A candidate who has passed the Degree Examination...

Anx.21 B - M.Sc Medical Physics (Uni dept) 2007-08 of 21

BHARATHIAR UNIVERSITY, COIMBATORE-641 046

REGULATIONS AND SYLLABUS FOR M.Sc. MEDICAL PHYSICS DEGREE COURSE

(University Department) WITH COMPULSORY DIPLOMA IN NANO SCIENCE

(with effect from 2007-2008)

1. Eligibility for admission to the course: - A candidate who has passed the Degree Examination in B.Sc. Physics with allied / Ancillary Maths & Chemistry or Triple Major with Physics, Maths & Chemistry, B. Sc. Medical Technology (Radiation Theraphy) / B. Sc. Electronics of this University or an examination of some other University accepted by the syndicate as equivalent thereto shall be eligible for admission to the Master Degree of this University. 2. Duration of the course: Four Semesters – The course includes, i. Hospital training for one month ii. Two weeks (or more) Pre-Orientation Programme for RSO certificate as stipulated by AERB and BARC. After the training students are eligible for appearing in RSO certificate (Level – III) conducted by RPAD, BARC Mumbai. 3. Practical training / Project work / summer training / practicum, internship, if any Students have to do project work during the IV Semester. 4. Requirement to appear for the examination i) Attendance percentage for each semester and ii) Hospital training before final semester 5. Medium of instruction: English 6. Passing minimum:

The candidate has to secure 50% minimum at the end semester examination and also 50% in the paper (Total of end semester and continuous internal assessment)

7. Classification of successful candidates Candidates who have passed in all the subjects will be declared as successful Candidates. 8. Conferment of degree All successful candidates will be eligible for the conferment of the degree

Annexure No. 21 B SCAA Dated 29.02.2008


9. Ranking All Candidates who have passed the papers in the first attempt will be ranked. The first rank holder will be awarded medal as per the existing norms Distinction: Those candidates who have secured 75% or more by passing all the papers within the duration of the course (Two years, four semesters) will be declared as passed the course with distinction. 10. Scheme of Examinations

• Each theory paper will be taught for five hours per week. Total teaching hours for a

paper is 75 hours. • Practical: Six hours / Week. • Each theory paper has been divided in to 5 Units. • The course will be conducted by Department of Physics Bharathiar University, in

collaboration with GKNM Hospital Coimbatore. Theory and practical will be conducted at both the places

• End semester examination will be for three hours duration. Maximum marks for end semester is 60.

• Internal Marks: Each paper includes continuous internal assessment marks (40 Marks) awarded by the concerned teacher for continuous internal assessment. The guidelines for marks are minimum two tests, assignments, Seminar and Problem solving (tutorials)


Scheme of Examinations First Semester Title of Paper Marks Paper I Non Ionizing Radiation Physics, 100 Paper I Fundamental Radiation Physics 100 Paper III Microelectronics and Instrumentation 100 Paper IV Numerical Methods and computer Programming 100 Practicals Electronics lab 100

Second Semester: Paper V Anatomy and Physiology 100 Paper VI Radiation Physics I 100 Paper VII Biomedical Instrumentation 100 Paper VIII Radiation Generators and Detectors 100 Practicals Medical Physics Lab I 100 Third Semester Paper IX Medical Imaging Technology 100 Paper X Radiation Hazards Evaluation and Control 100 Paper XI Radiation Biology 100 Paper XII Radiation dosimetry 100 Practicals Medical Physics Lab II 100 Fourth Semester

Paper XIII Nuclear Medicine with applications 100 Paper XIV Advanced Physics of Radiation Therapy 100 Project Project Work and Viva Voce 100

------------------- Total 1800 -------------------


PAPER I

Non Ionizing Radiation Physics,

1. ROLE OF BIOACOUSTICS, BIOMAGNETISM & THERMOGRAPHY IN MEDICINE Electrical impedance and Biological impedance - Bio Acoustics - Acoustical

characteristics of human body - principles and theory of thermography - Biomagnetism – effects. 2. ULTRASOUND PHYSICS

Production, properties and propagation of ultrasonic wave - Ultrasonic Dosimetry - Destructive and nondestructive tests - Cavitation - Piezoelectric receivers - thermoelectric probe. 3. LASER TISSUE PHYSICS AND BIOMEDICAL OPTICS

Lasers: Theory and mechanism of laser action- lasers in blood flow medicine-Various types of optical radiation's - UV, visible and IR sources - measurement of flounce from optical sources - Optical properties of tissues - Applications of optical radiation's in detection and treatment of skin disorders. - Microscopy in medicine - Fluorescence microscope - focal microscope. 4. RADIO FREQUENCY AND MICROWAVES

Production and properties - interaction mechanism with biological systems: thermal and non-thermal effects on whole body, lens and cardiovascular systems. Hypothermia, tissue characterization BOOKS FOR STUDY AND REFERENCE : 1. S.S.Martelluci and A.N.Chester, Laser Photobiology and Photomedicine Plenum press, New York, 1985. 2. J.A.S.Carruth and A.L.Mekenzie, Medical Lasers, AdamHilger Ltd., Bristol, 1992. 3. J.P.Woodcock, Ultrasonics, Medical Physics Handbook series 1, Adam Hilger, Bristol, 1981. 4. J.R.Greening, Medical Physics, North Holland Publishing Co., New York, 1987.

PAPER II FUNDAMENTAL RADIATION PHYSICS

1. IONIZING RADIATION, THEIR PROPERTIES AND SOURCES OF RADIATION

Radioactivity, ionizing radiation, Characteristics of radiation, energy of radiation, radioactive decay, decay constant, decay chain, half-life mean life, activity, specific activity, special unites used in atomic and nuclear physics, Property of alpha, beta and gamma radiations, radioactivity laws, decay scheme and laws of successive transformations, natural radioactive series, radioactive equilibrium, alpha and beta ray spectra, gamma emission, electron capture, internal conversion, nuclear isomerism, artificial radioactivity, production of isotopes, growth of activity isotopic sources, neutron sources, fission products, nuclear reactors.


