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University of Pittsburgh Magee Women's Hospital (HDR GYN)

Our Facility:

UPMC Magee Women’s Hospital in UPMC Hillman Cancer Center and University of Pittsburgh is a leading academic and teaching hospital that serves as the premier Westen Pennsylvania facility for treatment of breast and gynecological cancers. The department of radiation oncology at UPMC Magee serves as a high-volume brachytherapy center, performing approximately 800-1000 fractions of HDR brachytherapy each year for gynecological cancer treatments. We started MRI based GYN brachytherapy in 2007 and have one of the largest and most robust follow-up databases for MRI based HDR brachytherapy for cervical cancer in North America. We also have performed LDR prostate with Cs-131 and LDR eye plaque with I-125 for 20 years. In addition, we performed partial breast HDR and IORT until 2017. We are in the process of starting prostate HDR brachytherapy program in the Fall, 2024.

Our department has Elekta Nucletron HDR remote afterloader and Oncentra treatment planning system for HDR brachytherapy. Varian Variseed system is used for LDR prostate brachytherapy.

We are equipped with a dedicated HDR brachytherapy procedure suite in the department that has anesthesia capability. Also, our department has a Siemens go. Open Pro large bore CT scanner and our MRI suite is located next to the radiation oncology department with a GE 1.5T scanner and a Siemens Vida 3T scanner.

Our department has provided training and education for not only internal trainees but also external trainees and fellows for more than 20 years. Our team provides unmatched training in all aspects of brachytherapy for physicians and physicists alike. We are a skilled and dedicated multidisciplinary team with vast experience in brachytherapy.

 

Fellowship Description:

We will focus on GYN HDR brachytherapy.

  1. Based on ABS Brachytherapy 300 in 10 curriculum recommendations, we will assign the trainees to 1) follow brachytherapy physicians for consult and follow-ups, 2) attend multi-disciplinary team GYN tumor boards/chart rounds, 3) observe and perform applicator insertion procedures in the department and in the operating room and contouring with various GYN applicators using CT and MRI datasets, predominantly with MR image set, 4) work with the physicists for treatment planning and QAs, 5) learn post procedures and care, 6) review and discuss consensus guidelines, clinical trials and outcomes data.
  2. We will work with the trainees for clinical projects and/or educational activities relevant to brachytherapy.
  3. If physicist(s) come with the physician trainee(s), we will also separately work with the physicist(s) for brachytherapy QAs, CT and MR imaging utilization/implementation, and planning and evaluation process in depth.
  4. The training focuses on predominantly GYN HDR brachytherapy due to caseloads, but non-GYN LDR brachytherapy cases are also performed in the facility:
    1. Prostate LDR seed implants with Cs-131 isotope in the operating room is performed on weekly basis, and the trainees will be able to observe and get hands on experiences.
    2. Eye Plaque LDR with I-125 isotope is performed as well, and the trainees will be exposed to the procedures.
  5. Prostate HDR brachytherapy program is planned to start in the Fall, 2024. After the program is up and running, the trainees will observe the cases and get hands on experiences.

 

Case volume:

  1. Average GYN HDR brachytherapy volume per year at UPMC Magee
    • Vag Cylinder: 100-130
    • R&T: 25-30
    • Hybrid (Vienna or Venezia):  20-25
    • Multichannel cylinder: 15-20
    • T and Cyl or Y applicator: 15-20
    • SYED interstitial: 20-25
    • Total number of patients: 200-250
    • Total fractions: 700-1000
    Vaginal Cylinder: CT based planning, All other applicators: MRI based planning is performed in a majority of cases.
  2. Average LDR prostate seed implants per year: about 50-70 patients (1-2 cases per week)
  3. Average LDR eye plaque cases per year: about 20-30 patients (1-2 cases per month)

 

Resident Expectations and Learning Objectives:

  1. All the trainees/residents will complete all the assignments given by the site faculty and gain clinical knowledge and enough experience in hands on training.
  2. All the trainees/residents will be able to perform brachytherapy procedure independently for MRI and CT image based planning workflow.
  3. All the trainees/residents will understand a detailed workflow and the role of each member of multidisciplinary teams for brachytherapy clinical operations and patient and staff safety.

 

ABS Fellowship Application: University of Pittsburgh Magee Women's Hospital, HDR GYN