Medical Physics Research Articles

AAPM task group report 314: Fault recovery in external beam radiation therapy.

Task Group (TG) 314 of the American Association of Physicists in Medicine (AAPM) was charged to develop guidance for recovering from fault states in radiation therapy, specifically regarding the delivery of photon or electron beams using a linear accelerator (linac) including ancillary systems. The fault conditions addressed may involve software, hardware, or a combination of causes. The report provides detailed recommendations for the proactive steps to be taken before a fault, the actions to be taken at the time of a fault, and the safety steps before returning a linac to clinical service, as well as the activities that device manufacturers and standard organizations can do to prevent and resolve the faults. A user-maintained log of prior faults; establishment of remote access by the vendor; and user training in emergency gantry, couch, and door motions are all useful proactive steps. At the moment of downtime and after ensuring the safety of the patient, the report stresses the importance of capturing fault information, prompt contact with the service engineer after the initial assessment, and considerations for communicating the estimated duration before the linac is returned to service. The medical physicist has a critical responsibility to assess the impact of the fault on patient care. Before resuming clinical use, the medical physicist must both determine the level of testing required to ensure safe operation of the linac and ensure any partially or totally delivered treatments have been correctly saved for accurate completion of the treatment fraction. The report stresses the roles of the radiation therapist, medical physicist, and service engineer to efficiently and safely address linac downtime. The appendices contain a description of the efforts of several organizations regarding linac safety: Integrating the Healthcare Enterprise-Radiation Oncology, International Standards Organization/International Electrotechnical Commission, Radiation Oncology Safety Stakeholder Initiative, and the AAPM Vendor Relations and Product Usability Subcommittee. Disclaimer: The recommendations of this TG should not be used to establish regulations. These recommendations are guidelines for Qualified Medical Physicists and others to use and appropriately interpret for their institution and clinical setting. Each institution may have site-specific or state-mandated needs and requirements which may modify their usage of these recommendations.

Assessing Lifetime Cancer Risk for Radiotherapists using the Excess Relative Risk (ERR) and Excess Absolute Risk (EAR) Models.

This research assesses the occupational radiation exposure of workers in the Radiotherapy Department at Usmanu Danfodiyo University Teaching Hospital, Sokoto, where ionizing radiation is frequently utilized. The study evaluates the annual effective dose, individual distribution ratios, and collective effective dose for the personnel. The obtained annual effective doses range from 0.25 to 2.75 mSv, and the collective effective doses range from 8.58 to 90.09 man-mSv for Administrative and Medical Physicists, respectively. No radiotherapist received an annual effective dose exceeding 5 or 10 mSv, ensuring that the lifetime cancer risk remains below 75%. This retrospective study relies on at least five years of thermoluminescent dosimetry (TLD) records to evaluate whole-body occupational exposure among personnel interacting with ionizing radiation. The TLDs were read using a Harshaw dual-4500 TLD reader on a quarterly basis over the five-year study period. The results indicate that no radiologist received an annual effective dose surpassing the 20 mSv limit recommended by UNSCEAR.

Barriers and Facilitators to Becoming a Medical Physicist in Bangladesh

The notion of gender equity is debatable, and worldwide health professionals are exploring the argument. However, the contextual situation and experience are different in each country and vary across cultures. There is an extensive amount of literature that presents women’s participation and involvement as increased in science, technology, engineering and mathematics over the last decades (Frize et al., 2022); however, there are variations in data and analyses documented which refer to the gender disparity of medical physicists (MPs) Worldwide (Barabino et al., 2020; Crowe and Kairn, 2016). Medical physics is one of the fields in health care where women are underrepresented, with only 29.8% of the workforce reported identifying as females in this sector (Tsapaki et al., 2018; Tsapaki and Rehani, 2015). Historically, the healthcare profession is male-dominated (Witz, 1990), with women being underrepresented in many specialist fields like academic medicine, surgical specialities and leadership positions (Kramer et al., 2021). The Nursing profession is, however, excluded from this category and considered a woman’s job. Furthermore, women’s contributions to the healthcare industry are not frequently acknowledged (Paradis et al., 2021). Moreover, the career trail for men and women in the healthcare profession is suggestively different (Baig, 2020). Broadly, regarding leadership positions and the range of decision-making, there are observable gender discrepancies in the industry. One of the main reasons for this is social restrictions, which women in specific geographic locations like Bangladesh encounter frequently. The lack of support or a platform for women to practice their profession with autonomy impedes their progress or movement upward in their careers. Women's unhindered involvement, participation and career development in patient care will improve healthcare provision, especially in caring for vulnerable patient groups like the elderly, individuals with significant co-morbidities, and minorities (Covington et al., 2020). In addition, involving more women in healthcare will not only reduce the gender disparity and empower them but also create a sense of confidence in the professions and services provided and, as a result, improve overall well-being. This study will aim to understand the views and experiences of gender-based discrimination among practising medical physicists in Bangladesh.

