-
☆The Abdomen is defined as the portion of the body that lies between the _______ & the ________ and that contains the __________.
- THORAX
- PELVIS
- PERITONEAL CAVITY
-
☆Generally speaking, the kidney tolerance dose to irradiation in the adult is:
2000 cGy delivered at 180 to 200 cGy per fraction
-
☆The most common site of pancreatic tumors is the ______ of the pancreas.
HEAD of the pancreas
-
☆Wilms' tumor is a tumor originating in the _______.
-
☆Neuroblastoma is a tumor most often originating in the __________.
Sympathetic Nervous System
often arising in abdomen, chest or neck
-
☆When pelvic irradiation is delivered in an obese patient in the supine position, the concern is that uncertainty of dose due to variations in patient _________ would be caused when attempts were made to eliminate skin folds.
uncertainty of DOSE due to variations in patient THICKNESS
-
☆To reduce the volume of __________ within a pelvic field, the patient's position should be prone on a belly board.
Small Bowel
-
☆The primary purpose of a testicular shield is to reduce the amount of _________ dose in the testes.
INTERNAL SCATTERED dose in the testes
-
☆Of gynecological tumors treated with radiation therapy, the most common type is:
Squamous cell carcinoma of the Cervix
-
☆The depth of the deep inguinal nodes can vary from _____ to _____cm depending on the patient's size.
2-18 cm
-
Dose rates _________ with field size.
(increase or decrease)
Increase
-
In the case of a patient that is unlikely to complete treatment, how should kidney shielding be accomplished?
Once the kidney tolerance dose has been reached, insert a 5-HVT block in the anterior & posterior fields
-
The dose under a 5-HVT kidney block is approximately ______ to ______% of the dose delivered at mid-depth on the central axis.
10-20%
-
The amount of dose under a 5-HVT kidney block depends on the beam ________, the size of the _______, and the size of the ________.
- beam ENERGY
- size of the FIELD
- size of the KIDNEY BLOCK
-
The organs in which normal tissue tolerance is of concerns when treating pancreatic tumors are:
(3)
-
When a three field technique (anterior and lateral opposed fields) is used in the treatment of pancreatic tumors, the best dose distribution is achieved with wedge(s) in the ________ field(s) and more weighting on the ________ field(s).
- wedges in the LATERAL fields
- more weighting on the ANTERIOR field
-
When children are treated for Wilms' tumor, the medial field margin should be include the __________.
Width of the spine
-
What are three methods to reduce the volume of small bowel in the pelvis?
- 1. Surgically implanted expander
- 2. Mesh sling placement
- 3. Prone position
-
How much of the kidney should be excluded from the treatment field in order to preserve proper function?
2/3 of the kidney must be excluded
-
When patients with advanced cervical carcinoma are treated, the majority is delivered via ________.
External beam irradiation
-
A central pelvic shield is sometimes used in the treatment of opposed anterior and posterior fields following intra-cavitary irradiation to protect the _______, _______, and tissues irradiated to a high dose via the intra-cavitary implant
-
Due to the dome-like shape of the diaphragm in the anterior-posterior view, it is impossible to treat the entire abdominal cavity without also including some volume of ________ and _________.
Lung & Heart
-
Whole-abdominal treatment fields should be shaped to minimize the volume of irradiated ________ to reduce the risks of myelosuppression.
Bone Marrow
-
Insertion of a 1-HVT block in both fields during the entire course of treatment would deliver approx ______ of the dose in the shielded organs and the dose distribution under the shields would be similar to that of using ______ shields only during a portion of the treatment.
-
What are the three methods of kidney blocking?
- 1. Fully blocking the kidneys once tolerance dose is reached
- 2. Blocks that allow partial transmission of the beam for the entire treatment course
- 3. Fully shielding from one field only
-
☆The 10-year survival for patients with all stages of Hodgkin's disease is approximately:
80%
-
☆The patient position for treatment of a mantle field in Hodgkin's disease is usually supine with the ________ extended and the arms __________.
- CHIN extended
- arm RAISED ABOVE THE HEAD
-
☆It is always important to align the patient with the ________ laser every day because if it is not, the field is rotated with respect to the patient's body.
Sagittal
-
☆Tattoos made in the patient's skin indicating irradiated areas can shift due to _______ and ________.
-
☆The advantages of ________ therapy are that it provides superior normal-tissue sparing and improved precision.
