Newsletter
American Association of Physicists in Medicine VOLUME 27 NO. 6
NOVEMBER/DECEMBER 2002
AAPM President’s Column Health of the AAPM Robert G. Gould San Francisco, CA As I write this, the joint meeting of the RSNA and the AAPM is fast approaching and with it my final conference as president of the AAPM. It has been a good year. The AAPM is financially strong, our Headquarters staff is a cohesive and productive team, our committees are industrious and well led, and our membership numbers continue to grow. What lies ahead? The Montreal meeting was a great success in many ways. Financially, the meeting exceeded profit projections, but it was also a strong scientific meeting. After several years of decline, the number of diagnostic abstract submissions nearly doubled and the number of therapy abstracts was at a record level. Some of the increase in abstract submissions is attributable to the greater participation of Canadian medical physicists, but growth occurred even if these were not considered in the count. The AAPM should find ways to maintain this momentum, particularly the diagnostic component. Members specializing in diagnostic imaging
2002 ASTRO and RSNA Residency Grants Announced Steven Goetsch Chair, Development Committee
should continue to view the Annual Meeting as an important and significant forum for diagnostic papers. In September, Chairman of the Board Charlie Coffey, President-Elect Marty Weinhous, Deputy Director Angela Keyser and I were invited to attend a board of directors meeting of the RSNA. At this meeting, Dr. Nick Bryan, president of the RSNA who has attended the last two AAPM Annual Meetings, stated that he was most impressed by the science at the AAPM meeting and hoped that we could find ways to increase RSNA participation at our meeting. For many years at the RSNA Annual Meeting, the RSNA/ AAPM Symposium, a plenary session, has been held on Thursday afternoon. Perhaps a joint AAPM/RSNA session could be (See Gould - p. 2)
The AAPM has announced the recipients of the two Clinical Residencies in Radiation Oncology sponsored by the American Society for Therapeutic Radiology and Oncology (ASTRO) and two Clinical Residencies in Diagnostic Medical Physics sponsored by the Radiological Soci(See Grants - p. 3)
Exec. Director’s Col. p 4 Gov’t. Affairs Column p 5 Education Counc. Rep. p 6 New ACR CT Accred. p 7 Summer Undergraduate Fellowship Program p 10 ISIORT p 13 Medical Events Revisited ... New Part 35 p 14 Int’l Conference - Cuba p 15 Partners in Physics p 16 A Plea to Physicists p 18 JACMP Ed.-in-Chief p 19 PUBCOM News p 20 Memorial p 21 New Members p 22 Letters to the Editor p 23
AAPM NEWSLETTER
Gould
NOVEMBER/DECEMBER 2002
(from p. 1)
held at our Annual Meeting. We should also try to increase participation of other organizations in our meeting. The financial strength of our society is in large part due to the guidance and skills of our Headquarters staff under the directorship of Sal Trofi. Our reserves have grown sufficiently for the AAPM Board of Directors to approve deficit budgets over the last three years, although in only one of these years was a small actual deficit recorded. That is, while deficits have been budgeted, revenues have exceeded projections and spending has been below budget. Financial strength means we can do more things as an association to further our goals in promoting medical physics, encouraging and educating medical physicists, and disseminating technical information. Support activities of Headquarters staff are also critical to the fulfillment of these goals. Headquarters staff has developed into a team with a strong sense of unity and loyalty to the AAPM. A corp d’esprit has developed that increases their productivity and greatly benefits the Association. But change is coming as Sal Trofi announced his retirement in January of 2004 and presented the Board with a proposed transition plan to a new director. In Montreal, the Board of Directors not only accepted this plan but, recognizing the value and cohesiveness of Headquarters staff, moved aggressively to implement it by voting to promote Angela Keyser as our next executive di-
rector upon Sal’s retirement. This assures that the Headquarters team will remain intact and the transition should proceed smoothly. I congratulate Angela and look forward to her help in leading our Association. Last, I have been watching the growth of our Association over the last several years. Our membership statistics, which have been reported in the Newsletter, show a 20% growth in full members over the past two years, an apparently healthy increase. But a significant portion of this increase is due to Headquarters maintaining a better membership database that is able to track and limit how long members remain at the student and junior levels. Long-term junior members have been forced up or out and clearly they have chosen to become full members. The result has been a decline of 73% in junior membership and a 50% decline in student membership over the same period. Thus, looking at these three categories together, we have seen only a 2% growth in membership over the past two years. What is not clear from the data is if the number of students entering medical physics has changed. It is most likely that the numbers have been relatively constant. However, what is clear is that not enough young people are entering the field of medical physics to meet current and future demands. TheAAPM Placement Bulletin has had record numbers of job openings (and the advertising revenue from the Bulletin has also been at record levels). Both my immediate prede2
cessors, Ken Hogstrom and Charlie Coffey, emphasized the importance of attracting new people into medical physics. I share that view and encourage our members to think about this issue, develop new ideas to draw people into medical physics and to actively participate in recruiting new people. Finally, I want to thank the membership for their support during my presidency. To those members on councils and committees, serving on the Board of Directors and acting as liaisons and representatives of the AAPM, I both thank you for your efforts on behalf of the AAPM and for your contributions to our profession. I congratulate you for your achievements. I also thank Headquarters for all their help. They never said no. And I am deeply grateful to all the members of EXCOM, Charlie Coffey, Melissa Martin, Sal Trofi, Marty Weinhous and Jerry ■ White.
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
Grants
(from p. 1)
ety of North America (RSNA) Research and Education Fund. The awards were made on a competitive basis, according to Dr. Bhudatt Paliwal, chairman of the Awards Selection Subcommittee of the AAPM Development Committee. One of the ASTRO residency grants was awarded to the University of Florida. The program director at this facility is Jatinder Palta and the resident will be Hilary Akapati, Ph.D. from Rice University. The University of Wisconsin was selected for the second award. The program director is Rupak Das and the resident will be Yankhua Fan, who received a Ph.D. in physics from Moscow State University. ASTRO has sponsored eleven previous residencies dating back to 1992. The RSNA Research and Education Fund Residency Grants were awarded to two universities. One award was made to the University of Texas M.D. Anderson Hospital, with John Hazle as program director and Xinming (John) Rong to be the resident. Dr. Rong holds a Ph.D. in nuclear engineering from the University of Missouri. The University of Alabama, Birmingham, received the
Hilary Akapati
Yankhua Fan
Xinming (John) Rong
Michael Yester and Benjamin Zeff
second RSNA Residency with Michael Yester as the program director and Benjamin Zeff to be the resident. Dr. Zeff holds a Ph.D. from the University of Maryland. RSNA has sponsored three previous grants in this program, in addition to co-sponsoring six pre-doctoral fellowships. For a complete listing of all forty fellows and residents since 1990, please check the AAPM Web site. Applications for Support for Clinical Residency in Imaging,
Announcement:
sponsored by the AAPM, and Support for Clinical Residencies in Radiation Oncology, sponsored by Varian, will be available on November 15, 2002, with a February 1, 2003 deadline. Applications for the Fellowship for Graduate Study in Medical Physics, sponsored by the RSNA and AAPM, will be available on November 15, 2002 with an April 15, 2003 deadline. ■
New Additions to Medical Physics Online
We are pleased to announce that readers can now access full manuscripts of all articles published in Medical Physics back to Volume 13 (1986) at Medical Physics Online (http://medphys.org). This is the first part of our plan to have full manuscripts for all past issues available online. We hope to complete this project by early in 2003. – Colin G. Orton, Editor, Medical Physics – 3
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
Executive Director’s Column Sal Trofi College Park, MD
Fellowships and Residencies The mailing accompanying this newsletter contains applications for a sponsored Fellowship, an Imaging Residency, and two Radiation Oncology Clinical Residencies. Applications for residencies must be received at AAPM Headquarters by February 1, 2003. Applications for the fellowship must be received at AAPM Headquarters by April 15, 2003. •The AAPM/RSNA Fellowship is offered to individuals and is a two-year pre-doctoral study in medical physics that will begin on July 1, 2003.Graduate study must be undertaken in a medical physics doctoral degree program accredited by CAMPEP. The amount of the award will be $18,000 per year for two years. This fellowship is funded through the AAPM Education Endowment Fund. •The AAPM Imaging Residency is offered to institutions to sponsor a clinical residency. This is a two-year grant to support a clinical residency in imaging. The residency program must be accredited by CAMPEP, or have applied for CAMPEP accreditation by the end of the second year of funding. The amount of the award will be $18,000 per year
for two years beginning July 1, 2003. This residency should be funded through the AAPM Education Endowment Fund, but because funds are currently insufficient, it will be funded by general funds. •The Varian Oncology Systems Clinical Residencies are offered to institutions to sponsor two, two-year clinical residencies in radiation oncology. The amount of each residency award will be $18,000 per year for two years beginning July 1, 2003. The residency programs must be accredited by CAMPEP, or have applied for CAMPEP accreditation by the end of the second year of funding. Varian Associates funds these residencies and has been doing so since 1993.
