Newsletter
A M ERIC A N ASSOCIATION OF PHY SICIST S IN ME D I CI NE VOLUME 33 NO. 6
NOVEMBER/DECEMBER 2008
AAPM President’s Column the last year or so—sorry but no new volunteer commitments until my AAPM regency has expired. The viability of the project spiraled downward from there--- I had thought that my pledge of financial support would be sufficient, but it seemed that sweat equity was also an absolute requirement. Unfortunately my pledge of sweat equity had been given to another until the end of 2009.
Gerald A. White Colorado Springs, CO
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everal weeks ago I found myself addressing the board of directors and staff of a local organization of community activists. Lots of comfort was, for me, to be found there. It seems as though a lot of what I spent so much time on in the ‘60s (alas, it was not all Math and Physics) has come back to us again. The purpose of my visit was to make a pitch for a particular project I thought they should undertake. I’d done a fair amount of preparation; adapting a national program to match our unique circumstances in Colorado Springs, collecting resources for both intellectual and materials support and providing a source of funding for start up with a plan for subsequent fiscal viability. It was, in my somewhat biased opinion, a proposal that would be so appealing as to immediately move forward. My sails were deflated when they put to me one question—how much of my own time would I be willing to commit to the implementation of the project? I invoked the message that I’ve been giving to a great many for
Treasure and participation, capital and labor, money and time are all essential for any substantial project and accomplishment. It doesn’t seem to me as though they always need to come together from the same sources. A paired contribution of wealth and self gives great benefit to any organization, but is not necessary for progress. Participants, members of the group endeavor, can supply one or both, but it is vital to have, at a minimum, one of the two thrown in to the communal pot. Last week at the orientation for new members of the AAPM Board I came across the data that there are nearly 1000 volunteer AAPM members participating in roughly 250 committees, task groups and workgroups. A quick calculation (assuming, conservatively, a 1 hour per week time commitment and $100/hour cost of physicist effort) gives us a time contribution worth a bit over $5 million per year. This contribution of about 15% of AAPM members dwarfs the annual dues contributions of all of us. These are folks who support with both time and treasure, the former coming in
increasingly short supply while the need for the incredibly productive activities of the Association continues to grow. We can’t grow much more time, but we can grow a bit more treasure. Many of us can’t find more time to move the AAPM forward, but surely we can all find bit more money. The AAPM Education and Research Fund awaits our attention. The recent defeat of the initiative for an increase in the AAPM dues structure calls out for a more vigorous dialog on the need for support from all of us, in a tangible fashion, for the mission of the Association. We are closing a year of reflection after 50 years of progress. We have, without a doubt, suitably celebrated the present, but we must also honor the past and prepare for the future by assuring a strong and adequate financial base for the Association. May the 51st year bring us the opportunity to make that a reality. TABLE OF CONTENTS Chair of the Board’s Column President-Elect’s Column Executive Director’s Column Editor’s Column Education Council Report Professional Council Report Leg. & Reg. Affairs Website Editor’s Column American Board of Radiology EFOMP Conference Update ACR Accreditation DBIS Program Update Health Policy/Economics Web-based Modules Persons in the News
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AAPM Newsletter
November/December 2008
Chairwoman of the Board’s Column
Mary K. Martel UT MD Anderson Cancer Center “Thank You”
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will write one more column postBoard meeting in December at RSNA, but this column will serve as my “thank you” to colleagues, friends and family. Interwoven in the thankyou’s will be some comments on continuing issues that women face in our field. It is not so obvious how to become involved in the volunteer work of the AAPM, and sometimes you have to catch a lucky break. I have Jean St. Germain to thank for placing me on the Rules Committee which she was chairing at the time. With her mentorship and vast knowledge of the AAPM, this was an ideal spot for a younger member to learn committee work. Then, through work on a task group (thanks to senior colleagues Dick Fraass and Randy Ten Haken for suggesting me), fellow task group member, Jatinder Palta, recommended me as the scientific program director for the annual meeting. This role as program director opened up the passageway to higher level committees in the AAPM organization, including eventual election to the Board of Directors. This is only a snapshot of my work in the AAPM, but it shows that it helps to have a number of people serving as guides through the AAPM labyrinth.
However, when I received the call to run for President of the AAPM, I said no, citing such reasons as new job tasks and a young son. But once I was called for the third year in a row (this time by Howard Amols), I realized that I needed, and could, figure out how to juggle my personal, job and professional responsibilities. Too, I had in mind that the last (and the first) woman president was Ann Wright a long 25-some years ago. This in turn has caused me to reflect on the scarcity of women in leadership roles in our AAPM society. As a matter of fact, as a co-director for the scientific program annual meeting in 1999 with Maryellen Giger, there has not been a woman in such role since, or ever as education program director. And, as long as I have been an AAPM member, I do not recall any woman as a Council Chair, one of the most important roles in the society. Another issue is that lower salaries persist for women when compared to men, across the board, according to the AAPM survey, though median years of experience are approximately the same. And currently, there is one AAPM Board member, out of approximately 30, that is a woman (other than on EXCOM). There has been only one woman Coolidge award winner, Edith Quimby, which was near the beginning of the start of the AAPM. While one would have hoped that the mentioning of a gender gap would be irrelevant in the year 2008, the facts as they are indicate differently. There is some good news in that a number of women have played roles as secretary and treasurer on the Executive Committee. Several women have been awarded the AAPM’s Achievement Award through the years. And I observe more midcareer women as members in task groups and committees. Too, though
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approximately 19% of the Full members are women, approximately 30% of the Student members are women, showing a larger pool of women for potential leadership roles in the future. However, it is likely that there will be a call to action at the beginning of the year for those interested to help address the leadership imbalance. This may include putting together a mentorship program, identifying women for some of the key organization tasks, and helping women gain in job arena though better negotiation. Should an enthused group come together and gel, it may be possible to form an AAPM chapter “without borders”, ensuring a seat at the AAPM Board of Directors table. Back to the thank-you’s. Besides the people I have already mentioned, I would like to thank the people on EXCOM that I have worked with during the past 3 years. In particular, Don Frey, Howard Amols and Russ Ritenour encouraged a collaborative environment on EXCOM, much appreciated by me. I have learned much from the current members of EXCOM: Jerry White, Maryellen Giger, Gary Ezzell, Mary Moore and Angela Keyser. I have worked with some amazing members of the Board (you know who you are!). And it would not have been possible to devote the time and energy needed for EXCOM/Board work without the strong and loving support of my husband, John Carr, and my son, Max. Finally, to thank my parents, Ambrose and Maxine Martel, I will finish with an apropos comment made recently by Tina Fey when accepting an Emmy award: “I want to thank my parents for somehow raising me to have confidence that is disproportionate to my looks and abilities. Well done, that is what all parents should do!”
