bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO‐DE‐201‐04: Skits and Panel Discussion
Authors: Miller R. 
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‐DE‐BRA‐04: Hands‐On Fluoroscopy Safety Training with Real‐Time Patient and Staff Dosimetry
Authors: Vanderhoek M , Bevins N 
Published: July 2016

Purpose:Fluoroscopically guided interventions (FGI) are routinely performed across many different hospital departments. However, many involved staff members have minimal training regarding safe and optimal use of fluoroscopy systems. We developed and taught a hands‐on fluoroscopy safety class incorporating real‐time patient and staff dosimetry in order to promote safer and more optimal use of fluoroscopy during FGI.Methods:The hands‐on fluoroscopy safety class is taught in an FGI suite, unique to each department. A patient equivalent phantom is set on the patient table with an ion chamber positioned at the x‐ray beam entrance to the phantom. This provides a surrogate measure of patient entrance dose. Multiple solid state dosimeters (RaySafe i2 dosimetry systemTM) are deployed at different distances from the phantom (0.1, 1, 3 meters), which provide surrogate measures of staff dose. Instructors direct participating clinical staff to operate the fluoroscopy system as they view live fluoroscopic images, patient entrance dose, and staff doses in real‐time. During class, instructors work with clinical staff to investigate how patient entrance dose, staff doses, and image quality are affected by different parameters, including pulse rate, magnification, collimation, beam angulation, imaging mode, system geometry, distance, and shielding.Results:Real‐time dose visualization enables clinical staff to directly see and learn how to optimize their use of their own fluoroscopy system to minimize patient and staff dose, yet maintain sufficient image quality for FGI. As a direct result of the class, multiple hospital departments have implemented changes to their imaging protocols, including reduction of the default fluoroscopy pulse rate and increased use of collimation and lower dose fluoroscopy modes.Conclusion:Hands‐on fluoroscopy safety training substantially benefits from real‐time patient and staff dosimetry incorporated into the class. Real‐time dose display helps clinical staff visualize, internalize, and ultimately utilize the safety techniques learned during the training.RaySafe/Unfors/Fluke lent us a portable version of their RaySafe i2 Dosimetry System for 6 months.
TU‐D‐204‐02: The Linear No‐Threshold Model (LNT): Made to Be Tested, Made to Be Questioned
Authors: Miller R. 
Published: July 2016

Making of the Atomic Bomb2015 is the 70th anniversary of the detonation of the first atomic bomb. Since then, few scientific issues have aroused so much public controversy as the effects of radiation. This lecture will present the extraordinary historical genesis and the thoughts of great men and women in the development of the atomic bomb. In addition, the difficult military and political decisions will be covered such as: target selection, the debate over whether to give the Japanese government a demonstration of its power and whether to use it at all. Also, were the German and Japanese scientists developing there own bomb? Declassified top secret documents now help in answering some of these questions.
TU‐D‐201‐03: Results of a Survey On the Implementation of the TG‐51 Protocol and Associated Addendum On Reference Dosimetry of External Beams
Authors: Kim G , Muir B , Culberson W , Davis S , Huang Y , Lee S , Lowenstein J , Sarfehnia A , Tolani N , Siebers J 
Published: July 2016

Purpose:The working group on the review and extension of the TG‐51 protocol (WGTG51) collected data from American Association of Physicists in Medicine (AAPM) members with respect to their current TG‐51 and associated addendum usage in the interest of considering future protocol addenda and guidance on reference dosimetry best practices. This study reports an overview of this survey on dosimetry of external beams.Methods:Fourteen survey questions were developed by WGTG51 and released in November 2015. The questions collected information on reference dosimetry, beam quality specification, and ancillary calibration equipment.Results:Of the 190 submissions completed worldwide (U.S. 70%), 83% were AAPM members. Of the respondents, 33.5% implemented the TG‐51 addendum, with the maximum calibration difference for any photon beam, with respect to the original TG‐51 protocol, being <1% for 97.4% of responses. One major finding is that 81.8% of respondents used the same cylindrical ionization chamber for photon and electron dosimetry, implying that many clinics are foregoing the use of parallel‐plate chambers. Other evidence suggests equivalent dosimetric results can be obtained with both cylindrical and parallel‐plate chambers in electron beams. This, combined with users comfort with cylindrical chambers for electrons will likely impact recommendations put forward in an upcoming electron beam addendum to the TG‐51 protocol. Data collected on ancillary equipment showed 58.2% (45.0%) of the thermometers (barometers) in use for beam calibration had NIST traceable calibration certificates, but 48.4% (42.7%) were never recalibrated.Conclusion:This survey provides a snapshot of TG‐51 external beam reference dosimetry practice in radiotherapy centers. Findings demonstrate the rapid take‐up of the TG‐51 photon beam addendum and raise issues for the WGTG51 to focus on going forward, including guidelines on ancillary equipment and the choice of chamber for electron beam dosimetry.
TU‐D‐201‐07: Severity Indication in High Dose Rate Brachytherapy Emergency Response Procedure
Authors: Li K , Rustad F 
Published: July 2016