Biomedical Imaging Research Opportunities Workshop AAPM is partnering with the ARR (Academy of Radiology 4
Research), BMES (Biomedical Engineering Society), and the RSNA (Radiological Society of North America) to sponsor the 1st Annual Biomedical Imaging Research Opportunities Workshop (BIROW). Many other leading societies in medical imaging are also participating in this event. BIROW will take place January 31 – February 1, 2003 at the Hyatt Regency in Bethesda, MD. For this first workshop, AAPM staff members are managing the online registration, online abstract submission and overall meeting logistics. BIROW is intended to identify and explore opportunities for basic science research and engineering development in biomedical imaging as well as related diagnosis and therapy. The workshop will include invited speakers on selected topics, focused breakout groups, and discussion with invited government representatives. After the presentations, panel discussions will be conducted in breakout groups on the four topics, with panelists including the speakers, representatives of sponsoring societies and other leaders in the field from academia, government and industry. The relevance of noteworthy posters and ideas from the floor will be discussed. White papers will be prepared from the breakout sessions and ultimately distributed and published. The white papers will summarize and make recommendations related
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
to the four topics with regard to opportunities and challenges. Registration for BIROW closes on January 3, 2003. For further details, go to: http://www.birow. org/.
Staff News On August 23, 2002, Michael Woodward, AAPM Director of Information Services, and his fiancée, Renee Gross from Philadelphia, Pennsylvania, eloped. They later held a small ceremony for family and friends followed by a honeymoon cruise to the Caribbean. Catherine Murashchyk joined the staff in September as
our new applications developer. Catherine is originally from the Ukraine and has degrees in both computer science and biochemistry. She most recently was working as a senior software developer for Orchid Technologies in Washington, DC. Jennifer Davis, AAPM’s receptionist, has recently announced her engagement to Jimmy Delp. They are planning a September 27, 2003 wedding.
Wednesday, December 24-25, 2002 and Wednesday, January 1, 2003. Some staff will take vacation days during the holiday season, but sufficient help will be available to service your needs. This is my last column for the 2002 year. I want to take this opportunity, speaking for all the staff, to wish you and your loved ones a happy and healthy holiday season. ■
Closing Remarks The AAPM office will be open on all regularly scheduled workdays during the holiday season, but will be closed on Tuesday and
Government Affairs Column
Angela L. Lee College Park, MD I would like to thank the Florida Chapter for inviting me to speak at their fall meeting. The meeting took place on September 20th in Cocoa Beach, FL. It was a joint meeting with the Health Physics Society’s Florida Chapter. There
were approximately 150 physicists in attendance. The AAPM portion of the meeting included discussions on IMRT, Zevalin (the first FDA approved radiolabeled antibody for cancer treatment) and a two-hour Medical Errors Course. The HPS portion of the meeting included several interesting discussions on Homeland Security, one on NCRP Report Number 138 and another conducted by a local FBI agent. Overall, it was an excellent meeting, and it was an honor to be a part of it. If other states are interested in having me speak at their chapter meeting, I can be reached at angie@aapm.org. The Nuclear Regulatory Commission held a Stakeholder Workshop on September 10th at 5
their headquarters in Rockville, MD. The primary purpose of the workshop was to make stakeholders aware of changes that have been made to 10 CFR Part 35. Linda Psyk of the NRC gave an insightful presentation that clearly illustrated, in color, what stayed the same, what has been added, and what has been deleted from 10 CFR Part 35. I have spoken to the NRC and this presentation will be put on their Web site soon. When this presentation becomes available, AAPM will provide a link to it in the Government Affairs section of the Web site. The Disaster Preparedness for Radiology Professionals: Response to Radiological Ter(See Gov’t Affairs - p. 6)
AAPM NEWSLETTER
Gov’t Affairs
NOVEMBER/DECEMBER 2002
(from p. 5)
rorism primer is in the final draft stages. This is a document that has been co-sponsored by AAPM, ACR and ASTRO. This “living” (changing) document is available on the ACR Web site. The ACR Web site has other helpful disaster preparedness materials. I have some paper copies of this draft primer. If you would like a copy, please e-mail me at angie@aapm.org and I will gladly send you a copy. Donna J. Dean, Ph.D. has been named the first deputy director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB). NIBIB is the newest of the NIH institutes and centers, and supports fundamental research that applies principles of engineering and imaging sciences to biological systems and to human health and well-being. Dr. Dean served as acting NIBIB director from January 2001 until September 2002, when Roderic I. Pettigrew, Ph.D., M.D. became the first NIBIB director. Dr. Dean has spoken at several AAPM meetings. Join me in congratulating Dr. Dean on her new position at NIBIB. It looks as though Congress will have to return to Washington after the November elections to finish work on the Appropriation bills and other congressional business. ■ See you at RSNA.
