AAPM Newsletter July/August 2006 Vol. 31 No. 4 by AAPM Docs

Newsletter

AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE VOLUME 31 NO. 4

JULY/AUGUST 2006

AAPM President’s Column The Ad Hoc Method E. Russell Ritenour Minneapolis, MN “Ad Hoc, ad loc and quid pro quo. So little time and so much to know” – Jeremy Hillary Boob, PhD, The Nowhere Man in the Yellow Submarine. Once it has become clear that there is a problem or an opportunity or just something that needs to get organized in the AAPM, one way to proceed is for the president to appoint an ad hoc committee. I’ve appointed three ad hocs recently and, in this column, I want to introduce them to the membership. Any time you want to check up on ad hocs that

may have been created, read their charges, or find out who is on the committees, go to aapm.org and click as follows: AAPM/Committees/Administrative Committees.

First, there is the Ad Hoc Committee on Golden Anniversary Planning. Chaired by Jean St. Germain, the charge to this committee is “to formulate and coordinate activities and projects related to the 50th anniversary of the AAPM. These activities and projects may occur before the anniversary year and may continue after that year.” As you probably know, 2008 will be the 50th anniversary of the AAPM. Many people have come up with great ideas for commemorating 50 years of the association’s activities. It was felt that we needed one group to coordinate everything. Jean plans to recruit members from the various committees that will be affected by or are (See Ritenour - p. 2)

TABLE OF CONTENTS

Chairman of the Board Report Howard Amols New York, NY On April 21 we held our first orientation session for new board members. Twelve newly elected board members, including three new representatives-at-large, five new chapter representatives, two new members of EXCOM (Secretary Gary Ezzel and President-elect Mary Martel), plus two council chairs (recently ‘el-

4193A.pmd

evated’ to ad hoc members of the board), met at AAPM Headquarters in College Park. The purpose of the meeting was to educate newly elected members about AAPM structure, governance, and board responsibilities as defined in the AAPM Articles of Incorporation, Bylaws, and Rules. Presentations were made by me, President Russ Ritenour, Executive Director Angela (See Amols - p. 3)

President-elect Report Executive Dir’s. Column Professional Council Education Council CAMPEP News Summer Undergrad. Prgm. Science Council Report Research Seed Funding Leg. & Reg. Affairs Health Policy/Economics Media Relations Subcomm. ABS Annual Meeting Chapter News ACR FAQs Letters to the Editor

7/19/2006, 2:13 PM

p 5 p 7 p 8 p 9 p 11 p 11 p 12 p 13 p 15 p 18 p 20 p 23 p 25 p 27 p 31

AAPMNEWSLETTER NEWSLETTER AAPM

Ritenour

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 1)

needed for planning, such as the Meeting Coordination and History committees. If you have suggestions for events, displays, or activities, please contact Jean. Second, there is the Ad Hoc Committee on Systems for Virtual Meeting Presence. Chaired by Donna Siergiej, the charge of this committee is “to recommend several possible systems that would allow electronic meetings of the board of directors of the AAPM. These systems should span a range of performance and cost that covers systems from basic conference calling to complete virtual presence. Some of the functions that should be included at various levels of complexity include: discussion participation, the ability to see projected material, and voting. Other features, such as the ability to communicate one-on-one with individuals at the board meeting, may be addressed as deemed appropriate.” Basically, we acknowledge that because of the expense of travel, workload in people’s day jobs, and a variety of other good reasons, there are times when a board member might not be able to travel to a meeting, but could spare the time to attend electronically. This committee is going to assess the cost of some low end and high end options so that the board can see what is feasible. George Sherouse is a member of the committee, and staff support will be provided by Michael Woodward, AAPM’s director of information services.

If Donna’s committee comes up with some technology that allows full virtual meetings for many or all members, and if the board thinks that the expense is reasonable, the board may consider having one or more virtual meetings per year. This leads us to the third ad hoc, one that will examine a lot of options for how the board of directors functions - the Ad Hoc Committee of the Board on ‘Board Meetings.’ This committee is chaired by Ken Vanek. I won’t list all of the board members who are on the committee, but if you check the Web site you’ll see quite a few cumulative years of experience in AAPM affairs there. The actual charge of the committee is a bit lengthy to print here, but the gist of it is that the committee is going to investigate the pros and cons of some ideas for changing the way the board functions. For one thing, is it necessary to have two board meetings per year? There is a consensus that we should have a board meeting at the annual meeting, but does the board need to meet, physically, at the RSNA Annual Meeting? The current schedule has committees and councils meeting a few days before the board meets. That doesn’t give much time for thoughtful analysis of things that come up at the meeting before they are presented to the board. Should we decouple board meetings from committee meetings? This committee will also look at ways that we might make changes in the agenda at board meetings so as to allow more time for the board to engage in extended dis-

cussion of issues and less time listening to reports. Normally, at this point in the column, I’d suggest that you contact Ken Vanek if you have ideas you’d like to share with him. However, by the time you read this, the committee will have already submitted recommendations to the chairman of the board. The recommendations will then be circulated to the board in July so that there can be discussion of the recommendations at the board meeting in Orlando. So, if you have ideas, please contact Chairman of the Board Howard Amols, your board representative, or one of the at-large board members. As always, please feel free to contact me. See you in ■ Orlando.

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER

Amols

JULY/AUGUSTAAPM 2006 NEWSLETTER

(from p. 1)

Keyser, Director of Finance and Administration Cecilia Hunter, Meetings and Programs Director Lisa Rose Sullivan, Director of Information Services Michael Woodward, and Murray Bevan, Esq from the AAPM’s legal consultants Courter, Kobert & Cohen. Heretofore, new board members usually sat down to their first board on Thursday of the AAPM Annual Meeting in July or August completely ‘cold’ and often overwhelmed, carrying two thick loose-leaf binders filled with committee reports, a 15-page annual budget report, action items and various other nearly incomprehensible documents, many of

Howard Amols speaking at last year’s RSNA Meeting. “I am not young enough to know everything.” –Oscar Wilde

which were completed for them only hours before the actual board meeting. The content, format, and nature of many of these documents were completely alien to many new board members, yet they were expected to read them over the next several hours

JULY/AUGUST 2006

simultaneously with the ongoing discussions and debates, and then to vote intelligently on issues and policies of the AAPM, including the $6 million plus annual budget. For many years current and former members of EXCOM and the board have been lamenting (often publicly, myself included) over the horrible inefficiency of this system. Small wonder many of us think the board of directors is inefficient and ineffective. Indeed, the system under which the board currently operates could not have been better designed if marginal effectiveness had been the goal. This problem did not develop overnight, nor should it be interpreted as a (See Amols - p. 4)

Advanced Therapy Dosimeter. • N e w wider dynamic ranges: - Ideal for HDR monthly QA as recommended by TG-40 - 200.0 pA to 1.000 μA full scale current - 200.00 pC to 20.00 mC full scale charge •

N e w timer functions: -

Timed charge and dose measurement for HDR 20 interval settings from 1 to 9,999 seconds Front panel selectable Customer customizable

• Ultra long term stability error of approximately 0.1% per 5 years "We take trade-ins of any make or model or you can upgrade your existing model." *NO PURCHASE NECESSARY. Begins 8/1/05 and ends 6/30/06. Open to USA legal residents, 21 years of age or older. Fluke Corporation employees and members of their immediate families, its representatives and any sponsor affiliates are not eligible. Promotion void where prohibited. For Official Rules and complete details go to www.flukebiomedical.com/rms.

Your gold standard “reference grade electrometer” just got better.

Fluke Biomedical. The accuracy you need from a company you can trust. Call 440.248.9300 or visit www.flukebiomedical.com/rms. *Hurry - register online today for an iPAQ Pocket PC drawing! ©2006 Fluke Biomedical.

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

Amols

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p.3)

negative reflection on the wisdom of our founding directors. The AAPM Articles of Incorporation and most of the bylaws were written 41 years ago when the board of directors consisted of 16 members, a few chapters (I think two, but perhaps someone will correct me on this), 133 members, two full-time staff employees, and almost no money in the bank. Over the ensuing 40 years things have changed. We now have 5700 members, 20 Chapters, 37 voting members of the board (plus seven non-voting members), 20 full-time employees, a very substantial reserve fund (now safely sequestered under my name in a Costa Rican bank, thank you all very much), but with mostly the original bylaws, and a few rules changes. Historically, at least three serious efforts have been made to restructure the board, including last year’s unsuccessful attempt to change the bylaws which, if successful, would have drastically reduced the total number of board members and the way in which they are elected. Personally I was greatly disappointed that this effort failed, but there were several good reasons why it did. In retrospect, supporters of the change probably did not do an adequate job explaining to the members exactly what the problem was or how the proposed restructuring of the board would have solved the problem. A contributing factor was undoubtedly the opposition of many members to eliminate chapter reps. and a perception that the

smaller board would concentrate AAPM ‘power’ into the hands of too small a group. Honestly folks, I had no intentions of launching an AAPM invasion of Poland if the board restructuring plan had been passed. I still believe that most of the concerns that some members had with regard to the restructuring can be addressed, and I have asked Dan Pavord and the Regional Organization Committee (amongst its members includes five current or former chapter reps. plus one chapter president) to take another look at last year’s restructuring plan and to come up with alternate proposals to address concerns about the plan. Actually, last year’s vote on this plan failed to pass by less than a dozen votes, although voter turnout was less than 30% (which is about the average response rate for all AAPM elections, including the election of officers and board members-at-large), which suggests either a lot of apathy or a lot of ‘don’t know.’ Be that as it may, we must find other ways to improve the efficiency and effectiveness of our board of directors, and the April 21 orientation session was an important step towards that end. The session included a good deal of questions and open discussion, and several suggestions on how we can improve board efficiency under the current structure. So the game plan now is to continue our efforts to design a plan to restructure the board, but in a way that is acceptable to a majority of our members, while at the same time changing the modus operandi of the current

board so that it can effectively fulfill its function, which is to: •Set organizational direction and determine the AAPM’s mission •Participate in regular strategic planning and set a vision for the future •Set major goals and develop strategies •Approve operational or annual plans and oversee financial management •Measure progress on strategic plan, monitor and evaluate programs and services •Provide legal and moral oversight OK, ‘how we gonna do dat?’ Several ideas were discussed including: 1. Changing the times of committee and council meetings, the annual business meeting, and board meetings. Under the current system these all occur within days of each other, giving board members no time to study or digest the issues they’re supposed to deal with. 2. Conduct more of the perfunctory board functions online, such as rubber stamping committee reports, task group reports, presidential appointments, etc., thus leaving more time at ‘live’ board meetings to discuss the issues listed above. 3. Advise board members of upcoming actions and proposals (generated by EXCOM, staff, and/or committees) long in advance of board meetings so that real thought can be given to these issues before the actual meeting. 4. Devote significant blocks of time at ‘live’ board meetings for

