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Acquiring Treatment Planning Skills Is Important for Medical Physicists

S Sutlief1*, Z Huang2*, P Xia3*, (1) Banner MD Anderson, Phoenix, AZ, (2) Saint Thomas Hospital, Brentwood, TN, (3) The Cleveland Clinic Foundation, Cleveland, OH


(Monday, 7/15/2019) 2:45 PM - 3:45 PM

Room: Stars at Night Ballroom 1

Medical physicists in radiation oncology play a critical role in the oversight of treatment plan development and quality assurance. The skills necessary for this role are most frequently taught during a dosimetry rotation and are not sufficiently used during routine practice by many medical physicists. This session will focus on the skill set of the modern medical dosimetrist and how medical physicists can use that information to enhance their competencies during treatment planning, plan checks, and troubleshooting of issues identified by the medical dosimetrist. Competencies in treatment planning include interpretation of the physician’s prescription, rigid and deformable image registration, contouring guidelines and dose tolerances for normal tissue structures, planning techniques appropriate for common treatment types and avoidance regions, and management of plan objectives used in inverse planning. The medical physicist should be aware of resources available to develop these skill sets. Modern planning techniques include constraints to minimize unwanted stray dose and maximize dose gradients at the PTV boundary, avoidance sectors in volumetric arc therapy and static gantry IMRT, dynamic MLC delivery of breast tangents, and special considerations for brain, head and neck, lung, abdomen, and pelvis treatments. The medical physicist should possess the competencies necessary to create or troubleshoot modern treatment plans. Automated treatment planning includes techniques for iterative OAR objective optimization, techniques to use libraries of previous plans to generate a plan best suited to meet clinical objectives, and techniques to generate an optimal plan space with multiple plans from which physicians can consider clinical trade-offs and priorities to choose the most appropriate plan for a particular patient. The medical physicist should understand the mechanics of these techniques and the potential pitfalls they present.

Learning Objectives:
1. Identify learning resources about treatment planning appropriate for medical physicists.
2. Understand modern treatment planning approaches medical physicists should master.
3. Learn techniques used to oversee automated treatment planning.



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