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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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.
slide4
Screening
  • Diagnosis
  • Staging
  • Therapy
  • Follow-up
slide10
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.
slide14
Uses ionizing radiation
  • Not as available as MR
  • Faster
  • Cheaper
slide16
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.
slide18
Sometimes shows mets when other modalities don’t
  • Poorer anatomic localization than other modalities
  • Can be used to indicate treatment with yttrium 90-octrotide
slide20
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
slide22
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
slide24
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.
slide26
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
slide28
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
slide32
The use of radiology techniques in the performance of treatment
  • Intra arterial chemo catheter
  • Embolization
    • Simple
    • Chemo
  • Alcohol ablation/cryotherapy
  • RF ablation
  • Focused ultrasound
slide34
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
slide42
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.
slide48
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.
slide52
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.
slide54
G1/M are sensitive
  • S is resistant
slide56
Position in the mitotic cycle
  • Molecular checkpoint activation
  • Hypoxia
  • Repopulation
slide58
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.
slide60
IMRT uses a multi-leaf collimator shape a radiation beam to limit exposure of adjacent structures.
slide62
Omas of the CNS
    • Schwanoma
    • Chordoma
    • Meningioma
    • Pituitary adenoma
  • AVM
  • Trigeminal neuralgia
  • Pterygium
  • Heterotopic ossification
  • Trigeminal neuralgia
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