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

discussion of AAPM goals and long range planning. I’ve also appointed an Ad Hoc Committee of the Board on ‘Board Meetings’ chaired by Ken Vanek, with six additional current board members to make recommendations on how to improve the efficiency of the board. President Russ Ritenour has also appointed an Ad Hoc Committee on ‘Systems for Virtual Meeting Presence,’ which is charged with studying systems that would allow electronic meetings of the board of directors. The bottom line, however, is that the AAPM Board of Directors represents and is responsible to you, the membership. Basically, if you don’t tell us what you want, you have very little chance of getting it! Let your thoughts be known. We’re not mind readers. Talk to your chapter reps. E-mail or call board members-at-large. Come to the annual business meeting—admittedly it’s usually as boring as watching molasses flow in January, but that’s largely because hardly anybody shows up. It’s held every year on Wednesday afternoon at the AAPM Annual Meeting. It’s open to everyone and the last portion of it is an open forum. And finally, volunteer for a committee or task group that is really important to you. If you’re new to the system and none of the committee chairs know you are, I know it can be frustrating to ‘break in.’ It takes a little persistence. But if making your job or profession more rewarding is important to you, keep plugging away. I hope to see you all in Orlando.

Just For Frustration Thinking outside of the box. Without lifting your pencil draw 4 lines thru all 9 points.

■

President-elect Report Improving Communication Fluidity Mary K. Martel Chicago, IL I spoke at the spring meetings for the Florida and Penn-Ohio AAPM chapters this year (and thoroughly enjoyed them both; the hospitality of both chapters was wonderful). Each meeting was well attended by chapter members. One item that I mentioned in my talks was how to improve communication between the membership and the board. The board is currently engaged in discussion of how best to do this. Taking a show of hands at the chapter meetings, I asked how many people in the audience read the AAPM Newsletter on a regular basis (and not just “look at the pictures”!) and how many regularly read the medphys listserver (L-Soft list server at LISTS.WAYNE.EDU (1.8d) [LISTSERV@LISTS.WAYNE.EDU]). The listserver has a variety of topics ranging from practical clinical

matters to debates about professional matters, and is managed through LISTSERV at Wayne State University. I read both the AAPM Newsletter (published as hard copy every month and via an e-mail reminder to the membership) and the listserver (sent to me as a daily e-mail). The show of hands at the chapter meetings indicated that a majority (60% or so) of people read through the listserver e-mail, but 80-90% read the newsletter on a regular basis. Even with the sampling of only two chapters, this indicates that though the newsletter is not as interactive as a listserver, it remains a vital conduit of information to obtain or-

4193A.pmd

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

7/19/2006, 2:13 PM

(See Martel - p. 6)

AAPMNEWSLETTER NEWSLETTER AAPM

Martel

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 5)

ganization news from the board and the councils (and perhaps some enjoyment from the letters to the editor). Besides the monthly newsletter, the AAPM Web site is a good portal of information for members, as well. Interactive communication with the membership via the Web site is being discussed, perhaps through the currently underutilized bulletin board feature. An idea for an “Ask the Expert” Web site feature has also been advanced. The Web site editor (now currently being se-

lected) will be the point person to help design and implement such features. AAPM chapter representatives are also a great resource for communication between the board and the members. Board members-at-large are also accessible, via the phone, and at least through e-mail [http://aapm.org/org/structure/default.asp]. The business meeting at the annual meeting was specifically created for the membership to interact with the organization leaders, as are the two meetings of the board during the summer meeting and the RSNA meeting. However, I would be

interested in hearing from any member with constructive ideas on how to improve the flow of information in both directions between the leadership and the membership. Please e-mail your comments to me at mkmartel ■ aapm@yahoo.com.

We make continuing education simple AAPM Online Continuing Education Obtain medical physics continuing education credits by enrolling in the AAPM Online Continuing Education program. Sources of information listed in the Online Continuing Education program for which continuing education credits can be obtained include: • AAPM Virtual Library presentations • Medical Physics journal articles • AAPM reports and proceedings • NCRP reports • Other governmental reports Earn credits in the areas of: • CT • Diagnostic • Digital Radiography • Mammography • MRI • Nuclear Medicine • PACS, DICOM, and Monitors • Quality Assurance Programs • Radiation Oncology • Radiation Dosimeters • Radiation Protection • Ultrasound Join the hundreds of other AAPM members who are using the AAPM Online Continuing Education Program for their continuing education, research, and information needs Access the Online Continuing Education site at www.aapm.org/educ/rdce.asp 6

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

Executive Director’s Column 9%+ growth in membership the AAPM experienced in 2005, the lapse rate compares favorably with the 334 members who lapsed in 2005. The good news is that 145, or approximately 42%, of the lapsed members reinstated by June 8.

2005 Salary Survey Angela Keyser College Park, MD

Membership Membership growth has been steady in the first half of 2006, with membership numbers already exceeding the level anticipated in the 2006 budget. Overall membership had grown 3.6% by mid-June to 5,852 individual members and 57 affiliates, with the largest growth being an increase of 13% in the student category. Full membership in June was up 2.6% from year-end 2005. The RSNA provided the contact information for the 226 attendees of the 2005 RSNA Meeting who identified themselves as medical physicists, but not as members of the AAPM. Staff members sent them information on the benefits of AAPM membership. By mid-June, 12 applications had been received from these contacts. Following established AAPM policies, memberships lapsed for 346 members who did not pay their dues prior to the March 1 deadline. When you consider the

The 2005 Salary Survey is available online only. You can download a PDF from the Web or have the document e-mailed to you. If you have any problems, please contact HQ.

New Online Membership Directory Features

mation is listed in the Online Membership Directory under “Service History.” Members now have the ability to self-report AAPM activities prior to 1994. •AAPM members in the United States can now be mapped using Yahoo Maps on the Member Directory. Link to “map” under an individual’s address information and the 99 closest members to this individual are shown on a map. •Committee minutes are now available to all AAPM members online. Visit individual committee Web pages from the AAPM committee tree to view.

Staff Recognition

•Individuals who have been members of the AAPM for 25 years or more now have a “banner” running along the top of their online membership directory listing that acknowledges their 25year membership. •HQ implemented a membership database back in 1994 and began tracking service history on individual members. This inforJean Rice Nancy Vazquez Jennifer Davis Zailu Gao Hadijah Robertson Cecilia Hunter Karen MacFarland Lynne Fairobent Clarise Gilmore Lisa Giove

Part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of high-performing professionals. The following AAPM team members celebrated an AAPM anniversary in the first half of 2006. I want to publicly thank them and acknowledge their efforts.

12 years of service 10 years of service 5 years of service 5 years of service 5 years of service 3 years of service 3 years of service 2 years of service 1 year of service 1 year of service

4193A.pmd

7/19/2006, 2:13 PM

■

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

Professional Council Report Seeing the World through Rose-Colored Bifocals Gerald A.White Council Chair Medical physicists are, I think, generally an optimistic bunch of folks. Optimistic, at least, when it comes to the essential parts of our work. We anticipate that our research will lead to intellectually interesting and perhaps useful results, that our teaching will create a foundation for our students in their careers and that our efforts in the clinic will result in better diagnoses, relief of suffering and cure for a great many of our patients. How, then, do we explain the undercurrent of dissatisfaction that we often seem to hear at our gatherings, physical or electronic? It seems to me that we are looking at our world through a set of bifocals, one lens ground to focus on our work and the other designed to focus on professional issues. The former is cast from rose-colored glass, the latter is too often hazy; the lens is not clear and the color is dark. There is, hopefully, a pathway to do some color matching—to put our professional skills on a par with our scientific and educational skills—and thus gain both the confidence and control that will allow us to integrate our work effort; to have the rose-colored lenses for both foci. The Professional Track of the 2006 AAPM Meeting will offer

a jump start in that direction for both academic/research and clinical physicists. The initial session (Sunday morning) will feature a talk by Francis Macrina (vice president for research, Virginal Commonwealth University) on “Authorship, Competing Interests, and the Responsible Conduct of Research.” Dr. Macrina is widely published and has a national reputation in this area (results-oriented AAPM members will likely do a quick literature search before committing the time to hear his lecture—if you are one of them , don’t overlook the New York Times article on his work by Gina Kolata, 21 October 2003.) The podium will be shared by D. Jay Freedman who will talk about “Ethical Conflicts in the Clinical Workplace.” He has acquired quite the portfolio of actual and potential ethics conflicts during his tenure as chair of the AAPM Ethics Committee. Two sessions on medical errors will allow us to substitute theoretical foundations (Tuesday’s session by Peter Dunscombe and Todd Pawliki) and application of the theory in practical situations

(on Wednesday by Bruce Thomadsen and Jatinder Palta) for the hand wringing and nervous speculation that so often is our focus when “error reduction” is mentioned. Monday’s session on “Intellectual Property and Journal Issues” by Journal Editors William Hendee and Michael Mills, and lawyer/medical physicist Michael Davis, will offer the solace that comes with increased knowledge for those who publish, want to publish and who want to better understand the issues and conflicts with intellectual property in science. A panel on Tuesday that is put together by Melissa Martin will shine a light on the work of the Conference of Radiation Control Program Directors Suggested State Regulations for QA. Here knowledge of the underpinnings of the regulations that roll out to all 50 states will lay the foundation for individual medical physicists to talk to our state regulators from a position of knowledge and confidence. Tuesday and Wednesday sessions on Maintenance of Certification and HIPPA compliance will dispense sufficient background and coping skills to lower the blood pressure of any of us who are chronically upset about these two perennially and emotionally charged areas. And, as a reward for the hardy knowledge seekers, Jim Hevezi and I will lift the veil on many of the obscure but vital details of the reimbursement system

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

for medical physics services on Thursday afternoon. Elsewhere in this newsletter Lynne Fairobent describes the speakers for the Monday morning President’s Symposium, who are Dr. von Eschenbach, former director of the NCI and incoming commissioner of the FDA, and Dr. Jaczko, commissioner of the NRC. How many times have I heard a colleague exclaim (in reference to some government

agency), “What are these guys thinking?!?!” Well, this is a chance for all of us to find out exactly that. And I anticipate that even the harshest skeptics among us will be surprised at the insight and knowledge that is to be gained from this rare opportunity to interact with these scientists who are at the highest policymaking levels of these two agencies that are of great importance to medical physics.

