AAPM Newsletter January/February 2000 Vol. 25 No. 1

Newsletter AMERICAN ASSOCIATION

OF

PHYSICISTS

IN

VOLUME 25 NO. 1

MEDICINE JANUARY/FEBRUARY 2000

AAPM President’s Column A New Millennium

By Kenneth Hogstrom Houston, TX It is my pleasure to serve as your president as we enter the new year. Although this year will be the first in a new century and in a new millennium, its true significance for us will be measured by what we, together, can accomplish during it. It will be an opportunity for each of us to contribute to the growth of medical physics. As we progress through the year, I hope to use this column to share many of our common goals and accomplishments as well as share my personal thoughts.

Leadership within our association is key, and the efforts of your Executive Committee (EXCOM) should be recognized for the past year. First, I want to acknowledge outgoing Chairman of the Board, Larry Rothenberg, who has so carefully led our Board meetings and has provided much wisdom to EXCOM for the past three years. Second, I wish to recognize Jim Galvin, who has completed three years of outstanding and dedicated service as our Secretary. Third, I want to recognize our past

President, Geoff Ibbott, who has led our society with skilled direction and tireless energy.

Fourth, I want to thank Melissa Martin, who has completed her second year as Treasurer in a meritorious manner. I look forward to working closely with this year’s Excom: Chairman of the Board G e o f f Ibbott, President-elect Charles Coffey, Treasurer Melissa Martin, Secretary Jerry White, and Executive Director Sal Trofi.

In the upcoming year, we will remain focused on the mission of our Association, which is to advance the practice of physics in medicine and biology by encouraging innovative research and development, disseminating scientific and technical information, fostering the education and professional development of

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medical physicists, and promoting the highest quality medical services for our patients. For those members who have not had the chance, I encourage reading our Association’s objectives for accomplishing its mission, which can be found in the Membership Directory or the AAPM web page.

My vision for the AAPM is for us to maintain its high level of productivity and contributions to medical physicists that result in our being a recognized, respected, and valued member

INSIDE TABLE OF CONTENTS President’s Column………...p.1 Accelerator Maintenance Soc....p.4 Chairman’s Report………....p.6 HCFA/CAMPEP Residency…...p.8 TG-51 Recommendations.....p.11 Executive Director’s Column…..p.12 Treasurer’s Report………...p.13 2000 Budget………………p.14 AAPM Investments………p.16 TG-21 to TG-51……………p.16 Letters to Editor……………p.18 New Members……………p.19 Wanted: New Editor………p.23

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of the medical team. Ways in which objectives are being met can be appreciated by looking at what our Committees routinely accomplish. Similarly, by looking at changes in Committees and their membership, our budget for 2000, Boardapproved actions, and other initiatives, we can envision some of the new directions we might expect in 2000.

2000 Committee Appointments The success of the AAPM is dependent upon its members’ voluntary service. On behalf of the membership of our Association, I want to thank all who served during 1999 and to those who have volunteered for 2000. I would like to recognize the changes in Committee Chairs. Beth Schueler will replace Jerry White as Chair of the Training of Technologists Committee, and David Keys will replace Dick Lane as Chair of the Legislation and Regulation Committee. Jatinder Palta will replace Ravi Nath as Chair and John Boone will replace Ron Price as Vice Chair of Science Council. In Science Council, G e o f f C l a r k e replaces Wlad Sobol as Chair of the Magnetic Resonance Committee, Jeff Williamson replaces Jatinder Palta as Chair of the Radiation Therapy Committee, and Rock Mackie replaces Phil Judy as Chair of the Research Committee. For Administrative Committees Bruce Curran replaces Ken Vanek as Chair of the Annual Meeting Coordinating Committee, and Rene Smith replaces

Rick Nelson as Chair of the Regional Organization Committee. There are several changes in Chairs of Subcommittees and Chairs of new Subcommittees and Task Groups.

Please join me in thanking those Chairs rotating for their many years of contributions and in welcoming the new Chairs. There are several new Committee members to welcome as well; please refer to your 2000 Membership Directory or to our web site for this year’s appointments. Having been responsible as Presidentelect for all 2000 appointment recommendations to the Board, I want to thank all who volunteered and everyone for their cooperation in the process. For those who volunteered and were not appointed, and for those interested in pursuing appointments for 2001, I recommend your attending meetings of those Committees in which you are interested, introducing yourself to the Chair, and volunteering to the Chair to serve on Task Groups or Subcommittees.

2000 Budget I am pleased to report that the Association is financially healthy. The Association is projecting a $0.634 million profit for 1999. This will result in approximately $4.3 million in reserve at the end of 1999, reaching our goal of one year’s budget in reserve; our 1999 expense budget was $3.7 million. The 2000 expense budget is approximately $5.6 million, approximately $0.3 million greater than budgeted

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revenue. This year’s budget is an anomaly because the AAPM is hosting the World Congress.

This requires the budget to be greater and for annual meeting profits to be decreased. This happens about once every 12 years and should not be of major concern. Because of our strong financial position, the Association is in a position to increase its funding of programs.

The Board approved an increased budget of $108,576 for Professional Council. First, the budget increase will partially fund a joint project with ACMP (and possibly ACR) for a new study on medical physics work values by Abt Associates that will be expanded to include medical physics services for radiation oncology special procedures and medical physics services in diagnostic imaging. Second, it will include the purchasing of an independent analysis of the HCFA HOPPS rule, which is expected to be published in the first half of 2000. Third, the role of the AAPM in gover nment af fairs will be expanded through funding a government relations specialist and a limited number of medical physicists to travel to Washington, D.C. for the purpose of addressing specific issues with appropriate members of Congress.

The Board approved an increased budget of $71,450 for Education Council. First, the budget increase will assist funding of international attendees of a Diagnostic Physics Summer School in Budapest, Hungary and of Mexican attendees of a Southwest AAPMsponsored Symposium on

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Quality Assurance for the Third Millennium in Puerta Vallarta, Mexico. Second, it will support the development of a new slide set for physician residency training by the Medical Physics Education of Physicians Committee. Third, the Public Education Committee has planned a new brochure on the Role of the Medical Physicist in Radiation Oncology. Fourth, the Education and Training of Medical Physicists Committee has planned a Spring meeting to review and update recommended didactic curriculum in medical physics education programs (presently AAPM Report No. 44).

The Board approved an increased budget of $44,560 for Science Council. The budget increase will fund task group activities of the Biological Effects, Ultrasound, and Radiation Protection Committees.

Training of Medical Physicists One area where I believe we could improve our knowledge is the supply and demand for medical physicists. Just a few years ago, it seemed that there might be an excess of medical physicists, and now just the opposite seems true. At our recent Board meeting in Chicago, Placement Director Robert Rice reported that the number of listings in the AAPM placement service is projected to be 385 for 1999. Also, Executive Director Sal Trofi reported that for 1999 the Association’s growth is expected to be 2.6% (70) for full members. The AAPM has not been consistent

in providing statistics that are called for in Section 3.6.8.1.1 of our Rules; however, I am pleased to report that the Education and Training of Medical Physics Committee has established a Medical Physicist Workforce Subcommittee. The Subcommittee will be chaired

by John Horton, who is also a member of ASTRO’s Workforce Committee. The Subcommittee is charged with determining the size and distribution of the workforce, developing models to project the need for medical physicists over the next 10 years, determining the number of medical physicists being trained annually, and communicating this information to the membership and other professional organizations annually.

Another area that impacts training is the Development Committee, which provides funding for graduate education and resident training fellowships. The AAPM Development Fund is healthy, having just exceeded $1 million. This allows the Development Committee to expand its programs, as was done by the recently approved increase in frequency of the 2-year Ph.D. graduate fellowships from biannually to annually. As the Development Committee continues to increase support for medical physics training and other programs, it is looking at ways to increase the funding base through planned giving. Committee Chair Steve Goetsch appointed Jean St. Germain as interim chair of a newly created Planned Giving Subcommittee. Planned giving will offer each of us an opportunity to leave behind part of our estate to benefit future genera-

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tions of medical physicists.

The last thing I want to mention about training is that the AAPM continues to be a sponsor of CAMPEP and that I am very excited that more medical physics residency training progra m s a re a p p ly i n g f o r CAMPEP accreditation. I want to personally encourage graduate education and residency training programs to seek CAMPEP accreditation, as I believe this strengthens our programs as well as increases the visibility of our profession, both at our respective institutions and as a group.

