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EQUIPMENT AND CALIBRATION TECHNIQUE
RT-311: RADIATION THERAPY
DANIELE CLYDE P. CACHA, RRT

College of Radiologic Technology
COLLEGE OF RADIOLOGIC TECHNOLOGY
Calayan Educational Foundation, Inc.
EQUIPMENT AND CALIBRATION

TECHNIQUE
Radiotherapy Units
Main Modalities of Radiotherapy
1. BRACHYTHERAPY – therapy with a short distance between radiation source

and the target volume.
2. TELETHERAPY- the delivery of radiation treatment to the patients from the

machine located remote from the body

TECHNIQUE
Comparison Between Brachytherapy and Teletherapy
Brachytherapy
1. By placing the radiation source or sources is inside or immediately

adjacent to the volume of tissues to be treated, the dose to the other tissues
before arriving at the treatment volume.
2. Inside the treatment volume, the necessary dose is non-uniform and dose
gradients are often high.

TECHNIQUE
3. Normally accessible sites for brachytherapy are either near the surface of
the body or near natural body cavities.
4. With the limitation imposed by statement number (3), any volume may be
treated by using a sufficiently complex array of sources.
5. Dose rate are usually relatively low.


TECHNIQUE
Teletherapy
1. Any volume of the body is accessible to beam therapy but the relative dose to the
tissue outside the treatment volume in general will be greater than that of
brachytherapy.
2. By suitable design, any required degree of dose uniformity can be achieved inside the
treatment volume.
3. There is no physical limitation to the size of the volume that can be treated.
4. Dose rate are usually relatively high.


TECHNIQUE
Types of Brachytherapy Equipment
1. After-loading Systems
2. Implants
3. Eye Plaques
4. Intravascular brachytherapy

TECHNIQUE
Brachytherapy Sources
ELEMENT HALF LIFE EFFECTIVE ENERGY (MeV)

Radium 226 1620 yrs. 1.2 MeV
Cesium 137 30 yrs. 0.66 MeV
Iridium 192 74 yrs. 0.34 MeV
Iodine 135 60 days 0.027 MeV
Gold 198 2.7 days 0.41 MeV

TECHNIQUE
Types of Brachytherapy Procedures
1. Endocavitary – it is the introduction of radioactive sources contained in

“applicators” or in molded devices inside natural pathological or operative
cavities.
2. Interstitial – placement of radioactive source (needles, wires, seeds) directly into
the tumor site and adjacent tissue.
3. Contact – it is direct contact application of radionuclides to the skin surface or
other sites (cornea, external mucous membrane) of radioactive sources (usually
beta-emitters) for the treatment of every superficial neoplasm.

TECHNIQUE
Two Brachytherapy Systems
1. LDR (Low Dose Rate)

• 40-500 cGy/hr.
• 3-4 days
2. HDR (High Dose Rate)

• Greater than 1200 cGy/hr.
• 10-20 min

TECHNIQUE
Types of Teletherapy Equipment and Their Energy Range
1. Superficial X-ray – for surface lesions

• 10 kV Grenz Ray
• 40 – 140 kV – Superficial
2. Orthovoltage – for deep and semi - deep lesions

• 250 kV – Deep x-ray or Radioisotope Teletherapy
• 600kV - Radioisotope Teletherapy (Cs 137)
3. Supervoltage or Megavoltage – for both deep and superficial lesions

• 2 MeV – Radioisotope Teletherapy
• 4 – 8 MeV – Linear Accelerator
• 20 MeV – Betatron

TECHNIQUE
Teletherapy Sources
TYPES OF SOURCES ENERGY RANGE DISTANCE (SSD)

Grenz ray 10 keV Dermatological Purpose
Superficial ray 50 – 140 keV 15 cm SSD

Orthovoltage 200 – 300 keV 25 cm SSD
Teleisotope
Cs – 137 600 keV 50 cm SSD
Co – 60 1.25 MeV
Megavoltage e 1 MeV 80 – 100 cm SSD

TECHNIQUE
Types of Teletherapy Procedures
1. Conventional Roentgen Therapy – utilize x-rays produced by equipment functioning with

voltage not exceeding 400 kV.
• Short distance roentgen therapy – 3 - 5 cm lesion depth using voltage from 50 – 60 kV
• Middle distance roentgen therapy – 15 - 30 cm lesion depth using voltage greater

than 100 kV
• Deep roentgen therapy – for depth seated lesions, uses voltage from 250 – 400 kV

TECHNIQUE
2. External Radiotherapy with High Energy Protons – most commonly used method for
irradiation of deep and semi - deep seated tumors
• Cobalt 60 teletherapy unit

• Linear Accelerator
• Betatrons
3. External Radiotherapy with Fast Electrons
• Betatrons capable of producing energies up to 45 MeV

• LINAC capable of producing energies up to 25 MeV

TECHNIQUE
Radiation Calibration Technique
Dosimetry
Dosimetry refers to the measurement of radiation dose, and it demonstrates

how the radiation is distributed or attenuated throughout the patient's body
(absorbing medium).

TECHNIQUE
The dosimetrist devises a treatment plan that best fulfills the physician's
prescription for the desired dose to the tumor/target volume while minimizing the
amount of radiation to critical normal structures or tissues.
Each organ of the body has a tolerance dose to radiation that limits the
amount it can receive and still function normally. If an organ receives an excess of the
tolerance dose, the organ can fail, resulting in a fatal complication.