Education Council Report Don Frey Chair, Education Council The AAPM Education Council has been having a busy and productive year. A recent issue of Radiologic Science and Education Journal focused on physics education of technologists. Beth Schueler, chair of the Medical Physics Education of Allied Health Professionals Committee, reports that all of the articles in the issue relate to the role of medical physics in radiological science. Most of the articles were prepared by AAPM members. The journal is available online at: http:/ /www.aers.org/Vol7_1.pdf. The AAPM Summer School is a unique educational experience. The atmosphere of the summer school encourages close interaction between the participants and the faculty. Special times are set aside in a social setting to encourage this interaction. The summer school is an ideal location for the participants to meet the leading experts in medical physics. The AAPM encourages this interaction by providing 10 scholarships for newer members. Next year’s summer school promises to be of great interest. The topic is IMRT and Directors Jatinder Palta and T. Rock Mackie have put together a program that will focus on the practical application of IMRT in clinical practice. Participants will take home a wide variety of materials to help them with their everyday clinical problems. The location of the Summer 6
School is Colorado College, which is situated in the foothills of the Rockies in Colorado Springs. The dates are June 2226, 2003. The Medical Physicist in Radiation Oncology brochure, designed for patients on the role of the medical physicist in radiation oncology, has proved to be very popular. It is one of the most frequently requested AAPM publications. The Public Education Committee, chaired by Ken Hogstrom, has been working on a similar brochure for patients on the role of the diagnostic physicist. This should be available in early spring 2003. Last summer (2002) was the second time the AAPM Summer Undergraduate Fellowship Program was available. This 10week program is designed to expose undergraduate students to medical physics research and clinical practice. It is directed by the Summer Undergraduate Fellowship Program Subcommittee, which is chaired by Ken Hogstrom. Please see the article by George Sandison in this Newsletter for more details. Re-
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
cruitment of talented individuals into medical physics is an important issue for the long-term stability of our profession. I would encourage each of you to contact your local high schools and colleges to present talks to physics groups and on career days about medical physics as a career. The AAPM Virtual Library continues to expand and use of the site has been increasing steadily. The material from the 2002 Annual Meeting is now available in the library, which will remain free to AAPM members through 2003. In addition to the educational material from the Annual Meeting, several presentations from AAPM corporate members have been added. The AAPM
hopes that these presentations can serve to provide information to the membership about the corporate sponsors’ products in a unique way. If you have not logged onto the site recently, I would encourage you to take advantage of the educational materials that are available. Access to the Virtual Library is through AAPM.org. Many of the lectures in the Virtual Library are available for continuing education credits through the AAPM RDCE program. There are now well over 100 quizzes available. Thus the RDCE program should allow any AAPM member to get any needed credit. Jacqueline Gallet serves as chair of the RDCE Subcommittee. Access to
the RDCE program is through AAPM.org. The annual fee for the RDCE program will increase to $25 in 2003, but it remains one of the least expensive ways to obtain CAMPEP-approved credit. This will be my last Newsletter article as chair of the Education Council. It has been a wonderful five years and I would like to take the opportunity to thank the hardworking individuals who have served as committee chairs and the many AAPM volunteers who have contributed to the strength of the AAPM by serving on Education Council Committees, Subcommittees and Task Groups. ■
Overview of the New ACR CT Accreditation Program Cynthia H. McCollough Chair, Physics Subcommittee, ACR CT Accreditation Committee In 1997, the ACR approved the development of an accreditation program for CT. Since that time, many knowledgeable and dedicated individuals, including radiologists, medical physicists, and ACR staff members, have volunteered countless hours toward the development of the CT Accreditation Program. The program is under the guidance of the CT Accreditation Committee, chaired by Robert Zeman, M.D. I was pleased to be asked to chair the Physics Subcommittee, which includes fellow physicists Mike
McNitt-Gray, Ph.D., Tom Payne, Ph.D., Tom Ruckdeschel, M.S., and physics-savvy radiologist, James Brink, M.D. I am particularly pleased to report that the Physics Subcommittee members were involved in the full gamut of committee activities from the beginning, and have contributed significantly to the shaping of the program, especially with respect to dealing with the wide range of rapidly evolving equipment and dose awareness issues. The ACR’s CT Accreditation Program will evaluate the following primary determinants of clinical image quality and, ultimately, the quality of patient care: –qualifications of personnel –equipment performance 7
–effectiveness of quality control measures –clinical images and exam protocols For the program to achieve its full potential in reducing dose and improving image quality, it is essential that medical physicists contribute to each of these areas. An affordable, high quality CT phantom was developed to permit a standardized and comprehensive evaluation of all QC parameters. It can be used by the medical physicist and onsite QC personnel in the pursuit of the goals of the accreditation program. (See CT Accred. - p. 8)
AAPM NEWSLETTER
CT Accred.
NOVEMBER/DECEMBER 2002
(from p. 7)
Process Overview When a facility first applies to the ACR for accreditation, the application questionnaire will require information concerning the qualifications of the radiologists, radiologic technologists, and medical physicists (see side bar for the requirements of a qualified medical physicist). Additional information, such as the number and types of CT scanners, will be requested. After this information is reviewed and approved by the ACR, the facility will be sent the Full Application, which involves the acquisition of clinical and phantom images and the submission of scan protocols, safety policies, and quality assurance program documentation. The facility receiving ACR CT Accreditation will be awarded a three-year certificate recognizing its achievement. Clinical images from the basic clinical examinations, phantom images, and radiation dosage measurements will be required of new scanners added between accreditation cycles.
The Role of the Physicist The qualified medical physicist plays an essential role in the accreditation program; he or she must perform initial performance testing upon installation of a CT system, supervise the ongoing equipment quality control program, be available for consulta-
tions relating to radiation dose to the patient or facility personnel, and work in close collaboration with the radiologist, technologist, and manufacturer to optimize imaging protocols. As the use of CT continues to grow, it is imperative that the medical physics community assists in the safe and efficient use of this powerful imaging tool. The medical physicist also plays an important role in the technical description of the clinical imaging protocols. The physicist’s input is key in correctly describing the technical parameters of each imaging protocol such as kVp, mA, time per rotation, pitch, zaxis collimation of each channel and number of channels, reconstructed slice width, etc. Several of these parameters may require the specialized knowledge of the medical physicist in order to be correctly interpreted.
Phantom Testing: Image Quality The Physics Subcommittee met in March of 1999 for a “Scan-athon,” where we discussed and scanned all of the then-current commercial (and several “homemade”) CT image quality phantoms, in an attempt to determine if any existing phantom met the needs of the program. We attempted to find a method by which different phantoms could be used to test similar image quality properties. After much data collection, review, analysis and discussion, the committee determined that it would be necessary, as with each of the other ACR 8
Accreditation programs, to allow only one phantom design. The committee worked to design a phantom that was easy to use, measured all the image quality parameters required by the ACR standards, was made from solid materials, and could be reproducibly and economically manufactured. The design specifications were sent to all known phantom manufacturers to obtain prototype phantoms and cost estimates. In the end, only one manufacturer chose to provide a prototype phantom. Following refinement of the prototype and contractual negotiations, a contract was awarded to GammexRMI. In order to assess the technical performance of each CT scanner, phantom images of the ACR CT Accreditation Phantom will be required using the facility’s typical head and body exam protocols. The specific performance criteria evaluated using the phantom include: –Slice width and positioning –CT number accuracy –Low contrast resolution –High contrast resolution –Image uniformity
Phantom Testing: Dose Dose measurements are required for the accreditation process and are to be made using the standard head and body CTDI phantoms and a CTDI pencil ionization chamber. The physicist instruction manual is very detailed with regard to how dose should be measured and
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
provides instructional material to assist the facility physicist with performing estimates of patient dose parameters such as Effective Dose and Dose Length Product. An Excel spreadsheet is provided to assist with these calculations.
Clinical Images Clinical images from a basic, specialty and pediatric (if applicable) exam must be submitted from each scanner using the site’s routine exam protocols. Specific instructions as to what type of exams are required are included in the application packet.
Summary In summary, it has been an extraordinary experience to participate in the development of the ACR CT Accreditation Program. I am confident that in spite of the growing pains involved in developing and going through such a comprehensive quality assessment (and improvement) program, the radiology community, and the patients that we serve, will benefit from the accreditation experience. For further information, or to request an application packet, please contact the ACR CT Accreditation Program office in Reston, Virginia at 800-227■ 5463.
