Ⅰ．SIMPLE MATHEMATICS OF RADIATION THERAPY 3
Proportion 3
Simple direct proportion 3
Algebraic or arithmetic proportion 3
Geometric proportion 5
Graphic proportion 5
Simple inverse proportion 7
Algebraic inverse proportion 7
Graphic inverse proportion 8
Inverse square proportion 9
Algebraic inverse square proportion 10
Geometric inverse square proportion 11
Graphic inverse square proportion 12
Mathematical law of decay 13
Decimal system and scientific notation 17
The slide rule 20
Ⅱ．MATTER AND ENERGY 27
Historical background 27
Ancient theories 27
Dalton＇s theory 27
Avogadro＇s law 28
Prout＇s hypothesis 28
Arrhenius＇ theory 29
Avogadro＇s number 29
States of matter 31
Structure of the atom 32
Historical background 32
Present concept 34
Atomic number 39
Mass number 39
Equivalence of mass and energy 41
Ⅲ．THE NATURE OF RADIATION 46
Definition 46
Types of radiation 46
Electromagnetic radiation 47
Quantum theory 49
X-rays 51
Production 51
X-ray spectra 52
Properties of x-rays 54
Bremsstrahlung (brems radiation) 55
Gamma-rays 56
Source 56
Properties 58
Energy 59
Radiation of particles 61
Alpha-particles 62
Beta-particles 68
Neutrons 71
Electrons 74
Positrons 74
Cosmic rays 75
Summary 76
Ⅳ．REACTIONS BETWEEN RADIATION AND MATTER 78
Photon interactions with matter 78
Transmission of photons 79
Unmodified or classical scattering 79
Photoelectric interaction with true absorption 80
Modified scattering 83
Pair production 85
Characteristic radiation 86
Interactions of particulate radiation with matter 91
Alpha-particles 91
Beta-particles 92
Positrons 92
Absorption of photon radiation 93
True absorption 93
Scattering 94
Inverse square law 95
The meaning of absorption curves 95
Attenuation of a heterogeneous x-ray beam 106
Ⅴ．X-RAY PRODUCTION AND CONTROL 109
Historical introduction 109
Principle of modern production of x-rays 111
Conditions necessary for the production of x-rays 113
Essential features of a therapy x-ray tube (100-250 Kv) 115
Valve tubes 119
Construction 120
Principle 120
Generating and control equipment 121
High voltage transformer 121
Voltage control devices 123
Autotransformer 123
Rheostat 124
Current control in x-ray tube 125
Control of current direction－rectification 126
Villard circuit 129
Constant potential circuit 131
Cables 133
High frequency x-ray generator 134
Ultra short distance therapy 136
Chaoul therapy unit 136
Philips therapy unit 139
General Electric Maximar-100 140
Ⅵ．QUANTITY OF X-RAYS AND GAMMA-RAYS 141
Historical introduction 141
Modern definition of the roentgen 143
Tissue exposure dose in roentgens 144
Measurement of the roentgen 145
The gamma-ray roentgen 148
Victoreen condenser-r-meter 149
Other types of dosimeters 155
Units of radiation dosage 156
Roentgen 156
Roentgen equivalent physical 157
Rad 158
Roentgen equivalent man 158
Factors affecting intensity of x-rays 159
Kilovoltage 159
Milliamperage 161
Time 161
Distance 161
Filtration 164
Factors affecting gamma-ray quantity 165
Ⅶ．X-RAY QUALITY 166
Factors 166
Analysis of x- ray beams 168
Modification of x-ray beams by filters 169
Clinical aspects of x-ray quality－half value layer 172
Other methods of specifying x-ray quality 179
Equivalent constant potential 179
Equivalent wavelength 180
Ⅷ．DOSAGE IN X-RAY THERAPY 182
Air dose 182
Calibration of an x-ray machine 182
Errors in dose calibration 184
Skin or surface exposure dose 186
Area of treatment field 188
Depth of irradiated part 189
