Planning Assignment (3 field rectum)
|
|
- Mary Nelson
- 5 years ago
- Views:
Transcription
1 Megan Sullivan Clinical Lab Rectum April 25, 2016 Planning Assignment (3 field rectum) Use a CT dataset of the pelvis. Create a CTV by contouring the rectum (start at the anus and stop at the turn where it meets the sigmoid colon). Expand this structure by 1 cm and label it PTV. Create a PA field with the top border at the bottom of L5 and the bottom border 2 cm below the PTV. The lateral borders of the PA field should extend 1-2 cm beyond the pelvic inlet to include primary surrounding lymph nodes. Place the beam isocenter in the center of the PTV and use the lowest beam energy available (note: calculation point will be at isocenter). Contour all critical structures (organs at risk) in the treatment area. List all organs at risk (OR) and desired objectives/dose limitations, in the table below: Organ at risk Desired objective(s) Achieved objective(s) Bladder Whole bladder (QUANTEC) o V80 < 15% o V75 < 25% o V70 < 35% o V65 < 50% V80 = 0 V75 = 0 V70 = 0 V65 = 0 Bowel space Contour peritoneal space (QUANTEC) o V45 Gy < 195 cc Left femoral head Femoral head QUANTEC o V50 < 10% o V45 < 25% o V40 < 40% Right femoral head Femoral head QUANTEC o V50 < 10% o V45 < 25% o V40 < 40% V45 = 40.3 cc V50 = 0% V45 = 0% V40 = 0% V50 = 0% V45 = 0% V40 = 0%
2 a. Enter the prescription: 45 Gy at 1.8 /fx (95% of the prescribed dose to cover the PTV). Calculate the single PA beam. Evaluate the isodose distribution as it relates to CTV and PTV coverage. Also where is/are the hot spot(s)? Describe the isodose distribution, if a screen shot is helpful to show this, you may include it. This plan used a 6MV beam. The CTV and PTV are overly covered. Nearly the entire PTV falls within the 100% isodose line and nearly the entire CTV falls within the 110% isodose line. This plan is very, very hot posteriorly. The mean coverage for the PTV is 122.5% which equals cgy and there is a 3D Dose MAX of 194.7%. 6MV PLAN
3 b. Change to a higher energy and calculate the beam. How did your isodose distribution change? This plan used a 23MV beam. Overall, it is less hot than the previous plan, but it is still unacceptable. There is a slight skin sparing effect in comparison to the 6MV beam. This is evident by the 110% isodose line pulling away from the surface. This effect becomes more noticeable when viewing higher isodose levels. The PTV is now covered by the 95% line and the CTV is covered by the 105%. The mean coverage for PTV is now 117% which equals cgy and the hot spot is 161.1%. In relation to the 6MV plan, low dose is covering more tissue in the 23MV plan whereas high dose is covering less. Additionally, low dose is pushing more anteriorly with the 23MV beam. 6MV PLAN 23MV PLAN
4 c. Insert a left lateral beam with a 1 cm margin around the ant and post wall of the PTV. Keep the superior and inferior borders of the lateral field the same as the PA beam. Copy and oppose the left lateral beam to create a right lateral field. Use the lowest beam energy available for all 3 fields. Calculate the dose and apply equal weighting to all 3 beams. Describe this dose distribution. This plan used 6MV beams. The use of two lateral beams diminished the posterior hot spot as well as the low dose falling anteriorly. However, there are now two hot spots out laterally on either side. This plan is on the right path, but the weighting is favoring the lateral beams too much and resulting in too much unwanted dose laterally. Additionally, this area of the body has too great of a separation for 6MV beams to deliver the dose in an effective manner. 3 FIELD 6 MV PLAN
5 d. Change the 2 lateral fields to a higher energy and calculate. How did this change the dose distribution? This plan used 23MV beams on the lateral fields and a 6MV beam on the PA field. The use of higher energy on this plan was a positive change as the lateral fields are not nearly as hot and the monitor units on the lateral beams went down significantly. The plan is also less hot posteriorly and significantly less hot out laterally. This is due to the fact that the 23MV beams do not have to work as hard to deliver dose to the prescribed volume as the 6MV beams. However, there are still 95% isodose lines present in the lateral fields which is still too hot. Weighting the beams differently will be effective in achieving less dose laterally. 6 MV PLAN 6 MV & 23 MV PLAN
6 e. Increase the energy of the PA beam and calculate. What change do you see? This plan used 23MV beams on all three fields. This plan has benefited from completely using high energy beams because of the amount of tissue the beam must attenuate to deliver 95% to 100% of the target volume. The change to high energy on the PA has reduced the amount of 110% and reduced the number of MUs for the PA beam while still obtaining coverage. The hotspot is solely posterior which makes it easy to distribute this hotspot with the use of wedges. 23 MV PLAN
