bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO‐E‐18C‐03: Incorporating Active Learning Into A Traditional Graduate Medical Physics Course
Authors: Burmeister J 
Published: July 2014

Purpose:To improve the ability of graduate students to learn medical physics concepts through the incorporation of active learning techniques.Methods:A traditional lecture‐based radiological physics course was modified such that: (1) traditional (two‐hour) lectures were provided online for students to watch prior to class, (2) a student was chosen randomly at the start of each class to give a two minute synopsis of the material and its relevance (two‐minute drill), (3) lectures were significantly abbreviated and remaining classroom time used for group problem solving, and (4) videos of the abbreviated lectures were made available online for review. In the transition year, students were surveyed about the perceived effects of these changes on learning. Student performance was evaluated for 3 years prior to and 4 years after modification.Results:The survey tool used a five point scale from 1=Not True to 5=Very True. While nearly all students reviewed written materials prior to class (4.3±0.9), a minority watched the lectures (2.1±1.5). A larger number watched the abbreviated lectures for further clarification (3.6±1.6) and found it helpful in learning the content (4.2±1.0). Most felt that the two‐minute drill helped them get more out of the lecture (3.9±0.8) and the problem solving contributed to their understanding of the content (4.1±0.8). However, no significant improvement in exam scores resulted from the modifications (mean scores well within 1 SD during study period).Conclusion:Students felt that active learning techniques improved their ability to learn the material in what is considered the most difficult course in the program. They valued the ability to review the abbreviated class lecture more than the opportunity to watch traditional lectures prior to class. While no significant changes in student performance were observed, aptitude variations across the student cohorts make it difficult to draw conclusions about the effectiveness of active learning.
MO‐E‐18C‐05: Global Health Catalyst: A Novel Platform for Enhancing Access to Medical Physics Education and Research Excellence (AMPERE)
Authors: Ngwa W , Moreau M , Asana L 
Published: July 2014

Purpose:To develop a platform for catalyzing collaborative global Cancer Care Education and Research (CaRE), with a prime focus on enhancing Access to Medical Physics Education and Research Excellence (AMPERE)Methods:An analysis of over 50 global health collaborations between partners in the U.S. and low and middle income countries (LMIC) in Africa was carried out to assess the models of collaborations in Education and Research and relative success. A survey was carried out with questions including: the nature of the collaboration, how it was initiated, impact of culture and other factors, and recommendations for catalyzing/enhancing such collaborations. An online platform called Global Health Catalyst was developed for enhancing AMPERE.Results:The analysis yielded three main models for global health collaborations with survey providing key recommendations on how to enhance such collaborations. Based on this, the platform was developed, and customized to allow Medical Physicists and other Radiation oncology (RadOnc) professionals interested in participating in Global health to readily do so e.g. teach an online course module, participate in training Medical Physicists or other RadOnc health professionals in LMIC, co‐mentor students, residents or postdocs, etc. The growing list of features on the platform also include: a feature to enable people to easily find each other, form teams, operate more effectively as partners from different disciplines, institutions, nations and cultural backgrounds, share tools and technologies, obtain seed funding to develop curricula and/or embark upon new areas of investigation, and participate in humanitarian outreach: remote treatment planning assistance, and participation in virtual Chart Rounds, etc.Conclusion:The developed Global Health Catalyst platform could enable any Medical Physicist or RadoOnc professional interested in global health to readily participate in the Education/training of next generation RadOnc professionals and global health leaders, and enhance AMPERE, especially for LMIC.
MO‐E‐18C‐06: Enriching Medical Physics Education By Visualizing The Invisible
Authors: Sprawls P 
Published: July 2014