Allied Professionals Medical physicists have the opportunity for leadership amongst their allied professionals, which not only benefits those professionals, but also medical physicists. In addition to the activities of our Training of Technologists Committee, the AAPM is actively involved in other projects. As has been mentioned in an earlier Newsletter, the AAPM is a Charter Member of the Alliance for Quality Medical Imaging and Radiation Therapy, whose purpose is to ensure that personnel who perfor m medical imaging examinations and deliver radia t ion t he ra p y t re a tm e n ts should be required to demonstrate competence in their area of practice. The current focus of the Alliance is to gain passage of legislation that will require that states comply with standards for accreditation of educational programs and for credentialing of personnel through licensure, as specified in the 1981 Consumer-Patient

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Radiation Health and Safety Act. During the annual RSNA meeting, I represented the AAPM at a meeting of the Alliance. My presence and that of ACMP Chairman Jim Smathers were well received, and we have been assisting the Alliance in the bill’s technical wording. Although not directly affecting medical physicists, our membership supports our general position regarding licensure of professional medical physicists.

During the annual meeting of ASTRO, President Geoff Ibbott, AAPM liaison to AAMD Art Boyer, and I attended a meeting of AAMD Task Group 8. Our participation in this effort is to assist medical

dosimetrists in establishing a mechanism for accrediting medical dosimetry training programs, in creating additional medical dosimetry training programs that can share educational resources, and in finding funding mechanisms to support these efforts. There is presently an acute shortage of newly trained medical dosimetrists, due to the demand for 3D treatment planning and there being only five AAMD-recognized medical dosimetry training programs.

In another effort led by Marty Weinhous, a task group of the Remotely Directed Continuing Education Subcommittee is investigating the possibility of the Medical Dosimetry Certifi-

cation Board utilizing the services of our RDCE program.

In another initiative, I have appointed an Ad-hoc Committee with Jim Galvin as Chair and Larry Berkley as Vice Chair that will assist the radiotherapy accelerator maintenance personnel in the formation of their own professional society. I envision the society to be independent, but aligned with the AAPM. I expect that their society would have annual meetings in conjunction with ours and that our headquarters office would be hired to provide administrative services to the new society. I have expanded on this topic in a separate article.

AAPM Forms Ad-hoc Committee to Assist in Formation of Professional Society for Radiotherapy Accelerator Maintenance Personnel

by Kenneth Hogstrom Houston, TX During the annual meeting of the Radiological Society of North America in Chicago, the Executive Committee of the American Association of Physicists in Medicine (AAPM) consented to my forming, effective January 1, 2000, an ad-hoc committee entitled “Formation of Professional Society for Radiotherapy Accelerator Maintenance Personnel.” The objectives of the ad-hoc committee will be (1) to provide radiotherapy accelerator maintenance personnel an opportunity to form a professional society, (2) to facilitate the

process so long as they wish to proceed, and (3) to ensure that the AAPM and medical physicists maintain a strong professional relationship with radiotherapy accelerator maintenance personnel through any society formed. The formation of the ad-hoc committee follows two investigating committee meetings held on July 26 and October 31, 1999 between AAPM representatives and radiotherapy accelerator service providers from Elekta, Siemens, Varian, third parties, and local institutions.

The ad-hoc committee is charged with (1) scheduling and hosting a forum for the purpose of initiating the plan-

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ning process for establishment of a professional society for accelerator engineers and technicians, (2) providing leadership and logistical support throughout the process of forming this professional society, (3) helping establish mechanisms that promote a high degree of professionalism amongst its members and that ensure a continued high level of competition amongst companies providing accelerator maintenance service, (4) encouraging the professional society to maintain a strong relationship with medical physicists by incorporating features such as allowing the AAPM to be a member organi-

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zation, utilizing administrative services of AAPM headquarters on a for-fee basis, conducting annual meetings in conjunction with the AAPM annual meeting, and allowing medical physicists to have associate or other class of membership, and (5) reporting progress regularly to the AAPM. Jim Galvin will chair the adhoc committee, and Larry Berkley will serve as vice chair.

There will be representatives from Elekta, Siemens, Varian, third party service personnel, and institutional service personnel. Other AAPM members will include liaisons from key committees and at least 2 atlarge AAPM members. I will be an ex-officio member, and there will be a representative from AAPM headquarters.

The first major action of the ad-hoc committee will be its hosting the first organizational meeting of interested radiotherapy accelerator engineers and technicians. The logistics of the meeting will be coordinated by the AAPM Headquarters Office (Sal Trofi, Executive Director and Angela Keyser, Deputy Executive Director).

The meeting will be held on Saturday and Sunday, July 2223, 2000, just prior to the 2000 World Congress on Medical Physics and Biomedical Engineering and the AAPM Annual Meeting. The meeting will take place at the AAPM host hotel, the Sheraton Chicago.

Hotel rooms should be reserved prior to the housing registration deadline, June 23.

Advanced registration will cost $50, and registration after June 1 will cost $100. Details regarding registration and housing can be obtained from

Farhana Khan in the AAPM office (phone: 301-209-3375 or email: farhana@aapm.org).

For those interested in attending the World Congress following this meeting, registration is available on a daily and weekly basis, and information can be accessed through the internet at http://www.wc2000.org.

The program of the July 2223 meeting will be developed by the ad-hoc committee and is expected to consist of a series of lectures followed by discussion groups. Questions expected to be addressed are: (1) What is a professional society? (2) What are the benefits of a professional society? (3) How are professional societies structured and administered?

(4) What are the fiscal costs of a professional society? (5) What mechanisms are there for funding a professional society? (6) What are the steps necessary to form a professional society? (7) How will the professional society be formed? (8) What will be the geographic scope of the society? (some have suggested to initially limit membership to the United States and Canada) (9) What is the potential role of the AAPM in the society? and (10) What are the next steps?

In summary, the formation of an ad-hoc committee is a statement that the AAPM is committed to the successful formation of a professional society for radiotherapy accelerator engineers and technicians and will facilitate formation of the society.

However, the society will consist of accelerator maintenance personnel and will be organized and maintained by

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accelerator maintenance personnel, not the AAPM. We look forward to participation of all engineers and technicians who want to be of part this founding effort. Medical physicists are encouraged to discuss these plans with their radiotherapy accelerator maintenance providers.

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Report from the Chairman of the Board

by Geoffrey Ibbott Lexington, KY The final two months of 1999 were very busy indeed.

In addition to participating in the annual RSNA meeting, and conducting our own committee, council, and board meetings, the AAPM has been involved in several other activities. I will use this column to mention a few of the activities with which I was involved.

RSNA It is traditional for the AAPM president to be invited to say a few words at the opening session of the RSNA meeting. I was given the opportunity to speak briefly, and for those who were not able to attend that session, the following were my comments: “Mr. President, ladies and gentlemen, colleagues and friends: I bring you the greetings of the AAPM, and our congratulations for what promises to be another record-setting annual meeting of the RSNA. As you know, the AAPM traditionally meets in conjunction with the RSNA, where we have the opportunity to associate with our physician colleagues, learn about each others’ research, and share ideas for advances in radiology and radiation oncology.

“Our relationship with the RSNA predates the careers of many of us here today. It was 41 years ago, during the 1958 meeting of the RSNA, that the AAPM was formed. For years prior to this date, medical physicists had participated in

the RSNA meetings, but desire d a m e c ha nis m t o address the professional needs of medical physicists. Later, of course, scientific and educational components were added.

“During the past 41 years the AAPM has grown in numbers, stature and impact. We publish a highly regarded journal, and our scientific reports provide the foundation for much of the clinical medical physics work done today. Our educational programs benefit people from all over the world. We have successfully communicated our concerns and opinions to various regulatory agencies, with resulting benefits to both patients and our professions.

“The AAPM has benefited significantly from its relationship with the RSNA. First, we are grateful for your contributions to our development fund. The RSNA’s contribution helped to establish the fund, and inspired others to contribute.

“We are all thankful also for your funding of our medical physics imaging fellowships.

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These fellowships are helping to provide a stream of qualified, well-trained individuals to support the clinics and contribute to radiological research and technical development.