7 f. Add the lowest angle wedge to the two lateral beams. What direction did you place the wedge and why? How did it affect your isodose distribution? (To describe the wedge orientation you may draw a picture, provide a screen shot, or describe it in relation to the patient. (e.g., Heel towards anterior of patient, heel towards head of patient..) This plan used 23MV beams on all three fields. The 15 degree wedge was added to both lateral fields with the heel of the wedge positioned posteriorly and the toe positioned anteriorly on both fields. This wedge orientation requires the wedge to be flipped i.e. 15 LEFT on the right lateral field and 15 RIGHT on the left lateral field. This orientation is necessary because the hotspot was solely posterior and having the heel of the wedge lined up with the hotspot allows more attention of the beam to this area of the field thus delivering less dose to this portion. Using wedges has pushed the dose anteriorly and reduced the 110% in the field. The 95% isodose line is still covering the PTV, and nearly the entire CTV is covered by the 100%. Wedging the lateral beams is necessary, but 15 degree wedges are not enough. This is evident based on the presence of the remaining 110% isodose line positioned posteriorly. 23 MV PLAN WITH 15 DEGREE WEDGES
8 g. Continue to add thicker wedges on both lateral beams and calculate for each wedge angle you try (when you replace a wedge on the left, replace it with the same wedge angle on the right). What wedge angles did you use and how did it affect the isodose distribution? The first wedge increase was to 30 degree wedges. This change resulted in the posterior region to be less hot than with the 15 degree wedges. The 95% isodose line is covering nearly the entire field but the 100% line is not quite covering the CTV. Increasing the weighting of the PA field would improve the dose distribution by decreasing the dose out laterally and providing more target coverage. The second wedge increase was to 45 degree wedges. This change resulted in the complete coverage of the CTV and PTV. All of the fields are significantly hotter than before, but this makes for a solid starting point because coverage was achieved. Modifications in weighting will play a vital role in improving this plan. Because of the outcome with the 45 degree wedges, I chose not to continue on to 60 degree wedges. This plan would not benefit from pushing anymore dose anteriorly. This can be observed by the coverage of the 100% isodose line coming close to the posterior aspect of the CTV and the amount of 110% isodose line that was pushed anteriorly. 30 DEGREE WEDGE PLAN 45 DEGREE WEDGE PLAN
9 h. Now that you have seen the effect of the different components, begin to adjust the weighting of the fields. At this point determine which energy you want to use for each of the fields. If wedges will be used, determine which wedge angle you like and the final weighting for each of the 3 fields. Don t forget to evaluate this in every slice throughout your planning volume. Discuss your plan with your preceptor and adjust it based on their input. Explain how you arrived at your final plan. The energy used for all three fields is 23 MV. Both lateral fields have a 45 degree wedge with the heels positioned posteriorly in order to push dose anteriorly. A weighting of 2:1:1 of the PA, RLAT, and LLAT beams, respectively, was used. Some goals to obtain with a three-field prone rectum include minimizing the hotspot to about %, keep the low dose in the lateral tissue to no more than 80%, and have the PTV covered with the 95% isodose line and the CTV covered with the 100% isodose line. In order to improve the plan, I added multi-leaf collimators (MLCs) on all fields. On both lateral fields the MLCs were brought in to block out the posterior hotspot. The PA field used MLCs to block out the right and left femurs as well as some normal tissue. These blocks were shaped with the goal to block out the hotspots as much as possible while still including the sacrum and maintaining at least a 1 cm margin around the PTV. Additionally, I rotated the gantry a few degrees on both lateral fields in order to match divergence anteriorly. The end result: i. For PTV coverage, 100% of the volume is covered with 99% of the dose and over 95% of the volume is covered with 100% of the dose. ii. For CTV coverage, 100% of the volume is covered with 100% of the dose. iii. No more than 80% isodose coverage is spread out into lateral tissue and the quantity is kept to a minimum. iv. The overall hotspot is 106.1% LLAT FIELD PA FIELD RLAT FIELD
10 AXIAL CORONAL SAGITTAL
11 BLADDER PTV CTV BOWEL FEMURS FINAL DVH
12 4 field pelvis Using the final 3 field rectum plan, copy and oppose the PA field to create an AP field. Keep the lateral field arrangement. Remove any wedges that may have been used. Calculate the four fields and weight them equally. How does this change the isodose distribution? What do you see as possible advantages or potential disadvantages of adding the fourth field? The isodose lines display a much more even distribution. Adding a fourth field decreases the overall hotspot and eliminates the presence of 105% isodose line completely. Also, this is another field that would be blocking out the femoral heads and could potentially redistribute beam weight from the lateral fields to reduce dose to the femoral heads. Also, there is less dose deposited into normal tissue laterally. On the downside, because the bladder and bowel are both positioned anteriorly, these OR are now receiving entrance dose from the AP field in addition to the already present exit dose from the PA field. Additionally, the isocenter is often positioned posteriorly resulting in a low treatment table height. An anterior beam could potentially not have clearance with the treatment table. 3 FIELD BLADDER 4 FIELD BLADDER DVH COMPARING 3 FIELD PLAN WITH 4 FIELD PLAN
