IAEA Training Material on Radiation Protection in Radiotherapy

Radiation Protection in
Radiotherapy

Part 5
External Beam Radiotherapy
Lecture 2 (cont.): Equipment and safe design
4. Other EBT irradiation units
 Betatron - not produced anymore
 Tomotherapy - discussed before in
IMRT
 Neutrons - beyond the scope of the
present course
 Gamma knife
 Protons

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Betatron
 Circular accelerator for
electrons
 Change of magnetic field
with increasing electron
energy
 Allows flexibility in energy
selection up to 50MeV
 Beam currents and
therefore output is
typically low

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Gammaknife
 Used for stereotactic brain irradiations
 201 sources of Co-60 around a patients
head - only sources which shall
contribute to the irradiation are
‘unplugged’
 alignment crucial

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Gamma knife head applicator

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Patient in gamma knife collimator head
(from Ertl et al. Phys. Med. Biol. 42 (1997) 2137)

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Protons
 Positively charged particles - directly
ionizing radiation
 About 2000 times heavier than electrons
 less angular struggling
 more difficult to steer
 The lightest of heavy charged particles
(such as C, Ne, Si, Ar) used for
radiotherapy

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Comparison to other radiation types

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 Passive Scanning

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Radiation Protection in Radiotherapy Part 5, lecture 2 (cont.) - Other and associated equip 10
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Radiation Protection in Radiotherapy Part 5, lecture 2 (cont.) - Other and associated equip 11
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 Passive beam
delivery
system
Spread Out Bragg
Peak SOBP

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Active Scanning

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Radiation Protection in Radiotherapy Part 5, lecture 2 (cont.) - Other and associated equip 14
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Present of Proton Radiotherapy
 23 proton radiotherapy facilities worldwide
(1998) - virtually all of them not dedicated
(and optimized!) for radiotherapy
 About 25000 patients treated up to 1998
worldwide - nearly half for eye melanoma
 At least 10 dedicated radiotherapy centres
planned...

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 Courtesy of
Tsukuba Rotating
Hitachi

Facility Gantry

Cyclotron
Accelerator

Fixed Beam
delivery
system
Copyright © Hitachi, Ltd. 1999, All Rights
Reserved. 　

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Rotating Gantry at Loma Linda
Proton Radiotherapy Centre

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Rotating Gantry - a large facility

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Protons
 Potentially better dose distribution
 More expensive
 Often combined with basic research
(e.g. nuclear physics) or other
applications (e.g. radiation testing for
space applications) to be more cost
efficient
 Large facility required

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Where things may go:
Robotic Pencil Beam Delivery
Future concept
of radiotherapy
with ultimate
flexibility...

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5. Associated radiation equipment
required for radiotherapy
 CT scanners
 Radiotherapy simulators
 For treatment planning systems refer to
part 10 of the course

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CT
scanner

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CT scanners
 Covered in the training course on diagnostic
radiology
 Used in radiotherapy to acquire patient
information required for treatment planning
 A CT scanner for radiotherapy should have:
 a flat couch top like the treatment units
 a large bore to allow scanning patients in a variety of
treatment positions
 high spatial accuracy

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Simulator

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Radiotherapy simulator
 A diagnostic X Ray unit mimicking the
geometry of a treatment unit
 Diagnostic aspects covered in course of
diagnostic radiology
 Additional features:
 field defining wires
 centre of field indication
 couch matches treatment couch

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Simulator control Fluoroscopy
X Ray screen
Control screen

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Radio-
therapy
Simulator

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Simulator
 Many movement
options
 Can be adjusted to
mimic treatment
units with different
focus to axis
distance

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Simulator control screen

Machine parameters
similar to linac

Varian Medical systems

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Another simulator

Huestis/Cascade simulator

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Summary
 There is a large variety of equipment
currently in use for external beam
radiotherapy
 Generally, the design includes redundant
features which ensure that no unwanted
exposure can take place
 Computer control becomes increasingly
important for the operation of equipment

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Where to Get More Information
 Part 10
 Medical Physics Textbooks
 Manufacturers brochures and
webpages
 VARIAN
 Siemens
 Elekta (including former Philips)
 Nucletron…

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Any questions?
 Question:

When purchasing a new piece of equipment what

must be considered?
Acknowledgments
 John Drew, Westmead Hospital,
Sydney
 Patricia Ostwald, Newcastle Mater
Hospital

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