Practical Radiotherapy: Physics and Equipment, 3rd Edition

Description:

Now in its third edition, Practical Radiotherapy continues to keep pace with current and emerging technologies, patient pathways, and the rapidly expanding role of therapeutic radiographers.

Extensively revised and updated, this accessible book examines all the essential aspects of radiotherapy, from the physics and mathematics of radiation beams, to in-depth descriptions of the equipment used by radiotherapy practitioners, to new and expanded coverage of MR-linac and Halcyon technology, proton therapy, stereotactic body radiotherapy, sealed-source verification and quality assurance for MV equipment.

Covers all the core information essential to radiotherapy practice

Describes the major aspects of therapeutic radiography in a practical context

Includes updated self-assessment tests, images and diagrams, supplemental reading suggestions and more radiotherapy-specific examples

Features expanded coverage of legislation, advanced treatment delivery, flattening filter free treatment and more

Practical Radiotherapy is a valuable resource for radiotherapy and medical physics students, radiotherapists, therapeutic radiographers, radiation therapists, clinical oncologists and oncology nurses.

Table of contents:

Acknowledgement of Previous Contributors

CHAPTER 1: Introduction to Radiotherapy Practice

1.1 Introduction

1.2 What Is Radiotherapy?

1.3 Working with Ionising Radiations

1.4 How Radiotherapy Works

1.5 Radiotherapy Beam Production

1.6 Treatment Delivery and Planning

1.7 Treatment Accuracy and Patient Immobilisation

1.8 Technology and Techniques

1.9 Current Radiotherapy Practice

References

Further Reading

CHAPTER 2: Mathematical Skills Relevant for Radiotherapy Physics, Atomic Structure, and Radioactivity

