniformity
Random errors in imaging chain
Systematic errors in imaging chain
12.9.4 Quality Assurance of Scintillation Cameras
QC Performance Tests Using the NEMA Protocol
12.9.5 Single Photon Emission Computed Tomography (SPECT)
12.9.5.1 SPECT Image Data Collection
Multi-headed Cameras
SPECT Collimators
12.9.5.2 Image Reconstruction in SPECT
Filtered Back-projection Applied to Emission Tomography
Iterative Reconstruction Applied to Emission Tomography
12.9.5.3 Filtration in SPECT Image Reconstruction
Image filtration
Types of Filters Used in SPECT FBP Reconstructions
Reduction in star artifact
High-frequency noise suppression
Filtered back-projection: window filter
Types of Filters Used in SPECT Iterative Reconstructions
OSEM vs. FBP
Molecular SPECT
Signal Enhancement for Restoration of Lost Information
12.9.5.4 Photon Attenuation in SPECT Image Reconstruction
Chang attenuation correction
Concomitant radioisotopic transmission data acquisition
X-ray transmission computed tomography data acquisition
12.9.5.5 Quality Assurance of SPECT Cameras
12.9.5.6 Studies with Diagnostic SPECT Radiopharmaceuticals
12.9.6 Positron Emission Tomography (PET)
12.9.6.1 Scientific & Technical Discoveries Leading to PET
12.9.6.2 Coincidence-detection of Annihilation Photons
Coincidence Detection System
12.9.6.3 Types of Recorded Events
True and prompt coincidences
Scattered coincidences
Random coincidences
Multiple coincidences
Advanced PET: false coincidences derived from prompt gammas
12.9.6.4 PET Detector Materials
Key Properties of Scintillators
Quantum detection efficiency
Energy resolution
Photoelectron yield
Photon yield
Decay time
12.9.6.5 Characteristics & Hierarchical Assembly of PET Detector Elements
Typical Whole-body PET/CT System Incorporating TOF
Time of flight (TOF).
Comparison with preclinical PET/CT systems: phoswich detectors
12.9.6.6 Acquisition of Coincidence Data
Defining the orientation of an LOR
Indexation of an LOR
Modes of events recording
2D vs. 3D acquisitions
Angular mashing and undersampling
Data Assembly & Representation: The Sinogram
The sinogram
"Squaring the circle".
12.9.6.7 Data Corrections in PET
Normalization of Detectors & Their Circuitry
Measurement of normalization coefficients
Correction for Attenuation
Modeling and calculation
Measurement using transmission from isotopic source
Measurement using transmission CT scan
Correction for Scattering
Analytical methods
Dual-energy methods
Model-based methods
Correction for Random Coincidences
Prompt timing window method
Delayed timing window method
Correction for Dead Time in PET
Nonparalyzable detection system
Paralyzable detection system and pulse pileup
Contributors to dead time in PET detectors
Measurement of dead time in PET
Noise-equivalent Counts & Scatter Fraction
Noise-equivalent counts (NEC) and count rate (NECR)
Scatter Fraction (SF).
12.9.6.8 PET Image Quality
Spatial Resolution of PET
Positron range
Noncollinearity of annihilation photons
Detector element size
Detector element construction: depth encoding.
Geometric layout of detectors and detector blocks
Photodetector PMT array: numbers and packing of PMTs.
Combining these uncertainties
Sensitivity of PET
Coincidence detection efficiency
Detection system geometrical efficiency
Detector active fraction
System sensitivity
12.9.6.9 Emerging Technologies for Improving PET Performance & Scope
Silicon Photomultipliers (SiPM) in PET
Avalanche photodiodes
"Geiger-mode" APDs and silicon photomultipliers
Total-Body PET Imaging
12.9.6.10 Artifacts of PET Images & Their Minimization
Metallic implants
Contrast media
Truncation errors
12.9.6.11 Clinical Applications of PET Radiopharmaceuticals
12.9.6.12 Interpretation & Quantification of PET Images
Semi-quantitative PET Imaging: Standardized Uptake Value (SUV)
Filtration in PET image reconstruction
Combining Radioactive Modalities: Theranostics
Theranostic cancer management
Theranostic partnership: MRT plus PET and SPECT in prostate cancer treatment
12.10 PHYSICAL, BIOLOGICAL & EFFECTIVE HALF LIVES
Reservations Concerning the Biological Half-Life
12.11 KINETIC MODELING TECHNIQUES FOR NUCLEAR MEDICINE
Biological modeling
Noncompartmental methods
Distributed modeling
Kinetic (or "dynamic") compartmental modeling
12.11.1 Constructing a Compartmental Kinetic Model
12.11.2 Modeling Receptor-Ligand Data in PET & SPECT Imaging
Radioligand In Vitro Assay Model
Dissociation Constant
Binding potential (BP).
