AAPM Newsletter July/August 2010 Vol. 35 No. 4

Newsletter

A M E R I C A N A S S O C I AT I O N O F P H Y S I C I S T S I N M E D I C I N E We advance the science, education and professional practice of medical physics

AAPM Column VOLUME President’s 35 NO. 4

JULY/AUGUST 2010

AAPM President’s Column Michael G. Herman, Mayo Clinic

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his year continues to provide activity for AAPM and for medical physics.

In this column I would like to touch on recent interactions AAPM has had with NRC and FDA, cooperative safety initiatives, 2012/2014 growing pains and the dues increase.

AAPM Dues Increase – It has been a number of years since AAPM increased dues. The previous Board of Directors proposed increase was defeated in 2008 by the first vote of the entire membership instead of a vote of the members in attendance at the Annual Business meeting. We did not communicate the real needs for increased funding clearly. Since that time, AAPM has reduced expenses and worked to achieve as many established goals and requested activities as possible. As many of you know, especially if you serve on a committee or task group, we had to reduce funding to many activities across all councils in 2009 and 2010. While we continue to get things done, it is at a slower pace and without some support that we would have liked to have. Our treasurer will outline more of this in specific detail in her column. My request to you is to support the modest dues increase of $50 proposed, along with a cost of living adjustment in future years, so we don’t fall behind again. I encourage you to become more involved and see how and where the money is being spent and to help shape the direction of the organization and profession you participate in. This increase really is important to the continuing function and success of the Included in this issue: AAPM to meet our Mission to advance the science, education and professional practice of medical physics.

Chair of the Board p. 4 NRC and FDA - In early June President Elect Tony Seibert, GRAC chair Doug Pfeiffer and I visited NRC headquarters in Washington.

Lynne Fairobent, our government and regulatory affairs staff setup these meetings for direct communication between AAPM and NRC on topics relevant to medical physicists. We met with Chairman Jaczko, commissioners Magwood and Ostendorff and Deputy Executive Director Michael Weber. While we submitted a packet of material with multiple points, in our ~25 minute meetings, we made the following points consistently: we wished to know when action was going to be taken to remedy the problem with Part 35 rule making for credentialing medical physicists. NRC began to recognize the ABR certification process as sufficient to allow a diplomate to be recognized as an AMP or RSO in October 2005. NRC did not recognize individuals who were certified prior to this date if they were not already acting as AMP or RSO. AAPM petitioned NRC to change this in 2006 and while NRC has recognized the hardship this has caused, still expects the remedy process to take more (years) time. We urged the commissioners

Treasurer President-Elect Executive Director Editor Education Council Professional Council Leg. & Reg. Affairs ACR Accreditation Website Editor New Professionals SC Chapter News Travel Grant Report Educational Workshop Report ABR Report International Ed. Activities Persons in the News Obituary

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continued - AAPM President’s Column to consider an expedited process to reduce the hardship and the probability of a shortage of AMP and RSO. They understood our position, but did not offer direct solutions.

We also asked about the status of ABMP NRC recognition to be sufficient for AMP and RSO and were told the decision on ABMP was near completion ( done within ~months). We talked about the credentials of ACMUI members and that AAPM believes that ACMUI members should left to right: J. Anthony Seibert, Chairman Gregory be qualified Jaczko, Mike Herman and Doug Pfeiffer and actively practicing in the subspecialty they represent on the ACMUI. We commented on recent discussion about the release of patients treated with iodine and suggested that hotel stays should left to right: Mike Herman, Commissioner William Magwood, Doug Pfeiffer and J. Anthony Seibert not be recommended to patients. Finally, we discussed the imminent need for a single event reporting database that is nationwide, accepted adequate event information related to all modalities and is evaluable in a straight forward manner. The commissioners also understood this request, but believe that NRC has a good left to right: J. Anthony Seibert, Mike Herman, reporting system for the domain of their jurisdiction. They Commissioner William Ostendorff and Doug Pfeiffer indicated that they would not oppose the development of a larger national event reporting system.

A number of us attended the Food and Drug Administration Public Meeting on Device Improvements to Reduce the Number of Under-Doses, Over-Doses, and Misaligned Exposures From Therapeutic Radiation on June 9-10, 2010. Per Halvorsen (Chair of the Professional Council), Jim Galvin (Chair of the Treatment Delivery Subcommittee of the Therapy Physics Committee) and I presented slides on behalf of AAPM in response to the FDA questions.

I spoke in the first session on device improvements and error reporting. We reminded everyone at the meeting that all of us (manufacturers, the entire medical team, regulators and elected officials) are in this together and we can only make real progress in increasing safety if we all cooperate. We proposed that manufacturers have their complete hazard and validation test data uniformly reported in the 510(k) review process and that the same information be summarized and distributed to users in the form of usable product documentation. Manufacturers should also provide increased communication/ display standardization for improved consistency and reduced errors and they should increase and possibly automate built-in safety checks. We also suggested that the FDA 510(k) process could be enhanced by a thorough review of additional safety and testing data provided by the manufacturers and also through leveraging objective external expert reviews (that could be provided e.g. by a technology assessment institute or by a vetted list of external reviewers). My final point was focused on creating, for all medical radiation events and independent of modality, a single, national, standardized event reporting system that would be easy-to-use, non-punitive, respect privacy, based on standardized data entry/nomenclature and be evaluated for patterns and dissemination of critical safety information. Such a system is critical to learning form mistakes.

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continued - AAPM President’s Column Jim Galvin presented in the session on user training. He emphasized that radiation therapy treatment team members must be appropriately trained, certified and licensed to operate the equipment used for treatment and that the AAPM supports passage of the CARE bill (H.R. 3652) that would require specific qualifications for each of the team members involved in the delivery of radiation to patients.

We stated that safe practice in radiation therapy comes from facilities that follow standard operating procedures that have been reviewed through an accrediting process. We stated that user training was critical to safe treatment and that this must include understanding safety and potential errors and must be device and protocol specific. The training must be complete, up to date, done at the right time and refreshed often enough to be meaningful. A good training program will be developed through cooperation between manufacturers and users, and improved through evaluation from both groups. We pointed out that proper training requires sufficient staffing numbers and an environment that provides necessary time to engage in quality training.

Finally, Per Halvorsen reminded us in the session on quality assurance again that a culture of safety requires all stakeholders to take responsibility for their part. We suggested that professional societies should cooperatively develop consistent practice standards and operating procedures; that manufacturers should provide clear reports of lessons learned during validation testing and they should specify the QA requirements for their new devices. We also stated that the FDA should require manufacturers to follow consensus QA programs and use common terminology for communication and messaging. We pointed out that we will need help from Congress to require facilities to provide the resources needed to operate effective QA programs, and ensure that staff members are properly trained.

We continue to work on our final written comments to FDA which are due July 15th that address these and other topics in response to the FDA questions. Please see Lynne Fairobent’s column on page 19 for more information on this and other government and regulatory activities.

2012-2014 is the future – we continue to navigate through a transitionary and unsettled period in the medical physics profession for those receiving initial training and board certification. The transition for training was planned some time (~10 years) ago and done in a deliberate fashion to establish clear, uniform expectations for medical physics education and clinical experience. It is the belief of many that such training and experience, combined with board certification provides the best indication of competence to practice independently in a subspecialty of medical physics. It is our responsibility to patients to provide qualified medical physicists to support their care. The economic down turn has coincided with the last few years of this transition, making the market very difficult and leaving many asking what qualifications they should have or how should they obtain them. We must all continue to take responsibility for actions that move this effort forward. Those doing training should make sure they are delivering education and clinical training that meet CAMPEP accreditation requirements. Others doing training should be working toward CAMPEP accreditation. Those in programs should understand clearly what the ramifications of receiving an M.S. or Ph.D. degree or residency certificate may be. If you have questions, please talk to your program director/mentor/senior colleague to best understand what your particular situation is. What we all wish to have is uniformly and superbly prepared medical physicists involved in patient care.

Safety Task force and initiatives – the AAPM, ACR and ASTRO Patient Safety Taskforce met in mid May to continue developing consensus plans to improve safety in radiation therapy. The focus remained on proper team qualifications, practice accreditation and standards of practice, uniform event reporting and improvements to the FDA equipment process. Many of these topics were discussed with NRC, FDA and again at the June Safety in Radiation Therapy meeting. We will continue to look for synergy and opportunities for cooperation with other organizations, manufacturers and government agencies to improve safety in the use of medical radiation.

As the annual meeting comes upon us, I hope to see each of you at the meeting and I welcome your insight and comments as we move forward with our profession.

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AAPM Chair of the Board’s Column Maryellen Giger, University of Chicago

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ith this newsletter, we are approaching the 52nd Annual Meeting of the AAPM, which will be held in Philadelphia. The meeting will again be a busy week, including various symposia, refresher courses, and presentations, as well as activities of the Education, Science, and Professional Councils. In addition, the AAPM Board of Directors will meet.

The BOD is a very important component of the AAPM with its duties detailed in our By-Laws, Article 1. As Chairman of the BOD, presiding over these meetings is one of my major duties. Updates and discussions at the BOD meetings include, for example, AAPM’s recent interactions with the FDA and Congress on the role of qualified clinical medical physicists (QMP) in the safe use of radiation in diagnostic and therapeutic procedures, the Treasurer’s report and the need for a dues increase, the role of AAPM in technology assessment and comparative effectiveness, developments in achieving the 2012/2014 ABR requirements for medical physicists, implementation of the new Administrative Council, and outcomes from a recent meeting of the ad hoc Committee on Strategic Planning.

It seems that each year becomes busier and busier for the AAPM, as reflected in the material in the AAPM newsletters. Many of the issues discussed at Board meetings are also presented throughout the various articles in the AAPM newsletters, and I encourage all of you to read them carefully.

In addition, I am happy to announce that the RSNA has decided to continue to support the medical physics profession through the generous contribution of $67,000 per year for two years as matching funds towards two new imaging physics residencies. The training of qualified clinical medical physicists includes either a CAMPEP-approved imaging physics or therapy physics residency. As discussed in my prior newsletter articles, it appears that we may have a sufficient number of CAMPEP-approved graduate programs, a rapidly growing number of CAMPEP-approved therapy physics residency programs, and only a few CAMPEP-approved imaging physics residency programs. The support of the RSNA will support new imaging physics residency programs.

Applications for these new residency awards will be announced soon on the AAPM website.

In closing, I ask that you all consider carefully the dues increase request as outlined by our Treasurer, Janelle Molloy, in this newsletter. Only with this due increase will we be able to continue the various programs that support medical physicists and their chosen careers. As always, please contact me with any suggestions or comments. Thank you.

PROPOSAL TO INCREASE MEMBERSHIP DUES Make plans to attend the Annual Business Meeting on Wednesday, July 21, 2010, in the Pennsylvania Convention Center, Philadelphia, PA, from 5:30 to 6:45 p.m. where members will discuss the Board-approved proposal to increase membership dues beginning in 2011. The vote of the full membership will take place in August. The proposal includes a one-time $50 increase for Full Members in 2011, with a cost of living adjustment in the years thereafter.

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AAPM Treasurer’s Column Janelle Molloy, Lexington,KY

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his is the second of two articles focused on assisting AAPM members with our decision regarding the pending vote to increase annual dues. The proposal will include a onetime increase of $50 followed by annual cost of living increases. By mandate of the AAPM Board of Directors, the Finance Committee is required to present an annual budget that is balanced, to within statistical and predictive uncertainty. An increase in $50 will result in almost $300,000 dollars of increased revenue per year.

I will attempt to answer what I anticipate would be reasonable questions that members will have prior to potentially approving the increase.

Has AAPM been aggressive in reducing expenditures?

Yes. The 2010 annual budget was constructed to be revenue neutral. Based on decreases in revenue that were described in the last newsletter issue, many spending cuts were implemented in order to achieve this. Some of the budget cuts could be construed as positive steps towards increased efficiency, while others have potentially undermined the progress of important initiatives. I provide here a partial list of actions that were taken last year in order to reduce costs.

• Face-to-face meetings were routinely replaced with teleconferences • Liaison travel to related meetings was reduced • On-site support at RSNA by AAPM staff was reduced • Provision of food and refreshments for committee members at national meetings was reduced • Financial support for related, international meetings was reduced • AAPM research start-up grants were reduced by 50% • Travel grants for students were eliminated • Summer research fellowships were reduced by 50% • One full time staff position at headquarters was eliminated • The annual meeting “Night out” is being scaled down The size of the headquarters staff has increased over the years. Is this justified and have measures been taken to ensure that the office is run efficiently?

In addition to the staffing cut listed above, the efficiency of the headquarters office was assessed compared to other benchmarks within the community. Metrics included operating, productivity and efficiency, ratios comparing AAPM with other associations of similar budget size and geography. Statistics published by the industry show AAPM compares favorably in virtually all areas of staffing and financial operations.

AAPM also conducts of review of headquarters operations every three years with findings reported to the Board and posted online at http://www.aapm.org/org/organization. asp. Some of the services provided by headquarters staff include support for related organizations such as CAMPEP and ACMP, which are reimbursed by these organizations. Reductions in headquarters staff would result in decreased support for important AAPM initiatives and members.

Consider that each of the councils and many committees have a staff support person assigned to it. These individuals assist with project implementation, take minutes, organize meetings and assist with logistics. This represents important improvements in our ability to function efficiently, as these tasks would otherwise detract from the time volunteers have to devote to critical initiatives. And here I will add a personal commentary, in that I have uniformly experienced our staff as being prompt, efficient, supportive and skilled.

