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.

Use of different imaging techniques in neurology.

• Halperin EC, Wazer DE, Perez CA, Luther WB. Perez and Brady's principles and practice of radiation oncology. 7th ed. JB Wolters Kluwer: Philadelphia, 2019.
• Khan FM, Sperduto PW, Gibbons JPPotish RA. Khan's treatment planning in radiation oncology. 5th ed. Wolters Kluwer: Philadelphia, 2022.
• Ell PJ, Gambhir S. Nuclear medicine in clinical diagnosis and treatment. 3nd ed. Churchill Livingstone, Edinburgh, 2004.
• Sutton D. Textbook of radiology imaging. 7th ed. Churchill Livingstone: New York , 2002.

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.

Written exam

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

1. Podobnik G, Strojan P, Peterlin P, Ibragimov B, Vrtovec T. HaN-Seg: The head and neck organ-at-risk CT and MR segmentation dataset. Med Phys 2023;50:1917-1927.

2. Mekiš J, Strojan P, Mekiš D, Hočevar Boltežar I. Change in voice quality after radiotherapy for early glottic cancer. Cancers (Basel) 2022;14:2993.

3. Nuyts S, Bollen H, Ng SP, Corry J, Eisbruch A, Mendenhall WM, Smee R, Strojan P, Ng WT, Ferlito A. Proton therapy for squamous cell carcinoma of the head and neck: Early clinical experience and current challenges. Cancers (Basel) 2022;14:2587.

4. Strojan P, Šifrer R, Ferlito A, Grašič-Kuhar C, Lanišnik B, Plavc G, Zidar N. Neuroendocrine carcinoma of the larynx and pharynx: A clinical and histopathological study. Cancers (Basel) 2021;13:4813.

5. Žumer B, Pohar Perme M, Jereb S, Strojan P. Impact of delays in radiotherapy of head and neck cancer on outcome. Radiat Oncol 2020;15:202.