AAPM Newsletter
November/December 2008
President-Elect’s Column
Maryellen Giger University of Chicago
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his is my last newsletter article as President-Elect of the AAPM, written in October 2008. It has been a wonderful year of continuous learning about the AAPM and its many functions, and of meeting more and more member volunteers of the association. I am almost finished with my major task of appointing/reappointing chairs and members of the various Councils and committees for 2009. The “yellow book” of committee ads on the AAPM website contributed some to the postings and appointments, however, the main recruitment method continues to be face-to-face [or phone-to-phone] communication between the various AAPM members. I spent much of my time at the AAPM annual meeting in Houston talking in the hallway. In addition, Lisa Giove of the AAPM staff pleasantly and tirelessly worked with me to query the various chairs of committees, subcommittees, task groups, and work groups for new members. The accumulated list of volunteers of all the councils, committees, subcommittees, task groups, and work groups will be presented for approval to the AAPM Board of Directors at their November 2008 board meeting.
I have also enjoyed the many chapter meetings I have attended during this President-Elect year. As usual, as communication opens and/ or improves, so do appreciation and understanding, and I have learned to value even more the chapters’ role in the AAPM. Each chapter’s Board representative holds two important positions in communication – bringing the latest news from the AAPM Board to their own chapter members and contributing to the growth and organization of the AAPM as an active Board member. As I visited these chapters, I enjoyed giving different presentations. Usually I offered three types of presentations: a status of the AAPM presentation [either as an overview or with a specific focus on, for example, the 2012/2014 initiative or licensure], a research presentation on multimodality breast CAD, or a mixture of both. Fortunately, I was able to give all three types throughout the year, with different chapters having different interests. Jerry White, Angela Keyser, and I met with the RSNA Board of Directors to discuss initiatives and plans for the upcoming year. RSNA
continues to be a strong colleague of the AAPM and multiple initiatives are of interest to both. Many AAPM members are actively involved in the RSNA’s Quantitative Imaging Initiative, with much involvement by John Boone, as chair of the AAPM Science Council as well as a member of the RSNA Research Development Committee. Also, the RSNA acknowledges the need to increase the number of medical physics residency programs in diagnostic imaging, and will be working with the AAPM to develop ways to expedite the acceptance and enactment of such residency programs. The RSNA is also enthusiastically working with the AAPM on the creation of webbased modules for the teaching of physics to radiology residents – a major effort led by Bill Hendee. I say goodbye and thank you to Mary Martel, our Chairwoman of the Board, and Gary Ezzell, our Secretary. I have enjoyed tremendously working with them on EXCOM. I know they are only a phone call away to taking on new AAPM volunteer roles. And so remember, it is never too late to volunteer. The experience is educational and rewarding.
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AAPM Newsletter
November/December 2008
AAPM Executive Director’s Column competitive basis to be an AAPM summer fellow. Each summer fellow receives a stipend from the AAPM. For more information, go to: http://www.aapm.org/education/ SUFP/
Angela R. Keyser College Park, MD Meeting Dates he 2009 AAPM Summer School will be held June 2125 at Colorado College. The topic will be Clinical Dosimetry Measurements in Radiotherapy with Dave Rogers and Joanna Cygler serving as Program Directors.
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The 2009 AAPM Annual Meeting will be held July 26 – 30 in Anaheim, California. The Call for Abstracts will be available online in early January. Registration and housing information with be posted in March. Undergraduate Fellowship Opportunities The Summer Undergraduate Fellowship program is designed to provide opportunities for undergraduate university students to gain experience in medical physics by performing research in a medical physics laboratory or assisting with clinical service at a clinical facility. In this program, the AAPM serves as a clearinghouse to match exceptional students with exceptional medical physicists, many who are faculty at leading research centers. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a
The Minority Undergraduate Summer Experience (MUSE) program is designed to expose minority undergraduate university students to the field of medical physics by performing research or assisting with clinical service at a U.S. institution (university, clinical facility, laboratory, etc). The charge of MUSE is specifically to encourage minority students from Historically Black Colleges and Universities, Minority Serving Institutions or non-Minority Serving Institutions to gain such experience and apply to graduate programs in medical physics. For more information, go to: http://www.aapm.org/ education/muse/ FYI • 2009 dues renewal notices were distributed in October. Sixteen AAPM Chapters have elected to have HQ collect their chapter dues. Make sure to check to see if your chapter is participating. If it is, we hope that you will appreciate the convenience of paying your national and chapter dues at one time! • The most up-to-date schedule for AAPM meetings during the RSNA meeting is available online at: http:/www.aapm.org/meetings rsna08/schedule.asp • Make plans to join your colleagues on Tuesday, December 2008 for the AAPM \Reception during RSNA at the Chicago Hilton. Thanks to Landauer, Inc. and RTI Electronics for their financial contributions
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to offset the costs for this event. • Due to budget cuts and time constraints, BIROW 6, scheduled for January 15 -16, 2009, has been canceled. The BIROW organizers are considering the future of the program, and the possibility of holding the meeting in early 2010. Headquarters News Ramy James was promoted to the position of Accounting Manager in mid-August. Since joining the staff in April, Ramy has proven himself to be an asset to the HQ team. We welcomed Lakea (Kea) Shirriel to the HQ team in September as the Accounting Assistant.
Part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of highperforming association management professionals. Several AAPM team members have celebrated an anniversary in the last half of 2008. I want to publicly thank them and acknowledge their efforts (see page 5). I began my journey as a member of the HQ team in November, 1993 and I continue to marvel at the commitment of the AAPM volunteers to the medical physics profession and to this organization. In this, the last newsletter of the 2008 year, I want to take the time to sincerely thank you for your continued support and for the confidence that you place in me as your Executive Director. The AAPM Headquarters office will be closed Thursday, November 27 – Friday, November 28, Thursday, December 25 – Friday, December 26 and Thursday, January 1 – Friday, January 2. I wish you and your loved ones a happy and healthy holiday season.
