bluuebunny/crossref_metadata_2025_split huggingface dataset:
SU‐G‐TeP4‐09: Development of a Plan Data Aggregator for Time Efficient Physics Second‐Checks of Machine Parameters for External Beam Treatment Plans
Authors: Belley M , Schmidt M , Knutson N , Price M 
Published: July 2016

Purpose:Physics second‐checks for external beam radiation therapy are performed, in‐part, to verify that the machine parameters in the Record‐and‐Verify (R&V) system that will ultimately be sent to the LINAC exactly match the values initially calculated by the Treatment Planning System (TPS). While performing the second‐check, a large portion of the physicists’ time is spent navigating and arranging display windows to locate and compare the relevant numerical values (MLC position, collimator rotation, field size, MU, etc.). Here, we describe the development of a software tool that guides the physicist by aggregating and succinctly displaying machine parameter data relevant to the physics second‐check process.Methods:A data retrieval software tool was developed using Python to aggregate data and generate a list of machine parameters that are commonly verified during the physics second‐check process. This software tool imported values from (i) the TPS RT Plan DICOM file and (ii) the MOSAIQ (R&V) Structured Query Language (SQL) database. The machine parameters aggregated for this study included: MLC positions, X&Y jaw positions, collimator rotation, gantry rotation, MU, dose rate, wedges and accessories, cumulative dose, energy, machine name, couch angle, and more.Results:A GUI interface was developed to generate a side‐by‐side display of the aggregated machine parameter values for each field, and presented to the physicist for direct visual comparison. This software tool was tested for 3D conformal, static IMRT, sliding window IMRT, and VMAT treatment plans.Conclusion:This software tool facilitated the data collection process needed in order for the physicist to conduct a second‐check, thus yielding an optimized second‐check workflow that was both more user friendly and time‐efficient. Utilizing this software tool, the physicist was able to spend less time searching through the TPS PDF plan document and the R&V system and focus the second‐check efforts on assessing the patient‐specific plan‐quality.
MO‐A‐BRC‐00: TG167: Clinical Recommendations for Innovative Brachytherapy Devices and Applicators
Authors: Nath Ravinder 
Published: July 2016

Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence‐based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved. The physicist's role, along with physician colleagues, in this process is highlighted for innovative products or applications and includes evaluation of 1) dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use, 2) risks and benefits from regulatory and safety perspectives, and 3) resource assessment and preparedness. Further, calibration methods should be traceable to a primary standards dosimetry laboratory such as NIST in the U.S. or to other primary standards dosimetry laboratory located elsewhere. Clinical users should follow standards as approved by their country's regulatory agencies that approved such a brachytherapy device. Integration of this system into the medical source calibration infrastructure of secondary standard dosimetry laboratories such as the ADCLs is encouraged before a source is introduced into widespread routine clinical use. The AAPM and GEC‐ESTRO have developed guidelines for the safe and consistent application of brachytherapy using innovative brachytherapy devices and applications. The current report covers regulatory approvals, calibration, dose calculations, radiobiological issues, and overall safety concerns that should be addressed during the commissioning stage preceding clinical use. These guidelines are based on review of requirements of the U.S. NRC, FDA, Department of Transportation, International Electrotechnical Commission Medical Electrical Equipment Standard 60601, European Commission for CE Marking, and institutional review boards and radiation safety committees.

Learning Objectives:
Understand the necessary dosimetric considerations for clinical implementation (including calibrations, dose calculations, and radiobiological aspects) to comply with existing societal dosimetric prerequisites for sources in routine clinical use.
Evaluate risks and benefits from regulatory and safety perspectives.
Identify necessary resources and create a plan for clinical introduction of innovative brachytherapy device or applications.Consultant for Theragenics Corp.; R. Nath, Consultant to Theragenics Corp.
MO‐AB‐BRA‐03: Development of Novel Real Time in Vivo EPID Treatment Verification for Brachytherapy
Authors: Fonseca G , Podesta M , Reniers B , Verhaegen F 
Published: July 2016

Purpose:High Dose Rate (HDR) brachytherapy treatments are employed worldwide to treat a wide variety of cancers. However, in vivo dose verification remains a challenge with no commercial dosimetry system available to verify the treatment dose delivered to the patient. We propose a novel dosimetry system that couples an independent Monte Carlo (MC) simulation platform and an amorphous silicon Electronic Portal Imaging Device (EPID) to provide real time treatment verification.Methods:MC calculations predict the EPID response to the photon fluence emitted by the HDR source by simulating the patient, the source dwell positions and times, and treatment complexities such as tissue compositions/densities and different applicators. Simulated results are then compared against EPID measurements acquired with ∼0.14s time resolution which allows dose measurements for each dwell position. The EPID has been calibrated using an Ir‐192 HDR source and experiments were performed using different phantoms, including tissue equivalent materials (PMMA, lung and bone). A source positioning accuracy of 0.2 mm, without including the afterloader uncertainty, was ensured using a robotic arm moving the source.Results:An EPID can acquire 3D Cartesian source positions and its response varies significantly due to differences in the material composition/density of the irradiated object, allowing detection of changes in patient geometry. The panel time resolution allows dose rate and dwell time measurements. Moreover, predicted EPID images obtained from clinical treatment plans provide anatomical information that can be related to the patient anatomy, mostly bone and air cavities, localizing the source inside of the patient using its anatomy as reference.Conclusion:Results obtained show the feasibility of the proposed dose verification system that is capable to verify all the brachytherapy treatment steps in real time providing data about treatment delivery quality and also applicator/structure motion during or between treatments.
MO‐B‐BRC‐03: CT‐Based Prostate HDR
Authors: Zoberi J. 
Published: July 2016

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra‐ or post‐operative setting. During intra‐operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra‐operative prostate HDR is U/S. Alternatively, in the post‐operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations.Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting.

