bluuebunny/crossref_metadata_2025 huggingface dataset:
MO‐AB‐BRA‐05: [18F]NaF PET/CT Imaging Biomarkers in Metastatic Prostate Cancer
Authors: Harmon S , Perk T , Lin C , Eickhoff J , Choyke P , Dahut W , Apolo A , Humm J , Larson S , Morris MJ , Perlman S , Liu G , Jeraj R
Published: July 2016

Purpose:

Clinical use of 18F‐Sodium Fluoride (NaF) PET/CT in metastatic settings often lacks technology to quantitatively measure full disease dynamics due to high tumor burden. This study assesses radiomics‐based extraction of NaF PET/CT measures, including global metrics of overall burden and local metrics of disease heterogeneity, in metastatic prostate cancer for correlation to clinical outcomes.

Methods:

Fifty‐six metastatic Castrate‐Resistant Prostate Cancer (mCRPC) patients had NaF PET/CT scans performed at baseline and three cycles into chemotherapy (N=16) or androgen‐receptor (AR) inhibitors (N=39). A novel technology, Quantitative Total Bone Imaging (QTBI), was used for analysis. Employing hybrid PET/CT segmentation and articulated skeletal‐registration, QTBI allows for response assessment of individual lesions. Various SUV metrics were extracted from each lesion (iSUV). Global metrics were extracted from composite lesion‐level statistics for each patient (pSUV). Proportion of detected lesions and those with significant response (%‐increase or %‐decrease) was calculated for each patient based on test‐retest limits for iSUV metrics. Cox proportional hazard regression analyses were conducted between imaging metrics and progression‐free survival (PFS).

Results:

Functional burden (pSUVtotal) assessed mid‐treatment was the strongest univariate predictor of PFS (HR=2.03; p<0.0001). Various global metrics outperformed baseline clinical markers, including fraction of skeletal burden, mean uptake (pSUVmean), and heterogeneity of average lesion uptake (pSUVhetero). Of 43 patients with paired baseline/mid‐treatment imaging, 40 showed heterogeneity in lesion‐level response, containing populations of lesions with both increasing/decreasing metrics. Proportion of lesions with significantly increasing iSUVmean was highly predictive of clinical PFS (HR=2.0; p=0.0002). Patients exhibiting higher proportion of lesions with decreasing iSUVtotal saw prolonged radiographic PFS (HR=0.51; p=0.02).

Conclusion:

Technology presented here provides comprehensive disease quantification on NaF PET/CT imaging, showing strong correlation to clinical outcomes. Total functional burden as well as proportions of similarly responding lesions was predictive of PFS. This supports ongoing development of NaF PET/CT based imaging biomarkers in mCRPC.

Prostate Cancer Foundation
MO‐AB‐BRA‐09: Development and Evaluation of a Biomechanical Modeling‐Assisted CBCT Reconstruction Technique (Bio‐Recon)
Authors: Zhang Y , Nasehi Tehrani J , Wang J
Published: July 2016

Purpose:

To develop a Bio‐recon technique by incorporating the biomechanical properties of anatomical structures into the deformation‐based CBCT reconstruction process.

Methods:

Bio‐recon reconstructs the CBCT by deforming a prior high‐quality CT/CBCT using a deformation‐vector‐field (DVF). The DVF is solved through two alternating steps: 2D–3D deformation and finite‐element‐analysis based biomechanical modeling. 2D–3D deformation optimizes the DVF through an ‘intensity‐driven’ approach, which updates the DVF to minimize intensity mismatches between the acquired projections and the simulated projections from the deformed CBCT. In contrast, biomechanical modeling optimizes the DVF through a ‘biomechanical‐feature‐driven’ approach, which updates the DVF based on the biophysical properties of anatomical structures. In general, Biorecon extracts the 2D–3D deformation‐optimized DVF at high‐contrast structure boundaries, and uses it as the boundary condition to drive biomechanical modeling to optimize the overall DVF, especially at low‐contrast regions. The optimized DVF is fed back into the 2D–3D deformation for further optimization, which forms an iterative loop. The efficacy of Bio‐recon was evaluated on 11 lung patient cases, each with a prior CT and a new CT. Cone‐beam projections were generated from the new CTs to reconstruct CBCTs, which were compared with the original new CTs for evaluation. 872 anatomical landmarks were also manually identified by a clinician on both the prior and new CTs to track the lung motion, which was used to evaluate the DVF accuracy.

