Applied Radiology
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Applied Radiation Oncology
Applied Radiation Oncology (ARO) is pleased to offer you a selection of free CME accredited courses to choose from, as part of your free subscription to ARO.
ARO Journal-CME
Accreditation/Designation Statement
These activities have been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of IAME and Anderson Publishing.
The Institute for Advanced Medical Education (IAME) designates these Journal-based activities for a maximum of 1 AMA PRA Category 1 Credit™ each. Physicians should only claim credit commensurate with the extent of their participation in the activity.
Please Note: Prior to January 1, 2023 these activities qualified for SA-CME credits.
A Narrative Review on Radiation Oncology Physician Well-Being in the United States
Kimberly R. Gergelis, MD; Kimberly S. Corbin, MD; Kaitlin W. Qualls, MD; Yuhchyau Chen, MD, PhD; Nadia N. Laack, MD
Estimated time for completion: 1 hour   •   Date of release and review: December 1, 2023   •   Expiration Date: November 30, 2024
Despite limited studies on burnout among radiation oncologists in the United States, especially when compared with data from other countries, there is a prevalence of burnout among radiation oncologists of all career stages, including trainees, attendings, program directors, and academic chairs. This narrative review summarizes articles reporting on burnout and well-being among attending and resident radiation oncologists in the United States, examines burnout at career stages, discusses the impact of COVID-19, and provides strategies to reduce burnout in the radiation oncology field.
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Special Considerations of Pelvic Radiation Therapy in the Adolescent and Young Adult (AYA) Female Population
Sudha R. Amarnath, MD
Estimated time for completion: 1 hour   •   Date of release and review: September 1, 2023   •   Expiration Date: August 31, 2024
This review article describes specific considerations for pelvic radiation therapy in the adolescent and young adult (AYA) cancer population, including fertility and premature ovarian insufficiency, sexual health, financial toxicity, and psychological impact. Awareness of these effects and available resources can help radiation oncologists to better communicate and counsel patients, set clear and realistic expectations, and proactively manage late side effects that can impair quality of life and long-term survivorship.
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Stereotactic Radiosurgery for Brain Metastases: Review of Existing Data and Future Directions
Elham Rahimy, MD;* Scott G. Soltys, MD
Estimated time for completion: 1 hour   •   Date of release and review: June 1, 2023   •   Expiration Date: May 31, 2024
The growing use of stereotactic radiosurgery (SRS) for brain metastases has exposed several unknowns, which are under investigation. This review aims to discuss the existing data that support SRS use and can provide the reader with a basis for making judgements in clinical situations in need of answers. The article also discusses various major pending clinical trials.
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Future of Radiation Oncology Education: Transforming Scholarly Teaching Into Medical Education Scholarship
Anurag Saraf, MD; Graham Boyd, MD; Alexandra De Leo, MD; Phylicia D. Gawu, DO; Chelsea C. Pinnix, MD, PhD; Steve Braunstein, MD, PhD; Rachel Jimenez, MD; Idalid Franco, MD, MPH; Lisa Singer, MD, PhD
Estimated time for completion: 1 hour   •   Date of release and review: March 1, 2023   •   Date of review: February 9, 2024  •   Expiration Date: February 28, 2025
Medical education must develop and adapt through robust education scholarship, applying novel teaching with evidence-based best practices to optimally convey new concepts. Continued growth in undergraduate, graduate and continuing medical education as well as in diversity, equity, and inclusion efforts, are critical for the future of radiation oncology. This review article explores how education scholarship can facilitate these advances in areas from artificial intelligence to technology-oriented teaching.
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A Proposed Way Forward From the Prior Authorization Crisis in Radiation Oncology
Praveen Pendyala, MD; Alexander G. Goglia, MD, PhD; Ronald D. Ennis, MD
Estimated time for completion: 1 hour   •   Date of release and review: March 1, 2022   •   Date of review: February 9, 2024  •   Expiration Date: February 28, 2025
The authors review the rationale behind the establishment of prior authorization (PA) by health care payers, discuss issues with the current system with a focus on radiation oncology, and propose multiple changes that could improve the system for clinicians, payers, and patients.
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The Emerging Role of Digital Therapeutics in Medical, Surgical and Radiation Oncology
Will Jin, MD;1* Santosh Mohan, MMCi, COPHIMS;2 Matt Adams, BS;3 Sarah Hoffe, MD;4 Edmondo Robinson, MD, MBA2
Estimated time for completion: 1 hour   •   Date of release and review: June 1, 2022   •   Expiration Date: April 30, 2024
Recent studies have shown the emergence of digital therapeutics (DTx) as potential solutions in the cancer care continuum to improve medication adherence, chemotherapy tolerance, and overall survival, while potentially reducing financial toxicity. In this review, the authors examine these new modalities and possible future benefits for cancer patients.