“Of course, the AAPM is grateful to be able to participate in the RSNA annual meetings.

We enjoy this opportunity to learn from our physician colleagues and at the same time to contribute to the education of radiologists and radiation onocologists. My physicist colleagues and I are proud of our association with radiologists and with the RSNA, and look forward to continuing our relationship far into the next century. Thank you.”

ACR Task Force Earlier this year, the ABR, the ACR, the ARRS, and the RSNA formed a committee for a cardiovascular imaging whose mission is to improve patient care by advancing clinical practice, research and education in the imaging of cardiovascular disease. As part of this effort, the committee has formed a task force for cardiovascular imaging, which will have representation from 14 radiological and cardiological societies, including the AAPM. I was asked to nominate several medical physicists for consideration, from which I am pleased to report that the ACR has selected Dr. Richard Morin, of Jacksonville, Florida. This task force will be another important component

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in our efforts to coordinate activities among cardiologists, medical physicists, radiation oncologists, and radiologists.

American Heart Association As mentioned in a previous column, I was contacted earlier this year by the chairman of the American Heart Association’s Council on Cardiovascular Radiology. This chairman had restructured the Council, making room for for mal liaisons from organizations including the AAPM. As a result, I attend a meeting of the Council in Atlanta last November.

The Council on Cardiovascular Radiology is one of 12 scientific councils of the AHA. The council conducts a lot of business, including addressing funding for cardiovascular research, developing of educational information for members of the public, and coordination of clinical and research efforts with other professionals. Most Council members were unfamiliar with the AAPM, and I was given the opportunity to describe Medical Physics’ own role in hospitals and clinics, our meetings and publications, as well as three specific interests of the AAPM that I felt were of relevance to the AHA: the education of users of Radiation and Radioactive materials and their technical staff; scientific contributions in imaging and therapeutic uses of Radiation; and a possible role for the AAPM in the AHA council and committee structure.

The council includes a com-

mittee on Imaging Sciences. I have asked for and been given the opportunity to nominate potential members for this committee from the Medical physics community. I anticipate my final action with regard to the AHA will be to suggest a more permanent liason from the AAPM.

Council of Scientific Society Presidents One of the pleasures of the office of President is the opportunity to represent the AAPM at meetings of the Council of Scientific Society Presidents. This is a prestigious group, with considerable influence in Washington. Meetings are generally attended by 40 or 50 officers of wellknown scientific societies, and the speakers are almost always people of great prominence in government, federal institutions, or research institutions.

This meeting was no exception: The first speaker was the Hon. Doug Walgren, seventerm member of the House Science Committee, who encouraged us to stay in frequent contact with legislators.

Mary Wooley, president of Research! America, described the powerful impact that carefully designed surveys of the public can have on members of Congress.

Norman Augustine, past CEO of Lockheed Corporation, gave a talk on Essentials for Leadership in a Time of Change. Other speakers included Duncan Moore, Associate Director of Technology at the Executive Office of the President, and John Jankowski, Director of R & D Statistics

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at NSF. Paul Hawken, author and publisher of the “Smith and Hawken” catalog spoke on “Natural Capitalism: Next Revolution.” Stephen Pinker, director of the Center for Cognitive Neuroscience at MIT Spoke on “Cognitive Neurobiology: Language,” and Eric Mazur, a professor of physics at Harvard spoke on “Peer Instruction.”

A number of other speakers gave excellent talks, and several workshops were held on the development of methods for more effective public communication.

FDA and NRC Consultants The AAPM was recently given the opportunity to recommend medical physicists to the FDA and to the NRC who could be called as consultants when specific expertise is needed. Earlier this year, I wrote to Thomas Shope at the FDA recommending the following physicists for consultation on issues involving imaging equipment and procedures: Drs. Price, C. Wilson, Wagner, Strauss, Pizzutiello, Sobol, McKetty, Seibert, Gould, Judy, Chakraborty, D. McCollough, Boone, P. Carson, and Rothenberg. For Therapy Equipment and Procedures, I recommended Drs. Palta, Nath, Biggs, Bova, Marbach, Klein, Thomadsen, Glasgow, Horton, Boyer, and Bourland. For treatment planning systems, I suggested Drs. Starkschall, Chui, Rosen, Stafford, Fraass, Papanikolaou, and Sontag.

To Gary Purdy at the NRC, I proposed Drs. S. Balter, Kelsey, Lieto, M. Fox, M.

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Martin, Williamson, Ezzell, and Yester.

NRC Advisory Committee The AAPM recently became aware that one of the medical physics positions on the NRC’s Advisory Committee for the Medical Uses of Isotopes (ACMUI) has been vacant for over a year. The AAPM submitted nominations over a year ago, and learned recently that no action appears to have been taken. Consequently, I have written a strongly word-

ed letter to Ms. Kathleen Haney at the NRC asking that action be taken promptly not only on our nominees for the physics position, but also on the nominees submitted for the vacant radiation oncologist position.

HCFA Finally, I have recently written to the Administrator of the Health Care Financing Administration (HCFA) as well as a staff member with whom the AAPM has had contact, asking that the AAPM be informed of the current status and anticipated future developments

associated with the Hospital Out-Patient Perspective Payment System (HOPPS) proposal. It is our impression from conversations with several people involved in the process, that the HOPPS proposal, scheduled to be unveiled sometime between April and July of 2000, is a precursor to a more comprehensive reform of payment for hospital out-patients. Any response we receive will be shared with the AAPM membership.

HCFA Reimbursement for CAMPEP Residency Programs

by Eric Klein St. Louis, MO On March 30th 1999, the Health Care Finance Administration (HCFA) confirmed that formal medical physics residency programs are considered to be an approved educational activity. This confirmation strengthens a provider’s (hospital) request to have training costs associated with physics residents reimbursed. In the regulatory guide 42 CFR 413.85, medicare supports hospital costs associated with, specific and other, appropriate training programs. Though medical physics is not a specific listed program, the March 30th letter confirms that it is an appropriate training program for and allowable for reimbursement, as long as certain criteria are met. They are as follows:

The program must be accredited by CAMPEP. If state licensure for the program is required, and licensure is granted to the program, this may serve in lieu of CAMPEP accreditation. CAMPEP has a specific methodology and set of requirements for accreditation. No state licensure program includes medical physics to date.

The provider must incur costs associated with training.

The provider must control the curriculum and determine graduation requirements.

The provider must control administrative duties and the day-to-day operation.

The provider must employ the faculty.

The provider must provide and control the classroom and clinical instruction.

How an institution would

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initiate receiving reimbursement is as follows: 1) Apply for CAMPEP accreditation. Applications can be obtained from Dr. Richard Lane, Chairman, Residency Education Program Committee of CAMPEP. 2) Once accreditation has been received, immediately alert the finance department of the institution, specifically someone who handles reimbursement. If CAMPEP accreditation has not been received, but is in process, a HCFA intermediary may still approve reimbursement for your program.

3) Provide the finance department with all direct costs for the individual. Direct costs include salary and benefits. The indirect costs, such as those associated with faculty, space, etc. are very difficult to

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pass through due to HCFA’s distain for “joint product”. In other words, on-the-job-training is not a true additional cost as a technical task is being performed for the patient and nothing additional is being expedited due to the training. If an institution attempts to pass through indirect costs, careful documentation with justification is required. In addition the department must clearly outline that the provider has fulfilled the requirements listed above. This should not be a problem for hospital based

physics programs, or for clinics where the university provides the faculty and that the hospital pays the university for the physics faculty efforts and that the hospital still has administrative responsibility.

4) The finance department then adds these costs to the department center cost. The amount reimbuirsed depends on the amount submitted and the percentage of medicare to total generated revenue. Typically finance will further add costs such as global hospital costs (human resources, etc.).

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the hospital can be on the order of 0.25 FTE or greater.

A copy of the letter sent by HCFA can be obtained from Mr. Eric E. Klein.

Editor’s Note: This important article is being reprinted due to layout errors, for which we apologize.

