Chapter 20 Radiation Therapy
CT imaging
Most common means of data capture. Three dimensional ionizing radiation-based technique image x-rays interact with detectors after attenuation to body tissues. CT scan and combines x-ray principles in advance computer technologies. The x-ray source moves in an ark around the body part being scan continually sent out beams of radiation. As to being passed through the body, the tissue absorbed small amount of radiation, depending on their densities. The beans are converted to signals they are projected onto a computer screen. These images look like radiographs of slices through the body. They are typically perpendicular to the long axis of the patient's body.
Who do you report a medical event to
NRC (nuclear regulatory commission)
Anterior
Near to the front of the body
Proximal
Near to the point of origin or attachment
Posterior
Near two or at the back of the body
Superficial
On or near the body surface
How often should the door interlock be checked
Once a day
How often do you check the camera and audio video
Once daily
How often should the treatment chart be checked
Once daily
Tonsils
Or a series of lymphatic knowledgeable in bedded in mucous membrans. Protect against foreign body infiltrated by producing lymphocytes.
OAR
Organs at risk
Efferent lymphatic vessels
Overall are smaller in diameter than the afferent vessels their valves open away from the node facilitating one way flow.
Fowler's position
Patient sitting in a semi sitting up position
Horizontal or transverse plane
Perpendicular to the mid sagittal, parasagittal, and coronal planes. Divides the human body to superior and inferior parts
Coronal or frontal plane
Perpendicular to the sagittal plane and vertically divides the body into anterior and posterior sections
Posterior
Posterior= dorsal = back
radiograph
Provide a two dimensional image of the interior of the body
Surface and sectional anatomy
Provide the foundation that the radiation therapist need to be effective in simulation, treatment planning, in the daily administration of therapy treatment.
PET/CT
Provides anatomic and is a logic information. This is commonly used because it can direct the radiation oncology team to ensure that the treatment field covers all diseased areas.
Maxillary sinus
Pyramid shaped cavity that is enclosed in the maxilla. is the largest of the paranasal sinuses
Ipsilateral
Refers to a body component on the same side of the body
Contralateral
Refers to the opposite side of the body
Hypersthenic Habitus
Represent about 5% of the population. Short, wide trunk, great body weight, and a heavy skeletal framework.
Hyposthenic habitus
Represents approximate 35% of the population. Do you abdominal cavity falls between the synthetic in the asthenic
What is the manubrim depression called
SSN
Scattering beams
Scatter the x-ray foil electrons
Vertebral column
Seven cervical, 12 thoracic, five lumbar, five sacral, and for coccygeal
nuclear medicine imaging
Short lived isotopes are injected into the body
What the largest mass of lymphatic tissue
Spleen
Anterior cavity contains
Sub divided by the muscle called the diaphragm. The two part or at the thoracic cavity in the abdominal pelvic cavity
SCF
Supraclavicular fossa is commonly treated (prophylactic treatment)
Where is the scapula located?
T1 - T4
Carina
T4 and T5
Thoracic cavity subdivided into
The Pericardial cavity and the two pleural cavities
immunity
The ability of the body to defend itself against infectious organisms in foreign bodies. Specifically, lymphocytes and macrophages protect the body by recognizing responding to the foreign matter
Nuclear medicine
The branch of medicine that you just radioisotopes in the diagnosis and treatment of disease uses ionizing radiation to provide information about physiology and anatomical structures
Lymph
The excessive tissue fluid consisting mostly of water and plasma proteins from capillaries
Breast lymphatics
The exhilarate, trans pectoral, and internal memory pathways
Image deformation
The process of shifting or contouring images to ensure the anatomic features are properly matching or register. The deformation of the image can help to account for anatomic changes between two town points they are turning the anatomy on one image into the exact location of another
Body cavities
The space within the body that contains internal organs The two main cavities are the posterior or dorsal and anterior or ventral cavities
Dorsal cavity contains
The spinal or vertebral cavity and the cranial cavity
Anatomic position
The subject stands upright, with feet together flat on the floor, toes pointed forward, arms straight down by the sides of the body with the palms facing board, fingers extended, and thumbs pointing away from the body.
efferent lymphatic vessels
Their valves open away from the node facilitating a one-way flow
MRI disadvantages
They are expensive magnetic shooting requirements, lower thorough put (less patients an hour), increase cost in comparison with CTs
Seperation
Thickness of someone's body
Where is the xiphoid process located?