2. RADIATION PHYSICS Radiation quantities and units, particle flux and fluence, energy flux and fluence, cross- section linear and mass absorption coefficient, stopping power and LET. Exposures and its measurement. Electronic equilibrium Bragg-Gray principle and air wall chamber, Kerma rate constant. Relative biological Effectiveness, radiation weighing factors, absorbed dose, equivalent dose, tissue weighting factors, effective dose, ambient and directional equivalent dose and their relevance to dosimetry, tissue equivalence, dose commitment and collective dose.

Internal exposure: Effective half-life, selectivity of organs, beta particles dosimetry, committed dose and dose coefficients. Dosimeters: Primary dosimeters, secondary dosimeters, direct reading dosimeters, chemical and calorimetric devices. 3. INTERACTION OF ELECTROMAGNETIC RADIATION WITH MATTER AND RADIATION SHIELDING

Thompson scattering - photoelectric and Compton process and energy absorption - Klein - Nishina cross sections - pair production - Attenuation coefficient and mass energy absorption coefficient - relative importance of various process - interaction of charged particles with matter - energy loss per ion pair, primary and secondary ionization - dependence of collision energy loss on the physical and chemical state of the absorber - Cerenkov radiation - electron absorption - Bremsstrahlung - Range - energy relation - passage of heavy charged particles through matter - loss of collision - Brag curve - specific ionization - stopping power and radiation stopping power - Beth Bloch formula Interaction of neutron with matter - scattering - capture - neutron induced nuclear reaction.

Neutron sources, properties, energy classification, elastic and inelastic scattering, nuclear reaction, neutron activation, radioisotopes production. 4. X-RAY GENERATORS X-ray production, properties, characteristics and continuous spectra, X-ray units, ratings of X-ray tubes, filtration, effective energy, penetration and quality of X-rays absorption of X-rays, angular distribution of X-rays, basic requirements of medical diagnostic, therapeutic and industrial radiographic tubes, rotating anode tubes for mobile, dental, mammography, CT and DSA applications, three phase 6-pulse and 12-pules circuits, capacitors discharge units, constant potential units with electronic stabilization, high frequency generator, voltage doubler circuits, for therapy, tube current, measurement of kV and mAs and time, hand timers, photo timers control panel, complete X-ray circuits and modem computerized X-ray systems, image intensifier and close circuit TV system. BOOKS FOR STUDY AND REFERENCE; 1. Christensen, Physics of Diagnostic Radiology, Lea and Febiger, Philadelphia 1990. 2. W.R.Hendee, Medical Radiation Physics, Year Book Medical Publishers Inc., London, 1981. 3. R.F.Mould, Radiotherapy Treatment Planning, Medical Physics Hand Book Series


No.7, Adam Hilger Ltd.,Bristor, 1981. 4. S.C.Klevenhagen, Physics of Electron Beam Therapy, Medical Physics Hand Book Series No.6, Adam Hilger Ltd.,Bristor, 1981. 5. G.C.Bentel, Radiation Therapy Planning, Macmillan Publishing Co., New York, 1992. 6. Govinda Rajan, Advanced Medical Radiation Dosimetry, Prentice hall of India Pvt.Ltd., New Delhi, 1992.

PAPER III MICROELECTRONICS AND INSTRUMENTATION

1. ANALOG ELECTRONICS

Ideal op-amps: Characteristics and frequency response - CMRR - mathematical operations - comparator - logarithmic and instrumentation amplifiers - RC oscillators - negative resistance oscillator - active filters - Multivibrator circuits - waveform generators - 555 timers and their applications - wave shaping circuits - advanced power supply circuits - voltage to frequency and frequency to voltage conversion - introduction to SPICE. 2. DIGITAL ELECTRONICS

Combination digital systems : Boolean algebra and basic theorems - logic functions and circuit implementation - data processing circuits: multiplexers and demultiplexers - binary encoders and decoders. Arithmetic circuits : Basic binary adders and subtractors - decimal adders and subractors. Sequential digital systems : Flip-flops-triggering of flip-flops - D and T type flip-flops - asynchronous, synchronous, decade and modulo-N counters - Shift registers - A/D and D/A conversion circuits - semiconductor memories. 3. MICROPROCESSORS

8086/8688 microprocessors - internal architecture and assembly language programming - principles of interfacing. 4. OPTOELECTRONICS

Introduction - photo sensors - light emitters - LED and LCD - alphanumeric displays – opto coupler - fiber optics - optical fiber and its characteristics - CRO. 5. INSTRUMENTATION AND SIGNAL PROCESSING

Elements of measuring systems - capacitive transducer - inductive transducer- LVDT - electrical strain gauges - resistance thermometer - thermistor - piezoelectric and photoelectric transducers - signal amplification - signal attenuation - signal linearization - bias removal - signal manipulation - signal transmission - digital signal processing.


