Brachytherapy med phy-03

Barchytherapy Physical and Clinical
Aspeects
21/02/1436
Osama Anjak.1
‫ﻘﺮب‬‫ﻋﻦ‬‫اﻹﺸﻌﺎﻋﻴﺔ‬ ‫اﻠﻣﻌﺎﻠﺟﺔ‬
Brachytherapy:
Physical and Clinical Aspects-III
‫ـﻖ‬‫ﺟ‬‫ﻧ‬
ٔ
‫ا‬‫ﺴﺎﻤﺔ‬
ٔ
‫ا‬
‫اﻠﺳﻮرﻳﺔ‬‫اﻠﺬرﻳﺔ‬ ‫اﻠﻄﺎﻘﺔ‬‫ﻫﻴﺌﺔ‬
‫اﻠﺜﺎﻧﻴﺔ‬‫اﻠﺳﻨﺔ‬
‫اﻠﻄﺒﻴﺔ‬‫اﻠﻔﻴﺰﻳﺎء‬‫ﻤﺎﺠﺳﺘﻴﺮ‬
‫اﻠﻌﻟﻮم‬‫ﻜﻟﻴﺔ‬–‫دﻤﺷﻖ‬‫ﺠﺎﻤﻌﺔ‬
2015/2014
Chapter 13: Brachytherapy:
Physical and Clinical Aspects
09 Nov., 2014Osama Anjak2
IAEA
International Atomic Energy Agency
‫اﻠﻣﻄﺒﻗﺎت‬)‫اﻠﻗﻮاﻠﺐ‬(‫اﻠﺳﻄﺤﻴﺔ‬ ‫ﻠﻟﻣﻌﺎﻠﺟﺔ‬
•‫ﯾﺔ‬‫ر‬‫ﻗﺷ‬ ‫ﺳرطﺎﻧﯾﺔ‬ ‫ﺧﻼﯾﺎ‬ ‫ﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﺎﻟب‬
)squamous cell carcinoma(‫ﻓﻲ‬
‫اﻟﺟﺑﯾن‬ ‫ﻣﻧطﻘﺔ‬.
•‫اﻟﻘﺛﺎطر‬ ‫اﻷﺷﻛﺎل‬ ‫ﻓﻲ‬ ‫ﯾﻼﺣظ‬‫ﻟﺗ‬‫وﺿﻊ‬
‫اﻟﻣ‬‫ﺻﺎدر‬‫ا‬ً‫ﺎ‬‫آﻟﯾ‬ ‫ﺗﺣﻣﯾﻠﻬﺎ‬ ‫ﯾﻘﺔ‬‫ر‬‫وط‬ ،‫اﻟﻣﺷﻌﺔ‬.
‫ـﺘﺎﺑﺘﻬﺎ‬‫ﻜ‬ ‫وﻃﺮق‬‫اﻠﺟﺮﻋﺔ‬‫ﻤﻮاﺻﻔﺎت‬DOSE SPECIFICATION AND
REPORTING
•‫ﯾر‬‫ر‬‫اﻟﺗﻘ‬ ‫ﯾﺳﺗﺧدم‬ICRU reports 38 and 58‫ﯾﻌﺗﻣد‬ ‫ﻛﺄﺳﺎس‬
‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗدوﯾن‬ ‫ﻓﻲ‬ ‫ﻋﻠﯾﻪ‬.‫ﻣﻌوﻣﺎت‬ ‫أﻗل‬ ‫ﯾﺣدد‬ ‫وﻫو‬
minimum information‫ﺗطﺑﯾق‬ ‫ﻋﻧد‬ ‫ﺗدوﯾﻧﻬﺎ‬ ‫ﯾﺟب‬
‫اﻟﻣﺛﺎل‬ ‫ﺳﺑﯾل‬ ‫وﻋﻠﻰ‬ ‫اﻟداﺧﻠﯾﺔ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬:
–‫اﻟﻐرس‬ ‫طرﯾﻘﺔ‬ ‫وﺻف‬
–‫اﻟﻣﻌﺎﻟﺞ‬ ‫اﻟﺣﺟم‬ ‫ﺗﺣدﯾد‬volume of interest.
–‫اﻟﻛﻠﯾﺔ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﺣدﯾد‬.
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫إﻋطﺎء‬ ‫طرﯾﻘﺔ‬.
–‫ﺑﺎﻟـ‬ ‫ة‬‫ﻣﻘدر‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬cGy/h‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻠﻰ‬1 m.
‫اﻹﺸﻌﺎﻋﻴﺔ‬‫اﻠﺟﺮﻋﺔ‬
‫اﻠﻨﺳﺞ‬‫ﺿﻣﻦ‬‫اﻠﺰرع‬
•‫ﺑﻬﺎ‬ ‫اﻟﻣوﺻﻰ‬ ‫اﻟﻣﻌﻠوﻣﺎت‬ICRU report 38‫ﺗطﺑﯾق‬ ‫ﻋﻧد‬
‫اﻟﻧﺳﺎﺋﯾﺔ‬ ‫ام‬‫ر‬‫ﻟﻸو‬ ‫اﻟداﺧﻠﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬:
–‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﺗﻘﻧﯾﺔ‬ ‫وﺻف‬.
–‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬/‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣدة‬.
–‫اﻟﻣرﺟﻌﻲ‬ ‫اﻟﺣﺟم‬ ‫ﺗﺣدﯾد‬reference volume.
–‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻟﻧﻘط‬ ‫ﻋﻧد‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬.( )
–‫اﻟﻣﻧطﻘﺔ‬ ‫أﺑﻌﺎد‬pear shaped‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﻠﻘت‬ ‫اﻟﺗﻲ‬60 Gy
isodose‫اﻟﻣرﺟﻌﻲ‬ ‫اﻟﺣﺟم‬ ‫ﻣن‬
•‫ﯾر‬‫ر‬‫اﻟﺗﻘ‬ ‫ﻓﻲ‬ ‫ﺑﻬﺎ‬ ‫اﻟﻣوﺻﻰ‬ ‫اﻟﻣﻌﻠوﻣﺎت‬ICRU report 58‫ﻋﻧد‬
‫اﻟﻧﺳﺞ‬ ‫ﺿﻣن‬ ‫ع‬‫اﻟزر‬ ‫ﺑﺗﻘﻧﯾﺔ‬ ‫اﻟداﺧﻠﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗطﺑﯾق‬interstitial
implant:
–‫اﻟﻣﻌﺎﻟﺞ‬ ‫ي‬‫اﻟﺳرﯾر‬ ‫اﻟﺣﺟم‬ ‫وﺻف‬clinical target volume.
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬Sources‫اﻟﻣﻌﺗﻣدة‬ ‫اﻟﺗﻘﻧﯾﺔ‬ ،technique‫ﻣدة‬ ،
‫اﻟﻐرس‬implant time)‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣدة‬.(
–‫اﻟﻛﻠﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬.
–‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬ ‫وﺻف‬.
–‫اﻟﻣرﺗﻔﻌﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬‫و‬ ‫اﻟدﻧﯾﺎ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ذات‬ ‫اﻟﻣﻧﺎطق‬ ‫ﺗﺣدﯾد‬high and low
dose region‫اﻟﻣﺗﺟﺎﻧﺳﺔ‬ ‫اﻟﺟرع‬ ‫ذات‬ ‫اﻟﻣﻧﺎطق‬‫و‬dose uniformity
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬ ‫ﻣﻧﺣﻧﯾﺎت‬Dose-volume histograms (DVH).

Aspeects
21/02/1436
Osama Anjak.2
‫اﻟﻧﺳﺎﺋﯾﺔ‬ ‫ﻟﻸورام‬ ‫اﻟداﺧﻠﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬
‫أﻣﺎﻣﯾﺔ‬ ‫ﺻورة‬–‫ﺧﻠﻔﯾﺔ‬(AP)
‫اﻟﻣطﺑﻘﺎت‬ ‫وﺿﻊ‬ ‫ﻟﺗﺣدﯾد‬
‫ﺑﻬﺎ‬ ‫اﻟﻣوﺻﻰ‬ ‫اﻟﻣﻌﻠوﻣﺎت‬ICRU report 58‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗطﺑﯾق‬ ‫ﻋﻧد‬
‫اﻟﻧﺳﺎﺋﯾﺔ‬ ‫ام‬‫ر‬‫ﻟﻸو‬ ‫اﻟداﺧﻠﯾﺔ‬
•‫وﺑداﺧﻠﻬﺎ‬ ‫اﻟﻣطﺑﻘﺎت‬‫و‬ ‫ﻟﻠﺣوض‬ ‫وﺟﺎﻧﺑﯾﺔ‬ ‫ﺧﻠﻔﯾﺔ‬ ‫أﻣﺎﻣﯾﺔ‬ ‫ة‬‫ر‬‫ﺻو‬
‫ﻣﺷﻌﺔ‬ ‫ﻏﯾر‬ ‫ﻣﻌدﻧﯾﺔ‬ ‫ات‬‫ر‬‫ﻛ‬ ‫ﻋن‬ ‫ة‬‫ر‬‫ﻋﺑﺎ‬ ‫وﻫﻣﯾﺔ‬ ‫ﻣﻧﺎﺑﻊ‬.
AP and lateral radiographs of cervix treatment
‫اﻠﻨﺳﺎﺋﻴﺔ‬ ‫ام‬‫ر‬‫و‬
ٔ
‫ﻠﻼ‬ ‫اﻠﺪاﺧﻟﻴﺔ‬ ‫اﻠﻣﻌﺎﻠﺟﺔ‬
Integrated Brachytherapy Unit (IBU)
‫ﺑﺎرﯾﺲ‬ ‫ﻧﻈﺎم‬The Paris system
•‫ﻧظﺎم‬ ‫ﯾﻌﺗﻣد‬‫ﯾس‬‫ر‬‫ﺑﺎ‬‫اﻟﻣ‬ ‫طول‬ ‫ﺑﯾن‬ ‫اﻟﻌﻼﻗﺔ‬ ‫ﻋﻠﻰ‬ ‫أﺳﺎﺳﻲ‬ ‫ﺑﺷﻛل‬‫ﺻدر‬
‫اﻟﻣ‬ ‫ﺑﯾن‬ ‫اﻟﻔﺎﺻﻠﺔ‬ ‫اﻟﻣﺳﺎﻓﺔ‬‫و‬ ‫اﻟﻣﺷﻊ‬‫اﻟﻣﻐروﺳﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫ﺻﺎدر‬.
•‫اﻷﺳﺎﺳﯾﺔ‬ ‫اﻋد‬‫و‬‫اﻟﻘ‬:
–‫ﻧﻔس‬ ‫ﻓﻲ‬ ‫ة‬‫ﻣﺗﻧﺎظر‬ ،‫ازﯾﺔ‬‫و‬‫ﻣﺗ‬ ،‫ﻣﺳﺗﻘﯾﻣﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﻧﺎﺑﻊ‬ ‫ﺗﻛون‬ ‫أن‬ ‫ﯾﺟب‬
‫ي‬‫اﻟﻣرﻛز‬ ‫اﻟﻣﺳﺗوي‬ ‫ﯾدﻋﻰ‬ ‫اﻟﻣﺳﺗوي‬ ‫ﻫذا‬ ‫اﻟﻣﺳﺗوي‬Central Plane‫ان‬‫و‬
‫اﻟﻣ‬ ‫اﺗﺟﺎﻩ‬‫ﺻدر‬‫ع‬‫اﻟزر‬ ‫ﻣﺣور‬ ‫ﻫو‬ ‫اﻟﻣﺳﺗﻘﯾم‬Implantation Axis
–‫اﻟﻣرﺟﻌﯾﺔ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫أي‬ ‫ﻣﺗﺟﺎﻧﺳﺔ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻣﻧﺎﺑﻊ‬ ‫ﺗﻛون‬ ‫أن‬ ‫ﯾﺟب‬
‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻣﻧﺎﺑﻊ‬ ‫ﻟﻛﺎﻓﺔ‬ ‫ﺛﺎﺑت‬ ‫اﻟﺧطﻲ‬.
–‫ﺑﺷﻛل‬ ‫ﻋﺔ‬‫وﻣوز‬ ،‫ﻣﺗﺳﺎوﯾﺔ‬ ‫ﺑﯾﻧﻬﺎ‬ ‫ﻓﯾﻣﺎ‬ ‫اﻟﻣﺳﺎﻓﺔ‬‫و‬ ‫ازﯾﺔ‬‫و‬‫ﻣﺗ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬
‫ي‬‫اﻟﻣرﻛز‬ ‫اﻟﻣﺳﺗوي‬ ‫ﻣﻊ‬ ‫ﺗﻘﺎطﻌﻬﺎ‬ ‫ﯾﻛون‬ ‫ﺑﺣﯾث‬ ‫ازﯾﺔ‬‫و‬‫ﻣﺗ‬ ‫اﻟﻣﺳﺗوﯾﺎت‬ ‫ﻓﻲ‬ ‫ﻣﻧﺗظم‬
‫إﻣﺎ‬‫ﻣﺛﻠﺛﺎت‬‫أو‬‫ﻣرﺑﻌﺎت‬.
•‫ﻣﻌدل‬‫ﻋﺔ‬‫اﻟﺟر‬‫اﻟﻣﻣﺗﺻﺔ‬‫اﻷﺳﺎﺳﻲ‬Basal absorbed Dose:
–‫ﯾﺣدد‬‫اﻟﻣﻘدار‬‫اﻟﻣرﺟﻌﻲ‬‫ﻓﻲ‬‫ﻧظﺎم‬‫ﺑﺎرﯾس‬‫ﺗوزع‬‫ﻋﺔ‬‫اﻟﺟر‬ً‫ﺎ‬‫دوﻣ‬‫ﻓﻲ‬
‫اﻟﺳطﺢ‬‫ي‬‫اﻟﻣرﻛز‬‫ﻟﻠزرع‬‫وﯾﺗﻣﯾز‬‫ﺑﻣﻌدل‬‫ﻋﺔ‬‫اﻟﺟر‬‫اﻟﻣﻣﺗﺻﺔ‬‫اﻷﺳﺎﺳﯾﺔ‬
‫وﻫﻲ‬‫ﻣﺗوﺳط‬‫ﻣﻌدل‬‫ﻋﺔ‬‫اﻟﺟر‬‫اﻟﻣﻣﺗﺻﺔ‬‫اﻷدﻧﻰ‬‫ﻓﻲ‬‫ﻧﻘﺎط‬‫ﺗﻘﻊ‬‫داﺧل‬
‫اﻟﻣﺣﯾط‬‫اﻟﻣﺷﻛل‬‫ﺑﺎﻟ‬‫ﻣﺻﺎدر‬‫اﻟﺧﺎرﺟﯾﺔ‬‫اﻟﻣﻐروﺳﺔ‬.
–‫اﻟﻣﻘدار‬‫اﻟﻣرﺟﻌﻲ‬‫ﻫو‬‫اﻟﺗوزع‬‫اﻟﺳطﺣﻲ‬‫اﻟذي‬‫اﻓق‬‫و‬‫ﯾﺗ‬‫ﻣﻊ‬‫ﺣﺟم‬‫اﻟورم‬
‫وﯾﺳﺎوي‬85 %‫ﻣن‬‫ﻋﺔ‬‫اﻟﺟر‬‫اﻟﻣﻣﺗﺻﺔ‬‫اﻷﺳﺎﺳﯾﺔ‬.
85%×‫اﻟﻘﺎﻋدي‬ ‫اﻟﻣﻘدار‬=‫اﻟﻣرﺟﻌﻲ‬ ‫اﻟﻣﻘدار‬
Reference Dose = Basal Dose × 85%

Aspeects
21/02/1436
Osama Anjak.3
BD4
BD3
BD2
BD1
Basal Dose = (BD1+BD2+BD3+BD4)/4
Reference Dose = 0.85 x Basal Dose
BD2BD1 BD3 BD4
‫اﻷﺳﺎﺳﯾﺔ‬ ‫اﻟﺟرﻋﺔ‬ ‫ﺣﺳﺎب‬basal dose‫واﻟﺟرﻋﺔ‬
‫اﻟﻣرﺟﻌﯾﺔ‬Reference Dose‫ﺑﻣﺳﺗوي‬ ‫ﻏرس‬ ‫ﺣﺎﻟﺔ‬ ‫ﻓﻲ‬
‫واﺣد‬
Equal source strengths
60 cGy/h
40 cGy/h
•‫اﻟﺟرﻋﺔ‬ ‫ﻣﻌدل‬ ‫ﯾﺗﻧﺎﻗص‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺑﯾن‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﺑزﯾﺎدة‬
‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬.
Ref. Dose
Rate
36 cGy/h
15
BD3
BD4
BD = 39+43+43+43
4
= 42 cGy/h
Ref. Dose = 0.85 x BD
= 0.85 x 42
= 35.7 cGy/h
BD1BD1
BD2
Correct
Incorrect
How to choose the central plane???