Free receptor density (Bmax).
In Vivo Model for PET Brain Receptor Binding Studies
12.12 OPTIMIZING DIAGNOSTIC DOSES TO NUCLEAR MEDICINE PATIENTS
Diagnostic Reference Levels in Nuclear Medicine
Applying ALARA-like Radiation Protection Principles to the Patient
Reducing Doses from Diagnostic Administrations
Dose-reduction example: 67Ga vs. 68Ga imaging for infection
Dose-reduction example: 111In vs. 68Ga imaging for neuroendocrine tumors
12.13 ABSORBED DOSE ARISING FROM A RADIONUCLIDE IN THERAPY
SUMMARY
PROBLEMS
REFERENCES
Chapter 13 CHARACTERISTICS OF RADIOTHERAPY PHOTON BEAMS
13.1 COMPONENTS OF THE INCIDENT BEAM
13.2 DETERMINATION OF BEAM CHARACTERISTICS
13.2.1 Monte Carlo Modeling
13.2.2 Source Models
13.3 KILOVOLTAGE BEAMS
13.3.1 Accelerated Electrons
13.3.2 Target and Filters
13.3.3 Collimation
13.3.4 Contamination
13.4 PHOTON BEAMS FROM ELECTRON ACCELERATORS
13.4.1 Initial Electron Beam
13.4.2 Target
13.4.3 Flattening Filter
Flattening Filter Free Beams
13.4.4 Collimation
Custom Field Definition
Impact of Collimation on Accelerator Output
Occlusion of Source by Collimation
13.4.5 Monitor Chamber
13.4.6 Modulated Fields
Modulation with a Multileaf Collimator
13.4.7 Intervening Components
Intervening Materials
Intervening Magnetic Fields
13.4.8 Leakage
13.4.9 Neutron Production and Activation
13.4.10 Final Beam
13.4.11 Source Models for Photon Beams
13.5 COBALT-60 BEAMS
13.5.1 Source and Collimation
13.5.2 Leakage
13.5.3 Beam Modulation
SUMMARY
PROBLEMS
REFERENCES
Chapter 14 THE INTERACTION OF PHOTON BEAMS WITH A SCATTERING MEDIUM
14.1 QUANTIFYING DOSE IN A SCATTERING MEDIUM
14.1.1 Static Fields
14.1.2 Dynamic Fields
14.1.3 Comparing Dose Distributions
14.2 COMPONENTS OF DOSE IN A SCATTERING MEDIUM
14.3 PATTERNS OF DOSE IN A SCATTERING MEDIUM
14.3.1 Dose Build-Up
14.3.2 Surface Dose
14.3.3 Beyond dm
14.3.4 Lateral Electronic Equilibrium
14.3.5 Off-Axis Dose Distribution
Side Scatter
14.3.6 Narrow Beams
14.3.7 Contour Shape
14.3.8 Dose at Exit Surface
14.3.9 Inhomogeneities
14.3.10 Energy Absorption in Biological Material
Structure of Bone
Dose to Bone
Dose Near a Bone Interface
Air Cavities
Lung
14.3.11 Inadvertent Dose in the Medium
Sources and Impacts
Impact of Collimation
14.3.12 Modulation
Transmission Modulation
Superposition Modulation
14.3.13 Impact of Magnetic Fields
14.4 EMPIRICAL DESCRIPTIONS OF PHOTON BEAM DOSE DISTRIBUTIONS
14.4.1 Functions Used to Describe Central Axis Dose
Relationship Between the Functions
14.4.2 Tissue-Air Ratio
Effect of Distance from the Source on the Tissue-Air Ratio
Variation of Tissue-Air Ratio with Field Size and Depth
Derivation of Tissue-Air Ratios
14.4.3 Backscatter Factor and Peak Scatter Factor
Backscatter/Peak Scatter Factor and Beam Quality
14.4.4 Percentage Depth Dose
Dependence of PDD on Source to Surface Distance
Dependence of Depth Dose on Beam Modifiers
14.4.5 Tissue-Phantom Ratio and Tissue Maximum Ratio
14.4.6 Off-axis Ratio
14.4.7 Scatter-Air Ratio and Scatter Maximum Ratio
14.4.8 Equivalent Squares and Circles for Rectangular and Irregular Fields
