bluuebunny/crossref_metadata_2025 huggingface dataset:
SU‐F‐BRB‐06: Validation of Dose Calculation for Helical Tomotherapy with a Rigidly Moving Object
Authors: Chao E , Lucas D , Beneke M , Casey D , Henderson D , Homp J , Kammeyer T , Lai S , Mauer C , O'Connell R , Schnarr E
Published: June 2015

Purpose:

To validate dose calculations in a rigidly moving object.

Methods:

An off‐line version of the TomoTherapy™ dose calculation software was extended to allow dose calculation for rigidly moving objects. The interface allows users to extract the necessary data from TomoTherapy patient archives to perform an off‐line dose calculation, and to specify arbitrary translational motion by creating a text file with a column for time, and columns for x, y, and z translations. Film measurements were performed using a phantom that was rigidly moved with the same motion profile as used in the calculation. A variety of motion profiles were studied and the motion profiles were applied to delivery plans with varying field sizes (1, 2.5, and 5 cm) and with dynamic jaws and static jaws.

Results:

Calculations matched measurements to within 2% or 1 mm for the variety of motion profiles studied. A 4‐mm step motion in the longitudinal (IEC‐Y) direction timed to occur halfway through a 1 cm field‐width delivery resulted in a 29% decrease in both the calculated dose and measured dose in a central region of the dose profile. For a 5 cm field‐width dynamic jaw delivery, the 4 mm step motion resulted in a more broadly distributed reduction in dose of 8%. A 6 mm sinusoidal motion in the longitudinal direction with a 6 second period had a negligible impact on delivered dose for one particular delivery plan. Similarly, a step motion in the transverse direction (IEC‐X) had a negligible impact on delivered dose other than to shift the dose volume.

Conclusion:

A research version of the TomoTherapy™ dose calculator can accurately calculate dose for a rigidly moving object. Further studies with more clinical motion traces and with clinical treatment delivery plans will yield valuable insight into the impact of motion on the delivered dose.
MO‐AB‐BRA‐02: A Novel Scatter Imaging Modality for Real‐Time Image Guidance During Lung SBRT
Authors: Redler G , Bernard D , Templeton A , Nair C Kumaran , Turian J , Chu J
Published: June 2015

Purpose:

A novel scatter imaging modality is developed and its feasibility for image‐guided radiation therapy (IGRT) during stereotactic body radiation therapy (SBRT) for lung cancer patients is assessed using analytic and Monte Carlo models as well as experimental testing.

Methods:

During treatment, incident radiation interacts and scatters from within the patient. The presented methodology forms an image of patient anatomy from the scattered radiation for real‐time localization of the treatment target. A radiographic flat panel‐based pinhole camera provides spatial information regarding the origin of detected scattered radiation. An analytical model is developed, which provides a mathematical formalism for describing the scatter imaging system. Experimental scatter images are acquired by irradiating an object using a Varian TrueBeam accelerator. The differentiation between tissue types is investigated by imaging simple objects of known compositions (water, lung, and cortical bone equivalent). A lung tumor phantom, simulating materials and geometry encountered during lung SBRT treatments, is fabricated and imaged to investigate image quality for various quantities of delivered radiation. Monte Carlo N‐Particle (MCNP) code is used for validation and testing by simulating scatter image formation using the experimental pinhole camera setup.

Results:

Analytical calculations, MCNP simulations, and experimental results when imaging the water, lung, and cortical bone equivalent objects show close agreement, thus validating the proposed models and demonstrating that scatter imaging differentiates these materials well. Lung tumor phantom images have sufficient contrast‐to‐noise ratio (CNR) to clearly distinguish tumor from surrounding lung tissue. CNR=4.1 and CNR=29.1 for 10MU and 5000MU images (equivalent to 0.5 and 250 second images), respectively.

Conclusion:

Lung SBRT provides favorable treatment outcomes, but depends on accurate target localization. A comprehensive approach, employing multiple simulation techniques and experiments, is taken to demonstrate the feasibility of a novel scatter imaging modality for the necessary real‐time image guidance.
MO‐AB‐BRA‐09: Temporally Realistic Manipulation a 4D Biomechanical Lung Phantom for Evaluation of Simultaneous Registration and Segmentation
Authors: Markel D , Levesque I R. , Larkin J , Leger P , El Naqa I
Published: June 2015

Purpose:

To produce multi‐modality compatible, realistic datasets for the joint evaluation of segmentation and registration with a reliable ground truth using a 4D biomechanical lung phantom. The further development of a computer controlled air flow system for recreation of real patient breathing patterns is incorporated for additional evaluation of motion prediction algorithms.