09 Nov., 2014Osama Anjak
17
Correct Incorrect
How to choose the central plane???
 
Thickness of treated volume
Single plane implant 0.5 x sources separation
12mm between wires
Reference isodose
x x xx ~ 6mm

Aspeects
21/02/1436
Osama Anjak.4
Thickness of treated volume
Two plane “triangular” implant 1.2 x sources separation
x x
x
x
x
15mm
~ 18mm
Reference isodose
)(=1.2x15mm
Two plane “squares” implant 1.5 x sources separation
x x 18mm12mm
Reference isodose
‫ﻣﺜﺎل‬:‫ﺑﺎرﯾﺲ‬ ‫ﻧﻈﺎم‬The Paris system
• An Ir-192 wire implant consists of 4 wires, (straight
and parallel), each 50mm long, separation 15mm.
Wire strength (at mid implant),
AKR= 450nGy.h-1mm-1 at 1 metre
50mm
Side view
x x x
1 2 3 4
1 2 3 4
P1 P3P2
central plane
15
mm
Ir-192
‫اﻟﺤﻞ‬Calculation:
‫اﻷﺳﺎﺳﯿﺔ‬ ‫اﻟﻨﻘﺎط‬ ‫ﻧﻌﯿﻦ‬Basal Point‫ﻛﻞ‬ ‫ﻋﻨﺪ‬ ‫اﻟﺠﺮﻋﺔ‬ ‫ﻣﻌﺪل‬ ‫ﻧﺤﺴﺐ‬ ‫ﺛﻢ‬
‫ﻧﻘﻄﺔ‬(P1,P2 and P3)
‫اﻟﻨﻘﻂ‬ ‫ﻛﻞ‬ ‫ﺑﯿﻦ‬ ‫اﻟﻔﺎﺻﻠﺔ‬ ‫اﻟﻤﺴﺎﻓﺔ‬Basal Point‫اﻷﺳﺎﺳﯿﺔ‬Pi‫وأﺳﻼك‬
‫اﻟﻤﺸﻌﺔ‬ ‫اﻟﻤﺼﺎدر‬Wi
P1 P2 P3
W1 7.5 22.5 37.5
W2 7.5 7.5 22.5
W3 22.5 7.5 7.5
W4 37.5 22.5 7.5
x x x
W1 W2 W3 W4
P1 P3P2
15mm
From these we can use the “50 mm” crossline curve to
read off the dose rates (in Gy.h-1).
P1 P2 P3
W1 0.38 0.083 0.035
W2 0.38 0.38 0.083
W3 0.083 0.38 0.38
W4 0.035 0.83 0.38
Totals 0.878 0.926 0.878 (Gy.h-1)
+
x x x
W1 W2 W3 W4
P1 P3P2
15mm
0.395 0.417 0.395 (Gy.h-1)
Correcting for the wire strength used : ie. 450nGy.h-1mm-1 at 1m
(SK= 0. 45μGy.h-1mm -1 at 1m)
Therefore multiply the totals by 0.45
P1 P2 P3
Corrected Basal
Point Dose Rates
Mean Basal Dose Rate = (0.395+0.417+0.395)/3
= 0.402 (Gy.h-1)
Reference Dose Rate = 0.85 x 0.402 = 0.342 (Gy.h-1)
Time for 65Gy = 65/0.342 = 190 hours = 7.92 days
Totals 0.878 0.926 0.878 (Gy.h-1)

Aspeects
21/02/1436
Osama Anjak.5
‫ﻣﺜﺎل‬2:‫ﺑﺎرﯾﺲ‬ ‫ﻧﻈﺎم‬The Paris system
• An Ir-192 two plane implant, 5 wires, triangular cross
section Each wire 70mm long. Separation 20mm.
Calculate the Air Kerma (AKR) of the wire required to
give 25 Gy in 2.5 days
W3 W4
P1
x
20mm
20mm
P3
P2
y
300
300
20mm
20mm 20mm
W1 W2
W5
Use trigomometry to
obtain the required
distances
eg. P1 from Wire 1 (and 4 and 3)
10/x = cos300 therefore x = 10/ cos300 = 11.55mm
eg.P2 from Wire 3 (and 5)
20/y = cos300 therefore 20/ cos300 = 23.1mm
W3 W4
P1
x
20mm
20mm
P3
P2y
300
300
20mm
20mm 20mm
W1 W2
W5
Dose Rates for 1μGy.h-1mm -1 at 1metre
P3P2P1
DRDist.DRDist.DRDist.
0.09523.10.2411.550.2411.55W1
0.2411.550.2411.550.09523.1W2
0.06230.50.09523.10.2411.55W3
0.2411.550.2411.550.2411.55W4
0.2411.550.09523.10.06230.5W5
0.8770.9100.877Totals
Mean Basal Dose Rate = 0.888 Gy.h-1
Reference Dose Rate = 0.85 x 0.888
= 0.7548 Gy.h-1
Dose Rates for 1μGy.h-1mm -1 at 1metre
BUT we wish to give 25Gy in 2.5 days (ie. 60 hours)
Therefore the reference dose rate required is 25/60 = 0.417 Gy.h-1
= 0.552 μGy.h-1mm -1 at 1metre
= 552 nGy.h-1mm -1 at 1metre
• Two-plane implant to deliver 25 Gy Superficial
plane 5-cm wires 2, Deep plane 7-cm wires 3.
Separation between sources 18mm
• Activity of wire (midway through treatment)
air kerma rate 0.5 μGy/h/mm at 1 m (0.1193
mG/mm)
•‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ع‬‫ﺗوز‬:
W3 W4
A
x
50mm
C
B
y
300
300
18mm
18mm
70mm
W1 W2
W5

Aspeects
21/02/1436
Osama Anjak.6
CBAWire
DRDist.DRDist.DR
(Gy/h)
Dist.
(mm)
0.046520.80.124510.40.124510.4W1
0.124510.40.124510.40.046520.8W2
0.036527.50.055520.80.134010.4W3
0.134010.40.134010.40.134010.4W4
0.134010.40.055520.80.036527.5W5
0.47550.49400.4755Totals
•‫اﻟﻧﻘط‬ ‫ﻓﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬‫و‬ ‫اﻟﻣﺳﺎﻓﺔ‬A, B, C:
Mean Basal Dose Rate = (0.4755+0.4940+0.4755)/3
= 0.4816 Gy.h-1
Reference Dose Rate = 0.85 x 0.4816
= 0.4095 Gy.h-1
CBAWire
DRDist.DRDist.DR
(Gy/h)
Dist.
(mm)
0.47550.49400.4755Totals
Treatment time = 25Gy/0.4095
= 61.05 h
= 2 day + 13h
• A lesion has dimensions of 40mm x 30mm x
5mm
1. Suggest a suitable wires arrangement,
using the Paris system.
2. Calculate the wire strength, in air kerma
rate at 1 metre per mm of wire, that is
needed to treat this lesion to a prescribed
dose of 65Gy in 6 days .
09 Nov., 2014Osama Anjak3309 Nov., 2014Osama Anjak34
•‫ع‬‫ﺗوز‬ ‫ﻋﻠﻰ‬ ‫ﯾﻌﺗﻣد‬ ‫اﻟﻣوﺻوﻓﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻓﻲ‬ ‫اﻻﻫﺗﻣﺎم‬ ‫أن‬ ‫ﺑﻣﺎ‬
‫ﻋﺔ‬‫اﻟﺟر‬dose distribution‫ﺑﻊ‬‫ر‬‫أ‬ ‫ﻧﺳﺟل‬ ‫أن‬ ‫ﻋﻠﯾﻧﺎ‬ ‫ﻓﯾﺟب‬
‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫ﺑدﻗﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫وﺻف‬ ‫أﺟل‬ ‫ﻣن‬ ‫ﻋﺔ‬‫ﻟﻠﺟر‬ ‫ﻣﻘﺎدﯾر‬
‫ع‬‫ﺑﺎﻟزر‬:
.1‫اﻟﻛﻠﯾﺔ‬ ‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬Total reference air kerma.
.2‫اﻟورم‬ ‫ﻣﻧطﻘﺔ‬ ‫داﺧل‬ ‫اﻟﻣرﻛز‬ ‫ﻓﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﺗوﺳط‬.
.3‫اﻟدﻧﯾﺎ‬ ‫ﻋﺔ‬‫اﻟﺟر‬)‫اﻷﺻﻐرﯾﺔ‬Minimum dose(‫أﺟل‬ ‫ﻣن‬ ‫ﻫﺎﻣﺔ‬ ‫وﻫﻲ‬
‫ﺑﺎﻟورم‬ ‫اﻟﺗﺣﻛم‬.
.4‫ﻋن‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻓﯾﻬﺎ‬ ‫ﺗرﯾد‬ ‫اﻟﺗﻲ‬ ‫اﻟﻣﻧطﻘﺔ‬150%‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﺗوﺳط‬ ‫ﻋن‬
‫ﻣن‬ ‫أﻗل‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻓﯾﻬﺎ‬ ‫ﺗﻛون‬ ‫اﻟﺗﻲ‬ ‫اﻟﻣﻧطﻘﺔ‬‫و‬ ‫اﻟﻣرﻛز‬ ‫ﻓﻲ‬90%‫ﻣن‬
‫اﻟﻣوﺻوﻓﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬
‫اﻠﻣﺷﻌﺔ‬ ‫اﻠﻣﺼﺎدر‬ ‫ﺣﻮل‬ ‫اﻠﺟﺮﻋﺔ‬‫ﺗﻮزع‬DOSE DISTRIBUTIONS AROUND
SOURCES
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻗﻲ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫ﯾﻘﺳم‬
‫ﻗﺳﻣﯾن‬ ‫إﻟﻰ‬ ‫اﻟداﺧﻠﯾﺔ‬:
–‫طرﯾﻘﺔ‬ ‫ﺗﻌﺗﻣد‬AAPM TG 43‫اﻟﺗﺻﺣﯾﺣﺎت‬ ‫ﻛﺎﻓﺔ‬ ‫ﺗطﺑﯾق‬ ‫ﻋﻠﻰ‬
‫اﻟﺣﺎﺿر‬ ‫اﻟوﻗت‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬.
–‫اﻟﺗﻲ‬‫و‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫أﺟل‬ ‫ﻣن‬ ‫اﻟﻘدﯾﻣﺔ‬ ‫اﻟطرق‬ ‫ﻣن‬ ‫اﻟﻌدﯾد‬ ‫ﯾوﺟد‬
‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺧطط‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫ﻓﻲ‬ ‫ﻋﻠﯾﻬﺎ‬ ‫اﻻﻋﺗﻣﺎد‬ ‫ﯾﻣﻛن‬:
•‫أﺳﺎس‬ ‫ﻋﻠﻰ‬ ‫ﺣﺳﺎﺑﺎت‬‫ﻧﻘطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬‫اﻟﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﻻﻋﺗﻣﺎد‬
‫اء‬‫و‬‫ﺑﺎﻟﻬ‬
•‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬:
–‫ﻓﻠﺗر‬ ‫ﺑدون‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻓﻲ‬ ‫ﻣﺳﺗﻘﯾم‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬Unfiltered.
–‫ﻓﻠﺗر‬ ‫ﻣﻊ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻓﻲ‬ ‫ﻣﺳﺗﻘﯾم‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬Filtered
–‫ﻓﻠﺗر‬ ‫وﻣﻊ‬ ‫اﻟﻣﺎء‬ ‫ﻓﻲ‬ ‫ﻣﺳﺗﻘﯾم‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬Filtered

Aspeects
21/02/1436
Osama Anjak.7
SOURCES
•‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺣول‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬ ‫ﯾﺗم‬
‫ﻏﺎﻣﺎ‬ ‫ﻓوﺗوﻧﺎت‬ ‫ﺗﺣدﺛﻬﺎ‬ ‫اﻟﺗﻲ‬ ‫اﻟﺗﻔﺎﻋﻼت‬ ‫اﻻﻋﺗﺑﺎر‬ ‫ﺑﻌﯾن‬ ‫آﺧذﯾن‬
‫ﻣن‬ ‫ﺑﻛل‬ ‫ﺗﺗﺄﺛر‬ ‫وﻫﻲ‬:
–‫اﻟﻣﻧﺑﻌﺛﺔ‬ ‫اﻷﺷﻌﺔ‬Emitted radiation‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻣن‬.
–‫اﻟﻣﺣﯾط‬ ‫اﻟوﺳط‬Surrounding media‫اﻟﻣﺷﻊ‬ ‫ﺑﺎﻟﻣﺻدر‬
)‫اﻟﻧﺳﺞ‬.(
•‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫ﻋن‬ ‫اﻟﻧﺎﺗﺟﺔ‬‫و‬ ‫ﻧﻘطﺔ‬ ‫أﯾﺔ‬ ‫ﻋﻧد‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫اﻋﺗﺑﺎر‬ ‫ﯾﻣﻛن‬
‫ﻧﻘطﯾﺔ‬ ‫ﻣﺻﺎدر‬ ‫ﻋن‬ ‫اﻟﻧﺎﺗﺟﺔ‬ ‫ﻋﺎت‬‫اﻟﺟر‬ ‫ع‬‫ﻛﻣﺟﻣو‬ ‫اﺣد‬‫و‬.
SOURCES
•‫اﻟﺣر‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻗﻲ‬ ‫ﻧﻘطﻲ‬ ‫ﻣﺻدر‬Point source in free space:
–‫ﻟﻼﻣﺗﺻﺎص‬ ‫ﺗﺄﺛﯾر‬ ‫أﯾﺔ‬ ‫ﯾوﺟد‬ ‫ﻻ‬ ‫اﻟﺣﺎﻟﺔ‬ ‫ﻫذﻩ‬ ‫ﻓﻲ‬absorption‫أو‬
‫اﻟﺗﺑﻌﺛر‬scattering.
–‫اﻟﺗرﺑﯾﻊ‬ ‫ﺑﻘﺎﻧون‬ ‫ﻓﻘط‬ ‫ﯾﺗﻌﻠق‬ ‫اء‬‫و‬‫ﺑﺎﻟﻬ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬
‫اﻟﻘطر‬ ‫ﻧﺻف‬ ‫ﻟﺷﻌﺎع‬ ‫ﻛﺗﺎﺑﻊ‬ ‫اﻟﻌﻛﺳﻲ‬r‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻋن‬,
r
SOURCES
•‫ﺑﺎﻟﻧﺳﺞ‬ ‫أو‬ ‫ﺑﺎﻟﻣﺎء‬ ‫ﻧﻘطﻲ‬ ‫ﻣﺻدر‬Point source in water or
tissue:
–‫أﯾﺔ‬ ‫ﻓﻲ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﺗﺄﺛر‬ ‫ﺑﺎﻟﻣﺎء‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫وﺿﻊ‬ ‫ﻋﻧد‬
‫اﻟﺗﺑﻌﺛر‬‫و‬ ‫اﻻﻣﺗﺻﺎص‬ ‫ﻣن‬ ‫ﺑﻛل‬ ‫ﻟﻠﻣﺻدر‬ ‫ة‬‫ﻣﺟﺎور‬ ‫ﻧﻘطﺔ‬.
–‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻋن‬ ‫ات‬‫ر‬‫ﺳﻧﺗﯾﻣﺗ‬ ‫ﺑﺿﻊ‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻛﺎﻧت‬ ‫إذا‬)‫ﺿﻣن‬
‫اﻟﻣﺎدي‬ ‫اﻟوﺳط‬(‫وﻫذا‬ ‫اﻟﻌﻛﺳﻲ‬ ‫اﻟﺗرﺑﯾﻊ‬ ‫ﺑﻘﺎﻧون‬ ‫ﺑﺷدة‬ ‫ﺗﺗﺄﺛر‬ ‫ﻓﺈﻧﻬﺎ‬
‫ﻣﺗﻌﺎدل‬ ‫اﻟﺗﺑﻌﺛر‬‫و‬ ‫اﻻﻣﺗﺻﺎص‬ ‫ﺗﺄﺛﯾر‬ ‫أن‬ ‫أن‬ ‫ﯾﻌﻧﻲ‬.
5.‫اﻠﻣﺷﻌﺔ‬ ‫اﻠﻣﺼﺎدر‬ ‫ﺣﻮل‬‫اﻠﺟﺮﻋﺔ‬ ‫ﺗﻮزع‬
-‫ﺧﻮارزﻤﻴﺔ‬AAPM TG 43 algorithm
•‫ﻋﺎم‬ ‫ﻓﻲ‬1995‫اﻟطﺑﯾﯾن‬ ‫ﯾﺎﺋﯾﯾن‬‫ز‬‫ﻟﻠﻔﯾ‬ ‫ﯾﻛﯾﺔ‬‫ر‬‫اﻷﻣ‬ ‫اﻟﻬﯾﺋﺔ‬ ‫أدﺧﻠت‬AAPM
‫ﻫﺎ‬‫ﻣﻧﺷور‬ ‫ﺿﻣن‬ ‫وذﻟك‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻟﺣﺳﺎب‬ ‫ﺟدﯾدة‬ ‫ﺻﯾﻐﺔ‬TG 43
report.‫أﺟل‬ ‫ﻣن‬ ‫ﺑﺎﻟﺑﻌدﯾن‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬ ‫ﻋﻠﻰ‬ ‫ﯾطﺑق‬ ‫ﺣﯾث‬
‫ﻣﺛل‬ ‫اﻟﺷﻛل‬ ‫اﻧﯾﺔ‬‫و‬‫اﺳط‬ ‫ﻣﺷﻌﺔ‬ ‫ﺑﻣﺻﺎدر‬ ‫اﻟداﺧﻠﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬Pd-103, I-
125; Ir-192.
•‫أدﺧل‬‫ﯾر‬‫ر‬‫اﻟﺗﻘ‬AAPM TG 43‫ﻓﻲ‬ ‫اﻟﻣﻌﺗﻣدة‬ ‫ﯾﺎﺋﯾﺔ‬‫ز‬‫اﻟﻔﯾ‬ ‫ﻟﻠﻣﻘﺎدﯾر‬ ‫ﺟدﯾدة‬ ‫ﻣﻔﺎﻫﯾم‬
‫ﻣﺛل‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬:
–‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﺷدة‬Air kerma strength
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﺛﺎﺑت‬Dose rate constant.
–‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﺗﺎﺑﻊ‬Radial dose function.
–‫اﻻﺗﺟﺎﻫﺎت‬ ‫ﻛﺎﻓﺔ‬ ‫ﻓﻲ‬ ‫ﻣﺗﺳﺎوﯾﺔ‬ ‫ﻏﯾر‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻛون‬ ‫ﺗﺄﺛﯾر‬Anisotropy function.
‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺣول‬ ‫اﻟﺟرﻋﺔ‬ ‫ﺗوزع‬
-‫ﺧوارزﻣﯾﺔ‬AAPM TG 43 algorithm
•‫اﻟﻘطﺑﯾﺔ‬ ‫اﻹﺣداﺛﯾﺎت‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﻻﻋﺗﻣﺎد‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫وﺻف‬ ‫ﯾﺗم‬polar
coordinate system‫ﻣرﻛز‬ ‫ﻓﻲ‬ ‫اﻹﺣداﺛﯾﺎت‬ ‫ﻣرﻛز‬ ‫أن‬ ‫إﻟﻰ‬ ‫اﻻﻧﺗﺑﺎﻩ‬ ‫ﻣﻊ‬
‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬.
r is the distance from the origin
to the point of interest P (r, )
 is the angle with respect to the
long axis of the source
Point P (ro, o) is the reference point
that lies on the transverse bisector of
the source at a distance of 1 cm from
the origin ( ro=1cm and o=p/2)
ro
o=p/2
‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬
-‫ارزﻣﯾﺔ‬‫و‬‫ﺧ‬AAPM TG 43 algorithm
•‫ﻧﻘطﺔ‬ ‫ﻋﻧد‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬P(r.)Dose rate at point-of-interest‫اﻟﻣﺎء‬ ‫ﻓﻲ‬:
r is the distance (in cm) from the origin to the point-of-interestP
 is the angle between direction of radius vector r and the long axis
of the source
o defines the source transverse plane and is equal to p/2 radians
Sk is the air-kerma strength of the source (mGy.m2.h-1)
L is the dose rate constant in water
G(r, ) is the geometry factor
g(r) is the radial dose function
F(r, ) is the anisotropy function

Aspeects
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Osama Anjak.8
-‫ارزﻣﯾﺔ‬‫و‬‫ﺧ‬AAPM TG43 algorithm
•‫ﺗﻌرف‬‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﺷدة‬SK‫ﯾر‬‫ر‬‫ﺑﺎﻟﺗﻘ‬AAPM TG 43:‫ﺿرب‬ ‫ﺣﺎﺻل‬
‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﺑﻣرﺑﻊ‬ ‫اﻟﮭواء‬ ‫ﻓﻲ‬ ‫اﻟﻣرﺟﻌﯾﺔ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬
•‫وﺣدة‬‫اﻟﻘﯾﺎس‬:mGy.m2.h-1
•‫ﺣﯾث‬:dref‫اﻟﻣرﺟﻌﻲ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫ﻋﻧدﻫﺎ‬ ‫ﻧﻌرف‬ ‫اﻟﺗﻲ‬ ‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻫﻲ‬.
•‫اﻟرﻣز‬ ‫ﯾﺳﺗﺧدم‬U‫ﻟﻠﻣﺻدر‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻟﺷدة‬ ‫اﻟﻘﯾﺎس‬ ‫وﺣدة‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﺧﺗﺻﺎر‬ ‫ﻟﻠدﻻﻟﺔ‬
‫اﻟﻣﺷﻊ‬.
1 U = 1mGy.m2.h-1 = 1cGy.cm2.h-1
air kerma rate at
distance l m
Distance
air kerma strength.
Sk(U) = air Kerma source strength (U)
Conversion factors from 1 mCi:
• Ir-192 : 1 mCi = 0.238 U
• I-125 : 1 mCi = 0.787 U
• Pd-103: 1 mCi = 0.773 U
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﺛﺎﺑت‬)L(Dose rate constant:‫ﻣﻌدل‬ ‫ﺑﺄﻧﻪ‬ ‫ﯾﻌرف‬
‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﻟﻣﺎء‬ ‫ﻋﺔ‬‫اﻟﺟر‬1cm‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬ ‫اﻟﻌرﺿﻲ‬ ‫اﻟﻣﺣور‬ ‫ﻣن‬
)‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻟﻧﻘطﺔ‬(‫اﻟﻣﺎء‬ ‫ﻓﻲ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﺷدة‬ ‫ﻟوﺣدة‬ ‫ﺑﺎﻟﻧﺳﺑﺔ‬.
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﺛﺎﺑت‬)L(‫ﺑﺎﻟﺣﺳﺑﺎن‬ ‫ﯾﺄﺧذ‬:
•‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺷﻛل‬ ‫ﺗﺄﺛﯾر‬Effects of source geometry.
•‫اﻟﻣﺻدر‬ ‫ﻛﺑﺳوﻟﺔ‬ ‫ﺿﻣن‬ ‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺎدة‬ ‫اﻟﻣﻛﺎﻧﻲ‬ ‫ع‬‫اﻟﺗوز‬.
•‫اﻟﺗرﺷﯾﺢ‬‫اﻟذاﺗﻲ‬Self-filtration‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺿﻣن‬.
•‫اﻟﺗﺑﻌﺛر‬Scattering‫اﻟﻣﺷﻊ‬ ‫ﺑﺎﻟﻣﺻدر‬ ‫اﻟﻣﺣﯾط‬ ‫اﻟﻣﺎء‬ ‫ﺿﻣن‬.
cGy hr-1U-1Seed
0.686Pd-103 (Model 200)
1.036I-125 (6702)
0.965I-125 (6711)
0.968Cs-137 (3M)
1.11Ir-192 (stainlesssteel clad)
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﺛﺎﺑت‬)L(Dose rate constant:
TG43 Update (2004) and L.Liu et al, MP31:477 (2004)
•‫ﻫﻧدﺳﻲ‬ ‫ﻣﻌﺎﻣل‬Geometry factor G(r,):‫ﺑﺎﻟﺣﺳﺑﺎن‬ ‫ﯾﺄﺧذ‬ ‫اﻟﻣﻌﺎﻣل‬ ‫ﻫذا‬
‫اﻟﺣﺎد‬ ‫اﻟﺗﻧﺎﻗص‬geometric falloff‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻣﻊ‬ ‫اﻟﻔوﺗوﻧﺎت‬ ‫ﻟﺗدﻓق‬r‫ﻋن‬
‫ﺿﻣن‬ ‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺎدة‬ ‫اﻟﻣﻛﺎﻧﻲ‬ ‫ع‬‫اﻟﺗوز‬ ‫ﻋﻠﻰ‬ ً‫ﺎ‬‫أﯾﺿ‬ ‫وﯾﻌﺗﻣد‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬
‫اﻟﻣﺻدر‬.
•‫ﯾﺗﻧﺎﺳب‬ ‫اﻟﻧﻘطﯾﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫أﺟل‬ ‫ﻣن‬‫اﻟﻣﻌﺎﻣل‬
G(r,)‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﺑﻊ‬‫ر‬‫ﻣ‬ ‫ﻣﻊ‬ ً‫ﺎ‬‫ﻋﻛﺳ‬
•G(r,) a 1/r2
•‫اﻟﺧطﯾﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫أﺟل‬ ‫ﻣن‬:
•‫ﺣﯾث‬b=2-1‫و‬h=r.sin .
•‫اﻟﻣﺻﺎدر‬ ‫أﺟل‬ ‫ﻣن‬ً‫ﺎ‬‫ﻋﻛﺳ‬ ‫ﯾﺗﻧﺎﺳب‬ ‫اﻟﺧطﯾﺔ‬
‫ﻣر‬ ‫ﻣﻊ‬‫ﺑ‬‫ﺗﻛون‬ ‫ﻋﻧدﻣﺎ‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻊ‬r >> L
•‫ھﻧدﺳﻲ‬ ‫ﻣﻌﺎﻣل‬Geometry factor G(r,):‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻟﻌدد‬
The “Geometry Factor” G(r,) – for L = 3.0 mm

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Osama Anjak.9
•‫ﻣﻌﺎﻣل‬‫اﻟﻘطﺑﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬Radial dose function g(r):‫ﺗﺄﺛﯾر‬ ‫ﺑﺎﻟﺣﺳﺑﺎن‬ ‫ﯾﺄﺧذ‬
‫اﻟﻌرﺿﻲ‬ ‫اﻟﻣﺳﺗوي‬ ‫ﻓﻲ‬ ‫اﻟﻣﺎء‬ ‫ﻓﻲ‬ ‫اﻟﺗﺑﻌﺛر‬‫و‬ ‫اﻟﺗوﻫﯾن‬transverse-plane
‫اﻟﺣﺎد‬ ‫اﻟﺗﻧﺎﻗص‬ ‫ﻋدا‬ ‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬‫أﻧﻪ‬ ‫ﺣﯾث‬‫ﻓﻲ‬ ‫اﻻﻋﺗﺑﺎر‬ ‫ﺑﻌﯾن‬ ‫أﺧذ‬
‫اﻟﻬﻧدﺳﻲ‬ ‫اﻟﻣﻌﺎﻣل‬.
•‫ﻣﻌﺎﻣل‬‫اﻟﻘطﺑﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬Radial dose function g(r):‫ﺑﺗرﺷﯾﺢ‬ ً‫ﺎ‬‫أﯾﺿ‬ ‫ﯾﺗﻌﻠق‬
filtration‫اﻟﻣﺻدر‬ ‫وﺑﻣﺎدة‬ ‫اﻟﻛﺑﺳوﻟﺔ‬ ‫ﻏﻼف‬ ‫ﺑﻣﻌدن‬ ‫اﻟﻔوﺗوﻧﺎت‬.
The transverse-plane of a cylindricallysymmetric source is that plane which is perpendicular
to the longitudinalaxis of the source and bisects the radioactivitydistribution.
r(cm)
g(r)
I-125
(6702)
I-125
(6711)
Ir.192
0.5 1.040 1.040 0.994
1 1.000 1.000 1.000
2 0.851 0.831 1.010
3 0.670 0.632 1.020
4 0.510 0.462 1.010
5 0.389 0.344 0.996
From Meli JA, Anderson LL, Weaver KA:
Interstitial Brachytherapy,Raven, New York 1990
•‫ﻣﻌﺎﻣل‬‫اﻟﻘطﺑﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬g(r)‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻟﻌدد‬
The “radial dose function” g(r),
125I
•‫ﻣﻌﺎﻣل‬Anisotropy function F(r,):‫ع‬‫ﺗوز‬ ‫أن‬ ‫اﻻﻋﺗﺑﺎر‬ ‫ﺑﻌﯾن‬ ‫ﯾﺄﺧذ‬
‫اﺣدة‬‫و‬ ‫ﻟﯾﺳت‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬anisotropy)ٍ‫ﻣﺗﺳﺎو‬ ‫ﻏﯾر‬(‫ﻛﺎﻓﺔ‬ ‫ﻓﻲ‬
‫اﻟﻣﺎء‬ ‫ﻓﻲ‬ ‫اﻟﺗﺑﻌﺛر‬‫و‬ ‫اﻻﻣﺗﺻﺎص‬ ‫ﺗﺄﺛﯾر‬ ‫ﻣﻊ‬ ‫اﻻﺗﺟﺎﻫﺎت‬.
•‫اﺣد‬‫و‬ ‫ﺑﺄﻧﻪ‬ ‫ﯾﻌرف‬unity‫ﻣﺳﺗوي‬ ‫ﻓﻲ‬transfer plane.
• Decreases in directions off the transfer plane:
• As r decreases
• As  approaches 0o or 180o
• As the source encapsulation thickness increases
• As the photon energy decreases
Anisotropy function F(r,)
for iodine-125 (model 6702) seeds
r(cm) 0.5 1.0 2.0 5.0
0o 0.45 0.50 0.54 0.63
15o 0.62 0.68 0.70 0.77
30o 0.82 0.87 0.87 0.87
90o 1.00 1.00 1.00 1.00
From Meli JA, Anderson LL, Weaver KA:
Interstitial Brachytherapy,Raven, New York 1990
•‫ﻣﻌﺎﻣل‬Anisotropy function F(r,)‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻟﻌدد‬
‫ﻣﻌﺎﻣل‬Anisotropy function F(r,)