CLINICAL IMPLEMENTATION OF RAPIDARC Treatment Planning Strategies to Improve Dose Distributions
CLINICAL IMPLEMENTATION OF RAPIDARC Treatment Planning Strategies to Improve Dose Distributions Rebecca M. Howell, Ph.D., D.A.B.R, The University of Texas at M.D. Anderson Cancer Center Overview 2 Commissioning
More informationTreatment Planning Techniques for Larger Body Habitus Patients for Breast/Chestwall and Regional Lymph Nodal Irradiation
Treatment Planning Techniques for Larger Body Habitus Patients for Breast/Chestwall and Regional Lymph Nodal Irradiation By Ruth Ann M. Good, CMD. R.T. (R)(T) Virginia Commonwealth University, Richmond,
More informationClinical Implementation of Volumetric Modulated Arc Therapy
Clinical Implementation of Volumetric Modulated Arc Therapy UT M.D. Anderson Cancer Center Ramaswamy Sadagopan, Rebecca M. Howell, Weiliang Du and Peter Balter Definition 2 Intensity Modulated Arc therapy
More informationTG-119 IMRT Commissioning Tests Instructions for Planning, Measurement, and Analysis Version 10/21/2009
TG-119 IMRT Commissioning Tests Instructions for Planning, Measurement, and Analysis Version 10/21/2009 DISCLAIMER: This publication and associated spreadsheets and digital files are based on sources and
More informationIMRT in clinical practice at the UMC-Utrecht. Utrecht
3 IMRT in clinical practice at the UMC-Utrecht Utrecht Clinical use of IMRT Improvement of local control without increased incidence of normal tissue complications + Dose escalation in the prostate Step-and
More informationReview of fundamental photon dosimetry quantities
Review of fundamental photon dosimetry quantities Narayan Sahoo Main sources of the materials included in this lecture notes are: (1) Radiation Oncology Physics: A Handbook for Teachers and Students Edited
More informationOutline. Chapter 11 Treatment Planning Single Beams. Patient dose calculation. Patient dose calculation. Effect of the curved contour surface
Chapter 11 reatment Planning Single Beams Radiation Dosimetry I Outline Basic terminology Curved contour surface correction (bolus, compensators, wedges) Oblique beam incidence Correction for tissue inhomogeneities
More informationDosimetric Calculations. Lonny Trestrail
Dosimetric Calculations Lonny Trestrail 20 October 2008 Objectives Dose Distribution Measurements PDD, OCR TAR, SAR, TPR, TMR, SPR, SMR Arc or Rotational Therapy Isodose Curves Point Dose Calculations
More informationRadiotherapy Treatment Planning and Delivery
Radiotherapy Treatment Planning and Delivery SCOPE 1: Study of Chemoradiotherapy in Oesophageal Cancer Plus or Minus Erbitux A randomised phase II/III multi-centre clinical trial of definitive chemo-radiation,
More informationMath Review. Overview
Drawn by Steve Yan, CMD Math Review Shirley Ann Pinegar-Johnston MS RT(R)(T)CMD Overview Drawn by Steve Yan, CMD Divergence & Intensity DIVERGENCE X-rays travel in Straight but Divergent lines INTENSITY
More informationRelative Dosimetry. Photons
Relative Dosimetry Photons What you need to measure! Required Data (Photon) Central Axis Percent Depth Dose Tissue Maximum Ratio Scatter Maximum Ratio Output Factors S c & S cp! S p Beam profiles Wedge
More informationMonitor Unit Calculations Part 1. Return to our first patient. Purpose. 62 yr old woman with Stage IIIB (T1N3M0) NSCLC rt lower lobe Dose prescription
Monitor Unit Calculations Part 1 George Starkschall, Ph.D. Department of Radiation Physics U.T. M.D. Anderson Cancer Center Return to our first patient 62 yr old woman with Stage IIIB (T1N3M0) NSCLC rt
More informationVariSource High Dose Rate Afterloader Procedures. For Performing Breast Brachytherapy with. The SAVI TM Applicator
VariSource High Dose Rate Afterloader Procedures For Performing Breast Brachytherapy with The SAVI TM Applicator Contents I. CT Evaluation (~1 week prior to insertion) II. SAVI Applicator Implantation
More informationMonitor Unit Calculations Part 2. Calculation of machine setting. Collimator setting
Monitor Unit Calculations Part 2 George Starkschall, Ph.D. Department of Radiation Physics U.T. M.D. Anderson Cancer Center Calculation of machine setting reference dose machine setting =, reference dose
More information3D Treatment Planning and verification with hand calculations
3D Treatment Planning and verification with hand calculations Randy Holt, PhD, CEO Pacific Crest Medical Physics, Inc Chico, CA Dosimetric Calculations Calibration and Measurement Conditions Patient Conditions
More informationThe Royal Australian and New Zealand College of Radiologists. FRANZCR Examination Part I Radiation Oncology. Radiotherapeutic Physics.
