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: The smallest indivisible part of anelement having all the characteristics of that
element is known as Atom.
Atoms are specified as ZXA
Where, Z = atomic number, and A = mass number.
According to Niels Bohr, electrons revolve inspecific orbits around the nucleus, named as K,L,Metc; K being innermost orbit.
These orbits are synonymous with energy levels.
Here energy refers to the potential energyof theelectron. This energy depends upon the coulombforces of attraction b/w the nucleus and the orbitalelectrons. Higher the atomic number greater isthis binding energy.
Energy level diagram (H2nucleus
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The term radiation applies to the emission and propagation of energy through
space or a material medium.RADIATION
ELECTROMAGNET
IC
PARTICULATE
:
Refers to the energy propagated by traveling
corpuscles, which have definite rest mass, definitemomentum and a defined position at any instant.
Elementary atomic particles: electron, proton, neutron.
Positron, neutrino and mesons are subatomic particles.
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Mode of energy propagation forphenomena such as light waves,X
Rays, Rays etc. Was defined by Maxwellin terms of
oscillating electrical and magneticfields being at right angles to eachother.
Travel with velocity of 310m/s in free space
Transfer energy from place to place in quanta (E= h)
In passing through matter the intensity is reduced because ofabsorption and scatter
Obeys inverse square law in free space, i.e intensity at any
place varies inversely as the square of distance (I 1/d2 )
EM radiation ranges from the
wavelength of 107 m(radio waves) to 10-13 m (Ultra high-energy x-rays).
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TWO MAJOR FORMS OF ELECTROMAGNETIC RADIATION USED INMODERN DAY RADIOTHERAPY:
Discovered by Wilhelm Rontgen in 1895.
Two different mechanism of X Ray production:
Characteristic X rays:Emitted when incidentelectrons with a kinetic energy > BE of the orbitalelectrons, ejects the orbital electron and leaves the
atom ionized. The resulting vacancy when filled byouter electrons result in emission of characteristicradiation
Bremsstrahlung: Radiative collision(interaction) b/w a high speed incident electron andnucleus. The electron passing near a nucleus, suffers a
sudden deflection and deceleration due to Coulombforces of attraction lose a part of its energy asbremsstrahlung radiation
The nuclei with unstable n/p combinations undergo intranuclear
disintegration to achieve more stable state with release of charged particle/ EM radiationsknown as GAMMA RAYS.
Co Ni+ e- + (2 photons of energies 1.17 and 1.33 MeV)
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DIRECTLY IONISING INDIRECTLYIONISINGCharged particles:
electrons
protonsalpha particle
Uncharged ParticlesNeutrons
Protons
photoelectric effect compton effect pairproduction
High speed electrons
ionisation and exitation
Biological Effects
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The photon-beam may undergo the following four processes:
Attenuation: removal of radiation from the beam by the matter.
Attenuation may occur due to scattering and absorption.
Absorption: taking up of the energy from the beam by the irradiated
material. It is absorbed energy, which is important in producing the
radiobiological effects
Scattering: change in the direction of the photons and it contributes to
both attenuation and absorption. Its a cause ofproblem in both
diagnostic and therapeutic radiology.
Transmission: Any photon, which does not suffer the above processes
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Attenuation occurs exponentially, that
is a given fraction of the photos is
removed for a given thickness of the
attenuating material. Thus its
impossible to reduce this beam to
nothing.
Attenuation (dN i.e. reduction in number of photon) is proportional to numberof incident photons (N) and thickness of absorber (dx)
dN Ndx
Also Higher Z more attenuation; Higher photon energy smaller
A reduction in intensity of beam of radiation when it passes through anymaterial
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The fractionalreduction
produced in any monoenergeticphoton beam; is constant for anygiven material per unit thickness (cm-1).
dI/I = - dx = 0.693/ HVL
Depends on:
1. energy of the photons2. nature of material i.e. the no. of electrons present in that
thickness and densityof the material.
dividing linear attenuationcoefficient by density; is a more fundamental coefficient. Does notinvolve density but rather the atomic composition.