Purpose:To enhance the understanding of medical physics concepts and develop higher levels of learning relating to invisible physics phenomena such as radiation. To provide medical physics educators in all countries of the world with understanding of knowledge structures in the human brain, the different levels of learning, and the types of knowledge required for higher level functions such as problem solving, creative innovations, and applied clinical applications. To provide medical physics educators with an open access resource (tool) that they can use in their teaching activities to enrich and elevate the level of learning for their students, residents, etc. with respect to the invisible realm of medical physics.Methods:An experienced clinical medical physicist and educator has created and provided with open access three complementary web‐based resources to achieve the purposes described above. One is a module focusing on the medical physics learning process with respect to mental knowledge structures, how they relate to outcomes and applications, and learning activities that are required to develop the required knowledge structures. The second is an extensive set of visuals that educators can use in their activities (classes, small group discussions, etc.) to visualize the invisible. The third is an interactive online simulation where learners can adjust factors and visually observe changes in x‐radiation. These resources are available online at www.BLINDEDFORREVIEW.Results:Medical physics education, especially for non‐physicists, is becoming much more interesting and useful especially with respect to invisible radiation. The global impact is that medical imaging professionals can be more effective in optimizing x‐ray imaging procedures and risk management when they have knowledge levels that enhance problem solving, innovation, and creativity.Conclusion:Medical physics educators in all institutions can be much more effective and efficient in the sharing of their knowledge and experience when enhanced with high‐quality visuals.
MO‐E‐9A‐01: Risk Based Quality Management: TG100 In Action
Authors: Huq M , Palta J , Dunscombe P , Thomadsen B 
Published: July 2014

One of the goals of quality management in radiation therapy is to gain high confidence that patients will receive the prescribed treatment correctly. To accomplish these goals professional societies such as the American Association of Physicists in Medicine (AAPM) has published many quality assurance (QA), quality control (QC), and quality management (QM) guidance documents. In general, the recommendations provided in these documents have emphasized on performing device‐specific QA at the expense of process flow and protection of the patient against catastrophic errors. Analyses of radiation therapy incidents find that they are most often caused by flaws in the overall therapy process, from initial consult through final treatment, than by isolated hardware or computer failures detectable by traditional physics QA. This challenge is shared by many intrinsically hazardous industries. Risk assessment tools and analysis techniques have been developed to define, identify, and eliminate known and/or potential failures, problems, or errors, from a system, process and/or service before they reach the customer. These include, but are not limited to, process mapping, failure modes and effects analysis (FMEA), fault tree analysis (FTA), and establishment of a quality management program that best avoids the faults and risks that have been identified in the overall process. These tools can be easily adapted to radiation therapy practices because of their simplicity and effectiveness to provide efficient ways to enhance the safety and quality of treatment processes. Task group 100 (TG100) of AAPM has developed a risk‐based quality management program that uses these tools. This session will be devoted to a discussion of these tools and how these tools can be used in a given radiotherapy clinic to develop a risk based QM program.Learning Objectives:

Learn how to design a process map for a radiotherapy process.
Learn how to perform a FMEA analysis for a given process.
Learn what Fault tree analysis is all about.
Learn how to design a quality management program based upon the information obtained from process mapping, FMEA and FTA.
MO‐E‐12A‐01: Quantitative Imaging: Techniques, Applications, and Challenges
Authors: Jackson E , McNitt‐Gray M , Jeraj R , Cao Y 
Published: July 2014

The first symposium in the Quantitative Imaging Track focused on the introduction of quantitative imaging (QI) by illustrating the potential of QI in diagnostic and therapeutic applications in research and patient care, highlighting key challenges in implementation of such QI applications, and reviewing QI efforts of selected national and international agencies and organizations, including the FDA, NCI, NIST, and RSNA. This second QI symposium will focus more specifically on the techniques, applications, and challenges of QI. The first talk of the session will focus on modalityagnostic challenges of QI, beginning with challenges of the development and implementation of QI applications in single‐center, single‐vendor settings and progressing to the challenges encountered in the most general setting of multi‐center, multi‐vendor settings. The subsequent three talks will focus on specific QI challenges and opportunities in the modalityspecific settings of CT, PET/CT, and MR. Each talk will provide information on modality‐specific QI techniques, applications, and challenges, including current efforts focused on solutions to such challenges.Learning Objectives:

