1. RADIOISOTOPES USED IN BRACHYTHERAPY Dr.Vijay Palwe Dr. Gaurav Bahl

4. Robert Abbe (American surgeon ): First used Ra after loading technique for treatment of cancer. 1910 :1st text-book of Radium therapy Wickham & Degrais . 1920-30s : major work in Paris “ Paris System ” 1930s : Meredith developed “Manchester System” 1934 :“ Paterson-Parker” History

14. Radioactive sources: Past, present and future ? Yb169, Yu169, I125, Pd103, Yb169 P32 P32, Sr/Y90 Ir192 -- Intra vascular --- Cardiac stents— Catheter based cardiac— Catheter based peripheral - Au198, Cs131 I125, Pd103 Au198 I125 , Pd103 Rn222 -- Permanent implant – Conventional dose-rate- Ultra low dose rate-- -- I125, Pd103,Yb169 Yb169, Ir192 Cs137 Ir192 Ir192 Ra226 --- --- Interstitial --- Non after loading - After loading-- HDR Am241,Ir192, Yb169 Yb169,Ir192, Co 60 Cs137 Ir192 Ra226 Co60 Intracavitory--- LDR HDR Future Current Traditional Application

15. Properties of radioactive sources Permanent Implant Seeds 1.48 0.013 17 day 0.020 Pd103 Palladium Permanent Implant Seeds 1.45 0.025 59.6 day 0.028 I125 Iodine HDR ICA Sphere 13.07 11 5.26 yrs 1.25 Co60 Cobalt LDR/HDR Seeds, Wires, ribbon 4.69 6 73.8 day 0.379 Ir192 Iridium LDR ICA & Interstitial Tubes Needle 3.28 6.5 30 yrs 0.662 Cs137 Cesium Perm. implant Temp. mould Gas 8.25 16 3.83 day 0.83 Rn222 Radon LDR ICA & Interstitial Tubes Needle 8.25 16 1626yrs 0.83* Ra226 Radium Clinical applicaion Source form Exposure rate constant HVL Pb (mm) T1/2 E (mev) Isotope Element

16. LDR Temp Interstitial Seeds 0.885 0.060 340 day 0.043 Sm145 Samarium LDR Perm. Imp Seeds 0.64 0.030 9.69 day 0.030 Cs131 Cesium High LET LDR ICA Tubes - - 2.65 day 2.4 n Cf252 Californium LDR Interstitial Seeds 1.80 0.48 32 day 0.093 Yb169 Ytterbium LDR ICA Tubes 0.12 0.12 432 yrs 0.060 Am241 Americanum Ocular Plaque - - 28.9 yrs 2.24 b Sr90-Y90 Sr / Y Permanent Implant Seeds 2.35 6 2.7 day 0.412 Au198 Gold Clinical applicaion Source form Exposure rate constant HVL Pb (mm) T1/2 E (mev) Isotope Element

18. 0.66mg/cm 0.66mg/cm 1.0mg/cm 0.33mg/cm 0.66mg/cm Uniform Indian Club Dumb bell Tube TYPES OF RADIUM NEEDLES

19. Uranium Ra Rn RaA RaB RaC Pb α α α βγ βγ T 1/2 1620Yrs 3.83days 3.05min 26.8min 19.7min Stable Radium : provides constant source, replenishes decaying stock of Radon

20. Wall thickness: 0.5mm of Pt+Ir alloy 1mm of Pb to stop β Gold foil : 0.1 mm thick Cells : used for loading Physical characters of Ra 226 needles Outer case(Pt+10%Ir) Space forRa+filler mixture Eyelet hole cells

23. Miniature cylindrical source of CAESIUM 137: ( Cs 137 ) 5mm Active bead (1.1mm dia.) Stainless steel 1.8 Miniature cylindrical source

24. Spacer beads Retaining spring Min.cyl.sources Spiral spring Screw thread Source train Manual afterloading system of Cs Source train consist of flexible stainless steel holder containing miniature source separated by spherical steel spacers 1.8 mm in diameter. Sources and spacers retained by a steel spring.

25. Cs 137 is incorporated in glass bead & encapsulated in stainless steel ball bearing. which with inactive spacer beads, can be pneumatically loaded from intermediate safe to pt. applicator. Remote afterloading system of Cs 2.5mm

28. 192 Ir wire( coil form) Single Pin Hair Pin Physical forms of 192 Ir- Core dia 0.1mm 0..4mm Sheath thickness 0.1mm 0.4mm Overall 0.3mm 0.6mm Wire Hair pins

35. Titanium end cup Lead Xray marker Pd plated grafite pellet Laser weld 103Pd seed 0.8mm 4.5mm

41. NEWER ISOTOPES IN BRACHYTHERAPY

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