Treatment Techniques and Anatomic Relationships Flashcards
ie. Various Treatment Types and Procedures
List the different types of Radiation Therapy Treatments/Techniques (8 main)
- 3D Conformal Radiation Therapy
- Electron Beam
- IMRT (Intensity Modulated Radiation Therapy)
- Stereotactic Radiosurgery (SRS)
- Stereotactic Body Radiation Therapy (SBRT)
- Total-Body Irradiation (TBI)
- IGRT (Image Guided Radiotherapy)
- Particle Beam Radiotherapy (ex. protons)
Which type of Radiation Therapy Treatment is being described?
“Treats small tumors within the cranium at a high dose”
SRS
Which type of Radiation Therapy Treatment is being described?
“a radiation beam that has varying intensities throughout the beam”
IMRT
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”
3D Conformal Radiation Therapy (3D-CRT)
Which type of Radiation Therapy Treatment is being described?
“a monoenergetic beam that is used for superficial tumors”
Electron beam
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”
IGRT
Which type of Radiation Therapy Treatment is being described?
“high-energy charged particles, such as protons, alpha particles, and carbon ions”
Particle Beam Radiotherapy
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”
SBRT
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”
TBI
______ = 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
Bragg Peak (Proton Bragg Peak)
Protons DO or DO NOT have an exit dose?
DO NOT
The dose curve of a proton beam starts off HIGH or LOW?
LOW
The following graph is of what?
Proton Bragg Peak
the following are examples of what?
EPID (Electronic Portal Imaging Device; port films)
KV
MV cone beam CT
ultrasound
IGRT
what are examples of machines that can perform SRS (Stereotactic Radiosurgery) (2)
CyberKnife or Gamma Knife
T/F:
even though less common, SRS can also treat some tumors in the spine
TRUE
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
SRS (Stereotactic Radiosurgery)
SRS of intracranial lesions may require a ______ to be attached to the patient’s head
frame
SRS can be frameless or use a frame nowadays… if a frame is used, it is actually connected to the trt table
SRS treatment positioning MUST BE accurate and within +/- ___ mm
+/- 1 mm
SRS treatment positioning must be within +/- 1 cm
FALSE
it is mm, NOT cm watch and read carefully on registry
tumors treated with SRS are typically less than __ cm in size
less than 3 cm in size typically
how many fractions does SRS treat tumors in?
1 fraction
IMRT uses ________ treatment planning and dynamic _____
inverse treatment planning and dynamic MLCs
T/F: the dose of IMRT beams IS uniform
FALSE - IMRT doses ARE NOT UNIFORM
MODULATED
IMRT has many smaller beams sometimes called __________
beamlets
what is the common size of IMRT beamlets?
commonly as small as 1 cm x 1 cm
what type of treatment technique scatters easily?
electron beam
since an electron beam scatters easily (not heavy particles) what is used to confine the beam?
a cone; “electron cones”
define “Penumbra”
fuzziness we see on Field Size (FS) edges
electron beam field edges balloon out why?
because of scatter.
Electron beams are not definitive like photon beams
electron beams have a “rapid falloff” of dose… what does that mean for deeper organs?
it means that deeper organs and tissues will receive very little or no dose
what treatment technique is planned using 3D imaging, such as CT scans (computed tomography)
3D-CRT
(3D Conformal Radiation Therapy)
in the following example, the patient is laying face up/on their back - what do we call that?
SUPINE
in the following example, the patient is lying face down/on their stomach - what do we call that?
PRONE
patient setup must be ____________ from the CT sim to each daily trt
hint - the word starts with an R
reproducible
T/F:
the patient is lined up using lasers mounted on the walls and ceilings and the tattoo marks on their skin
TRUE
T/F:
there are NO lasers on the ceiling of trt rooms
FALSE - there is very much indeed lasers on ceiling and walls to help create/locate our isocenter
Which of the following three options best matches the description?
“Help to constrain patient”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Simple immobilization devices
Which of the following three options best matches the description?
“Help to position patient for treatment”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Patient positioning aids
Which of the following three options best matches the description?
“Limit the patient’s movement and create a very reproducible patient setup”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Complex immobilization devices
Which of the following three options best matches the description?
“Does NOT limit the patient’s movement”
“Can be used for multiple patients”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Patient positioning aids
Which of the following three options best matches the description?
“Used with positioning aids”
“Not as restricting”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Simple immobilization devices
Which of the following three options best matches the description?
“Customized for each patient”
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Complex immobilization devices
Which of the following three options best matches the examples?
–> tape, rubber band, arm-to-foot straps
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Simple immobilization devices
Which of the following three options best matches the examples?
–> Alpha Cradle, Vac-Lok, thermoplastic molds, bite blocks
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Complex immobilization devices
Which of the following three options best matches the examples?