Personnel Qualification – Medical Physicist A qualified medical physicist is an individual who is competent to practice independently one or more of the subfields in medical physics. The American College of Radiology (ACR) considers that certification and continuing education in the appropriate subfield(s) demonstrate that an individual is competent to practice in one or more of the subfields in medical physics and to be a qualified medical physicist. The ACR recommends that the individual be certified in the appropriate subfield(s) by the American Board of Radiology (ABR). The appropriate subfields of medical physics for CT Accreditation are Diagnostic Radiological Physics and Radiological Physics. Continuing education for a qualified medical physicist should be in accordance with the ACR Standard for Continuing Education (CME). The qualified medical physicist must be familiar with the principles of imaging physics and of radiation protection; the guidelines of the National Council on Radiation Protec-
9
tion and Measurements; laws and regulations pertaining to the performance of the equipment being tested; the function, clinical uses, and performance specifications of the imaging equipment; and calibration processes and limitations of the instruments used for performance testing. The qualified medical physicist may be assisted by properly trained individuals in obtaining data. These individuals must be approved by the qualified medical physicist in the techniques of performing tests, the function and limitations of the imaging equipment and test instruments, the reason for the tests, and the importance of the test results. The qualified medical physicist is responsible for and must be present during initial and annual surveys and must review, interpret, and approve all data, as well as provide a signed report of conclusions. The qualified medical physicist should be available for consultation regarding patient dosimetry issues within a reasonable period of time.
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
Summer Undergraduate Fellowship Program Update George Sandison Incoming Chair, Summer Undergrad. Fellowship Prog. Last summer was the second time the AAPM Summer Undergraduate Fellowship Program was run. The 10-week program’s aim is to expose the fellows to medical physics research and clinical practice and so influence them to undertake graduate study leading to a career in medical physics. Competition for a fellowship was very strong with a total of 46 applicants and the nine winners having an average GPA of 3.82. Part of the formula for success in attracting this large pool of outstanding students was the advertising of the program in the newsletter of the Society of Physics Students. Ken Hogstrom and Sharon Cohen deserve loud applause for their dedication to making this program a success and laying the foundation for committed support from the AAPM membership. Special thanks are also due to those members who volunteered to serve as mentors for the fellows this past summer. We encourage those mentors not selected to volunteer again next year. A large base of potential mentors across the country helps the subcommittee to best meet the individual fellows’ requests. Below are the highlights of each fellow’s summer work for 2002. Eva Bookjans – Centre College/Jean Pouliot – UC San Francisco: Eva was involved in
an ongoing effort to improve patient positioning and organ motion verification during radiation therapy at UCSF. She familiarized herself with the evolving field of electronic portal imaging and the technology of amorphous silicon flat panel detectors. Eva learned to commission and calibrate a 3D reconstruction tool, combining hardware, software and organ implanted radioopaque markers to achieve a high degree of precision in tumor targeting. Kengyeh Chu – Duke University/Peter Biggs – Massachusetts General Hospital: Kengyeh’s project was the alpha testing of a 3D ultrasound system as a tool for image guided therapy. The manufacturer provided a commercial 3D ultrasound device that was fitted with a localizing device to determine the coordinates in real space of any point in the scan. This unit was installed in a CT scanner room for ease of access and to compare the ultrasound images with those of CT. His main contribution was to move the project forward by removing some of the bugs in the software and to begin investigating problems of CT-ultrasound fusion. Based on his work, a number of recommendations were made to the manufacturer to improve the efficiency of the device and the usefulness of the software. Jennifer Clark – Transylvania University/Ali Meigooni – Uni10
versity of Kentucky: During the summer fellowship period, Jennifer acquired a great deal of clinical experience. She was actively involved in the planning and implementation of brachytherapy treatments such as interstitial seed implants for the treatment of prostate cancer, both low- and high-dose rate intracavitary implants for cervical cancer, and intra-vascular brachytherapy to prevent the restenosis of heart vessels that have undergone angioplasty. Jennifer also had the opportunity to observe treatments at the university’s Gamma Knife facility, which performs stereotactic radiosurgery for brain tumors. Additionally, she experienced radiation medicine as a whole by doing rotations in several of the department’s other areas, including dosimetry, where she learned about treatment planning for external beam radiation therapy. Finally, Jennifer got to know many of the doctors, nurses, physicists, therapists, dosimetrists, and physics and therapy students that work in the department, and is looking forward to joining them as a medical physics student after she graduates. Britt Erickson – North Park University/Michael Herman – Mayo Clinic: Britt immediately set to work on clinical physics problems related to measurement of complex radiation dose patterns produced during the deliv(See Undergraduate - p. 12)
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AAPM NEWSLETTER
Undergraduate
NOVEMBER/DECEMBER 2002
(from p. 10)
ery of radiation therapy. Guided by Drs. Debra Brinkmann and Michael Herman, she made measurements, performed data analysis and presented results on the clinical problem to ensure overlapping radiation fields are matched correctly. She also compared to measurement the predictive accuracy of a commercial radiation treatment planning system for overlapping fields. Britt made radiation measurements using various dosimetry systems in both electron and photon beams for this project. Russell Kincaid – Syracuse University/Andrzej Krol – SUNY Upstate Medical University: Russell spent the summer working in the laboratory of Professor Andrzej Krol, a researcher in the Department of Radiology at SUNY Upstate Medical University. Professor Krol is a specialist in the development and application of ultra-fast laser-based advanced x-ray sources for radiology, especially their applications to mammography and tomographic reconstruction in nuclear medicine. In June, Russell helped gather baseline contrast data for a conventional mammography x-ray unit. He later continued his work on a project involving tomographic reconstruction of scintimammographic nuclear medical data for improved detection of breast cancer. Amy Meyers – Lewis University/Russell Hamilton – University of Chicago: Under the supervision of Dr. Hamilton and other
trained staff, Amy learned the duties and responsibilities of a medical physicist while actively participating in the clinical operation by constructing treatment plans for radiation therapy patients based on volumetric imaging data (CT and MRI scans), measuring delivered radiation doses, and performing quality assurance measurements. She also had the opportunity to observe and assist in some of the newest procedures, including intensity modulated radiation therapy (IMRT), stereotactic guided radiosurgery and functional neurosurgery. For her assigned research project, Amy studied radiation therapy treatment planning for prostate cancer patients comparing the use of three-dimensional conformal treatments and IMRT. This study will provide valuable information about the relative toxicities of these methods and might lead to IMRT optimization techniques that will provide improved outcomes for these patients.
sive radiation field measurements of photon and electron beams from the linac into a pencil beam dose calculation algorithm. Suzanne gained an appreciation for the precision, accuracy, variety of measurement techniques and computer skills required in the field of medical physics. In addition to working with the linac, she attended weekly tumor board meetings, where a team of physicians (including medical oncologists, radiation oncologists, surgeons, radiologists, and pathologists) discussed difficult and interesting cases and suggested the best possible courses of cancer treatment. Inverse treatment planning and intensity modulated radiation therapy are especially striking to Suzanne. As the daughter of a breast cancer survivor, she has taken a keen interest in this technology that successfully targets malignant tumor cells, while sparing nearby normal organs, thus reducing the disabling complications of treatment.