CIRMS Holds Eighth Annual Meeting at NIST

by George Xu Troy, NY The Council on Ionizing Radiation Measurements and Standards (CIRMS) held its eighth annual meeting at the National Institute of Standards and Technology (NIST) in Gaithersburg, MD on October 13-15, 1999. CIRMS represents thousands of users of ionizing radiation and radioactive sources engaged in industrial radiation processing and sterilization, medical radiation diagnostics and therapy, nuclear power generation, worker radiation protection, and environmental measurement programs. CIRMS provides a forum for discussing ionizing radiation issues; identifying, defining and prioritizing needed work; disseminating information on standards; and

organizing workshops and meetings to advance ionizing radiation technology.

More than 160 participants from industry, federal and state agencies, national laboratories, and the academic community attended the meeting, and presented lectures and posters which addressed the specialties of the four CIRMS subcommittees: Medical Applications, Occupational Radiation Protection, Public and Environmental Radiation Protection, and Industrial Applications and Materials Effects. To encourage the next generation of scientists in these disciplines, a Student Travel Grant program was added to the annual meeting. Industry and organizational contributions permitted five students to attend the annual meeting and present their research in a ple-

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nary session.

The 1999 Annual Meeting used a parallel workshop format for its subcommittee meetings held on the first day. This change in format enabled each subcommittee to present several invited talks on key issues germane to its area of scientific and technical interest, and then proceed with a review of the subcommittee’s Measurement Program Descriptions (MPDs). This new format for the annual meeting enabled participants to hear of the latest developments in their respective areas and then move on to consideration of the main working documents, the MPDs, generated by CIRMS. Judging from the significant increase in the overall meeting participation (50% increase over CIRMS ‘98) CIRMS has enhanced its role as

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THE FORUM for dialog on key measurement issues effecting the entire radiation community.

Medical Applications Subcommittee (Co-Chairs: Tom Heaton, FDA, and Larry DeWerd, University of Wisconsin) The over 45 participants in the Medical Applications Subcommittee session heard 11 papers on diverse topics covering areas such as BANG gels, the calibration of beta and intravascular sources, low energy brachytherapy seeds and photon dosimetry. In reviewing the existing MPDs, the Medical Applications Subcommittee acknowledged that four MPDs in this area have been completed or are nearly complete. These included: MPD A.1 on Mammography; MPD A.4.1 on Absorbed Dose to Water; MPD A.5 on Air Kerma Standards for Diagnostic Beams; and MPD A.6 on Air Kerma Standards for Photon Brachytherapy. Three of the existing MPDs warranted some revision: MPD A.2.1 on Radioactivity Standards for Nuclear Medicine; MPD A.3.1 on 2D/3D Dose Mapping for Therapy; and MPD A.7 on Dosimetry for Intravascular Brachytherapy. In addition, ten possible new MPDs were discussed, several of which dealt with standards and measurements for brachytherapy.

Public and Environmental Radiation Protection (PERP) Subcommittee (Chair: David McCurdy, Duke Engineering and Engineering Services) The 24 participants in the

PERP Subcommittee session heard seven presentations, many dealing with sample verification processes and traceabilit y .

T he re w a s a n extended discussion of the key elements needed for a verification protocol. Out of this emerged an outline for the criteria for quality control sample preparation. Related to this are the issues of traceability through Performance Evaluation programs and the criticality of material quality to the credibility of any analytical results. Some fundamental issues related to the PERP MPDs were noted: a) survey instrumentation; b) waste cleanup and site remediation; c) atom counting techniques; and d) field survey instruments. As a result of this workshop, a new written standard will be proposed to ANSI N42.2. The topics and issues noted in this session will be suggested as the outline for this standard. At least six organizations volunteered to participate in writing this new standard.

Occupational Radiation Protection (ORP) Subcommittee (Chair: Kenneth Swinth, Swinth Associates) The over 45 participants in the ORP Subcommittee session heard 12 presentations along with two short contributions.

Of these, emphasis was given to the issues pertaining to neutron measurements including calibrations and dosimetry.

The occupational radiation protection subcommittee dealt with facilities, measurements and standards for neutrons.

This topic was particularly

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timely in light of the recent criticality accident in Japan.

Developments in the area of electronic dosimetry for neutrons were presented. The progress being made on microRad calibrations and their traceability to NIST was also covered, along with recent developments in personnel dosimeters for beta dosimetry. The seven existing O R P MPD s w e re b r i e f l y reviewed. Four new topical areas that could lead to MPDs w e re s ugge s t e d.

These include: a) neutron dosimetry; b) proficiency testing; c) portable multi-channel analyzers (MCAs) and d) the calibration of installed area monitors.

The concerns related to these areas will need to be discussed and developed and, in some instances, may lead to activities, such as the development standards outside of CIRMS.

Industrial Applications and Materials Effects (IAME) Subcommittee (Chair: Paul Farrell, Brookhaven Technology Group; Vice-Chair: Kenneth Koziol: SteriGenics, Inc.) In contrast to the other subcommittees, the IAME Subcommittee generally deals with the radiation effects on non-living matter. This year the IAME session concentrated on radiation effects on materials considered for use in space programs. The over 22 attendees heard 12 presentations.

Three of these dealt with the emergence of electron beam cured carbon fiber composites and structures that could be made from such, as well as limitations to the survivability of traditional organic matrix

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materials in the space environment. Ion beam effects on polymers, new electron beam capabilities resulting from industry/university cooperation and NIST’s own radiation source capabilities were covered as well as some dosimetry issues and the effects of dose on viruses in human fibroid tissue. In reviewing the IAME MPDs, it was felt that alanine dosimetry and its spin resonance measurements will take hold in medical device sterilization (MDP D.5) and in food irradiation (MPD D.7). A new MPD covering electronbeam-cured composites may be needed. MDP D.4.1 on neutron effects on reactor vessels will have to be expanded to encompass recent Nuclear Regulatory Commission inter-

ests in the effects on cables and other materials near reactors. Later this year, the National Physical Laboratory in the United Kingdom will publish the results of an alanine based dosimetry intercomparison it conducted with all of the radiation processing facilities in Europe.

The annual gathering of the radiation user community is a key element of the planning processes for state and federal agencies. CIRMS encourages one-on-one interactions, open group discussions, and prioritization of the national measurements and standards needs through consensus. These collective efforts help industry and government to more effectively solve short-term problems, and to prepare ade-

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quately for the future needs of emerging radiation technologies. The new officers for CIRMS this year are Dr. George Xu from Rensselaer Polytechnic Institute, President, Mr. Joseph McDonald fr om Pacific Northwest National Laboratory, 1st Vice President, Dr. Arthur Heiss from Bruker Instrument, 2nd Vice President, and Mr. John Micka from University of Wisconsin Madison, as Secretary/Treasurer.

The next annual meeting of CIRMS will be held at NIST on October 30 - November 1, 2000. For further information visit the web site at www.cirms.org.

TG-51 Recommendations

by William F. Hanson David Followill for the AAPM Radiation Therapy Committee Houston, TX Effective January 1, 2000, Task Group 51 [Med Phys, 26, 18471870, (1999)] will be formally recognized and radiotherapy facilities are encouraged to begin using it.

TG-21 is still recognized and acceptable for at least the next two years.

These two years will allow physicists to wait until their next scheduled chamber calibration (ADCL) to obtain their absorbed dose factor. They then can implement TG-51 at an appropriate time after that.

It is recommended that when

your chamber goes to be re-calibrated (ADCL), that both an absorbed dose and an air kerma calibration be obtained at least this one time. This will allow you to perform a TG-21 and TG51 calibration comparison to determine the magnitude of the change in beam output [see http://RPC.mdanderson.org for TG-51 conversion forms].

If you use a parallel plate chamber, the recommended procedure is to assign a factor based on a cross calibration with an ADCL calibrated cylindrical chamber in a high energy electron beam [see TG-39 report (Med Phys, 21 1251-1260 (1994)]. Recall that TG-51 recommends that parallel plate chambers not be used for photon beams.

11

Physicists are encouraged to attend/participate in TG-51 refresher courses/workshops presented by many of the local AAPM Chapters. Additional information regarding the implementation of TG-51 can be found in the RPC/RDS newsletter article in this issue. If you have any questions, please feel free to contact the RPC. at (713)792-3226

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

Executive Director’s Column

by Sal Trofi College Park, MD Medical Physics Journal A CD-ROM with the full text of articles for the 1997-1999 years is in production and is scheduled to be inserted in the monthly mailing you will receive about February 1st. The CD-ROM will also contain Abstracts for the 1975-1996 years. All Members will receive a copy of the CD-ROM as a privilege of membership. Nonmember subscribers do not receive the CD-ROM with their subscription and are not eligible to purchase a copy.

