COURSE UNIT TITLE

: PHYSICS OF RADIOTHERAPY

Description of Individual Course Units

Course Unit Code Course Unit Title Type Of Course D U L ECTS
MDF 6004 PHYSICS OF RADIOTHERAPY ELECTIVE 4 2 0 10

Offered By

Medical Physics

Level of Course Unit

Third Cycle Programmes (Doctorate Degree)

Course Coordinator

ASSOCIATE PROFESSOR AYŞEGÜL YURT

Offered to

Medical Physics

Course Objective

To comprehend the properties of different types of radiation used in medicine, to understand their interaction with matter, to learn the technical and dosimetric properties of imaging, simulation, and treatment devices; to comprehend dose calculation methods and treatment planning principles, to be able to create appropriate treatment techniques and treatment plans, to gain the knowledge and skills of implementing the treatment plan accurately

Learning Outcomes of the Course Unit

1   Having an understanding of the types of radiation, the effects of radiation on the matter and units of radiation dose
2   Comprehending properties of simulation and treatment devices and accessories used in radiation therapy and being able to use them
3   Understanding the importance of tumor dose specifications in treatment planning techniques and ability of understanding the principles of treatment planning system
4   Ability of comprehending basic properties of dose calculation techniques and applying them; ability to calculate dosimetric parameters, dose distributions and treatment times
5   Ability to discuss the importance of inhomogeneity and contour irregularities that affect the treatment plan, gaining the knowledge and skills about all of the treatment techniques used in radiotherapy, capability of choosing the appropriate treatment plan for the patient, implement the plan appropriately and evaluate the process
6   Ability to select and apply appropriate quality control procedures for the treatment techniques
7   Ability to follow the developments and new technologies related to treatment techniques

Mode of Delivery

Face -to- Face

Prerequisites and Co-requisites

None

Recomended Optional Programme Components

None

Course Contents

Week Subject Description
1 The meaning and development of Medical Physics Types and uses of radiation in medicine Radioactivity, radioactive decay, the half-time
2 Interaction of radiation with matter (Photoelectric, Compton, Pair Production, Photodisintegration, Coherent Scattering, Excitation, Absorption of beams) Dose units (activity, dose, absorbed dose, equivalent dose and linear energy transfer)
3 Simulation devices used in radiotherapy (Conventional and CT simulators) Treatment devices used in external radiotherapy (X-ray devices (kV), Cobalt-60 devices)
4 Linear accelerators Imaging systems of treatment devices (EPID, kV-MV cone beam CT)
5 Nominal standard dose, partial tolerance, the cumulative effect of radiation, time-dose and fractionation, linear quadratic model (LQ), biological equivalent dose (BED). Tumor dose specification (gross tumor volume, clinical tumor volume, planning target volume, irradiated volume, internal target volume)
6 Stages of treatment planning (collection of diagnostic information, localization and simulation, treatment planning and dose calculation, treatment implementation, treatment verfication) Simulation and planning of the treatment (patient position, equipment for immobilization, lead blocks, compensators, bolus and collimators (MLC))
7 Principles of CT simulation, multi modality image recording and fusion, treatment planning system and network (software, hardware, dicom, dicom RT) Dose calculation techniques (fixed SSD, isocentric (SAD), MU), rotational treatment techniques and MU calculations
8 Inhomogeneity correction methods (TAR, power law tissue-air ratio, equivalent tissue-air ratio, isodose shift, correction of contour irregularities, bolus, compansators) Dosimetric parameter concepts (percent depth dose (PDD), tissue air ratio (TAR), tissue phantom ratio (TPR), tissue maximum ratio (TMR), (BSF), (PSF), (SAR), (SMR), (Sc), (Sp))
9 Isodose curves (photon and electron isodose curves, wedge filter isodose curves, determination of wedge angle, geometrical and physical penumbra, determination of field size)
10 Characteristics of dose profiles (flatness and symmetry) Energy and field selection (selection of energy according to field depth, single and multiple coplanar and non-coplanar fields, fields with and without wedges, fields with a combination of photon and electron, conjunction of adjacent fields)
11 Principles of treatment planning systems, dose calculation algorithms, MU calculation with fixed SSD and isocentric techniques, heterogenity correction, bolus and flattening filter, virtual simulation (BEV,DDR), plan optimisation and evaluation methods (uniformity, dose constraints, dose volume histograms (DVH), biological parameters (TCP, NTCP))
12 Treatment techniques (2D conventional and 3D conformal, SSD and SAD) Fixed gantry IMRT techniques and treatment planning (MLC based static/dynamic IMRT, Inverse, forward, optimisation)
13 Arc based treatment planning techniques (tomotherapy, IMAT, RapidArc, VMAT, Inverse, Forward, Optimisation) Special radiotherapy techniques (total body irradiation, total skin electron irradiation, stereotactic radiotherapy) Radiotherapy ith respiration control (Active breathing control, gating, tracking, 4DRT)
14 IGRT systems (port film, KV-MV systems, EPID, in room CT, Cone Beam CT, Ultrasound) Quality control for all treatment techniques and radiation safety Treatment planning verification (MU checking using appropriate dosimeters, comparison of planned and calculated dose distributions (gamma index, isodose profiles), set-up verification (EPID, in-vivo dosimetry, cone beam CT))