Thoracic, T10
Where is the supersternal notch located
Thoracic, T2
What are the 3 cardinal principles to keep exposure low
Time, distance, shielding
TD5/5 (tolerance dose)
Total dosage over 5 years
Lateral
Toward one side or the other
Medial
Toward the midline of the body
Inferior
Towards the feet
Superior
Towards the head
Facial bones
Two maxillary bones, two zygomatic bones, two nasal bones, Two lacrimal bones, to Palentine bones, to inferior conchae, One foamer, and one mandible
Floating ribs
Two pairs of ribs that are only attached posterior
What quadrant is the spleen located
Upper left
Breast quadrants
Upper outer, upper inner, lower outer, and lower inner
Positron Emission Tomography (PET)
Use a short-lived a radio isotope such as carbon 11, nitrogen 13, fluorine 18, and oxygen 15 in a solution, he injected into a patient. The radio isotope circulate through the body in a middle part of a charger like giant called possess Jones. These positions Collabs conventional electrons in body tissues and cause a release of cameras. These razor detected and record it. The computer create a colored PET scan that shows functions rather than structure. It can't detect blood flow through organ such as the brain and heart. Diagnosed coronary artery disease, and identify the extent of a stroke or heart attack damage
Non-ionizing imaging
Use alternative means of imaging the body, such as magnetic fields in magnetic resonance imaging MRI echoed Sandwave in ultrasound scanning.
Ultrasound
Use high frequency sound waves that are not heard by the human ear. These waves travel forward and continue to move until they make contact with an object; at that point, a certain amount of the sound bounces back. uses a transducer The image that is produced is called a sonogram no exposure to ionizing radiation
Lipowitz metals
Used for blocks lead, Tin, cadmium, bismuth, eutectic alloy
Ionizing imaging
Uses ionizing radiation to produce images that primarily show anatomy. examples: -conventional radiography -computed tomography (CT) -nuclear medicine imaging -particularly possess John and mission tomography (PET) -Fusion of PET and CT (PET/CT)
What is the best way to ensure the isocenter is correct
Verification films
XY jaws
X makes the jaws go wider y makes the jaws go longer jaws of a collimator
What three axis evolve around the isocenter
X,y, and z Or table, gantry, collimator
Table axis
Y- up and down x- left and right z- in and out
ASIS
anterior superior iliac spine
Four sutures of the skull
coronal, lambdoid, squamous, sagittal
skull sutures
coronal, sagittal, squamous, lambdoid
DRR
digitally reconstructed radiograph
EPID
electronic portal imaging device
Edema
excessive accumulation of fluid in a tissue that produces swelling
EOP
external occipital protuberance bottom of head back of neck
external beam radiation therapy
gamma radiation generated from cobalt-60 is aimed at a tumor, destroying the tissue
trendeleburg position
lying on back with body tilted so that the head is lower than the feet
Lim Fattic system consist of
lymphatic vessels, lymphatic organs, and the fluid that circulates through it called lymph
PSIS
posterior superior iliac spine
Where is the sella turcica located?
sphenoid bone T4
SSN
suprasternal notch
Edema
swelling
Ionization
the process of adding or removing electrons from an atom or molecule, which gives the atom or molecule a net charge
chemotherapy
the use of drugs to treat a disease
Brachytherapy
the use of radioactive materials in contact with or implanted into the tissues to be treated
Photon beam
this type of beam deposits energy in small packets all along their path through tissue.
Orthogonal films
two images taken 90 degrees apart. They may be required for treatment planning purposes to define the location and relationship of various anatomic structures relative to the field's isocenter
adjuvant therapy
used after the primary treatments have been completed to decrease the chance that a cancer will recur
False ribs are called
vertebrochondral ribs
True ribs are called
vertebrosternal ribs
parasagittal plane
vertical plane that is parallel to the median sagittal plane and divides the body into unequal components, both right and left
Flattening Filter
*as x-rays emerge after hitting the target there are more in the center vs edge ---metal absorber that flattens the beam out by absorbing more photons at center of the beam --- dual E linacs have separate flattening filters for each energy --->constructed of metals: tungsten, steel, lead, uranium or aluminum flattening protons
palliation treatment
-symptom control -makes advanced stages more comfortable -pain relief
Three main functions of the lymphatic system
1) Lim Fattic vessels drain tissue space of interesting you will fluid that escapes from body capillaries and loose connective tissue, filtered it, and returned it to the bloodstream overall maintains the fluid levels in the body 2) lymphatic system absorbs fats and transports them into the bloodstream 3) The intricate System plays a major role in the body's defense and immunity
How does cancer cells spread
1) Lymphatic system 2) blood 3) seeding
Correct order of steps
1) diagnosis 2) concaltation 3) simulation 4) RT planning 5) physics check 6) final chart check 7) start treatment 8) end treatment
What is the most common field size
10x10
How many pairs of ribs
12 pairs
Common wedge angles
15, 30, 45, 60
To treat posteriorly
180 degrees
Parallel beams
180 degrees also called POP
What year was x-rays discovered
1895
14 bones of the face
2 maxillary 2 zygomatic 2 nasal 2 lacrimal 2 palatine 2 inferior conchae 1 mandible 1 vomer
How many bones in the skull
29
How many pairs of spinal nerve
31 pairs
How many bones in an adult vertebral colum
33
What is a vaclock
A immobilization device, complex.