14.4.9 Estimation of Parameters for Irregular Fields
14.4.10 Central Axis Depth Dose and Beam Quality
14.5 ABSOLUTE DOSE - DOSE OUTPUT
14.5.1 Variations with Field Size - Component Scatter Factors
Total Scatter Factors
Collimator Scatter Factors
Phantom Scatter Factors
14.5.2 Asymmetric Fields
14.5.3 Treatment Accessories
14.5.4 Impact of Flattening Filter
14.5.5 Narrow Beams
14.5.6 Modulated and Composite Beams
14.6 TABULAR DATA IN THE APPENDIX
SUMMARY
PROBLEMS
REFERENCES
Chapter 15 EXTERNAL PHOTON BEAM DOSE CALCULATION
15.1 INTRODUCTION
15.2 ABSOLUTE AND RELATIVE DOSE
15.2.1 Device Output - Absorbed Dose Determination
15.2.2 Beam Output Determination
15.3 DOSE CALCULATION REQUIREMENTS
15.3.1 Uncertainties, Deviations, Errors, and Tolerances
15.3.2 Dose Calculation Accuracy
Absolute Dose
Relative Dose
Calculation Rigor
15.3.3 Spatial Resolution and Calculation Speed
15.3.4 Required Information
15.3.5 Independent Dose Calculation
15.4 DEFINITION OF THE GEOMETRY AND MEDIA
15.4.1 Coordinate Systems
Imaging/Simulation
Treatment Plan
Treatment
15.4.2 Definition of Media
Determination of Electron Density from CT - Theoretical
Determination of Electron Density from CT - Experimental
Determination of Media Composition
Determination of Media from Other Imaging Modalities
Estimation of Electron Scattering and Stopping Power from CT
15.4.3 Medium for Calculation and Specification of Dose
15.4.4 Geometry and Calculation Grids
15.4.5 Depth and Path-Length Scaling in Heterogeneous Media
15.4.6 Medium Artifacts
15.5 CLASSIFICATION OF ALGORITHMS
15.6 ALGORITHMS BASED ON EMPIRICAL DESCRIPTIONS OF DOSE DISTRIBUTIONS
15.6.1 Basic Point Dose and MU Calculations
Calculation Based on TPR
Calculation Based on PDD
Kilovoltage Therapy Output
15.6.2 Combining Primary and Scatter
Primary Dose in a Phantom
Addition of Scatter
15.6.3 Corrections for Inhomogeneities
Alteration of Isodose Curves by Contour Shape
Dose Corrections for Tissue Inhomogeneities
15.6.4 Corrections in Non-uniform Fields
15.7 ALGORITHMS BASED ON DEPOSITION KERNELS
15.7.1 Dose Deposition Kernels
15.7.2 Calculation with Pencil Beam Kernels
Correction for Inhomogeneities
Correction for Energy and Directional Variations
15.7.3 Calculation with Point Kernels
Correction of Kernel for Inhomogeneities
Correction of Kernel for Energy Variations
Correction of Kernel for Directional Variations
Collapsed Cone Convolution
15.8 ALGORITHMS BASED ON EXPLICIT PARTICLE TRANSPORT
15.8.1 Stochastic Methods
Monte Carlo Requirements
Geometry, Beams and Environment
Medium
Dose and Uncertainty
15.8.2 Deterministic Methods
15.9 COMPARISON OF PHOTON DOSE CALCULATION ALGORITHMS
15.9.1 Differences in Dose Calculation
15.9.2 Clinical Impact of Differences in Dose Calculation
SUMMARY
PROBLEMS
REFERENCES
Chapter 16 PHOTON BEAM TREATMENT: DOSE PRESCRIPTION AND REPORTING
16.1 THE RADIOTHERAPY TREATMENT CYCLE
16.2 UNCERTAINTIES IN TREATMENT PLANNING AND DELIVERY
16.2.1 Dosimetry
16.2.2 Geometry
Equipment-Related Uncertainties
Patient and Organ Positioning
16.3 DEFINITION OF VOLUMES
16.3.1 Definition of Anatomical Volumes
