Field Of Medical Physics Research Articles

MO‐C‐12A‐01: Quantitative Imaging Initiatives: Why, Who, What, and How?

Over the past decade, there has been an increasing focus on quantitative imaging (QI), which, according to one definition, is “the extraction of quantifiable features from medical images for the assessment of normal or the severity, degree of change, or status of a disease, injury, or chronic condition relative to normal” (www.rsna.org/QIBA). To achieve the goals of QI requires the development and standardization of data acquisition, data analysis, and data display techniques, as well as appropriate reporting structures. As such, successful implementation of QI relies heavily on expertise from the fields of medical physics, radiology, statistics, and informatics as well as collaboration from vendors of imaging acquisition, analysis, and reporting systems. When successfully implemented, QI techniques will provide image‐derived metrics with known bias and variance that can be validated with anatomically and physiologically relevant measures, including treatment response, and the heterogeneity of that response, and outcome. Such non‐invasive measures can then be used effectively in clinical and translational research as well as patient care. In addition to modality‐specific QI efforts implemented by individual scientific organizations, national and international organizations, including the NCI, RSNA, FDA, and NIST, appreciating the tremendous potential of QI but also understanding the associated challenges, have become increasingly involved. This symposium session will focus on 1) introducing QI and illustrating why it is important, even though challenging, in both research and clinical applications, and 2) providing overviews of QI efforts from national and international organizations, including the RSNA, NCI, FDA, and NIST.Learning Objectives: Understand the importance and potential of QI in research and clinical applications. Understand key challenges of QI and current barriers to implementation. Understand the current QI efforts of several national and international agencies and organizations, including the FDA, NCI, NIST, and RSNA.

TU‐C‐BRF‐01: Innovation in Medical Physics and Engineering

We seek to heighten the awareness of the role of research and innovation that leads to clinical advances in the field of medical physics and engineering. Marie Curie (discovery and use of radium) and Harold Johns (Co‐60 tele‐therapy) in radiotherapy, and pioneers in imaging (Allan Cormack and Godfrey Hounsfield for the CT and Paul Lauterbur, Peter Mansfield for MRI, etc.) were scientists often struggling against great odds. Examples of more recent innovations that are clearly benefitting our patients include IMRT, Image Guided Radiation Therapy and Surgery, Particle Therapy, Quantitative imaging, amongst others.We would also like to highlight the fact that not all of the discovery and engineering that we benefit from in today’s world, was performed at research institutions alone. Rather, companies often tread new ground at financial and reputational risk. Indeed the strength of the private sector is needed in order to bring about new advances to our practice. The keys to long term success in research and development may very well include more public and private research spending. But, when more investigators are funded, we also need to recognize that there needs to be a willingness on the part of the funding institutions, academic centers and investigators to risk failure for the greater potential achievements in innovation and research. The speakers will provide examples and insight into the fields of innovation and research in medical physics from their own first hand experiences.Learning Objectives: To obtain an understanding of the importance of research and development towards advances in physics in medicine. To raise awareness of the role of interdisciplinary collaborations in translational research and innovation. To highlight the importance of entrepreneurships and industrial‐institutional research partnerships in fostering new ideas and their commercial success. To recognize and account for the risk of failure for the greater potential achievements in innovation and research.

MO‐A‐9A‐01: Innovation in Medical Physics Practice: 3D Printing Applications

3D printing, also called additive manufacturing, has great potential to advance the field of medicine. Many medical uses have been exhibited from facial reconstruction to the repair of pulmonary obstructions. The strength of 3D printing is to quickly convert a 3D computer model into a physical object. Medical use of 3D models is already ubiquitous with technologies such as computed tomography and magnetic resonance imaging. Thus tailoring 3D printing technology to medical functions has the potential to impact patient care. This session will discuss applications to the field of Medical Physics. Topics discussed will include introduction to 3D printing methods as well as examples of real‐world uses of 3D printing spanning clinical and research practice in diagnostic imaging and radiation therapy. The session will also compare 3D printing to other manufacturing processes and discuss a variety of uses of 3D printing technology outside the field of Medical Physics.Learning Objectives: Understand the technologies available for 3D Printing Understand methods to generate 3D models Identify the benefits and drawbacks to rapid prototyping / 3D Printing Understand the potential issues related to clinical use of 3D Printing