Suzanne Topalian – Boston University/Arthur Olch – Childrens Hospital of Los Angeles: At one of only two hospitals in the U.S. that provides radiation treatment exclusively for children with cancer, Suzanne has been introduced to some of the most advanced technologies in this field. Her work with Dr. Olch involved re-calibration of the linear accelerator used for radiation treatments in conjunction with the creation of the radiation beam models utilized for 3-D treatment planning. The beam models were created by incorporating exten-
David Vonk – Arizona State University/Steve Sapareto – Good Samaritan Regional Medical Center: During David’s fellowship in Phoenix he was exposed to clinical aspects of medical physics, while working with Dr. Sapareto in a major radiation oncology center, and also to the research aspects of medical physics, while working with Dr. Rez at the University. This collaborative training effort succeeded because Dr. Sapareto has extensive experience in training medical physicists, dosimetrists and therapists, and
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Dr. Rez has a strong interest in fundamental electron transport theory. This is the first year that Drs. Sapareto and Rez have participated in the program. “David is very bright and a delight to work with. His fellowship has been so successful that we have created a part-time work/study position for him during his final school year. We look forward to having other students in the future,” said Dr. Sapareto. David Scott Winter – Trinity University/Paul Keall – Virginia Commonwealth University: The focus of the fellowship was to
work on the project “Radiobiological calculations for genetic radiotherapy”. Genetic radiotherapy is an innovative marriage of gene therapy and radiation therapy. In genetic radiotherapy, cancer cells are infected with a virus that makes these cells more sensitive to–and more easily destroyed by–radiation such as X rays. The technique is currently evolving from laboratory studies to clinical trials. The aim of this particular project was to incorporate human patient data from large clinical radiotherapy trials with experimental gene therapy data from laboratory work, and
develop a quantitative model to predict the increase in cancer cure rates with genetic radiotherapy. Scott’s part in this project was the development of a Web-based calculator to allow users to input various genetic radiotherapy parameters, and predict the likelihood of tumor control for the given regime. This model may help scientists to determine when to apply the radiation and gene therapy treatments, and how many treatments to give, in order to maximize the synergy of combined gene and radiation treatments. ■
Report on the 3rd Meeting of the International Society for Intra-Operative Radiation Therapy (ISIORT) Peter J. Biggs Boston, MA The third in a series of biennial international conferences dedicated to intra-operative radiation therapy (IORT) was held in Aachen, Germany from September 11–14. Previous meetings were held in Pamplona (Spain) in 1998 and Boston, Massachusetts in 2000. Over 50 attendees from many countries, including the USA, Italy, Germany, France, Spain, The Netherlands, Japan and Austria, participated in the proceedings. There were workshops on mobile accelerators and the role of HDR in an intra-operative setting. There were individual sessions on physics, GU, upper GI, GYN, colorectal, soft tissue sarcoma and breast can-
cer. Experience in the area of lung, pediatric and head and neck cancer was also discussed. A major hurdle faced by proponents of intra-operative radiation therapy is the high cost of a dedicated facility in the OR. The alternative, transporting the patient from the OR to the radiotherapy area, is quite feasible, but in most centers this method taxes the interests of all the parties after a number of years. Thus, the entry into the field of IORT of mobile linear accelerators that can be used in existing OR rooms without requiring additional shielding, makes the cost and logistics of setting up an IORT program much easier and therefore provides a stimulus to the field. There are two manufacturers of mobile linear accelerators, 13
Intraop Incorporated of Santa Clara, California which manufactures the Mobetron, and Hitesys of Milan, Italy which manufactures the Novac7 unit. The Mobetron operates at electron energies of 4, 6, 9 and 12 MeV while the Novac7 operates at 3, 5, 7 and 9 MeV. To date, there are six Mobetron units operating in the US while there are 12 Novac7 systems operating in Italy, Germany and Greece, with another six soon to be installed. Thus, there has been a resurgence of interest in IORT thanks to these mobile units. Many of these new centers have been in operation for several years, have treated a large number of patients and have gained much experience with this new equipment. (See ISIORT - p. 14)
AAPM NEWSLETTER
ISIORT
NOVEMBER/DECEMBER 2002
(from p. 13)
Of the papers presented, by far the majority were from Europe with the major contributors being from Germany and Italy. This is perhaps not surprising, given the large number of mobile units installed there in the last few
years. There has been much interest in Europe recently in the use of a single fraction of IORT in breast cancer to replace the conventional external electron beam boost. Early results indicate no increase in morbidity using this technique.
The next phase in this field is the setting up of randomized trials to compare treatments with IORT as a boost to those without IORT. The next meeting of the ISIORT will be held in November 2004 â– in New York.
Medical Events Revisited - Highlights of New Part 35 David J. Keys, Ph.D. Chair, Legislation and Regulation Committee davek@med-phys.com First, a retraction. In the September/October 2002 AAPM Newsletter, I indicated that: •The terms Misadministration and Medical Event have been replaced by the term Medical Event. The term Medical Event excludes cases involving patient intervention. I refer you to § 35.3045 for a complete definition. Gone are the 10% teletherapy total dose, 30% weekly dose errors; replaced by 20% total dose, 50% single fraction error. Under the new definition, if the dose to the right lung is prescribed for 40 Gy in 20 fractions using Co60 teletherapy and the left lung is inadvertently treated for 16 Gy, a Medical Event would not occur because the dose to the unintended organ, while greater than 50 rem, is less than 50% of the prescribed dose to specified organ.
Sounded too good to be true, and it was. In the above example, the dose to the left lung would be a reportable medical event. The actual rule governing this situation is: 35.3045 (a) (3) A dose to the skin or an organ or tissue other than the treatment site that exceeds by 0.5 Sv (50 rem) to an organ or tissue and 50 percent or more of the dose expected (to the skin, organ, or tissue) from the administration defined in the written directive (excluding, for permanent implants, seeds that were implanted in the correct site but migrated outside the treatment site). I have added in italics the phrase (to the skin, organ, or tissue). Thus one needs to consider what the dose to the skin, organ, or tissue would have been if the field were applied properly. In this case, let us assume 5% due to leakage and scatter. Thus, one would expect approximately 200 cGy to a point in the left lung.
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Since 1600 cGy was given, this would be a reportable medical event (all NRC-defined Medical Events are reportable). Now consider the following example, a H&N field is to be treated with two fields, using 45 degree wedges and a hinge angle of 90 degrees. For one reason or another, the lateral field is set up and calculated using a hinge angle of 95 degrees. Upon review of the plan, it is determined that the tumor volume which was properly covered did receive the prescribed dose. However, there is now tissue, which was irradiated by the lateral field due to the five degree difference in angle, but was not intended to be irradiated by the primary beam. That strip of tissue would receive more than 50 cGy, which would be more than 50% greater than the 3-5% dose intended. Clinically, there would be no significance to the patient. According to the rule this would still be a medical event and would need to be reported. As a physicist, if this were to happen on an accelerator, I would review our procedures and dis-
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cuss the problem with staff, but nothing more would be warranted. In the strictest sense, even a misplacement 0.5 cm too deep, too shallow, or too wide of a prostate seed intended for the periphery of the implant could represent a medical event. This misplacement (not a migrating seed) will result in a dose to some amount of tissue that will be more than 50 cGy and more than 50% of the dose that was planned. The same could be said of a Co-60 field, which is 0.5 cm larger than expected. The actual dose to tissue in the penumbra could easily be greater than 50 cGy and greater than 50% of the dose intended. My initial interpretation was based on the realization that nearly all misadministrations under the old part 35 due to the inadvertent placement of fields, catheters (hdr), applicators, or seed location have been deemed not significant by medical experts
evaluating the cases. This is particularly true if the wrong site received less than 50% of the prescibed tumor dose (2000 cGy in my Co-60 example). It seems reasonable to report something as a medical event only if it results in acute ill effects for the patient. This approach is closer to the reporting requirements of the FDA for medical devices. The NRC did take a similar approach in regards to patient intervention. 10 CFR 35.3045(b) states: “(b) A licensee shall report any event resulting from intervention of a patient or human research subject in which the administration of byproduct material or radiation from byproduct material results or will result in unintended permanent functional damage to an organ or a physiological system, as determined by a physician.”
sidered a mistake, a setup error, something that needs to be evaluated by the facility and corrected. This is the approach many practices take for accelerator-based treatments. In the relatively few cases involving linear accelerators in which I have been made aware and in which the patient was truly affected, the radiation oncologist has always informed the patient when an error has occurred. Having rationalized my initial response, I must now state and emphasize that, regardless of significance, one must always report any event as required by law. The issue of margins remains to be addressed by the NRC. Perhaps an interim solution would be to define, as a matter of policy, justifiable margins of error acceptable in your practice. In this way, small, insignificant variations in treatment would be considered as part of your standard of prac■ tice.