Methodological notes on physical parameters of low-level laser irradiation. Part 2. Light dosage at laser therapeutic sessions

Purpose. The general goal of this methodological article, consisting of two parts, is to provide a unifying theoretical approach to the still debated problem on determining the depth of laser light penetration into biotissues and the dosage of laser therapeutic effect from the standpoint of modern medical physics. The purpose of the second part of the article is to demonstrate that calculation of the absorbed dosage at laser therapy sessions is similar to the calculation of classical doses in radiobiology and radiation therapy.Materials and methods. The authors reviewed current state of terms and definitions related to the calculation of doses in ionizing and non-ionizing radiation. The Monte Carlo method was used to simulate the soft tissue volume in which 95 % of radiation energy is absorbed. A classical absorbed dose measured in Grays was estimated. Numerical simulation of absorbed doses for various typical laser therapy procedures was performed.Results. It has been shown that the effective irradiated volume of tissues, despite of small variations in soft tissue density between patients, allows to calculate the absorbed radiation dose in Grays, similar to radiobiological doses. Comparative findings on a single local absorbed dose for various percutaneous therapeutic procedures do not contradict the known clinical data, and even more, make the relationship of different doses for different therapeutic purposes more clear. As it has been found, typical doses range from 0.7 Gy for intravascular blood irradiation to 106 Gy for destructive photodynamic therapy and UV therapy procedures in dermatology.Conclusion. The proposed methodological approach proposes a new look at both the problem of the depth of laser light penetration into biotissues and the problem of laser light doses during therapeutic and diagnostic procedures from a unified medical and physical standpoint.

A bibliometrics analysis based on the application of artificial intelligence in the field of radiotherapy from 2003 to 2023.

Recent research has demonstrated that the use of artificial intelligence (AI) in radiotherapy (RT) has significantly streamlined the process for physicians to treat patients with tumors; however, bibliometric studies examining the correlation between AI and RT are not available. Providing a thorough overview of the knowledge structure and research hotspots between AI and RT was the main goal of the current study. A search was conducted on the Web of Science Core Collection (WoSCC) database for publications pertaining to AI and RT between 2003 and 2023. VOSviewers, CiteSpace, and the R program "bibliometrix" were used to do the bibliometric analysis. The analysis comprised 615 publications from 64 countries, with USA and China leading the pack. Since 2017, there have been more and more publications about RT and AI every year. The research center that made the biggest contribution to this topic was Maastricht University. The most articles published journal in this field was Frontiers in Oncology, while Medical Physics received the greatest number of citations. Dekker Andre is the author with the greatest number of published articles, while Philippe Lambin was the most often co-cited author. In the newly identified research hotspots, "autocontouring algorithm", "deep learning", and "machine learning" stand out as the main terms. In fact, our bibliometric analysis offers insightful information on current research directions and advancements pertaining to the use of AI in RT. For academics looking to understand the connection between AI and RT, this study is a great resource because it highlights current research frontiers and hot trends.