Intraoperative radiation therapy (IORT)
-
☆High- and low- dose total body irradiation is used in the preparation for a _________ and in the treatment of ____________.
- BONE MARROW TRANSPLANT (preparation)
total dose: 900-1200 cGy
- CHRONIC LYMPHOCYTIC LEUKEMIA (treatment)
- total dose: 100-400 cGy
-
☆The most common position for patients receiving total-skin electron irradiation is ___________.
Standing with legs spread & arms raised
-
☆The main goal of radiation therapy in patients with bone metastasis is to prevent ________ and reduce _________.
- prevent FRACTURES
- reduce PAIN
-
☆In patients treated for a spinal cord compression, the treatment field should include approximately two ____________ in each direction beyond demonstrable disease.
approx TWO VERTEBRAL BODIES in each direction beyond demonstrable disease
-
Which 6 cancers commonly metastasize to the inguinal nodes?
- Vulva
- Distal third of the vagina
- Urethra
- Anal canal
- Penis
- Uterine Cervix
*Vance Danced Under A Purple Umbrella Crazily*
-
Total skin electron irradiation (TSEI) is often used in the treatment of cutaneous diseases such as ________ and _________, where a high dose is needed in the first centimeter of tissue over the entire body while the underlying tissues are spared.
- Mycosis Fungoides
- Kaposi's Sarcoma (AIDS)
-
The total dose prescribed for TSEI treatment of mycosis fungoides is ________ and typically ____ to ____ electron beam energies are used in order to limit the amount of _________.
- 3600 cGy
- 4 to 6 MeV beams
- Bremsstrahlung
-
What are the most common sites for bony metastases?
(4)
- Ribs
- Spine
- Sacrum
- Long bones in extremeties
-
________ lesions, which appear on x-rays as a less dense area in a bone, are most frequently associated with __________ or metastasis from malignant disease in breasts, kidneys, or the thyroid gland.
Lytic lesions (reduced bone density)
Multiple Myeloma
-
___________ lesions, areas that appear denser than bone on an x-ray, are often metastatic from the breasts, prostate gland, or Hodgkin's disease.
Osteoblastic lesions (increased bone density)
-
______ ______ photon fields can be used to spare underlying lung tissue when treating rib metastasis.
OPPOSED TANGENTIALS photon fields for rib mets
-
What is the average depth of the spinal cord?
4 to 6 cm
-
The average dose and fractionation schedule for multifocal brain metastasis treatment is _____ cGy in ____ week
or
_____ cGy in ____ weeks
- 2000 cGy in 1 week
- or
- *3000 cGy in 2 weeks*
-
A typical treatment regimen of the cervix would include:
- 40-50Gy via a four field box
- ⇨ Cone down with midline block (MLB)
-
Patients with colorectal carcinoma are usually treated in the prone position, using ________ and ___________ fields.
- Posterior
- &
- Opposed Lateral Wedged fields
- colorectal: prone ↡⇄ω
-
When treating a prostate tumor with a four-field box technique, the best rectal and bladder protection is achieved through _______ _______ fields.
Conformal Lateral fields
-
A __________ technique is usually the preferred field arrangement when treating bladder tumors.
power point indicates IMRT as tx of choice
-
When a posterior and opposed lateral fields with wedges are used to treat a rectal tumor, to reduce the hot spot under the thin portion of the wedges, one can _________ (increase/decrease) the weight on the lateral fields and ________________.
DECREASE the weight on the lateral fields
ADD an ANTERIOR FIELD
-
The gap between the mantle & para-aortic fields, assuming the same field length and SAD, is calculated and set correctly if the patient is in the same position and the _________ margin of the posterior para-aortic field coincides with the marker indicating the _________ margin of the anterior margin of the mantle field.
- Cephalad (superior)
- Caudal (inferior)
-
The most serious late consequence of high-dose TBI is __________ but thrombocytopenia occurs after _____ to _____ cGy.
Radiation pneumonitis
100-150 cGy (thrombocytopenia)
-
When higher energy beams are not available to treat a prostate, heavier weight should be placed on the _________ & _________ fields.
Anterior & Posterior fields
-
Patients with cancer of the anal canal are usually treated with _______ and _______ fields.
- Anterior & Posterior Wedged fields
- ⇵ω
45-50Gy w/ 15-20Gy boost
-
Lesions in the lower 1/3 of the vagina require that the _______ and _______ lymph nodes be treated.
-
What does DICOM stand for?
