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1.Aim of Radiotherapy The goal of radiotherapy is to deliver a prescribed dose of radiation to the Target while sparing surrounding Healthy tissues to the largest extent possible 2.Organ Motion Intra-fraction motion during the fraction Heartbeat Swallowing Coughing Eye movement Inter-fraction motion - in between the fractions Tumour change Weight gain/loss Positioning deviation Breathing Bowel and rectal filling Bladder filling Muscle relaxation/tension 3. Respiratory motion affects: Respiratory motion affects all tumour sites in the thorax, abdomen and Pelvis. Tumours in the Lung, Liver, Pancreas, Oesophagus, Breast, Kidneys, prostate Tumour displacement varies depending on the site and organ Location Lung tumours can move several cm in any direction during irradiation It is most prevalent and prominent in Lung cancers 4. Problems associated with respiratory motion during RT Image acquisition limitations Treatment planning limitations Radiation delivery limitations 5. Methods to Account for Respiratory Motion 1. Motion encompassing methods 2. Respiratory gating methods 3. Breath hold methods 4. Forced shallow breathing with abdominal compression 5. Real-time tumor tracking methods Summary: The management of respiratory motion in radiation oncology is an evolving field IGRT provides a solution for combating organ motion in radiotherapy Delivering higher dose to tumor and less dose to normal tissue. Limited clinical studies, needs to be studied further IGRT – the future of radiotherapy
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Dr. Faiza delivers an insightful lecture on the distinguishing characteristics of skeletal, smooth, and cardiac muscles, offering a comprehensive understanding of their histology, physiological anatomy, electrophysiological properties, and contractile mechanisms. Through meticulous tabulation and comparison, she aims to equip learners with a detailed comprehension of the unique features and functionalities of each muscle type. Beginning with a detailed exploration of histological differences, Dr. Faiza outlines key distinctions such as multinucleation in skeletal muscle, mononucleation in smooth and cardiac muscles, and the presence of striations in skeletal and cardiac muscles. She meticulously elucidates the structural arrangement of each muscle type, highlighting their cellular morphology and organization within tissues. Transitioning to physiological anatomy, Dr. Faiza navigates through various aspects including innervation, level of control, initiation of contraction, and modification by hormones. By delineating the role of the somatic nervous system in skeletal muscle control, and contrasting it with the autonomic nervous system's influence on smooth and cardiac muscles, she offers a nuanced understanding of neural regulation in muscle physiology. Furthermore, Dr. Faiza delves into electrophysiological properties, elucidating the mechanisms underlying action potential generation, duration, and ionic basis in each muscle type. Through insightful analysis, she reveals how differences in action potential characteristics contribute to variations in muscle contraction speed, duration, and resistance to fatigue. Finally, Dr. Faiza meticulously examines the contractile mechanisms of skeletal, smooth, and cardiac muscles, shedding light on the sliding filament theory, mechanisms of calcium action, and speed of contraction. By comprehensively comparing these mechanisms, she provides learners with a deep understanding of the intricate processes governing muscle contraction and function. Through engaging presentation and meticulous analysis, Dr. Faiza's lecture serves as a valuable resource for students seeking a thorough understanding of the fundamental differences between skeletal, smooth, and cardiac muscles.
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Difference Between Skeletal Smooth and Cardiac Muscles
MedicoseAcademics
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Stereotactic Body Radiation Therapy
1.
Stereotactic Body Radiation
Therapy: Is It Ready For Primetime? Joseph Herman MD, MSc Department of Radiation Oncology
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Treatment Planning
Liver Planning Target Volume Target Volumes
6.
Target Volumes Gross
Tumor Volume Planning Target Volume
7.
Pre-radiation 6 months
post-radiation Radiographic Response
8.
Survival as a
Function of Dose Dawson et. al., J Clin. Onc . 18:2210, 2000 ; Ben-Josef et al 2006 Time (years)
9.
IMRT Plan to
Deliver High Dose to Potential Resection Margin Vineberg and Ten Haken, 2004
10.
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Image Alignment:
AP Radiographs Reference Image Treatment Image Hepatic microcoil
13.
Body Frame
14.
15.
Breath Hold at
Normal Exhale Pressure Volume Flow Valve closed, Breath held Valve open
16.
17.
Synchrony ™ camera
Treatment couch Linear accelerator Manipulator Image detectors X-ray sources Targeting System Robotic Delivery System Cyberknife
18.
19.
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SRS Axial View
GTV 60% 50% Koong et al. Stanford; IJROBP 2004
21.
SRS Coronal View
GTV 60% 50% Koong et al. Stanford; IJROBP 2004
22.
23.
24.
25.
Small Animal Irradiation
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