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You didn't even photoshop a RW or LP face onto the guy, c'mon man!
as an aside for those who've never seen the movie, Google 'Trainspotting' and 'worst toilet in Scotland'I am my target audience...
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I am my target audience...
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If I remember this patient correctly, perineural invasion was noted on path, so he also received STADT.
This joke triggers me deeply...If I remember this patient correctly, perineural invasion was noted on path, so he also received STADT.
This would work if radiation worked for GBMView attachment 348691
A dear colleague of mine has been arguing that GBMs subclinically invade the brainstem and ultimately many patients die because of that.
We should be targetting the brainstem! He made this nice meme for me.![]()
Extensive brainstem infiltration, not mass effect, is a common feature of end-stage cerebral glioblastomas - PubMed
With improving care, severe mass effect appears to be less common in GBM patients today, whereas dissemination, including life-threatening brainstem invasion, is now more pronounced. This has major implications regarding preclinical GBM models, as well as the design of clinical trials aimed at...pubmed.ncbi.nlm.nih.gov
Irradiating the brainstem extensively has the bonus of making a GBM patient so nauseous they'd rather be dead, which is helpful for those who need the push to make an advance directive.This would work if radiation worked for GBM
This would work if radiation worked for GBM
Didn't mean to trigger! I'm irradiating GBMs obviously. Radiation works; a bit depn on age and MGMT status. Although I'm sure you have seen GBMs laugh in the face of RT more so than almost any other tumor. But I can't stand upsetting you. A more appropriate statement would be:Radiation improves overall survival in GBM.
It is not curative intent. But, the overall survival benefit with radiation therapy alone is on the order of 4 months, similar to temozolomide, Optune, and many other blockbuster drugs elsewhere in the body.
Let's not sell radiation any shorter than it's already sold.
I mean, there is data for 48 fractions…
I would definitely fail hard if I tried to change your mind on this.View attachment 349872
Been that kind of day.
Just finished my last IMRT medical necessity note of the day.... Very gratifyingView attachment 349872
Been that kind of day.
View attachment 349872
Been that kind of day.
Weekly OTV: needs no medical necessity note (is it really medically necessary?)Just finished my last IMRT medical necessity note of the day.... Very gratifying
Falling out of an airplane without a parachute... "This brisk wind is really clearing my sinuses"We’re gonna run an experiment.
The predetermined conclusion it will save money because well we are going to pay you less.
Oh and also you have to be in it if you’re picked.
I don’t understand why people get so hung up on “at least I don’t have to document anymore”. Yeah my center loses millions and my job is on the chopping block “BUT THE DOCUMENTATION BURDEN IS SOO MUCH LESS”. As usual the point is lost on so many.
Falling out of an airplane without a parachute... "This brisk wind is really clearing my sinuses"
MR Guided traditional fractionation with adaptive. Squeeze while the squeezing is good.
Plus spaceOAR just in case. What's another $4k between friendsMR Guided traditional fractionation with adaptive. Squeeze while the squeezing is good.
😂This meme just came upon me. which is only a slight modification of what was actually saidView attachment 350385
*45 fx prostate RT with daily adaptation on MR-linac with submission of a fresh 77301 each timeIs there a patient getting 45 fractions of prostate RT on an MR-linac? I bet there is
Is this actuay being paid out as such? Just because it is “billed” dont mean you get paid!*45 fx prostate RT with daily adaptation on MR-linac with submission of a fresh 77301 each time
Is there a patient getting 45 fractions of prostate RT on an MR-linac? I bet there is
Genesis is buying some.Spratt said there’s a reason private groups are buying mri Linacs
He said it - but I’m not aware of many (or any?) yet
Genesis is buying some.
I could be thinking of a different group but - by "some", didn't they buy like, 12? I'm told they bought so many they essentially got a "bulk discount".Genesis is buying some.
In my dreams, the clinical trials showing benefit are published concurrently with the rise in use of (and billing for) MRI linacs so benefit managers/CMS don't clamp down super hard on early adopters milking the system before the rest of us get a whiff of a chance to use it.It would be incredibly smart for the company to give genesis so many for cheap. This is how it happens.
It will take sometime but now that they have a clinical trial they can POINT to (unlike what we have seen in proton) there will be patients wanting this. Get ready to compete against your local genesis. Then next thing you know your hospital is getting one.
These mri Linac companies are doing it well.
In my dreams, the clinical trials showing benefit are published concurrently with the rise in use of (and billing for) MRI linacs so benefit managers/CMS don't clamp down super hard on early adopters milking the system before the rest of us get a whiff of a chance to use it.
But we all know how this song and dance goes.
Please don’t give these lords of hellpits any ideas!Next thing you’ll see is places opening up an MR Linac fellowship. Some grifter place like Willis Knighton that’s trying to open up a residency or maybe Inova may just swing right and open a MRI Linac fellowship!
****tier fee schedule? Gotta make it up in volume!Wonder how they’ll bill for it.
I could be thinking of a different group but - by "some", didn't they buy like, 12? I'm told they bought so many they essentially got a "bulk discount".
I don’t think they are all for the us. It may be that some of these machines are cheaper overseas because billing is so much lower?I could be thinking of a different group but - by "some", didn't they buy like, 12? I'm told they bought so many they essentially got a "bulk discount".