FRANZCR Examination Part I Radiation Oncology Radiotherapeutic Physics Candidate No.: The Royal Australian and New Zealand College of Radiologists FRANZCR Examination Part I Radiation Oncology Radiotherapeutic
More informationMonitor Unit Verification for Small Fields
Monitor Unit Verification for Small Fields Patrick Higgins, Ph.D University of Minnesota Department of Radiation Oncology October 10, 2013 The Issues: How do we verify the monitor units calculated by the
More informationAbsorption measurements for a carbon fiber couch top and its modelling in a treatment planning system
Absorption measurements for a carbon fiber couch top and its modelling in a treatment planning system G. Kunz, F. Hasenbalg, P. Pemler 1 1 Klinik für Radio-Onkologie und Nuklearmedizin, Stadtspital Triemli
More informationField size and depth dependence of wedge factor for internal wedge of dual energy linear accelerator
Journal of BUON 8: 55-59, 2003 2003 Zerbinis Medical Publications. Printed in Greece ORIGINAL ARTICLE Field size and depth dependence of wedge factor for internal wedge of dual energy linear accelerator
More informationBreast Treatment System REFERENCE MANUAL
Breast Treatment System REFERENCE MANUAL This manual may not be reproduced in whole or in part, by mimeograph or any other means, without the written permission of Diacor, Inc. The MammoRx Breast Treatment
More informationSnapShot IMRT with compensators and FFF beams
SnapShot IMRT with compensators and FFF beams Vladimir Feygelman, PhD (1) Moffitt Cancer Center, Tampa, FL, USA Disclosure VF has a sponsored research agreement with.decimal. A short history of radiotherapy
More information1. Question Answer cgy / MU cgy / MU 2. Question Answer
GS020113: Introduction to Medical Physics III: Therapy s to home work problem set assigned on 3/22/11 1. Question A patient is set up at 100 cm SSD on a 6 MVX machine. The dose rate at 10 cm in phantom
More informationRadiotherapy physics & Equipments
Radiotherapy physics & Equipments RAD 481 Lecture s Title: Beam Modification devices in Radiotherapy Dr. Mohammed Emam Vision :IMC aspires to be a leader in applied medical sciences, health care education
More informationBasics of Proton Therapy. Proton Treatment Planning and Beam Optimization
Basics of Proton Therapy Proton Treatment Planning and Beam Optimization SAM Educational Session, WE D BRB 2 Mark Pankuch, PhD Northwestern Medicine Chicago Proton Center Today s objectives Review the
More informationCommissioning an IMRT System for MLC Delivery. Gary A. Ezzell., Ph.D. Mayo Clinic Scottsdale
Commissioning an IMRT System for MLC Delivery Gary A. Ezzell., Ph.D. Mayo Clinic Scottsdale Taking the broad view of commissioning Commissioning elements Validating the dosimetry system Commissioning the
More informationJOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 3, NUMBER 4, FALL 2002
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 3, NUMBER 4, FALL 2002 Comparison of monitor unit calculations performed with a 3D computerized planning system and independent hand calculations: Results
More informationMOTION FOOT MX. Manual
MOTION FOOT MX Manual Real Technology - Real People CONTENTS Intruduction....4 Patient Selection....4 Foot Components....4 Special Precautions....5 Set-Up....6 Change Heel Height & Dorsi Flexion Range....
More informationvideo Purpose Pathological Gait Objectives: Primary, Secondary and Compensatory Gait Deviations in CP AACPDM IC #3 1
s in CP Disclosure Information AACPDM 71st Annual Meeting September 13-16, 2017 Speaker Names: Sylvia Ounpuu, MSc and Kristan Pierz, MD Differentiating Between, Secondary and Compensatory Mechanisms in
More informationDisclosures. What Is So Hard? End of ITV: Gating is the Best ITV Killer 8/3/2016. Daniel A. Low, Ph.D. UCLA. Varian Grant Siemens Grant Accuray Grant
Real Timefullness 8/3/2016 End of ITV: Gating is the Best ITV Killer Daniel A. Low, Ph.D. UCLA Varian Grant Siemens Grant Accuray Grant Disclosures What Is So Hard? Light Ultrasound MRI X Ray Planar X
More information13 QUALITY ASSURANCE OF A LINEAR ACCELERATOR 13.1 COLLIMATOR ISOCENTER, JAWS, LIGHT FIELD VS INDICATORS, COLLIMATOR ANGLE INDICATORS.
