DOSE DISTRIBUTION

1) One plane :Central plane of implant is chosen

2) Dose distribution in other areas: Multiple planes
for isodose calculation either
Parallel
OR
Perpendicular to the central plane.
Prescribed Dose :
 Dose defined at the time of planning by the team of radiation oncologist and
medical physicist.
Minimum Target Dose (MTD) :
 Minimum dose at the periphery of the CTV.
 It should be adequate to treat CTV.
 It defines the treatment volume and should entirely encompass the clinical target
volume.
MINIMUM PERIPHERAL DOSE : AMERICAN CENTRES (MISNOMER)
 90% of the Prescibed dose ( Manchester System For Interstitial Therapy.)

 The MTD is known as the reference dose in the PARIS system.

Mean Central Dose(MCD) :
 It is taken to be the arithmetic mean of the local minimum doses b/w sources in
the central plane OR central planes
 MEAN CENTRAL DOSE

Implant in more than Complex Implants

Implant in one plane
one plane

• Arithmetic mean of the •Single plane may

• MCD is in the
local minimum doses b/w not include all the
central plane
each set of three adjacent sources.
• Arithmetic
source lines. •Sub divide the
mean of the
• The minimum dose lies volume.
doses at mid
at the intersection of •Then choose a
distance b/w
perpendicular bisector of separate central
each pair of
sides of triangles. plane for each sub
adjacent source
(GEOMETRIC AND volume.
lines.
EQUIDSITANT )
Three practical methods are acceptable for determining mean central dose.
1. Implants with Parallel Lines :

2. Evaluation of dose profiles:

 Calculate dose profiles for one or more axes through the center of the
implant
 expected to pass through as many local minima as possible.
 Determine, by inspection, the local minimum doses.
 The mean of these local minimum values is the mean central dose
3:Inspection of dose distribution:
 Plot the dose distribution in the central plane.
 Isodose lines varying by 5% (at most 10%) of the local dose in the central
region,
 the local minima can be determined by inspection
 Correlation between radiation dose with late effects and
recurrence

HIGH DOSE VOLUME LOW DOSE VOLUME

Volume encompassed by the isodose

corresponding to 150% of MCD
• It is defined as the volume within
around the source in any plane
the CTV ,encompassed by an
parallel to the central plane.
isodose corresponding to 90% of the
prescribed dose.
• To correlate radiation late
• If the CTV is not covered by the
damage ,the high dose volume
minimum target isodose ,there’ll be
around sources should be assessed.
low dose region & local recurrence.
•DIMENSIONS
 Time and Dose rate for temporary implants

TIM DOS
E E
Avg. overall
Overall Instantaneous treatment dose
Irradiation time
treatment time dose rate rate

• It is the quotient
of the total dose
• Total time
• Time during • It is the quotient and the overall
elapsed from the
which the of the dose and treatment time.
beginning of the
radioactive the irradiation • It is useful for
first irradiation to
source is present time , for a given continuous LDR
the end of last
in the patient. fraction or pulse. irradiation with or
one.
without
interruption.
 Time Dose Pattern for Temporary Implants

Continuous Non-Continuous Fractionated

Pulsed Irradiation
Irradiation Irradiation Irradiation

•
• A single high
• The overall • Irradiation time
• The overall dose source is
treatment time is sub-divided
treatment used to give a
is greater than into multiple
time is equal sequence of short
the irradiation fractions .
to the irradiation(pulses)
time due to the • The overall
irradiation to simulate
planned short treatment time is
time. continuous LDR.
interruption much greater • Time interval is
during the than the total shorter than few
treatment . irradiation time. hours.
Hyperfractionated
Irradiation :

 When two or more fractions are

given per day.
 When the time interval between short
high dose rate irradiation reaches or
exceeds four hours, irradiation
should be considered as
hyperfractionated.
 If the time interval is equal to one or
several days then it should be
considered as fractionated
irradiation.
 Description of Sources

 Radionuclide used (with or

without filtration).
 Type of source used : wires ,
seeds ,seed ribbons ,hairpin ,
needle etc.
 Length of each line source.
 Reference air kerma rate of each
source and source line.
 The distribution of strength
within the source should be
described (uniform or differential
loading).
 DESCRIPTION OF TECHNIQUE AND SOURCE PATTERN

 No. Of sources used.

 Separation between source lines and plane.
 Geometric pattern form by the sources with the central plane of implant(e.g.-
triangles , squares ).
 The surfaces in which the implant lies i.e ; planes or curved surfaces.
 Crossing sources are placed at one or more ends.
 The material used to carry the radioactive substance (flexible and rigid).
 Type of remote after loading if used.
THANK YOU