16.3.2 International Volume Definitions - Margins
Target Volume
Establishing the Setup Margin
OAR Volume
Treated Volume
16.3.3 Definition of Functional Volumes
Continuous Functional Distributions
Discrete Functional Volumes
16.4 DOSE SPECIFICATION AND EVALUATION
16.4.1 Dose Prescribing and Dose Reporting-Dose-Volume
Reference Points
Dose-Volume Histograms
Dose-Volume Parameters
16.4.2 Dose Evaluation-Physical Metrics
Evaluation Using Dose-Volume Parameters
Other Physical Metrics
16.4.3 Dose Evaluation-Radiobiological Metrics
TCP, NTCP, and UTCP
Fractionation Correction
Equivalent Uniform Dose (EUD)
16.4.4 Dose Prescription
Physical Prescription
Radiobiological Prescription
16.4.5 Spatial Dose Assessment
SUMMARY
PROBLEMS
REFERENCES
Chapter 17 PHOTON BEAM TREATMENT: PLANNING AND DELIVERY
17.1 TREATMENT BEAM DEFINITION
17.1.1 Pairs of Beams
Opposing Pairs of Beams
Combinations of Opposing Pairs
17.1.2 Wedged Fields
17.1.3 Multiple Coplanar Beams with Beam Shaping
17.1.4 Coplanar Rotation and Arc Therapy-Static Fields
17.1.5 Beam Modulation
17.1.6 Rotation and Arc Therapy-Modulated Fields
17.1.7 Noncoplanar Delivery
17.1.8 Stereotactic Treatments
Stereotactic Treatments with Multiple Static Sources
Stereotactic Treatments with C-arm Accelerators
Stereotactic Treatments with Robotically Mounted Accelerators
Comparison of Stereotactic Techniques
17.1.9 Matching Fields
17.1.10 Whole Body Irradiation
Conventional
Targeted
17.2 TREATMENT PLAN OPTIMIZATION
17.2.1 Treatment Planning as an Optimization Problem
17.2.2 Objectives, Constraints, and Search Space
Cost Functions
Constraints
Search Space
Constraints as Objectives
Radiobiological Objectives
17.2.3 Solutions
Solution Acceptability and Sources of Information
Convexity
Degeneracy
Robustness
17.2.4 Optimization Algorithm
Starting Point
Search Algorithm
Deterministic
Stochastic
Finishing Point
Bixel-Based vs. Direct Aperture Optimization
17.2.5 Multi-criteria Optimization
17.3 TREATMENT VERIFICATION, CORRECTION, AND ADAPTATION
17.3.1 Geometric Verification
kV vs. MV X-ray Imaging
In-Room Imaging Options for IGRT
Digitally Reconstructed Radiographs for Verification
Positioning and Immobilization
Target Localization
17.3.2 Geometric Correction
Setup Correction
Motion Management
17.3.3 Dosimetric Verification
Imaging Panels as Dosimeters
Pre-treatment Verification
Direct Patient In Vivo Dosimetry
In Vivo Dosimetry Using Imaging Panels
Dose Recalculation and Accumulation
Dosimetric Audit
17.3.4 Treatment Adaptation
Manual Adaptation
Adaptive Re-planning
Real-time Adaptation to Motion
17.3.5 Functional Guidance, Adaptation, and Assessment
SUMMARY
PROBLEMS
REFERENCES
Chapter 18 EXTERNAL ELECTRON BEAMS
18.1 ELECTRON BEAM CHARACTERISTICS
18.1.1 Initial Electron Beam
18.1.2 Scattering Foils
18.1.3 Collimation
18.1.4 Modulated Fields
18.1.5 Intervening Components
18.1.6 Leakage
18.1.7 Neutron Production and Activation
18.1.8 Final Beam
18.1.9 Source Models for Electron Beams
18.2 ABSORBED DOSE IN A SCATTERING MEDIUM
18.2.1 Electron Pencil Beams
18.2.2 Surface Dose
18.2.3 Dose Build-up
18.2.4 Beyond dm
