MED PHYS 1E03

Quan66es and Units

MED PHYS 1E03

Intensity of an x-ray beam J/m2/s

Exposure, X C/kg (air kerma Kair gray (Gy) = J/kg)

Dose, D gray(Gy) 1 rad = 0.01Gy

Equivalent Dose, sievert (Sv) = J/kg 1 rem = 0.01Sv

Quan66es and Units
MED PHYS 1E03

Exposure

Radia6on output from an x-ray tube

Radia6on exposure is measured using an air ionisa6on chamber.

Units - Roentgen 1R = 2.58X10-4 C/kg

Dose
Dose D is the amount of energy deposited per unit mass (Gy) 1 gray = 1 J/kg

However this does not take into account the eects of dierent types of radia6on
Charged Par6cle Tracks
MED PHYS 1E03

If a charged par6cle passes through a material, it will leave a track of

ionised and excited atoms.
The track characteris6cs will depend on the type of charged par6cle i.e. an
electron and an alpha par6cle having the same ini6al energy will produce
very dierent looking tracks.
For the electron, the events along the track are far more widely spaced than
from the alpha par6cle track. The alpha par6cle is said to be more densely
ionising.
We should note here that when an ionisa6on event occurs, a secondary
electron is produced which may have sucient kine6c energy to produce its
own track. These are know and delta, , rays.
Charged Par6cle Tracks
MED PHYS 1E03

Electron
Charged Par6cle Tracks
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Electron
Charged Par6cle Tracks
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Neutral atom

Electron
Charged Par6cle Tracks
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Electron
Charged Par6cle Tracks
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Electron
Charged Par6cle Tracks
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Electron
Charged Par6cle Tracks
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Delta ray

Electron
Charged Par6cle Tracks
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Alpha
Charged Par6cle Tracks
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Alpha
Linear Energy Transfer (LET)
MED PHYS 1E03

LET is normally expressed as keV/m.

For example, say an electron has an LET of 0.25 keV/m.
This would mean the electron would release, on average,
250eV of energy for every 10-6 m of material.
In contrast and alpha par6cle with the same ini6al energy
will have an LET of 250 keV/m i.e.1000 6mes more.
Linear Energy Transfer (LET)
MED PHYS 1E03

The LET of a par6cle will depend on its charge and its velocity in the
medium.
The greater the charge and the slower the velocity, the larger the value of
the LET.

LET (keV/m) Alpha

electron
Log scale

Depth into 6ssue (cm)

This means that as a par6cle losses energy in the material its velocity will
reduce and hence the LET will increase.
So towards the end of its range, the energy deposi6on is largest and ends
in what is called the Bragg peak.
Equivalent Dose
MED PHYS 1E03

Equivalent Dose H = D x Wr (sievert Sv)

Photons (all energies) Wr = 1

Electron (all energies) Wr = 1
Neutrons Wr = 5-20 depending on
energy
Protons Wr = 5
Alpha Wr = 20
Eec6ve Dose
MED PHYS 1E03

Eec6ve Dose = D x Wr x Wt (sievert Sv)

Gonads Wt = 0.2
Bone marrow Wt = 0.12
Colon Wt = 0.12
Breast Wt = 0.05
Liver Wt = 0.05
Skin Wt = 0.01
Rela6ve Biologic Eec6veness
MED PHYS 1E03

As the LET of the radia6on increases, the ability to produce biological damage also
increases. This rela6ve eect is quan6ta6vely described by what is called the
rela+ve biologic eec+veness (RBE) and is given by:

Dose of standard radia-on necessary to produce a given eect

Dose of test radia-on necessary to produce the same eect

Standard radia6on is taken as an x-ray source in the range 200-250 keV.

Radical Produc6on
MED PHYS 1E03

If the DNA is damaged by the radia6on itself i.e. the macromolecules in the
cells are excited or ionised, we call it a direct damage mechanism. However,
most of the energy absorbed by the cells is in the 70% water content.

H2O (energy) H2O+ + e-

The ionised water molecule breaks up into a hydrogen ion H+ (a proton) and a
Hydroxyl radical OH which is very reac6ve.

H2O+ OH + H+
Another reac6on is one in which the water molecule may be excited by the
ionisa6on event leaving it in an excited state. This excita6on leads to the
molecule breaking apart to give a hydrogen radical H and the hydroxyl radical
OH. Both of these are reac6ve en66es. The forma6on of these radicals then
leads to indirect damage of DNA.
Cell Survival Curves
MED PHYS 1E03

Cells that are s6ll able to proliferate afer irradia6on are said
to have survived.

