The aim of this diploma thesis is the design of linear accelerator for oncology treatment. The design focuses on the improvement of the aesthethical side of the accelator, but also comes up with inventional solutions how to improve the radiation treatment of oncology patients to higher the chances of successful treatment of cancer.

There is a present and future need for the medical isotope Actinium-225, currently in short supply worldwide.  Only a couple manufacturers produce it in very low quantities.  In roughly the past 10 years the medical community has explored the use of Ac-225 and its daughter Bismuth-213 for targeting a number of differing cancers by way of Targeted Alpha Therapy (TAT). This method utilizes the alpha-decay of both Ac-225 (half-life 10 days) and Bi-213 (half-life 46 min) to kill cancerous cells on a localized basis.  Maximum energy is delivered to the cancer cells thereby greatly minimizing healthy tissue damage. This research proposes a production method using a high-energy photon spectrum (generated by a linear accelerator or LINAC) to irradiate a sample of Radium-226 (half-life 1600yrs).  The photo-neutron reaction liberates neutrons from Ra-226 atoms leaving behind Radium-225 (half-life 14.7 days).  Ra-225 decays naturally through beta emission to Ac-225.  Previous research demonstrated it is possible to produce Ac-225 using a LINAC; however, very low yields resulted which questioned the feasibility of this production method.  This research proposes a number of LINAC and radium sample modifications that could be greatly increase yield amounts for practical use. Additionally, photo-neutron cross-section data for Ra-226 was used, which led to improved yield calculations for Ra-225.  A MATLAB® model was also created, which enables users to perform quick yield estimates given several key model parameter inputs.  Obtaining a sufficient supply of radium material is also of critical importance to this research.  Therefore information was gathered regarding availability and inventory of Radium-226.  This production method would serve as a way to not only eliminate many hazardous radium sources destined for interim storage, but provide a substantial supply of Ac-225 for future cancer treatment. / Master of Science

A International Comission on Radiation Units and Measurements (ICRU) recomenda que a incerteza total de um tratamento radioterápico não deva ultrapassar de 5%, ou seja, cada etapa do processo de entrega da dose absorvida ao volume alvo do paciente tenha incerteza menor que esse valor (ICRU 50, 1993; ICRU 62, 1999). O cuidado com essas incertezas inicia-se na instalação da máquina (neste caso, de um Acelerador Linear Clínico), passando pela sua aceitação, pelo comissionamento, perdurando nos controles de qualidade posteriores e até em novos comissionamentos, se necessários. Os parâmetros físicos dosimétricos mínimos necessários a serem comissionados para feixes de fótons e elétrons são: Porcentagem de Dose em Profundidade (PDD), Perfis de Campos abertos e filtrados, Fatores de Espalhamento Total (Scp), Cone (Fcone) e de Transmissão (de Filtros em cunha FF, Bandeja FB, e de Transmissão intra FMLC,intra e de fuga inter lâminas FMLC,inter), além da Determinação da Posição Virtual da Fonte de Elétrons através da SSD efetiva (SSDeff). Para tal, a American Association of Physicists in Medicine (AAPM), através do seu protocolo mais recente, apresenta objetos simuladores, tipos e tamanhos de detectores, arranjos e procedimentos experimentais específicos, através dos quais é possível inferir os parâmetros dosimétricos de feixes de fótons e elétrons, usando varredura destes com câmara de ionização (CI), considerando o erro total das medidas menor do que 1% (AAPM TG 106, 2008). Entretanto