18.2.5 Relationship Between Beam Quality and Central Axis Dose Distribution
18.2.6 Contamination/Bremsstrahlung Tail
18.2.7 Off-Axis Distribution
18.2.8 Oblique Incidence
18.2.9 Medium Inhomogeneities
18.2.10 Internal Shielding
18.2.11 Equivalent Fields
18.2.12 Output Variations
18.3 ELECTRON BEAM DOSE CALCULATION
18.3.1 Calculation of Output
18.3.2 Pencil Beam Algorithm
Determination of Spatial Dependence
Impact of Beam Angular Variations
Conversion to Dose
Dose Distribution for Arbitrary Field Shape
Incorporating Bremsstrahlung
More Rigorous Pencil Beam Methods
18.3.3 Monte Carlo
18.3.4 Comparison of Pencil Beam Algorithms with Monte Carlo
18.4 ELECTRON BEAM TREATMENT PLANNING AND DELIVERY
18.4.1 Dose Specification
18.4.2 Treatment Beam Placement
18.4.3 Shielding
18.4.4 Bolus Compensation
18.4.5 Electron Field Matching
18.4.6 Electron-Photon Field Matching
18.4.7 Total-Skin Electron Therapy
Fixed-Fields Technique
Rotational Technique
18.4.8 Electrons vs. Photons for Superficial Treatments
18.5 TABULAR DATA IN THE APPENDIX
SUMMARY
PROBLEMS
REFERENCES
Chapter 19 RADIOTHERAPY WITH NEUTRONS, PROTONS AND HEAVY IONS
19.1 RATIONALE FOR CONSIDERING HIGHER LET PARTICLES
19.1.1 Neutrons
19.1.2 Protons
19.1.3 Heavy Ions
19.2 NEUTRON RADIOTHERAPY
19.2.1 Early Studies with Neutrons
19.2.2 Neutron Generating Equipment, Dosimetry and Treatment Planning
Deuterium Tritium (D-T) Generators
Cyclotrons
Collimation of Fast Neutrons
19.2.3 Current Fast Neutron Therapy Programmes
19.2.4 Boron Neutron Capture Therapy
Therapeutic Basis for BNCT
Neutron Sources
Suitable Boronated Compounds
Treatment Planning
Clinical Results
19.3 PROTON RADIOTHERAPY
19.3.1 Clinical Indications for Charged Particle Therapy
19.3.2 Proton Treatment Radiobiology and Fractionation
19.3.3 Proton Beam Facilities
19.3.4 Scanning Spot Beams versus Passive Scattering
19.3.5 Treatment Planning
19.4 HEAVY PARTICLE BEAMS
19.4.1 Carbon Ions
19.4.2 Other Particles and Heavy Ions
19.5 THE FUTURE OF PARTICLE THERAPY
PROBLEMS
REFERENCES
Chapter 20 BRACHYTHERAPY
20.1 BRACHYTHERAPY-INTRODUCTION
20.1.1 Historical Perspective: Radium and Radon
20.1.2 Definitions and Classifications
20.2 SOURCES USED IN BRACHYTHERAPY AND THEIR PHYSICAL CHARACTERISTICS
20.2.1 Gamma-Emitting Radioisotopes Used in Brachytherapy
Cesium-137
Cobalt-60
Gold-198
Iridium-192
Iodine-125
Palladium-103
20.2.2 Beta-Emitting Radioisotopes Used in Brachytherapy
Ruthenium-106
Strontium-90
Phosphorus-32
20.2.3 Neutron-Emitting Radioisotopes Used in Brachytherapy
Californium-252
20.3 DOSE PRESCRIPTION AND CALCULATIONS
20.3.1 Introduction: Historical Perspective
20.3.2 The Stockholm and Paris Systems
20.3.3 The Manchester System
20.3.4 Current Dosimetric Systems
20.3.4.1 TG-43 Calculation
20.3.4.2 Model-based Calculation
20.3.5 Current Dosimetric Systems
20.3.5.1 Intracavitary Brachytherapy
20.3.5.2 Interstitial Brachytherapy
20.3.5.3 Superficial Brachytherapy (Surface Plaques and Molds)
Eye plaques
Surface molds
20.3.5.4 Intravascular Brachytherapy
Temporary Intravascular Brachytherapy
Permanent Intravascular Brachytherapy
