Clinical Rotations

Disclaimer: Year 3 and Year 4 Therapy and Diagnostic Physics Rotations listed below are intended as representative (sample) clinical experiences and required tasks. The number and specific clinical opportunities may vary with individual students.

Therapy Physics Clinical Rotations Year 3 and Year 4

Introduction to Clinic
Rotation I: Conventional 3D Treatment Planning
Rotation II: Radiosurgery
Rotation III: Brachytherapy
Rotation IV: IMRT/Rapid Arc
Rotation V: Teaching and Other Experiences

General Comments:

  1. Introduction to Clinic activities should occur within Weeks (1-12) of Year 3; numbers in brackets indicate observations.
  2. Rotations I, II, II, IV, and V will be 10 weeks in length each and will be required in both Year 3 and Year 4. If patient numbers are low or daily tasks within the assigned rotation are completed, the student with permission may participate in another rotation on a day to day basis.
  3. Additional duties, acquired skills, and conference attendance will occur throughout both Year 3 and Year 4.
  4. Skill levels include Observation, Participation, and Competency
    1. Observation is learning by observing the work assignment performed by another professional (recorded by student as "Observed" in Typhon software; Typhon® is a documentation software tool originally developed for health career students that has been adapted for use in the accounting and validation of completed clinical rotation activities and assignments).
    2. Participation is learning by assisting with or contributing to the work assignment performed by another professional (recorded by student as "Assisted" in Typhon software).
    3. Competency is performing the work assignment independently with subsequent mentor review (recorded by student and co-signed by mentor as "Done" in Typhon software).
  5. Numbers in brackets [ ] indicate suggested observations; number in parentheses ( )indicate minimum required assignments to gain competency.
     

I. Introduction to Clinic: Simulator/Immbolization/DailyTreatment

Skill Level: OBSERVATION

  1. Conventional Simulation: Setup and Treats [10] sign off with simulator sheet
    • CNS Verification [3]
    • Breast Verification [3]
    • Electron Verification [5]
    • Adjacent Fields Verification [3]
  2. CT Simulation: Brain [2] - sign off with simulator sheet
    • Breast conventional [2]
    • CNS [2]
    • H&N [2]
    • Lung [2]
    • Pelvis [2]
    • Limb [3]
    • Peds [5]
    • Hodgkins [2]
    • Lung with Breath-hold, Compression, or Gating [5]
  3. Machine Setups and CIAOs: IMRT Brain [3] sign off by therapist & date
    • IMRT Prostate [3]
    • IMRT Lung [3]
    • IMRT Peds [3]
    • Electrons [8]
    • Hodgkins [2]
    • Lung with Breath-hold, Compression, or Gating [3]
  4. Patient Treatments: One Day in Each Treatment Room
  5. Nurse/Patient Interactions and Physician & Resident/Patient Interactions [3 each]
     

II. Clinical Rotation I: Conventional 3D Treatment Planning

Skill Level: COMPETENCY

  1. Setup and Treats (Calculations only) (10)
  2. Lung Palliation (5)
  3. Lung Conformal (5)
  4. Breast Tangents (5)
  5. Breast Three Field (4)
  6. Pelvis (Three and/or Four Fields) (5)
  7. CNS (5)
  8. Limbs (Skin, Melanoma, Lymphoma, Sarcoma) (10)
  9. Total Skin Electron TSE (2)
  10. Total Body Irradiation TBI (Including Lung Blocks) (5)
  11. Electron (simple) (10)
  12. Electron (Monte Carlo Calculation and Compensator) (5)
  13. Weekly Chart Checks (x 30 weeks)
  14. Physics Chart Closeouts (x 4 months)
  15. Block Fabrication photon (4) and electron (5)
     

III. Clinical Rotation II: Radiosurgery

Skill Level: COMPETENCY

  1. Brain (cone and mMLC) (10)
  2. Lung (5) (with breath-hold, compression, or gating)
  3. Prostate (5)
  4. Spine (5)
  5. Nerve Disorders (3)
  6. Other (H&N, Liver) (2)
  7. Participate in 20 Radiosurgery Treatments
  8. Image Fusion Procedures (10)
     