Quality of the x-ray beam 191
Tissue or tumor dose 191
Absorbed dose 191
Central axis depth dose 193
Factors in depth dose percentage 196
Beam quality 196
Depth of lesion 201
Area of treatment field 202
Treatment distance 207
Exit dose 209
Isodose charts 211
Ⅸ．THERAPY PLANNING 214
Tumor localization and verification 214
Delimitation of field size 217
Cones 218
Diaphragms 219
Lead shields 220
Problem of adjacent or divided ports 221
Beam direction 223
Protractor 223
Pin-and-arc 225
Back pointer 226
Delivery of adequate radiation dosage 227
Crossfire radiation technic 227
Isodose curves in therapy planning 230
Composite isodose curves 233
Determination of dosage at critical points 238
Rotation therapy 244
Tumor-air ratio method 244
Transit dose method 252
Grid therapy 255
Sources of error in radiation therapy 257
Integral dose 259
Duties of the x-ray technician in radiotherapy 260
Establishment of rapport with patient 260
Assisting the radiologist 262
Ⅹ．RADIOACTIVE AND NUCLEAR PHYSICS 266
Definition 266
Historical background 266
Nuclides 268
Factors in nuclear stability 269
Neutron-proton ratio 269
Odd-even rules 270
Nuclear binding energy 270
Nuclear forces 271
Exchange forces 271
Types of nuclear disintegration 272
Alpha-decay 272
Beta-decay 273
Internal conversion 274
K-capture 275
Isomeric transition 275
Gamma-ray emission 276
Artificial radioactivity 276
Types of nuclear reactions 279
Alpha-particle bombardment 280
Neutron bombardment 280
Proton bombardment 282
Deuteron bombardment 282
Gamma-ray bombardment 283
The radioactive decay process 284
Displacement law 284
Radioactive decay scheme 286
Radioactive disintegration or decay constant 287
The unit of radioactivity 296
Specific radiation intensity，Iγ 298
Radioactive equilibrium 298
Ⅺ．SUPERVOLTAGE GENERATORS AND PARTICLE ACCELERATORS 301
Radium alpha-particles 301
Particle accelerators 302
Van de Graaff generator 302
Cyclotron 304
Synchrocyclotron 308
Betatron 310
Synchrotron 312
Linear accelerator 313
Nuclear reactor 317
Neutron physics 317
The fission reaction 319
Uranium fission 322
The nuclear reactor 323
Practical applications of nuclear reactor 328
Ⅻ．RADIUM AND RADON THERAPY 330
Historical survey 330
Radium 332
Decay and radiations of radium 332
Alpha-particles 333
Beta-particles 334
Gamma-rays 335
The radium series 336
Radioactive constants of radium 337
Disintegration constant 338
Half life 338
Average life 339
Radon 339
Source 339
Properties 340
Radioactive constants 341
Radioactive equilibrium 341
Gamma-ray dosage determination 347
Strength or activity of a radioactive source－the curie 349
Comparative dosage of radon and radium－determination of millicurie-hours 350
Determination of Iγ for radium 354
Absorbed dose－the rad 359
Types of radium applicators 361
Defects in radium needles 363
Gamma-ray therapy planning 364
Quimby system 366
Surface radium therapy 369
Quimby system 369
Paterson-Parker system 372
Cavitary radium therapy 380
Interstitial radium therapy 386
Paterson-Parker system 389
Martin system 399
Quimby system 401
Interstitial therapy with radioistopes 403
Cobalt-60 404
Iridium-192 404
Methods of checking accuracy of implant 405
ⅩⅢ．SURFACE BETA-RAY THERAPY 407
Natural beta-particle emitters 408
Radium series 408
Radon 409
Radium (D + E) 411
Artificial beta-particle emitting radionuclides 441
Strontium-90 411
Radiophosphorus 415
ⅩⅣ．SUPERVOLTAGE THERAPY 417
Telecurie therapy 417
Radium beam units 418