Results:

Using 10 projections for reconstruction, the average (± s.d.) relative errors of reconstructed CBCTs by the clinical FDK technique, the 2D–3D deformation‐only technique and Bio‐recon were 46.5±5.9%, 12.0±2.3% and 10.4±1.3%, respectively. The average residual errors of DVF‐tracked landmark motion by the 2D–3D deformation‐only technique and Bio‐recon were 5.6±4.3mm and 3.1±2.4mm, respectively.

Conclusion:

Bio‐recon improved accuracy for both the reconstructed CBCT and the DVF. The accurate DVF can benefit multiple clinical practices, such as image‐guided adaptive radiotherapy.

We acknowledge funding support from the American Cancer Society (RSG‐13‐326‐01‐CCE), from the US National Institutes of Health (R01 EB020366), and from the Cancer Prevention and Research Institute of Texas (RP130109).
MO‐A‐209‐00: Financial Perspectives On Scientific Publishing
Authors: Armato Samuel
Published: July 2016

Scientific publishing is a major endeavor of the AAPM. Although publishing requires substantial resources, it has the potential to generate both reputation and revenue to further the missions of our society. The AAPM owns and publishes two journals: Medical Physics and the Journal of Applied Clinical Medical Physics (JACMP). Medical Physics, with the tagline “The international journal of medical physics research and practice,” publishes research concerned with the application of physics and mathematics to the solution of problems in medicine and human biology, with an emphasis on theoretical and experimental approaches. The JACMP is an applied journal that publishes papers designed to help clinical medical physicists perform their responsibilities more effectively and efficiently for the greater benefit of patients. The two journals reflect two different missions, reach two different (yet often overlapping) audiences, engage two different publication approaches, and operate under two different financial models. A journal must serve both “producers” (authors who submit manuscripts to – and ultimately have their work published in – the journal) and “consumers” (readers – either individuals who access journal content or subscribing institutions that make the journal's content available to its members). Any viable publication model and cost‐recovery structure must satisfy the interests of both groups without sacrificing the needs of the scientific community. The purpose of this symposium is to explore the roles of the AAPM's two journals in advancing the scientific and clinical missions of the society and to understand the complex interplay of economic factors that impact financial decisions governing the journals and the returns they bring to the AAPM.

Learning Objectives:

Appreciate the complementary roles of Medical Physics and JACMP in advancing the scientific and clinical missions of the AAPM.

Understand AAPM resources committed to the two journals and the return on these investments.

Understand the role of the AAPM's Journals Business Management Committee in the financial stability of the two journals.

Explore the potential benefits and pitfalls of various economic and publication models for the two journals.

J. Bourland, Member, Journals Business Management Committee, AAPM.
MO‐B‐201‐02: Motion Management for Proton Lung SBR
Authors: Flampouri S.
Published: July 2016

The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on‐going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanics of the application and the related physiology especially related to respiration. The image‐guided radiation beam control, or tumor tracking, further realized the endeavor for precision‐targeting. During tumor tracking, the respiratory motion is often constantly monitored by non‐ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X‐ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly‐developed MR guided RT.

Learning Objectives:

Through this presentation, the audience will

understand basic roles of commonly used imaging modalities for lung cancer studies;

familiarize the major advantages and limitations of each discussed motion control methods;

familiarize the major advantages and limitations of each discussed radiation beam control methodology and tumor tacking method;

understand the key points in motion management for a high quality SBRT program.
MO‐DE‐204‐02: Optimization of the Patient CT Dose in Europe
Authors: Tsapaki V.
Published: July 2016

The main topic of the session is to show how dose optimization is being implemented in various regions of the world, including Europe, Australia, North America and other regions.

A multi‐national study conducted under International Atomic Energy Agency (IAEA) across more than 50 less resourced countries gave insight into patient radiation doses and safety practices in CT, mammography, radiography and interventional procedures, both for children and adults. An important outcome was the capability development on dose assessment and management.

An overview of recent European projects related to CT radiation dose and optimization both to adults and children will be presented. Existing data on DRLs together with a European methodology proposed on establishing and using DRLs for paediatric radiodiagnostic imaging and interventional radiology practices will be shown.

Compared with much of Europe at least, many Australian imaging practices are relatively new to the task of diagnostic imaging dose optimisation. In 2008 the Australian Government prescribed a requirement to periodically compare patient radiation doses with diagnostic reference levels (DRLs), where DRLs have been established. Until recently, Australia had only established DRLs for computed tomography (CT). Regardless, both professional society and individual efforts to improved data collection and develop optimisation strategies across a range of modalities continues. Progress in this field, principally with respect to CT and interventional fluoroscopy will be presented.