IV. Clinical Rotation III: Brachytherapy

Skill Level: COMPETENCY

  1. LDR GYN Plans (2)
  2. LDR Prostate Seed Plans (8)
  3. LDR Mesh Plans (8)
  4. LDR Opthalmic Implants (6)
  5. HDR GYN T&O (3 complete sets) and Vaginal Cylinder (5 complete sets)
  6. HDR Breast Contoura (8)
  7. HDR Inverse Planning (GYN x 4)
  8. HDR Lung, Sarcoma, Syed Neblett (any combination 5)
  9. LDR Precalculations and Seed Ordering/Receiving (10)
  10. Operating Room (OR) Participation (20)
  11. Participate in Yearly Brachytherapy Software QA Procedures
     

V. Clinical Rotation IV: IMRT/RapidArc

Skill Level: COMPETENCY

  1. H&N with Nodes (8) QA (3)
  2. Prostate (5) QA (3)
  3. Prostate with Nodes (5) QA (3)
  4. Lung (5) QA (3)
  5. Brain (10) QA (3)
  6. Other (GI and Breast) (5) QA (3)
  7. IMRT/Rapid Arc Comparisons (10)
     

VI. Clinical Rotation V: Teaching and Other Experiences

Skill Level: OBSERVATION, PARTICIPATION & COMPETENCY

  1. Teaching: Assist and Grade Practicum in Year 3
    • Assist 3rd Year Students in Year 4
    • Assist and Grade Therapy Physics Lab in Year 4
    • Assist with Therapy Lectures for Radiation Therapy School (4 lectures)
  2. Diagnostic Radiology: Assist Diagnostic Physicist in QA Procedures [1 week]
    • Observe Gated CT/PET studies [3 patients]
    • Observe Radio-Immuno Therapies [2 patients]
    • Attend Diagnostic Film Readout Sessions [5 sessions]
  3. Radiation Safety: Observe Shipping and Receiving Duties [2]
    • Observe I-131 Thyroid Room Decontamination Duties [2]
    • Observe Radiation Protection Surveys for Brachy Patients [10]
    • Observe Rad Protection Shielding Surveys (HDR & Linac) [1]
    • Perform Shielding Calculation Report for Linac Room (1)
  4. Off Site (Clarksville or Franklin Facilities) (one week)
  5. CyberKnife and GammaKnife (suggested HCA Nashville and Baptist Hospital, Knoxville)
  6. Treatment Planning with Alternate RTP Computer (3D Plans x 5)
     

VII. Additional Duties and Acquired Skills

A. Quality Assurance
Skill Level: COMPETENCY

  1. Monthly Linac QA (20)
  2. Yearly Linac QA (2 complete)
  3. Linac QA (Argus) Software (6 month review)
  4. Simulator QA (monthly x 4 and yearly x 1)
  5. HDR QA (daily 10, monthly 5, and quarterly 3)
  6. LDR QA (source inventory, calibration, and disposal x 10)
  7. IGRT and CBCT QA (daily x 10 and yearly x 1 )
  8. Co-60 Unit Monthly QA x 1
  9. Superficial/Orthovoltage Output QA x 3
  10. Radiosurgery QA (daily x 10 and yearly x 1)
  11. RTP Linac Beam Commissioning (photon & electron)
  12. RTP Brachytherapy Source Commissioning (HDR Ir-192, Cs-137, & I-125)
  13. Surface Dose Evaluation (Photon x 1 and Electron x 1)
  14. Wellhofer Water Tank (proper QA and use) requires check-off
  15. Wellhofer MatriXX (proper QA and use) requires check-off
  16. Wellhofer Compass (proper QA and use) requires check-off
  17. Quasar IGRT Phantom (proper QA and use) requires check-off
  18. Quasar Gating Phantom (proper QA and use) requires check-off

