Non-Invasive therapy Notes GPT Flashcards

(80 cards)

1
Q

What major global trend in healthcare spending drives interest in non-invasive therapies?

A

Rising healthcare costs as a growing fraction of GDP worldwide.

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2
Q

Why is an ageing population particularly relevant for non-invasive therapies?

A

Older patients often have multiple or systemic conditions, making invasive surgery riskier and less scalable.

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3
Q

Which diseases have become predominant as a result of vaccination and better infection control?

A

Non-communicable (chronic) diseases such as cancer, heart disease, and diabetes.

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4
Q

Why can systemic or metastatic disease be poorly addressed by surgery alone?

A

Surgery is local; metastases often spread throughout the body and require whole-body (systemic) treatments.

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5
Q

Give one main advantage of non-invasive therapies over invasive methods.

A

Reduced trauma to healthy tissues, often leading to faster recovery times.

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6
Q

Name two non-invasive modalities covered in this course.

A

(1) Radiation therapy (ionizing or non-ionizing), (2) Ultrasound-based therapy, (3) Drug-based approaches, etc.

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7
Q

What defines ionizing radiation in terms of photon energy? (threshold)

A

Ionizing radiation has photon energies above about 10 eV, sufficient to knock electrons off atoms.

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8
Q

State the equation linking photon energy (E) to frequency (f).

A

E=hf, where h is Planck’s constant.

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9
Q

How are X-rays typically generated for radiotherapy?

A

By accelerating electrons in a linear accelerator (LINAC) and colliding them with a metal target.

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10
Q

How do gamma rays differ from X-rays in their source?

A

Gamma rays arise from radioactive decay in nuclei; X-rays typically come from electronic transitions or bremsstrahlung in an X-ray tube.

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11
Q

What are alpha particles composed of, and how deeply do they penetrate tissue?

A

Alpha particles are helium nuclei (2 protons + 2 neutrons); they have very poor penetration (a few cell layers).

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12
Q

In what scenario is alpha-particle therapy often used?

A

As alpha-emitting radiopharmaceuticals for metastatic bone lesions or targeted alpha therapies.

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13
Q

Why do protons deposit most of their energy at the Bragg peak?

A

Because protons slow down rapidly near the end of their path in tissue, releasing maximal energy there.

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14
Q

Which formula is used to calculate absorbed dose (D)?

A

D=E/m (energy deposited per unit mass).

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15
Q

What is the half-value layer (HVL) in radiation physics?

A

The thickness of an absorber that reduces the beam intensity by 50%.

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16
Q

Name the key biological molecule targeted by ionizing radiation.

A

DNA. Radiation-induced double-strand breaks can trigger cell death.

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17
Q

Why is fractionation used in radiation therapy?

A

It allows normal cells to repair damage while tumor cells, often less proficient at repair, accumulate lethal damage.

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18
Q

What is the main advantage of proton therapy over conventional X-rays?

A

Protons spare healthy tissue beyond the tumor due to the sharp dose falloff after the Bragg peak.

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19
Q

How do beta particles differ from alpha particles?

A

Beta particles are high-speed electrons (or positrons), with deeper penetration than alpha particles but shallower than photons.

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20
Q

Give an example of a radiopharmaceutical for beta therapy.

A

Iodine-131 for thyroid cancer, or beta-emitting isotopes linked to antibodies in radio-immunotherapy.

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21
Q

How does oxygenation influence radiotherapy efficacy?

A

Oxygen enhances the formation of free radicals, increasing radiation-induced DNA damage in tumor cells.

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22
Q

What is the typical energy range for medical LINAC X-ray beams?

A

Around 6–15 MeV.

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23
Q

Name two types of non-ionizing electromagnetic radiation used therapeutically.

A

Visible/Infrared light (lasers) and microwaves (RF waves).

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24
Q

How does laser light cause tissue heating or ablation?

A

Photons elevate electron energy levels in tissue molecules, converting photonic energy into heat.