Understand key general challenges of QI application development and implementation, regardless of modality.
Understand selected QI techniques and applications in CT, PET/CT, and MR.
Understand challenges, and potential solutions for such challenges, for the applications presented for each modality.
MO‐F‐16A‐01: Implementation of MPPG TPS Verification Tests On Various Accelerators
Authors: Smilowitz J , Bredfeldt J , Geurts M , Miller J 
Published: July 2014

Purpose:To demonstrate the implementation of the Medical Physics Practice Guideline (MPPG) for dose calculation and beam parameters verification of treatment planning systems (TPS).Methods:We implemented the draft TPS MPPG for three linacs: Varian Trilogy, TomoHDA and Elekta Infinity. Static and modulated test plans were created. The static fields are different than used in commissioning. Data was collected using ion chambers and diodes in a scanning water tank, Delta4 phantom and a custom phantom. MatLab and Microsoft Excel were used to create analysis tools to compare reference DICOM dose with scan data. This custom code allowed for the interpolation, registration and gamma analysis of arbitrary dose profiles. It will be provided as open source code. IMRT fields were validated with Delta4 registration and comparison tools. The time for each task was recorded.Results:The tests confirmed the strengths, and revealed some limitations, of our TPS. The agreement between calculated and measured dose was reported for all beams. For static fields, percent depth dose and profiles were analyzed with criteria in the draft MPPG. The results reveal areas of slight mismatch with the model (MLC leaf penumbra, buildup region.) For TomoTherapy, the IMRT plan 2%/2 mm gamma analysis revealed poorest agreement in the low dose regions. For one static test plan for all 10MV Trilogy photon beams, the plan generation, scan queue creation, data collection, data analysis and report took 2 hours, excluding tank setup.Conclusions:We have demonstrated the implementation feasibility of the TPS MPPG. This exercise generated an open source tool for dose comparisons between scan data and DICOM dose data. An easily reproducible and efficient infrastructure with streamlined data collection was created for repeatable robust testing of the TPS. The tests revealed minor discrepancies in our models and areas for improvement that are being investigated.
MO‐F‐16A‐06: Implementation of a Radiation Exposure Monitoring System for Surveillance of Multi‐Modality Radiation Dose Data
Authors: Stewart B , Kanal K , Dickinson R , Zamora D 
Published: July 2014

Purpose:We have implemented a commercially available Radiation Exposure Monitoring System (REMS) to enhance the processes of radiation dose data collection, analysis and alerting developed over the past decade at our sites of practice. REMS allows for consolidation of multiple radiation dose information sources and quicker alerting than previously developed processes.Methods:Thirty‐nine x‐ray producing imaging modalities were interfaced with the REMS: thirteen computed tomography scanners, sixteen angiography/interventional systems, nine digital radiography systems and one mammography system. A number of methodologies were used to provide dose data to the REMS: Modality Performed Procedure Step (MPPS) messages, DICOM Radiation Dose Structured Reports (RDSR), and DICOM header information. Once interfaced, the dosimetry information from each device underwent validation (first 15–20 exams) before release for viewing by end‐users: physicians, medical physicists, technologists and administrators.Results:Before REMS, our diagnostic physics group pulled dosimetry data from seven disparate databases throughout the radiology, radiation oncology, cardiology, electrophysiology, anesthesiology/pain management and vascular surgery departments at two major medical centers and four associated outpatient clinics. With the REMS implementation, we now have one authoritative source of dose information for alerting, longitudinal analysis, dashboard/graphics generation and benchmarking. REMS provides immediate automatic dose alerts utilizing thresholds calculated through daily statistical analysis. This has streamlined our Closing the Loop process for estimated skin exposures in excess of our institutional specific substantial radiation dose level which relied on technologist notification of the diagnostic physics group and daily report from the radiology information system (RIS). REMS also automatically calculates the CT size‐specific dose estimate (SSDE) as well as provides two‐dimensional angulation dose maps for angiography/interventional procedures.Conclusion:REMS implementation has streamlined and consolidated the dosimetry data collection and analysis process at our institutions while eliminating manual entry error and providing immediate alerting and access to dosimetry data to both physicists and physicians.Brent Stewart has funded research through GE Healthcare.
MO‐G‐BRE‐07: Risk Assessment of Surface Image Guided Stereotactic Radiosurgery
Authors: Manger R , Paxton A , Pawlicki T , Kim G 
Published: July 2014