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Osama Anjak.10
•‫ﻋﺎم‬ ‫ﻓﻲ‬ ‫ﺗم‬2004‫أﺟرت‬AAPM‫ﯾر‬‫ر‬‫اﻟﺗﻘ‬ ‫ﻋﻠﻰ‬ ‫ﺗﻌدﯾل‬TG 43
protocol‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﻣوز‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﺑﺣﺳﺎب‬ ‫اﻟﺧﺎص‬
‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻔوﺗوﻧﻲ‬ ‫اﻟﻣﺻدر‬.
•‫اﻟرﻣز‬ ‫ﺗﺣﻣل‬ ‫ﯾر‬‫ر‬‫اﻟﺗﻘ‬ ‫ﻣن‬ ‫اﻟﻣﻌدﻟﺔ‬ ‫اﻟﻧﺳﺧﺔ‬)TG 43U1(
‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﺷدة‬ ‫ﯾف‬‫ر‬‫ﻟﺗﻌ‬ ‫ﺗﻌدﯾل‬ ‫ﺗﺗﺿﻣن‬SK‫ﺗﻌرف‬ ‫اﻟﺗﻲ‬‫و‬
‫اﻟﺧﻼء‬ ‫ﻓﻲ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ً◌ً‫ﺎ‬‫ﺣﺎﻟﯾ‬(Kd(d))vac‫وﻫذا‬
‫ﻋن‬ ‫ﯾد‬‫ز‬‫ﺗ‬ ‫اﻟﺗﻲ‬ ‫اﻟطﺎﻗﺔ‬ ‫ذات‬ ‫اﻟﻔوﺗوﻧﺎت‬ ‫ﻟﻛﺎﻓﺔ‬ ‫ﯾﺻﻠﺢ‬ ‫ﯾف‬‫ر‬‫اﻟﺗﻌ‬
‫طﺎﻗﺔ‬cut-off energy‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻋﻧد‬d‫اﻟﻣﺻدر‬ ‫ﻣرﻛز‬ ‫ﻣن‬
‫اﻟﻣﺷﻊ‬.
•‫اﻟﻣﺳﺎﻓﺔ‬d‫ﻣن‬ ‫أﻛﺑر‬ ‫ﺗﻛون‬ ‫ﺑﺣﯾث‬ ‫ﻣﺳﺎﻓﺔ‬ ‫أﯾﺔ‬ ‫ﺗﻛون‬ ‫أن‬ ‫ﯾﻣﻛن‬
‫اﻟﻛﺎﺷف‬‫و‬ ‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬ ‫ﺑﻌد‬ ‫أﻛﺑر‬.
•‫اﻟﺷرط‬”‫اﻟﺧﻼء‬in vacuum”‫ﺗﺻﺣﯾﺢ‬ ‫ﯾﺟب‬ ‫أﻧﻪ‬ ‫ﯾﻌﻧﻲ‬
‫ﺗوﻫﯾن‬ ‫أﺟل‬ ‫ﻣن‬ ‫اﻟﻘﯾﺎﺳﺎت‬‫اﻟﻔوﺗون‬‫اﻟﻛﺑﺳوﻟﺔ‬ ‫وﺟدار‬ ‫اء‬‫و‬‫ﺑﺎﻟﻬ‬
‫اﻟﻣﺻدر‬ ‫ار‬‫و‬‫ﺑﺟ‬ ‫ﺟﺳم‬ ‫أﯾﺔ‬ ‫ﻋن‬ ‫اﻟﻧﺎﺗﺞ‬ ‫اﻟﺗﺑﻌﺛر‬ ‫أﺟل‬ ‫ﻣن‬ ‫أﯾﺿﺎ‬‫و‬
،‫اﻟﻣﺷﻊ‬)‫اﻟﺳﻘف‬‫و‬ ‫ان‬‫ر‬‫اﻟﺟد‬ ، ‫ﻛﺎﻷرض‬(..
•‫اﻟطﺎﻗﺔ‬Cut-off energy d)‫ﺗﺳﺎوي‬5 keV(‫ﻛﺎﻓﺔ‬ ‫ﺗﺳﺗﺛﻧﻲ‬
‫ﻓﻲ‬ ‫ﺗﺳﺎﻫم‬ ‫أن‬ ‫دون‬ ‫ﯾد‬‫ز‬‫ﺗ‬ ‫اﻟﺗﻲ‬ ‫اﻹﺷﺎﺑﺔ‬ ‫وﻓوﺗوﻧﺎت‬ ‫اﻷﻗل‬ ‫اﻟطﺎﻗﺎت‬
‫ﻋن‬ ‫ﯾد‬‫ز‬‫ﺗ‬ ‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫اﻟﻧﺳﯾﺞ‬ ‫ﺿﻣن‬ ‫ﻋﺔ‬‫اﻟﺟر‬1 mm.
•‫اﻟﺑروﺗوﻛول‬ ‫ﯾﻘدم‬TG 43 protocol‫ﻟﺣﺳﺎب‬ ‫دﻗﯾﻘﺔ‬ ‫ﯾﻘﺔ‬‫ر‬‫ط‬
‫ﻟﻠﻣﺻﺎدر‬ ‫اﻟﻬﻧدﺳﯾﺔ‬ ‫اﻷﺷﻛﺎل‬ ‫ﻛﺎﻓﺔ‬ ‫أﺟل‬ ‫ﻣن‬ ‫اﻟﻣﻣﺗﺻﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬
‫اﻟﻣﺷﻌﺔ‬
‫اﻟﺗﻘرﯾر‬ ‫ﺗﻌدﯾل‬Update AAPM Task Group No. 43 Report
•‫ﻋﺎم‬2004‫اﻟﻠﺟﻧﺔ‬ ‫ﻗﺑل‬ ‫ﻣن‬ ‫اﻟﺗﻘرﯾر‬ ‫ﺗﻌدﯾل‬ ‫ى‬‫ﺟر‬AAPM Low-
energy Interstitial Brachytherapy Dosimetry subcommittee (LIBD)
‫ﺑرﻗم‬ ‫اﻟﺗﻌدﯾل‬ ‫وﺻدر‬updated protocol”TG-43U1”
•‫اﻟﺗﻌدﯾل‬ ‫ﺗﺿﻣن‬:
.1‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﺷدة‬ ‫ﺗﻌرﯾف‬ ‫ﺗﻌدﯾل‬SK.
.2‫ي‬‫اﻟظﺎﻫر‬ ‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﻧﺷﺎط‬ ‫ﻣﻔﻬوم‬ ‫إﻟﻐﺎء‬apparent activity‫ﻣن‬
‫ة‬‫اﻟﻣﻌﺎﯾر‬ ‫ﻋﻧد‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺷدة‬ ‫اﺳﺗﺧدام‬‫و‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫اص‬‫و‬‫ﺧ‬.
.3‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﺳﺎوي‬ ‫ﻋدم‬ ‫ﻣﻔﻬوم‬ ‫إﻟﻐﺎء‬anisotropy constant‫ﺣول‬
‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺣول‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﺑﺗﺄﺛﯾر‬ ‫اﺳﺗﺑداﻟﻪ‬‫و‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬.
.4‫ﻟﺑﻌض‬ ‫ﺟدﯾد‬ ‫اء‬‫ر‬‫اﺳﺗﻘ‬‫ات‬‫ر‬‫اﻣﺗ‬‫ر‬‫اﻟﺑﺎ‬‫أﻗﺻر‬‫و‬ ‫أطول‬ ‫ﻟﻣﺳﺎﻓﺎت‬ ‫اﻟﺟداول‬‫و‬.
.5‫اﻷﺳﺎﺳﻲ‬ ‫اﻟﺗﻘرﯾر‬ ‫ﻓﻲ‬ ‫وردت‬ ‫اﻟﺗﻲ‬ ‫اﺑت‬‫و‬‫اﻟﺛ‬ ‫ﺑﻌض‬ ‫ﺗﺻﺣﯾﺢ‬
Brachytherapy seeds examined in the
updated protocol”TG-43U1” Includes
Consensus g(r) values for two 103Pd sources

Aspeects
21/02/1436
Osama Anjak.11
The WAFAC measurement
scheme, involving the
subtraction of the results of
a second measurement
using the small chamber
length in order to remove
any possible effects due to
the presence of the front
and back aluminized-PET
electrodes. The middle
electrode lengths shown are
for the original WAFAC
‫ﺣﺠﯿﺮة‬‫اﻟﺘﺄﯾﻦ‬‫اﻟﻘﯿﺎس‬ ‫ﻓﻲ‬ ‫اﻟﻤﺴﺘﺨﺪﻣﺔ‬
‫ﺣﺠﯿﺮة‬‫اﻟﻘﯿﺎس‬ ‫ﻓﻲ‬ ‫اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫اﻟﺘﺄﯾﻦ‬
The WAFAC Ion Chamber
-‫اﻟﻧﻘطﯾﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫ى‬‫أﺧر‬ ‫اﺋق‬‫ر‬‫ط‬Other calculation methods for point sources
•‫اﻟﻧﻘطﻲ‬ ‫اﻟﻣﻧﺑﻊ‬ ‫ﻣودﯾل‬ ‫ﻋﻠﻰ‬ ‫ﺑﺎﻻﻋﺗﻣﺎد‬ ‫ﻋﺎت‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫ﯾﻣﻛن‬
point source models‫أﺟل‬ ‫ﻣن‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫وﻣﻌدل‬
‫ﺑﺎﻻﻋﺗﻣﺎد‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺧطط‬ ‫ﻓﻲ‬ ‫أﺟرﯾت‬ ‫اﻟﺗﻲ‬ ‫ﺣﺳﺎﺑﺎت‬ ‫اﻟﺗﺣﻘق‬
‫ﻋﻠﻰ‬TG 43 protocol.
•‫ي‬‫اﻟظﺎﻫر‬ ‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﻧﺷﺎط‬ ‫ﺑﻣﻌرﻓﺔ‬Aapp‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬
‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫وﺛﺎﺑت‬GAKR‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫اء‬‫و‬‫ﺑﺎﻟﻬ‬d‫ﻣن‬
‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬
•‫طﺎﻗﺔ‬ ‫ﻣن‬ ‫أﻛﺑر‬ ‫أو‬ ‫ﺗﺳﺎوي‬ ‫اﻟطﺎﻗﺔ‬ ‫ذات‬ ‫اﻟﻔوﺗوﻧﺎت‬ ‫أﺟل‬ ‫ﻣن‬Ir-192‫ﯾﺟب‬
‫ﯾدﻋﻰ‬ ‫ﺗﺻﺣﯾﺢ‬ ‫ﻣﻌﺎﻣل‬ ‫إدﺧﺎل‬Meisberger function M(d)‫ﻟﺗﺻﺣﯾﺢ‬
‫اﻟﻣﺎء‬ ‫ﻓﻲ‬ ‫اﻟﺗﺑﻌﺛر‬‫و‬ ‫اﻻﻣﺗﺻﺎص‬.‫ﻟﻠﻣﺳﺎﻓﺔ‬ ‫ﺗﺎﺑﻊ‬ ‫وﻫو‬d‫أو‬ ‫اﻟﺛﺎﻟﺛﺔ‬ ‫اﻟﻘوة‬ ‫ﻣن‬
‫اﺑﻌﺔ‬‫ر‬‫اﻟ‬polynomial of third or fourth degree
•‫ﻣﻌدل‬ ‫ﺣﺳﺎب‬ ‫ﯾﻣﻛﻧﻧﺎ‬ ‫اء‬‫و‬‫ﺑﺎﻟﻬ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫ﻓﺔ‬‫ر‬‫ﺑﻣﻌ‬
‫ﺑﺎﻟﻣﺎء‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬:
-‫اﻟﻨﻘﻄﯿﺔ‬ ‫ﻟﻠﻤﺼﺎدر‬ ‫أﺧﺮى‬ ‫طﺮاﺋﻖ‬Other calculation methods for point sources
‫اﻻﻣﺗﺻﺎص‬ ‫ﺗﺄﺛﯾر‬‫ﺑﺎﻟﻣﺎء‬ ‫اﻟﺗﺑﻌﺛر‬‫و‬
Attenuation & scattering effect in water
SourceDose point
Water
p
‫أﺟل‬ ‫ﻣن‬ ‫اﻻﻣﺗﺻﺎص‬‫و‬ ‫اﻟﺗﺑﻌﺛر‬ ‫ﺗﺻﺣﯾﺢ‬Ir-192‫و‬Cs-137
‫ﻟﻠﻣﺳﺎﻓﺔ‬ ‫ﻛﺗﺎﺑﻊ‬distance from source (d).
The original work by
Meisberger assumed that
the correction factors are
valid at distances between
1 cm and 10 cm. It has
been shown that the
discrepancy becomes
appreciable at distances
exceeding 5 cm.

Aspeects
21/02/1436
Osama Anjak.12
•‫ﯾﺗﻌﻠق‬‫ﺑﺎﻟﻣﺎء‬ ‫اﻟﻣﺎء‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬‫ﻛﯾرﻣﺎ‬ ‫ﺑﻣﻌدل‬
‫اﻟﻛﺗﻠﻲ‬ ‫اﻟطﺎﻗﺔ‬ ‫اﻧﺗﻘﺎل‬ ‫ﻣﻌﺎﻣل‬ ‫ﺑﻧﺳﺑﺔ‬ ‫ﺑﺎﻟﻣﺎء‬ ‫اء‬‫و‬‫اﻟﻬ‬
ratio of mass energy transfer coefficients:
•‫ﻛﺎﻓﺔ‬ ‫أﺟل‬ ‫ﻣن‬‫اﻟﻧﻛﻠﯾدات‬‫أﻋﻠﻰ‬ ‫طﺎﻗﺔ‬ ‫ذات‬ ‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻣﺷﻌﺔ‬
‫ﻣن‬200keV‫ي‬‫ﺗﺳﺎو‬ ‫اﻟﻧﺳﺑﺔ‬ ‫ﻫذﻩ‬1.11‫اﻟﯾود‬ ‫أﺟل‬ ‫وﻣن‬-125‫اﻟﺑﻼدﯾوم‬‫و‬-103
‫ي‬‫ﺗﺳﺎو‬ ‫اﻟﻧﺳﺑﺔ‬1.01.
•‫ﺣﺳﺎب‬ ‫ﯾﺗم‬‫ﺑﺎﻟﻣﺎء‬ ‫اﻟﻣﻣﺗﺻﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬‫ﻋﻧد‬
‫اﻟﻣﺳﺎﻓﺔ‬d‫ﯾﺘﻢ‬ ‫اﻟﺘﻲ‬ ‫وﻧﻘﻄﺔ‬ ‫اﻟﻤﺸﻊ‬ ‫اﻟﻤﺼﺪر‬ ‫ﺑﯿﻦ‬ ‫ﺗﻔﺼﻞ‬ ‫اﻟﺘﻲ‬
‫ﺑﺎﻟﻤﺎء‬ ‫اﻟﻤﺎء‬ ‫ﻛﯿﺮﻣﺎ‬ ‫ﻣﻌﺪل‬ ‫ﻣﻦ‬ ،‫ﻋﻨﺪھﺎ‬ ‫اﻟﺠﺮﻋﺔ‬ ‫ﺗﻌﯿﻦ‬.
•‫اﻹﺷﻌﺎع‬ ‫ﻣﻌﺎﻣل‬ ‫ﺗﺟﺎﻫل‬ ‫ﯾﻣﻛن‬ ‫ﻋﻣوﻣﺎ‬Radiation fraction
‫أﻗل‬ ‫وﻫو‬ ‫ﻩ‬‫ر‬‫ﻟﺻﻐ‬0.3%‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫ﺑﺎﻟﻧﺳﺑﺔ‬ ‫ﻣن‬
‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬
•‫اء‬‫و‬‫ﺑﺎﻟﻬ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫ﺑﺗﻌﯾن‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ة‬‫ر‬‫ﻣﻌﺎﯾ‬ ‫ﯾﺗم‬
‫اﻟﻣرﺟﻌﻲ‬‫ﻣﺳﺎﻓﺔ‬ ‫أﯾﺔ‬ ‫ﻋﻧد‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬ ‫ﻓﺈن‬
d‫ﺑﺎﻟﻣﻌﺎدﻟﺔ‬ ‫ﯾﻌطﻰ‬:
•‫اﻟﻣﻣﺗﺻﺔ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬‫ﺑﺎﻟﻣﻌﺎدﻟﺔ‬ ‫ﺗﻌطﻰ‬ ‫ﺑﺎﻟﻣﺎء‬
•‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻋن‬ ‫اﻟﺗﻌﺑﯾر‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻌﺎﻣﺔ‬ ‫ة‬‫ر‬‫اﻟﻌﺑﺎ‬
‫ﻫﻲ‬ ‫ﺑﺎﻟﻣﺎء‬ ‫اﻟﻣﻣﺗﺻﺔ‬:
•‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻧد‬ ‫ﻋﺔ‬‫ﺑﺳر‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫إﻟﻰ‬ ‫اﻟوﺻول‬‫و‬ ‫اﻟﺳﻬوﻟﺔ‬ ‫أﺟل‬ ‫ﻣن‬
‫ة‬‫ر‬‫ﻗﺻﯾ‬)e.g., 1 cm(‫ﻣن‬‫ﺗﻘرﯾب‬ ‫ﯾﻣﻛن‬ ‫ﻧﻘطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬
‫ﻣن‬ ‫ﻛل‬‫و‬‫ﻋﻠﻰ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫وﺑﺎﻟﺗﺎﻟﻲ‬
‫ﻣﺳﺎﻓﺔ‬1cmً‫ﺎ‬‫ﯾﺑ‬‫ر‬‫ﺗﻘ‬ ‫ﯾﺳﺎوى‬ ‫ﻧﻘطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫ﻣن‬:
‫اﻠﻣﺷﻌﺔ‬‫اﻠﻣﺼﺎدر‬‫ﺣﻮل‬‫اﻠﺟﺮﻋﺔ‬‫ع‬‫ز‬‫ﺗﻮ‬
‫ﻣﺼﺎدر‬‫ﺧﻄﯿﺔ‬
Linear (line) sources

