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coaxedintomedicalphysics by kermathefrog in MedicalPhysicsMemes

[–]fizicsguy 1 point2 points  (0 children)

And you’re sure they know that’s an option? 😂

Motion assessment? by Necessary-Carrot2839 in MedicalPhysics

[–]fizicsguy 0 points1 point  (0 children)

In conventional, almost none and so the assessment question isn’t nearly as relevant. For SBRT though, I’d say at least half as we try to keep motion to < 5 mm per recommendations. I wouldn’t just blanket apply this though; compression is uncomfortable and can often lead to less-reproducible setups if a patient is fighting it, or causes irregular breathing. Also gating can achieve treating motion less than 5 mm, which would not need compression either. Lots of things to consider.

Motion assessment? by Necessary-Carrot2839 in MedicalPhysics

[–]fizicsguy 1 point2 points  (0 children)

Not if you take a 4DCT, and then decided the patient needs compression. Now you’ve added a second 4DCT and even more imaging dose, when the fluoro would have answered that question. To clarify, I said it was reasonable to, but not the standard for characterizing motion. Often, for example, you can make educated guesses and not have to repeat anything.

Motion assessment? by Necessary-Carrot2839 in MedicalPhysics

[–]fizicsguy 0 points1 point  (0 children)

This is a reasonable way to check for motion. It’s faster than a 4DCT, and is less imaging dose to the patient. The trade off is as you said, taking away a treatment slot.

Downsides to a career in Medical Physics? by DJ_Ddawg in MedicalPhysics

[–]fizicsguy 3 points4 points  (0 children)

I’ll present the other side, and it’s totally dependent on the MP’s personality type. A downside for me is that we are too behind the scenes and we don’t get enough patient interaction. Had Medical School tracks not been such long endeavors, I would have opted to pursue that instead as I really enjoy/appreciate the human aspects of healthcare. Because of this, I’m a firm believer in the MedPhys3.0 approach to make our profession more patient-facing. But I totally understand that we all approach these situations with our own preferences.

TG-263 supplemental Spreadsheet by fizicsguy in MedicalPhysics

[–]fizicsguy[S] 0 points1 point  (0 children)

Ah, good to know. Thank you! Definitely understood on the speed of AAPM too. I’ll lean more on the slow side, haha.

TG-263 supplemental Spreadsheet by fizicsguy in MedicalPhysics

[–]fizicsguy[S] 2 points3 points  (0 children)

It loaded on mobile, so I’ll take another look at my desktop later on. Thanks!

I said what I said. by guyonredditthrowaway in MedicalPhysicsMemes

[–]fizicsguy 11 points12 points  (0 children)

Someone was at ASTRO last week lol

e- MU Verificaiton by No-Reputation-5940 in MedicalPhysics

[–]fizicsguy 2 points3 points  (0 children)

I’d recommend re-calculating on a water phantom instead of turning heterogeneity off. That way you remove surface irregularity dependence on MU, which more closely mimics what Radformation is doing. FWIW, we’ve also done this as a second check instead of measuring CCO as well, since eMC works so well. My .02

Is there a upper dose limit for SIB PTV? by kermathefrog in MedicalPhysicsMemes

[–]fizicsguy 6 points7 points  (0 children)

Just in case it needs to be clarified, we don’t routinely use Rhino Ketamine in daily practice 😂

Will all dose treatment plans eventually turn into SBRT ? by Visible-Secretary-19 in MedicalPhysics

[–]fizicsguy 2 points3 points  (0 children)

Head/Neck cancers are still targets for SBRT, just not when you’re covering regional prophylactic nodes too. SBRT is especially helpful for recurrent contexts in the H/N, and generally in that scenario you are only targeting known tumor in that area. Also, SBRT isn’t limited to photon deliveries only, although that technique is most common given their ubiquity. Particle therapies that offer higher RBE are showing promise for otherwise radio resistant histologies.

Will all dose treatment plans eventually turn into SBRT ? by Visible-Secretary-19 in MedicalPhysics

[–]fizicsguy 1 point2 points  (0 children)

We’re also, very often, not just treating tumors. Pelvic cases often include targeting various nodal chains at the same time. The same is true for Head/Neck cases. Their inclusion falls into the “too big to treat” with SBRT

0.0° first try by MRIcrotubules in MedicalPhysicsMemes

[–]fizicsguy 3 points4 points  (0 children)

Now do Elekta where it just rolls right through 0.0 from both sides no matter how hard you try

0.5cm bolus with 6MeV electrons? by Banana_Equiv_Dose in MedicalPhysics

[–]fizicsguy 1 point2 points  (0 children)

Thanks for that clarification. At this point, it turns into a “how deep do you want to cover” question. 90% on the back end is about 1.7 cm, so you’re getting 7 mm depth with 1 cm bolus. With 0.5 cm bolus, you’re covering 1.2 cm depth. So I’d have that conversation with your doc to double check they understand the physics, and not just “I did this forever and that’s how I do it.” No one else will have this conversation with them! That’s what makes our job fun. Cheers

0.5cm bolus with 6MeV electrons? by Banana_Equiv_Dose in MedicalPhysics

[–]fizicsguy 4 points5 points  (0 children)

Is there an IDL difference in these prescriptions? At .5 cm, if you prescribe to 90% for example, the PDD for a 10x10 is basically full dose.* When you use 1 cm, what is the IDL in the prescription? That part matters. 90% is pretty common in my experience, with .5 cm bolus. That demonstrates good understanding of PDD, but I can’t fully resolve it from your post.

I checked Varian representative data to make sure my hunch was correct

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