B. Special Dosimetric Techniques
Skill Level: COMPETENCY

  1. TLD for TSE (2)
  2. TLD for Cs-137 Irradiator Output Determination (1) and/or TLD for Cs-137 Blood Irradiator (1)
  3. DVS Clinical Application and Dosimetry Evaluation (3 patients)
  4. Patient In-vivo Dosimetry & Analyses (diodes or Al Oxide OSL) (25)
     

VIII. Conference Attendance

Skill Level: PARTICIPATION

  1. AAPM TG Report Seminar
  2. Thursday new patient conference: weekly
  3. Thursday case presentation conference: twice per month
  4. Tumor Board: once per month rotation including Lung, GYN, Medical Oncology, GI, Breast (resident an/or attending signature)
  5. Medical Physics Webinars: as available
  6. Physics Refresher Q & A for Residents (January - March) [10]

Note: Journal Club Seminar Series will meet twice per month during the Clinical Rotations. Subject matter will include recent publications from the medical physics and radiation oncology literature.
 

Diagnostic Physics Clinical Rotations Year 3 and Year 4

Introduction to Clinic
Rotation I: General Radiology
Rotation II: Angiography/Fluoroscopy
Rotation III: Mammography
Rotation IV: CT
Rotation V: Nuclear Medicine and PET
Rotation VI: Ultrasound
Rotation VII: MRI (magnetic resonance imaging)

General Comments:

  1. Introduction to Clinic activities should occur within Weeks (1-5) of Year 3.
  2. Rotations I, II, II, IV, V, VI, VII will be approximately 7 weeks in length each and will be required in both Year 3 and Year 4. If patient procedures are low or daily tasks within the assigned rotation are completed, the student with permission may participate in another rotation on a day to day basis.
  3. Additional duties, acquired skills, and conference attendance will occur throughout both Year 3 and Year 4.
  4. Skill levels include Observation, Participation, and Competency
    1. Observation is learning by observing the work assignment performed by another professional (recorded by student as "Observed" in Typhon software; Typhon® is a documentation software tool originally developed for health career students that has been adapted for use in the accounting and validation of completed clinical rotation activities and assignments).
    2. Participation is learning by assisting with or contributing to the work assignment performed by another professional (recorded by student as "Assisted" in Typhon software).
    3. Competency is performing the work assignment independently with subsequent mentor review (recorded by student and co-signed by mentor as "Done" in Typhon software).
       

Introductory Clinical Observations

Goals and Objectives
This is an initial rotation that is intended to introduce the student to the clinical imaging environment, the types of technologist quality control, and the regulations pertaining to use of radiation machines. This rotation is of 4 to 5 weeks duration and includes approximately one week in each of the following:

  • General Radiography
  • Angiography/Fluoroscopy
  • Mammography
  • CT
  • Nuclear Medicine and PET
  • Ultrasound
  • MRI (magnetic resonance imaging)

The student will meet the lead technologists, area managers, technologists, radiologists, physics faculty and staff, and associated personnel in each area, learn the layout of the Diagnostic Imaging department and the types of imaging procedures performed routinely within the division.

Skill Levels to be demonstrated by the Resident:

  • Observe: Observe other health care providers during clinical procedure
  • Participant: Takes active role and assists supervisory physicist and/or technologist in required work assignment and reports writing
  • Competency: Completes required work assignment and reports writing with minimum or no supervision
     

General Radiography - Rotation I

Goals and Objectives

  • Understand the principles of image formation with screen-film, Computed Radiography (CR) and Digital Radiography (DR) systems
  • To understand image quality in static 2-D projection imaging
  • Learn to perform and evaluate QC testing

Year 1
At a minimum, the student is to assist with the following:

  • Annual compliance testing
  • Entrance skin dose calculation
  • Fetal dose calculation and risk estimate
  • Acceptance test
  • Assist with shielding calculation or evaluation

Year 2
The student is to perform each of the following with minimal supervision:

  • Annual compliance test
  • Shielding calculation for at least one general radiographic room
  • Shielding inspections for at least one general radiographic room
  • Patient dose calculation, fetal dose calculation, and risk estimate
  • The student is to assist with the following: Troubleshooting of equipment performance or image quality issues and developing a technique chart for a film-based diagnostic x-ray machine.