AAPM Newsletter
November/December 2008
Editor’s Column
Mahadevappa Mahesh Johns Hopkins University
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his is the last issue for this celebrated 50th anniversary year of the AAPM and we are already laying out plans for the 2009 issues. As always, the year has come and is going quite fast and all of us have become a year wiser. This year the newsletter underwent some changes in order to lower the overall cost of producing a quality print newsletter. As year ends, the AAPM Newsletter is facing another major hurdle with regards to the budget. The Professional Council, the Newsletter’s parent committee, informed me last week that the 2009 newsletter budget was reduced during the recent Budget
Subcommittee Meeting with the recommendation to discontinue printing of the newsletter from the January/February 2009 issue onwards. I did not expect the economic uncertainty and the ‘Wall Street’ issues to hit the ‘Main Street’ so fast. I plan to make an appeal to the AAPM Board of Directors to reconsider the recommendation of discontinuing the printing of the newsletter for the following reasons: As I mentioned in my May/June 2007 editorial column (volume 32, number 3; page 5), according to the AAPM members’ survey, the 89% of the survey respondents preferred the print version of the newsletter. The newsletter is the only printed document mailed to all AAPM members and serves as historical documentation of the association and its activities for the years to come. The newsletter budget request for 2009 amounts to less than 1% of the annual AAPM budget after taking into account the anticipated advertisement revenues. The newsletter expenses
AAPM STAFF ANNIVERSARIES Years of Service as of July - December, 2008 Lisa Rose Sullivan Penny Slattery Michael Woodward Farhana Khan Peggy Compton Noel Crisman-Fillhart Yan-Hong Xing Tammy Conquest Corbi Foster Jackie Ogburn
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for this year are already lower by nearly 40% compared to previous years. I am hoping this appeal to restore the newsletter budget and to grant permission and to continue printing the newsletter will receive a positive response from the AAPM Executive Committee, Board of Directors and the Finance Committee. In the event that my appeal fails, this will be considered to be the last printed version of the newsletter that is mailed to all the members of the AAPM. Having said that, the newsletter will still be published on time but only electronically and will be available on the AAPM website to all of the members of the association. Members will have access to all of the previous issues and current issues including links to extended articles from next year onwards. As the last 2008 issue of the newsletter reaches AAPM members, I’d like to thank the AAPM staff, particularly Ms. Nancy Vazquez, for all of her work on the newsletter and Ms. Farhana Khan for her help in establishing a presence on the AAPM website. I would like to express my sincere thanks to Angela Keyser and the headquarters’ staff, the Newsletter Editorial Board and the Executive Committee for their help and advice. Finally, I would also like to thank my wife and kids for their cooperation in this task. As this issue arrives at your desk, we are entering the holiday season and I wish you and your family a very happy holiday season.
AAPM Newsletter
November/December 2008
Education Council Report
Herb Mower Education Council Chair
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his is my last contribution as Chair of the Education Council as, with this edition of the Newsletter and the close of the calendar year I complete my six years of service to the Association in this capacity. What a great six years it has been. We have seen a lot of growth and progress in the Council during this period including, but not limited
to: recognition of the importance of graduate student and resident members; recognition of our minority members; complete restructuring and overhaul of programs designed to teach diagnostic radiology residents; enhancement and expansion of our outreach programs to high school and college physic teachers; development of electronic educational activities including recording our meetings; on-line learning modules, etc.; greater interaction with related societies including expansion into the cardiology arena and exchange of ideas and programs with our European medical physics colleagues; expanded involvement in the international arena including sponsoring or cosponsoring activities with them; establishment of a virtual library; creation of new panels and displays for our meeting booths; expansion of our offerings at the RSNA
including adding a designated therapy physics vertical tract; and addition of educational symposia / workshops to name but a few. During this time we have also strengthened the interactions between the various councils within the Association as well as our interactions with EXCOM and the Board. The Council Chairs and Vice-Chairs now meet together twice a year to evaluate various activities of each council and their relationship to the other councils and the Association. The council chairs now sit as non-voting members on the Board to allow for better flow of ideas and information between the two groups. I have enjoyed this opportunity of working with so many of you over these past six years. My heartfelt thanks to all the chairs, vice-chairs and members (see Mower - p. 9)
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AAPM Newsletter
November/December 2008
Professional Council Report
Michael Mills Professional Council Vice-Chair
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fter spending a week in Texas, near Austin, worrying about Hurricane Gustav, I was relieved to have missed it completely! On Sunday, I returned to Louisville, had my airplane catch a wind shear, took a side trip to Nashville, and then made it back to Louisville, only to find our neighborhood in shambles and my home without power! And I thought I had escaped scot-free; what a surprise. I never thought of Louisville as a potential target for a hurricane. Our power finally returned on Saturday, but by that time I was in Boston at ASTRO. This column will focus on a couple of things that happened there and other events after the AAPM meeting.
codes. Based on the information provided by CMS, the Advisory Panel satisfied itself that the Packaging of these codes almost eliminates payment for imaging costs. The Panel once again recommended that imaging and delivery codes not be bundled, this time for a period of two years and that CMS perform an evaluation of the penetration of imaging technologies and costs in the community over these two years. The Panel felt this was a productive, helpful and reasonable recommendation. The response from CMS is due on (Saturday) November 1, and will probably be released by October 31. With only a little final tweaking of the verbiage and minor edits, the Code of Ethics passed by the Board of Directors has been accepted for publication in Medical Physics. As I write this column, the Board of Directors is conducting a final vote on the edited version. Congratulations again to TG-109.
With all the activity focused on re-election, bailout and financial Armageddon, it is unlikely that such mundane governmental machinations as the CARE bill will receive much attention in the few session days scheduled for this Congress. We may expect the bill to be reintroduced next year; but perhaps without the presence of a strong supporter, Edward Kennedy, Senator from MA. Let us hope he recovers well from his surgery and treatments.
The Subcommittee on practice guidelines has reviewed a number of TG reports. One important task of the subcommittee is to review task group reports nearing completion (primarily from Science Council) in terms of clinical practice implications. Feedback is given to the TG and parent committee to allow the TG to address any professional issues before the report is finalized. This broader review is done to help make sure that practice guidance derived from TG reports is not taken to extreme in regulatory interpretation and is reasonably achievable in the majority of medical physics practices.
My third meeting with the Advisory Panel on Ambulatory Payment Classification (APC) Groups took place August 27 and 28. Of interest to the Radiation Oncology community, there was a request for additional information respecting the controversial packaging of radiation oncology imaging and delivery
The Joint Medical Physics Licensure Subcommittee continues to work to prepare grassroots and documentation to support licensure and formal registration for medical physicists. This will improve consistency and quality of practicing medical physics. If you have not checked out the licensure
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/ registration map on the AAPM government affairs webpage, please do so. Consider offering to participate in the grassroots effort in your state. Professional Services continues to work toward developing tools and documents that help medical physicists in professional activities. The Blue/Yellow Books are being revised, the professional survey is being made more robust, new working groups are being developed to address professional needs with AAPM support and stature. The Medical Physics Workforce Subcommittee under the leadership of Ned Sternick met at ASTRO and approved a proposal for a workforce study of the medical physics community, both therapy and imaging / diagnostic. The scope of work will include demographics, rates of individuals entering and leaving the field, demand and supply factors, and the anticipated effect of the 2012/2014 ABR decision. The recommended proposal is from The Center for Health Workforce Studies / University at Albany, SUNY. The recommendation must be presented by the Professional Council to the Board of Directors for approval. The Diagnostic Work and Workforce Subcommittee is now Chaired by Ed Nickoloff. Ed, you might remember produced the AAPM diagnostic work studies in the early 1990s. I am working with Ed to use current professional work measures and procedures to produce a contemporary document. The methodology will be similar to the Abt studies for therapy physics. We expect to have a preliminary survey instrument completed and tested by the end of next year. Please see the articles by Wendy Smith and Lynne Fairobent for other issues of importance within the Professional Council. Of particular interest is the current controversy over Cs-137 irradiators; Lynne’s article details the latest happenings in this arena.
