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  1. 1. February 21, 2016 1 Brachytherapy: Physical and Clinical Aspects-I 2015-2016 Chapter 13: Brachytherapy: Physical and Clinical Aspects 10 Feb. 2016Osama Anjak2 IAEA International Atomic Energy Agency
  2. 2. February 21, 2016 2 20152014 10Feb.2016 4OsamaAnjak
  3. 3. February 21, 2016 3 OsamaAnjak 5 MPh212: : : (1 . (2 : LDR, HDR PDR (3 . (4 . 10Feb.2016 OsamaAnjak 6 MPh212: : : (5 )( ICRU (6 . (7 : . 10Feb.2016
  4. 4. February 21, 2016 4 OsamaAnjak 7 MPh212: : : 0.6 cc . TPS) .( . . 10Feb.2016 OsamaAnjak 8 10Feb.2016
  5. 5. February 21, 2016 5 9 1. Diagnostic Radiology 2. Nuclear Medicine 3. Radiotherapy 10Feb.2016OsamaAnjak 10 External Beam Radiotherapy [EBRT] Brachytherapy Radiotherapy ~ 90 %~10 % 10Feb.2016OsamaAnjak
  6. 6. February 21, 2016 6 11 : Radical Treatment Palliative Treatment. 10Feb.2016OsamaAnjak 12 Radiotherapy Radiotherapy Teletherapy Teletherapy Brachytherapy Brachytherapy 20-300kV Linear Accelerator Cobalt Units 10 Feb. 2016Osama Anjak Cs137Co60
  7. 7. February 21, 2016 7 Osama Anjak 13 Patient External Beam Therapy [EBT] 10 Feb. 2016 10 Feb. 2016 Osama Anjak 14
  8. 8. February 21, 2016 8 OsamaAnjak 15 (Brachytherapy) 10Feb.2016 : Brachytherapy) curietherapy( )( . )Target( 10 Feb. 201616 Osama Anjak
  9. 9. February 21, 2016 9 : ) ( : ) temporaryimplants( permanentimplants . 10 Feb. 201617 Osama Anjak : : Intracavitary: ) ......( Interstitial: tumorvolume. SurfersApplicator . 10 Feb. 201618 Osama Anjak
  10. 10. February 21, 2016 10 : targetvolume : . 10-20 10 Feb. 201619 Osama Anjak OsamaAnjak 20 (Brachytherapy) . ) intracavitary.( interstitial) .( surface application . 10Feb.2016
  11. 11. February 21, 2016 11 : : . . Systme deParis. )(. . 10 Feb. 201621 Osama Anjak HenriBecquerel February 189626 )1898(PierreCurie Ra226 1901 ) ( Brachytherapy : CurieTherapy 10 Feb. 2016Osama Anjak22
  12. 12. February 21, 2016 12 PierreCuriesselfinflictedsevereskinCuries selfreactiontoradium.1903 10 Feb. 2016Osama Anjak23 July, 1895. Mme. Curie s post doctoral work was to study the Uranium rays 10 Feb. 2016Osama Anjak24
  13. 13. February 21, 2016 13 ThefirstsuccessfulbrachytherapytreatmentswereperformedsoonafterMarie andPierreCuriesdiscoveryofradiumin1898.Thispictureshowshowradium (226Ra)surfaceapplicatorswereusedforthetreatmentofskincancer. 10 Feb. 201625 Osama Anjak Radium applicators for surface and intracavitary applications, used by Danlos and later by Wickham 10 Feb. 201626 Osama Anjak
  14. 14. February 21, 2016 14 OsamaAnjak Brachytherapy: Short distance therapy Greek word brachys, 10Feb.2016 27 (Brachytherapy) 10 Feb. 2016 Osama Anjak 28 Radiation Sources
  15. 15. February 21, 2016 15 SealedRadioactivesources : . [BSS] 10 Feb. 2016Osama Anjak29 activity . . wipetests 10 Feb. 2016Osama Anjak30
