bluuebunny/crossref_metadata_2025_split huggingface dataset:
SU‐F‐E‐11: Perception and Implementation of Collaborative Documentation Technologies Among Medical Physics Educators and Industry Professionals: A Current Practice Survey
Authors: Johnson Angela N. 
Published: July 2016

Purpose:Collaboration on documents and manuscripts plays a central role in conveying medical physics concepts between interdisciplinary teams, necessary for knowledge‐building, acquiring funding, and translating scientific concepts to applied medical solutions. Conventional tools and emerging internet‐based solutions are used in generating and disseminating physics documents among teams. This research aimed to gain insights on how medical physics professionals and educators are using collaborative documentation software and team practices.Methods:An online survey based on a modified version of the Noel & Roberts (2004) collaborative documentation survey in 'Computer Supported Cooperative Work’ was used to collect data from 102 industry practitioners and educators engaged primarily in medical physics. Items includes 30 scaled and qualitative assessments of software use, inputs, time spent on documentation tasks and related activities (meetings, leadership, task assignment, etc.), number of collaborators, documentation volume and practices, revision and publication strategies, and attitudes toward documentation software.Results:Of 102 respondents, 74 completed all survey sections, and 58/74 (78%) reported using collaborative document technologies, but only 35% of these were fully satisfied with the technology. A total of 27/58 (47.37%) reported collaborative documentation tools assisted in meeting established deadlines. Most collaborative documentation projects spanned weeks, and required a commitment of 17.68 hours/week (2 – 80, median 15). Between 2–100 synchronous meetings lasting 1–5 hr/meeting were required, most commonly held before starting writing (43.64%) to discuss technical contents (85.96%), document requirements (61.40%), assign tasks (54.39%), or resolve team conflicts (52.63%). Results were presented as a visual infographic, potentially useful as a teaching aid.Conclusion:While reportedly easy to use, most online collaborative tools did not fully meet physicist documentation needs, including deficiencies in security, load times, information presentation capabilities, and role assignment. These insights can help improve collaborative documentation software development and training programs for new authors in medical physics fields.The author is an employee of GE Healthcare. This study was completed through the author's academic doctoral work and no funding or other interests were provided by the author's employer.
SU‐F‐P‐04: Implementation of Dose Monitoring Software: Successes and Pitfalls
Authors: Och J 
Published: July 2016

Purpose:to successfully install a dose monitoring software (DMS) application to assist in CT protocol and dose management.Methods:Upon selecting the DMS, we began our implementation of the application. A working group composed of Medical Physics, Radiology Administration, Information Technology, and CT technologists was formed. On‐site training in the application was supplied by the vendor. The decision was made to apply the process for all the CT protocols on all platforms at all facilities. Protocols were painstakingly mapped to the correct masters, and the system went ‘live’.Results:We are routinely using DMS as a tool in our Clinical Performance CT QA program. It is useful in determining the effectiveness of revisions to existing protocols, and establishing performance baselines for new units. However, the implementation was not without difficulty. We identified several pitfalls and obstacles which frustrated progress. Including: Training deficiencies, Nomenclature problems, Communication, DICOM variability.Conclusion:Dose monitoring software can be a potent tool for QA. However, implementation of the program can be problematic and requires planning, organization and commitment.
SU‐F‐P‐08: Medical Physics Perspective On Radiation Therapy Quality and Safety Considerations in Low Income Settings
Authors: Van Dyk J , Meghzifene A 
Published: July 2016

