Atomic number Z (protons)

Ex. Radium-226 into Radon-222 (Z-2)(A-4) (Helium-4 ion) is emitted α particle Alpha decay
Atomic mass number A (protons+neutrons)
Ex. Nitrogen-13 into carbon-13 Proton into a neutron (z-1)(same A) β+ particle (positron), neutrino
1. Basic de nitions from atomic Number of neutrons in atom N
Ex. Cobalt-60 into nickel-60 Neutron into a proton (z+1)(same A) β- particle (electron), neutrino Beta decay structure
Atomic|molecular mole contains 1 NA =
6.022x10^23 atom/mol | molecule/mole
Ex. Berillum-7 into lithium-7 Proton into a neutron (z-1)(same A) Electron Capture ~ neutrino

Often emitted after α or β radiation

1. Plantry motion of electrons. (Coulomb
force)
Weakly ionising : no charge, no mass Waves of electromagnetic radiation Gamma rays ~ photons
(Any time a charged particle is accelerated
Penetrate really far 2. No energy loss while electron in orbit. or decelerated, part of its energy is emitted
Gamma decay (Larmor’s law , bremsstrahlung) in the form of photon (Bremsstrahlung)
Releases excess energy to be absorbed by 2. Bohr’s model of the hydrogen
an orbital electron (usually in the K-shell). 3. Quantisation of angular momentum. (L =
Charactacteristic X-ray (photon) or Auger atom
nh)
electrons are released Internal conversion ~ orbital electron
De-excitation energy, when excited neuclus
changes from excited state to stable state. 4. Emission of photon during atomic
transition. ( hv = Ei — Ef)
8. Models of Radioactive Decay
Total energy

Momentum
Conserved physical quantities in nuclear 3. Multi-electron atom
Charge transformation:

Atomic number
Nucleaons are bound to the nucleus with
the strong force.
Atomic mass number
Atomic & Nuclear 4. Nuclear structure The strong force between two particles is a
The total energy of particles released from
Q = {M(P) — [M(D)+m]}c^2 transformation is Structure very short rang force.

Charge.
Occurs when a parent nuclide P is
bombarded with thermal neutrons in a Mass number.
The conserved physical quantities in a
nuclear reactor.
nuclear reactions are:
5. Nuclear Reactions Linear momentum. (p = mv)
Cross section for the nuclear reaction.
Probability for it to occur is governed by: 7. Activation of Nuclides Mass-energy. (E=mc^2)
Neutron fluency rate.
(Radioactivation)
Ex. 59Co (n, γ) 60Co
Energy difference between the quantum
state of the parent P and the quantum
state of the daughter D.

Decay Energy Q
Electromagnetic radiation.
Emit in form of:
Kinetic energy of the reaction products.

Decay constant λ.

6. Radioactivity (Unstable Activity: the number of radioactive nuclei at

Formalism based on: time t. A(t)
nucleus decays into a new
nucleus) Speci c Activity a: the parent’s activity per
unit mass. a = λNA/A

Units Becquerel (1 Bq = 1 s^-1)

Radioactive Processes
Is the time required for a nuclei to decay to
half of the initial value.
Half life (T1/2)
MSc. ELHAM BARNAWI λ = ln2 / t1/2

Transient Equilibrium (t1/2)D < (t1/2)P

Equilibrium
Secular equilibrium (t1/2)D << (t1/2)P
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 Absorbed completely & some of
its energy is transferred to light
charged particles (electrons &
positrons).

Results from elctronic transitions between

Characteristic x-ray atomic shells.

Results manly from electron-nucleus

Four categories: Bremsstrahlung columb interactions.

Gamma ray Results from nuclear transition.

Annihilation quantum Results from positron-electron annihilation.

Direct photon-nucleus interactions

(photodisintegration).

Interactions of photon with nuclei: Interaction between the photon and the
electrostatic eld of the nucleus (pair
production).

Loosely bound electron, aka free (unbound)

Photoelectric effect predominates at low electron (Compton effect, triplet
photon energies. production). (EB << hv)
1. Types of indirectly ionising Interactions of photon with orbital
photon irradiation electron:
Compton eefct predominates at Tightly bound electron, aka the whole
intermediate photon energies. atom (photoelectric effect). (EB ≤ hv)
4. Relative predominance of
individual effects Photon disappears
Pair production predominates at high
photon energies.
Photon fate after the interaction with an
The scattered photon has the same energy
atom:
and no light charged particles are released.

