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Procedures: 2. DOSI/Treatment Volume Localization > Treatment Techniques and Anatomic Relationships > Flashcards

Treatment Techniques and Anatomic Relationships Flashcards

ie. Various Treatment Types and Procedures

1
Q

List the different types of Radiation Therapy Treatments/Techniques (8 main)

A
  1. 3D Conformal Radiation Therapy
  2. Electron Beam
  3. IMRT (Intensity Modulated Radiation Therapy)
  4. Stereotactic Radiosurgery (SRS)
  5. Stereotactic Body Radiation Therapy (SBRT)
  6. Total-Body Irradiation (TBI)
  7. IGRT (Image Guided Radiotherapy)
  8. Particle Beam Radiotherapy (ex. protons)
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2
Q

Which type of Radiation Therapy Treatment is being described?
“Treats small tumors within the cranium at a high dose”

A

SRS

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3
Q

Which type of Radiation Therapy Treatment is being described?
“a radiation beam that has varying intensities throughout the beam”

A

IMRT

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4
Q

Which type of Radiation Therapy Treatment is being described?
“Conforms the radiation beam so that the target volume receives the prescribed dose, and the surrounding healthy tissue receives a much lower dose”

A

3D Conformal Radiation Therapy (3D-CRT)

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5
Q

Which type of Radiation Therapy Treatment is being described?
“a monoenergetic beam that is used for superficial tumors”

A

Electron beam

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6
Q

Which type of Radiation Therapy Treatment is being described?
“Patient is imaged prior to trt to confirm the position; shifts of the table can be made before trt for more accuracy in trt delivery”

A

IGRT

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7
Q

Which type of Radiation Therapy Treatment is being described?
“high-energy charged particles, such as protons, alpha particles, and carbon ions”

A

Particle Beam Radiotherapy

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8
Q

Which type of Radiation Therapy Treatment is being described?
“treats small tumors outside the cranium with a very high dose for about 3-5 fractions”

A

SBRT

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9
Q

Which type of Radiation Therapy Treatment is being described?
“radiation therapy that targets the whole body to prepare for bone marrow transplants and to treat other malignancies”

A

TBI

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10
Q

______ = The dose curve of a proton beam starts off low at the beginning, but then rapidly rises toward the end of the path and then abruptly falls to zero

A

Bragg Peak (Proton Bragg Peak)

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11
Q

Protons DO or DO NOT have an exit dose?

A

DO NOT

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12
Q

The dose curve of a proton beam starts off HIGH or LOW?

A

LOW

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13
Q

The following graph is of what?

A

Proton Bragg Peak

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14
Q

the following are examples of what?

EPID (Electronic Portal Imaging Device; port films)
KV
MV cone beam CT
ultrasound

A

IGRT

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15
Q

what are examples of machines that can perform SRS (Stereotactic Radiosurgery) (2)

A

CyberKnife or Gamma Knife

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16
Q

T/F:
even though less common, SRS can also treat some tumors in the spine

A

TRUE

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17
Q

The following diseases would likely be treated with what Treatment Technique?

-AVMs (Arteriovenous Malformations)
-Trigeminal neuralgia
-Acoustic neuromas
-Meningiomas
-Pituitary adenomas
-Metastatic and primary bone tumors

A

SRS (Stereotactic Radiosurgery)

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18
Q

SRS of intracranial lesions may require a ______ to be attached to the patient’s head

A

frame

SRS can be frameless or use a frame nowadays… if a frame is used, it is actually connected to the trt table

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19
Q

SRS treatment positioning MUST BE accurate and within +/- ___ mm

A

+/- 1 mm

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20
Q

SRS treatment positioning must be within +/- 1 cm

A

FALSE
it is mm, NOT cm watch and read carefully on registry

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21
Q

tumors treated with SRS are typically less than __ cm in size

A

less than 3 cm in size typically

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22
Q

how many fractions does SRS treat tumors in?

A

1 fraction

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23
Q

IMRT uses ________ treatment planning and dynamic _____

A

inverse treatment planning and dynamic MLCs

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24
Q

T/F: the dose of IMRT beams IS uniform

A

FALSE - IMRT doses ARE NOT UNIFORM
MODULATED

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25
Q

IMRT has many smaller beams sometimes called __________

A

beamlets

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26
Q

what is the common size of IMRT beamlets?

A

commonly as small as 1 cm x 1 cm

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27
Q

what type of treatment technique scatters easily?

A

electron beam

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28
Q

since an electron beam scatters easily (not heavy particles) what is used to confine the beam?