Purpose:The last few years have seen a significant growth of interest in the global radiation therapy crisis. Various organizations are quantifying the need and providing aid in support of addressing the shortfall existing in many low‐to‐middle income countries (LMICs). The Lancet Oncology Commission report (Lancet Oncol. Sep;16(10):1153‐86, 2015) projects a need of 22,000 new medical physicists in LMICs by 2035 if there is to be equal access globally. With the tremendous demand for new facilities, equipment and personnel, it is very important to recognize quality and safety considerations and to address them directly.Methods:A detailed examination of quality and safety publications was undertaken. A paper by Dunscombe (Front. Oncol. 2: 129, 2012) reviewed the recommendations of 7 authoritative reports on safety in radiation therapy and found the 12 most cited recommendations, summarized in order of most to least cited: training, staffing, documentation/standard operating procedures, incident learning, communication/questioning, check lists, QC/PM, dosimetric audit, accreditation, minimizing interruptions, prospective risk assessment, and safety culture. However, these authoritative reports were generally based on input from high income contexts. In this work, the recommendations were analyzed with a special emphasis on issues that are significant in LMICs.Results:The review indicated that there are significant challenges in LMICs with training and staffing ranking at the top in terms quality and safety.Conclusion:With the recognized need for expanding global access to radiation therapy, especially in LMICs, and the backing by multiple support organizations, quality and safety considerations must be overtly addressed. While multidimensional, training and staffing are top priorities. The use of outdated systems with poor interconnectivity, coupled with a lack of systematic QA in high patient load settings are additional concerns. Any support provided to lower resourced settings must address the multiple facets associated with these quality and safety indicators.
SU‐F‐P‐20: Predicting Waiting Times in Radiation Oncology Using Machine Learning
Authors: Joseph A , Herrera D , Hijal T , Hendren L , Leung A , Wainberg J , Sawaf M , Gorshkov M , Maglieri R , Keshavarz M , Kildea J 
Published: July 2016

Purpose:Waiting times remain one of the most vexing patient satisfaction challenges facing healthcare. Waiting time uncertainty can cause patients, who are already sick or in pain, to worry about when they will receive the care they need. These waiting periods are often difficult for staff to predict and only rough estimates are typically provided based on personal experience. This level of uncertainty leaves most patients unable to plan their calendar, making the waiting experience uncomfortable, even painful. In the present era of electronic health records (EHRs), waiting times need not be so uncertain. Extensive EHRs provide unprecedented amounts of data that can statistically cluster towards representative values when appropriate patient cohorts are selected. Predictive modelling, such as machine learning, is a powerful approach that benefits from large, potentially complex, datasets. The essence of machine learning is to predict future outcomes by learning from previous experience. The application of a machine learning algorithm to waiting time data has the potential to produce personalized waiting time predictions such that the uncertainty may be removed from the patient's waiting experience.Methods:In radiation oncology, patients typically experience several types of waiting (eg waiting at home for treatment planning, waiting in the waiting room for oncologist appointments and daily waiting in the waiting room for radiotherapy treatments). A daily treatment wait time model is discussed in this report. To develop a prediction model using our large dataset (with more than 100k sample points) a variety of machine learning algorithms from the Python package sklearn were tested.Results:We found that the Random Forest Regressor model provides the best predictions for daily radiotherapy treatment waiting times. Using this model, we achieved a median residual (actual value minus predicted value) of 0.25 minutes and a standard deviation residual of 6.5 minutes. This means that the majority of our estimates are within 6.5 minutes of the actual wait time.Conclusion:The goal of this project was to define an appropriate machine learning algorithm to estimate waiting times based on the collective knowledge and experience learned from previous patients. Our results offer an opportunity to improve the information that is provided to patients and family members regarding the amount of time they can expect to wait for radiotherapy treatment at our centre.AJ acknowledges support by the CREATE Medical Physics Research Training Network grant of the Natural Sciences and Engineering Research Council (Grant number: 432290) and from the 2014 Q+ Initiative of the McGill University Health Centre.
SU‐F‐P‐22: Will the Low Residency Placement Rate Scare Talented Candidates Away from Our Profession?
Authors: Loughery B , Hendrickson K , Burmeister J 
Published: July 2016