Demands on a continuing education online-study program for physicians

Physicians have an intense and irregular workday life. Thus, they need to use their time for continuing education in the most efficient way. This presents a major challenge to suppliers of continuing study programs. Our online master program Physico-Technical Medicine (PTM) addresses working physicians who want to acquire knowledge in the fields of biomedical engineering and medical physics [1]. We attach great importance to the special needs of our participants. Therefore, we investigated which general conditions are most important for the working physician regarding qualifying continuing education.

TU‐C‐116‐01: The Elements of a Highly Effective Educational Session

The class or conference room is the common setting for educational sessions in both academic institutions and continuing education conferences and programs such as those sponsored by the AAPM. A major value of a class/conference room program is one of efficiency by bringing a group of learners together to share in a common learning experience under the guidance of one or more learning facilitators (lecturers or presenters). The challenge is providing truly effective learning, especially in the field of medical physics. An effective learning activity is one which enables an individual to perform specific functions or tasks. The design of an educational activity needs to take into consideration the desired outcomes with respect to what the learners should be able to do. The distinction is that of being able to apply the knowledge to perform specific physics functions rather than just knowing and being able to recall facts, and perhaps do well on written examinations. These are two different types of knowledge structures within the human brain and distinctly different learning activities to develop each. Much of medical physics education, especially at the postgraduate and continuing education level, is for the purpose of enhancing the ability of physicists and other related professionals to perform applied procedures and tasks. An example we will use in this session is optimizing CT image quality and dose. The knowledge structure for this is best developed by observing and interacting with the physics activities that are being studied by working directly in the laboratory, clinic, or other real‐world environment under the direction of a knowable leader.The major limitation of the class/conference room is its physical separation from the applied physics activities taking place elsewhere and the limitation on one‐to‐one or small group activities. In this session we will focus on five initiatives that will consider these limitations and contribute to more effective class/conference room activities. They are:• Effective representations of the physics reality in the classroom • Development of useful knowledge structures in the human brain• Efficient utilization of class/conference room time and resources• Guided interactions, feedback, and real time assessment• Testing and verification of achievement. The function of the human brain will be considered with respect to learning experiences that contribute to effective medical physics knowledge structures. The characteristics of various types of educational activities will be compared with respect to their effectiveness for producing desired outcomes along with their limitations. The design of highly‐effective classroom/conference presentations and activities will be demonstrated with an emphasis of using technology to enhance human performance of both learners and the learning facilitators. The value and process of assessment for both the learners and facilitators/instructors during class activities will be described along with techniques to improve the use of audience response systems. There are many issues associated with the design of effective testing and question writing. This session will discuss effective test design which includes determining the best form of testing to use. Forms of testing will be discussed. Planning tests to assure reliability and effectiveness will be considered. Item writing requires knowledge of effective techniques to make sure questions are clear and unambiguous.Learning Objectives:1. Develop and provide highly effective medical physics educational sessions.2. Use technology to enhance human performance in the educational process.3. Integrate audience response systems into their presentations.4. Understand various types of testing and determine which should be used in various circumstances5. Write questions that are clear and effective

SU-E-T-492: High Precision Cross Sections and Physics Models for Proton Interactions Below 20 MeV in Geant4