Perform State Compliance Inspections on the following:
Radiographic: Digital (5 performed), Portable (5 performed) Dental, standard (1 performed), Dental, Panoramic/Cephalometric (1 participate)

  1. Appropriate documentation
  2. Be able to operate each machine and evaluate mechanical or safety issues.
  3. Be able to use ionization chamber, spreadsheets, light meter
  4. Evaluation of light field versus x-ray field and receptors, beam limiting devices
  5. Beam and X-Ray field alignment, Source to Image Distance (SID) measurement.
  6. Ability to use Computed Radiography (CR) image processors
  7. Beam Quality evaluations, timer, reproducibility, Automatic Exposure Controls (AEC), Half Value Layer
  8. Entrance Skin Exposure (ESE) evaluation (fluoroscopy)
  9. Scattered Radiation measurements.
     

Angiography And Fluoroscopy - Rotation II

Goals and Objectives

  • Understand the principles of image formation with fluoroscopic systems utilizing image intensifiers and/or digital (flat-panel) image receptors
  • Understand the theory of operation and the clinical uses of transmission ion chambers and other dosimetry devices in fluoro applications
  • Operate several different fluoroscopy systems for purposes of quality control testing
  • Learn the radiation safety concerns for patients, personnel, and public
  • Discuss the interactions of the variable imaging parameters associated with the fluoroscopic configurations and their impact on patient dose and image quality
  • Understand the imaging and patient dose concerns with special procedures, including: last-image hold, road-mapping, serial (radiographic) imaging, digital subtraction imaging, rotational fluoro acquisitions, etc.
  • Estimate patient entrance skin dose as well as fetal dose from a variety of fluoroscopic procedures
  • Perform and evaluate QC testing

Year 1
The student is to assist with the following:

  • Annual compliance testing
  • Shielding calculation for at least one fluoro or interventional room
  • Shielding inspections for at least one fluoro or interventional room
  • Entrance skin dose calculation for at least two different procedures (one general and one interventional) and skin dose measurements using aluminum oxide optically stimulated dosimeters X 2.
  • Fetal dose calculation and risk estimate
  • Acceptance test

Year 2
The student is to perform each of the following with minimal supervision:

  • Annual compliance test
  • Shielding calculations including lead protection annual inspections
  • Patient dose calculation, skin dose measurements using aluminum oxide optically stimulated dosimeters x 2, fetal dose calculation, and risk estimate

The student is to assist with the following:

  • Troubleshooting of equipment performance or image quality issues, developing a technique chart for a CR-based diagnostic x-ray machine, and evaluating occupational dose for workers in a diagnostic x-ray facility for the purposes of determining radiation monitoring requirements.

Perform State Compliance Inspections
Fluoroscopic: Under-table fixed (1 performed), Over-table fixed (1 performed), Fixed C-Arm (3 performed), Portable C-Arm (4 performed), Mini C-Arm (1 performed)
 

Mammography - Rotation III

Goals and Objectives

  • To appreciate the differences between general radiography and mammography
  • To observe the technologist and radiologist at work in a mammography environment
  • To become familiar with the Technologist QC program
  • To perform and document an annual inspection of a mammography unit
  • To understand MQSA and its effect on the role of the physicist in mammography
  • To become familiar with mammography references, regulations, and guidance documentation
  • To calculate the shielding required for a mammography room
  • To calculate the average glandular dose for a mammogram
  • To appreciate the differences that digital mammography is bringing to mammographic imaging

Year 1
The student is to assist with the following:

  • Annual compliance testing of at least two screen-film mammography units
  • Annual compliance testing of at least four full-field digital mammography units
  • Annual compliance testing of the prone stereo biopsy unit
  • Shielding calculation
  • Screen speed uniformity and artifact testing
  • Evaluation of view boxes and viewing conditions

Year 2
The student is to perform at least one of the following with minimal supervision:

  • Annual compliance testing
  • Screen speed uniformity and artifact testing
  • Evaluation of view boxes and viewing conditions

The student is to assist with the following:

  • Troubleshooting of QC problems in mammography.

