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Welcome to Season 4! 

The Accelerators (Dr. Matt Spraker and Cameron Tharp, MPH, RT(T)) kick it off with a sequel to our prior podcast on the Advanced Practice Radiation Therapist (APRT) role. 

We host friends-of-the-show Drs. Join Luh and Marsha Haley, Radiation Oncologists who bring important past experiences and unique expertise to the discussion. 

We kick off by examining some articles from the Spring 2025 issue of ASRT's Radiation Therapist:

• Caldwell and Lee, Defining Advanced Practice Radiation Therapy at MDACC
• Burch et al., Advanced Practice Role in IGSRT for Nonmelanoma Skin Cancer Treatment
• Beckert, Implementation of an APRT in Online Adaptive Radiation Therapy

We then explore "scope creep", a phrase used to describe mid-level healthcare provider encroachment on traditional physician roles. One example is the UPenn study comparing the interpretations of Radiology Assistants with physician residents. Don't miss the excellent YouTube review of this study by Physicians for Patient Protection. Join shares his experience with another example, California Assembly Bill (AB) 890.

Later, Join shares some discussion about the APRT among ASRT and CARROS members at the ACR 2025 meeting.

This leads to an open discussion of what APRTs should do -- versus could do -- in a radiation oncology clinic. As evidenced by Table 1 in Caldwell and Lee, the tasks are wide ranging, may replicate existing roles of US radiation therapists, and might make more sense in international markets than in the United States.

We close by reviewing Marsha's letter to the IJROBP editor in response to an APRT role scoping review. 

Here are some other things we discussed in the episode.

• Physicians for Patient Protection Website
• AMA successfully fights scope of practice expansions (2024)
• Patients at Risk Audio and Video Podcast
• Council of Affiliated Regional Radiation Oncology Societies (CARROS)
• Beckert et al., Impact of APRT for on-table adaptive radiotherapy
• Shah et al., Radiation Oncology Workforce Analysis Review
• Book recommendation: Lower Ed by Tressie McMillan Cottom
• Patients at Risk Video - Deficiencies in NP Education

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host the 2025 ACRO candidates for Vice President/President-Elect in the first ever radiation oncology election debate! 

Well, it's more like a friendly discussion, but Simul asked them their opinions on 4 great topics. 

1. What differentiates ACRO from other radiation oncology societies? 
2. Can you explain ACRO's position on physician supervision of radiation oncology services over the years? 
3. Why link accreditation to payment in ROCR?
4. Should proton therapy be included in ROCR, and what is your position on the PPS exemption program? 

The Accelerators Podcast is a Photon Media production. For more from Matt, visit his website. For more from Simul, visit his blog, Radiation Medicine: Dollars and Sense.

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Accelerators co-host Dr. Matt Spraker is joined by radiation oncologists Drs. Bobby Koneru and Mudit Chowdhary for an update on low dose radiotherapy for osteoarthritis! 

Dr. Koneru is a radiation oncologist in Freeport, IL and prolific social media educator on benign indications. Dr. Chowdhary is a radiation oncologist at Northside Hospital in Atlanta, Georgia, and a friend of TAP (see his prior episodes).

We start by discussing their ASTRO 2024 panel on benign indications for radiotherapy; it sounds like there was a lot of knowledge sharing among those getting started with these treatments.

Bobby and Mudit share how they built a referral network for their successful practices.

We close by discussing some practical tips and recommended educational resources. 

Here are some other things we discussed in the show, or links that may be helpful in building your benign radiotherapy practice: 

• Matt's LDRT & Benign Resource List
• Radiotherapy Academy for Benign Diseases (RT-ABC)
• Makarova et al., RCT showing LDRT reduces disability risk in OA
• English Translation of the DEGRO-AG “Radiotherapy of Benign Diseases”
• TAP reviews LDRT with Dr. Austin Dove 
• Alvarez et al., Radiotherapy for Benign Conditions Contouring Atlas
• LDRT for arthritis PRIMR video

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Dr. Stacy Wentworth, Radiation Oncologist, Author, and Podcaster!

We discuss her career and how she developed her voice as a physician content creator. Do not miss her Less Radical narrative podcast about the life of Bernie Fisher, it is a masterpiece!

In this episode, we cover our experiences with our evolving careers. As a radiation oncologists solidify their clinical and technical expertise, how can they expand their ability to help the world?