Purpose:The low placement rate (∼25%) of medical physics residency match applicants is well‐known to medical physics graduate students, and is beginning to be appreciated by prospective students. We examine this placement rate in detail and its potential impact on future recruitment into our profession based on survey data of both match applicants and program directors.Methods:To evaluate and validate residency placement rates, we analyzed annual CAMPEP graduate and residency program reports and data from individual graduate program websites. Programs were excluded if they had no graduates or ambiguous placement statistics. We surveyed medical physics match applicants and directors of CAMPEP‐accredited residency programs to gauge their attitudes toward this placement rate.Results:Cumulative data extracted from program websites agreed with CAMPEP reports to within 20 graduates (7% error) and 2 residents (2% error) in 2013. The 2013 residency placement rate was 25.5% for MS and 30.8% for PhD graduates. Overall placement rates range from 0% to 66%. 108 match applicants and 40 program directors responded to the survey. The vast majority of graduates (85.2%) responded that the current residency placement rate is a problem for our profession, compared to only 40% of program directors. More strikingly, 40% of match applicants responded that they would reconsider entering the profession if they had prior knowledge of this residency placement rate.Conclusion:Our current residency placement rate presents a bleak picture to prospective students interested in board certified clinical practice. Survey data indicates that this may deter future students from our profession. While our profession seeks solutions, we have an ethical obligation to ensure that incoming students are fully educated about their professional prospects. Moreover, we must evaluate effects of current initiatives on the attractiveness of our education and training infrastructure to prevent the loss of talented future medical physicists.
SU‐F‐P‐25: Dosimetric Changes of Brainstem Caused by Weight Loss During Intensity‐Modulated Radiation Therapy for Nasopharyngeal Carcinoma
Authors: Hu W , Yu C , Cai Y , Zhou X , Wang W , Yang H 
Published: July 2016

Purpose:To explore dosimetric effects of brainstem (BS) caused by weight loss during the course of intensity‐modulated radiation therapy (IMRT) for nasopharyngeal carcinoma (NPC).Methods:Seventy‐seven patients who were diagnosed with NPC by pathology biopsy have been enrolled. Every patients should receive weight measurement weekly and three times of computed tomography (CT) scans and replanning, at the 15th and 25th fraction during the treatment, respectively. The vertical diameter at the level of odontoid process (d1) and cervical vertebra 3 (d2) be measured from CT images (Supporting document Figure 1). All IMRT plans were designed by inverse planning with commercial treatment planning systems (Corvus 6.2 version, NOMOS Corporation). The dose differences between plan and actual delivery were generated to compare.Results:The weight loss was more in week 4–5 (3.21±2.19kg) than in week 1–3 (1.79±1.83kg) (Supporting document Figure 2). The d1 and d2 decreased was more significantly in week 4–5 than week 1–3, 2.83±1.75mm vs. 0.55±0.75mm and 2.98±2.96mm vs. 1.23±2.09mm, respectively. The maximum dose to the brainstem (BS Dmax) and the percentage of brainstem volume receiving ≥50Gy (BS V50) increased more significantly in week 4–5 than week 1–3, −3.02±5.49Gy vs. −1.85 ±4.88Gy and −1.85±4.88% vs. −0.77±3.32%, respectively. The changes of d1 and d2 and the BS‐V50 and BS‐Dmax were closely related to weight loss (p≤0.001)(Supporting document Table 1).Conclusion:The study results indicate that weight loss leads to the vertical diameter reduction, which results has a close relationship with dose of the brainstem during IMRT of NPC.This study was supported by Zhejiang Provincial Medicine and Health Foundation (2013KYB290) and Research Foundation of Science and Technology Department of Zhejiang Province 2015C33257
SU‐F‐P‐28: A Method of Maximize the Noncoplanar Beam Orientations and Assure the Beam Delivery Clearance for Stereotactic Body Radiation Therapy (SBRT)
Authors: Zhu J 
Published: July 2016

Purpose:Develop a method to maximize the noncoplanar beam orientations and assure the beam delivery clearance for SBRT, therefore, optimize the dose conformality to the target, increase the dose sparing to the critical normal organs and reduce the hot spots in the body.Methods:A SBRT body frame (Elekta, Stockholm, Sweden) was used for patient immobilization and target localization. The SBRT body frame has CT fiducials on its side frames. After patient's CT scan, the radiation treatment isocenter was defined and its coordinators referring to the body frame was calculated in the radiation treatment planning process. Meanwhile, initial beam orientations were designed based on the patient target and critical organ anatomy. The body frame was put on the linear accelerator couch and positioned to the calculated isocenter. Initially designed beam orientations were manually measured by tuning the body frame position on the couch, the gantry and couch angles. The finalized beam orientations were put into the treatment planning for dosimetric calculations.Results:Without patient presence, an optimal set of beam orientations were designed and validated. The radiation treatment plan was optimized and guaranteed for delivery clearance.Conclusion:The developed method is beneficial and effective in SBRT treatment planning for individual patient. It first allows maximizing the achievable noncoplanar beam orientation space, therefore, optimize the treatment plan for specific patient. It eliminates the risk that a plan needs to be modified due to the gantry and couch collision during patient setup.
SU‐F‐P‐31: Dosimetric Effects of Roll and Pitch Corrections Using Robotic Table
Authors: Mamalui M , Su Z , Flampouri S , Li Z 
Published: July 2016

