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PHYS 383: Applications of physics in medicine (offered at the University of Waterloo from
Jan 2015)
Course Description:
This course is an introduction to physics in medicine and is intended to introduce students to
various techniques and concepts in physics, including ionizing radiation, used in medicine
particularly in oncology, for diagnosis and treatments of diseases. The course has been designed
to follow the basic curriculum of a Medical Physics training program where students will gain
insight to the importance of radiological physics in medicine and issues associated. The course is
an introduction to the AAPM academic program recommendations for graduate degree in
medical physics. The course is aimed at students with a career interest in medical physics and
who may pursue graduate studies in medical physics.
Course Schedule:
Radiological Physics and Dosimetry I
Week 1
Day 1
Day 2
Week 2
Day 3
Day 4
Week 3
Day 5
Day 6
Atomic and Nuclear Structure
Classification of Radiation
Quantities and Units Used for Describing Radiation Fields
Quantities and Units Used for Describing the Interaction of Ionizing
Radiation with Matter
5. Indirectly Ionizing Radiations: Photon Beams
6. Exponential Attenuation
Radiological Physics and Dosimetry II
7. Photon Interactions with Matter
8. Indirectly Ionizing Radiations: Neutron Beams
9. Neutron Interactions with Matter
10. Directly Ionizing Radiations
11. Interactions of Directly Ionizing Radiations with Matter
12. Radioactive Decay
Radiological Physics and Dosimetry III
13. Charged Particle and Radiation Equilibrium
14. Radiation Dosimetry
15. Calorimetric Dosimetry
16. Chemical (Fricke) Dosimetry
17. Cavity Theory
18. Ionization Chambers
19. Calibration of Photon and Electron Beams with Ionization Chambers
20. Dosimetry and Phantoms for Special Beams (or Non-TG-51
Compliant Beams)