Some members have not yet subscribed to the Online Journal. The Online Journal is absolutely FREE to all members, but you must subscribe to activate your access. To subscribe, go to <http://www.medphys.org> and look for the box that says "How to get Medical Physics Onlineâ&#x20AC;?. There is also some confusion among the membership about receiving the paper copy of the Journal if you subscribe to the Online Journal.

You will not lose the paper copy of the Journal by subscribing to the Online Journal, unless you elected not to receive it. This is also true for Student and Emeritus Members who elected to pay for the paper version of the Journal.

2000 Summer School The AAPM 2000 Summer School will be held immediately following the Chicago 2000 World Congress, July 29 August 1 at Northern Illinois University in Dekalb. The topic is "General Practice of Radiation Oncology in the Next Cen-

tury" and the school is intended for the medical physicists and radiation oncologists who are implementing new radiotherapy technology in the next century. Hands-on workshops are planned. Almon Shiu and David Mellenberg are the Program Directors and Kevin Corrigan chairs the Midwest Chapter Local Arrangements Committee. You will receive registration materials in your March membership mailing.

Information will be available on the AAPM web site on February 15th.

Chicago 2000 World Congress

Plans are going smoothly for the World Congress on Medical Physics and Biomedical Engineering scheduled July 23-28 in Chicago. Approaching deadlines are: April 3 - Authors will be notified of paper disposition May 15 - Deadline to receive Discounted Registration fees May 15 - Deadline for payment of $50 abstract fee for accepted abstracts May 26 - Scientific program available on wc2000.org June 19 - Deadline for housing reservations June 19 - Deadline for advance meeting registration July 1 - No refunds given for cancellations received after this time We are pleased to announce that the Chicago 2000 World Congress will include a Job Fair. There will be a special area within the exhibit hall just for companies participating in the Job Fair. This will allow a

12

presence for companies wanting to make new contacts and recruit new hires. Companies typically recruit for first job seekers as well as experienced engineers and medical physicists. Over 10,000 companies have been invited to participate in this unique opportunity.

Attendees seeking a job will electronically submit their resume for posting on the web and to be included in a Resume Book that will be distributed to the participating companies prior to the Chicago 2000 World Congress. More information will be posted in February on <http://www.wc2000.org>.

Other News The Publication Committee has decided to post most AAPM task group reports to the AAPM web site. They are now in the process of selecting those that are still relevant to the profession of medical physics. This process should be completed during the first half of 2000.

The Membership Directory is scheduled to be shipped midJanuary. If we meet that schedule, Members should receive their copy at about the same time as this newsletter.

In past years there have been

AAPM NEWSLETTER

10 monthly mailings. Beginning in 2000, there will be 12 month-

ly mailings. This was made possible because the Placement

JANUARY/FEBRUARY 2000

Bulletin is now included in your monthly mailing.

Report from the Treasurer 2000 PROGRAM BUDGET

by Melissa Martin, AAPM Treasurer Bellflower, CA At the December 1, 1999 Board of Directors meeting, the proposed budget for the year 2000 was approved as detailed on the following pages. Several factors impact this budget in contrast to our two previous outstanding years of operation.

The good news is that for the past two years (98 and 99), we have had excellent annual meetings, success with the Medical Physics Journal, support from our Corporate Affiliates and other programs resulting in returns on our activities of at least $600,000 per year. We will have achieved our target of having in reserves an amount adequate to cover one normal yearâ&#x20AC;&#x2122;s operating expenses of about $ 4,000,000.

The proposed budget for the year 2000 is over $5 million to accommodate unusual activity within our organization this particular year.

The budget for the year 2000 is shows deficit of -$307,944 due to three significant factors: 1) the commitment made previously to host the World Congress Meeting for which we will return 1/3 of the profits to the International Organizations, 1/3 to the Biomedical Engineers, and then pay our own meeting expenses out of our 1/3 of the

profits, 2) the significantly increased Professional Council activities approved at the annual Board Meeting, details of which will be given in an article

by Michael Gillan, Chairman of the Professional Council and 3) an increase in space for headquarters adequate for the next ten years.

Experience from the 1988 World Congress Meeting in San Antonio showed that over the following two years, the increased number of exhibitors at those two annual meetings more than made up the deficit from the 1988 meeting. We certainly hope that we see a similar increase from this yearâ&#x20AC;&#x2122;s World Congress. The meeting looks to be outstanding and all of us are encouraged to attend.

Sal Trofi and the staff at Headquarters have given 110% of their efforts to the organization of the World Congress Meeting already and have committed to completing this task in their normally outstanding style.

Negotiations to obtain increased space for our headquarters operations adequate for the next ten years is nearing completion. The Headquarters Office Space Committee consisting of Ned Sternick, Jim Deye, Jean St. Germain, Sal Trofi and Melissa Martin have been working with the Staubach Corporation to obtain a final contract for over a year to take effect prior to or at least by the expiration of our current

13

lease which ends on August 1, 2001 at the American Center for Physics. A meeting of the HOS Committee and representatives of the EMCC will meet with the AIP at the ACP in early January to negotiate and evaluate the needs of our organization for computer access and support in the new contract. In the 2000 budget is anticipation of some of these costs and renovations to be initiated in this year. A final report from the HOS Committee will be made upon conclusion of our negotiations.

As indicated on this budget, we are a very active organization with many successful programs. The dedication and volunteer efforts of our members keeps us growing. I wish to extend my thanks for all the efforts exhibited by both our members and the staff to keep this organization functioning within a very tight budget.

Please continue to support our activities and plan to attend the World Congress Meeting in July 2000.

AAPM 2000 Programmatic Budget Revenue

Expenses Direct

Overhead

Net Total

Membership Dues Dues Renewal Notices Applications and Reinstatements

$753,429

Subtotal

$158,800 13,000 2,500 $174,300

$2,999 9,855 51,008 $63,861

$161,799 22,855 53,508 $238,161

$591,630 (22,855) (43,308) $525,468

$209,750 3,790 34,000

$70,976 24,000 80,000 44,650 15,000 10,000

$2,427 15,452 11,302 3,883 140

$247,540

$244,626

96,174 $129,378

$73,403 39,452 91,302 48,533 15,140 10,000 96,174 $374,004

$136,347 (35,662) (57,302) (48,533) (15,140) (10,000) (96,174) ($126,464)

$16,000 48,000 8,000 $72,000

$6,492 61,987 4,002 $72,482

$22,492 109,987 12,002 $144,482

($22,492) (109,987) (12,002) ($144,482)

$71,450 108,576 44,560 161,085 30,000 57,518 $473,189

$6,091 2,352 1,592 47,469 18,488 5,132 $81,124

$77,541 110,928 46,152 208,554 48,488 62,650 $554,313

($63,441) (110,928) (46,152) (201,054) (48,488) (62,650) ($532,713)

$25,000

$181,937 3,532 34,165 8,591 145,238 49,806

($206,937) (3,532) (34,165) (25,291) (145,238) (49,806) (42,000) (45,694) ($552,664)

($6,652) 28,047 6,000 3,500 2,500 14,215 $47,610

10,200 $763,629

Membership Services Placement Bulletin Membership Directory Monthly Mailings Nerwsletter Salary Survey AAPM Brochures AAPM Web Site Subtotal

Organizational Board of Directors Executive Committee Elections & Society Votes Subtotal

Councils and Committees Education Council Professional Council Science Council Administrative Committees Ad Hoc Committees Liaisons with other Organizations

$14,100

7,500

Subtotal

$21,600

Administrative Professional Services Investment Management Telephone and Mail Headquarters Travel General Operations AAPM Database Credit Card (Processing Costs) AIP Services

42,000 41,804 $125,504

3,889 $427,159

$206,937 3,532 34,165 25,291 145,238 49,806 42,000 45,694 $552,664

$5,000 750

$16,652 3,203

$21,652 3,953

2,400 $8,150

3,885 $23,740

6,285 $31,890

16,700

Subtotal

Other Income CAMPEP AAPM Mailing Lists Credit Card Royalties Computers in Physics, Royalties WWW Host Services and Advertising Malpractice Insurance Program Subtotal

