Course Material 

Overview

This exercise consists of participants reading a short clinical vignette about the pre-selected post-operative spine case. Then, they will review the relevant investigations – including operative notes and pre- + post-operative imaging, before attempting to contour the clinical target volume. Adjacent critical organs may also need to be delineated. (e.g. spinal cord, thecal sac, nerve roots, bowel)

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During the webinar, the session will start off with sub-speciality experts (surgeon, radiologist, radiation oncologist) giving a short talk on the relevant aspects of clinical management.
This will be followed by a break-out practicum session where participants can compare their interpretation of CTV with other group members, and against the suggested CTV by the expert.

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Lastly, we will end the session with the radiation oncologist running through his CTV contour and explaining why he did, or did not, include certain areas. This is be followed by an overall panel discussion with the invited experts.

Audience

This program is designed to meet the interest of radiation oncologists and radiation oncology residents.

Program

Each of the workshop sessions will last for two hours.  The session will cover the following areas:

• (Pre-course) Access to platform and hands-on contouring by participants

• Short talks each by sub-site surgeon, radiation oncologist and radiologist

• Presentation of the case and delineation guidelines used

• Breakout session to review participants’ contours in comparison to the reference contours

• Summary of key points by expert panel 

• Discussion between participants and experts

Learning Objectives

• To be familiar with indications, types of surgeries, types of implants for spinal mets

• To appreciate the various imaging modalities used in spine mets imaging, both in the de novo and post op setting. To be familiar with the types of artefacts seen with spinal implants and strategies to mitigate these

• To be able to identify residual tumors and expected post-operative changes

• To be able to define the high-risk CTV for post-op spine SBRT

• To be aware of the common pitfalls in delineation

Faculty

Dr Robert Chen

Senior Consultant NeuroRadiologist
Singapore General Hospital

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Dr. Chen is trained in both Neuroradiology and Emergency Radiology, where he was a fellow and subsequent staff at Massachusetts General Hospital, Harvard Medical School. He is board certified in the USA with a Certificate of Added Qualification (CAQ) in Neuroradiology and is currently the Director of Neuroradiology at SGH.

His interests include all facets of neuroimaging, resident education, operations, and wellness.

Dr Eddie Tan

Consultant Neurosurgeon
National Neuroscience Institute

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Dr Eddie Tan completed his neurosurgical training in 2018, and was awarded the College of Surgeon’s Gold Medal 2019 as the best performing advanced surgical trainee in Neurosurgery. He is currently a Consultant Neurosurgeon at the National Neuroscience Institute in Singapore. He has subspecialty interest in brain tumour surgery, particular in tumours of the skull base.

Dr Joshua Palmer

Associate Professor
Director of CNS and pediatric radiation oncology
CNS Radiation Oncologist
The Ohio State University Wexner Medical Center

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Dr. Palmer is a radiation oncologist specializing in the treatment of central nervous system (CNS) malignancies, such as primary and secondary brain tumors as well as cancers of the spine. I am also a committed physician-scientist, devoting a significant portion of my professional time to prospective clinical trials and strategies to improve the efficacy of radiation. I have published over 100 manuscripts, book chapters and abstracts, including publications in such leading medical journals as Cancer Cell, Lancet Oncology, NEJM, JAMA Oncology, Radiotherapy and Oncology, Journal of Neuro-Oncology and Neurology.

My research focuses on translational oncology, biomarker discovery and the interaction of diet on cancer therapy. I serve as a national co-PI on three brain metastasis trials in the NRG Oncology and ALLIANCE for Clinical Trials groups, including the ALLIANCE A071801 study investigating single fraction vs fractionated radiosurgery for resected brain metastasis. I am also a member of the International Guideline Harmonization Group for neurocognitive problems and colorectal cancer, and a committee member on the National Comprehensive Cancer Network’s pediatric CNS tumors national guidelines.

Moderators

Dr Brendan Chia
Consultant Radiation Oncologist
National Cancer Centre Singapore

Facilitators

Dr Balamurugan Vellayappan
Senior Consultant Radiation Oncologist
National University Cancer Institute Singapore

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Dr Timothy Cheo
Consultant Radiation Oncologist
National University Cancer Institute Singapore

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Dr Soon Yu Yang
Consultant Radiation Oncologist
National University Cancer Institute Singapore

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Dr Daniel Tan
Senior Radiation Oncologist
Asian Alliance Radiation & Oncology

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Dr Kevin Chua
Consultant Radiation Oncologist
National Cancer Centre Singapore

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Dr Grace Kusumawidjaja
Consultant Radiation Oncologist
National Cancer Centre Singapore