MQSA (Mammography Quality Standards Act of 1992)
Digital Mammography (3 participate, 1 perform under supervision), Film-based (1 participate, if available) Stereotactic (1 participate)

(Note: Should the DMP student complete 20 MQSA inspections and 1 mammography facility inspection, the student could be mammography qualified by the end of the DMP Program.)

  1. Be able to evaluate and write up the manufacturers standards for MQSA testing (digital). Know testing procedures for film based.
  2. Ability to operate machine.
  3. Knowledge of appropriate documentation, regulations, and mandates with respect to testing, personnel, penalties, documentation, quality controls.
  4. Evaluation of light field versus image receptor and x-ray field with appropriate paddles.
  5. Evaluation of compression thickness determination with digital readout.
  6. Evaluation of compression force.
  7. Phantom: use and evaluation (specks, contrast, fibers, masses.)
  8. Spatial Resolution evaluation.
  9. Uniformity evaluation.
  10. Density Control function evaluation.
  11. Entrance Skin Exposure (Dose) evaluation.
  12. Beam Quality: Half Value Layer, kVp reproducibility, timer reproducibility
  13. Evaluation of technologists QC program and documentation.
  14. Viewbox evaluation.
  15. Light box evaluation.
  16. Needle localization (stereotactic)
     

Computed Tomography - Rotation IV

Goals and Objectives
Year 1
The student is to assist with the following:

  • Acceptance test
  • Annual compliance testing
  • Shielding calculation
  • Shielding inspection
  • Dose calculation/estimation
  • Fetal dose calculation and risk estimate
  • Quantitative techniques for determination of lung perfusion

Year 2
The student is to perform the following with minimal supervision:

  • Annual compliance test
  • Shielding calculations
  • Patient dose calculation, fetal dose calculation and risk estimate

Accreditation Testing: CT (3 annual, 1 submission)

  1. Ability to review testing criteria and write up appropriate QC testing procedures for physicist and technologist.
  2. Knowledge and use of appropriate testing tools: Phantoms (include CatPhan), angle gauge, ionization chambers
  3. Ability to operate machines.
  4. Ability to perform the prescribed Annual Survey
  5. Ability to perform the Accreditation submission.
  6. Ability to evaluate the total Accreditation submission, including the clinical submission materials.

Computed Tomography Evaluation
Couch positioning, gantry angle, laser light accuracy, slice increment, slice localization
High-contrast spatial resolution
Slice thickness accuracy
Slice position accuracy
Image uniformity and noise
CT number accuracy
Low-contrast object detectability
Inplane distance accuracy
 

NUCLEAR MEDICINE AND PET - Rotation V

Goals and Objectives
Year 1
The student is to assist with the following:

  • Acceptance test
  • Annual compliance testing of nuclear medicine camera
  • Annual compliance testing of a PET unit
  • Shielding calculation of a PET/CT facility based on AAPM report 108.
  • Shielding inspection of a PET facility
  • Patient Dose calculation
  • Fetal dose calculation and risk estimate
  • Quantitative techniques for determination of cardiac function x 3
  • Quantitative techniques for determination of PET SUV values x 3
  • Clinical respiratory gated-PET studies x 3
  • Quantitative techniques for bone densitometry x 3

Year 2
The student is to perform the following with minimal supervision:

  • Annual compliance test
  • Shielding calculations
  • Patient dose calculation, fetal dose calculation and risk estimate

The student is to assist with the following:

  • Troubleshooting image quality or equipment performance issues

Accreditation Testing: Nuclear Medicine (2 annual, 1 submission)

