Medical Physicist at St George Cancer Center, Sydney. Special interest in brachytherapy. Opinions are my own and not the views of my employer

Sydney, New South Wales
Joined September 2019
The potential underlying physics here makes sense. High Z material adjacent to OAR = โฌ†๏ธ prob of photoelectric effect
Can a simple finding on CT predict tox after prostate SBRT? Excited to share our newly published study! Pts with periurethral calcifications had higher risk of developing acute gr2+ gu tox. A simple, cost-free biomarker that warrants further study. ๐Ÿ”— doi.org/10.1016/j.ctro.2026.โ€ฆ
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Could we further reduce radiation-induced lymphopenia by using SABR to < irradiated volumes and # fx where appropriate, while optimising plans to reduce circulating blood dose? An important consideration as RT and immunotherapy become increasingly integrated.
Nice work! Study shows more RT fx > more lymphocyte depletion > worse OS. Palliative RT setting, but relevant to definitive/SBRT. Post-RT lymphocyte = underutilized biomarker IMO (though cheap, routinely collected) but increasingly important w more RT/IO integration. @OncoAlert
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Critical trial, ProtecT, shows surgery and radiotherapy have equal cancer control. Favorable sexual preservation and less incontinence with radiation #pcsm #prostatecancer #ASTRO26
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Always intrigued by brachy studies published with such high toxicity, as weโ€™ve seen in other studies it can be much better. doi.org/10.1016/j.ijrobp.202โ€ฆ doi.org/10.1016/j.radonc.202โ€ฆ What drives these differences? Hoping we can answer via ENCOMPASS registry encompassbrachy.org/
Iโ€™ve been saying this for yearsโ€ฆ Now we have randomized data. GETUG P05: brachytherapy boost vs dose-escalated EBRT in intermediate-risk prostate cancer. Oncologic outcomes similar but far more toxicity with brachy. #ASTRO26 #ProstateCancer @ASTRO_org @NehaVapiwala @AmarUKishan @DrAndrewLoblaw @seanmmcbride @HimanshuNagarMD @TylerSbrt @seanmmcbride @alison_tree @Soum_Roy_RadOnc @NicholasZaorsky @angela_jia_
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This will be a game changer for oligometastatic SBRT
Replying to @DrSpratticus
#astro26 Can treat multi target liver to 10 Gy in single breath hold of ~20 sec. Speed like never before. Thanks to our clinical trials, physics, RTTs, dosimetrists, physicians and the whole team for the immense work that went into to being one of the only sites in the world to already have this technology!
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Fascinating! In a world where submissions to journals are tending towards work performed with assistance from AI, the responsibility of reviewers and AEs has never been greater. If ever there was an argument for improved recognition of this service, this is it!
Terence Tao, one of the most well known mathematicians, speaks up on AI in mathematics in his new paper: โ€œWhat if an AI tool generates a lengthy proof that is verified to be correct, but which nobody โ€” ๐˜ฏ๐˜ฐ๐˜ต ๐˜ฆ๐˜ท๐˜ฆ๐˜ฏ ๐˜ต๐˜ฉ๐˜ฆ ๐˜ฉ๐˜ถ๐˜ฎ๐˜ข๐˜ฏ๐˜ด ๐˜ธ๐˜ฉ๐˜ฐ ๐˜ฑ๐˜ณ๐˜ฐ๐˜ฎ๐˜ฑ๐˜ต๐˜ฆ๐˜ฅ ๐˜ต๐˜ฉ๐˜ฆ ๐˜ต๐˜ฐ๐˜ฐ๐˜ญ โ€” understands? This is no longer hypothetical. Sites devoted to collecting mathematical problems already contain dozens of AI-generated proof submissions. Many of these are likely to be correct; but in a substantial number of cases no human expert has yet volunteered to verify and vouch for them, and in several cases the human submitters have themselves declared that they are not qualified to do so. We may soon be faced with the very real possibility of a verified proof of a major result that NO HUMAN understands well enough to explain. For a proof to actually contribute to its field, then, it is NOT enough for it to be correct, and NOT enough for it to be readable. It also needs to be accepted and valued by the community: other mathematicians need to ๐—ฑ๐—ถ๐—ด๐—ฒ๐˜€๐˜ ๐˜๐—ต๐—ฒ ๐—ฟ๐—ฒ๐˜€๐˜‚๐—น๐˜ ๐—ฎ๐—ป๐—ฑ ๐—ถ๐—ป๐—ฐ๐—ผ๐—ฟ๐—ฝ๐—ผ๐—ฟ๐—ฎ๐˜๐—ฒ ๐—ถ๐˜ ๐—ถ๐—ป๐˜๐—ผ ๐˜๐—ต๐—ฒ๐—ถ๐—ฟ ๐—ผ๐˜„๐—ป ๐˜„๐—ผ๐—ฟ๐—ธ. Our current publication infrastructure relies on human editors and referees to provide this acceptance, voluntarily and largely without credit. This work is routinely regarded as less prestigious than the work of generating proofs in the first place; but it is an essential component of the profession, and it is precisely the mechanism by which the individual achievements of mathematicians are converted into collective progress and understanding. Finally, even publication is not the last stage. Key results should ultimately become part of the definitive textbooks and reference material of their subject, in the form in which ๐˜๐—ต๐—ฒ๐˜† ๐—ฎ๐—ฟ๐—ฒ ๐˜๐—ฎ๐˜‚๐—ด๐—ต๐˜ ๐˜๐—ผ ๐˜๐—ต๐—ฒ ๐—ป๐—ฒ๐˜…๐˜ ๐—ด๐—ฒ๐—ป๐—ฒ๐—ฟ๐—ฎ๐˜๐—ถ๐—ผ๐—ป ๐—ผ๐—ณ ๐˜€๐˜๐˜‚๐—ฑ๐—ฒ๐—ป๐˜๐˜€. This process of canonicalization is the slowest stage of all. It requires broad, deliberative consensus, and it is the stage least amenable to optimization by AI tools.