#26 General Practice of Radiation Oncology Physics in the 21st Century
Author: Almon Shiu & David MellenbergISBN: 9781930524460 ISBN10: 0944838987
Published: 2000 | 368 pp |
Price: $ 75.00
Medical Physics | April 2001
"This book constitutes the proceedings of the 2000 Summer School held at Northern Illinois University, DeKalb, IL from July 29 to August 1, 2000. It is edited by two experienced medical physicists with long and active careers in the field of Radiation Therapy. The topic selection for the Summer School and subsequently this monograph is of a very timely nature. It deals with those key issues of IMRT, forward and inverse treatment planning for external beams, brachytherapy advances in HDR and intravascular brachytherapy, and image guided prostate implantation. Lest we forget the fundamentals beneath these advanced topics, chapters on the TG-51 calibration protocol for high energy photon and electron beams, TG-43 for brachytherapy source specifications, and basic terminology for dose specification and reporting are included in the list of topics. As with all AAPM Summer Schools, the presentations are prepared and delivered by the experts in their particular area of Medical Radiation Physics and this proceedings is certainly of the same high quality.
"The first six chapters (230 pp.) of the book are devoted to external beam radiation therapy with the remaining four chapters (126 pp.) covering the various aspects of brachtherapy physics. The first chapter deals with dose specifications, prescriptions, DVH analysis, and the quantitative tools that have become popular in performing these determinations. The importance of the standardization of reporting and evaluation of delivered radiation dose is stressed in this chapter along with a clear description of normal tissue complication probabilities, tumor control probabilities, and biological modeling of tumor response to radiation dose.
"Chapter 2 covers three dimensional treatment planning algorithms, commissioning, implementation, and quality assurance of 3D planning systems. The first section on convolution/superposition photon dose algorithms is particularly clear in its presentation and very easy to follow. Either that or I am finally getting the hang of this material. The second section of the chapter details what is different about the 3DRTP process and the additional attention to detail that is needed in commissioning, testing, and certifying a true 3D treatment planning system. The authors also comment on the demands of system management for keeping the system working properly.
"Advanced forward treatment planning is described in Chapter 3 along with the main areas of application for these planning techniques. The use of superimposed MLC segments for the treatment of complicated target-sensitive structure complexes is the main focus of the chapter. Additionally, these forward planned segments are easily verified using established methods and intuitive in nature.
"Chapter 4, dealing with inverse treatment planning and IMRT, is the most complicated chapter in that the first section presents methods by which inverse planning or optimization is computed. The second section of the chapter focuses on the delivery of IMRT fields using dynamic multileaf collimators. This section is extremely helpful in alerting the reader to the limitations and potential problems that can occur from MLC driven radiation fields. What struck me about the descriptions in this section were the large effects on the final delivered dose produced by inter- and intra-leaf transmission, the tongue and groove effect, and the influence of the shape of the leaf end.
"Chapter 5 deals with TG-51 and it is a delight to read. For those physicists that want to get the definitive word on how to apply the new calibration protocol, what pitfalls to avoid, and what optimum sequences to follow to do or convert to TG-51, this is the document to read. It is clear and concise and written in a way that only someone who really knows the details can express them.
"Chapter 6 deals with quality assurance for treatment planning and dose delivery by advanced techniques-3D conformal, FRTP, and IMRT. The first section titled state-of-the-art treatment delivery systems is a comprehensive, though not exhaustive, description of the history of linear accelerators, linac components, EPIDs, record and verify systems, and system integration. Planning and acceptance testing is covered along with flowcharts on how to select a linac, produce purchase agreements, and accelerator installation, testing, and commissioning. General QA is covered later in the section. The second portion of the chapter is devoted to the extensive detail of QA for 3DRTP and IMRT. This section described in great detail the tests to be performed, how to perform them, and the level of acceptability for each test. Truly useful numeric data are available.
"Chapter 7 covered the intricacies and details of TG-43 and the recent recommendations of the
AAPM concerning the calibration and use of I-125. It is an efficiently written chapter that covers exactly what is needed for the clinical medical physicist. It also gives information on the history of the various changes in the output of various sources and includes references to recent AAPM recommendation on the use of I-125 and Pd-103.
"Chapter 8 is divided into two sections, the first covering intravascular brachytherapy with the second on image guided prostate implants. The first section starts with a description of the clinical studies performed to date and includes a description of the process by which radiation is thought to help prevent restenosis. This is followed by a description of the dosimetry required for determining the dose at distances of 1.5 mm from the radiation source. This section provides a good introduction to intravascular brachytherapy for those medical physicists who may soon be asked to start these programs. The references at the end of the chapter will also prove invaluable.
"Chapter 9 is a very detailed chapter focusing on high dose-rate brachytherapy. It begins by describing briefly the advantages and disadvantages of LDR and HDR brachytherapy and radiobiological considerations when determining the dose to deliver using HDR as compared to LDR. The chapter details the use of various diagnostic modalities for the acquisition of source location, and goes on to describe various types of HDR implant procedures in detail. The sections on breast implantation and HDR for cancer of the uterine cervix are particularly noteworthy and useful.
"Chapter 10 is the final chapter and deals with detectors for measuring 2D and 3D dose distributions. With treatment delivery systems and techniques becoming more complex and difficult to perform, knowledge of these various means by which to verify the actual dose delivered to the patient is becoming more and more important. This chapter provides good background information on selecting the proper detector for the job from those that are available.
"As with all AAPM Summer School proceedings, the presentations and chapters are prepared by individuals actively working in those respective areas. As such, the data is detailed, current, and practical. Practicing medical physicists in therapeutic radiology would certainly benefit by having access to the information available in this publication."
Bruce J. Gerbi
Bruce J. Gerbi, Ph.D. is a practicing medical physicist and Associate Professor in the Department of Therapeutic Radiology, Radiation Oncology at the University of Minnesota, Minneapolis, Minnesota.