μ is proportional to Z^4/(hv)^3 Photon scattered The scattered photon has a lower energy &
Atomic attenuation coefficient A photon with energy hv interacts with a k- the energy excess is transferred to light
shell orbital electron. Photoelectric effect. charged particle (electron).
they use τa some times why?!

Either Interact with orbital electrons &

μ/ρ is proportional to Z^3/(hv)^3
deposits their energy. (Collision loss).
Light charged particles produced in the
Mass attenuation coefficient
absorbing medium:
Or Interact with the electrostatic eld of
Angle φ represents the angle between the
direction of incident photon and the recoil
(Incoherent scattering) a photon with
energy hv interact with a loosely bound Interactions of major importance: Photon Interactions the nuclei (radiation loss).

electron. orbital electron. Compton scattering by free electrons.

The probability per unit parts length that a

The two annihilation quanta have energy of photon will have an interaction with the
0.511 MeV each. absorber.
The combined KE of the electron-positron Pair production (including triplet
Emitted approximately 180 degrees to pair = hv - 2mc^2 production). The most important parameter: Linear attenuation coefficient μ
it depends on: The energy of the photon
each other. (Momentum & energy beam & Z number of the absorber.
conservation).
The thickness that attenuates the beam
A photon interacts with an atom just by Half-value layer (HVL) intensity to 50%.
de ecting its direction causing excitation
to the whole atom. It maintain the same
hv < 10 keV wave length. Rayleigh scattering. 3. Types of photon interactions Parameters for mono-energetic photon The thickness that attenuated the beam
with absorber beam: Mean free path (MFP) intensity to 36.8%.
Interactions of moderate importance:
It excite one electron only and it Chang its
direction (maintain the same wavelength). Thomson scattering by free electron. 2. Photon Beam Attenuation The thickness that attenuates the beam
The thing-value layer (TVL) intensity to 10%.
Photonuclear reactions (nuclear
photoelectric effect) Interactions of minor importance: The value for the attenuation coef cient
μ(hv,Z) represents a sum of values for all
individual interactions that a photon may
Thomson and Compton scattering by the
have with an atom.
nucleus.

Average (mean) energy absorbed Eab = Etr - Erad

Meson production. Negligible interactions:

Delbrück scattering.

MSc. ELHAM BARNAWI

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 As an energetic electron travels through
the matter, it undergoes (Coulomb
interactions) with the atomic orbital
Angular & spatial spread of pencil electron electrons or the atomic nuclei.
beam traversing an absorbing medium can
be approximated with a Gaussian Collide & lose their kinetic energy (KE) as a
Mass angular scattering power T/ρ distribution. form of radiation. (Energy lost) Described by (Stopping power).
7. Mass angular scattering power
Through these collisions the electrons may:
1. Difinitions Scatter by changing their direction of
motion. (Scattering) Described by (Angular scattering power).
Total linear stopping power Stot, represents
KE loss by the electron per unit path length Collision between incident electron and Elastic Collision.
Stot = dKE/dx in MeV/cm x: absorber atom could be:
Inelastic Collision.
Total mass stopping power (S/ρ)tot, is the
linear stopping power divided by the
(S/ρ)tot = 1/ρ dKE/dx in MeV.cm^2/g density of the absorbing medium.
The incident electron is de ected from its
Elastic Collision original path, but no energy loss occurs.
Electron-orbital electron interactions
(atomic ionisations & excitations) Mass collision stoping power (S/ρ)col
The incident electron collides with orbital
(S/ρ)tot: the rate of energy loss per gram & electron and loses part of its energy then
Electron-nucleus interactions per cm^2 is called mass stoping power & it 2. Types of Collisions de ect from its original path.
(bremsstrahlung production) Mass radiation stoping power (S/ρ)rad is a sum of two components:

Inelastic Collision The incident electron interacts near the

(S/ρ)tot = (S/ρ)col + (S/ρ)rad nucleus, de ects from its original path and
loses part of its KE in form of
The (S/ρ)rad is negligible thus (S/ρ)tot ≈ (S/ bremsstrahlung.
ρ)col Heavy charged particles
6. Stopping Power Electron Interactions
KE < 10 MeV, low Z, Collision (ionisation) b >> a , incident electron interact with the
dominates (S/ρ)col > (S/ρ)rad whole atom & few % of its KE will be
Charged particles:
Soft collision transferred to the orbital electrons.
KE > 10 MeV, high Z , Radiation The impact parameter (b) of interaction
(bremsstrahlung) dominates (S/ρ)col < (S/ Both components contribute, (S/ρ)tot = (S/ (electron trajectory) in uences the types of b ≈ a , inceident electron interact with an
ρ)rad ρ)col + (S/ρ)rad Light charged particles the inelastic interaction btween the orbital electron & up to 50% of its KE will
electron and an atom of radius (a) Hard collision be transferred to the orbital electrons.
Critical kinetic energy (KE)crit , (S/ρ)col ≈ (S/ 3. Inelastic Interaction
ρ)rad
b << a , incident electron interact the
atomic nucleus & emit a bremsstrahlung
Rate of energy loss for a therapy electron photon, with energy between (0 and the
KE of the electron. beam in water and water-like tissues, Radiation collision incident electron KE)
Total energy loss by electrons traversing an averaged over the electron rage, is about 2
Z number of the absorber. absorber depends on MeV/cm^2

Electron density of the absorber. The absorber atom eject an orbital

Inelastic Collisions between the incident Atomic Ionisation electron.
electron and an orbital electron are
4. Electron-orbital electron Coulomb interactions that result in:
Electron scattering and no energy loss Transfer of an orbital electron from its
(elastic collision): characterised by angular interactions Atomic Excitation allowed shell to a higher level shell
scattering power.
Coulomb interaction between the incident
Electron scattering & some KE loss in form electron & an absorber nucleus results in:
of bremsstrahlung (radiation loss): 5. Electron-nucleus interaction
characterised by radiation stopping power.

MSc. ELHAM BARNAWI

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 The QA program is essentially
a set of policies and
procedures to maintain the
quality of patient care

Training

Qualifications

Periodic calibration of radiation generators

1. Staffing Calibration or sources.

Roles & Responsibilities Periodic QA of radiation equipment

Approximate accuracy of +-5% of dose The physicist should be directly involved in

delivery, uncertainty with 95% con dence the treatment planning process to insure a
interval. Treatment Plannings good guality control of the treatment.
3. Dosimetric Accuracy (p.377)

The radiotherapy facilities must be

equipped with appropriate type and
Justification
quality of radiation beams, also with a
suf cient number of machines to handle
Market Evaluation External Beam Unite the patient load.

Users Opinions
Ex. Providing remote afterloaders, which
4. Equipment Speci cations minimise radiation exposure to the
Bid Specifications
(p.378) 2. Equipment workers. That allows better nursing care or
Brachytherapy Sources optimising source placement.
Final Evaluation

Simulator Digital reconstructed radiograph DRR

Price Negotiations

Linear Accelerator The precent depth-dose and TPR/TMR

Radiographic Simulator
Quality Assurance tables can be generated by the computer
or manually by interpolation of the
measured data.
CT Simulator
5. Acceptance Testing (p.379) 1. Central Axis Depth Dose Tables The measured data and the computer-
generated depth dose distributions for all
Brachytherapy
clinically used depths and eld size should
agree with -+2% or (-+1%).
Remote Afterloaders
Isodose curves should agree within -+2% in
the central part of eld (1 cm inside the eld
edge).
8. Risk Assessment in RT
Within about 2 mm in the penumbra
region (between 90% & 20% decrement
Input the beam data into the treatment- 2. Isodose Curves lines).
Linear Accelerator
planning computer. Check for the
computer-generated dose distributions. Same carteria apply to the wedge isodose
Cobalt-60 Unit Linear Accelerator Table 17.7 P. 406 curves.

Radiographic Simulator 7. Periodic QA (p.395) Calculate how many MUs needed to deliver
a certain dose at a point at depth on the
Simulator central axis.