โ€ ๐Ÿ“ Terence Tao concludes: โ€œWe will transition from an era of proof scarcity to an era of proof abundance. Most of our institutions โ€” journals, priority conventions, hiring and promotion criteria, prizes, the very notion of a research program โ€” were designed under the assumption of scarcity, and it should not surprise us if they behave poorly under abundance. In some areas, particularly in education and in the training of young mathematicians, it will be crucial to emphasize ๐˜๐—ต๐—ฒ ๐—ถ๐—ฟ๐—ฟ๐—ฒ๐—ฑ๐˜‚๐—ฐ๐—ถ๐—ฏ๐—น๐˜† ๐—ต๐˜‚๐—บ๐—ฎ๐—ป ๐—ฎ๐˜€๐—ฝ๐—ฒ๐—ฐ๐˜ of our work, and to restrict the use of AI tools quite tightly; the goal of training a mathematician is NOT achieved by producing correct homework. In other areas, we will need to take the initiative on AI usage, and define best practices for incorporating these tools into our workflows on our own terms rather than on terms set for us by vendors.โ€ __ [I highlighted & capitalized words in the text for clarity]
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๐ŸŒ Today is World Brachytherapy Awareness Day. Proud to work alongside an incredible multidisciplinary team delivering brachytherapy and helping advance patient care through research, innovation and collaboration. #ThisIsBrachytherapy
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Joel Poder retweeted
Local salvage therapies alone for #ProstateCancer recurrence after radiotherapy maintained >75% androgen deprivation therapyโ€“free survival at 2 years with manageable rates of severe adverse events, supporting their use in selected patients. ja.ma/4aQLVz6
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๐ŸŽ—๏ธ 20 Days Until #BrachytherapyAwarenessDay ๐ŸŒธ Interventional Radiotherapy for Breast Cancer Accelerated Partial Breast Irradiation (APBI) with HDR #Brachytherapy ๐Ÿ“Š 10-Year GEC-ESTRO Results: ๐ŸŽฏ Local recurrence: 2.5% โค๏ธ Overall survival: 95% ๐Ÿ˜Š Excellent cosmetic outcome: >85% ๐Ÿ›ก๏ธ Acute Grade โ‰ฅ2 toxicity: 5% ๐Ÿ’ก Precise treatment. ๐Ÿ›ก๏ธ Less healthy tissue irradiated. โณ Shorter treatment. โค๏ธ Better quality of life. #Interventional_Radiotherapy #BreastCancer #APBI #HDRBrachytherapy #RadiationOncology #PrecisionMedicine #ThisIsBrachytherapy @oncodaily @UroGec @OncoDailyRT
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Loved to see this: ๐Ÿ”ฅBringing Biology to Brachy๐Ÿ”ฅ At the Annual Meeting of the @AmericanBrachy Society, co-sponsored by @RRS_RadRes, organized by @SMarkovina2 in #LosAngeles๐Ÿ™ "Lost in Translation"๐Ÿ˜‰ americanbrachytherapy.org/meโ€ฆ We should do more of these #radbio collaborationsโ€ผ๏ธ
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Fantastic long term data for HDR boost. Very interesting to see lower side effect profile for TRUS based over CT based planning. More confidence in contouring or greater certainty in needle positioning at time of treatment? @agomeziturriaga @KamravaMD
ยกOtro gran trabajo en #ESTRO2026! Compartimos los resultados a largo plazo de la braquiterapia HDR boost en cรกncer de prรณstata (TC based vs TRUS). Datos robustos con mรกs de 10 aรฑos de seguimiento medio que avalan un excelente control y supervivencia de los pacientes.
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Happy to share that the first manuscript from the ENCOMPASS prostate brachytherapy consortium has now been published in @BrachyJournal sciencedirect.com/science/arโ€ฆ @PBlanchardMD @MarioTerlizziFR @agomeziturriaga @DrAmanTaggar @ArjitB_medphys
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This type of work is helping inform the development of larger international collaborative initiatives under ENCOMPASS, focused on outcomes, workflows, imaging, dosimetry, and quality assurance in prostate brachytherapy.
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Huge thank you to all collaborators, participating institutions, and international brachytherapy societies who helped distribute and support the survey. Publication available here: authors.elsevier.com/sd/artiโ€ฆ #Brachytherapy #RadiationOncology #MedicalPhysics #RadOnc
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I do wonder for these IR patients getting brachytherapy that LDR is a better option. Our institutional BCR are lower than whatโ€™s been reported. Of course this is also single site - our ENCOMPASS consortium is working on a prospective registry to collect this data internationally
We've applied to pool data from our site and NRG 0232 (LDR +/- EBRT) and 0538 (SBRT arm). Stay tuned!
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This is the type of data we need! Really hope to get this off the ground in Australia
For unfavourable risk prostate cancer, @CDNCancerTrials #PR24 is accruing and is just about to randomize patient 200!
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Congratulations @cristian_udo and co-authors on putting this together. Hard to take too much away given the differences in how toxicity was collected amongst SBRT studies and only 1 brachytherapy trial included from single site. We need more data before making conclusions
Curious about whether #SBRT or #brachy is better treatment for intermediate risk prostate cancer? See @cristian_udo @JAMANetworkOpen article just posted! JAMANetworkOpen.2026;9(2):e260146. doi:10.1001/jamanetworkopen.2026.0146 @DrSpratticus @AmarUKishan @nickva1 @alison_tree
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