1) Immobilization devices are used to fix patients in a reproducible position for radiation therapy in order to minimize positioning errors and reduce the dose to surrounding healthy tissues.
2) Early immobilization methods included plastic head cups, neck rolls, and plaster casts, while modern techniques use thermoplastic masks, vacuum bags, and foam molds for rigid fixation.
3) Positioning devices like breast boards and knee cradles are also used to maneuver body parts out of the beam path or into a position allowing better beam access for treatment. Precise immobilization combined with IGRT continues to improve the accuracy and safety of radiation therapy.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
Patient Positioning and Immobilization Devices In Radiotherapy PlanningSubhash Thakur
This is a overview of the devices used in the radiotherapy planning. These are specifically designed for patient proper positioning, reproducibility and immobilization of patient during radiotherapy treatment.
Management of cacrinoma cervix: Techniques of radiotherapy (2D conventional, 3D Conformal radiotherapy (3DCRT) and IMRT with a review of various contouring guidelines.
Patient Positioning and Immobilization Devices In Radiotherapy PlanningSubhash Thakur
This is a overview of the devices used in the radiotherapy planning. These are specifically designed for patient proper positioning, reproducibility and immobilization of patient during radiotherapy treatment.
LDR and HDR Brachytherapy: A Primer for non radiation oncologistsSantam Chakraborty
A small presentation I made for a 30 minutes class comparing and contrasting LDR and HDR brachytherapy. Good for a person with non radiation oncology background to grasp the basics.
Robust Challenges of Bladder Protocol management ,Knowledge & UnderstandingSubrata Roy
Bladder protocol is routinely used for patients undergoing pelvic radiation to reduce radiation enteritis. It is very difficult to maintain constant volume, especially in the last two weeks due to radiation enteritis and cystitis
LDR and HDR Brachytherapy: A Primer for non radiation oncologistsSantam Chakraborty
A small presentation I made for a 30 minutes class comparing and contrasting LDR and HDR brachytherapy. Good for a person with non radiation oncology background to grasp the basics.
Robust Challenges of Bladder Protocol management ,Knowledge & UnderstandingSubrata Roy
Bladder protocol is routinely used for patients undergoing pelvic radiation to reduce radiation enteritis. It is very difficult to maintain constant volume, especially in the last two weeks due to radiation enteritis and cystitis
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Triangles of Neck and Clinical Correlation by Dr. RIG.pptx
Immobilisation and stabilisation devices
1. PRESENTER : DR.MOUMITA PAUL
1st Year PGT
MODERATOR : DR.P.P.MEDHI
REGISTRAR,DEPARTMENT OF
RADIATION ONCOLOGY
BBCI
2. Any device that helps to establish and
maintain the patient in a fixed,well defined
position from treatment to treatment over a
course of radiotherapy or prevent the patient
from moving during a single treatment
session.
3. Main :
To limit movement of the patient
To reduce the probability of positioning errors
Primary goal in treatment using radiation
therapy :
---to deliver curative dose of radiation to the
target
---minimising the dose to surrounding normal
tissue as far as possible.
4. Incidental benefits:
Reduction in daily set up time
Reduction in patient’s fear and worry
No need for the patient to be awake,alert and
co-operative.
Conversion into a rigid body
5. Immobilisation techniques primarily address
the issue of reducing intratreatment motion
and improving reproducibility of patient
position from day to day.
……1.Target volume margins
2.Radiobiological rationale behind
immobilisation.
3.Use of 3D treatment planning and
programs and new treatment modalities.
6.
7. Slope of dose response curve of
many tumours is sufficiently
large,i.e.little change in dose
will significantly reduce
tumour control probability.
y= % change in control/%
change in dose
y50~ 1.3 to 2
Strong corelation between
local recurrence and
inadequate coverage of
defined target volume within
high dose region.
8. The development of new immobilisation
methods and materials has made it possible
to immobilise almost any area of body of a
co-operative patient to 3mm, allowing use of
margins of no more than 5mm, except when
target motion within the patient is an
issue.Special techniques for head and neck
targets can yield positional accuracies of 1-2
mm or even less for invasive immobilisation.
9. 1.Target volume to be treated
2.Structures to be spared
3.Treatment portal arrangement
4.General condition and comfort of patient
10. Ease of use
Ease of constructing the device
Patient comfort : Fully supported in a comfortable
and relaxed position
Device should conform to the patient’s external
surface contours
The device should optimally position the patient so
as to minimise the normal tissue complications
It should not obstruct the path for beam
Device should be usable on simulator,CT/MRI and
other treatment planning imaging systems
Surface dose should not be altered
Adequate space for reference marks
Rigid and hold its shape over time
Re-usability
11. Early Days :
Plastic head cups(doggy dish)
Standardised neck rolls
Masking tapes
Not to move during treatment
Hold the breath
12. Skin marks
Plaster of Paris cast
Bite blocks
Vacuum molded plastic masks
Polyurethane foam molds
14. Used for aligning the
patient for
immobilisation.
