Gulmay D3300 X-ray Therapy Machine System

Gulmay D3300 roentgen ray Therapy Machine SystemGulmay D3300 x-ray therapy tool system from Gulmay Medical Ltd. understructureKilovoltage unit was one of the first external beam therapy utilise in a radi some otherapy department. Despite its popularity then, departments opt into using a megavoltage elementary appliance overdue to its versatility in interposition. The uses kilovoltage therapy, especially fiddling x-ray therapy remains astray important in treating certain back toothcer affected roles. Gulmay Medical Ltd is one of the originations run awaying manufacturers in Kilovoltage x-ray therapy equipments. One of its latest accomplishments was make Gulmay D3300, a combined superficial and orthovoltage unit, beam efficacy ranging from 20-400kv. In this essay, I will be describing the physical aspects of a Gulmay seed and x-ray pipework used in spite of appearance this machine, their role in the production of x-ray as good as its alter mechanism. I will be disc ussing the uses of having such(prenominal) combined units, the benefits and the complications it will cause to both the NHS, departments and the patients as well as the advantages and disadvantages of using gelded out lead screen outing inside a intercession.DescriptionThe generator aims to magnify the initial input voltage to a substantial amount, enough to potentiate x-rays with a certain Half encourage layer (Flinton, 2009). The CP225 generator which can be attached to the D3300, is powe inflammation by 3200W-4500w and has the capacity to generate voltage from 220V to 20-225KV (Gulmay Medical Ltd, 2014). Connected to the generator is the roentgenogram pipework, via cables joined to both the anode and the cathode (figure one). The pipeworks are in a unipolar locating whereby the negative potential from the generator is fed into the cathode and the anode is maintained at a ground potential (Earth). (Flinton, 2009)Figure one A map of the equipments inside a Gulmay Superficia l x-ray therapy machine (Gulmay Medical Ltd, 2014).The CP225 generator is able to attach to a heights power x-ray pipe, 225/11, which can take up to 225V, ideally suited for its generator (Gulmay Medical Ltd., 2014). The subway system is covered in a metal ceramic material and compromises on a ceiling support or on a outrage stand. The mounting requires a manual force to move in the one-third axes -transverse, longitudinal and vertical, as well as rotational and tilt style of the pipework (Flinton, 2009).The cathode assembly, inside the tube is held by a ceramic dielectric aimed to insulate it from the metal housing of the tube and consists of a single watt filament. Compared to the cathode, the anode is structurally dissimilar, as shown in figure two. Made out of copper, the anode is any wielded onto the metal tube envelope or a ceramic dielectric is sandwiched between them. The anode has extensions cognise as an integral hood and located on the side of the hood is a de sired x-ray exit know as a beryllium window, which has a filtration of 0.8mm Be. The tube is enclosed within a vacuum to ensure the electrons do not interact with other particles, slowing down the production of pure x-rays (Flinton, 2009).Figure two The natural structure of an x-ray tube (Flinton, 2009, p.153)As the heat builds up within the tube, it is removed from the target through conduction of the Copper anode acting as a heat sink due to its large size. To ensure in force(p) and rapid heat conduction, a cooling system is attached to the tube which ensures a spicy temperature difference away from the target (Figure one). Because the x-ray tube is unipolar, it is safe to ensure the flowing cooling medium within the cooling system is water, (Gulmay Medical Ltd., 2014) and therefore cost effective to implement. Since water is a conductor of heat, it is constantly replaced by new cool water at a time it has heated up.When the electrical current passes through from the generator to the tube via the cable, it reaches the cathode assembly heating up the tungsten filament. The filament then emits electrons in a process known as thermionic emission. The filament develops into a way cup containing a static negative charge stopping the electrons from diffusion and to coerce them together to ensure the electrons aim at a minuscule sectional area of the anode (Flinton, 2009).The cathode haves highly negatively pol rallyd that the grouped electrons are shoot and strike a target within the anode, made from tungsten. The electrons originate to decompress and release capability creating x-rays and heat (Xstrahl, 2014). The integral hood absorbs any undesirable electrons and prevents secondary x-rays from scoreing (extra focal radiation), whilst the beryllium window allows the primary x-rays to leave the tube (Flinton, 2009).DiscussionEvan et al. (2001) states that by having a combined superficial and orthovoltage unit quite a than two units, it will save half the money to facilitate carve up shielded treatment rooms. There will also be a reduction in capital costs, spares, precautionary maintenance and quality master resources. However, by having a combined unit, the beam characteristics should be compromised as they are all necessitated by the use of a single X-ray tube to generate a beam as well as if the machine was to break down, the department may be at a divergence of all kilovoltage treatment capacity.By having a low energy treatment, it is simple to treat superficial lesions. The low energy components of Gulmay d3300 allow many kowtow lesions to be interact up to 5mm deep, and by having a medium energy component it will allow treatments of pare lesions up to 2cm deep to be interact (Klevenhagen and Thwaites , 1993, and Glees, J.P and Wolstenholme, V., 2006). The aim of superficial x-ray therapy is to apply the fate superficially, maintaining the omit of strip sparing in order for the treatment to be successful. The r eelect in dose with depth is slower for x-rays than electron, thus the dose is at a lower place the treatment site is higher, being virtually effective in superficial treatment. Majority of the internal anatomical sites are not significantly unnatural by the radiation, The drawbacks to this is if treating an area neighbouring structures in which contain poor blood allow for and are at risk of radiation damage such as cartilages, then it would be