A

a cone; “electron cones”

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29
Q

define “Penumbra”

A

fuzziness we see on Field Size (FS) edges

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30
Q

electron beam field edges balloon out why?

A

because of scatter.
Electron beams are not definitive like photon beams

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31
Q

electron beams have a “rapid falloff” of dose… what does that mean for deeper organs?

A

it means that deeper organs and tissues will receive very little or no dose

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32
Q

what treatment technique is planned using 3D imaging, such as CT scans (computed tomography)

A

3D-CRT
(3D Conformal Radiation Therapy)

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33
Q

in the following example, the patient is laying face up/on their back - what do we call that?

A

SUPINE

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34
Q

in the following example, the patient is lying face down/on their stomach - what do we call that?

A

PRONE

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35
Q

patient setup must be ____________ from the CT sim to each daily trt

hint - the word starts with an R

A

reproducible

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36
Q

T/F:
the patient is lined up using lasers mounted on the walls and ceilings and the tattoo marks on their skin

A

TRUE

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37
Q

T/F:
there are NO lasers on the ceiling of trt rooms

A

FALSE - there is very much indeed lasers on ceiling and walls to help create/locate our isocenter

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38
Q

Which of the following three options best matches the description?
“Help to constrain patient”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Simple immobilization devices

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39
Q

Which of the following three options best matches the description?
“Help to position patient for treatment”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Patient positioning aids

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40
Q

Which of the following three options best matches the description?
“Limit the patient’s movement and create a very reproducible patient setup”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Complex immobilization devices

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41
Q

Which of the following three options best matches the description?
“Does NOT limit the patient’s movement”
“Can be used for multiple patients”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Patient positioning aids

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42
Q

Which of the following three options best matches the description?
“Used with positioning aids”
“Not as restricting”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Simple immobilization devices

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43
Q

Which of the following three options best matches the description?
“Customized for each patient”

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Complex immobilization devices

44
Q

Which of the following three options best matches the examples?
–> tape, rubber band, arm-to-foot straps

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Simple immobilization devices

45
Q

Which of the following three options best matches the examples?
–> Alpha Cradle, Vac-Lok, thermoplastic molds, bite blocks

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Complex immobilization devices

46
Q

Which of the following three options best matches the examples?
–> head holders (timos), sponge pillows, foam cushions, neck rolls

  1. Patient positioning aids
  2. Complex immobilization devices
  3. Simple immobilization devices
A

Patient positioning aids

47
Q

T/F:
contrast media can be used during CT simulation process

A

TRUE

48
Q

what does contrast media do?

A

highlight specific organs to further help create the trt plan

49
Q

T/F:
contrast media can highlight the area(s) being treated AND highlight critical structures to be avoided

A

TRUE

50
Q

what are the two basic categories of contrast agents?

A

negative (radiolucent) and positive (radiopaque)

51
Q

which is easier to penetrate by x-ray, thus appears darker? Radiolucent OR Radiopaque

And why

A

Radiolucent -

these contrast media agents have low atomic numbers and x-rays can penetrate easier/more… whereas Radiopaque agents have higher atomic numbers and absorb x-ray photons more and appear opaque (white)

52
Q

_________ is a heavy metal salt, and is THE MOST commonly used contrast agent for gastrointestinal tract examinations

hint - is chunky

A

Barium Sulfate

53
Q

T/F:
Barium sulfate can be administered orally or rectally (in an aqueous (water-based) suspension)

A

TRUE

54
Q

what is the atomic number of Barium sulfate?

And what can we gather from it?

A

Z = 56

we gather it is a high Z number SO Barium sulfate appears radiopaque (absorbs xray photon rays well… appears white)

55
Q

iodine-based contrast materials are typically injected via _____

A

IV (intravenous; into the vein)

56
Q

what is a good and commonly used contrast media for visual enhancement of vascular organs and structures

A

iodine- based contrast

57
Q

what is the Z number for iondine?

A

Z = atomic number = 53

58
Q

define “peristalsis”

A

intestinal contractions

59
Q

T/F:

Air can be considered a contrast agent

A

TRUE - think, breath hold during CT sim

60
Q

define “intrathecal”

A

lumbar puncture; into spinal cord

61
Q

__________ ________ __________ Therapy treats small tumors, excluding the cranium, with very high doses in 3-5 fractions

A

stereotactic body radiation therapy

62
Q

what technique prepares a patient for a bone marrow transplant?