este mesmo protocolo cita de maneira sucinta ou pouco detalhada, a possibilidade da utilização de dosímetros tipo gel para o citado comissionamento, já que possuem diversas vantagens a serem consideradas na Radioterapia, como equivalência ao tecido mole (Z e ), independência energética num amplo intervalo de energia de fótons e elétrons, além da alta resolução espacial. Desta forma, o objetivo geral deste trabalho é apresentar de forma inédita, o comissionamento dos parâmetros físicos dosimétricos de aceleradores lineares clínicos (PFDALC), especificamente através do dosímetro Fricke Xilenol Gel (FXG), como método alternativo e/ou complementar aos internacionais vigentes. Para tal, neste trabalho foram desenvolvidos dispositivos e procedimentos que proporcionassem aos usuários uma forma prática, eficiente e de baixo custo para obtenção dos parâmetros citados através do FXG, em relação aqueles obtidos com a CI (método padrão). Todos os resultados dos parâmetros físicos dosimétricos obtidos com o dosímetro citado foram validados com a CI, considerando a incerteza preconizada para a mesma. Esses resultados sugerem que o FXG efetivamente poderá ser utilizado para o comissionamento de aceleradores lineares clínicos e que um protocolo específico para este dosímetro poderá ser gerado. / The International Commission on Radiation Units and Measurements (ICRU) recommends that the total radiotherapy treatment uncertainty should not exceeds 5%, in other words, considering that each step involved in the absorbed dose delivery process should not surpass the cited value (ICRU 50, 1993; ICRU 62, 1999). The uncertainties considered are those involved with, the machine installation (in this work, a Clinical Linear Accelerator), its acceptance, commissioning, followed by those related to subsequent quality controls and even new commissioning, if necessary. The minimum required physical dosimetric parameters to be commissioned for electron or photon beams are: the Percentage Depth Dose (PDD), the filtered and open Field Profiles, Total Scatter Factors (Scp), Cone Factor (Fcone), Transmission Factors: Wedge Filter (FF), Tray (FB), intra Leaf (FMLC,intra) and inter Leaf Leakage (FMLC,inter), besides the Virtual Source Position Determination (SSDeff). For this purpose, the American Association of Physicists in Medicine (AAPM), through its last protocol, provides guidelines on phantom and detector selections, setting up of phantom for data acquisition (for scanning and no-scanning data), procedures for acquiring the cited beam parameters with ionizing chambers (CI) and methods to reduce the total measurement error lower than 1% (AAPM TG 106, 2008). However, this protocol does not present any information or details about the physical dosimetric parameters for clinical linear accelerators (PFDALC), through gel dosimeters once they present several useful advantages for Radiotherapy, such as: soft tissue equivalence (Z and ), wide energy independence range for photons or electrons beams and high spatial resolution. The scope of this work is to present an innovative way for physical dosimetric parameters commissioning, specifically using the Fricke Xylenol Gel (FXG) dosimeter, like an alternative and/or complementary method to that employed internationally. Devices and procedures have been developed for this work in order to infer the cited parameters, in a practical, efficient and low cost way, compared to that used with CI (standard method). All the FXG results obtained were validated with the CI, considering the uncertainty recommended for the last one. The results suggest that the FXG effectively can be used for physical dosimetric parameters commissioning for clinical linear accelerators and a new specific protocol can be generated.