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

So, the lens cleaner is on the table in Orlando. We have the opportunity to engage in important professional issues in our academic, research and clinical lives, and to raise our level of comfort to that of our scientific and clinical activities. I say, rosecolored bifocals all around. ■

Education Council Report Herbert W. Mower Council Chair If all goes according to plan, the electronic version of this newsletter should be posted prior to the AAPM Annual Meeting. I am sure that this will happen. The ‘snail mail’ version is targeted to arrive at your address just prior to the meeting. I never bet on the US Postal Service! Thus, it is with expectation that I touch briefly on some of the upcoming events at the annual meeting and beyond. The annual meeting always presents you with many opportunities to delve into the inner workings of the association and, perhaps, become involved. Much has been said recently about involvement; Are there academic requirements for this? Is the type of employer important? I can only speak for the Education Council and we are open and encourage member participation so that we have repre-

sentation from all member types and categories. There are several ways to get involved: respond to the president-elect’s appeal, speak to the committee or subcommittee chair, or speak to me. Even better, if you are in Orlando, stop by the meeting of the particular committee, subcommittee or task group that interests you. All of these are open to all of our members. At the end of the meeting, if the activities of this group appeal to you, let the chair know of your interest.

How old is the AAPM? Do you remember when the local chapter started in your area? What was life like for a medical physicist in the early years of the association? The History Committee, under the leadership of Bob Gould, will be highlighting some of these activities and events as they help us prepare for our upcoming fiftieth anniversary. To help kick off this event, they will be making a presentation at the Education Council Symposium at the annual meeting. This will be Sunday morning, July 30 th, 8–9:30 AM. Also as a part of the symposium, Ben Stein of the American Physical Society will be talking about the “Discoveries & Breakthroughs in Science” program of the APS. The AAPM is a full partner in this and there are many exciting opportunities to utilize the content of these programs and to be part of a future program. (See Mower - p. 10)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

Mower

JULY/AUGUST 2006 JULY/AUGUST 2006

Massoth, chair of the “Medical Physics Education of Physicians” committee, to re-evaluate their recommendations. We hope that they can organize an effort with some good preliminary results by the middle of January 2007 as the RSNA has recognized the challenges set forth in the forum, and is hoping to have results from the AAPM in time for their “Physics Summit Planning Committee” meeting about the beginning of February. They recognize the challenges involved in the physics education process and want to help us continue this work in an expeditious manner. Bill Hendee and I have been asked to participate on this committee as representatives of the AAPM. This working group,

(from p. 9)

Ben’s presentation will be a great introduction to this process! Under the direction of Bill Hendee, we had an excellent weekend symposium reviewing the teaching of physics in radiology and radiation oncology residency programs, as well as in medical physics programs. This symposium was not the end but only the beginning of an effort that we are committed to keep in high gear as we address the many issues and challenges identified. To this end, Philip Heintz’s subcommittee on “Review of Radiation Physics Syllabi for Residents” is coming back to life with a great deal of momentum. He is working with Richard

FILM

EPID

ION CHAMBER ARRAYS

similar to the recent physics summit, will probably be a ‘by invitation’ event. If you feel that you have something that should be considered, please let Bill or me know. We are looking for ideas, as well as the appropriate people to recommend to the RSNA for invitation to the retreat. The Education and Training of Medical Physicists Committee under Ervin Podgorsak will be looking into similar issues related to the training of medical physicists. Feel free to forward any thoughts on this to him. The AAPM Summer School has always been a great venue over the years for the clinical medical physicist to keep up with changes in the field. As this newsletter comes out, this year’s

3D GELS AND SOLIDS

No Additional Hardware or Software Components Needed

New in RIT113 Version 4.4

IMRT

MLC

• CR Correction: - 2D flatness / uniformity - 2D spatial calibration • USB driver for Vidar Dosimetry Pro Advantage film scanners • 2D spatial calibration for film - improved spatial accuracy • DTA & Subtraction Composite Analysis • Statistical and trend analysis of data • Enhanced image overlay RIT113 Version 4.3 Highlights • Automated 21 Point Film Processor correction • IMRT Dose thresholding • Image Information Tool • MATLAB export

14 IMRT QA Routines with a revolutionary IMRT Multi-Measurement Process that gives you a suite of measurements including DTA, Gamma Function, Analysis, Profiles, Isodose, Subtraction, and Addition in a single button click.

• • • • • • •

MLC Transmission Analysis (TG50) MLC 50% Fluence Analysis (TG50) MLC Interrupted Treatment MLC Calibration Technique Varian DMLC Test Patterns MSK Test Pattern (TG53) Bayouth MLC Analysis

Visit us in booth #317 at AAPM 719-590-1077 • sales@radimage.com • www.radimage.com © 2006 Radiological Imaging Technology, Inc. Protected by Patents 6528803, 6675116, 6934358, 6934653, 6937751, 7013228, 7016464, 7024026, 1252550 and other pending US and foreign patents. ISO 13485 Certified • FDA 510(k) Clearance • CE Marked

Rev. 6/06

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

school will be over. However, Paul Feller and his committee are hard at work looking for great ideas and locations for the upcoming summer schools. As has been our practice in the past few years, we work on a two-year cycle for location with one year (2005) having the summer school in the same city/area as the annual meeting, and held immediately before or after the meeting. The next year (2006) the two events are separated both in time and location. The schools also try to work on a three-year rotation between therapy, diagnostic, and specialty topics. Thus there are many opportunities to mix and match in the planning process. Feel free to communicate with Paul or other members of the Summer School Subcommittee with your suggestions on future summer school topics and possible locations. I am sure that they will be happy to work with you in this regard. â&#x2013;

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

CAMPEP News Brenda Clark CAMPEP President One new application for graduate program accreditation has been received and two applications for reaccreditation are anticipated. One new residency training program has been accredited in the last two months and there remain two programs under review. Congratulations to: Radiation Oncology Physics Residency Training Program The University of Texas M.D. Anderson Cancer Center, Houston, Texas Dir.: X. Ronald Zhu, PhD Of interest, the review of this particular program was completed in record time thanks to much streamlining of our processes; a works-in-progress that will continue. We are working towards the goal of being able to identify a timeline

at the time the application is logged. By now some of you should have been able to try out our new online application for Continuing Education Accreditation, which we trust has greatly simplified the process. Work is ongoing to improve the workflow and presentation, so if you have any comments or suggestions after using this new tool, please write and tell us of your experience. Also, we are preparing for our Orlando board meeting where, among other issues, we will be discussing the ideas presented at the Forum on Physics Education of Radiologists, Medical Physicists and Radiation Oncologists held in Atlanta in January, reported in an earlier edition of this newsletter. We are always interested in feedback, so please write to me with your comments or suggestions (e-mail: brclark @ottawahospital.on.ca).

Summer Undergraduate Fellowship Program 2006 Awards Shantelle Corado College Park, MD The Summer Undergraduate Fellowship Program Subcommittee announced the recipients of the Student Summer Fellowship Award for 2006. The SUFP Subcommittee, chaired by Dr. George A. Sandison, reviewed

applicants and made the final decisions on individual winners. The AAPM Summer Undergraduate Fellowship Program received 63 applications from which 12 awards were given. Each recipient was assigned to an AAPM member that applied to become a Summer Undergraduate Fellowship Program Mentor.

The award, totaling $4,000 per year, begins on May 1, 2006 and continues through September 30, 2006. The AAPM Summer Undergraduate Fellowship Program is sponsored directly by the AAPM General Fund. The awards are as follows: (See Undergrad. Awards - p. 12)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

Undergrad. Awards Awardees Tyler Sullivan Jared Newton Emily Schuetz David Wacker Raymond Acciavatti Joshua Carey Daniel Robertson Mark A. Hoggarth Zacariah E. Labby Francisco Robles Jeffrey Irion Abhik Kumar

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 11)

Mentor Mr. Rajeev Badkul Dr. George Ding Dr. Warren D’Souza Mr. Gregory Gibbs Dr. Andrew D. Maidment Dr. John Pacyniak Dr. Harald Paganetti Dr. John Roeske Dr. Bruce Thomadsen Dr. Fang-Fang Yin Dr. Bruce Faddegon Dr. Steve Jiang

Institution University of Kansas Medical Center Vanderbilt University Medical Center University of Maryland School of Medicine Colorado Associates in Medical Physics University of Pennsylvania Cox Health Systems Massachusetts General Hospital University of Chicago University of Wisconsin Duke University Medical Center UCSF Comprehensive Cancer Center Massachusetts General Hospital

■

Science Council Report John Boone Council Chair The research interests and needs of AAPM members are diverse, not only in terms of focus (e.g. diagnostic imaging versus radiation oncology research), but also in terms of percent of effort (e.g. primary clinical physicists versus primary researchers). Science Council, by its nature, tends to be more research oriented in terms of its membership. As a consequence, Science Council deliberations tend to focus on the needs of primarily research-oriented medical physicists. However, I would like to broaden the focus of Science Council to include primarily clinical medical physics who desire to engage in research on a more part-time basis. For these physicists there is often a frustration because dedicated time for research is hard to come by. Nevertheless, many primarily clinical medical physicists have devel-

oped the ability to perform publication-quality research with limited available time. The clinical physicists who are successful in maintaining a publication record do so using a variety of strategies, three of which come to mind: (1) the brute force approach – work before or after hours on research, making an already long day even longer, (2) find time for research – dependent upon how efficiently one gets other matters taken care of (clearly there is a wide range of human behavior which effects efficiency), and (3) maintain strong collaborations with individuals who are focused primarily in research. In an effort to better serve the needs of clinical medical physicists (both diagnostic and therapeutic) who are interested in research, I would like to hear from those of you who do have significant clinical duties but consider yourselves successful in terms of

research publications (and grant funding). Please e-mail me (jmboone@ucdavis.edu, in the subject line, please insert “Research Strategies”) indicating the number of hours you are engaged in clinical duties and in research, whether you are primarily diagnostic, radiation oncology, or nuclear medicine (etc.), how many peer-reviewed articles you have published as first, second, or last author in the past five years (2001-2006 publication years), and what your personal strategy is for maintaining a successful research track record. All personal information will be kept confidential by me; only trends and general observations will be made public. By better understanding the strategies which medical physicists utilize, Science Council may better be able to develop initiatives which strengthen the research environment for primarily clinical medi■ cal physicists.