In this light, events not causing clinical ill effects would be con-
Report on the International Conference on Medical Physics Havana, Cuba Azam Niroomand-Rad, Victor Fajer, Roberto Fraxedas and Irving Lerch Collaborators, Int’l Conference on Medical Physics The first Cuba–USA medical physics collaboration was an International Conference on Medical Physics that was held in Havana, Cuba, April 8-10, 2002. This conference was organized by the Cuban Physical Society
(SCF), the American Association of Physicists in Medicine (AAPM), and the American Physical Society (APS) with the support of the US Liaison Committee to IUPAP (USLC). Partial financial support for participants was provided by the APS, USLC and the Latin American Center for Physics (CLAF). The co-organizers of this meeting were Victor Fajer, president of the Cuban Physical Society, and 15
Azam Niroomand-Rad, vicepresident of IOMP and chair of the AAPM International Affairs Committee. The APS was represented by Irving Lerch, director of International Affairs and member of the executive committee for the US Liaison Committee to IUPAP. The objective of this workshop was to discuss “Technology and Medical Physics in Patient Diag(See Cuba - p. 16)
AAPM NEWSLETTER
Cuba
NOVEMBER/DECEMBER 2002
(from p. 15)
nosis and Therapy”. The main topics covered were: HDR Brachytherapy: update and perspectives; recent advances in radiation therapy with LINAC’s, DMLC, IMRT, QA and QC in medical physics procedures; image fusion in diagnostic imaging; digital image applications in medical imaging; signal processing and analysis in biomedicine; and laser techniques in medicine. The faculty made numerous presentations in two refresher courses and a number of scientific sessions. Also, 41 posters were presented. The conference was held at Havana’s International Press Center, with two conference rooms and a poster
exhibit hall. There was a total of 103 participants (29 from foreign countries and 74 from Cuba). The program began with welcoming remarks by Drs. Fajer, Lerch and Niroomand-Rad. The closing ceremony was conducted by Dr. Yamila de Armas, viceminister of health care of the Cuba Ministry of Health, and Dr. Niroomand-Rad. Dr. Yamila de Armas made warm remarks regarding the significance of this conference for the Cuban medical physicists. Best hope and wishes for future USA-Cuba ecollaborations were exchanged. An evening visit was paid to the new facilities of the National Institute of Oncology (INOR). Dr. Rodolfo Alfonso, head of the Radiation Physics Section,
showed the radiotherapy installations and the works performed by the medical physicists. The attendees were also able to hear Cuban music and taste local food and beverages, visit Old Havana and enjoy local hospitality in their free time. This conference left not only knowledge among the participants, but also the warm feeling of brotherhood and friendship. We would like to express our appreciation to all AAPM faculty and the local organizing committee for their extraordinary efforts in organizing this program, which attributed to much of the program’s success. We had a memorable experience and es■ tablished new friendships.
An Update on the AAPM Partners in Physics (PIP) Program Mahadevappa Mahesh Curator, PIP mmahesh@jhmi.edu The Partners in Physics (PIP) Program has been in place for more than 15 years under the International Affairs Committee (IAC) of the AAPM. Many thanks to the members and affiliated associations of AAPM who, by word of mouth or through personal contacts, have been silently sponsoring candidates under this program. The purpose of this article is to bring PIP to the attention of the general membership and to request AAPM members, local chapters and other affiliated organizations to consider
sponsoring candidates for this program.
Objectives of Partners in Physics Program The objectives of PIP are to provide opportunities for collaboration between the medical 16
physicists in the developing countries and the AAPM members or the AAPM-affiliated associations. As medical physics is rapidly evolving around the world, medical physicists in developing countries often find it hard to practice due to the scarcity of resources, training or education. Accessing the resources is possible through memberships in professional societies through personal contacts or visits to established centers, etc. However, for many medical physicists in developing countries, most of these options are difficult to achieve for a number of reasons, most significantly the lack of financial resources. This program attempts to build
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
bridges with those practicing in developing countries by providing them access to some of the resources AAPM members currently have. The PIP program provides AAPM membership with correspondence III status to the medical physicists in developing countries. The PIP members will receive some of the AAPM resources such as the Medical Physics Journal, Physics Today and other scientific publications. In addition, they will be eligible to attend/register for all AAPM-sponsored meetings at a reduced registration fee. Currently, electronic (E-PIP) membership is also available for those wishing to receive all the materials electronically. All new applicants are encouraged to apply under this category. This choice depends on the applicant’s ac-
cess to the internet in his/her country. The cost of this program for the sponsoring candidate is one half or one quarter (in the case of E-PIP) of the AAPM full annual membership fee, and the commitment is for a minimum of three years. This program is ideal for AAPM local chapters that wish to participate in educational activities. For example, the local chapter (Mid-Atlantic Chapter of AAPM) with which I am associated, is currently sponsoring four candidates. At present, the PIP application from a practicing medical physicist from a developing country is reviewed and approved by the PIP Curator. Attempts are made to avoid more than one applicant from the same center. Preference is given to the applicant involved with the education of students and/or other medical physicists in
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the area/region. The AAPM members or the affiliated associations wishing to become sponsors can also name a practicing medical physicist from a developing country, or can choose one from the waiting list of the approved candidates for a particular country or region. Thanks to the early efforts of Drs. Perry Sprawls and Azam Niroomand-Rad, we have 52 partners in 29 different countries (see figure). Of these, 33 are currently sponsored by individual AAPM members and the rest by local chapters and other affiliated organizations. For those who are interested in sponsoring a candidate, or if you have any questions regarding the program, please contact me at mmahesh@jhmi.edu. Thank you. â–
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
Half Page Virtual Library Ad Repeat from Last Issue Remove Box Lines
A Plea to Medical Physicists Azam Niroomand-Rad Chair, AAPM Int’l Affairs Committee, on behalf of Dr. M.R. Raju, Andhra Pradesh, India After having worked for more than three decades in the field of nuclear particles for cancer treatment, and as I have stated in my review paper, “Particle Radiotherapy: Historical Developments and Current Status” in Rad.Res.145, 391-407(1996), I feel that unless individuals who are working to improve the quality of medicine start taking some active role in meeting the needs
of people at large, the gulf between the quality of treatment received by the haves and havenots will widen further. With this in mind, I have taken voluntary retirement from the Los Alamos National Laboratory and I have been spending most of my time in rural India since 1994. I am now developing a rural cancer center in the village of Pedamiram, near Bhimavaram Town, Andhra Pradesh, India with an emphasis on prevention and the importance of early detection of cancer. In India, most of the cancer centers are located in big cities, while 18
more than 75% of the population lives in villages. Currently, more than 75% of the patients are in advanced, incurable stages by the time they go for treatment. I am trying to build a rural cancer center as a model to significantly increase the percentage of patients with early, curable disease seeking help. We have received approval from the Bhabha Atomic Research Center to build a radiotherapy facility with an area of about 10,000 square feet. This building will have rooms for external beams of low and high energy, simulation, high dose and
