BackTable Vascular & Interventional

Ep. 552 Dosimetry University Part I: Treatment Planning with Dr. Tyler Sandow and Dr. Nima Kokabi

20 snips
Jun 17, 2025
Join interventional oncologists Dr. Tyler Sandow from Ochsner Health and Dr. Nima Kokabi from UNC Chapel Hill as they delve into the intricacies of Y90 treatment planning. They discuss optimizing therapy through multidisciplinary tumor boards and collaboration between academic and private practices. The episode highlights their preferred dosimetry tools and imaging techniques like cone beam CT. Additionally, they explore the challenges of coordinating care and navigating insurance hurdles for liver cancer patients, emphasizing the need for meticulous planning and patient care.
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ADVICE

Order Map-Treat for Resin Efficiency

  • Scheduling mapping and treatment back-to-back for resin microspheres expedites patient care.
  • Allow insurance authorization time but plan clinic to treatment within about two weeks.
INSIGHT

Dosimetry Intent Matters Most

  • Dosimetry guidelines emphasize treatment intent to optimize dosing and avoid killing normal liver.
  • Disease control, not complete eradication, is often a successful palliative goal in metastatic disease.
INSIGHT

Dosimetry Apps as Aids

  • Dosimetry apps are useful tools but not perfect substitutes for clinical judgment.
  • Updates for calibration and software improve accuracy but apps should be one tool in the toolbox.
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