Final Case Logs

University of Wisconsin La Crosse - Med Dosimetry (Acct #9094)
Case ID #: 1388-20230117-001 (Status: Pending) Date of Encounter: 1/17/2023

Student Information - Curry, Meshan
Semester: Spring
Course: DOS 771 Clinical Internship I
Clinical Instructor: HAAS, Beth
Clinical Site: Trident Medical Center
Machine Demographics
Age: 65 years
Biological Sex: Female
Race: White, Non Hispanic
Clinical Information
Time with Machine: 30 minutes
Consult with Clinical Instructor:
Procedures/Skills (Observed/Assisted/Performed) (Critical in Bold)
Simulation/CT - Other (Asst)
Other Questions About This Case
Clinical Notes
Right Supraclav & Axilla. Patient had severe limited spasticity in right arm. The right arm was adducted to the body with no mobility. The patient also
had limited mobility in the neck area. The patient was setup different from usual cases with a large rectangular vaclok on the breastboard. No
wingboard was utilized. I assisted in making the vaclok along with other therapists. The vaclok was molded around the patient at angle 5, the highest
possible setting. The patient was not able to have IV contrast due to the creatinine levels being too high. I pushed the patient's ct to eclipse for
treatment planning.
Semester: Spring
Age: 69 years
Biological Sex: Male
Contouring - Pelvis (Perf)
Clinical Notes
I pushed the patient's planning ct to eclipse. The patient was a prostate patient. I contoured the bladder, space oar, rectum, and femoral heads with the
approval of my clinical instructor. I also dropped the contours in care path for the physician to contour the PTV.
Semester: Spring
Group Encounter
Clinical Notes
Chart Rounds
Dr. Margaret MacDowell, Dr. Laurie Harrell
The radiation oncologists, the physics team, CT therapist, and dosimetry meet weekly to discuss new patient starts and any unique patients that are
undergoing treatment. This a quality assurance procedure to assure that patient's are being treated correctly by each oncologist. The dose and length of
treatment times were discussed between the oncologists as well as physics. The dosimetrist noted any notes about the patient that would be needed
over the course of treatment.
Semester: Spring
Age: 49 years
Race: Black or African American
Contouring - Extremity (Perf)
Clinical Notes
The patient had a right hip ct. I contoured the patient's kidneys due to the autocontour not working due to metastasis covering up some of the patient's
kidneys. I also set the patient's isocenter in ct and pushed the exam to eclipse.
Semester: Spring
Age: 72 years
Clinical Notes
I performed the contours on a prostate patient, including bilateral femurs, space oar, rectum, and small bowel. I then dropped the task in care path for
the physician to contour the prostate and sv's something that she requests to do on her own.
Semester: Spring
Age: 67 years
Simulation/CT - Head & Neck (Asst)
Clinical Notes
I helped re-ct a larynx patient with contrast that did not have enough ct-slices to ensure adequate coverage. The patient was anxious so the first ct
therapist did not get enough slices. After completing the ct, I then sent the scan to eclipse.
Semester: Spring
Age: 42 years
Contouring - Brain (Perf)
Dose Calculations - Craniospinal Calculation (Computer) (Asst)
Simulation/CT - Brain (Asst)
Treatment Technique Type - Photon (Asst)
Clinical Notes
I imported, contoured, and assisted in planning a treatment to a whole brain at 300cGy in 10 fractions.
Semester: Spring
Age: 55 years
External Beam Treatment Planning - Pelvis (Asst)
Dose Calculations - MU Calculation (Computer) (Perf)
Treatment Technique Type - Photon (Perf)
Clinical Notes
I performed a palliative 2D treatment plan for a right female pelvis.
Semester: Spring
Age: 65 years
External Beam Treatment Planning - Spine (Asst)
Contouring - Spine (Perf)
Image Fusion - TPCT - CT (Perf)
Clinical Notes
I performed a 3D treatment plan composed of opposing fields on a T-Spine volume from T9-T12. My plan was then compared against another
treatment plan performed by a dosimetrist. It was found that our plans were similar, meeting all tolerances for organs at risk and the prescribed PTV
dose. It was determined that either plan could be used for treatment.
Semester: Spring
Age: 77 years
External Beam Treatment Planning - Spine (Perf)
Contouring - Spine (Perf)
Clinical Notes
I performed a 2D treatment plan on a palliative L1-L3 spine, 3000cGy in 10 fractions. I performed all contours and generated the plan evaluation
form. I also communicated with the radiation oncologist to confirm that the plan was appropriate. The radiation oncologist approved the plan. I also
set up communication for the patient to be scheduled to start Monday of next week.
Semester: Spring
Age: 51 years
External Beam Treatment Planning - Extremity (Perf)
Dose Calculations - MU Calculation - 2nd Check (Computer) (Perf)
Simulation/CT - Extremity (Asst)
Clinical Notes
I planned a 3D photon treatment plan on a right axilla. I performed the contours, calculations, and received approval from the physician on the plan.
Semester: Spring
Age: 43 years