Aspeects
21/02/1436
Osama Anjak.13
•‫اﻟﺧطﯾﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬ ‫ﯾﻣﻛن‬
‫ﺑﺎﺳﺗﺧدام‬ ‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬‫ﺳﯾﻔرﯾت‬ ‫ﺗﻛﺎﻣل‬
Sievert integral‫ﻋﺎم‬ ‫ﻓﻲ‬ ‫ﯾت‬‫ر‬‫ﺳﯾﻔ‬ ‫ﻗﺑل‬ ‫ﻣن‬ ‫طﺑق‬ ‫اﻟذي‬
1921.
•‫ﺑﺄﻧﻪ‬ ‫اﻟﺧطﻲ‬ ‫اﻟﻣﺻدر‬ ‫اﻋﺗﺑر‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬ ‫أﺟل‬ ‫ﻣن‬
‫ة‬‫ر‬‫ﺻﻐﯾ‬ ‫ﻧﻘطﯾﺔ‬ ‫ﻣﺻﺎدر‬ ‫ع‬‫ﻣﺟﻣو‬elementary point
sources‫اﻟﻣوﺿﻊ‬ ‫ﻓﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻓﻲ‬ ‫ﯾﺳﺎﻫم‬ ‫ﻣﻧﻪ‬ ‫وﻛل‬P
‫ﻓﯾﻪ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫ي‬‫ﯾﺟر‬ ‫اﻟذي‬.
-‫ﻣﺼﺎدر‬‫ﺧﻄﯿﺔ‬Linear (line) sources
•‫اﺣﺗﻣﺎﻻن‬ ‫اﻟﻣﺳﺄﻟﺔ‬ ‫ﻟﻬذﻩ‬ ‫ﯾوﺟد‬:
–‫ﻓﻠﺗر‬ ‫ﺑدون‬ ‫ﺧطﯾﺔ‬ ‫ﻣﺻﺎدر‬Unfiltered line source
–‫ﻓﻠﺗر‬ ‫ﻣﻊ‬ ‫ﺧطﯾﺔ‬ ‫ﻣﺻﺎدر‬Filtered line source
•‫ﻧﻘطﺔ‬ ‫ﻋﻧد‬ ‫ﺑﺎﻟﻣﺎء‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﯾﺗﻌﯾن‬P‫ﻣﻌدل‬ ‫ﺣﺳﺎب‬ ‫ﻣن‬
‫اﻟﻧﻘطﺔ‬ ‫ﻋﻧد‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻓﻲ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬P
•‫ﻓﻠﺗر‬ ‫ﺑدون‬ ‫ﺧطﯾﺔ‬ ‫ﻟﻣﺻﺎدر‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻓﻲ‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬Air kerma in air for
unfiltered line source in air
‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬
Air kerma rate in air
1. For point source
2. For line source
3. For line source
-‫ﻣﺼﺎدر‬‫ﺧﻄﯿﺔ‬Linear sources
•‫ﻓﻠﺗر‬ ‫ﻣﻊ‬ ‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫أﺟل‬ ‫ﻣن‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬filtered
line source‫اء‬‫و‬‫اﻟﻬ‬ ‫وﻓﻲ‬:
•‫ﻓﻠﺗر‬ ‫ﻣﻊ‬ ‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫أﺟل‬ ‫ﻣن‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬filtered
line source‫اء‬‫و‬‫اﻟﻬ‬ ‫وﻓﻲ‬:
t thickness of source capsule wall
m attenuation coefficient for photons traversing the capsule

Aspeects
21/02/1436
Osama Anjak.14
‫ﺗﻛﺎﻣل‬‫ﺳﯾﻔرﯾت‬Sievert integral:
•‫ﺗﻛﺎﻣل‬ ‫ﯾﺳﺗﻌﻣل‬‫ﯾت‬‫ر‬‫ﺳﯾﻔ‬‫أﺟل‬ ‫ﻣن‬ ‫ﻓﻲ‬ ‫اﺳﻊ‬‫و‬ ‫ﺑﺷﻛل‬
‫ﻣﻊ‬ ‫اﻟﺧطﯾﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬‫ﻓﻠﺗﯾر‬
•‫روﻟف‬ ‫اﻟﺳوﯾدي‬ ‫اﻟطﺑﻲ‬ ‫ﯾﺎﺋﻲ‬‫ز‬‫اﻟﻔﯾ‬ ‫اﺳم‬ ‫اﻟﺗﻛﺎﻣل‬ ‫ﻫذا‬ ‫ﻋﻠﻰ‬ ‫أطﻠق‬‫ﯾت‬‫ر‬‫ﺳﯾﻔ‬
Rolf Sievert‫ﻋﺎم‬ ‫ﻓﻲ‬1921‫اﻟﺗﻛﺎﻣل‬ ‫ﻫذا‬ ‫أوﺟد‬ ‫اﻟذي‬ ‫ﻫو‬ ‫ﻛوﻧﻪ‬.
•‫ﺗﻛﺎﻣل‬ ‫ﯾﺣﺳب‬‫ﯾت‬‫ر‬‫ﺳﯾﻔ‬‫اﻟﻣﺻدر‬ ‫ﻛﺑﺳوﻟﺔ‬ ‫ﻓﻲ‬ ‫ﯾﺣدث‬ ‫اﻟذي‬ ‫اﻟﻔوﺗوﻧﻲ‬ ‫اﻟﺗوﻫﯾن‬
‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدم‬ ‫اﻟﻣﺷﻊ‬.
•‫اوﯾﺔ‬‫ز‬ ‫أﺟل‬ ‫ﻣن‬‫ﻣن‬ ‫أﺻﻐر‬0.35‫ادﯾﺎن‬‫ر‬radian) < 20o(‫ﯾﻣﻛن‬
‫اﻟﻣﻌﺎدﻟﺔ‬ ‫اﺳﺗﺧدام‬:
•‫ﻓﻠﺗر‬ ‫ﻣﻊ‬ ‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫ﺣول‬ ‫اﻟﻣﻣﺗﺻﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬:
‫ﺣﯾث‬:
M(d,):‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫طول‬ ‫ﻋﻠﻰ‬ ‫ﯾﺣدث‬ ‫اﻟذي‬ ‫واﻟﺗﺑﻌﺛر‬ ‫اﻻﻣﺗﺻﺎص‬ ‫ﺗﺻﺣﯾﺢ‬ ‫ﻣﻌﺎﻣل‬.
d:‫واﻟﻧﻘطﺔ‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻣﻘطﻊ‬ ‫ﺑﯾن‬ ‫اﻟﻣﺳﺎﻓﺔ‬P‫اﻟﺟرﻋﺔ‬ ‫ﺣﺳﺎب‬ ‫ﯾﺟري‬ ‫اﻟﺗﻲ‬
‫ﻋﻧدھﺎ‬.
:‫اﻷﺷﻌﺔ‬ ‫ﺟزء‬radiation fraction
‫ﺗﻘﻧﯾﺎت‬‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬
DOSE CALCULATION PROCEDURES
‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬DOSE CALCULATION PROCEDURES
ً‫ﺎ‬‫ﯾﺪوﯾ‬ ‫اﻟﺠﺮﻋﺔ‬ ‫ﺣﺴﺎب‬Manual dose calculations
ً‫ﺎ‬‫ﯾدوﯾ‬ ‫ﻋﺎت‬‫اﻟﺟر‬ ‫ﺟﻣﻊ‬Manual summation of doses
•‫وذﻟك‬ ‫ﻧﻘطﻲ‬ ‫ﻣﺻر‬ ‫ﻫو‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫ﻛل‬ ‫اﻋﺗﺑﺎر‬ ‫ﯾﻣﻛن‬ ‫أوﻟﻲ‬ ‫ﯾب‬‫ر‬‫ﺑﺗﻘ‬
‫ﻋﻧدﻫﺎ‬ ‫اﻟﺣﺳﺎب‬ ‫ي‬‫ﯾﺟر‬ ‫اﻟﺗﻲ‬ ‫اﻟﻧﻘطﺔ‬ ‫ﺑﯾن‬ ‫اﻟﻣﺳﺎﻓﺔ‬ ‫ﻛﺎﻧت‬ ‫إذا‬(point
of interest)‫ﺿﻌف‬ ‫ﻣن‬ ‫اﻷﻗل‬ ‫ﻋﻠﻰ‬ ‫أﻛﺑر‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫وﻣرﻛز‬
‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻣن‬ ‫اﻟﻔﻌﺎل‬ ‫ء‬‫اﻟﺟز‬ ‫طول‬active length.
–‫ﻛل‬ ‫ﻋن‬ ‫اﻟﻧﺎﺗﺟﺔ‬ ‫ﻋﺎت‬‫اﻟﺟر‬ ‫ع‬‫ﻣﺟﻣو‬ ‫ﺗﺳﺎوي‬ ‫ﻧﻘطﺔ‬ ‫أﯾﺔ‬ ‫ﻋﻧد‬ ‫اﻟﻛﻠﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬
‫ﺑﻣﻔردﻩ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬.
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﺑذور‬ ‫ﻛﺎﻓﺔ‬ ‫أﺟل‬ ‫ﻣن‬seed sources)‫اﻟﻔﻌﺎل‬ ‫ء‬‫اﻟﺟز‬ ‫طول‬
active length ~3 mm(‫ﺿﻣن‬ ‫ﺗﻘرﯾﺑﺎ‬ ‫ﯾﻛون‬5 %‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻧد‬
‫ﻣن‬ ‫أﻛﺑر‬5 mm.
–‫اﻟﺧطﯾﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫أﺟل‬ ‫ﻣن‬)‫اﻟﻔﻌﺎل‬ ‫ء‬‫اﻟﺟز‬ ‫طول‬~2 cm(‫ﯾﻣﻛن‬
‫اﻟﻐرس‬ ‫أﺟل‬ ‫ﻣن‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻟﺣﺳﺎب‬ ً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫اﻟﻣﻌدة‬ ‫اﻟﺟداول‬ ‫اﺳﺗﺧدام‬
‫ﻣن‬ ‫ﺑﻣﺳﺎﻓﺔ‬0.5‫إﻟﻰ‬5 cm.
ًً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫اﻟﻣﻌدة‬ ‫اﻟﺟداول‬ ‫اﺳﺗﺧدام‬Pre-
calculated)‫اطﻠس‬atlases‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬.(
•‫اﻟﺗﻲ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺣﺎﻻت‬ ‫ﺑﻌض‬ ‫أﺟل‬ ‫ﻣن‬
‫ﻧظﺎﻣﯾﺔ‬ ‫ﺑطرق‬ ‫ﺗﺗم‬standard pattern
‫ﻓﯾﻬﺎ‬ ‫ﯾﺳﺗﺧدم‬ ‫اﻟﺗﻲ‬ ‫ﻛﺗﻠك‬linear array,
tandem and ovoids, vaginal
cylinder‫ﺟداول‬ ‫اﺳﺗﺧدام‬ ‫ﯾﻣﻛﻧﻧﺎ‬
‫ﺑﻌﯾن‬ ‫اﻷﺧذ‬ ‫ﻣﻊ‬ ً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫اﻟﻣﻌدة‬ ‫اﻟﺣﺳﺎب‬
‫اﻟﻣﺳﺗﺧدم‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺷدة‬ ‫اﻻﻋﺗﺑﺎر‬
‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬.
ًً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫اﻟﻣﻌدة‬ ‫اﻟﺟداول‬ ‫اﺳﺗﺧدام‬Pre-calculated.