In the US, dose reduction and optimization efforts for computed tomography have been promoted and mandated by several organizations and accrediting entities. This presentation will cover the general motivation, implementation, and implications of such efforts.

Learning Objectives:

Understand importance of the dose optimization in Diagnostic Radiology.

See how this goal is achieved in different regions of the World.

Learn about the global trend in the dose optimization and future prospectives.

M. Rehani, The work was a part of the work of IAEA where I was an employee and IAEA is a United Nations organization
MO‐C‐BRB‐01: Welcome and Greetings from Invited Guests
Authors: Curran B.
Published: July 2016

With the profound changes currently occurring in medicine, the role of the medical physicist cannot stagnate, but must evolve to meet the challenges and opportunities that are presented. Medical physicists must understand these changes and establish themselves not only as relevant but as leaders in this new environment. We must increase our presence in clinical settings such as tumor boards, patient rounds, and the development of new diagnosis, imaging, and treatment techniques. By establishing ourselves as competent scientists, we can and must participate in the development of technologies through research, teaching, and clinical implementation. As medical physicists we must define our roles and value to our physician colleagues, patients, referring physicians, and senior administrators. We cannot afford to be viewed solely as quality assurance technologists, but need to move forward in step with medical and practice advances, becoming recognized as having a leadership role in providing quality research, technological development, and quality patient care.

In this session, four leaders in medical research and healthcare will discuss their observations on how medical physicists have contributed to advancements in healthcare and opportunities to continue leadership in providing quality medicine through the applications of physics to research, education, and clinical practice.

Learning Objectives:

Understand the changes in the healthcare environment and how medical physicists can contribute to improving patient care.

Learn how medical physicists are currently leading research efforts to improve clinical imaging and diagnosis.

Understand the role of medical physicists in developing new technology and leading its translation into clinical care.
MO‐C‐BRB‐04: Observations of a Nuclear Radiologist on the Value of the Medical Physicist
Authors: Greenspan B.
Published: July 2016

With the profound changes currently occurring in medicine, the role of the medical physicist cannot stagnate, but must evolve to meet the challenges and opportunities that are presented. Medical physicists must understand these changes and establish themselves not only as relevant but as leaders in this new environment. We must increase our presence in clinical settings such as tumor boards, patient rounds, and the development of new diagnosis, imaging, and treatment techniques. By establishing ourselves as competent scientists, we can and must participate in the development of technologies through research, teaching, and clinical implementation. As medical physicists we must define our roles and value to our physician colleagues, patients, referring physicians, and senior administrators. We cannot afford to be viewed solely as quality assurance technologists, but need to move forward in step with medical and practice advances, becoming recognized as having a leadership role in providing quality research, technological development, and quality patient care.

In this session, four leaders in medical research and healthcare will discuss their observations on how medical physicists have contributed to advancements in healthcare and opportunities to continue leadership in providing quality medicine through the applications of physics to research, education, and clinical practice.

Learning Objectives:

Understand the changes in the healthcare environment and how medical physicists can contribute to improving patient care.

Learn how medical physicists are currently leading research efforts to improve clinical imaging and diagnosis.

Understand the role of medical physicists in developing new technology and leading its translation into clinical care.
MO‐C‐BRB‐05: Medical Physics ‐ Adding Value in Industry
Authors: Kennedy K.
Published: July 2016

With the profound changes currently occurring in medicine, the role of the medical physicist cannot stagnate, but must evolve to meet the challenges and opportunities that are presented. Medical physicists must understand these changes and establish themselves not only as relevant but as leaders in this new environment. We must increase our presence in clinical settings such as tumor boards, patient rounds, and the development of new diagnosis, imaging, and treatment techniques. By establishing ourselves as competent scientists, we can and must participate in the development of technologies through research, teaching, and clinical implementation. As medical physicists we must define our roles and value to our physician colleagues, patients, referring physicians, and senior administrators. We cannot afford to be viewed solely as quality assurance technologists, but need to move forward in step with medical and practice advances, becoming recognized as having a leadership role in providing quality research, technological development, and quality patient care.

In this session, four leaders in medical research and healthcare will discuss their observations on how medical physicists have contributed to advancements in healthcare and opportunities to continue leadership in providing quality medicine through the applications of physics to research, education, and clinical practice.

Learning Objectives:

Understand the changes in the healthcare environment and how medical physicists can contribute to improving patient care.

Learn how medical physicists are currently leading research efforts to improve clinical imaging and diagnosis.

