Areas of Focus

Helping Make Your Life Easier

Helping make your life easier with high quality dosimetry planning and quick turnaround times

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Pelvis

Focusing on larger and more irregularly shaped pelvic target volumes, VMAT provides substantial dose conformity over previously standard three-dimensional radiation treatment planning.  This has allowed for radiation dose escalation due to often studied reduced side effects with VMAT technique.  Significant dose reduction to small bowel and other sensitive gastrointestinal organs has made VMAT a standard technique when treating the pelvis.

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Head & Neck

Head and neck cancers have often been associated with very difficult and time-consuming radiation treatment planning.  When IMRT was introduced, the difficult issue of treating the posterior neck lymph nodes was finally solved.  This also led to significant organ at risk radiation dose reduction as well.  VMAT offered the additional solution of time, reduction in monitor units, and even improved dose reduction of organs at risk than IMRT.  Often, two arc plans provide similar conformity and better homogeneity than IMRT radiation plans.

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Chest

Lung irradiation has always presented a dosimetry problem with doses above 20Gy to the nearby healthy lung.  VMAT has allowed higher doses to be delivered than previous generations of radiation dosimetry planning as well.  The tradeoff is that VMAT does, in fact, deliver a greater low dose radiation wash than previous generations as well.  Due to this, previous lung DVH parameters of v5Gy and v10Gy, are now closely monitored.  Stereotactic body radiation therapy (SBRT) delivers high levels of radiation to the tumor.  This is done instead of surgery (eliminating major surgeries) and the results have been compared extensively.  Breathing motion issues have been addressed with deep inspiration breath hold, 4DCT, and gated treatments as well.

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Pediatrics

Radiation has always been a cancer treatment that has been attempted to be reduced and/or avoided due to the long-term side effects that it can have on growth and cognitive function development.  When radiation has decided to be given, dosimetry must be handled with extreme care.  VMAT has allowed a reduction in monitor units and time for children.  Often, they are anesthetized and that presents it's own set of challenges. There have been extensive advances in full craniospinal radiation dosimetry planning in recent years as well. Cransiospinal VMAT is becoming more popular and more accepted in the radiotherapy community.

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Breast

One of the few radiation dosimetry techniques that has not thoroughly changed over time.  For the most part, whole breast radiation has been considered the standard of care using three-dimensional radiation planning techniques.  There have been more recent efforts for partial breast treatment, brachytherapy and/or VMAT/IMRT techniques.  The issues remain of minimizing radiation dose to the heart and to the ipsilateral lung.  Using VMAT/IMRT has the consequence of low dose radiation to the contralateral breast and lungs.  Much effort has been made to increase the homogeneity of dose delivered within the breast via field in field or electronic compensation methods.  Novel approaches with deep inspiration breath hold with gating have been utilized to reduce radiation to healthy lung and heart.

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CNS

Standard of care for primary brain tumors is VMAT.   In recent years, VMAT has been used for palliative radiation dosimetry as well.  While delivering standard dose to the whole brain, it allows a higher dose to be delivered to the brain metastases simultaneously.  Alternatively, stereotactic radiosurgery can deliver extremely high doses to individual brain mets with as little as only one isocenter. This reduces the amount of brain surgeries required and, therefore, offers patients a higher quality of life.

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Additional Information

It's to be noted that the regions listed above are not our only target areas. We provide remote dosimetry services for every aspect of the body, which includes the areas listed above.

If you have any additional questions, or concerns, don't hesitate to contact us, as we are available to answer your inquiries.

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Next Steps
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