bluuebunny/crossref_metadata_2025_split huggingface dataset:
TU‐A‐141‐01: Multi Modal PET/CT Imaging for Therapy Response Early Prediction and Therapy Monitoring
Authors: Hatt M , Lambin P , Kinahan P 
Published: July 2013

Monitoring a patient's response during treatment plays an important role in optimizing personalized treatment strategy. It may offer the possibility to predict future response early during treatment and adapt therapy. It calls for an optimal use of existing and under development imaging technologies as well as image and data processing and analyses for characterizing tumor response. This lecture will provide an overview of three complementary points related to therapy response monitoring using PET/CT. The first one concerns the growing interest and potential future role of multi modal PET/CT imaging in response to therapy studies, from a clinical point of view. This will help the audience identifying which combinations of disease, associated treatments and radiotracers are concerned. The second point is associated with the technical issues and methodological requirements associated with implementing response to therapy monitoring in clinical studies, in terms of standardization and homogeneity of acquisition protocols (reproducibility) and optimal use of existing image reconstruction methods. Finally, the third point concerns the way produced images are exploited, processed and manually or semi‐automatically analyzed then integrated in multifactorial Decision Support Systems. Current and future trends in the development of advanced methods dedicated to facilitate processing and analysis of multi modal and sequential images PET/CT (and PET/MRI) will be discussed, as well as their potential future role for response to therapy monitoring based on multi modal imaging integrated with non imaging biomarkers of predictors.Learning Objectives1. Review the current and future role of multi modal PET/CT imaging in early prediction and monitoring of response to therapy in several clinical oncology and radiotherapy applications.2. Understand the requirements regarding standardization of imaging protocols and image generation in order to exploit multi modal image‐derived indices to characterize response to therapy.3. Envision the future directions in developing semi automated methods for multi modal images analysis and multifactorial decision support systems integrating imaging and non imaging biomarkers.
TU‐B‐137‐01: Radiobiological Principles of Fractionated Radiotherapy and the Potential for Hypofractionation
Authors: Orton Colin G 
Published: July 2013

Firstly, we will review why we fractionate at all, looking first at physical reasons then at the radiobiological aspects. Mechanisms by which radiation kills cells and ways cell damage can be repaired will be reviewed. Using the linear‐quadratic model we will show the effect of radiobiological parameters which we can control for radiotherapy including dose/fraction, number of fractions, time between fractions, overall treatment time, and dose rate. We will show that there is a “Window of Opportunity” at low doses/fraction within which we can control cancers without exceeding normal tissue tolerance. We will then show how the use of highly conformal radiotherapy widens this “Window of Opportunity” so that we can use higher doses/fraction and hence hypofractionation. Finally, we will review some potential caveats that might reduce the effectiveness of hypofractionation and, possibly, make it inappropriate for some cancers. These are the presence of significant fractions of hypoxic cancer cells, the possibility that low‐dose hyper‐radiosensitivity in normal surrounding tissue cells might reduce the effectiveness of conformal therapies, and the lengthening of treatment times when using high doses/fraction thus allowing intra‐fraction repair of cancer cells.Learning Objectives1. To understand why we fractionate and how the linear‐quadratic model can be used to demonstrate the effect of radiobiological parameters which we can control for radiotherapy.2. To understand why hypofractionation might be possible with highly conformal radiotherapy.3. To understand the circumstances when hypofractionation might not be appropriate.
TU‐E‐116‐01: Clinical Implementation for Advanced Brachytherapy Dose Calculation Algorithms Beyond the TG‐43 Formalism
Authors: Thomson R , Ballester F , Beaulieu L 
Published: July 2013

