RADIOBIOLOGY RADIOLOGIC UNITS

PRELIM Air kerma

LESSON 1: RADPHYSICS = measured in C/kg or Roentgen(R)
= Radiation exposure or intensity
CONCEPT OF RADIATION = amount of charge (electrons) liberated per kilogram of Air
Matter = anything that occupies space and has form or shape. (Ionization)
Mass = quantity of matter contained in any physical object. • 1𝑅 = 2.58𝑥10−4 𝐶/𝐾𝑔
Weight = force exerted by a body under the influence of gravity.
ABSORBED DOSE
Energy = measured in Gray (Gy) or Rad
= Ability to do work = amount of energy deposited/ absorbed per kilogram of tissue
= The law of conservation of energy states that energy may be • 1Gy = 1 Joule/Kg
transformed from one form to another, but it cannot be created or • 100 Rad = 1 Joule/Kg
destroyed. • 1Rad = .01 Gy

Potential = is the ability to do work by virtue of position. DOSE EQUIVALENT

Kinetic = the energy of motion: it is possessed by all matter in = measured in Sieverts (Sv) or Rem
motion: a moving automobile, a turning windmill wheel, a falling = Express the quantity of radiation received by radiation workers.
guillotine blade. • 1Sv = 1 Joule/Kg
Chemical = is the energy released by a chemical reaction. • 100 Rem = 1 Joule/Kg
Electrical = is represents the work that can be done when an • 1Sv = .01 Rem
electron moves through an electric potential difference (voltage)
Thermal (heat) = is the energy of motion at the molecular level. ACTIVITY
Nuclear = is the energy that is contained within the nucleus of an = Unit of radioactivity - Bq = Becqeurel - Ci = Curie
atom. = unit of the quantity of radioactive material and not the radiation
emitted by that material
Radiation = Energy emitted and transferred through matter. • 1Ci = 3.7𝑥1010 Bq

Two Types of Radiation: SPECIAL QUANTITIES OF RADIOLOGIC SCIENCE AND THEIR UNITS
1. Ionizing Radiation = Capable of removing an orbital electron Radiographic Special International System (SI)
from an atom with which it interacts. Quantities Units Units
Sources of Ionizing Radiation: Exposure C/kg Air Kerma (𝐺𝑦𝑎 )
○ Natural Background Radiation = radon Dose J/kg 𝐺𝑟𝑎𝑦𝑡 (𝐺𝑦𝑡 )
○ Man-made Radiation = computer, cctv, nuclear power Effective dose J/kg Sievert (Sv)
plant, x-ray Radioactivity 𝑠 −1 Becquerel (Bq)
Discovery of X-ray
Wilhelm Conrad Roentgen discovered x-ray by accident in FUNDAMENTALS OF PHYSICS
November 8, 1895. Velocity
= Sometimes called “speed”
Amazing features about the discovery of x-rays: = Measure of how fast something is going, the rate of change of its
1. Quite by accident position with time.
2. Fewer than a dozen contemporaries of Roentgen had previously = Velocity=d/t ; Where d represents the distance, and t is time
observed x-radiation, but none of these other physicists had • Example: = What is the velocity of a ball that travels 60 m
recognized its significant or investigated it. in 4s? ans: 15 m/s
3. Followed his discovery with such scientific vigor that within little
more than a month he had ascribed to x-radiation nearly all the NEWTON’S LAW OF MOTION
properties recognized today. 1. Law of inertia = a body will remain at rest or continue
moving with a constant velocity in a straight line unless
BASIC RADIATION PRODUCTION acted on by an external force.
Filtration = usually aluminum, inserted into x-ray tube housing so 2. Law of force = push or pull on an object
that low energy x-rays emitted by the tube are absorbed before = states that the force applied to move an object is equal to the
they can reach the patient. mass of the object times the acceleration.
Collimation = restricts the useful beam to that part of the body = F=ma ; Where m is mass and a is acceleration
requiring examination and thereby spares adjacent tissue from = SI unit of force is the NEWTON (N). In the CGS system the unit is
unnecessary exposure.; joint to joint the dyne (1N = 10^3 dyne)
Intensifying screen (IS) = reduce the exposure of the patient to x- 3. To every action there is an equal and opposite reaction.
rays by more than 95% compared with examinations without IS.
Protective apparel = lead aprons and gloves Weight
Gonadal shielding = for the reproductive organs and pregnant = Is a force on a body caused by the downward pull of gravity on it.
women. = Weight of an object is equal to the product of its mass and the
Protective barriers acceleration of gravity
• Primary Radiation Barriers – e.g., wall, door, floor; = Wt = mg
protection from primary exposure of radiation. = Unit of weight are the same as those for force: newtons and
• Secondary Radiation Barriers – protection from scattered dynes. In the British system is measured in pounds.
radiation; e.g., radiation apron
Momentum X-RAY INTERACTION WITH MATTER
= The product of the mass of an object and its velocity, represented
by p. FIVE X-RAY INTERACTION WITH MATTER
= p = mv ✓ Classical Scattering
= The greater the velocity of an object, the more momentum the ✓ Compton Effect
object possesses. ✓ Photoelectric Effect
= ↑Velocity ↑Momentum ✓ Pair Production
✓ Photodisintegration
Work
= Force applied times the distance over which it is applied. Low energy x-rays- interact with the whole atom
= Work = Fd Moderate- interact with the electrons
= Units of work are the joule (J) in SI and the erg in CGS. High Energy- interact with the nuclei