AAPM Newsletter
November/December 2008
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AAPM Newsletter
November/December 2008
Legislative and Regulatory Affairs • Only 40% used for blood irradiation, with about 25% material irradiations, 25% animal irradiations and 10 % other. • Of the x-ray units, 50% were for blood irradiation, while 19% were for material irradiation and 32% for animals. • Forty percent of the medical linacs were used predominantly for blood irradiation and 11% for animals. Lynne Fairobent College Park, MD AAPM comments activities:
on
NRC
CsCl Sources. The American Association of Physicists in Medicine (AAPM) participated in the recent workshop by the U. S. Nuclear Regulatory Commission (NRC) on the potential removal of Cesium Chloride (CsCl) sources. Participating in the workshop for AAPM were Mike Taylor, INOVA Fairfax Hospital and me. I would like to thank all of you that responded to the survey conducted to assist in preparing the AAPM comments to the NRC. Results from the AAPM survey: • Of the 363 respondents, 297 had irradiators, 84.6% of those used Cs-137 as the source, 9.3% used conventional x-ray units and 6% used medical linear accelerators (linacs). • The Cs units represented the major vendors. Only 10% were purchased within the last two years, with 7% planning on replacing the units within the next 5 years. • A quarter of the cesium units had had some malfunction but most were repaired in less than 7 days. Of the x-ray units, 35% had malfunctions, with 44% being repaired within 7 days.
This survey indicates that, while fairly reliable, conventional x-ray units and medical linacs account for a small minority of the irradiators in the field. They had slightly more downtime than cesium units. The cesium units have been reliable and their users, in general, have no plans to replace them. Forced removal of the cesium irradiators would result in a very large loss of resources, both radiation sources and funds, not only for blood banks but for research institutions as well. AAPM’s full comments can be found at: http://www.aapm. org/pubs/newsletter/references/ AAPMFinalCommentsCsCl.pdf NRDC Petition. The National Resources Defense Council (NRDC) submitted a petition to the NRC on May 26, 2008 (73FR30321). In part NRDC is stated: “The petitioner also notes that NRC has authorized a two to three year supply of HEU for export to Canada for Mo-99/Tc-99m medical isotope production. The petitioner suggests that the Canadian firm, MDS Nordion, that extracts the Mo99/Tc-99m from the HEU could use LEU material because at least two other Mo-99 producers have been doing so ‘’for more than 30 years.’’ Although MDS Nordion would incur
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an additional expense associated with the conversion, the petitioner believes it would be ‘’a small price to pay for the elimination of HEU.’’ The petitioner does not believe that establishing a firm date for ending civilian use of HEU will be detrimental to medical isotope production.” AAPM submitted comments on the Petition which recommended that any decision to grant the NRDC Petition proceed with caution and ensure that if a date is set for terminating the exportation of highly enriched uranium (HEU), this date be established to ensure that the production of medical radionuclides will not be compromised in any manner. AAPM’s full comments can be found at: http://www.aapm.org/pubs/newsletter/references/AAPMNRDCPeitionFinalComments.pdf (Mower from p. 6) of the several committees, subcommittees, task groups and working groups under the Council. You folks have really done all the work To each and every one of you goes the credit. My role has been primarily twofold: gate keeper to keep things moving and defender of our budget. Undoubtedly the latter has been the most challenging but, I feel, we have increased our investment in the educational activities of the Association for the betterment of our organization, our members, our medical colleagues, and our patients. I look forward to welcoming our new leadership in the Council: Tony Seibert as Chair and Melissa Martin as ViceChair. They bring a lot of knowledge and enthusiasm to the Council and I am sure that the Council and Association will continue to provide great educational experiences under their leadership.
AAPM Newsletter
November/December 2008
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AAPM Newsletter
November/December 2008
AAPM Website Editor’s Column twice.) This can be confusing if you change topics but are still looking at information on a prior topic. If you select a subtopic menu, you will change the information displayed but you may also open up a new main topic menu. The reports section has been a catch-all for the output of committees but it is difficult to find information on a specific topic. We could redesign the underlying database to improve navigation, but Christopher Marshall NYU Medical Center
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My goal is to continue to make incremental changes to the website in 2009, rather than to undertake a radical redesign. One reason is that members are now used to the current interface, with all its quirks, but a more fundamental reason is that we may need to rebuild the website on a content management platform at some point in the future. In the meantime we will work to optimize the appearance and the navigation. The home page does not take full advantage of the display characteristics of newer equipment, but just stretching content out leads to other problems, so we will approach that issue carefully. The current menu system has undesirable characteristics. If you click on a main topic, the information that is displayed does not change (although it will in many cases if you click
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just visited AAPM HQ for other purposes and extended the trip to spend a productive afternoon discussing plans for the website in 2009 with our IS director, Michael Woodward and our Webmistress Farhana Khan. Members may not realize that Farhana also builds and maintains sites for the sister organizations that have management relationships with the AAPM.
a better solution could be the content management approach. We can also provide alternate pathways to topical reports through the menu structure, as we have done in several cases already. Compounding all of this are the limitations of the search engine when information is in PDF format, which we hope to resolve with a new search engine next year. We are also looking at other ways for outsiders (such as potential recruits to our (see Marshall - p. 14)
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AAPM Newsletter
November/December 2008
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AAPM Newsletter
November/December 2008
American Board of Radiology Statistics for the ABR Initial Certification Examinations in Radiologic Physics
by G. Donald Frey, Medical Nuclear Physics Geoffrey S. Ibbott, Therapeutic Radiologic Physics Richard L. Morin, Diagnostic Radiologic Physics
O
ne of the primary responsibilities of The American Board of Radiology is to administer valid, secure examinations for the purpose of certifying that its diplomates have acquired and demonstrated the requisite standard of knowledge and practical experience to practice in the disciplines of radiologic physics (Therapeutic Radiologic Physics – TRP, Diagnostic Radiologic Physics – DRP, and Medical Nuclear Physics – MNP). The Radiologic Physics Trustees with the ABR staff and a team of highly dedicated volunteers develop the examinations that are offered each year. The exams include several written exams: Part 1 General; Part 1 Clinical; Part 2 – TRP, DRP, MNP; and an oral exam – TRP, DRP, MNP. The requirements for taking the exams and a content overview may be found on the ABR website (http://theabr.org/RP_Pri_home. htm).
years, the written exams have been administered at national Pearson VUE testing centers that are located in cities throughout the United States thus affording more convenience for the candidates. In June 2008, a total of 327 candidates took the oral examination with the breakdown also shown below. The statistics for the past 5 years are given in Table 2 (also available on the ABR website: http://theabr. org/RP_Pri_Score.htm). When scoring the written exams, each question is analyzed by the ABR psychometrics group. Any questions with unusual statistics are reviewed by subject-matter experts to verify that questions are unambiguous and keyed correctly (for example, questions that proved
to be extremely difficult and questions that low-scoring candidates answered correctly more frequently than highscoring candidates). The Difficulty for each question (the total percentage of examinees answering the question correctly) and the Discrimination for each question (how well a question discriminates between the upper and lower groups of examinees in the total exam) are also evaluated. A statistical analysis of the total examination is prepared and reviewed, using a coefficient factor of reliability that judges the overall quality of the examination. Thus, it is possible to determine the degree of reliability of a given examination and to utilize this information in preparing subsequent examinations.