With the recent introduction of heterogeneity correction algorithms for brachytherapy, the AAPM community is still unclear on how to commission and implement these into clinical practice. The recently‐published AAPM TG‐186 report discusses important issues for clinical implementation of these algorithms. In this practical medical physics course, specific examples on how to perform the commissioning process are presented, as well as descriptions of the clinical impact from recent literature reporting comparisons of TG‐43 and heterogeneity‐based dosimetry. A proposed commissioning flowchart will be discussed, guiding the audience through the clinical process. Further, QA tests specific to these new heterogeneity correction algorithms for brachytherapy will be explained. Potential changes in brachytherapy dose prescriptions will be discussed, with pitfalls identified to minimize likelihood for errors.Learning Objectives:1. Identify key clinical applications needing advanced dose calculation in brachytherapy.2. Review TG‐186 guidelines, commission process, and dosimetry benchmarks.3. Evaluate clinical cases using a commercially available system and compare to TG‐43 dosimetry
TU‐F‐500‐01: Point and Counter Point Debate: Brachytherapy Is Better Than External Beam Therapy for Partial Breast Irradiation
Authors: Todor D , Becker S 
Published: July 2013

Partial breast irradiation (PBI) by either brachytherapy or external beam (EB) therapy is frequently used for the treatment of certain populations of breast cancer patients. The claim that brachytherapy is better than EB for PBI is the Proposition debated here.Advantages claimed for brachytherapy for PBI include:• brachytherapy is associated with smaller treatment volumes, lower integral doses, and smaller doses/fraction to normal tissues• dosimetric parameters which affect toxicity have been thoroughly investigated for brachytherapy• brachytherapy is supported by over ten years of study with excellent local control and minimal toxicity• with brachytherapy, evidence‐based treatment planning guidelines have been published.Advantages claimed for EB therapy include:• all clinics have linacs, whereas not all have an HDR unit or LDR facilities• brachytherapy requires specific skills and training that not all radiation oncologists have• brachytherapy is an invasive procedure• a brachytherapy program requires greater effort and staff to commission and maintain• brachytherapy is performed BID, which is inconvenient to patients• not all patients are appropriate for brachytherapy treatmentArguing FOR the Proposition is Dorin Todor, Ph.D. Dr. Todor obtained his Ph.D. in Physics from Old Dominion University, Norfolk, VA followed by a one‐year Research Fellowship at Memorial Sloan Kettering Cancer Center, New York. Since then he has worked at the Virginia Commonwealth University where he is currently an Associate Professor. His major research interests include real‐time 3D HDR source position detection and tracking, and dual fusion imaging for intraoperative planning, execution and evaluation of brachytherapy implants.Arguing against the Proposition is Stewart Becker, Ph.D. Dr. Becker obtained his M.S. and Ph.D. degrees in Medical Physics from the University of Wisconsin, Madison after which he moved to the Department of Radiation Oncology, New York University Medical Center, where he is currently Senior Physicist and Assistant Professor. His major research interests include image‐guided radiotherapy, and whole and accelerated partial breast radiotherapy.Learning Objectives1. To understand why brachytherapy might be better than external beam therapy for partial breast irradiation2. To understand why external beam therapy might be better than brachytherapy for partial breast irradiation3. To know how brachytherapy and external beam therapy differ when applied to partial breast irradiation
TU‐G‐WAB‐01: Advanced Applications in Deformable Registration
Authors: Brock K , Dong L , Hawkes D 
Published: July 2013

The field of deformable image registration has seen many technical advances over the past decade, with increases in accuracy, the speed of the algorithms, and the flexibility of the algorithm to handle complex, multi‐modality images. These technical advances have enabled further advances in the applications of deformable image registration. This symposium will cover exciting new applications of deformable registration, ranging from population models, to image‐guided treatments outside of external beam radiotherapy, to image validation through correlative pathology. Deformable registration is generally thought of to be between two images of the same patient, for purposes of aiding the patient's radiotherapy treatment. However, novel applications are using deformable registration in applications outside of this space. Examples will include the investigation of population based information, such as the determination of a risk‐based CTV. The use of deformable registration for image validation through correlative pathology will be described including challenges and results of early studies. Exciting advances of hybrid registration technology for robust and efficient deformable registration for image‐guided surgery will also be illustrated.Learning Objectives:1. Describe the use of deformable registration for advanced image‐guided treatments.2. Understand the application of deformable registration for population‐based models.3. Describe the use of deformable registration for image validation in correlative pathology.Dr. Brock has financial interest in deformable registration technology through a licensing agreement with Ray Search Laboratories.
TU‐G‐141‐07: An Innovative Iterative Neighboring Volume Morphing Algorithm Based On Landmark Mesh to Create 3DCT During Treatment
Authors: Wu H , Lu M , Cheng C 
Published: July 2013