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25
What is the typical tissue penetration depth of visible or near-infrared light in photodynamic therapy?
Usually only a few millimeters, owing to high absorption/scattering in tissue.
26
What is photodynamic therapy (PDT)?
A treatment where a photosensitizing drug is activated by light to produce reactive oxygen species, killing target cells.
27
Why is tissue ablation via laser pulses often preferred over continuous beams?
Pulsing avoids excessive heat spread, permitting precise ablation with minimal damage to surrounding tissue.
28
Define “microwave ablation.”
Tissue heating using electromagnetic waves in the microwave range (300 MHz–300 GHz) to induce dielectric heating.
29
What is dielectric heating?
Heating caused by the oscillation of polar molecules (e.g., water) in an alternating electromagnetic field.
30
Why do microwaves generally penetrate deeper than visible light?
Longer wavelengths and different interaction with tissue reduce absorption/scattering.
31
Mention one common clinical application of microwave ablation.
Ablation of liver tumors, kidney tumors, or lung metastases.
32
In the bioheat equation, which term represents heat addition from laser or microwave power?
q s , the source term.
33
How is mild hyperthermia (38–40°C) beneficial in combination cancer therapy?
Increases local blood flow and oxygen, enhancing radiosensitivity or drug delivery.
34
Above what temperature is rapid tissue necrosis likely (>45°C)?
Extreme hyperthermia range, leading to protein denaturation and coagulation.
35
Why are matching layers or coupling gels used in non-ionizing therapy?
To reduce reflection losses at the tissue–device interface by better matching acoustic/optical impedances.
36
What is the thermal coefficient R used for in thermal dose calculations?
R adjusts required exposure time based on how many degrees above or below 43°C the tissue is.
37
Briefly state a typical synergy when laser or microwave hyperthermia is combined with chemotherapy.
Enhanced drug perfusion and increased cell membrane permeability to cytotoxic agents.
38
Define ultrasound in terms of frequency range.
Acoustic waves above human hearing, i.e. >20 kHz, typically MHz range in medical imaging/therapy.
39
Write the 1D linear acoustic wave equation in terms of pressure (p).
∂2𝑝/∂𝑡2=𝑐2∂2𝑝/∂𝑥2
40
What physical quantity does acoustic impedance (Z) represent?
The product of medium density ρ and sound speed c; it measures resistance to sound propagation.
41
What happens at a boundary if two tissues have very different acoustic impedances?
Increased reflection of the ultrasound wave at that interface.
42
List two main types of mechanical effects induced by therapeutic ultrasound.
(1) Acoustic radiation force, (2) Acoustic streaming, (3) Cavitation.
43
What is HIFU and its primary therapeutic action?
High Intensity Focused Ultrasound, used to heat and ablate tissue at a small focal region.
44
Define cavitation in the context of ultrasound.
Formation and oscillation (or collapse) of gas bubbles in the medium under acoustic pressure changes.
45
Differentiate between stable and inertial cavitation.
Stable cavitation: bubbles oscillate over many cycles; inertial cavitation: bubbles collapse violently, creating high shear forces.
46
How do shockwaves differ from standard ultrasound waves?
Shockwaves are steep, high-amplitude pulses with near-discontinuous pressure changes (used in lithotripsy or histotripsy).
47
State one advantage of ultrasound over laser for deep tissue thermal therapy.
Ultrasound penetrates deeper in soft tissue with less scattering compared to optical wavelengths.
48
What is “microstreaming” around an oscillating bubble?
Localized fluid motion around a bubble, which can enhance drug mixing or shear forces.
49
Mention one clinical application of shockwave therapy besides lithotripsy.
Shockwave therapy for musculoskeletal issues (e.g., tendon healing) or “histotripsy” for tissue fractionation.
50
In ultrasound thermometry, what imaging feature can be tracked to estimate temperature change?
Speckle pattern shifts in B-mode images.
51