Other coefficients which are more fundamental include:Atomic attenuation coefficient (atoms/cm)Electronic attenuation coefficient (electrons/ cm)
= 0.1/cm
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Thickness of a given material requiredto attenuate the intensity of a beam to
half of its original value. = 0.693/HVL
HVL is an expression of thequality/penetrating power of the
beam.
For a heterogeneous beam,1st andsubsequent HVLs are not constant, but1st HVL is less than subsequent HVLs.
An important clinical implication of hvlis in SHIELDING.
For practical purposes, the shielding
material which reduces beamtransmission to 5% of its original is
considered acceptable.
Semilog plot showing exponential
attenuation of a monoenergetic beam
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After passing through 5HVL, intensityof a monoenergetic beam reduces toless than 5% of original
The recommended minimumthickness of lead for shieldingforvarious megavoltage beam qualitiesis
Co60 - 5.5cm
4MV - 6.0cm
6MV - 6.5cm
10MV - 7.0cm
25MV - 7.0cmHVL MEASUREMENT: Material for HVL measurement vary with energy ofradiation.
Radiation upto 30kV-CellophaneRadiation at 30-150kV-AluminiumRadiation at 120-600kV-Copper
Radiation at 500kV-2MV-Lead
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Coherent scattering
Photoelectric effect
Compton effect
Pair production.
Photodisintegration
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(ELASTIC SCATTERING/UNMODIFIED SCATTERING/CLASSICAL SCATTERING/RAYLEIGH SCATTERING)
Process described by considering
radiation as waves rather than asparticles.
Involves bound electrons.
Occurs with higher atomic number
materials and low energy radiations(
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In this phenomena, the photon
disappears altogether afterinteracting with the bound electron.
Entire energy of the photon istransferred to an orbital electron.While part of the incident photonenergy is used to overcome thebinding energy, the rest of it is usedas the K.E. of the photo electron.
h= BE + mv
The process results in ionization ofthe atom and the resulting vacancythus created is filled by an outer shell
electron with emission ofcharacteristic X rays (fluorescentradiation) of the atom.
internal atomicabsorption
Auger electrons
(internal PE effect)
The angular distribution of emittedphoto electrons depend on thephoton energy:
For low energy: 90 degreesFor higher energies:
progressively
forward direction.
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Mass photo electric coefficient (/) :
/ = k Z/E
ABSORPTION EDGES :
/ versus photon energy plot shows
discontinuities at levels of energies
corresponding with the binding energies of
the various electronic shells.
Two important consequences
Near the absorption edges, the lower
energy photons are less attenuated andmore penetrating than higher energy
photons.
Any substance is transparent to its own
characteristic radiation, energies of which
are always a little less than corresponding
binding energies.
Mass photoelectric attnuation coeffecient plottedagainst photon energy
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PE effect forms the basis of many applications in diagnosticradiology.The difference in atomic number of various tissuessuch as bones, nucleus and fat amplifies the differencein X ray absorption to Z times.
This Z dependence is also exploited when usingcontrast mediums with high atomic numbers (BaSO4and hypaque).
The Z dependence also leads to higher absorption ofenergy in bones while using orthovoltage machines, wherePE effect is dominant.
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(MODIFIED/INCOHERENT/INELASTIC SCATTERING)
Arthur Holly Comptonin 1923
Predominates between 200KeV and
4MeV.Photons interact with freeelectrons
The photon collides with electron andhands over part of its energy to it and
itself continues in a new direction (i.e.its scattered) but with reduced energyand hence increased wavelength.
The wavelength change depends neither
on the material being irradiated nor onthe radiation energy, but only upon theangle through which the radiation isscattered.
The Compton effect results in both
attenuation and absorption.