Purpose: For the emerging 4D planning radiation treatment, 3DCT during treatment delivery is required. However, it is time consuming or impossible to acquire 3DCT during treatment delivery. This project will generate the 3DCT for any time instant based on a set of motion features (landmarks). Methods: Previously acquired 4DCT is used for landmark selection. The landmarks are monitored in real‐time during treatment delivery using two orthogonal x‐ray images. For any set of landmarks acquired at target phase T, the 3DCT of the nearest 4DCT phase will be selected as the source phase S based on landmark mesh similarity. The iterative morphing algorithm has 8 steps based on neighboring density volume, including landmark selection, isosurface and tumor center identification, landmark mapping using weighted 3‐layer mesh neighbors, landmark mesh similarity comparison, backward morphing based on density volume, and iterative volume morphing. It will generate the corresponding 3DCT at target phase. Results: To validate the morphing algorithm, first, the landmark mapping process using artificial deformation is assessed. The source 3DCT is deformed artificially by non‐linear matrices, which generated a ground truth to evaluate the resulting 3DCT. The iterative algorithm is appraised successfully with the artificial deformation approach. The second validation applies the landmark mapping and the volume morphing on real tumor data. Both the source and target 3DCTs are different phases of a lung 4DCT data. The statistical results, such as the min, max, and histogram of the density difference are summarized, which showed the resulting 3DCT is similar to the target 3DCT. The next step is to apply the whole algorithm to the unknown target 3DCT. Conclusion: The iterative morphing algorithm is innovative and time saving. It has many potential applications in real‐time image guided radiation treatment, such as online treatment error detection and intervention.Industrail Support from PerkinElmer Inc, Varian Medical Research
WE‐A‐103‐01: Ultrasound
Authors: Hangiandreou N , Larson S , Madsen E 
Published: July 2013

Ultrasound quality control (QC) testing is often over‐looked in ultrasound imaging practice because there are few regulations requiring regular QC of these systems. Many sites rely on the manufacturer's preventive maintenance program to ensure these systems are functioning optimally. However, the regulatory climate is changing, placing emphasis on safe and effective imaging practice. Regular QC testing of ultrasound equipment is a valuable tool that helps ensure proper function and good image quality in ultrasound imaging. This two‐hour session is organized in two parts. The first hour will cover the basic concepts of ultrasound performance measurement, including the tests that are recommended for acceptance and annual testing as well as routine QC, the rationale for these tests, and specific testing methods. It will also include what the physicist needs to know about ultrasound accreditation. The next hour includes two presentations related to quantitative assessment of ultrasound QC. First presented is the work of the AAPM working group on Quantitative B‐mode Ultrasound QC Test Development. This group has designed software intended to aid in the evaluation of transducer element condition. The second presentation will demonstrate use of a user‐friendly automation software, developed at the University of Wisconsin, for periodic rapid quality assurance (QA or QC) using the tissue‐mimicking conical window phantom described last year. The phantom has been designed specifically for determination of three basic parameters. A method for organizing an electronic filing system for paperless recording of results will also be described.Learning Objectives:1. Understand what constitutes an effective ultrasound QC program.2. Achieve familiarity with common ultrasound QC test methods and phantoms.3. Understand what the physicist needs to know about ultrasound program accreditation.4. Learn about a public software tool being developed by the AAPM Ultrasound Subcommittee to detect and assess transducer uniformity artifacts.5. Learn about a user‐friendly automation software tool to address the most‐recommended ultrasound QC tests.
WE‐C‐141‐01: Research and Relevance of Brachytherapy Dose Calculation Advancements
Authors: Rivard MJ , Ibbott GS , Ballester F , Tedgren A Carlsson , Mourtada F 
Published: July 2013