TECHNIQUE
STRUCTURE TOLERANCE DOSE
TESTES 500 cGy
OVARY 500 cGy
LUNG (WHOLE LUNG) 1,800 cGy
KIDNEY (WHOLE KIDNEY) 2,300 cGy
LIVER (WHOLE ORGAN) 3,500 cGy
SPINAL CORD (5 cm3) 4,500 cGy


TECHNIQUE
The first step in dosimetry is to obtain a contour or CT scan of the patient in
treatment position.
A contour is an outline of the external surface of the patient’s body at the level
of the central axis (center of treatment field).

TECHNIQUE
This is typically performed in the transverse plane, but other planes maybe
used. Then the tumor volume and critical dose limiting internal structures are
transferred from the simulation radiographs and drawn onto the contour.
With CT scanning, the tumor and internal structures and their relationships
are directly visible. These images are then interfaced with the treatment-planning
computer system for development of the plan.
To obtain an even distribution of radiation to the target volume, radiation is

delivered from various angles, all focused on the area of interest.

TECHNIQUE
The dosimetrist optimizes the plan by eliminating any areas of dose
inhomogeneity such as "hot spots.“
One method to adjust for hot spots is to add a wedge filter. Another method of
reducing hot pots is to change the weighting of the radiation beams by, for example,
delivering a greater dose of radiation from the anterior field than from the posterior
field.
Another major task of the dosimetrist is to monitor the dose that critical
structures are receiving and to keep the dose within the established guidelines
dictated by the physician.

TECHNIQUE
Isodose line/curve – is a summation of areas of equal radiation dosage and

may be stated as percentage of the total prescribed dose.

TECHNIQUE
Dose Rate Determination
Radiation dosimeter – is any device that is capable of providing a reading (M) that is a
measure of the dose (D) deposited in the dosimeter’s sensitive volume (V) by
ionizing radiation
• Absolute dosimeter – produces a signal from which the dose in its sensitive volume
can be determined without requiring calibration in a known field of radiation
• Relative dosimeter – requires a calibration in a known radiation field


TECHNIQUE
ABSOLUTE DOSIMETRY – a technique that yields information directly on absorbed
dose in Gy. Also referred to as calibration
RELATIVE DOSIMETRY – comparison of two dosimeter readings, one of them being in

reference conditions

TECHNIQUE
Types of Dosimeter
1. Ionization chamber
2. Film badge – 10 rem
3. TLD (Lithium Fluoride) – 5 rem
4. OSL (Aluminum Oxide) – 1 rem

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Evolve.

EQUIPMENT AND CALIBRATION TECHNIQUE

RT-311: RADIATION THERAPY

DANIELE CLYDE P. CACHA, RRT

EQUIPMENT AND CALIBRATION

Main Modalities of Radiotherapy

1. BRACHYTHERAPY – therapy with a short distance between radiation source

2. TELETHERAPY- the delivery of radiation treatment to the patients from the

EQUIPMENT AND CALIBRATION

1. By placing the radiation source or sources is inside or immediately

EQUIPMENT AND CALIBRATION

5. Dose rate are usually relatively low.

EQUIPMENT AND CALIBRATION

4. Dose rate are usually relatively high.

EQUIPMENT AND CALIBRATION

EQUIPMENT AND CALIBRATION

ELEMENT HALF LIFE EFFECTIVE ENERGY (MeV)

EQUIPMENT AND CALIBRATION

1. Endocavitary – it is the introduction of radioactive sources contained in

EQUIPMENT AND CALIBRATION

1. LDR (Low Dose Rate)

2. HDR (High Dose Rate)

EQUIPMENT AND CALIBRATION

1. Superficial X-ray – for surface lesions

2. Orthovoltage – for deep and semi - deep lesions

3. Supervoltage or Megavoltage – for both deep and superficial lesions

EQUIPMENT AND CALIBRATION

TYPES OF SOURCES ENERGY RANGE DISTANCE (SSD)

Superficial ray 50 – 140 keV 15 cm SSD

EQUIPMENT AND CALIBRATION

1. Conventional Roentgen Therapy – utilize x-rays produced by equipment functioning with

• Short distance roentgen therapy – 3 - 5 cm lesion depth using voltage from 50 – 60 kV

• Middle distance roentgen therapy – 15 - 30 cm lesion depth using voltage greater

EQUIPMENT AND CALIBRATION

• Cobalt 60 teletherapy unit

3. External Radiotherapy with Fast Electrons

• Betatrons capable of producing energies up to 45 MeV

EQUIPMENT AND CALIBRATION

Dosimetry refers to the measurement of radiation dose, and it demonstrates

EQUIPMENT AND CALIBRATION

EQUIPMENT AND CALIBRATION

TESTES 500 cGy

OVARY 500 cGy

LUNG (WHOLE LUNG) 1,800 cGy

KIDNEY (WHOLE KIDNEY) 2,300 cGy

LIVER (WHOLE ORGAN) 3,500 cGy

SPINAL CORD (5 cm3) 4,500 cGy

EQUIPMENT AND CALIBRATION

EQUIPMENT AND CALIBRATION

To obtain an even distribution of radiation to the target volume, radiation is

EQUIPMENT AND CALIBRATION

EQUIPMENT AND CALIBRATION

Isodose line/curve – is a summation of areas of equal radiation dosage and

EQUIPMENT AND CALIBRATION

• Relative dosimeter – requires a calibration in a known radiation field

EQUIPMENT AND CALIBRATION

RELATIVE DOSIMETRY – comparison of two dosimeter readings, one of them being in

EQUIPMENT AND CALIBRATION

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