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continued - AAPM Treasurer’s Column Have other potential sources of revenue been considered?

Yes. However, the possibilities are limited and cannot be instituted immediately or with certainty.

Much of our revenue derives from advertising, which is a source over which we have limited control and has decreased recently. Other possibilities include charging fees for access to the virtual library and increasing meeting registration fees. We are reticent to increase revenue via these means, as this will mostly be funded by members and thus increase the effective dues rate.

What services do I really get for my dues?

I consider the impact of the AAPM on my own professional career on a day-to-day basis, and find numerous benefits. Some of these are direct, such as access to the membership data base, access to the placement service, communication regarding pending regulations, and access to the many task group reports that provide guidance for my daily clinical and academic practice. Others are indirect, such as reaping the benefits of the advocacy that many of our active members devote on behalf of our profession. My monthly paycheck benefits from AAPM involvement in CPT code structuring. Regulations are influenced by AAPM and this helps to ensure my ability to hire only qualified medical physicists to support our clinic.

I encourage each of our members to consider the strengths of AAPM and what membership in our professional society means to us. A vote in favor of this dues proposal can ensure that the benefits we receive will continue to support our profession in the future.

New This Year - Midweek Mixer Tuesday, July 20 • 5:30 pm – 7:30 pm Grand Hall, Convention Center AAPM is trying something new this year with the Tuesday night social program.

Philadelphia offers many great restaurants and clubs within walking distance, so this year we’re providing you with a perfect way to meet up with your colleagues before heading off to dinner. The Midweek Mixer will immediately follow the afternoon Tuesday sessions. Head to the Grand Hall for appetizers and beverages. Arrange to meet with friends in one of the four brightly marked quadrants: Green Bar - The Bath Item Gift Hypothesis Yellow Bar - The Hofstadter Isotope Red Bar - The Work Song Nanocluster Blue Bar - The Lizard-Spock Expansion

If you haven’t already made restaurant reservations, we’ll have four reservations desks with concierges ready to assist.

Midweek Mixer Ticket Prices: Adult $30 Ages 12 -20 $15 Ages 3 - 11 $10 Ages 2 and under free

Please note: Each adult Midweek Mixer ticket will include 1 drink ticket, good for beer or a glass of wine. Once your ticket is used, cash will be accepted. No tickets required for soft drinks.

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President-Elect’s Column J. Anthony Seibert, UC Davis Medical Center

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ver the past several months I have represented the AAPM at the Council of Radiation Control Program Directors in Newport, Rhode Island, the AAPM-sponsored CT dose summit in Atlanta, Georgia, and a day with the Nuclear Regulatory Commissioners in Washington D.C. (See the comments by Mike Herman in his newsletter column). In addition, my colleague, John Boone and I worked with lawmakers in the state of California regarding pending legislation on the issues of dose reporting in computed tomography – with the effort of including the role of the medical physicist in the legislation. Indeed, it has been a busy spring.

Highlights of the CRCPD meeting – I was honored and proud to attend the 42nd Annual National Conference on Radiation Control, where the theme was “Opportunities and Innovations in Radiation Protection.” The AAPM pre-meeting training session, coordinated by Melissa Martin and Lynne Fairobent, featured the clinical needs, current procedures, and regulatory requirements for practice and oversight of a brachytherapy program. Certainly this was a very timely topic of much interest to the state regulators and all attendees, particularly given the attention to current events regarding misadministration of sources in brachytherapy procedures. Attendance was excellent, as were the presentations by all AAPM members. Speakers included Melissa Martin, Ralph Lieto, Mary Fox, Ileana Iftimia, Eileen Cirino, Jessica Hiatt, Herb Mower, and Bruce Curran. Congratulations and sincere thanks are due to their fantastic effort in this very valuable and close interaction between the CRCPD and AAPM. Lynne Fairobent and Amanda Potter provided excellent support and coordination of AAPM activities throughout the meeting.

On another issue, representatives from the AAPM met with CRCPD member representatives responsible for the implementation of recommendations regarding the approval and registration requirements of medical physicists, Part ZZ. These documents are used by the states as examples to implement regulations, rules, and guidelines based upon their content. AAPM’s goals are to establish consistent definitions of the Qualified Medical Physicist (QMP) and subspecialties therein, as defined on the AAPM website, while the language in the initial draft of the Part ZZ document were incompatible with that definition and not stringent enough regarding the qualifications and experience of “approved” medical physicists. Interactions of AAPM representatives led by Melissa Martin, and input from Doug Pfeiffer, Herb Mower, Ralph Lieto and other physicists at the table with the CRCPD committee resulted in very fruitful discussions, and a re-editing of the Part ZZ draft document to conform more closely to the QMP definition, along with more stringent requirements on experience and “grandfathering” to the extent possible. In short, the continued CRCPD – AAPM interactions and collaborative efforts are extremely important and beneficial – one might say “priceless” – to our membership.

Finally, medical physicist John McCrohan from the FDA delivered the John C. Villforth Lecture on “Imaging Patients Bill of Rights” in which he spoke about medical imaging procedures chiefly focused on computed tomography scanning and patient safety issues. Three main themes were promulgated: (1) Justification; (2) Optimization; (3) Oversight, all of which fall largely under the purview of the diagnostic medical physicist in facilitating improvements and initiatives for the care and safety of the patient. Justification for performing any exam should be based on appropriateness criteria and awareness of the patient’s specific situation and needs. Optimization involves calibration of equipment, verification of image quality / dose information, implementation of procedures that can reduce unnecessary radiation exposure, and maximizing the benefit - risk ratio to the patient. Oversight at the facility level includes medical physicist education and training,

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Two opportunities to serve the community during the AAPM Annual Meeting in Philadelphia

Philabundance Service Project (no on-site registration)

Philabundance is the Philadelphia region’s largest food bank and hunger relief organization. AAPM wishes to serve the community by enlisting volunteers who will sort and pack food at a local food bank on Saturday, July 17. This is an excellent opportunity to catch up with colleagues while you work to help others. Transportation will be provided from the Philadelphia Marriott 12th Street entrance promptly at 8:30am Saturday morning. No on-site registration.

Registration is free: http://www.aapm.org/meetings/2010AM/GenInfo. asp#service

American Red Cross Blood Drive

Tuesday, 10:00am-3:00pm Exhibit Hall B Make your appointment online to donate blood. http://www.aapm.org/meetings/2010AM/GenInfo. asp#blood All blood donors will receive a pin to wear proudly on their meeting badge.

Not only will you save a life with your blood donation, but from July 1st through September 12th, 2010 all presenting donors who donate blood at an American Red Cross Penn-Jersey Region blood drive will be entered into that week’s drawing to win a $250 GiftCertificates.com SuperCertificate® redeemable for $250 worth of gift certificates from hundreds of stores, hotels, airlines, theaters and more. You will also be entered to win the Grand Prize giveaway of a $2,500 GiftCertificates.com SuperCertificate®!

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continued - AAPM President-Elect’s Column evaluation of periodic quality control and performing annual physics testing, review of acquisition protocols, assistance in the implementation of an accreditation program, and participation in verification and recording of radiation doses with contribution and comparison to a future National Dose Registry. Cooperation with the FDA in providing expert testimony and response to specific questions on CT is ongoing, and the AAPM is backing the presence of medical physicist input and participation with the recognized accreditation bodies for advanced imaging modalities recently announced through the Medicare Improvements for Patients and Providers Act (MIPPA) changes affected in January 2010.

CT Dose Summit in Atlanta – Carrying on the theme of computed tomography, the CT Dose Summit meeting on “An interdisciplinary approach to optimizing image quality and managing patient dose” was simply outstanding, with kudos and congratulations going to program directors Bill Hendee, Cynthia McCollough, and Dianna Cody for a very informative program, and showcasing the AAPM as the leading organization along with the Medical Image Technology Alliance (MITA) and the American College of Radiology as cosponsors in taking action with regards to Program Organizers (L - R): Bill Hendee, Dianna Cody, John Boone, Cynthia McCollough and Tony Seibert the issues confronting CT and need for optimization from the perspectives of clinical use, technical quality, radiation dosimetry, patient protocols, regulatory oversight, accreditation, and futures. For you members that didn’t get a chance to attend, the content of the presentations is posted on the AAPM website, at http://aapm. org/meetings/2010CTS/ProgramInfo.asp . I strongly encourage those of you with responsibilities in the oversight of computed tomography to browse through the materials – your time will be well spent. Soon, upon completion of the audio track / powerpoint production, free access to the presentations with synched audio will be available to AAPM members via the AAPM virtual library. In addition, CT scanning protocol examples, initially beginning with CT perfusion, will soon be posted on the website for access by members. These are just a few of the services provided to you, the membership, by the altruistic volunteerism of fellow members of the AAPM and the diligent support of the headquarters staff.… definitely, we all benefit.

Taking action……. My colleague John Boone and I were contacted by the California Radiological Society in early May regarding proposed legislation on radiation safety and CT (Senate Bill 1237, Padilla) with amendments suggested regarding dose index reporting for computed tomography scanners beginning in 2012. Although I was unable to attend, John met with 8 state regulators and legislative staff / lobbyists to discuss the bill; the original language was clearly deficient and did not include the role of the qualified medical physicist (diagnostic QMP). Given a total of 2 hours to respond, John crafted some suggested language below that I also had a chance to review prior to delivering to the staff of state Senator Padilla: The CTDIvol should be displayed on the console of all CT scanners, if this is technically feasible for that make and model of scanner. The reference CTDIvol should be verified to be accurate to within 15% by a qualified medical physicist* (QMP) on an annual basis.

Verification should be performed for both a standard body (abdomen) CT protocol and a standard head CT protocol. If the displayed (reference) CTDIvol accuracy is off by more

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continued - AAPM President-Elect’s Column than -15% or +15%** for either the head or the body protocols, the equipment shall be re-serviced and the dose index again verified, or a correction chart shall be generated and posted at the machine’s control panel. The indicated reference values shall be measured using the computed tomography dose index - volume (CTDIvol), as defined in AAPM*** Report 96, “The Measurement, Reporting, and Management of Radiation Dose in CT”. If major maintenance that could affect radiation output is performed, or when any major change in equipment operation, including but not limited to the introduction of a new software package, occurs, indicated CTDIvol dose index values should be reverified within 10 days of CT scanner operation. * QMP as defined at AAPM website: http://aapm.org/medical_physicist/fields.asp ** accuracy = 100% x (reference value - measured value) / measured value *** http://www.aapm.org/pubs/reports/ Ideally, this recommended language would certainly benefit from the “official” review and vetting

by Science Council, Professional Council, and the Government and Regulatory Affairs Committee (GRAC) from the perspective of ensuring appropriate and consistent language, and also have the backing of the AAPM to provide enhanced legitimacy to the recommendations. On the other hand, when asked for input it is our individual responsibilities as medical physicists to take action when there is insufficient time to get feedback, and to provide recommendations indicating the need for oversight by a qualified medical physicist for the improvement of patient safety and care.

As for updates to the current bill, although amendments were made, the recommended language offered above regarding the medical physicist was not included; however, there might still be another opportunity during committee review prior to a vote for adoption, which will likely occur within the month. This is being pursued.

Thanks, and looking forward to Philadelphia – In conclusion, I would like to thank the Penn-Ohio Chapter officers and members for their gracious hospitality during my visit to the 2010 Spring Dinner Meeting in Warren, Ohio on May 7. It is very gratifying to touch base with members and to listen to the discussion regarding scientific, clinical, educational, and professional issues at the grass roots level in different regions of the country. This allows me to gain a sense of the membership, and gives me a perspective in sharing many of the issues at the highest levels within the Executive Committee. Finally, I look forward to the annual meeting in Philadelphia, and conversing with many of you. As always, please feel free to contact me through the AAPM website or at my email, jaseibert@ucdavis.edu.

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AAPM Executive Director’s Column Angela R. Keyser, College Park, MD 2009 Professional Survey

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he 2009 Professional Survey is available online only. You can download a PDF from the web at http://www.aapm.org/pubs/protected_files/surveys/ AAPM-Salary09.pdf or have the document emailed to you from the following site: http://www.aapm.org/AAPMUtilities/download.asp?file=surveys/AAPMSalary09.pdf. If you have any problems, please contact HQ. Annual Meeting News • For many years, continuing education sessions have been held between 7:30 and 9:30 AM, with scientific sessions following. In 2010, on Tuesday and Wednesday, some educational sessions will take place later in the day and some science tracks will begin at 7:30 AM. • Visit the Vendors! Make sure to block out time in your Annual Meeting schedule to visit the Exhibit Hall. An online Buyers Guide is available at: http://www.aapm.org/meetings/2010AM/ BuyersGuide.asp. A list of companies exhibiting is posted online. Hours: • Sunday, July 18 – 1:00 – 5:30 PM • Monday, July 19 – 9:30 AM – 5:30 PM • Tuesday, July 20 – 9:30 AM – 5:30 PM • Wednesday, July 21 – 9:30 AM – 1:00 PM • AAPM is partnering with the American Red Cross to sponsor a Blood Drive on Tuesday, July 20 from 10AM – 3PM. Please consider donating! You can schedule an appointment online at: http://www. membersforlife.org/pennj/schedule/login.php?sponsorcode=14602.

• New this year is the Tuesday night Mid-Week Mixer which will immediately follow the afternoon Tuesday session and will include appetizers and beverages. Philadelphia offers many great restaurants and clubs within walking distance of the convention venue. If you haven’t already made restaurant reservations, we’ll have four reservations desks with concierges ready to assist.