In treatment of cancer using high energetic radiation the problem arises how to irradiate the tumor without damaging the healthy tissue in the immediate vicinity. In order to do this, intensity modulated radiation therapy (IMRT) is used. In this thesis, the general goal is to modulate the homogeneous radiation field delivered by an external accelerator using a multileaf collimator in comparison with beam modifying devices. In order to generate intensity modulated fields in a static mode with multileaf collimators, the heuristic algorithm of Galvin, Chen and Smith is used. This method aims at finding a segmentation with a small number of segments, taking account of mechanical constraints such as leaves can move only in one direction, on one row, the right and left leaves cannot overlap (Interleaf Collision) and also every element between the leaf and the side of the collimator to which the leaf is connected is also covered (no holes in leaves). During the implementation of the algorithm, the initial intensity matrix with the desired radiation rates is inserted and using essential transformations, a positive combination of special matrices, segments, corresponding to fixed positions of multileaf collimator are obtained. All calculations end with the superposition of segments which leads to the creation of the 3-D matrix that will be used to irradiate the tumor. The algorithm is implemented in C++. The calculations are fast and the procedure is user friendly. The model is implemented for the case of protection the spinal cord while treating a tumor in the neck area. Furthermore, dose distributions obtained with this model and beam modifying devices in the neck area were compared. / Κατά τη θεραπεία του καρκίνου με χρήση υψηλής ενέργειας ακτινοβολίας, πρόβλημα αποτελεί ο περιορισμός της ακτινοβολίας στον όγκο στόχο και ο περιορισμός της συμμετοχής του υγιούς ιστού, της γειτονικής περιοχής, στο ελάχιστο. Προκειμένου να επιλυθεί το πρόβλημα αυτό χρησιμοποιείται ακτινοθεραπεία με πεδία ακτινοβολίας διαμορφωμένης έντασης (Ιntensity Μodulated Radiαtion Therapy – IMRT), με τη βοήθεια των κατευθυντήρων πολλαπλών φύλλων (Multileaf Collimators- MLC). Στόχος της συγκεκριμένης διπλωματικής εργασίας είναι η διαμόρφωση του ομοιογενούς πεδίου ακτινοβολίας, που διανέμεται μέσω του γραμμικού επιταχυντή χρησιμοποιώντας κατευθυντήρα πολλαπλών φύλλων και η σύγκριση των αποτελεσμάτων της προσομοίωσης με τις συσκευές διαμόρφωσης δέσμης (Beam Modifying Devices). Προκειμένου να παραχθούν τα διαμορφωμένης έντασης πεδία ακτινοβολίας, σε στατική μορφή, χρησιμοποιήθηκε ο αλγόριθμος των Galvin, Chen και Smith. H μέθοδος αποσκοπεί στην τμηματοποίηση του πίνακα με τα επιθυμητά ποσοστά ακτινοβολίας σε έναν μικρό αριθμό τμημάτων “segments”, λαμβάνοντας υπόψιν μηχανικούς περιορισμούς. (i) Τα φύλλα δύναται να κινηθούν μόνο κατά μήκος μιας διεύθυνσης, (ii) σε μια γραμμή, το αριστερό και το δεξί φύλλο δεν μπορούν να επικαλυφτούν (Interleaf Collision) και (iii) κάθε στοιχείο μεταξύ του φύλλου και της πλευράς του διαμορφωτή, με την οποία είναι συνδεδεμένο, είναι πάντα καλυμμένο (Νo holes in leaves). Κατά την υλοποίηση του αλγορίθμου, εισάγεται ο αρχικός πίνακας με τα επιθυμητά ποσοστά ακτινοβολίας και με τη χρήσης κατάλληλων μετασχηματισμών, προκύπτει ένας συνδυασμός από ειδικούς πίνακες (segments), οι οποίοι αντιστοιχούν σε θέσεις των κατευθυντήρων πολλαπλών φύλλων και θα χρησιμοποιηθούν για την ακτινοβόληση του όγκου. Ο αλγόριθμος υλοποιήθηκε σε C++. Οι υπολογισμοί είναι γρήγοροι και η διεργασία είναι φιλική προς το χρήστη. Το μοντέλο υλοποιήθηκε για την περίπτωση προστασίας της σπονδυλικής στήλης κατά τη θεραπεία όγκου στην περιοχή του λαιμού. Τέλος, οι κατανομές δόσεις που προέκυψαν με την προαναφερθέν μοντέλο συγκρίθηκαν με αυτές των συσκευών διαμόρφωσης δέσμης.