Lymphabgiography
A specialized technique that use injected as to help visualize it lymphatic system
lymphangiography
A specialized technique that uses injected dyes to help visualize the lymphatic sustem
What agency developed professional practice standards
ASRT (American society of radiologic technologist)
Paranasal sinuses
Air spaces lined with mucous membranes to reduce the weight at the school and give a resonant to sound to the voice
Four dimensional images
Allow for movement
ARRT
American Registry of Radiologic Technologists
Anterior
Anterior= ventral= front
Skull
Approximately has 22 bones: A true cranial bones and 14 considered facial bones
ALARA
As Low As Reasonably Achievable
Deep
Away from the body surface
Distal
Away from the point of origin or attachment
Umbilus
Belly button located in the lumbar region L4
What mimics tissue and brings does closer to skin?
Bolus
Cranial cavity
Brain and pituitary gland
Ionizing images
CT PET
CT images show
CT images show bone detail well. CTs also show: 1) air (black) 2) water (dark/grey) 3) fat/blood (gray/light) 4) bone/metal (white)
Physique or body habitus
Can be Divided into four groups: 1) hypersthenic habitus 2) Sthenic habitus 3) huposthenic habitus 4) asthenic habitus
what does metastasize mean
Cancer grows or spreads
Asthenic habitus
Center for seek, light body weight, and a lighter skeletal framework. Makes up about 10% of the population
Types of spinal curvature
Cervical curvature, thoracic curvature, lumbar curvature, sacral curvature
Connection between sternum
Clavical
Larnxy
Connect the lower portion of the furnace above it into the trachea below it. It extends from the tip of the epiglottis at the level of the junction of C3 and C4 to the lower portion of the carotid Cartlidge at the level of C6 vertebra. It is subdivided into three anatomic regions the supraglottis, Glottis, subaglottis
afferent lymphatic vessels
Contain one-way valves that open into the node bringing the limp into it
MRIs record
Data that is based on the magnetic properties of the hydrogen nuclei, which can be thought of as tiny magnet spinning in random directions. These magnets interact with neighboring atoms it was all applied magnetic fields. In this imaging modality a strong uniform magnetic energy is applied to small magnetic fields that live parallel to the direction to the direction of the external magnet. The patient is ports with radio waves, which causes nuclei to send out a week radio signal that is detected and rework into a plan or image of body
Compensatory Vertible curves or secondary vertebral curves
Develop after birth as a child learns to sit up and walk
Primary vertebral curves
Develop in utero as a fetus develops in the sea shaped fetal position and they are present at birth
Sensitive radiation detection devices
Display images of radioactive drugs taken through the body in their uptake in tissue areas of increased uptake or the dark spots demonstrate high activity areas that correspond to pathologic change
median sagittal plane also called mid sagittal plane
Divides the body into two symmetric right and left sides
Sagittal plane
Divides the body vertically into right and left sides
Virtual simulation
Done on the computer without the patient being present
Afferent lymphatic vessels
Enter the lymph node several points along to come back service. They contain one-way valves open open into the node brain to limp into it
lymph
Excessive tissue fluid that consist mostly of water and plasma proteins from capillaries
Lithtomy position
Flat on back with knee and legs upp
lymphatic system
Flows in one direction
Mediastinum
Heart, aorta, trachea, esophagus, thymus, bronchial tubes, lymphatics
Sthenic habitus
Heavy scale to framework, elementary track is high but with the stomach located slightly lower in the trunk
What is the vertex
Highest point of the skull
Planes
Imaginary flat surfaces that pass through the body
Pharynx
In brainiest to that extends from the base of the skull to the esophagus. It connects the nasal and oral cavity's with the Lenix and esophagus. It is divided into the nasopharynx, ortho Phoenix, and larnygopharynx
sterum
Is a flat bone
Four dimensional computer tomography (4D CT)
Is able to track the movement of a moving tumor throughout the entire breathing cycle, so physicians can fall exactly where the tumor is located at all points of the cycle.
Thymus
Is larger and children and shrinks as we age helps with immunity
Spleen
Is the largest mass of lymphatic tissue in the body at roughly 12 cm in length. It is located posterior into the left of the stomach any of Domino cavity between the fundus of the stomach and the diaphragm. The spleen actively filters blood, removes old red blood cells, manufactures lymphocytes, and stores Blood
Image fusion
Is when you combine PET and CT OR Or MRI and CT
Lymphatic capillaries join to form
Larger lymphatic vessels
Where is the iliac crest located
Lumbar, L4
Pleural cavity
Lungs
Prone
Lying face down
Supine
Lying face up
Non ionizing images
MRI ULTRA SOUND
MRI Advantage's
MRI has a diagnostic advantage over CT and that it provides information about chemicals in an organ or tissue. Does MRI can be used in a non-invasive biopsy on tumors
What is the largest parineal sinuse
Maxillary
What do you do if the ODI is out
Mechanical distance indocator