This is the way to meet up with your colleagues before heading off to dinner.

• The 2010 Annual Business Meeting will follow the Town Hall meeting in Room 201B and will include a discussion of proposed Bylaws changes and a dues increase proposal. The proposed Bylaws changes and the dues increase proposal will then be voted on by the membership in the fall.

Use the online Meeting Planner at http://www.aapm.org/meetings/2010AM/MeetingProgram.asp to generate your personal meeting schedule by compiling sessions, talks and committee meetings you plan to attend into a single chronological document. You must be logged in to the abstract system to use the Meeting Planner. Then, compile your schedule, download the .vcs file to import to your PDA, or print it out as a reference. If the time of your meeting, session or talk changes, the planner automatically updates your personal schedule. A specially formatted mobile program now available for iPhone, BlackBerry, etc. at the following site: http://www.aapm.org/m/mtg/ Selected speakers have been asked to provide handouts for their presentations. The speakers will either provide the handout for posting on the website pre-meeting or at show site, to be posted following the meeting. Please check the Handout site for the progress on submissions.

Scientific registrants will be given lunch bundle coupons with their badge and other registration materials. These complimentary coupons are good for lunch in Hall A on both Monday and Tuesday.

Make plans to eat lunch in the exhibit hall on these days between 11:30 AM -1:30 PM, and visit with the AAPM exhibitors.

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Education

July/August 2010

AAPM staff members realize the amount of waste created by a single meeting. Most green ideas cost nothing extra, and some even save our association money. Our efforts to be more environmentally responsible include the following: • AAPM does not produce any promotional postcards or brochures; all meeting program information can be found on-line.

• The Pennsylvania Convention Center’s caterer, ARAMARK, uses multiple products that are costeffective as well as sustainable. Greenwaves, Eco-Products, and EATware provide full product lines of 100% decomposable and biodegradable materials. All lines conform to FDA requirements and are made from 100% Bamboo, corn starch, paper, and other natural fibers.

• Brede Exposition Services, our official service contractor, produces signs on reusable Sintra plastic.

Brede reuses, and then recycles miles of carpet. Aluminum and cardboard from the show floor is recycled.

• Philadelphia is ranked one of the top ten green cities by SustainLane.com.

2010 Summer School Make sure to register for the 2010 AAPM Summer School, Teaching Medical Physics: Innovations in Learning, to be held immediately follow the Annual Meeting, July 22 – 25 at the University of Pennsylvania. This 2.5 day program is designed to help medical physicists become better teachers of physicians, graduate students and technologists. Highlights of the program include presentations by four academic physicists who are widely recognized as master teachers, a national expert on problembased learning and a radiologist who is highly recognized as a masterful speaker. Each participant will leave with an action plan he or she has designed to be a better teacher.

Staff Recognition Part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of highperforming professionals. The following AAPM team members celebrated an AAPM anniversary in the first half of 2010. I want to publicly thank them and acknowledge their efforts.

Nancy Vazquez Jennifer Hudson Zailu Gao Cecilia Hunter Karen MacFarland Lynne Fairobent Lisa Giove Laurie Hayden Onasis Budisantoso Ramy James Amanda Potter

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14 years of service 9 years of service 9 years of service 7 years of service 7 years of service 6 years of service 5 years of service 3 years of service 2 years of service 2 years of service 2 years of service

Therapy Physics

AAPM Newsletter

July/August 2010

Editor’s Column

Mahadevappa Mahesh, Johns Hopkins University

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hile writing my column this morning, I recalled a recent radio interview with William Powers regarding his book ‘Hamlet’s Blackberry’.

In his book, Powers argues that individuals need to pull the plug once in a while and escape from the world of connectivity. One way of doing so is to have, what he calls, an ‘Internet Sabbath’. He and his family strictly follow this philosophy by not connecting to the internet on the weekends. Seeing as though we are currently in the age of an information explosion, we can never get enough of or away from the internet, this is a very interesting point of view. A short time ago, I also heard that many IT companies are letting their employee’s have downtime from the world-wide-web in hope that it will increase their productivity. In fact, I often sit far away from my desk (no outside connection) and even away from my office when I write and find it very helpful. Any way, as we all struggle to manage our time and still gather the maximum amount of information, I think reading this newsletter regularly is one good source to gather the most information about our profession. In this issue, there are many interesting articles from the EXCOM about the recent activities of the AAPM, both locally and nationally. Also, I would like to draw your attention to the ‘Persons in the News’ section listing recent accolades of many of our members. Finally, I wish all of you a happy summer and look forward to seeing many of you in Philadelphia at the annual meeting.

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AAPM Newsletter

July/August 2010

Education Council Report George Starkschall, Houston, TX

S

ometimes I feel like a broken record, chanting the mantra of the three fields of activity of a medical physicist: clinical service, research and development, and teaching. Even though we believe this to be true (we even say as much on the AAPM website http://www.aapm. org/medical_physicist/default.asp), the fact is that very few of us get compensated explicitly for our teaching activities. As part of our routine responsibilities, we are often expected to provide didactic teaching to graduate students, medical residents, allied health students, etc., and clinical instruction to medical physics residents; however, how often is the educational component of our time explicitly identified in our departmental budget?

Or are the resources we expend in education folded into our clinical and research time? Or are our educational activities, no matter how extensive, identified as an additional uncompensated responsibility, adding additional hours to the very long day of the medical physicist?

One might argue that if we explicitly identified the true cost of our educational efforts to our institutional leadership, they may come to the conclusion that education was not something worth pursuing. Is this a situation that is conducive to good education, however? Are we really saying that education is fine as long as we don’t have to expend any resources to support it? Would it not be better to provide education in an environment in which its value is recognized by its leadership and this recognition is demonstrated by financial support? If, on the other hand, education is identified as a line item in a budget, and the true costs of education are explicitly identified, then education is being perceived as something of value. Because an administration may be allocating a substantial amount of resources to supporting educational activities, it needs to track where these resources are going, and is more likely to be interested in and supportive of education. More importantly, one would hope that as a consequence of explicitly paying for education, an administration will demand accountability and insist that the quality of education provided is worth the expenditure.

The old saying,”You get what you pay for” holds when it comes to education. If you pay nothing for education, then either you will get nothing, or you will perceive it as nothing, or both.

If you plan to attend the 2010 Annual Meeting, please be sure to attend some of the presentations related to medical physics education. The Education Council Symposium, chaired by Perry Sprawls, will be held in Room 201B of the Convention Center from 11 am to 12:30 pm on Sunday, and will address web-based resources in the teaching of medical physics. The Innovations in Medical Physics Education session, chaired by Don Frey, will be held in Room 203 of the Convention Center from 4 pm to 5 pm on Wednesday, and will consist of six proffered oral presentations on various innovative concepts in medical physics education. Several Educational posters will be on display in the Exhibit Hall and the Education General Poster Discussion will be held from 3 pm to 4:30 pm on Sunday. Finally, I want to remind you of the 2010 AAPM Summer School, Teaching Medical Physics: Innovations in Learning, to be held on the campus of the University of Pennsylvania immediately following the Annual Meeting. The Summer School, organized by Bill Hendee, is designed to enable participants become better teachers of medical physics, and will consist of didactic presentations as well as audience participation and break-out sessions.

The AAPM is providing many opportunities this summer for medical physicists to improve the quality of the education they provide; I hope to see many of you at the Annual Meeting and at the Summer School.

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AAPM Newsletter

July/August 2010

Therapy Program Includes:

Imaging Program Includes:

Scientific Symposia

Scientific Symposia

• Secondary Cancer Risks

• •

• •

• •

• Advances in CT Dose Reduction and Dose

The Use of GPUs in Radiation Therapy Machine Learning Techniques for Radiation Therapy Nano-Cancer and Radiation Therapy Multicriteria Optimization to Handle Multiple Tradeoffs in Treatment Planning and Delivery The Science of Quality Improvement Technical aspects of SBRT

• • • •

•

• •

Proffered Abstract Submissions

Measurements Advances in Breast Imaging Advances in MRI Advances in Image Guided Interventions New Trends for Translating Emerging Imaging Technology to Address the Cancer Problem Physics in the Evolution of Contrast Agents in Ultrasound Emerging X-ray Imaging Techniques Advances in Cardiovascular Imaging

• Adaptive RT

• •

• •

• • • • • • • •

Brachytherapy Electron Therapy – Advanced Planning and Delivering Techniques IMRT Informatics - Infrastructure and QA; Quality

Management Measurements Monte Carlo (photon, electron, particles) Outcome Modeling and Design of New Clinical Trials Particle Therapy – Planning and Delivery Radiobiology - Treatment Planning and Evaluation Specialized non-IMRT Photon Techniques Stereotactic Radiosurgery and Radiotherapy Tx Planning and Delivery

More than 50 hours of continuing education in medical imaging and radiation therapy physics will be offered. This will include SAMS courses for diagnostic, medical nuclear, and radiation therapy physicists. www.aapm.org/meetings/2010AM

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Proffered Abstract Submissions • CAD

• • •

• •

• • • • • • • • • •

Computed Tomography Display and Pacs Dosimetry, Radiation Protection, and Quality Control (Imaging) Fluoroscopy Image Registration, Fusion, Segmentation, and Visualization Image Science Magnetic Resonance Imaging Mammography Multi-Modality Imaging Non-Conventional Imaging Nuclear Medicine Optical and Other Imaging Radiography Ultrasound Vascular, Endovascular, and Cardiac Imaging

AAPM Newsletter

July/August 2010

Professional Council Report Per Halvorsen, Newton, MA

Challenges and opportunities As most of you probably know, the profession is facing a large number of challenges simultaneously this year – and many of these challenges represent some of the best opportunities for substantive changes in a long time.

To name a few: • Mainstream media coverage of errors in x-ray based imaging and therapy procedures, focusing a spotlight on the lack of standards whether in the realm of training, delineation of duties (scope of practice), clinical procedures, or quality assurance.

• Hearings and consideration of new regulations/legislation by Congress, FDA, NRC, and state legislatures.

• Implementation of the accreditation requirements of the 2008 MIPPA law for imaging.

• ASTRO joining the ACR’s radiation oncology accreditation program and proposing stronger standards for accreditation.

• ABR’s upcoming requirement for clinical residency training.

• CARE bill receiving new momentum from the recent media coverage of errors.

Your volunteer colleagues within the AAPM have been actively engaged in all these issues, and we hope this opens a window of opportunity to finally achieve a strong, consistent standard for clinical medical physics in the United States.

At the same time, we’re actively evaluating how to best structure the Association to meet these challenges and improve the professional practice environment for all of us. In April, a representative (hence diverse) group of AAPM members met for a 2-day Strategic Planning session to consider both the “external and internal environments” and reach consensus on some core strategies for the Board’s consideration. The group’s report should be ready for the Board’s consideration when it meets in Philadelphia. We are also actively discussing with the leaders of the ACMP how we can better coordinate our efforts for maximum effect. Finally, the integration of the new Administrative Council is proceeding very well, with the Professional Council and Administrative Council leaders collaborating to ensure a smooth transition.

In short, we are evaluating structural and strategic “tweaks” in parallel with the responses to the professional practice issues listed above, and I firmly believe the Association and the profession will be better for it.

Collaboration within AAPM and with other societies The four Councils within the AAPM have actively collaborated to testify in the Congressional hearing on radiation in medicine, and the FDA public hearing in early June on radiotherapy safety. The AAPM was represented at the June FDA hearing by Jim Galvin from Science Council, Mike Herman from Excom, and Per Halvorsen from Professional Council. Leaders of all four Councils were involved in preparing the testimony for the hearing. Similarly, the AAPM has coordinated closely with ASTRO, ACR, RSNA, ACMP, ASRT, HPS, CRCPD, MITA and others to prepare for the hearings and to arrange the “CT Dose Summit” in April and the “Safety in Radiotherapy Meeting” which will be held June 24-25 in Miami. Hopefully this period of active collaboration will lead to closer relations on many issues where we have shared goals.

See Lynne Fairobent’s Government Relations article on page 19 in this Newsletter, and the eNews updates, for an overview of legislative and regulatory developments. The licensure initiative is proceeding well, with active consideration in at least three states. A state-by-state effort is unfortunately necessary, since professional licensure is a “state right” – our physician, nurse, and technologist/therapist colleagues followed the same path many years ago. The licensure subcommittee is under the Government and Regulatory Affairs Committee (GRAC), which was transferred to the Administrative Council in January – of course, we still have a strong interest in the subcommittee’s progress as it was initiated within the Professional Council and will have a direct impact on the professional practice environment.

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AAPM Newsletter

July/August 2010

continued - Professional Council Report Another “ABR wrinkle” Judging from recent comments on the (unaffiliated) medphys “list server”, many students and new professionals have encountered problems this year in qualifying for the ABR Part I examination, owing to the new requirement for three medical physics courses and one biological science course if the candidate is not enrolled in, or a graduate of, a CAMPEP-approved medical physics graduate degree program.

Though the unaffiliated list server is a convenient forum for expressing one’s opinion, please remember that it is not affiliated with either the AAPM or the ABR. Hence, statements to the effect of “the AAPM should do something” or “the ABR should reconsider” will likely go unanswered if the list server is the only forum where these opinions are expressed. If you or a colleague are experiencing difficulties with the ABR exam admission requirements, please contact the ABR directly (http://www.theabr.org/about/contact.html), and if you do not receive appropriate guidance from the ABR staff, feel free to contact one of the ABR Physics Trustees directly. They are your professional colleagues and care deeply about the profession and their colleagues – this is absolutely not an “academic exercise” but is a concerted effort to raise the professional standard for clinical medical physics. As such, they want this transition to succeed for everyone involved.