$15,000 32,000 6,000 3,500 2,500 20,500 $79,500

Page 14

AAPM 2000 Programmatic Budget Revenue

Expenses Direct

Overhead

Net Total

Meetings Annual RSNA World Congress Subtotal

2,566,225 $2,566,225

$122,823 24,000 2,154,824 $2,301,647

$34,448 31,581 159,212 $225,241

$157,271 55,581 2,314,036 $2,526,888

($157,271) (55,581) 252,189 $39,337

Subtotal

$217,425 20,400 $237,825

$109,413 14,310 $123,723

$23,166 351 $23,517

$132,579 14,661 $147,240

$1,212,400

95,817 27,622 $123,439

$990,718 37,122 $1,027,840

$221,682 (37,122) $184,560

$3,457 1,840 $5,297

$4,657 11,840 $16,497

$3,343 (4,840) ($1,497)

$17,100 18,950 $36,050

($17,100) (18,950) ($36,050)

Education Programs Summer School Review Courses, Medical Physics

$84,846 5,739 $90,585

Medical Physics Journal Journal Production Journal Business Management Subtotal

$1,212,400

$894,901 9,500 $904,401

Subtotal

$8,000 7,000 $15,000

$1,200 10,000 $11,200

Publications Books Reports

Other Organizations Contributions and Donations Dues and other payments

$17,100 18,950 $36,050

Subtotal

Sponsored Residencies Varian RSNA ASTRO Elekta Subtotal

Totals before Investment Revenue

$30,000 30,000 30,000 15,000 $105,000

$30,000 30,000 30,000 15,000 $105,000

$409 409 409 409 $1,635

$30,409 30,409 30,409 15,409 $106,635

($409) (409) (409) (409) ($1,635)

$5,248,719

$4,579,790

$1,176,873

$5,756,663

($507,944)

Investment Revenue From Operations Transfer from Investment funds Subtotal

Grand Total, Accrual Basis

$50,000 150,000

$50,000 150,000

$200,000

$200,000

$5,448,719

Page 15

$4,579,790

$1,176,873

$5,756,663

($307,944)

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

AAPM Investments

By John Kent, Chairman Investment Advisory Committee Indianapolis, IN An Investment Fund was established in 1989 to manage assets held in reserve to assure that the commitments of AAPM will be honored. In 1990 total assets in the Investment Fund were approximately one million dollars. By the end of this year, the Investment Fund will exceed $ 4.5 million. Dividends and unrealized capital gains from this Fund accounted for more than 50% of 'profits' over the past four years.

The importance of AAPM investments to the financial stability of the organization should not be understated.

With recent gains in the equities markets, assets of the Investment Fund grew to the point where it became cost effective to hire the services of an investment advisor. Earlier this year, after an extensive interview process, the AAPM retained CFG Wealth Management Services as an investment advisor.

CFG Wealth Management Services will assist in establishing investment policy and guidelines, recommend an investment strategy to meet our objectives, monitor asset allocation and investment performance relative to the appropriate benchmark and provide quarterly performance reports.

Our investment advisor has recommended we utilize the

investment management process and services developed by SEI Investments. SEI is an institutional fund manager with over $ 80 billion under management. SEI Trust Company has become the custodian of the Investment Fund.

Twenty-three managers currently manage assets of the Investment Fund, each with a unique investment style, covering seven different asset classes. This asset allocation strategy is expected to increase the return of the Fund while decreasing the standard deviation of the value of our investments relative to our pervious allocation. The AAPM will begin to receive detailed quarterly reports beginning in January 2000.

Thereâ&#x20AC;&#x2122;s A Change in the Air (TG-21 to TG-51)

by David Followill, Houston, TX By now most medical physicists are aware that the AAPM has published a new protocol for the calibration of highenergy photon and electron radiotherapy beams (Medical Physics 26 (9), Sept. 1999).

The Radiological Physics Center (RPC) and Radiation Dosimetry Services (RDS) from the University of Texas M. D. Anderson Cancer Center will

change to the new protocol on January 1, 2000. This change to the new protocol will impact all of the RPC audit programs (on-site visits, TLD, remote tools, patient record review) and the RDS TLD forfee services. Implementation of the TG-51 protocol will result in an approximate 0-2% change, in the absorbed dose measured and calculated by the RPC and RDS, depending on the modality and energy.

Since both RPC and RDS will

16

implement the same change in absorbed dose the two TLD audit programs will remain equivalent. We are urging all radiotherapy facilities to consider making the change to the new TG-51 protocol, but only after everyone involved at your facility has been properly notified of the consequences.

The RPC will assess all doses against the TG-51 protocol.

However, institutions participating with RDS will have the option of specifying their

AAPM NEWSLETTER

absorbed dose according to a specific protocol (i.e., TG-21, TG-51 or other).

Implementation of the TG-51 protocol by the RPC will also impact those institutions participating in Cooperative Clinical Trials funded by the National Cancer Institution.

For a given dose prescription, adopting the new protocol is likely to result in the patient receiving 2% less radiation with all megavoltage beams, i.e. Cobalt 60, x-ray and electrons. Since the absorbed dose measured and calculated by the RPC will change approximately 0-2% for interinstitutional protocol patients, the RPC is recommending that the cooperative clinical trial groups make no change in the numerical values of the prescribed dose listed in their treatment protocols. However, for nonprotocol patients, each institution must assess its own dosimetry practices and decide whether or not to change patient dose prescriptions to compensate for changes in dosimetry.

All the following items should be considered prior to making the change to the new protocol.

Determine in advance how much you think you will change your determination of absorbed dose. This most likely will require independent measurements as some parameters and chamber calibrations have changed.

The new protocol recommends that clinical percent depth dose should incorporate a shift to the effective point of measurement for both photons and electrons.

Since Air Ker ma, and Absorbed Dose to water have

units of cGy, there has been confusion over chamber calibration factors using these different quantities. The TG51 protocol is specifically for calibration factors that are Absorbed Dose to water.

If the change is 2.5% or greater, contact the RPC before implementing the change.

Discuss with the radiation oncologist the proposed changes, and how these changes may influence the dose he/she delivers to patients.

Inform everyone else who may be involved (dosimetrists, therapists, etc.).

Choose a date to make the change. (e.g. at the next annual calibration of the unit, the first of a given month, or another date significant for your institution. We have chosen 1/1/2000 as a significant, memorable date.)

Make the change, documenting when you made the change and the magnitude and direction of the change.

All of the institutions that participate in the RPC and RDS TLD programs have been sent calculation forms to assist them in the conversion to the new protocol and to document the magnitude of the change.

If you are not a participant in one of our TLD programs and believe these forms may be of use to your institution, please go to HYPERLINK http://RPC.mdanderson.org, where you can download the forms.

Your cooperation in making this transition as smooth as possible is appreciated. Our physicists have made themselves knowledgeable with the new protocol. Please feel free

17

JANUARY/FEBRUARY 2000

to contact us at (713) 792-3226 with questions and problems if you need assistance.

D. Followill, J. Lowenstein and W. Hanson Radiological Physics Center Marilyn Stovall Radiation Dosimetry Services

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

Letters to the Editor Conformal Radiation Therapy - Unproven Technology

by R. J. Schulz Johnson, VT A front-page article in the N.Y. Times (Sunday, October 3rd) dealt with the everincreasing use of bone-marrow transplants for the treatment of recurring breast as well as brain and ovarian cancers. As pointed out by the Times' reporters, the arguments for bone-marrow transplants for these cancers are based mainly upon theoretical considerations, and although they have not been subjected to rigorous clinical trials, they are widely available from hospitals as well as for-profit corporations. Bone-marrow transplants, which are painful, debilitating and cost upwards of $80,000, are sought by patients who have been convinced that they offer the last, best chance for survival. One has to wonder whether the unbridled enthusiasm of the providers of bone-marrow transplants is fueled by humanitarian or economic considerations.

Although vastly different in terms of patient discomfit and individual cost, there are parallels between bone-marrow transplants and some of the newer and more complex schemes being touted for the delivery of radiation therapy.