Purpose: Geant4 is a Monte Carlo (MC) toolkit with an increasing use in the field of medical physics. Electromagnetic processes are well validated, but for hadronic interactions of charged particles at energies of the order of a few MeV, particularly for low Z materials, there are no physics models able to reproduce the experimental data. With the default version of Geant4, the cross sections and production of secondary particles for proton-nucleus interactions at an energy below 20 MeV are not satisfactory. In this study, a new physics package to simulate particles below 20 MeV has been added to Geant4. Methods: A new Geant4 package has been developed to simulate proton interactions below 20 MeV using the data on reaction cross sections and production of secondary particles contained in evaluated nuclear databases. The new package has been tested making use of the TENDL-2009 and TENDL-2012 databases to simulate the 18O(p,x) interactions for energies ranging from 4 MeV up to 20 MeV. For this particular reaction, we have also included in the database the accurate data that can be found in the IAEA medical database. Results: The obtained energy spectra of the secondary particles produced by the 18O(p,n) and 18O(p,gamma) reactions were compared with those calculated with the standard Geant4 physics, QGSP_BIC_HP, and also with suitable MCNPX calculations. The neutron and gamma production obtained with the new Geant4 package and TENDL/IAEA-libraries are significant from 4 MeV, while with the standard Geant4 physics there is no production of neutrons for energy below 8 MeV, while above 8 MeV the gamma and neutron production shows a wrong yield. Conclusion: A new high precision physics package with corresponding cross section libraries have been successfully added to the Geant4 MC toolkit for particle energies below 20 MeV, improving the accuracy and production rates of different secondaries.

TU‐C‐137‐01: Your First Job; Finding and Keeping It

New members to the field of Medical Physics find themselves in a very competitive market and will benefit from guidance on job seeking skills, negotiating salary/benefits, what type of job to look for, etc. Additionally, expectations may be different between employer and employee, and an understanding of how the clinical environment works as well as how it is changing will help newly employed physicists excel at their job.Learning Objectives:1. To understand the job market and how to successfully perform a job search2. To understand the importance of negotiating salary and benefits prior to employment3. To understand the nuances of today's clinical environment and how it is changing, in order to more easily adapt and excel.

Performance-optimized clinical IMRT planning on modern CPUs

Intensity modulated treatment plan optimization is a computationally expensive task. The feasibility of advanced applications in intensity modulated radiation therapy as every day treatment planning, frequent re-planning for adaptive radiation therapy and large-scale planning research severely depends on the runtime of the plan optimization implementation. Modern computational systems are built as parallel architectures to yield high performance. The use of GPUs, as one class of parallel systems, has become very popular in the field of medical physics. In contrast we utilize the multi-core central processing unit (CPU), which is the heart of every modern computer and does not have to be purchased additionally. In this work we present an ultra-fast, high precision implementation of the inverse plan optimization problem using a quasi-Newton method on pre-calculated dose influence data sets. We redefined the classical optimization algorithm to achieve a minimal runtime and high scalability on CPUs. Using the proposed methods in this work, a total plan optimization process can be carried out in only a few seconds on a low-cost CPU-based desktop computer at clinical resolution and quality. We have shown that our implementation uses the CPU hardware resources efficiently with runtimes comparable to GPU implementations, at lower costs.

Mapping the literature of radiation therapy

This study characterizes the literature of the radiation therapy profession, identifies the journals most frequently cited by authors writing in this discipline, and determines the level of coverage of these journals by major bibliographic indexes. Cited references from three discipline-specific source journals were analyzed according to the Mapping the Literature of Allied Health Project Protocol of the Nursing and Allied Health Resources Section of the Medical Library Association. Bradford's Law of Scattering was applied to all journal references to identify the most frequently cited journal titles. Journal references constituted 77.8% of the total, with books, government documents, Internet sites, and miscellaneous sources making up the remainder. Although a total of 908 journal titles were cited overall, approximately one-third of the journal citations came from just 11 journals. MEDLINE and Scopus provided the most comprehensive indexing of the journal titles in Zones 1 and 2. The source journals were indexed only by CINAHL and Scopus. The knowledgebase of radiation therapy draws heavily from the fields of oncology, radiology, medical physics, and nursing. Discipline-specific publications are not currently well covered by major indexing services, and those wishing to conduct comprehensive literature searches should search multiple resources.