  1. Ability to review testing criteria and write up appropriate QC testing procedures for physicist and technologist.
  2. Knowledge and use of appropriate testing tools and evaluation of data:
    • Evaluate Intrinsic Uniformity
    • Evaluate System Uniformity
    • Evaluate Intrinsic or System Spatial Resolution
    • Evaluate Sensitivity
    • Evaluate Energy Resolution
    • Evaluate Count Rate parameters
    • Evaluate the overall System Performance for SPECT and PET Systems
    • System Interlocks testing
    • Dose Calibrators - (accuracy test)
      1. measurement of battery voltage (if applicable)
      2. Zero adjustment (if applicable)
      3. Background adjustment
      4. Constancy test
      5. Linearity
      6. Accuracy with NIST traceable standards
      7. Geometry
    • Thyroid Uptake and Counting Systems
      1. I-123 capsule or long-lived standard calibration check
      2. Count of background
      3. High voltage/gain checks
      4. Energy resolution
      5. Reliability: Chi-square test, for the measurement of organ function and the assay of patient samples.
  3. Ability to operate machines.
  4. Ability to perform the prescribed Annual Survey
  5. Ability to perform the Accreditation submission testing.
  6. Ability to evaluate the total Accreditation submission, including the clinical submission materials.
     

Ultrasound - Rotation VI

Goals and Objectives
Year 1
The student is to assist with the following:

  • Acceptance test
  • Annual compliance testing
  • Observe and understand the role of ultrasound in Prostate Seed Brachytherapy treatment planning procedures x 2 patients

Year 2
The student is to perform the following with minimal supervision:

  • Annual compliance test

The student is to assist with the following:

  • Troubleshooting of equipment performance or image quality issues.

Ultrasound (5 annual surveys, Complete QC Development)

  1. Knowledge of accreditation criteria.
  2. Ability to develop and implement a QC program for a freestanding clinic.
  3. Ability to operate machine.
  4. Knowledge of phantoms and evaluation of data:
    • System Sensitivity (Depth of penetration/ visualization)
    • Lateral Resolution
    • Axial Resolution
    • Image Uniformity
    • Horizontal Measurement Accuracy
    • Vertical Measurement Accuracy
    • Focal Zone
    • Dead Zone Measurement
    • Low Contrast object detectability (optional)
    • Electrical Safety Check
    • Mechanical Safety Check
    • Horizontal Measurement Accuracy
  5. Ability to perform the prescribed Annual Survey
  6. Ability to perform the Accreditation submission testing.
  7. Ability to evaluate the total Accreditation submission, including the clinical portion.
     

Magnetic Resonance Imaging - Rotation VII

Goals and Objectives
Year 1
The student is to assist with the following:

  • Acceptance test
  • ACR annual testing
  • Review siting considerations, participate in site planning (if available)
  • Quantitative techniques for determination of T1 and T2 relaxation times
  • Quantitative techniques of MR Spectroscopy

Year 2
The student is to perform each of the following with minimal supervision:

  • Annual survey

The student is to assist with the following:

  • Troubleshooting of equipment performance or image quality issues

Accreditation Testing: MRI (2 annual surveys, 1 submission)

  1. Ability to review testing criteria and write up appropriate QC testing procedures for physicist and technologist.
  2. Knowledge and use of appropriate testing tools and phantoms
  3. Ability to operate machines.
  4. Ability to perform the prescribed Annual Survey
  5. Ability to perform the Accreditation submission.
  6. Ability to evaluate the total Accreditation submission, including the clinical submission materials

Magnetic Resonance Imaging Evaluation
Geometric Accuracy
High-contrast spatial resolution
Slice thickness accuracy
Slice position accuracy
Image intensity uniformity
Percent-signal ghosting
Low-contrast object detectability
Weekly QC records evaluation
 