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

Report on the AAPM Research Seed Funding Initiative Award Mark J. Rivard, AAPM RSFI Review Committee Chair Paul J. Keall, AAPM Therapy Research Committee The inaugural AAPM Research Seed Funding Initiative (RSFI) Award was given at the Awards Ceremony at the 2005 AAPM Annual Meeting in Seattle. The initiative is an annual one-year, $25,000 award to develop an exciting investigator-initiated concept which will hopefully lead to successful longer term project funding from the NIH or similar entities. The award is open to AAPM members within five years of receipt of their Ph.D. who have yet to receive other major grants. It is expected that subsequent research results will be submitted for presentation at future AAPM meetings. Five-page, high-quality applications were received along with biosketches and a support letter from the applicant’s department chair guaranteeing time and resources required to perform the work should the application be successful. Thirteen applications were received in 2005, and 17 were received in 2006. Seven reviewers with significant research experience and expertise in both diagnostic radiology and radiation therapy physics volunteered their time to review and rank the proposals. To avoid a potential conflict of interest, the reviewers were chosen from ‘neutral’ insti-

tutions without applicants. After distributing preliminary reviews to rank the applications, the final decision was made during a phone conference. Improvements to the review processes were also discussed, and these changes will be posted with the 2006 AAPM RSFI announcement. Dr. Andrei Pugachev is the 2005 recipient of the AAPM RSFI award for his project FDG Uptake as an Indicator of Tumor Microenvironment. The overall goal of this project is to improve the understanding of the mechanisms and processes underlying the intratumoral inhomogeneities of [18F]-FDG uptake and to evaluate the feasibility of using these inhomogeneities to deduce information that can be potentially used for IMRT treatment planning. Dr. Pugachev has made significant progress and will present his results at the 2006 annual meeting in Orlando. Dr. Tom Hu is the 2006 recipient. His project, entitled Monitoring Myocardial IschemicReperfusion Induced Calcium Homeostasis Alteration by MRI in Small Murine Model, was also exemplary. The wide-reaching goal of this project is to use MRI to determine the role of calcium for heart health. Dr. Hu will formally receive the RSFI award at the 2006 annual meeting in Orlando, and we wish him great suc-

cess with his medical physics research endeavors. All the applicants are commended for assembling highquality proposals covering a diverse spectrum of topics. Currently, there is only funding for one award, and the chances of success are low. However, the AAPM will seek additional funding sources for this competitive award to support future research projects. If you have ideas on how to secure additional funding, or would like to sponsor a research award, please do not hesitate to contact Cecilia Hunter, AAPM Finance & Administration Director, at 301/209-3381 or cecilia@aapm.org. As in prior years, the 2007 RSFI award deadline will be mid-February. We thank the people who supported and conceived the Research Initiative, and also those who supported the Educational and Research Endowment fundraising efforts. Among others, these individuals include: Drs. John Boone, Steve Goetsch, Joel Gray, Rock Mackie, Jatinder Palta, and Ned Sternick. The anonymous reviewers are also acknowledged for their considerable time and effort. Finally, we extend our thanks to Cecilia Hunter and Shantelle Corado at AAPM Headquarters for their superb administration of the application, review, and award processes. ■

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

STEREOTACTIC RADIOSURGERY QA MINIMIZE CUMULATIVE ERRORS

To ensure accurate patient treatment you need to quantify and minimize cumulative errors. The Lucy® 3D QA Phantom is a comprehensive dosimetry and imaging phantom which analyzes the patient treatment chain from beginning to end. With only one phantom you can evaluate CT or MRI scanning, image transfer and image fusion algorithms, treatment planning, and dose delivery within the exact coordinate system of commercially available stereotactic head frames. )UDPH VSHFLÀF LQWHUIDFHV DUH DYDLODEOH IRU DOO OHDGLQJ 656 GHYLFHV

EXRADIN ION CHAMBERS

1283-21, 06/06

QA SOFTWARE

PHANTOMS

BEAM QA

DOSIMETRY

PH 800.261.4446 PH 608.831.0025 www.standardimaging.com

4193A.pmd

7/19/2006, 2:13 PM

BRACHYTHERAPY

AAPM NEWSLETTER AAPM NEWSLETTER

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

Legislative and Regulatory Affairs Column Lynne Fairobent College Park, MD

AAPM Annual Meeting – President’s Symposium Our two featured speakers for this year’s President’s Symposium are the Honorable Andrew C. von Eschenbach, M.D., acting commissioner of the U.S. Food and Drug Administration (FDA) and former director of the National Cancer Institute (NCI), and the Honorable Gregory B Jaczko, Ph.D., commissioner of the U.S. Nuclear Regulatory Commission (NRC). This provides an exciting opportunity for AAPM members to hear firsthand the issues confronting two of the main federal agencies involved in the regulation of the practice of medical physics. The NRC’s mission is to regulate the nation’s civilian use of byproduct, source, and special nuclear materials to ensure adequate protection of public health and safety, to promote the common defense and security, and to protect the environment. The NRC’s authority has recently been expanded by Congress to include the use of accelerator-produced material. The FDA is the oldest consumer protection agency in the world, celebrating its 100th year of service. The FDA is responsible for protecting the public health by assuring the safety, efficacy, and security of human and

veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics, and products that emit radiation. The FDA is also responsible for advancing the public health by helping to speed innovations that make medicines and foods more effective, safer, and more affordable; and helping the public get the accurate, science-based information they need to use medicines and foods to improve their health. The Honorable Andrew C. von Eschenbach, M.D. was appointed acting commissioner of the FDA in September 2005. Until recently, he held that appointment concurrently with his former position as director of the NCI, to which he was named in January 2002. Dr. von Eschenbach is a nationally recognized urologic surgeon, medical educator, and cancer advocate. He also is a cancer survivor. Prior to his appointment as director of the NCI, Dr. von Eschenbach spent 25 years at the University of Texas M.D. Anderson Cancer Center in Houston,

ultimately serving as executive vice president and chief academic officer. A native of Philadelphia, Dr. von Eschenbach earned a bachelor of science degree from St. Joseph’s University in 1963, and a medical degree from Georgetown University School of Medicine in 1967. He completed residencies in general surgery and urology at Pennsylvania Hospital in Philadelphia and was then an instructor in urology at the University of Pennsylvania School of Medicine. From 1968 to 1971, Dr. von Eschenbach served as a lieutenant commander in the U.S. Navy Medical Corps. His full resume can be found at: http:// www.fda.gov/oc/ voneschenbach/bio.html. The Honorable Gregory B. Jaczko was confirmed by the full Senate on May 26, 2006 for a term ending June 30, 2008. He had been serving under recess appointments that would have concluded upon the adjournment of the current session of Congress later this year. Immediately prior to assuming that post, Dr. Jaczko served as appropriations director for Sen. Harry Reid (DNV) and had also served as the senator’s science policy advisor. In addition, he has been an adjunct professor at Georgetown University teaching a science and policy course. Originally from upstate New York, Dr. Jaczko earned a bachelor’s degree from Cornell University and a Ph.D. in

4193A.pmd

7/19/2006, 2:13 PM

(See Fairobent - p. 16)

AAPMNEWSLETTER NEWSLETTER AAPM

Fairobent

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 15)

particle physics from the University of Wisconsin-Madison. His full biographical sketch can be found at: http://www.nrc.gov/ who-we-are/organization/ commfuncdesc.html.

Time is Running Out – AAPM/CRCPD Survey on Status of Part 35 Adoption by State The AAPM, in conjunction with the Conference of Radiation Control Program Directors (CRCPD), recently conducted a survey of the State Program Directors to determine which states have adopted 10 CFR Part 35 and the new training and experience (T&E) requirements. We have results from 21 states and are continuing to get the remaining states to respond. The results are below. For therapy physicists—if you are not currently on a license in an Agreement State that has not adopted the new Part 35 T&E requirements, then you should contact your state agency to see what action you need to take to be listed on a license prior to the adoption of the regulation by the state. This is critical in order for you to be grandfathered as an Authorized Medical Physicist after your state adopts the regulation. If you do not get listed on a license prior to adoption, at this time you will have to provide the documentation required by the alternate pathway specified in 10 CFR Part §35.51 instead of via board certification and a precep-

Survey on Status of Part 35 Adoption by State Que s tions

Ye s

Total

Have you adopted Part 35?

Have you adopted the T&E requirements of Part 35?

Does the adoption take a legislative change?

Have you added medical physicists to your licenses yet?

If no, do you plan to before adopting the T&E rule?

12*

Do you maintain a registry of medical physicists approved to practice in your state?

20*

For NY, TX, FL and HI: Do the T&E rule requirements conflict with state licensure rules?

3 **

*Some states didn’t answer this question. **NY hasn’t responded yet.

tor statement. As of this date, neither the American Board of Radiology nor the American Board of Medical Physics has been granted recognized status by the NRC. States responding to date are: Iowa, Virginia, Kansas, Connecticut, Alabama, South Dakota, Wisconsin, North Carolina, West Virginia, Idaho, Colorado, Hawaii, Arizona, Utah, Louisiana, Nebraska, Texas, Arkansas, Pennsylvania, Vermont, and Tennessee. The following is additional information on specific states: •Wisconsin: WI has actually adopted most of 10 CFR 35 but still needs to adopt the final changes that went into effect October 2005. They are currently in the process of revising their rule. WI hopes to have them done by the end of this year,

2006, but that is determined by the legislature. •Virginia: Final regulations become effective in July 2006. •Hawaii: Next amendment cycle in 2007 •Arizona: Next one to two months; license condition is used to enforce physicist standard even though it is not in rule. •North Carolina: 2007 •Arkansas: Regulations are awaiting approval of the Board of Health and signature of the governor. Hopefully by August 2006; T&E in 2008 regulations revision. •Nebraska: They have been drafted and are waiting for public review, etc. Hope to have Part 35 into their regulations within six to nine months. •Texas: They have adopted most sections except for the Training and Experience sections, for which they are waiting for the

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

additional NRC rulemaking regarding board recognition. The additional amendments are scheduled to be adopted in 2007. •Alabama: They have completed the rule, it has been out for comment and has received final approval. It is scheduled to go into effect June 23, 2006. •Tennessee: Late 2007 or early 2008.

