bluuebunny/crossref_metadata_2025_split huggingface dataset:
TU‐D‐201‐02: Medical Physics Practices for Plan and Chart Review: Results of AAPM Task Group 275 Survey
Authors: Fong de los Santos L , Dong L , Greener A , Johnson J , Johnson P , Kim G , Mechalakos J , Napolitano B , Parker S , Schofield D , Wells M , Yorke E , Ford E 
Published: July 2016

Purpose:AAPM Task Group (TG) 275 is charged with developing riskbased guidelines for plan and chart review clinical processes. As part of this work an AAPM‐wide survey was conducted to gauge current practices.Methods:The survey consisted of 103 multiple‐choice questions covering the following review processes for external beam including protons: 1) Initial Plan Check, 2) On‐Treatment and 3) End‐of‐Treatment Chart Check. The survey was designed and validated by TG members with the goal of providing an efficient and easy response process. The survey, developed and deployed with the support of AAPM headquarters, was released to all AAPM members who have self‐reported as working in the radiation oncology field and it was kept open for 7 weeks.Results:There are an estimated 4700 eligible participants. At the time of writing, 962 completed surveys have been collected with an average completion time of 24 minutes. Participants are mainly from community hospitals (40%), academicaffiliated hospitals (31%) and free‐standing clinics (18%). Among many other metrics covered on the survey, results so far indicate that manual review is an important component on the plan and chart review process (>90%) and that written procedures and checklists are widely used (>60%). However, the details of what is reviewed or checked are fairly heterogeneous among the sampled medical physics community.Conclusion:The data gathered from the survey gauging current practices will be used by TG 275 to develop benchmarks and recommendations for the type and extent of checks to perform effective physics plan and chart review processes.
TU‐D‐201‐08: Experience Complying with The Joint Commission Element of Performance On Radiation Dose Index Monitoring
Authors: Supanich MP 
Published: July 2016

Purpose:A new Joint Commission element of performance effective July 2015 requires incidents where the radiation dose index exceeds a defined level be reviewed, analyzed and compared to external benchmarks. This work offers a comprehensive review of the CT exams in which the notification level was exceeded and the reason at one academic medical center. This review may help other institutions set reference levels at clinically relevant values.Methods:Radiation Dose Structured Reports from each of the 5 diagnostic CT scanners at our institution are automatically sent to our radiation dose index monitoring software platform, Radimetrics from Bayer Healthcare. Global notification levels for CTDIvol and DLP were configured in Radimetrics for head, chest and abdomen studies for 0–2 year old, 2–13 year old and adult age categories. Global CTDIvol notification levels were set lower than the AAPM recommended values. Additional notification levels were configured for specific protocols that do not use AEC or have better or limited image quality requirements. Notifications of exams exceeding the global or protocol specific notification levels were reviewed on an ongoing basis by a Qualified Medical Physicist and the reason(s) for the acquisition or exam exceeding the level recorded.Results:Out of 80 notifications for acquisitions or exams exceeding notification levels over an 8 month period, 72 occurred due to large patients or due to implants or external hardware in the scan range. Four instances of the incorrect protocol being selected were recorded and 4 instances of incorrect manual technique application were observed.Conclusion:Properly configured notification levels, even below those recommended by AAPM, produce few dose notifications on modern scanners using AEC and/or iterative reconstruction. Using SSDE instead of CTDI for notifications may provide more clinically relevant data on exams well above or below the clinical norm for dose and image quality.Mark P. Supanich: Global Informatics Advisory Board Member: Bayer HealthCare
TU‐D‐BRC‐00: The EPID Strikes Back
Authors: Sawant Amit 
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‐207B‐02: Delta‐Radiomics: The Prognostic Value of Therapy‐Induced Changes in Radiomics Features for Stage III Non‐Small Cell Lung Cancer Patients
Authors: Fave X , Zhang L , Yang J , Mackin D , Stingo F , Followill D , Balter P , Jones A , Gomez D , Court L 
Published: July 2016

