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Beam Modification devices in Radiotherapy Moderator: Prof. S.C. Sharma  Head Of Department  Department of Radiotherapy PGIMER
Why Beam modification?
Introduction ,[object Object]
Types of beam modification  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Problem in beam modification ,[object Object],[object Object],[object Object],[object Object]
Types of beam modification devices ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Shielding ,[object Object],[object Object],[object Object],[object Object],[object Object]
Shielding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Shielding ,[object Object],[object Object],[object Object]
Shielding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Shielding 250 KV 4 MV Lesser amount of scattered  radiation with megavoltage radiation means that the  attenuation  produced by shielding is also more. The  higher scatter contribution  to the overall dose results in  lower dosage  adjacent to the shielded area in kilovoltage radiation . 100% 50% 5.0 cm Co 60 (1.25 MeV) 7.0 cm 10 MV 6.5 cm 6 MV 6.0 cm 4 MV Required lead thickness Beam energy
Shielding ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Custom blocks ,[object Object],[object Object],[object Object],[object Object],[object Object]
Custom blocks Outline of the treatment field being traced on radiograph using a Styrofoam cutting device. Electrically heated wire pivoting around a  point  (simulating  the source) cutting the styrofoam block Cavities in the styrofoam block  being used to cast the Cerrobend blocks.
Custom Blocks
Custom blocks ,[object Object],[object Object],[object Object],[object Object],[object Object]
Special Shielding
Independent Jaws ,[object Object],[object Object],[object Object],[object Object],[object Object]
Multileaf Collimators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multileaf Collimators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Tongue Beam
Multileaf collimators Y X Y X
Multileaf Collimators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Multileaf Collimators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Compensators ,[object Object],[object Object],[object Object],[object Object],[object Object],Notice the reduction in the hot spot
Compensators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],h' h d d h’/h 1
Compensators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Compensators ,[object Object],[object Object],[object Object],[object Object]
Compensators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Compensators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Beam Spoilers ,[object Object],[object Object],[object Object],% depth dose Depth (cm) D = 5 D = 10 D = 20 D = 40 D = Tray to surface distance .4 .8 1.2 100%
Wedge Filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Wedge filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],X X Y This area will have a hot spot.
Wedge Filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Wedge Filters ,[object Object],[object Object],[object Object],[object Object],[object Object]
Wedge filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],θ
Wedge filters ,[object Object],[object Object],[object Object],[object Object]
Wedge filters ,[object Object],[object Object],[object Object],[object Object],[object Object]
Wedge Filters
Wedge filters
Wedge filters - Design This angle is the wedge angle. % DD at each point is calculated and tabulated A B C D E 105 76 43 39 35 Wedge isodose 62 68 67 55 40 Non wedge isodose E D C B A 1.7 1.1 .79 .71 .87 Ratio (W: NW) 1 .66 .42 .38 - Transmission ratio 0 6.5 13.6 15.2 - mm Pb
Wedge filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],φ Θ  = 90 –  φ  / 2
Wedge filters Compensators may be used to overcome the deficit or a different wedge angle can be used, so that part acts as a compensator. The body contour can be more curved as a result, the isodose curves are not obtained in the manner desired. A small range of hinge angles can be covered by a given wedge angle without producing significant variation(±5%). A different value of wedge angle is required for different beam angles Solution Problem
Wedge filters ,[object Object],[object Object],[object Object],[object Object],[object Object]
Flattening filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Flattening filters ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bolus ,[object Object],[object Object],[object Object],[object Object]
Bolus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bolus ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Breast Cone ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Penumbra trimmers ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Penumbra trimmers ,[object Object],[object Object],[object Object],3.  P = AB ( SSD + d – SDD)/ SDD d B 1. CD/ AB =  MN/ OM C D A E P O M N A 2. CD/ AB =  SSD + d – SDD / SDD SSD SDD
Electron beams  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Electron Beam ,[object Object],[object Object],[object Object],[object Object]
Direct / Internal Shielding ,[object Object],[object Object],[object Object],[object Object],lead wax Tissue to be shielded Tissue to be treated
Scattering foil ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Primary foil Secondary foil Electron cone
Conclusion ,[object Object],[object Object],[object Object],The price of safety in radiotherapy is an eternal vigilance  .
Thank You

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Beam Modification in Radiotherapy

  • 1. Beam Modification devices in Radiotherapy Moderator: Prof. S.C. Sharma Head Of Department Department of Radiotherapy PGIMER
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  • 11. Shielding 250 KV 4 MV Lesser amount of scattered radiation with megavoltage radiation means that the attenuation produced by shielding is also more. The higher scatter contribution to the overall dose results in lower dosage adjacent to the shielded area in kilovoltage radiation . 100% 50% 5.0 cm Co 60 (1.25 MeV) 7.0 cm 10 MV 6.5 cm 6 MV 6.0 cm 4 MV Required lead thickness Beam energy
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  • 14. Custom blocks Outline of the treatment field being traced on radiograph using a Styrofoam cutting device. Electrically heated wire pivoting around a point (simulating the source) cutting the styrofoam block Cavities in the styrofoam block being used to cast the Cerrobend blocks.
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  • 40. Wedge filters - Design This angle is the wedge angle. % DD at each point is calculated and tabulated A B C D E 105 76 43 39 35 Wedge isodose 62 68 67 55 40 Non wedge isodose E D C B A 1.7 1.1 .79 .71 .87 Ratio (W: NW) 1 .66 .42 .38 - Transmission ratio 0 6.5 13.6 15.2 - mm Pb
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  • 42. Wedge filters Compensators may be used to overcome the deficit or a different wedge angle can be used, so that part acts as a compensator. The body contour can be more curved as a result, the isodose curves are not obtained in the manner desired. A small range of hinge angles can be covered by a given wedge angle without producing significant variation(±5%). A different value of wedge angle is required for different beam angles Solution Problem
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