Range 1.5 to 5 m
Line width < 0.5 mm
at 3m
Line length >43 cm at
3m
15. The indexing bar can be
placed at the desired
indexing indents of the
couch and it can be
locked down by rotating
the levers.
The base plate then can
be positioned over the
pins of the two pin
indexing bar.
16. The plate onto which
the head
immobilisation systems
are secured is usually
referred to as a base
plate.
It’s material should be
strong, yet it should
minimally attenuate
the radiation beam.
Most base plates are
acrylic and recently
carbon fibre base
plates are hugely
developed.
17. Provide means to facilitate intertreatment set up
reproducibilty.
Head cups,Head and Neck supports,Foam rubber
wedges which are carefully indexed by
size,shape,elevation above the treatment couch.
18. Head and Neck supports—
Clear – plastic
Opaque – foam rubber or polyurethane foam
Indexed supports provide Head and Neck height or
slant info for set up duplication.
19. 1960s – Complete body
support or helmets were
cast from POP.
Advantages : Easily
available,relatively
inexpensive,modified
with ease.
Disadvantage :
Immobilisation not very
good, not reused,get
damaged with use very
soon
Mostly used in children
for—
CSI for Medulloblastoma
CNS Leukemia
20. 1970s
A transparent form fitting plastic
shellfabricated using a special vacuum
forming device – Vacu-former.
PVC sheets electrically heated to soften the
plastic and then formed over a plaster model
of the patient by creating a vacuum between
them.
Quite stable.
21. Made from perspex sheets
It forms hard nonmalleable material when mixed
and allowed to set.
Materials required :
POP bandage and powder
Perspex sheet
Vaseline
Base plate
Head rest
22.
23. Advantages: Disadvantages:
Effective fixation.
Close conformity
between body surface
and mould.
Portals can be marked.
Windows may be cut.
Wax bolus can be applied.
Can be used for CT/MRI
without causing any
distortion of image.
Difficult and
cumbersome to
make.
Relatively
delicate,with
use/rough handling it
may get fractured.
Expensive.
Cannot be reused.
25. Low temperature
orthopedic plastics.
Polycaprolactone/PV
C/Cellulose acetate.
Softens at 60 degree
centigrade(working
temp.)
Melts at 150 degree
centigrade(melting
point)
Solid sheets or a flat
plastic mesh of
different thicknesses.
26. Precut thermoplastic mesh
Softened by soaking in warm water for a few
minutes.
Then mask stretched around the topside of a
patient who is already in the treatment position
Soft thermoplastic moulded to the patient’s body
contours,and in a few minutes the mask hardens.
27. Advantages: Disadvantages:
Can be used practically
for all body parts.
Relatively easy to make.
Portals can be marked on
surface with ease.
Treatment windows can
be cut.
Wax bolus can be fixed to
surface.
Can be used with CT/MRI
scan.
Expensive(Rs1500-
3500).
Windows cut cannot
be reused.
When old becomes
brittle and too soft
when activated.
Material ages in
direct relation to
circumstances.
28. Consists of a shell (envelope) of tough urethane
plastic material which is partially filled with pre
expanded polystyrene micro spheres.
Semi deflated cushion moulded around the
patient’s gross body contours.
When air is removed from the cushion by vacuum
pump,microspheres are pulled together tightly
within the cushion and becomes rigid.
29.
30. Advantages Disadvantages
Easy to use.
Reasonably good
immobilisation.
Requires little time to
prepare.
Comfortable for patient.
Can be reused.
Contour and shape
may change with
handling and use.
Expensive.
31. 2 component chemical systems
Patient placed in the treatment positionon top of a
plastic bag.
The bag rests within a specialised form constructed
of solid Styrofoam blocks.
When two chemicals are combined in the bag,they
begin to expand into a polyurethane foam.
As the foam rises,technician maneuvers it around
the patient.
Support given to anatomic structures that do not lie
flat on the treatment couch.
Once the foam hardens,the customised device is
ready for use.
32. Used in combination with other patient
support systems for
•Ca breast
•Ca prostate
•Lower extrimities
•Lung
•Pituitary gland
•Head and Neck region
33. Advantages Disadvantages
Rigid
Stable
Radiolucent
Comfortable
Do not prevent patient
movement and rotation
when used by
themselves.
Cannot conform
completely to changes
in body contour as
other methods.
34.
35. Alternative method for immobilisation of head and neck
patients
For those who cannot tolerate thermoplastic mould due to
claustrophobia/anxiety.
