Medical Dosimetry Graduate Certificate Program IU Graduate School & The Department of Radiation Oncology IU Simon Cancer Center

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1 Medical Dosimetry Graduate Certificate Program IU Graduate School & The Department of Radiation Oncology IU Simon Cancer Center All students accepted into the Medical Dosimetry Graduate Certificate Program will have completed: Bachelor s degree, (Radiation Therapy preferred but not required), maintaining a GPA of 3.5 or higher. Certification through the ARRT as a Radiation Therapist PreRequisite Courses: College Algebra and Trigonometry or Pre-Calculus Cross-Sectional Anatomy Radiation and Cancer Biology Twelve Month Course of Study Concepts for Preparation and Planning in Medical Dosimetry I Concepts for Preparation and Planning in Medical Dosimetry II Medical Physics for Radiation Oncology I Medical Physics for Radiation Oncology II Clinical Oncology and Dosimetric Considerations Independent Study / Research in Radiation Oncology 2 credit hours 1 credit hour 1 credit hour 2 credit hours 1 credit hour 2 credit hours Clinical Practicum I Introduction to General Dosimetry 1 credit hour Clinical Practicum II Intermediate Planning for Medical Dosimetry 4 credit hours Clinical Practicum III Advanced Topics in Medical Dosimetry 6 credit hours Clinical Practicum IV Assessment Challenges in Medical Dosimetry 3 credit hours

2 Curriculum Synopsis Concepts for Preparation and Planning in Medical Dosimetry I This course is an introduction for the skills and technologies needed to pursue a career in medical dosimetry. It is designed for the student who has already completed a program in Radiation Therapy Technology and provides background information on both the professional and technological side. Includes both didactic lectures and hands on lab computer activities. Professional Relations and Responsibilities Ethical Conduct & Code of Ethics for AAMD, MDCB Professional / Legal Perspective / Malpractice Scope of Practice for Medical Dosimetry Professionalism and Professional Development External Beam Monitor Unit Calculations Dosimetric Quantities Photon and Electron Manual Calculations Central Axis and Off Axis Dose Calculation Manual Correction for Inhomogeneity Special Topics and Dose Calculation Math Topical Review with Dosimetric Applications Geometric and Trigonometric Applications Logarithmic Applications Imaging Modalities / Targets Radiographic Magnetic resonance (MR) Ultrasound Computed Tomography Nuclear Medicine (PET) Imaging / Sectional Anatomy Review Contouring / Segmentation of Targets Contouring / Segmentation of OAR Cancer Patient Management Signs and Symptoms Cancer Treatment Modalities Cancer Management Radiation Protection Dose Equivalent Protection Regulations NRC Regulations for External Beam and Brachytherapy Computer Technology and Networking Hardware Technologies Software Networking Technologies / PACS / Dicom

3 Concepts for Preparation and Planning in Medical Dosimetry II Designed to give the student a thorough understanding of treatment planning considerations for the patient, the course addresses conventional planning techniques as well as newer technologies. Lab Course with hands on lab sessions supervised by instructor. 3-D Treatment Planning ICRU Reports 50, 62 Nomenclature for Targets Reference Point & Normalization Virtual Simulation 3D Conformal Planning Evaluating the Plan Techniques for Mantle, Involved Field for Hodgkins Disease Electron Beam Planning IMRT Planning ICRU Report 83 Segmentation Considerations Choosing the Beam Arrangement IMRT Optimization, Constraints, Priorities Plan Evaluation SBRT Planning Meeting Protocol Requirements Segmentation Considerations Treatment Planning and Plan Evaluation Brachytherapy Planning Gynecological Brachytherapy Prostate Brachytherapy Brachytherapy Manual Calculations Proton Planning Introduction to Proton Planning EMR Technology The Electronic Medical Record Requirements / Documentation Billing Requirements

4 Clinical Oncology and Dosimetric Considerations The course consists of a series of site specific oncology lectures given by radiation oncologist lecturers. After completing this course, the medical dosimetrist should be able to participate in the discussion about optimal treatment planning for specific anatomical sites and offer helpful suggestions when asked. Cancers of the Head and Neck Cancers of the Central Nervous System Cancers of the Gastrointestinal Tract esopho-gastric, pancreas, liver, rectum, anal Cancers of the Genitourinary Tract - prostate, bladder, testis Gynecologic Malignancies cervix, uterine, vulvar, vaginal, ovarian The Lymphomas Cancers of the Skin melanoma, non-melanoma, mycosis fungoides Breast Cancer Pediatric Malignancies Extremity Soft Tissue Sarcomas Benign Malignancies Metastic Disease Discussions include: Anatomy, Pathology, Physiology, Lymphatic Drainage Treatment Techniques and Beam Arrangements Dose Calculation Considerations Critical Organs and Dose Limiting Factors Positioning and Immobilization Age Specific Considerations