National Institutes of Health Funding in Radiation Oncology: A Snapshot

Currently, pay lines for National Institutes of Health (NIH) grants are at a historical low. In this climate of fierce competition, knowledge about the funding situation in a small field like radiation oncology becomes very important for career planning and recruitment of faculty. Unfortunately, these data cannot be easily extracted from the NIH's database because it does not discriminate between radiology and radiation oncology departments. At the start of fiscal year 2013 we extracted records for 952 individual grants, which were active at the time of analysis from the NIH database. Proposals originating from radiation oncology departments were identified manually. Descriptive statistics were generated using the JMP statistical software package. Our analysis identified 197 grants in radiation oncology. These proposals came from 134 individual investigators in 43 academic institutions. The majority of the grants (118) were awarded to principal investigators at the full professor level, and 122 principal investigators held a PhD degree. In 79% of the grants, the research topic fell into the field of biology, 13% in the field of medical physics. Only 7.6% of the proposals were clinical investigations. Our data suggest that the field of radiation oncology is underfunded by the NIH and that the current level of support does not match the relevance of radiation oncology for cancer patients or the potential of its academic work force.

Physico-technical medicine: teaching technical skills to the intensivist

The requirements for the intensivist in handling medical technology are constantly growing. It appears necessary to acquire technological competences particularly within the fields of medical technology and physics. In the master's degree program 'MasterOnline Physico-Technical Medicine', such technical authority is conveyed. To cope with the intensive vocational situation of the physician, this study course follows the blended-learning concept; that is, it is conceived as an online study course with small portions of intermittent presence phases. Within the first year, technical basic skills such as 'measurement technique', 'informatics', and 'advanced physics' are covered. Subsequently, two of various advanced courses in different fields of medical technology ('technology in intensive care medicine', 'technology in surgery', 'technical cardiology', 'radiology', and other) are selected.

Valedictory editorial from the Chairman of the IFMBE Journal Committee on the occasion of a change of Editors

The management structure of Medical and Biological Engineering and Computing differs slightly from many other similar journals in that it is the official journal of the IFMBE and is a valuable source of income for it. Rather than the usual structure of the editor and their staff, an editorial board and publisher, the IFMBE has created a Federation Journal Committee which oversees management aspects of the journal although not direct editorial matters. These latter are the province of the editor and their editorial board and advisers. This steers a course between the IFMBE and the natural requirement to generate income and the ambition to raise the profile and circulation of the journal. After sitting as member of the FJC, I became Chairman in 2009 and so had the privilege of advising the current editor on management issues with respect to the journal and also lead the search committee for the new editor. It has been a pleasure and a privilege to work with Jos Spaan over these 7 years while he has been editor. The journal is widely respected in the Medical Physics and Biomedical Engineering fields for its high standards. Jos has made a major contribution to advancing this good reputation. He has willingly and enthusiastically given huge amounts of his time to the editorial process. The lifeblood of the journal is the response time to submitted articles but also the quality of the editorial judgment, both in respect to direct appraisal of submissions and in appointing high quality editorial assistants. Jos has been outstanding in all these respects and I know from personal experience that he has given up many evenings and weekends personally to ensure that the editorial process has been rapid and of the highest standards. The quality and scope of submissions in the journal reflect these qualities. We have been very fortunate to have had such a diligent and discriminating editor over this period and this is reflected in the improved impact factor and continuing high standing of the journal. I would also like to thank the team of hard-working and diligent associated editors he recruited who have so willingly given up a great deal of their time to maintaining the high standards of the journal. In particular, I would like to thank Ruben Coronel who has been Deputy Editor and in addition has taken responsibility for new submissions since September 1st of this year in order to free time for the Editor in Chief to prepare for the transition to the new editor. This will be a hard act to follow. The search for a new editor was protracted as the search committee, with valuable contributions from the immediate and current IFMBE presidents, set out to recruit a new editor with a high existing scientific standing who would be able to continue this tradition of excellence and also increase the high standing of the journal through their reputation and international contacts. Jos’s own special interest was in cardiovascular engineering; we have been very fortunate to appoint a new editor with a strong international reputation in the allied field of Neuroengineering, Nitish Thakor. He has a literal international standing in that he has academic appointments in both the USA and Singapore, as well as a wealth of editorial experience and international contacts. He is an ideal person to further the reputation and standing of the journal and I welcome him to the new position. He has already started the handover and will formally become the new editor from January 2013. The prospects for the journal are therefore excellent. Of course, there are challenges in the scientific publishing world. These include the increase in submissions, especially from countries who are increasing their scientific D. Holder (&) Department of Medical Physics, University College London, London, UK e-mail: d.holder@nhs.net

