Reta Zeto

Service Journal-Professional
December 11, 2022

Introduction to Dosimetry for R.T.(T)

I had the opportunity of volunteering at Sharp Healthcare Grossmont Hospital in San
Diego where I am currently doing my clinical work in the radiation oncology department. A
radiation therapist in the department is interested in medical dosimetry, and she asked if she
could shadow the dosimetry department and gain some knowledge about the field. I was in the
same situation about 1.5 years ago and was curious to see what the behind-the-scenes team did to
bring the treatment plans out on the treatment floor. As radiation therapists we receive a brief
overview of what dosimetry is and how it’s done while we are in therapy school. It has always
been a fascinating field for me as I’ve been a therapist for about 11 years prior to deciding to
enroll in the University of Wisconsin La Crosse medical dosimetry program. Before I began, I
had also shadowed a dosimetrist in the department to gain some knowledge on what the job
entailed and to get a base understanding of how treatment plans come together.
This therapist that I had previously worked with is currently interested in enrolling in a
medical dosimetry program. She wanted to shadow the dosimetry department and get a little
introduction to dosimetry. I started with introducing her to the two-planning stations that are
used in the clinic, which are RayStation and Precision. I decided to show her how to use
RayStation with a whole brain plan. Before we started with the plan, I showed her the different
tabs we use before we begin planning and what they all do. Since whole brain plans are
straightforward, the therapist’s see them quite a bit on the treatment floor and are also the typical
sim and treat case. I did a step-by-step explanation of the entire plan. First, we imported the
patient and then contoured the brain, right lens, left lens, right orbit, and left orbit. The next step
was to see what the physician’s prescription called for so we can set that up in the plan section.
We added a right lateral beam so the physician can draw his blocks, which he eventually did and
then we opposed that field to get our left lateral beam. We used 6 MV energy and calculated our
plan. The plan was reviewed to make sure we liked the coverage, and I explained what we look
for, such as the flash around the brain, the blocking of the eyes and the inferior border which the
physician wanted below C2. The plan was then reviewed by the physician, and we wrote it up for
the therapists to deliver on the treatment machine. What is delivered in about 10 minutes takes
about an hour to two hours to plan because it is very detailed. I also briefly went over how we set
up IMRT and VMAT treatment plans and what the optimizer does. As well as what objectives
and constraints are used in the optimizer depending on the site being treated. This teaching
experience was very beneficial to me, and I was very happy to share that knowledge I have
gained over the past 16 months of being in this program. I have been trained by an extraordinary
group of professionals that have given me the confidence to be able to teach what I have learned.
This opportunity showed me how much knowledge I have gained and currently gaining in such a
short amount of time. Also, this experience gave me some insight on teaching and how I might
be interested in educating other students with the field once I have some years of experience. The
therapist was satisfied with the bit of introduction she received and was interested in learning
more. This was a great opportunity for me as well as the therapist that was learning about
dosimetry.