bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO‐DE‐201‐03
Authors: Fahey F. 
Published: June 2015

Fundamental knowledge of radiologic anatomy and physiology is critical for medical physicists. Many physicists are exposed to this topic only in graduate school, and knowledge is seldom formally evaluated or assessed after Part I of the ABR exam. Successful interactions with clinicians, including surgeons, radiologists, and oncologists requires that the medical physicist possess this knowledge. This course presents a review of radiologic anatomy and physiology as it applies to projection radiography, fluoroscopy, CT, MRI, U/S, and nuclear medicine. We will review structural anatomy, manipulation of tissue contrast, the marriage between anatomy and physiology, and explore how medical imaging exploits normal and pathological processes in the body to generate contrast.Learning Objectives:

Review radiologic anatomy.
Examine techniques to manipulate tissue contrast in radiology.
Integrate anatomy and physiology in molecular imaging.
MO‐DE‐204‐06
Authors: Pelc N. 
Published: June 2015

A great deal of progress has been made in iterative/statistical image reconstruction for x‐ray CT, and major vendors have products available for their systems. These image reconstruction algorithms are nonlinear, and therefore present challenges related to image quality evaluation. For example, pixel noise standard deviation is likely not to correlate to perceived image quality and spatial resolution is likely to be contrast dependent. The purpose of this symposium is to inform medical physicists on these challenges and what methods are available for judging image quality and improvements. Following this background, speakers will describe the methods that are available on various commercial systems.The symposium consists of:Kyle Myers: “Evaluation of Nonlinear Reconstruction MethodsKarl Stierstorfer: “Advanced Reconstruction Methods on Siemens CT Systems”Jiang Hsieh: “Advanced Reconstruction Methods on GE CT Systems”Wenli Wang: “Advanced Reconstruction Methods on Toshiba CT Systems”Sandra Halliburton: “Advanced Reconstruction Methods on Philips CT Systems”Panel DiscussionLearning Objectives:

Challenges and methods for evaluating image quality in nonlinear systems
Understand the advanced reconstruction methods available on commercial systems
Understand the benefits provided by the advanced reconstruction techniques
Research support: Philips Healthcare and GE Healthcare
MO‐E‐BRD‐00: Breast Brachytherapy: The Phoenix of Radiation Therapy
Authors: Libby Bruce 
Published: June 2015

Is Non‐invasive Image‐Guided Breast Brachytherapy Good? – Jess Hiatt, MSNon‐invasive Image‐Guided Breast Brachytherapy (NIBB) is an emerging therapy for breast boost treatments as well as Accelerated Partial Breast Irradiation (APBI) using HDR surface breast brachytherapy. NIBB allows for smaller treatment volumes while maintaining optimal target coverage. Considering the real‐time image‐guidance and immobilization provided by the NIBB modality, minimal margins around the target tissue are necessary.Accelerated Partial Breast Irradiation in brachytherapy: is shorter better? ‐ Dorin Todor, PhD VCUA review of balloon and strut devices will be provided together with the origins of APBI: the interstitial multi‐catheter implant. A dosimetric and radiobiological perspective will help point out the evolution in breast brachytherapy, both in terms of devices and the protocols/clinical trials under which these devices are used. Improvements in imaging, delivery modalities and convenience are among the factors driving the ultrashort fractionation schedules but our understanding of both local control and toxicities associated with various treatments is lagging. A comparison between various schedules, from a radiobiological perspective, will be given together with a critical analysis of the issues.

to review and understand the evolution and development of APBI using brachytherapy methods
to understand the basis and limitations of radio‐biological ‘equivalence’ between fractionation schedules
to review commonly used and proposed fractionation schedules
Intra‐operative breast brachytherapy: Is one stop shopping best?‐ Bruce Libby, PhD. University of VirginiaA review of intraoperative breast brachytherapy will be presented, including the Targit‐A and other trials that have used electronic brachytherapy. More modern approaches, in which the lumpectomy procedure is integrated into an APBI workflow, will also be discussed.Learning Objectives:

To review past and current clinical trials for IORT
To discuss lumpectomy‐scan‐plan‐treat workflow for IORT
MO‐E‐213‐02: Medical Physicist Involvement in Implementing Patient Protection Standards
Authors: Seibert J. 
Published: June 2015