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Osama Anjak.15
ًً‫ﺎ‬‫ﻣﺳﺑﻘ‬ ‫اﻟﻣﻌدة‬ ‫اﻟﺟداول‬ ‫اﺳﺗﺧدام‬Pre-calculated.
‫اﻟﺤﺎﺳﻮﺑﯿﺔ‬ ‫اﻟﺒﺮاﻣﺞ‬ ‫اﺳﺘﺨﺪام‬Computerized treatment planning
ً‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺗوﺿﻊ‬Source Localization:
•‫ﻣن‬ ‫ﻋدد‬ ‫ﺑﺎﺳﺗﺧدام‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫اﺿﻊ‬‫و‬‫ﻣ‬ ‫ﺗﻌﯾن‬ ‫ي‬‫ﯾﺟر‬
‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﺗﺻوﯾر‬ ‫ﺗﻘﻧﯾﺎت‬:
–‫ﻣﺗﻌﺎﻣدﺗﺎن‬ ‫ﺻورﺗﺎن‬ ‫ﺗﻘﻧﯾﺔ‬Two orthogonal films.
–‫اﺣﺔ‬‫ز‬‫إ‬ ‫ﻣﻊ‬ ‫ﺻورﺗﺎن‬ ‫ﺗﻘﻧﯾﺔ‬Two stereo-shift films
–‫اﺣد‬‫و‬ ‫ﻣرﻛز‬ ‫ذات‬ ‫ﺛﻼﺛﺔ‬ ‫أو‬ ‫ﺻورﺗﺎن‬)‫ﺑﺎﻟﻣﺣﺎﻛﻲ‬(Two or
three isocentric films.
–‫ي‬‫اﻟﻣﺣور‬ ‫اﻟطﺑﻘﻲ‬ ‫اﻟﺗﺻوﯾر‬ ‫ﺗﻘﻧﯾﺔ‬Computerized
tomography (CT) scanning.
‫ﻣﺗﻌﺎﻣدﺗﺎن‬ ‫ﺻورﺗﺎن‬ ‫ﺗﻘﻧﯾﺔ‬
Two orthogonal films
‫ﻣﺗﻌﺎﻣدﺗﺎن‬ ‫ﺻورﺗﺎن‬ ‫ﺗﻘﻧﯾﺔ‬
Two orthogonal films
Integrated Brachytherapy Unit (IBU)
‫إزاﺣﺔ‬ ‫ﻣﻊ‬ ‫ﺻورﺗﺎن‬ ‫ﺗﻘﻧﯾﺔ‬
Two stereo-shift films

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21/02/1436
Osama Anjak.16
ً‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺗوﺿﻊ‬Source Localization:
•‫وﺧﺎﺻﺔ‬ ُ‫ﺎ‬‫ﯾدوﯾ‬ ‫اﻟﺣﺳﺎﺑﺎت‬ ‫اء‬‫ر‬‫إﺟ‬ ‫اﻟﺻﻌب‬ ‫ﻣن‬ ‫ﯾﻛون‬ ‫ﻣﺎ‬ ‫ﻏﺎﻟﺑﺎ‬
‫ﻛﺑﯾر‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻋدد‬ ‫ﯾﻛون‬ ‫ﻋﻧدﻣﺎ‬)‫اﻟﺑذور‬ ‫ﻏرس‬‫أو‬
‫اﻟﺧطﯾﺔ‬ ‫اﻟﻣﺻﺎدر‬.(
•‫ﯾﻣﻛن‬ ‫اﻟﺗﻲ‬ ‫اﻟﺣﺎﺳوﺑﯾﺔ‬ ‫اﻣﺞ‬‫ر‬‫اﻟﺑ‬ ‫ﻣن‬ ‫اﻟﻌدﯾد‬ ‫ﺣﺎﻟﯾﺎ‬ ‫ﯾﺗوﻓر‬
‫ﺧﻼل‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫اﺳﺔ‬‫ر‬‫د‬ ‫اء‬‫ر‬‫إﺟ‬ ‫ﻏﻲ‬ ‫ﺗﺳﺎﻋد‬ ‫اﻟﺗﻲ‬‫و‬ ‫اﺳﺗﺧداﻣﻬﺎ‬
‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗطﺑﯾق‬.
‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬Dose distribution display:
•‫اﻟﺑﻌد‬ ‫ﺛﻧﺎﺋﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺗوﺿﺢ‬ ‫اﻟﺣﺎﺳوﺑﯾﺔ‬ ‫اﻣﺞ‬‫ر‬‫اﻟﺑ‬ ‫ﺗﻠك‬ ‫ﻣﻌظم‬
2-D distribution of dose‫ﯾﺣوي‬ ‫اﻟذي‬ ‫ي‬‫اﻟﻣﺳﺗو‬ ‫ﻓﻲ‬
‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬
•‫اﻟﺛﻼﺛﺔ‬ ‫ﺑﺎﻷﺑﻌﺎد‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺣﺳﺎب‬ ‫ي‬‫ﯾﺟر‬matrix of
points in 3-D
‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬Dose distribution display:
•‫ﻋﺎدة‬ ‫اﻟﺣﺎﺳوﺑﯾﺔ‬ ‫اﻣﺞ‬‫ر‬‫اﻟﺑ‬ ‫ﻫﺎ‬‫ﺗظﻬر‬ ‫اﻟﺗﻲ‬ ‫اﻟﻧﺎﺗﺞ‬ ‫ﺗﺑﯾن‬:
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬ ‫ﻣﻧﺣﻧﯾﺎت‬Isodose rate curves
–‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫اﻟﻣﻧطﻘﺔ‬)‫اﻟﻐرس‬ ‫ﻣوﺿﻊ‬(Target of interest.
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣوﺿﻊ‬Location of the sources.
•‫اﻷﺑﻌﺎد‬ ‫ﺛﻼﺛﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫اﺳﺔ‬‫ر‬‫د‬3-D‫ﻣن‬ ‫أﻓﺿل‬ ‫ﻧﺗﺎﺋﺞ‬ ‫ﯾﻌطﻲ‬
‫ﻣﻧطﻘﺔ‬ ‫ﻓﻲ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ع‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫وﻣﻌرﻓﺔ‬ ‫ع‬‫اﻟزر‬ ‫ﻧﺗﺎﺋﺞ‬ ‫ﺗﺣﻠﯾل‬ ‫أﺟل‬
‫اﻟﻬدف‬target volume‫ﺑﻪ‬ ‫اﻟﻣﺣﯾطﺔ‬ ‫اﻟﺳﻠﯾﻣﺔ‬ ‫اﻟﻧﺳﺞ‬‫و‬.
•‫ظﻬﺎر‬ٕ‫ا‬‫و‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻣﻌرﻓﺔ‬ ‫أﺟل‬ ‫ﻣن‬ ‫اﻟﺣﺳﺎﺑﺎت‬ ‫ﻧﺗﺎﺋﺞ‬ ‫ﺗﺳﺗﺧدم‬
‫ع‬‫ﺗوز‬ ‫ﻣﻧﺣﻧﯾﺎت‬ ‫إظﻬﺎر‬ ‫إﻟﻰ‬ ‫ﺑﺎﻹﺿﺎﻓﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻣﻧﺣﻧﯾﺎت‬
‫ﻋﺔ‬‫اﻟﺟر‬dose-volume histograms (DVH).

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Osama Anjak.17
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬Dose distribution display:‫ورم‬ ‫ﻣﻌﺎﻟﺟﺔ‬ ‫ﺣﺎﻟﺔ‬
‫رﺣم‬
‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬Dose distribution display:‫ورم‬ ‫ﻣﻌﺎﻟﺟﺔ‬ ‫ﺣﺎﻟﺔ‬
‫ﺑروﺳﺗﺎت‬
‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗوزع‬Dose distribution display:‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻣﻧﺣﻧﯾﺎت‬
‫اﻹﺷﻌﺎﻋﯾﺔ‬DVH‫اﻟﻤﺠﺎورة‬ ‫واﻟﻤﻨﺎطﻖ‬ ‫اﻟﺒﺮوﺳﺘﺎت‬ ‫أﺟﻞ‬ ‫ﻣﻦ‬
)‫اﻟﻤﺴﺘﻘﯿﻢ‬rectum‫اﻟﻤﺜﺎﻧﺔ‬ ،bladder‫اﻹﺣﻠﯿﻞ‬ ،urethra.(
‫اﻟﺑروﺳﺗﺎت‬ ‫ﻣﻌﺎﻟﺟﺔ‬:‫اﻷﺑﻌﺎد‬ ‫ﺛﻼﺛﻲ‬ ‫ﻣﻧظر‬3D‫ﻣﻧطﻘﺔ‬ ‫ﻓﻲ‬ ‫ﻟﻸﻋﺿﺎء‬
‫اﻟﺑذور‬ ‫ﻣوﺿﻊ‬ ‫ﻣﻊ‬ ‫اﻟﻐرس‬.

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Osama Anjak.18
‫اﻟﻣﺳﺗﻘﯾم‬ ‫ﺳرطﺎن‬ ‫ﻣﻌﺎﻟﺟﺔ‬Brachytherapy in treatment of rectal
carcinoma:
•‫ﺧﺎﺻﺔ‬ ‫ﻣطﺑﻘﺎت‬ ‫ﺑﺎﺳﺗﺧدام‬ ‫اﻟﻣﺳﺗﻘﯾم‬ ‫ام‬‫ر‬‫ﻷو‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗطﺑﯾق‬ ‫ﯾﺗم‬
standard tandem applicator‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻣﺻدر‬ ‫ﺑداﺧﻠﻬﺎ‬ ‫ﯾوﺿﻊ‬
‫ﻟﻺدﺧﺎل‬ ‫ﻣﻧﺎﺳب‬ ‫ﻗطر‬ ‫ﻧﺻف‬ ‫ذات‬ ‫ﻟﻠﻧﺳﺞ‬ ‫ﻣﻛﺎﻓﺋﺔ‬ ‫اد‬‫و‬‫ﻣ‬ ‫ﻣن‬ ‫اﻧﺔ‬‫و‬‫اﺳط‬ ‫ﺿﻣن‬
‫اﻟﻣﺳﺗﻘﯾم‬ ‫ﺿﻣن‬.
•‫اﻧﺔ‬‫و‬‫اﻻﺳط‬ ‫ﻗطر‬ ‫ﺗﺄﺛﯾر‬:
–‫اﻧﺔ‬‫و‬‫ﻟﻼﺳط‬ ‫اﻟﺧﺎرﺟﻲ‬ ‫اﻟﺳطﺢ‬ ‫ﻋﻠﻰ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﺗﻧﺎﻗص‬ ‫اﻧﺔ‬‫و‬‫اﻻﺳط‬ ‫ﻗطر‬ ‫ازداد‬ ‫ﻛﻠﻣﺎ‬.
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫ج‬‫ﺗدر‬ ‫ﯾﺗﻧﺎﻗص‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻋن‬ ‫اﻟﺑﻌد‬ ‫زﯾﺎدة‬ ‫ﻣﻊ‬dose gradient
decreases‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫ﻟﻠﺟر‬ ‫ﻣوﺣد‬ ‫ﻏﯾر‬ ‫ﺗوزع‬ ً‫ﺎ‬‫ﻣﺣدﺛ‬uniform dose
distribution‫اﻟﺳﻣﺎﻛﺔ‬ ‫ذات‬ ‫ﻟﻬﺎ‬ ‫اﻟﺗﻲ‬ ‫ام‬‫ر‬‫ﺑﺎﻷو‬.
‫اﻟﻣﺳﺗﻘﯾم‬ ‫ﺳرطﺎن‬ ‫ﻣﻌﺎﻟﺟﺔ‬Brachytherapy in treatment of rectal
carcinoma:
•‫ﺑﻌد‬ ‫ﻟﻠﺣوض‬ ‫ﺟﺎﻧﺑﯾﺔ‬ ‫إﺷﻌﺎﻋﯾﺔ‬ ‫ة‬‫ر‬‫ﺻو‬ ‫اء‬‫ر‬‫إﺟ‬ ‫ﯾﺗم‬
‫اﻟﻣطﺑق‬ ‫وﺿﻊ‬)‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻧﺳق‬ ‫ﺑداﺧﻠﻪ‬
‫اﻟوﻫﻣﯾﺔ‬dummy seeds(‫ﺣﻘﻧﺔ‬ ‫ﻣﻊ‬‫ﯾوم‬‫ر‬‫ﺑﺎ‬
‫ﻟﻠﻣﻌﺎﻟﺟﺔ‬ ‫اﻟﻣﺧﺻص‬ ‫اﻟﻣﻛﺎن‬ ‫ﻓﻲ‬.
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻣﻧﺣﻧﯾﺎت‬Isodose
distribution‫ﯾﺣوي‬ ‫ﺧطﻲ‬ ‫ﻣﺷﻊ‬ ‫ﻟﻣﺻدر‬
‫ﻋﻠﻰ‬16‫اﻟﻜﻮﺑﺎﻟﺖ‬ ‫ﻣﻦ‬ ‫ﺑﺬرة‬-60)0.5 Ci.(
‫اﻟﻤﻨﺤﻨﯿﺎت‬ ‫ﻋﻠﻰ‬ ‫اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫اﻟﻘﯿﺎس‬ ‫وﺣﺪة‬
cGy.
‫اﻟﻣﺳﺗﻘﯾم‬ ‫ﺳرطﺎن‬ ‫ﻣﻌﺎﻟﺟﺔ‬:
•‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻘدار‬5 fractions of 8 10 Gy each.
•‫اﻟﻌﻣق‬:‫ﻣن‬1‫إﻟﻰ‬3 cm‫اﻟﻣﺻﺎدر‬ ‫ﻟﺣﺎﻣل‬ ‫ي‬‫اﻟﻣرﻛز‬ ‫اﻟﻣﺣور‬ ‫ﻣن‬
‫اﻟﻣﺷﻌﺔ‬source train.
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺟﻠﺳﺔ‬ ‫ﻣدة‬:30 minutes.
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺑدء‬ ‫ﻗﺑل‬ ‫ﻟﺗﺣﺿﯾر‬ ‫ﻣدة‬)‫اﻹﻋداد‬ ‫ﻣرﺣﻠﺔ‬patient Set-up:(
about 30 minutes
•‫ﯾﻌطﻰ‬ ‫ﯾض‬‫ر‬‫اﻟﻣ‬ ‫أن‬ ‫ﺣﯾث‬ ‫ﻗرب‬ ‫ﻋن‬ ‫اﻟﻧﺳﺎﺋﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗﺷﺑﻪ‬ ‫ﻻ‬
epidural unaesthetic‫اﻟﻧﻣط‬ ‫ﻫذا‬ ‫ﯾﺗﻠﻘﻰ‬ ‫اﻟذي‬ ‫ﯾض‬‫ر‬‫اﻟﻣ‬ ‫أن‬ ‫ﻛﻣﺎ‬ ،
‫وﻣﺗﺣرك‬ ‫اﺳﺗﯾﻘﺎظ‬ ‫ﺑﺣﺎﻟﺔ‬ ‫ﯾﻛون‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣن‬.
‫اﻠﻣﺳﺘﻗﻴﻢ‬‫ﺴﺮﻃﺎن‬‫ﻤﻌﺎﻠﺟﺔ‬Brachytherapy in treatment of
rectal carcinoma:
Inflatable multichannel
endorectal brachytherapy
applicator,(Nucletron)
09 Nov., 2014OsamaAnjak107
‫ام‬‫ر‬‫أو‬ ‫ﻣﻌﺎﻟﺟﺔ‬‫ي‬‫اﻟﻣر‬esophageal cancer:
•‫ﺑﻼﺳﺗﯾﻛﯾﺔ‬ ‫اد‬‫و‬‫ﻣ‬ ‫ﻣن‬ ‫ع‬‫ﻣﺻﻧو‬ ‫ﺧﺎص‬ ‫ﻣطﺑق‬ ‫ﺑﺎﺳﺗﺧدام‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺗطﺑق‬
‫ﺻﻠﺑﺔ‬ ‫وﺷﺑﻪ‬ ‫ﺷﻔﺎﻓﺔ‬)‫ﻗﺎﺳﯾﺔ‬(‫اﻟﻲ‬‫و‬‫ﺣ‬ ‫طول‬ ‫ذات‬60 cm.‫إدﺧﺎل‬ ‫ي‬‫ﯾﺟر‬
‫ﺑﺎﻟﻣﻧظﺎر‬ ‫ﺑﺎﻻﺳﺗﻌﺎﻧﺔ‬ ‫اﻟﻣطﺑق‬gastroscope‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻣوﺿﻊ‬ ‫وﯾﺣدد‬
‫اﻟوﻫﻣﯾﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻧﺳق‬ ‫ﺑﺎﺳﺗﺧدام‬“dummy seeds”‫وﯾﺗم‬
‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﺗﺻوﯾر‬ ‫ﺑﺎﺳﺗﺧدام‬ ‫ﻣوﺿﻌﻬﺎ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬.
•‫اﻟﻌﻼﺟﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬dose prescription:6 – 10 Gy.
•‫ﻟﻠﻣﺻﺎدر‬ ‫ي‬‫اﻟﻣرﻛز‬ ‫اﻟﻣﺣور‬ ‫ﻣن‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻋﻣق‬:0.8 – 1 cm.
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺟﻠﺳﺔ‬ ‫ﻣدة‬:‫اﻟﻲ‬‫و‬‫ﺣ‬2 minutes.