Table 1: Number of candidates taking the ABR Radiologic Physics exams in 2008.
Table 2: ABR Radiological Physics exam results for the years 2004 – 2008. Part 1—General
The most recent written exams were administered August 20-23, 2008 with the candidate numbers shown in Table 1. For the past 2
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Part 1—Clinical
AAPM Newsletter
November/December 2008
Part 2—Therapy
Part 2—Diagnostic
Part 2—Medical Nuclear
Oral: First-Time Takers
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AAPM Newsletter
November/December 2008
European Federation of Organizations for Medical Physicists physicists adopted by all member countries.
Herb Mower Education Council Chair
T
he European Federation of Organizations for Medical Physicists (EFOMP) held their second “Conference on Medical Physics” on September 17-20, 2007 in Krakow, Poland. EFOMP represents a community of more than 6,000 medical physicists and 35 countries in Europe. The Congress meets biannually to discuss matters of common concern to the various countries members, recommending various programs and procedures which, it hopes, will be adopted by the member organizations and countries. At present one of the major activities of EFOMP is the establishment of uniform education and training programs for medical
With Poland hosting the conference this year, there was a tribute to Maria Skłodowska Curie and Pierre Curie for their discovery of radium and polonium. The conference opened with a trumpet fanfare, cut off prior to completion, similar to that played every hour on the hour from the bell tower at St. Mary’s church on the town square. EFOMP has as one of its goals the establishing of a means of recognition of competence in medical physics that will be recognized between various European countries. This is not unlike our desire to have reciprocity licensure recognition between various states. The Federation is also developing guidelines for the education and training of medical physicists, again to be adopted uniformly amongst its member countries. The recommendation is a graduate degree in medical physics followed by two years of clinical experience. This is not unlike our current recommendations. In addition to the tribute to the Curies, the meeting also addressed other educational issues, developing
modalities as heavy ion therapy and thermal imaging. The last day was primarily devoted to ‘young’ medical physicists with 12 presentations from medical physics students studying in Poland (7), Czech Republic (2), Germany (2), and Latvia (1). These were excellent! Attendance at the meeting was about 33% higher than last year at the first conference and included more than 60 oral presentations and about 90 posters. I had the opportunity to present a synopsis of our recent workshop on “Becoming a Better Teacher of Medical Physics” and to co-chair one of the sessions. The participants were very interested in our workshop as, though they are working diligently on establishing uniform curricula and clinical training standards, they have not to date delved into the challenges and opportunities afforded in teaching medical physics. Overall it was an exciting conference with amply opportunity to exchange programs and ideas between the US and AAPM and our European peers. Plans are well underway for the 2009 meeting to be held in Munich, Germany.
(Marshall from p. 11) field) to navigate to information of interest. My intention is to develop alternative approaches and then have the website editorial board review them, but this would also be a great time to receive individual suggestions or complaints via the feedback box below. We have ideas on how to provide you with more information through the “MY AAPM” menu. If you use
(or would like to use) a mobile device to access our website, we are currently considering whether to create an optimized version of the website to serve you better. Please comment on these issues via the feedback box. As a follow-up item to my last report, the video interview with the Founding Members who attended the Annual Meeting has been received,
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so we hope to have that “live” on the website soon. I hope that you find the Website useful, visit it often, and send me your feedback at : http://www.aapm.org/pubs/ newsletter/WebsiteEditor/3306.asp
AAPM Newsletter
November/December 2008
ACR Accreditation Radiologic Technologists - perform 24 stereotactic breast biopsy exams over a 24-month period. Medical Physicists - perform 2 stereotactic breast biopsy physics surveys over a 24-month period.
ACR Stereotactic Breast Biopsy Accreditation: Frequently Asked Questions for Medical Physicists by Priscilla F. Butler, M.S. Senior Director, ACR Breast Imaging Accreditation Programs Does your facility need help on applying for stereotactic breast biopsy accreditation? Do you have a question about the ACR Stereotactic Breast Biopsy QC Manual? Check out the ACR’s accreditation web site portal at www.acr.org; click “Accreditation,” then “Stereotactic Breast Biopsy.” Most of the stereotactic breast biopsy accreditation application and QC forms are available for downloading. You can also call the Diagnostic Modality Accreditation Information Line at (800) 227-0145. In each issue of this newsletter, I’ll present questions of particular importance for medical physicists. Q. What the continuing experience requirements must I meet for stereotactic breast biopsy accreditation? A. The Stereotactic Breast Biopsy Accreditation Program’s continuing experience requirements has recently changed to allow more flexibility and to mirror the counting time period used in Mammography Accreditation: Interpreting Physicians - perform 24 stereotactic breast biopsies over a 24month period.
Q. I am no longer qualified in stereotactic breast biopsy because I have not maintained my continuing experience. (I currently meet the continuing education requirements.) May I requalify so that my facility can apply for accreditation with the ACR? A. Yes. You may requalify as follows: Interpreting Physicians - perform 3 hands-on stereotactic breast biopsy procedures under a qualified physician. Radiologic Technologists - perform 5 hands-on stereotactic breast biopsy procedures under a qualified physician or technologist. Medical Physicists - perform 1 hands-on stereotactic breast biopsy physics survey under a qualified medical physicist. Q. The ACR 1999 Stereotactic Breast Biopsy Quality Control Manual directs us to make 4 exposures of the ACR MAP phantom for QC testing. Since many stereotactic breast biopsy units have small field-of-views, this allows all test objects in the 4 quadrants of this larger phantom to be imaged. However, our stereotactic breast biopsy unit has a relative large field-ofview that covers almost the entire wax insert. May we use fewer exposures for routine QC? A. Yes. You may use the following test procedures if your stereotactic breast biopsy unit’s field-of-view is relatively large:
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Test Procedure Steps For Digital Image Receptors 1. Position the phantom (without the acrylic disk) so that the wax insert is centered in the field of view. Use the light localizer to facilitate the positioning. If the lateral approach is most commonly used for biopsies, apply compression to the phantom using a paddle without an aperture. If the vertical approach is most commonly used, do not install a compression paddle. 2. Take a scout view (0º) exposure using the site’s standard technique for a 4–4.5 cm thick compressed breast. Inspect the image to ensure that the entire insert area has been included. Record the technique factors on the data form. 3. As shown in Fig. 1, position the needle holder as far as possible from the chest wall and toward the right side to enable visualization of the fifth and sixth fibers. 4. Acquire a scout view image. 5. As shown in Fig. 2, move the needle holder as far as possible from the chest wall and toward the left side to enable visualization of the third and fourth fibers. 6. Acquire a scout view image. 7. View the images from steps 4 and 5 to determine the number of fibers, speck groups, and masses visible. Adjust window level and width settings to maximize detection of each object type. Use the scoring method for fibers, specks, and masses described below. 8. Examine the phantom images for artifacts. It may help to use several different window level and width settings to be sensitive to all artifacts.