2.1 Mathematical Skills Relevant for Radiotherapy Physics

2.2 Basic Physics Relevant to Radiotherapy

2.3 Heat and Temperature

2.4 Electricity, Magnetism, and Electromagnetic Radiation

2.5 The Electromagnetic Spectrum

2.6.4 Electron Orbits

2.6.5 Atomic Energy Levels

2.7 Classification of Nuclides

2.9 Background Radiation

Further Reading

CHAPTER 3: X‐ray Production

3.1 Introduction

3.2 The X‐ray Tube

3.3 X‐ray Production

3.4 X‐ray Output Intensity

3.5 Beam Quality

3.6 Factors Affecting the Output Intensity and Quality of the Beam

3.7 X‐ray Production and Clinical Practice

Further Reading

CHAPTER 4: Radiation Detection and Measurement

4.1 The Unit of Absorbed Dose

4.2 Free‐Air Ionisation Chamber

4.3 Cavity Chamber (Cylindrical or Thimble Chamber)

4.4 Parallel Plate (Pancake) Chambers

4.5 Air Kerma

4.6 Dosimetry of Megavoltage Photons

4.7 Radiation Detection and Measurement

4.8 Thermoluminescent Dosimeters

4.9 TLD Detector Types

4.10 Optically Stimulated Luminescence (OSL) Dosimetry

4.11 Dosimetry in CT

4.12 MRI LinAc

References

Further Reading

CHAPTER 5: X‐ray Interactions with Matter

5.1 Introduction

5.2 X‐ray Interaction Processes

5.3 Electron Interactions and Ranges

Further Reading

CHAPTER 6: Principles of Imaging Modalities

6.1 Introduction

6.2 2D Imaging

6.3 Plain Radiography Image Generation

6.4 CT

6.5 MRI

6.6 Ultrasound

6.7 PET

6.8 Image Registration, Image Fusion, and Multimodality Imaging

6.9 Hybrid and Functional Imaging

6.10 Future Perspectives of Pre‐treatment Imaging

References

Further Reading

CHAPTER 7: Principles of Treatment Accuracy and Reproducibility

7.1 Introduction

7.2 Scanner Aperture Size

7.3 Reference Points and Anatomical Landmarks

7.4 Treatment Tattoos Versus Semipermanent Skin Marks

7.5 Lasers and Treatment Setup

7.6 Volume Definitions and Target Defining Concepts

7.7 Treatment Bolus and 3D Bolus Printing

7.8 Immobilisation Shells

7.9 Immobilisation Equipment for Head and Neck Treatment

7.10 Immobilisation Techniques and Proton Beam Radiotherapy

7.11 Immobilisation Equipment for Breast Treatment

7.12 Respiratory Movements

7.13 Thorax Immobilisation

7.14 Immobilisation Equipment for Pelvic Treatment

7.15 Superficial Radiotherapy

7.16 Position Reproducibility in Emergency or Palliative Radiotherapy

7.17 Immobilisation for Less Common Techniques

7.18 Immobilisation Equipment for Treatment of Extremities

7.19 Immobilisation of the Paediatric Radiotherapy Patient

7.20 Stereotactic Radiotherapy

7.21 Conclusion

Acknowledgements

References

Further Reading

CHAPTER 8: Radiotherapy Beam Production

8.1 Introduction

8.2 Kilovoltage Equipment

8.3 Superficial and Orthovoltage Equipment

8.4 Inverse Square Law

8.5 Quality Assurance Tests

8.6 Linear Accelerators

8.7 Production and Transport of the RF Wave

8.8 Ancillary Equipment

8.9 Treatment Head

8.10 Patient Support System

8.11 Imaging Systems

8.12 Other Linear Accelerator Designs

8.13 Quality Assurance of a Linear Accelerator

8.14 Cyclotrons and Proton Beams

8.15 Gamma Knife

8.16 Intraoperative Radiotherapy

8.17 Treatment Delivery Techniques

Acknowledgements

References

CHAPTER 9: Principles and Practice of Treatment Planning

9.1 Introduction

9.2 Treatment Planning Principles

9.3 ICRU Guidelines

9.4 Treatment Planning Objectives

9.5 Treatment Planning Process

9.6 Advanced Treatment Planning

9.7 Quality Assurance

References

CHAPTER 10: Image‐guided Radiotherapy and Treatment Verification

10.1 Introduction

10.2 Fundamental Principles of Treatment Verification

10.3 Site‐specific Uncertainties and Protocols

10.4 Record and Verify Systems and Computer‐Controlled Delivery

10.5 Conclusion

References

CHAPTER 11: Quality Management in Radiotherapy

11.1 Introduction

11.2 What Is Quality?

11.3 Quality Assurance and Quality Control

11.4 Quality Management

11.5 QMS

11.6 ISO 9000

11.7 The Radiotherapy QMS

11.8 Document Control

11.9 Concessions and Non‐conformances

11.10 Clinical Governance

11.11 Risk Management

11.12 Risk Assessment

11.13 Reducing Risk

11.14 Clinical Incidents: Reporting and Learning

11.15 Why Is it Important to Report?

11.16 Clinical Audit

References

CHAPTER 12: Radiation Protection

12.1 Dangers of Ionising Radiations

12.2 Rationale for Radiation Protection

12.3 Radiation Protection in Practice

12.4 Radiation Protection by Design

12.5 Personal Monitoring

12.6 Radiation Protection Legislation

12.7 Radiation Protection Organisations

12.8 IR(ME)R 2018

12.9 IRR 2017

References

CHAPTER 13: The Use of Radionuclides in Molecular Imaging and Molecular Radiotherapy

13.1 Introduction

13.2 Radionuclides

13.3 Imaging Equipment

13.4 Single Photon Emission Computed Tomography (SPECT)

13.5 Positron Emission Tomography (PET)

13.6 Hybrid Imaging Systems

13.7 Radiopharmaceuticals

13.8 Tumour (Molecular) Imaging and Molecular Radiotherapy (MRT)

13.9 Radiation Protection Related to Radioactive Substances

13.10 Dosimetry

References

CHAPTER 14: Brachytherapy Physics and Equipment

14.1 Introduction

14.2 The Journey from Live Loading to Remote Afterloading

14.3 Brachytherapy Terminology

14.4 The Impact of Dose Rate

14.5 Afterloading Equipment

14.6 HDR Afterloaders

14.7 Brachytherapy Dosimetry

14.8 Transfer of Information to the Treatment Unit and Checking of Data

14.9 Principles of Safe Treatment Delivery

14.10 Treatment Protocols in Brachytherapy

14.11 Clinical Examples

14.12 Conclusion

References

Index

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