Money matters: Though we’ve mentioned it before, it bears repeating: As you know, the Association has limited resources and cannot support all projects simultaneously. In November, the Board approved the budget for 2010 with significant reductions in funding for many Council and Committee level activities, prompted by the membership’s rejection of a proposed dues increase. I encourage you to look carefully at each Council’s projects and voice your opinion on whether we have prioritized correctly – we are all volunteers, and welcome your constructive criticism and suggestions for how we can do a better job with the resources available to us. If we are to continue without any dues increase in the foreseeable future, further cuts in projects and existing programs will surely be necessary in 2011.

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AAPM Newsletter

July/August 2010

Legislative and Regulatory Affairs Lynne Fairobent, College Park, MD

NRC Releases SECY-10-0062: Reproposed Rule: Medical Use of Byproduct Material – Amendments/Medical Event Definitions (RIN 3150-AI26) n the August 6, 2008 Federal Register (73 FR 45635) NRC initially proposed a rule to amend 10 CFR Part 35 related to reporting and notification of medical events and to clarify requirements for permanent implant brachytherapy. NRC received a total of 57 comment letters. Many of the comments were form letters with identical language. Most of the comments were from medical universities, hospitals, private physicians, and professional organizations representing the medical community. The comments were primarily not supportive of parts of the rulemaking.

I

NRC has had the final rule on hold due to the substantial number of medical events that were reported to the NRC during late summer and early fall of 2008. NRC staff has been reviewing and analyzing the circumstances of, and data from, these events. Based on its evaluation of this information, including an independent analysis by an NRC medical consultant, the NRC staff believes that a number of medical events that were reported in 2008 would not be categorized as medical events under the proposed rule published on August 6, 2008. NRC staff believes this is inconsistent with the original regulatory intent, which was to clarify the requirements for permanent implant brachytherapy so that licensees would be able to identify medical events more easily and in a more timely manner. An unintended effect of the proposed rule would have been that some significant events would not be identified, categorized, and reported as medical events. Additionally, the evaluation of the circumstances and data from the substantial number of medical events reported in 2008 prompted the staff to reevaluate the regulations related to training requirements and time frames for licensees to assess the dose to the treatment site for permanent implant brachytherapy.

Therefore, the proposed rule language and rationale have been modified to reflect this new information and the NRC staff is recommending that the Commission publish the revised proposed rule for public comment.

The reproposed rule would amend the current regulations by: 1. adding activity-based criteria for defining some medical events for permanent implant brachytherapy; 2. adding a requirement to report, as a medical event, any administration requiring a written directive (WD) if a WD is required and not prepared, and documentation in medical records or licensees’ standard written procedures that existed prior to the administration is insufficient to determine if a medical event has occurred; 3. clarifying requirements for WDs for permanent implant brachytherapy; 4. adding a requirement that licensees provide and document training to their staff on the requirements of § 35.3045; 5. adding a requirement that licensees must assess the dose to the treatment site no later than 60 days from the date that the patient leaves the post-treatment recovery area; and 6. making certain administrative and clarification changes.

The reproposed rule would facilitate the ability of medical licensees to recognize some medical events in permanent implant brachytherapy earlier and, therefore, be able to take corrective actions sooner than under current regulations. These changes to the regulations are based in part on recommendations from the ACMUI as well as the staff’s evaluation of the circumstances of, and data from, the substantial number of medical events reported in 2008.

SECY-10-0062 provides the staff’s recommendations to the Commission. Included in the draft staff paper are: the comments received on the proposed rule published on August 6, 2008, and the changes made to the proposed rule as a result of the evaluation of the circumstances of and data from the substantial number of medical events reported in 2008, are discussed in detail in the draft Federal Register Notice. Additionally, per SRM-COMSECY-09-0026, “Request For Rebaselining of Medical Event Definition Rulemaking to Reflect Recent Veterans Administration Experience” changes made to the proposed rule language published on August 6, 2008, are highlighted in Rule Language Changes.

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AAPM Newsletter

July/August 2010

continued - Legislative and Regulatory Affairs The Commission has scheduled a hearing on July 8th to discuss the staff’s recommendations and to hear input from the stakeholder community. AAPM has been invited to testify. After the Commission briefing, the Commissioners will vote on issuing the reproposed rule.

If you have any questions, please contact Lynne Fairobent, AAPM’s Manager of Legislative and Regulatory Affairs at lynne@aapm.org.

NRC Issues Proposed Rule – Part 37 (75 FR 33901) Physical Protection of Byproduct Material; Proposed Rule On June 15th, NRC issued a proposed rule 10 CFR Part 37, Physical Protection of Byproduct Material; Proposed Rule in the Federal Register.

The purpose is to amend NRC regulations to establish security requirements for the use and transport of category 1 and category 2 quantities of radioactive material, which the NRC considers to be risk-significant and therefore to warrant additional protection. Category 1 and category 2 thresholds are based on those established in the International Atomic Energy Agency (IAEA) Code of Conduct on the Safety and Security of Radioactive Sources, which NRC endorses. The objective of this proposed rule is to provide reasonable assurance of preventing the theft or diversion of category 1 and category 2 quantities of radioactive material. The proposed regulations would also include security requirements for the transportation of irradiated reactor fuel that weighs 100 grams or less in net weight of irradiated fuel. The proposed rule would affect any licensee that is authorized to possess category 1 or category 2 quantities of radioactive material, any licensee that transports these materials using ground transportation, and any licensee that transports small quantities of irradiated reactor fuel.

This rulemaking will codify the requirements in effect via specific orders issued to licensees with category 1 and category 2 sources.

The proposed rule and additional information can be found at www.regulations.gov at NRC 2008-0120. Comments are due to NRC October 15, 2010. Comments specific to the information collection aspects of this proposed rule are due to NRC July 15, 2010.

In addition to the proposed rule, NRC has posted the following documents at www. regulations.gov NRC 2010-0194: Draft Implementation Guidance, Draft Regulatory Analysis and EA and FONSI for review and comment.

NRC plans to hold two public meetings or workshops on the rule and guidance. These are tentatively scheduled for September 1 in Austin TX and September 20 in Rockville.

If you have any questions, please contact Lynne Fairobent, AAPM’s Manager of Legislative and Regulatory Affairs at lynne@ aapm.org.

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AAPM Newsletter

July/August 2010

ACR Accreditation

Priscilla F. Butler, Senior Director ACR Breast Imaging Accreditation Programs

ACR Accreditation: Frequently Asked Questions for Medical Physicists Does your facility need help on applying for accreditation? In each issue of this newsletter, I’ll present frequently asked questions (FAQs) of particular importance for medical physicists. You may also check out the ACR’s accreditation web site portal (www.acr.org; click “Accreditation”) for more FAQs, accreditation applications and QC forms.

T h e ACR’s new CT, MRI, Nuclear Medicine and PET Accreditation Program requirements for medical physicists and MR scientists went into effect on January 1, 2010. The following questions are actual ones received by the ACR regarding these new requirements. To see more FAQs on this topic, please visit the ACR website.

Q. If I am board certified, do I still need to document that I have 15 CME of credits in the last 36 months?

A. Yes. Upon renewal of the facility’s accreditation, medical physicists must meet these continuing education requirements regardless of how they met their initial qualifications (i.e., through the “Board Certification,” the “Not Board Certified in Required Subspecialty” or the “Grandfathered” options.)

Q. Must a medical physicist be able to show that he/she has obtained 15 CME in each accredited modality he/she surveys in the last 36 months?

A. No. The requirements state that the medical physicist must obtain 15 CEU/CME in the prior 36 months and they must include credits pertinent to the accredited modality. This allows the medical physicist flexibility to obtain continuing education that would most benefit their professional needs.

For example, a medical physicist may annually survey facilities with ACR accreditation in CT, MRI, nuclear medicine and PET. With the recent attention on CT dose, he/she decides to attend an 8-hour course on reducing dose in CT. With the prior 36 months he/she also obtains 4 hours in MRI, 2 hours in nuclear medicine and 1 hour in PET. Because the total is 15 hours in the prior 36 months and he has at least 1 hour pertinent to each accredited modality, this meets the ACR requirement.

This 2.5 day program is designed to help medical physicists become better teachers of physicians, graduate students and technologists. In addition to hearing several keynote speakers, participants will engage in work sessions where they will share experiences and learn from one another. Each participant will leave with an action plan he or she has designed to be a better teacher. There will be plenty of opportunity to interact with the Summer School faculty, who have been chosen for their teaching expertise. The Summer School will take place on the historic and scenic University of Pennsylvania campus. http://www.aapm.org/meetings/2010SS/

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AAPM Newsletter

July/August 2010

AAPM Website Editor Report Christopher Marshall, NYU Medical Center

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hope that you have all checked out the redesigned “Placement Service” section that I decided somewhat arbitrarily to rename the “Career Services” section. Although we may not keep the new name, the section itself is, at least in my opinion, greatly improved. Thanks are due to the IS group for pulling this together by squeezing time from their overloaded schedule. We had an exciting and long day rolling this one out! Unfortunately the underlying database uses obsolete technology and I know that the Placement Services Subcommittee is thinking hard about how best to move forward on that issue, which will require more than borrowed time.

The Medical Physics Journal platform is being revamped and the online interface to the journal content will change substantially and for the better. Once this is in place we will re-examine the portion of the AAPM website that relates to the Journal since the new interface will render portions of that redundant.

As the Annual Meeting approaches consider taking advantage of tools that the IS group rolled out to help you. You can view a mobile version of the meetings program on a smartphone and if you are active on committees you can assemble and edit your personal meeting schedule and import it to common calendar applications. Click on the “Philly When?” icon on the website to access the meeting website and these tools.

Here are some items “from the mailbag” – I usually receive a few comments from individual members after each report, and while I repond to all of them (although not always immediately) the issues are often relevant to a wider audience.

One member was thrilled with our RSS feeds. There are lots of ways for you to use feeds to keep posted on new announcements, new jobs postings and/or Medical Physics Journal articles. We also feed new jobs out to Twitter as they are posted. A different member reported that his institution blocked access to social networks including Twitter – but one could always use a smartphone or RSS in such situations. Yet another thought that access to our entire website was blocked by his institution which uses “Websense” to classify sites. Ours is classed as a “worker or professional” site and his institution generates a warning message as a result. While it did not block access, we all had visions of “Big Brother” keeping track of us. A member thanked us for the personalized announcements that appear if you are logged-in, including committee meetings, elections and upcoming chapter meetings, but another complained that his chapter meetings were not listed.

The meeting must first be registered on our website by your chapter, and we must know that you are a member of that chapter to provide the alert. Check your personal profile under “My AAPM” and direct your complaints to your chapter if necessary. A member reported that searches on our site such as DICOM 2010 pulled up a vast number of meeting abstracts; this turned out to be related to how the meeting abstract system keeps track of current abstracts and it has been addressed. We actually have an excellent search engine – the problems you may have with search are usually related to the way that items are named or the fact that pdf pages (like the Reports and the Newsletter) are not searchable except from within the pdf itself.

I do appreciate your comments – favorable or otherwise.

I hope that you find the Website useful, visit it often, and send me your feedback at http://www. aapm.org/pubs/newsletter/WebsiteEditor/3504.asp

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AAPM Newsletter

July/August 2010

New Professionals Subcommittee Report Jeffrey S. Wyler, New Professionals Subcommittee Member

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here are several career paths to take in Medical Physics: government, research, university-based, large clinic, small clinic, consulting. Our last article dealt with part-time consulting, this time we will take a look at consulting as a primary career.

One of the first decisions to make is to determine whether you will be a self-employed consultant or part of a consulting group. This will determine the direction of future decisions. If you go the self-employed route liabilities need to be addressed on both the professional and business realms. Count on maintaining professional liability insurance and looking into forming a business entity that provides protection, such as a limited liability corporation. Insurance and business formation are not cost-prohibitive, but they do add layers of complexity and require a time commitment to organization on a routine basis.

Regardless if you are self-employed or part of a group, you will be representing the field of Medical Physics and must balance patient needs with the demands of the contracted client. This may seem like the same situation as that posted to full-time employees, but it’s amazing how the need for job security can influence the decision making process. Juggling the expectations of the client, ethical behavior, and financial obligations is high-risk/high-reward. Financial reward is dependent on business acumen and work ethic. Ideally, you can cater your effort to your financial needs. Realistically, you will traverse lean times because of market conditions that you cannot control and because, as a small entity, you will be hard pressed to insulate yourself against these fluctuations. The reward of being your own boss cannot be overlooked, though. This perceived freedom is, to me, the primary reward for going the consultant route.

Legally, a better description for consultant would be independent contractor as this is how the IRS will classify it. Medical physics service groups can be set up many ways. Some groups “employ” medical physicists on a full or part time basis. They then may also provide these employees with benefits such as the ones that a medical physicist would have if he/she worked for a large institution. Or, the group, may “contract” for outside services with a medical physicist, provide no group benefits, and issue a 1099 to that physicist for tax purposes. One reason for doing the latter is, at least in some states, there are pension issues if one is an employer and has employees. The contract relationship between a physicist and a physics group or an institution such as a hospital is a complex issue. In the past, you could write a brief contract up, submit it to hospital management, and do your thing. Anymore, a very large, standard, contract, which needs to be modified to address specific services and fees, is supplied for every client. I prefer that the senior-most administrative person responsible sign the contract. You never know when you may have to refer someone to the contract signed by the Big Guy. There is currently a sub-committee in the AAPM with an assigned mission to develop helpful guidelines for drafting a contract.