Learning Objectives:
Review prostate HDR techniques based on the imaging modality
Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy
Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions
MO‐B‐BRC‐04: MRI‐Based Prostate HDR
Authors: Mourtada F. 
Published: July 2016

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra‐ or post‐operative setting. During intra‐operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra‐operative prostate HDR is U/S. Alternatively, in the post‐operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations.Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting.

Learning Objectives:
Review prostate HDR techniques based on the imaging modality
Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy
Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions
MO‐A‐207B‐01: Radiomics: Segmentation & Feature Extraction Techniques
Authors: Veeraraghavan H. 
Published: July 2016

Image segmentation is one of the core problems for applying radiomics‐based analysis to images. However, achieving repeatable and accurate segmentations for large datasets is challenging. The choice of segmentation method, the metrics used to evaluate the quality of such segmentations all depend on the specific clinical problem. This course will introduce three approaches, namely, fully automatic, interactive, and semi‐automatic methods for generating segmentations. The pros and cons of each approach and when to choose a specific method will be discussed. Evaluation and assessment of the quality of a segmentation method is essential before it can be deployed for high‐throughput analysis such as radiomics. This course will present some of the metrics that can be used for assessing quality of segmentations and highlight their advantages and deficiencies.Another important issue with respect to generating high quality segmentations and ultimately extracting robust radiomics features is image pre‐processing. A few pre‐processing techniques that can be used to improve the robustness of the analysis for MR and CT images will be presented.

Learning Objectives:
Understand the difference and applicability of various segmentation methods.
Understand how pre‐processing can be used to improve the robustness of feature extraction and segmentation
Understand some basics of evaluating the quality of segmentations and the relevance of such metrics for clinical problems.
MO‐B‐BRC‐02: Ultrasound Based Prostate HDR
Authors: Chang Z. 
Published: July 2016

Brachytherapy has proven to be an effective treatment option for prostate cancer. Initially, prostate brachytherapy was delivered through permanently implanted low dose rate (LDR) radioactive sources; however, high dose rate (HDR) temporary brachytherapy for prostate cancer is gaining popularity. Needle insertion during prostate brachytherapy is most commonly performed under ultrasound (U/S) guidance; however, treatment planning may be performed utilizing several imaging modalities either in an intra‐ or post‐operative setting. During intra‐operative prostate HDR, the needles are imaged during implantation, and planning may be performed in real time. At present, the most common imaging modality utilized for intra‐operative prostate HDR is U/S. Alternatively, in the post‐operative setting, following needle implantation, patients may be simulated with computed tomography (CT) or magnetic resonance imaging (MRI). Each imaging modality and workflow provides its share of benefits and limitations.Prostate HDR has been adopted in a number of cancer centers across the nation. In this educational session, we will explore the role of U/S, CT, and MRI in HDR prostate brachytherapy. Example workflows and operational details will be shared, and we will discuss how to establish a prostate HDR program in a clinical setting.

Learning Objectives:
Review prostate HDR techniques based on the imaging modality
Discuss the challenges and pitfalls introduced by the three imagebased options for prostate HDR brachytherapy
Review the QA process and learn about the development of clinical workflows for these imaging options at different institutions
MO‐B‐207B‐00: Harmonization & Robustness in Radiomics
Authors: Court Laurence Edward 
Published: July 2016

Feature extraction for radiomics studies typically comprises the following stages: Imaging, segmentation, image processing, and feature extraction. Each of these stages has associated uncertainties that can affect the quality of a radiomics model created using the resulting image features. For example, the imaging device manufacturer and model have been shown to impact the values of image features, as have pixel size and imaging protocol parameters. Image processing, such as low‐pass filtering to reduce noise, also changes calculated image features and should be designed to optimize the information content of the resulting features. The details of certain feature algorithms, such as co‐occurrence matrix bin sizes, are also important, and should be optimized for specific radiomics tasks. The volume of the region of interest should be considered as image features can be related to volume and can give unanticipated results when the volumes are too small. In this session we will describe approaches to quantify the variabilities in radiomics studies, including the most recent results quantifying these variabilities for CT, MRI and PET imaging. We will discuss methods to optimize image processing and feature extraction in order to maximize the information content of the image features. Finally, we will describe work to harmonize imaging protocols and feature calculations to help minimize uncertainties in radiomics studies.Learning Objectives:At the end of this session, participants will be able to:

Identify the sources of uncertainty in radiomics studies (CT, PET, and MRI imaging)
Describe methods for quantifying the magnitude of uncertainties
Describe approaches for mitigating the effects of the uncertainties on radiomics modelsFunding from NIH, CPRIT, Varian, Elekta; L. Court, NCI, CPRIT, Varian, Elekta
MO‐C‐BRB‐02: The Physicists’ Leadership Role in Academic Radiology: The Chair's Perspective
Authors: Arenson R. 
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‐03: Delivering Value Outside the Ivory Tower
Authors: Beyer D. 
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‐DE‐204‐00: International Symposium: Patient Dose Reduction in Diagnostic Radiology
Authors: Lief Eugene 
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‐DE‐201‐02: Self Awareness
Authors: Johnson J. 
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