AAPM Newsletter
Figure 1. Position of the needle holder to enable imaging of the 5th and 6th fibers.
November/December 2008
Figure 2. Position of the needle holder to enable imaging of the 3rd and 4th fibers.
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AAPM Newsletter
November/December 2008
Navigating through the complex world of Clinical Physics
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AAPM Newsletter
November/December 2008
Discoveries and Breakthroughs in Science Getting Medical Physicists and Medical Physics Research on Local TV News: The Discoveries and Breakthroughs Inside Science Program
D
iscoveries and Breakthroughs Inside Science (DBIS) http:// www.aip.org/dbis/ is an internationally syndicated news service delivering science, technology, engineering and mathematics (STEM) segments to subscribing local television news stations and other media outlets. The program is organized by the American Institute of Physics (AIP). DBIS brings together a coalition of STEM societies including AAPM which provide financial support, story ideas and peer review to the program. One of the goals of DBIS is to encourage awareness and appreciation of the role that STEM researchers and STEM research play in the general public’s daily life. Why Use Local TV News? DBIS primarily focuses on local television news because studies demonstrate that this media outlet is the primary source of information for the majority of the U.S. public. The Pew Research Center reports that 71% of the U.S. public watches local TV news regularly, a far greater percentage than any other type of news source (Pew, 2007). The National Science Foundation’s Science and Engineering Indicators 2008 reports that 49% of survey respondents named television as their leading source of news about science and technology (National Science Board, 2008). Pew also points to the U.S. public’s steadily increasing use of the web over the past seven years (Pew, 2008). DBIS partners agree that STEM professional organizations and their members need to play a significant role in informing the public about STEM developments. DBIS Program: DBIS delivers twelve 90-second broadcasts each month to
participating television stations and other subscribers. Scripts, source background and contact information are included to encourage follow-up coverage. When possible, Spanishlanguage versions of DBIS stories are also produced, featuring new footage of Spanish-speaking scientists. Science Insider web pages provide additional content about each DBIS story. Subscribing televisions news stations post these pages on their own web sites, reporting 703,000 visits to the top 100 DBIS pages over the past year. AIP provides these reports on its DBIS web site which had 244,773 visits in 2006.
surveyed participants before and after two treatments of varying exposures to DBIS news reports over a week, and compared their responses to a control group. He found differences in beliefs, attitudes, and intentions as a function of exposure, with higher exposures to DBIS news reports leading to greater awareness and appreciation of the role of STEM in society and greater support for STEM research. Respondents who watched a greater number of DBIS news reports had more positive perceptions of science, engineering and math, greater retention of story ideas, and a greater number of peer conversations regarding STEM.
DBIS has a minimum average audience of 47 million per monthly feed and is distributed to more than 100 clients. Other outlets for DBIS include Voice of America which has an international reach to over 13 countries. Over 900,000 mass transit riders watch DBIS in 7 major U.S. cities on Transit TV. Roo Media Network has 2.5 million DBIS video streams (over a 4 month period) on their website. The Newsroom.com, HowStuffWorks.com, and the Denver Post websites receive DBIS segments on their websites thanks to Voxant. ScienceDaily also receives DBIS segments which has 276,000 hits per month. DBIS is distributed through Clip Syndicate which sends DBIS to the Associated Press, Bloomberg TV, and Clear Channel Television. One of our most recent new venues for DBIS is eScienceLabs.co which the segments to support their on-line education labs.
Role of DBIS Partners: DBIS partners increase the diversity, quality and reliability of reporting in areas of STEM research while providing a stable financial base. Each week AIP gathers story ideas from partners and other sources. Partners also suggest experts to review the research findings, critique the script, and comment on the application of the discovery or breakthrough. Currently, the chairman of AAPM’s Media Relations Committee, Dr. Sudarshan Chamakuri, works directly with the DBIS program, but he needs your help. Some of the needs include someone to: participate in the DBIS weekly conference call (as desired, especially if there is a story that pertains to AAPM), help DBIS find outside experts to verify AAPMrelated stories (DBIS will contact you with these requests), forward story ideas from AAPM members to DBIS (when possible), and review scripts on AAPM-related segments (DBIS will send you scripts with a deadline in approximately 48 hours).
Impact over Time: As part of an extensive NSF grant, Dr. Brian Southwell at the University of Minnesota examined the effects of short-term exposure to DBIS. Using a random sampling of 900 individuals from an area with no previous exposure to DBIS, Dr. Southwell
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If you would like to volunteer or for more information about the DBIS program, please contact Emilie Lorditch, DBIS Manager and Senior Science Editor, at 301-209-3029 or elorditch@aip.org
AAPM Newsletter
November/December 2008
Health Policy/Economic Issues Fusing Images in Radiation Oncology
James M. Hevezi, Ph.D., FACR, FAAPM Methodist Cyberknife Center San Antonio, Texas
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ith the advent of Image Guided Radiation Therapy (IGRT), there are now two instances wherein image data sets may be “fused” with one another to obtain information in the planning stages of the treatment course and the utilization of IGRT before/during treatment delivery. This column discusses fusion and the procedure codes that may be used to cover the work. Fusion in Treatment Planning Most treatment planning image data sets are based on Computed Tomography (CT) axial data sets obtained through the targeted anatomic area of the body. The GammaKnife® Stereotactic Radiosurgery (SRS) system (manufactured by Elekta) is an exception and utilizes Magnetic Resonance Imaging (MRI) data sets directly in the planning process. SRS procedures chiefly target areas in the brain and MRI is considered the “gold standard” for imaging in this area. In most treatment planning systems, CT axial data sets are brought into the contouring area of the planning system. If the software is set up to receive other image data sets such as MRI, Positron Emission Tomography (PET) or PET/CT, these data sets are brought into the fusion area of the
software. Both image data sets must be DICOM compatible for the fusion work to be initiated. Each planning system may display these image sets in separate windows, generally axial sets in one window and coronal or saggital images in another window. At this point, corresponding points are chosen on each data set in the axial presentations as “starting points” for the software to begin the fusion process. Subsequently, the fusion process is initiated with most software systems utilizing a mutual information type algorithm to overlay the data sets accurately, even though the slice thicknesses, magnification and other scan parameters may have been different during the image acquisition process. After the fusion process is complete, the fused data sets are evaluated by the medical physicist or dosimetrist to insure that anatomic fidelity was obtained. Most fusion software allows for manual manipulation of one data set against the other if small modifications are necessary. These manipulations can be a translation or rotation of the data set to obtain the necessary congruence for planning purposes. In the case of a cranial MRI fusion onto a CT brain data set, there are many anatomic clues for reliability of fusion, so the manual manipulation may not be necessary. However, in more complex body sites such as the thorax, spine, abdomen or pelvis, manual adjustments are often necessary before ample congruence between data sets are achieved. Depending on the acquisition scan geometry used in each case, fusion fidelity may be only achievable in a volume close to the radiation targeted volume, with less accurate fused anatomy away from this volume. This situation is frequently encountered in body MRI/CT fusions and, many times, great effort will be expended in obtaining accurate image fusion data for planning purposes.