–> head holders (timos), sponge pillows, foam cushions, neck rolls
- Patient positioning aids
- Complex immobilization devices
- Simple immobilization devices
Patient positioning aids
T/F:
contrast media can be used during CT simulation process
TRUE
what does contrast media do?
highlight specific organs to further help create the trt plan
T/F:
contrast media can highlight the area(s) being treated AND highlight critical structures to be avoided
TRUE
what are the two basic categories of contrast agents?
negative (radiolucent) and positive (radiopaque)
which is easier to penetrate by x-ray, thus appears darker? Radiolucent OR Radiopaque
And why
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)
_________ is a heavy metal salt, and is THE MOST commonly used contrast agent for gastrointestinal tract examinations
hint - is chunky
Barium Sulfate
T/F:
Barium sulfate can be administered orally or rectally (in an aqueous (water-based) suspension)
TRUE
what is the atomic number of Barium sulfate?
And what can we gather from it?
Z = 56
we gather it is a high Z number SO Barium sulfate appears radiopaque (absorbs xray photon rays well… appears white)
iodine-based contrast materials are typically injected via _____
IV (intravenous; into the vein)
what is a good and commonly used contrast media for visual enhancement of vascular organs and structures
iodine- based contrast
what is the Z number for iondine?
Z = atomic number = 53
define “peristalsis”
intestinal contractions
T/F:
Air can be considered a contrast agent
TRUE - think, breath hold during CT sim
define “intrathecal”
lumbar puncture; into spinal cord
__________ ________ __________ Therapy treats small tumors, excluding the cranium, with very high doses in 3-5 fractions
stereotactic body radiation therapy
what technique prepares a patient for a bone marrow transplant?
TBI
_____ _____ = dose curve of protons starts low off, but then rapidly rises and then abruptly falls to zero
Bragg Peak
FILL IN THE BLANKS:
- ________ = towards the front
- ________ = towards the back
- ________ = towards the head
- ________ = towards the feet
- ________ = near midline/center
- ________ = away from midline/center
- ________ = nearer to the point of origin/attachment
- ________ = away from the point of origin/attachment
- ________ = on or near the surface
- _______ = away from the body surface
- anterior
- posterior
- superior
- inferior
- medial
- lateral
- proximal
- distal
- superficial
- deep
Body Habitus definitions -
define “Hypersthenic”
short, wide trunk, great body weight, and heavy skeletal framework
Body Habitus definitions -
define “Hyposthenic”
average physique
Body Habitus definitions -
define “Sthenic”
of considerable weight, with a heavy skeletal framework
Body Habitus definitions -
define “Asthenic”
slenderer physique, light body weight, and light skeletal framework
a CT slice is utilizing what plane/view
axial/transverse/horizontal
AP is another term for ______/______
Coronal/Frontal
Lateral is another term for ______
Sagittal
Transverse is another term for _____/_____
AXial/horizontal
TD 5/5 for -
Bladder
6500 cGy
TD 5/5 for -
Brachial plexus
6000 cGy
TD 5/5 for -
Brain
4500 cGy
TD 5/5 for -
Cauda equina
6000 cGy
TD 5/5 for -
Colon
4500 cGy
TD 5/5 for -
Esophagus
5500 cGy
TD 5/5 for -
Femoral head
5200 cGy
TD 5/5 for -
Heart
4000 cGy
TD 5/5 for -
kidney
2300 cGy
TD 5/5 for -
larnyx necrosis
7000 cGy
TD 5/5 for -
larnyx edema
4500 cGy
TD 5/5 for -
Lens
1000 cGy
TD 5/5 for -
Liver
3000 cGy
TD 5/5 for -
Lung
1750 cGy
TD 5/5 for -
optic chiasm
5000 cGy
TD 5/5 for -
optic nerve
5000 cGy
TD 5/5 for -
parotid gland
3200 cGy
TD 5/5 for -
rectum
6000 cGy
TD 5/5 for -
retina
4500 cGy
TD 5/5 for -
spinal cord
4700 cGy
TD 5/5 for -
small intestine
4000 cGy
TD 5/5 for -
stomach
5000 cGy
TD 5/5 for -
TMJ mandible
6000 cGy
TD 5/5 for -
thyroid
4500 cGy
what is “intrarterial”, ie. if contrast is adminstered intrarterially, how is it administered?
into artery
Which has a higher atomic number, radiolucent contrast agent, or radiopaque?
radiopaque (bright) agents have a higher atomic number when compared to radiolucent (dark) agents
air, oxygen, and carbon dioxide are examples of radiolucent or radiopaque contrast agents?
radiolucent
iodine, gadolinium, and barium are examples of radiolucent or radiopaque contrast agents?
radiopaque contrast agents
radiolucent contrast agents appear ___bright//dark___ whereas radiopaque appear ____bright//dark____
radiolucent appear dark, whereas radiopaque appear bright.
is the following describing SIMPLE immobilization devices or COMPLEX?
“limit the patient’s movement and create a reproducible setup; customized for each patient”
COMPLEX
is the following describing SIMPLE immobilization devices or COMPLEX?
“help to constrain the patient; moderately restrictive”
SIMPLE
the following are examples of COMPLEX or SIMPLE immobilization devices?
-rubber bands
-shoulder pulls
SIMPLE
the following are examples of COMPLEX or SIMPLE immobilization devices?
-alpha cradles
-vac-loks
-aquaplasts
-bite blocks
COMPLEX