Having discussed the organizational and professional responsibilities above, it would seem that being a consultant should be rather straightforward. My experience has shown me that a hard-working, ethical physicist is the exception instead of the rule. You have to look past the money portion of being a consultant and remember that we are professionals first and businesspersons second. Every minute of every day that you are consulting, you are representing your “brand” as well as that of consultants and Medical Physicists in general. It’s hard to think of your actions as advertisement, but the limited interactions you have with the clinical staff will leave a “brand” impression. In the traditional full-time employee role you will interact on many more levels with clinical staff: more meetings, after-hours social events, company functions, etc. You have many more opportunities and a more prolonged time frame to make positive impressions. As a consultant, the time frame to make positive impressions is generally limited to clinical hours. Do not let your “brand” impression turn into a caricature.

Choosing to become a full-time consultant brings added responsibilities to the already challenging role of Medical Physicist. Care should be taken to ensure that all required liabilities are addressed and that your bases are covered on the business side. Each of your actions will create the impression that not only your current clinic but also the Radiation Therapy community as a whole will have of you professionally.

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AAPM Newsletter

July/August 2010

Chapter News

Iris Z. Wang, President-elect, UNYAPM Chapter of AAPM Buffalo, NY

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he Upstate New York Association of Physicists in Medicine (UNYAPM, A Chapter of the AAPM) held its semi-annual meeting at Staybridge Suites, University of Rochester, on May 6th, 2010.

The meeting started with an invited talk by Mr. Will Wells from ViewRay Incorporated. As imageguided radiation therapy (IGRT) is becoming important for improving treatment accuracy in the new era of radiotherapy, engineers from ViewRay have been working on development of a novel MR-guided Cobalt-60 gamma ray radiotherapy unit. The design of the system was presented by Mr. Wells, which had drawn much interest from both therapeutic and diagnostic physicists in the audience.

The second annual Young Investigators Competition was then held in this spring meeting of UNYAPM, with six graduate students from University at Buffalo and Roswell Park Cancer Institute participating. The young investigators showcased a broad spectrum of scientific or clinical-related research projects, all in good quality of work. The seven topics presented were: External beam dose perturbation from non-radioactive I-125 seeds: film and Monte Carlo measurements, by J. Steinman; High resolution CCD based micro-angiographic fluoroscopic x-ray detector in single photon counting mode for radionuclide imaging, by A Panse; Reduction of effective dose using region-of-interest techniques for neuroangiography, by K. Gill; Loss of biological effects from prolonged treatment times for sliding window IMRT versus VMAT treatment techniques, by J. Schmitt; Study of the effect of the line-focus principle on generalized MTF for the microangiographic fluoroscope (MAF) system, by S. Gupta; Influence of water temperature during absolute calibration on patient dose delivery, and Risk of secondary cancer resulting from unaccounted exposures associated with Gamma KnifeŽ radiosurgery for the model 4C and Perfexion™, both

by T. Tran. The top-scored winner was Jonathan Schmitt, which was selected by three faculty judges for his impressive presentation discussing potential radiobiological differences between conventional IMRT and Volumetric Modulated Arc Therapy (VMAT). Dr. Michael Schell, president of UNYAPM, presented Schmitt with the certificate of Young Investigators Award in conclusion of the proffered paper session.

The closing session of the meeting was a panel discussion for Error Reduction in Radiation Oncology, moderated by Dr. Schell. This is the response of UNYAMP chapter to the recent New York Times article reporting some cases of error happening in radiation therapy. Dr. Janiki Krishnamoorthy from the New York State Department of Health (NYDOH) was invited as guest speaker to the panel discussion. She first introduced some statistics of misadministration cases reported to the NYDOH in recent years, which were lessons to all clinical physicists. This then lead to discussions of how these incidents can be prevented. The attendees agreed that actions should be taken in each individual clinic or hospital, such as, enforcing annual training with documentation of competency of the personnel, and re-evaluating all aspects of policy and procedures as technologies are changing. Physicists from different institutes exchanged their experiences and ideas of how to reduce error. Simulation training approach was brought up by the University of Rochester Medical Center staff and was discussed for its feasibility and value in radiation therapy personnel training. Some other discussions also included the involvement of government regulatory body, prevention initiatives by the vendors, and joint efforts with therapists and dosimetrists.

In the end, Dr. Schell proposed an Error Reduction Committee to be formed in the UNYAPM chapter. This committee will help to pool upstate regional resources together to identify means for reducing errors and initiate actions.

The next semi-annual UNYAPM meeting is scheduled for October 6th to be held at Roswell Park Cancer Institute, Buffalo, NY. As always, non-members are also welcome to attend. Details can be obtained from the chapter secretary, Dr. Ciprian Ionita (cnionita@buffalo.edu) and the chapter web site (www.UNYAPM.org).

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Chapter News

Steven Goetsch, Education Chair An Liu, President Bradford Krutoff, Past President

Southern California Chapter Names 2010 Norm Baily Award Recipients

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he Sixteenth Annual Norm Baily Student Awards were given at a Southern California Chapter meeting held at the UCLA Faculty Center on May 18, 2010. This year the awards were expanded in number from three to six and included three Graduate Student Awards and three Postdoctoral Fellow Awards in light of a record number of 16 abstracts received.

The three winners of this year’s awards Graduate Student awards are University of California San Diego student Carrie Yan Jiang (advisor Steve Jiang) “Real-time dose reconstruction for treatment monitoring”; San Diego State University Student Shawn Newlander (advisor Usha Sinha), “A diffusion tensor magnetic resonance imaging study to investigate changes in the white matter microstructure of the brain associated with APOE”; and UCSD student Zhen Tian (advisor Steve Jiang) “GPU-based iterative CT reconstruction via edgepreserving total variation regularization for dose reduction”.

(left to right): Carrie Yan Jiang, Shawn Newlander, Xuejan Gu, Chunhua Men, Zhen Tian, Xun Jia

The three winners of this year’s Postdoctoral Fellow Awards are all from UC San Diego, advised by Steve Jiang. They are Xuejan Gu “An accurate and efficient finite-size pencil beam based dose calculation engine for online adaptive IMRT replanning”; Xun Jia “GPU-based fast cone beam CT reconstruction from undersampled and noisy projection data via total variation” and Chunhua Men “A novel aperture-based algorithm for fast treatment plan optimization of volumetric modulated arc therapy”.

The 2010 Norm Baily awards include a certificate from Chapter President An Liu and an award of $500.00. These awards are given in memory of the late Professor Norm Baily of the University of California San Diego.

Chapter News

Jian Wang, President of ORVC Report of 2010 ORVC Spring Educational Symposium

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he 2010 Spring Educational Symposium of Ohio River Valley Chapter recently was held on Saturday, March 6th, at the University of Cincinnati Vontz Center for Molecular Studies. The Spring Meeting is dedicated to medical physics education. It is an opportunity for the graduate students, post-doctoral researchers, and residents within the Chapter to present their research.

The meeting program consisted of one Keynote Address and 11 student/trainee presentations.

The meeting attracted about 100 participants and over 20 vendor sponsors, both of the numbers are record highs for our Chapter.

Suggested by our Chapter members, starting from this year, our Keynote Address was named as James G. Kerieakes Keynote Lecture to honor our distinguished Chapter member James G. Kerieakes, Ph.D., FAAPM. Dr. Kerieakes is a professor emeritus of the University of Cincinnati and a pioneer of medical physics. He served as president of AAPM and received its highest

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continued - Report of 2010 ORVC Spring Educational Symposium awards, the William D. Coolidge Award and the Gold Medal. He had served various committees within the AAPM and other societies and received numerous awards. The meeting was honored with the attendance of Dr. Kerieakes and his wife Helen Kereiakes.

The first James G. Kerieakes Keynote Lecture was delivered by Cedric X. Yu, D.Sc., FAAPM. Dr. Yu is the endowed Carl M. Mansfield professor at the University of Maryland, and he gave a wonderful Keynote Address entitled “IMAT: Principles and Historic Perspectives.” Dr. Yu presented various aspects of Intensity-Modulated Arc Therapy (IMAT), including its history, principles, clinical implementation and QA, and future development directions. Dr. Kereiakes presented the plaque of James G. Kereiakes Keynote Lecture to Dr. Yu (Photo 1).

Eleven abstracts selected by the Executive Board of the Photo 1: James G Kereiakes Keynote Lecture Chapter were presented in the meeting. Each speaker plaque was presented to Dr. Yu L to R: Jian Z. was awarded a travel grant. A panel of judges was Wang (President), Michael S. Gossman, (PresidentElect), Cedric X. Yu and James G. Kereiakes appointed to select the top three best presentations.

Serving on the Judge Panel, were Ishmael E. Parsai, Ph.D., FACRO of the University of Toledo, Jerome G. Dare, Ph.D., FAAPM, professor emeritus of the Ohio State University, and Gregory E. Madison, M.S. of the Center for Cancer Care in WV. There were many strong presentations, with the followings taking the top honors: Qingya Zhao of Purdue University with “Impact/effect of respiratory motion in proton beam therapy with uniform scanning”, Jordyn Detwiler of University of Toledo with “Dosimetric Comparison of Three Multi-Lumen Brachytherapy Applicators with the Original MammoSite® Balloon Used in Partial Breast Irradiation (PBI)”, and Zhibin Photo 2: The ceremony of top presentations.

Huang, Ph.D. of the Ohio State University L to R: Michael S. Gossman (President-Elect), Zhibin Huang with “How Early Can We Predict the Outcome (3rd place), Ishmael E. Parsai (Judge), Qingya Zhao (1st place), Jordyn Detwiler (2nd place), Gregory E. Madison for Cervical Cancer during Radiation (Judge), Jerome G. Dare (Judge), Jian Z. Wang (President) Therapy?”. Qingya Zhao was awarded the 1st Place of Best Presentations - the ORVC Award, with Jordyn Detwiler and Zhibin Huang taking 2nd Place (IsoAid Award) and 3rd Place (Q-FIX Award) (Photo 2). The awards were named after the entity providing sponsorship for it.

The Symposium concluded with our Chapter Business Meeting. Items discussed including Chapter By-Laws revision, medical physicist state licensure, financial report and the Chapter fall meeting.

Michael S. Gossman, M.S., President-Elect, briefly summarized the rationale of Chapter ByLaws revisions and the ongoing poll for approval. We urged the chapter members to vote on this important Chapter document. Chapter Board Representative Howard Elson, Ph.D., updated the members regarding the state licensure of medical physicists and his survey on this issue at the beginning of this year. Michael Lamba, Ph.D., former Secretary/Treasurer and Rebecca Richardson, M.S., current Secretary/Treasurer, gave a report regarding the Chapter’s current

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continued - Report of 2010 ORVC Spring Educational Symposium financial standing. The Chapter treasury remains healthy as a result of good turnouts from the recent meetings. Jian Wang, Ph.D., President, briefly discussed the arrangement of the Chapter fall meeting and will solicit a hosting institute and decide the date shortly after this meeting.

On the evening of March 5th, a night-out of the symposium was organized for our Chapter members, which was sponsored by Varian Medical System, Inc. Before the night-out event, Chapter members had the opportunity to join the Varian Brachytherapy User Meeting held earlier in the evening. The clinical forum was titled “Ohio River Valley Learning Symposium for Accelerated Partial Breast Irradiation (APBI) Latest Treatment Solutions and Rational” and hosted by Varian Medical Systems, Inc. In conclusion, I would like to extend a big thank you to President-Elect Michael S. Gossman, M.S. his outstanding efforts securing vendors and financial backing for the meeting as it was instrumental in the success of the Symposium. Rebecca Richardson, M.S. (Secretary/Treasurer) and Michael Lamba, Ph.D. (former Secretary/Treasure) both deserve acknowledgement for their tireless work coordinating the meeting arrangements and on-site details at the University of Cincinnati. Matthew Meneike, Ph.D. (Past President) and Howard Elson, Ph.D. (Chapter Board Representative) also provided valuable guidelance and contribution to the success of this meeting. Finally I would take this opportunity to acknowledge the generous support of the following corporate participants: Platinum sponsor: Varian; Golden sponsors: Isoaid and WFR Aquaplast/Q-fix; Silver sponsors: Acceletronics/RadParts/TheraView, Best Industries/CNMC Company,

BrachySciences, IBA Dosimetry, Integra/Radionics, IsoRay, LACO, Nelco

Worldwide, Nucletron, Philips, PTW, Resonant Medical, Siemens OCS,

Sun Nuclear, Tomotherapy

2008 AAPM-IPEM Travel Grant Report Jean Moran, PhD Department of Radiation Oncology University of Michigan Medical Center

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t was an honor to receive the travel grant from the Institute of Physics and Engineering in Medicine and the American Association of Physicists in Medicine. Thanks to the generosity of the grant, I visited several centers in the United Kingdom to learn about their research, clinical, and educational programs in medical physics in June 2009. Throughout my trip, I was warmly welcomed to each center by my UK colleagues.