20.4 MINIATURE X-RAY THERAPY SOURCES
20.4.1 Introduction
20.4.2 Xoft® Source
20.4.3 Intrabeam®
20.5 QUALITY ASSURANCE AND RADIATION SAFETY WITH SEALED SOURCES
20.5.1 Quality Assurance and Radiation Safety in HDR Brachytherapy
20.5.2 Quality Assurance and Radiation Safety in LDRBrachytherapy with Interstitial Implants
20.5.3 Quality Assurance and Radiation Safety in Brachytherapy Using Eye Plaques
20.5.4 Quality Assurance and Radiation Safety in Intravascular Brachytherapy
20.6 UNSEALED SOURCE RADIOTHERAPY-HISTORICAL PERSPECTIVEAND GENERAL CONSIDERATIONS
20.6.1 Unsealed Source Radiotherapy-Historical Perspective
20.6.2 Classification of Radioisotopes
20.6.3 Clinically Used Unsealed Radioisotopes
20.7 UNSEALED SOURCES USED FOR THERAPEUTIC PURPOSES
20.7.1 Iodine-131 (Radioiodine)
20.7.2 Phosphorus-32
20.7.3 Lutetium-177, Yttrium-90, and Indium-111
20.8 UNSEALED SOURCES USED FOR PALLIATIVE PURPOSES
20.8.1 Strontium-89
20.8.2 Samarium-153
20.9 QUALITY ASSURANCE FOR UNSEALED SOURCES AND RADIATION SAFETY
20.10 ADVANTAGES OF BRACHYTHERAPY OVER EXTERNAL BEAM RADIOTHERAPY
PROBLEMS
REFERENCES
Chapter 21 MOLECULAR RADIOTHERAPY
21.1 INTRODUCTION
Learning from external beam irradiations
Unsealed isotopes therapies: coming of age?
21.2 OPPORTUNITIES AND CHALLENGES FOR MOLECULAR RADIOTHERAPY
Thyroid cancer
Hematological malignancies
Metastatic neuroendocrine tumors (NETs).
Metastatic, castration-resistant prostate cancer
Pediatric malignancies
Alpha-therapies for a range of malignancies
Beyond palliation? Bone-seeking radionuclidic therapy that extends life
21.3 HYBRID EXTERNAL BEAM AND MOLECULAR RADIATION THERAPIES
21.4 LQ MODEL APPLIED TO MOLECULAR RADIOTHERAPY
EBRT mechanisms vs. MRT mechanisms
21.4.1 BED and Lea-Catcheside Factor
Limiting values of G
G and BED expressions for MRT
Variations in parameters a, b and TP
21.5 APPLICATION OF BED TO PLANNING AND IMPLEMENTATION OF HYBRID THERAPIES
Limitations of the method
21.5.1 Example of Hybrid Therapy
21.6 INTERNAL RADIOPHARMACEUTICAL DOSE ASSESSMENT
21.6.1 The Absorbed Dose in EBRT and MRT
21.6.2 Different Approaches to Absorbed Dose Assessment
Historical development
21.6.3 Simplified Development of MIRD Formalism
Calculating the Mean Absorbed Dose in MIRD: Time-integrated Activity Ã
Calculating the Mean Absorbed Dose in MIRD: The S-Factor
Combining Ã and S-Factor
21.6.4 General Time-dependent Formulation of MIRD
21.6.5 Time-independent Formulation of MIRD
Self-irradiation of a Target
Conversion to Equivalent Dose: Limitations of Concept
21.7 THE "RADAR" FORMULATION
Calculation of the Time-integrated Activity
Calculation of the Dose Factor: Use of Computational Phantoms
21.8 THE EFFECTIVE DOSE: LONG-TERM STOCHASTIC RISK PREDICTION
21.8.1 Efficacy and Limitations of the Effective Dose
Comparison between dose coefficients
21.8.2 Dose Assessments of Common DiagnosticNuclear Medicine Investigations
Limitations of the "Effective Dose" Concept in Nuclear Medicine
21.9 RELATIVE BIOLOGICAL EFFECTIVENESS: STOCHASTICAND DETERMINISTIC PREDICTIONS
Linear energy transfer
Variations in LET for particles.