Purpose:To quantify the dosimetric effect of roll and pitch corrections being performed by two types of robotic tables available at our institution: BrainLabTM 5DOF robotic table installed at VERO (BrainLab&MHI) dedicated SBRT linear accelerator and 6DOF robotic couch by IBA Proton Therapy with QFixTM couch top.Methods:Planning study used a thorax phantom (CIRSTM), scanned at 4DCT protocol; targets (IGTV, PTV) were determined according to the institutional lung site‐specific standards. 12 CT sets were generated with Pitch and Roll angles ranging from −4 to +4 degrees each. 2 table tops were placed onto the scans according to the modality‐specific patient treatment workflows. The pitched/rolled CT sets were fused to the original CT scan and the verification treatment plans were generated (12 photon SBRT plans and 12 proton conventional fractionation lung plans). Then the CT sets were fused again to simulate the effect of patient roll/pitch corrections by the robotic table. DVH sets were evaluated for all cases.Results:The effect of not correcting the phantom position for roll/pitch in photon SBRT cases was reducing the target coverage by 2% as maximum; correcting the positional errors by robotic table varied the target coverage within 0.7%. in case of proton treatment, not correcting the phantom position led to the coverage loss up to 4%, applying the corrections using robotic table reduced the coverage variation to less than 2% for PTV and within 1% for IGTV.Conclusion:correcting the patient position by using robotic tables is highly preferable, despite the small dosimetric changes introduced by the devices.
SU‐F‐R‐42: Association of Radiomic and Metabolic Tumor Volumes in Radiation Treatment of Glioblastoma Multiforme
Authors: Lopez C , Nagornaya N , Parra N , Kwon D , Ishkanian F , Markoe A , Maudsley A , Stoyanova R 
Published: July 2016

Purpose:High‐throughput extraction of imaging and metabolomic quantitative features from MRI and MR Spectroscopy Imaging (MRSI) of Glioblastoma Multiforme (GBM) results in tens of variables per patient. In radiotherapy (RT) of GBM, the relevant metabolic tumor volumes (MTVs) are related to aberrant levels of N‐acetyl Aspartate (NAA) and Choline (Cho). Corresponding Clinical Target Volumes (CTVs) for RT planning are based on Contrast Enhancing T1‐weighted MRI (CE‐T1w) and T2‐weighted/Fluid Attenuated Inversion Recovery (FLAIR) MRI. The objective is to build a framework for investigation of associations between imaging, CTV, and MTV features better understanding of the underlying information in the CTVs and dependencies between these volumes.Methods:Necrotic portions, enhancing lesion and edema were manually contoured on T1w/T2w images for 17 GBM patients. CTVs and MTVs for NAA (MTVNAA) and Cho (MTVCho) were constructed. Tumors were scored categorically for ten semantic imaging traits by neuroradiologist. All features were investigated for redundancy. Two‐way correlations between imaging and RT/MTV features were visualized as heat maps. Associations between MTVNAA, MTVCho and imaging features were studied using Spearman correlation.Results:39 imaging features were computed per patient. Half of the imaging traits were replaced with automatically extracted continuous variables. 21 features were extracted from MTVs/CTVs. There were a high number (43) of significant correlations of imaging with CTVs/MTVNAA while very few (10) significant correlations were with CTVs/MTVCho. MTVNAA was found to be closely associated with MRI volumes, MTVCho remains elusive for characterization with imaging.Conclusion:A framework for investigation of co‐dependency between MRI and RT/metabolic features is established. A series of semantic imaging traits were replaced with automatically extracted continuous variables. The approach will allow for exploration of relationships between sizes and intersection of imaging features of tumors, RT volumes, metabolite concentrations and comparing those to therapy outcome, quality of life evaluation and overall survival rate.This publication was supported by Grant 10BN03 from Bankhead Coley Cancer Research Program, R01EB000822, R01EB016064, and R01CA172210 from the National Institutes of Health, and Indo‐US Science & Technology Forum award #20‐2009. Bhaswati Roy received financial assistance from University Grant Commission, New Delhi, India.
SU‐F‐I‐05: Dose Symmetry for CTDI Equivalent Measurements with Limited Angle CBCT
Authors: Singh V , McKenney S , Sunde P , Feng W , Bakalyar D 
Published: July 2016