Recomended or Required Reading

Khan FM. The physics of radiation therapy , Second, Third and Fourth Edition. Lippincott Williams & Wilkins, Philadelphia, 1994, 2003, 2009.

Khan FM, Gerbi BJ. Treatment Planning in Radiation Oncology , Second and Third Edition.
Lippincott Williams & Wilkins, Philadelphia, 2007, 2012

Edward C. Halperin, Carlos A. Perez, Luther W. Brady Principles and Practice of Radiation Oncology Third, Fourth and Fifth Edition. Lippincott Williams & Wilkins, Philadelphia, 1997, 2003, 2008.

Wolfgang Schlegel, Thomas Bortfeld, Anca-Ligia Grosu New Technologies in Radiation Oncology Springer, 2006.

Steve Webb, Intensity-Modulated Radiation Therapy Taylor and Francis, 2001.

Arro J. Mundt, John C. Roeske Intensity Modulated Radiation Therapy 2005.

P.Mayles, A.Nahum, J.C.Rasenwald Handbook Of Radiotherapy Physics Theory and Practice Taylor and Francis, 2007.

Pam Cherry, Angela M. Duxbury Practical Radiotherapy Physics And Equipment Wiley-Blackwell, 2009.

Planned Learning Activities and Teaching Methods

Using all available technical and dosimetric equipment to make the relevant applications in radiotherapy after having theoretical knowledge about the subject from Turkish and foreign books, periodicals, and protocols.

Assessment Methods

SORTING NUMBER SHORT CODE LONG CODE FORMULA
1 MTE MIDTERM EXAM
2 FIN FINAL EXAM
3 FCG FINAL COURSE GRADE MTE * 0.40 + FIN* 0.60
4 RST RESIT
5 FCGR FINAL COURSE GRADE MTE * 0.40 + RST* 0.60


Further Notes About Assessment Methods

None

Assessment Criteria

To be announced.

Language of Instruction

Turkish

Course Policies and Rules

To be announced.

Contact Details for the Lecturer(s)

To be announced.

Office Hours

To be announced.

Work Placement(s)

None

Workload Calculation

Activities Number Time (hours) Total Work Load (hours)
Lectures 14 4 56
Tutorials 14 2 28
Preparations before/after weekly lectures 14 8 112
Preparation for midterm exam 1 24 24
Preparation for final exam 1 30 30
Final 1 1 1
Midterm 1 1 1
TOTAL WORKLOAD (hours) 252

Contribution of Learning Outcomes to Programme Outcomes

PO/LOPO.1PO.2PO.3PO.4PO.5PO.6PO.7PO.8PO.9PO.10PO.11PO.12PO.13PO.14PO.15PO.16PO.17PO.18
LO.1222222224222
LO.2433322222222222
LO.3443452322222323
LO.42224524222533444
LO.52224524222533443
LO.622554354445544424
LO.72222434