The physics & technology of radiation therapy

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The physics & technology of radiation therapy

by Patrick N. McDermott and Colin G. Orton

Medical Physics Publishing, c2010

  • : hard cover
  • : soft cover

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Includes index

内容説明・目次

巻冊次

: hard cover ISBN 9781930524323

内容説明

An introductory textbook to the physics and technology used in radiation therapy that is the outgrowth of a course taught to medical residents in radiation oncology and which has been classroom tested over many years. Every effort has been made to make explanations clear and simple without oversimplifying - the book has been designed to be interesting to read as well as clinically relevant. The first half of the book contains the radiation physics necessary to understand radiation therapy. The second half of the book covers the applied physics and technology of radiation therapy. Topics include: treatment machines, beam calibration, dosimetric parameters, MU calculations, dose distributions in patients, electron beams, brachytherapy, radiation safety, quality assurance, imaging, and special modalities. Features: Comprehensive end of chapter summaries; Numerous example-problems; Full problem set for each chapter with selected answers; Clinically-realistic linac dosimetry data for practice MU calculations; ABR physician board certification physics topic matrix; ARRT exam topic matrix.

目次

Preface Acknowledgments Chapter 1 Mathematics Review 1.1 Exponents 1.1.1 Multiplication 1.1.2 Division 1.1.3 An Exponential Raised to a Power 1.1.4 A Product Raised to a Power 1.1.5 Base e 1.2 Logarithms 1.3 Geometry 1.4 Trigonometry Problems Chapter 2 Review of Basic Physics 2.1 Units for Physical Quantities 2.2 Mechanics 2.2.1 Newton's Second Law 2.2.2 Work 2.2.3 Work Energy Theorem and Energy Conservation 2.2.4 Power 2.3 Electricity and Magnetism 2.3.1 Charge and the Coulomb Force 2.3.2 Electric Fields 2.3.3 Current 2.3.4 Potential Difference 2.3.5 The Electron Volt - A Unit of Energy Not Voltage 2.3.6 Magnetism 2.4 Electromagnetic Spectrum 2.5 The Special Theory of Relativity 2.6 Review of Atomic Structure Problems Bibliography Chapter 3 Atomic Nuclei and Radioactivity 3.1 Basic Properties of Nuclei 3.2 Four Fundamental Forces of Nature 3.3 Nuclear Binding Energy: Mass Defect 3.4 Stability of Nuclei 3.5 Antimatter 3.6 Properties of Nuclei and Particles 3.7 Radioactivity 3.8 Mathematics of Radioactive Decay 3.9 Activity 3.10 Half-Life 3.11 Mean-Life 3.12 Modes of Decay 3.12.1 Alpha Decay 3.12.2 Electromagnetic Decay 3.12.3 Beta Decay 3.13 Decay Diagrams 3.14 Radioactive Equilibrium 3.14.1 Secular Equilibrium 3.14.2 Transient Equilibrium 3.15 Production of Radionuclides 3.15.1 Fission Byproducts 3.15.2 Neutron Activation 3.15.3 Particle Accelerators Chapter Summary Problems Bibliography Chapter 4 The Production of X-Rays I: Technology 4.1 Introduction 4.2 X-Ray Tubes 4.3 Therapy X-Ray Tubes 4.4 X-Ray Film and Screens 4.5 X-Ray Generator Chapter Summary