Table Of ContentJayaraman • Lanzl
Clinical Radiotherapy Physics
Springer-Verlag Berlin Heidelberg GmbH
Subramania Jayaraman
Lawrence H. Lanzl
Clinical
Radiotherapy Physics
Second Edition
With the Editorial Assistance of Elisabeth F. Lanzl
With 246 Figures and 62 Tables
f|p|Springer
Subramania Jayaraman, Ph.D.
Chief Medical Physicist
Valley Radiation Oncology
1301 S 7th Avenue, Suite 400
Phoenix, Arizona 85007
USA
Lawrence H. Lanzl 1", Ph.D.
Professor Eremitus Medical Physics
UniversityofChicago, Chicago Illinois
5750 S Kennwood Avenue
Chicago, Illinois 60637
USA
Title of the original edition:
Clinical Radiotherapy Physic: Volume I and II
© CRC Press, Boca Raton, New York, London, Tokyo 1996
ISBN 978-3-642-62155-0
Library of Congress Cataloging-in-Publication-Data
Jayaraman, Subramania. Clinical radiotherapy physics S. Jayaraman and L.H. Lanzl; with the editorial assistance of
Elisabeth F. Lanzl. 2nd ed. p.; cm. Includes bibliographical references and index.
ISBN 978-3-642-62155-0 ISBN 978-3-642-18549-6 (eBook)
DOI 10.1007/978-3-642-18549-6
1. Medicalphysics. 2. Radiotherapy. I. Lanzl, Lawrence H. (Lawrence Herman). 1921- II. Title. [DNLM:1. Radiotherapy.
2. Physics, 3. Radiation, Ionizing. 4. Radiometry. WN 250 J42c 2004]
R895.J39 2004 615.8'42--dc21 203054202
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Dedication
Asthethoughtsandideasforthissecondeditionwerebeingfinalized,Ilostmycoau-
thorandmyseniorbymanyyearsinthefield,Prof.LawrenceH.Lanzl.Hepassedaway
atage80aftermakingatremendouscontributiontothefieldofmedicalphysics.His
careerhadmanybrilliantfacets.Hewasaresearcher,developer,inventor,innovator,
teacher,organizer,andleaderparexcellence.Hecommandedspecialrespectandlove
fromtheinternationalcommunityofmedicalphysicists,notonlyasaprofessional,but
alsoasaperson.Hewasfullofnoblethoughtsand,togetherwithhiswifeElisabeth,
livedalifewithgreatvalues.Itwasmyspecialprivilegeandhonortohaveknownhim
andworkedwithhimbothascolleagueandfriend.Quiteappropriately,thissecond
editionofClinicalRadiotherapyPhysicsisdedicatedtohismemory.
November2002 SubramaniaJayaraman
Preface to Second Edition
The first edition of Clinical Radiotherapy Physics was published in 1996 and was
received well. It consisted of two volumes and contained a total of twenty chapters.
The current second edition contains the same number of chapters under the same
headings,butcombinesthemintoonesinglevolume.Thescopeofthetexthasremained
the same as for the first edition. Several sections have been revised and expanded.
Some new sections have been added to make the text current. All references and
citationshavebeenupdated.Morerecentpractices,recommendations,andprotocols
havebeencovered.Ourpurposetooutlinetheacceptedstandardsofpractice,rather
thanupcomingbutasyetunprovedtrends,hasbeenmaintained.However,suchtrends
arementionedwithreferenceswhereverappropriatetoarousethecuriosityofresearch-
mindedreaders.
Preface to First Edition
Thistextisanintroductiontoradiotherapyphysics.Theemphasisinmuchofthework
isontheclinicalaspectsofthefield;thus,thebookshouldbeespeciallyusefulforper-
sonswhoarealreadygraduatephysicistsandplanforacareerinclinicalradiotherapy
physics.Atpresent,thetreatmentofcancerpatientswithionizingradiationisateam
effortbyradiationoncologists,radiationtherapists,aswellasclinicalphysicists.The
bookisintendedtobeofusetopersonsineachoftheseareas.
Historically,clinicalmedicalphysicsasaprofessioncanbedatedtotheyear1913,
when William Duane became the first full-time hospital-employed physicist in the
UnitedStatesandSydneyRuss,thefirstintheUnitedKingdom.Thesetwophysicists
workedonsimilarproblemsrelatedtotheuseofradiumandradonforthetreatment
ofcancerandotherdiseases.
