radioisotopes, ultrasound
TRANSCRIPT
Unit 8Medical Physics
Walter Hall
School of Health Sciences
University of Ulster
Topics for this session
• Fibre Optics and Lasers in medicine
• Light in therapy
• Ultrasound in therapy
• Radioisotopes in therapy
• Choosing modalities
Fibre Optics
Fibre Optics Explained
• Glass fibres around 120 micrometres dia
• Can carry light up to 50km without need for repeaters or boosting
• Commonly known applications are in data and voice communications
Why the light “Stays in”
• When light meets an interface between 2 materials it will be transmitted or refracted
• Fibre optics manipulate this phenomenon
Refractive Index and TIR
ZigZag – NOT STRAIGHT!
Lower Refractive Index
Medical Application
• Fibre optic tube• Light source• Lens• Can be used to
explore natural body cavities
• OR small artificial ones
Medical Application
Advantages
• Can examine a variety of structures without requiring surgery
• Minor apertures can expand role further
• Can carry out surgical procedures via specialised variants of endoscope
• Incision is small – post-operative recovery is much quicker
Light in Therapy
• Fibre optics can convey special light such as LASERs
• Light Amplification by Stimulated Emission of Radiation
• LASER is useful as surgical tool
How It Works
• Pump energy – optical or electrical
• Excite Atoms
• Create population inversion – more excited than non-excited atoms
• Stimulate emission
Properties
• Directional
• Monochromatic
• Coherent – all the photons are in step with each other
Types
• Helium – Neon
• Argon Ion
• Neodymium – YAG
• CO2
• Solid State – GaAlAs
High Power Laser Applications• Eye Surgery –
– corrective surgery– retinal welding
• Cosmetic - Hair Removal– Procedures on skin – birthmark removal
• General Surgery – tumour removal
• Neurosurgery
• Oncology – activation of specialised drugs
Surgical
• Cutting
• Cauterisation
• Opening Blocked Arteries
• Retinal Re-attachment
• Corrective Eye Surgery
• Photo-stimulation
Other Light Applications
• SAD (Seasonal Affective Disorder)
• Skin Disorders
• Delayed Sleep Phase Syndrome
Low Level Laser Therapy• Physiotherapy
• Cells are stimulated by pulses of light, usually from a solid-state laser
• Pain Relief
• Increases Blood Flow
• Stimulates more rapid healing• Wounds• Strained Muscles• Leg Ulcers
Ultrasound in Therapy
• Useful with injuries to soft tissue and joints
• Can aid the bodies own repair mechanisms – heat and increased circulation
• Relieve pain and increase mobility
• Sports medicine makes great use of it
Specialised Techniques
• Lithotripsy• Derived from the Greek for “Breaking
Stones”
• Break down of areas of calcification in areas like kidneys and gall bladder
• TENS• Transcutaneous Electrical Nerve Stimulation
Why use Ultrasound?
• Readily available
• Proven technology
• Painless
• No need for surgery
• Safe and relatively cheap
• Not always effective
• Some procedures may require repetition
Radioisotopes in Therapy
• Nuclear medicine utilises unsealed radioactive sources often attaching to a pharmaceutical to encourage uptake by specific tissue
• Therapeutic applications also use sealed sources
Radiations
helium nucleus – penetrates only a few cm in air – stopped by a sheet of paper
energetic electrons – penetrate up to a metre in air – stopped by a few mm of Al
high energy electromagnetic rays – penetrate many metres in air - only stopped by several cm of lead
Example Application
• Iodine131
• Half life 8 days emitter
• Used to test thyroid function
• Used to treat thyroid cancer or thyrotoxicosis
Example Application
• Iridium 192
• Half life 74 days emitter
• Used to treat breast cancer
• Used as a wire which is inserted for a time and then removed
Example Application
• Caesium 137
• Half life 30 years emitter
• Used to treat reproductive organ tumours
• Up to 200 others are used– Lutetium 177 - and – Yttrium 90
Example Application
• Cobalt 60
• Half life 5.27 years emitter
• General radiation therapy
• Teletherapy units
• Largely replaced by linear accelerators which produce high energy X-rays
Half Life
• Overall half life is a combination of – radioactive half-life– biological half-life
– Radioisotope decays– Radioisotope is excreted
Ionisation
Ionisation In Tissue One million ion pairs per mm 10,000 ion pairs per mm 1,000 ion pairs per mm
• Water is ionised
• H+ and OH- attack cell walls and chromosomes
• Kills or modifies cells
Afterloading
• Catheters introduced to treatment area
• Therapist controls insertion of sources from behind shielding
Teletherapy
• Useful for a wide variety of radiotherapy applications
Attributes of Therapeutic Isotopes
• In a physical form which can be manipulated• Can be beta emitters• Co60 is a gamma emitter
Problems
• Radiation protection issues
• Dosimetry changes over time
• Finite life span of isotopes
• Side effects
Side Effects
• Hair loss – may be permanent
• Fatigue
• Inducing other cancers
• Damage to epithelial surfaces
• Inflamation and swelling
• Infertility
Which Modality?
• What is available
• What does the clinician recommend
• What can the patient tolerate
• Is there a safer/cheaper alternative?
• Can potential risks be justified?
QUESTIONS?