Absorbed dose in the context of Effective radiation dose

Radiation therapy or radiotherapy (RT, RTx, or XRT) is a treatment using ionizing radiation, generally provided as part of cancer therapy to either kill or control the growth of malignant cells. It is normally delivered by a linear particle accelerator. Radiation therapy may be curative in a number of types of cancer if they are localized to one area of the body, and have not spread to other parts. It may also be used as part of adjuvant therapy, to prevent tumor recurrence after surgery to remove a primary malignant tumor (for example, early stages of breast cancer). Radiation therapy is synergistic with chemotherapy, and has been used before, during, and after chemotherapy in susceptible cancers. The subspecialty of oncology concerned with radiotherapy is called radiation oncology. A physician who practices in this subspecialty is a radiation oncologist and practicing radiographer are therapeutic radiographer.

Radiation therapy is commonly applied to the cancerous tumor because of its ability to control cell growth. Ionizing radiation works by damaging the DNA of cancerous tissue leading to cellular death. To spare normal tissues (such as skin or organs which radiation must pass through to treat the tumor), shaped radiation beams are aimed from several angles of exposure to intersect at the tumor, providing a much larger absorbed dose there than in the surrounding healthy tissue. Besides the tumor itself, the radiation fields may also include the draining lymph nodes if they are clinically or radiologically involved with the tumor, or if there is thought to be a risk of subclinical malignant spread. It is necessary to include a margin of normal tissue around the tumor to allow for uncertainties in daily set-up and internal tumor motion. These uncertainties can be caused by internal movement (for example, respiration and bladder filling) and movement of external skin marks relative to the tumor position.

An X-ray image intensifier (XRII) is an image intensifier that converts X-rays into visible light at higher intensity than the more traditional fluorescent screens can. Such intensifiers are used in X-ray imaging systems (such as fluoroscopes) to allow low-intensity X-rays to be converted to a conveniently bright visible light output. The device contains a low absorbency/scatter input window, typically aluminum, input fluorescent screen, photocathode, electron optics, output fluorescent screen and output window. These parts are all mounted in a high vacuum environment within glass or, more recently, metal/ceramic. By its intensifying effect, It allows the viewer to more easily see the structure of the object being imaged than fluorescent screens alone, whose images are dim. The XRII requires lower absorbed doses due to more efficient conversion of X-ray quanta to visible light. This device was originally introduced in 1948.

The gray (symbol: Gy) is the unit of ionizing radiation dose in the International System of Units (SI), defined as the absorption of one joule of radiation energy per kilogram of matter.

It is used as a unit of the radiation quantity absorbed dose that measures the energy deposited by ionizing radiation in a unit mass of absorbing material, and is used for measuring the delivered dose in radiotherapy, food irradiation and radiation sterilization. It is important in predicting likely acute health effects, such as acute radiation syndrome and is used to calculate equivalent dose using the sievert, which is a measure of the stochastic health effect on the human body.

Acute radiation syndrome (ARS), also known as radiation sickness or radiation poisoning, is a collection of health effects that are caused by being exposed to high amounts of ionizing radiation in a short period of time. Symptoms can start within an hour of exposure, and can last for several months. Early symptoms are usually nausea, vomiting and loss of appetite. In the following hours or weeks, initial symptoms may appear to improve, before the development of additional symptoms, after which either recovery or death follows.

ARS involves a total dose of greater than 0.7 Gy (70 rad), that generally occurs from a source outside the body, delivered within a few minutes. Sources of such radiation can occur accidentally or intentionally. They may involve nuclear reactors, cyclotrons, certain devices used in cancer therapy, nuclear weapons, or radiological weapons. It is generally divided into three types: bone marrow, gastrointestinal, and neurovascular syndrome, with bone marrow syndrome occurring at 0.7 to 10 Gy, and neurovascular syndrome occurring at doses that exceed 50 Gy. The cells that are most affected are generally those that are rapidly dividing. At high doses, this causes DNA damage that may be irreparable. Diagnosis is based on a history of exposure and symptoms. Repeated complete blood counts (CBCs) can indicate the severity of exposure.

X-ray detectors are devices used to measure the flux, spatial distribution, spectrum, and/or other properties of X-rays.

Detectors can be divided into two major categories: imaging detectors (such as photographic plates and X-ray film (photographic film), now mostly replaced by various digitizing devices like image plates or flat panel detectors) and dose measurement devices (such as ionization chambers, Geiger counters, and dosimeters used to measure the local radiation exposure, dose, and/or dose rate, for example, for verifying that radiation protection equipment and procedures are effective on an ongoing basis).

A thermoluminescent dosimeter, or TLD, is a type of radiation dosimeter, consisting of a piece of a thermoluminescent crystalline material inside a radiolucent package.

When a thermoluminescent crystal is exposed to ionizing radiation, it absorbs and traps some of the energy of the radiation in its crystal lattice. When heated, the crystal releases the trapped energy in the form of visible light, the intensity of which is proportional to the intensity of the ionizing radiation to which the crystal was exposed. A specialized detector measures the intensity of the emitted light, and this measurement is used to calculate the dose of ionizing radiation the crystal was exposed to. Since the crystal density is similar to human soft tissue density, the dose measurement can be used to calculate absorbed dose.

Radiation exposure is a measure of the ionization of air due to ionizing radiation from photons. It is defined as the electric charge freed by such radiation in a specified volume of air divided by the mass of that air. As of 2007, "medical radiation exposure" was defined by the International Commission on Radiological Protection as exposure incurred by people as part of their own medical or dental diagnosis or treatment; by persons, other than those occupationally exposed, knowingly, while voluntarily helping in the support and comfort of patients; and by volunteers in a programme of biomedical research involving their exposure. Common medical tests and treatments involving radiation include X-rays, CT scans, mammography, lung ventilation and perfusion scans, bone scans, cardiac perfusion scan, angiography, radiation therapy, and more. Each type of test carries its own amount of radiation exposure. There are two general categories of adverse health effects caused by radiation exposure: deterministic effects and stochastic effects. Deterministic effects (harmful tissue reactions) are due to the killing/malfunction of cells following high doses; and stochastic effects involve either cancer development in exposed individuals caused by mutation of somatic cells, or heritable disease in their offspring from mutation of reproductive (germ) cells.

Absorbed dose is a term used to describe how much energy that radiation deposits in a material. Common measurements for absorbed dose include rad, or radiation absorbed dose, and gray, or Gy. Dose equivalent calculates the effect of radiation on human tissue. This is done using tissue weighting factor, which takes into account how each tissue in the body has different sensitivity to radiation. The effective dose is the risk of radiation averaged over the entire body. Ionizing radiation is known to cause cancer in humans. We know this from the Life Span Study, which followed survivors of the atomic bombing in Japan during World War 2. Over 100,000 individuals were followed for 50 years. 1 in 10 of the cancers that formed during this time was due to radiation. The study shows a linear dose response for all solid tumors. This means the relationship between dose and human body response is a straight line.

Equivalent dose (symbol H) is a dose quantity representing the stochastic health effects of low levels of ionizing radiation on the human body which represents the probability of radiation-induced cancer and genetic damage. It is derived from the physical quantity absorbed dose, but also takes into account the biological effectiveness of the radiation, which is dependent on the radiation type and energy. In the international system of units (SI), its unit of measure is the sievert (Sv).