21. Relative Dosimetry Techniques
22. Dosimetry by Pulse-Mode Detectors
23. Microdosimetry
Fundamentals of Imaging in Medicine
Week 4
Week 5
Week 6
Week 7
Day 7
Day 8
Day 9
Day 10
Day 11
Day 12
Day 13
1. X-Ray Production
2. Energizing and Controlling the X-Ray Tube
3. X-Ray Tube Heating and Cooling
4. X-Ray Image Formation and Contrast
5. Scattered Radiation and Contrast
6. Radiographic Receptors
7. The Photographic Process and Film Sensitivity
8. Film Contrast Characteristics
9. Radiographic Density Control
10. Blur, Resolution, and Visibility of Detail
11. Radiographic Detail
12. Image Noise
13. Fluoroscopic Imaging Systems
14. Dose and Dose Reduction Issues
15. Digital X-Ray Imaging Systems and Image processing
16. Computed Tomography image formation
17. Computed Tomography Image Quality
18. Principles of Ultrasound Imaging
19. Principles of Magnetic Resonance Imaging. .
20. Principles of Nuclear Medicine/Imaging
Radiobiology I
1. Review of Interaction of Radiation with Matter
2. Radiation Injury to DNA
3. Repair of DNA Damage
4. Radiation-Induced Chromosome Damage and Repair
5. Survival Curve Theory
6. Cell Death: Concepts of Cell Death (Apoptosis and Reproductive
Cell Death)
7. Cellular Recovery Processes
8. Cell Cycle
9. Modifiers of Radiation Response—Sensitizers and Protectors
Radiobiology II
10. RBE, OER, and LET
11. Cell Kinetics
12. Radiation Injury to Tissues
13. Radiation Pathology—Acute and Late Effects
14. Histopathology
15. Tumor Radiobiology
16. Time, Dose, and Fractionation
17. Radiation Genetics: Radiation Effects of Fertility and Mutagenesis
18. Molecular Mechanisms
19. Drug Radiation Interactions
Radiation Protection and Radiation Safety
Day 14
Week 8
Week 9
Day 15
Day 16
Day 17
Day 18
Week 10
Day 19
Day 20
1. Introductions and Historical Perspective
2. Interaction Physics as Applied to Radiation Protection
3. Operational Dosimetry
4. Radiation Detection Instrumentation
5. Shielding: Properties and Design
6. Statistics
7. Radiation Monitoring of Personnel
8. Internal Exposure
9. Environmental Dispersion
10. Biological Effects
11. Regulations
12. High/Low Level Waste Disposal
13. Nonionizing Radiation
Radiation Therapy I
Radiation oncology
• Overview of Clinical Radiation Oncology
• Radiobiological Basis of Radiation Therapy
External Beam Radiation Therapy
• Clinical Photon Beams: Description
• Clinical Photon Beams: Point Dose Calculations
• Clinical Photon Beams: Basic Clinical Dosimetry
• Clinical Electron Beams
• Special Photon and Electron Beams
Treatment Planning
• Target Volume Definition and Dose Prescription Criteria (ICRU
50 and ICRU 62)
• Photon Beams: Dose Modeling and Treatment Planning
• Photon Beams: Treatment Planning
• Clinical Photon Beams: Patient Application
• Clinical Electron Beams: Dose Modeling and Treatment Planning
Radiation Therapy II
Radiation Therapy Devices
• Radiation Therapy Machines
• Linear Accelerator (Linac)
• Tomotherapy
• CyberKnife
• Machine Acquisition
• Quality Control/Quality Assurance (QC/QA)
• Phantom Systems and Water Tanks
Radiation Therapy III
Special Techniques in Radiotherapy
• Special External Beam Radiotherapy Techniques: Basic
Characteristics, Historical Development, Quality Assurance
(Equipment and Treatment), Diseases Treated
• Intensity-Modulated Radiotherapy (IMRT)
Radiation Therapy with Neutrons, Protons, and Heavy Ions
• Rationale
• Neutrons
• Protons
• Heavy Ions (Helium, Carbon, Nitrogen, Neon, Argon)
• Brachytherapy: Basic Physical Characteristics
• Brachytherapy: Clinical Aspects
Stereotactic Radiosurgery
Respiratory-gated radiation therapy
Total Body irradiation (TBI)
Total skin electron irradiation (TSEI)
Intra-operative Radiotherapy (IORT)
Photodynamic Therapy (PDT)
Nuclear Medicine
• Principles of radioisotope imaging
• Production of radioisotopes
• Biological uptake
• Physical and biological half life
• Gamma Cameras
• Types of scans – SPECT, tomographic
PET imaging
Radiation Protection in Radiotherapy.
Operational Safety Guidelines
Structural Shielding of Treatment Installations
Imaging for Treatment Guidance and Monitoring
Week 11
Day 21
Day 22
Motion and Motion Management
CT and 4D CT
Portal Imaging
Cone-Beam CT
2D and 3D Ultrasound
Fusion, Registration, Deformation
Motion Management through Gating and Coaching
Day 23
Special Topics
Week 12
Computational Skills
Day 24
Professional Ethics/Conflict of Interest/Scientific Misconduct
• Data, Patient Records, Measurement Results, and Reports
• Publications and Presentations
• General Professional Conduct
 Course Text:
 Review of Radiation Oncology Physics: A Handbook for Teachers and Students,
Podgorsak, E., editor, International Atomic Energy Agency, Educational Reports
Series, Vienna, Austria (2003).
 Other Useful Texts:
 The Physics of Radiology, Johns, H. E., Cunningham, J. R., Thomas, Springfield,
Maryland, USA, (1994).
 The Physics of Radiation Therapy, Khan, F., M., Williams and Wilkins, Baltimore,
Maryland, USA, (1994).
 The Physics of Radiotherapy X-rays from Linear Accelerators, Metcalfe, P., Kron, T.,
Hoban, P., Medical Physics Publishing, Madison, Wisconsin, USA, (1997).
 Modern Technology of Radiation Oncology: A Compendium for Medical Physicists
and Radiation Oncologists, Van Dyk, J., editor, Medical Physics Publishing,
Madison, Wisconsin, USA, (1999).
 Radiobiology for the Radiologist, Eric J. Hall and Amato J Giaccia Lippincott
Williams & Wilkins