Purpose:CTDI measurements, useful for characterizing the x‐ray output for multi‐detector CT (MDCT), require a 360° rotation of the gantry; this presents a problem for cone beam CT (CBCT) due to its limited angular rotation. The purpose of this work is to demonstrate a methodology for overcoming this limited angular rotation so that CTDI measurements can also be made on CBCT systems making it possible to compare the radiation output from both types of system with a common metric.Methods:The symmetry of the CTDI phantom allows a 360° CTDI measurement to be replaced with two 180° measurements. A pencil chamber with a real‐time digitizer was placed at the center of the head phantom (16 cm, PMMA) and the resulting exposure measurement from a 180° acquisition was doubled. A pair of edge measurements, each obtained with the gantry passing through the same 180 arc, was obtained with the pencil chamber at opposite edges of the diameter of the phantom and then summed. The method was demonstrated on a clinical CT scanner (Philips, Brilliance6) and then implemented on an interventional system (Siemens, Axiom Artis).Results:The equivalent CTDI measurement agreed with the conventional CTDI measurement within 8%. The discrepancy in the two measurements is largely attributed to uncertainties in cropping the waveform to a 180°acquisition. (Note: Because of the reduced fan angle in the CBCT, CTDI is not directly comparable to MDCT values when a 32 cm phantom is used.)Conclusion:The symmetry‐based CTDI measurement is an equivalent measurement to the conventional CTDI measurement when the fan angle is large enough to encompass the phantom diameter. This allows a familiar metric of radiation output to be employed on systems with a limited angular rotation.
SU‐F‐I‐29: Investigating the Impact of the Amount of Contrast Material Used in Abdominal CT Examinations Regarding the Diagnosis of Appendicolith
Authors: Lavdas E , Boci N , Sarantaenna L , Godevenos A , Ntavelis I , Theodoropoulos T , Zaimis G , Mavroidis P 
Published: July 2016

Purpose:The purpose of this study is to report the case of a young adult in which the incomplete oral administration of contrast material led to diagnosis of an appendicolith, which cause acute appendicitis.Methods:A male 34 years old underwent CT examination due to acute abdominal pain in the upper abdomen. An ultrasound examination of the upper abdomen and kidneys, an x‐ray examination of the abdomen and a CT scan of the entire abdomen and pelvis after both oral and IV administration of contrast material were performed. In the ultrasound examination, both kidneys gallbladder and spleen appeared normal and the x‐ray examination did not show any pathological findings. As part of the CT examination, the patient received oral contrast material less than 500 ml due to lack of cooperation by the patient as a result of his abdominal pain.Results:The CT abdomen revealed a severely inflamed appendix that was significantly dilated at 1.1 cm. Moreover, it demonstrated a 1.4 cm appendicolith. The portion of the oral contrast material that was injected to the patient covered the upper abdomen and as a result an appendicolith could be revealed in the lower abdomen. If the patient had received the 1,000ml of contrast material, the whole abdomen would have been covered with the contrast in danger to lose the appendicolith, which caused the inflammation.Conclusion:Based on the findings of this study, in suspicion of acute appendicitis nephrolithiasis and ureterolithiasis, we propose to start the CT protocol with a CT scan without oral contrast material and then proceed with oral and IV contrast not only to succeed gastric intestinal differentiation but also to avoid covering the lower abdomen and obscure any small stones that may exist.