13 QUALITY ASSURANCE OF A LINEAR ACCELERATOR 13.1 COLLIMATOR ISOCENTER, JAWS, LIGHT FIELD VS INDICATORS, COLLIMATOR ANGLE INDICATORS. 13.1.1 TRAINING GOAL 13.1.1.1 Among the responsabilities of a medical
More informationPurpose. Outline. Angle definition. Objectives:
Disclosure Information AACPDM 69 th Annual Meeting October 21-24, 2015 Speaker Names: Sylvia Õunpuu, MSc and Kristan Pierz, MD Gait Analysis Data Interpretation: Understanding Kinematic Relationships Within
More informationCHAPTER 4 PRE TREATMENT PATIENT SPECIFIC QUALITY ASSURANCE OF RAPIDARC PLANS
47 CHAPTER 4 PRE TREATMENT PATIENT SPECIFIC QUALITY ASSURANCE OF RAPIDARC PLANS 4.1 INTRODUCTION Advanced treatment techniques use optimized radiation beam intensities to conform dose distribution to the
More informationIntroduction. Introduction. The CyberKnife SRS/SBRT System. Introduction. Contour Structures. CyberKnife Components
Introduction The CyberKnife SRS/SBRT System James M. Hevezi,, Ph.D., FACR CyberKnife Unit San Antonio, Texas CyberKnife Components Treatment Delivery (G3 Platform San Antonio) Robot (modified German auto
More informationPhysics and Quality Assurance
Disclosure Physics and Quality Assurance Consultancy agreements with Nucletron, Hologic Mahta M. McKee, MS, DABR Department of Radiation Oncology Wake Forest University Health Sciences Agenda Current Treatment
More informationOptimization in high dose rate vaginal cylinder for vaginal cuff irradiation
Rep Pract Oncol Radiother, 2008; 13(1): 35-48 Original Paper Received: 2007.07.09 Accepted: 2007.12.13 Published: 2008.02.29 Authors Contribution: A Study Design B Data Collection C Statistical Analysis
More informationTREATMENT OF THE TORSO
TREATMENT OF THE TORSO TREATMENTS: Wrap around the points One person Two persons Screwdriver technique Bounce technique Two person wrap around technique * Torso * Wrap around technique WRAPPING THE POINTS
More informationCushions for pressure relief in the seated position
Cushions for pressure relief in the seated position Name Size in cm. Item no. About the device Application Seat 42 x 42 x 5 70008 Seat cushion, extra strong. Pressure distribution for the mitigation of
More informationCOMPASS. Dr. Lutz Müller. AK IMRT Bamberg April D IMRT Verification in Patient Anatomy
COMPASS 3D IMRT Verification in Patient Anatomy AK IMRT Bamberg April 2010 Dr. Lutz Müller Patient-specific Verification? CT Treatment unit Gantry =0 Treatmt unit Patient couch X-ray beam Patient couch
More informationvideo Outline Pre-requisites of Typical Gait Case Studies Case 1 L5 Myelomeningocele Case 1 L5 Myelomeningocele
Outline Evaluation of Orthosis Function in Children with Neuromuscular Disorders Using Motion Analysis Outcomes Terminology Methods Typically developing Case examples variety of pathologies Sylvia Õunpuu,
More informationInvestigation of Buildup Dose for Therapeutic Intensity Modulated Photon Beams in Radiation Therapy
University of South Florida Scholar Commons Graduate Theses and Dissertations Graduate School 7-14-2010 Investigation of Buildup Dose for Therapeutic Intensity Modulated Photon Beams in Radiation Therapy
More information1. Hip flexion Muscles: Iliopsoas (psoas major + iliacus)
Chap. 5 Testing the muscles of the Lower Extremity Part I. Manual Muscle Testing of the hip joint muscles 1. Hip flexion Muscles: Iliopsoas (psoas major + iliacus) Rectus femoris Sartorius Tensor fascia
More informationConstancy checks of well-type ionization chambers with external-beam radiation units
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 16, NUMBER 6, 2015 Constancy checks of well-type ionization chambers with external-beam radiation units Sara L. Hackett, 1a Benjamin Davis, 2 Andrew
More informationSee JAY Product Comparison Guide notes to the right. Cushions HCPCS Code Page # Lateral Stability Forward Stability. Backs HCPCS Code Page #
CUSHIONS & BACKS PRODUCT RATING See JAY Product Comparison Guide notes to the right. Cushions Page # Lateral Stability Forward Stability Pressure Management JAY Basic E2601/E2602 5 1 2 3 4 5 1 2 3 4 5
More informationRebound Air Walker. Introduction. Product Presentation
Rebound Air Walker Product Presentation Introduction The Rebound Air Walker features a host of details designed to provide added protection, superior compression, simplified application and usage, improved
More informationCommissioning and quality assurance of a commercial intensity modulated radiotherapy (IMRT) treatment planning system PrecisePLAN
22 Turkish Journal of Cancer Volume 37, No.1, 2007 Commissioning and quality assurance of a commercial intensity modulated radiotherapy (IMRT) treatment planning system PrecisePLAN SATISH PELAGADE 1, KALPANA
More informationExperimental verification of a Monte Carlo-based MLC simulation model for IMRT dose calculations in heterogeneous media
Experimental verification of a Monte Carlo-based MLC simulation model for IMRT dose calculations in heterogeneous media N Tyagi 1, B H Curran, P L Roberson, J M Moran, E Acosta and B A Fraass Department
More informationIntroduction. Materials and Methods
STANDARD WEDGE AND TRAY TRANSMISSION VALUES FOR VARIAN, SEIMENS, ELEKTA/PHILIPS ACCELERATORS; A QUALITY ASSURANCE TOOL David S. Followill, Nadia Hernandez, and William F. Hanson Introduction The Radiological
More informationFoot System Prosthetist Manual
Introduction Foot System Prosthetist Manual The Motionfoot is a hydraulic ankle, with a carbon fiber foot plate. It features; Very high ankle range of motion, up to 50. Smooth hydraulic transition from
More informationBASIC ORTHOPEDIC ASSESSMENT Muscle and Joint Testing
BASIC ORTHOPEDIC ASSESSMENT Muscle and Joint Testing The following tests are for the purpose of determining relative shortening, restriction or bind of muscle tissues. In this context the term bind in
More informationAxis of rotation is always perpendicular to the plane of movement
Sports scientists and medical practitioners use formal terms to describe directionality, joint movement, and muscle movement. These universal terms let us use fewer words when describing movement, teaching,
More informationOUTPUT at dmax in tissue 8x8 20x20 At 100cm SSD At 100cm SAD
RAPHEX 2001 T1. All of the following are true regarding Percentage Depth Dose (PDD) except: A. Increases with increasing energy. B. Depends on field size. C. Is the dose at depth expressed as a % of the
More informationRecent Advances in Orthotic Therapy for. Plantar Fasciitis. An Evidence Based Approach. Lawrence Z. Huppin, D.P.M.