June 1, 2006 Senate Confirms Three Appointees as Commissioners of the NRC On May 26, 2006 the United States Senate confirmed the appointment of Dr. Dale E. Klein as a member of the commission, with a term ending June 30, 2011. Dr. Klein will succeed Dr. Nils Diaz as the NRC chairman effective July 1, 2006. Dr. Klein has an impressive background and extensive experience in the nuclear field. Since November 15, 2001 he has served as assistant to the secretary of defense for Nuclear, Chemical and Biological Defense Programs. In that capacity he was the principal staff assistant and advisor to the secretary of defense and the undersecretary of defense for Acquisition and Technology for all matters concerning the formulation of policy and plans for nuclear weapons and nuclear, chemical, and biological defense. Prior to his appointment by President Bush, Dr. Klein was the vice-chancellor for Special Engineering Programs at

the University of Texas System, while also serving as a professor in the Department of Mechanical Engineering (Nuclear Program) at the University of Texas at Austin. Dr. Klein served as the chairman and executive director of the Amarillo National Research Center. A fellow of the American Society of Mechanical Engineers and the American Nuclear Society, Dr. Klein has also received a wide variety of professional awards. He earned all of his degrees, including his Ph.D. in nuclear engineering, from the University of Missouri-Columbia. He has been widely published in technical journals and newspapers and has coedited one book. In addition to confirming the appointment of Commissioner Gregory Jaczko, as previously stated, the Senate also confirmed that of Commissioner Peter Lyons. Both commissioners had been serving under recess appointments that would have concluded upon the adjournment of the current session of Congress later this year. Commissioner Lyons now holds a term that will end June 30, 2009. Biographies of Commissioners Jaczko and Lyons can be found at: http:// www.nrc.gov/who-we-are/organization/commfuncdesc.html.

Acting Director – National Cancer Institute

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

the National Institutes of Health in September 2005 as NCI’s deputy director for Translational and Clinical Sciences. Immediately before his recruitment to the NCI, he chaired the National Cancer Advisory Board. His extensive academic and research career in the cancer field includes positions at the University of Michigan, Johns Hopkins University, and Stanford University, before his most recent position at the University of Wisconsin, where he was director of the university’s Comprehensive Can■ cer Center.

The 2007 Call for Nominations and Applications is available on the AAPM Web site at http:// www.aapm.org/org/ committees/ awards_honors/ index.html Please note that the deadline to receive nominations and applications is October 15, 2006

John Niederhuber, M.D. was appointed as the acting director of the NCI effective June 11. Dr. Niederhuber joined

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER

JULY/AUGUST 2006 JULY/AUGUST 2006

Health Policy/Economic Issues Wendy Smith Fuss Health Policy Consultant

AAPM Works with Radiation Oncology Coalition to Resolve Inappropriate Policies Associated with IMRT Planning The AAPM has been working with a Coalition of Radiation Oncology Stakeholders to address recent policies affecting those services that may be billed on the same day as, or during the same course of therapy as, CPT code 77301 Intensity Modulated Radiation Therapy (IMRT) Planning. More specifically, the Centers for Medicare and Medicaid Services (CMS) at the national level, and Noridian Administrative Services at the local level (a Medicare Part B Contractor for 11 states)1 have published directives that improperly bundle medical physics, dosimetry calculations, treatment planning and other procedure codes with the IMRT Planning code (CPT 77301). To make matters worse, the National Correct Coding Initiative (NCCI) has implemented incorrect code edits and is interpreting the bundled procedures not only on the “same day” as the IMRT planning, but for the “entire course of therapy.” The AAPM agreed to work with the Radiation Oncology

Coalition to resolve these issues. The coalition includes the AAPM, the American Brachytherapy Society, the American College of Radiation Oncology, the American College of Radiology, the American Society for Therapeutic Radiology and Oncology, the Association of Freestanding Radiation Oncology Centers, the Radiology Business Management Association, the Society for Radiation Oncology Administrators and several radiation oncology consulting firms. IMRT Planning (CPT 77301) The IMRT planning code, CPT 77301 (Intensity modulated radiotherapy plan, including dose-volume histograms for target and critical structure partial tolerance specifications), was established in 2002 to include the work associated with planning for the delivery of narrow, patient specific, spatially and temporally modulated beams of radiation to solid tumors within a patient, which typically takes place over several days. Medical physics services are essential and medically necessary and are separate and distinct services provided to patients undergoing a course of radiation therapy, including IMRT. The ASTRO/ACR Guide to Radiation Oncology Coding 2005 supports that position and specifically states that “The medical

physics CPT codes that are not bundled into CPT 77301 are CPT codes 77300, 77336, and 77370.” The building block methodology that went into the creation of CPT code 77301 did not include the work or practice expense inputs associated with dosimetry calculations, physics assessments or medical physics consultations. AAPM Initiatives Jerry White, chair of the Professional Council, James Hevezi, chair of the Professional Economics Committee, and AAPM Health Policy Consultant Wendy Smith Fuss participated in two conference calls coordinated by ASTRO on May 11th and June 14th to discuss these issues and how best to resolve them. The coalition agreed to three actions in hopes of resolving these issues, including: •Sending a joint coalition letter to Herb Kuhn, director of the Center for Medicare Management •Sending individual association letters to Noridian Administrative Services and the National Correct Coding Initiative Medical Directors •If necessary, launch a grassroots campaign by contacting regulators and members of Congress. In addition to the joint coalition letter that was sent to Herb Kuhn

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

on May 16th, the AAPM has sent individual correspondence to the CMS, Noridian Administrative Services (a Medicare Part B Carrier) and the National Correct Coding Initiative. Each letter is specific to medical physics and makes several recommendations to resolve the issues associated with the IMRT Planning code. The AAPM recommends that CMS and its contractors: 1) Issue a national directive stating what codes were originally used as the building block for CPT code 77301; 2) Instruct the National Correct Coding Initiative contractor to issue a correction regarding the

component codes for CPT code 77301; 3) Release payment or reissue payment for any claims that were improperly denied/recouped due to this improper policy; and 4) Issue a clear directive regarding IMRT coding and payment policy under the Hospital Outpatient Prospective Payment System.

coding and payment policies associated with IMRT. ________ 1

Noridian Administrative Services is the Medicare Part B carrier for Alaska, Arizona, Colorado, Hawaii, Iowa, Nevada, North Dakota, Oregon, South Dakota, Washington and Wyoming. â&#x2013;

The AAPM believes that these actions will assist CMS and their contractor medical directors in establishing/re-establishing appropriate local medical policy and coverage determinations regarding IMRT Planning. The AAPM will continue to work with the coalition to correct and clarify

4193A.pmd

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

Media Relations Subcommittee, and You Jeffrey P. Limmer Subcommittee Chair It seems that there are changes and potential changes happening around every corner of the AAPM. One of these changes is a morphing of the former ‘Professional and Public Relations Committee’ into the ‘Media Relations Subcommittee’ of the Public Education Committee under the Education Council. I accepted the chair when Mary Fox was ‘promoted’ to the chair of the Public Education Committee. The Public Education Committee approved this new subcommittee on November 27th, 2005. The charge is as follows: Media Relations Subcommittee The charge is to educate and raise awareness of the public on (a) the role of medical physics in healthcare, (b) technology that the medical physicist develops or oversees, (c) medical physics research, and (d) education and training of medical physicists. Communications will utilize a variety of effective media, such as television, radio, newspaper, and the Public Education Web site. Activities will include, but are not limited to: 1. Developing video clips via third party sources, e.g., AIP DBIS program; 2. Hosting a press room at the annual and other AAPM meetings, and

3. Coordinating the release of public statements made by the AAPM with appropriate AAPM staff and committees. Membership The membership will be appointed by the Public Education Committee and should consist of six to nine members consistent with the following guidelines: •Subcommittee chair •Three members-at-large with background in public relations of professional, scientific, and educational matters of imaging, therapeutic, and medical health physics •Three liaisons, one each from Professional, Science, and Education councils •One non-medical physicist member •One ex-officio member of headquarter staff •AIP liaison, ex-officio member •One AAPM Manager of Legislative and Regulatory Affairs We still have a few openings. Please contact me if you are interested. If you do not have the time to be on a committee, you can still participate (read on). The following are some of the projects which we are working on: AAPM Convention - Virtual Press Room Changes AAPM creates a “virtual press room” on their meeting Web site where we can deposit the press

release as well as supplementary materials (such as author written, lay language versions of meeting papers) that aim to make it as easy as possible for reporters to do stories on the meeting—even if they can’t leave their desks. For the last two years’ worth of virtual press rooms, see: http:/ /www.aapm.org/meetings/ 04AM/VirtualPressRoom/ and http://www.aapm.org/meetings/ 05AM/default.asp?press=open. We do have a small chance of getting a reporter or two to come to the national meeting. We will take care of those who do attend by giving them press kits and making ourselves available, and by helping them track down meeting speakers they would like to interview. Last year, at the Seattle meeting, we even had a press luncheon (see: http:// w w w. e u r e k a l e r t . o r g / pub_releases/2005-07/aiopnpt071405.php). Despite vigorous efforts, we only got four to five reporters to show up. We did get a piece on the Seattle NPR station. However, the reporter never showed up—he did everything by going to the virtual press room! The NPR story is at http:/ /www.publicbroadcasting.net/ kplu/news.newsmain?action= article&ARTICLE_ID=799748. The press gets dozens or even hundreds of good story ideas in their e-mail every day–without having to leave their desks! The more good news tips we can bring to them, the better we will

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

do. So this year, we want to focus efforts on making the virtual press room as good as it possibly can be, and getting reporters to go to it to do stories. This is where we will get the most bang for our buck in the 21st century. Is there a way to offer the electronic equivalent of coffee and donuts to the press that use our virtual press room? Let me know if you have ideas; we are trying to figure that one out. For each annual meeting, I create a press release highlighting five to seven AAPM meeting papers that we think are most likely to get coverage from health and science reporters at newspapers, magazines, broadcast media and trade publications. (For press releases from the last two years, see: http://www.eurekalert.org/ pub_releases/2004-07/aiop3nm071204.php and http:// w w w. e u r e k a l e r t . o r g / pub_releases/2005-06/aiop4pt062805.php. About a month before the meeting we send the press release to several hundred science, medical and health reporters. Our intended audience for this year’s annual meeting consists of reporters at media outlets including the Orlando Sentinel, the New York Times, NPR, Science, the Associated Press, Wired Online, and many others. These reporters are generally nonscientists who can grasp scientific concepts if explained in laypersons’ terms, and they are writing for a public which usually wishes to connect science research to potential benefits in their own lives. Very importantly, the reporters

are interested in learning about new results that have not widely been reported in the news media, as well as the potential, or actual clinical implications, of our work. Web Page – Virtual Press Room Once the page is finalized, it will also be available to AAPM members online. One idea is to update the site with videos and house it on the AIP server, while the AAPM Web site will contain a link to it, or within an AAPM page. The bottom line is that AIP will take care of updating and maintaining the content. They just need our input. Our thought is that abstracts touching upon the following kinds of topics have the most success in getting into the media: —A new diagnostic or therapeutic technique that is now clinically available and that medical physicists know about, but that not too many people in the general public know about yet (example from 2005: image-guided radiation therapy) —An novel technique in the early stages that people generally don’t know about but can potentially have great impact (example from 2005: using CT for mammography) —A public policy issue, current event, or report that medical physicists can comment on (examples from past years: full-body CT scans, national toxicology report naming radiation as a carcinogen).