  16. 16. February 21, 2016 16 : ) (. -226: = 0.988 Ci/g (original definition: 1 Ci/g) -60: = 1130 Ci/g (carrier free); 300 Ci/g (in practice) -137: =80Ci/g. HDR -192][Ir192 -60[Co60] 10 Feb. 2016Osama Anjak31 : Halflife . Specificactivity: )( . Radiationenergy: ) (. 10 Feb. 201632 Osama Anjak
  17. 17. February 21, 2016 17 The Ideal Brachytherapy source Puregammaemitter- . Mediumgammaenergy: homogenous dose. . High specific activity: . highdoserate 10 Feb. 201633 Osama Anjak The Ideal Brachytherapy source daughterproduct longhalflife.)Cs137Co60( mediumhalflife )I125(. 10 Feb. 201634 Osama Anjak
  18. 18. February 21, 2016 18 10 Feb. 2016Osama Anjak35 Photonsources ) ( ) electroncapture internalconversion( (examples:Co60,Cs137,Ir192,I125,Pd103) Betasources Emitelectronsfollowingbetasourcedecay (example:Sr90/Y90) Neutronsources Emitneutronsfollowingspontaneousnuclearfission (example:Cf252) OsamaAnjak 36 : The SI unit of activity is the Becquerel (Bq) given as 1 Bq = 1 s1. The old unit of activity, the curie (Ci), was initially defined as the activity of 1 g of radium-226 and given as 1 Ci = 3.71010 s1. 1 Ci = 3.7 1010 Bq 10Feb.2016 1 Ci = 37 GBq 1 mCi = 37 MBq
  19. 19. February 21, 2016 19 Brachytherapy Sources Radionuclide Half-life Photon Energy (MeV) Half-value Layer (mm lead) Ra226 1600 years 0.047 - 2.45 (0.83 ave) 8.0 Rn222 3.83 days 0.047 - 2.45 (0.83 ave) 8.0 Co60 5.26 years 1.17, 1.33 11.0 Cs137 30.0 years 0.662 5.5 Ir192 74.2 days 0.136 - 1.06 (0.38 ave) 2.5 Au198 2.7 days 0.412 2.5 I125 60.2 days 0.028 ave 0.025 Pd103 17.0 days 0.021 ave 0.008 10 Feb. 201637 Osama Anjak
  20. 20. February 21, 2016 20 -226]Ra226[: Radium Ra Z=88. 226nucleons: 88protons 138neutrons , , . . , ) ( . 10 Feb. 2016Osama Anjak39 -226]Ra226[: -226Ra]226[ : & 10 Feb. 2016Osama Anjak40 Ra-226 Radionuclide: Radium-226 Half Life (T1/2) Atomic Number 88 Atomic Weight 226 1640 years Specific activity 37 GBq/g Chemical Form Radium bromide Radium chloride Physical Form A pellet or solution housed within a ceramic outer-housing
  21. 21. February 21, 2016 21 41 -226Ra]226[: : 10Feb.2016OsamaAnjak Major Gammas: E(keV) # per 100 dis 18.6 3.59 262 0.005 601 0.00049 Average gamma E=190keV 42 -226Ra]226[: : Major Alpha: E(MeV) # per 100 dis 4.784 94.45 4.601 10.4 4.340 0.0065 :Ci1 2cm10 )gammadose(1mrad.hr0.217. 10Feb.2016OsamaAnjak
  22. 22. February 21, 2016 22 OsamaAnjak 43 -226Ra]226[: : 226: Radiation Characteristics Principal Emissions Max. Energy (MeV) Dose Rate (Sv/h/GBq at 1m) Recommended Shielding Progeny Gamma/X-ray 186 (32.8%) 3.3 HVL Lead: 0.4 mm n/a Alpha () 4.785 (94.6%) n/a n/a Rn-222 10Feb.2016 OsamaAnjak 44 -226Ra]226[: : DetectionandMeasurement : GMdetectors radiation contaminationsurveymeter. ZnS(Ag)alpha scintillationdetector Methodof detection: 10Feb.2016
  23. 23. February 21, 2016 23 OsamaAnjak 45 -137Cs]137[ 10Feb.2016 -137Cs]137[ Cs 55. C28 . . 1860. 1882 . 10 Feb. 2016Osama Anjak46