Belfast City Hospital I began my trip to the United Kingdom in Belfast, Northern Ireland. On Sunday, I enjoyed a journey along the coastal route of Northern Ireland, courtesy of Alan Hounsell and Conor McGarry. We had a beautiful clear, sunny, warm day. I was assured throughout my trip that the weather was out of the ordinary! It was a delightful day with highlights of a visit to Carrick-a-Rede (originally a precarious rope bridge used by fisherman that would be retracted in the winter), the Giant’s Causeway (an incredible

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continued - 2008 AAPM-IPEM Travel Grant Report natural rock formation), and a picnic lunch near the beach looking out over Scotland. While enjoying the sunshine, we had wonderful discussions about quality control systems in the UK and in the US for linear accelerators and intensity modulated radiation therapy (IMRT). Belfast City Hospital had recently expanded and I was impressed to see the new linear accelerator suites, complete with skylights over the control room areas. Throughout the day, Alan and I engaged in extensive discussions on quality management programs and independent review. I was impressed by Conor McGarry and Alan Hounsell at the the formal quality assurance (QA) program and by the Giants Causeway, Northern Ireland independent audits of programs that are performed in the UK. Additionally, Conor and I discussed variability in IMRT optimization and QA results with different treatment planning systems and versions of the systems. I also had the opportunity to visit the radiation biology laboratory in the Centre for Cancer Research and Biology where Conor is working with Kevin Prise to explore the links between tumor biology and modulated beam delivery. I look forward to following their research.

Castle Hill Hospital /University of Hull My next stop was to England to visit the new radiation therapy department at Castle Hill Hospital.

I have known Andy Beavis for several years and it was a pleasure to see him, to meet his team and to visit the department. The new department opened in 2008 and has some wonderful features that focus on patient comfort and movement of patients through the department throughout their care. For example, each vault has two changing rooms attached so that each patient can prepare for treatment immediately before entering the vault and then get dressed immediately after treatment. We also discussed treatment planning for IMRT and treatment planning system commissioning. A highlight of my visit was a trip to the University of Hull to visit the VERT Development Laboratory and try out the system. VERT is a virtual laboratory system of a radiation therapy treatment room used for training new therapists and other personnel.

The safety and training aspects of the system were so compelling that the Cancer Reform Strategy report by the Department of Health in England recommended and purchased the virtual environment system for all radiation therapist training programs throughout England. The system consists of a special high definition screen and goggles that allow the therapists to walk around the treatment machine. A patient model can be viewed from all angles in the virtual environment on the tabletop with immobilization equipment. The therapist can use a hand pendant for a given linear accelerator to move the major components such as the gantry and table. One indicator of the importance of this system is that, during my trip, my hosts at each center mentioned the VERT training system. The capabilities of the training system continue to be expanded for other potential users, including for physicists.

Yorkshire Cancer Centre/University of Leeds My next stop was to Leeds to visit the new Yorkshire Cancer Centre, where Viv Cosgrove was my host. One of the highlights of the department is its stereotactic body radiotherapy program.

At the time of my visit, the department had recently moved into its new premises housing several linear accelerators equipped with the latest technological improvements. For example, the department has a linear accelerator and vault equipped for advanced research with a videocamera based monitoring system, cone beam CT system (CBCT), and micro-MLC to investigate the benefits of different advanced technology approaches. While at the Cancer Centre, I enjoyed discussions with colleagues about our research on the use of advanced technologies for partial breast irradiation as well as the challenges of applying advanced technology and approaches to breast cancer. In general, we agreed that optimization approaches for treatment of breast cancer may be more challenging to implement since the complex approaches used for other sites, such as head-and-neck, are infrequently followed for treatment of the breast (e.g. a lack of breast contours when planning). During my visit, I also had the pleasure of meeting with Dr. Emma

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continued - 2008 AAPM-IPEM Travel Grant Report Thomas, who was a fellow at the University of Michigan several years earlier. I look forward to following the research developments by Viv Cosgrove and his colleagues in evaluating the advantages of different technology for treatment.

Royal Marsden Hospital and Institute of Cancer Research – Sutton The next part of my trip was to visit the Royal Mardsen Hospital in Sutton. It was a pleasure to meet with Steve Webb and colleagues. I have a connection to RMH and Steve. My advisor as an undergraduate student was Jacquelyn Yanch, who was one of Steve’s graduate students. My interactions with Dr. Yanch during my undergraduate years were my first experience with medical physics as a field, and it was during that time that I encountered Steve’s Medical Imaging book as a text in one of my classes. Those experiences, combined with mentorship from David Nigg, led to my committing to pursue a career in medical physics.

During my visit, it was clear that RMH is a dynamic environment. Throughout the day, our discussions touched on different aspects of clinical trials and quality and advances in research.

For example, I met with Mike Partridge, Chris South, Ros Perrin and Sarah Gulliford to discuss advances in functional imaging. Phil Evans, Ellen Donovan and I talked about hypofractionation for breast cancer and research challenges in that area. I met with a dynamic group working on imaging for radiation therapy. I also spoke with James Bedford about one of the latest clinical innovations – developments around optimized arc therapy. James has developed Autobeam, an in-house optimization system for volumetric arc therapy (VMAT) where final calculations are performed in the clinically approved planning system. Jim Warrington gave me a tour of the clinical physics area and we discussed the challenges of clinical workflow. At the time of my visit, RMH was undergoing construction to accommodate further updates to their program.

During my visit, I enjoyed learning about a number of projects funded by the Institute of Cancer Research which also helps support a very active graduate program. It was a pleasure to meet the next generation of investigators in our field: David Roberts, Ros Perrin, Hafiz Zin, Florian Buttner, and Remo Crescenti and to learn about their research projects.

Oxford The following week I visited the Oxford Cancer Center. During my visit the department was completing its move into a new cancer center facility, which was a recurring theme of my trip. Dr. Bernadette Lavery and Dr. Amanda Salisbury provided a guided tour of the new and the old centers. The new Oxford Cancer Center facility includes a patient-centered focus on the design.

For example, the Cancer Center has a rooftop garden for patients, visitors, and employees.

Elizabeth Macaulay leads the Radiotherapy Physics Program. We discussed the challenges of IMRT and when it should be used, and also talked about the clinical needs for improved technology for electron beam shaping. This discussion resonated with me, because I worked with multileaf-collimated electron beams of the MM50 Racetrack Microtron as a graduate student at the University of Michigan. As a field we invest incredible resources in shaping photons with IMRT and in proton therapy centers. But Elizabeth and I were in agreement that there are clinical needs that could be met with investments to improve electron beam shaping and delivery.

In the afternoon, I met with the Medical Physics and Clinical Engineering group and delivered a seminar about the Clinical Trials Quality Assurance structure in the US. The seminar allowed us the opportunity to discuss the challenges of advanced technologies in clinical trials, as well as some of the work of AAPM Task Group 113 on physics practice standards for clinical trials. Our discussion also included multi-segment approaches for breast cancer, IMRT for head and neck cancer, and multileaf collimated electron beams.

Later, we had a group meeting to discuss possible research project with members of the Clinical Trials Support Unit at Oxford. These individuals support the work of the Early Breast Cancer

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continued - 2008 AAPM-IPEM Travel Grant Report Trials Group. For this part of my trip, I was joined by colleagues from the University of Michigan, Robin Marsh, Reshma Jagsi, and Lori Pierce, with whom I work on several projects related to breast cancer.

During our visit, we met with Sarah Darby, Caroline Taylor, Paul McGale, David Cutter, and Candace Correa (a University of Michigan resident at the time on fellowship with the group) to talk about the work of the breast cancer trials group. We also discussed the impact of evolving technology on the treatment of breast cancer, especially as the availability of new technology may lead to changes in practice.

A visit to the rooftop garden at Oxford Cancer Center Royal Marsden London hosted by Bernadette Lavery (on the right) with The final stop of my trip was to the Royal Marsden Robin Marsh (beginning from the left), Reshma Jagsi, Hospital in London, where I was hosted by Margaret Jean Moran, and Lori Pierce from the University of Michigan.

Bidmead. It was another wonderful day of learning.

Caroline Lamb gave me a tour of the treatment area and also told me about her projects investigating the accuracy of a tilt-and-roll tracking system for patient setup. I enjoyed discussions with Margaret, Caroline, Rollo Moore, and others about the challenges of selecting which quality tests to perform, especially as technology continues to evolve. One of the primary concerns still involves determining the proper frequency of testing.

Following my presentation, we had additional discussions about the use of electronic dosimeters for IMRT verification, and standards of practice for pre-treatment quality assurance for IMRT. I also learned about the active volumetric arc therapy program at RMH-London. We also discussed approaches to quality in England and broadly discussed the work of AAPM task groups, such as TG142 on QA for linear accelerators, TG119 on IMRT commissioning for different software and hardware systems, TG120 on dosimetry metrology, and TG100, which is a report that promises to challenge us to reshape our approach to quality assurance as a field.

Acknowledgements I would like to thank the AAPM and IPEM for the travel grant which provided me an incredible opportunity to discuss and share different ways of conducting research in medical physics. Each center I visited was unique. At the same time, I also saw that radiotherapy practice is evolving in a similar way as in the US as accelerators are installed with on-board imaging and arc therapy delivery capabilities. It was impressive to see the technological investments being made alongside facility improvements that are focused on enhancing the patient care experience. Regardless of where we work, we are all challenged to provide the best care possible with the available resources while simultaneously working on advancements to the field.

I would like to thank my generous hosts who made this trip a wonderful experience: Alan Hounsell and Conor McGarry at Belfast City Hospital, Andy Beavis at Castle City Hospital/ University of Hull, Viv Cosgrove and Emma Thomas at the Yorkshire Cancer Centre/University of Leeds, Steve Webb at the Royal Marsen Hospital – Surrey, Elizabeth Macauley, Candace Correa, and Sarah Darby at Oxford, and Margaret Bidmead at the Royal Marsden - London.

My hosts put together a wonderful program for me. I appreciate their generosity in hosting me.

And finally, thank you to the AAPM and IPEM. It was an honor to receive this award and I am excited about opportunities for future collaboration with colleagues in the UK, especially in quality assurance programs, electronic dosimeters, and breast cancer research.

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MEETING HIGHLIGHTS This year the Tuesday and Wednesday agenda will feature parallel scientific and education tracks. Scientific proferred and education sessions will run in parallel beginning from 7.30 am and ending at 5.30 pm on Tuesday and Wednesday only.

Joint Imaging/Therapy Program Includes: Scientific Symposia • • •

•

•

•

•

Proffered Abstract Submissions

Optimization of MRI for Treatment Planning Real-time Image Guidance for Radiation Therapy Compressed Sensing in Image Reconstruction and Dose Optimization Opportunities for New Investigators: Clinical Trials Research Using Data from Multi-Institutional Clinical Trials Functional MRI for Imaging Tumor Vasculature in Conjunction with Radiation Therapy and Anti-

Angiogenic Therapies Electron Paramagnetic Oxygen Imaging. The use of Magnetic Resonance Imaging and Spectroscopy for In-Vivo Dosimetric and Verification of Therapy Photon and Proton Beams Latest Developments in Ultrasound Guidance, Monitoring and Treatment in Therapy

•

• • • • • • • •

•

Advanced Screening, Diagnostic and Treatment Technologies for Lung Cancer Image-Guided Localization Image-Guided Radiation Therapy In-room Imaging Technologies Inter- and Intra-fraction Motion Modeling Margin Assessment Nanotechnology Applications in Imaging and Therapy Small Animal Imaging and Therapy Target and Normal Organ Definition - Image Registration, Fusion, Molecular and Functional Imaging Therapy Assessment Imaging

SPECIAL SYMPOSIUM ON PATIENT SAFETY • • • •

Walt Bogdanich, New York Times Correspondent William Hendee, Ph.D., Founder National Patient Safety Foundation Michael Herman, Ph.D., President AAPM Ola Holmberg, Head of Radiation Protection of Patients, IAEA

SUNDAY, JULY 18 2:00 PM - 4:00 PM

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Report on AAPM, ACMP, IOMP Endorsed Educational Workshop Cheng B Saw, PhD (International Organizer) Nguyen Truong Son, MD, PhD (Host Organizer)

Modern Radiation Oncology Cho Ray Hospital, Ho Chi Minh City, Vietnam May 5th – 8th, 2010 A four-day educational workshop with the theme, “Modern Radiation Oncology” was held at Cho Ray Hospital, Ho Chi Minh City, Vietnam from May 5th - 8th, 2010. This workshop was sponsored

by Varian Medical Systems, Transmedic, Prowess, and Cho Ray Hospital. The International Atomic Energy Agency (IAEA) also funded a technical expert (Cheng B Saw, PhD) to participate in this workshop. The educational program was submitted for review and thereafter endorsed by the American Association of Physicists in Medicine (AAPM), American College of Medical Physics (ACMP), and International Organization for Medical Physics (IOMP).

The principal objectives of this educational workshop are to share (a) the international experience in the implementation of modern radiation oncology in particular three dimensional (3D) treatment planning, conformal radiation therapy (CRT), and intensity-modulated radiation therapy (IMRT), (b) the current practice of brachytherapy, and (c) the quality assurance associated with modern practice of external beam radiation therapy and brachytherapy. Another objective is to update the need of additional medical physics manpower and training to support the expanding radiation oncology community in Vietnam. The assessment of medical physics manpower was presented

by Professor Phan Sy An, President of the Vietnam Association for Medical Physics.