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

DBIS NSF supported, Discoveries and Breakthroughs Inside Science (DBIS) is a syndicated science and engineering news service for local television newscasts with the following features: •Twelve 90-second segments are produced per month •Each segment is reviewed for scientific accuracy •DBIS features a broad range of topics in engineering, science, technology and mathematics. The DBIS TV program (www.aip.org/dbis) is a local television newsfeed which is intended to show members of the general public how the work of scientists and engineers improves people’s lives. As a benefit to the AAPM and its members, one of the things that we are developing is a special page of DBIS videos for AAPM members that they can be used in outreach efforts. See this draft version of Medical Physics “In the News” at http:// www.aip.org/dbis/AAPM/. DBIS FAQ Q. What is in motion right now regarding Medical Physics DBIS? Answer: We seek recommendations on AAPM members who can serve as outside experts to provide input into the medical physics story ideas we are currenty evaluating. (If you are an expert and interested, let us know.) Q. What does DBIS need the AAPM Media Relations Subcommittee for? (See Limmer - p. 23)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

WIN THIS 4 PL AS 2” M COLO A R T V!

GOING TO AAPM? TM

TAKE THE FILMQA CHALLENGE AND WIN THIS 42” PLASMA TV! Visit us at booth #1138 and have a chance at winning a Samsung HP-R4272 42” Plasma TV Grand Prize* by having the fastest time for performing a multiple-film analysis using the FILMQA verification software. Three runners up win an iPod nano! Start practicing today by downloading a FREE 60-day trial of FILMQA at www.3cognition.com TM

* Visit www.3cognition.com for the competition details and rules.

H BOOT

1138

“I love the multiple film analysis. It used to take me at least an hour to do the analysis and now it takes me 5 minutes!” John Keane Garden City, New York

ISP Quality management of applied radiation.

INTERNATIONAL SPECIALTY PRODUCTS

973.628.3531 or 973.628.3688 Technical assistance: 973.628.3138 or 866.218.0594

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

Limmer

(from p. 21)

Answer: When our producers complete scripts on medical physics related stories, we will send it to you for any comments you may have (we also check the stories with the main experts; and we seek any comments within 24-48 hours of sending the script; the TV world is crazy fast!). Q. Are there any other media avenues already used by AIP by which the committee can work with AIP? Answer: Yes—we absolutely would love to write more stories on medical physics for our Inside Science News Service (www.insidescience.org)—we feed these stories to print reporters to encourage them to write more about specific science topics. Here are a couple of examples of ISNS stories: “National Toxicology Report Raises Concern Among Medical Physicists” http://www.inside science.org/isns/reports/2005/ 003.html and “Whole-Body Scans More Marketing than Science, Say Medical Physicists” http://www.insidescience.org/ isns/reports/2002/052.html. Is there anyone out there who can recommend story ideas for DBIS, as well as AAPM experts whom we can interview? Other Media? (Brainstorming) Podcast: We are exploring the possibility of doing radio Podcast of DBIS segments or downloadable “sound bites” from the medical physics virtual press room.

Radio: We were thinking out loud: Could the AIP and the AAPM do physics (and as a subset, medical physics) radio spots like the architects (AIA) do (Have you heard their ads which educate the public on their profession?)? Web: Looking at other professional Web sites, e.g. the layout for http://www.aia.org/ has a very nice “feel” and a good virtual press room. Wikipedia When you are on hold or have a free minute, take a look at the content at http://www.wiki pedia.org/. I invite you to correct or elaborate upon any medical physics-related topics where you have knowledge. Try searching for medical physics… This could become the world encyclopedia or lexicon. Submitting content in the areas that affect our profession is a good thing.

Collaboration (present and investigative) We are always looking for other organizations which may provide synergy in media relations. Some of those that we are looking into for new collaborative efforts are: AIP, RSNA, the American Physical Society, and the American Cancer Society. If you have ideas for more, let us know. Our committee wishes to give special thanks to the AIP, and especially to Ben Stein who serves the AIP as manager of Member Society Media Services in the Media & Government Relations Division in College Park, MD. As you can see, there are many ways that you can help influence the public’s perception of medical physics through the Media Relation’s Subcommittee–even without committee membership. We look forward to hearing from ■ you.

2006 American Brachytherapy Society Annual Meeting The Increasing Role of Brachytherapy Physics Mark J. Rivard, AAPM Brachytherapy Physics Subcommittee Chair William S. Bice, ABS Physics Committee Chair From May 10-12, the 27 th American Brachytherapy Society (ABS) annual meeting took place at the Marriott Hotel in Philadelphia, PA http://www.american

brachytherapy.org/meetings. Typical of prior meetings, diverse topics pertaining to brachytherapy were included in the program, which primarily covered treatment for prostate, gynecological, and breast cancers. However, this meeting stood out due to significant inclusion of brachytherapy physics to

4193A.pmd

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

7/19/2006, 2:13 PM

(See Rivard - p. 24)

AAPMNEWSLETTER NEWSLETTER AAPM

Rivard

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 23)

complement the strong contributions by radiation oncologists. ABS membership is approximately 1,400, and this meeting had a good turnout of 263 attendees. Exhibitors contributed an additional 160 participants, and the expansive exhibitor hall included 30 vendors and 75 poster presentations. Attendees traveled from 13 countries and 32 U.S. states. Historically attendance by medical physicists has been about 10%. This meeting, with its focus on brachytherapy physics, saw physicist attendance climb to more than 25% of the attendees, 66 in total. This was largely due to a mandate by the ABS Board of Directors to include a medical physicist on the Scientific Program Committee. About 25% of the oral presentations were given by medical physicists. Invited physics sessions included Cervical Brachytherapy Physics (Ning Yue, Ali Meigooni, and Zoubir Ouhib, chaired by Jerry Meli); Prostate Brachytherapy Physics (Wayne Butler, Ed Holupka, and Vrinda Narayana, chaired by Ravi Nath); and New Advances in Brachytherapy Physics (Dimos Baltas, Stephen Davis, and Jean Pouliot, chaired by Keith Furutani). Ron Sloboda and Jose Perez-Calatayud chaired the proffered brachytherapy physics papers session. Other sessions in which physicists participated included a session on enhancing the therapeutic ratio in prostate brachytherapy (Bill Bice) and a session on Image-based

brachytherapy for Cervical Cancer (Jason Rownd and Christian Kirisits). Martina Descovich won a resident travel award for her presentation on “Megavoltage Cone-Beam CT to Complement CT-Based Treatment Planning for HDR Brachytherapy.” Wayne Butler’s proffered paper on the inadequacy of D90 in evaluating prostate implants was judged best of the physics submissions, and was one of four manuscripts presented at the meeting’s Plenary Session. Annually the ABS bestows the Ulrich Henschke award for significant contributions to the field of brachytherapy. This year’s recipient was Jeff Williamson for his laudable accomplishments over 20 years. Previous physicists honored by this award since 1981 include Lowell Anderson, Eric Hall, Jack Fowler, Ravi Nath, and Colin Orton. Clearly this was an important meeting for medical physicists. Meetings held specifically for physicists included the ABS Physics Committee, the AAPM High Energy Brachytherapy Dosimetry Working Group (covering dosimetric prerequisites and consensus datasets, chaired by Zuofeng Li), and a joint meeting by AAPM/ABS/ESTRO physicists for plans to increase transnational coordination. Our European colleagues have made great strides in several areas that have been sadly neglected in the U.S. Collaborative efforts currently underway promise to quickly enhance the quality of brachytherapy physics practiced on both sides of the Atlantic.

Due to the increased professional and educational programs for brachytherapy physics offered by the AAPM, ABS and other professional societies, it is an exciting time for medical physicists to be more involved with this highly interdisciplinary field. The time is ripe for physicists to assume leadership roles within the ABS. It is expected that physics inclusion in the meeting, along with breakout sessions and physics committees, will continue to develop and evolve with each year. The 2006 ABS meeting was the first time that CAMPEP MPCEC credits were available. In order to continue to encourage physicist participation and attendance, a procedure is now in place to offer CAMPEP credits at all future ABS meetings: 2007 will be in Chicago, 2008 is a joint ESTRO/ABS meeting in Boston, and 2009 may be in San Diego. Looking forward to see■ ing you next year!

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

Chapter News Southern California Chapter Names Norm Baily Award Recipients Steven Goetsch, Education Chair Marianne Plunkett, Chapter President The Twelfth Annual Norm Baily Student Awards were given at a Southern California Chapter meeting held at the UCLA faculty center on May 11, 2006. The

of Helical Tomotherapy for the Treatment of Prostate Cancer;” and Michael Speiser (advisor Tim Chapter News Solberg) gave a talk on “Working with 3D Monte Carlo Simulations in Conjunction with Treatment Planning Calculations and Film Measurements.” This year marks the first Norm Baily Student Award winner from a graduate program outside the UCLA Biomedical Physics program. The San Diego State University M.S. Program in Physics with emphasis on radiological physics has been in existence

Marianne Plunkett (left) presents award certificates and checks to (l to r) Adam Kesner (UCLA), Suzi Topalian (SDSU) and Michael Speiser (UCLA).

awards were sponsored by Philips Medical Systems. This year’s winners included Adam Kesner (advisor Daniel Silverman) who gave a talk entitled “Deconvolution in PET: Techniques Using Image CoRegistration of PET with Atlas and CT Images;” Suzi Topalian of San Diego State University (advisor Mark Young, SDSU and Grossmont Cancer Center) gave a talk titled “Clinical Effectiveness

since 1972. A nice crowd of members, students and associate members attended the dinner meeting. Each student received a certificate from Chapter President Marianne Plunkett (Hoag Hospital) and an award of $500. These awards are given in memory of the late Professor Norm Baily of the University of California San Diego.