  24. 24. February 21, 2016 24 OsamaAnjak 47 -137Cs]137[ Cs-137 Radionuclide: Caesium-137 Half Life (T1/2) Atomic Number 55 Atomic Weight 137 30.2 years RadiationCharacteristics Principal Emissions Maximum Energy (MeV) DoseRateat1m Distance (mSv/h/GBq) Recommended Shielding Progeny Gamma/Xray 0.662 =0.103 HVLlead:6.5mm n/a Beta 0.511 n/a n/a Ba137m 10Feb.2016 -137[Cs-137] 10 Feb. 2016 Osama Anjak 48 T1/2 =30.2 Year 0.662 MeV - 0.514 MeV 94.6% - 1.176 MeV 5.4% 0.662 1.176 0.0 Relativemass-energy(MeV)
  25. 25. February 21, 2016 25 OsamaAnjak 49 -137: DetectionandMeasurement : -GMdetectors -scintillationdetector - ionchamber Methodof detection: ExternalWholebody Dosimetry 10Feb.2016 OsamaAnjak 50 -137: radiotherapysourcefor treatmentofcancers . : moisturedensity )( ...... 10Feb.2016
  26. 26. February 21, 2016 26 )SSDL.( . 51 10 Feb. 2016Osama Anjak -137: Cs-137 ) ( -226. gynecological applications) ( ) ( 1015. 10 Feb. 2016 Osama Anjak 52
  27. 27. February 21, 2016 27 OsamaAnjak 53 -60Co]60[ 10Feb.2016 -60Co]60[ . . . 10 Feb. 2016Osama Anjak54 Co60 Radionuclide: Cobalt60 HalfLife(T1/2) AtomicNumber 27 Atomic Weight 60 (33Nutron) 5.27years SpecificActivity: 300Ci/g(41,800GBq/g)
  28. 28. February 21, 2016 28 -60Co]60[ 60. 59 60 : . 10 Feb. 2016Osama Anjak55 RadiationCharacteristics Principal Emissions Maximum Energy(keV) DoseRateat1m Distance (mSv/h/GBq) Recommended Shielding Progeny Gamma/Xray =370 HVLLead:1.2cm Ni60 Beta 318(100%) -60Co]60[ Osama Anjak56 T1/2 =5.272 Year - 0.31 MeV 99.88% 2.505 - 1.48 MeV) 0.12% 1.332 2.818 0.0 Relativemass-energy(MeV) 1.173 MeV 1. 332 MeV 10 Feb. 2016
  29. 29. February 21, 2016 29 OsamaAnjak 57 -60Co]60[ -60+ -137 10Feb.2016 OsamaAnjak 58 -60Co]60[ DetectionandMeasurement : -GMdetectors -scintillationdetector - ionchamber Methodof detection: ExternalWholebody Dosimetry 10Feb.2016
  30. 30. February 21, 2016 30 OsamaAnjak 59 -60Co]60[ radiotherapysourcefortreatmentof cancers )SSDL( : )NDT( ......... 10Feb.2016 )SSDL( 60 10 Feb. 2016Osama Anjak
  31. 31. February 21, 2016 31 10 Feb. 2016 Osama Anjak 61 192-: Ir-192 Radionuclide: Iridium-192 Half Life (T1/2) Atomic Number 77 Atomic Weight 192 (122Nutron) 74.02 day Specific Activity : 450 Ci/g Radiation Characteristics Principal Emissions Average Energy (keV) Dose Rate at 1 m Distance (mSv/h/GBq) Recommended Shielding (HVL) Progeny Gamma/X-ray 309.4 0.16 HVL = 3mm of Lead Beta 208.9 (Max. =672) - Total absorption: 1mm glass or 1.9mm plastic 192- . HDR applications. (75 days) ). ( 34 effective activity acceptable treatment time 10 Feb. 2016 Osama Anjak 62
  32. 32. February 21, 2016 32 -192)Ir192( Ir192 Cs137 Ir192 136keV1062) effective energy350 keV( Ir192 10 Ci (370 GBq) 10 Feb. 2016 Osama Anjak 63 Co-60 & Ir-192 10 Feb. 2016 Osama Anjak 64
  33. 33. February 21, 2016 33 -198)Au198( Au198 10 Feb. 2016 Osama Anjak 65 10 Feb. 2016Osama Anjak66 Isotope Half- Life Photon energy (MeV) HVL (mm Pb) Air Kerma rate per GBq at

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