Understand the role of medical physicists in developing new technology and leading its translation into clinical care.
MO‐C‐BRB‐06: Panel Discussion on Leadership
Authors: Curran B.
Published: July 2016

With the profound changes currently occurring in medicine, the role of the medical physicist cannot stagnate, but must evolve to meet the challenges and opportunities that are presented. Medical physicists must understand these changes and establish themselves not only as relevant but as leaders in this new environment. We must increase our presence in clinical settings such as tumor boards, patient rounds, and the development of new diagnosis, imaging, and treatment techniques. By establishing ourselves as competent scientists, we can and must participate in the development of technologies through research, teaching, and clinical implementation. As medical physicists we must define our roles and value to our physician colleagues, patients, referring physicians, and senior administrators. We cannot afford to be viewed solely as quality assurance technologists, but need to move forward in step with medical and practice advances, becoming recognized as having a leadership role in providing quality research, technological development, and quality patient care.

In this session, four leaders in medical research and healthcare will discuss their observations on how medical physicists have contributed to advancements in healthcare and opportunities to continue leadership in providing quality medicine through the applications of physics to research, education, and clinical practice.

Learning Objectives:

Understand the changes in the healthcare environment and how medical physicists can contribute to improving patient care.

Learn how medical physicists are currently leading research efforts to improve clinical imaging and diagnosis.

Understand the role of medical physicists in developing new technology and leading its translation into clinical care.
MO‐D‐BRB‐02: SBRT Treatment Planning and Delivery
Authors: Yang Y.
Published: July 2016

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image‐guided patient setup and on‐treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real‐time image guidance during SBRT dose delivery using gated/un‐gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state‐of‐art imaging and planning techniques.

Learning Objectives:

Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA.

Update on the use of multi‐dimensional and multi‐modality imaging for reliable guidance of SBRT.

Discuss treatment planning and QA issues specific to SBRT.

Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT.

NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems
MO‐DE‐201‐03: Empathy
Authors: Ritenour E.
Published: July 2016

Medical physicists possess technical knowledge and problem solving skills required to deliver high quality diagnosis and treatment in the clinic, to provide excellence in research, or to transfer expertise in industrial or regulatory environments. As the healthcare industry rapidly evolves, medical physicists must make a case for ensuring recognition of their value. One of many ways the AAPM is working to ensure stewardship of the profession is through development of the Medical Physics Leadership Academy (MPLA).

This session will provide an introduction to the MPLA and one of its focus areas of emotional intelligence. The session will make the case for emotional competencies in addition to technical competencies. MPLA work group representatives will share consolidated results from conducting 360 feedback assessments used to measure emotional competencies of medical physicists. Some emotional competencies contribute more to professional success than others, and the session will explain how to overcome shortcomings. Two specific emotional competencies will be covered: selfawareness and empathy.

Learning Objectives:

Understand the importance of medical physics leadership in the future of health care

Understand emotional intelligence and emotional competencies and ways they can be measured

Utilize self‐awareness and empathy to improve management of our own emotions and others
MO‐D‐BRC‐00: In Memoriam of Jan Van De Geijn: Knowledge‐Based Planning
Authors: Xia Ping
Published: July 2016

Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented.

The objectives of this session are:

Understand differences among these three advanced planning tools

Provide clinical assessments on the utility of the advanced planning tools

Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs.

Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical
MO‐D‐BRC‐02: Auto‐Planning
Authors: Xia P.
Published: July 2016

Treatment planning is a central part of radiation therapy, including delineation in tumor volumes and critical organs, setting treatment goals of prescription doses to the tumor targets and tolerance doses to the critical organs, and finally generation of treatment plans to meet the treatment goals. National groups like RTOG have led the effort to standardize treatment goals of the prescription doses to the tumor targets and tolerance doses to the critical organs based on accumulated knowledge from decades of abundant clinical trial experience. The challenge for each clinical department is how to achieve or surpass these set goals within the time constraints of clinical practice. Using fifteen testing cases from different treatment sites such as head and neck, prostate with and without pelvic lymph nodes, SBRT spine, we will present clinically utility of advanced planning tools, including knowledge based, automatic based, and multiple criteria based tools that are clinically implemented.

The objectives of this session are:

Understand differences among these three advanced planning tools

Provide clinical assessments on the utility of the advanced planning tools

Discuss clinical challenges of treatment planning with large variations in tumor volumes and their relationships with adjacent critical organs.

