Slackers radiation oncology fact stack
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Slackers Radiation Oncology Fact Stack. Mike Ori. Disclaimer. These represent my understanding of the subject and have not been vetted or reviewed by faculty. Use at your own peril. I can’t type so below are common missing letters you may need to supply e r l

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Slackers Radiation Oncology Fact Stack

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Slackers radiation oncology fact stack

Slackers Radiation Oncology Fact Stack

Mike Ori


Disclaimer

Disclaimer

  • These represent my understanding of the subject and have not been vetted or reviewed by faculty. Use at your own peril.

  • I can’t type so below are common missing letters you may need to supply

  • e r l

  • I didn’t use greek letters because they are a pain to cut and paste in.


Slackers radiation oncology fact stack

  • What are the five stages of cancer diagnosis and therapy


Slackers radiation oncology fact stack

  • Screening

  • Diagnosis

  • Staging

  • Therapy

  • Follow-up


Slackers radiation oncology fact stack

  • What is the most successful use of radiology for screening


Slackers radiation oncology fact stack

  • Mammography


Slackers radiation oncology fact stack

  • What is one area where radiology techniques have not been successful in screening


Slackers radiation oncology fact stack

  • Ultrasound screening of the prostate


Slackers radiation oncology fact stack

  • Explain the role of contrast kinetics in MRI


Slackers radiation oncology fact stack

  • Wash-in and wash-out times help differentiate benign and malignant

  • Normal tissue tends to have slower wash-in and wash-out kinetics than tumor.


Slackers radiation oncology fact stack

  • What is a sestamibi scan


Slackers radiation oncology fact stack

  • Use of 99mTc-sestamibi to identify areas of angiogenesis and tumor.


Slackers radiation oncology fact stack

  • Compare sestamibi scans to MRI


Slackers radiation oncology fact stack

  • Uses ionizing radiation

  • Not as available as MR

  • Faster

  • Cheaper


Slackers radiation oncology fact stack

  • What is octreotide scanning


Slackers radiation oncology fact stack

  • A somatostatin-like compound that can interact wit somatostatin receptors on the surface of cells. Some types of cancer (neuro-endocrine mostly) are notable for such receptors.


Slackers radiation oncology fact stack

  • Compare octreotide scanning to MRI/CT


Slackers radiation oncology fact stack

  • Sometimes shows mets when other modalities don’t

  • Poorer anatomic localization than other modalities

  • Can be used to indicate treatment with yttrium 90-octrotide


Slackers radiation oncology fact stack

  • What is MRI spectroscopy


Slackers radiation oncology fact stack

  • The use of the MRI machine to perform spectroscopic analysis of tissue to look for marker compounds that indicate growth or abnormal metabolism.

  • Rarely used capability due to reimbursement


Slackers radiation oncology fact stack

  • What radiographic techniques can be used to stage cancer


Slackers radiation oncology fact stack

  • CT

    • The workhorse

  • PET

    • Especially when combine with CT

  • MRI

    • Increasing in use. Dominant in some areas

  • Radionucleotide bone scans

    • For skeletal mets

  • Ultrasound

    • Rarely


Slackers radiation oncology fact stack

  • How does PET scanning work


Slackers radiation oncology fact stack

  • Fluoro-D-Glucose is injected into the body. Hot spots appear in any tissue actively metabolizing glucose. This includes tumors but also inflammed and regnerating areas.


Slackers radiation oncology fact stack

  • For what cancers is PET scanning approved


Slackers radiation oncology fact stack

  • Non-small cell lung cancer

  • Colorectal cancer

  • Melanoma

  • Lymphoma

  • Head and neck cancer (not thyroid or CNS)

  • Esophageal

  • Cervical

  • Breast monitoring and restaging

  • Thyroid restaging


Slackers radiation oncology fact stack

  • Explain radionucleotide bone scans


Slackers radiation oncology fact stack

  • 99mTC-methylene diphosphonate is injected into the body and incorporated into hydroxyapatite in the bone by osteoblasts. Thus areas of bone growth are visible.