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For PET or PET/CT fusion, DICOM image data sets are obtained for these sets and the CT planning axial data set. Typically, the PET/CT fusion with the planning CT data set is a twostep process in the fusion software area of the planning system. First, the PET data set is fused to the CT data set obtained during the PET/CT acquisition. Subsequently, the CT from the PET/CT data set is fused to the CT planning data set and complete fusions of the three data sets are obtained. Again, the data sets are evaluated by the medical physicist and reported back to the radiation oncologist. Other DICOM compatible image sets may be fused to the CT planning set using the techniques described above. The Special Medical Radiation Physics Consultation code (CPT 77370) is used to cover the work of the medical physicist in performing fusion for treatment planning purposes. The radiation oncologist provides a written request and the medical physicist submits a written report back to the radiation oncologist describing the fidelity of congruence between the fused data sets and any anatomic discrepancies/idiosyncrasies between the data sets for the patient study at hand. Fusion in Treatment Delivery A more recent use of the image fusion process occurs in IGRT. With the advent of SRS and Stereotactic Body Radiation Therapy (SBRT) large single doses or up to 5 fractions of radiation are delivered precisely to targets within the body. These targets must be accurately localized to ensure that large radiation doses are not delivered to critical normal structures nearby. Imaging techniques during radiation therapy delivery are brought to bear in assuring that accuracy is achieved for each fraction delivered to the patient. These techniques may take the form of orthogonal kV or
AAPM Newsletter MV imaging techniques (use CPT 77421, Stereoscopic X-ray guidance for localization of target volume for the delivery of radiation therapy to cover this procedure), ultrasonic imaging techniques (use CPT 76950, Ultrasonic guidance for the placement of radiation therapy fields), CT imaging techniques (use CPT 77014, Computed tomography guidance for placement of radiation therapy fields), and others where applicable. For example, fluoroscopic guidance may be used to image the application of brachytherapy needles for permanent implants and CPT 76001 (Up to 1 hour of Fluoroscopy) may be used to cover this work. Further, IGRT may also be available to align targets in Intensity Modulated Radiation Therapy (IMRT) procedures. Note that the Centers for Medicare and Medicaid Services (CMS) does not provide separate reimbursement for IGRT in the hospital outpatient setting as image guidance is packaged into the primary procedure. It is important that outpatient departments continue to charge for IGRT as the costs will be captured in future rate setting. The fusion process for IGRT will take a different track than the fusion process described above for radiation therapy planning. Once the treatment plan has been approved by the radiation oncologist, digitally reconstructed radiographs (DRRs) are generated from the approved CT plan. These DRRs can take the form of orthogonal projection radiographic images with an isocenter location integral to them, CT slices, axial and saggital ultrasound images and others. Depending on the IGRT system used, the DRRs are subsequently compared to “live” images taken at the time of patient set up for radiation treatment delivery or during the treatment delivery, by fusing the image data sets. The fusion process will indicate how the patient and/or treatment couch must be moved in order
to obtain congruent targets that overlay accurately. The radiation oncologist will approve “shifts” so that treatment can proceed or allow the radiation therapists to make the necessary adjustments based on the fusion congruence. There are specific supervision requirements for each of the different forms of IGRT and these are outlined in the ASTRO/ACR Coding Guide for 2007 (2008 Supplement).
November/December 2008 for treatment planning and treatment delivery, and billing these procedures appropriately. References: 1.Current Procedural Terminology (CPT®) copyright 2008, American Medical Association. 2.ASTRO/ACR Guide to Radiation Oncology Coding 2007 (2008 Supplement).
In summary, two types of image fusion are being utilized in radiation oncology. This article describes the requirements for performing fusion
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AAPM Newsletter
November/December 2008
Web-based Physics Education Modules A Note of Recognition by George S. Bisset III, MD - Liaison for Education, RSNA Board of Directors and William Hendee, PhD - RSNA-AAPM Physics Education Task Force Chair
T
he Radiological Society of North America and the American Association of Physicists in Medicine are fortunate to have dedicated members who actively participate in many different society activities, including holding leadership positions and supporting educational efforts. One innovative example of such participation is the creation of web-based physics education
materials for radiology residents and radiologists. These web-based instructional modules will contain information on the basic science underlying imaging. The modules will be produced in two phases. Phase 1, which is underway now, will include modules on Radiography, Fluoroscopy, Mammography, Computed Tomography, Ultrasound, Magnetic Resonance Imaging, Nuclear Medicine and Radiation Biology. Each module is being developed by a team led by a physicist and including one or more radiologists. These modules are an excellent opportunity for physicists and radiologists to work together to improve the basic science
education of resident radiologists. The modules will also be of interest to practicing radiologists, especially those participating in the American Board of Radiology’s Maintenance of Certification program. The individuals listed on the following page were selected based on the strength of their proposals in response to a joint RFP issued by RSNA and AAPM. On behalf of the RSNA Board of Directors and the AAPM, we recognize these dedicated individuals for their expertise, hard work, and generosity in sharing their work with the radiology and physics communities.
Persons in the News Dr. Stewart Bushong to receive the Texas Radiological Society Gold Medal
Dr. Richard Morin elected President of the Florida Radiological Society
A number of members
T
he Texas Radiological Society has awarded the Gold Medal of the society, it highest honor, to AAPM Member Dr. Stewart Bushong and Dr. Paul Ellenbogen for 2009. Dr. James Hevezi has been selected to present the award at the annual meeting in Ft. Worth, Texas this spring.
have asked me about the sources for the films shown at the beginning and end of the Gala Banquet in Houston. Here they are:
R
ichard L. Morin, PhD, FACR was elected President of the Florida Radiological Society at its annual meeting. Dr. Morin is the first Medical Physicist to serve in this office.