Methods:

A pair of preserved porcine lungs was pneumatically manipulated using an in‐house computer controlled respirator. The respirator consisted of a set of bellows actuated by a 186 W computer controlled industrial motor. Patient breathing traces were recorded using a respiratory bellows belt during CT simulation and input into a control program incorporating a proportional‐integral‐derivative (PID) feedback controller in LabVIEW. Mock tumors were created using dual compartment vacuum sealed sea sponges. 65% iohexol,a gadolinium‐based contrast agent and 18F‐FDG were used to produce contrast and thus determine a segmentation ground truth. The intensity distributions of the compartments were then digitally matched for the final dataset. A bifurcation tracking pipeline provided a registration ground truth using the bronchi of the lung. The lungs were scanned using a GE Discovery‐ST PET/CT scanner and a Phillips Panorama 0.23T MRI using a T1 weighted 3D fast field echo (FFE) protocol.

Results:

The standard deviation of the error between the patient breathing trace and the encoder feedback from the respirator was found to be ±4.2%. Bifurcation tracking error using CT (0.97×0.97×3.27 mm3 resolution) was found to be sub‐voxel up to 7.8 cm displacement for human lungs and less than 1.32 voxel widths in any axis up to 2.3 cm for the porcine lungs.

Conclusion:

An MRI/PET/CT compatible anatomically and temporally realistic swine lung phantom was developed for the evaluation of simultaneous registration and segmentation algorithms. With the addition of custom software and mock tumors, the entire package offers ground truths for benchmarking performance with high fidelity.
MO‐AB‐207‐03: ACR Update in Nuclear Medicine
Authors: Harkness B.
Published: June 2015

A goal of an imaging accreditation program is to ensure adequate image quality, verify appropriate staff qualifications, and to assure patient and personnel safety. Currently, more than 35,000 facilities in 10 modalities have been accredited by the American College of Radiology (ACR), making the ACR program one of the most prolific accreditation options in the U.S. In addition, ACR is one of the accepted accreditations required by some state laws, CMS/MIPPA insurance and others. Familiarity with the ACR accreditation process is therefore essential to clinical diagnostic medical physicists. Maintaining sufficient knowledge of the ACR program must include keeping up‐to‐date as the various modality requirements are refined to better serve the goals of the program and to accommodate newer technologies and practices. This session consists of presentations from authorities in four ACR accreditation modality programs, including magnetic resonance imaging, computed tomography, nuclear medicine, and mammography. Each speaker will discuss the general components of the modality program and address any recent changes to the requirements.

Learning Objectives:

To understand the requirements of the ACR MR Accreditation program. The discussion will include accreditation of whole‐body general purpose magnets, dedicated extremity systems well as breast MRI accreditation. Anticipated updates to the ACR MRI Quality Control Manual will also be reviewed.

To understand the requirements of the ACR CT accreditation program, including updates to the QC manual as well as updates through the FAQ process.

To understand the requirements of the ACR nuclear medicine accreditation program, and the role of the physicist in annual equipment surveys and the set up and supervision of the routine QC program.

To understand the current ACR MAP Accreditation requirement and present the concepts and structure of the forthcoming ACR Digital Mammography QC Manual and Program.
MO‐AB‐201‐01: Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra‐223
Authors: Phillips L.
Published: June 2015

The role of the Radiation Safety Officer at a medical facility can be complicated. The complexity of the position is based on the breadth of services provided at the institution and the nature of the radioactive materials license. Medical practices are constantly changing and the use of ionizing radiation continues to rise in this area. Some of the newer medical applications involving radiation have unique regulatory and safety issues that must be addressed. Oversight of the uses of radiation start at the local level (radiation safety officer, radiation safety committee) and are heavily impacted by outside agencies (i.e. Nuclear Regulatory Commission, State Radiologic Health, The Joint Commission (TJC), etc).

This session will provide both an overview of regulatory oversight and essential compliance practices as well as practical ways to assess and introduce some of the new applications utilizing radioactive materials into your medical facility.

Learning Objectives:

Regulatory Compliance and Safety with New Radiotherapies: Spheres and Ra‐223 (Lance Phillips)

Understand the radioactive materials license amendment process to add new radiotherapies (i.e., SIR‐Spheres, Therasphere, Xofigo).

Understand the AU approval process for microspheres and Xofigo.

Examine the training and handling requirements for new procedures.

Understand the process involved with protocol development, SOP in order to define roles and responsibilities.

