Clinical Radiation Physic

Atom
• An atom was the smallest indivisible component
of matter.
• subatomic particles : protons and neutrons in the
nucleus of the atom, and electrons orbiting that
nucleus.
• Electrons are negatively charged particles.
Protons are positively charged particles.
Neutrons are uncharged (neutral) particles.
• The diameter of an atom is about 10−8 cm
 Atom
• The mass number {A} :The total number of
protons and neutrons in a nucleus .
• The atomic number {Z} :The total number of
protons or electron .
• Electron has seven shell or energy levels :
{K,L,M,N,O,P Q } .
• Electron is revolving around nucleus so central
fussion force that keeping electron away .
 Radiation
• Def: The propagation of energy from a radiative
source to another medium .
• The transmission of energy can take the form of
particulate radiation or electro-magnetic
radiation (i.e., electromagnetic waves).
• visible light, X-rays and g-rays are grouped
together under the terms “electromagnetic
radiation”
• Proton ,Neutron ,Alpha ,Beta & Electron are
grouped under the term {particulate radiation }
 Radiation
• Radio waves → the longest wavelengths →the lowest
frequencies & energies .
• X-rays and g-rays→ the lowest wavelengths →the
highest frequencies & energies.
• Photon : the smallest unit of electromagnetic
radiation & has no mass .
• Common features of electromagnetic radiation :
(1) It propagates in a straight line.
(2) It travels at the speed of light (nearly 300,000 km/s).
 Radiation
(3) It transfers energy to the medium through
which it passes, and the amount of energy
transferred correlates positively with the
frequency and negatively with the wavelength of
the radiation.
(4) The energy of the radiation decreases as it
passes through a material, due to absorption and
scattering, and this decrease in energy is
negatively correlated with the square of the
distance traveled through the material.
 Radiation
• Type of radiation :
(1) Ionizing Radiation : has the ability to remove
electrons from atoms (high-energy) .
Ionizing radiation can be electromagnetic or particulate
radiation .
(2) Nonionizing electromagnetic radiation : e.g
Radio waves ,Microwaves , Infrared light ,Visible light &
Ultraviolet light.
Clinical radiation oncology uses photons
(electromagnetic) and electrons or (rarely) protons or
neutrons .
Type of radiation
 Electromagnetic Radiation
X-Rays
• X-rays were discovered by Roentgen in 1895 .
• X-rays tube : consist of :
(1) Glass envelop →empty from air (does not
oxygenation with tungsten) .
(2) Anode → positive electrode (tungsten
target) .
(3) Cathode → negative electrode (tungsten
filament ).
X-rays tube
X-rays tube
 Electromagnetic Radiation
• Physics of X-ray production : Two mechanisms :
First : Characteristic X-rays :
The photon (kinetic energy ) may interact with
atom of the target by ejecting an orbital electron
such as K,L M→ electron is leaving the atom
(ionization)→ an outer orbital electron is fall
down to fill that defect (loss of energy as
characteristic X-rays ) .
Characteristic X-ray generation
 Electromagnetic Radiation
Second : Bremsstrahlung X-rays:
The photon while passing near a nucleus may
deflected by action of coulomb forces of
attraction and loss an energy as bremsstrahlung
(Braking radiation ) .
X-rays produced by bremsstrahlung have a broad
energy spectrum (→ heterogeneous), while
characteristic X-rays are monoenergetic beams.
Bremsstrahlung X-rays
X-ray spectrum
 Electromagnetic Radiation
Mechanisms of action:
 The heat must be equilibrium throughout the X-
ray tube by using metallic oil :
(1) distributed the heat.
(2) separated area between anode & cathode
(high voltage difference) .
 Increase the current → Increase the production
of X-rays .(↑KeV → ↑energy ).
 Electromagnetic Radiation
If the electron is move from cathode to anode
→ the current of the tube is increase by ml Am
pair .In therapeutic X-ray machine {25 ml Am
pair} but in diagnostic X-ray machine {1000 ml
Am pair}→↑↑produced heat (rotating anode).
X-ray tube coated by lead to protected from RT.
The filter is absorb the soft radiation which can
affect skin pt (hazard) :
1) In diagnostic X-ray (low energy) less than
120KeV → Aluminum filter (0.5 → 4mm thick).
 Electromagnetic Radiation
2) In therapeutic X-ray:
a) Superficial X-ray : intermedium energy (120-
180 KeV)→ copper filter (0.3 – 0.5 mm thick).
b) Deep X-ray (orothovoltage ): high energy
(180 – 400 KeV)→ Sorious filter is content 3 layer :
first layer (proximal to tube) → tin.
second layer → copper (3mm thick).
third layer → Aluminum.
Filter can ↓X-ray & improving the beam quality .
 Half Value Layer {HVL}
• Def: The thickness of any material that reducing
the intensity of the beam to half from initial
value .
• Quality of beam is measured by HVL .
• Types of HVL :
(1) First HVL → decrease 50% of beam .
(2) Second HVL → decrease 25% of beam .
(3) Third HVL → decrease 12.5% of beam .
(4) Fourth HVL→ decrease 6.25% of beam .
HVL
 HVL
• The absorbent materials that are generally used
are aluminum, copper and lead.
• HVL of cobalt is 1.1 cm lead .
• Uses in radiotherapy :
(1) Filters.
(2) Blocks→ five HVLs thick transmits 3.125%
of the incoming radiation.(cobalt block is about
5.5 cm lead ).
• The HVL is generally used to characterize low-
energy X-ray machines.
 Electromagnetic Radiation
Gamma Rays
 Gamma rays are physically identical to X-rays,
but they are emitted from atomic nuclei .
 An unstable atomic nucleus →excess energy in
the form of either an intranuclear electron (e−)
(beta particle) or a helium nucleus (an “alpha
particle”). If it still possesses excess energy after
that, gamma rays are emitted in order to reach
its steady state.
Gamma Rays
 Gamma Rays
 Gamma rays have well-defined energies.
 For example : Cobalt 60 → two monoenergetic
gamma rays with a mean energy of 1.25 MV
(1.17 and 1.33 MV) are emitted after beta rays
of 0.31 MV energy have been emitted during
the decay of cobalt 60 .
Ionizing Radiation
 Ionizing Radiation
Electron Beam Therapy
 Electron is clinically useful in treatment of
superficial tumors : for examples
1) Treatment of skin & lip.
2) Treatment of H&N cancer { parotid}.
3)Boost dose to neck LN.
4)Total skin irradiation {mycosis fungicide}.
5)Boost dose to chest wall {breast cancer}.
 Electron Beam Therapy