Purpose:To determine how radiomics features change during radiation therapy and whether those changes (delta‐radiomics features) can improve prognostic models built with clinical factors.Methods:62 radiomics features, including histogram, co‐occurrence, run‐length, gray‐tone difference, and shape features, were calculated from pretreatment and weekly intra‐treatment CTs for 107 stage III NSCLC patients (5–9 images per patient). Image preprocessing for each feature was determined using the set of pretreatment images: bit‐depth resample and/or a smoothing filter were tested for their impact on volume‐correlation and significance of each feature in univariate cox regression models to maximize their information content. Next, the optimized features were calculated from the intratreatment images and tested in linear mixed‐effects models to determine which features changed significantly with dose‐fraction. The slopes in these significant features were defined as delta‐radiomics features. To test their prognostic potential multivariate cox regression models were fitted, first using only clinical features and then clinical+delta‐radiomics features for overall‐survival, local‐recurrence, and distant‐metastases. Leave‐one‐out cross validation was used for model‐fitting and patient predictions. Concordance indices(c‐index) and p‐values for the log‐rank test with patients stratified at the median were calculated.Results:Approximately one‐half of the 62 optimized features required no preprocessing, one‐fourth required smoothing, and one‐fourth required smoothing and resampling. From these, 54 changed significantly during treatment. For overall‐survival, the c‐index improved from 0.52 for clinical factors alone to 0.62 for clinical+delta‐radiomics features. For distant‐metastases, the c‐index improved from 0.53 to 0.58, while for local‐recurrence it did not improve. Patient stratification significantly improved (p‐value<0.05) for overallsurvival and distant‐metastases when delta‐radiomics features were included. The delta‐radiomics versions of autocorrelation, kurtosis, and compactness were selected most frequently in leave‐one‐out iterations.Conclusion:Weekly changes in radiomics features can potentially be used to evaluate treatment response and predict patient outcomes. High‐risk patients could be recommended for dose escalation or consolidation chemotherapy.This project was funded in part by grants from the National Cancer Institute (NCI) and the Cancer Prevention Research Institute of Texas (CPRIT).
TU‐D‐207B‐04: Identifying High‐Risk Tumor Volume Based On Multi‐Region and Integrated Analysis of Multi‐Parametric MR Images for Prognostication of Glioblastoma
Authors: Ren X , Cui Y , Gao H , Li R 
Published: July 2016

Purpose:To identify high‐risk tumor volume for predicting survival in patients with glioblastoma on the basis of multi‐region and integrated analysis of multi‐parametric MR images.Methods:In this retrospectively study, 34 patients with glioblastoma from the Cancer Imaging Archive (TCIA) were analyzed. The patients were included if all of the pre‐operative 1) T1‐weighted contrast‐enhanced (T1c), 2) T2‐weighted fluid‐attenuation inversion recovery (FLAIR), and 3) diffusion‐weighted (DW) MR images were available. The apparent diffusion coefficient (ADC) map was calculated from the DW images. Both the FLAIR and ADC images were co‐registered onto the T1c image by rigid transformation. For each patient, gross tumor volume (GTV) was first semi‐automatically delineated with a cell automation and level‐set evolution algorithm. To fully capture the intrinsic intra‐tumor heterogeneity of glioblastoma reflected on multiparametric MR images, we further segmented the delineated tumor into several spatially distinct and phenotypically consistent subregions using k‐means clustering, with T1c, FLAIR, and ADC voxel intensities as input features. The optimal number of clusters was determined based on the Calinski‐Harabasz statistic. Finally, tumor volumes associated with potentially high‐risk subregions were evaluated in terms of overall survival (OS) prediction.Results:Three tumor subregions were identified within each glioblastoma. The tumor volume associated with the subregion of the lowest mean ADC values was prognostic of OS, with a concordance index (CI) of 0.648 (log‐rank P=0.005, hazard ratio=3.82) and outperforming GTV (CI=0.627, log‐rank P=0.019, hazard ratio=3.04). Less or similar prognostic performances were achieved for tumor volumes associated with subregions of the highest mean T1c intensities (CI=0.607, log‐rank P=0.035, hazard ratio=2.57) and the highest mean FLAIR intensities (CI=0.613, log‐rank P=0.014, hazard ratio=3.08).Conclusion:Multi‐region, integrated analysis of multi‐parametric MRI identified high‐risk tumor volume in glioblastoma. Integration of functional imaging with conventional MR sequences can potentially improve prediction of survival.
TU‐D‐207B‐05: Intra‐Tumor Partitioning and Texture Analysis of DCE‐MRI Identifies Relevant Tumor Subregions to Predict Early Pathological Response of Breast Cancer to Neoadjuvant Chemotherapy
Authors: Wu J , Gong G , Cui Y , Li R 
Published: July 2016