RADIATION PATIENT AND WORKER DOSE APPLICATION (SI PADI)

Medical procedures for diagnostic and therapeutic purposes currently use many sources of ionizing radiation. Monitoring patient and radiation worker doses is needed to keep the radiation dose received to a minimum. The purpose of the patient and radiation worker dose application is to facilitate the task of Medical Physicists in conducting patient and radiation worker dose audits so that they become faster and more effective. The patient and radiation worker dose application is made based on dose audits conducted by Medical Physicists by monitoring patient doses on CT Scan examinations using CT dose index volume (CTDIvol) and dose length product (DLP) parameters on CT Scans and patient doses of the Siemens Somatom 128 slice Cathlab using Dose Area Product (DAP) data on the Philips Azurion 7 C-Arm. Radiation worker dose audits are conducted using evaluation data from TLD badges, TLD eyes, and pocket dosimeters of radiation workers working at Karawang Regional Hospital. Data processing uses a spreadsheet program. The menus on the dashboard are combined with formulas so that the data automatically appears in tables, graphs, or special formats as needed. The radiation patient and worker dose information system (Si Padi) was successfully developed at Karawang Regional Hospital to realize efforts to optimize radiation protection and safety for patients and radiation workers. Keywords: patient dose, radiation worker dose, dose audit, CT dose index (CTDI), dose length product (DLP), dose area product (DAP), Si Padi application.

EFFECTIVENESS OF GLASS SHIELDING AGAINST GAMMA RAYS BY ADDING ZNO IN AL2O3 – PBO – B2O3 USING PHY-X/PSD APPLICATION FOR RADIOPHARMACY PREPARATION ROOM IN NUCLEAR MEDICINE INSTALLATION IN MILITARY HOSPITAL

Radiation exposure from radioisotope 131I, when mixed with pharmaceutical materials, has a high enough exposure to be accepted by medical physicists, so a barrier such as glass shielding is needed to reduce the impact. One is using ZnO material mixed with Al2O3 - PbO - B2O3. The ability of ZnO as glass shielding to withstand radiation is carried out using the Phy-X / PSD application. The mole variations used are 2, 4, 6, 8, and 10 moles and use a photon energy of 0.15 MeV – 15 MeV, while the parameters used are LAC, MFP, HVL, TVL, and Zeff. To achieve effective results, the performance of ZnO will be compared with WO3 without additional materials. The primary material used is Al2O3 - PbO - B2O3, commonly used in withstanding radiation from radioactive substances, especially 131I. The value of each parameter indicates the ability of the material to withstand radiation; for the LAC and Zeff parameters, the results of the values continue to decrease with increasing photon energy used and are at a stable point when reaching a photon energy of 0.2 MeV and 1 MeV for Zeff. Meanwhile, MFP, TVL, and HVL show an increase in photon energy use. The difference in results between parameters indicates the practical ability of the material according to the characteristics that have been determined theoretically, especially in the 10 mol variation. In addition, the relationship between the differences in the results of these parameters supports the radiation absorption capacity of the glass protector studied. Keywords: Gamma Rays, ZnO, Glass Protector Calculation, Phy-X/PSD, radiopharmaceuticals, nuclear medicine.

Thai Guideline for Nuclear Medicine Investigations of Neurocognitive Disorders: Nuclear Medicine Society of Thailand, the Neurological Society of Thailand, and Thai Medical Physicist Society Collaboration

Nuclear medicine investigations play a significant role in diagnosing dementia, mainly using imaging techniques such as positron emission tomography (PET) and single-photon emission computed tomography (SPECT). By providing functional and molecular data via brain imaging, nuclear medicine investigations offer valuable insights that complement clinical evaluations and structural imaging in the early detection, diagnosis, and differentiation of various types of dementia, leading to more accurate diagnosis and personalized treatment planning. Therefore, the Nuclear Medicine Society of Thailand, the Neurological Society of Thailand, and the Thai Medical Physicist Society have collaborated to establish these practical nuclear medicine investigation guidelines aiming to (1) identify the role of nuclear medicine studies in patients with neurocognitive disorders; (2) assist referrers in requesting the most appropriate procedure for diagnosis of each type of neurocognitive disorders; and (3) identify scientific evidence that is useful to assisting nuclear medicine professionals in recommending, performing, interpreting, and reporting the results of nuclear medicine investigations in patients with neurocognitive disorders.