 Electron is used as a single field .

 Electron interaction : it may interact with atomic
electron or nuclei of the medium .
(1) In low atomic number : eg water or tissue →
electrons lose energy mainly by ionizing atomic
electron ( ionization & excitation).
(2) In higher atomic number : eg lead→
electrons lose energy mainly by Bremsstrahlung
( braking radiation).
 Electron Beam Therapy
 Characteristics of clinical electron beams :
{1} Central axis depth –dose curves :
a) T here is region of uniform dose followed by
a rapid drop-off of dose . It ↓↓ with ↑ Energy.
b) The useful depth in cm { 80% - 90%} is equal to
1/3 – 1/4 of electron energy in Mev .
c) Use the higher En if you are doubt of depth.
d)NO skin sparing→ superficial tumor ttt .
e) Shield of electron = En/2 + 1 (lead) .
Electron Beam Therapy
 Electron Beam Therapy
{2} Isodose curves :
a) Electron scattering is the main cause of the
shape of isodose curve .
b) Spread of the isodose curve is due to scattering
it depending on: Energy, Field size & collimation.
c) Lateral bulging :
- in low En → all isodose curves.
- in high En → only low isodose curves bulge
out.
Isodose curve of electron
Isodose curve of electron
 Electron Beam Therapy
{3} X-ray contamination :
-The X-ray contamination dose at the end of
the electron range can be determined by reading
off the dose value when tail becomes straight at
central axis .
-It is caused by interaction of electron with
collimation system & the body tissues.
- In low En { less than 10 Mev} → applicator put
on the skin of pt but in high En { more than 10
Mev→ applicator put away from skin (15cm).
Relative depth dose distributions of photons and
electrons
Ionizing Radiation Units
 Ionizing Radiation Units
 Roentgen (R):{unit of exposure} In normal air
conditions (0°C and 760 mmHg pressure), this is
the amount of X-radiation or gamma radiation
that produces 2.58 × 10−4 coulombs of electrical
charge (in the form of ions) in one kilogram of air.
 Gray (Gy):{unit of absorption} This is the amount
of radiation amount that cause one joule to be
absorbed per kilogram of irradiated material.
1 Gy = 1 J/kg.
1 Gy = 100 cGy = 100 Rad
 Ionizing Radiation Units
 Becquerel (Bq): {Activity unit }This is an activity
of one disintegration per second.
1 Ci = 3.7 × 1010 Bq.
1 Bq = 2.7 × 10-11 Ci.
Radioactivity: This is the transition of an unstable
nucleus to a steady state through the emission
of particulate or electromagnetic radiation from
the nucleus.
 Curie (Ci): {Activity unit } This is an activity of
3.7 × 1010 disintegrations per second.
 Ionizing Radiation Units
Sieverts (Sv) : is the unit of radiation protection although
an older unit is called the rem .
1 Sv = 1Gy (dose equivalent ).
- If the dose is expressed in units of rad the dose
equivalent unit is rem.
1 rem = 10-2 j/kg.
1 rem = 10 mSv .

