Clinical aspects of imaging and therapy

Regular enrolement

Therapy
Preparation of patients for radiotherapy: choice of patients and consultation, purpose and types of radiotherapy – palliation, radical RT, tele-brachytherapy, patient positioning – purpose, tools, simulation – purpose, types (classical, virtual), practical aspects
Treatment planning: spatial information – purpose, types (historical overview), need for treatment planning, ICRU recommendations, types of treatment planning (2D, 2.5D, 3D), possibilities and limitations
Radiotherapy: treatment beam verification – purpose, types (technical feasibility), dose verification – purpose, types of measurements (advantages, disadvantages)
Radiation damage: radiobiology of tumors and normal tissues, principles of photon and electron radiation damage, tolerance doses for different tissues, mechanisms of radiation damage and clinical manifestations
Selected cases from clinical practice: preparation of the patients with head and neck, lung, colorectal, cervix, and brain tumors
Stereotaxic radiation therapy (SRS and SRT)
Intensity modulated radiation therapy (IMRT)
Image-guided radiation therapy (IGRT)
Imaging
Ultrasound: clinical indications, US images of most common pathological processes, advantages and disadvantages of US technologies
CT: clinical indications, CT images of most common pathological processes, advantages and disadvantages of CT technologies
MRI: clinical indications, MRI images of most common pathological processes, advantages and disadvantages of MRI technologies
Nuclear medicine and PET: clinical indications, nuclear medicine/PET images of most common pathological processes, advantages and disadvantages of nuclear medicine/PET technologies

• Perez CA, Luther WB. Principles and practice of radiation oncology. 4th ed. JB Lippincott: Philadelphia, 2003.
• Khan FM, Potish RA. Treatment planning in radiation oncology. Williams & Wilkins: Baltimore, 1998.
• Valk P.E., Bailey D.E., Townsend D.W., Maisey M.N.: Positron emission tomography. Springer Verlag; London, Heidelberg, New York, 2003
• Murray I.P.C. and ELL P. EDS. Nuclear medicine in clinical diagnosis and treatment. 2nd ed. Churchill Livingstone, Edinburgh, 1998.
• David Sutton, Textbook of Radiology Imaging. Churchill Livingstone: New York, Edinburgh, London (last edition).

Students get familiar with the theoretical basis of therapy and imaging as health care disciplines.
Competences:
Understanding of the criteria of patient selection for radiotherapy, procedure of patient preparation for radiotherapy, radiotherapy itself, and treatment verification; understanding of the conventional and advanced radiotherapy techniques. Understanding of selection of various imaging techniques (US, CT, MRI, nuclear medicine/PET).

Knowledge and understanding:
Students get familiar with the procedures of diagnostics and therapy, especially patient prepration, planning and therapy itself, where the collaboration between physicans and physicists is essential. Understanding of the medical, radiobiological and radiophysical basis, essential for development of treatment plan, as the key process of the inter-disciplinary collaboration.
Application:
Understanding of key imaging and radiotherapeutic procedures
Reflection:
Critical assessment of quality of imaging and therapeutic procedures .
Transferable skills:
Ability of critical evaluation of imaging and therapeutic literature; identification and solving of the imaging and therapeutic problems; ability to communicate effectively with the experts from a related medical fields.

Lectures, seminars, consultations.

Oral exam

grading: 5 (fail), 6-10 (pass) (according to the Statute of UL)

1. TAKES, Robert P., STROJAN, Primož. The controversy in the management of the N0 neck for squamous cell carcinoma of the maxillary sinus. Eur. arch. oto-rhino-laryngol., 2013, 6 str., doi: 10.1007/s00405-013-2591-0.
2. STROJAN, Primož, GRAŠIČ-KUHAR, Cvetka, ŽUMER, Barbara, KADIVEC, Maksimiljan, KARNER, Katarina Barbara, FAJDIGA, Igor, JANČAR, Boris, GALE, Nina, POLJAK, Mario, KOCJAN, Boštjan, ZAKOTNIK, Branko. TPF induction chemotherapy and concomitant irradiation with cisplatin and cetuximab in unresectable squamous cell carcinoma of the head and neck. Head Neck, 2013, vol. , no. , str., doi: 10.1002/hed.23506
3. Strojan P, Šoba E, Lamovec J, Munda A. Extramedullary plasmacytoma: clinical and histopathologic study. Int J Radiat Oncol Biol Phys 2002; 53: 692-701.
4. Šmid L, Budihna M, Zakotnik B, Šoba E, Strojan P, Fajdiga I, Žargi M, Oblak I, Dremelj M, Lešničar H. Postoperative concomitant irradiation and chemotherapy with mitomycin C and bleomycin for advanced head and neck carcinoma. Int J Radiat Oncol Biol Phys 2003; 56: 1055-1062.