INTRODUCTION

OF
CO -60 UNIT

NILESH KUMAR
PG RADIATION PHYSICS
DEPARTMENT OF RADIATION PHYSICS
• Overview

Radionuclide's such as radium-226, cesium-137, and cobalt-60 have been

used as sources of gamma rays for teletherapy.

These gamma rays are emitted from the radionuclide's as they undergo
radioactive disintegration.

Of all the radionuclide's, Co-60 has proved to be the most suitable for
external beam radiotherapy.
The reasons for its choice over radium and cesium are higher
possible specific activity (curies per gram), greater radiation
output per curie, and higher average photon energy .
 A typical source activities are in the order of 5000-10,000 ci and provide
typical dose rate at 80 cm from the teletherapy source of the order of 100-
200 cGy/min.

 often the output of teletherapy machine is started in Rmm ( roentgen per

minute at 1 m ) as a rough guide for source strength .

 Treatment head has the capacity to take a source with an activity of 10,000
roentgens per hour at a meter ( RHm ) .
 COBALT-60 UNIT

Source

 The 60Co source, usually in the form of a solid cylinder, disks, or pallets, is
contained inside a stainless-steel capsule and sealed by welding.

 This capsule is placed into another steel capsule which is again sealed by
welding.

 The double-welded seal is necessary to prevent any leakage of the

radioactive material.
 The Co-60 source decays to Ni-60 with the emission of β particles (Emax = 0.32
MeV) and two photons per disintegration of energies 1.17 and 1.33 MeV.

 These gamma rays constitute the useful treatment beam.

 The β particles are absorbed in the cobalt metal and the stainless-steel capsules
resulting in the emission of bremsstrahlung x-rays and a small amount of
characteristic x-rays.

 A typical teletherapy 60Co source is a cylinder of diameter ranging from 1.0 to

2.0 cm and is positioned in the cobalt unit with its circular end facing the patient
 Source Housing / source head

 It consists of a steel shell filled with lead for shielding purposes and a device
for bringing the source in front of an opening in the head from which the
useful beam emerges.

 a heavy metal alloy sleeve is provided to form an additional primary shield

when the source is in the off position.
 A number of methods have been developed for moving the source from the
off position to the on position.

 These methods are -:

I. Rotating wheel
II. Sliding drawer
III. mercury shutter
IV. moving jaw
 Rotating wheel

 The source mounted on a

rotating wheel inside the
sourcehead to carry the source
from the off position to the on
position.
 Sliding drawer

A pneumatically driven source

drawer is used for moving the
source between shielded
position and treatment position.

The pneumatic cylinder will

return the sourceautomatically
to radiation-off position in case
of any failure.
 Mercury shutter

 mercury is allowed to flow into

the space immediately below
the source to shut off the beam.
 Moving jaw

 The source is fixed in front of the

aperture and the beam can be
turned on and off by a shutter
consisting of heavy metal jaws.
 Beam Collimation

 The size and orientation of the radiation beam is controlled by the collimator
assembly.

 Two pairs of motorized jaws generate rectangular and square field of desired size.

 The collimator can also be rotated around the radiation beam axis.

 The radiation field can be visualized by a high intensity light during patient
positioning
 The centre of the radiation field
is indicated by the collimator
cross hairs.

 Two sets of trimmers are

provided to decrease the
penumbra of the beam.

 The lower pad of the collimator

is prepared to receive wedge
filters and shadow tray for the
beam shaping lead blocks.
 Penumbra

 Penumbra refers the region at the edge of beam where dose rate changes
rapidly as function of distance from beam axis.

Types of penumbra :

Geometric
Transmission
 Transmission penumbra

• It is the region irradiated by photons which are transmitted through the edge of
the collimator blocks

 Geometrical penumbra :

 formula =

• it is formed due to dimension of source.

• It is formed due to finite source size and must be concern in teletherapy

machines where the sources is between 1 – 2 cm in size.
 Conclusions :

 penumbra increases with increase in source diameter , SSD , and depth.

Penumbra width decreases with a increase in SDD

penumbra trimmers - :

 it consists of extensible , heavy metal bars to attenuate the beam in the

penumbra region.

 increase the source to diaphragm distance , reducing the geometric

penumbra.
 Gantry

 The gantry can rotate by 360°. The rotational movement of the gantry is
motorized and controlled in two directions continuously; its rotation speed
can be adjusted.

 Teletherapy machines are most often mounted isocentrically, allowing the

beam to rotate about the patient at a fixed SAD. They can be used either as
fixed field machines or rotation units.

 Most cobalt-60 unit machines have SAD of 80 cm.

 The axis of rotation of the three structures:
Gantry
Collimator
Couch
coincide at a point known as the Isocenter.

Isocentric Mounting
 Enhances accuracy.
 Allows faster setup and is more accurate than older non isocentrically
mounted machines.
 Makes setup transfer easy from the simulator to the treatment machine
 Patient Support Assembly / Couch

 Treatment Bed has motorized movements

 Horizontal
 Vertical
 . Lateral.
 Table Top - 90°rotation to each side
 Base - 90° rotation to each side
 Control Console

 Control Console is situated outside the bunker

 Interlocks present on the console for- :

Air Pressure
 Door
Head Lock -Treatment Head has a swivel movement of +/- 180°.
 OFF Shield
 Treatment Mode.
 Wedge Filter.
Tray Interlock.
 Timer
 Timer

 The prescribed target dose is delivered with the help of two treatment
timers -:

 primary timer - the primary timer actually controls the treatment time.

 secondary timer - accounts for the source movement from OFF to ON

position and agin to OFF position ( shutter time )

 Formula of shutter time =

 where , R1 - meter reading for given time ( say 2 min )
R2 - Meter reading for two consecutive times ( 1+1 min )

eg - :
MR 1 MR 2 Mean
Meter reading
Time 1 min
+ 300 v 36.15 nc 36.14 nc 36.145 nc
 Warning lights

• Red light: Radiation present- do not enter room

• Green Light: time elapsed

• Malfunction: both red and green lights still on- means that machine is still
in on position after prescribed dose has been delivered. Remove patient.
 Beam shaping and modifying devices

 The system has accessories like -:

wedge filters
Breast cone
Sheilding blocks, to modify the beam shape or beam attenuation.

