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#RSNA2022 #rsna22 diaries
Conversations between O-arm and MP re RSNA meeting
O-arm: Hey doc! How is it going over there @rsna #rsna2022? My cousin’s teenage daughter was telling that you are posting a lot on Instagram. What’s up with that?
1/
Conversations between O-arm and MP re RSNA meeting
O-arm: Hey doc! How is it going over there @rsna #rsna2022? My cousin’s teenage daughter was telling that you are posting a lot on Instagram. What’s up with that?
1/
MP: Why can’t we #MedPhys not allowed to be instagramers? @aapmHQ
O-arm: I was just teasing you doc. As a teacher it is always best to make your students feel comfortable communicating w you, especially if they think you can understand them
2/
O-arm: I was just teasing you doc. As a teacher it is always best to make your students feel comfortable communicating w you, especially if they think you can understand them
2/
MP: Yes. Is that all or did you want to ask me something else?
O-arm: How is the technical exhibits over there? Anything new that I need to be concerned about, that would make me obsolete?
3/
O-arm: How is the technical exhibits over there? Anything new that I need to be concerned about, that would make me obsolete?
3/
Weekend after #AAPM2022: Beautiful weather, MP is getting ready to do his mindfulness exercise (vacuuming) – comes out of the garage & was surprised to see his buddy ‘The Eastern Box Turtle’, slowing coming up his driveway
Here is conversation between the Turtle & the MP
1/
Here is conversation between the Turtle & the MP
1/
MP: Hey buddy, what are you doing? It might have taken you some time to come all the way from park.
Turtle: Yes doc, I was on my way to a picnic behind ur home & also wanted to talk to you. I heard that you were up in the Tony’s ‘Big Rig (BR)’ & thinking of a new career
2/
Turtle: Yes doc, I was on my way to a picnic behind ur home & also wanted to talk to you. I heard that you were up in the Tony’s ‘Big Rig (BR)’ & thinking of a new career
2/
MP: Well, the news came faster than the “hare” that challenged your ancestor for a race and lost
Turtle: Yes, I got worried because other day, you were very nice to explain about #CT and that u loved working where my cousin saw you
3/
Turtle: Yes, I got worried because other day, you were very nice to explain about #CT and that u loved working where my cousin saw you
3/
Can we improve how we treat cancer with stereotactic radiation? Yes, we can.
Here’s a @ClinOncology editorial with Drs. @MichaelTMilano & Alina Mihai on including clinical treatment volumes (CTVs) for microscopic disease.
authors.elsevier.com/a/1eVwJ3K%7E8R…
#radonc #medphys 1/
Here’s a @ClinOncology editorial with Drs. @MichaelTMilano & Alina Mihai on including clinical treatment volumes (CTVs) for microscopic disease.
authors.elsevier.com/a/1eVwJ3K%7E8R…
#radonc #medphys 1/
Radiation therapy (RT) can non-invasively treat microscopic disease. In curative settings, RT complements or competes w/ surgery to improve cancer care and patient outcomes.
I’ll discuss how matters using curative lung cancer and metastatic disease as examples. 2/
I’ll discuss how matters using curative lung cancer and metastatic disease as examples. 2/
Stereotactic RT lets us give very high doses safely. Advances in medical physics & computer programming, matched w/ clinical trials, show we can improve tumor control & decrease central “in-field” failures. Its evolution initially required ignoring microscopic disease. 3/
I cleared my schedule in anticipation of 2nd jab side-effects, and I’m aching all over with muscle pains, so it’s just the right time to channel my inner grumpy old man (I’m moving like one anyway).
In other words:
🔹Time to critique #ESTRO2021 abstracts! 🔹
#radonc #medphys
In other words:
🔹Time to critique #ESTRO2021 abstracts! 🔹
#radonc #medphys
Standard disclaimer:
I’m just one abstract reviewer. My opinions and dislikes may not be representative.
I’m not targeting any specific authors - so even if you feel this hits too close to home, it’s probably not you that I’m thinking of (five other people did the same!)
I’m just one abstract reviewer. My opinions and dislikes may not be representative.
I’m not targeting any specific authors - so even if you feel this hits too close to home, it’s probably not you that I’m thinking of (five other people did the same!)
I reviewed clinical track abstracts this year, while my previous involvement has been on the physics track. That's obviously colouring my experience.
(I am but a lowly physicist, etc, etc ... 😂)
(I am but a lowly physicist, etc, etc ... 😂)
Is there a radiation dose-response relationship for rectal cancer managed non-surgically?