If the angle by which the electron isscattered is and the angle bywhich the photon is scattered is, then the following formuladescribes the change in thewavelength ()of the photon:
1 2 = = 0.024 ( 1- cos )
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Energy of scattered electron is :
E = h ( 1- Cos)1 + (1- Cos)
Energy of scattered photon is :
h = h .1 + ( 1- Cos)
Where, = h /mc { also, mc = 0.511MeV}h = energy of incident photon
Direct hit (= 180 degree, = 0degrees): Will result in electronreceiving maximum possibleenergy while the scatteredphoton will be left with minimum
possible energy.
Grazing hit(= 0 degree, =90 degrees): Will result inscattered electron with noenergy and scattered photon
with maximum energy.
Independent of Z,
depends only on thenumber of electrons pergram.
The coefficient is
practically same for allelements excepthydrogen, since electronper gram for all elements
except hydrogen is
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The Compton attenuation coefficient does
not depend on the atomic number, so, for
shielding in megavoltage radiation any
material can be used with similar efficacy.
There is no excess radiation absorption by
bones as compared to soft tissues in the
megavoltage range where Compton effect is
dominant.
No bone shielding effect, as seen in
orthovoltage radiation with dominant
photoelectric effect.
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The fraction of the energy imparted to the recoil electron
increases as the beam energy increases. So, higher beam
energies allow greater absorption of radiation dose in the
body with less scattering of energy.
As the photon energy increases there is a corresponding
increase in the forward scatter of the beam, resulting in
better dose distribution.
The radiation scattered is independent of incident energy
and has a maximum energy of 0.511 MeV at 90 degrees and
0.255MeV for the radiation scattered backwards; the photons
scattered at angles < 90 degrees will have energies more
than 0.511MeV gradually approaching the incident photon
energy
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Photon of energy > 1.02 MeV interacts strongly withelectromagnetic field of nucleus, the photon disappears, and apositron (e+) and an electron (e-) appear. This effect is known aspair production
Particles travel in a forward direction relative to the incidentphoton. Any energy distribution is possible, but
usually divided equally i.e. halfof the
available energy (hv - 1.02) MeV
ANNIHILATION RADIATION
e+ + e-
Ray
0.511Mev
Ray
0.511Mev
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Pair production results froman interaction with theelectromagnetic field of
the nucleus and as suchthe probability of thisprocess increases rapidlywith the atomic number( Z2)
In addition, the likelihood ofthis interaction increasesas the logarithm of theincident photon energy
above the treshold ( lo E
CLINICAL
IMPLICATIONS: Beyond 4 MeV pair
production results inincreasing mass
attenuation coefficientsspecially for higheratomic numberelements.
High energy radiations
(>20 MeV) are less
penetrating than somelower energy radiations
and are not used inradiothera .
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Interaction of a high energy photon with an atomic nucleus leading to
emission of one or more nucleons, mostly neutrons.
Occurs when the photon has energy greater than the binding energyof the nucleus itself.
Example : Cu + Cu + n Threshold energy: the difference between the rest energy of the
target nucleus and that of the residual nucleus plus the emittednucleons. For majority of atoms the threshold energy for this effect isabout 10 MeV.
Chances of occurrence increases rapidly with increasing energy untilmaximum is reached at 5MeV above threshold, after this the chancefalls off with equal rapidity.
Nowadays, the main use of this reaction is for energy calibration of
machines producing high energy photons.
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Total mass attenuationof beam is sum of four individual coefficients
(/) = ( /) + (coh/) + (/) + (/)
total P.E coherent compton pair
So, the energies important for radiotherapy ranges from orthovoltage(50 - 500kev) to megavoltage( 4-20 MeV).
At low energies PE is
dominant decreases rapidly
with increase in energy to
reach a minimum at 0.1
MeV, in low Z materials.
medium energy range i.e
from 0.2 to 4 MeV, Compton
effect is the predominant
mode of attenuation in low
atomic number materials
pair production starts at
1.02MeV and increases with
photon energy, making very
high energy(>20 MeV) less
penetrating
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Taking up of energy from thebeam by the irradiated material
Most of electrons set in motionby the above interactions loseenergy by inelastic collisionswith the atomic electrons of thematerial.
