Table Of ContentISODOS£ ATLAS
Series in Radiology
VOLUME 5
1. J. Odo Op den Orth, The Standard Biphasic-Contrast Examination of the
Stomach and Duodenum: Method, Results and Radiological Atlas.
1979. ISBN 90247 2159 8
2. J. L. Sell ink and R. E. Miller, Radiology of the Small Bowel. Modern
Enteroclysis Technique and Atlas.
1981. ISBN 90 247 2460 0
3. J. Skucas and R. E. Miller, Radiology of the Colon: Technique and Atlas
(provisional title)
1981.
4. S. Forg.ks, Bones and Joints in Diabetes Mellitus
1981. ISBN 9024723957
Series ISBN 90 247 2427 9
ISODOS£ ATLAS
for use in radiotherapy
Edited by
Gy. Nemeth
M.D., C.Sc. (med.)
Department of Oncoradiology, Weil Emil Hospital. Budapest
H. Kuttig
Dr. med. habil.
Professor of Radiology
University Department of Radiology
(Czerny Hospital), Heidelberg
1981
MARTINUS NIJHOFF PUBLISHERS
THE HAGUE/BOSTON/LONDON
Distributors:
for the United States for Hungary, Albania,
and Canada Bulgaria, China,
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Kluwer Boston, Inc.
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of Korea, Mongolia, Poland,
USA
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Democratic Republic of Vietnam,
for all other countries and Yugoslavia
Kluwer Academic Publishers Group Akademiai Kiad6
Distribution Center P.O.B.24
P.O. Box 322 H-1363
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The Netherlands Hungary
This volume is liSted in the Library of Congress Cataloging in Publication Data
ISBN-13: 978-94-009-8278-9 e-ISBN-13: 978-94-009-8276-5
001: 10.1007/978-94-009-8276-5
English translation by K. Takacsi-Nagy
Joint edition published by
MARTINUS NIJHOFF PUBLISHERS
P.O.B. 566, 2501 eN The Hague, The Netherlands
and
AKAOI:MIAI KIADO
P.O.B. 24, H-1363, Budapest, Hungary
Copyright © Akademiai Kiad6, Budapest 1981
Softcover reprint of the hardcover 1st edition 1981
All rights reuTVed. No part of this publication mey be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, mechanical, photocopying, recording, or
otherwise, without the prior written permission of the publisher, Martinus NijhoH Publishers,
P.O. Box 566, 2501 CN The Hague, The Netherlands.
Contents
Preface 7 Breast 89
Breast and chest wall 91
Abbreviations 8
Regional lymph nodes of the breast 100
Skin 9
Gastrointestinal tract
and extraintestinal abdominal
Head and neck 13
organs 107
Orbit 15
Esophagus 109
Nasal and paranasal sinus 18
Stomach 122
Oral cavity 26
Rectum 126
Tongue 26
Liver 132
Floor of the mouth 28
Gingiva 30
Female genital organs 133
Buccal mucosa 31
Pharynx 33 Uterine cervix 135
Nasopharynx 33 Parametrium 135
Oropharynx 40 Uterine cervix and parametrium 154
Tonsil 40 ·Pelvis 163
Uvula 41 Ovary 168
Base of the tongue 42 Vagina 172
Hypopharynx 42 Vulva 173
Larynx 46
Auditory canal and middle ear 52 Male genital organs 177
Parotid 57 Prostate 179
Thyroid 59
Cervical lymph nodes 62 Urinary tract 183
Kidney 185
Thorax 69
Bladder 194
Lung 71
Mediastinum 81 Paraaortic lymph nodes 219
I
Contents 5
Skeletal system 231 Central cranial cavity 246
Sellar region 253
Mandible 233
Posterior cranial cavity 256
Vertebral column 234
Medulloblastoma 259
Femur 238
References 263
Central nervous system 239
Anterior cranial cavity 241 Index of authors 269
I
6 Contents
Preface
When compiling the present atlas our aim has been to provide the practis
ing radiotherapist with a handbook which would help him to plan the
radiation therapy of tumours of individual organs. Apart from a few ex
ceptions, all isodose charts in this atlas show dose distributions resulting
from external irradiation. Combination of external irradiation with intra
cavitary radium therapy is presented in the treatment of carcinoma of the
uterine cervix, in which case the two techniques are complementary.
Thd immense material of the pertinent literature could, naturally, not
have been included in the atlas. As a result of scrupulous selection, the
isod-.:se charts shown may not invariably be the optimum ones, and some
of them may not be the most modern. However, the usefulness of the
information they provide has made us to keep them all the same.
We did not intend to change the original charts in any way and stan
dardization of the isodoses was not undertaken. Radiation parameters are
given in the figure captions and, if available, information has also been
provided on the phantoms used by the authors.
Naturally, the isodoses presented will not automatically apply to all situ
ations and all apparatuses without due attention to the individual patient
::Jnd technical details such as penumbra and source diameter. They merely
serve as a starting point and will help to save time and work during treat
ment planning also with the computer.
It has been another important consideration of ours to provide help for
those radiotherapists who have no access to all the modern equipment on
the market. An exact reproduction of the techniques is in most cases PQS
sible 0,1 the basis of the information provided in the captions, but if this
were insufficient, the exhaustive reference list makes it possible to check
in the original publication.
It is a further aim of the present atlas to stimulate radiotherapists to
improve the existing techniques and devise new, more effective ones.
The Editors
I
Preface 7
Abbreviations
A anterior
CR centre of rotation
FAD focus to axis distance
FID focus to isocentre distance
FSD focus to skin distance
HVT half-value thickness
L left
p posterior
R right
SAD source to axis distance
SSD source to skin distance
I
8 Abbreviations
Skin
Gamma rays n-rays 2.5 MeV electrons
from radium strontium gO monoenergetic
surface applicator and parallel
epidermis
-- -
1=--10ri.;n:::.:
I - --
--~
subcutaneous
10 255075 100 fatty tissue
% 20mm
30mm
10
Fig. 1. Isodose distribution in the skin using different forms of irradiation
226-Ra
90-Sr
X-ray (100 kV, HVT 4 mm AI. FSD 20 em)
(Wright et al. 1956)
111
Skin