BOOK FOR STUDY AND REFERENCE : 1. R.J.Maddock and D.M.Calcutt, Electronics: A Course for Engineers, ELBS, London,

1997. 2. J,Millmann and C.C.Halkias, Integrated Electronics, McGraw Hill, Singapore, 1997. 3. T.L.Floyd, Digital Fundamentals, Charles Menil Publishing Co., Prentice Hall, 1991. 4. A.P.Malvino and D.P. Leach, Digital principles and applications, McGraw Hill, 1991. 5. Alan S. Morris, Principles of measurement and instrumentation, Prentice Hall of India,

New Delhi, 1999

PAPER IV NUMERICAL METHODS AND COMPUTER PROGRAMMING

UNIT – I - Solutions of equations Bisection method – False position method – Newton Raphson method – Basic Gauss elimination method – Gauss elimination with partial pivoting – Gauss Jordan method – Gauss – Jacobi iteration Method – Gauss Seidal iteration method – Inversion of a matrix using Gauss elimination method – Method of triangularisation (LU decomposition method) UNIT – II – Curve fitting and Interpolation Method of least squares – straight line, parabola, y= axn, y= aebx, y=a+bxn

type curves – sum of squares of residuals for straight line and parabola fit – Forward & Backward differences Gregory Newton forward and backward interpolation formula for equal intervals – Divided differences – properties of divided differences – Newton’s divided difference formula – Lagrange’s interpolation formula for unequal intervals. UNIT – III – Eigen values and Numerical integration Power method to find dominant Eigen value – Inverse poser method to find all eigen values – Jacobi method to find eigen values (only 2x2 and 3x3 matrices) – Trapezoidal rule – Simpson’s - rule – Error estimates Gaursian Quadrature. Unit – IV – Differentiation and ordinary differential equations Newton’s forward and backward difference formula to get the derivatives (First and Second order) for equal interval data – Divide difference tables to calculate derivatives for unequal intervals – Taylor series method for first order differential equations – Basic Euler’s method – Improved Euler’s method – Modified Euler’s method – Runge – Kutta IV order method – RK method for simultaneous first order differential equations – RK method for second order differential equations – Milne`s predictor corrector formula. UNIT –V - Computer programming in C Constants – Varibles – Data types – operators and Expression – Input – output statements – control statements functions – arrays – one, two, multidimensional array declarations and initializations – simple applications.


Text Books: 1) K. Venkataraman, “Numerical methods in science and engineering”, National publishing

company, Madras –1996 2) P.Kandasamy, K.Thilgavathy, K. Gunavathy, “Numerical methods”, S.Chand &

Company Ltd., New Delhi, 2007 3) E. Balagurusamy, “Numerical methods”, Tata McGraw Hill Publishing Company Ltd,

New Delhi, 2006 4) E. Balagurusamy, “Ansi C”, Tata McGraw Hill Publishing Company Ltd, New Delhi,

2004 Reference:

1) John H. Mathews, “Numerical methods for mathematics, science and engineering, Prentice Hall of India Pvt. Ltd., New Delhi 2000.

2) S.G. Kochan, “Programming in C”, CBS Publishers & Distributors, Delhi, 1991.

PRACTICALS ELECTRONICS LAB

(Offered at Bharathiar University, Coimbatore) 1. Bridge Rectifier – Ripple factor, percentage of regulation. 2. Dual regulated power supply 3. Astable multivibrator 4. Abbe's refractometer 5. Logic gates. 6. Operational Amplifier – Characteristic of sum difference amplifier and integrator 7. Filters – high pass, low pass and band pass 8. X-ray powder diffraction method 9. Copper arc spectrum 10. Characteristics of G.M.Counter 11. Microprocessor intel 8086 12. IC regulated power supply 13. Discriminator and multivibrator 14. Binary counters 15. Digital to Analog and Analog to Digital conversion 16. Digital circuits for measurements 17. Experiments with solid State Nuclear Track 18. Bridge Amplifer 19. Coincidence and anti-coincidence circuits


PAPER V ANATOMY AND PHYSIOLOGY

1. BASIC ANATOMY AND PHYSIOLOGY, PHYSICS OF DIAGNOSTIC RADIOLOGY:

Anatomical position and nomenclature- Human development – cellular structure – function and growth- tissue differentiation - sex cells, early development -The structure of tissues - the systems - skin, cartilage and bone - Bacteria - bones - the skeleton - joints - The Skeletal system - the skull - Vertebral column - thorax etc. - the muscular system - the thoracic cage - the mediastinum, the diaphragm the abdominal cavity and abdominal regions - anatomy of the heart. 2. DIGESTIVE SYSTEM

Functions of mouth, teeth, esophagus, stomach, small intestine, large intestine - digestion and assimilation of carbohydrates – Alimentary - Fats and proteins - Gastric juice - Pancreatic juice - Function of liver and spleen, blood and circulatory system, Blood and its composition, RBC and WBC - blood grouping - coagulation of blood, artery, vein, capillaries and cardiovascular - heart structure and functions - Physiological properties of heart muscle, cardiac dynamics - EEG - blood pressure and its regulation – Homeostasis- Metabolism. 3. LOCOMOTOR SYSTEM

Haematopoesis, blood, respiration, blood flow, Body fluids, renal urinary functions – Endocrine systems - Pituitary glands and its functions - functions of adrenal, thyroid etc., secretion - chemistry - physiological actions, effect on removal, effect on administration, hormonal assay - detailed molecular mechanism of hormone action. 4. EXCRETORY SYSTEM and RESPIRATORY SYSTEM.

Urinary systems - Kidney and its functions - water and electrolyte metabolism. Physical laws of respiration - Trachea - lungs and its functions - oxygen transport - nervous regulation of respiration. 5. REPRODUCTIVE ORGANS AND ITS FUNCTIONS:

Reticule endothelial and reproductive system - Reproductive Organs and functions. Hormonal control over reproduction. Mammary glands Pregnancy- Growth and aging. 6. NEUROLOGICAL SYSTEM

Pathways, nerve conduction, key bio signals -Brain and spinal cord - its functions - central nervous system and Autonomic Nervous system functions - Physiology of special senses hearing, taste, vision, etc. (eye, ear etc), 7. RADIOGRAPHIC ANATOMY AND DISEASES

Anatomy and physiology as applied to radio diagnosis and radiotherapy – x-ray anatomy – CT MRI anatomy – surface anatomy applied to RD and RT – introduction to the nature of diseases and trauma – inflammation, infection, etc


BOOKS FOR STUDY AND REFERENCE: 1. C.H.Best and N.B.Taylor, A.Text in applied Physiology, Williams and Wilkins Company, Baltimore, 1986. 2. C.K.Warrick, Anatomy and Physiology for radiographers, Oxford University press, 1988. 3. J.R.Brobek, Physiological Basis of Medical Practice, Williams and Wilkins, London, 1995. 4. Playfair, J.H.L., and Lydard, P.M. ( 1995) Medical Immunology for students. Churchill Livingstone.