A few electrons will lose energyby the Bremsstrahlunginteractions with the nuclei. Thisenergy is irradiated out of thelocal volume as X-rays and istherefore not included in thecalculation of locally absorbedenergy.
In most interactions involvingthe soft tissues, thebremsstrahlung component is
negligible
ENERGY ABSORPTION
COEFFICIENT:The product of the
energy transfercoefficient(tr) and (1-g)where g is the fraction of
energy of secondarycharged particles lost toBremsstrahlung in thematerial.
en =tr(1-g)
Mass energy absorptioncoefficient: en/
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91% 15% 46% 71% 96%
% of attenuated energy which is absorbed
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FEATURE ORTHOVOLTAGE MEGAVOLTAGE
ENERGY 50-150-500 KeV 4-20Mev
SOURCE Electricity Electricity/Radioisotopes
SKIN SPARING Absent Present
PENETRATION Less More
BONE SPARING Absent Present
BONE SHEILDING Present Absent
DOSE RATE Less High
PDD Lower Higher
SSD 40 cm 80-100 cm
BEAM MODIFICATION Difficult Easy
RBE More Less
LET More Less
ORTHOVOLTAGE VERSUS MEGAVOLTAGE
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PARTICULATE RADIATION
Ionizing/ Charged particles Uncharged particles
Electrons (e+) Neutrons
Protons (p+)
Alfa particles (4He2)
Pi-mesons (+/-/0)
The charged particle interactions are mainly mediated byCoulomb forcesbetween the electric fields of the travellingcharged particle and the electric fields of orbital electron andnuclei of atoms
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modes of interactions of charged particles
STOPPING POWER
Rate of kinetic energy loss per unit path length of the particleS=dE/dx
Rate of energy loss or stopping power is proportional to the square ofparticle charge and inversely to the square of its velocity.
S= k charge/velocity
Thus as the particle slows down, its rate of energy loss to the
medium increases
COLLISIONAL LOSSCollision between the particleand the electron cloudresulting in ionization orexcitation ( more importantin low Z elements)
RADIATIVE LOSSCollision between nucleus andcharged particle, resulting in
Bremsstrahlung radiation
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:
As the particle slows down itsrate of energy loss increasesand so does the ionization orabsorbed dose to themedium. This peaking ofdose at the end of theparticle range is called theBraggs peak.
Seen with protons andheavier charged particles,not with electrons.
The protons and heavier charged particles provide a muchsought after advantage in radiotherapy; their ability toconcentrate dose inside a target volume and minimize dose to
the surrounding normal tissues
CLINICALIMPLICATION :
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Electrons are light particles with negligible mass and single negative charge. As
a result they penetrate deeperthan other charged particles but at the same time
undergo greater scattering
Electrons lose energy predominantly by ionization and excitation.
May interact with the electric field of the nucleus and result in Bremsstrahlung
radiation. The probability of Bremsstrahlung increases with electron energy and
atomic number of medium.
Suffer multiple scattering and direction change, because of smaller mass. This
leads to a smudging of the Bragg's peak which is hence not seen in electrons.
DELTA RAY: An electron ejected as a result of ionization, having sufficient
energy to produce an ionization track of its own is called secondary electron or
delta ray.
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The ionization pattern produced by a beam of electrons ischaracterized by a constant value from the surface to adepth equal to about half the range, followed by a rapid
dose falloff to almost zero at a depth equal to the range.
ThisRapid dose fall off is speciallyis specially seen in
electrons in the energy range of6 -15 MeV making these useful treatment modality forsuperficial lesions.
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Neutrons are indirectly ionizing.
Interact basically by two processes:
1) Nuclear disintegrations, with emission of heavy charged particles,
gamma rays and neutrons; contributing around 30% of the total dose in
tissues.
