(Sunday, 4/5/2020) 8:00 AM - 10:00 AM [Mountain Time (GMT-6)]
Several alternatives to linear-accelerator based treatments exist in practice, and for varying clinical reasons. The goal of this session is to provide the attendee with exposure to two different types of modalities that a medical physicist may encounter in a clinical setting, with the underlying topics of discussion: LDR brachytherapy for eye plaques and radiopharmaceutical therapy with implementation principles.
Uveal melanomas are the most common primary intraocular malignancy in adults. Due to the size of these lesions and their location relative to several critical organs, steep dose gradients and high dose conformality are necessitated, suggesting the use of brachytherapy. For small to medium sized tumors, low dose rate brachytherapy using eye plaques is the most common method of treatment in the US. The treatment of uveal melanomas using low dose rate eye plaque brachytherapy can present several unique challenges to the physicist and requires a high degree of attention and coordination at each step. The presentation will provide an overview of anatomical considerations, the process of treatment plan design, and expectations of the physicist throughout the course of treatment.
Radiopharmaceutical Therapy (RPT) is fast becoming a mainstream modality with the development and approval of new emitters and conjugates. Physicians from both Radiation Oncology and Nuclear Medicine are expressing interest in, learning the fundamentals of, and aiming to implement radiopharmaceutical therapy in their clinic. These new programs will require physics support and expertise. This session aims to educate physicists in the basics of radiopharmaceutical therapy in general, what distinguishes it from external beam therapy and from diagnostic nuclear medicine, as well as focusing specifically on the modalities that are currently in use: 1. Ra-223 dichloride, 2. Y-90 microspheres, 3. I-131 sodium iodide, 4. Lu-177 DOTATATE. Additionally, an overview of some of the more fundamental principles of RPT dosimetry including the two major dosimetric approaches are presented: a) the MIRD absorbed fraction methodology using patient activity and phantom-based S values and b) patient-specific anatomy-based Monte Carlo methodologies.
Learning Objectives:
1. Preparation of LDR brachytherapy plaques, including isotopes, types of plaques, planning objectives/considerations, quality assurance, and radiation safety.
2. Understand operating room procedures, and coordination of the various groups required for LDR brachytherapy eye plaque treatment.
3. Understand how to set up/oversee a radiopharmaceutical program and identify safety concerns.
4. Familiarize the different approaches for normal organ dosimetry vs tumor dosimetry in RPT.
Funding Support, Disclosures, and Conflict of Interest: Dr. Robert Hobbs is a consultant for RAPID, LLC.
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