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
low dose rate brachytherapy, treatment planning, a mould room, etc., in addition to the patient waiting hall, examination rooms, etc. I am getting this building built mostly with my personal resources so far. I am happy to inform you that the foundation work is complete and we expect to finish the construction before the end of this year. Background information regarding our efforts can be viewed at the Web pages: http:// www.mgmtrust.org. Please see the section on cancer control under The Mahatma Gandhi Memorial Medical Trust which is a charitable organization. I am hoping that some of you will help me in offering your services and in procuring some of the radiation equipment required for cancer treatment. I am hoping that with the help of some of you, I will be able to develop a good model for a rural cancer center with an emphasis on prevention and the importance of early detection and with the hope that this will be a good demonstration project by concerned scientists working on the forefront of cancer treatment and joining together as ‘scientists for social action’. (Dr. M.R. Raju: Mahatma Gahdhi Memorial Medical Trust, Pedamiram, Bhimavaram-534204 (A.P), India. Email: mgmtrust@vsnl.com) ■
Announcement A New Editor-in-Chief for the Journal of Applied Clinical Medical Physics (JACMP) Ken Vanek Search Committee, JACMP The American College of Medical Physics is very pleased to announce the appointment of Edwin C. McCullough, Ph.D., as the new editor-in-chief for the Journal of Applied Clinical Medical Physics. Dr. McCullough succeeds Dr. Peter R. Almond who successfully pioneered the journal through its conceptual years and the first two years of publication. Dr. McCullough has a distinguished record in medical physics and is well-known throughout the medical physics community. Certified by the American Board of Radiology in therapeutic radiological physics, he is also a Fellow of the American Association of Physicists in Medicine and the American College of Medical Physics. Professor McCullough was the head of the Radiation Physics Section, Division of Radiation Oncology at Mayo Clinic/Foundation in Rochester, Minnesota for 27 years from 1973 to 2000. He is past president of the AAPM and past vice-president of the Radiological Society of North America (RSNA). Dr. McCullough has over 100 publications in various 19
Edwin C. McCullough journals, books, and conference proceedings. He has served on the editorial boards of the Journal of Medical Physics, Radiology, Neuroradiology, and the Journal of Computer Assisted Tomography. In addition, he has served as a reviewer for the International Journal of Radiation Oncology, Biology, and Physics. JACMP is an international electronic medical physics journal dedicated to applied medical physics topics. Currently, internet access to the journal is free. One can access the clinically oriented articles at http://ojps.aip.org/acm. ■
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
Publications Committee News Julie Dawson Chair, PUBCOM The Publications Committee (PUBCOM) held its latest meeting in Montreal on July the 14th. In that meeting members heard reports from Allan deGuzman (AAPM Newsletter editor), Colin Orton (Medical Physics editor-in-chief) and, in the absence of Sal Trofi, Julie Dawson presented the Headquarters’s report. Allan deGuzman indicated that ways to increase the Newsletter revenue are being evaluated. He will present a plan at RSNA to transfer the Newsletter operations to Headquarters. Plans for the future include some new feature sections for the Newsletter. The chair expressed her strong support for the excellent work performed by Allan and Susan de Guzman (managing editor). Colin Orton presented the Medical Physics report. Some of the main points made in the report include the following: •Manuscripts from outside North America increased by about 30%. •The number of online subscribers is 3500. •Improvement in publication times (decrease for 20 days in manuscripts submittal/acceptance turnaround time!). The Headquarters report indicated a decline in revenue from
books sales. This trend will be further evaluated at the RSNA meeting. The following are the key issues that PUBCOM has been addressing since the meeting in Montreal: •PUBCOM has established a process for publishing “OnlineOnly Stand Alone” Task Group reports. Task group reports not printed in Medical Physics will be considered for publication as online-only documents. At this time, one report has been approved in this category and members will be notified of its posting on the AAPM Web site via email. •The stand alone report, “Quality Control in Diagnostic Radiology,” was recently mailed to all members (September). The Revised Report 44, “Academic Program Recommendations for Graduate Degrees in Medical Physics,” will be published as a printed stand alone report during the first quarter of 2003. This document will also be posted 20
online. The report, “Solo Practice of Medical Physics in Radiation Oncology,” has been submitted to PUBCOM and is presently under review. •The possibility of making a limited number of Task Group reports available online to nonAAPM members is being explored. A two-year time lag between time of availability of a report for AAPM members and online access of the same document to non-members is planned. Reports selected to this program would be on topics of wide interest. The rationale for this proposal is to make some of our reports available to physicists in countries where resources for library acquisitions or funds for AAPM membership are scarce. However, while assisting colleagues in other countries, we must make sure that we are protecting the benefits available exclusively to AAPM members. Preserving the sources of income for AAPM is also of paramount importance! ■
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
Memorial J[ohn] Garrett Holt John S. Laughlin, Mary Ellen Masterson-McGary, Radhe Mohan, Yakov Pipman and Jean St. Germain New York, NY stgermaj@mskcc.org The Department of Medical Physics of the Memorial SloanKettering Cancer Center records with deep sorrow the death of our friend and colleague, J[ohn] Garrett Holt, at his home in Holly Hill, Florida. Garrett was born in Saarau, Germany in 1925 and retained the cadence of his native German language throughout his life. He proudly became a US citizen in 1939 and was a veteran of World War II. In 1950 following the war, he received his degree in physics from Hamilton College in Clinton, NY and pursued graduate study at the Brooklyn Polytechnic Institute and Hunter College. After graduating from college, Garrett began his working career as a research assistant at Memorial Hospital in New York in 1951. Three years later, he accepted a position as a staff physicist at NYU College of Medicine [Bellevue Medical Center]. In 1955, he moved to California and remained on the west coast until 1964. He was recruited back to Memorial Hospital in 1964 and continued to serve on the medical staff there until his retirement in 1982.
Garrett was among the pioneers in the profession of medical physics. He was certified by the American Board of Radiology in radiological physics in 1953, and was honored as a Fellow of the College in 1968. He received the AAPM Farrington Daniels Award in 1983. Garrett published seminal work in radiation dosimetry, both as it relates to brachytherapy and external beam therapy. His work advanced the understanding of ion chamber dosimetry, calorimetry, Fricke dosimetry, thermoluminescent dosimetry, and film dosimetry. He devoted significant time and energy to serving on numerous task groups in order to develop national and international standards for radiation dosimetry. He was also among the first physicists to advocate and use the computer for radiation treatment planning. Among Garrett’s most memorable accomplishments, however, was the major influence he had on a large number of accom21