Power CLASSICAL SCATTERING

= Rate of doing work = Energies below 10 keV
= The SI unit of power is the joule/second (J/s), which is called the = Sometimes called Coherent or Thompson scattering
watt (W). The British unit of power is the horsepower (hp). = Incident photon interacts with a target atom, causing it to
• 1hp = 746 W become excited. The target atom immediately releases this excess
• 1000W =1kW energy as a secondary or scattered photon with wavelength equal
= P = Work/t (λ = λ’) to that of the incident atom and therefore equal energy.
= Change in direction of the x-ray without a change in its energy.
THE ATOM = no energy transfer and therefore no ionization.
Atom = They thought all matter was composed of 4 substances:
earth, water, air and fire, modified by four basic essences: wet, dry, COMPTON EFFECT
hot and cold. = Occurs between moderate energy x-rays and outer shell
electrons.
John Dalton = It results in ionization of the target atom, change in photon
= English Chemist direction, and reduction of photon energy.
= According to Dalton, an element was composed of identical = The wavelength of the scattered x-ray is greater than that of the
atoms that reacted the same way in chemical reactions. incident x-ray.
▪ For example, all oxygen atoms were alike. They looked = Such radiation is the source of most of the occupational radiation
alike, they were constructed alike, and they reacted alike. exposure that radiologic technologist receives.
However, very different from atoms of any other
element. PHOTOELECTRIC EFFECT
= Physical combination of one type of atom with another was = Interactions with inner shell electrons of target atoms, so that x-
visualized as being an “hook and eye affair”. ray is not scattered but totally absorbed.
= The incident photon disappears, and the K-shell electron, now
J.J Thomson called a photoelectron, is ejected from the atom.
= English Physicist = Characteristic x-rays are produced following a photoelectric
= He described the atom as something like “plum and pudding”, interaction in a manner similar described earlier.
where the plum represented negative electric charges (electrons- = The ejection of a K-shell photoelectron by the incident x-ray
corpuscles), and the pudding was a shapeless mass of uniform results in a vacancy in the K-shell, and corrected by an outer shell
positive electrification. e, dropping into vacancy, accompanied by the emission of x-ray.
= These characteristic x-rays are also secondary radiation/scattered
Enrest Rutherford radiation, and contribute nothing of diagnostic value.
= 1911 British Physicist
= He disproved Thomson’s model of atom. PAIR PRODUCTION
= Introduced nuclear model, w/c described the atom as containing = Occurs with x-rays that have energies greater than 1.02 MeV.
a small, dense, positively charged center surrounded by a negative = The photon interacts with the nuclear force field, and two
cloud of randomly located electrons. He called the center of the electrons that have opposite electrostatic charges are created, one
atom “nucleus”. positively charged (positron), and one negatively charged.