5 Medical Physics for Radiation Oncology I Medical Physics I covers nuclear physics, production of X-rays, and ionizing radiation. The course provides the basis for the field of medical physics and the production of radiation. Review of Math and Physics Concepts Structure of Matter Production of X-rays Calculations Nuclear Transformations Clinical Radiation Generators Interactions of Ionizing Radiation Medical Physics for Radiation Oncology II Medical Physics II addresses the physics considerations for measurement of absorbed dose, dose distributions, dosimetric calculations, treatment planning for photons, electrons and brachytherapy, other advanced technologies and quality assurance from the physicist point of view. Measurement of Ionizing Radiation Measurement of Absorbed Dose System of Dosimetric Calculations Patient Data, Corrections, Setup Electron Beam Therapy Quality Assurance Total Body Irradiation Stereotactic Radiosurgery Quality of X Ray Beams Dose Distribution and Scatter Analysis Isodose Distributions Field Considerations Brachytherapy 3D Conformal / IMRT Planning Monte Carlo Introduction Proton Planning

6 Independent Study / Research in Radiation Oncology This course is comprised of two separate components, both of which highlight the student s ability to work independently as well as oral and written communication skills. Each student prepares treatment plans requiring advanced planning skills and the ability to interpret the physician s written instructions or a clinical protocol for assigned site-specific data sets. All aspects of the planning processes are critiqued by members of the physics/dosimetry staff in an open discussion peer review format where they are judged on contouring skills, plan optimization, following ICRU guidelines, protocols, oral communication skills, critical thinking skills, and time management. In addition, each student works independently on a research project, preparing both a written research paper and a power point presentation on a treatment planning topic of their choice. The paper is written in a format consistent with the AAMD/CIVCO student writing competition guidelines published on the AAMD website page. It is highly recommended that the students submit their research to the student writing contest or as a potential poster presentation for the AAMD. Examples of Advanced Planning Cases: 3D Intact Breast Compensation Methods 3D Techniques for Chestwall & Nodal Volumes IMRT Techniques for Chestwall & Nodal Volumes IMRT Head/Neck with SIB Technique IMRT Prostate Multiple Phase Technique 3D SIB Technique for the Pancreas Protocol Sarcoma of an Extremity Planning Methods 3D Planning for the Partial Brain IMRT Planning for the Partial Brain IMRT Pelvis for Anal or Vulvar planning SBRT Planning for the Lung-Liver-Spine

7 Clinical Practicum I General Dosimetry Introduction This clinical experience provides the student with a general overview of clinical activities. The student will observe and assist with day to day activities from the preparation of the patient for treatment through the planning process, and meeting minimum competency levels is required. The clinical rotation consists of 90 contact hours. Competency List Summer Session Electronic Medical Record and Chart Management Overview of CT / Simulation Requirements for Dosimetry Monitor Unit Calculations Acquiring / Importing Images from the CT Simulator Acquiring / Importing Images from PACS for PET, MR, Diagnostic CT, Other Registration of Images Contouring Tools Creating the 2D SSD Plan Creating the 2D SAD Plan Creating a 3D Coplanar Plan

8 Clinical Practicum II Intermediate Planning for Medical Dosimetry Clinical rotations at various clinical sites provide a broad experience in 2D, 3D and IMRT planning as well as experience with brachytherapy planning and physics quality assurance tasks. Demonstration of clinical competency is required. Clinical rotation consists of 360 contact hours. Required Competency List Fall Semester Conventional Simulation Requirements Irregular Field Calculations CT Simulation for Head / Neck CT Simulation for Breast Block Fabrication for Electrons Fabrication of Custom Bolus 3D Treatment Planning for: Esophagus Lung Tangent Breast Field in Field, E compensators Conventional 3D Head / Neck PLanning Non-Coplanar 3D Treatment Plan Chestwall & Nodal Regions Electron Treatment Planning IMRT Treatment Planning Introduction: Pancreas Prostate Introduction to Brachytherapy Low Dose Rate GYN Treatment Plan Introduction to Proton Therapy Planning Physics Quality Assurance of the Treatment Chart

9 Clinical Practicum III Advanced Topics in Medical Dosimetry This clinical rotation allows the student to participate in and demonstrate competency for advanced technologies, including IMRT, SBRT, VMAT and Proton therapy. The rotation includes 540 clinical contact hours. Required Competency List Spring Semester IMRT Planning Prostate Planning Head / Neck SIB IMRT Sequential Phase Left Chestwall/Nodal Intensity Modulated V-MAT Planning Rapid Arc Planning SBRT Planning SBRT Lung SBRT Liver SBRT Spine Cone Beam CT verification Process SRS Gamma Knife Observations / Planning Techniques for Gamma Knife Brachytherapy HDR QA, Planning, Treatment Delivery Physics Quality Assurance Electron Cutout Measurement Daily Morning QA Monthly Verification Linear Accelerator IMRT QA

10 Clinical Practicum IV Assessment Challenges in Medical Dosimetry During this clinical experience, the student will function as a medical dosimetrist, choosing one site from each of the listed categories. The student will communicate with the radiation oncologist about all aspects of the plan and the plan will be approved by the radiation oncologist. In addition, all plans will also be checked by the certified medical dosimetrist and a board certified physicist. The rotation consists of 210 clinical contact hours. Competency Checklist - Summer Session Conventional 2D Planning Conventional 3D planning IMRT Treatment Planning VMAT Treatment Planning SBRT Planning Brachytherapy Planning