Short answer: Yes - at least based on published patient series
Longer answer: See our #ESTRO2020 Poster Highlight - or thread below
#rectalcancer
#radonc
postersessiononline.eu/173580348_eu/c…
Short answer: Yes - at least based on published patient series
Longer answer: See our #ESTRO2020 Poster Highlight - or thread below
#rectalcancer
#radonc
postersessiononline.eu/173580348_eu/c…
Non-operative management of rectal cancer is becoming increasingly important - more and more patients are offered observation instead of surgery if they have a complete response after (chemo-)radiotherapy #radonc #ESTRO2020
Most published series are only reporting on that select group of patients - the ones who got a complete response. That's great if we want to understand if observation is a safe strategy for those patients #ESTRO2020
thelancet.com/journals/lance…
thelancet.com/journals/lance…
New #radonc attendings:
Your first cases will take a long time. That's normal. It means you understand how big #cancer care is and are doing your best by your patients. Be patient with yourself. It will get easier. You *do* know what you are doing.
(1/n)
Your first cases will take a long time. That's normal. It means you understand how big #cancer care is and are doing your best by your patients. Be patient with yourself. It will get easier. You *do* know what you are doing.
(1/n)
Also, don't forget:
1. Expert contours vary.
2. Imaging now is better than the old trials that often define care.
3. Dose has a gradient.
(2/n)
1. Expert contours vary.
2. Imaging now is better than the old trials that often define care.
3. Dose has a gradient.
(2/n)
4. Prescription doses are basically never threading the therapeutic window like a needle. You know the standard of care. It's usually a pretty wide lane.
(3/n)
(3/n)
We created a 6-part #SBRT credentialing course at @UCSDRadMed, and we’re making it publicly available during #COVID19. All videos were produced and edited by @dbrown_medphys and include Dr. Daniel Simpson or me. Videos are linked below. Enjoy! #MedPhys @aapmHQ #RadOnc @ASTRO_org
As promised, here is a #tweetorial on spatially-fractionated radiotherapy aka Lattice aka GRID.
If you missed the #CTOS2019 talk by @Notorious_RBE, this one is for you!
If you missed the #CTOS2019 talk by @Notorious_RBE, this one is for you!
Spatial fractionation aims to intentionally deliver heterogeneous dose: alternating “hot” and “cold” areas with a differential of 30-100% Rx.
Thats right: you want 30% cold spots in tumor. (👇 #MedPhys reaction).
Thats right: you want 30% cold spots in tumor. (👇 #MedPhys reaction).
It seems crazy, but it is associated with excellent response and limited toxicity. Per reports. That are retrospective.
Dramatic response in rads refractory sarcoma: link.springer.com/article/10.100…
Case series of 71 palliative patients: ncbi.nlm.nih.gov/pubmed/1052442…
Dramatic response in rads refractory sarcoma: link.springer.com/article/10.100…
Case series of 71 palliative patients: ncbi.nlm.nih.gov/pubmed/1052442…
Part II of today’s tweetorial for International clinical trials day: #CTD2019 #ICTD2019
Why do you want to give physicists a central role in your radiotherapy trials?
#medphys #radonc
@ipemnews @EFOMP_org @aapmHQ @EORTC @CTRad_CChan
Why do you want to give physicists a central role in your radiotherapy trials?
#medphys #radonc
@ipemnews @EFOMP_org @aapmHQ @EORTC @CTRad_CChan
First, what characterises medical physicists?
- We're quantitative, systematic & analytical
- We're trained in modelling, data visualisation, & interpretation of evidence
(And sometimes we - by which I mean me - go exploring in caves, which is almost like running a trial 😅)
- We're quantitative, systematic & analytical
- We're trained in modelling, data visualisation, & interpretation of evidence
(And sometimes we - by which I mean me - go exploring in caves, which is almost like running a trial 😅)
But importantly, we understand the opportunities and limitations in current technology & are uniquely placed to understand current gaps in knowledge.
We can ask
“How can we best utilise technology to improve outcomes?”
“Will this be achievable in daily practice?”
We can ask
“How can we best utilise technology to improve outcomes?”
“Will this be achievable in daily practice?”
Today is International Clinical Trials Day! #CTD2019
In the spirit of #CTD2019, I thought I’d take a bit of time to talk about medical physicists and radiotherapy trials #medphys #radonc
@ipemnews @EFOMP_org @aapmHQ
In the spirit of #CTD2019, I thought I’d take a bit of time to talk about medical physicists and radiotherapy trials #medphys #radonc
@ipemnews @EFOMP_org @aapmHQ
Why should radiotherapy trialists care about medical physicists? And why should physicists involve themselves in trials?
The short answer: It makes trials a whole lot better!
The slightly longer answer: It ensures maximum value from data that we are entrusted by patients
And the properly detailed answer will take a couple of tweetorials ☺️
The slightly longer answer: It ensures maximum value from data that we are entrusted by patients
And the properly detailed answer will take a couple of tweetorials ☺️