Aspeects
21/02/1436
Osama Anjak.19
‫ام‬‫ر‬‫أو‬ ‫ﻣﻌﺎﻟﺟﺔ‬‫ي‬‫اﻟﻣر‬esophageal cancer:
•‫اﻟﺻدر‬ ‫ة‬‫ر‬‫ﺻو‬ ‫ﺗﺑﯾن‬AP chest
radiograph‫ﻣﺣﻣل‬ ‫اﻟﻣطﺑق‬ ‫ﻣوﺿﻊ‬
‫ﻋﻠﻰ‬ ‫اﻟﺳﻬم‬ ‫وﯾدل‬ ‫اﻟوﻫﻣﯾﺔ‬ ‫ﺑﺎﻟﻣﺻﺎدر‬
‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫اﻟﻣﺣﺗﻣل‬ ‫اﻟﻣوﺿﻊ‬.
•‫ـ‬‫ﻟ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻣﻧﺣﻧﯾﺎت‬16‫ﻣﺻدر‬
‫اﻟﻛوﺑﺎﻟت‬ ‫ﺑذور‬ ‫ﻣن‬ ‫ﻣﺷﻊ‬-60)0.5 Ci
each(‫ـ‬‫ﻟ‬‫ﺑﺎ‬ ‫ة‬‫ر‬‫ﻣﻘد‬cGy
•‫ﺑﺘﻘﻨﯿﺔ‬ ‫اﻟﺒﺮوﺳﺘﺎت‬ ‫ﺗﻌﺎﻟﺞ‬HDR brachytherapy‫إﺿﺎﻓﯿﺔ‬ ‫ﺟﺮﻋﺔ‬ ‫ﻣﻊ‬
‫ﺧﺎرﺟﯿﺔ‬ ‫إﺷﻌﺎﻋﯿﺔ‬ ‫ﺑﺤﺰم‬.
‫اﻟﺒﯿﻀﺎء‬ ‫اﻟﻨﻘﻂ‬ ‫ﺗﻤﺜﻞ‬17‫أﻧﺎﺑﯿﺐ‬
‫اﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻤﺴﺘﺨﺪﻣﺔ‬ ‫اﻟﻘﺴﻄﺮة‬.‫ﻓﻲ‬
‫ﻣﺼﻔﻮﻓﺔ‬ ‫اﻟﺰرﻗﺎء‬ ‫اﻟﻨﻘﻂ‬ ‫ﺗﺒﯿﻦ‬ ‫ﺣﯿﻦ‬
‫اﻹﺷﻌﺎﻋﯿﺔ‬ ‫اﻟﺠﺮع‬ ‫ﺣﺴﺎب‬ ‫ﻣﻮﺿﻊ‬
‫اﻟﺠﺮﻋﺔ‬ ‫ﻣﻨﺤﻨﯿﺎت‬Isodose contours
80%, 90%, 100%, 120%, 125 %
‫ﻣﻨﮭﺎ‬ ‫ﻟﻜﻞ‬ ‫اﻟﻠﻮن‬ ‫ﺑﺤﺴﺐ‬.
‫اﻟﮭﺪف‬ ‫ﻣﻨﻄﻘﺔ‬Target)‫ﻏﺪة‬
‫اﻟﺒﺮوﺳﺘﺎت‬(‫اﻟﺠﺮﻋﺔ‬ ‫اﻷﺣﻤﺮ‬ ‫اﻟﻤﻨﺤﻨﻲ‬
10 Gy‫اﻟﺨﻂ‬ ‫ﻋﻠﻰ‬100 %.
•‫ﺑﺘﻘﻨﯿﺔ‬ ‫اﻟﺒﺮوﺳﺘﺎت‬ ‫ﺗﻌﺎﻟﺞ‬HDR brachytherapy‫إﺿﺎﻓﯿﺔ‬ ‫ﺟﺮﻋﺔ‬ ‫ﻣﻊ‬
‫ﺧﺎرﺟﯿﺔ‬ ‫إﺷﻌﺎﻋﯿﺔ‬ ‫ﺑﺤﺰم‬.
‫اﻟﻘﺴﺎطﺮ‬Catheters‫اﻷﺧﻀﺮ‬ ‫ﺑﺎﻟﻠﻮن‬
‫اﻟﻤﺸﻌﺔ‬ ‫اﻟﻤﺼﺎدر‬ ‫ﺗﺤﻮي‬.
‫اﻟﮭﺪف‬ ‫ﻣﻨﻄﻘﺔ‬ ‫اﻷﺣﻤﺮ‬ ‫اﻟﻠﻮن‬.‫اﻹﺣﻠﯿﻞ‬
‫اﻷزرق‬ ‫ﺑﺎﻟﻮن‬.‫اﻟﺰھﺮ‬ ‫ﺑﺎﻟﻮن‬ ‫واﻟﻤﺴﺘﻘﯿﻢ‬.
‫اﻟﺤﺎﻗﻦ‬ ‫ﺟﮭﺎز‬ ‫ﺑﺎﺳﺘﺨﺪام‬ ‫اﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺗﻤﺖ‬
‫اﻵﻟﻲ‬HDR‫ﻟﻤﺼﺪر‬Ir-192]10 Ci
(370 GBq)[
‫اﻟﺠﺮﻋﺔ‬10 Gy to the 100 % isodose
‫اﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻣﺪة‬10 minutes
‫ﻣﻌﺎﻟﺠﺔ‬‫ﺧﺎرﺟﯿﺔ‬ ‫إﺷﻌﺎﻋﯿﺔ‬ ‫ﺣﺰم‬ ‫اﻟﺒﺮوﺳﺘﺎت‬
Shaping the beam with MLC - prostate
AP View Lateral View
‫ﻣﻌﺎﻟﺠﺔ‬‫ﺧﺎرﺟﯿﺔ‬ ‫إﺷﻌﺎﻋﯿﺔ‬ ‫ﺣﺰم‬ ‫اﻟﺒﺮوﺳﺘﺎت‬
•‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺗﻘﻧﯾن‬Optimization of dose
distribution:
•‫ﺑﺘﻄﺒﯿﻖ‬ ‫اﻹﺷﻌﺎﻋﯿﺔ‬ ‫اﻟﺠﺮﻋﺔ‬ ‫ﺗﻮزع‬ ‫أﻣﺜﻠﺔ‬ ‫ﯾﺘﻢ‬:
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﺗوزﯾﻊ‬ ‫اﻋد‬‫و‬‫ﻗ‬Source distribution rules.
–‫اﻟﻬﻧدﺳﯾﺔ‬ ‫ات‬‫ر‬‫اﻻﻋﺗﺑﺎ‬Geometry.
–‫اﻟﺟرع‬ ‫ﻧﻘط‬ ‫ﺗﻌﯾن‬Specified dose points.
–‫اﻟﺗﻌدﯾل‬‫و‬ ‫اﻟﺗﺟرﺑﺔ‬Trial and adjustment

Aspeects
21/02/1436
Osama Anjak.20
‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺟﻠﺳﺔ‬ ‫ﻣدة‬ ‫ﺣﺳﺎب‬Calculation of treatment time
•‫ﻓﻲ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺟﻠﺳﺔ‬ ‫ﻣدة‬ ‫ﺣﺳﺎب‬ ‫ي‬‫ﯾﺟر‬
‫اﻟﻣﺳﺗوي‬ ‫اﻟﻐرس‬ ‫ﺣﺎل‬planar
‫اﻟﺣﺟﻣﻲ‬‫و‬volume‫ﺟداول‬ ‫ﻋﻠﻰ‬ ً‫ا‬‫اﻋﺗﻣﺎد‬
Patterson-Parker)‫ﻧظﺎم‬‫ﻣﺎﻧﺷﯾﺳﺗر‬
Manchester system(‫أﺟل‬ ‫ﻣن‬ ‫وذﻟك‬
‫ﻋﺎﻟﯾﺔ‬ ‫ﺑدﻗﺔ‬ ‫اﻟﻣطﻠوﺑﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫إﻟﻰ‬ ‫اﻟوﺻول‬
‫اﻟﻐرس‬ ‫ﻓﯾﻬﺎ‬ ‫ى‬‫ﺟر‬ ‫اﻟﺗﻲ‬ ‫اﻟﻣﻧطﻘﺔ‬ ‫ﻓﻲ‬.
•‫ﺑﺎﻻﻋﺗﻣﺎد‬ ‫اﻟﺣﺟم‬ ‫أو‬ ‫اﻟﻣﻧطﻘﺔ‬ ‫ﺗﻌﯾن‬ ‫ي‬‫ﯾﺟر‬
‫اﻟﻣﺗﻌﺎﻣدة‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﺻور‬ ‫ﻋﻠﻰ‬.
09 Nov., 2014
Osama Anjak115
‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﺟﻠﺳﺔ‬ ‫ﻣدة‬ ‫ﺣﺳﺎب‬Calculationof treatment time
‫اﻟﻣرﺟﻌﯾﺔ‬ ‫اﻟﻧﻘط‬ ‫اﺧﺗﯾﺎر‬Choice of reference points
•‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫ي‬‫ﯾﺟر‬ ‫اﻟﺗﻲ‬ ‫ﺟﻌﯾﺔ‬‫اﻟﻣر‬ ‫اﻟﻧﻘط‬ ‫اﺧﺗﯾﺎر‬ ‫ﯾﺟب‬
‫ﻟﺗوﺻﯾﺎت‬ ‫وﻓﻘﺎ‬ ‫ﻋﻧدﻫﺎ‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ICRU‫اﻟﺗﻘرﯾر‬ ‫ﻓﻲ‬ICRU
Reports 38‫و‬ICRU Reports 58.
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫اﻟﻬدف‬ ‫ﻣﻧطﻘﺔ‬ ‫ﺟﻌﯾﺔ‬‫اﻟﻣر‬ ‫اﻟﻧﻘط‬ ‫ﺗﻣﺛل‬ ‫اﻟﻌﻣوم‬ ‫ﻋﻠﻰ‬
‫اﻟﺻﻠﺔ‬ ‫ذﻟت‬ ‫ى‬‫اﻷﺧر‬ ‫اﻟﻣﻧﺎطق‬‫و‬.
•‫ﻋﻧﻬﺎ‬ ‫اﻟﻌﻼﺟﯾﺔ‬ ‫اﻟﺟﻌﺔ‬ ‫ﺣﺳﺎب‬ ‫ﯾﺗم‬ ‫اﻟﺗﻲ‬ ‫اﻟﻧﻘط‬ ‫اﺧﺗﯾﺎر‬ ‫ي‬‫ﯾﺟر‬
‫اﻟﻬدف‬ ‫ﻟﻣﻧطﻘﺔ‬ ‫ﺟﻲ‬‫اﻟﺧﺎر‬ ‫اﻟﻣﺣﯾط‬ ‫ﻋﻠﻰ‬target volume.
•‫ﻋﻧد‬‫اﻟﻛﻠﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬‫ﺧﻼل‬ ‫اﻟﻬدف‬ ‫ﻟﻬﺎ‬ ‫ﺗﻌرض‬ ‫اﻟﺗﻲ‬
‫اﻟﺗﻔﻛك‬ ‫اﻻﻋﺗﺑﺎر‬ ‫ﺑﻌﯾن‬ ‫ﻧﺄﺧذ‬ ‫أن‬ ‫ﯾﺟب‬ ‫اﻟﻐرس‬‫اﻷﺳﻲ‬‫ﻟﺷدة‬
‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬exponential decay
•‫اﻛﻣﯾﺔ‬‫ر‬‫اﻟﺗ‬ ‫ﻋﺔ‬‫اﻟﺟر‬Cumulative dose Dcum‫زﻣﻧﯾﺔ‬ ‫ﻣدة‬ ‫ﺧﻼل‬
t‫ﻫﻲ‬:
‫اﻻﺑﺗداﺋﻲ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬initial dose rate
‫اﻟﺗﻔﻛك‬ ‫ﺛﺎﺑت‬decay constant.
‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻧﻛﻠﯾد‬ ‫اﻟﻌﻣر‬ ‫ﻧﺻف‬half-life of the radioactive source.
‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬ ‫اﻟﻌﻣر‬ ‫ﻧﺻف‬ ‫ﻣن‬ ‫ﺑﻛﺛﯾر‬ ‫أﻗل‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣدة‬ ‫ﻛﺎﻧت‬ ‫إذا‬
•‫ﺑﺎﻟﻣﻌﺎدﻟﺔ‬ ‫اﻛﻣﯾﺔ‬‫ر‬‫اﻟﺗ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﻌطﻰ‬:
•‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣدة‬ ‫ﻛﺎﻧت‬ ‫إذا‬t‫اﻟﻌﻣر‬ ‫ﻧﺻف‬ ‫ﻣن‬ ‫ﺑﻛﺛﯾر‬ ‫أﻗل‬
‫أي‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬t << T1/2
‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫اﻟﻐرس‬ ‫ﺣﺎﻟﺔ‬ ‫ﻓﻲ‬:
•‫ﺑﺎﻟﻣﻌﺎدﻟﺔ‬ ‫اﻛﻣﯾﺔ‬‫ر‬‫اﻟﺗ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺗﻌطﻰ‬ ً‫ﺎ‬‫ﻋﻣوﻣ‬:
•‫اﻟزﻣن‬ ‫ﯾﻛون‬ ‫اﻟداﺋم‬ ‫اﻟﻐرس‬ ‫ﺣﺎل‬ ‫ﻓﻲ‬t = ‫اﻟﻣﻌﺎدﻟﺔ‬ ‫ﺗﺳﺗﺧدم‬
‫اﻟﻐرس‬ ‫ﻣدة‬ ‫ﻛﺎﻣل‬ ‫ﺧﻼل‬ ‫اﻛﻣﯾﺔ‬‫ر‬‫اﻟﺗ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻟﺗﻌﯾن‬ ‫اﻟﺗﺎﻟﯾﺔ‬)‫اﻟﺗﻔﻛك‬
‫اﻟﻣﺷﻊ‬ ‫ﻟﻠﻣﺻدر‬ ‫اﻟﺗﺎم‬complete source decay.(
‫اﻠﺟﺮﻋﺎت‬‫ﺗﻮزع‬‫ﺗﺨﻄﻴﻂ‬ ‫ﻧﻈﻣﺔ‬
ٔ
‫ﻻ‬ ‫اﻠﻗﺒﻮل‬ ‫ات‬‫ر‬‫اﺧﺘﺒﺎ‬
COMMISSIONING OF
BRACHYTHERAPY TPSs

