Physics, technical expertise critical to LINAC’s success

By Sarah Carey

Blaine Seese reviews an imaging plan for a patient.

Radiation therapy technician Blaine Seese reviews an imaging plan for a patient. Seese works exclusively with the LINAC in the Small Animal Hospital.

Approximately one year ago, the University of Florida Small Animal Hospital broke new ground technologically and clinically when it began making use of a linear accelerator that has allowed refined treatment options for a variety of cancer patients.

With the new LINAC came a need for additional staff expertise, which soon arrived in the form of a radiology-trained technician and even a visiting physicist. The technician, Blaine Seese, and the physicist, Atchar Sudhyadhom, each see their respective roles in enhancing not just technological excellence, but ultimately patient care.

“My mother used to work in radiation oncology at Florida Hospital, so I knew a little about the profession and decided that was what I wanted to do,” Seese said, adding that she had read an article about radiation therapy and its uses in veterinary medicine before she started school.

“I thought it sounded amazing, but sort of dismissed it because the field was, and is, so specialized and there are only a handful of RTs working in veterinary medicine in the whole country.”

Seese graduated from Santa Fe Community College in 2003 with an associate’s degree in radiography, and subsequently from Halifax Hospital’s radiation therapy program, which she completed in Daytona Beach, in 2004. She worked in Ocala a few months following her graduation from that program, and then got a job at Shands at UF, where she worked for three years.

A few years later, Seese received an email from an engineer who now works with the new LINAC, saying that UF was installing a machine and planned to hire a therapist.

“Thanks to Dr. Frank Bova from the McKnight Brain Institute, and Dr. Jim Farese, I was able to get the job,” Seese said.

Bova, a medical physicist in the College of Medicine’s department of neurosurgery, has worked closely and collaboratively for several years with the College of Veterinary Medicine’s oncology team to assist in providing stereotactic radiosurgery (SRS) to certain cancer patients and also helped add the SRS equipment package to the new LINAC.

Sense’s time at Shands allowed her to see “unusual” procedures and patients, but she is still amazed every day at what UF is able to do with the LINAC technology.

“It amazes me how much tougher our four-legged friends are, compared to how we can be,” Seese said. “And they still come in here in such good spirits day after day. I think UF’s radiation program is very innovative, and my goal is to keep pushing to try new treatment methods.”

She said she keeps tracks of statistics and follow-ups and added that she has been excited to see how well some of her patients are doing, after initially being expected to live only a few months without radiation. Among her most interesting cases were a snake with a very large tumor that was treated in the LINAC, and a rabbit with a large chest tumor which improved very quickly after treatment, and is still alive.

“The most challenging aspect of this job is keeping in mind the life expectancy of a pet,” Seese said. “A few of my patients have since succumbed to other ailments, but I guess in Oncology terms, their treatment was still a success. If I can keep someone’s pet alive and well for longer than their owners expected, I consider that a success.”

Atchar checks on a patient in the LINAC, February 2012.

Atchar Sudhyadhom checks on a patient in the LINAC, February 2012.

Atchar Sudhyadhom has worked with Bova at the Brain Institute since 2005, and was involved in the treatment of dogs and cats through SRS.

“When the UF veterinary college put in its own linear accelerator in 2010, I was asked if I would be interested in providing physics support for the beginning radiation therapy program,” he said. “Since our first patient was treated in the new LINAC in 2011, I’ve been involved with every SRS and stereotactic radiation therapy (SRT) case, and have enjoyed every moment of it.”

SRS is a technique where the entire dose of radiation is delivered all at once.

“When the tumor is close to more delicate tissues, we use SRT where the dose is divided typically into three smaller doses and given on alternate days, for example Monday, Wednesday and Friday,” explained Dr. Nick Bacon, a surgical oncologist and chief of the hospital’s oncology service.

Sudhyadhom’s hours at the veterinary college vary depending on the number of SRS or SRT cases scheduled. Although by training, Sudhyadhom is a medical physicist who can naturally provide support in the physics areas of radiation treatment, he has found that medical physicists actually play a big role in the entire process. And while his specific role varies with each case, Sudhyadhom most often helps with how the patient is imaged, helps to create a plan for the therapy, and finally assists with the actual treatment of the patient.

“I definitely have a hand in every step in the process, but sometimes I’m just on the phone providing support,” he said. “At the UF Small Animal Hospital, the situation is definitely different from most other veterinary radiation centers, in that since I can provide a high level of physics support here, we are able to perform more advanced procedures that require extra care to ensure safe treatment, such as SRS and SRT.”

One of the things Sudhyadhom finds most interesting about his work at the UF Small Animal Hospital is that there is often greater flexibility to consider options that are not considered in human treatments – partly because veterinary patients are already under anesthesia to keep them still for treatment.

“Technology-wise, we are already using some of the most advanced tools available for human treatments, but there is always more being developed for human treatments that we can start to use in the veterinary world as well,” Sudhyadhom said. “Some of our technology works even better on veterinary patients than it does in humans.”

He hopes to continue providing clinical physics support for both human and veterinary patients in the future, and that one day his research contributions will lead to improved technologies for radiation therapy for all patients, animal and human.

“It has truly been a lot of fun and a pleasure working here,” Sudhyadhom said. “I’ve definitely learned more than I’ve given back.”


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