RADIOACTIVE SOURCES USED IN BRACHYTHERAPY

From the time of its discovery in 1898, radium has been the most commonly used isotope in
brachytherapy. However, artificial radioisotopes offer special advantages in some situations
because of their gamma-ray energy, source flexibility, source size, and half-life.

A. Radium
Although radium is no longer clinically used in brachytherapy, the physics of this source is
discussed below for historic interest. A Iso, a vast amount of clinical data pertaining to radium

therapy exist in the literature which are often used by clinicians to compare treatment outcomes
and dosage specification in modern brachytherapy.
A.1. Decay
Radium disintegrates with a half-life of about 1,600 years to form radon:
88
226Raiih
1.600 years 86
226Rn_24He
The product nucleus radon is a heavy inert gas that in turn disintegrates into its daughter
at least
products. As a result of the decay process from radium to stable lead,
49 gamma rays are produced with energies ranging from 0.184 to 2.45 MeV. The average energy
and filtered by 0.5 mm
of the gamma rays from radium in equilibrium with its daughter products
of platinum is 0.83 MeV (1). A filtration of at least 0.5 mm platinum provided by the source case
is sufficient to absorb all a particles and most of the B particles emitted by radium and its
radium a
daughter products. Only gamma ray Leakage of radon gas from represents
a source

significant hazard if the source is broken.

The sources are, however, doubly encapsulated to prevent such an occurrence.

B. Cesium-137
that is used as a radium substitute in both
Cesium-137 is agamma-ray-emitting radioisotope
interstitial and intracavitary brachytherapy.
The advantages of 137Cs over radium are that it requires less shielding.
With a long half-life of about 30 years, these sources can be used clinically for about 7 years
to be adjusted to allovw for radioactive
without replacement, although the treatment times have
decay.137Cs emits gamma rays energy 0.662 MeV.
of
The B particles and low-energy characteristic x-rays are absorbed by
the stainless steel material, so that the clinical source is a pure gamma emitter.

C. Cobal t-60

used now. The main

60Co has been used for brachytherapy carlier also and is also being
fabrication of small sources
advantage of 60Co is its high specific activity, which allows than 137Cs and has a short
required for some special applicators. However, it is more expensive
half-life (5.26 years), necessitating more frequent replacement. Cobalt brachytherapy
sources are

usually fabricated in the form of a wire that is encapsul: d

 sources can be used to replace
stainless steel. The
in a sheath of platinum iridium
or
source is used in HDR Brachytheran
226Ra in intracavitary applications. Recently a 2Curie
units.

D. Iridium-192
with an average encrgy of 0.38 MeV. Because of the
1921r has a gamma -ray spectrum
has the
these sources require less shielding for personnel protection. 192Ir
owerenergy. half-life is long compared to the
disadvantage of a short half-life (73.8 days). However, the similar to
average treatment time so that the sources can be used in nonpermanent implants
radium and cesium. It is used in HDR Brachytherapy units.

E. Gold-198
eeds or "grains" consisting of a radioactive isotope of gold, 198Au, have been used in the past
tor interstitial implants. 198Au seeds have also been used in eye plaques for treating intraocular
tumors such as choroidal melanoma.
Currently 125I seeds are most commonly used lor eye
plaques. 198Au has a half-life of 2.7 days and emits a monoenergetic g ray of energy 0.412
MeV. B rays
of maximum energy 0.96 MeV are also emitted but are absorbed by the 0.I-mm-
thick platinum wall surrounding the seed.
F. lodine-125
1251 has gained a wide use for permanent
isotope overradon and 198Au are its
implants in radiation therapy. The advantages of this
and its lower
longer half-life (59,4 days), which is convenient for
storage, photon energy, which requires less shielding.
1251 decays exclusively by electron capture to an excited state
decays to the ground state with the emission of a 35.5-keV of 125Te, which spontaneously
the range of 27 to 35 keV also g photon. Characteristic
are
produced due to the electron capture and internal x-rays in
processes. conversion
G. Palla dium-103

103Pd seeds have

relatively more
clinical applications are similar to recently become available for use in
1251
those of 1251. Having a shorter brachytherapy. Their
half-life (17 days) than that of
(59.4 days), 103 Pd may provide a
dose is delivered at biologic advantage in permanent
a much faster
rate. implants because the
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DEPTH DOSE DISTRIBUTION CURVE FOR PHOTONS

T T

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DEPTH DoSE DISTRIBUTION FOR ELECTRONS

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60%

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100 200 300 mm

 A. HEAVY CHARGED PARTICLESs

their masses. Electrons

Charged particles may be classified as light or heavy, depending upon of a
and positrons are called "light" particles because of their very tiny mass (~1/1840 of mass

nuclei.
an electron. include protons, mesons, a-particles, and atomic
Examples ionization interactions
The rate of energy loss pcr unit path length or stopping power caused by
for charged particles is proportional to the square of the particle
charge and inversely
rate of energy loss
the particle slows down, its
proportional to the square of its velocity. Thus, as
increases and so does the ionization or absorbed dose to
the medium.
with depth and then very sharply
near
The dose deposited in water increases at first very slowly of dose near the end
almost zero value. This peaking
the end of the range. before dropping to an
of the particle range is called the Bragg peak.
and heavier charged particle
Because of the Bragg peak effect and mininmal scattering, protons
much sought after advantage in radiotherapy-the
ability to concentrate dose
beams provide a
normal tissues.
inside the target volume and minimize dose to surrounding

B. ELECTRONS of heavy particles.

matter are quite similar to those
Interactions of electrons when passing through scattering
small mass, the electrons suffer greater multiple
However, because of their relatively is not observed
motion. AS a consequence, the Bragg peak
and changes in the direction of
down process smear out the
forelectrons. changes in direction during the slowing
Multiple
Bragg peak. lose energy predominantly by
In water orsoft tissue, electrons, like other charged particles,
absorbed dose in the medium. As
and excitation. This results in deposition of energy or
ionization
consists of stripping electrons from
the atoms. If the energy
stated earlier, the ionization process
sufficient to overcome the binding energy,
it is displaced
transferred to the orbital electron is not excitation. Furthermore, in the
returns to it; this effect is called
from its stable position and then sufficient energy to produce an
of ionization, occasionally the stripped electron receives
process or a delta ray.
This ejected electron is called a secondary electron,
ionization track of its own.
electron may interact with the electromagnetic field of a
small an
Again, because of its mass,
The rate
and be decelerated so rapidly that a part of its energy is lost as bremsstrahlung.
nucleus of the electron
result of bremsstrahlung increases with the increase in the energy
of energy loss as a
and the atomic number of the medium.
 Photoelectric effect

JUUUUUUU
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Scatteredphoton

incident photon

target electron

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y511 kev

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Incident Y
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3. Pair Production
 LECTURE-H
ELECTRONS
IN RT
PHOTONS AND
PHySICSOF ROTON, NEUTRON,
PHySICS OF

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