Aspeects
21/02/1436
Osama Anjak.21
‫اﻟﺠﺮﻋﺔ‬ ‫ﺗﻮزع‬ ‫ﺗﺨﻄﯿﻂ‬ ‫أﻧﻈﻤﺔ‬ ‫اﺧﺘﺒﺎرات‬
‫اﻟﺼﻮرة‬ ‫ﺗﺸﻜﯿﻞ‬ ‫إﻋﺎدة‬ ‫اﺧﺘﺒﺎر‬Check of the reconstruction procedure
•‫اﻟرﺋﯾﺳﯾﺔ‬ ‫اﻟﻣﻛوﻧﺎت‬hardware devices‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﺗﺧطﯾط‬ ‫ﻟﻧظم‬treatment
planning systems (TPSs)‫ﻗرب‬ ‫ﻋن‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬:
–‫اﻟﺣﺎﺳب‬Computer.
–‫اﻟﻣرﻗﻣﺔ‬Digitizer.
–‫اﺳﻣﺔ‬‫ر‬‫اﻟ‬Plotter.
•‫اﻟﻧظﺎم‬ ‫ﻋﻣل‬ ‫دﻗﺔ‬ ‫اﺧﺗﺑﺎر‬ ‫ﯾﺟب‬)‫ﻟﻠﻧظﺎم‬ ‫اﻟﻣﻛوﻧﺔ‬ ‫ات‬‫و‬‫اﻷد‬(ً‫ﺎ‬‫ﯾ‬‫ر‬‫دو‬ ‫اﻟﺗﺧطﯾط‬ ‫اءات‬‫ر‬‫ﺟ‬ ٕ‫ا‬‫و‬
‫ع‬‫ﺗوز‬ ‫ﺿﻣن‬ ‫ﻣوﺿوﻋﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﺑﺳﯾط‬ ‫ﻟﻌدد‬ ‫ﺑﺳﯾطﺔ‬ ‫ات‬‫ر‬‫اﺧﺗﺑﺎ‬ ‫اء‬‫ر‬‫ﺑﺈﺟ‬ ‫وذﻟك‬
‫ﻣﺗﻌﺎﻣدﺗﺎن‬ ‫أﺷﻌﺔ‬ ‫ﺗﻲ‬‫ر‬‫ﺻو‬ ‫ﻋﻠﻰ‬ ‫ﻣوﺿﺢ‬ ‫ﻫو‬ ‫ﻛﻣﺎ‬ ‫ﻣﻌﻠوم‬.
•‫اﻟﺗﺣﻘق‬ ‫ات‬‫ر‬‫اﺧﺗﺑﺎ‬ ‫ﺗﺷﻣل‬ ‫أن‬ ‫ﯾﺟب‬Verification test‫اﻷﺷﻌﺔ‬ ‫ة‬‫ر‬‫ﺻو‬ ‫ﻣن‬ ‫اﻟﻧﻘل‬ ‫ﻋﻣﻠﯾﺔ‬
)‫اﻟﻔﻠم‬(‫ﺗﯾﺔ‬‫ر‬‫اﻟدﯾﻛﺎ‬ ‫اﻹﺣداﺛﯾﺎت‬ ‫إﻟﻰ‬Cartesian coordinates‫وﺗﺻﺣﯾﺢ‬ ‫ان‬‫ر‬‫اﻟدو‬‫و‬ ،
‫اﻷﺑﻌﺎد‬ ‫ﺗﻐﯾر‬magnification
‫اﻟﻘﯾﺎس‬ ‫ووﺣدات‬ ‫اﻟﻔﯾزﯾﺎﺋﯾﺔ‬ ‫اﻟﻣﻘﺎدﯾر‬ ‫اﻓق‬‫و‬‫ﺗ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫اﺧﺗﺑﺎر‬
•‫ﻟﻸﺧطﺎء‬ ‫اﻟرﺋﯾﺳﯾﺔ‬ ‫اﻟﻣﺻﺎدر‬‫ﻗرب‬ ‫ﻋن‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣﺟﺎل‬ ‫ﻓﻲ‬:
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ة‬‫ﻣﻌﺎﯾر‬ ‫ﻓﻲ‬ ‫اﻟﺧطﺄ‬.
–‫ﻋﻧد‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ع‬‫اﻟﺟر‬ ‫ﻗﯾﺎس‬ ‫وﺣدات‬ ‫اﻟﻔﯾزﯾﺎﺋﯾﺔ‬ ‫اﻟﻣﻘﺎدﯾر‬ ‫ﻣﻊ‬ ‫اﻟﺗﻌﺎﻣل‬ ‫ﻓﻲ‬ ‫اﻟﺧطﺄ‬
‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺣﺳﺎب‬ ‫ارزﻣﯾﺔ‬‫و‬‫ﺧ‬ ‫ﺗطﺑﯾق‬calculation algorithms.
•‫ﻓﻲ‬ ‫اﻟﻣﻘﺎدﯾر‬‫و‬ ‫اﻟﻣدﺧﻠﺔ‬ ‫ﯾﺎﺋﯾﺔ‬‫ز‬‫اﻟﻔﯾ‬ ‫اﻟﻣﻘﺎدﯾر‬ ‫ﻗﺎﺋﻣﺔ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ً‫ا‬‫ﺟد‬ ‫اﻟﻣﻔﯾد‬ ‫ﻣن‬
‫اﻟﺣﺳﺎب‬ ‫ﻧﺎﻣﺞ‬‫ر‬‫ﺑ‬ ‫ﻓﻲ‬ ‫اﻟﻣﺳﺗﺧدﻣﺔ‬ ‫اﻟﻘﯾﺎس‬ ‫ووﺣدات‬ ‫اﻟﺣﺳﺎﺑﺎت‬ ‫ﻧﺎﺗﺞ‬.
•‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫اﺻﻔﺎت‬‫و‬‫ﻣ‬ ‫إﻟﻰ‬ ‫ﺟﯾد‬ ‫ﺑﺷﻛل‬ ‫اﻻﻧﺗﺑﺎﻩ‬ ‫ﯾﺟب‬:
–‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺷدة‬)‫اﻟﺗﻌرض‬ ‫ﻣﻌدل‬ ‫أو‬ ‫اء‬‫و‬‫اﻟﻬ‬ ‫ﻛﯾرﻣﺎ‬ ‫ﻣﻌدل‬.(
–‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﻧﺷﺎط‬)MBq or mCi.(
‫اﻟﯾدوي‬ ‫اﻟﺣﺳﺎب‬‫و‬ ‫اﻟﺣﺎﺳب‬ ‫ﺑﯾن‬ ‫ﻣﻘﺎرﻧﺔ‬
•‫اﻟﺗﻲ‬ ‫اﻟﺧطﻲ‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺣول‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ع‬‫ﺗوز‬ ‫ﻧﺔ‬‫ر‬‫ﻣﻘﺎ‬ ‫ﯾﺟب‬
‫ﻣﻊ‬ ‫اﻟﺣﺎﺳوب‬ ‫ﻣن‬ ‫ﻋﻠﯾﻬﺎ‬ ‫ﻧﺣﺻل‬:
–‫ﻣﺷﺎﺑﻪ‬ ‫ﻣﺷﻌﺔ‬ ‫ﻟﻣﺻﺎدر‬ ‫ة‬‫ر‬‫اﻟﻣﻧﺷو‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫ﻗﯾم‬.
–‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻟﻧﻔس‬ ‫ﯾت‬‫ر‬‫ﺳﯾﻔ‬ ‫ﺗﻛﺎﻣل‬ ‫ﻣن‬ ‫ﻋﻠﯾﻬﺎ‬ ‫ﻧﺣﺻل‬ ‫اﻟﺗﻲ‬ ‫ﻗﯾم‬
•‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫أﺟل‬ ‫ﻣن‬ ‫إﺿﺎﻓﯾﺔ‬ ‫ات‬‫ر‬‫ﺑﺎﺧﺗﺑﺎ‬ ‫اﻟﻘﯾﺎم‬ ‫ﯾﺟب‬:
–‫اﻟﻧﻘطﯾﺔ‬ ‫ﻟﻠﻣﺻﺎدر‬ ‫اﻟﻌﻛﺳﻲ‬ ‫ﺑﯾﻊ‬‫ر‬‫اﻟﺗ‬ ‫ﻗﺎﻧون‬.
–‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻣن‬ ‫ﻟﻌدد‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺟﻣﻊ‬ ‫ﺣﺎﺻل‬.
–‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﻣﻌدل‬ ‫اﻓق‬‫و‬‫ﺗ‬dose rate‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺷدة‬ ‫ﻣﻊ‬
source strength
–‫اﻟزﻣن‬‫و‬ ‫ﻋﺔ‬‫اﻟﺟر‬ ‫ﺑﯾن‬ ‫اﻓق‬‫و‬‫ﺗ‬)‫اﻟﻣﻌﺎﻟﺟﺔ‬ ‫ﻣدة‬.(
‫اﻟﺗﻔﻛك‬ ‫ﺗﺻﺣﯾﺢ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫اﺧﺗﺑﺎر‬Check of the decay corrections
•‫ﻣن‬‫اﻟﻣؤﻗت‬ ‫اﻟﻐرس‬ ‫أﺟل‬:‫ﻣﻌدل‬ ‫ﺣﺳﺎب‬ ‫دﻗﺔ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫ﯾﺟب‬
‫وذﻟك‬ ‫اﻟﻐرس‬ ‫ة‬‫ر‬‫ﻓﺗ‬ ‫ﺿﻣن‬ ‫ﻣﺣددة‬ ‫ﻣدة‬ ‫ﺧﻼل‬ ‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬
‫ﻣﻊ‬ ‫اﻟﺣﺎﺳوﺑﻲ‬ ‫ﻧﺎﻣﺞ‬‫ر‬‫اﻟﺑ‬ ‫ﻣن‬ ‫ﻋﻠﯾﻪ‬ ‫ﻧﺣﺻل‬ ‫اﻟذي‬ ‫اﻟﺣﺳﺎب‬ ‫ﻧﺔ‬‫ر‬‫ﺑﻣﻘﺎ‬
‫اﻟﯾدوي‬ ‫اﻟﺣﺳﺎب‬.
•‫أﺟل‬ ‫ﻣن‬‫اﻟداﺋم‬ ‫اﻟﻐرس‬:‫ﺣﺳﺎﺑﺎت‬ ‫دﻗﺔ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫ﯾﺟب‬
‫اﻟﺗﻔﻛك‬ ‫ﻧﻬﺎﯾﺔ‬ ‫ﺣﺗﻰ‬ ‫ﻋﺔ‬‫ﻟﻠﺟر‬ ‫اﻟﺣﺎﺳوﺑﻲ‬ ‫ﻧﺎﻣﺞ‬‫ر‬‫اﻟﺑ‬.
•‫اﻟﺣﺎﻟﺗﯾن‬ ‫ﻛﻼ‬ ‫أﺟل‬ ‫ﻣن‬)‫اﻟﻣؤﻗت‬‫و‬ ‫اﻟداﺋم‬ ‫اﻏرس‬(‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫ﯾﺟب‬
‫ﻋﺔ‬‫اﻟﺟر‬ ‫وﻣﻌدل‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻟﺷدة‬ ‫اﻟﻘﯾﺎس‬ ‫وﺣدات‬ ‫اﺧﺗﯾﺎر‬
‫اﻟﻛﻠﯾﺔ‬ ‫ﻋﺔ‬‫اﻟﺟر‬‫و‬.
8.‫اﻟﻤﺸﻌﺔ‬ ‫اﻟﻤﺼﺎدر‬ ‫اﺧﺘﺒﺎرات‬
‫اﻟﻣﺳﺢ‬ ‫ات‬‫ر‬‫اﺧﺗﺑﺎ‬Wipe tests
‫اﻟﺷﺣن‬ ‫طرود‬Shipment package
•‫ﻓﺣص‬ ‫ﯾﺟب‬‫اﻟﺷﺣن‬ ‫طرود‬‫ﻋﻧد‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻋﻠﻰ‬ ‫اﻟﺣﺎوﯾﺔ‬
‫وﻛذﻟك‬ ‫ﻟﻠﺗﺧرﯾب‬ ‫ﺗﻌرﺿﻬﺎ‬ ‫ﻋدم‬ ‫ﻣن‬ ‫ﻟﻠﺗﺣﻘق‬ ‫ة‬‫ر‬‫ﻣﺑﺎﺷ‬ ‫اﺳﺗﻼﻣﻬﺎ‬
‫ﻟﻠﺗﺳرب‬ ‫ﺑﻬﺎ‬ ‫ح‬‫اﻟﻣﺳو‬ ‫اﻟﺳوﯾﺎت‬ ‫ﺗﺗﺟﺎوز‬ ‫ﻻ‬ ‫أﻧﻬﺎ‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬
‫اﻹﺷﻌﺎﻋﻲ‬.
•‫اﻟﻣﺳﺢ‬ ‫اﺧﺗﺑﺎر‬ ‫اء‬‫ر‬‫إﺟ‬ ‫ﯾﺟب‬‫اﻟطرد‬ ‫ﻟﺳطﺢ‬‫ﻋدم‬ ‫ﻣن‬ ‫ﻟﻠﺗﺣﻘق‬
‫إﺷﻌﺎﻋﻲ‬ ‫ﻧﻠوث‬ ‫أﯾﺔ‬ ‫وﺟود‬.
•‫اﻹﺷﻌﺎﻋﯾﺔ‬ ‫اﻟﺳوﯾﺎت‬ ‫ﻗﯾﺎس‬ ‫ﯾﺟب‬Radiation levels‫ﻋﻠﻰ‬
‫ﻣﺳﺎﻓﺔ‬ ‫ﻋﻠﻰ‬ ‫اﺿﻊ‬‫و‬‫ﻣ‬ ‫ﻋدة‬ ‫وﻋﻧد‬ ‫اﻟﺳطﺢ‬1m‫اﻟطرد‬ ‫ﻣن‬
‫اﻟﻣﺧﺻص‬ ‫اﻟﺳﺟل‬ ‫ﻓﻲ‬ ‫ذﻟك‬ ‫وﺗﺳﺟﯾل‬.
‫اﻟﻤﺸﻌﺔ‬ ‫اﻟﻤﺼﺎدر‬ ‫اﺧﺘﺒﺎرات‬
‫اﻟﻣﺳﺢ‬ ‫ات‬‫ر‬‫اﺧﺗﺑﺎ‬Wipe tests
‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﺗﻐﻠﯾف‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬)‫اﻟﻛﺑﺳوﻟﺔ‬(Individual
encapsulated sources:
•‫أﺟل‬ ‫ﻣن‬ ‫وذﻟك‬ ‫اﻟﻣﺷﻊ‬ ‫اﻟﻣﺻدر‬ ‫ﻛﺑﺳوﻟﺔ‬ ‫ﻋﻼف‬ ‫ﻣن‬ ‫اﻟﺗﺣﻘق‬ ‫ﯾﺟب‬
‫اﻟﻣﺷﻌﺔ‬ ‫ﻟﻠﻣﺎدة‬ ‫ﺗﺳرب‬ ‫أﯾﺔ‬ ‫وﺟود‬ ‫ﻋدم‬ ‫ﻣن‬ ‫اﻟﺗﺄﻛد‬radioactive
leakage‫إﺷﻌﺎﻋﻲ‬ ‫ﺗﻠوث‬ ‫أو‬contamination
–‫ة‬‫ﻣﺑﺎﺷر‬ ‫اﺳﺗﻼﻣﻬﺎ‬ ‫ﻋﻘب‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫ﻛﺎﻓﺔ‬ ‫اﺧﺗﺑﺎر‬ ‫ﯾﺟب‬.
–‫أﺷﻬر‬ ‫ﺳﺗﺔ‬ ‫ﻛل‬ ‫داﺋم‬ ‫ﺑﺷﻛل‬ ‫اﻟﻣﺧزﻧﺔ‬ ‫اﻟﻣﺷﻌﺔ‬ ‫اﻟﻣﺻﺎدر‬ ‫اﺧﺗﺑﺎر‬ ‫ﯾﺟب‬.
•‫ي‬‫ﺑﺋر‬ ‫ﻋداد‬ ‫ﺑﺎﺳﺗﺧدام‬ ‫اﻹﺷﻌﺎﻋﻲ‬ ‫اﻟﺗﻠوث‬ ‫ﻗﯾﺎس‬ ‫ي‬‫ﯾﺟر‬‫وﻣﺿﺎﻧﻲ‬
‫اﻟﺣﺳﺎﺳﯾﺔ‬ ‫ﻋﺎﻟﻲ‬sensitive scintillation well counter
•‫اﻟﻲ‬‫و‬‫ﺣ‬ ‫اﻟﺗﻠوث‬ ‫ﻣﻘدار‬ ‫ﻛﺎن‬ ‫إذا‬ ‫ﻣﻠوث‬ ‫أﻧﻪ‬ ‫اﻟﻣﺻدر‬ ‫إﻟﻰ‬ ‫ﯾﻧظر‬200
Bq (~5 nCi).

Brachytherapy med phy-03

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