Research and Relevance of Brachytherapy Dose Calculation Advancements Organizer: Mark J. Rivard Moderator: Geoffrey S. Ibbott Speakers: Facundo Ballester, Asa Carlsson Tedgren, Firas Mourtada Brachytherapy dosimetry is undergoing a renaissance with the scrutiny of the AAPM TG‐43 dose calculation formalism and comparisons with alternate approaches such as the Monte Carlo method, the grid‐based Boltzmann solvers, and the collapsed‐cone technique. Treatment planning systems (TPS) using these more advanced, model‐based dose calculation algorithms (MBDCAs) are now available for clinical use. However, their accuracy and the preferred method for their use have not been established. Thus, it is important for smooth integration of new radiotherapy technology to not interrupt the cohesion of the current paradigm. Consequently, the AAPM, the European Society for Radiation Oncology (ESTRO), and the Australasian Brachytherapy Group (ABG) have forged an alliance to establish clinical benchmark cases for medical physicists to evaluate the TPS that incorporate MBDCA as the dose engine for brachytherapy. This is one charge of the Model Based Dose Calculation Algorithms in Brachytherapy working group. In support of these efforts, comparisons for several MBDCAs are underway and benchmark cases are being prepared.Learning Objectives:1. presentation on the background and rationale for MBDCA,2. quantitative comparisons amongst the MBDCA techniques, and3. the current status of the benchmark cases with plans for availability to the medical physics community.
WE‐E‐137‐01: RSO Refresher Training
Authors: Martel C , Fahey F 
Published: July 2013

The Role of the Radiation Safety Officer in the Medical InstitutionMedical institutions generally have a variety of sources of ionizing radiation including radioactive materials, x‐ray devices, and linear accelerators. The role of the RSO can vary widely from one facility to the next. The authority for the regulatory oversight of radioactive materials is delegated to the RSO via a radioactive materials license, and the responsibilities are clearly established. However, authority over other sources of ionizing radiation is less clear which can Result in significant gaps in radiation safety management programs. The responsibility of the RSO is least clear in the area of Radiation Therapy. The RSO may be involved in oversight where radioactive materials are used, but rarely are involved in oversight of external beam therapy. The lack of clarity regarding oversight authority, roles and responsibilities has led to medical events and serious gaps in radiation safety that leave patients, workers and the public at risk. Each institution must perform a thorough review to ensure that a consistent framework for managing radiation safety for all sources of ionizing radiation is applied. The Role of the Radiation Safety Officer in Nuclear MedicineNuclear medicine needs be practiced in a manner that is effective, safe for both employees and patients and compliant with all local, state and federal regulations. It is also imperative to meet the standards set by accrediting bodies such as the Joint Commission. Therefore, it is essential that the radiation safety officer work closely with the professional and technical staff working in nuclear medicine to accomplish this. In this presentation, the role of the radiation safety officer in nuclear medicine and the partnership between radiation safety and nuclear medicine will be discussed. This discussion will be in the context of both smaller programs with a specific radioactive materials license as well as larger programs with a broad license where institutional radiation safety committee may also be established. The items that will be review will be establishment of a hot laboratory for handling radiopharmaceuticals, the planning of an imaging room, particularly in the context of hybrid imaging, the acceptance of radiopharmaceutical shipments, personnel monitoring and the implementation of a set of good practices for radiation safety. Lastly, the communication of radiation dose and its potential, associated risk with patients and their families will be discussed.Learning Objectives:1. To understand the role and responsibilities of the Radiation Safety Officer within a medical institution2. To understand the role and responsibilities of the Radiation Safety Officer in a Nuclear Medicine Department.3. To be aware of health physics responsibilities that often are part of the responsibilities of the medical physicist.4. To understand the responsibility for safety with all sources of radiation, machines and materials.
WE‐E‐103‐02: Past, Present and Future Roles of ROC Analysis in Medical Imaging and Quantitative Image Analysis
Authors: Giger M , Toledano A , Myers K , Jiang Y 
Published: July 2013