Purpose:To develop a process map detailing the steps in the clinical workflow for surface imaging guided stereotactic radiosurgery (SRS), conduct a failure mode and effects analysis (FMEA) based on the process map, and perform fault tree analysis (FTA) on the steps with the highest risk priority number (RPN).Methods:A multi‐disciplinary team was assembled to develop a comprehensive process map listing the steps from initial consult to final treatment of a patient receiving surface image guided SRS. This process map represents the ideal workflow that would lead to successful treatment. An FMEA was conducted to determine the failure modes for each of the surface imaging related steps in the workflow and their relative risks. The risk priority numbers were calculated as the product of the occurrence, severity, and lack of detectability. The failure modes were ranked by RPN to determine the relative risk of the various steps in the process, and FTA was used to identify the potential causal relationshipsResults:The SRS process map contained over 90 steps, resulting in an FMEA with over 150 failure modes – about 25% associated with surface imaging. Based on the FMEA, the steps with the highest RPN were related to image registration, target delineation, and image handling. Surface imaging processes had considerably lower RPNs on average due to the high detectability of failure.Conclusion:The process map and FMEA presented in this work has reinforced the importance of image registration and target delineation in SRS. Clinicians considering proactive quality management of their SRS and/or surface imaging programs should be able to use the process map and FMEA as a template for their analyses. Although the occurrence rate and detection efficiency are dependent on the policies and procedures of an institution, the steps with the greatest RPN should not vary greatly.
MO‐G‐BRE‐08: Taxonomy of Corrective Actions in Radiotherapy
Authors: Sutlief S , Brown D 
Published: July 2014

Purpose:Various causal taxonomies have been developed for healthcare incidents and for radiation therapy in particular. The causal analysis of incidents leads to corrective actions which can also be organized into a taxonomy. Such a corrective action classification system would provide information about the situational context, the action type, and the leverage of the action in order to detect patterns in the corrective actions frequently employed in radiation therapy. It would also provide practical guidance to the radiation therapy community for determining the appropriateness and potential effectiveness of proposed corrective actions.Materials:A review of causal analysis reports and corrective action plans was conducted using the following sources: US NRC medical event reports, IAEA reports, ROSIS submissions, US Veterans Health Administration reports, and singleincident report sources. The corrective actions presented in the published sources were then mapped onto four corrective action taxonomy prototypes: role‐based, safety‐context‐based, responsibility‐based, and hierarchy of hazard control. The resulting corrective action taxonomy was then validated through use of the published sources.Results:The responsibility‐based taxonomy and hierarchy of hazard taxonomy provided more intuitive and sensible categories than the role‐based taxonomy or the safety‐context taxonomy. The most frequent corrective actions were added safety barriers, training, process standardization, and development of a quality improvement program where one was lacking.Conclusion:Published corrective action statements in radiation therapy emphasize what to do more so than whom the recipient is or which process step is affected. The hierarchy of hazard taxonomy provides a suitable framework for radiation therapy and has the advantage of providing insight into the likelihood that a particular corrective action will mitigate the recurrence of the error it was meant to correct. This information would be useful to medical center administration, safety personnel, and regulators who must assess the projected efficacy of corrective actions.Derek Brown is a director of TreatSafely, LLC.
MO‐G‐BRF‐01: BEST IN PHYSICS (JOINT IMAGING‐THERAPY) – Sensitivity of PET‐Based Texture Features to Respiratory Motion in Non‐Small Cell Lung Cancer (NSCLC)
Authors: Yip S , McCall K , Aristophanous M , Chen A , Aerts H , Berbeco R 
Published: July 2014

