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Slackers Radiation Oncology Fact Stack

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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  1. Slackers Radiation Oncology Fact Stack Mike Ori

  2. 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.

  3. What are the five stages of cancer diagnosis and therapy

  4. Screening • Diagnosis • Staging • Therapy • Follow-up

  5. What is the most successful use of radiology for screening

  6. Mammography

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

  8. Ultrasound screening of the prostate

  9. Explain the role of contrast kinetics in MRI

  10. 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.

  11. What is a sestamibi scan

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

  13. Compare sestamibi scans to MRI

  14. Uses ionizing radiation • Not as available as MR • Faster • Cheaper

  15. What is octreotide scanning

  16. 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.

  17. Compare octreotide scanning to MRI/CT

  18. Sometimes shows mets when other modalities don’t • Poorer anatomic localization than other modalities • Can be used to indicate treatment with yttrium 90-octrotide

  19. What is MRI spectroscopy

  20. 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

  21. What radiographic techniques can be used to stage cancer

  22. 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

  23. How does PET scanning work

  24. 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.

  25. For what cancers is PET scanning approved

  26. 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

  27. Explain radionucleotide bone scans

  28. 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

  29. What is the role of radioactive iodine in the treatment of thyroid neoplasia

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

  31. What is image guided therapy

  32. The use of radiology techniques in the performance of treatment • Intra arterial chemo catheter • Embolization • Simple • Chemo • Alcohol ablation/cryotherapy • RF ablation • Focused ultrasound

  33. What is RECIST

  34. 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

  35. What type of radiation is used in radiotherapy

  36. Ionizing radiation such as x-rays, gamma rays, electrons, protons

  37. What device produces the radiation used most predominantly in the US

  38. The linear accelerator or linac

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

  40. None.

  41. Differentiate teletherapy from brachytherapy

  42. 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.

  43. What is linear energy transfer

  44. The amount of energy transferred per unit length of track

  45. What is the bragg peak

  46. The point of maximum energy release along a track.

  47. Differentiate directly ionizing from indirectly ionizing radiation

  48. 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.

  49. What is the primary method of cell killing caused by radiation

  50. Double stand DNA breaks that are improperly repaired.

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