PAPER VI

RADIATION PHYSICS I

1. PHYSICS OF TELETHERAPY PLANNING Beam therapy including modern trends – benign and malignant tumours, tissue tolerance

dose and tumour lethal dose — output calibration procedures Treatment planning parameters - absorbed dose and integral dose - - build - up, central axis depth doses for different energies and their determination - TAR, TMR and tissue phantom ratio - their relationship - back scatter factor - isodose curves determination using tissue equivalent phantoms – tissue air ratio – tissue maximum ratio - use of RFA with computers - isodose charts - beam direction devices - correction for body inhomogenities – wedge filters – shielding blocks and compensators – tele gamma therapy – mega voltage x-ray therapy – particulate beam therapy 2. PRINCIPLES OF EXTERNAL BEAM TREATMENT PLANNING

Pretreatment procedures- two and three dimensional localization techniques - contouring - simulation of treatment techniques- Beam modifying devices - Field arrangements – Single, Parallel opposed fields – Multiple fields-Wedged fields – Moving field techniques – Electrons – Field shaping and in homogeneities. Clinical applications – Treatment planning of Gynecologic, prostate, Urinary bladder cancers – Head and Neck and Thorax Cancers – Hodgkin's disease and Total body irradiation – Central Nervous system planning – Skin Irradiation by Electrons. 3. PHYSICS OF BRACHYTHERAPY

Physical properties and uses of radio isotopes Ra 226, Co-60, Cs-137, Au-198, Ta-182, Ir-192, and I-125- Dose rates - Manual and computer Calculation methods

Intracavitry, interstitial techniques and advantages, criteria for source selection, radium and radium substitutes. Cesium-137. Cobalt-60, iridium-192, iodine-125 source, Paterson parker and Manchester dosage systems. After loading techniques, manual and remote, advantages radiographic localization of implanted sources, Beta ray applicators, use of computers in brachytherapy dosimetry, QA in brachytherapy equipment and sources. Calibration of sources, checking of source integrity and uniformity.


4. COMPUTER IN TREATMENT PLANNING

Review of algorithms used for treatment planning computation, Photon beam, electron beam, interstitial and intracavitary therapy, factors to be incorporated in computational algorithms, hardware and software requirements, cost effectiveness of TPS. 5. INDUSTRIAL APPLICATION OF RADIATION:

Principles of industrial radiography with X-ray and gamma ray, radiographic exposure devices, photographic film technique, radiographic contrast, definition and sensitivity, intensifying screens and penetrameters. Principles and measurement of thickness and level in different applications, density and moisture, hydrogen in hydrocarbons, well logging, composition analysis. Principals of operation of consumer products using radiation sources fire detector, baggage inspection systems, static eliminators, luminous paints and gas mantles. Industrial radiation processing: gamma chambers radiation sterilization, irradiation of food and medical products. BOOKS FOR STUDY AND REFERENCE : 1. Christensen, Physics of Diagnostic Radiology, Lea and Febiger, Philadelphia 1990. 2. W.R.Hendee, Medical Radiation Physics, Year Book Medical Publishers Inc., London, 1981. 3. R.F.Mould, Radiotherapy Treatment Planning, Medical Physics Hand Book Series No.7, Adam Hilger Ltd.,Bristor, 1981. 4. S.C.Klevenhagen, Physics of Electron Beam Therapy, Medical Physics Hand Book Series No.6, Adam Hilger Ltd.,Bristor, 1981. 5. G.C.Bentel, Radiation Therapy Planning, Macmillan Publishing Co.,New York, 1992. 6. Govinda Rajan, Advanced Medical Radiation Dosimetry, Prentice hall of India Pvt.Ltd., New Delhi, 1992.

PAPER VII

BIO MEDICAL INSTRUMENTATION

1.BIOSIGNAL ACQUISITION: Physiological signal amplifiers – isolation amplifiers – differential amplifiers- bridge

amplifiers – chopper amplifiers – noises and CMRR – medical preamplifier design. 2.BIOELECTRIC SIGNAL RECORDING

Bioelectric potentials – resting and action potentials – half cell potentials- Surface, needle and micro electrodes, electrical equivalent circuits – 3.PHYSIOLOGICAL ASSIST DEVICES

Cardiac pacemakers – natural and artificial pacemakers-pacemaker batteries-defibrillator-A.C./D.C synchronized defibrillator – stimulators – bladder stimulators – heart lung machine various types of oxygenators- kidney machine – hemodialysing units – peritoneal dialysis.


4.CLINICAL AND OPERATION THEATER EQUIPMENTS.

Flame photometer – Spectroflurophotometer – pH meters – Audiometer – Endoscopes – Electromagnetic and laser blood flow meters – ventilators – diathermy units – ultrasonic, microwave diathermy techniques. 5.BIOTELEMETRY AND SAFETY INSTRUMENTATION

Design of a biotelemetry system, radiotelemetry with subcarrier – multiple channel telemetry systems- problems in implant telemetry – uses of biotelemetry – physiological effects of 50Hz current – microshock and macroshock – electrical accidents in hospitals – devices to protect against electrical hazards. BOOKS FOR STUDY AND REFERENCE 1. Jacobson and Webster, Medicine and Clinical Engineering, Prentice Hall of India, New Delhi, 1979. 2. R.S.Khandpur, Handbook of Biomedical Instrumentation, Tata McGraw Hill, New Delhi, 1990. 3. M.Arumugam, Biomedical Instrumentation, Anuradha Publishing Co.,Kumbakkonam, Tamilnadu 1992. 4. Richad Aston, Principles of Biomedical Instrumentation and measurements, Merrill Publishing Co., London ,1990.