Recent Advances in Orthotic Therapy for Plantar Fasciitis An Evidence Based Approach Lawrence Z. Huppin, D.P.M. Assistant Clinical Professor, Western University of Health Sciences, College of Podiatric
More informationENHANCED PARKWAY STUDY: PHASE 2 CONTINUOUS FLOW INTERSECTIONS. Final Report
Preparedby: ENHANCED PARKWAY STUDY: PHASE 2 CONTINUOUS FLOW INTERSECTIONS Final Report Prepared for Maricopa County Department of Transportation Prepared by TABLE OF CONTENTS Page EXECUTIVE SUMMARY ES-1
More informationkvue IGRT Couch top One couch top, multiple treatment solutions For Varian, Elekta, Siemens, Proton and more The Best of Both Worlds
TM kvue IGRT Couch top One couch top, multiple treatment solutions For Varian, Elekta, Siemens, Proton and more kvue The Best of Both Worlds kvue IGRT COUCH TOP One couch top, multiple treatment solutions
More informationAeris Activity. Product Manual
Aeris Activity Product Manual Instructions The Aeris Activity Foot System has been designed and manufactured for specific patient weights. Failure to follow the weight guidelines and/or overload conditions
More informationComparison of ionization chambers of various volumes for IMRT absolute dose verification
Comparison of ionization chambers of various volumes for IMRT absolute dose verification Leonid B. Leybovich, a) Anil Sethi, and Nesrin Dogan Department of Radiation Oncology, Loyola University Medical
More informationKintrol Instructions for Use Product Number: VS4
Kintrol Instructions for Use Product Number: VS4 Introduction The Kintrol foot/ankle combines hydraulics and fiberglass to provide K2 ambulators an exceptionally normal walking gait regardless of surface
More informationSee JAY Product Comparison Guide notes to the right. Cushions HCPCS Code Page # Lateral Stability Forward Stability. Backs HCPCS Code Page #
PRODUCT CATALOG PRODUCT RATING See JAY Product Comparison Guide notes to the right. Cushions HCPCS Code Page # Lateral Stability Forward Stability Pressure Management JAY Basic E2601/E2602 5 1 2 3 4 5
More informationHow to Design Medical Accelerator Systems for Reliability: IBA PT System
How to Design Medical Accelerator Systems for Reliability: IBA PT System Yves Jongen Founder & Chief Research Officer Ion Beam Applications s.a. Belgium 1 Outline A short introduction of a proton therapy
More informationCT Transcatheter Aortic Valve Replacement (TAVR) Planning VPMC-13165C
CT Transcatheter Aortic Valve Replacement (TAVR) Planning VPMC-13165C TAVR: Overview of the Application Overview: CT Transcatheter Aortic Valve Replacement (TAVR) planning assists with the assessment of
More informationIntelli-Gel Cushions. cushions. kirton-healthcare.co.uk
Cushions kirton-healthcare.co.uk 3 What is a Pressure Ulcer? A pressure ulcer is an injury to the skin and tissue under it. Sitting or lying in the same position will begin to cut off the flow of blood
More informationAllPro Foot. Posterior Mount Product Manual
AllPro Foot Posterior Mount Product Manual Instructions The AllPro PM foot system has been designed and manufactured for specific patient weights. Failure to follow the weight guidelines and/or overload
More informationThe dose distribution of medium energy electron boosts to the laryngectomy stoma
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 2, NUMBER 1, WINTER 2001 The dose distribution of medium energy electron boosts to the laryngectomy stoma Ellen D. Yorke* Memorial Sloan-Kettering Cancer
More informationANATOMICAL TERMINOLOGY: Body Movement
ANATOMICAL TERMINOLOGY: Body Movement Fill in the Blank 1. Johnny has just performed a bicep curl (up) in weight training class. What motion did his arm make from the elbow? 2. Anita has just pointed her
More informationCommissioning of Elekta 6MV FFF Versa HD and Pinnacle
Commissioning of Elekta 6MV FFF Versa HD and Pinnacle Poster No.: R-0044 Congress: Type: Authors: Keywords: DOI: 2014 CSM Scientific Exhibit L. Bendall, I. Patel, N. McGrath, C. Rowbottom; MANCHESTER/
More informationKinterra Instructions for Use Product Number: ROM-00-XXXXX-XX
Kinterra Instructions for Use Product Number: ROM-00-XXXXX-XX Introduction Patient Selection Assembly Alignment The Kinterra foot/ankle system combines hydraulics and carbon fiber, to provide low to moderate