PHSOR05 Presentation Time: 9:20 AM: Practice Patterns and Physics Staffing for HDR Brachytherapy: Results of an IROC Nationwide Survey of Medical Physicists

PHSOR05 Presentation Time: 9:20 AM: Practice Patterns and Physics Staffing for HDR Brachytherapy: Results of an IROC Nationwide Survey of Medical Physicists

Theoretical investigation of dosimeter accuracy for linear energy transfer measurements in proton therapy: A comparative study of stopping power ratios

BackgroundAccurate measurement of linear energy transfer (LET) is crucial in medical physics, particularly for proton therapy dosimetry. High atomic-number (Zeff) materials such as BaFBr and low-Zeff materials such as Al2O3 and water are commonly used in dosimeters. PurposeTo evaluate the feasibility and accuracy of the use of various dosimetry materials (water, air, Al2O3, aluminum (Al), BaFBr, and oxygen) for measuring LET by comparing their stopping power (ratios) via the Bethe-Bloch theory and semiempirical models. MethodsStopping power ratios were calculated via the PSTAR database for proton energies ranging from 0.01 MeV to 10,000 MeV. The Bethe-Bloch theory with density and shell corrections was used for high-energy protons, whereas a semiempirical model was applied for low-energy protons. Calculations validation involved comparing the computed stopping powers SRIM-2008 and PSTAR for materials such as water, aluminum, air, Al2O3, BaFBr, and oxygen. ResultsThe stopping power water-to-air ratio remains stable, while the Al2O3-to-water and air-to-water ratios highlight their differing attenuation properties. The BaFBr-to-water ratio shows significant material-dependent differences, and the water-to-Al2O3 ratio is particularly relevant for proton therapy dosimetry calculations in medical physics. These results demonstrate consistency across materials but do not inherently confirm the accuracy of LET measurements. However, a comparison of theoretical models with computed stopping powers SRIM-2008 and PSTAR showed strong agreement, particularly for high-energy protons where the Bethe-Bloch theory was applied, suggesting that the models reliably predict stopping power at these energy levels. ConclusionsThis study confirms the feasibility of using high-Zeff materials such as BaFBr and low-Zeff materials such as Al2O3 and water for the use of LET measurements in proton therapy. The results validate the use of the Bethe-Bloch theory, computed stopping powers and semiempirical models in dosimetric applications, enhancing the precision of LET measurements and contributing to improved radiation therapy outcomes.

AAPM task group report 135.B: Quality assurance for robotic radiosurgery.

AAPM Task Group Report 135.B covers new technology components that have been added to an established radiosurgery platform and updates the components that were not well covered in the previous report. Considering the current state of the platform, this task group (TG) is a combination of a foundational task group to establish the basis for new processes/technology and an educational task group updating guidelines on the established components of the platform. Because the technology discussed in this document has a relatively small user base compared to C-arm isocentric linacs, the authors chose to emphasize the educational components to assist medical physicists who are new to the technology and have not had the opportunity to receive in-depth vendor training at the time of reading this report. The TG has developed codes of practice, introduced QA, and developed guidelines which are generally expected to become enduring practice. This report makes prescriptive recommendations as there has not been enough longitudinal experience with some of the new technical components to develop a data-based risk analysis.

Characterization of X-ray Beams: Determination of K\(_{a,e}\) for Comparison with DRLs