Purpose:PET‐based texture features are used to quantify tumor heterogeneity due to their predictive power in treatment outcome. We investigated the sensitivity of texture features to tumor motion by comparing whole body (3D) and respiratory‐gated (4D) PET imaging.Methods:Twenty‐six patients (34 lesions) received 3D and 4D [F‐18]FDG‐PET scans before chemo‐radiotherapy. The acquired 4D data were retrospectively binned into five breathing phases to create the 4D image sequence. Four texture features (Coarseness, Contrast, Busyness, and Complexity) were computed within the the physician‐defined tumor volume. The relative difference (δ) in each measure between the 3D‐ and 4D‐PET imaging was calculated. Wilcoxon signed‐rank test (p<0.01) was used to determine if δ was significantly different from zero. Coefficient of variation (CV) was used to determine the variability in the texture features between all 4D‐PET phases. Pearson correlation coefficient was used to investigate the impact of tumor size and motion amplitude on δ.Results:Significant differences (p<<0.01) between 3D and 4D imaging were found for Coarseness, Busyness, and Complexity. The difference for Contrast was not significant (p>0.24). 4D‐PET increased Busyness (∼20%) and Complexity (∼20%), and decreased Coarseness (∼10%) and Contrast (∼5%) compared to 3D‐PET. Nearly negligible variability (CV=3.9%) was found between the 4D phase bins for Coarseness and Complexity. Moderate variability was found for Contrast and Busyness (CV∼10%). Poor correlation was found between the tumor volume and δ for the texture features (R=−0.34−0.34). Motion amplitude had moderate impact on δ for Contrast and Busyness (R=−0.64− 0.54) and no impact for Coarseness and Complexity (R=−0.29−0.17).Conclusion:Substantial differences in textures were found between 3D and 4D‐PET imaging. Moreover, the variability between phase bins for Coarseness and Complexity was negligible, suggesting that similar quantification can be obtained from all phases. Texture features, blurred out by respiratory motion during 3D‐PET acquisition, can be better resolved by 4D‐PET imaging with any phase.
MO‐G‐BRF‐06: Radiotherapy and Prompt Oxygen Dynamics
Authors: Kissick M , Campos D , Adamson E , Niles D , Torres A , L Che Fru , Kimple R , Fain S , Jacques S , van der Kogel A 
Published: July 2014

Purpose:Adaptive radiotherapy requires a knowledge of the changing local tumor oxygen concentrations for times on the order of the treatment time, a time scale far shorter than cell death and proliferation. This knowledge will be needed to guide hypofractionated radiotherapy.Methods:A diffuse optical probe system was developed to spatially average over the whole interior of athymic Sprague Dawley nude mouse xenografts of human head and neck cancers. The blood volume and hemoglobin saturation was measured in real time. The quantities were measured with spectral fitting before and after 10 Gy of radiation is applied. An MRI BOLD scan is acquired before and after 10 Gy that measures regional changes in R2* which is inversely proportional to oxygen availability. Simulations were performed to fit the blood oxygen dynamics and infer changes in hypoxia within the tumor.Results:The optical probe measured nearly constant blood volume and a significant drop in hemoglobin saturation of about 30% after 10 Gy over the time scale of less than 30 minutes. The averaged R2* within the tumor volume increased by 15% after the 10 Gy dose, which is consistent with the optical results. The simulations and experiments support likely dynamic metabolic changes and/or fast vasoconstrictive signals are occurring that change the oxygen concentrations significantly, but not cell death or proliferation.Conclusion:Significant oxygen changes were observed to occur within 30 minutes, coinciding with the treatment time scale. This dynamic is very important for patient specific adaptive therapy. For hypofractionated therapy, the local instantaneous oxygen content is likely the most important variable to control. The invention of a bedside device for the purpose of measuring the instantaneous response to large radiation doses would be an important step to future improvements in outcome.