Kerma : is the kinetic energy released in the medium.{ The
first interaction point }.
The kerma is measured in the same units as absorbed dose
(Gy).
Ionizing Radiation Units
 The Interaction of Radiation with Matter
 Radiation is scattered and absorbed when it passes
through tissue.
The intensities of monoenergetic X-rays or gamma
rays attenuate exponentially within tissues.
I = I0 . e-mt {I = intensity of outgoing radiation beam ,
I0 = intensity of incoming radiation beam, m =
absorption coefficient , t = tissue thickness}
The intensity of radiation constantly decreases as it
propagates within tissues. This decrease depends on
the type of tissue and its thickness.
 The Interaction of Radiation with Matter
 Types of interaction : five types :
First :Photoelectric Effect : {less than 35 kV}
- Def: a phenomenon in which a photon interacts
with an atom & eject one of the orbital electron
from the atom .
- Occur usually in K,L,M or N shells .
- The photon is first absorbed by atom & then
transferred to atomic electron.
-The basic interaction in diagnostic radiology.
The Interaction of Radiation with Matter

- After electron has been ejected from atom{ an

excited state}→ filled by another orbital electron
with emission of characteristic X-rays .
- This interaction depend on :
(1) Energy of photon.
(2) Z number of the material.
- ψ(photoelectric effect) = Z3 ÷ E3
- The bone (Z= 14) is absorbed the energy 8 times
of the soft tissue (Z= 7) .Bone is become white .
photoelectric effect
The Interaction of Radiation with Matter

Second : Compton Effect :{35 kV–50 MV }

- The photon interacts with an atomic electron
{outer shell } → In this interaction the electron
receives some energy from photon & It is
emitted at an angle φ {scattering} , then the
photon with reduced energy is scattered at
angle Φ.
- Depend on : (1) Energy. (2) Number of electron
in atom .{ all material can absorbed the same→
the picture is become gray ) ‫ى‬
( ‫رماد‬
Compton Effect
Compton Effect
 The Interaction of Radiation with Matter
- In higher energy → scattering become forward &
become very little .
- In lower energy → scattering become back word
- In medium energy→ scattering become side
direction .
-The absorption of incoming radiation is the same for
bone and soft tissues .
- The basic interaction in therapeutic radiotherapy
- It has no dependency on the atomic number (Z) of
the absorbent material, but it does depend on the
electron density of the material.
The Interaction of Radiation with Matter
Third : Pair Production :
- The threshold photon energy level for pair
production is 1.02 MeV.
- The photon interact with the nucleus → creating
a pair consisting of a negative & positive electron
.
-The probability of pair production occurring
2
increases as Z increases. { ∏ ∞ Z }.
Pair Production
 The Interaction of Radiation with Matter
Forth : Photo disintegration :
- Occur in higher energy (more than 10 Mev ).
- The photon is inter to nucleus → reaction of all
particle into nucleus and emit the neutron with
gamma rays , Then the neutron is react with other
material in the room because the neutron has no
charge →Isotopes but these isotope has low half
time (second).
- Resolve : room → a) air condition to pick out the air .
b) low pressure . c) the door cover by material
absorbed the neutron (paraffin)
The Interaction of Radiation with Matter
fifth: Coherent Effect :
- Occur in lower energy and not use in therapy .
- The photon is hitting the electron → electron is
absorb the energy first & then give off the
energy out the atom .
- The coherent effect is the reason that the sky is
blue during the day and reddish at sunset .
Coherent Effect
 Radiotherapy machine
(1) Simulator machine :
- Very important machine in radiotherapy.
- Types of simulator :
A) Conventional Simulator.
B) CT Simulator .
- Mechanism of action : X-ray tube →
photoelectric effect .
 Functions Of Conventional Simulator
• Localize target and critical normal
structures.
• Generate Verification radiograph.
• Mark field outlines and reference points on
patient.
• Demonstrate feasibility of planned fields.
• Check block position.
• Determine mobile volumes.
 CT simulator

70cm or

85cm

Flat top couch

 Radiotherapy machine
(2) Cobalt-60 Teletherapy Unit:
- Natural radioactive source (1 to 2cm diameter ).
-The activity of the source is generally between
5,000 and 15,000 Ci .
- The decay of Co-60 starts with a beta−decay,
and then two gamma emissions with energies of
1.17 and 1.33 MV. {1.25Mev}
-The half-life of Co-60 is 5.27 years.
- Use for tumors with depths of <10 cm.
-The source–skin distance (SSD) is 80–100 cm.
Cobalt-60 Teletherapy Unit
 Radiotherapy machine
(3) Linear Accelerator (Linac) :
 A device that accelerates charge particle { e} to
acquire high energy by using electromagnetic
waves (with high freq.) through a linear tube .
 Magnetron : a device for producing microwaves
(electromagnetic waves ) of freq. 3000 μHz.These
waves vary functionally according to design of
accelerator { 1) Travelling wave accelerator.
2) Standing wave accelerator .
Magnetron
 Linear Accelerator (Linac)
 Types of radiation :
(1) Generation of X-ray : when electron beam
strikes a 1 mm tungsten target placed at the end
of the tube → Flattening filter (absorbed hazer
radiation & beam intensity uniform).
(2) Electron beam generation : The electron is
allowed to pass from the exit window of the
tube without striking the target(it is removed
from the end of tube )→ Scattering foil (to allow
a uniform with fluence .
linear accelerator (linac)
Linear Accelerator (Linac)
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