PAPER VIII: RADIATION GENERATORS AND DETECTORS 1. TELECOBALT MACHINES:

Co-60 and Cs-137 as teletherapy sources - source containers - international source capsule - effect of penumbra and construction of collimators - shutter systems and their operation – calibration procedures and acceptance tests for Telegamma machines.

2. MEDICAL ACCELERATORS:

Linear Accelerator- Standing wave guide and travelling wave guides - magnetrons and klystrons - cyclotron, betatron - particle therapy machines - Van de Graff generator and Microtron. Calibration procedures for teletherapy machines, acceptance tests - QA procedures - relative merits of X and gamma rays, electrons and other high energy particles. 3. BRACHYTHERAPY MACHINES

Applicators- Radium tubes – Needles- Seeds-Ophthalmic applicators – design and structure – Manual After loading – Remote Afterloading machines – source driving mechanisms – Integrated Brachytherapy units. 4. PRINCIPLES OF RADIATION DETECTION - USING ION CHAMBERS:

Free air ionization: secondary standard dosimeters - basic circuits for dose and dose - rate measurements : condenser type chambers and thimble chambers - Victorian R meter - theory of


gas filled ionization chamber - GM counter - working and different uses - recovery time and dead time – quenching 5. PRINCIPLES OF RADIATION DETECTION - USING SCINTILLATION DETECTORS, CALORIMETRY AND THERMOLUMINESCENCE:

Scintillation detectors - theory and construction of a scanner - calorimeter - solid state detectors - chemical system: film dosimetry - TLD, general requirements of dosimeters - Brag - Gray cavity theory - physical and biological factors governing RBE REFERENCES: 1. W.R.Hendee, Medical Radiation Physics, Year Book Medical Publishers Inc., London, 1981. 2. S.C.Klevenhagen, Physics of Electron Beam Therapy, Medical Physics Hand Book Series No.6, Adam Hilger Ltd.,Bristor, 1981. 3. G.C.Bentel, Radiation Therapy Planning, Macmillan Publishing Co., New York, 1992. 4. Govinda Rajan, Advanced Medical Radiation Dosimetry, Prentice hall of India Pvt.Ltd., New Delhi, 1992.

PRACTICAL MEDICAL PHYSICS LAB I

(Offered at GKNM Hospital, Coimbatore – 641 046) 1. Standardization of spectrophotometer – Determinations of concentration of biofluids. 2. Study of voltage – current characteristics of an ion chamber 3. Pulse shaping circuits 4. Gamma ray spectroscopy using Nal (TI) and Ge detector 5. Inverse square law and attenuation of gamma rays 6. Absorption of Beta rays and end point energy of beta particles – feather analysis 7. Half life of short life isotope 8. Statistics of counting 9. Calibration on gamma ray – spectrometer and identification of unknown sources 10. Calibration of Pocket Dosimeter 11. Attenuation of X and Gamma rays through various materials. 12. Calibration of ion chambers. 13. Auto radiography test for brachytherapy sources 14. Determination of specific Gamma ray emission 15. Computer aided treatment planning 16. Experiments with solid state nuclear Track


PAPER IX: MEDICAL IMAGING TECHNOLOGY

1. X-RAY IMAGING TECHNOLOGY X-rays – nature of image – Intensifier screens -Electronic image intensifiers – focal plane topography – true topography - X-ray computed tomography -different generations - spiral CT - contrast scale system concepts - viewing system - image quality considerations. Physical Principles of X-ray diagnosis, density, contrast, detail and definition of radiograph, choice of kV. MA, filtration, FSD, screens, films, grids, contrast media, concept of modular transfer function and its applications, radiographic technique, special procedures Myelography, tomography, fluoroscopy, pelvimetry, film processing, image intensifiers and television monitoring, reduction of patient dose, quality assurance in diagnostic radiology, performance standards, acceptance and QA tests, test tools for KV, timer focal spot size, collimator, beam alignment, high contrast, film screen, contact, and grid alignment. CT scanners and their applications, Digital subtraction radiography(DSA) – mammography – Xero radiography. 2. NUCLEAR MAGNETIC RESONANCE IMAGING SYSTEMS:

Principals of NMR imaging systems - chemical shift - Fourier Transformation of FID signal – Applications – particular applications to brain function – MRI- imaging of proton density – image modification using relaxation times. 3. ULTRASONICS:

Ultrasonic waves - generation and detection of ultrasound - A scan B scan and M mode - Echo cardiograph visualization - CM and pulsar system – Doppler – Electrical impedance (applied potential) topography; Radiotherapy imaging systems - duplex scanning - display devices ultrasonic imaging. 4. THERMOGRAPHIC AND NUCLEAR MEDICINE IMAGING TECHNIQUES:

Physics of thermography - infrared detectors - thermographic equipment's - quantitative medical thermography - pyroelectric vidicon camera - application thermography - radiation detectors - positron emission computed tomography- SPECT (elementary ideas) - density measurements, image reconstruction. 5. OTHER IMAGING TECHNIQUES:

Fluorescence imaging - Fluorescence Life - time imaging - Tissue trans-illuminations - optical coherence tomography - Electrical impedance tomography (EIT) - Electrical Source imaging (ESI) - Magnetic source imaging. BOOKS FOR STUDY AND REFERENCE :

1. R.S.Khandpur, Hand book of Biomedical instrumentation, Tata McGraw Hill Publishing Co., Ltd., New Delhi 1990.

2. R.Aston, Principals of Biomedical Instrumentation and Measurement, Merril publishing co., London, 1990.

3. A.Maccuski, Medical Imaging Systems, England Cliffs, N.J.Prentice Hall, 1996. 4. M.Arumugam, Biomedical Instrumentation, Anuradha Publishing Co., Kumbakonam,

Tamilnadu, 1992.