Ping Xia received research grant from Philips. Jackie Wu received research grant from Varian; P. Xia, Research support by Philips and Varian; Q. Wu, NIH, Varian Medical
MO‐DE‐BRA‐06: 3D Image Acquisition and Reconstruction Explained with Online Animations
Authors: Kesner A
Published: July 2016

Purpose:

Understanding the principles of 3D imaging and image reconstruction is fundamental to the field of medical imaging. Clinicians, technologists, physicists, patients, students, and inquisitive minds all stand to benefit from greater comprehension of the supporting technologies. To help explain the basic principles of 3D imaging, we developed multi‐frame animations that convey the concepts of tomographic imaging. The series of free (gif) animations are accessible online, and provide a multimedia introduction to the main concepts of image reconstruction.

Methods:

Text and animations were created to convey the principles of analytic tomography in CT, PET, and SPECT. Specific topics covered included: principles of sinograms/image data storage, forward projection, principles of PET acquisitions, and filtered backprojection. A total of 8 animations were created and presented for CT, PET, and digital phantom formats. In addition, a free executable is also provided to allow users to create their own tomographic animations – providing an opportunity for interaction and personalization to help foster user interest.

Results:

Tutorial text and animations have been posted online, freely available to view or download. The animations are in first position in a google search of “image reconstruction animations”. The website currently receives approximately 200 hits/month, from all over the world, and the usage is growing. Positive feedback has been collected from users.

Conclusion:

We identified a need for improved teaching tools to help visualize the (temporally variant) concepts of image reconstruction, and have shown that animations can be a useful tool for this aspect of education. Furthermore, posting animations freely on the web has shown to be a good way to maximize their impact in the community. In future endeavors, we hope to expand this animated content, to cover principles of iterative reconstruction, as well as other phenomena relating to imaging.
TU‐D‐201‐01: 2016 Economics Update
Authors: Fontenot J , Fuss W
Published: July 2016

The purpose of this session is to introduce attendees to the healthcare reimbursement system and how it applies to the clinical work of a medical physicist. This will include general information about the different categories of payers and payees, how work is described by CPT codes, and how various payers set values for this work in different clinical settings. 2016 is another year of significant changes to the payment system. This presentation will describe the work encompassed in these codes and will give attendees an overview of the changes for 2016 as they apply to radiation oncology. Finally, some insight into what can be expected during 2017 will be presented. This includes what information is typically released by the Centers for Medicaid and Medicare Services (CMS) during the year and how we as an organization respond. This will include ways members can interact with the AAPM professional economics committee and other resources members may find helpful. Learning objectives1) Basics of how Medicare is structured and how reimbursement rates are set.2) Basic understanding of proposed changes to the 2016 Medicare rules.3) Describe economics and policy resources that are available from the AAPM and how to interact with the professional economics committee.
TU‐D‐BRB‐03: Dual‐Energy CT: Considerations in Radiation Therapy
Authors: Coolens C.
Published: July 2016

Dual‐energy CT technology is becoming increasingly available to the medical imaging community. In addition, several models of CT simulators sold for use in radiation therapy departments now feature dual‐energy technology. The images provided by dual‐energy CT scanners add new information to the radiation treatment planning process; multiple spectral components can be used to separate and identify material composition as well as generate virtual monoenergetic images. In turn, this information could be used to investigate pathologic processes, separate the properties of contrast agents from soft tissues, assess tissue response to therapy, and other applications of therapeutic interest. Additionally, the decomposition of materials in images could directly integrate with and impact the accuracy of dose calculation algorithms.

This symposium will explore methods of generating dual‐energy CT images, spectral and image analysis algorithms, current and future applications of interest in oncologic imaging, and unique considerations when using dualenergy CT images in the radiation treatment planning process.

Learning Objectives:

Understand acquisition techniques and processing algorithms used in dual‐energy CT imaging.

Discover current and future applications of dual‐energy CT images in the radiological oncology setting.

Introduce some of the unique considerations and QA requirements when integrating a dual‐energy CT scanner into the radiation therapy environment.

N. Pelc: GE Healthcare, Philips Healthcare, Sony; U. Schoepf: Consultant for and / or research support from Astellas, Bayer,;Bracco, GE, Guerbet, Medrad, Siemens
TU‐D‐202‐00: Rest In Peace ‐ ITV
Authors: van Herk Marcel
Published: July 2016

Respiratory motion has long been recognized as an important factor affecting the precision of radiotherapy. After the introduction of the 4D CT to visualize the respiratory motion in 3D, the internal target volume (ITV) has been widely adopted as simple method to take the motion into account in treatment planning and delivery. The ITV is generated as the union of the CTVs as the patient goes through the respiratory cycle. Many issues have been identified with the ITV. In this session three alternatives for the ITV will be discussed: 1) An alternative motion‐inclusive approach with better imaging and smaller margins, called mid‐position CT. 2) The tracking approach and 3) The gating approach.