Althoughtherewerenofull-timeclinicalmedicalphysicistsbefore1913,theutility
of physics to the practice of medicine was recognized much earlier. For example,
Galileo’s work on the principle of the pendulum was used by physicians of his day
formeasuringtheheartrateofpatients.Intheearly1800s,thephysicianNeilArnott,
inEngland,pioneeredtheideathatthecurriculumofphysiciansintrainingshould
VIII PrefacetoFirstEdition
include the study of physics. Arnott’s textbooks were translated from English into
several languages. He also appears to have been the first to use the term ”medical
physics“inhiswritings(1825).Tothisday,thestudyofphysicsisincludedeitherin
medicalschools(e.g.,inEngland,Russia,andChina)orinthepremedicalcurriculum
(e.g.,intheUnitedStatesandCanada).
Inthistext,wehavetriedtokeepthetreatmentofapatientinperspectiveasmuch
as possible, in order to keep the book clinically oriented. The sequence and depths
ofcoverageofthedifferenttopicsreflectourpreferencebasedonourownteaching
experienceandmaybefoundtodifferfromothertextsonthesubject.
We have made an attempt to have the subject develop gradually from chapter to
chapter,withminimumcross-referencesbetweenchapters.However,werecommend
thatareaderdoaquickread-throughofallthechapters,andthendoamorethorough
study of each chapter. In this way, it may be possible to appreciate best how some
basicaspectsthatarecoveredintheearlychaptershaverelevancefordiscussionsto
followinlaterchaptersthatareprogressivelymoreclinicallyoriented.Withadesireto
haveapresentationthatcansatisfyphysicists,wehaveusedmathematicalexpressions
as needed, but we have made an effort to add enough narrative descriptions. Non-
physicistusersofthebookcanmerelybrowsetheequationsandstudythetextaround
them.
Thefirstfourteenchaptersofthetextcoverbasicphysicsandprinciplesofradiation
dosimetry.Thebeginningchapterscovertheessentialsofatomicandnuclearphysics,
whichprovidethebackgroundforthelaterchapters.Thephysicsoftheuseofphotons
andelectronshasbeenemphasizedbecauseoftheirwidespreadapplicationinradio-
therapyclinics.Theuseofhadronicparticles(suchasneutrons,protons,pions),still
beingexperimental,hasbeenaddressedonlyinminimumdetail.Afewparagraphsare
devotedtoleptons,quarks,andotherrecentlyidentifiedfundamentalparticlesforthe
purposeofcompleteness.
The sources of high-energy photons and electrons are particle accelerators, par-
ticularlylinearaccelerators.Webelievethattheprinciplesofacceleratorsofcharged
particlesarecoveredinsufficientdetailforpresent-daymedicalphysicists.
Radiationfieldsarequantifiedintermsofradiationunitsandmeasurements.Quan-
titiesusedinclinicalpracticearedefinedandexplained.Thetermsanddefinitionsused
inthetextfollowtherecommendationsoftheappropriateinternationalcommittees.
However,whereitwasnecessary,wefelttheneedtoaddafewnewtermstoimprove
theclarityofthepresentations.
Chapters 15 to 20 are devoted to planning of radiation treatments and radiation
safety.Thetextiswrittentoincluderecentconceptsandnewrefinements.Brachyther-
apy is an important area of present-day radiotherapy. Thus, radioactivity and the
accompanying dosimetry considerations are included in the text. It should be real-
ized that the largest exposure of man to ionizing radiations comes from deliberate
irradiationinproceduresofdiagnosticandtherapeuticradiology.Therefore,thelater
chaptersaredevotedtoradiationsafetyandsafetystandards.Thephilosophyonwhich
thesestandardsarebasedhasundergoneachangeinrecentyears,andtheauthorsfelt
stronglythatthechangesshouldbeincludedinthetext.
Acknowledgements
Whenwritingabook,onecallsonpastexperiencesandinsightsfromone’steachers,
associates,students,bothpastandpresent,aswellaspreviouswriters.Iwouldliketo
acknowledgemydebttoallofthese.TheauthorsthankElisabethF.Lanzl,whohas
helpedtomakethetextreadablebymakingherexpertiseineditingavailableforboth
thefirstandsecondeditions.
LawrenceH.Lanzl
First,Iwishtothankmy(late)father,AyakarambulamRajagopalanSubramanian,and
mymother,SaraswathiSubramanian,forshoweringtheirloveandaffectiononme,as
theybelievedinmeandencouragedmesincechildhoodtowardaccomplishment.So
alsoIacknowledgethespecialloveandaffectionofmywifeSyamalaandmydaughters,
SaramatiandSahana.