Niel’s Bhor PHOTODISINTEGRATION

= 1913, Danish Physicist = Energies above 10 MeV, can escape interaction with electrons
= Improved Rutherford’s description of the atom. and the nuclear electrostatic field and be absorbed directly by the
= Bohr’s model was a “miniature solar system” in w/c the electrons nucleus.
revolved about the nucleus in prescribed orbits or energy levels. = When this happens, the nucleus is raised to an excited state and
X-ray Interaction with Matter instantaneously emits a nucleon or other nuclear fragment.
PRELIM MOLECULAR COMPOSITION
LESSON 2: HUMAN BIOLOGY = Five principal types of molecules are found in the body
= Four of these molecules
Radiobiology = The study of the effects of ionizing radiation on ▪ Proteins
biologic tissue. ▪ Lipids (fats)
• Diagnosis ▪ Carbohydrates (sugars and starches)
• Therapy ▪ Nucleic acids—are macromolecules

Human Radiation Response WATER = shape

= The effect of x-rays on humans is the result of interactions at the = The most abundant molecule in the body, and it is the simplest.
atomic level. = It consists of two atoms of hydrogen and one atom of oxygen
= If the radiation response increases in severity with increasing (H2O) and constitutes approximately 80% of human substance.
radiation dose, it is called a deterministic effect and occurs within = water molecules exist both in the free state and in the bound
days after the radiation exposure. ‖ ―if the incidence of the state, that is, bound to other molecules.
radiation response increases with increasing radiation dose, it is ▪ Homeostasis = the concept of the relative constancy of
called a stochastic effect and is not observed for months or years. the internal environment of the human body.
▪ Catabolism = Breaking down into smaller units of
Table: Summary of Acute Radiation Lethality macromolecules.
Period Approximate Mean Clinical Signs and ▪ Anabolism = the production of large molecules from
Dose (𝑮𝒚𝒕 ) Survival Symptoms small.
Time
(Days) PROTEINS
Prodromal >1 --- Nausea, = Approximately 15% of the molecular composition of the body
vomiting, = Long-chain macromolecules that consist of a linear sequence of
diarrhea amino acids connected by peptide bonds
Latent 1-100 --- None = Twenty-two amino acids are used in protein synthesis
Hematologic 2-10 10-60 Nausea, = The linear sequence, or arrangement, of these amino acids
vomiting, determines the precise function of the protein molecule.
diarrhea, = The generalized formula for a protein is CnHnOnNnTn, where the
anemia, subscript ―n refers to the number of atoms of each element in the
leukopenia, molecule; T represents trace elements.
hemorrhage, ✓ 50% of the mass of a protein molecule is carbon,
fever, infection ✓ 20% oxygen,
Gastrointestinal 10-50 4-10 Same as ✓ 17% nitrogen,
hematologic ✓ 7% hydrogen,
plus electrolyte ✓ 6% other elements
imbalance,
lethargy, fatigue, ▪ Enzymes = are molecules that are necessary in small
shock quantities to allow a biochemical reaction to continue
even though they do not directly enter into the reaction.
Central nervous >50 0-3 Same as
▪ Hormones = are molecules that exercise regulatory
system gastrointestinal
control over some body functions, such as growth and
plus ataxia,
development.
edema, system
▪ Antibodies = constitute a primary defense mechanism of
vasculitis,
the body against infection and disease.
meningitis
LIPIDS (fats)
Atomic Composition of the Body
= organic macromolecules composed solely of carbon, hydrogen,
• 60.0& hydrogen • 0.2 calcium
and oxygen.
• 25.7% oxygen • 0.1% phosphorus
= represented by the general formula, CnHnOn
• 10.7% carbon • 0.1% sulfur
= lipids are composed of two types of smaller molecules:
• 2.4% nitrogen • 0.8% trace elements
▪ glycerol
▪ fatty acid
Molecular Composition of the Body