The RSO and The RSC: Challenges and Opportunities (Colin Dimock)

Understand how to form an effective Committee.

Examine what the Committee does for the Program and the RSO.

Understand the importance of Committee engagement.

Discuss the balance of the complimentary roles of the RSO and the Committee.

The Alphabet Soup of Regulatory Compliance: Being Prepared for Inspections (Linda Kroger)

Recognize the various regulatory bodies and organizations with oversight or impact in Nuclear Medicine, Radiology and Radiation Oncology.

Examine 10CFR35 requirements as they relate to the everyday practice of Nuclear Medicine and Radiation Oncology.

Understand the nature of available guidance documents (e.g., NUREG 1556).

Examine the commonalities between TJC and CMS preparedness.
MO‐AB‐210‐01: Ultrasound Imaging and Therapy‐Hands On Workshop
Authors: Lu Z.
Published: June 2015

The goal of this ultrasound hands‐on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound.

HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well‐defined regions of necrosis. This completely non‐invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands‐on demonstrations with on‐site instructors at separate stations.

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands‐on environment with live demonstrations of the techniques.

Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high‐intensity focused ultrasound and in diagnostic ultrasound QC.

Learning Objectives:

Learn ultrasound physics and safety for HIFU applications through live demonstrations

Get an overview of the state‐of‐the art in HIFU technologies and equipment

Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging

Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools

List of supporting vendors for HIFU and diagnostic ultrasound QC hands‐on workshop:

Philips Healthcare

Alpinion Medical Systems

Verasonics, Inc

Zonare Medical Systems, Inc

Computerized Imaging Reference Systems (CIRS), Inc.

GAMMEX, Inc.,

Cablon Medical BV

Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32
MO‐AB‐210‐02: Ultrasound Imaging and Therapy‐Hands On Workshop
Authors: Sammet S.
Published: June 2015

The goal of this ultrasound hands‐on workshop is to demonstrate advancements in high intensity focused ultrasound (HIFU) and to demonstrate quality control (QC) testing in diagnostic ultrasound.

HIFU is a therapeutic modality that uses ultrasound waves as carriers of energy. HIFU is used to focus a beam of ultrasound energy into a small volume at specific target locations within the body. The focused beam causes localized high temperatures and produces a well‐defined regions of necrosis. This completely non‐invasive technology has great potential for tumor ablation and targeted drug delivery. At the workshop, attendees will see configurations, applications, and hands‐on demonstrations with on‐site instructors at separate stations.

The involvement of medical physicists in diagnostic ultrasound imaging service is increasing due to QC and accreditation requirements. At the workshop, an array of ultrasound testing phantoms and ultrasound scanners will be provided for attendees to learn diagnostic ultrasound QC in a hands‐on environment with live demonstrations of the techniques.

Target audience: Medical physicists and other medical professionals in diagnostic imaging and radiation oncology with interest in high‐intensity focused ultrasound and in diagnostic ultrasound QC.

Learning Objectives:

Learn ultrasound physics and safety for HIFU applications through live demonstrations

Get an overview of the state‐of‐the art in HIFU technologies and equipment

Gain familiarity with common elements of a quality control program for diagnostic ultrasound imaging

Identify QC tools available for testing diagnostic ultrasound systems and learn how to use these tools

List of supporting vendors for HIFU and diagnostic ultrasound QC hands‐on workshop:

Philips Healthcare

Alpinion Medical Systems

Verasonics, Inc

Zonare Medical Systems, Inc

Computerized Imaging Reference Systems (CIRS), Inc.

GAMMEX, Inc.,

Cablon Medical BV

Steffen Sammet: NIH/NCI grant 5R25CA132822, NIH/NINDS grant 5R25NS080949 and Philips Healthcare research grant C32
MO‐B‐304‐00: Journal of Applied Clinical Medical Physics: Mission and Submission
Authors: Richardson Susan
Published: June 2015

The JACMP began publication in February, 2000 and is the world's oldest open‐access medical specialty journal. Today it publishes about 200 articles in six issues annually. The JACMP archive experiences about 400,000.pdf downloads annually and a typical JACMP.pdf article is downloaded about 600 or 700 times during the first year after publication. Anyone with web access can reach these articles, having wide distribution and benefiting as many patients as possible.

Preparing a manuscript for publication in the JACMP (or any other journal) is a straightforward process. The primary purpose of a manuscript is to communicate knowledge and experience. A relatively fixed format has been developed to meet this goal; this format consists of an Abstract, Introduction, Methods and Materials, Results, and Conclusions. In addition to fitting your experience into that format, it is important to recognize your audience and direct your manuscript to that audience. Finally, it is important to write your manuscript in clear English, enlisting the aid of a copyeditor, if such an individual is available.