 They are placed on the machine between the collimator and the patient.
 wedge filters

 special filters or absorbing blocks are placed in the path of a beam to

modify its isodose distribution.

 The most commonly used beam-modifying device is the wedge filter.

 This is a wedge-shaped absorber that causes a progressive decrease in the

intensity across the beam, resulting in a tilt of the isodose curves from their
normal positions.
 the isodose curves are tilted
toward the thin end, and the
degree of tilt depends on the slope
of the wedge filter.

 In actual wedge filter design, the

sloping surface is made either
straight or sigmoid in shape .
 The wedge is usually made of a dense material, such as lead or steel, and is mounted
on a transparent plastic tray,

 which can be inserted in the beam at a specified distance from the source .

 This distance is arranged such that the wedge tray is always at a distance of at least
15 cm from the skin surface,

so as to avoid destroying the skin-sparing effect of the megavoltage beam.

 Wedge Systems

 Wedge filters are of two main types -:

I. individualized wedge system,

 which requires a separate wedge for each beam width, optimally designed
to minimize the loss of beam output.

 A mechanism is provided to align the thin end of the wedge with the border
of the light field
2 . The second system uses a universal wedge -:

 a single wedge serves for all beam widths.

 Such a filter is fixed centrally in the beam, while the field can be opened to
any size.

 only a small part of this wedge is effective in producing the given wedge
angle.

 The rest, being unwedged, does not contribute to the isodose tilt but reduces
the beam intensity .
 the individualized system reducing the beam output, it is preferred for use
in cobalt teletherapy.

 The universal wedge, is useful for linear accelerator beams where the
output is more.

 From the setup and treatment planning points of view, the universal wedge
is simpler to use than the individualized filter.
 Effect on Beam Quality

 The wedge filter alters the beam quality by preferentially attenuating the lower-
energy photons (beam hardening)

 to a lesser extent, by Compton scattering, which results in energy degradation (beam

softening).

 For the 60Co beam, because the primary beam is essentially monoenergetic, the
presence of the wedge filter does not alter the central axis percent depth dose
distribution.

 For x-rays, on the other hand, there can be some beam hardening , and as a result
the depth dose distribution can be somewhat altered, especially at large depths
 Breast Cone

 A beam modifying and directing device used for a tangential fields therapy

 Advantages: –

 Directs beam to the central axis of the area of interest, where a tangential beam is applied to a
curved surface

 Helps position, the patient with an accurate SSD

 Endplate provides compensation,

 which enhances surface dose and presses down the tissue.

 Effective shielding of lungs

 SHIELDING BLOCKS

 Aims of shielding-

 protect critical structures ( organ )

 avoid unnecessary radiation to normal tissues

 matching adjacent fields

 An ideal shielding material should have the following characteristics :

 high atomic no
 high density
 easily available
 inexpensive
 easily modifiable

 The most commonly used shielding material for photons is Lead ( Pb )

The thickness of shielding block used depends upon the energy of the radiation
The shielding material which reduces beam transmission to 5% of its original is
considered acceptable .

The term half value layer is an expression for the attenuation produced by any material.

half-value layer (HVL) is defined as the thickness of an absorber of specified composition

required to attenuate the intensity of the beam to half its original value.

Practically thickness of lead between 4.5 – 5 half value layers which results in 5% or less
of primary beam transmission.
 Custom blocks

• The conformal blocks are made with low melting point alloy called Cerrobend.

• The Cerrobend material consists of 50.0% bismuth, 26.7% lead, 13.3% tin, and 10.0%
cadmium .

• The main advantage of Cerrobend over lead is that it melts at about 70 °C (compared with
327 °C for lead) and therefore, can be easily cast into any shape.

• At room temperature, it is harder than lead.

• The minimum thickness of Cerrobend blocks required for blocking may be calculated from
Table 13.1 using its density ratio relative to lead (e.g., multiply lead thickness by 1.21).
 Placing of shielding material

 In kilovoltage radiation shielding is readily achieved by placing sheets of lead on the

surface directly

 It is because of the lower penetrating power of beam

 In megavoltage radiation,

Thicker blocks used.

Placed higher up in shadows trays (15-20cm )

 T - ROD mechanism in cobalt-60 unit

 The external T-ROD shall be fitted with this indicator rod incase of failure of
Automatic source retracting system to push the source to the OFF condition.

 Source stuck during treatment – Emergency situation when the Cobalt-60 source
gets stuck in between the “off” and “on” position .

 Rotate gantry to side opposite to maze wall – Insert “T-rod” and push it till the
source reaches “safe” position
 The beamstopper

 The beamstopper is a lead-filled steel assembly, which acts as a beam

absorber. The beamstopper attenuates 99.9% of the primary beam.

 A beam stopper is used to intercept the beam for additional shielding of the

exit beam. The beam stop also acts as a counterweight for the head of the
machine.
 References -:

I. KHAN’S The Physics of Radiation Therapy

II. Radiation Oncology Physics: E.B. Podgorsak
III. Article - BARC DEVELOPS COBALT-60 TELETHERAPY MACHINE FOR CANCER TREATMENT