Problems Bibliography Chapter 5 X-Ray Production II: Basic Physics and Properties of Resulting X-Rays 5.1 Production of X-Rays: Microscopic Physics 5.1.1 Characteristic X-Rays 5.1.2 Bremsstrahlung Emission 5.2 X-Ray Spectrum 5.3 Efficiency of X-Ray Production 5.4 Directional Dependence of Bremsstrahlung Emission 5.5 X-Ray Attenuation 5.5.1 Beam Divergence and the Inverse-Square Effect 5.5.2 Attenuation by Matter 5.6 Half-Value Layer (HVL) 5.7 Mass Attenuation Coefficient Appendix: Roentgen and the Discovery of X-Rays Chapter Summary Problems Bibliography Chapter 6 The Interaction of Radiation with Matter 6.1 Photon Interactions With Matter 6.1.1 Coherent Scattering 6.1.2 Photoelectric Effect 6.1.3 Compton Scattering 6.1.4 Pair Production 6.1.5 Photonuclear Reactions 6.1.6 Total Mass Absorption Coefficient 6.2 Interaction of Charged Particles with Matter 6.2.1 Electron Interactions with Matter 6.2.2 Stopping Power 6.2.3 Range 6.2.4 Mean Energy To Produce An Ion Pair 6.2.5 Heavy Charged Particle Interactions and the Bragg Peak 6.3 Neutron Interactions with Matter Chapter Summary Problems Bibliography Chapter 7 Radiation Measurement Quantities 7.1 Introduction 7.2 Exposure 7.3 Charged Particle Equilibrium 7.4 Some Important Radiation Dosimetry Quantities 7.5 Dose Buildup and Skin Sparing 7.6 Absorbed Dose to Air 7.7 Dose in a Medium Calculated from Exposure 7.8 Dose In Free Space 7.9 An Example of Photon Interactions: History of a 5.0 MeV Photon in Water 7.10 Monte Carlo Calculations 7.11 Microscopic Biological Damage Chapter Summary Problems Bibliography Chapter 8 Radiation Detection and Measurement 8.1 Introduction 8.2 Phantoms 8.3 Gas Ionization Detectors 8.3.1 Ionization Chambers 8.3.2 Survey Meter Ion Chambers 8.3.3 Charge Collection and Measurement 8.3.4 Proportional Counters 8.3.5 Geiger-Muller (GM) Counter 8.3.6 Summary of Gas Ionization Detectors 8.4 Solid-State Detectors 8.4.1 Thermoluminescent Dosimeters 8.4.2 Film 8.4.3 Diodes 8.4.4 MOSFETS 8.4.5 Polymer Gels 8.5 Liquid Dosimeters 8.5.1 Calorimeters 8.5.2 Chemical Dosimetry Chapter Summary Problems Bibliography Chapter 9 External Beam Radiation Therapy Units 9.1 Introduction 9.2 Medical Electron Linear Accelerators 9.2.1 Source of Microwave Power 9.2.2 The Treatment Head 9.2.3 Linear Accelerator Auxiliary Subsystems 9.2.4 Interlocks and Safety Systems 9.2.5 Patient Support Assembly 9.3 Cobalt-60 Teletherapy Units 9.4 Cyclotrons 9.5 Photon Beam Characteristics Chapter Summary Problems Bibliography Chapter 10 Central Axis Dose Distribution 10.1 Introduction 10.2 Percent Depth Dose (PDD) 10.3 Source of Microwave Power 10.4 Tissue-Air Ratio (TAR) 10.5 Backscatter and Peak Scatter Factors 10.6 Tissue-Phantom Ratio (TPR) and Tissue-Maximum Ratio (TMR) 10.7 Equivalent Squares 10.8 Linear Interpolation Chapter Summary Problems Bibliography Chapter 11 Calibration of Megavoltage Photon Beams 11.1 Normalization Conditions 11.1.1 Normalization Conditions for Co-60 11.1.2 Normalization Conditions for Linear Accelerators 11.2 Steps in Beam Calibration 11.3 Ion