Digital Imaging and Communications in Medicine
-
DICOM (Digital Imaging and Communications in Medicine) is an established standard format for the use and exchange of medical ________, media and ________ across a computer network. (a LAN or a WAN)
DICOM (Digital Imaging and Communications in Medicine) is an established standard format for the use and exchange of medical DATA, media and IMAGES across a computer network. (a LAN or a WAN)
-
Factors to consider in deciding btw an SSD or SAD technique are:
1. the importance of ________ in the particular patient
2. the amount of _____ delivered through the field
3. the actual _______ between the collimator and the patient's skin surface.
- 1. the importance of REPRODUCIBILITY in the particular patient
- 2. the amount of DOSE delivered through the field
- 3. the actual DISTANCE between the collimator and the patient's skin surface
-
Where is Point A located?
- 2cm superior of the external cervical os
- and
- 2cm lateral to the uterine tandem
-
CT's operate in the energy range of _____ to _____ kev and are highly ___________.
- 20 to 140 kev
- highly collimated
-
Positron emission tomography utilizes beta ______ decay.
Beta PLUS
Pet = beta Plus
-
Nuclear medicine utilizes beta _______ decay.
Beta MINUS
nuke Med = beta Minus
-
Positron emission tomography is used because cancer cells metabolize ________ at a higher rate.
Glucose
-
The primary particles involved in Magnetic Resonance are:
(3)
Electron, protons & neutrons which possess the quality called "spin"
-
Anatomical MRI's are _____ weighted while Functional MRI's are _____ weighted.
Anatomical T-1
Functional T-2
-
Patients are not to eat for ____ hours prior to a PET/CT.
NPO 6 hours
no exercise for 24 freaking hours!!!!
-
An off axis point is any point not on the ____________. The off axis point is used as a __________ point to tell the Dr what the dosage and effect on the tissue at that point will be as well as to find the __________.
- any point not on the CENTRAL AXIS
- CALCULATION point
- Off Axis Ratio (OAR)
often used w/ hodgkin's mantle fields
-
The iliac crest is at the level of ______ in the spine.
L-4
-
What is the typical width of spinal cord fields?
8 cm
-
The staging system for Hodgkin's disease is the __________ system.
Ann Arbor system
-
A _______________ is a computer generated 2D radiograph displaying skeletal anatomy rendered from a three dimensional data set, such as CT or MRI.
Digitally Reconstructed Radiograph (DRR)
-
In a 3 field abdomen to treat pancreatic ca, increasing the weight of the anterior and left lateral fields or adding a posterior beam will decrease the dose to the ________.
-
In a 3 field abdomen to treat pancreatic ca, increasing the weight on both lateral fields would decrease the dose to the __________.
-
TD 5/5 of the bladder:
60 Gy
-
TD 5/5 of the heart:
45 Gy
-
TD 5/5 of the intestine:
45 Gy
-
TD 5/5 of the kidneys:
20 Gy
-
TD 5/5 of the salivary gland:
50 Gy
-
TD 5/5 of the rectum:
60 Gy
-
TD 5/5 of the spinal cord:
45 Gy
-
What is the most common intracranial tumor?
Metastatic disease from a primary tumor elsewhere in the body
-
What does ARRT, RT(T) stand for?
American Registry of Radiologic Technologists, Registered Technologist (Radiation Therapy)
-
When treating a whole abdomen, the _____ field is generally longer than the ____ field in order to treat the inguinal lymph nodes.
AP (longer)
PA
-
Wilm's tumor, which is primarily a tumor of the kidney (peds), has been know to metastasize to the ______ which requires ___________ treatments.
- metastasizes to the LUNG
- "whole lung" treatments
-
When tumors of the head of the pancreas, bile duct and distal stomach are treated, the _______ kidney is usually included in the treatment field.
Right kidney
-
When tumors of the body or tail of the pancreas, or tumors in the proximal & mid-gastric area are treated, the _______ kidney is often included in the treatment field.
Left kidney
-
A patient receiving TSEI and TBI use eye shields to protect the:
(3)
- Cornea
- Conjunctiva
- Eyelashes
-
The effectiveness of an immobilization method is largely dependent on _______________.
Patient Cooperation
-
Lymph nodes above the diaphragm treated in a typical Mantle field:
(6)
- Cervical
- Supraclavicular
- Infraclavicular
- Axillary
- Mediastinal
- Hilar
-
Lymph nodes below the diaphragm treated in a typical Hodgkin's:
- Para-Aortic
- Inguinal
- Pelvic
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