A dental mold is formed to the patient’s maxillary
teeth,and a vacuum creates suction to the hard palate.
The dental mold is attached to the carbon fibre frame
which is fixed to the table’s indexing system frame.
36. All immobilisation devices in some sense are
positional devices.
Positioning devices are ancillary devices which
maintain the patient in a non standard
treatment position.
37. Set up the patient in a special position designed to
improve the therapeutic ratio and patient’s
comfort.
Optimal beam access is limited by external
anatomic features such as extrimities,a large
belly,or a pendulous breast.
Proximity of the target (PTV) to the surrounding
radiosensitive structures.
38. Neck rolls
Foam wedges
Head holders
Arm board
Knee saddle
Thigh stirrups
•Hand grip
•Over head arm
positioner
•Shoulder retractor
PATIENT ELEVATION
SYSTEM
•Breast board
•Prone breast platform
support
•Thermoplastic
brassiere,breast ring
•Belly board
39. Used to maneuver body parts out of the way
of the beam or into a better position.
40. Designed to position the extrimities in a
comfortable and reproducible manner.
Used for soft tissue sarcomas in the arms or legs.
Necessary to remove the uninvolved arm or leg
from the path of the radiation beam.
42. Patient nudged into
a position with arms
and shoulders down.
Footboard attached
to hand grips through
nylon ropes with
adjustable tension.
Reproducible.
Very useful for
treating head and
neck cancers with
lateral fields.
43. 1.Tilt board
Severe obesity
Lung disease
Used for treating lung cancer
through lateral fields without the
interference of arms or shoulders.
severe sloping chest by positioning the
patient so that the antero-posterior vertical
beam impinges orthogonally.
44.
45. Used in the treatment of breast cancer with
parallel opposed tangential fields.
46. Made up of rigid plastic
The back support includes a head holder
It is cut away to prevent interference with the
tangential field for steep beam angles
47. Rigid trough like supporting device mounted
on top of the treatment couch.
Involved breast hangs under window in the
bottom of the trough.
Provides improved separation between the
target and the normal tissues.
Lateral tangential films are used for
treatment.
Reduces pulmonary,cardiac,skin
complications.
48.
49. Treatment of women with large,flaccid or
pendulous breasts.
Prevents severe skin reactions resulting from
skin overlap in the inframammary fold.
50. Thick mattress for
supporting the patient
prone with a window
cut out for the
patient’s belly.
Provide more comfort
and stability in prone
position(obese
patient).
Reduces the amount of
intestine in the lateral
radiation fields.
51. Head fixation devices :
1.Gill-Thomas-Cosman
system
Frame fixed to the head
with a dental mold.
Occipital tray with a
cast of the occiput.
Strap that holds the
device tightly.
52. Consist of a rod in
each external
auditory canal and
a clip moulded to
the bridge of the
nose.
53. For IMRT of head
and neck.
Bone screws set
into the inner
table of the skull.
Screws have
internal threads
and can receive
the standoffs
which remain in
place during the
course of therapy.
54.
55. Integrates a compact robotically positioned
linac with image guided stereotactic
localisation.
Basic components:
Robotic linac
Image guided hardware:
-- a pair of orthogonal X ray sources
-- imaging panel
56.
57. Implantation of fiducial markers in or around
the tumours
Patient stabilisation
Body length vacuum bag
CT and PET images
Thin cuts 1.25 mm HR DRR(Digitally
reconstructed radiography)
DRR compared to images acquired by
orthogonal X ray sources.
58. ExacTrac, a fast and
highly accurate X ray
system, provides
detailed target
visualisation and non-
coplaner positioning
and monitoring for
stereotactic cranial
radiosurgey
treatments.
59. The ExacTrac frameless radiosurgery system
ensures highly accurate delivery of single or
multi-fraction treatment with a patient-
friendly mask that facilitates a streamlined
workflow.
Reproducible conformity with a precise non-
invasive stereotactic mask system.
Compatible with multiple couch tops.
Allows for time saving and patient-friendly
treatment without comprising accuracy.
60. The Brainlab Non-Invasive Mask System uses
a U-shaped frame,two vertical posts, a three
piece thermoplastic mask,and an optimal
bite block attachment for noninvasive cranial
immoilisation.
61. The Brainlab noninvasive mask system uses
three pieces of thermoplastic material
custom molded to the patient’s head and
attached to vertical posts on either side of
the patient’s head.
These posts are then attached to a U-
shapped frame which is attached to the
treatment couch,thus providing
immobilisation of head.
62. Immobilisation and positioning is an
indispensable part of radiotherapy treatment.
With better on board imaging and better
target localisation systems and softwares
(IGRT) the need for rigid immobilisation is
gradually decreasing.