Chamber Calibration 11.4 Beam Quality 11.5 The Task Group 51 Dose Equation 11.6 Calibration Conditions 11.7 An Example of TG-51 Calculations 11.8 Constancy Checks of Beam Calibration Chapter Summary Problems Bibliography Chapter 12 Calculation of Monitor Unit/Timer Setting for Open Fields 12.1 Introduction 12.2 Normalization Conditions 12.3 Head Scatter and Phantom Scatter 12.4 Dose Rate Calculations 12.4.1 Percent Depth Dose Calculations (SSD = SAD) 12.4.2 Isocentric Calculations 12.4.3 Dose Rate at an Arbitrary Distance 12.4.4 The Equivalence of PDD and TMR Calculations Chapter Summary Problems Bibliography Chapter 13 Shaped Fields 13.1 Introduction 13.2 Field Shaping Methods 13.2.1 Asymmetric Jaws 13.2.2 Blocks 13.2.3 Multileaf Collimators 13.3 Dose Rate Calculations for Shaped Fields: Symmetric Jaws, Central Axis 13.3.1 Approximate Methods for Estimating the Equivalent Square of a Blocked Field 13.3.2 Clarkson Integration 13.4 Dose Rate Calculations for Shaped Fields at Points Away from the Central Axis 13.5 Dose Rate Calculations with Asymmetric Jaws 13.6 Dose Under a Blocked Region Chapter Summary Problems Bibliography Chapter 14 Dose Distributions in Two and Three Dimensions 14.1 Isodose Charts 14.2 Skin Contour 14.2.1 Isodose Shift Method 14.2.2 Effective SSD Method 14.2.3 Ratio of TAR (rTAR) Method 14.3 Parallel-Opposed Fields 14.3.1 Adding Isodose Distributions 14.3.2 Beam Weighting 14.4 Wedges 14.4.1 Wedged Fields 14.4.2 Wedge Transmission Factor 14.4.3 Dose Rate Calculations with a Wedge Present 14.5 Multiple Beams 14.6 Dose-Volume Specification and Reporting 14.7 Evaluation of Patient Dose Distributions 14.8 Arc or Rotation Therapy 14.9 Surface Dose 14.10 Bolus 14.11 Beam Spoilers 14.12 Tissue Compensators 14.13 Tissue Inhomogeneities 14.14 Field Matching 14.15 Patient Positioning and Immobilization Devices Chapter Summary Problems Bibliography Chapter 15 Electron Beam Dosimetry 15.1 Introduction 15.2 Electron Applicators 15.3 Field Shaping 15.4 Dose Rate Calculations for Electron Beams 15.5 Internal Blocking 15.6 Isodose Curves 15.7 Inhomogeneities 15.8 Field Matching Chapter Summary Problems Bibliography Chapter 16 Brachytherapy 16.1 Introduction 16.2 Review of Radioactivity 16.3 Radioactive Sources 16.4 Brachytherapy Applicators 16.5 Source Strength and Exposure Rate Constant 16.6 Dose Rate Calculations from Exposure Rate 16.7 Specification of Source Strength 16.8 Task Group 43 Dosimetry 16.9 Accumulated Dose from Temporary and Permanent Implants 16.10 Systems of Implant Dosimetry 16.10.1 A Point Source 16.10.2 A Linear Array 16.10.3 Planar and Volume Implants 16.11 Intracavitary Treatment of Cervical Cancer 16.12 Along and Away Tables 16.13 Localization of Sources 16.14 High Dose Rate Remote Afterloaders Chapter Summary Problems Bibliography Chapter 17 Radiation Protection 17.1 Dosimetric Quantities Used for Radiation Protection 17.2 Exposure of Individuals to Radiation 17.3 Biological Effects of Radiation 17.3.1 Carcinogenesis 17.3.2 Risk to Fetus/Embryo 17.3.3 Genetic Effects 17.4 Radiation Protection