Aims: The aim of this experimental study was to quantify the entrance surface air kerma (Ka,e) of X-ray beams in radiographic examinations, and the obtained values were compared with national and international Diagnostic Reference Levels (DRLs). Place and Duration of Study: Sample: Department of Medical Physics and Radiology, Franciscan University (UFN), between June 2023 and August 2024. Methodology: Initially, the main quality control (QC) tests were applied to characterize the radiographic equipment. During the evaluation of the X-ray beam, a dosimetric set was used, and for the same QC geometry, Air Kerma Rate (KAIR) measurements were obtained to determine the output of the X-ray tube. Under the same conditions, a phantom without water and the same filled with water were used to determine the backscatter factor (BSF), which was then used to estimate the Ka,e for the main radiographic examinations. Results: The results of this study are consistent with other studies and identified the region/anatomy with the highest radiation exposure, highlighting the importance of its optimization and verifying that continued professional training should be integrated into best practices to ensure greater safety in procedures. The results obtained evidence the necessity for adjustments in image acquisition protocols, as the Ka,e values found in this study, although within the limits established by the national DRLs, exceed the reference values of countries such as the United Kingdom and Japan in the areas of the skull, abdomen, and lumbar spine. This discrepancy highlights the importance of the periodic review and update of DRLs, in accordance with international recommendations and the technological evolution of equipment. Dose optimization is an ongoing process that involves the evaluation of image quality, the appropriate selection of technical parameters, and the implementation of specific dose protocols. The continuous training of radiology professionals is essential to ensure the correct application of imaging techniques and the minimization of patient exposure to ionizing radiation. Conclusion: This study shows the importance of evaluating radiation dose in diagnostic imaging and the need for a multidisciplinary approach to dose optimization. Implementing quality assurance programs, updating DRLs, and providing ongoing training for professionals are essential to ensure patient safety and high-quality diagnostic imaging. The methodology adopted in this study can contribute to the ongoing education of radiology professionals, promoting the correct application of imaging techniques and reducing patient exposure to ionizing radiation.

PP03 Presentation Time: 4:18 PM: International Collaboration Reveals Medical Physics Residents Will Perform Brachytherapy in Their First Position and Desire Additional Training Opportunities

PP03 Presentation Time: 4:18 PM: International Collaboration Reveals Medical Physics Residents Will Perform Brachytherapy in Their First Position and Desire Additional Training Opportunities

Current status of the working environment of brachytherapy in Japan: a nationwide survey-based analysis focusing on radiotherapy technologists and medical physicists.

Brachytherapy (BT), especially in high dose rate (HDR), has become increasingly complex owing to the use of image-guided techniques and the introduction of advanced applicators. Consequently, radiotherapy technologists and medical physicists (RTMPs) require substantial training to enhance their knowledge and technical skills in image-guided brachytherapy. However, the current status of the RTMP workload, individual abilities and quality control (QC) of BT units in Japan remains unclear. To address this issue, we conducted a questionnaire survey from June to August 2022 in all 837 radiation treatment facilities in Japan involving RTMPs. This survey focused on gynecological cancers treated with HDR-BT (GY-HDR) and permanent prostate implantation using low-dose-rate BT (PR-LDR). The responses revealed that the average working time in the overall process for HDR varied: 120min for intracavitary BT and 180min for intracavitary BT combined with interstitial BT. The QC implementation rate, in accordance with domestic guidelines, was 65% for GY-HDR and 44% for PR-LDR, which was lower than the 69% observed for external beam radiation therapy (EBRT). Additionally, the implementation rate during regular working hours was low. Even among RTMP working in facilities performing BT, the proportion of those able to perform QC for BT units was ~30% for GY-HDR and <20% for PR-LDR, significantly lower than the 80% achieved for EBRT. This study highlights the vulnerabilities of Japan's BT unit QC implementation structure. Addressing these issues requires appropriate training of the RTMP staff to safely perform BT tasks and improvements in practical education and training systems.

Integration of a dose management system in the public hospitals of Cyprus: Key areas and initial outcomes.

Despite the growing use of dose management systems (DMSs), there is limited guidance on their optimal setup. This study aims to fill this gap by outlining the process followed to integrate "DOSE" (Qaelum NV, Belgium) DMS within the Cypriot public hospitals. DOSE was connected to the available central PACS, followed by a thorough data and functioning validation. A preliminary study was also conducted to assess the DOSE's ability to establish typical dose values in diagnostic radiography. Overall, over 70 x-ray units were configured. For some connections, it was necessary to first adjust the unit's DICOM attributes or to utilise the DICOM coercion technique. The DICOM image header was sometimes preferred over the DICOM RDSR, as the chosen data source. This study underscored the importance of understanding the equipment's technical capabilities for a successful DMS integration, while personnel with expertise in diagnostic radiology and the IT aspects of medical physics proved to have a vital role in the process. The pilot study showed that DOSE is an effective tool for establishing typical dose values and assessing compliance with relevant dose levels.

