ELECTRON BEAM THERAPY

Dr Akhila K B
Flow of presentation

 Interaction of electrons with matter

 Characteristics of electron beam
 How it differs from photons?
 Clinical applications.
 Conclusion
 Interaction of electrons With matter

 Elastic collisions occur with either atomic electrons or with atomic nuclei
- characterized by change in only direction with no loss of energy
 Inelastic collisions occur with
- atomic electrons results in ionization and excitation of atoms
-atomic nuclei results in production of BREMSSTRAHLUNG x
rays (braking radiation)
Electron production
Characteristics of electron beams

1.Depth dose curve

2.Isodose curves
3.Field flatness and symmetry
- beam collimation
4.Field size dependance
Central axis depth dose
 Rmax is defined as the depth at which extrapolation of the tail of the
central-axis depth dose curve meets the bremsstrahlung background

 It is the largest penetration depth of electrons in the absorbing medium.

 Rp is defined as the depth at which the tangent plotted through the

steepest section of the electron depth dose curve intersects with the
extrapolation line of the background due to bremsstrahlung

 The depth Rq is defined as the depth where the tangent through the
dose inflection point intersects the maximum dose level
Choice of energy and feild size

 Selection of Energy
 For PTV = E/3 (R90) in cm
 D max - 2 x Energy in mm
 Treatment depth (d 90%) – 3 x Energy in mm
 R 50 – 4 x Energy in mm
 Practical Range – 5 x Energy in mm
 When beam energy increases

 Surface dose

 d max

 Beam penetration

 X-ray contamination increases

ISODOSE CURVES

 SCATTERING of electron plays an important role in determining SHAPE OF ISODOSE

CURVES
 As the beam penetrates a medium, beam expands rapidly below the surface due to scattering
However individual spread depends on
a) Energy
b) Field size
c) Collimation
C.FIELD FLATENESS AND SYMMETRY:

 Uniformity index: Ratio of areas inside 90% and 50% isodose lines at this depth

 0.70 or higher is acceptable with field sizes larger than 10 x 10 cm

BEAM COLLIMATION:
 Beam scattering foils :
 usually made of lead
 widen beam
 uniform distribution across treatment field
DUAL FOIL SYSTEM FOR BEAM COLLIMATION:
First foil: widens beam (multiple scattering)

Second foil: maintains beam uniformity in cross section

 Thickness of second foil is differentially varied across beam to produce a desired degree of
beam widening and flattening
 Beam collimation

 Beam defining collimators provides a variety of

field sizes and to maintain or improve flateness of
the beam

 Primary collimator : defines maximum field size

 Secondary collimator : defines treatment filed

SSD effect
PHOTON BEAM ELECTRON BEAM
Interacts indirectly Interacts directly
Penetration is deeper Penetration is shallower

Surface dose is lower Surface dose is higher

Scattering is less
Gradual dose decrease beyond therapeutic range
Scattered more widely by intervening air, treatment
head components, & body tissues
Steep dose decrease beyond therapeutic range (this
character makes them so useful ) upto < 15 MeV & =>
25 MeV behaves similar to that of photons

High skin sparing effect Very less /nonexistent skin sparing effect

Choice of beam energy is not much more critical Choice of beam energy and treatment depth is more
critical (as dose decreases rapidly beyond 90% isodose
level)
Electron isodose curve Photon isodose curve
Electron dosimetry
Photon dosimetry
6MV Photon and 6Mev electron in
artiste
 Choice of energy and feild size

 Depth of target volume

 Minimum target dose
 Choice of field size in electron beam therapy should be strictly based on isodose coverage
of target volume

 Usually target volume lies within 90% isodose curve, However in treatment of the breast,
energy is often chosen so that depth dose at chest wall–lung interface is 80% .
 Rationale for this lowering of energy is to
spare lung (target volume for chest wall
irradiation is quite superficial and that a
minimum of 80% (even 70%) isodose curve is
sufficient for chest wall

 Beyond 80% depth dose, dose falloff is

characteristically rapid at these beam energies)
Correction for air gaps and beam
obliquity

Ekstrand and Dixon showed that beam

obliquity tends to
increase side scatter at dmax
shift dmax toward surface
decrease depth of penetration (as
measured by depth of 80% dose).
Tissue inhomogeneities

 Dose distribution significantly altered in presence of tissue inhomogeneities such as bone,

lung, and air cavities

 Beam depth dose values depend upon density of material through which they are passing

 Therefore cavities/zones of low density material such as lungs, have a much greater effect
upon dose pattern for electrons than they do for X-rays
Effect of air cavity  (a) Shadow of air are shifted
distally,

 (b) Dose beneath air cavity

increases (loss of side-scatter
equilibrium)

 (c) Influence of air increases

laterally with depth.

 Ex: Head and neck (e.g., nasal

passages, ethmoid sinuses,
maxillary sinuses, larynx, and
mastoids)
Effect of bone
a. In shadow of bone are shifted
proximally

b. Dose outside bone-water

interface increases by
approximately 5% ( loss of side-
scatter equilibrium)

c. Influence of bone increases

laterally with depth.
Problems of adjacent feilds

When two adjacent electron fields are

 overlapping or abutting : excessively high doses in junction region

 Separating fields : under dose parts of tumor

(tumors treated are superficial & fields are usually abutted)

Increased air gap b/w applicator & surface: electron beam profile becomes less flat (increased
scattering of electrons by air)
When an electron field is abutted at surface with a photon field:

 Hot spot develops on side of photon field

 Cold spot develops on side of electron field.(out scattering of electrons from electron field)

Ex :salivary gland tumors:

a. electrons -75%- 80% of dose
b. Photons -20% - 25% of dose

SOLUTION: Polysterene wedge or beam edge modifier

Electron cone and cut outs
Cerroband
Uses

 Skin and lips

 Chest wall
 Neck
 In the form of boost
- Breast tumour cavity
- Posterior neck nodes
- Scar areas
 Total skin irradiation –Mycosis fungoides
Thank you !!!