Principles 17.5 NRC Regulations 17.5.1 Annual Dose Limits 17.5.2 Medical License and General Requirements 17.5.3 Written Directives and Medical Events 17.5.4 Examples of Events Reported to the NRC 17.5.5 Radiation Protection for Brachytherapy Procedures 17.5.6 NRC Safety Precautions for Therapy Units 17.6 Personnel Monitoring 17.7 Shipment and Receipt of Radioactive Packages 17.7.1 Package Labels 17.7.2 Receipt of Radioactive Packages (NRC Regulations) 17.8 Shielding Design for Linear Accelerators 17.8.1 Primary Barriers 17.8.2 Secondary Barriers 17.8.3 Neutrons 17.8.4 The Entryway 17.8.5 Radiation Protection Survey of a Linear Accelerator Chapter Summary Problems Bibliography Chapter 18 Radiation Protection 18.1 Introduction 18.2 Equipment Quality Assurance 18.2.1 Linear Accelerators 18.2.2 NRC Regulations Pertaining to QA 18.2.3 Dosimetry Instrumentation 18.3 Patient Quality Assurance 18.3.1 Physics Chart Checks 18.3.2 Weekly Physics Chart Checks 18.3.3 Portal Imaging 18.3.4 In Vivo Dosimetry 18.4 Starting New Treatment Programs 18.5 Mold Room Safety 18.6 Patient Safety 18.7 Radiation Therapy Accidents 18.7.1 A Linear Accelerator Calibration Error 18.7.2 An HDR Accident 18.7.3 Malfunction 54 18.7.4 Co-60 Overdose Chapter Summary Problem Bibliography Chapter 19 Imaging in Radiation Therapy 19.1 Introduction 19.2 Digital Images 19.3 Conventional Simulators 19.4 Computed Tomography 19.4.1 Development of CT Scanners 19.4.2 CT Image Reconstruction 19.4.3 CT Numbers and Hounsfield Numbers 19.4.4 Digitally Reconstructed Radiographs 19.4.5 Virtual Simulation 19.4.6 4D CT 19.5 Magnetic Resonance Imaging 19.6 Image Fusion/Registration 19.7 Ultrasound Imaging 19.8 Functional/Metabolic Imaging 19.9 Portal Imaging 19.9.1 Port Films 19.9.2 Electronic Portal Imaging Devices 19.10 Image-Guided Radiation Therapy Chapter Summary Problems Bibliography Chapter 20 Special Modalities in Radiation Therapy 20.1 Introduction 20.2 Intensity Modulation in Radiation Therapy 20.2.1 IMRT Delivery Techniques 20.2.2 Inverse Treatment Planning 20.2.3 Inverse Planning Issues 20.2.4 Case Study: Prostate Cancer 20.2.5 Aperture-Based Optimization 20.2.6 Physics Plan Validation 20.2.7 Whole-Body Dose and Shielding 20.3 Stereotactic Radiosurgery 20.3.1 Introduction 20.3.2 Linac-Based Radiosurgery 20.3.3 Gamma Knife 20.3.4 Imaging 20.3.5 Treatment Planning 20.3.6 Dosimetry 20.3.7 Quality Assurance 20.4 Proton Radiotherapy 20.4.1 Introduction 20.4.2 Potential Advantages of Protons 20.4.3 Proton Therapy Accelerators 20.4.4 Production and Selection of Different Energy Beams 20.4.5 Lateral Beam Spreading and Field Shaping with Protons 20.4.6 Beam-Delivery/Transport 20.4.7 Dose Calculations and Treatment Planning for Proton Therapy 20.4.8 Dose Distributions 20.4.9 Calibration of Proton Beams and Routine Quality Assurance 20.4.10 Future Developments Chapter Summary Problems Bibliography Appendix A - Board Certification Exams in Radiation Therapy Appendix B - Dosimetry Data Appendix C - MEVALAC Beam Data Appendix D - Answers to Selected Problems
巻冊次