plished medical physicists, radiation oncologists, instrument makers, and electronics engineers. For many young physicists who passed through the Department of Medical Physics at Memorial Sloan-Kettering, Garrett was the first person they met. His warm personality and exuberant joy in his work made many young physicists certain they had chosen the correct profession. Garrett loved nothing better than a vigorous intellectual argument with a challenging opponent. He often said that when he met his match one day – an adversary who routinely beat him in every intellectual debate – he married her. Thelma became Garrett’s loving companion and helpmate for over 40 years. Garrett’s working life was unfortunately cut short by multiple sclerosis. Nevertheless, after his retirement, Garrett remained determined to pursue his life-long dream of building the perfect sailboat and living on the water with Thelma at his side. With Thelma’s support, he had that boat built (the “Maggie Duff”) and together they sailed the length of the intracoastal waterway, as well as throughout the Florida Keys and Chesapeake Bay system. Garrett and Thelma had three sons and two grandchildren. He has been buried at the Arlington National Cemetery. ■
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
New Member List Welcome to the following new members who have joined AAPM from April through July, 2002. Nzhde Agazaryan Los Angeles, CA Hamid Aghdam Bowie, MD Imad M Ali St. Louis, MO George J Andl Atlanta, GA Jaiteerth S Avadhani San Gabriel, CA George R Baily Henderson, NV Rolf Baumann Hannover, GERMANY Jette Borg Toronto, ON, CANADA Neal M Boucher Lebanon, NH Maria-Ester Brandan Mexico City, MEXICO Iain Bruinvis Heerlen, NETHERLANDS Marco C Carlone Ottawa, ON, CANADA Kish Chakrabarti Rockville, MD Dennis A Cheek San Antonio, TX Tian Chen Fort Worth, TX Lip Teck Chew Singapore, SINGAPORE Jongmin Cho Vancouver, BC, CANADA Patrick L Chow Los Angeles, CA Lawrence Crowley Midland, MI Francisco Cutanda Las Palmas De GC, SPAIN Xiaodong Ding Concord, CA Richard Dunia Orange, CA David G Englehart St Louis, MO Jackeline Esteban Pearland, TX Vito L Fodera Brooklyn, NY Margarida Fragoso London, UNITED KINGDOM James K Geoghegan Nashville, TN
Alexander Georgiades Ridgewood, NJ Jennifer Stacy Glass Vacaville, CA Jose J Guedea Queretaro, MEXICO Mariana Guerrero Baltimore, MD Terrance A Harms San Antonio, TX Malcolm P Heard Houston, TX Bret H Heintz Alamo Heights, TX Todd M Hill Rossford, OH Emily Y Hirata Madison, WI Jennifer Lynn Holladay Conyers, GA Masao Hoshina Tokyo, JAPAN Kang Huang Texarkana, TX James W Israel Bristol, WV Kenneth M Jackson Austin, TX Si Young Jang College Station, TX Hazim A Jaradat Madison, WI Chunsheng Jiang Lexington, MA A Kyle Jones Gainesville, FL Nina Kalach Surrey, BC, CANADA Chan-Hyeong Kim Troy, NY Susan B Klein Bloomington, IN Steven Jay Knapp Martinez, GA Renee Korol Sudbury, ON, CANADA Joseph S Krzysik Dallas, PA Susan M Lang Detroit, MI Ghyslain Leclerc Quebec, QC, CANADA Steve P Lee Los Angeles, CA Jun Lian Stanford, CA
Jose Gabriel Lira Gomes Funchal, PORTUGAL Wu Liu Madison, WI Haisong Liu Rochester, NY Jorge Llacer Los Gatos, CA Ronald Eugene Long Pensacola, FL Hilary Loupee Covington, GA David Macias-Verde Las Palmas de GC, SPAIN Prem Narain Maheshwari Miami, FL Harish K Malhotra Williamsville, NY Luis FC Marques Carnaxide, PORTUGAL Catherine J Merry London, UNITED KINGDOM Vesselin Miltchev SWITZERLAND Lama K Muhieddine Cleveland, OH John P Naughton Norwood, MA Massimo Pasquino Ivrea, ITALY Nicolas Recalde Columbia, SC Scott E Reed Las Vegas, NV Kenneth M Richardson Charlotte, NC Antinogenes L Romaguera Fernandez Mendoza, ARGENTINA Mihaela Rosu Ann Arbor, MI Russell L Ruo Rochester, NY Dennis V Savitskij St. Louis, MO Bryan J Schaly London, ON, CANADA Nejdeh Shahbazian New York, NY Jennifer M Shealy Greenville, NC Yunhong Shu Rochester, MN Mirela Shulman Lawrence, NY
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Piero U Simoni Waukesha, WI Laura T Smith New Baltimore, MI Svante Soderstrom Stockholm, SWEDEN Scott A Sorensen Kansas City, MO Pavel V Stavrev Edmonton, AB, CANADA Stephen Steciw Edmonton, AB, CANADA Anton Sukhanov Hadera, ISRAEL Katsuyuki Ken Taguchi Lincolnshire, IL Pablo G Tahoces SPAIN Olivier Tousignant St Laurent, QC, CANADA Jaime Urribarri Boston, MA Rafaela Varela Rohena Cape Coral, FL Laura E Vladimirovs Altamonte Springs, FL Elizabeth R Votovich Glendale, AZ Amjad Waheed Sydney, NS, CANADA Brad J Warkentin Edmonton, AB, CANADA Soon Moh Wong SINGAPORE Rudolph R Woode New York, NY Hui Yan Detroit, MI Jeffrey T Yap Pittsburgh, PA Omar A Zeidan Gainesville, FL Jining Zhou Richmond, VA â–
AAPM NEWSLETTER NOVEMBER/DECEMBER JANUARY/FEBRUARY 2002 2001 AAPM NEWSLETTER
Letters to the Editor Thank You Mary Ellen Smajo Advocate Christ Medical Center, Oak Lawn, IL At the conclusion of the AAPM Summer School, when I was asking people, “Who do I thank?” the answer was, “Write to the editor of the Newsletter”. So, in the “better late than never” category, I’m (finally) writing to thank the AAPM for selecting me to receive a Summer School tuition scholarship and the Capintec Award for travel expenses. Without these awards, I would not have been able to attend either the Montreal AAPM Meeting or the Intravscular Brachytherapy Summer School. Both were extremely beneficial, great opportunitites to learn and to network with colleagues. As our IVBT program had only recently begun, the Sumer School was especially valuable. So, “Thank you, AAPM!” for providing not only wonderful and needed educational opportunities, but also the means to participate ■ in them.
an article on page 11 comparing Accreditation and Certification. In the main paragraph in the second column on page 11, it states ‘For medical physicists, several certification routes are available, including the American Board of Health Physics (ABHP) in medical health physics, the ... ’. I believe that this is an error since ABHP only offers certification in comprehensive medical physics. It is noted that the ABMP does a medical HP board, which I believe is the only one of its kind. This is an area that has been brought up in discussions in numerous forums. Being a certified health physicist, I have taken note that it is often pointed out that CHP’s are not necessarily qualified for medical HP positions because ABHP does not certify in the medical specialty. This is a continuing consideration for the AAHP, but to the best of my knowledge, they still have not moved toward any specialty certifications. If you have any questions feel free to call me. Thank you for ■ your time.
HELP! Accreditation & Certification Ken ‘Duke’ Lovins Loveland, OH klovins@seidata.com In the September/October 2002 AAPM Newsletter there is
Stewart C. Bushong Houston, TX sbushong@bcm.tmc.edu Radiologic Science for Technologists first appeared in 1974 and has been exceedingly successful. It is now in it’s seventh edition and is used by es23
sentially all of the radiography programs in the US and many abroad, having been translated into several other languages. I am now working on the 8th edition which my editor will send to radiography educators for review. In the past these reviews have not been particularly helpful. I would like to recommend some medical physicists as reviewers. Anyone interested? There is a deeper reason for this solicitation. I have failed my editor in not having my successor identified should I croak prematurely! What a tragedy that would be! But should that occur, the publisher will assign this project to a radiography educator; when this needs to remain under the care of a medical physicist. Only a medical physicist has the fund of knowledge to maintain the information content and popularity of this book. I’m looking for the following characteristics: young (whatever that means); recognized writing skills; some relationship with a radiography training program; and not afraid to work nights and weekends. You won’t make much $$$$$, but the satisfaction is exceptional and you’ll be invited to all kinds of super rad tech parties!........ ■
AAPM NEWSLETTER
NOVEMBER/DECEMBER 2002
AAPM NEWSLETTER Editor Allan F. deGuzman Managing Editor Susan deGuzman
Please send submissions (with pictures when possible) to the editors at: e-mail: deguzman@wfubmc.edu (336)773-0537 Phone (336)716-7837 Fax 2340 Westover Drive, Winston-Salem, NC 27103 The AAPM Newsletter is printed bi-monthly. Next Issue: January/February 2003 Postmark Date: January 15 Deadline: December 13, 2002
Editorial Board Happy Holidays!
Arthur Boyer Nicholas Detorie Kenneth Ekstrand Geoffrey Ibbott C. Clifton Ling Richard Morin
Peace on Earth!
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.org http://www.aapm.org
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