This educational workshop was organized as morning and afternoon sessions with separate intent. In the morning sessions, the faculty members explained the concepts and the use of 3D treatment planning for the implementation of CRT and IMRT. In the afternoon sessions, the attendees followed up with practical workshop demonstration of the features of the 3D treatment planning with the application specialists. As the emphasis was on modern radiation oncology, the practical workshops were held so that the attendees could become familiar with the full-features of 3D treatment planning systems from various vendors. The practical workshops were organized by separating the attendees into five small groups. The small group concept allows for more personal interactions with the application specialists as well as within the group and faculty to discuss 3D treatment planning. Five treatment planning system vendors: Elekta, Philips, Varian, Nucletron, and Prowess have graciously participated in this educational workshop.

The international faculty members for this educational workshop were: 1. Cheng B Saw, PhD, Chair (Penn State Hershey Cancer Institute, Hershey, PA, USA), 2. Shanglian Bao, PhD (Peking University, Beijing, China), 3. Charlie Ma, PhD (Fox Chase Cancer Center, Philadelphia, PA, USA), 4. Henry Wagner, Jr, MD (Penn State Hershey Cancer Institute, Hershey, PA, USA), 5. Ibrahim Wahid, MD (Wijaya Medical Center, Kuala Lumpur, Malaysia), 6. Robert Zwicker, PhD (University of Kentucky, Lexington, KY, USA).

The organizers for this educational workshop were Cheng B Saw, PhD representing the international committee and Nguyen Truong Son, MD, PhD, Director of Cho Ray Hospital for the host committee.

The workshop officially commenced on May 6, 2010 with the welcoming addresses from Dr. Nguyen Truong Son, Professor Phan Sy An, and Cheng B Saw, PhD. Both Dr. Son and Prof. Phan emphasized the enthusiastic opportunity to sponsor this educational workshop since it was the first such workshop attended by both radiation oncologists and medical physicists. Such workshop fosters closer collaboration among the disciplines to provide better cancer care for the patients. Dr. Saw took this opportunity to thank the attendees in particular those that have come from the remote areas of Vietnam to attend this workshop. In addition, Dr. Saw also highlighted

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continued - Report on Endorsed Educational Workshop the generous hospitality of the Vietnamese, the opportunity to hold this educational workshop in Vietnam, thank the vendors for supporting, and Dr. Son for hosting this workshop.

The lecture presentations were organized to highlight the transition and essentials of modern radiation oncology practice.

The paradigms in the practice of radiation oncology have changed with the introduction of 3D treatment planning systems.

The ability to view and perform planning in three dimensions allows the implementation of CRT and IMRT techniques which are routinely used in the clinics in the United States.

The implementation of this modern radiation oncology practice requires the Welcoming Dinner Reception Photo use of new technologies to acquire patient data, 3D treatment planning, and dose delivery. Dr. Zwicker presented a review and updates on the implementation of IMRT techniques. This was followed by a presentation on patient acquisition system by Dr. Bao and reference beam dosimetry using the AAPM (TG-51) and IAEA (TRS-398) protocols by Dr. Ma. The commissioning of modern medical linear accelerator was presented by Dr. Saw. Dr. Wagner who is one of the two radiation oncologists on the faculty presented the physician perspectives on the use of image-guidance to assist in the identification of target and critical structures for dose planning.

The treatment planning aspects were emphasized the next day. Dr. Saw presented the philosophical change in the transition from 2D to 3D treatment planning. This included the need to evaluate isodoses in three dimensions and the use of 3D tools such as isodose surface display and colorwash representations. The program proceeded with the presentation on the use of MLC for dose planning by Dr. Bao. The definitions of target and critical structures consistent with ICRU Reports No. 50 and 62 were presented by Dr. Zwicker. Dr. Ma presented the strategies for 3D treatment planning in the implementation of the CRT and IMRT treatment techniques. Finally, Dr. Wagner presented the issues facing the physician in defining the target and critical structures on the 3D treatment planning systems. These included the awareness of the limitations of the imaging data in identifying the extent of the diseases, the contouring techniques, and the need for radiation oncologists to perform patient setup using advanced imaging system.

The last day of the program concentrated on the clinical aspects in the practice of modern radiation oncology and brachytherapy. The early presentation was made by Dr. Ma on the advanced technology of the motion-gated techniques and image-guided radiation therapy (IGRT) systems.

This was followed by the management of head and neck cancers and the treatment of lung cancers presented by Drs. Wahid and Wagner respectively.

Special lectures were requested by the host committee with emphasis on quality assurance and brachytherapy. Quality assurance on Simulator, CT-Simulator, modern medical linear accelerator was presented by Dr. Saw and brachytherapy by Dr. Zwicker. Low-dose-rate and high-doserate brachytherapy were reviewed by Dr. Zwicker. The last topic of the program was on remote afterloading systems which was not presented due to the lack of time.

Ten copies of the textbook Foundation of Radiological Physics, authored by C.B.Saw, were distributed as door prize to the participants from Vietnam. The criteria of distribution were decided by the host committee.

This educational workshop was an overwhelming success with over 250 registrations which is more than has been planned for to accommodate the practical treatment planning sessions.

Of the total registrations, 21 of the attendees were from neighboring countries: Singapore,

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continued - Report on Endorsed Educational Workshop Malaysia, Indonesia, and Sri Lanka. This well attended workshop reflected the eagerness of the Vietnamese radiation oncology community to embrace new and advanced technology of the immediate future. It is an “eye opening” event for the members of the radiation oncology community. The overwhelming concerns have been how to implement CRT and IMRT with the limited manpower and know-how in this expanding radiation oncology community. This issue has to be worked out within the Vietnamese radiation oncology community and their federal agencies.

Currently there are 16 Cobalt teletherapy units and 11 medical linear accelerators in Vietnam to support a population of 84 millions and 4 medical linear accelerator are being installed. Based on the general conversation with the host committee, this workshop has provided the much needed learning experience for the radiation oncology community. The President of VAMP has expressed the need to continue this educational workshop next year in Hanoi echoing the acute need of training in this fast expanding radiation oncology community.

After the workshop, the host members together with the International faculty took a tour of the upper Mekong Delta. The Mekong Delta/River is the main waterway of the people in the south of Vietnam. The tour included the observation of the wet markets on the river, commercial stores in the production of art and crafts, rice On-Line pastries, and liquor production along in the the river. The buildings reflect the AAPM French influence in that region. After the tour, the faculty was treated with Virtual Library the well-known Vietnamese cuisine at the Pho-2000 restaurant, a restaurant visited by former President Clinton in 2000. Finally, the host gave the CT Dose Summit – faculty a brief tour of the Ho Chi Minh Scan Parameter Optimization City where the mode of transportation is primarily motor-cycles.

Program details:

http://www.aapm.org/meetings/2010CTS/ ProgramInfo.asp Coming soon….

Safety in Radiation – A Call to Action Program details: http://www.aapm.org/meetings/2010SRT/ProgramInfo.asp Access content and DVD ROM order information at… www.aapm.org/meetings/virtual_library/ 35 35

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On behalf of the faculty, the international organizer (Cheng B Saw, PhD) wishes to thank the host organizer, Dr. Son and his committee for providing such an extraordinary hospitality.

The willingness of the international faculty to travel to Vietnam to participate in the educational workshop are well-appreciated by the organizers and the local committee members.

Lastly, the organizers recognized the contributions of the IAEA and the vendors (in addition to those named above are Siemens, Tomotherapy, BrainLab, CNMC, IBA, LAP-Lasers, and PTW) in supporting the educational mission of this workshop.

AAPM Newsletter

July/August 2010

American Board of Radiology

Anthony M. Gerdeman Ph.D., ABR Director Psychometrics & Evaluation gerdeman@theabr.org

Radiologic Physics Initial Qualifying (“Written”) Examinations

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he purpose of this paper is to inform radiologic physicists, program directors, and other interested parties of the processes involved in developing, administering, and scoring the American Board of Radiology (ABR) radiologic physics qualifying (“written”) examinations. The candidates, once certified, will have a lifelong professional relationship with the ABR. It is important for the ABR to be transparent about the processes it uses to ensure that its examinations are fair, valid, and reliable, so that radiologic physicists and their program directors have accurate information about these high-stakes examinations.

Examinations Ensure the Public and Profession That ABR Diplomates Meet the “Gold” Standard The American Board of Radiology is one of 24 Member Boards of the American Board of Medical Specialties (ABMS). These boards adhere to a common set of standards for training, experience, and examinations leading to certification in a specialty. These standards are set by radiologic physicists, for radiologic physicists, as a means of exercising the privilege of professional selfregulation. The high level of respect for standards of the ABMS boards is evidenced by consistent ranking of “board certification” as one of the top factors valued by patients in selecting their physicists, and by hospital credentialing bodies that incorporate board certification into their credentialing and privileging processes. During the 75-plus years of the specialty-certifying board movement, ABMS board certification has come to represent the “gold standard” for radiologic physicists. All ABMS boards have mission statements similar to the ABR’s, focused on “serving patients, the public, and the medical profession.”

This mission is accomplished in part by the ABR’s certification that its diplomates have “acquired, demonstrated, and maintained a requisite standard of knowledge, skill, and understanding essential to practice of radiologic physics…” In this paper, the focus is on the “demonstration” aspect of this mission, which is the role of the qualifying (“written”) and certifying (“oral”) examinations administered by the ABR. Approximately 500 - 700 physicists take the initial qualifying examinations annually.

Examination Development Is Designed to Ensure Practice Relevance Certification examination development begins with the identification of the domain of knowledge, skills, and abilities that are “essential to the practice of radiologic physics,” as stated in the ABR’s mission. During its 75 years, the ABR has been privileged to have thousands of radiologists, physicists, and scientists, drawn from a pool of the most respected experts across the country, volunteer their time and expertise to create its examinations. Under the guidance of these content experts, the domain for testing has been identified and updated as needed.

The ABR creates test content outlines for the initial qualifying examinations. Content of the examinations is currently indicated via the study guide provided on the ABR website at http:// www.theabr.org/ic/ic_rp/ic_rp_study.html.

As exhibited on this section of the ABR website, the computer based examinations for Part 1 cover the basic radiologic physics and clinical aspects of radiologic physics. The Part 2 computer based examinations cover diagnostic radiologic physics, medical nuclear physics, and therapeutic radiologic physics. The interested reader may browse the ABR/radiologic physics website for further details including oral examinations.

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AAPM Newsletter

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continued - American Board of Radiology Examination Items Are Written to Specifications and Reviewed Extensively Preparation of test items (questions) is the next important step in creating a highly reliable and valid examination. For the radiologic physics initial qualifying examinations, the numerous item writers and test assembly committee members represent all geographical regions of the United States.

The item writers and committee members are in active practice and come from both academic institutions and private practices. The item writers are instructed to write and submit the items according to ABR guidelines and specific content assignments.

Next, the items undergo several stages of review to ensure their currency, importance, clarity and relevance to practice, This happens during a “test assembly” process. Prior to the test assembly meeting, each participant reviews all new and previously used items, individually and with several colleagues. New items include editorial suggestions from the ABR’s professional editors. These reviews result in notations for revisions, which are then brought forward during the test assembly meeting. During that meeting, specific examinations are developed, each including some previously used items that functioned well in the past and some new items. Before finalization of the examinations, the items are once again reviewed by the test assembly participants, with the result that each item is approved by experts in that particular subspecialty area of radiologic physics. This ensures well-balanced examinations aimed at the appropriate level of competency.

Once the test assembly has been completed, the exam is reviewed to establish a passing score in a procedure called Angoff standard setting. The content experts evaluate each item with respect to a standard representing minimum competence for safe and effective practice. Each expert’s ratings are then summed, and these sums are averaged across the experts to determine the recommended performance standard, pass or fail. The resulting standard is termed a “criterion-

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AAPM Newsletter

July/August 2010

continued - American Board of Radiology referenced” standard, rather than a “norm-referenced” standard. Such a standard is appropriate because the radiologic physics qualifying examinations are tests that measure content-related objectives. They are not intended to be norm-referenced tests or “graded on the curve,” in which a certain percentage of the candidates is predetermined to fail regardless of how high or low the group’s overall performance was with respect to the content.

Examinations Are Administered and Scored to Ensure Fairness and Accuracy The next step is to send the assembled examinations to the ABR’s computer-testing vendor, Pearson VUE, for administration in their nationwide network of professional testing centers.

Examinees register directly with Pearson VUE to take the examinations on selected dates. Each exam center has identical instructions and procedures to ensure a fair opportunity for each candidate to fully demonstrate his or her knowledge, skills, and ability on the examinations.

Immediately after the examinations, Pearson VUE sends the responses electronically to the ABR. Scoring is performed internally at the ABR by a qualified (doctorate level) psychometrician to ensure accuracy. An item analysis is conducted during the scoring process, and a critical review of each item is done to determine whether or not it has performed as expected. Because the examination is a content-mastery type of examination, designed to discriminate maximally at the passing point, pass/fail results rather than numeric scores are the appropriate form of reporting.

The item analysis presents statistical results for item difficulty and discrimination. The item difficulty index represents the percentage of examinees answering the item correctly. The discrimination index indicates to what extent more high-performing examinees answered correctly than lowperforming examinees. If a concern arises regarding an item or items that did not perform as expected in difficulty or discrimination, the content experts are contacted to discuss whether to remove those items from scoring. If any change is necessary, re-scoring is performed.

A reliable examination is one that has consistency or accuracy in the measurement of a particular achievement. A valid examination has relevance and yields reliable scores, that is, the test measures what it intends to measure and what it purports to measure. A highly accurate test does no good if what it measures is irrelevant to the intended decision or conclusion. Thus, the ABR evaluates item-analysis data carefully to ensure both reliability and validity in its examinations.