: soft cover ISBN 9781930524446

内容説明

This book is the outgrowth of a course taught to residents in radiation oncology at Wayne State University, at the suggestion of residents who saw a need for a technically-accurate text set at the correct mathematical level. It is intended to be a book to learn from, not a comprehensive compendium. It is written for members of the radiation therapy community such as radiation therapy technologists, dosimetrists, and radiation oncologists who may have taken college physics several years previously but still need to know the basic physics of radiation therapy. For graduate students in medical physics, it will serve as a review of the ""basics"". The material is written to be relevant to clinical practice, without covering specifics in treatment planning, and also with a close eye on board certification requirements.

目次

Preface Acknowledgments Chapter 1 Mathematics Review 1.1 Exponents 1.1.1 Multiplication 1.1.2 Division 1.1.3 An Exponential Raised to a Power 1.1.4 A Product Raised to a Power 1.1.5 Base e 1.2 Logarithms 1.3 Geometry 1.4 Trigonometry Problems Chapter 2 Review of Basic Physics 2.1 Units for Physical Quantities 2.2 Mechanics 2.2.1 Newton's Second Law 2.2.2 Work 2.2.3 Work Energy Theorem and Energy Conservation 2.2.4 Power 2.3 Electricity and Magnetism 2.3.1 Charge and the Coulomb Force 2.3.2 Electric Fields 2.3.3 Current 2.3.4 Potential Difference 2.3.5 The Electron Volt - A Unit of Energy Not Voltage 2.3.6 Magnetism 2.4 Electromagnetic Spectrum 2.5 The Special Theory of Relativity 2.6 Review of Atomic Structure Problems Bibliography Chapter 3 Atomic Nuclei and Radioactivity 3.1 Basic Properties of Nuclei 3.2 Four Fundamental Forces of Nature 3.3 Nuclear Binding Energy: Mass Defect 3.4 Stability of Nuclei 3.5 Antimatter 3.6 Properties of Nuclei and Particles 3.7 Radioactivity 3.8 Mathematics of Radioactive Decay 3.9 Activity 3.10 Half-Life 3.11 Mean-Life 3.12 Modes of Decay 3.12.1 Alpha Decay 3.12.2 Electromagnetic Decay 3.12.3 Beta Decay 3.13 Decay Diagrams 3.14 Radioactive Equilibrium 3.14.1 Secular Equilibrium 3.14.2 Transient Equilibrium 3.15 Production of Radionuclides 3.15.1 Fission Byproducts 3.15.2 Neutron Activation 3.15.3 Particle Accelerators Chapter Summary Problems Bibliography Chapter 4 The Production of X-Rays I: Technology 4.1 Introduction 4.2 X-Ray Tubes 4.3 Therapy X-Ray Tubes 4.4 X-Ray Film and Screens 4.5 X-Ray Generator Chapter Summary Problems Bibliography Chapter 5 X-Ray Production II: Basic Physics and Properties of Resulting X-Rays 5.1 Production of X-Rays: Microscopic Physics 5.1.1 Characteristic X-Rays 5.1.2 Bremsstrahlung Emission 5.2 X-Ray Spectrum 5.3 Efficiency of X-Ray Production 5.4 Directional Dependence of Bremsstrahlung Emission 5.5 X-Ray Attenuation 5.5.1 Beam Divergence and the Inverse-Square Effect 5.5.2 Attenuation by Matter 5.6 Half-Value Layer (HVL) 5.7 Mass Attenuation Coefficient Appendix: Roentgen and the Discovery of X-Rays Chapter Summary Problems Bibliography Chapter 6 The Interaction of Radiation with Matter 6.1 Photon Interactions With Matter 6.1.1 Coherent Scattering 6.1.2 Photoelectric Effect 6.1.3 Compton Scattering 6.1.4 Pair Production 6.1.5 Photonuclear Reactions 6.1.6 Total Mass Absorption Coefficient 6.2 Interaction of Charged Particles with Matter 6.2.1 Electron Interactions with Matter 6.2.2 Stopping Power 6.2.3 Range 6.2.4 Mean Energy To Produce An Ion Pair 6.2.5 Heavy Charged Particle Interactions and the Bragg Peak 6.3 Neutron Interactions with Matter Chapter Summary Problems Bibliography Chapter 7 Radiation Measurement Quantities 7.1 Introduction 7.2 Exposure 7.3 Charged Particle Equilibrium 7.4 Some Important Radiation Dosimetry Quantities 7.5 Dose Buildup and Skin Sparing 7.6 Absorbed Dose to Air 7.7 Dose in a Medium Calculated from Exposure 7.8 Dose In Free Space 7.9 An Example of Photon Interactions: History of