AAPM and Doyle Printing Green Partners
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“Our Friend the Atom” from the collection “Walt Disney Treasures: TommorowLand”, available from a variety of sources found on the web. “Atomic Age Civil Defense Film Library”; www. TheHistoricalArchive.com Jerry White
AAPM Newsletter
November/December 2008
Listed below are the topics and prospective individuals selected to develop the AAPM/RSNA web-based physics education program: “Basic Concepts in Radiography” - Edwin F. Donnelly, MD, PhD, FCCP, Ronald R. Price, PhD, David R. Pickens III, PhD “Radiographic Image Receptors” - Stewart C. Bushong, ScD, FAAPM, FACR, Pedro J. Diaz-Marchan, MD, Anand Prabhakar, MD “Basics of X-ray and Mammographic Systems” -George David, MS, Jerry D. Allison, PhD, James V. Rawson, MD “X-Ray Quality/Dose” - Ehsan Samei, PhD, Caroline Hollingsworth, MD, George S. Bisset III, MD, Charles M. Maxfield, MD, Nicole T. Ranger, MSc, Joseph Lo, PhD, James T. Dobbins III, PhD “Mammography Dose and Image Quality” - Tom Oshiro, PhD, DABR and Lawrence Bassett, MD, FACR “Fluoroscopy Systems/Dose/Quality” - Edward L. Nickoloff, DSc, FACR, FAAPM, FACMP, Jeffrey H. Newhouse, MD, Ronald Van Heertum, MD and Zheng Feng Lu, PhD “Interventional Dose/Quality” - Mark S. Rzeszotarski, PhD, Robert G. Dixon, MD, Philip H. Heintz, PhD, Donald L. Miller, MD and Mary E. Moore, MS, FAAPM “CT Systems” - Talissa A. Altes, MD and Mark B. Williams, PhD “Computed Tomography Image Quality and Protocols” - Kalpana M. Kanal, PhD, DABR, Brent K Stewart, PhD, DABMP and Martin Gunn, MBChB, FRANZCR “CT Dose” - Mahadevappa Mahesh, MS, PhD, Ehsan Samei, PhD and George S. Bisset III, MD “Basic Concepts in Nuclear Medicine” - Kenneth (Kip) Matthews II, PhD, DABR and L. Steven Bujenovic, MD “Radiation Detection/Instrumentation” - Nicole T. Ranger, MSc and Martin Charron, MD “Gamma Cameras / Image quality” - Ramsey D. Badawi, PhD and Bijan Bijan, MD “SPECT/SPECT-CT/Image Quality” - Ken Nichols, PhD, William Robeson, MS, Barry Babchyck, DSc and Christopher J. Palestro, MD “PET / PET-CT / Image Quality” - Habib Zaidi, PhD, PD, Charles Steiner, MD and Marie-Louise Montandon, PhD “Dose Estimates/Internal Dosimetry/ Safety/QC/Regulations” - Dolores Arginelli, PhD, Alberto Baroli, MD, PhD, Lorenzo Bianchi, PhD , Flavia Groppi Garlandini , Cristiana Peroni, Sandro Ridone, PharmD, MSc and Luca Vigna, BSc “Ultrasound – Concepts and Transducers” - Ann Scherzinger, PhD and Elizabeth Stamm, MD “Basic Ultrasound Imaging and Display” - Zheng Feng Lu, PhD, DABR, Jeffrey H. Newhouse, MD, Sherelle Lea Laifer-Narin, MD and Edward L. Nickoloff, DSc, FACR, FAAPM, FACMP “Advanced and Doppler Ultrasound Imaging” - Kwan-Hoong Ng, PhD, FIPM, MIPEM, DABMP, CSci, FinstP, AM and Basri Johan Jeet Abdullah, MBBS, FRCR, FAMM “Ultrasound Image Quality/ Artifacts/Safety” - Kevin Evans, PhD, Ricky Robert Layman Jr, MS, Benjamin A. Tourkow, MD and Adele Lipari, MD “MRI: Concepts and Tissue Properties” - Raleigh F. Johnson Jr, PhD, Thomas K. Nishino, PhD, Joseph Roebuck, PhD, MD and Stephen Seiler, MD “MRI: Instrumentation, Siting, and Shielding” - Wlad T. Sobol, PhD, DABR, DABMP, FAAPM, Desiree E. Morgan, MD, Joshua P. Smith, MD and Derek J. Schemmel, MD “MRI Image Formation” - Nathan Yanasak, PhD, Ramon E. Figueroa-Ortiz, MD, FACR and Jerry D. Allison, PhD “MRI Pulse Sequences” - Jerry D. Allison, PhD, James V. Rawson, MD and Nathan Yanasak, PhD “MRI: Image Acquisition, Reconstruction and Characteristics” - Denis Hoa, MD, Emmanuelle LE BARS, PhD, MSc, BSc and Antoine Micheau, MD, MSc, BSc “MRI Special Acquisition Methods” - M. Elizabeth (Beth) Meyerand, PhD and Victor M. Haughton, MD “MRI: Image Quality/Safety/Bioeffects” - Brent K. Stewart, PhD, DABMP, Kalpana M. Kanal, PhD, DABR and Felix S. Chew, MD “MRI Image Artifacts” - E. Russell Ritenour, PhD and Fred Ott, MD “MRI Tissue Properties, Contrast Agents and Reactions” - Tom C-C Hu, PhD, MBA, James V. Rawson, MD and Jerry D. Allison, PhD “Basic Radiation Biology” - Mark S. Rzeszotarski, PhD “Radiation Effects” - Karen Brown, MHP, Anne Dunne, MD and Albert Parlade, MD “Radiation Risks” - Donald Peck, PhD, Kimberly E. Applegate, MD, MS and Thomas L. Slovis, MD
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Editor
Mahadevappa Mahesh, MS, PhD Johns Hopkins University e-mail: mmahesh@jhmi.edu phone: 410-955-5115
Editorial Board Priscilla Butler, MS, Allan deGuzman, PhD, William Hendee, PhD, Chris Marshall, PhD (ex-officio) SUBMISSION INFORMATION Please send submissions (with pictures when possible) to: AAPM Headquarters Attn: Nancy Vazquez One Physics Ellipse, College Park, MD 20740 e-mail: nvazquez@aapm.org phone: (301) 209-3390
SUBMISSION SCHEDULE • The AAPM Newsletter is published bi-monthly. • Next issue: January/February • Submission Deadline: December 8
American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846