We discuss developing a voice outside the mainstream communication channels of medicine and academics, and going a different way. As radiation oncologists, it's in our DNA.

Editors note: Don't miss Simul's Substack post related to this show, "How to Publish Outside of the Academic 'Priesthood'".

Here are some other things mentioned during the show:

• Subscribe to Stacy's Substack, Cancer Culture
• Stacy's most popular article, Why Your Doctor is Leaving You
• Why Mars is Boring and Cancer is Not, by Stacy Wentworth
• Healthcare A to Z with Eric Bricker
• Zotero organizational software
• Eric Topol's Ground Truths 
• Will Dowd's monthly Lunar Dispatch
• How to start writing on Substack 
• An Inconvenient Truth, by Graypeace
• A biography of Juan Del Regato (ROI Institute)
• The NSABP
• Shibamoto and Takano, Non-surgical management of operable breast cancer review
• Hess et al., Phase 1 trial of low-dose radiotherapy for COVID-19

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Dr. Donald Abrams, MD, Medical and Integrative Oncologist at the UCSF Oscher Center for Integrative Health.

Donald offers a comprehensive review of a very poorly understood topic!

We review the history of cannabis regulation in the US and globally, different delivery forms, and Donald's observations throughout his oncology practice.

We additionally discuss indications for use in cancer care; is smoking cannabis safer than taking sugary edibles?

Of course, we discuss cannabis misinformation. Right now Donald offers the best discussion of this topic that we have seen.

We close the episode with a dicussion of CBD, the future, and a bit on studies of psychedelic therapies and melatonin.

Don't miss the ASCO Cannabis and Cannabinoids guideline. 

Here are some other things we discussed during the show:

• The Marijuana Tax Act and AMA opposition
• The Controlled Substences Act
• Federal Marijuana Compassionate Use Program
• Braun et al., JCO, National Survey of Medical Oncologists Perceptions
• NASEM report on The Health Effects of Cannabis
• Tashkin, Annals ATS, Effects of marijana smoking on the lung
• Nabiximols
• Waissengren et al, TAMO, Effect of cannabis on oxaliplatin-induced peripheral neuropathy
• Overview of cannabis for peripheral neuropathy (Cleveland Clinic)
• Munson et al, JNCI, Antineoplastic Activity of Cannabinoids
• Guzmán et al., Br J Cancer, Pilot study of CBD for recurrent GBM
• Twelves et al., Br J Cancer, Phase 1b study of CBD for recurrent GBM
• Book Rec: The First Cell, Azra Raza
• Piper et al, Cancers, Regarding cannabinoids and immunotherapy

The Accelerators Podcast is a Photon Media production. 

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The Accelerators Podcast co-host Dr. Simul Parikh is heading back around the globe, this time to discuss breast cancer!

He hosts Drs. Anna Kirby (Royal Marsden Hospital & Institute of Cancer Research), Sushil Beriwal (Allegheny Health Network, Varian Medical Systems), and Revathy Krishnamurthy (Tata Memorial Centre), Radiation/Clinical Oncologists from the UK, US, and India.

The group kicks off it's discussion by comparing and contrasting breast cancer screening processes in their respective countries. 

Then they run cases, examining varied cases of breast cancer and techniques: early stage, locally advanced, triple negative, PMRT, VMAT and SIB, and the oligometastatic state.

Here are other things that were discussed in the show:

• The PRIMETIME Trial (UK)
• SOUND Trial Findings and Discussion, American Society of Breast Surgeons
• Omission of Sentinal Lymph Node Biopsy, American College of Surgeons]
• Hypo-G Breast Abstract, ESTRO 2024
• FAST-Forward Boost Trial (UK, PI Anna Kirby)

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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Cameron Tharp, MPH, RTT joins The Accelerators (Drs. Matt Spraker and Simul Parikh), and we host radiation therapist Shaun Caldwell, EdD, RTT to discuss the Advanced Practice Radiation Therapist (APRT) role. 

Here are some things we discussed during the show:

• Mohan et al. on record and verify systems (1984)
• American Society of Radiologic Technologists (ASRT)
• American Registry of Radiologic Technologists (ARRT)
• Health Education England Advanced Clinical Practice Definition

Here are some peer reviewed publications on the APRT role:

• Lawlor and Leech. Scoping review of established APRT roles
• Skubish et al. Exploring possibilities for the APRT in the US

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Christine Gnaster, MS, DABR, FAAPM, Vice President of Product of Radformation and medical physicist Chelsea Page-Robertson for a #MedEd discussion of AutoContour, ClearCheck, and the use of AI in Radiation Oncology. 