More informationScientific Journal of Nuclear Medicine & Radiation Therapy
Scientific Journal of Nuclear Medicine & Radiation Therapy Research Article Radiotherapy Dose Calculation Program, for Monitoring and Commissioning Treatment Planning Systems - Ioannis Vamvakas*, Stella
More informationANALYSIS OF OFF-AXIS ENHANCDED DYNAMIC WEDGE DOSIMETRY USING A 2D DIODE ARRAY A CREATIVE PROJECT (3 SEMESTER HOURS) SUBMITTED TO THE GRADUATE SCHOOL
ANALYSIS OF OFF-AXIS ENHANCDED DYNAMIC WEDGE DOSIMETRY USING A 2D DIODE ARRAY A CREATIVE PROJECT (3 SEMESTER HOURS) SUBMITTED TO THE GRADUATE SCHOOL FOR THE DEGREE MASTER OF ARTS BY CHARLES TRAVIS WEBB
More informationASSESMENT Introduction REPORTS Running Reports Walking Reports Written Report
ASSESMENT REPORTS Introduction Left panel Avatar Playback Right Panel Patient Gait Parameters Report Tab Click on parameter to view avatar at that point in time 2 Introduction Software will compare gait
More informationBeam modeling and VMAT performance with the Agility 160-leaf multileaf collimator
JOURNAL OF APPLIED CLINICAL MEDICAL PHYSICS, VOLUME 14, NUMBER 2, 2013 Beam modeling and VMAT performance with the Agility 160-leaf multileaf collimator James L. Bedford, a Michael D. R. Thomas and Gregory
More informationA clinical comparison and analysis between conventional MLC based and solid compensator based IMRT treatment techniques
The University of Toledo The University of Toledo Digital Repository Theses and Dissertations 2009 A clinical comparison and analysis between conventional MLC based and solid compensator based IMRT treatment
More informationFoot mechanics & implications on training, posture and movement
Foot mechanics & implications on training, posture and movement Three Arches Three Arches These arches are not reciprocal. When the foot pronates ALL arches should fall. If the medial arch falls and the
More informationVentilation 12/1/2012. Clarification of Terminology. Osteology of Ventilation
Clarification of Terminology : the mechanical process by which air is inhaled and exhaled through the lungs. It describes only the movement of air. Respiration: a term used to describe the gas exchange
More informationBIORAPTOR Knotless Suture Anchor Arthroscopic Shoulder Instability Repair. Shoulder Series Technique Guide by: Thomas Youm, MD
BIORAPTOR Knotless Suture Anchor Arthroscopic Shoulder Instability Repair Shoulder Series Technique Guide by: Thomas Youm, MD As described by: Thomas Youm, MD Clinical Assistant Professor NYU Hospital
More informationCoaching the Triple Jump Boo Schexnayder
I. Understanding the Event A. The Run and Its Purpose B. Hip Undulation and the Phases C. Making the Connection II. III. IV. The Approach Run A. Phases B. Technical Features 1. Posture 2. Progressive Body
More informationFrog Dissection Pre-Lab
Name: Class: Date: Why are we dissecting a frog? Frog Dissection Pre-Lab Frogs and humans are vertebrates and they have very similar organ systems. Although all of the internal organs are not exactly the
More informationNormal and Abnormal Gait
Normal and Abnormal Gait Adrielle Fry, MD EvergreenHealth, Division of Sport and Spine University of Washington Board Review Course March 6, 2017 What are we going to cover? Definitions and key concepts
More informationAeris Performance 2. Product Manual
Aeris Performance 2 Product Manual Instructions The Aeris Performance 2 is designed to be maintenance free. The foot is water resistant; however, if the foot is submerged in water, the foot and foot shell
More informationThe MC commissioning of CyberKnife with MLC (Tips and Tricks)
The MC commissioning of CyberKnife with MLC (Tips and Tricks) Alain Guemnie Tafo, PhD UPMC Pinnacle, Harrisburg, PA Institute Gustave Roussy, Villejuif, France Disclaimer & Disclosure The views expressed
More informationRESPIRATORY MOTION IN RADIATION THERAPY
RESPIRATORY MOTION IN RADIATION THERAPY Significant effect on targets in the chest and upper abdominal cavities Can cause difficulty in reproducing radiation planning protocols in radiation treatment sessions
More informationThe information provided in this document came directly off the USA Hockey Website. All information is property of USA Hockey.