3. Monitor Unit Calculations Check the formalism to assure that doses

can be accurately delivered at a point for a
given energy, eld size, depth

6. Commissioning (p.393) The average leaf and interleaf transmission

Transmission should be less 2%

4. MLC Central Axis Depth Dose

Penumbra

Treatment-Planning Computer System

MSc. ELHAM BARNAWI

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 This step is done as soon as the beam can
be generated

The exposure levels outside the room will

not exceed the limits during the machine’s
testing. Considering the dose rate output,
Preliminary Radiation Survey workload, factors, occupancy factors.

Determine the expected dose levels as as a

function of machine output (MU/min) by
preforming a preliminary calibration of the
1. Intracavitary Sources and Applicators. To ensure that the sources and the machine output (cGy/MU).
associated equipment meet the user’s 1. Radiation Survey
speci cations. 14. Brachytherapy Equipment
Source Positioning. This is done after completion of the
REMOTE AFTERLOADERS (Table 17.6) 2. Interstitial Sources. (p.388) installation
Source Calibration.
Formal Radiation Protection Survey Measurement of head leakage, area survey,
test of interlocks, warning lights, emergency
switches.
This part is similar to the acceptance (a) check the geometric and spatial
testing of a linear accelerator. accuracies. The geometric accuracy of the radiographic
simulator should be as accurate as the
Machinist’s dial indicator is used.
This part deals with the simulator (b) performance evaluation of the x-ray LINAC in localizing treatment elds. Radiographic Simulator
2. Jaw Symmetry
performance like a diagnostic x-ray and f generator and the associated imaging
luoroscopic unit. system.

(a) Chick the patient positioning lasers. Checking the accuracy of image from the The light field edges.
CT scanner and the alignment of the Rotate the collimator through 180 degrees
simulation hardware: 13. Simulators (Table 17.5) then check the coincidence of:
(b) Check couch alignment under typical The intersection of diagonals and the
load conditions. position of cross-hair images.

Films are used to measure the coincidence

2) To ascertain that the speci ed 3. Coincidence between: light beam and radiation beam.
mechanical tolerances are met. CT Simulator
The alignment between them should be
within -+2 mm or 1% on a side
1) To assure the accuracy of target
localization and accuracy of DRRs.

Is the intersection point of the axis of

rotation of the collimator and the axis of
Isometric shift with couch motion. rotation of the gantry.

Optical distance indicators. If the two axis’s are missed, that woul create
4. Mechanical isocenter an uncertainty in the position of the
Field size indicator. isocenter.

Gantry angle & collimator angles.

12. Miscellaneous checks. (P.388)
LINAC Acceptance
Laser lights. Testing (p.379) Collimator
All lines should intersect or pass within 2
mm-diameter circle.

Tabletop.
All lines should intersect or pass within 2
The tennis racket insert. mm-diameter circle. It could be stricter in
Treatment Table stereotactic radiosurgery’s unit
5. Radiation Isocenter
All lines should intersect or pass within 2
Check the wedge angle by using wedge Gantry mm-diameter circle.
isodose distribution for 10 x 10-cm eld.
See chapter.11

The measured wedge angles should be

11. Wedges A) Focal spot displacement.
within -+2 degrees of the values speci ed.
Three general causes of beam
6. Multiple Beam Alignment misalignment: B) Asymmetry of collimator jaws.

Check
Linearity of monitor chambers is an C) Displacement in the collimator rotation
Total body irradiation. important requirement and should be axis or the gantry rotation axis.
checked as a function of dose rate and for
Total skin irradiation. special operating conditions, such as:

Projected leaf width at isocenter.

Arc rotation.
10. Monitor Chambers
Long-term stability check. Calibration of leaf positions: Check the
average net optical density and if the
deviation was -+20% of the average, that
would indicate positioning problems.
Revise chapter 14
9. Electron Beam Performance Leaf Travel: Maximum speci ed ranges of
leaf travel should be checked in both
directions.

The alignment checks described in (2&6) Leaf Speed: The maximum speci ed speed
8. X-Ray Beam Performance must be done on the newly installed MLC. should be veri ed.
(p.386) 7. Multileaf Collimator
Transmission: Transmission of radiation
through leaves, between leaves, and
beneath the leaves and jaws combined
should be measured.

Leakage: Leakage of radiation between

leaf faces in the closed position (also the
gaps) should be measured.

MSc. ELHAM BARNAWI

Field shaping: Accuracy of eld-shaping
software to create irregularly shaped elds
with the MLC should be checked. (Periodic
QA)
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