The Physics of Radiotherapy X-Rays and Electrons

This book is an updated successor to The Physics of Radiotherapy X-Rays from Linear Accelerators published in 1997. This new volume includes a significant amount of new material, including new chapters on electrons in radiotherapy and IMRT, IGRT, and tomotherapy, which have become key developments in radiation therapy. Also updated from the earlier edition are the physics beam modeling chapters, including Monte Carlo methods, adding those mysterious electrons, as well as discourse on radiobiological modeling including TCP, NTCP, and EUD and the impact of these concepts on plan analysis and inverse planning. This book is intended as a standard reference text for postgraduate radiation oncology medical physics students. It will also be of interest to radiation oncology registrars and residents, dosimetrists, and radiation therapists. The new text contains review questions at the end of each chapter and full bibliographic entries. Fully indexed. Selected questions and answers from The Q Book, The Physics of Radiotherapy X-Rays: Problems and Solutions are updated and integrated into the text.

Table of Contents:
Preface Acknowledgments Chapter 1-Medical Linear Accelerators 1.1 Introduction 1.2 Principles of Operation 1.3 Klystrons and Magnetrons 1.4 Electron Gun14 1.5 Accelerator Waveguide 1.6 Beam Delivery 1.7 Collimation 1.8 Wedges 1.9 Compensators 1.10 Electronic Portal Imaging Devices 1.11 On-Board Imaging Devices 1.12 Helical Tomotherapy 1.13 Gamma Knife and CyberKnifeReferences Questions Chapter 2-Interaction Properties of X-Rays and Electrons 2.1 Introduction 2.2 Cross Sections and Attenuation Coefficients 2.3 Photon Interaction Processes 2.4 Photon Beam Transport 2.5 Electron Interactions 2.6 Absorbed DoseReferences Questions Chapter 3-Dosimetry of Megavoltage X-Rays and Electrons 3.1 Introduction: Why Measure Dose? 3.2 The Ideal Dosimeter: Some Definitions 3.3 Radiotherapy Dosimetry Phantoms 3.4 Theory of Ionization Chamber Dosimetry 3.5 Ionization Chambers: Commercial Chambers and Electrometers 3.6 Semiconductor Detectors 3.7 Thermoluminescent Dosimeters 3.8 Film Dosimetry 3.9 Other Means of Dosimetry 3.10 Dosimeter Overview References Questions Chapter 4-X-Ray Beam Properties 4.1 Introduction 4.2 Calibration Field Factors 4.3 Build-up Region 4.4 Percentage Depth Dose 4.5 Isocentric Dose Ratios 4.6 Beam Dose Profiles 4.7 Attenuation and Shielding 4.8 A Few Comments on kV X-Rays References Questions Chapter 5-Linear Accelerator Electron Beam Properties 5.1 Introduction 5.2 Characterization of a Clinical Electron Beam 5.3 Depth Doses and Profiles 5.4 Electron Applicators and Cut-outs 5.5 Small and Irregular Fields 5.6 Variations in Geometry 5.7 Inhomogeneities 5.8 Typical Electron Beam Applications 5.9 A Few Comments on Protons References Questions Chapter 6-Radiotherapy Treatment Planning: X-Rays 6.1 Introduction 6.2 Isodose Curves 6.3 Monitor Unit Calculations 6.4 Classical Simulation 6.5 Computed Tomography Simulation 6.6 Other Treatment Planning Aids 6.7 Radiotherapy Treatment Planning Hardware 6.8 Dose Display 6.9 Dose-Volume Histograms 6.10 Defining Treatment Planning Volumes References Questions Chapter 7-Special Procedures: Stereotactic Radiotherapy and IMRT 7.1 The Rationale for Stereotactic Radiosurgery 7.2 Clinical Indications for SRS 7.3 Traditional Stereotactic Targeting 7.4 Frameless Stereotactic Targeting 7.5 SRS Treatment Planning 7.6 MMLC-based Radiosurgery Techniques 7.7 Robotic Radiosurgery: The CyberKnife 7.8 Stereotactic Body Radiotherapy 7.9 The Rationale for IMRT 7.10 Computation of Optimal Intensity Patterns for IMRT 7.11 MLC Leaf Sequences for IMRT 7.12 Dosimetric Properties of MLCs 7.13 Independent Plan Dosimetry Verification 7.14 Clinical Treatment with IMRT 7.15 Tomotherapy as an IMRT Modality 7.16 Analogy of Tomotherapy to CT Imaging 7.17 The TomoTherapy Hi-Art System® 7.18 Helical TomoTherapy Parameters 7.19 Clinical Use of Helical TomoTherapy References Questions Chapter 8-Calibration of Megavoltage Photon and Electron Beams 8.1 Introduction 8.2 Absolute Dosimetry with Ionization Chambers 8.3 Air-Kerma Calibration-based Protocols 8.4 Dose-to-Water Calibration-based Protocols 8.5 Uncertainty Analysis and Verification References Questions Chapter 9-Beam Models: Part I 9.1 Introduction 9.2 The Milan/Bentley Model 9.3 Inhomogeneity Corrections 9.4 Electron Pencil Beams 9.5 Brachytherapy Source Models References Questions Chapter 10-Beam Models: Part II 10.1 Introduction 10.2 Monte Carlo Simulation 10.3 BEAM 10.4 Geant4 10.5 Convolutions/Superposition Methods 10.6 Macro Monte Carlo References Questions Chapter 11-Quality Assurance in Radiotherapy 11.1 Introduction 11.2 Definition of Terms 11.3 Equipment That Requires QA 11.4 Intensity-Modulated Radiation Therapy (IMRT) QA 11.5 Image-Guided Radiation Therapy (IGRT) QA 11.6 In Vivo Dosimetry References Questions Chapter 12-Patient Immobilization and Image Guidance 12.1 Introduction 12.2 The ICRU Target Definitions 12.3 Patient Setup and Immobilization 12.4 Interfraction Motion Management: Image Guidance 12.5 Intrafraction Motion Management References Questions Chapter 13-Radiation Protection and Room Shielding 13.1 Introduction 13.2 The Framework of ICRP Report 60 13.3 Dose Limits 13.4 Room Shielding References Questions Chapter 14-Tumor and Normal Tissue Response 14.1 Introduction 14.2 Mechanism of Cell Killing 14.3 Introduction to Radiobiological Models 14.4 The Four Rs of Radiobiology 14.5 Linear Quadratic Model Including Tumor Proliferation 14.6 Models of Tumor and Normal Tissue Response 14.7 Equivalent Uniform Dose (EUD) 14.8 Clinical Trials Definitions 14.9 Current Issues in Radiobiology References Questions Answers to Chapter Questions Index