Radformation’s highlights from the Annual AAPM meeting in San Antonio, TX.
Medical Physics Community Surveys
The Radformation website is now home to hundreds of clinically-relevant and insightful radiation oncology surveys.
In addition to hosting the surveys, we’re adding new category-based analysis cards, grouping relevant surveys to provide new graphical insights from the data. We’re also combining duplicate responses for a more complete and thorough understanding of community practices. We’ll be adding new surveys on a periodic basis—several times over the course of the year—to ensure the database remains up-to-date.
Volumetric modulated arc therapy (VMAT), intensity-modulated arc therapy (IMRT), brachytherapy, and electrons are workhorses of radiation therapy. VMAT and IMRT use inverse planning methods to carefully shape incoming dose to maximize tumor control probability while minimizing the dose to adjacent healthy tissue. Brachytherapy uses radioactive sources to effectively target tissues, and electrons are ideal for superficial cancers due to their shallow depth of penetration. Together, these modalities provide a complement of tools for tackling the broad challenges encountered in radiation oncology. These surveys offer insights into the techniques, QA, calculations, and preferences from hundreds of clinicians on these topics. Read Now >
SRS and SBRT are forms of highly precise, hypofractionated treatments that offer a number of advantages over conventional methods for small lesions: shorter overall treatment time, proven tumor control, and cost effectiveness. The extremely tight spatial margins are typically achieved through steep dose gradients, stereotactic target localization, and rigorous motion management through immobilization and/or IGRT. Ensuring highly accurate delivery is critical in reducing acute toxicity in the surrounding radiosensitive volumes and maintaining tumor control. In this card, insights on current techniques, QA procedures, and methods for starting a new program are gathered from the community to assist those looking to learn more. Read Now >
EBRT is used commonly in breast treatment cancer to reduce recurrence risk in post-operative procedures such as mastectomies and lumpectomies. Post-surgery, narrow tissue margins exist that increase risk for recurrence. EBRT offers the ability to target the tissues surrounding the surgical site, chest wall, lymph nodes, and tumors that cannot be surgically removed. Anatomically, treating the breast presents a problem due to its proximity of the heart to target tissues. In order to improve dose homogeneity and simultaneously avoid these radiosensitive organs, techniques such as parallel opposed tangents, 4D simulation, deep-inspiration breath-holds (DIBH), and immobilization devices are used. Here is a list of clinically relevant insights on the topic. Read more >
Prostate external beam treatment is routinely used in low to intermediate-risk prostate cancer due to its high tumor control. Recent studies have shown hypofractionation, including stereotactic body radiation therapy (SBRT), has improved tumor control, decreased treatment time, and improved efficiency and cost-effectiveness. Due to the escalation in fraction dose, localization of the target volume and intra-treatment motion management is critical to successful treatment. This is further confounded with motion concerns caused by rectal and bladder filling, which displaces surrounding tissue. Here is a compilation of surveys discussing techniques, standards, and methods for prostate treatment. Read more >
Radiation therapy departments aim to deliver accurate, safe, high-quality treatment to their patients. In support of those efforts, professional guidelines have been created to provide a framework of standards for commissioning and QA, a process that establishes a baseline data set for clinical use. The accuracy of any treatment model is limited by the quality of the data used to create it and improper modeling can disrupt every workflow step downstream that utilizes these models.
For this reason, a comprehensive set of ongoing quality assurance (QA) tests ensure the functionality of these systems. QA is multi-faceted and is involved in many steps in the patient planning workflow from initial consultation to discharge. A list of relevant surveys detailing pertinent practicies in our field, from beam modeling to in vivo dosimetry, are posted here.
Workflow is the lynchpin in any successful operation of any clinic. More generally, workflow takes a series of fragmented repeatable processes and consolidates them into one efficient system. In a clinical setting, that process begins at a patient’s initial consultation and ends with patient discharge and follow-up. When designing a workflow, an efficient clinic must consider everything from administrative objectives and employee responsibilities to risk reduction and regulatory nuances while enhancing patient experience.. For this reason, the clinical workflow survey topic represents the largest of the categories, touching on ideas about roles, responsibilities, and optimization through automation. Read more >
Written by Tyler Blackwell
Tyler is a board-certified medical physicist with extensive clinical experience in radiation therapy. He is active in the medphys community including several AAPM committees, the AAPM Board of Directors, and as an ABR orals examiner. Tyler dabbles in real estate investing, loves preparing breakfast for his three kiddos, and enjoys playing adult coed soccer.
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