PAPER X: RADIATION HAZARDS EVALUATION AND CONTROL

1.RADIATION HAZARD EVALUATION AND CONTROL AND EMERGENCY PREPAREDNESS: Hazard evaluation by calculation, methods of calculation, time distance shielding, area monitoring, personal monitoring. Detection and measurement of contamination on work surface, person and samples, methods of decontamination, evaluation of radiation hazards in medical diagnostic and therapy installations, protective measure to reduce radiation exposure to staff and patients, radiation hazards in brachytherapy, departments and teletherapy departments, radioisotope laboratories and particles accelerator facilities, protective equipments, handling of patients, radiation safety during source transfer operation, special safety consideration for accelerator installations. 2. TRANSPORT OF RADIOACTIVE MATERIAL:

Examples of radioactive shipments for medical and industrial, research applications of radioactive sources and in connection with nuclear fuel cycle. Special form radioactive materials and non-special form radioactive materials, A1 and A2 values and basis of derivation of these values, low specific activity materials and surface contaminated objects. Design and test requirements of special form radioactive material, industrial package Type IP-!,IP-2 and IP-3 Type A packaging and Type B(U)/(M) packing, transport under exclusive use and special arrangements, expected packages and fissile exception, exempt radioactive material, approval requirements for radioactive materials, packaging and shipments, requirements for preparation, forwarding, storage and transport of packages, and marking and labeling requirements, limits on Non-fixed contamination and radiation level and temperature outside packages, transport documents, emergency response requirements. 3. PLANNING OF RADIATION INSTALLATION:

Of various types for different applications (X-ray diagnostic, deep therapy, telegamma ad accelerator installations, brachytherapy facilities, nuclear medicine facilities, etc.) effects of scattering, albedo, sky shine, noxious gas production, designing a shielded container for storage/transport of radioactive materials (e.g. gamma chamber, radiographic exposure device, nucleonic gauge, neutron source container etc). Emergency preparedness, emergency handling, graded approach, site emergency. 4. RADIATION PROTECTION STANDARDS AND REGULATIONS: -

Need for protection, philosophy of radiation protection, basic radiation protection criteria, External and internal exposure, additive risk model and multiplicative risk model. Risk coefficients. Dose to the foetus. Dose limits for occupational exposure, for public and special exposure situations. ICRP and AERB recommendations. Basic safety standards. Source, practices, types of exposures, interventions. Atomic energy act, Radiation protection Rules, Notifications, Transport regulations, Waste disposal rules, Food irradiation rules, licensing, approval of devices, installations, sites and packages containing radioactive material. Source of radioactive waste and classification of waste, treatment techniques for solid, liquid and gaseous effluents, permissible limits for disposal of waste, sampling techniques for air, water and solids,


ecological consideration, general methods of disposal, management of radioactive waste in medical and research institutions. 5. RADIATION SHIELDING

Shielding calculation for gamma radiation, choice of material, Primary and secondary radiation, source geometry, discrete sources, point, kemel method, introduction to Monte Carlo method, Beta shielding, Bremsstrahlung. Neutron shielding, scattering and absorption, activation of the shielding material, heat effects. Optimization of shielding, gamma, electron, neutron irradiation facilities. Transport and storage of containers for high activity sources. Shielding requirements for medical and research facilities including accelerator installations BOOKS FOR STUDY REFERENCE:

1. R.F.Mould, Radiation Protection in Hospital, Adam Hilger Ltd., Bristol, 1985. 2. A.Martin and S.A.Harbison, An introduction to Radiation Protection,John Wiley & Sons

Inc., New York, 1981. 3. ICRP Publications ( ALL ) 4. NCRP Publications ( ALL )

PAPER XI: RADIATION BIOLOGY

1. ACTION OF RADIATION ON LIVING CELLS: Elements of cell biology – Effects of ionizing radiation at molecules and cellular levels –

secondary effects - Target theory - single hit and multi hit target theory - other theories of cell inactivation - concepts of micro dosimetry - direct and indirect action – free radicals and molecular products - cellular effects of radiation – bacterial and mammalian cell survival - application in cancer therapy, food preservation, radiation sterilization etc. – radio sensitivity at different phases of the cell cycle - inactivation - division delay - DNA damage- depression of macromolecular synthesis - giant cells - chromosomal damage - point mutations - survival parameters – in vitro and in vivo experiments on mammalian cell systems - RBE - response - modifiers - LET, oxygen, cell stage – physical chemical and biological factors influencing the effect of radiation - recovery mechanism radio protective and radio sensitizing chemicals - radiometric substances - chemical mutagenesis - effects of UV, microwave and other non-ionizing radiations. Physics and biological factors affecting cell survival, tumour re-growth, normal tissue response, repair redistribution in the cell cycle- basis for dose fractionation in beam therapy

2. RADIOBIOLOGICAL MODELS:

Strandqvist Isoeffect curves – Concepts of Nominal Standard Dose (NSD) – CRE model - Time dose fraction (TDF) model - Linear Quadratic models. 3. SOMATIC EFFECTS OF RADIATION :

Bergonis - Tribondeau law - radiosensitivity protocol of different tissues inhuman LD 50/30 - effect of radiation on skin - blood forming organs, lenses of eyes, blood constituents, embryo, digestive tract, endocrine glands, dependence of effect on does, dose rate, type and


energy of radiation syndrome - effects of chronic exposure to radiation - radiation carcinogenesis - shortening of life span risk estimates. 4. RADIOBIOLOGICAL BASIS OF RADIOTHERAPY :

Tumour growth kinetics - rational of fractionation - problem of hypoxic compartment and quiescent cells - radiobiology of malignant neoplasm - solution of hypoxic cell sensitizers, hyperthermia, recourse to high LET radiation - combination of chemotherapy and radiotherapy - chronoradiobiology and its applications to get better cure - problem of tumor regression. Application of various models in clinical radiotherapy - Practical Considerations.

