Downloaded 19 times
Uploaded byMatthew Katz
Stereotactic radiation
This document discusses stereotactic radiation therapy and the importance of precision in delivering localized radiation treatment. It uses the analogy of golf to explain the technical factors involved in stereotactic radiation, including geometry, accuracy, reproducibility, and power. High precision is needed for both palliative and curative treatments of cancers like brain metastases. Treatment planning and quality assurance aim to ensure the radiation is delivered exactly as planned to minimize risk while maximizing tumor coverage. New technologies like 6 degree of freedom couches and pretreatment imaging help improve accuracy and efficiency of stereotactic radiation treatments.
More Related Content
Similar to Stereotactic radiation
Stereotactic radiation
- 1. STEREOTACTIC RADIATION ImprovingOur Short Game Matthew Katz, MD October 6 2014
- 2. Radiation Therapy Purpose Cure Organ Preservation Relief of Symptoms
- 3. Radiation and Golf Human factors Technical/Physical Factors Geometry Accuracy Reproducibility Power Credit: Ben Hogan
- 4. Need for HighPrecision Palliative Brain metastasis Spinal metastasis Curative Lung cancer Liver Retreatment Past radiation Delivered in 1-5 treatments
- 5. Stereotactic Radiation 3D coordinate system localizes area for treatment Radiosurgery = single dose SBRT = 5 treatments or less
- 6. Immobilization for Accuracy Framed Frameless
- 7. Goal = Par2 Quality Assurance Treatment Planning Simulation
- 8. Getting to theGreen Neurosurgery Radiation Oncology
- 9. Treatment Planning andQA Established stroke Angle of approach aligning beam to tumor, or “target” Power (dose) Dry run and safety checks complete before patient arrives No adjusting approach on the fly
- 10. Treatment room =Green Multidisciplinary Team Neurosurgery Radiation Oncology Radiology Treatment Planning Radiation Therapists Nursing
- 11. Stereotactic = Longputt • <1 - 5 mm accuracy • Low tolerance for change in conditions • No Mulligans
- 12. Our Pros onthe Green Ensure correct treatment delivery Execution of ideal approach Efficiency, comfort for patient
- 13. Ensuring It’s SafeTo Treat
- 14.
- 15. Staying Even Par 6 Degrees of Freedom (6DOF)
- 16. Imaging Before Treatment Pretreatment Ensure accurate treatment Less time to treatment = better accuracy Source: Dave Pelz
- 17. Advantages of 6DOFCouch Less chance of patient moving before treatment More accurate, more comfortable More efficient, less waiting time
- 18.
- 19. Questions? Contact me Email: [email protected] Twitter: @subatomicdoc
Editor's Notes
- #3 Highly technical field Often a ‘black box’ and lot of unknowns, so hard to explain
- #4 Use golf as a metaphor
- #7 Use to require invasive surgery with screws placed in body to ensure patient didn’t move Technologic advances allow frameless treatment for most patients
- #8 Establish Angle of approach Power No birdies or eagles. Need to complete all steps for safe treatment. But want to avoid bogeys, unnecessary steps
- #9 Begins with the right medical expertise Strong neurosurgery team led by Dr. Cook Radiation Oncology Associates Dr. Harris background in engineering Dr Hunter has neurosurgical training before changing to radiation oncology Dr. O’Meara was MSKCC’s first stereotactic body fellow, NCI/Navy
- #10 Treatment is designed for perfect shot, allowing for small variation Once ready for treatment, waits should be minimized if plan executed well
- #11 Once on the green, our short game needs to be perfect We can only move on to treatment itself when treatment perfectly aligned, ball in the hole Some simpler radiation treatments can be easier to rap it in
- #12 Stereotactic radiation is high precision treatment Need to est
- #13 Radiation Therapy = Our ball strikers Goal = single set-up, image before treatment For stereotactic treatment, doctor and physicist come to review the setup
- #14 Need to evaluate patient’s condition, set up treatment position correctly Use minimal necessary radiation exposure to confirm accurate alignment Analyzing at the treatment machine requires agreement from therapist, physicist and doctor If it’s not good enough, keep doing it until it’s right
- #15 Patient couch can only be rotated in one direction Currently no ability to rotate in two directions Slowed setups if the patient is rotated slightly the wrong way
- #16 Helps keep us on the intended line [direction a player intends their ball to roll on] One-putt depends upon ability to fine-tune setup after first images
- #17 Goal is to minimize Mulligans No extra imaging or radiation exposure before treatment
- #18 Helps the treatment team stay in rhythm