Purpose:Understanding the corresponding dose to different staff during the High Dose Rate (HDR) Brachytherapy emergency response procedure could help to develop a strategy in efficiency and effective action. In this study, the variation and risk analysis methodology was developed to simulation the HDR emergency response procedure based on severity indicator.Methods:A GammaMedplus iX HDR unit from Varian Medical System was used for this simulation. The emergency response procedure was decomposed based on risk management methods. Severity indexes were used to identify the impact of a risk occurrence on the step including dose to patient and dose to operation staff by varying the time, HDR source activity, distance from the source to patient and staff and the actions. These actions in 7 steps were to press the interrupt button, press emergency shutoff switch, press emergency button on the afterloader keypad, turn emergency hand‐crank, remove applicator from the patient, disconnect transfer tube and move afterloader from the patient, and execute emergency surgical recovery.Results:Given the accumulated time in second at the assumed 7 steps were 15, 5, 30, 15, 180, 120, 1800, and the dose rate of HDR source is 10 Ci, the accumulated dose in cGy to patient at 1cm distance were 188, 250, 625, 813, 3063, 4563 and 27063, and the accumulated exposure in rem to operator at outside the vault, 1m and 10cm distance were 0.0, 0.0, 0.1, 0.1, 22.6, 37.6 and 262.6. The variation was determined by the operators in action at different time and distance from the HDR source.Conclusion:The time and dose were estimated for a HDR unit emergency response procedure. It provided information in making optimal decision during the emergency procedure. Further investigation would be to optimize and standardize the responses for other emergency procedure by time‐spatial‐dose severity function.
TU‐D‐BRC‐02: Free Information ‐ EPID‐Based In Vivo Dosimetry
Authors: Greer P. 
Published: July 2016

There has been increased deployment of gantry‐mounted linacs with onboard kilovoltage x‐ray imagers. Despite this trend, most clinics still employ beam's‐eye‐view (BEV) imaging using flat panel electronic portal imaging devices (EPIDs) as a highly useful means of verifying geometric localization pre‐ and post‐delivery. In recent years, there has been increased interest in the use of EPIDs for a variety of clinical and investigational applications ranging from megavoltage cone‐beam CT, in vivo dosimetry, patient‐specific QA to real‐time target localization for dynamic MLC‐based tumor tracking. In conjunction, there are several innovative EPID designs currently under investigation that hold great promise in bringing novel imaging and image‐guidance applications into clinical practice.This symposium is aimed at clinical and research‐oriented medical physicists who want to learn more about current and future megavoltage imaging technology and applications. In this symposium, we will examine the (i) interesting applications that make use of current EPID technology such as volumetric 4D image‐based models, real‐time position estimation for dynamic MLC tracking, etc., (ii) clinical applications such as in vivo EPID dosimetry and (iii) innovative high‐performance EPID designs and exciting future applications, including designs based on thick segmented scintillators, hybrid kV/MV imagers using segmented strip scintillators, and energy‐resolving EPIDs based on multilayer imagers and poly‐Silicon active matrix flat panel imagers.Learning Objectives – In this symposium, the attendees will learn

