NOV 2025 Oncology Cartoons By Dr Kanhu Charan Patro

NOV 2025 Oncology Cartoons By Dr Kanhu Charan Patro

1. DR KANHU CHARAN PATRO M.D, D.N.B[RT], MBA, FICRO, FAROI, PDCR, CEPC www.slideshare.net/search/slideshow?searchfrom=header&q=oncology+cartoons www.facebook.com/oncologycartoons/photos_albums 116 th Volume/NOVEMBER 2025 ONCOLOGY CRATOONS EDUCATIVE E-BOOK

2. The First Attempt to Treat Cancer with X Rays by Doctor Chicotot 16 th OCT 2025/ HISTORY CHAT GPT This is a famous historical illustration titled “The First Attempt to Treat Cancer with X-Rays by Doctor Chicotot ” (1896). Context Shortly after Wilhelm Conrad Röntgen discovered X-rays in 1895, physicians across Europe began experimenting with them for medical use. Dr. Victor Chicotot , a French physician, was one of the earliest to apply X-rays in the treatment of cancer. The image depicts Chicotot irradiating a patient’s face tumor with an early X-ray tube. Importance This is one of the earliest recorded attempts at radiation therapy. At the time, the biological effects of radiation (both therapeutic and harmful) were poorly understood. Many early pioneers developed severe radiation burns themselves. This experiment laid the groundwork for what later evolved into radiation oncology as a medical specialty. Artistic/Scientific Value The image is often reproduced in textbooks and museums because it captures the dramatic transition from discovery to clinical application. It symbolizes both the hope of new treatment and the risk of using technology before its dangers were fully understood.

3. VARIOUS ARTEFACTS IN CT SCAN 17 th OCT 2025/ RADIOLOGY CHAT GPT MOTION ARTEFACT METAL/STREAK ARTEFACT RING ARTEFACT WINDMILL ARTEFACT DETECTOR ISSUE Beam hardening from the dense petrous OUTFIELD ARTEFACT PART OUTSIDE THE SFOV

4. Vertebral Hemangioma 18 th OCT 2025/ BRAIN Shambhavi Sharma/Reports of Practical Oncology and Radiotherapy/2023

5. GORHAM-STOUT DISEASE/SYNDROME 19 th OCT 2025/ BENIGN AMIT ROY/Advances in Radiation Oncology ( 2022) Aspect Details Definition Rare idiopathic disorder with progressive osteolysis (vanishing bone disease) due to vascular/lymphatic proliferation Pathology Replacement of bone marrow with angiomatous/lymphangiomatous tissue → bone resorption → fibrous tissue replacement Sites Involved Shoulder, pelvis, skull, mandible, ribs, spine Clinical Features Pain, deformity, pathological fractures, chylothorax if thoracic bones involved Radiation Therapy Indicated for progressive/symptomatic disease or chylothorax control Dose Range 36–45 Gy in 1.8–2 Gy fractions (30–45 Gy used; <20 Gy ineffective) Outcomes 75–80% local control; pain relief; halts further osteolysis Other Treatments Surgery, bisphosphonates, interferon- α, sirolimus , propranolol

6. RADIATION THERAPY FOR PTERYGIUM 20 th OCT 2025/ BENIGN Paul T. Finger/BRACHYTHERAPY/2023 Aspect Details Indication Recurrent pterygium after surgical excision; aggressive/vascular pterygium with high recurrence risk Timing Usually applied postoperatively within 24–48 hours of excision Dose Single fraction 5–10 Gy (commonly 7–8 Gy) to scleral surface; or fractionated regimen e.g., 2 Gy × 5 fractions (total 10 Gy) Technique Surface application using strontium-90 (Sr-90) applicator or beta-plaque; shields used to protect cornea and lens Procedure Local anesthesia, surgical excision of pterygium , immediate application of beta-radiation probe to bare sclera for prescribed duration Advantages Reduces recurrence rate significantly compared to surgery alone Risks/Complications Scleral necrosis, cataract, keratitis, delayed epithelial healing (rare with modern dosing)

7. RADIATION THERAPY FOR ORBITAL PSEUDOTUMOR 21 st OCT 2025/ BENIGN Bruno Fionda /OCULAR IMMUNOLOGY AND INFLAMMATION/2023 Aspect Details Indication Refractory orbital pseudotumor (idiopathic orbital inflammation) not responding to corticosteroids or immunosuppressants . Pain, proptosis , vision-threatening inflammation. Dose Conventional: 20 Gy in 10 fractions (2 Gy/fraction).Alternative: 20–30 Gy in 10–15 fractions.Low-dose regimens: 4–10 Gy in 2–5 fractions for palliation/recurrence. Procedure External beam radiotherapy (EBRT), typically with 6 MV photons . Immobilization with thermoplastic mask . CT-based planning, conformal fields/IMRT preferred to spare lens and optic nerve . Field : orbit only, margin to cover inflammation. Response Symptom relief in 60–80% of cases (pain, edema, proptosis ).Best results in lymphoid-predominant histology; fibrotic type responds less. Toxicity Usually minimal with low doses. Possible late effects: cataract, dry eye, retinopathy (rare at ≤20 Gy ).