Reviewing the articles submitted to JACMP is a rewarding yet difficult task. A reviewer must evaluate submitted articles critically, objectively, and express opinions diplomatically regarding work presented to the journal. A perspective from a JACMP section editor and experienced reviewer will describe the key points that progress a journal article to publication. As a reviewer, the difficulties experienced as a reviewer such as an incomplete or incorrect citations, incorrect formats, etc. will also be described.

Learning Objectives:

Attendees will learn the history and philosophy behind the development of the Journal of Applied Clinical Medical Physics.

After attending this presentation, the participant will be able to prepare a well‐written manuscript suitable for publication in the JACMP or any other peer‐reviewed journal.

Attendees will learn what typical submission mistakes and difficulties are from the perspective of a section editor and experienced article reviewer.
MO‐B‐BRB‐01: Optimize Treatment Planning Process in Clinical Environment
Authors: Feng W.
Published: June 2015

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image‐guided‐radiation‐therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality.

In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include:

Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS.

Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process

Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning

Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment.

Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi‐automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality

Learning Objectives:

Gain familiarity with the workflow of modern treatment planning process.

Understand the scope and challenges of managing modern treatment planning processes.

Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.
MO‐B‐BRB‐02: Maintain the Quality of Treatment Planning for Time‐Constraint Cases
Authors: Chang J.
Published: June 2015

The radiotherapy treatment planning process has evolved over the years with innovations in treatment planning, treatment delivery and imaging systems. Treatment modality and simulation technologies are also rapidly improving and affecting the planning process. For example, Image‐guided‐radiation‐therapy has been widely adopted for patient setup, leading to margin reduction and isocenter repositioning after simulation. Stereotactic Body radiation therapy (SBRT) and Radiosurgery (SRS) have gradually become the standard of care for many treatment sites, which demand a higher throughput for the treatment plans even if the number of treatments per day remains the same. Finally, simulation, planning and treatment are traditionally sequential events. However, with emerging adaptive radiotherapy, they are becoming more tightly intertwined, leading to iterative processes. Enhanced efficiency of planning is therefore becoming more critical and poses serious challenge to the treatment planning process; Lean Six Sigma approaches are being utilized increasingly to balance the competing needs for speed and quality.

In this symposium we will discuss the treatment planning process and illustrate effective techniques for managing workflow. Topics will include:

Planning techniques: (a) beam placement, (b) dose optimization, (c) plan evaluation (d) export to RVS.

Planning workflow: (a) import images, (b) Image fusion, (c) contouring, (d) plan approval (e) plan check (f) chart check, (g) sequential and iterative process

Influence of upstream and downstream operations: (a) simulation, (b) immobilization, (c) motion management, (d) QA, (e) IGRT, (f) Treatment delivery, (g) SBRT/SRS (h) adaptive planning

Reduction of delay between planning steps with Lean systems due to (a) communication, (b) limited resource, (b) contour, (c) plan approval, (d) treatment.

Optimizing planning processes: (a) contour validation (b) consistent planning protocol, (c) protocol/template sharing, (d) semi‐automatic plan evaluation, (e) quality checklist for error prevention, (f) iterative process, (g) balance of speed and quality

Learning Objectives:

Gain familiarity with the workflow of modern treatment planning process.

Understand the scope and challenges of managing modern treatment planning processes.

Gain familiarity with Lean Six Sigma approaches and their implementation in the treatment planning workflow.
MO‐D‐213‐01: Workflow Monitoring for a High Volume Radiation Oncology Center
Authors: Laub S , Dunn M , Galbreath G , Gans S , Pankuch M
Published: June 2015

Purpose:

Implement a center wide communication system that increases interdepartmental transparency and accountability while decreasing redundant work and treatment delays by actively monitoring treatment planning workflow.

Methods:

Intake Management System (IMS), a program developed by ProCure Treatment Centers Inc., is a multi‐function database that stores treatment planning process information. It was devised to work with the oncology information system (Mosaiq) to streamline interdepartmental workflow.Each step in the treatment planning process is visually represented and timelines for completion of individual tasks are established within the software. The currently active step of each patient's planning process is highlighted either red or green according to whether the initially allocated amount of time has passed for the given process. This information is displayed as a Treatment Planning Process Monitor (TPPM), which is shown on screens in the relevant departments throughout the center. This display also includes the individuals who are responsible for each task.IMS is driven by Mosaiq's quality checklist (QCL) functionality. Each step in the workflow is initiated by a Mosaiq user sending the responsible party a QCL assignment. IMS is connected to Mosaiq and the sending or completing of a QCL updates the associated field in the TPPM to the appropriate status.