Christine kicks us off with an approachable overview of how tools like AutoContour actually work. We discuss how Radformation have trained hundreds of models to help you contour in clinic. She also shares how they are approaching current challenges in the field of automated contouring. 

We then discuss ClearCheck, how it is linked to AutoContour, and why it is so much more than a checklist for dosimetry review. Chelsea shares how her and Matt have implemented AutoContour and ClearCheck in their practice. 

We close with a discussion of the "psychology" of implementing AI tools in the Radiation Oncology clinic. Should we trust the computer to draw clinical target volumes? Are we planning to green boxes? Are these tools going to us worse clinicians? 

Plus, all the (live) music that makes us happy.

Here are some other things we discussed during the show:

• See a list of AutoContour's included models
• Radformation Acquires Limbus AI
• TAP Re-irradiation Episode
• AAPM TG 132
• Dean et al., CB-CHOP plan review strategy
• Chen et al., Physician vs. AI Chat Bot for cancer
• Physics World, "Automation in the radiotherapy workflow"
• Batumalai et al., Survey of RO professionals perceptions of automation

Editor's Note: While our love for their products is genuine, The Accelerators were compensated for this episode and Radformation participated in planning the content. The discussions in this episode are the opinions of the participants and are not clinical advice.

Please see our website for complete information on our past and current sponsors.

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) team up with Vision RT for the first of two tech-forward episodes! 

We are joined by Mike Tallhamer, MSc DABR, Chief of Radiation Physics at Advent Health for a masterclass on Surface Guided Radiotherapy (SGRT). We discuss how VisionRT has leveraged SGRT to enhance the radiotherapy planning and delivery.

After reviewing SGRT basics, we discuss how SimRT can be used to improve the patient experience: no set up tattoos and "open mask" radiotherapy. We also review its use as a platform for respiratory management.

We then discuss MapRT, a new SGRT tool that gives planners knowledge of vault geometry. Increased planning efficiency could increase access to advanced techniques.

We close with a discussion of AlignRT, a patient positioning and monitoring tool, and DoseRT, a technology providing real-time visualization of dose delivery.
 
Here are other some things we discussed during the show:

• Jarvis et al., Dartmouth Cherenkov Imaging experience
• VisionRT's open face mask solutions for head and neck radiotherapy
• Moser et al., Women's experience with tattoos in breast radiotherapy
• The patient-led Remove the Mask project, video and website
• Matt on Out.Of.The.Basement, IGRT episodes part 1, 2, and 3
• TAP re-irradiation episode for #ESTRO23
• ESTRO "Challenges in Reirradiation: From Art to Science" Webinar Series
• Cherenkov radiation
• Zhang et al., SGRT reduced PTV margins for sarcoma
• SGRT Community Upcoming Meetings & Videos for more educational content
• Learn more about SGRT reimbursement

Editor's Note: TAP were compensated for this episode and VisionRT participated in planning the content. The discussions in this episode are the opinions of the participants and are not clinical advice.

Please see our website for complete information on our past and current sponsors.

The Accelerators Podcast is a Photon Media production. 

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Sam Mazin, Ph.D. and Sean Shirvani, MD, CTO and CMO of RefleXion. This Rad Onc startup have created a linear accelerator with on board PET/CT. This allows for SCINTIX biology-guided radiotherapy for bone and lung disease. 

Sam and Sean join the show to share their story in medical entrepreneurship, discuss the technology, and their vision for the future of our field. 

Why is SCINTIX any better than fusing a PET/CT to a standard CT simulation? 

PET/CT on board and in real time offers potential safety advantages and opportunities for personalized therapy. 

Many would argue that novel radio-molecules and total metastatic ablation are the future of our field. Sam and Sean invite us to think bigger and a lot more creatively about how that future might look for our patients. 

Here are some other things that were discussed during the show.

• Bob Timmerman and Nina Sanford on TAP, Parts 1 and 2
• RefleXion Research Program Information
• Shankar Siva and others with a good discussion about total metastatic ablation, X
• SCINTIX receives FDA clearance, RefleXion