New England Chapter Summer Meeting Mark J. Rivard Chapter President-elect The NEAAPM Annual Summer Meeting was held on June 9, 2006 at the Wentworth by the Sea Marriott Hotel in New Castle, NH. It was an all-day affair with eight magnetic speakers covering the following topics: Addressing Challenges of Teaching Medical Physics (Herbert Mower); Radiotherapy at the Radiological Physics Center (David Followill); IMRT Biological Modeling (Gene Cardarelli); PET/CT Instrumentation and Clinical Applications (Georges El Fakhri); Breast Tomosynthesis (Andrew Maidment); MLC Electron Modulation (Eric Klein); Brachytherapy Calibrations, (Larry DeWerd); and Statistical Analysis of Brachytherapy Dosimetry Parameters (Mark Tries). Even with the antediluvian rains flooding New England since midMay, the meeting was well attended (n=51) with physicists coming from all over the region. The quality of the meeting was further enhanced by high turnout and generous support from our corporate sponsors. During lunch, the NEAAPM Board of Directors, led by President YC Lo, fi(See New England - p. 26)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

Chapter News - continued New England

(from p. 25)

nalized plans to announce the incoming board members. Starting in 2007 these new officers will be Gene Cardarelli (presidentelect), Martin Fraser (AAPM representative), and George Inglis (NEAAPM officer-atlarge). Our final chapter meeting of the year will be held in October at the Tower Hill Botanic Gardens, a scenic venue for autumn foliage, rolling hills, and exciting medical physics presentations off the Orangerie. For more information on past and future meetings, please visit our Web site at chapter.aapm.org/NE.

Ohio River Valley Douglas Frye Chapter President-elect The Ohio River Valley Chapter recently held the first of its semiannual meetings for 2006 at the Dayton Marriott Hotel. The meeting consisted of a registration/continental breakfast, morning presentations with a break for coffee and vendor displays, lunch in the vendor display areas, student presentations, and a business meeting. The scintillating morning presentations were devoted to IMRT QA or IGRT and consisted of the following presenters and topics:

NEAAPM Board Meeting in the Solarium â&#x20AC;&#x201C; (l to r) YC Lo (president), Mark Rivard (president-elect), Richard Behrman (AAPM representative), Peter Biggs (election committee chairman), Erli Chen (secretary/treasurer), and Dan Cahill (officer member-at-large).

A Simplified Method to Check IMRT MU Settings (Mike Loyd); IGRT Utilizing the HiArt Tomotherapy System, (Tewfik Bichay); IGRT Utilizing the Varian BOI and CBCT, (Rabih Hammoud); IGRT Utilizing the Siemens MVision System (Jean-Francois Aubry). The stimulating student presentations included: A quantitative dose reduction analysis in MammoSite Balloon by Monte Carlo calculations (ZhengDong Zhang); Anatomy matching protocol using Varian Vision software (Christopher Abraham); Neutron fluence measurements around the Siemens Oncor linear accelerator (Todd Hill); A Monte Carlo evaluation of IMRT without a flattening filter (David Pearson) and Comparative investigation of dosimetric tools in IMRT (Aaron Garcia).

The chapter provided each of the student presenters with a $250 travel award. During the business session, Chapter President Andy Schneider and Secretary/Treasurer Nick Schrueder briefly described the financial status of the chapter. Nick also announced his intention to step down at the end of his term. Nickâ&#x20AC;&#x2122;s quiet efficiency has been appreciated and will be sorely missed. Andy introduced the Chapter Presidentelect Douglas Frye. Chapter Representative Board Member Paul Feller gave a quick summary of the weighty matters and issues before the AAPM board, including the possible reanimation of the board reorganization, a proposal for board member presence in the AAPM booth at the annual meeting during vendor display hours as an outreach to the membership, and board diversity ala MS/ PhD and clinical/academic.

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

The next ORVC 2006 meeting is tentatively scheduled for November 18th in Indianapolis. It is anticipated that the students selected to present will again each receive a travel award.

The chapter wishes to recognize our vendor partners whose generosity and presence enlivened and enhanced the meeting: Siemens, IMPAC, Tomotherapy, Standard Imaging, Fluke Bio-

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

medical, RIT, Best Medical, Sun Nuclear, North American Scien■ tific, and Varian.

ACR CT Accreditation Frequently Asked Questions for Medical Physicists Does your facility need help applying for ACR accreditation? Do you have a question about the ACR Diagnostic Modality Accreditation Program? Check out the ACR’s Web site at www.acr.org; click “Accreditation,” then scroll down to the modality program. You can also call the Diagnostic Modality Accreditation Information Line at (800) 770-0145. In issues of this newsletter, I’ll present questions of particular importance for medical physicists.

Priscilla F. Butler Senior Director, ACR Breast Imaging Accreditation Programs Q. How do I know what detector configuration (N xT) I am using if the scanner console doesn’t explicitly report that information? A. In multi-detector-row CT (MDCT), the reconstructed slice thickness is not always the same as the Tomographic thickness of one data channel (T as defined in the ACR accreditation documents). For example, a given helical acquisition protocol on a GE MDCT scanner specifies the acquisition parameters in terms of “Thick, Speed and Mode or Pitch.” Here “Thick” refers to the reconstructed image thickness and not the underlying detector collimation (T). This definition of T is consistent with International Standards, but can be confusing because users also associate “T” or “t” with the image thickness.

In MDCT, the two parameters are not the same and both are important to know. For ACR accreditation reporting and measurements, particularly the CTDI measurements and calculations, it is imperative that the physicists know the underlying detector configuration for any given helical protocol. Below we provide a conversion table for GE LightSpeed QX/i and LightSpeed Plus systems (4detector-row scanners) that allows the physicist to determine detector configuration if the console acquisition parameters (Thick/Speed/Pitch) are known. In future software versions (LS2002), the values of N x T and the IEC pitch will be explicitly reported on the operator’s console, making the table below unnecessary. However, LS2002 will not be available for the QX/i systems (the original 4-detectorrow systems); thus users of those systems will want to continue to consult the table that follows on page 28.

The ACR CT Accreditation Physics Subcommittee is working to provide similar information for other manufacturers’ systems. Instructions for use of the conversion table: First determine and record the site’s clinical protocols for adult head, high resolution chest, adult abdomen and pediatric abdomen exams. Once these are described, then this conversion table can be used to determine the values of N and T that correspond to the given helical acquisition parameters. This information is valid only for the specific make and models of scanners listed. Q. Our multi-slice CT system uses a spiral Adult Abdomen protocol. The instructions for section 5 say to use the adult abdomen protocol and “perform an axial scan instead while keeping the remaining technical parameters unchanged.” Our system CAN’T perform an axial scan (See ACR FAQs - p. 28)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

JULY/AUGUST 2006 JULY/AUGUST 2006

Conversion Table for GE LightSpeed QX/i and LightSpeed Plus Systems Note: The figures in blue in the table below are instances where the reconstructed slice thickness (Thick) is not the same as the channel thickness T. The n M e as ure in Axial M ode with: (for module 1 and CTDI)

If He lical Protocol is :

Calculate CTDIvol with:

Thick (mm)

Table Spe e d (mm/rot)

Pitch

T (mm)

Table Spe e d (mm/rot)

Pitch (IEC de finition)

1.25

3.75

4 (4i mode)

1.25mm

3.75

0.75

1.25

7.5

1. 2 5

7.5

1.5

2.5

3.75

1.25

3.75

0.75

2.5

7.5

2.5

7.5

0.75

2.5

7.5

1.25

7.5

1.5

2.5

2. 5

1.5

3.75

7.5

2.5

7.5

0.75

3.75

11.25

3.7 5

11.25

0.75

3.75

2. 5

1.5

7.5

2.5

7.5

0.75

11.25

3.75

11.25

0.75

2.5

1.5

22.5

3.75

22.5

1.5

7.5

11.25

3.75

11.25

0.75

7.5

0.75

7.5

22.5

3.75

22.5

1.5

7.5

1.5

0.75

1.5

ACR FAQs

(from p. 27)

with the same detector configuration that is used in our spiral adult abdomen acquisition protocol. What detector configuration should I use?

How do I turn my spiral acquisition protocol into an axial protocol with the correct slice thickness (CT number calibration and slice thickness images, Film page 1, Boxes 4-12; Module 1)?

A. In multi-detector-row CT (MDCT), the reconstructed slice thickness is not always the same as the Tomographic thickness of one data channel (T as defined in the ACR accreditation docu-

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

ments). For a given helical acquisition protocol, the user must determine the corresponding values of N and T, as defined in the accreditation documents (see FAQ number 1). The reconstructed image thickness is often not the same as the underlying detector collimation (T). The following guidelines should be used to determine what axial scan parameters are to be used for the axial images required for Module 1. 1.)The kVp, mA, time per rotation, scan FOV, display FOV, reconstruction algorithm, reconstructed slice width, and dose reduction technique should all match those of the adult abdomen protocol described in Table 1, unless otherwise directed. The axial table increment should be set to zero so that the phantom stays in the correct position between exposures. (a.) For Film page 1: Boxes 5, 6, 7 and 8, use a reconstructed slice thickness of approximately 1, 3, 5 and 7 mm, respectively. (b.) For Film page 1: Boxes 9, 10, 11 and 12, use a kVp value other than that listed in Table 1. 2.) Film Page 1, Boxes 4 and 9-12: Use the same values of N and T as specified for the adult abdomen protocol in Table 1. (a.) If an axial acquisition cannot be made using that selection of N and T, keep T the same as described in Table 1 and use the next smallest allowed value of N. Example: Siemens Sensation 16 system with N = 16 and T =