Results:

Approximately one patient a week is identified during the workflow process as needing to have his/her treatment start date modified or resources re‐allocated to address the most urgent cases. Being able to identify a realistic timeline for planning each patient and having multiple departments communicate their limitations and time constraints allows for quality plans to be developed and implemented without overburdening any one department.

Conclusion:

Monitoring the progression of the treatment planning process has increased transparency between departments, which enables efficient communication. Having built‐in timelines allows easy prioritization of tasks and resources and facilitates effective time management.
MO‐D‐213‐04: The Proximity to the Skin of PTV Affects PTV Coverage and Skin Dose for TomoTherapy
Authors: Reynolds T , Higgins P , Watanabe Y
Published: June 2015

Purpose:

The proximity to the skin surface of the PTV for the patients with skin disease could be a concern in terms of the PTV coverage and actual surface dose (SD). IMRT optimization algorithms increase the beam intensity close to the skin in order to compensate for lack of scattering material, leading to enhanced SD but potential hot spots. This study aims to investigate the effect of PTV proximity to the skin on planning and measured SD

Methods:

All measurements were done for 6 MV X‐ray beam of Helical TomoTherapy. An anthropomorphic phantom was scanned in a CT simulator in a routine manner with thermoplastic mask immobilization. PTVs were created with varying distances to the skin of 0 mm ‐(PTV1), 1 mm‐ (PTV2), 2 mm‐(PTV3) and 3 mm‐(PTV4). Also, a 5 mm bolus was used with PTV1 (PTV5). All planning constraints were kept the same in all studies (hard constraint: 95% of the prescription dose covered 95% of the PTV). Gafchromic film (EBT3) was placed under the mask on the phantom surface, and the resulting dose was estimated using RIT software.

Results:

Optimizing the dose using different PTVs lead to average planned target doses of 10.8, 10.3, 10.2, 10.3 and 10.0 Gy, with maximum doses 12.2, 11.2, 11.1, 11.1 and 10.0 Gy for PTV1, PTV2, PTV3, PTV4 and PTV5, respectively. EBT3 measurements indicated a significant decrease of SD with skin distance by 12.7% (PTV1), 21.9% (PTV2), 24.8% (PTV3) and 28.4% (PTV4) comparing to prescription dose. Placement of a 5 mm bolus on the phantom surface resulted in a SD close to prescribed (+0.5%).

Conclusion:

This work provides a clear demonstration of the relationship between the skin dose and the PTV to the skin distance. The results indicate the necessity of a bolus even for TomoTherapy when high skin dose is required.
MO‐D‐213‐07: RadShield: Semi‐ Automated Calculation of Air Kerma Rate and Barrier Thickness
Authors: DeLorenzo M , Wu D , Rutel I , Yang K
Published: June 2015

Purpose:

To develop the first Java‐based semi‐automated calculation program intended to aid professional radiation shielding design. Air‐kerma rate and barrier thickness calculations are performed by implementing NCRP Report 147 formalism into a Graphical User Interface (GUI). The ultimate aim of this newly created software package is to reduce errors and improve radiographic and fluoroscopic room designs over manual approaches.

Methods:

Floor plans are first imported as images into the RadShield software program. These plans serve as templates for drawing barriers, occupied regions and x‐ray tube locations. We have implemented sub‐GUIs that allow the specification in regions and equipment for occupancy factors, design goals, number of patients, primary beam directions, source‐to‐patient distances and workload distributions. Once the user enters the above parameters, the program automatically calculates air‐kerma rate at sampled points beyond all barriers. For each sample point, a corresponding minimum barrier thickness is calculated to meet the design goal. RadShield allows control over preshielding, sample point location and material types.

Results:

A functional GUI package was developed and tested. Examination of sample walls and source distributions yields a maximum percent difference of less than 0.1% between hand‐calculated air‐kerma rates and RadShield.