The following topics will be addressed by Marcel van Herk (“Is ITV the correct motion encompassing strategy”): Magnitude of respiratory motion, effect of motion on radiotherapy, motion encompassing strategies, and software solutions to assist in motion encompassing strategies. Then Paul Keall (“Make margins simple: Use real‐time target tracking”) will discuss tracking with: clinical drivers for tracking, current clinical status of tumor tracking, future tumor tracking technology, and margin margin challenges with and without tracking. Finally Daniel Low will discuss gating (“Gating is the best ITV killer”): why ITV in the first place, requirements for planning, requirements at the machine, benefits and costs.

The session will end with a discussion and live demo of motion simulation software to illustrate the issues and explain the relative benefit and appropriate uses for the three methods.

Learning Objectives:

Explain the 4D imaging and treatment planning process.

Summarize the various approaches to deal with respiratory motion during radiotherapy

Discuss the tradeoffs involved when choosing one of the three discussed approaches.

Explain in which situation each method is the best choice

Research is partly funded by Elekta Oncology Systems and the Dutch Cancer Foundation; M. van Herk, Part of the research was funded by Elekta Oncology Systems and the Dutch Cancer Foundation
TU‐D‐202‐02: Make Margins Simple: Use Real‐Time Target Tracking
Authors: Keall P.
Published: July 2016

Respiratory motion has long been recognized as an important factor affecting the precision of radiotherapy. After the introduction of the 4D CT to visualize the respiratory motion in 3D, the internal target volume (ITV) has been widely adopted as simple method to take the motion into account in treatment planning and delivery. The ITV is generated as the union of the CTVs as the patient goes through the respiratory cycle. Many issues have been identified with the ITV. In this session three alternatives for the ITV will be discussed: 1) An alternative motion‐inclusive approach with better imaging and smaller margins, called mid‐position CT. 2) The tracking approach and 3) The gating approach.

The following topics will be addressed by Marcel van Herk (“Is ITV the correct motion encompassing strategy”): Magnitude of respiratory motion, effect of motion on radiotherapy, motion encompassing strategies, and software solutions to assist in motion encompassing strategies. Then Paul Keall (“Make margins simple: Use real‐time target tracking”) will discuss tracking with: clinical drivers for tracking, current clinical status of tumor tracking, future tumor tracking technology, and margin margin challenges with and without tracking. Finally Daniel Low will discuss gating (“Gating is the best ITV killer”): why ITV in the first place, requirements for planning, requirements at the machine, benefits and costs.

The session will end with a discussion and live demo of motion simulation software to illustrate the issues and explain the relative benefit and appropriate uses for the three methods.

Learning Objectives:

Explain the 4D imaging and treatment planning process.

Summarize the various approaches to deal with respiratory motion during radiotherapy

Discuss the tradeoffs involved when choosing one of the three discussed approaches.

Explain in which situation each method is the best choice

Research is partly funded by Elekta Oncology Systems and the Dutch Cancer Foundation; M. van Herk, Part of the research was funded by Elekta Oncology Systems and the Dutch Cancer Foundation
TU‐D‐209‐04: How Useful Are Indirect Dose Metrics for Estimating Peak Skin Dose in Interventional Cardiology?
Authors: Jones A , Pasciak A
Published: July 2016

Purpose:

The purpose of this study was to determine if a relationship between indirect dose metrics and PSD could be established for fluoroscopically‐guided interventional cardiology procedures.

Methods:

PSD were measured directly using XR‐RV3 radiochromic film for 94 consecutive fluoroscopically guided interventional cardiology procedures performed at two sites. Procedures were both diagnostic and therapeutic in nature. Radiation dose structured reports (RDSR) were collected for each procedure and used to calculate indirect estimates of PSD which were compared to the measured PSD. Reference air kerma (Ka,r) was also compared to the measured PSD. Pearson's correlation coefficient was calculated for each metric and metrics were compared to measured PSD using a two‐tailed t‐test. Data were log transformed prior to statistical analysis.

Results:

Both Ka,r and the calculated PSD were closely correlated with measured PSD at each sites (Ka,r: 0.92 and 0.86, indirect PSD: 0.91 and 0.88). At one site, neither Ka,r nor indirect PSD was significantly different from the measured PSD (p = 0.22 and p=0.054, respectively), while at the second site both Ka,r and indirect PSD were significantly higher than measured PSD (p<0.0001 and p<0.0001, respectively). In almost all cases, both Ka,r and indirect PSD overestimated the true PSD.