Tube voltage in chest and abdomen DR imaging: Which settings return maximal non-prewhitening model observer with eye filter (NPWE) detectability?

The non-prewhitening computational model observer with eye filter (NPWE) has been shown to reasonably predict human observer performance in general radiography and is an appropriate substitute when real clinical trials are not feasible. In this study, the NPWE model observer is used to detect specific tasks (circular designer nodules) ranging between 1 and 30mm in diameter using chest and abdomen phantom images acquired across the diagnostic energy range (60-125 kVp) with and without an anti-scatter grid. The aim of this study was to derive tube voltage (kVp) settings that return maximal NPWE detectability (d') of designer nodules, for digital radiography (DR) chest and abdomen imaging. Images of a chest phantom (LucAl phantom) and a surrogate for an abdomen (18.5cm PMMA) were acquired across the diagnostic energy range (60-125 kVp) with matched effective dose (for the respective anatomies), with and without an anti-scatter grid, on a general x-ray system. Images were captured using an Agfa DX-D 40C wireless indirect caesium iodide (CsI) imaging panel. Modulation transfer function (MTF), normalized noise power spectrum (NNPS), and contrast (C) were measured in each image and the detectability index d' was calculated for circular designer nodules with diameters ranging from 1 to 30mm (in steps of 1mm). The calculated d' peaked at a nodule diameter of 3mm irrespective of tube voltage, for both chest and abdomen images. A tube voltage of 80kVp returned maximal d' for chest imaging across all nodule diameters both with and without an anti-scatter grid. A tube voltage of 70 kVp returned maximal d' for abdomen imaging. The NPWE observer model has been used to derive tube voltages (kVp) that return maximal detectability (d') of designer nodules for chest and abdomen radiography using a modern DR imaging system. This will provide the medical physicist with a starting point in the task of optimising tube voltage range for chest and abdomen imaging.

Gender and Ethnicity Bias of Text-to-Image Generative Artificial Intelligence in Medical Imaging, Part 2: Analysis of DALL-E 3.

Disparity among gender and ethnicity remains an issue across medicine and health science. Only 26%-35% of trainee radiologists are female, despite more than 50% of medical students' being female. Similar gender disparities are evident across the medical imaging professions. Generative artificial intelligence text-to-image production could reinforce or amplify gender biases. Methods: In March 2024, DALL-E 3 was utilized via GPT-4 to generate a series of individual and group images of medical imaging professionals: radiologist, nuclear medicine physician, radiographer, nuclear medicine technologist, medical physicist, radiopharmacist, and medical imaging nurse. Multiple iterations of images were generated using a variety of prompts. Collectively, 120 images were produced for evaluation of 524 characters. All images were independently analyzed by 3 expert reviewers from medical imaging professions for apparent gender and skin tone. Results: Collectively (individual and group images), 57.4% (n = 301) of medical imaging professionals were depicted as male, 42.4% (n = 222) as female, and 91.2% (n = 478) as having a light skin tone. The male gender representation was 65% for radiologists, 62% for nuclear medicine physicians, 52% for radiographers, 56% for nuclear medicine technologists, 62% for medical physicists, 53% for radiopharmacists, and 26% for medical imaging nurses. For all professions, this overrepresents men compared with women. There was no representation of persons with a disability. Conclusion: This evaluation reveals a significant overrepresentation of the male gender associated with generative artificial intelligence text-to-image production using DALL-E 3 across the medical imaging professions. Generated images have a disproportionately high representation of white men, which is not representative of the diversity of the medical imaging professions.

German radiation oncology's next generation: a web-based survey of young biologists, medical physicists, and physicians-from problems to solutions.

Radiation science is of utmost significance not only due to its growing importance for clinical use, but also in everyday life such as in radiation protection questions. The expected increase in cancer incidence due to an aging population combined with technical advancements further implicates this importance and results in ahigher need for sufficient highly educated and motivated personnel. Thus, factors preventing young scientists and medical personnel from entering or remaining in the field need to be identified. Aweb-based questionnaire with one general and three occupation-specific questionnaires for physicians, biologists, and medical physicists working in radiation oncology and research was developed and circulated for 6weeks. While the overall satisfaction of the 218 participants was quite high, there are some points that still need to be addressed in order to ensure acontinuing supply of qualified personnel. Among these were economic pressure, work-life balance, work contracts, protected research time, and ademand for an improved curriculum. Mentoring programs, improved education, and strengthening the value of societies in radiation sciences as well as translational approaches and more flexible working arrangements might ensure ahigh-quality workforce and thus patient care in the future.