Novel applications using currently available EPIDs
Use of EPIDs to perform in vivo dosimetry
Novel designs using high‐efficiency, energy resolving EPIDs and future applications of megavoltage imagingJ. Rottmann, Varian Medical SystemsP. Greer, Research Grant Funding from Radiation Oncology Institute (Grant ROI2013‐912), 2013–2014
TU‐D‐BRB‐00: Dual Energy CT in Radiation Therapy
Authors: Labby Zacariah 
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‐BRB‐01: Dual‐Energy CT: Techniques in Acquisition and Image Processing
Authors: Pelc N. 
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‐206‐01: Body Tomosynthesis Introduction
Authors: Bath M. 
Published: July 2016

The current use of tomosynthesis for musculo‐skeletal, abdominal, and thoracic imaging will be considered in four sections:A. Current Practice (M. Bath) : The presently available systems for body tomosynthesis will be reviewed and the current diagnostic applications described.B. Image Features and artifacts (M. FLynn): The consequence of a limited angle linear acquisition scan on image features and artifacts will be explained.C. Radiation Dose (J. Sabol): The organ dose associated with common tomosynthesis protocols will be reported and compared to the dose for radiographic and computed tomography procedures.D. Acceptance testing and Quality Assurance (K. Jones): Recommended medical physics acceptance test will be described and appriate programs for quality assurance discussed.

Learning Objectives:
Learn how body tomosynthesis is currently being used in diagnostic radiology.
Understand how scan acquisitions can be designed to optimize image content and minimize artifacts.
Learn to radiation dose associated with common protocols.
Understand how to best evaluate a newly purchased tomosynthesis system.J. Sabol, Presenter is an employee of GE Healthcare.
TU‐D‐206‐03: TS Body Dose
Authors: Sabol J. 
Published: July 2016

The current use of tomosynthesis for musculo‐skeletal, abdominal, and thoracic imaging will be considered in four sections:A. Current Practice (M. Bath) : The presently available systems for body tomosynthesis will be reviewed and the current diagnostic applications described.B. Image Features and artifacts (M. FLynn): The consequence of a limited angle linear acquisition scan on image features and artifacts will be explained.C. Radiation Dose (J. Sabol): The organ dose associated with common tomosynthesis protocols will be reported and compared to the dose for radiographic and computed tomography procedures.D. Acceptance testing and Quality Assurance (K. Jones): Recommended medical physics acceptance test will be described and appriate programs for quality assurance discussed.

Learning Objectives:
Learn how body tomosynthesis is currently being used in diagnostic radiology.
Understand how scan acquisitions can be designed to optimize image content and minimize artifacts.
Learn to radiation dose associated with common protocols.
Understand how to best evaluate a newly purchased tomosynthesis system.J. Sabol, Presenter is an employee of GE Healthcare.
TU‐D‐209‐02: A Backscatter Point Spread Function for Entrance Skin Dose Determination
Authors: Vijayan S , Xiong Z , Shankar A , Rudin S , Bednarek D 
Published: July 2016

Purpose:To determine the distribution of backscattered radiation to the skin resulting from a non‐uniform distribution of primary radiation through convolution with a backscatter point spread function (PSF).Methods:A backscatter PSF is determined using Monte Carlo simulation of a 1 mm primary beam incident on a 30 × 30 cm × 20 cm thick PMMA phantom using EGSnrc software. A primary profile is similarly obtained without the phantom and the difference from the total provides the backscatter profile. This scatter PSF characterizes the backscatter spread for a “point” primary interaction and can be convolved with the entrance primary dose distribution to obtain the total entrance skin dose. The backscatter PSF was integrated into the skin dose tracking system (DTS), a graphical utility for displaying the color‐coded skin dose distribution on a 3D graphic of the patient during interventional fluoroscopic procedures. The backscatter convolution method was validated for the non‐uniform beam resulting from the use of an ROI attenuator. The ROI attenuator is a copper sheet with about 20% primary transmission (0.7 mm thick) containing a circular aperture; this attenuator is placed in the beam to reduce dose in the periphery while maintaining full dose in the region of interest. The DTS calculated primary plus backscatter distribution is compared to that measured with GafChromic film and that calculated using EGSnrc Monte‐Carlo software.Results:The PSF convolution method used in the DTS software was able to account for the spread of backscatter from the ROI region to the region under the attenuator. The skin dose distribution determined using DTS with the ROI attenuator was in good agreement with the distributions measured with Gafchromic film and determined by Monte Carlo simulationConclusion:The PSF convolution technique provides an accurate alternative for entrance skin dose determination with non‐uniform primary x‐ray beams.Partial support from NIH Grant R01‐EB002873 and Toshiba Medical Systems Corp.
TU‐D‐209‐05: Automatic Calculation of Organ and Effective Dose for CBCT and Interventional Fluoroscopic Procedures
Authors: Xiong Z , Vijayan S , Oines A , Rudin S , Bednarek D 
Published: July 2016