Conclusion:

The initial results demonstrated that RadShield calculates air‐kerma rates and required barrier thicknesses with reliable accuracy and can be used to make radiation shielding design more efficient and accurate. This newly developed approach differs from conventional calculation methods in that it finds air‐kerma rates and thickness requirements for many points outside the barriers, stores the information and selects the largest value needed to comply with NCRP Report 147 design goals. Floor plans, parameters, designs and reports can be saved and accessed later for modification and recalculation. We have confirmed that this software accurately calculates air‐kerma rates and required barrier thicknesses for diagnostic radiography and fluoroscopic rooms.
MO‐DE‐304‐00: Workforce Assessment Committee Update
Authors: Mills Michael
Published: June 2015

The Abt study of medical physicist work values for radiation oncology physics services, Round IV is completed. It supersedes the Abt III study of 2008. The 2015 Abt study measured qualified medical physicist (QMP) work associated with routine radiation oncology procedures as well as some special procedures. As before, a work model was created to allow the medical physicist to defend QMP work based on both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The Abt study Round IV was designed to empower the medical physicist to negotiate a service or employment contract with providers based on measured national QMP workforce and staffing data.

For a variety of reasons, the diagnostic imaging contingent of AAPM has had a more difficult time trying estimate workforce requirements than their therapy counterparts. Over the past several years, the Diagnostic Work and Workforce Study Subcommittee (DWWSS) has collected survey data from AAPM members, but the data have been very difficult to interpret. The DWWSS has reached out to include more AAPM volunteers to create a more full and accurate representation of actual clinical practice models on the subcommittee. Though much work remains, through hours of discussion and brainstorming, the DWWSS has somewhat of a clear path forward. This talk will provide attendees with an update on the efforts of the subcommittee.

Learning Objectives:

Understand the new information documented in the Abt studies.

Understand how to use the Abt studies to justify medical physicist staffing.

Learn relevant historical information on imaging physicist workforce.

Understand the process of the DWWSS in 2014.

Understand the intended path forward for the DWWSS.
MO‐D‐BRD‐00: Electronic Brachytherapy
Authors: Culberson Wesley
Published: June 2015

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air‐kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir‐192 sources. Consequently, tissue‐specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations.

Learning Objectives:

To understand the basic principles of electronic brachytherapy and the various applications for which it is being used.

To understand the physics of the calibration and commissioning for electronic brachytherapy sources

To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques

Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.
MO‐D‐BRD‐03: Radiobiology and Commissioning of Electronic Brachytherapy for IORT
Authors: Zhang J.
Published: June 2015

Electronic brachytherapy (eBT) has seen an insurgence of manufacturers entering the US market for use in radiation therapy. In addition to the established interstitial, intraluminary, and intracavitary applications of eBT, many centers are now using eBT to treat skin lesions. It is important for medical physicists working with electronic brachytherapy sources to understand the basic physics principles of the sources themselves as well as the variety of applications for which they are being used. The calibration of the sources is different from vendor to vendor and the traceability of calibrations has evolved as new sources came to market. In 2014, a new air‐kerma based standard was introduced by the National Institute of Standards and Technology (NIST) to measure the output of an eBT source. Eventually commercial treatment planning systems should accommodate this new standard and provide NIST traceability to the end user. The calibration and commissioning of an eBT system is unique to its application and typically entails a list of procedural recommendations by the manufacturer. Commissioning measurements are performed using a variety of methods, some of which are modifications of existing AAPM Task Group protocols. A medical physicist should be familiar with the different AAPM Task Group recommendations for applicability to eBT and how to properly adapt them to their needs. In addition to the physical characteristics of an eBT source, the photon energy is substantially lower than from HDR Ir‐192 sources. Consequently, tissue‐specific dosimetry and radiobiological considerations are necessary when comparing these brachytherapy modalities and when making clinical decisions as a radiation therapy team. In this session, the physical characteristics and calibration methodologies of eBt sources will be presented as well as radiobiology considerations and other important clinical considerations.

Learning Objectives:

To understand the basic principles of electronic brachytherapy and the various applications for which it is being used.

To understand the physics of the calibration and commissioning for electronic brachytherapy sources

To understand the unique radiobiology and clinical implementation of electronic brachytherapy systems for skin and IORT techniques

Xoft, Inc. contributed funding toward development of the NIST electronic brachytherapy facility (Michael Mitch).The University of Wisconsin (Wesley Culberson) has received research support funding from Xoft, Inc. Zoubir Ouhib has received partial funding from Elekta Esteya.
MO‐DE‐BRA‐02: From Teaching to Learning: Systems‐Based‐Practice and Practice‐Based‐Learning Innovations in Medical Physics Education Programs
Authors: Kapur A
Published: June 2015

Purpose:

The increasing complexity in the field of radiation medicine and concomitant rise in patient safety concerns call for enhanced systems‐level training for future medical physicists and thus commensurate innovations in existing educational program curricula. In this work we report on the introduction of three learning opportunities to augment medical physics educational programs towards building systems‐based practice and practice‐based learning competencies.