Receiver Operating Characteristic (ROC) analysis has been a mainstay of many research developments as well as various clinical studies/trials. It has provided medical physicists with a way to objectively measure how data are presented in an image, how people perceive those images, and how one can compare different observers or different imaging modalities with each other. ROC analysis plays an important role in both technology assessment and clinical decision‐making, especially as various aspects of imaging biomarkers and personalized medicine are evaluated. Over the past five years, on average, almost 40 papers/year that were published in MEDICAL PHYSICS utilized ROC analysis. The challenges and opportunities in ROC analysis research and in its application in various tasks are active areas, including expanding the mathematical formulation for multiple lesions per image, location‐based sensitivity, and evaluation without ground truth, as well as expanding its role in imaging biomarker validation, assessing response to therapy, theranostics, and image‐based phenotyping with genomics (image‐omics).Learning Objectives:1. Review the mathematical foundations and implementation of ROC analysis in basic research and clinical trials; and understand the role and limitations of ROC analysis in large scale clinical studies/trials2. Recognize advances in ROC analysis in order to incorporate multiple lesions per image, location‐based sensitivity, evaluation without ground truth, theranostics, and others3. Appreciate the evolving role of ROC analysis in the evaluation of imaging biomarkers and image‐based phenotypingResearch supported by NIH, DOE, and DOD.COI: Stockholder, Hologic, Inc Shareholder, Quantitative Insights, Inc Royalties, Hologic, Inc Royalties, General Electric Company Royalties, MEDIAN Technologies Royalties, Riverain Technologies, LLC Royalties, Mitsubishi Corporation Royalties, Toshiba Maryellen Giger Corporation Researcher, Koninklijke Philips Electronics NV Researcher, U‐Systems, Inc
WE‐G‐137‐01: Medical Physics Economics
Authors: Goodwin J , White G , Dirksen B , Fuss W 
Published: July 2013

This presentation will review the aspects of medical physics economics and reimbursement that are relevant to the practicing clinical medical physicist. Covered topics will include:CPT© code development, valuation and useMedicare payment systems: Hospital Outpatient Prospective Payment System, Medicare Physician Fee Schedule and Ambulatory Surgical CentersGeneral coding and billing practicesUpcoming changes in reimbursementSources of informationAAPM economic activitiesKnowledge of these topics is essential to the practicing physicist to ensure that his/her work is recognized and billed for correctly. The presentation will not be a comprehensive billing seminar as coverage policies vary with location. However, general guidelines will be reviewed and sources of authoritative billing information will be included.Learning Objectives:1. Understand the three primary Medicare reimbursement systems, how they differ in coverage and in the way they determine reimbursement levels.2. Understand how CPT© codes are utilized to report billable work.3. Understand where to find authoritative billing and coding information.
TH‐B‐105‐01: Accuracy and Precision in Cranial Radiosurgery
Authors: Bichay T , Dieterich S , Schlesinger D 
Published: July 2013

Cranial radiosurgery has developed as a highly accurate treatment procedure for relatively small lesions. There is much discussion in the literature as to what degree of accuracy is possible when the treatment system is evaluated as a whole; including cranial fixation, localization, imaging, registration, contouring, dose calculation, etc. This is now commonly referred to as the end‐to‐end (E2E) test. The now‐dated AAPM report 54 (1995) suggested that the total uncertainty can reach 2–3 mm. However, many newer publications suggest a much tighter tolerance is achievable. This discussion will focus on the strengths, and weaknesses of well‐established cranial radiosurgery systems including Gamma Knife and CyberKnife, as well as linac‐based systems. The typical, and maximum accuracy of each system will be presented including benefits of mask immobilization and invasive ring fixation. The intent of these presentations is to outline the current state of cranial radiosurgery, and review relevant technologies that have improved our treatment accuracy. Limitations that still persist at this point will also be outlined and reviewed.Learning Objectives:1. Advantages of various radiosurgery technologies.2. Limitations of various radiosurgery technologies.3. Main hurdles in achieving sub‐millimeter treatment accuracy.4. Overall treatment accuracy assessed by E2E testing.