a 5.0 MeV Photon in Water 7.10 Monte Carlo Calculations 7.11 Microscopic Biological Damage Chapter Summary Problems Bibliography Chapter 8 Radiation Detection and Measurement 8.1 Introduction 8.2 Phantoms 8.3 Gas Ionization Detectors 8.3.1 Ionization Chambers 8.3.2 Survey Meter Ion Chambers 8.3.3 Charge Collection and Measurement 8.3.4 Proportional Counters 8.3.5 Geiger-Muller (GM) Counter 8.3.6 Summary of Gas Ionization Detectors 8.4 Solid-State Detectors 8.4.1 Thermoluminescent Dosimeters 8.4.2 Film 8.4.3 Diodes 8.4.4 MOSFETS 8.4.5 Polymer Gels 8.5 Liquid Dosimeters 8.5.1 Calorimeters 8.5.2 Chemical Dosimetry Chapter Summary Problems Bibliography Chapter 9 External Beam Radiation Therapy Units 9.1 Introduction 9.2 Medical Electron Linear Accelerators 9.2.1 Source of Microwave Power 9.2.2 The Treatment Head 9.2.3 Linear Accelerator Auxiliary Subsystems 9.2.4 Interlocks and Safety Systems 9.2.5 Patient Support Assembly 9.3 Cobalt-60 Teletherapy Units 9.4 Cyclotrons 9.5 Photon Beam Characteristics Chapter Summary Problems Bibliography Chapter 10 Central Axis Dose Distribution 10.1 Introduction 10.2 Percent Depth Dose (PDD) 10.3 Source of Microwave Power 10.4 Tissue-Air Ratio (TAR) 10.5 Backscatter and Peak Scatter Factors 10.6 Tissue-Phantom Ratio (TPR) and Tissue-Maximum Ratio (TMR) 10.7 Equivalent Squares 10.8 Linear Interpolation Chapter Summary Problems Bibliography Chapter 11 Calibration of Megavoltage Photon Beams 11.1 Normalization Conditions 11.1.1 Normalization Conditions for Co-60 11.1.2 Normalization Conditions for Linear Accelerators 11.2 Steps in Beam Calibration 11.3 Ion Chamber Calibration 11.4 Beam Quality 11.5 The Task Group 51 Dose Equation 11.6 Calibration Conditions 11.7 An Example of TG-51 Calculations 11.8 Constancy Checks of Beam Calibration Chapter Summary Problems Bibliography Chapter 12 Calculation of Monitor Unit/Timer Setting for Open Fields 12.1 Introduction 12.2 Normalization Conditions 12.3 Head Scatter and Phantom Scatter 12.4 Dose Rate Calculations 12.4.1 Percent Depth Dose Calculations (SSD = SAD) 12.4.2 Isocentric Calculations 12.4.3 Dose Rate at an Arbitrary Distance 12.4.4 The Equivalence of PDD and TMR Calculations Chapter Summary Problems Bibliography Chapter 13 Shaped Fields 13.1 Introduction 13.2 Field Shaping Methods 13.2.1 Asymmetric Jaws 13.2.2 Blocks 13.2.3 Multileaf Collimators 13.3 Dose Rate Calculations for Shaped Fields: Symmetric Jaws, Central Axis 13.3.1 Approximate Methods for Estimating the Equivalent Square of a Blocked Field 13.3.2 Clarkson Integration 13.4 Dose Rate Calculations for Shaped Fields at Points Away from the Central Axis 13.5 Dose Rate Calculations with Asymmetric Jaws 13.6 Dose Under a Blocked Region Chapter Summary Problems Bibliography Chapter 14 Dose Distributions in Two and Three Dimensions 14.1 Isodose Charts 14.2 Skin Contour 14.2.1 Isodose Shift Method 14.2.2 Effective SSD Method 14.2.3 Ratio of TAR (rTAR) Method 14.3 Parallel-Opposed Fields 14.3.1 Adding Isodose Distributions 14.3.2 Beam Weighting 14.4 Wedges 14.4.1 Wedged Fields 14.4.2 Wedge Transmission Factor 14.4.3 Dose Rate Calculations with a Wedge Present 14.5 Multiple Beams 14.6 Dose-Volume Specification and Reporting 14.7 Evaluation of Patient Dose Distributions 14.8 Arc or Rotation Therapy 14.9 Surface Dose 14.10 Bolus 14.11 Beam Spoilers 14.12 Tissue Compensators 14.13 Tissue Inhomogeneities 14.14 Field Matching 14.15 Patient Positioning and Immobilization Devices Chapter Summary Problems Bibliography Chapter 15 Electron Beam Dosimetry 15.1 Introduction 15.2 Electron Applicators 15.3 Field Shaping 15.4 Dose Rate Calculations for Electron Beams 15.5 Internal Blocking 15.6 Isodose Curves 15.7 Inhomogeneities 15.8 Field Matching Chapter Summary Problems Bibliography Chapter 16 Brachytherapy 16.1 Introduction 16.2 Review of Radioactivity 16.3 Radioactive Sources 16.4 Brachytherapy Applicators 