Methods:

All initiatives were introduced for senior ‐level graduate students and physics residents in an institution with a newly established medical‐physics graduate program and therapeutic‐physics residency program. The first, centered on incident learning, was based on a spreadsheet tool that incorporated the reporting structure of the Radiation Oncology‐incident Learning System (ROILS), included 120 narratives of published incidents and enabled inter‐rater variability calculations. The second, centered on best‐practices, was a zero‐credit seminar course, where students summarized select presentations from the AAPM virtual library on a weekly basis and moderated class discussions using a point/counterpoint approach. Presentation styles were critiqued. The third; centered on learning‐by‐teaching, required physics residents to regularly explain fundamental concepts in radiological physics from standard textbooks to board certified physics faculty members.

Results:

Use of the incident‐learning system spreadsheet provided a platform to recast known accidents into the framework of ROILS, thereby increasing awareness of factors contributing to unsafe practice and appreciation for inter‐rater variability. The seminar course enhanced awareness of best practices, the effectiveness of presentation styles and encouraged critical thinking. The learn‐by‐teaching rotation allowed residents to stay abreast of and deepen their knowledge of relevant subjects.

Conclusion:

The incorporation of systems‐driven initiatives broadens comprehension of the wider systems context of medical physics, enhances awareness of resources for innovation, communication and sustained learning while maintaining a metric‐driven focus on patient safety within the formative phase of student careers. The initiatives were well‐received, feasible, and utilized available or shared‐resources translatable across educational programs.
MO‐DE‐BRA‐03: TOPAS_edu: A Window Into the Stochastic World Through the TOPAS Tool for Particle Simulation
Authors: Perl J , Villagomez‐Bernabe B , Currell F
Published: June 2015

Purpose:

The stochastic nature of the subatomic world presents a challenge for physics education. Even experienced physicists can be amazed at the varied behavior of electrons, x‐rays, protons, neutrons, ions and the any short‐lived particles that make up the overall behavior of our accelerators, brachytherapy sources and medical imaging systems. The all‐particle Monte Carlo particle transport tool, TOPAS Tool for Particle Simulation, originally developed for proton therapy research, has been repurposed into a physics teaching tool, TOPAS_edu.

Methods:

TOPAS_edu students set up simulated particle sources, collimators, scatterers, imagers and scoring setups by writing simple ASCII files (in the TOPAS Parameter Control System format). Students visualize geometry setups and particle trajectories in a variety of modes from OpenGL graphics to VRML 3D viewers to gif and PostScript image files. Results written to simple comma separated values files are imported by the student into their preferred data analysis tool. Students can vary random seeds or adjust parameters of physics processes to better understand the stochastic nature of subatomic physics.

Results:

TOPAS_edu has been successfully deployed as the centerpiece of a physics course for master's students at Queen's University Belfast. Tutorials developed there takes students through a step by step course on the basics of particle transport and interaction, scattering, Bremsstrahlung, etc. At each step in the course, students build simulated experimental setups and then analyze the simulated results. Lessons build one upon another so that a student might end up with a full simulation of a medical accelerator, a water‐phantom or an imager.

Conclusion:

TOPAS_edu was well received by students. A second application of TOPAS_edu is currently in development at Zurich University of Applied Sciences, Switzerland. It is our eventual goal to make TOPAS_edu available free of charge to any non‐profit organization, along with associated tutorial materials developed by the TOPAS_edu community.

Work supported in part by the U.S. Department of Energy under contract number DE‐AC02‐76SF00515. B. Villagomez‐Bernabe is supported by CONACyT (Mexican Council for Science and Technology) project 231844.
MO‐DE‐BRA‐04: The CREATE Medical Physics Research Training Network: Training of New Generation Innovators
Authors: Seuntjens J , Beaulieu L , Collins L , Despres P , Devic S , El Naqa I , Nadeau J , Pike B , Reader A
Published: June 2015

Purpose:

Over the past century, physicists have played a major role in transforming scientific discovery into everyday clinical applications. However, with the increasingly stringent requirements to regulate medical physics as a health profession, the role of physicists as scientists and innovators has become at serious risk of erosion. These challenges trigger the need for a new, revolutionized training program at the graduate level that respects scientific rigor, attention for medical physics‐relevant developments in basic sciences, innovation and entrepreneurship.