FASES DEL MODELO DIDÁCTICO-PROCESAL SEGUIDAS EN LA CONSTRUCCIÓN DE SIMULACIONES EN LA ASIGNATURA DE FÍSICA MÉDICA PARA EL CONTEXTO DE ENSEÑANZA-APRENDIZAJE VIRTUAL

This research article is a theoretical and applied analysis of the phases of the pedagogical model followed in the construction of simulations in the field of Medical Physics. There is also an analysis of how the model contributes to the acquisition of procedural knowledge in medical education and how simulators are useful for the teaching of processes. By following the phases of this model in a particular case, some specific information has been obtained about an interactive simulation which was designed for the purpose of investigating the magnetic resonance phenomenon. This simulation was used as a teaching resource on a virtual education platform. It is important to note the interdisciplinary contributions of Cognitive Psychology, Information Technology, Education Sciences, Physics and Medicine. All of these fields contributed to the analysis of the way in which the acquisition of problem solving skills required in Medical Physics occurs through the use of simulations.

WE‐A‐213AB‐01: Second Cancers from Radiation Therapy Procedures

Second Cancers are the most common late effect among long‐term cancer survivors. Radiation has been a known risk factor for cancer induction based on atomic bomb survivor follow‐up. Over the last few decades, there has also been increasing data on second cancers in medically exposed populations, particularly radiotherapy patients. As treatments become more successful and patients survive longer after treatment, long‐term patient health considerations must play an increasing role in the selection of treatment. To this end, it is important that the field of medical physics become well educated in issues related to long‐term radiotherapy sequelae, including second cancers. The session chair will give an overview of retrospective dose reconstruction method commonly used in these large cohort studies second cancers in patients treated with radiation therapy. Understanding the dosimetry in these studies will provide a better understanding of the results of the studies, the dose response models, and gaps in knowledge regarding dose volume effects. In the remainder of the presentation, the speaker will focus on the current state of knowledge of second cancers, specifically focusing on information and limitations of the available literature. This will include the magnitude of risk of second cancers, including the impact of different demographics. It will also include etiological discussions, focusing on the risk attributable to radiation. This presentation will include the available data on the dose response of second cancers, including the large uncertainties inherent to both low and high dose regions. It will also highlight dosimetry for advanced radiotherapy techniques, and what associated doses might mean for the second cancer risk. Finally, the presentation will discuss examples of how second cancer risk can be reduced in routine clinical practice. Learning Objectives: increase the knowledge of clinical medical physicists regarding radiation‐ induced second cancers as well as stimulate further research in this broad and increasingly important area.Learning Objectives:1. To provide general overview of the dose reconstruction methods used in epidemiological retrospective cohort studies of radiation related late effects.2. To improve the understanding of the magnitude of the second cancer risk faced by radiotherapy patients.3. To improve the understanding of the etiology of second cancers.4. To present an overview of current knowledge on dose response for radiation induced second cancers.5. To discuss the impact of advanced radiotherapy techniques on the risk of second cancers6. To provide examples of how second cancer risk can be reduced in routine clinical practice.

WE-F-211-01: The Evolving Landscape of Scientific Publishing.

1. To appreciate the importance of scientific and clinical practice communication for the advancement of the medical physics field 2. To understand the roles of the Editorial Board and the Journal Business Management Committee in the promotion and advancement of Medical Physics 3. To explore technology-driven content delivery mechanisms and their role in facilitating content access and driving content usage 4. To understand the potential benefits and pitfalls of various economic and editorial models of scientific publications and the recent shifts away from the traditional role of libraries.