= are concentrated just under the skin and serve as a thermal
• 80% water • 1% carbohydrates
insulator from the environment.
• 15% protein • 1% nucleic acid
= serve as fuel for the body by providing energy stores.
• 2% lipids • 1% other
CARBOHYDRATES (sugars and starches)
CELL THEORY
= First considered to be watered, or hydrated, carbons,
➢ In 1665, Robert Hooke. ‘’biological building blocks’’
= Carbohydrates are called Saccharides, Monosaccharides,
➢ In 1673, Anton van Leeuwenhoek. ‘’living cells’’
Disaccharides
➢ In 1838, Schneider and Schwann showed conclusively
▪ Chemical formula for glucose, a simple sugar, is C₆H₁₂O₆
that in all plants and animals, cells are the basic functional
▪ Polysaccharides are large and include plant starches and
units.
animal glycogen.
➢ In 1953 Watson and Crick description of the molecular
structure of deoxyribonucleic acid (DNA)
NUCLEIC ACID (ARE macromolecules)
➢ Human Genome Projection.
= deoxyribonucleic acid (DNA)
= Ribonucleic Acid
= Located principally in the nucleus of the cell acid (RNA).
DEOXYRIBONUCLEIC ACID TYPES OF CELLS
= DNA serves as the command or control molecule for cell function RADIOSENSITIVITY CELL TYPE
= DNA contains all the hereditary information that represents a cell HIGH Lymphocytes
and, of course, if the cell is a germ cell, all the hereditary Spermatogonia
information of the whole individual. Erythroblasts
= DNA is the radiation-sensitive target molecule. Intestinal crypt cells
INTERMDEIATE Endothelial cells
RIBONUCLEIC ACID Osteoblast
= Located principally in the cytoplasm Spermatids
= Forms in the nucleus. Fibroblasts
Two types of RNA: LOW Muscle cells
▪ messenger RNA (mRNA) Nerve cells
▪ transfer RNA (tRNA)
= These molecules are involved in the growth and development of TISSUES COMPOSITION OF THE BODY
the cell through a number of biochemical pathways, most notably, TISSUE ABUNDANCE
protein synthesis. Muscle 43&
Fat 14%
NITROGENOUS BASE: AN ORGANIC BASE THAT CONTAINS Organs 12%
NITROGEN; Skeleton 10%
Purine = a nitrogenous base that has a double- ring structure; one Blood 8%
of two general categories of nitrogenous bases found in DNA & Subcutaneous tissue 6%
RNA; either adenine or guanine Bone marrow 4%
Skin 3%
Pyrimidine = a nitrogenous base that has a single-ring structure;
one of the two general categories of nitrogenous bases found in RELATIVE RADIOSENSITIVITY OF TISSUE AND ORGANS BASED
DNA& RNA; thymine, cytosine or uracil ON CLINICAL RADIATION ONCOLOGY
Level of Tissue or Organ Effects
Base-Pairing Rules = the rules stating that cytosine pairs w/ guanine radiosensitivity
& adenine pairs w/ thymine in DNA & adenine pairs w/ uracil in RNA High: 2-10 𝑮𝒚𝒕 Lymphoid tissue Atrophy
(200-1000 rad) Bone marrow Hypoplasia
Double Helix = shape of a DNA molecule formed when two twisted Gonads
DNA strands are coiled into a springlike structure & held together Intermediate: 10- Skin Erythema
by hydrogen bonds b/t the bases. 50 𝑮𝒚𝒕 GI tract Ulcer
(1000-5000 rad) Cornea Cataract
HUMAN CELLS Growing bone Growth arrest
The two major structures of the cell are; -nucleus and the Kidney Nephrosclerosis
cytoplasm. Liver Ascites
▪ Nucleolus - most of the RNA is contained in a rounded Thyroid Atrophy
structure. Low: >50 𝑮𝒚𝒕 Muscle Fibrosis
▪ Cytoplasm - makes up the bulk of the cell and contains (>5000 rad) Brain Necrosis
great quantities of all molecular components except Spinal Transection
DNA.

Endoplasmic reticulum = is a channel or a series of channels that

allows the nucleus to communicate with the cytoplasm.
Mitochondria = large bean structure.
= engine of the cell.
Ribosomes = are the site of protein synthesis.
Lysosomes = contain enzymes capable of digesting cellular
fragments and sometimes the cell itself.
=help to control intracellular contaminants.

