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Workshop:Liver Pancreas and Upper GI Oligometastases Imaging and SBRT Nov 20-22, 2025Faculty:Jelena LukovicLaura DawsonNicole HarnettCase Description:60 year gentleman with a history of hepatitis C cirrhosis, treated with Harvoni. Child Pugh 5A liver function. Lesion in segment 4B was identified on CT and radiographically consistent with hepatocellular carcinoma. After discussion with the patient and presentation at our MCC, a decision was made to proceed with SBRT. The CT report is summarized below: There is an arterial enhancing mass with washout in segment 4B, size currently 5.2 x 3.6 cm. The mass demonstrates washout and encases a branch of the left portal vein which is thrombosed. Differential attenuation of the thrombus between the proximal and distal vessel (series 18 image 50) suspicious for tumor thrombus centrally. The mass has broad-based contact with the anterior wall of the gallbladder; gallbladder serosal invasion is possible, but no frank intraluminal invasion is evident at this time. Contour Homework:• Liver on Slice 77• Gallbladder on Slice 77• Duodenum on Slice 77• CommonBileDuct on Slice 77• V_Portal_L on Slice 59• V_Portal_R on Slice 59• V_VenaCava_I on Slice 59• A_Aorta on Slice 59• Stomach on Slice 77• GTVp on Slices 65, 77• GTVpv on Slice 65 Disabled Contours: All contours disabledEnabled Contours: NoneResource Files:- Vignette- EduCase Training Video: How to contour, complete the homework, and save/submit- EduCase User Guide
Workshop:Liver Pancreas and Upper GI Oligometastases Imaging and SBRT Nov 20-22, 2025Faculty:Jelena LukovicLaura DawsonNicole HarnettCase Description:57 year-old woman with unresectable pancreatic adenocarcinoma status post 7 cycles of FOLFIRINOX and 4 cycles of gemcitabine/cisplatin. Local progression of pancreatic mass in the body of the pancreas with a CA 19-9 of 31,000. Primovist liver MRI demonstrates no hepatic metastases.The multiphasic pancreas protocol CT report is summarized below: Pancreatic body heterogeneous mass with duct obstruction, difficult to assess due to abnormal pancreatic body and tail with associated pancreatitis and inflammation. Extrapancreatic soft tissue abuts the posterior aspect of stomach, encases the splenic vein and portal splenic confluence with complete attenuation of the splenic vein and calibre change of the portal splenic confluence. There is hazy attenuation abutting the anterior superior mesenteric artery and soft tissue attenuation encases the splenic artery, common hepatic artery, and distal celiac artery. Para-aortic node abutting splenic artery measures up to 1.1 cm, suspicious.Contour Homework: • GTVp on Slices 84• Stomach on Slices 84• Duodenum on Slices 84• Gallbladder on Slices 84• Aorta on Slices 86• Celiac_Artery on Slices 86• Splenic_Artery on Slices 86• CommonHepatic_Artery on Slices 86• Portal_Vein on Slices 86• IVC on Slices 86• GTVn on Slices 76Disabled Contours: All contours disabledEnabled Contours: NoneResource Files:- Vignette- EduCase Training Video: How to contour, complete the homework, and save/submit- EduCase User Guide
Workshop:Liver Pancreas and Upper GI Oligometastases Imaging and SBRT Nov20-22, 2025Faculty:Jelena LukovicLaura DawsonNicole Harnett Case Description:59 yo woman with metastatic myoepithelial carcinoma of right parotid gland with a new oligometastases in segment 2 in the liver. MCC recommendation is to proceed with SBRT to the liver and to preserve limited systemic therapy options for the future. The radiologist describes this as a segment 2/3 metastasis measuring 6.4 x 7.2 cm.Contour Homework:• Stomach on Slices 92,104• Duodenum on Slice 104• LargeBowel on Slice 104• Liver on Slices 92,104• GTVm on Slice 92• portalV on Slice 92Disabled Contours: All contours disabledEnabled Contours: NoneResource Files: - Vignette- EduCase Training Video: How to contour, complete the homework, and save/submit- EduCase User Guide