Conclusions:

The use of a range of gantry angles and table positions, along with variation in procedural imaging requirements, limits the utility of indirect dose metrics for predicting PSD for interventional cardiology procedures.

A. Kyle Jones and Alexander S. Pasciak are owners of Fluoroscopic Safety, LLC.
TU‐FG‐207B‐04: NCI Funding Opportunities in Imaging and Image‐Guided Therapy
Authors: Farahani K.
Published: July 2016

Up‐to‐date knowledge about federal funding opportunities related to medical physics research, as well as obtaining skills for writing effective grant proposals are critical for academic and entrepreneurial medical physicists. In this symposium, program directors from key federal research funding agencies, including the National Cancer Institute, the National Institute of Biomedical Imaging and Bioengineering, and the National Science Foundation, will present information about current funding opportunities relevant to the field of medical physics. They will also provide insight to issues that applicants should pay special attention to when crafting their research grant proposals. In addition, the symposium will include presentations on research funding for small business concerns, and the results of an independent AAPM study of the National Institutes of Health funding of AAPM members from 2002–2015.

Learning Objectives:

To learn about current federal funding initiatives relevant to medical physics research

To learn about tactics important for crafting convincing research proposals

To learn about an independent study of NIH funding of research done by AAPM members

B. Whelan, this work was commissioned and funded by the AAPM
TU‐F‐PinS Room/Hall E‐00: Digital Breast Tomosynthesis II
Authors: Wilson Thaddeus
Published: July 2016

This session along with the others on Digital Breast Tomosynthesis (DBT) offered at this years meeting as part of the Educational, Scientific and Partners in Solutions is intended to meet the FDA requirements for physicists to survey a DBT system. Specifically this vendor offered session held as part of the Partners in Solutions is also meant to focus on those requirements. This session is being done along with the other two vendors of approved DBT systems in order to cover the machine specific features of those systems.
TU‐G‐PinS Room/Hall E‐00: Digital Breast Tomosynthesis III
Authors: Sammet Steffen
Published: July 2016

This session along with the others on Digital Breast Tomosynthesis (DBT) offered at this years meeting as part of the Educational, Scientific and Partners in Solutions is intended to meet the FDA requirements for physicists to survey a DBT system. Specifically, this vendor offered session held as part of the Partners in Solutions is also meant to focus on those requirements. This session is being done along with the other two vendors of approved DBT systems in order to cover the machine specific features of those systems.
TU‐H‐BRC‐01: A New Fabrication Method for Secondary Skin Collimation Using 3D Scanner and 3D Printer
Authors: Jung J , Potter N , Suh T , Liu C , Lu B
Published: July 2016

Purpose:

Using secondary skin collimation (SSC) to protect the critical organ surrounding the tumors is always desirable for electron and/or ortho‐voltage treatments. However, the time‐consuming and labor‐intensive fabrication processes of current method (manually fabricate the lead mask) restrict the general use of SSC. The aim of this study is to develop a new SSC fabrication method using 3D scanning and 3D printing technologies in order to largely decrease the human labor involvement and fabrication time, also improve the fabrication accuracy.

Methods:

First, the patient surface was scanned with a 3D scanner (Structure Sensor, Occipital, CO). The raw scan data was subsequently transferred to a 3D modeling software (Rhinoceros, Ver. 5.0, McNeel North America, Seattle, WA). The tumor contour was then digitized and shielding region was determined by clinicians in the same software. The corresponding SCC conformed to the skin surface was then automatically generated by the software with the proper shielding thickness. The shell of the SCC (with hollow inside) was consequently printed by a 3D printer (Lulzbot TAZ, Aleph Objects, CO) using plastic material. Finally, the hollow mold of SCC was filled up with a melted cerrobend alloy. Once the cerrobend alloy cooled down, the fabrication of SCC was accomplished.

Results:

The results indicated the proposed method can achieve a much shorter time on making a SCC compared with tradition fabrication method. The processes of making a skin contour model for patients have been eliminated with the new method. SCC created by the new method possessed better accuracy and better conformality to patient's skin contours.

Conclusion:

In this study, we have demonstrated a new method for the SCC fabrication. It is anticipated that our method can be an alternative way to replace conventional manual‐based methods for electron and/or ortho‐voltage SCC fabrication.