External Beam Treatment Planning - Breast - Tangential (Perf)
Contouring - Breast (Perf)
Simulation/CT - Breast (Asst)
Clinical Notes
I performed breast tangents on female patient. 6MV energy was used, along with equal weighting, field in field techniques, isodose lines were
normalized to 90% of the PTV receiving 100% of the dose.
Semester: Spring
Age: 53 years
External Beam Treatment Planning - Chest (Perf)
Contouring - Thorax (Perf)
Simulation/CT - Thorax (Perf)
Clinical Notes
I performed contouring and a 3D conformal lung plan using 6MV beam. 3 fields were utilized, an AP, PA, and left lateral beam. Field in Field were
also used. The plan was normalized to 95% of the PTV receiving 100% of the dose.
Semester: Summer
Course: DOS 772 Clinical Internship II
Age: 49 years
Consult with Clinical Instructor: 120 minutes
External Beam Treatment Planning - H & N (Perf)
Contouring - Head & Neck (Perf)
Treatment Technique Type - IMRT/VMAT/Tomotherapy (Perf)
Clinical Notes
I performed a treatment plan on a Larynx patient. He was given the dose 70 Gy in 35 fractions. The plan was normalized to 95%. The Plan was IMRT
with 3 arcs and I performed all contours, planning, and secondary calculations to my preceptor's satisfaction.
Semester: Summer
Age: 62 years
Simulation/CT - Thorax (Obs)
Clinical Notes
I performed a treatment plan on a distal esophagus patient. She was given 50 Gy in 25 fractions. The patient was IMRT and had 3 half arcs. The plan
was normalized to 95%. I performed all contours, planning, and secondary calculations to my preceptor's satisfaction.
Semester: Summer
Age: 60 years
External Beam Treatment Planning - Brain (Perf)
Clinical Notes
I performed a Sim & Start treatment same day plan on a 3D whole brain patient. She was 30Gy in 10 fractions. 6x energy was used along with FiF
technique.
Semester: Summer
Age: 73 years
Clinical Notes
I performed a treatment plan on a Prostate & SV's patient. He was given the dose 70 Gy in 28 fractions to the prostate and 56 Gy in 28 fractions to the
proximal SV's. The plan was normalized to 97%. The Plan was IMRT with 2 arcs and I performed all contours, planning, and secondary calculations
to my preceptor's satisfaction.
Semester: Summer
Age: 72 years
External Beam Treatment Planning - Brain (Perf)
Treatment Machine Participation - Verify treatment plan (Perf)
Clinical Notes
I performed a treatment plan on a GBM patient. She was given the dose 60 Gy in 30 fractions. The plan was normalized to 95%. The Plan was IMRT
with 3 full arcs and I performed all contours, planning, and secondary calculations to my preceptor's satisfaction.
Semester: Fall
Age: 72 years
Simulation/CT - Thorax (Asst)
Treatment Machine Participation - Respiratory Gating (Asst)
Clinical Notes
I performed a SBRT Lung plan on patient utilizing 6 FFF energy and 3 half-arcs to reduce dose the opposite lung, spinal cord, and heart.
Semester: Fall
Age: 62 years
External Beam Treatment Planning - Abdomen (Perf)
Contouring - Abdomen (Asst)
Clinical Notes
Due to a lack of new abdomen patients. I simulated an IMRT nodal irradiation of the abdomen. I utilized 3 full arcs and 10 MV energy to satisfy all
treatment metrics.
Semester: Fall
Age: 65 years
External Beam Treatment Planning - Pelvis (Perf)
Clinical Notes
I performed a re-irriadiation treatment on a prosate patient utlizing 10 MV beams and 3 full arcs. I had to be careful to meet the dose constraints for
the bladder, rectum, and femoral heads.
Semester: Fall
Age: 75 years
External Beam Treatment Planning - Extremity (Perf)
Simulation/CT - Extremity (Asst)
Clinical Notes
I performed a conformal treatment plan on a left humerus by using 6MV oblique beams to satisfy the treatment requirement.
Semester: Fall
Age: 60 years
Simulation/CT - Pelvis (Asst)
Brachytherapy - HDR Treatment Planning (Perf)
Clinical Notes
I performed an adequate treatment plan on cylinder GYN patient receiving 2100cGy in 3 fx with Iridium-192. Each treatment plan had low doses to
the bladder and rectum.
Semester: Fall
Course: DOS 773 Clinical Internship III
Age: 55 years
External Beam Treatment Planning - Breast - with s'clav (Perf)
Contouring - Breast (Perf)
Simulation/CT - Breast (Asst)
Treatment Machine Participation - Verify treatment plan (Perf)
Clinical Notes
I performed a 4 field left breast plan that required a quick turn around due to a patient's insurance.
Semester: Fall
Age: 52 years
External Beam Treatment Planning - Abdomen (Perf)
Contouring - Abdomen (Asst)
Clinical Notes
Due to a lack of Abdomen treatments, I simulated a pancreas IMRT treatment. I utilized 10 MV energy beams and 3 half arc beams to reduce dose to
the patient's spinal cord.
Semester: Fall
Age: 65 years
Brachytherapy - LDR Treatment Planning (Perf)
Clinical Notes
I simulated a LDR interstitial prostate patient that was performed in my clinic in the past. The clinical treatment plan I created satisfied all
parameters.

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University of Wisconsin La Crosse - Med Dosimetry (Acct #9094)

Case ID #: 1388-20230117-001 (Status: Pending) Date of Encounter: 1/17/2023

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