CELL PROLIFERATION
Cell proliferation = is the act of a single cell or group of cells to
reproduce and multiply in number.

Two types of Cells:

1. Somatic Cells
2. Genetic Cells

Meiosis = Genetic material can change during the division process

of genetic cells
PRELIM BIOLOGICAL FACTORS THAT AFFECT RADIOSENSITIVITY
LESSON 3: FUNDAMENTAL PRINCIPLES OF 1. Oxygen Enhancement Ratio (OER)
RADIOBIOLOGY 2. Age
3. Recovery
Law of Bergonie and Tribondeau 4. Chemical Agents
1906, 2 French Scientist Bergonie and Tribondeau 5. Hormesis
• The law states that the radiosensitivity of living tissue varies
with maturation and metabolism of the tissue being irradiated
✓ Stem cells are radiosensitive; mature cells are Oxygen Enhancement Ratio
radioresistant. • Ratio of the dose necessary to produce a given effect under
✓ Younger tissues and organs are radiosensitive. anoxic conditions to the dose necessary to produce the same effect
✓ Tissues with high metabolic activity are radiosensitive. under aerobic conditions.
✓ A high proliferation rate for cells and a high growth rate 𝑂𝐸𝑅
𝐷𝑜𝑠𝑒 𝑛𝑒𝑐𝑒𝑠𝑠𝑎𝑟𝑦 𝑢𝑛𝑑𝑒𝑟 𝑎𝑛𝑜𝑥𝑖𝑐 𝑐𝑜𝑛𝑑𝑖𝑡𝑖𝑜𝑛𝑠 𝑡𝑜 𝑝𝑟𝑜𝑑𝑢𝑐𝑒 𝑎 𝑔𝑖𝑣𝑒𝑛 𝑒𝑓𝑓𝑒𝑐
for tissues result in increased radiosensitivity. =
Physical Factors that affects Radiosensitivity 𝐷𝑜𝑠𝑒 𝑛𝑒𝑐𝑒𝑠𝑠𝑎𝑟𝑦 𝑢𝑛𝑑𝑒𝑟 𝑎𝑒𝑟𝑜𝑏𝑖𝑐 𝑐𝑜𝑛𝑑𝑖𝑡𝑖𝑜𝑛𝑠 𝑡𝑜 𝑝𝑟𝑜𝑑𝑢𝑐𝑒 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑒𝑓𝑓𝑒
1. Linear Energy Transfer Exercise:
2. Relative Biologic Effectiveness When experimental mouse mammary carcinomas are clamped and
3. Protraction and Fractionation irradiated under hypoxic conditions, the tumor control dose is 106
Linear Energy Transfer (LET) Gyt. When these tumors are not clamped and are irradiated under
• a measure of the rate at which energy is transferred from ionizing aerobic conditions, the tumor control dose is 40.5 Gyt. What is the
radiation to soft tissue OER for this system
• Another method of expressing radiation quality and determining 2.6
the value of the radiation weighting factor (WR) used in radiation OXYGEN EFFECT
protection • Tissue is more sensitive to radiation when irradiated in the
• Expressed in units of kiloelectron volt of energy transferred per oxygenated or aerobic state than when irradiated under anoxic
micrometer of track length in soft tissue (keV/μm). (without oxygen) & hypoxic (low oxygen) condition.
▪ As LET increases: HYPERBARIC/HIGH PRESSURE OXYGEN
➢ ionization occurs frequently • It has been used in radiation oncology
➢ Increases the ability to produce biologic damage Note: Diagnostic x-ray imaging is performed under conditions of full
➢ increases the probability of interaction with the target oxygenation.
molecule Age
Relative Biologic Effectiveness ❖ The age of a biologic structure affects its
• As the LET of radiation increases, the ability to produce biologic radiosensitivity.
damage also increases. ❖ Humans are most sensitive before birth.
𝐷𝑜𝑠𝑒 𝑜𝑓 𝑠𝑡𝑎𝑛𝑑𝑎𝑟𝑑 𝑟𝑎𝑑𝑖𝑎𝑡𝑖𝑜𝑛 𝑛𝑒𝑐𝑒𝑠𝑠𝑎𝑟𝑦 ❖ After birth, sensitivity decreases until maturity, at