beneficial to use an electron beam due to the rapid fall-off (Griffiths, 1994).When using an orthovoltage machine, the aim is to treat deep seated tumours at a close depth to the skin by applying a bulky amount of dose to the surface of the patient before it reaches the tumour site. The leave out of skin sparing can result into skin damage caused on a patient (Griffiths, 1994).Patients can suffer acute reactions and late reactions. When patients begin their treatment, the acute reaction will follow in stages. During the first treatment , the patient may feel warmth in the area being treated this is followed by the reddening of the skin, known as erythema, which can appear from a dose level of 1GY. As the dose escalates, the treated area will pop off itchy, sunburn like red, and is prone to injuries. Around 14 days, the coppers in the treated areas may fall out in a process known as epilation. By the time patients get to this stage finish their treatment course. This is due to the lengthy fractionations of treatment the degree of reactions becomes less severe. Once the treatment stops, skin will begin to heal and becomes tanned. However, patients that go through a long treatment will experience reactions at a great degree. The next stage in the skin reaction is dry desquamation, the desquamation of the skin in dry flakes. Furthering this treatment, the skin then becomes dark red or purplish and mobile will start to build up underneath causing oedema, which is tender to touch. It is broken down and blisters sta rt to form, the fluid begins to seep out of the skin. Patients treatment is then at a barricade due to the severity of the reaction. Within an orthovoltage machine, by giving a high dose, the stem cell pool within the skin will be destroyed and area of ulceration will remain lasting within the treated area of the patient (Lochhead, 1983, p. 107-108).Late reactions are dependent on the beam energy and the dosage level. The beam energy determines the part of the skin that is affected by the radiation.(Lochhead, 1983, p. 107-108). By using low beam energy of up to 300kv, the germinal or basal layer of the skin demonstrates the most change to the skin. Activity is lost within the cells and the skin becomes thin. Once the skin becomes damaged it will take a long time to heal. Places where the hair has epilated may become permanent due to the destruction of the hair follicles. key pattern glands are destroyed and superficial blood vessels deteriorate. Other blood vessels nearby would en large to compensate the damaged blood vessels, and patients may begin to form Telangiectasis, a condition whereby the patients skin becomes pale and the red blood vessels enlarge. An disfigurement to the patient may cause a necrosis of the skin.According to Griffiths et al. (1994, p.35) it was ideal that by creating multifeilds across the tumour, patients skin reactions may subside. However this had caused a high integral dose on the patient as well as sore skin. Now it is often more advantageous to have a megavoltage machine treating these tumours due to the skin sparing affect it provides for the patient and the orthovoltage is progressing to become outdated.One of the main forms of shielding in a superficial and orthovoltage machine is the use of a lead cut out. A lead cut out is made to define the treatment area as well as shielding normal healthy tissue paper from the radiation beam. This is used in conjunction with an applicator attached to the machine collimator. It also pr ovides management and localisation of the beam. For the face and areas close to the eye a specific lead mask is produced, to avoid radiation to critical structures nearby (Mills et al., 2012). The study of Medvedevas et al (2001) concludes that the application of lead shielding attenuates the dose received to normal tissue significantly. However, according to Flinton (2009) the drawbacks in using lead shielding is the elevation in dose on the beam side of the lead caused by the interactions that arise in the lead shielding behind the target volume, as a result from the high backscatter component at these energies. The build up to full back scatter is most rapid in microscopical field, more so in low energy beams. For small fields such as the eye, this is a problem. Mills et al (2012). At the point when treating the eye, shielding made from either tungsten or lead is inserted to cherish the lens. The problem encountered with eye shields is the contribution from scatter which reache s into the region under the shield from the surrounding field.(Mills et al., 2012, p. 125). A way to resolve this was by applying tissue akin material, i.e. wax, around the shield to absorb the scatter avoiding this problem.ConclusionReferenceEvans, P.A., Moloney, A.J., Mountford, P.J. . (2001). surgical operation assesment of the Gulmay D3300 kilovoltage X ray therapy unit. The British Journal of Radiology. 74 (882), 537-549.Flinton D.. (2009). Kilovoltage Equipment. In flushed P. and Duxbury A.M. Practical radiotherapy physics and equipment. 2nd ed. Oxford Wiley-Blackwell. 149-150.Glees, J.P and Wolstenholme, V.. (2006). The Role of Kilovoltage X-rays in the preaching of Skin Cancers. European Oncological Disease. 1 (1), 32-35.Griffiths, SE., Short, CA., Jackson, CS. and Ash,D. (1994). Radiotherapy principles to practice a manual for quality in treatment delivery. Edinburgh Churchil Livingstone. 33-37.Gulmay Medical Ltd.. (2014). Gulmay Corporate Brochure. operational http/ /www.gulmay.com/. Last accessed 27th April 2014.Klevenhagen, S.C. and Thwaites D.I.. (1993). Kilovoltage X rays. In Williams J.R. and Thwaites D.I. Radiotherapy Physics in practice. Oxford Oxford Medical Publications. 95-112.Lochhead,J.N. M. (1983). Care of the patient in radiotherapy. Oxford Blackwell Scientific. 105-111.Medvedevas, N., Adliene, D., Laurikaitiene, J., and Andrejaitis, A.. (2011). The role of shielding in superficial X-ray therapy. Radiaition Protection Dosimetry. 147 (1-2), 291-295.Mills, JA., Porter, H., Gill, D.. (2012). Radiotherapy beam production. In Symonds, P., Deeham, C., Mills, JA., and Meredith,C.Walter Millers textbook of Radiotherapy. Oxford Elsevier Health Sciences/Churchill Livingstone. 122-125.Xstrahl Medical. (2014). Physics of Low Energy Radiation. Available http//www.xstrahl.com/NewStep/physics-of-low-energy-radiation.html. Last accessed twenty-eighth April 2014.