16.5 Source Strength and Exposure Rate Constant 16.6 Dose Rate Calculations from Exposure Rate 16.7 Specification of Source Strength 16.8 Task Group 43 Dosimetry 16.9 Accumulated Dose from Temporary and Permanent Implants 16.10 Systems of Implant Dosimetry 16.10.1 A Point Source 16.10.2 A Linear Array 16.10.3 Planar and Volume Implants 16.11 Intracavitary Treatment of Cervical Cancer 16.12 Along and Away Tables 16.13 Localization of Sources 16.14 High Dose Rate Remote Afterloaders Chapter Summary Problems Bibliography Chapter 17 Radiation Protection 17.1 Dosimetric Quantities Used for Radiation Protection 17.2 Exposure of Individuals to Radiation 17.3 Biological Effects of Radiation 17.3.1 Carcinogenesis 17.3.2 Risk to Fetus/Embryo 17.3.3 Genetic Effects 17.4 Radiation Protection Principles 17.5 NRC Regulations 17.5.1 Annual Dose Limits 17.5.2 Medical License and General Requirements 17.5.3 Written Directives and Medical Events 17.5.4 Examples of Events Reported to the NRC 17.5.5 Radiation Protection for Brachytherapy Procedures 17.5.6 NRC Safety Precautions for Therapy Units 17.6 Personnel Monitoring 17.7 Shipment and Receipt of Radioactive Packages 17.7.1 Package Labels 17.7.2 Receipt of Radioactive Packages (NRC Regulations) 17.8 Shielding Design for Linear Accelerators 17.8.1 Primary Barriers 17.8.2 Secondary Barriers 17.8.3 Neutrons 17.8.4 The Entryway 17.8.5 Radiation Protection Survey of a Linear Accelerator Chapter Summary Problems Bibliography Chapter 18 Radiation Protection 18.1 Introduction 18.2 Equipment Quality Assurance 18.2.1 Linear Accelerators 18.2.2 NRC Regulations Pertaining to QA 18.2.3 Dosimetry Instrumentation 18.3 Patient Quality Assurance 18.3.1 Physics Chart Checks 18.3.2 Weekly Physics Chart Checks 18.3.3 Portal Imaging 18.3.4 In Vivo Dosimetry 18.4 Starting New Treatment Programs 18.5 Mold Room Safety 18.6 Patient Safety 18.7 Radiation Therapy Accidents 18.7.1 A Linear Accelerator Calibration Error 18.7.2 An HDR Accident 18.7.3 Malfunction 54 18.7.4 Co-60 Overdose Chapter Summary Problem Bibliography Chapter 19 Imaging in Radiation Therapy 19.1 Introduction 19.2 Digital Images 19.3 Conventional Simulators 19.4 Computed Tomography 19.4.1 Development of CT Scanners 19.4.2 CT Image Reconstruction 19.4.3 CT Numbers and Hounsfield Numbers 19.4.4 Digitally Reconstructed Radiographs 19.4.5 Virtual Simulation 19.4.6 4D CT 19.5 Magnetic Resonance Imaging 19.6 Image Fusion/Registration 19.7 Ultrasound Imaging 19.8 Functional/Metabolic Imaging 19.9 Portal Imaging 19.9.1 Port Films 19.9.2 Electronic Portal Imaging Devices 19.10 Image-Guided Radiation Therapy Chapter Summary Problems Bibliography Chapter 20 Special Modalities in Radiation Therapy 20.1 Introduction 20.2 Intensity Modulation in Radiation Therapy 20.2.1 IMRT Delivery Techniques 20.2.2 Inverse Treatment Planning 20.2.3 Inverse Planning Issues 20.2.4 Case Study: Prostate Cancer 20.2.5 Aperture-Based Optimization 20.2.6 Physics Plan Validation 20.2.7 Whole-Body Dose and Shielding 20.3 Stereotactic Radiosurgery 20.3.1 Introduction 20.3.2 Linac-Based Radiosurgery 20.3.3 Gamma Knife 20.3.4 Imaging 20.3.5 Treatment Planning 20.3.6 Dosimetry 20.3.7 Quality Assurance 20.4 Proton Radiotherapy 20.4.1 Introduction 20.4.2 Potential Advantages of Protons 20.4.3 Proton Therapy Accelerators 20.4.4 Production and Selection of Different Energy Beams 20.4.5 Lateral Beam Spreading and Field Shaping with Protons 20.4.6 Beam-Delivery/Transport 20.4.7 Dose Calculations and Treatment Planning for Proton Therapy 20.4.8 Dose Distributions 20.4.9 Calibration of Proton Beams and Routine Quality Assurance 20.4.10 Future Developments Chapter Summary Problems Bibliography Appendix A - Board Certification Exams in Radiation Therapy Appendix B - Dosimetry Data Appendix C - MEVALAC Beam Data Appendix D - Answers to Selected Problems

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