  • Needs follow-up anatomic imaging


Slackers radiation oncology fact stack

  • What is the role of radioactive iodine in the treatment of thyroid neoplasia


Slackers radiation oncology fact stack

  • RAI is used post surgery to destroy remaining thyroid tissue.


Slackers radiation oncology fact stack

  • What is image guided therapy


Slackers radiation oncology fact stack

  • The use of radiology techniques in the performance of treatment

  • Intra arterial chemo catheter

  • Embolization

    • Simple

    • Chemo

  • Alcohol ablation/cryotherapy

  • RF ablation

  • Focused ultrasound


Slackers radiation oncology fact stack

  • What is RECIST


Slackers radiation oncology fact stack

  • Response evaluation criteria in solid tumors is an heuristic used to quantify the change in a solid tumor over time.

    • CR = complete response

    • PR = partial response, 30% decrease

    • PD = progressive disease, 20% increase

    • SD = stable disease


Slackers radiation oncology fact stack

  • What type of radiation is used in radiotherapy


Slackers radiation oncology fact stack

  • Ionizing radiation such as x-rays, gamma rays, electrons, protons


Slackers radiation oncology fact stack

  • What device produces the radiation used most predominantly in the US


Slackers radiation oncology fact stack

  • The linear accelerator or linac


Slackers radiation oncology fact stack

  • How many linacs can fit on the head of a pin?


Slackers radiation oncology fact stack

  • None.


Slackers radiation oncology fact stack

  • Differentiate teletherapy from brachytherapy


Slackers radiation oncology fact stack

  • Teletherapy uses a radiation beam generated by source remote to the patient. This is your classic sci-fi death ray.

  • Brachytherapy places an intrinsically radioactive substance in close approximation to the target tissue.


Slackers radiation oncology fact stack

  • What is linear energy transfer


Slackers radiation oncology fact stack

  • The amount of energy transferred per unit length of track


Slackers radiation oncology fact stack

  • What is the bragg peak


Slackers radiation oncology fact stack

  • The point of maximum energy release along a track.


Slackers radiation oncology fact stack

  • Differentiate directly ionizing from indirectly ionizing radiation


Slackers radiation oncology fact stack

  • Directly ionizing radiation has sufficient energy to directly disrupt the atomic structure of DNA. Protons.

  • Indirectly ionizing radiation creates free radicals that damage DNA. X-rays.


Slackers radiation oncology fact stack

  • What is the primary method of cell killing caused by radiation


Slackers radiation oncology fact stack

  • Double stand DNA breaks that are improperly repaired.


Slackers radiation oncology fact stack

  • Why are oxygenated cells more susceptible to radiation than are hypoxic cells


Slackers radiation oncology fact stack

  • The ionizing process generates free electrons which are taken up by oxygen to generate oxygen radicals which attack DNA. In hypoxic conditions, less oxygen is available to generate free radicals.


Slackers radiation oncology fact stack

  • Which phase of the cell cycle is sensitive to radiation? Which is resistant?


Slackers radiation oncology fact stack

  • G1/M are sensitive

  • S is resistant


Slackers radiation oncology fact stack

  • What factors influence the survival of a radiated cell?


Slackers radiation oncology fact stack

  • Position in the mitotic cycle

  • Molecular checkpoint activation

  • Hypoxia

  • Repopulation


Slackers radiation oncology fact stack

  • Describe how a 50Gy dose of radiation is delivered to patients


Slackers radiation oncology fact stack

  • The dose is usually fractionated into multiple doses of ~2Gy. These are then delivered over the course of many days until the total prescription is delivered.


Slackers radiation oncology fact stack

  • Describe image modulated radiation therapy


Slackers radiation oncology fact stack

  • IMRT uses a multi-leaf collimator shape a radiation beam to limit exposure of adjacent structures.


Slackers radiation oncology fact stack

  • List several benign diseases for which radiotherapy can be prescribed


Slackers radiation oncology fact stack

  • Omas of the CNS

    • Schwanoma

    • Chordoma

    • Meningioma

    • Pituitary adenoma

  • AVM

  • Trigeminal neuralgia

  • Pterygium

  • Heterotopic ossification

  • Trigeminal neuralgia


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