A International Comission on Radiation Units and Measurements (ICRU) recomenda que a incerteza total de um tratamento radioterápico não deva ultrapassar de 5%, ou seja, cada etapa do processo de entrega da dose absorvida ao volume alvo do paciente tenha incerteza menor que esse valor (ICRU 50, 1993; ICRU 62, 1999). O cuidado com essas incertezas inicia-se na instalação da máquina (neste caso, de um Acelerador Linear Clínico), passando pela sua aceitação, pelo comissionamento, perdurando nos controles de qualidade posteriores e até em novos comissionamentos, se necessários. Os parâmetros físicos dosimétricos mínimos necessários a serem comissionados para feixes de fótons e elétrons são: Porcentagem de Dose em Profundidade (PDD), Perfis de Campos abertos e filtrados, Fatores de Espalhamento Total (Scp), Cone (Fcone) e de Transmissão (de Filtros em cunha FF, Bandeja FB, e de Transmissão intra FMLC,intra e de fuga inter lâminas FMLC,inter), além da Determinação da Posição Virtual da Fonte de Elétrons através da SSD efetiva (SSDeff). Para tal, a American Association of Physicists in Medicine (AAPM), através do seu protocolo mais recente, apresenta objetos simuladores, tipos e tamanhos de detectores, arranjos e procedimentos experimentais específicos, através dos quais é possível inferir os parâmetros dosimétricos de feixes de fótons e elétrons, usando varredura destes com câmara de ionização (CI), considerando o erro total das medidas menor do que 1% (AAPM TG 106, 2008). Entretanto este mesmo protocolo cita de maneira sucinta ou pouco detalhada, a possibilidade da utilização de dosímetros tipo gel para o citado comissionamento, já que possuem diversas vantagens a serem consideradas na Radioterapia, como equivalência ao tecido mole (Z e ), independência energética num amplo intervalo de energia de fótons e elétrons, além da alta resolução espacial. Desta forma, o objetivo geral deste trabalho é apresentar de forma inédita, o comissionamento dos parâmetros físicos dosimétricos de aceleradores lineares clínicos (PFDALC), especificamente através do dosímetro Fricke Xilenol Gel (FXG), como método alternativo e/ou complementar aos internacionais vigentes. Para tal, neste trabalho foram desenvolvidos dispositivos e procedimentos que proporcionassem aos usuários uma forma prática, eficiente e de baixo custo para obtenção dos parâmetros citados através do FXG, em relação aqueles obtidos com a CI (método padrão). Todos os resultados dos parâmetros físicos dosimétricos obtidos com o dosímetro citado foram validados com a CI, considerando a incerteza preconizada para a mesma. Esses resultados sugerem que o FXG efetivamente poderá ser utilizado para o comissionamento de aceleradores lineares clínicos e que um protocolo específico para este dosímetro poderá ser gerado. / The International Commission on Radiation Units and Measurements (ICRU) recommends that the total radiotherapy treatment uncertainty should not exceeds 5%, in other words, considering that each step involved in the absorbed dose delivery process should not surpass the cited value (ICRU 50, 1993; ICRU 62, 1999). The uncertainties considered are those involved with, the machine installation (in this work, a Clinical Linear Accelerator), its acceptance, commissioning, followed by those related to subsequent quality controls and even new commissioning, if necessary. The minimum required physical dosimetric parameters to be commissioned for electron or photon beams are: the Percentage Depth Dose (PDD), the filtered and open Field Profiles, Total Scatter Factors (Scp), Cone Factor (Fcone), Transmission Factors: Wedge Filter (FF), Tray (FB), intra Leaf (FMLC,intra) and inter Leaf Leakage (FMLC,inter), besides the Virtual Source Position Determination (SSDeff). For this purpose, the American Association of Physicists in Medicine (AAPM), through its last protocol, provides guidelines on phantom and detector selections, setting up of phantom for data acquisition (for scanning and no-scanning data), procedures for acquiring the cited beam parameters with ionizing chambers (CI) and methods to reduce the total measurement error lower than 1% (AAPM TG 106, 2008). However, this protocol does not present any information or details about the physical dosimetric parameters for clinical linear accelerators (PFDALC), through gel dosimeters once they present several useful advantages for Radiotherapy, such as: soft tissue equivalence (Z and ), wide energy independence range for photons or electrons beams and high spatial resolution. The scope of this work is to present an innovative way for physical dosimetric parameters commissioning, specifically using the Fricke Xylenol Gel (FXG) dosimeter, like an alternative and/or complementary method to that employed internationally. Devices and procedures have been developed for this work in order to infer the cited parameters, in a practical, efficient and low cost way, compared to that used with CI (standard method). All the FXG results obtained were validated with the CI, considering the uncertainty recommended for the last one. The results suggest that the FXG effectively can be used for physical dosimetric parameters commissioning for clinical linear accelerators and a new specific protocol can be generated.

