Peter Attia· MD
we were on the at the end of the old era we didn't even use CT planning we just had a couple of orthogonal films and we were literally drawing our tumor volumes out with a grease pencil on a physical X-ray and cutting and using that cutout to go trace a styrofoam negative and make a metal or a lead alloy block which you would slide this basically this aperture in the path the path of the beam that's the way it was done for decades and so we were still doing that when I started residency but by the end of residency we had full-on CT planning where now we're doing a full CT scan doing everything virtually and of course it's far more precise and you can model basically you can model multiple different iterations okay do I want a beam coming in from this angle do I want to bring in a an orthogonal beam from here do I want to u uh block out a little bit more of the chest wall to get the heart dose down i can see all that stuff now so we by the time I finished residency we were basically doing what we do now albeit with much slower computers and and you know just being in the infancy of that it was probably more like 20 to 30 minutes per patient but the last 15 years roughly to answer your question things have been much more automated and instead of having lead blocks that you're sliding into the path of the beam now everything is shaped in the head of the beam by our computer so you hit a button and when I've already programmed the the the uh treatment pro the treatment planning values the machine knows how to shape the beam to match the aperture of whatever you're trying to do so that's all fully automatic now