Mycareerinmedicalphysicsdevelopedlargelyduetotheopportunitiesofassocia-
tionswithseveraleminentphysicistsinthefield.AmongthemIwishespeciallytorec-
ognizeandthankProfessorLawrenceH.Lanzl,ProfessorNagalingamSuntharalingam
(ThomasJeffersonUniversity,Philadelphia),Dr.R.Chidambaram(Chairman,Atomic
EnergyCommission,India),S.Somasundaram(BhabhaAtomicResearchCenter,In-
dia), Professor Suresh K. Agarwal (University of Virginia, Charlottesville, Virginia),
AnthonyChung-Bin(Anchorage,Alaska),andDr.MartinRozenfeld(Chicago,Ilinois).
Iamindebtedtotheirclosenessandexpressionsoffaithinmeatdifferentphasesof
mycareer.
Ialsofinditappropriatetomentiontheextraordinaryresilienceofmycoauthor,
LawrenceH.Lanzl,whoworkedwithmeuntilhisverylastdaysamidstallhishealth
challenges.HewasaninspirationtomeinmanywayseversinceIfirstmethimin1967.
I am thankful to John A. Dover, M.D., President, Valley Radiation Oncology, and
hisseniorpartner,HerbertHitchon,D.O.,fortheirespecialinterestandsupportfor
completion of this second edition. So also, I thank the Springer-Verlag, Heidelberg,
Germany,forpublishingthissecondedition.
SubramaniaJayaraman
The Authors
Thetwoauthorswereassociatedwitheachotherprofessionallyformorethan34years.
Theyfirstmetin1967,whentheytookonassignmentsintheDosimetrySectionof
theInternationalAtomicEnergyAgency,Vienna,Austria.S.Jayaramanwasonleave
ofabsencefromtheBhabhaAtomicResearchCenter,Bombay,India,andLawrenceH.
LanzlwasonleavefromtheArgonneCancerResearchHospitaloftheUniversityof
Chicago,Chicago,Illinois.Also,forafewmonthsinthe1970s,Lanzlspentsometime
attheBhabhaAtomicResearchCenter.Next,inthe1980s,bothJayaramanandLanzl
workedintheDepartmentsofMedicalPhysicsandTherapeuticRadiologyatRush-
Presbyterian-St.Luke’sMedicalCenter,Chicago.Itwasthenthattheideaofwritinga
bookcrystallizedandresultedinthepublicationofthefirsteditionin1996.
Atpresent,S.JayaramanisChiefMedicalPhysicistatValleyRadiationOncology,
Phoenix, Arizona. L.H. Lanzl, who retired as Professor of Medical Physics, Depart-
mentofMedicalPhysics,RushUniversity,Chicago,unfortunatelypassedawayasthe
preparationofthissecondeditionwasinitsfinalstages.
Contents
Part I BasicPhysicsandRadioactivityDecay
1 ScopeofClinicalRadiotherapyPhysics ......................... 3
1.1 APhysicistinaClinic?.......................................... 3
1.2 PhysicalConceptsandRadiotherapy ............................. 3
1.3 CooperationbetweenPhysicistandPhysician ..................... 4
1.4 ScopeofthisBook ............................................. 5
References .................................................... 6
2 Atoms,Molecules,andMatter................................. 7
2.1 HistoricalOriginofAtomicPhysics .............................. 7
2.2 FormationofAtomsandElements ............................... 8
2.3 AtomicElectronConfiguration .................................. 11
2.3.1 ElectronOrbitsandEnergyLevels ............................... 11
2.3.2 IonizationandExcitationofAtoms............................... 14
2.3.3 CharacteristicX-RaysandAugerElectrons........................ 14
2.4 DefinitionofanElectronVolt(eV) ............................... 15
2.5 AtomicMass,MolecularMass,andAtomicMassUnit .............. 15
2.6 Avogadro’sNumber(N )....................................... 16
Av
2.7 PeriodicTableofElements ...................................... 17
2.8 MolecularBonds............................................... 17
2.8.1 IonicBonds ................................................... 17
2.8.2 CovalentBonds................................................ 17
2.8.3 HydrogenBonds............................................... 19
2.9 ElementaryParticles ........................................... 20
2.10 OuterSpaceandParticleResearch ............................... 24
References .................................................... 25
3 PropagationofEnergybyElectromagneticWaves ................ 26
3.1 RadioWaves,HeatWaves,andLightWaves........................ 26
3.2 WavePropagation.............................................. 26
3.3 Photons,Quanta,andtheElectromagneticSpectrum............... 28
3.4 LouisdeBroglie’sMatterWaves.................................. 29