𝑡𝑜 𝑝𝑟𝑜𝑑𝑢𝑐𝑒 𝑡𝑜 𝑎 𝑔𝑖𝑣𝑒𝑛 𝑒𝑓𝑓𝑒𝑐𝑡 which time humans are most resistant to radiation
𝑅𝐵𝐸 = effects.
𝐷𝑜𝑠𝑒 𝑜𝑓 𝑡𝑒𝑠𝑡 𝑟𝑎𝑑𝑖𝑡𝑎𝑖𝑜𝑛 𝑛𝑒𝑐𝑒𝑠𝑠𝑎𝑟𝑦 𝑡𝑜
𝑝𝑟𝑜𝑑𝑢𝑐𝑒 𝑡ℎ𝑒 𝑠𝑎𝑚𝑒 𝑒𝑓𝑓𝑒𝑐𝑡 ❖ In old age, humans again become somewhat more
Note: radiosensitive.
• The standard radiation, by convention, is orthovoltage x-radiation Recovery
in the range of 200 to 250 kVp. • If the radiation dose is not sufficient to kill the cell before its next
• (This type of x-ray beam was used for many years in radiation division (interphase death), then given sufficient time, the cell will
oncology and in essentially all early radiobiologic research) recover from the sublethal radiation damage it has sustained.
• Diagnostic x-rays have an RBE of 1. • This intracellular recovery is attributable to a repair mechanism
• LOWER RBE (less that 1) inherent in the biochemistry of the cell.
• HIGHER RBE (greater than 1) • Some types of cells have greater capacity than others for repair
Linear Energy Transfer and Relative Biologic Effectiveness of of sublethal damage.
Various Radiation Doses Note: If a tissue or organ receives a sufficient radiation dose, it
Type of Radiation LET (keV/ μm) RBE responds by shrinking.
25 MV x-rays 0.2 0.8 Interphase Death: occurs when the cell dies before replicating.
60 0.3 0.9 𝑅𝑒𝑐𝑜𝑣𝑒𝑟𝑦 = 𝐼𝑛𝑛𝑡𝑟𝑎𝑐𝑒𝑙𝑙𝑢𝑙𝑎𝑟 + 𝑹𝒆𝒑𝒐𝒑𝒖𝒍𝒂𝒕𝒊𝒐𝒏
𝐶𝑜 gamma rays
1 MeV electrons 0.3 0.9
Diagnostic x-rays 3.0 1.0
Chemical Agents
10 MeV protons 4.0 5.0 1. Radiosensitizers
Fast neutrons 500.0 10 2. Radioprotectors
5 MeV alpha particles 100.0 20 Radiosensitizers
Heavy nuclei 1000.0 30 • Agents that enhance the effect of radiation
Example: • Ex. halogenated pyrimidines, methotrexate, actinomycin D,
hydroxyurea, and vitamin K.
Radioprotectors
TWO WAYS OF LENGTHENING THE TIME OF IRRADIATION • Radioprotective compounds include molecules that contain a
PROTRACTION sulfhydryl group (sulfur and hydrogen bound together), such as
❖ The dose is delivered continuously but at a lower dose cysteine and cysteamine.
rate. Hormesis
FRACTIONATION • The biologic responses to low exposures to toxins or other
❖ The dose is delivered at the same dose in equal portions stressors
at regular intervals. • “Regardless of radiation hormesis, we continue to practice ALARA
Note: Dose protraction and fractionation cause less effect because (“as low as reasonably achievable”) vigorously as a known safe
time is allowed for intracellular repair and tissue recovery. approach to radiation management.
RADIATION DOSE-RESPONSE RELATIONSHIPS
Radiation dose response relationships
• A radiation dose-response relationship is a mathematical
relationship between various radiation dose levels and magnitude
of the observed response.
Characteristic of Radiation dose-response rel.
• Linear threshold
• Non-linear threshold
“Either threshold or non threshold”
Linear: Threshold and Nonthreshold

Nonlinear: Threshold and Nonthreshold

NOTE: “Skin effects resulting from high-dose fluoroscopy follow a

sigmoid-type dose response relationship.’’