2) Recoiling protons (predominant process) from hydrogen and recoiling
heavy nuclei from other elements, leading to redistribution of energy
between the colliding particles.
The most efficient recoil is seen if the colliding particle have same
mass(e.g. hydrogen nucleus) and this leads to the maximumabsorption.
This phenomenon has some practical implications: Hydrogenous materials like fats absorb neutrons more than heavier
materials and thus there is a 20% greater absorption in fat relative to
muscle.
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The recoil protons, set in motion after interaction with neutrons,
further cause ionization. The dense ionization produced by these
particles in the vicinity, results in high LET values more likely toinduce lethal damage in cells due to the dense ionization they
produce.
Biological effects of neutrons do not depend much on the
presence or absence of oxygen i.e. low Oxygen Enhancement
Ratio (OER).
Neutrons, being uncharged particles also penetrate deeply into
matter.
Despite these attractive radiobiological and physical properties,
neutrons are not commonly used in practical radiotherapy,
because of technical difficulties in production of these beams as
well as their complicated dosimetry.
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Have a very high linear energy transfer (LET) that is they havea very high ionization density
Exhibit the phenomena ofBraggs peak
However there are several practical and theoretical difficultieswith the use of these charged particles. Some of them include:
Width of the Braggs peak is very small (0.5cm) leading toinhomogeneous tumor dose in larger tumors
Generation of these charged particles requires expensive
and large machines. These large machines necessary forproduction of these beams often make it necessary to movethe patient instead of the gantry!
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The reactions that most commonly lead to cell damage usually occur at thelevel of the DNA although they may occur at the level of cell membranes,proteins etc.
Lethal double stranded DNA breaks are often irreparableand persist inthe form of micronuclei formation, chromosomal aberrations and loss ofreproductive integrity.
Some degree of protectionfrom chemical effects can be provided byaddition of anti oxidantswhich compete and take up some of the free
radicals
Radiation interacts with the atoms ofthe DNA molecule, or some othercellular component critical to the
survival of the cell
When radiation interacts with water toproduce free radicals cell
destructionIonizing radiation + HO HO + e
HO + HOHO +OH cell
damage
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Cells can die in several ways: Apoptosis Mitotic catastrophe Senescence Necrosis Autophagy
: delayed, over aperiod of days.
Most important for the effect ofradiotherapy of solid tumors is mitoticcatastrophe, which is caused by lethalchromosome damage.After irridiation, cells can passthrough one or few mitotic cyclesbefore mis-segregation of
chromosomes leads to loss ofreplicative potential (or clonogenicity) ofcells multimicronucleated cells canbe detected.
: A characteristicof radiosensitive cells eg. neoplastichematopoitic or lymphatic cells, is
death from radiation induced apoptosisvia the intrinsic, caspase 9 dependentpathway.Early/premitoticP53 dependent;occurs within 2 - 6 hours afterirradiation before cells enter mitosis
(primarily a consequence of DNAdamage)Late/postmitosis occurs aftermitosis; due to radiation induced lethalchromosome abberation.
Radiation induced senescence(p53 mediated cell cycle arrest) plays an
important role for development of normal tissue damage, for example fibrosis.
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The three major forms of interaction of radiation with matter,which are of clinical importance in radiotherapy are:
1. Compton effect.
2. Photoelectric effect.
3.
Pair production. Compton effect is the most important in modern-day megavoltage
radiation therapy.
Photoelectric effect is primarily important in diagnostic radiology.
There are several unresolved issues pertaining to the use ofparticulate radiations.
Radiation ultimately affects cells by two mechanisms, direct (DNAdependent) and Indirect (free radical dependent).
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COMPTON EFFECT
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BREMMSTRALUNG RADIATION CHARACTERISTIC X-RAY
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Pair productionPHOTOELECTRIC EFFECT
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PHOTO-DISINTEGRATIONCHARACTERISTIC X
RAY
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