When looking for a place to spend my professional volunteer time, the Cadence Proton Cancer Center in Warrenville, IL was

kind enough to accept my offer to spend extended time with them. Ideally 20% of my internship would have been spent with the proton center but due to a merger, only 15% of the time was available to spend there. Although I learned a TON about contouring and fusing, which is irreplaceable, I was not able to see any proton planning. So, during the last 6 weeks of my internship, I spent 4 extra hours a week volunteering my time to further my professional development, and experience proton treatment planning. I also continued to contour and fuse in Velocity, pictured at the bottom of this document. The first picture illustrates a fusion in Velocity of a prostate patient who has undergone both a computed tomography (CT) and a magnetic resonance imaging study (MRI). These two are fused together, allowing better contouring. Soft tissue structures, like the penile bulb, are more easily viewed on an MRI, thus the fusion allows for a more accurate localization of important, less dense, anatomy. The second image is a brain case. This patient has undergone both a CT and MRI for diagnostic and contouring purposes. During the time I volunteered at the proton center, I learned a great deal about general contouring, but I was also introduced to some anatomically tricky contouring. Illusive structures are fervent in the brain. MRIs are ideal when identifying the hippocampus and the optic chiasm. As provided in the image, CT and MRI images make very different data available, even in a more standard and obvious structure like the brain stem, the MRI allows for an ease and confidence in contouring. In the third image, brain contouring has been illustrated. When contouring for a proton plan, anatomy not typically required, is contoured. Due to the stopping power and the energy deposition, proton planning demands enhanced evaluation of an increased number of structures. The temporal lobes in the third image are a prime example of structures less often required in contouring. Although it was difficult to choreograph my schedule to include this continued availability in clinic, it was extremely beneficial. I was able to learn more due to a lack of responsibility during these hours. These hours were delegated to learning from my peers and mentors, and trying out my new skills. This time was even more beneficial because it was not an assignment, but time volunteered. This showed my proactive nature and enthusiasm for learning. I am greatly

appreciative to those who allowed me to observe and ask questions, and to those who took time to enhance my education.

Figure 1. Axial, sagittal, and coronal view of a prostate patients fused CT (primary) and MRI (secondary) studies.

Figure 2. Transverse slice of a brain patients CT (primary) and MRI (secondary).

Figure 3. Contours drawn on a brain patient in the transverse, sagittal, and coronal views.