Purpose:To compare PCXMC and EGSnrc calculated organ and effective radiation doses from cone‐beam computed tomography (CBCT) and interventional fluoroscopically‐guided procedures using automatic exposure‐event grouping.Methods:For CBCT, we used PCXMC20Rotation.exe to automatically calculate the doses and compared the results to those calculated using EGSnrc with the Zubal patient phantom. For interventional procedures, we use the dose tracking system (DTS) which we previously developed to produce a log file of all geometry and exposure parameters for every x‐ray pulse during a procedure, and the data in the log file is input into PCXMC and EGSnrc for dose calculation. A MATLAB program reads data from the log files and groups similar exposures to reduce calculation time. The definition files are then automatically generated in the format used by PCXMC and EGSnrc. Processing is done at the end of the procedure after all exposures are completed.Results:For the Toshiba Infinix CBCT LCI‐Middle‐Abdominal protocol, most organ doses calculated with PCXMC20Rotation closely matched those calculated with EGSnrc. The effective doses were 33.77 mSv with PCXMC20Rotation and 32.46 mSv with EGSnrc. For a simulated interventional cardiac procedure, similar close agreement in organ dose was obtained between the two codes; the effective doses were 12.02 mSv with PCXMC and 11.35 mSv with EGSnrc. The calculations can be completed on a PC without manual intervention in less than 15 minutes with PCXMC and in about 10 hours with EGSnrc, depending on the level of data grouping and accuracy desired.Conclusion:Effective dose and most organ doses in CBCT and interventional radiology calculated by PCXMC closely match those calculated by EGSnrc. Data grouping, which can be done automatically, makes the calculation time with PCXMC on a standard PC acceptable. This capability expands the dose information that can be provided by the DTS.Partial support from NIH Grant R01‐EB002873 and Toshiba Medical Systems Corp.
TU‐D‐209‐06: Head and Neck Tissue Dose From X‐Ray Scatter to Physicians Performing Cardiovascular Procedures
Authors: Fetterly K , Schueler B , Grams M , Sturchio G 
Published: July 2016

Purpose:The purpose of this work was to characterize the spatial distribution of scatter radiation to the head and neck of a physician performing an x‐ray interventional procedure and assess brain, eye lens, and carotid artery dose.Methods:Radiographic x‐ray beams were tuned to match the peak energy (56 to 106 keV) and HVL (3.5 to 6.5 mm Al) of x‐ray scatter originating from a patient during a fluoroscopic procedure. The radiographic beam was directed upon a Rando phantom from an inferior‐left location to mimic a typical patient‐operator geometric relationship. A lead‐equivalent protective garment was secured to the phantom. Direct exposure Gafchromic film (XRQA2) was placed between the transverse plane layers of the head and neck region of the phantom and exposed with 4 scatter‐equivalent radiographic beams. A 3×3 cm2 film placed at the left collar of the phantom was used to monitor incident dose in the position of a radiation monitoring badge. The films were converted to 2D dose distribution maps using FilmQA Pro software and an Epson 11000‐XL scanner. The 2D dose distributions maps were normalized by the left collar dose and the percent of left collar dose (%LCD) was calculated for select tissues.Results:The dose maps had high dynamic range (104) and spatial detail. Considering all transverse planes and 4 scatter beam qualities, the median %LCD values were: whole brain 8.5%, left brain 13%, right brain 5.4%, left eye lens 67%, right eye lens 25%, left carotid artery 72%, and right carotid artery 28%.Conclusion:Scatter radiation dose to an operator can be simulated using a tuned radiographic beam and used to expose a phantom and Gafchromic film, thereby creating detailed 2D dose distribution maps. This work facilitates individualized estimation of dose to select head and neck tissues based on an operator's radiation monitoring badge value.