Methods:

A grant proposal was funded by the Collaborative REsearch and Training Experience program (CREATE) of the Natural Sciences and Engineering Research Council (NSERC) of Canada. This enabled the creation of the Medical Physics Research Training Network (MPRTN) around two CAMPEP‐accredited medical physics programs. Members of the network consist of medical device companies, government (research and regulatory) and academia. The MPRTN/CREATE program proposes a curriculum with three main themes: (1) radiation physics, (2) imaging & image processing and (3) radiation response, outcomes and modeling.

Results:

The MPRTN was created mid 2013 (mprtn.com) and features (1) four new basic Ph.D. courses; (2) industry participation in research projects; (3) formal job‐readiness training with involvement of guest faculty from academia, government and industry. MPRTN activities since 2013 include 22 conferences; 7 workshops and 4 exchange travels. Three patents were filed or issued, nine awards/best papers were won. Fifteen journal publications were accepted/published, 102 conference abstracts. There are now 13 industry partners.

Conclusion:

A medical physics research training network has been set up with the goal to harness graduate student's job‐readiness for industry, government and academia in addition to the conventional clinical role. Two years after inception, significant successes have been booked, but the true challenge will be to demonstrate that with this training philosophy CREATE scholars gain access to a much broader job market.

Supported by the Natural Sciences and Engineering Research Council (NSERC) Canada
MO‐DE‐BRA‐05: Developing Effective Medical Physics Knowledge Structures: Models and Methods
Authors: Sprawls P
Published: June 2015

Purpose:

Develop a method and supporting online resources to be used by medical physics educators for teaching medical imaging professionals and trainees so they develop highly‐effective physics knowledge structures that can contribute to improved diagnostic image quality on a global basis.

Methods:

The different types of mental knowledge structures were analyzed and modeled with respect to both the learning and teaching process for their development and the functions or tasks that can be performed with the knowledge. While symbolic verbal and mathematical knowledge structures are very important in medical physics for many purposes, the tasks of applying physics in clinical imaging‐‐especially to optimize image quality and diagnostic accuracy‐‐requires a sensory conceptual knowledge structure, specifically, an interconnected network of visually based concepts. This type of knowledge supports tasks such as analysis, evaluation, problem solving, interacting, and creating solutions. Traditional educational methods including lectures, online modules, and many texts are serial procedures and limited with respect to developing interconnected conceptual networks. A method consisting of the synergistic combination of on‐site medical physics teachers and the online resource, CONET (Concept network developer), has been developed and made available for the topic Radiographic Image Quality. This was selected as the inaugural topic, others to follow, because it can be used by medical physicists teaching the large population of medical imaging professionals, such as radiology residents, who can apply the knowledge.

Results:

Tutorials for medical physics educators on developing effective knowledge structures are being presented and published and CONET is available with open access for all to use.

Conclusion:

An adjunct to traditional medical physics educational methods with the added focus on sensory concept development provides opportunities for medical physics teachers to share their knowledge and experience at a higher cognitive level and produce medical professionals with the enhanced ability to apply physics to clinical procedures.
MO‐DE‐303‐03
Authors: Bowen S.
Published: June 2015

This session will focus on quantitative imaging for assessment of tumor response to radiation therapy. This is a technically challenging method to translate to practice in radiation therapy. In the new era of precision medicine, however, delivering the right treatment, to the right patient, and at the right time, can positively impact treatment choices and patient outcomes. Quantitative imaging provides the spatial sensitivity required by radiation therapy for precision medicine that is not available by other means.

In this Joint ESTRO ‐AAPM Symposium, three leading‐edge investigators will present specific motivations for quantitative imaging biomarkers in radiation therapy of esophageal, head and neck, locally advanced non‐small cell lung cancer, and hepatocellular carcinoma. Experiences with the use of dynamic contrast enhanced (DCE) MRI, diffusion‐ weighted (DW) MRI, PET/CT, and SPECT/CT will be presented. Issues covered will include: response prediction, dose‐painting, timing between therapy and imaging, within‐therapy biomarkers, confounding effects, normal tissue sparing, dose‐response modeling, and association with clinical biomarkers and outcomes. Current information will be presented from investigational studies and clinical practice.

Learning Objectives:

Learn motivations for the use of quantitative imaging biomarkers for assessment of response to radiation therapy

Review the potential areas of application in cancer therapy

Examine the challenges for translation, including imaging confounds and paucity of evidence to date

Compare exemplary examples of the current state of the art in DCE‐MRI, DW‐MRI, PET/CT and SPECT/CT imaging for assessment of response to radiation therapy

Van der Heide: Research grants from the Dutch Cancer Society and the European Union (FP7)

Bowen: RSNA Scholar grant