Why do intense focused ultrasound pulses sometimes cause bubble formation?
High negative pressure phases can pull dissolved gases out, creating cavitation nuclei.
52
What is ARFI (Acoustic Radiation Force Impulse) imaging used for?
Measuring localized tissue displacement to estimate stiffness (useful for monitoring ablation zones).
53
What does ADME stand for in pharmacokinetics?
Absorption, Distribution, Metabolism, Excretion.
54
In oral delivery, why does pKa matter for drug absorption?
pKa determines the fraction of the drug in ionized vs. non-ionized form at GI tract pH, impacting membrane permeability.
55
State the Henderson-Hasselbalch equation for a weak acid.
p𝐾𝑎−pH=log⁡10([HA][A−])
56
What is the “first-pass effect” in drug metabolism?
The metabolism or inactivation of orally absorbed drugs in the liver before reaching systemic circulation.
57
Give one formula for renal clearance.
Clearance=excretion rate of drug*plasma concentration
58
Name the three main categories of drug targets in pharmacodynamics.
(1) Receptors, (2) Enzymes, (3) Macromolecules (DNA/RNA, structural proteins).
59
What is the mechanism of monoclonal antibodies in cancer therapy?
They can block growth factor receptors, trigger immune responses (ADCC, CDC), or deliver cytotoxic payloads.
60
What does the CRISPR/Cas9 system do?
Cuts DNA at a targeted sequence, allowing gene editing or gene repair.
61
How do oncolytic viruses help treat cancer?
They selectively infect and lyse tumor cells, often inducing immunogenic cell death.
62
Why might biologics be more specific than small-molecule drugs?
They can be engineered to target specific antigens or mutations, reducing off-target effects.
63
Give one advantage of transdermal drug delivery.
Avoids needle use and the first-pass hepatic effect, potentially improving patient compliance.
64
Give an example of a small-molecule chemotherapy mechanism.
DNA intercalation by doxorubicin interfering with topoisomerase II, inhibiting DNA replication.
65
List one reason to combine hyperthermia with radiotherapy.
Elevated temperature increases tumor oxygenation and radiosensitivity, enhancing treatment efficacy.
66
What does “sonothrombolysis” combine?
Thrombolytic drugs + ultrasound (often with microbubbles) to break down blood clots faster.
67
Why can ultrasound-driven cavitation improve thrombolysis?
Cavitation generates microstreaming and shear forces, enhancing clot penetration by the drug.
68
What is the main challenge in photodynamic therapy for deep tumors?
Limited light penetration (a few millimeters), restricting treatment depth.
69
How do thermosensitive liposomes aid combination therapy?
They release their drug payload when heated, targeting the release to hyperthermic regions.
70
Why can synergy reduce toxicity in combination treatments?
Lower doses of each agent may achieve the same or greater therapeutic effect, minimizing side effects.
71
Give an example of mechanical + drug synergy in cancer.
Ultrasound-triggered microbubbles enhancing local chemotherapy delivery (sonoporation).
72
Which imaging technique commonly monitors temperature in hyperthermia treatments?
MRI thermometry (phase shift method).
73
Write the photon energy–wavelength relationship in full.
E= hc/lambda
74
How is the intensity of a plane ultrasound wave typically expressed?
𝐼=𝑝rms2𝜌𝑐
75
State the linear wave equation for acoustic pressure in 3D.
∂2𝑝/∂𝑡2=𝑐2∇2𝑝/∂t 2
76
Give the form of the bioheat equation used for perfused tissue.
𝜌t𝐶𝑡∂𝑇∂𝑡=𝐾𝑡∇2𝑇−𝑤𝑏𝐶𝑏(𝑇−𝑇∞)+𝑞𝑠
77
How do you calculate thermal dose in terms of CEM at 43°C?
CEM43=∑𝑡𝑖 𝑅(43−𝑇𝑖) , with R≈0.5 per 1°C above 43°C.
78
Write the Henderson-Hasselbalch equation for a weak base.
p𝐾𝑏−pH=log⁡10([B𝐻+][B]) or adapted similarly to acid form.
79
Name a key factor examiners often expect you to link between physics and clinical outcomes.
The rationale behind dose-fractionation or synergy (e.g., how mild hyperthermia specifically boosts radiotherapy).
80
What are two major benefits of combining therapies in an exam answer?
(1) Synergistic efficacy allowing dose reduction and fewer side effects, (2) Overcoming tumor resistance via multiple mechanisms.