The information provided in this document came directly off the USA Hockey Website. All information is property of USA Hockey. For more information on Goaltending or USA Hockey please visit www.usahockey.com
More informationAmmonia Treatment Instructions Page 1 of 5
Page 1 of 5 Original version by Douglas Call Updated January 21, 2009 by David Jones Department: Chemical Engineering Location: Fenske 102 (access thru room 103) Contact: BP Matthew Holbrook 161 Fenske
More informationPosture Pump PENTAVEC Model 2500 Instructions
Posture PENTAVEC Model 2500 Instructions page 1 of 6 TRAINING INSTRUCTIONS CAUTION: CAREFULLY READ AND ADJUST THE PELVIC AND FOOT-UNIT BELTS PER "ADJUSTING THE PELVIC PULL" INSTRUCTIONS ON THE FOLLOWING
More information1. Zinn, L. (2009). Zinn and the Art of Road Bike Maintenance, 3rd Ed. Boulder, CO: Velo Press.
Bike Fit Clinic 3/11/2014 James Cunningham, PT, DPT, OCS 1. Zinn, L. (2009). Zinn and the Art of Road Bike Maintenance, 3rd Ed. Boulder, CO: Velo Press. Basic frame guidelines Should be able to have at
More informationAllPro Foot. Product Manual
AllPro Foot Product Manual Instructions The AllPro Foot System has been designed and manufactured for specific patient weights. Failure to follow the weight guidelines and/or overload conditions caused
More informationTHE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING
THE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING THE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING AirSelect puts comfort, control and healing in the hands of
More informationTHE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING
THE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING THE ULTIMATE COMBINATION DESIGNED FOR COMFORT + ENGINEERED FOR HEALING AirSelect puts comfort, control and healing in the hands of
More informationUnity Sleeveless Elevated Vacuum System
Unity Sleeveless Elevated Vacuum System 14/03/201 4 Form 8 Vacuum Advantages of vacuum suspension Very firm suspension providing excellent security and improved proprioception Elevated vacuum tends to
More informationGoaltending Development
AGES 8 AND UNDER Goaltending Development LESSON WORKBOOK JOE EXTER 2 Goaltending is a combination of sound structural technique and athleticism. It is important for coaches and goaltenders to consistently
More informationOtto Bock and Springlite Feet
Otto Bock and Springlite Feet Advantage DP2 The Advantage DP2 is Otto Bock s lightest weight dynamic pylon foot system. It is an ultra lightweight foot that offers energy return and dynamic response. It
More informationIdeal Heel Promotes proper alignment and reduces lever arms
IDEAL Technologies Ideal Heel Promotes proper alignment and reduces lever arms The Ideal Heel is an innovation that shifts the ground contact point forward. The runner lands with more ground clearance
More informationSee JAY Product Comparison Guide notes to the right. Cushions HCPCS Code Page # Lateral Stability Forward Stability. Backs HCPCS Code Page #
PRODUCT CATALOG PRODUCT RATING See JAY Product Comparison Guide notes to the right. Cushions HCPCS Code Page # Lateral Stability Forward Stability Pressure Management JAY Basic E2601/E2602 6 1 1 1 JAY
More informationZoubir Ouhib Lynn Cancer Institute
Zoubir Ouhib Lynn Cancer Institute April 2015 Speaker for ELEKTA Brachytherapy using miniature X-ray sources Energy
More informationK2 Foot. Product Manual
K2 Foot Product Manual Instructions The K2 is designed to be maintenance free. The foot is water resistant; however, if the foot is submerged in water, the foot and foot shell should be rinsed with fresh
More informationA dose delivery verification method for conventional and intensitymodulated radiation therapy using measured field fluence distributions
A dose delivery verification method for conventional and intensitymodulated radiation therapy using measured field fluence distributions Wendel Dean Renner a) Math Resolutions, LLC, 5975 Gales Lane, Columbia,
More informationStudy & Manipulative Training Guide
Study Manipulative Training Guide What is the XCOLLAR? The XCollar is a complete Cervical Spine Splinting System designed especially for EMS. It ensures the highest level of patient safety while significantly
More informationElectronic Oncology Systems the Management and the Safety Measures. Hansen Chen, Director, TDSI
Electronic Oncology Systems the Management and the Safety Measures Hansen Chen, Director, TDSI Radiation Oncology Department People Place Equipments Procedures Patients Hansen Chen 2 Radiation Oncology
More informationExperimental Analysis on Vortex Tube Refrigerator Using Different Conical Valve Angles
International Journal of Engineering Research and Development e-issn: 7-067X, p-issn: 7-00X, www.ijerd.com Volume 3, Issue 4 (August ), PP. 33-39 Experimental Analysis on Vortex Tube Refrigerator Using
More informationVT PLUS HF performance verification of Bunnell Life-Pulse HFJV (High Frequency Jet Ventilator)
VT PLUS HF performance verification of Bunnell Life-Pulse HFJV (High Frequency Jet Ventilator) VT PLUS HF provides a special mode for evaluating the performance of high frequency ventilators while connected
More informationADVANCED CORE DECOMPRESSION SYSTEM X-REAM
ADVANCED CORE DECOMPRESSION SYSTEM X-REAM Percutaneous Expandable Reamer PRO-DENSE Core Decompression Procedure Kit SURGICAL TECHNIQUE Advisory Board C. Lowry Barnes, MD Wael Barsoum, MD Robert Heck, MD
More information