Purpose:To predict early pathological response of breast cancer to neoadjuvant chemotherapy (NAC) based on quantitative, multi‐region analysis of dynamic contrast enhancement magnetic resonance imaging (DCE‐MRI).Methods:In this institution review board‐approved study, 35 patients diagnosed with stage II/III breast cancer were retrospectively investigated using DCE‐MR images acquired before and after the first cycle of NAC. First, principal component analysis (PCA) was used to reduce the dimensionality of the DCE‐MRI data with a high‐temporal resolution. We then partitioned the whole tumor into multiple subregions using k‐means clustering based on the PCA‐defined eigenmaps. Within each tumor subregion, we extracted four quantitative Haralick texture features based on the gray‐level co‐occurrence matrix (GLCM). The change in texture features in each tumor subregion between pre‐ and during‐NAC was used to predict pathological complete response after NAC.Results:Three tumor subregions were identified through clustering, each with distinct enhancement characteristics. In univariate analysis, all imaging predictors except one extracted from the tumor subregion associated with fast wash‐out were statistically significant (p< 0.05) after correcting for multiple testing, with area under the ROC curve or AUCs between 0.75 and 0.80. In multivariate analysis, the proposed imaging predictors achieved an AUC of 0.79 (p = 0.002) in leave‐one‐out cross validation. This improved upon conventional imaging predictors such as tumor volume (AUC=0.53) and texture features based on whole‐tumor analysis (AUC=0.65).Conclusion:The heterogeneity of the tumor subregion associated with fast wash‐out on DCE‐MRI predicted early pathological response to neoadjuvant chemotherapy in breast cancer.
TU‐D‐207B‐07: Radiomic Response Assessment for Recurrent Glioblastoma Treated with Bevacizumab in the BRAIN Trial
Authors: Grossmann P , Narayan V , Huang R , Aerts H 
Published: July 2016

Purpose:To develop radiomic biomarkers for non‐invasive response assessment of Bevacizumab (Avastin; Genentech) treatment in recurrent glioblastoma multiforme (GBM).Methods:We analyzed prospectively acquired data from the BRAIN trial. For 167 patients, we extracted 71 radiomic features each from normalized post‐contrast T1‐weighted and fluid attenuation inversion recovery (FLAIR) sequences at baseline (pretreatment), and at follow‐ups of six and twelve weeks (post‐treatment), respectively, where available. For every imaging modality and time point, we selected 10 comprehensive features using an unsupervised feature selection approach that did not take clinical outcomes into account to limit overfitting. We investigated these features in terms of their prognostic value for overall survival (OS), progression‐free survival (PFS), as well as early and late progressors.Results:T1 and FLAIR features showed only low correlation at baseline (mean positive and negative Pearson correlation of ‐ 0.13 and 0.3) indicating complementary effects of imaging modalities at the radiomic level. We identified a textural‐heterogeneity feature (large area emphasis) that had higher prognostic value of OS at baseline as compared to conventional tumor volume (C‐index 0.71 vs 0.52, p = 0.006). Highest prognostic value was observed for the delta difference between baseline and six week follow‐up values for short‐run lengths of image intensities (Cindex 0.86, p = 2×10−8). Radiomic features generally showed similar or lower performances for PFS. Comparing radiomic feature values of early and late progressors directly showed significant differences in tumor surface and textural features after correcting for multiple‐testing (Wilcoxon rank sum test, p < 0.05).Conclusion:For the first time, our study allows the definition of radiomic response phenotypes of Bevacizumab treatment in recurrent GBM by leveraging high‐quality prospective trial data. Importantly, our data suggests the increased benefit of measuring radiomic patient profiles longitudinally after treatment has been initiated to monitor progression and resistance for immediate intervention and treatment adaptation.
TU‐FG‐204‐00: Compliance with the AAPM CT Clinical Practice and Joint Commission Guidelines
Authors: Szczykutowicz Timothy 
Published: July 2016