W h at I h av e previously referred to as Conformal Therapy(1) is also based upon tentative theoretical considerations that suggest improved cure

rates, has not been evaluated by randomized clinical trials, is unlikely to have a significant impact upon the overall cancer cure rate, and will cost more than the conventional treatment methods it is intended to replace (and may, in the aggregate, cost society more than bone-marrow transplants due to the much larger number of radiation treatments compared with transplant procedures).

Because of their acknowledged contributions to radiation therapy and frequent participation clinical procedures, physicists are now accepted as full-fledged members of the radiation therapy team which plans and implements patient treatments.

However, with added decision-making responsibilities, comes added responsibilities, and principal among them is the development of a perspective on how various cancers are treated and current cure rates. These data are readily obtained from the American Cancer Society(2) which has numerous, easily-understood publications on this subject.

Having gained this perspective, physicists will appreciate the complexities of this disease whose causes have yet to be elaborated, and one that has been systematically studied in the laboratory and attacked in the clinic for many decades.

Considering that radiation has been widely employed for cancer treatment since the early part of this century, we must ask ourselves how likely is it that a tactic as

18

simple as further improvement in dose distributions accompanied by modest increases in the tumor dose will have a significant impact upon cure rates?

The rational approach for the evaluation of any new treatment technique, which is likely to offer only a small improvement in survival, is a randomized/prospective trial.

In many cases, e.g., bone-marrow transplants and Conformal T he ra p y , s uc h t r i a l s a r e exceedingly difficult to implement, especially when they are already in widespread use.

The use of historical controls may be the best we can do but these cannot take into account present improvements in medical management from which conventionally-treated as well as Conformal-Therapy patients will benefit.

Now I've been there and done that, and I understand that physicists are intrigued by this sophisticated, new, computer-controlled equipment.

But perhaps the time has come when we should stop and ask ourselves whether clinical results are likely to improve as a result of the introduction of these new treatment techniques (and especially whether they may possibly do more harm due to smaller treatment volumes and dose escalation). Unless physicists develop a considerable degree of skepticism, and manufacturers are persuaded to tone down the current level of hyperbole, it is quite likely that Conformal Therapy will go the way of bone-marrow trans-

AAPM NEWSLETTER

plants with everyone doing it, the cost of treatments steadily rising, but no one being sure that the patients are doing any better.

I think that this is a matter that deserves a good deal of consideration and discussion by medical physicists not only for ethical reasons but also

because the arguments for new procedures are being closely scrutinized by hospital administrators and health-care insurers.

1. Further Improvements in Dose Distributions are Unlikely to Affect Cure Rates, R. J. Schulz, Med. Phys. 26, 10071009 (1999).

JANUARY/FEBRUARY 2000

2. American Cancer Society, 1599 Clifton Road N. E., Atlanta, GA 30329, Tel. 800 227-2345 or e-mail at www.cancer.org.

AAPM Welcomes our New 1999 Members Aleissa, Khalid A. I. Riyadh, SAUDI ARABIA Al-Enezi, Neda Moottish Riyadh, SAUDI ARABIA Al-Ghorabie, Fayez Hammad Makkah, SAUDI ARABIA Al-Qaisieh, Bashar M. Amman, JORDAN Ananthamoorthy, Rubi Kingston, ON, CANADA Aoki, Chuck Toshio Pasadena, CA Armour, Stephen Russell Denver, CO Auerbach, Edward J. Minneapolis, MN Baldock, Clive Brisbane, AUSTRALIA Ballester, Facundo Valencia, SPAIN Baryshnikov, Boris V. Madison, WI Bauer, Linda A Birmingham, AL Bea Gilabert, Jose Valencia, SPAIN Beatty, John F. Boston, MA Becerra, Lino R. Charlestown, MA Bercier, Yanic Montreal, QC CANADA Bergman, Alanah M. Vancouver, BC CANADA Bernstein, Matt A. Rochester, MN

Bharucha, Zubin H. Lexington, KY Brannan, Charles Thomas Huntington, WV Breen, Stephen Leonard Surrey, UNITED KINGDOM Brock, Kristy Kay Ann Arbor, MI Bruning, Horst F. Livermore, CA Bulz, Gyongyver Calgary, AB CANADA Buncick, Milan Correll Memphis, TN Burke, Thomas M Bothell, WA Butler, Laura Elane Jackson, TN Byng, Jeffrey W. Toronto, ON CANADA Callihan, Robert William Baton Rouge, LA Carmona Meseguer, Vicente Valencia, SPAIN Carrascosa, Miguel Guasp Valencia, SPAIN Carrott, David T. Agoura Hills, CA Cederbaum, Martin Haifa, ISRAEL Chardon, Sophie Kirschweiler, GERMANY Cherry, Christopher Patrick Houston, TX

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Choi, Mark Hodae Skokie, IL Chretien, Mario Quebec, CANADA Christou, Christina Ioannou Greenville, NC Chu, Kenneth C London, ON CANADA Coleman, Jesse Harrison Tuscumbia, AL Colgan, Mark E. Gainesville, FL Colussi, Valdir C. Cleveland, OH Cordrey, Ivan L. Maryville, TN Crouthamel, Daniel Ivan Madison, WI Cullen, Walter Sudbury, MA Cunningham, David Andrew Fort Collins, CO Czaplinski, Craig Charles Allentown, PA Daffin, Frank Cecil Birmingham, AL Dardzinski, Bernard J Cincinnati, OH Das, Shiva K. Durham, NC Davies, Alun R.Swindon, UNITED KINGDOM Deacon, Glenn R. Chula Vista, CA Deng, Jun Stanford, CA

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JANUARY/FEBRUARY 2000

Derenzo, David J. Chicago, IL Dickow, Danny Y. Sierra Vista, AZ Drogin, Ariel B. Lexington, KY Drzazga, Zofia Katowice, POLAND Duhaini, Ibrahim M. A. Inkster, MI Dunn, Stpehen E. Manchester, NH Dzemidzic, Mario Indianapolis, IN Eisenberg, Michael David Westwood, CA Elangovan, D. Pune, INDIA Elekes, Almos A Shorewood, WI Etemadnia, Amirali Richmond Hill, ON, CANADA Fan, Pei New York, NY Farrer, Daniel Homer Lexington, KY Felice, Marc A Philadelphia, PA Franklin, Elizabeth M. Graham, NC Freestone, Graham P. Hamilton, NEW ZEALAND Fung, Albert Y.C. New York, NY Garcia-Cobian, Jose Tupac Greenville, NC Gavathas, Evangelos Salisbury, MD Gearheart, Darren M Lexington, KY Ghedi, Barbara Cellatica, Brescia, ITALY Gilath, Chaim Haifa, ISRAEL Gill, Bradford Aaron Amherstview, ON CANADA Glennie, Gilbert D Charlottesville, VA Glick, Stephen Jeffrey Worcester, MA

Gonzalez, Albin L. Nashville, TN Grant, John B. Sydney, NS CANADA Hafeli, Urs Otto Cleveland, OH Hagness, Chris R. Rochester, MN Hames, Sean Michael Lynchburg, VA Hammoud, Rabih W. Dearborn, MI Harper, Kenneth R. Anchorage, AK Hashemian, Abdolreza Ossining, NY Hegyi, Gyorgy Laszlo Montreal, QC CANADA Hillman, Elizabeth Marjorie C London, UNITED KINGDOM Hinderer, Ralf Madison, WI Hinsberg, Marielle V Vlissingen, NETHERLANDS Horsch, Karla Jane Chicago, IL Hossain, Murshed Philadelphia, PA Howell, Kimberly Ann Middleton, WI Hussain, Kazi M. Boston, MA Ibrahim, Khalil Greenville, NC Jackson, Alan M. Detroit, MI Janicki, Christian Montreal, PQ CANADA Jenkins, Todd P. Wendell, NC Jeraj, Robert Ljubljana, SLOVENIA Johnson, Kevin Roderick RA London, UNITED KINGDOM Jones, David Maurice Temple, TX Jones, Lois Charlotte Sydney, AUSTRALIA