5. GENETIC EFFECTS OF RADIATION :

Threshold and linear dose - effect relationship - factors affecting frequency of radiation induced mutations recessive and dominant mutations - gene controlled hereditary diseases - human data on animals and lower species - doubling dose and its influence of genetic equilibrium.

BOOKS FOR STUDY AND REFERENCE : 1. E.J.Hall, Radiobiology for Radiologists, J.B.Lippincott Co., Philadelphia, 1987 2. S.P.Yarmonenko, Radiology of Humans and animals, MIR,Publishers, Moscow, 1990.

PAPER XII: RADIATION DOSIMETRY 1. RADIATION DETECTION AND MEASUREMENT

Principles of measurements of radiation and radioactivity, Gas filled ionization chamber, proportional counters, GM counters, semiconductor detectors, BF3 counters for neutron detection. TLD Thermo luminescent dosimetry: process and properties, glow curves and dose response, photon energy dependence, fading, physical from of TL materials, residual TL and annealing for reuse, repeated read out of TLDs. TL instrumentation, ultra thin TLDs, graphite/boron carbide mixed TLDs, glow curve analysis. 2. IONIZATION DOSIMETRY

Theoretical Aspects of Ionization dosimetry – Bragg-Gray theory – Models and equations – Practical aspects of Ionization dosimetry – Characteristics of ionization chambers – Polarity effect- Stability and collection efficiency – ion chambers for low and medium energy photon dosimetry- Principles of low current measurements. 3. LOW AND MEDIUM ENERGY DOSIMETRY AND HIGH ENERGY DOSMETRY

In-Phantom measurements – Reference conditions – Comparison with ICRU equations – In-air measurements – Comparisons of two methods – Exposure and kerma calibrations ( in-air) – K-curves- D-curves – Concept of CPE and TE – Determination of In-water absorbed dose- Graphite dosimetric calibration. Historical developments – High energy photon dosimetry – CSDM, SAM Models- C factors – Development of Electron Beam Dosimetry- Concept of Cavity Gas Calibration factor for High energy dosimetry – Development of New High Energy


Dosimetry Formalism – Reference Depth- Gradient correction – Saturation correction – Average Stopping power ratio – Comparison of Electron and Photon Dosimetry- Electron Beam Dose Transfer Formalism. 4. STANDARDIZATION OF ELECTRONS, X-RAY AND GAMMA RAY BEAMS:

Standardization of X-ray and high energy beams, design of free air chambers, characteristics of free air chambers and graphite chambers, intercomparison of standard chambers for ensuring trace ability, standardization of electron beams used in radiotherapy-calibration of secondary standards, details of IAEA and other protocols for dosimetry of photon and electron beams, standardization of brachytherapy sources and sealed source in terms of their radiation output, calibration of protection level dosimeters in terms of dose equivalent units. 5.RADIATION DOSIMETRY PHANTOMS AND BEAM MODIFIERS

Interstitial and intracavitary Phantoms in radiation dosimetry criteria - TER sheet phantoms – Mix D - other TE systems, random phantoms problems of shielding in radiation therapy - making of low melting point alloy shields for therapy of lymphoma, radiotherapy gadgets, tissue compensators. BOOKS FOR STUDY AND REFERENCE: 1. Christensen, Physics of Diagnostic Radiology, Lea and Febiger, Philadelphia 1990. 2. W.R.Hendee, Medical Radiation Physics, Year Book Medical Publishers Inc., London, 1981. 3. R.F.Mould, Radiotherapy Treatment Planning, Medical Physics Hand Book Series No.7, Adam Hilger Ltd.,Bristol, 1981. 4. S.C.Klevenhagen, Physics of Electron Beam Therapy, Medical Physics Hand Book Series No.6, Adam Hilger Ltd., Bristol, 1981. 5. G.C.Bentel, Radiation Therapy Planning, Macmillan Publishing Co.,New York, 1992. 6. Govinda Rajan, Advanced Medical Radiation Dosimetry, Prentice hall of India Pvt.Ltd., New Delhi, 1992.

PRACTICALS

MEDICAL PHYSICS LAB II

1. Thyroid uptake measurement 2. Calibration of Scanners and Gamma Camera 3. Techniques of different organs scanning methods. 4. Activity measurement of Source calibrator 5. Treatment Planning of (a) Single Direct field (b) Two opposing fields 6. Treatment Planning of (a) 3 fields (b) Multiple fields 7. Treatment planning of Arc & Rotation Therapy in Co-60 and Linear Accelerator 8. Brachy therapy planning for Manual after loading Intra cavitary treatments. 9. Brachy therapy planning for Manual after loading interstitial treatments. 10. Brachy therapy planning for Remote after loading Intracavitary treatments.


11. Brachy therapy planning for Remote after loading interstitial treatments. 12. Use of simulator for treatment verification 13. Protection survey of Tele & Brachy therapy installations. 14. Acceptance & calibration techniques of Teletherapy machines. 15. In phantom dosimetry for Teletherapy.( Ion chamber or TLD) 16. In phantom dosimetry for brachytherapy ( Ion chamber or TLD) 17. Glow curve analysis and dose measurements in TLD 18. Chemical dosimeter – Standardization.