A

TBI

63
Q

_____ _____ = dose curve of protons starts low off, but then rapidly rises and then abruptly falls to zero

A

Bragg Peak

64
Q

FILL IN THE BLANKS:

  1. ________ = towards the front
  2. ________ = towards the back
  3. ________ = towards the head
  4. ________ = towards the feet
  5. ________ = near midline/center
  6. ________ = away from midline/center
  7. ________ = nearer to the point of origin/attachment
  8. ________ = away from the point of origin/attachment
  9. ________ = on or near the surface
  10. _______ = away from the body surface
A
  1. anterior
  2. posterior
  3. superior
  4. inferior
  5. medial
  6. lateral
  7. proximal
  8. distal
  9. superficial
  10. deep
65
Q

Body Habitus definitions -

define “Hypersthenic”

A

short, wide trunk, great body weight, and heavy skeletal framework

66
Q

Body Habitus definitions -

define “Hyposthenic”

A

average physique

67
Q

Body Habitus definitions -

define “Sthenic”

A

of considerable weight, with a heavy skeletal framework

68
Q

Body Habitus definitions -

define “Asthenic”

A

slenderer physique, light body weight, and light skeletal framework

69
Q

a CT slice is utilizing what plane/view

A

axial/transverse/horizontal

70
Q

AP is another term for ______/______

A

Coronal/Frontal

71
Q

Lateral is another term for ______

A

Sagittal

72
Q

Transverse is another term for _____/_____

A

AXial/horizontal

73
Q

TD 5/5 for -
Bladder

A

6500 cGy

74
Q

TD 5/5 for -
Brachial plexus

A

6000 cGy

75
Q

TD 5/5 for -
Brain

A

4500 cGy

76
Q

TD 5/5 for -
Cauda equina

A

6000 cGy

77
Q

TD 5/5 for -
Colon

A

4500 cGy

78
Q

TD 5/5 for -
Esophagus

A

5500 cGy

79
Q

TD 5/5 for -
Femoral head

A

5200 cGy

80
Q

TD 5/5 for -
Heart

A

4000 cGy

81
Q

TD 5/5 for -
kidney

A

2300 cGy

82
Q

TD 5/5 for -
larnyx necrosis

A

7000 cGy

83
Q

TD 5/5 for -
larnyx edema

A

4500 cGy

84
Q

TD 5/5 for -
Lens

A

1000 cGy

85
Q

TD 5/5 for -
Liver

A

3000 cGy

86
Q

TD 5/5 for -
Lung

A

1750 cGy

87
Q

TD 5/5 for -
optic chiasm

A

5000 cGy

88
Q

TD 5/5 for -
optic nerve

A

5000 cGy

89
Q

TD 5/5 for -
parotid gland

A

3200 cGy

90
Q

TD 5/5 for -
rectum

A

6000 cGy

91
Q

TD 5/5 for -
retina

A

4500 cGy

92
Q

TD 5/5 for -
spinal cord

A

4700 cGy

93
Q

TD 5/5 for -
small intestine

A

4000 cGy

94
Q

TD 5/5 for -
stomach

A

5000 cGy

95
Q

TD 5/5 for -
TMJ mandible

A

6000 cGy

96
Q

TD 5/5 for -
thyroid

A

4500 cGy

97
Q

what is “intrarterial”, ie. if contrast is adminstered intrarterially, how is it administered?

A

into artery

98
Q

Which has a higher atomic number, radiolucent contrast agent, or radiopaque?

A

radiopaque (bright) agents have a higher atomic number when compared to radiolucent (dark) agents

99
Q

air, oxygen, and carbon dioxide are examples of radiolucent or radiopaque contrast agents?

A

radiolucent

100
Q

iodine, gadolinium, and barium are examples of radiolucent or radiopaque contrast agents?

A

radiopaque contrast agents

101
Q

radiolucent contrast agents appear ___bright//dark___ whereas radiopaque appear ____bright//dark____

A

radiolucent appear dark, whereas radiopaque appear bright.

102
Q

is the following describing SIMPLE immobilization devices or COMPLEX?

“limit the patient’s movement and create a reproducible setup; customized for each patient”

A

COMPLEX

102
Q

is the following describing SIMPLE immobilization devices or COMPLEX?

“help to constrain the patient; moderately restrictive”

A

SIMPLE

103
Q

the following are examples of COMPLEX or SIMPLE immobilization devices?

-rubber bands
-shoulder pulls

A

SIMPLE

104
Q

the following are examples of COMPLEX or SIMPLE immobilization devices?

-alpha cradles
-vac-loks
-aquaplasts
-bite blocks

A

COMPLEX

Procedures: 2. DOSI/Treatment Volume Localization (7 decks)

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