TRU-IMP: techniques for reliable use of images in medical physics; a graphical user interface to analyze and compare segmentations in nuclear medicine.

Background. In the context of pharmacokinetic analyses, the segmentation method one uses has a large impact on the results obtained, thus the importance of transparency.Innovation. This paper introduces a graphical user interface (GUI), TRU-IMP, that analyzes time-activity curves and segmentations in dynamic nuclear medicine. This GUI fills a gap in the current technological tools available for the analysis of quantitative dynamic nuclear medicine image acquisitions. The GUI includes various techniques of segmentations, with possibilities to compute related uncertainties.Results. The GUI was tested on image acquisitions made on a dynamic nuclear medicine phantom. This allows the comparison of segmentations via their time-activity curves and the extracted pharmacokinetic parameters.Implications. The flexibility and user-friendliness allowed by the proposed interface make the analyses both easy to perform and adjustable to any specific case. This GUI permits researchers to better show and understand the reproducibility, precision, and accuracy of their work in quantitative dynamic nuclear medicine.Availability and Implementation. Source code freely available on GitHub:https://github.com/ArGilfea/TRU-IMPand location of the interface available from there. The GUI is fully compatible with iOS and Windows operating systems (not tested on Linux). A phantom acquisition is also available to test the GUI easily.

SNMMI Procedure Standard/EANM Practice Guideline for Brain [18F]FDG PET Imaging, Version 2.0.

PREAMBLEThe Society of Nuclear Medicine and Molecular Imaging (SNMMI) is an international scientific and professional organization founded in 1954 to promote the science, technology, and practical application of nuclear medicine. The European Association of Nuclear Medicine (EANM) is a professional nonprofit medical association that facilitates communication worldwide between individuals pursuing clinical and research excellence in nuclear medicine. The EANM was founded in 1985. The EANM was founded in 1985. SNMMI and EANM members are physicians, technologists, and scientists specializing in the research and practice of nuclear medicine.The SNMMI and EANM will periodically define new guidelines for nuclear medicine practice to help advance the science of nuclear medicine and to improve the quality of service to patients throughout the world. Existing practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner, if indicated.Each practice guideline, representing a policy statement by the SNMMI/EANM, has undergone a thorough consensus process in which it has been subjected to extensive review. The SNMMI and EANM recognize that the safe and effective use of diagnostic nuclear medicine imaging requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guideline by those entities not providing these services is not authorized.These guidelines are an educational tool designed to assist practitioners in providing appropriate care for patients. They are not inflexible rules or requirements of practice and are not intended, nor should they be used, to establish a legal standard of care. For these reasons and those set forth below, both the SNMMI and the EANM caution against the use of these guidelines in litigation in which the clinical decisions of a practitioner are called into question.The ultimate judgment regarding the propriety of any specific procedure or course of action must be made by the physician or medical physicist in light of all the circumstances presented. Thus, there is no implication that an approach differing from the guidelines, standing alone, is below the standard of care. To the contrary, a conscientious practitioner may responsibly adopt a course of action different from that set forth in the guidelines when, in the reasonable judgment of the practitioner, such course of action is indicated by the condition of the patient, limitations of available resources, or advances in knowledge or technology subsequent to publication of the guidelines.The practice of medicine includes both the art and the science of the prevention, diagnosis, alleviation, and treatment of disease. The variety and complexity of human conditions make it impossible to always reach the most appropriate diagnosis or to predict with certainty a particular response to treatment.Therefore, it should be recognized that adherence to these guidelines will not ensure an accurate diagnosis or a successful outcome. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources, and the needs of the patient to deliver effective and safe medical care. The sole purpose of these guidelines is to assist practitioners in achieving this objective.