This research was supported by the Global Ph.D. Fellowship Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (Grant No. 2015H1A2A1034071), Republic of Korea.
TU‐H‐204‐01: Work of ICRP in relation to activities of medical physicists
Authors: Rehani M.
Published: July 2016

Since 1928, the International Commission on Radiological Protection (ICRP) has developed, maintained, and elaborated the International System of Radiological Protection used world‐wide as the common basis for radiological protection standards, legislation, guidelines, programs, and practice. ICRP provides and periodically revises radiation and tissue weighing factors, provides and updates recommended dose limits for occupational and public exposures, recommends dose levels for termination of pregnancy, and estimates threshold doses for tissue reactions (deterministic effects). ICRP developed the dose quantity “effective dose”.

NCRP Council Committee 1 (CC‐1) is charged with developing recommendations for revising radiation protection guidance for the United States. Topics to be discussed include a summary of current ICRP guidance, NCRP CC‐1 directions, NRC regulatory changes on the horizon, and potential implications of radiation protection guidance changes on the practice of medicine. The opinions of AAPM members on potential changes are welcomed.

NCRP Program Area Committee (PAC) 4 has oversight of activities in radiation protection in medicine, including protection of patients and training of health care workers. Documents have been published recently on diagnostic reference levels and achievable doses, health effects of preconception and prenatal radiation exposure, and administrative policies for quality assurance and peer review of tissue reactions associated with fluoroscopically guided interventions. Additional documents are in preparation.

Learning Objectives:

To understand the international system of radiation protection and learn about the work of the International Commission on Radiological Protection (ICRP) in relation to activities of medical physicists

To understand the ongoing work of NCRP in developing new guidance for radiation protection in the U.S.

To understand the ongoing work of NCRP in developing new recommendations for radiation protection in medicine.

To learn about other national organizations in US whose work plays a useful role in the activities of medical physicists.

M. Rehani, Work done as part of being member of ICRP. ICRP is an independent charity.
TU‐H‐201‐03: Panel Discussion Member
Authors: Palta J.
Published: July 2016

The New New Symposium is a symposium for members relatively new to the organization to learn about the organizational structure and operational procedures of the society; how decisions are made, how the council and committee leadership is appointed and operates, opportunities for volunteer involvement, and a brief overview of the services and efforts provided by the HQ staff and the website. Attendees will hear from council chairs, key staff and chairs, and members with volunteer experience.

After the symposium a social hour ensues with opportunities to interact with key AAPM members. The New Member Symposium is a (free) ticket option when you register online for the Annual Meeting. And don't forget registrants receive one (free) ticket for a beverage of your choice during the social afterwards.
TU‐H‐BRC‐08: Use and Validation of Flexible 3D Printed Tissue Compensators for Post‐Mastectomy Radiation Therapy
Authors: Craft D , Woodward W , Kanke J , Kry S , Salehpour M , Howell R
Published: July 2016

Purpose:

Patient‐specific tissue equivalent compensators can be used for post‐mastectomy radiation therapy (PMRT) to achieve homogenous dose distributions with single‐field treatments. However, current fabrication methods are time consuming and expensive. 3D‐printing technology could overcome these limitations. The purposes of this study were to [1] evaluate materials for 3D‐printed compensators [2] design and print a compensator to achieve a uniform thickness to a clinical target volume (CTV), and [3] demonstrate that a single‐field electron compensator plan is a clinically feasible treatment option for PMRT.

Methods:

Blocks were printed with three materials; print accuracy, density, Hounsfield units (HU), and percent depth doses (PDD) were evaluated. For a CT scan of an anthropomorphic phantom, we used a ray‐tracing method to design a compensator that achieved uniform thickness from compensator surface to CTV. The compensator was printed with flexible tissue equivalent material whose physical and radiological properties were most similar to soft tissue. A single‐field electron compensator plan was designed and compared with two standard‐of‐care techniques. The compensator plan was validated with thermoluminescent dosimeter (TLD) measurements.

Results:

We identified an appropriate material for 3D‐printed compensators that had high print accuracy (99.6%) and was similar to soft tissue; density was 1.04, HU was ‐ 45 ± 43, and PDD curves agreed with clinical curves within 3 mm. We designed and printed a compensator that conformed well to the phantom surface and created a uniform thickness to the CTV. In‐house fabrication was simple and inexpensive (<$75). Compared with the two standard plans, the compensator plan resulted in overall more homogeneous dose distributions and performed similarly in terms of lung/heart doses and 90% isodose coverage of the CTV. TLD measurements agreed well with planned doses (within 5 %).

Conclusions:

We have demonstrated that 3D‐printed compensators make single‐field electron therapy a clinically feasible treatment option for PMRT.