Recent work has demonstrated improvement of image quality with low atomic number (Z) linear accelerator (linac) targets and energies as low as 3.5 MV compared to a standard 6 MV therapeutic beam. In this work, the incident electron beam energy has been lowered to energies between 1.90 and 2.35 MeV. The improvement of megavoltage planar image quality with the use of carbon and aluminum linac targets has been assessed compared to a standard 6 MV therapeutic beam. Common electronic portal imaging devices contain a 1.0 mm copper conversion plate to increase detection efficiency of a therapeutic megavoltage spectrum. When used in imaging with a photon beam generated with a low-Z target, the conversion plate attenuates a substantial proportion of photons in the diagnostic range, thereby reducing the achievable image quality. Image quality as a function of copper plate thickness has been assessed for planar imaging and cone beam computed tomography.

[pt] O objetivo desta dissertação é o estudo de procedimentos para avaliação da confiabilidade metrológica do tamanho de campo irradiado (TCI) por aceleradores lineares. No contexto das recentes alterações no panorama regulamentar dos serviços de radioterapia, com a implementação da RDC número 20, em 2006, pela Agência Nacional de Vigilância Sanitária (ANVISA), foi estabelecida a compulsoriedade do uso do densitômetro óptico na verificação do TCI, como parte do controle da qualidade. Questões associadas à implementação prática dos recentes requisitos para medição do tamanho de campo irradiado e as recentes indicações do potencial uso de filmes radiocrômicos para o controle da qualidade em radioterapia motivaram a realização do presente trabalho. Foram empregados três diferentes procedimentos para avaliação do tamanho de campo irradiado por aceleradores lineares utilizados em treze serviços de radioterapia localizados no Estado do Rio de Janeiro, utilizando filmes radiocrômicos EBT QD mais, RTQA, densitômetro óptico DensiX tipo T52001 ou scanner de transmissão Microtek. Os resultados destacam a contribuição das fontes de incerteza de medição para cada procedimento realizado e indicam a necessidade de considerá-la na avaliação da conformidade utilizando o densitômetro óptico (DO). Devido às propriedades do filme radiocrômico RTQA, o mesmo não pode ser utilizado no procedimento de medição com DO. Em conclusão, o uso do procedimento de medição utilizando scanner mostrou-se mais adequado para avaliação das dimensões de campos de radiação não-homogêneos. / [en] The objective of the present work is to study different procedures for metrological evaluation of the size of the radiation field emitted by linear accelerators. In the context of the recent requirements determined by the publication of the RDC number 20, in 2006, by National Agency for Sanitary Vigilance (Anvisa), the compulsory use of the optical densitometer for the measurements of the field size during quality control tests was introduced. Practical implementation issues associated with these requirements and the recent studies indicating the potential use of radiochromic films for measurements of the field size motivated the present work. Three different procedures were employed in order to evaluate the radiation field size emitted by linear accelerators used in thirteen radiotherapy services located in Rio de Janeiro, using radiochromic films EBT QD plus and RTQA, optical densitometer DensiX type T52001 or scanner Microtek. The results indicate the contribution of the measurement uncertainty associated to each procedure performed, highlighting the importance of its consideration during tests for conformity assessment with the recently required optical densitometer. Nevertheless, the RTQA radiochromic film properties precluded its use in the procedure using optical densitometer. In conclusion, among the evaluated procedures for radiation field evaluation, the use of the scanner was the most appropriate, especially if dimensional non-homogeneities are present.

