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Before beginning this assignment, review the Supine CSI PowerPoint

presentation found in D2L.
For this assignment you will be describing a typical CSI setup in either
the prone or supine position. Next semester you will have the
opportunity to actually complete the treatment plan for a CS patient. At
that time you will see how to visually align diverging beams. For this
project you have to draw or provide diagrams that illustrate what is
being matched. You will also calculate the angle required to match the
beam divergence opposed to visually aligning the beams.

We are doing this assignment for several reasons 1) these calculations
are frequently required on the MDCB exam; 2) to better understand the
rationale when setting up and matching fields

You may use your clinical preceptor, discussions with classmates and
textbook resources to provide the following information. REMEMBER
pictures are helpful to illustrate your explanations.

Craniospinal Irradiation (CSI) Assignment

Patient position is extremely important. Pretend you are the

dosimetrist called to go into the simulator and assist with the CSI
setup. Be very specific and descriptive in your answers.

1. Is the patient a child or an adult? What might you have to do
differently based on the size and age of your patient? (5 points)
2. How will the patient be positioned? Supine or prone? After
describing which orientation, include all the devices used.
Describe head position, chin position, arm position, how will you
assure your patient is aligned? List everything that you would
check before leaving the CT. Sometimes a board is placed under
the lower torso, describe if this will be used for your patient and
why or why not? (25 points)

The following questions are generic CSI questions:
1. How is the spine matched to the head ports for a craniospinal
setup? BE SPECIFIC. Give me the formulas used to determine any
angles and give an example of using the formula(s). Provide a
diagram or drawing (20 points)
2. If you wanted to remove any divergence from the eyes in the
cranial port, how would this be accomplished? Why would you do
this? Show a formula and how it can be used. Provide a diagram or
drawing. (10 points)
3. For treatment planning, approximately where will you place the
isocenter for each field for the patient above, will the isocenters
be moved? Why or why not? What are the approximate field
borders? (25 points)
4. If two spine ports must be matched due to the length of the spine,
tell me how you would accomplish this and how would you assure
that there is no overlap? (10 points)
5. If feathering the gap is required between 2 fields, what does that
mean? Can you describe how this could be accomplished?
(provide details as if you had to explain exactly what will be done
to the radiation therapist who is treating the patient) (5 points)