The focus of work of medical physicists in 1980's was on quality control and quality assurance. Radiation safety was important but was dominated by occupational radiation protection. A series of over exposures of patients in radiotherapy, nuclear medicine and observation of skin injuries among patients undergoing interventional procedures in 1990's started creating the need for focus on patient protection. It gave medical physicists new directions to develop expertise in patient dosimetry and dose management. Publications creating awareness on cancer risks from CT in early part of the current century and over exposures in CT in 2008 brought radiation risks in public domain and created challenging situations for medical physicists. Increasing multiple exposures of individual patient and patient doses of few tens of mSv or exceeding 100 mSv are increasing the role of medical physicists. Expansion of usage of fluoroscopy in the hands of clinical professionals with hardly any training in radiation protection shall require further role for medical physicists. The increasing publications in journals, recent changes in Safety Standards, California law, all increase responsibilities of medical physicists in patient protection. Newer technological developments in dose efficiency and protective devices increase percentage of time devoted by medical physicists on radiation protection activities. Without radiation protection, the roles, responsibilities and day‐to‐day involvement of medical physicists in diagnostic radiology becomes questionable. In coming years either medical radiation protection may emerge as a specialty or medical physicists will have to keep major part of day‐to‐day work on radiation protection.Learning Objectives:

To understand how radiation protection has been increasing its role in day‐to‐day activities of medical physicist
To be aware about international safety Standards, national and State regulations that require higher attention to radiation protection than in past
To be aware about possible emergence of medical radiation protection as a specialty and challenges for medical physicists.
MO‐F‐304‐00: PQI
Authors: Jones Aaron 
Published: June 2015

With the current Maintenance of Certification (MOC) requirement for a practice quality improvement (PQI) project every 3 years, we all (well, most of us) find ourselves searching for projects that are both manageable and likely to have a positive impact on our clinical practice. In this session we will walk through the use of the Plan, Do, Study, Act (PDSA) cycle to address a common finding in practices where fluoroscopically guided interventions (FGI) are performed: variation in procedural doses among physicians. We will also examine strategies to secure physician support using carrots, not sticks.Learning Objectives:

Review the PDSA cycle and its application to PQI.
Discuss strategies for action in the example presented.
Examine strategies for successful group PQI projects.
A. Kyle Jones: Owner, FluoroSafetyJoseph R. Steele: Consultant, FluoroSafety
MO‐F‐304‐01: Applying PDSA to a Practical Clinical Problem: Variation in Procedural Doses Among Interventional Radiologists
Authors: Jones A. 
Published: June 2015

With the current Maintenance of Certification (MOC) requirement for a practice quality improvement (PQI) project every 3 years, we all (well, most of us) find ourselves searching for projects that are both manageable and likely to have a positive impact on our clinical practice. In this session we will walk through the use of the Plan, Do, Study, Act (PDSA) cycle to address a common finding in practices where fluoroscopically guided interventions (FGI) are performed: variation in procedural doses among physicians. We will also examine strategies to secure physician support using carrots, not sticks.Learning Objectives:

Review the PDSA cycle and its application to PQI.
Discuss strategies for action in the example presented.
Examine strategies for successful group PQI projects.
A. Kyle Jones: Owner, FluoroSafetyJoseph R. Steele: Consultant, FluoroSafety
MO‐F‐304‐02
Authors: Steele J. 
Published: June 2015

With the current Maintenance of Certification (MOC) requirement for a practice quality improvement (PQI) project every 3 years, we all (well, most of us) find ourselves searching for projects that are both manageable and likely to have a positive impact on our clinical practice. In this session we will walk through the use of the Plan, Do, Study, Act (PDSA) cycle to address a common finding in practices where fluoroscopically guided interventions (FGI) are performed: variation in procedural doses among physicians. We will also examine strategies to secure physician support using carrots, not sticks.Learning Objectives:

Review the PDSA cycle and its application to PQI.
Discuss strategies for action in the example presented.
Examine strategies for successful group PQI projects.
A. Kyle Jones: Owner, FluoroSafetyJoseph R. Steele: Consultant, FluoroSafety
MO‐FG‐BRD‐01: Real‐Time Imaging and Tracking Techniques for Intrafractional Motion Management: Introduction and KV Tracking
Authors: Fahimian B. 
Published: June 2015

Intrafraction target motion is a prominent complicating factor in the accurate targeting of radiation within the body. Methods compensating for target motion during treatment, such as gating and dynamic tumor tracking, depend on the delineation of target location as a function of time during delivery. A variety of techniques for target localization have been explored and are under active development; these include beam‐level imaging of radio‐opaque fiducials, fiducial‐less tracking of anatomical landmarks, tracking of electromagnetic transponders, optical imaging of correlated surrogates, and volumetric imaging within treatment delivery. The Joint Imaging and Therapy Symposium will provide an overview of the techniques for real‐time imaging and tracking, with special focus on emerging modes of implementation across different modalities. In particular, the symposium will explore developments in 1) Beam‐level kilovoltage X‐ray imaging techniques, 2) EPID‐based megavoltage X‐ray tracking, 3) Dynamic tracking using electromagnetic transponders, and 4) MRI‐based soft‐tissue tracking during radiation delivery.Learning Objectives:

Understand the fundamentals of real‐time imaging and tracking techniques
Learn about emerging techniques in the field of real‐time tracking
Distinguish between the advantages and disadvantages of different tracking modalities
Understand the role of real‐time tracking techniques within the clinical delivery work‐flow
MO‐FG‐BRD‐02: Real‐Time Imaging and Tracking Techniques for Intrafractional Motion Management: MV Tracking
Authors: Berbeco R. 
Published: June 2015

Intrafraction target motion is a prominent complicating factor in the accurate targeting of radiation within the body. Methods compensating for target motion during treatment, such as gating and dynamic tumor tracking, depend on the delineation of target location as a function of time during delivery. A variety of techniques for target localization have been explored and are under active development; these include beam‐level imaging of radio‐opaque fiducials, fiducial‐less tracking of anatomical landmarks, tracking of electromagnetic transponders, optical imaging of correlated surrogates, and volumetric imaging within treatment delivery. The Joint Imaging and Therapy Symposium will provide an overview of the techniques for real‐time imaging and tracking, with special focus on emerging modes of implementation across different modalities. In particular, the symposium will explore developments in 1) Beam‐level kilovoltage X‐ray imaging techniques, 2) EPID‐based megavoltage X‐ray tracking, 3) Dynamic tracking using electromagnetic transponders, and 4) MRI‐based soft‐tissue tracking during radiation delivery.Learning Objectives:

Understand the fundamentals of real‐time imaging and tracking techniques
Learn about emerging techniques in the field of real‐time tracking
Distinguish between the advantages and disadvantages of different tracking modalities
Understand the role of real‐time tracking techniques within the clinical delivery work‐flow
MO‐FG‐BRB‐01: Investing to Address the Global Cancer Challenge
Authors: Atun R. 
Published: June 2015

The global burden of cancer is growing rapidly with an estimated 15 million new cases per year worldwide in 2015, growing to 19 million by 2025 and 24 million by 2035. The largest component of this growth will occur in low‐to‐middle income countries (LMICs). About half of these cases will require radiation treatment. The gap for available cancer treatment, including radiation therapy, between high‐income countries (HICs) and LMICs is enormous. Accurate data and quantitative models to project the needs and the benefits of cancer treatment are a critical first step in closing the large cancer divide between LMICs and HICs. In this context, the Union for International Cancer Control (UICC) has developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC) with a charge to answer the question as to what it will take to close the gap between what exists today and reasonable access to radiation therapy globally by 2035 and what the potential clinical and economic benefits are for doing this. The Task Force has determined the projections of cancer incidence and the infrastructure required to provide access to radiation therapy globally. Furthermore it has shown that appropriate investment not only yields improved clinical outcomes for millions of patients but that it also provides an overall economic gain throughout all the income settings where this investment is made. This symposium will summarize the facets associated with this global cancer challenge by reviewing the cancer burden, looking at the requirements for radiation therapy, reviewing the benefits of providing such therapy both from a clinical and economic perspective and finally by looking at what approaches can be used to aid in the alleviation of this global cancer challenge. The speakers are world renowned experts in global public health issues (R. Atun), medical physics (D. Jaffray) and radiation oncology (N. Coleman).Learning Objectives:

To describe the global cancer challenge and the corresponding potential benefits of addressing this challenge.
To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge.
To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.
MO‐FG‐BRB‐04
Authors: Van Dyk J. 
Published: June 2015

The global burden of cancer is growing rapidly with an estimated 15 million new cases per year worldwide in 2015, growing to 19 million by 2025 and 24 million by 2035. The largest component of this growth will occur in low‐to‐middle income countries (LMICs). About half of these cases will require radiation treatment. The gap for available cancer treatment, including radiation therapy, between high‐income countries (HICs) and LMICs is enormous. Accurate data and quantitative models to project the needs and the benefits of cancer treatment are a critical first step in closing the large cancer divide between LMICs and HICs. In this context, the Union for International Cancer Control (UICC) has developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC) with a charge to answer the question as to what it will take to close the gap between what exists today and reasonable access to radiation therapy globally by 2035 and what the potential clinical and economic benefits are for doing this. The Task Force has determined the projections of cancer incidence and the infrastructure required to provide access to radiation therapy globally. Furthermore it has shown that appropriate investment not only yields improved clinical outcomes for millions of patients but that it also provides an overall economic gain throughout all the income settings where this investment is made. This symposium will summarize the facets associated with this global cancer challenge by reviewing the cancer burden, looking at the requirements for radiation therapy, reviewing the benefits of providing such therapy both from a clinical and economic perspective and finally by looking at what approaches can be used to aid in the alleviation of this global cancer challenge. The speakers are world renowned experts in global public health issues (R. Atun), medical physics (D. Jaffray) and radiation oncology (N. Coleman).Learning Objectives:

To describe the global cancer challenge and the corresponding potential benefits of addressing this challenge.
To describe what radiation therapy infrastructure, in terms of facilities, equipment and personnel, will be required to address this challenge.
To describe models of addressing personnel and infrastructure mobilization and capacity building within regions where significant cancer treatment disparities exist.
MO‐FG‐BRA‐02: Modulation of Clinical Orthovoltage X‐Ray Spectrum Further Enhances Radiosensitization of Cancer Cells Targeted with Gold Nanoparticles
Authors: Wolfe T , Reynoso F , Cho J , Quini C , Cortez M , Manohar N , Krishnan S , Cho S 
Published: June 2015

Purpose:To assess the potential to amplify radiosensitization of cancer cells targeted with gold nanoparticles by augmenting selective spectral components of X‐ray beam.Methods:Human prostate cancer cells were treated for 24h with gold nanorods conjugated to goserelin acetate or pegylated, systematically washed and irradiated with 250 kVp X‐rays (25mA, 0.25mm Cu‐ filter, 8x8cm2 field size, 50cm SSD) with or without an additional 0.25 mm Erbium (Er) filter. As demonstrated in a companion Monte Carlo study, Er‐filter acted as an external target to feed Erbium K‐shell X‐ray fluorescence photons (∼50 keV) into the 250 kVp beam. After irradiation, we performed measurements of clonogenic viability with doses between 0 ‐6Gy, irreparable DNA damage assay to measure double‐strand breaks via γH2AX‐foci staining, and production of stable reactive oxygen species (ROS).Results:The clonogenic assay for the group treated with conjugated nanoparticles showed radiosensitization enhancement factor (REF), calculated at the 10% survival fraction aisle, of (1.62±0.07) vs. (1.23±0.04) with/without the Er‐filter in the 250 kVp beam, respectively. The group treated with pegylated nanoparticles, albeit retained in modest amounts within the cells, also showed statistically significant REF (1.13±0.09) when the Erbium filter was added to the beam. No significant radiosensitization was observed for other groups. Measurements of ROS levels showed increments of (1.9±0.2) vs. (1.4±0.1) for combined treatment with targeted nanoparticles and Er‐filtered beam. γH2AX‐foci showed 50% increase for the same treatment combination, confirming the enhanced radiosensitization in a consistent fashion.Conclusion:Our study demonstrates the feasibility of enhancing radiosensitization of cancer cells by combining actively targeted gold nanoparticles and modulating the X‐ray spectrum in the desired energy range. The established technique will not only help develop strategies to maximize nanoparticle‐mediated radiosensitization but also offer a convenient way to acquire unprecedented insights into the role of photon energy for the observed radiosensitization effects.Supported by DOD/PCRP grant W81XWH‐12‐1‐0198
MO‐FG‐BRA‐04: Leveraging the Abscopal Effect Via New Design Radiotherapy Biomaterials Loaded with Immune Checkpoint Inhibitors
Authors: Hao Y , Cifter G , Altundal Y , Sinha N , Moreau M , Sajo E , Makrigiorgos G , Ngwa W 
Published: June 2015

Purpose:Studies show that stereotactic body radiation therapy (SBRT) of a primary tumor in combination with immune checkpoint inhibitors (ICI) could Result in an immune‐mediated regression of metastasis outside the radiation field, a phenomenon known as abscopal effect. However toxicities due to repeated systematic administration of ICI have been shown to be a major obstacle in clinical trials. Towards overcoming these toxicity limitations, we investigate a potential new approach whereby the ICI are administered via sustained in‐situ release from radiotherapy (RT) biomaterials (e.g. fiducials) coated with a polymer containing the ICI.Methods:New design RT biomaterials were prepared by coating commercially available spacers/fiducials with a biocompatible polymer (PLGA) film containing fluorescent nanoparticles of size needed to load the ICI. The release of the nanoparticles was investigated in‐vitro. Meanwhile, an experimentally determined in‐ vivo nanoparticle diffusion coefficient was employed in analytic calculations based on Fick's second law to estimate the time for achieving the concentrations of ICI in the tumor draining lymph node (TDLN) that are needed to engender the abscopal effect during SBRT. The ICI investigated here was anti‐CTLA‐4 antibody (ipilimumab) at approved FDA concentrations.Results:Our in ‐vitro study results showed that RT biomaterials could be designed to achieve burst release of nanoparticles within one day. Meanwhile, our calculations indicate that for a 2 to 4 cm tumor it would take 4–22 days, respectively, following burst release, for the required concentration of ICI nanoparticles to accumulate in the TDLN during SBRT.Conclusion:Current investigations combining RT and immunotherapy involve repeated intravenous administration of ICI leading to significant systemic toxicities. Our preliminary results highlight a potential new approach for sustained in‐situ release of the ICI from new design RT biomaterials. These results provide impetus for more studies to leverage the powerful abscopal effect, while minimizing systemic toxicities through the new approach.