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Jonker, Leendert Simon The Hague, NETHERLANDS Kaipi, Grammati Athens, GREECE Karam, P. Andrew Rochester, NY Kawasaki, Shuichi Gunma, JAPAN Keller, Harry Madison, WI Kim, Donsoo Lowell, MA Kordomenos, John N. Zion, IL Kowski, Ryszard Piotr LODZ, POLAND Kriss, Aaron Andrew Broomfield, CO Kruse, Jon J. Rochester, MN Kwan, Alexander LC Edmonton, AB CANADA Lazarre, Charles H. Dallas, TX Lee, Rena J. Boston, MA Lee, Sung-Woo College Station, TX Li, Jinsheng Stanford, CA Li, Jonathan G. Stanford, CA Li, Lucy Qi Bedford, MA Li, Qiang Chicago, IL Libby, Bruce Richmond, VA Lightstone, Alexander Wolf Toronto, ON CANADA Lipoti, Jill Ann Trenton, NJ Litzenberg, Dale William Ann Arbor, MI Liu, Xinming Houston, TX Lliso-Valverde, Francoise Valencia, SPAIN Lockman, David M. Royal Oak, MI

AAPM NEWSLETTER

Love, Joel Thomas Columbia, MO Luo, Jianbin James Lancaster, CA Mallios, George John Skokie, IL Mandelin, Paul M. Waukegan, IL Mansson, Lennart Ljungby, SWEDEN Marsden, Peter John London, ENGLAND Masutani, Yoshitaka Chicago, IL McMahon, Joseph Chicago, IL Mechalakos, James G New York, NY Mehta, Godrej N. Hauppauge, NY Menon, Geetha Edmonton, AB CANADA Metevier, Lawrence John Slidell, LA Meyer, Michael Clark, NJ Meyer, Shawn Lee Denver, CO Michaud, Daniel Trois-Rivieres, QC CANADA Miller, Randall Peter Halifax, NS CANADA Mitra, Raj K. Philadelphia, PA Moody, Jonathan Bryan Southfield, MI Moore, William C. East Patchogue, NY Neck, Daniel W. Baton Rouge, LA Nelson, Andrea Boston, MA Neuweg, Doug A. Springfield, IL Nguyen, Hoan Thuc Greenville, NC Opsahl-Ong, Beale Niskayuna, NY Ozluoglu, Nese Ankara, TURKEY

Painter, Travis A. Lexington, KY Palmans, Hugo Gent, BELGIUM Palmer, Matthew R. Boston, MA Pang, Dalong Austin, TX Pavlonnis, Leticia L. Middlebury, CT Pereira Jr., Pedro Paulo RJ, BRAZIL Philip, Podimannil S. Houston, TX Pignoli, Emamuele Milano, ITALY Plazas, Maria Cristina Santafe d Bogata, COLOMBIA Pomije, Brian D. Alpine, CA Poonawalla, Aziz H. Houston, TX Popple, Richard A. Houston, TX Price, Robert A. Philadelphia, PA Provost, Daniel Z. Sudbury, ON CANADA Provost, Terrence Joseph Cleveland, OH Qian, Yao-Jin Huntington Beach, CA Radau, Perry E London, ON CANADA Radford, Dee-Ann Houston, TX Rathee, Satyapal Winnepeg, MB CANADA Ratner, Martin J. Carle Place, NY Reed, Scott Edward E. Scott Depot, WV Rinks, Adrian Newport Beach NSW, AUSTRALIA Rioux, Alexandre Montreal, QC CANADA Robert, Normand Toronto, ON CANADA Rodgers, Joseph J.

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JANUARY/FEBRUARY 2000

Buford, GA Ryan, Steven Daniel Portland, ME Sachithanandam, Shankar Barani Oklahoma City, OK Satterthwaite, James C. Boston, MA Schaaf, David Nicholas Birmingham, MI Scharff, Jennifer H. Madison, WI Scott, Robert Alfred Providence, RI Shahnazi, Kambiz New Haven, CT Shelton, Gina L. San Antonio, TX Shepard, Jon D. Gainesville, FL Sherif, Mohamed Ogdensburg, NY Siddiqi, Nayyer J. Detroit, MI Skeist, Loren R. Hauppauge, NY Slayton, Michael H. Mesa, AZ Snyder, Charles Harold Longwood, FL Soldano, Michael Hamilton, OH Solonenko, Michael G Philadelphia, PA Soltysik, David Alan Gainesville, FL Stanley, Michelle Renee Clemson, SC Staryszak, Michael Francis Lexington, KY Stefanovski, Zoran Skopje, REPUBLIC OF MACEDONIA Steger, Theodore Roosevelt Houston, TX Stratford, Jennifer S. San Diego, CA Sullivan, Michael T Lafayette, LA

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

Tattam, David Anthony Amersham Bucks, ENGLAND Thekkeparayil, Sreevalsan Carmichael, CA Tran, Toan Ngoc Hanoi, VIETNAM Turmel, Jim Spatanburg, SC

Cohen, Lionel Cambridge, MA

Unal, Orhan Madison, WI

del Regato, Juan A. Tampa, FL

Vaniachine, Alexandre V. Stockholm, SWEDEN Varner, John C. Lithia Springs, GA Velez, Graciela R Cordoba, ARGENTINA Venencia, Carlos Daniel Cordoba, ARGENTINA

Derr, Stephen M. Naples, FL

Wadi Ramahi, Shada Chicago, IL Wang, Jing New York, NY Ward, Heidi Alissa Rochester, MN Weber, Bruce Allen Miami, FL Weening, Richard Henry Drexel Hill, PA Weinberg, Rebecca Brentwood, TN Wiik, David Adamson Mobile, AL Wilson, Kevin E. Bedford, MA

Reid, Ann M. Stephentown, NY

Deceased Members

Hartson, Mary E. Anderson, IN Mitchell, Thomas P. Gainesville, FL

Trembaczowki, E. Bialystok, POLAND Zakharchenko, Gheorgiy A. MOLDOVA

Zhang, George Madison, WI Zhang, Tiezhi Madison, WI Zygmanski, Piotr Boston, MA

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NEW CORPORATTE AFFILIATE MEMBERS Biodex Medical Systems Shirley, NY Accelectronics, Inc. Lake Bluff, IL Helax, Inc. Benecia, CA

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Instrumentarium Imaging Inc. Milwaukee, WI Mentor Santa Barbara, CA Unfors Instruments Davisburg, MI

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

Wanted: Newsletter Editor

by Robert Dixon Winston-Salem, NC (with SLIGHT approval from Marsha) I have been AAPM newsletter editor for six years with the invaluable help of my wife Marsha, goddess and managing editor, but it’s time I stepped aside for a less experienced man (or woman).

Consequently, I will step down as of January 1, 2001 and the AAPM needs a new editor. PUBCOM has formed a search committee with Ned Sternick as chair, so if you are interested, please contact Ned (esternick@aol.com).

A prospective editor can propose his own model for a managing editor, i.e., AAPM headquarters has agreed to act as managing editor; or, the editor may hire his own local

managing editor (or he can move in with my wife).

I have had a great time as editor, but I look forward to having more time to spend flying my newly acquired exSoviet military jet. The picture shows me just after training with Major A. Makarenko—a former Soviet air force pilot who also trained the Iraqis before the Gulf War. (If you’d like more information on where to get one, try the web page kgb.org). In that regard, it occurs to me that there are several AAPM members who are pilots. I saw Adrian Oliver arrive in his Piper Lance at the Nashville airport during the summer meeting. Joe Blinick and Larry Reinstein (both pilots) also flew into Nashville in Joe’s Cessna-182. Other AAPM pilots include Ivan Bre-

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zovich, Sheri Henderson, Walter Kopecky, Rodney Wimmer, and David Neblett, and there are probably others I don’t know about. Larry Reinstein was interested in forming a special interest group, so if you are a pilot, send him a message.

AAPM NEWSLETTER

JANUARY/FEBRUARY 2000

Editorial Board Board Editorial Benjamin Archer Bruce Curran Marsha Dixon Don Frey John Kent Richard Morin Alfred Smith

AAPM NEWSLETTER MANAGING EDITOR

EDITOR-IN-RESIDENCE

Marsha Dixon

Robert Dixon (336) 721-9171 Phone (336) 721-0833 Fax e-mail: rdixon@rad.wfubmc.edu

NEXT ISSUE March/April, 2000

DEADLINE February 15, 2000

MAIL DATE March 15, 2000

AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE One Physics Ellipse College Park, Maryland 20740-3846 (301) 209-3350 Phone (301) 209-0862 Fax e-mail: aapm@aapm.acp.org http://www.aapm.org

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