8. SWI IMAGE IN DIFFERENTIATING ACOUSTIC SCHWANNOMA AND MENINGIOMA 22 nd OCT 2025/BRAIN MINKOOK SEO / (KSMRM)/2020

9. SWI IMAGE IN DIFFERENTIATING LOW GRADE AND HIGH GRADE GLIOMA 23 rd OCT 2025/BRAIN Omer Aydin / Pol J Radiol , /2017

10. DYNAMIC CONTRAST IMAGE AND DIFFERENCE FROM CONTRAST IMAGE 24 th OCT 2025/BRAIN Omer Aydin / Pol J Radiol , /2017 Feature Contrast MRI DCE-MRI Type Static Dynamic DESCRIPTION A standard MRI scan with a contrast agent (typically Gadolinium) to highlight blood vessels, tissues, or lesions at a specific time point. A functional imaging technique where multiple images are taken over time after contrast injection to study the dynamics of contrast uptake and washout in tissues Purpose Better tissue contrast Evaluate tissue vascularity/permeability Image Acquisition One or few time points Repeated sequences over time Data Type Anatomical, qualitative Functional, quantitative/kinetic Analysis Visual inspection Pharmacokinetic modeling (e.g., Ktrans , Ve , Kep ) Parameters Anatomical only Functional ( Ktrans , Ve , etc.) Common Use Tumor detection Tumor grading, treatment response

11. K-TRANS IN DCE IMAGES WITH RESPET TO GLIOMA 25 th OCT 2025/BRAIN Omer Aydin / Pol J Radiol , /2017 K-trans (Volume Transfer Constant) A quantitative parameter from DCE MRI. Reflects how quickly contrast agent moves from blood plasma into the extracellular extravascular space (EES) . High K-trans = high vascular permeability and often increased blood flow K^trans (Volume Transfer Constant) is a key pharmacokinetic parameter derived from Dynamic Contrast-Enhanced MRI (DCE-MRI) . It reflects vascular permeability and perfusion , specifically the rate at which contrast agent moves from the blood plasma into the extravascular extracellular space (EES ). In gliomas, K^trans values vary depending on tumor grade due to differences in angiogenesis, blood-brain barrier (BBB) integrity, and vascular permeability . Glioma Type / Grade K^trans Value Interpretation Clinical Significance Low-Grade Glioma (Grade II) Low (near-normal) Intact BBB, low vascular permeability Minimal or no enhancement on DCE; low K^trans helps differentiate from high-grade tumors Anaplastic Glioma (Grade III) intermediate Partially disrupted BBB, increased but variable permeability Moderate enhancement and heterogeneous K^trans ; may aid in treatment planning and progression monitoring Glioblastoma Multiforme (Grade IV) High Severely disrupted BBB, high angiogenesis and permeability High K^trans in enhancing regions; correlates with aggressiveness and poor prognosis Pseudoprogression / Radiation Necrosis Variable (often high) Leaky vessels post-treatment; not due to tumor May mimic recurrence; advanced imaging + clinical correlation needed

12. Borrmann’s Types of Advanced Gastric Cancer 26 th OCT 2025/STOMACH Cristina Díaz del Arco/cancers/2021

13. FAPI PET = Fibroblast Activation Protein Inhibitor PET 27 th OCT 2025/PET Yuriko Mori/RSNA/2023 FDG PET has limitations in tumors with low glycolytic activity (e.g., mucinous tumors, some hepatocellular cancers). Tumor stroma can be a more universal target —present even when tumor cells have low metabolic rate. FAPI PET shows very high tumor-to-background ratio due to minimal physiological uptake in most normal tissues. Can be performed without fasting and often within 10–20 minutes post-injection (faster workflow). ca ncers with low FDG uptake: Prostate cancer (especially PSMA-negative) Hepatocellular carcinoma (HCC) Mucinous adenocarcinomas (colon, ovary, pancreas) Sarcomas Head & neck cancers (for high-contrast tumor delineation) Peritoneal carcinomatosis (better detection vs FDG) Tumor staging, restaging, and radiotherapy planning (better GTV delineation Feature FDG PET FAPI PET Target Glucose metabolism (GLUT transporters, hexokinase) Fibroblast Activation Protein (tumor stroma) Physiological uptake High in brain, heart, bowel, urinary tract Low in most normal tissues (except healing wounds, inflammation, uterus, pancreas) Preparation Fasting, control of blood glucose No fasting, minimal prep Scan timing 60 min post-injection 10–20 min post-injection Best for Highly glycolytic tumors (lung, lymphoma, melanoma) Low-FDG tumors, tumor delineation, fibrosis imaging Limitations Low uptake in some tumors, high background in brain/heart Still investigational, false positives in inflammation & healing Regulatory status Widely approved Mostly research / early clinical use

14. FAPI PET = Fibroblast Activation Protein Inhibitor PET 28 th OCT 2025/PET Yuriko Mori/RSNA/2023

15. Role of FAPI PET in Gastric Cancer 29 th OCT 2025/STOMACH Yuyun sun/RSNA/2024 68 Ga-FAPI PET/CT had higher accuracy in diagnosis of gastric mucinous adenocarcinoma or signet ring cell carcinoma  compared with  18 F-FDG PET/CT and demonstrated the potential to improve treatment strategies and predict prognosis.