The role of a medical physicist involved with clinical CT activities is changing rapidly. No longer is the physicist responsible for simply ensuring scanner QA. This shift is evident by looking at the trend to regulate more and more aspects of what activities must be performed to keep a CT practice within compliance. In this symposium, new guidelines from the ACR, Joint Commission, and several states will be addressed. An overview of these regulations will be provided. Then, three speakers will provide an in‐depth account of how their CT protocol Optimization team functions. Lastly, a representative from the Joint Commission will provide recent surveyor education, experience, and trend information.

Learning Objectives:
Understand the ACR, Joint Commission, and aspects of several state regulations/guidelines related to the clinical practice of CT.
Learn how a CT protocol optimization is organized and what tasks physicists perform from the perspective of four different institutions.T. Szczykutowicz, TPS provides CT protocols to GE Healthcare under a license agreement. TPS receives grant support from GE Healthcare.
TU‐FG‐204‐04: An Overview of the CT Protocol Optimization Team at MD Anderson Cancer Center
Authors: Cody D. 
Published: July 2016

The role of a medical physicist involved with clinical CT activities is changing rapidly. No longer is the physicist responsible for simply ensuring scanner QA. This shift is evident by looking at the trend to regulate more and more aspects of what activities must be performed to keep a CT practice within compliance. In this symposium, new guidelines from the ACR, Joint Commission, and several states will be addressed. An overview of these regulations will be provided. Then, three speakers will provide an in‐depth account of how their CT protocol Optimization team functions. Lastly, a representative from the Joint Commission will provide recent surveyor education, experience, and trend information.

Learning Objectives:
Understand the ACR, Joint Commission, and aspects of several state regulations/guidelines related to the clinical practice of CT.
Learn how a CT protocol optimization is organized and what tasks physicists perform from the perspective of four different institutions.T. Szczykutowicz, TPS provides CT protocols to GE Healthcare under a license agreement. TPS receives grant support from GE Healthcare.
TU‐FG‐204‐05: Diagnostic Imaging: Surveyor Education, Survey Experience, and Trends
Authors: Browne A. 
Published: July 2016

The role of a medical physicist involved with clinical CT activities is changing rapidly. No longer is the physicist responsible for simply ensuring scanner QA. This shift is evident by looking at the trend to regulate more and more aspects of what activities must be performed to keep a CT practice within compliance. In this symposium, new guidelines from the ACR, Joint Commission, and several states will be addressed. An overview of these regulations will be provided. Then, three speakers will provide an in‐depth account of how their CT protocol Optimization team functions. Lastly, a representative from the Joint Commission will provide recent surveyor education, experience, and trend information.

Learning Objectives:
Understand the ACR, Joint Commission, and aspects of several state regulations/guidelines related to the clinical practice of CT.
Learn how a CT protocol optimization is organized and what tasks physicists perform from the perspective of four different institutions.T. Szczykutowicz, TPS provides CT protocols to GE Healthcare under a license agreement. TPS receives grant support from GE Healthcare.
TU‐FG‐207B‐00: Federal Funding Opportunities and Grantsmanship
Authors: Farahani Keyvan 
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 membersB. Whelan, this work was commissioned and funded by the AAPM
TU‐FG‐207B‐02: NIBIB Funding Opportunities
Authors: Krosnick S. 
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 membersB. Whelan, this work was commissioned and funded by the AAPM
TU‐FG‐207B‐03: NCI Small Business Funding Opportunities
Authors: Narayanan D. 
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 membersB. Whelan, this work was commissioned and funded by the AAPM