The diploma thesis on the topic "Activation of Collimating System of Linear Accelerator through Photon Radiation and its Impact on the Doses Received by the Staff" is divided into two parts, a theoretical and a practical part. The introductory theoretical part is devoted to the basic information about ionizing radiation. What are the types of ionizing radiation, its characteristics, properties and sources of ionizing radiation. Furthermore, there are mentioned direct and indirect interactions of ionizing radiation, a brief description of charged particle accelerators, collimator systems and radioisotope irradiation devices. Another part deals with radiation protection, basic legislation, methods and principles of radiation protection, personal dosimetry and medical supervision of radiation workers. Literary sources, available internet links and valid legal regulations were used for the work. In the practical part, a number of measurements were carried out to measure and to analyse the doses of secondary radiation of the linear accelerator collimator system for different photon beam energies, depending on time, distance from source, position of radiologic assistant around the table when working with the patient, as well as sizes of irradiated field. The aim of the work was to find out how large the doses of secondary radiation are, although measurable, but their values are not sufficient to be detected by personal dosimeters of radiological assistants. Confirm the hypothesis that the doses from the secondary radiation of the linear accelerator collimator system are so low that the dose power does not exceed 0.031 mGy/hr. The results obtained from various measurements are processed into transparent tables and graphically displayed. Based on the results of the measurements, the hypotheses were confirmed.

The diploma thesis on "Radiation exposure of persons working at risk of ionising radiation at the Pilsen University Hospital" is divided into two parts. The first analyses personal effective doses of the employees of the Pilsen University Hospital in 20092013, and the second focuses on measurements of secondary radiation created after the activation of collimator systems of linear accelerators. The introduction of the theoretical part discusses the history of radiology, followed by a summary of information on the sources of ionising radiation, its characteristics, properties, methods of interaction with the environment and biological effects on organisms. The chapter on radiation protection focuses on basic legislative regulations relevant to the topic. In the Czech Republic, radiation protection of people working with sources of ionising radiation is mostly based on Act No. 18/1997 Coll., on peaceful uses of nuclear energy, and Regulation of the State Office for Nuclear Safety No. 307/2002 Coll., on radiation protection. The thesis also lists dose limits and basic information about personal dosimetry, and the theoretical section is concluded with information on the methods of protecting personnel and on provided healthcare. The thesis uses as its sources primary literature, internet links, current legislation and data from the database of the State Office for Nuclear Safety on records from personal dosimeters in the analysed period. The thesis had two objectives. The first was to compare levels of exposure at the Pilsen University Hospital. The analysis involved 579 persons in total; after arranging the data into tables and dividing employees into groups by the type of tasks they perform and their job, it was possible to compare median value indicators, confirming the hypothesis that persons carrying out intervention tasks are exposed to more ionising radiation. In order to compare the development of doses over time, a double-selection t-test was performed on data from 2009 and 2013, confirming the effectiveness of anti-radiation measures adopted at the University Hospital and a reduction in the exposure of employees in this period. The second objective was to confirm or deny the hypothesis that secondary radiation created by collimator systems, while measurable, is not sufficiently large to be detected by personal dosimeters. In order to achieve this objective, measurements were carried out at the Oncology and Radiology Clinic of the Pilsen University Hospital. The first measurements tried to determine the relationship between dose and time at various levels of energy, the second compared the relationship between dose and distance from the collimator plane and the third monitored the number of exposures until the collimator plates are saturated and dose is no longer increased. All results were arranged in tables and projected in charts. The results of the research confirmed the hypothesis that secondary radiation created during the use of high-energy equipment is just below the detection limits of personal dosimeters. For this reason, it is recommended to frequently rotate personnel working with the equipment.

No description available.