16. CRAB AND SLIM CRAB IN MYELOMA 30 th OCT 2025/STOMACH PINTREST

17. SPLENIC CONSTRAINTS IN ABDOMINAL RT 31 st OCT 2025/OAR K KESWANI/CLINICAL ONCOLOGY/2022 SILVIA BISELLO/CURRENT ONCOLOGY/2022

18. MRI PICTURES OF VASCULAR ANOMALIES 1 st NOV 2025/BRAIN GOOGLE DURAL AVF NO NIDUS CAVERNOMA POPCORN DEVELOPMENTAL VENOUS ANAOMOLY CAPUT MEDUSAE SIGN AVM- NIDUS BAG OF WORM CAPILLARY TALANGECTESIA SACCULAR ANEURYSM

19. International Penile Advanced Cancer Trial( InPACT ) 2 nd NOV 2025/PENIS Sian Cooper/IJROBP/2025

20. International Penile Advanced Cancer Trial( InPACT ) 3 rd NOV 2025/PENIS Sian Cooper/IJROBP/2025

21. ( InPACT ) Trial penis – Target Volume for Neoadjuvant 4 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

22. ( InPACT ) Trial penis - Target Volume for post pelvic Sx 5 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

23. ( InPACT ) Trial penis - Target Volume for No pelvic Sx 6 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

24. WHY SHOULD WE INCLUDE PREPUBIC FAT IN THE TARGET? 7 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

25. ( InPACT ) Trial penis - Target Volume for pubic fat 8 th NOV 2025/PENIS Sian Cooper/IJROBP/2025 A V O I D

26. ( InPACT ) Trial penis – OAR DOSE CONSTRAINTS 9 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

27. ( InPACT ) Trial penis – Neoadjuvant DOSE SCHEDULE 10 th NOV 2025/PENIS Sian Cooper/IJROBP/2025 Region / Situation Indication Dose (25 #) Macroscopic pelvic nodes (CTV_P) Gross pelvic nodal disease 45 Gy Macroscopic inguinal nodes (CTV_I) Gross inguinal nodal disease 45 Gy Pelvic/inguinal nodes If inguinal disease present or staging unknown 45 Gy Prepubic fat All patients 45 Gy Common iliac nodes Only if pelvic nodal involvement 45 Gy

28. Region / Situation Indication Dose (25 fractions) Macroscopic pelvic nodes (CTV_P) Boost 54 Gy Macroscopic inguinal nodes (CTV_I) Boost 57 Gy Pelvic nodes High-risk inguinal disease (≥2 nodes, extracapsular spread) 54 Gy Inguinal nodes High-risk (≥2 nodes, extracapsular spread) 54 Gy (boost to 57 Gy if gross disease) Inguinal nodes Low-risk (1 node, no extracapsular spread) 45 Gy Prepubic fat All patients 54 Gy (boost if gross disease) Common iliac If pelvic nodal disease 45 Gy (boost to 57 Gy if gross disease) ( InPACT ) Trial penis - POST OP DOSE SCHEDULE- No Pelvic Sx 11 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

29. ( InPACT ) Trial penis - POST OP DOSE SCHEDULE- Pelvic Sx 12 th NOV 2025/PENIS Sian Cooper/IJROBP/2025 Region / Situation Indication Dose (25 fractions) Macroscopic pelvic nodes (CTV_P) Boost 54 Gy Macroscopic inguinal nodes (CTV_I) Boost 57 Gy Pelvic nodes Positive pelvic nodal dissection 54 Gy Pelvic nodes Negative pelvic nodal dissection No RT Inguinal nodes High-risk disease (≥2 nodes, extracapsular spread, or gross disease) 54 Gy (boost to 57 Gy if gross) Inguinal nodes Low-risk (1 node, no extracapsular spread) 45 Gy Prepubic fat All patients 54 Gy Common iliac If pelvic disease at dissection 54 Gy (boost if gross disease)

30. ( InPACT ) Trial penis - POST OP DOSE TRAGET COVERGAE 13 th NOV 2025/PENIS Sian Cooper/IJROBP/2025

31. CONSTRAINTS IN ABDOMINAL RT- SOLITARY KIDNEY 14 th NOV 2025/OAR SILVIA BISELLO/CURRENT ONCOLOGY/2022

32. 🎗 " Breathe with Care" – Lung Cancer Awareness 🎗 15 th NOV 2025/ PUBLIC CHAT GPT Inhale hope, exhale the fear, Lung cancer signs — let’s keep them clear. A cough that stays, breath that’s tight, Check it early, win the fight . Smoking, smog, and toxic air, Take a stand — show you care. This November, spread the word, Let every breath of life be heard. Every breath is a battle cry, For those who fight, and those who die. Smoke and silence steal the years, But hope still rises through the tears . It's not just lungs — it's life at stake, So raise your voice, be wide awake. November calls — stand tall, stand true, The fight for lungs begins with you