Spatial and spectral performance of a chromotomosynthetic hyperspectral imaging system

The spatial and spectral resolutions achievable by a prototype rotating prism chromotomosynthetic imaging (CTI) system operating in the visible spectrum are described. The instrument creates hyperspectral imagery by collecting a set of 2D images with each spectrally projected at a different rotation angle of the prism. Mathematical reconstruction techniques that have been well tested in the field of medical physics are used to reconstruct the data to produce the 3D hyperspectral image. The instrument operates with a 100 mm focusing lens in the spectral range of 400-900 nm with a field of view of 71.6 mrad and angular resolution of 0.8-1.6 μrad. The spectral resolution is 0.6 nm at the shortest wavelengths, degrading to over 10 nm at the longest wavelengths. Measurements using a point-like target show that performance is limited by chromatic aberration. The system model is slightly inaccurate due to poor estimation of detector spatial resolution, this is corrected based on results improving model performance. As with traditional dispersion technology, calibration of the transformed wavelength axis is required, though with this technology calibration improves both spectral and spatial resolution. While this prototype does not operate at high speeds, components exist which will allow for CTI systems to generate hyperspectral video imagery at rates greater than 100 Hz.

The impact of computer display performance on the quality of digital radiographs: a review

Radiography makes an essential contribution to the processes of examination, diagnosis and treatment planning in dentistry. While the use of film-based imaging still predominates in dentistry, digital imaging is gaining wider acceptance and the use of this modality is anticipated to expand in the future. Two concerns associated with this transition have been raised in the literature. The first of these is the dissatisfaction experienced by many dental professionals with quality of digital radiographs when compared to plain film. In addition, there are indications that practitioners feel limited in their understanding of those factors impacting on digital image quality. One key area highlighted in the literature as having a significant influence on digital radiographic quality and interpretation concerns the performance of the display device. Within the last decade, research derived from the fields of medical radiology and physics have demonstrated that suboptimally performing displays degrade image quality, thereby increasing the potential for compromised diagnostic outcomes. In the field of medicine, this has resulted in the establishment of standards applicable to computer displays used in diagnostic radiology. Conversely, limited guidelines exist in the field of dentistry. The aim of this review is to provide an outline of these standards and highlight the important relationship between computer display performance and digital image quality.

Education and training of medical physicists in South East Asia: accomplishments and challenges.

John Cameron has made significant contributions to the field of Medical Physics. His contributions encompassed research and development, technical developments and education. He had a particular interest in the education of medical physicists in developing countries. Structured clinical training is also an essential component of the professional development of a medical physicist. This paper considers aspects of the clinical training and education of medical physicists in South-East Asia and the challenges facing the profession in the region if it is to keep pace with the rapid increase in the amount and technical complexity of medical physics infrastructure in the region.

MedAustron—Project overview and status

MedAustron is the Austrian ion therapy and research centre, presently under construction in Wiener Neustadt, Austria. The facility is based on a synchrotron which will deliver proton beams with kinetic energies up to 250 MeV and carbon ion beams up to 400 MeV/nucleon for clinical applications. In addition to the clinical applications, the accelerator will provide beams for nonclinical research in the fields of medical radiation physics, radiation biology and experimental physics with a proton energy range extended beyond medical requirements to 800MeV. An overview is given on the historical development of the project. The main design features of the accelerator facilities and medical facilities are presented and the actual status of the project is summarized.

WE‐C‐224‐03: Medical Physics in Senegal: Status and Prospects

Senegal is one of the leading economies in the western sub‐Saharan region. Still, first‐class radiological equipments are lacking in the country. Radiation treatments are still done with 60Co sources and only a few x‐ray machines with limited capabilities are available for diagnostic imaging. This situation is compounded by maintenance issues that are not always easily overcome, due to lack of adequate funds devoted to this aspect of the running of a medical infrastructure. On the other hand, specialized personnel are also needed, in particular medical physicists. The situation has a serious impact on the health care of patients in this country.An ongoing effort to establish in Senegal an international interdisciplinary center is expected to contribute in solving the many issues existing in the field of medical physics. Indeed, the center will offer a strong medical physics component, with diagnosis and treatment tools as well as educational programs aimed at providing the basis for the improvement of health care.This communication will present the current status of medical physics in Senegal together with the interdisciplinary center project and its impact in health care in this country and beyond, in particular in Western Africa.