1.5 mm and reconstructed helical scan width = 5 mm. Axial images cannot be acquired using N = 16. Use the same value of T(1.5 mm) but the next lowest allowed value of N, which would be 12. Thus the 12 x 1.5 mm detector configuration would be used for the axial version of the spiral adult abdomen protocol with N = 16 and T = 1.5 mm. This is similarly true for the 16 x 0.75 mm detector configuration (use an axial 12 x 0.75 mm detector configuration). (b.) If the selection of N and T from Table 1, or the resultant values of N and T from 2a (above), will not allow the use of the reconstructed scan width specified in Table 1, select the next closest reconstructed scan width available. If two equally close choices are available, choose the larger scan width. Example: GE LightSpeed 4-slice system with N = 4 and T = 3.75 mm and helical reconstructed scan width = 5 mm. In axial 4 x 3.75 mm mode (3.75 mm @ 4i), a 5 mm wide scan cannot be reconstructed. The next closest allowed scan thicknesses are 2.5 and 7.5 mm. The larger values should be chosen, which would be 7.5 mm. Example: Siemens Sensation 16 system with N = 16 and T = 1.5 mm and reconstructed helical scan width = 5 mm. From 2a (above) a 12 x 1.5 mm or 12 x 0.75 mm axial scan would be used. A 5 mm wide scan cannot be reconstructed from this con-

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

figuration. The next closest allowed scan thickness, which is 4.5 mm, should be used. 3.)Film Page 1, Box 5: Use the same values of N and T as specified for the High Resolution Chest protocol in Table 1. (a.) If an axial acquisition cannot be made using that selection of N and T, keep T the same as described in Table 1 and use the next smallest allowed value of N. (b.) If the selection of N and T from Table 1, or the resultant values of N and T from 3a (above), will not allow the use of the reconstructed scan width specified in Table 1, select the next closest reconstructed scan width available. If two equally close choices are available, choose the larger scan width. 4.)Film Page 1, Box 6: Use largest allowed axial value of T ~ 3 mm for a reconstructed scan width ~ 3 mm. Choose the largest value of N allowed for an axial acquisition having T ~ 3 mm and a reconstructed scan width ~ 3 mm. Example: GE LightSpeed 8- or 16-slice system. Choose T = 2.5 mm, scan width = 2.5 mm, and N = 8. Example: Siemens Sensation 16 system. Choose T = 1.5 mm, scan width = 3 mm, and N = 12. 5.) Film Page 1, Box 7: Use largest allowed axial value of T ~ 5 mm for a reconstructed scan (See ACR FAQs - p. 30)

4193A.pmd

7/19/2006, 2:13 PM

AAPMNEWSLETTER NEWSLETTER AAPM

ACR FAQs

JULY/AUGUST 2006 JULY/AUGUST 2006

(from p. 29)

width ~ 5 mm. Choose the largest value of N allowed for an axial acquisition having T ~ 5 mm and a reconstructed scan width ~ 5 mm. Example: GE LightSpeed 8-slice system. Choose T = 5 mm, and N = 4. Example: Siemens Sensation 16 system. Choose T = 1.5 mm, scan width = 5 mm, and N = 8.

tems, state-of-the-art multi-slice systems, and still existent nonspiral systems). When the CT accreditation program was being developed and the image quality phantom being designed, fourslice spiral systems were only beginning to be installed. In light of the subsequent dramatic changes in CT technology and the changing nature of the installed base of CT systems, the need to redefine and clarify some aspects of

6.) Film Page 1, Box 8: Use largest allowed axial value of T ~ 8 mm for a reconstructed scan width ~ 8 mm. Choose the largest value of N allowed for an axial acquisition having T ~ 8 mm and a reconstructed scan width ~ 8 mm.

the accreditation program is unavoidable. Please contact the ACR if you find a situation on your equipment that is not addressed by either the application materials or an FAQ, and we will make every effort to provide clarification and adapt the program consistent with the needs of ■ the CT community.

DO YOU SEE WHAT WE SEE? THERE IS MUCH MORE TO THIS PHANTOM THAN MEETS THE EYE. The 467 Tissue Characterization Phantom provides a faster and easier method for tissue variation corrections in isodose treatment planning and it allows you to “see” more for reliable dose calculations. It offers a wide range of densities in the bone and tissue rods and data obtained using the phantom can easily be transferred to your treatment planning system to correct for tissue inhomogeneities.

Example: GE LightSpeed 8-slice system. Choose T = 3.75 mm, scan width = 7.5 mm, and N = 4. Example: Siemens Sensation 16 system. Choose T = 1.5 mm, scan width = 6 mm, and N = 12.

But we don’t stop there — we also provided an innovative method for verifying CT scanner distance measurement. An optional titanium insert rod can expand the range and utility of the phantom even further.

Note: The Physics Subcommittee of the ACR CT Accreditation Committee fully recognizes that the above schema is complex. The changes in CT scanner technology since the introduction of multi-slice CT systems in late 1998 have made it difficult to design an accreditation program that is valid for the wide range of systems currently in use throughout the United States (including entry-level single-slice spiral sys-

As a result, you get more reliable dose calculations, more tissue characterization in the sample variety and more performance with our Solid Water® base. It’s more of what you’d expect from Gammex. For more information on the 467 Tissue Characterization Phantom, contact Gammex today at 1-800-GAMMEX 1 (426-6391).

GAMMEX RMI® P.O. BOX 620327 MIDDLETON, WI 53562-0327 USA 1-800-GAMMEX 1 (426-6391) 1-608-828-7000 FAX: 1-608-828-7500 EMAIL: SALES@GAMMEX.COM

GAMMEX–RMI LTD KARLSRUHE HOUSE 18 QUEENS BRIDGE ROAD NOTTINGHAM NG2 1NB ENGLAND (++44) (0) 115-985-0808 FAX: (++44) (0) 115-985-0344 EMAIL: UKSALES@GAMMEX.COM

GAMMEX-RMI GMBH MAINZER LANDSTRASSE 176 60327 FRANKFURT/M GERMANY (49)(0)69-97 35 8-110/122 FAX: (49)(0)69-97 35 81 01 EMAIL: DESALES@GAMMEX.COM

4193A.pmd

7/19/2006, 2:13 PM

w w w. G A M M E X . c o m

AAPM NEWSLETTER AAPM NEWSLETTER

JANUARY/FEBRUARY 2001 JULY/AUGUST 2006

Letters to the Editor Donald G. Daenzer, MSc Medical Physicist (retired) Ocala, Florida Dondaenzer@wmconnect.com As an independent contractor, I was recently involved in the sorting of resumes and preliminary telephone interviews for a very interesting hospital-based senior physicist position. I went through a stack of approximately 25 resumes from Master’s and Ph.D. candidates. One c.v. was from a natural-born American citizen. The others were predominantly from Indian nationals and secondarily from Chinese applicants. Many of these applicants have impressive credentials. I support the fact that many of our leading-citizen scientific minds (and in the AAPM) were not born here, or perhaps enjoy dual citizenship. However, I merely report what I have seen. Perhaps others in our AAPM can figure out what has happened to math and science training in the American secondary and college educational systems.

Emeka S. Izundu, PhD Las Cruces, NM Emeka.Izundu@lpnt.net I do not agree with Howard Amol’s (MEDPHYS Digests 20 Feb 2006 to 21 Feb 2006 “2006-51”) analysis as Robert Pizzutiello (MEDPHYS Digests

- 20 Feb 2006 to 21 Feb 2006 “#2006-51”) described it. Those who say that Provider Status for Medical Physicists cannot be achieved, that “there is simply no data to support any of the assertions that suggest that such a scheme could succeed...”, that “All of the experts AAPM has consulted tell us that it’s impossible, or that “AAPM has neither the economic resources nor the political clout to do this...”, are simply speculating. Why then were chiropractors, physical therapists, social workers, to mention but a few, able to achieve this status? Or are those who support Non-Provider status for medical physicists trying to tell us that these professions are by far stronger than the medical physics profession? Is our status as ABMS listed medical specislists meaningless? There are many things we enjoy today, in the arts, sciences, and even in politics, that at one time were thought impossible to achieve. I am confident that the Medical Physics profession can attain Provider Status once we try. There is nothing wrong with trying. If we fail the first time, we can try again and again, until we succeed. That’s the way of life. Stagnation is not progressive. It is out of line with the thinking of any physicist to conclude that something is impossible to do without trying. In order to succeed, one has to try.

Priorities Herb Mower Burlington, MA Herbert.W.Mower@lahey.org Many of our members contribute their time and talents volunteering for the association. The number of hours is truly staggering and is one of the strengths of our organization. The average member, yeah, even the average volunteer, has no idea of the contributions of many of our members. We are truly grateful for all the time and work that our members provide at the council, commitee, subcommittee and other levels. It is also true that volunteering can be contagious. It spreads to coworkers and family members. It is also true that it is hard for many to say “No!” Once a volunteer says “Yes!,” the volunteer then undertakes a certain level of commitment. The question then comes up as to what that level of commitment should be and when the borders need to be stretched. One of the things that we, as volunteers, probably don’t do enough is to appreciate the sacrifices those around us make in order for us to volunteer. This can be fellow workers, our communities and our families. The decisions become more difficult as we get more involved. In addition to our work-related activities, over the years my family (wife and daughters) has been (See Mower - p. 32)

4193A.pmd

7/19/2006, 2:13 PM

AAPM NEWSLETTER AAPM NEWSLETTER

Mower

JULY/AUGUST JULY/AUGUST 2006 2006

(from p. 31)

very involved with local charity work. This summer, as a result of her contributions to the Camping Services division of the Merrimack Valley YMCA, Fran (my wife) is being inducted into their Hall of Fame. Of course we are very proud of this. The problem? The ceremonies, of course, are on Sunday July 30th in the

middle of Lake Winnipesaukee in New Hampshire–ouch!–right in the middle of committee and council meetings at the AAPM Annual Meeting, not to mention the Education Council’s Symposium. The decision? Fran has supported me in my many endeavors so I will be at her induction! Many thanks to those in the council who are covering for me. We

will arrive in Orlando that evening. But of greater importance: we need to remember to support and appreciate those who have made our journey easier as we have helped others. We need to stop and say “Thank you!” and let them know just how much their support has meant to us. We also need to remember to support them in their endeav■ ors.

AAPM NEWSLETTER Editor Allan F. deGuzman Managing Editor Susan deGuzman Editorial Board Arthur Boyer, Nicholas Detorie, Kenneth Ekstrand, Geoffrey Ibbott, C. Clifton Ling Please send submissions (with pictures when possible) to the editors at: e-mail: deguzman@wfubmc.edu or sdeguzman@triad.rr.com (336)773-0537 Phone (336)713-6565 Fax 2340 Westover Drive, Winston-Salem, NC 27103

The AAPM Newsletter is printed bi-monthly. Next Issue: September/October 2006

Postmark Date: September 15

Submission Deadline: August 15, 2006 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

4193A.pmd

7/19/2006, 2:13 PM