Additional Observation and Participation Experiences

QC OF MONITORS, FILM PROCESSORS, AND LASER/THERMAL PRINTERS
Goals and Objectives

  • Perform QC tests on diagnostic display devices including film processors, wet and dry process laser printers, and electronic displays
  • Establish baselines and action limits
  • Evaluate a darkroom according to MQSA (Mammography Quality Standards Act)
  • Understand the use of the SMPTE (Society of Motion Picture and Television Engineers) test pattern in assessing display quality
  • Identify and isolate common artifacts from processors, laser printers, and electronic displays

Year 1
The student is to assist with the following:

  • Darkroom fog and integrity tests (see quarterly mammography tests)
  • Processor quality control (daily) and fixer retention (quarterly)
  • Regular QC rounds of processors and printers
  • Recording and evaluation of processor and printer QC data
  • Monitor QC tests and adjustments
  • Service calls and follow-up for processors, printers, and monitors

Year 2
The student is to assist with the following:

  • Troubleshooting of equipment performance or image quality issues
  • Configuration and acceptance testing of new printers or monitors.
  1. Radiation Safety: Radionuclide Shipping and Handling (4 hours x 2) DOT Haz Mat training. The candidate should be able to prepare radioactive material for shipment.
  2. Nuclear Pharmacy: Preparation and Dosing of Radiopharmaceuticals (patient x 4)
  3. Nuclear Medicine Therapies
    1. Thyroid Ablation
      1. patient procedures x 3
      2. radiation safety survey, decontamination, & documentation (patients x 2)
    2. Immuno Therapy Procedures
      1. patient procedure x 3
      2. radiation safety survey, decontamination, & documentation (patients x 2)
    3. Internal Dosimetry Calculations/Estimations
      1. thyroid patients x 2
      2. immuno therapy patients x 2
    4. Cyclotron Facility
      1. Preparation and Dosing of Positron Radiopharmeuticals (patients x 2)
      2. Semiyearly Radiation Safety Survey/Inspection x 2
  4. Radiation Oncology: Image Guided Radiotherapy Techniques
    1. CT Simulation (patients x 4)
    2. On Board Imaging (OBI) during radiotherapy (patients x 4)
    3. Cone Beam CT (CBCT) during radiotherapy
      1. prior to IMRT radiotherapy (patients x 4)
      2. prior to Extracranial radiotherapy (patients x 4)
    4. Image Fusion Techniques
      1. MRI/CT (patients x 4)
      2. PET/CT (patients x 4)
    5. Respiratory Limited Radiotherapy
      1. breath hold (CT & radiotherapy) (patients x 2)
      2. abdominal compression (patients x 2)
      3. respiratory gating (CT and radiotherapy) (patients x 2)
    6. Opthalmic Brachytherapy with Ultrasound (patients x 2)
    7. Pulmonary/Bronchoscopy for HDR Brachytherapy (patients x 2)
  5. Vanderbilt Children's Hospital: Pediatric Imaging (CT, MRI, and US)
  6. Vanderbilt University Imaging Institute
    1. MRI (high strength Magnets
      1. animal studies
      2. patient studies
    2. Small Animal Imaging Techniques (micro CT, PET, and MRI)

Conference/Meeting Attendance and Teaching

  1. Weekly Attendance at Vanderbilt University Imaging Institute Seminar Series (Journal Club)
  2. Monthly Attendance at Radiology Fellows Research Discussion Meetings
  3. Grand Rounds Diagnostic Radiology Seminars (attendance x 6 per year)
  4. Resident/Attending Film-Readout Conferences: Film Review and Diagnostic Evaluation (5 hours for each sub-section, i.e., body, head, nuclear medicine, etc)
  5. Presentation of two diagnostic medical physics seminars per year to Medical Physics Faculty and Staff (topic to be approved by medical physicist mentor)
  6. Assist with Teaching:
    1. diagnostic medical physics laboratory (2 labs)
    2. resident physics lectures (2 lectures)
    3. resident physics board exam reviews (2 reviews)
  7. Department of Radiology Dose Reduction Safety Meeting (attendance x 2)
  8. Vanderbilt Medical Center or VA Radiation Safety Meeting (attendance x 2)