Plan is Approved with Jeff and Jibin
Sep 17, 2026 · 47 min · 12 segments
On this episode of *Plan is Approved*, we have the privilege of speaking with Brennan Diedrich, an expert Proton Dosimetrist. We cover two crucial topics: First, Brennan breaks down the complexities…
Brennan DiedrichGuestJibinHostJeffHostI'm going to admit this right now.
So all the cool things that I hear, Braxpeak and Heavy Adam, all that.
So tell us from a dosimetric perspective, right? I'm a dosimetry, so I understand that.
Yeah, it's essentially 3D planning, but no exit dose is kind of how I like to think about things.
We'd like to use, you know, if you're doing 3D planning because of that exit dose, you really try to like skim things as much as possible.
But with Protons, you want to be like as on FOSS as you possibly can with anything.
So it's like that combination of electron planning almost, except you have depth that you can go to.
And so the biggest thing about proton planning is uncertainty with the range.
So anytime that there's like air pockets in the bowel, I mean, you plant a prostate patient and, you know, we always talk about having an empty rectum.
And all of that air that's in the rectum, we have to override to muscle because if we plan and it's like, all right, while we're planning this, we're going to assume that there's air there.
And so we really got to be more conscious of the kind of anatomy changes from a day to day basis.
Cause like we tend to use lateral beams for our prostate, uh, 90 degree and a two 70 and you know, you're shooting right through the femoral heads.
I'm going to admit this right now.
So all the cool things that I hear, Braxpeak and Heavy Adam, all that.
So tell us from a dosimetric perspective, right? I'm a dosimetry, so I understand that.
Yeah, it's essentially 3D planning, but no exit dose is kind of how I like to think about things.
We'd like to use, you know, if you're doing 3D planning because of that exit dose, you really try to like skim things as much as possible.
But with Protons, you want to be like as on FOSS as you possibly can with anything.
So it's like that combination of electron planning almost, except you have depth that you can go to.
And so the biggest thing about proton planning is uncertainty with the range.
So anytime that there's like air pockets in the bowel, I mean, you plant a prostate patient and, you know, we always talk about having an empty rectum.
And all of that air that's in the rectum, we have to override to muscle because if we plan and it's like, all right, while we're planning this, we're going to assume that there's air there.
And so we really got to be more conscious of the kind of anatomy changes from a day to day basis.
Cause like we tend to use lateral beams for our prostate, uh, 90 degree and a two 70 and you know, you're shooting right through the femoral heads.
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