A survival curve is a plot of the dose of radia6on against the

surviving frac6on of cells
Single Hit Survival Curves
MED PHYS 1E03

Suppose we have N0 tumour cells and we irradiate them with a dose D. The number
that survive, N, is given by

D
D0
N = N 0e 1.E+06

9.E+05

When D = D0 N = 0.37 N0 8.E+05

Surviving Number of Cells 7.E+05

D0 is dened as the 6.E+05

mean lethal dose 5.E+05

4.E+05 N=0.37N0
3.E+05

2.E+05

1.E+05

0.E+00
0 2 4 6 8 10 12 14 16
D0=2Gy Dose (Gy)
Cell Survival Curves
MED PHYS 1E03

However this is simplis6c and we should really consider the cell as having many sites
that if all hit will kill the cell.

D
D0 n
N = N 0 [1 (1 e ) ] n=5

Dq is called the quasi threshold

Surviving Frac-on 1.5

0.15

0.015

0.0015
0 2 Dq 4 6 8 10 12 14 16
Dose (Gy)
Dose Rate
MED PHYS 1E03

If a given dose is delivered over a long period of 6me it will have less of an eect
than the same dose delivered quickly i.e. the dose rate is important.

Example of protracted dose :

6 Gy delivered in 3 minutes (2gy/min) is lethal for a mouse.

If delivered at 10mGy/hour for 600 hours the mouse will survive

Example of frac6onated dose :

If the 6Gy dose is delivered at the same i.e.2Gy/min, but in say 12 equal frac6ons of
500mGy each separated by a 24hour 6me period the mouse will survive .

In frac6ona6on it allows cells to repair in between doses.
Eects of Radia6on on Tissue
MED PHYS 1E03

Soma6c irradiated person

Gene6c - ospring

Determinis6c has a minimum dose, the higher the dose the more
severe the response.

Stochas6c has no threshold

To produce a response in humans within days or months takes a high
dose and the response is called early eect of radia6on exposure.
Acute Radia6on Syndrome
MED PHYS 1E03

Immediate (days or weeks) death due to high

exposure of radia6on.

Very rare

Thirty people experienced acute radia6on
syndrome at Chernobyl and died.

Three types:
Hematologic death
Gastrointes6nal death
Central nervous system death.
Acute Radia6on Syndrome
MED PHYS 1E03

Central nervous system (CNS) death:

Doses in excess of 50 Gy.

Death within hours

Hematologic and GI death:

Lower doses.

Longer 6me to death (days, weeks).
Acute Radia6on Syndrome
MED PHYS 1E03

Alexander Litvinenko
Lethal Dose
MED PHYS 1E03

The LD50/60 is the dose of radia6on to the whole body that causes 50% of
irradiated subjects to die within 60 days

Lethality %

100

75

50

LD50/60
25

1.0 2.0 3.0 4.0 5.0 6.0

Radia6on Dose (Gy)
Lethal Dose
MED PHYS 1E03

At the lower dose of about 1Gy no one is expected to die.

Lethality %

100

75

50

LD50/60
25

1.0 2.0 3.0 4.0 5.0 6.0

Radia6on Dose (Gy)
Lethal Dose
MED PHYS 1E03
Above approximately 6Gy all those irradiated die without substan6al medical
alen6on.
Above about 10Gy even with medical alen6on does not prevent death

Lethality %

100

75

50

LD50/60
25

1.0 2.0 3.0 4.0 5.0 6.0

Radia6on Dose (Gy)
Local Tissue Damage
MED PHYS 1E03

If only a part of the body is irradiated as opposed to the

whole body, a higher dose is required to produce a
response.
Local Tissue Damage
MED PHYS 1E03

Pa6ent underwent coronary angiography with a follow up due to complica6ons,

followed by a by pass graf. Probably dose exceeded 20Gy !!!!!

6 to 8 weeks afer Appearance afer Skin necrosis

mul6ple 16 to 21 weeks visible 18-21
angiography and with a small months later.
angioplasty ulcerated area
procedures. present.
Late Eects of Radia6on
MED PHYS 1E03

Result of low doses delivered over a long period of 6me.

Principal eects are radia6on induced cancers and gene6c eects.

Late eects are easy to see but impossible to associate a par6cular

late response with a previous radia6on exposure.

Three types of risk es6mate:

Rela6ve Risk
MED PHYS 1E03

If a large popula6on is exposed to radia6on but the dose is unknown then:

The rela6ve risk compares the number of persons in the exposed popula6on
showing a given late eect, to the number of persons showing the same late
eect in an unexposed popula6on.

Rela-ve Risk = Observed cases/Expected cases

Excess Risk
MED PHYS 1E03

The excess risk compares the number of observed cases of e.g. leukemia and
the number of cases expected.

Excess Risk = Observed cases - Expected cases

Absolute Risk
MED PHYS 1E03

If dose levels are known it may be possible to determine an absolute risk.

Example:
Absolute risk of radia6on induced malignant disease is approximately 10 cases
per million people per 0.01 Gy per year.
Where does dose come from?
MED PHYS 1E03
Percep6on of Risk
MED PHYS 1E03

PHYSICS
Eects Dicult to Assess
MED PHYS 1E03

Nagasaki &
Hiroshima
Eects Dicult to Assess
MED PHYS 1E03