- College: University of Washington
- Medical School: University of Washington School of Medicine
- Internship: Deaconess Medical Center
- Residency: University of Washington School of Medicine
Rizwan Nurani, MD is a board certified radiation oncologist who trwats patients with a wide range of cancers. Dr. Nurani, MD is a board certified radiation oncoogist who treats patients with a wide range of cancers. Dr. Nurani maintains the highest level of expertise on leading edge technologies and therapies to offer his patients the best possible care.
Dr. Nurani’s expertise in radiation treatment approaches includes stereotactic radiosurgery, intraoperative adaptive brachytherapy, external beam treatments with intensity modulation (IMRT), image-guided radiation therapy (IGRT), and the placement of radioprotective materials (SpaceOAR).
Our Cancer Care Technologies
Computer Tomography (CT) Scanning & Simulation allows the cancer specialists to design a treatment plan specifically for the patient based on the size, location, and shape of the tumor. The patient will have three-dimensional images (CT Scans) taken. These are used with the treatment planning software that helps determine how to best deliver the radiation beams while reducing damage to surrounding areas. In some cases, it may be necessary to mark the patient’s skin with a tiny marker so that the patient is perfectly realigned in the correct position for every session of radiation therapy. The need for a temporary or permanent marker will be discussed with the patient before the simulation.
Intensity- Modulated Radiation Therapy (IMRT)
Intensity-modulated radiation therapy (IMRT) is an advanced form of external radiation treatment that allows precise targeting of tumor cells. The CT simulator localization scan or other three-dimensional images provide the radiation oncologist with an understanding of the shape and location of the tumor. With 3D planning, the radiation oncologist specifies the dose from various beams and sums up those doses to calculate the dose to tumor and normal tissue (forward planning). With IMRT, the radiation oncologist specifies the dose desired to give the tumor and the doses acceptable to the normal tissues (as low as possible). Then the computer system provides millions of alternative beam positions and the varying intensities of each beam, comparing one plan to the next until the best plan is identified. This is called inverse planning. Since each beam is broken up into many sub-beams of varying intensity the process is called intensity-modulated radiation.
Image Guided Radiation Therapy (IGRT)
Image-Guided Radiation Therapy (IGRT) combines three-dimensional images, such as CT scans, with the precise technology of either 3-D or intensity-modulated radiation therapy (IMRT) to pinpoint and treat cancerous tumors. The images allow the cancer specialists to precisely localize the tumor each time radiation therapy is administered. This improves both accuracy of delivery and safety by reducing radiation exposure to other areas of the body including nearby tissue and organs. IGRT is used to treat tumors in areas of the body that are prone to movement, such as the lungs, liver, and prostate gland, as well as tumors located close to critical organs and tissues.
Cone Beam CT
Cone Beam CT is typically used to map the tumor in the oral cavity, or to check for dental decay or periodontal disease that must be addressed before the start of radiation treatment. The machine produces a cone-shaped x-ray beam that is rotated around the head to produce three-dimensional images of the patient’s teeth, bones, nerve pathways, and soft tissues. A cone beam CT is not the same as a conventional CT, but the images produced are very similar.
Calypso® 4D Localization System
The Calypso® treatment system finds and tracks the position of the prostate or lung tumor throughout radiation treatments. Since the prostate or lung tumor can move with breathing or the filling of the bladder or rectum, it is sometimes necessary to track organ or tumor movement in real-time and turn the radiation on and off depending upon whether the target is in the right place. The system works by implanting a tiny Calypso coil into the organ. The device is energized by an external magnetic field which causes the coil to send out a radio signal that can be located by the same external device that creates the magnetic field. This is similar to the GPS systems used in cars, but on a much more local scale. The process provides the ability to view the location and movement of the prostate or lung tumor. With this precise view of the location, adjustments can be made to the direction of the radiation beams during treatment, or the beam can be turned down if the radiation cannot track the tumor.
SpaceOAR® Hydrogel is used to protect the rectum from radiation exposure during prostate cancer treatment. It is a temporary, injectable gel that is placed between the prostate and rectum, acting as a spacer. It pushes the rectum away from the prostate, out of the area where radiation will be administered. SpaceOAR Hydrogel is injected as a liquid and solidifies into a soft, gel-like synthetic material that expands and creates the necessary space of about ½ to 1 cm. It is absorbed over three months and the prostate moves back to its original position.
Low-Dose Rate (LDR) Brachytherapy
Low-dose rate (LDR) brachytherapy delivers radiation using a radioactive device or implant placed inside the body. The device delivers a low dose of radiation to a limited area over a period of 20 to 50 hours. It is one of the most focused, precise forms of radiation therapy and spares much of the surrounding tissue. LDR can be used to treat various cancer sites, such as prostate, uterus, or cervix.