21.9.1 Consideration of RBEm for Deterministic Effects
Determinants of RBEm
RBE-weighted Absorbed Dose
21.10 OTHER DOSE-RELATED QUANTITIES FOR PREDICTINGDETERMINISTIC EFFECTS
21.10.1 Biologically Effective Dose
21.10.2 Dose Volume Histogram (DVH) and BED Volume Histogram (BVH)
21.10.3 Equivalent Uniform Dose (EUD)
21.10.4 Isoeffective Dose (DIsoE)
21.11 NORMAL TISSUE COMPLICATION PROBABILITY (NTCP)CURVE AND APPLICATIONS
21.11.1 Predicting MRT Renal Toxicity Using NTCP and BED
Aligning Outcomes of Different Treatments Using NTCP and BED
SUMMARY
PROBLEMS
REFERENCES
Chapter 22 RADIATION PROTECTION
22.1 INTRODUCTION
22.2 RADIATION QUANTITIES AND UNITS
22.2.1 Absorbed Dose. Organ Dose
22.2.2 Equivalent Dose and Radiation Weighting Factors
22.2.3 Effective Dose and Tissue Weighting Factors
22.3 SOURCES OF RADIATION
22.3.1 Background Radiation
22.3.2 Man-Made Radiation
22.4 EXPOSURE TO IONIZING RADIATION
22.4.1 Deterministic and Stochastic Effects
22.4.2 Dose Limits
Dose to the Embryo and Foetus
Dose to Patients with Implanted Electro-mechanical Devices
22.4.3 Exposure to Personnel from Diagnostic and Interventional Radiology
22.4.4 Risk of Second Cancer after Radiotherapy for Primary Cancer
22.4.5 Radiation Hormesis
22.5 RADIATION SHIELDING
22.5.1 Radiation Sources
22.5.2 Shielding Materials
22.5.3 Factors Affecting Shielding Calculations
Workload
Use Factor (U )
Direction Factor (f )
Occupancy Factor (T)
Inverse Square Law
Regulations
22.5.4 Shielding Calculations for External Beam Facilities
Primary Barriers
Secondary Barriers
Mazes
Shielded Doors and Ducts
Sky Shine
Photo-Nuclear Activation
Specialist Facilities
22.5.5 Shielding Calculations for Brachytherapy Techniques
High-Dose Rate Brachytherapy
After-loading Low-Dose Rate Brachytherapy
Other Techniques
22.5.6 Shielding Calculations for Diagnostic Radiology Facilities
22.5.7 Detailed Report Summarizing Calculations Performed
Provision of Room Design (including Plans and Elevation)
22.6 RADIATION SHIELDING EVALUATION
22.6.1 Inspection Before and During Bunker Construction
22.6.2 Radiation Warning Lights, Interlocks and Restrictions on the Access for Staff, Patients and the General Public
22.6.3 Radiation Survey and Report
22.7 PERSONNEL MONITORING
22.7.1 Personal Radiation Dosimeters - Types and Characteristics
22.7.2 Operational Quantities for Personnel Dosimetry
PROBLEMS
REFERENCES
APPENDICES
Appendix A BASIC DATA
Appendix B PHOTON RADIATION THERAPY DATA
Appendix C ELECTRON RADIATION THERAPY DATA
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Johns and Cunningham's The Physics of Radiology

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