Cobalt-60 teletherapy equipment 421
Cesium-137 teletherapy equipment 425
Supervoltage x-ray equipment 428
Comparison with orthovoltage 430
Supervoltage treatment planning 439
Betatron therapy 439
ⅩⅤ．MEDICAL USE OF RADIOACTIVE ISOTOPES 444
Radioisotopes in medical diagnosis 445
Geiger-Müller tubes 447
Principle 448
Quenching 453
Construction of G-M counters 456
G-M counter circuits 458
Scintillation counters 458
Devices for counting detector pulses 462
Scalers 463
Count rate meter 466
Well counter 467
Statistics of counting 469
Background 469
Statistical error 470
Coincidence loss 474
General types of counting 477
Absolute counting 478
Comparative counting 480
Properties of radioisotopes 480
Decay constant 481
Half life 481
Average life 482
Decay curves 482
Units of dosage 485
Specific activity 485
Effective half life 487
Diagnostic use of radioisotopes 490
Radioactive iodine in thyroid gland function 490
Blood volume studies with I131 serum albumin 496
Localization of brain tumors with IHSA 498
Radiophosphorus (P32) in the diagnosis of inaccessible tumors 499
Radioactive chromium (Cr51) in red blood cell studies 501
Cobalt-60 labeled vitamin B12 in pernicious anemia (Schilling test) 502
Iron-59 in the study of anemias 504
Internal therapy with radioisotopes 505
Systemic use of radioisotopes 505
Absorbed dose from beta-emitters 507
Absorbed dose from gamma-emitters 509
Examples of radioisotopes in therapy 511
Radioactive iodine (I131) 511
Radiophosphorus (P32) 514
Radioactive chromic or zirconyl phosphate 521
Radiogold (Au198) 521
ⅩⅥ．RADIOBIOLOGY 524
Physical basis of radiobiology 524
The cell 530
Normal anatomy 530
Elementary genetics 532
Malignant cells 533
Mode of action of ionizing radiation 534
Observable radiation effects on cells 536
Radiation effects on cytoplasm 539
Effect of radiation on sensitive tumors 539
Direct effect 542
Indirect effect 542
Volume effect 543
Effect at a distance 543
Tissue recovery after irradiation 544
Tissue reactions in radiation therapy 552
Acute radiation syndrome 556
Modification of radiation injury 558
ⅩⅦ．PROTECTION IN RADIOTHERAPY 561
The maximum permissible dose 561
Determination of whole body exposure 566
Personnel monitoring 567
Laboratory surveying 569
X-ray protection up to 2 Mev 570
Radium protection 576
Protection from whole body exposure 576
Protection from local exposure 583
Hazards in the use of radioactive isotopes in Teletherapy 584
External radioisotope therapy 584
Hazards in the internal use of radioisotopes 587
Radioisotope hazards to the patient 587
Radioisotope hazards to personnel 590
External radioisotope hazards to personnel 591
Gamma-radiation 591
Beta-radiation 594
Exposure of hands to beta- or gamma-radiation 595
Internal radioisotope hazards to personnel 596
Laboratory design and facilities 599
Arrangement and location 599
Surface material 599
Ventilation 600
Shielding 600
Decay chamber 601
Laboratory monitoring 601
Disposal of radioactive wastes 602
Decontamination 603
Recommendations for nursing procedures 604
Special instructions with radioiodine 605
Special instructions with radiophosphrous 607
Special instructions with radiogold 608
Unsafe practices in handling radioisotopes 608
Bibliography 611
Supplementary References 617
Handbooks 618
Appendix 619
Central axis depth dose data (Tables A to F) 620
Useful physical data (Table G) 642
Useful equations (Table H) 643
The Greek alphabet (Table I) 646
Index 647