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Breaking Barriers: The Past, Present and Future of Focused Ultrasound and Diffuse Intrinsic Pontine Glioma
Zachary K. Englander, MD, MS; Christopher Troy, MD; Masih Tazhibi, BA; Nina Yoh, MD; Hong-Jian Wei, PhD; Neil Feldstein, MD; Elisa Konofagou, PhD; Luca Szalontay, MD; Cheng-Chia Wu, MD, PhD,
Estimated time for completion: 1 hour   •   Date of release: December 1, 2022   •   Date of review: December 1, 2023  •   Expiration Date: November 30, 2024
The blood-brain barrier (BBB) remains a significant blockade for effective drug delivery in treating diffuse intrinsic pontine glioma (DIPG). Low-frequency focused ultrasound (FUS) therapy in conjunction with intravenous microbubbles can transiently disrupt the BBB in a localized manner to facilitate drug delivery. This review examines recent preclinical studies evaluating the safety and feasibility of FUS-mediated BBB opening in the brainstem. The authors also discuss the published phase 0-2 clinical trials of low-frequency FUS therapy in the adult glioma population, and phase 1 clinical trials in DIPG that are underway.
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Stereotactic Body Radiation Therapy (SBRT) vs Stereotactic Ablative Radiation Therapy (SABR): Does Terminology Differentiate Treatment Intent in Metastatic Cancer?
Kaitlyn Lapen, MD; Noah J. Mathis, BS; C. Jillian Tsai, MD, PhD; Jonathan T. Yang, MD, PhD; Erin F. Gillespie, MD
Estimated time for completion: 1 hour   •   Date of original release: December 1, 2021   •   Date of review: December 13, 2023  •   Expiration Date: December 31, 2024
The authors review published prospective trials and protocols on stereotactic radiation therapies for metastatic disease to determine whether the terms SBRT and SABR are being used differentially based on intent of treatment, defined by primary study outcome, and propose a distinct definition of each.
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Integrating MR-Guided Radiation Therapy Into Clinical Practice: Clinical Advantages and Practical Limitations
Leila T. Tchelebi, MD; Nicholas G. Zaorsky, MD, MS; Jennifer Rosenberg, MD; Kujtim Latifi, PhD; Sarah Hoffe, MD
Estimated time for completion: 1 hour   •   Date of release: September 1, 2021   •   Date of review: October 19, 2023   •   Expiration Date: August 31, 2024
While MR-guided radiation therapy (MRgRT) offers many benefits, it is a costly and resource-intensive investment that can strain radiation oncology clinics not adequately prepared to incorporate this treatment. This work reviews clinical advantages and practical limitations of MRgRT, and suggests ideal patients for this technology. The authors also provide a practical guide for centers acquiring MRI-based linear accelerators to foster seamless integration.
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MR-Guided Radiation Therapy for Oligometastatic Malignancies
Brittany R. Derynda, BA; *Casey L. Liveringhouse, MD; John M. Bryant, MD; Stephen A. Rosenberg, MD, MS
Estimated time for completion: 1 hour   •   Date of release: September 1, 2021   •   Date of review: October 19, 2023   •   Expiration Date: August 31, 2024
This review article describes technical advantages for MR-guided radiation therapy (MRgRT) that lead to the rationale for use in the oligometastatic setting. The authors summarize existing data demonstrating the feasibility, safety, and efficacy of MRgRT for various disease sites. Finally, the authors discuss ongoing clinical trials utilizing MRgRT, which will continue to define and expand its role.
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Actualizing Risk-Adapted Thoracic Stereotactic Body Radiation Therapy with MR Guidance
Lisa Singer, MD, PhD; Benjamin H. Kann, MD; Daniel N. Cagney, MD; Jonathan E. Leeman, MD; Sue S. Yom, MD, PhD; David Kozono, MD, PhD
Estimated time for completion: 1 hour   •   Date of release: September 1, 2021   •   Date of review: October 19, 2023   •   Expiration Date: August 31, 2024
While traditionally CT- and x-ray based, lung stereotactic body radiation therapy (SBRT) practices will likely be impacted by the emerging availability of MR guidance. This review provides an overview of the role of MR guidance in SBRT for the treatment of lung cancers. Limitations, data, and future directions for treatments are reviewed with a focus on peripheral, central, and ultracentral lung cancers.
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Practical Applications of the Internet of Things in Radiation Oncology
Nikhil G. Thaker, MD, MHA, MBA; Brian De, MD; Chirag Shah, MD; Sudhir Manda, MD; Trevor J. Royce, MD, MS, MPH; Sushil Beriwal, MD, MBA
Estimated time for completion: 1 hour   •   Date of release: September 1, 2022   •   Date of review: November 1, 2023   •   Expiration Date: August 31, 2024
As health care systems transform from traditional care delivery models to digital health models, IoT will enable integration of electronic health records and nonhealth care data with therapeutic augmented reality, wearable technologies, smart voice assistants, digital medicines, robots with artificial intelligence capabilities, continuous and Bluetooth-enabled monitors, and smart cameras. This review discusses the digital transformation of health care systems, IoT technology in cancer care, its practical applications in radiation oncology, and ongoing opportunities and challenges.
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