PAPER XIII: NUCLEAR MEDICINE PHYSICS WITH APPLICATIONS

1. PHYSICS OF NUCLEAR MEDICINE, SCANNERS AND PLANAR IMAGE CAMERAS: Radio isotopes in medical diagnosis invitro and invivo procedures – Radioactivity –

Physical, Biological and Effective Half Life - Specific activity – Radioactive decay chains – Transient and Secular Equilibrium – Different types of transitions and decays

Principles of Scintillation detectors - NaI (Tl) as a Scintillation detector – Properties of scintillators – Design and properties of a Photomultiplier tubes - Single head - dual head scanners - cameras - Auger cameras- Derivaiton of X,Y,Z coordinates - Design criteria, resolution, sensitivity measurements - choice of collimators - comparison between them, Quality assurance procedures in camera – Spatial resolution, Sensitivity, Flood field uniformity, Dead time, Resolving time and related QA parameters - different phantoms of quality assurance - quality control in instrumentation

2. PRINCIPES OF EMISSION TOMOGRAPHY:

Principles of SPECT & PET, Merits and Demerits of Planar Cameras, SPECT & PET CAMERAS - Image reconstruction techniques in SPECT & PET, 3. RADIO PHARMACEUTICALS & QUALITY CONTROL PROCEDURES :

Desirable characteristics of a radio nuclide - Radio nuclide generator systems – Radiopharmaeuticals – Positron emitting radionuclides - method of preparation, purity, quality, stability of radiopharmaeuticals – Investigational Radio pharmaceuticals.

Instrumentation – Dose calibrator – Radiopharmacy quality control - Generator and Radionuclide purity – Radiochemical Tagging – Sterility physical and safety aspects of therapeutic Nuclear Medicine. 4. CLINICAL APPLICATIONS:

Skeletal system – scanning methods- - Bone marrow scanning – Bone mineral measurements – Cerebrovascular system – Functional brain imaging – CSF imaging – Thyroid and Parathyroid imaging – Cardiovascular system – Thallium techniques – Respiratory system – perfusion agents – Gastro intestinal tract Liver and spleen imaging – Genitourinary system – Tumor and Inflammation imaging.


5. COUNTING STATISTICS AND STANDARDIZATION OF SOURCES Counting statistics, application of Poission’s statistics; goodness fit tests, Lexide’s divergence coefficients, pearson’s Chi-square test and students test, methods of measurements of radioactivity, defined solid angle and 4p b-g coincidence counting, standardization for beta emitters and electron capture nuclides with proportional, GM and scintillation counters, standardization of gamma emitters with scintillation spectrometers, routine sample measurements, re-entrant ionization chamber methods, methods using (h,g) and (n, p) reactions. BOOKS FOR STUDY AND REFERENCE: 1. W.H.Blahd, Nuclear medicine, McGraw Hill Co., New Delhi 1980. 2. W.N.Wagner, Principles of Nuclear Medicine, W.B.Saunders Co., London 1970. 3. J.Herbert and D.A.Rocha, Text Book of Nuclear Medicine, Vol 2 and 6, Lea and Febiger Co., Philadelphia, 1984. 4. S.Webb, The Physics of Medical Imaging, Medical Science Series, Adam Hilgers Publications, Bristol, 1984.

PAPER XIV: ADVANCED RADIATION THERAPY TECHNIQUES 1. Special techniques in Radiation therapy - Total Body Irradiation (TBI) Techniques - Large field dosimetry - Total Skin Electron Therapy(TSET) - Electron Arc treatment and dosimetry - Intraoperative radiotherapy - Image Guided Radiotherapy (IGRT) 2. Treatment aids: Block Cutting machines - Asymmetric Collimators - Multi leaf Collimator - 3-D planning and its importance - Conformal Radiotherapy - Motorized wedge - Universal Wedges - Dynamic wedge - Simulators in radiotherapy - Virtual Simulation Process - Portal vision - QA of portal vision - Compensators - inhomogenity compensator - Planar Compensators - Electronic Compensators - Treatment Planning Systems configuration and capabilities - TPS Algorithms - DICOM 3. Intensity Modulated Radiation Therapy - Planning process - Inverse treatment Planning - Dynamic MLC - Step and Shoot Technique - Compensator Based IMRT - Dose Verification Phantoms, Dosimeters and protocols - Transit dosimetry. 4. History of Stereotactic Radiosurgery / Radiotherapy - Dosimetry for Linac based SRS/SRT - Immobilisation devices for SRS and SRT - Planning Process - Linac based SRS/SRT - Cone based SRS - MLC based SRS/SRT Evaluation of SRS/SRT treatment plans - machine QA for SRS - Patient QA for SRS - Cyberknife. Gammaknife based SRS/SRT - Design aspects of Gammaknife - QA for gammaknife.


5. Particle therapy - Neutron therapy - Bragg peak - Proton therapy - Pi meson therapy - Cyclotron - Synchrocyclotron - Depth dose Characterestics of particle beams. BOOKS FOR STUDY AND REFERENCE: 1) S. Webb. The physics of three dimensional radiation therapy, Institute of Physics publishing, Philadelphia, 1993. 2) S. Webb. The physics of conformal radiotherapy, Institute of Physics publishing, Philadelphia, 1997. 3) S. Webb. Intensity Modulated radiation therapy, Institute of Physics 4) publishing, Philadelphia, 2001. 5) Faiz M. Khan, The Physics of Radiation Therapy, Lippincott Williams & Wilkins, Philadelphia, 3rd edition, 2003 6) Faiz M. Khan, Roger A. Potish, Treatment Planning in Radiation Oncology, Williams & Wilkins, Baltimore, 1998. 7) S.K. Jani, CT simulation for radiotherapy, Medical Physics Publishing, Madison, WI, 1993 8) J. Van Dyk, The Modern Technology of Radiation Oncology, Medical Physics Publishing, Madison, WI, 1999. 9) S.C. Klevenhagen Physics and dosimetry of therapy Electron beams, Medical Physics Publishing, Madison, WI, 1996. 10) J.F.Fowler, Nuclear Particles in Cancer Treatment, Adam Hilger Ltd., Philadelphia, Pa, 1981.

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