The item analysis produces other descriptive statistics such as mean, standard deviation, reliability coefficient, and standard error of measurement, which also are evaluated carefully by the psychometrician. Once the accuracy of the test results is ascertained, the recommended Angoff pass/fail score is re-evaluated and used as an aid by a group of content experts and psychometricians in setting a final passing score that is most reasonable in view of all the data available.

Results Letters Are Informative and Double-checked for Accuracy The next stage is to inform the examinees of their examination results. Letters are individualized reports of each examinee’s results (pass/fail). Each letter is checked and rechecked by the ABR’s staff to ensure that the results, feedback, and next steps in the individual’s certification process are accurately reported to the examinee. All letters are mailed on the same day. Beginning in 2010, results are also posted electronically on each examinee’s personal database (PDB).

Examination Process Refinements Continue The American Board of Radiology has 75 years of experience in serving patients, the public, and the medical profession. The entire process of developing, administering, scoring, and distributing the results of tests is generally done smoothly, efficiently, and accurately. Measurement science, the field of study known as “psychometrics,” has advanced over the years, and the ABR reviews and applies this science to produce high-quality examinations. The ABR’s commitment to candidates, diplomates, programs, the broader healthcare community, and patients is to continually advance its ability to deliver certification examinations with accuracy, fairness, reliability, and validity.

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AAPM Newsletter

July/August 2010

International Educational Activities Committee Cari Borrás, Chair WGNIMP

International Educational Exchange An Invitation

AMPR

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he “Work Group on Implementation of Cooperative Agreements between the AAPM and other National and International Medical Physics Organizations (WGNIMP)” within the AAPM’s International Educational Activities Committee, is inviting individual medical physicists and educational institutions to participate in the educational exchange program for medical physicists developed between the AAPM and the Spanish Medical Physics Society (SEFM) and between the AAPM and the Association of Medical Physicists in Russia (AMPR).

The programs involve educational, training and research activities in medical physics for either students (engaged either in an academic or in a clinical residence program) or professionals (called “invited members”). According to Agreements signed by the respective societies, “The education and training of medical physicists from either Spain or Russia in the USA will take place at the institutions accepting participants for a period of up to 6 months. The Students will obtain training in general and specialized aspects of Medical Physics in the different fields of Medical Physics. The Students and Invited Members while at each centre are expected to study on a fulltime basis with no unexcused absences.” Regarding research activities, the plan is to have “Development of joint research projects in research topics of common interest.”

The WGNIMP is interested in identifying: 1. Educational institutions in the United States willing to host Spanish and/or Russian medi-

cal physicists, both students and professionals.

a. What educational or research program(s) you are offering. Indicate the field of specialization and subspecialty, if appropriate (i.e. radiation therapy, IMRT)

b. The educational, skills and experience requirements the foreign medical physi cists ought to have.

c. The duration of the program (up to 6 months).

d. The possibility of financial assistance. (The agreements specify that the students and “invited members” in the exchange will come with funding, but additional as sistance, if available, would be welcome.)

2. Individual medical physicists, engaged in a clinical residence program or involved in a

specific research project interested in going either to Spain or Russia (please specify) to

advance their knowledge.

a. Type of institution sought (hospital, university, research center) i. If a hospital, type of training sought with details (e.g. clinical radiation

therapy, in vivo dosimetry) ii. If a university, type of educational program sought (graduate, post-gradu

ate…) iii. If a research center, specify project to be involved.

b. Expected outcome of the visit (certificate, letter, joint published paper, other – specify).

c. The duration of the program (up to 6 months).

d. Proof of financial solvency to live in the selected country for the required period.

e. A description of relevant language skills.

Should you be interested in applying, please send an e-mail responding to the questions above to Cari Borrás, Chair WGNIMP at cariborras@starpower.net.

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AAPM Newsletter

July/August 2010

Persons in the News Medical Physicist Maryellen Giger elected to National Academy of Engineering

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aryellen L. Giger, PhD, professor and vice chair in the Department of Radiology at the University of Chicago Medical Center, has been elected to the prestigious National Academy of Engineering (NAE), part of The National Academies.

To read more about Dr. Giger’s honor, please visit the following site: http:// www.uchospitals.edu/news/2010/20100301-giger.html

William R. Hendee PhD, Gold Medalist – American College of Radiology

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illiam R. Hendee, PhD, distinguished professor of radiology, radiation oncology, biophysics, and community and public health and former dean of the graduate school of biomedical sciences at the Medical College of Wisconsin in Milwaukee was awarded the ACR Gold Medal at the 2010 Annual Meeting and Chapter Leadership Conference in Washington DC. Some of Dr. Hendee’s past achievements include; former AAPM President and recipient of William D. Coolidge Award and winner of the 2006 gold medal from the American Roentgen Ray Society and 2007 gold medal from the Radiological Society of North America.

William Hendee accepting Gold Medal from ACR President Carol Rumack

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he American College of Radiology (ACR) recognized five AAPM members as New Fellows of the ACR during their Annual Meeting and Chapter Leadership Conference held in Washington, DC, May 15-19th, 2010. Following is a brief biography sketch of the newly-elected Fellows:

B

enedick A. Fraass Ph.D. received his MS and PhD in physics from the University of Illinois at Urbana-Champaign. After 5 years at the Radiation Oncology Branch of the NCI/NIH in Bethesda, MD, he helped found the Department of Radiation Oncology at the University of Michigan in 1984 as Director of the Radiation Physics. He is currently Allen S. Lichter Professor of Radiation Oncology and Director of Radiation Physics at the UM. Dr. Fraass is a fellow, Chair of the Multidisciplinary QA Subcommittee, and member of several other committees in ASTRO, and is very active in AAPM (fellow, chair of the Research Committee, and member of Science Council, Therapy Physics Committee, TG100), and member of the ACR/ASTRO/ AAPM Safety Task Force. He is also heavily involved in research, and has been principal investigator of a number of NIH-funded grants, including an NCI program project grant which has been funded from 1993 through 2011.

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AAPM Newsletter

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continued - Persons in the News

B

ob Pizzutiello became an active member of ACR in the 1980’s. He has served on the Physics Subcommittees for Mammography, Stereotactic Breast Biopsy and on the newly constituted Subcommittee for Breast Imaging. He serves as Chair of the Physics Committee of the NY State Radiological Society. Bob’s current appointments include President of Upstate Medical Physics (UMP) and Program Director for the UMP Diagnostic Medical Physics Residency Program – the first private practice diagnostic residency program to seek CAMPEP Accreditation. Most recently, Bob has added new responsibilities as Sr. VP for Diagnostic Services for Global Physics Solutions, Inc.- a Landauer Company.

R

andall K. Ten Haken is a Professor in the Department of Radiation Oncology at the University of Michigan Comprehensive Cancer Center in Ann Arbor, MI. He has been active in the ACR, AAPM in which he served on the Board of Directors from 1994-1996 and became a Fellow (FAAPM) in 1997, and the American Society for Radiation Oncology in which he served on the Board of Directors from 2003-2007 and became a fellow (FASTRO) in 2006. He is also a Fellow in the Institute of Physics (FInstP). Dr. Ten Haken earned his PhD from the University of Wisconsin-Madison.

S

tephen Thomas served on a number of ACR committees and participated in several ACR Annual Meetings as a Councilor-at-Large for physics.

Dr. Thomas is a Professor of Radiology at the University of Cincinnati, Department of Radiology where he was the Director of the Division of Medical Physics from 1991-1998. He was an ABR Trustee in Medical Nuclear Physics and currently is the ABR Associate Executive Director for Radiologic Physics. He has been active within the AAPM serving as President in 1997.

Dr. Thomas has been highly involved within the RSNA chairing various committees. He was a long-time member of the MIRD Committee of the SNM serving as chair from 2006-2008.

M

arilyn Wexler is currently a medical physics independent contractor.

Her professional society activities have been numerous, starting in the early 1980s with involvement in; the Southern California Chapter of the AAPM; the Los Angeles Radiological Society where she was elected as the first and only non-physician president of the Southern California Radiation Oncology Society; the AAPM where she has sat on over 20 committees, sub-committees and task groups and served as Board member for two terms; the ACR where she has chaired the Committee on Government Affairs and served as physics councilor on ten occasions; and currently sits on ASTRO’s Committee on Government Relations.

On a personal level, she has thoroughly, but not necessarily always, enjoyed a professional career in medical physics for over 30 years.

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AAPM Newsletter

July/August 2010

continued - Persons in the News Prof. Azam Niroomand‑Rad receives MSU Award

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r. Niroomand-Rad received an Outstanding Alumni Award in April 2010 from the Michigan State University in E. Lansing, Michigan. The Outstanding Alumni Award is awarded annually and recognizes a scientist who has demonstrated a distinguished career and leadership in field of natural sciences.

Prof. Niroomand-Rad received her PhD from Michigan State University in 1978 and completed her postdoctoral training at the University of Wisconsin in Madison in 1983. Dr. Niroomand-Rad was Director of Clinical Physics and Professor of Medical Physics in the Department of Radiation Medicine at Georgetown University School of Medicine in Washington, DC. She retired in 2007 and lives in Madison, Wisconsin.

Prof. Wolfgang Bauer, Chair of the Department of Physics and Astronomy at MSU, Prof Niroomand-Rad and Dr. James Kirkpatrick, Dean of the College of Natural Sciences at MSU presenting the Outstanding Alumni Award.

Dr. Niroomand-Rad has been very active over many years in research, education and training around the world as well as in her own institutions. She has served many professional organizations including AAPM and International Organization for Medical Physics (IOMP) and International Atomic Energy Agency (IAEA). Dr Azam served as the president of IOMP. In AAPM, she has served on many committees and task groups including Chair of AAPM/IOMP International Scientific Exchange Programs and International Affairs Committee. She was dedicated to promoting and developing the medical physics profession, particularly in developing countries. She worked with the International Labor Organization (ILO) in Geneva to have the field of medical physics be recognized in 2008. She also served as the president of IOMP.

Dr. Niroomand-Rad is a Fellow of AAMP (1997) and has received the AAPM Achievement Award in Medical Physics (2006). She has received many awards including the prestigious Marie Sklodowska Curie Award from IOMP (2009) and Honorary Doctorate from Regent of the University of the State of New York in 2001.

2010 Visit the Vendors Program Each attendee of the 2010 AAPM Annual Meeting will have the opportunity to win one of five free registrations for the 2011 AAPM Annual Meeting in Vancouver.

• • •

A VISIT THE VENDORS card will be given to each scientific meeting registrant at Registration when individuals pick up their meeting materials.

The objective is for the attendees to VISIT THE VENDORS listed on their card AND acquire a hole punch.

The drawing and prize announcements are scheduled for Wednesday July 21, during lunch time at 12:30 PM in the Exhibit Hall – winners do not have to be present to win.

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AAPM Newsletter

July/August 2010

Obituary L. Stephen Graham, PhD

L

. Stephen Graham, PhD, a renowned medical physicist, passed away on May 22, 2010 in Los Angeles, California.

An expert in nuclear instrumentation, particularly gamma cameras and SPECT systems, Steve, as he was known to his friends and colleagues, helped to develop many of the quality control procedures that assure appropriate operation of these systems. Specifically, he developed practical approaches to gamma camera and SPECT acceptance testing. The report of a task group chaired by Steve in the 1980s forms the basis of how many of these tests are still performed today.

He was born in 1933 in Frankfort, Indiana. He attended Pasadena College receiving a bachelor’s degree in physics in 1955. He also received a bachelor’s degree in divinity from Talbot Seminary in 1959 and a master’s degree in physical science from California State University in Long Beach in 1962. Drawn to medical physics, he later attended UCLA obtaining his PhD in 1971. Steve was on the faculty of UCLA as an Adjunct Professor in the Department of Radiological Sciences until the time of his retirement. He worked at the VA Medical Center in Sepulveda, CA from 1977 to 1994 when the Northridge earthquake devastated the nuclear medicine clinic within he worked. He then moved to the VA Medical Center in West Los Angeles until he retired. He was very active on a number of committees and task groups for the American Association of Physicists in Medicine, the American College of Radiology, the Society of Nuclear Medicine and the International Atomic Energy Agency. He was a fellow of both the American Association of Physicists in Medicine and the American College of Radiology.

Steve worked with many nuclear medicine clinics, not only in southern California but throughout the world to help them establish quality control programs for their nuclear medicine equipment.

He was thorough and meticulous in his work, and his reports reflected this attention to detail.

The quality of his reports was always of the highest order. Even the smallest clinic would get immediate attention from the large manufacturers for any negative finding if the report had Steve’s name on it.

Steve was an outstanding teacher and lecturer working with technologists, medical students, residents and physicists. His teaching style was caring and patient. He would answer any question without judgment. His educational sessions at national meetings were always very well attended. He also trained a number of PhD candidates and post-doctoral fellows from UCLA as well as those sent to him from around the world by the IAEA. He was a respected and congenial colleague, ever ready to share his sage advice on how to address some sticky issue with some new piece of equipment. He was a very modest man with a friendly smile and a warm twinkle in his eye. Steve was a Christian gentleman with a gentle spirit.

Dr. Graham is survived by his wife, Marianne and 2 sons, Michael and Daryl. Daryl has followed in his father’s footsteps and is working with a medical physics consulting firm reviewing quality control programs and performing acceptance testing for a number of nuclear medicine clinics in southern California. Steve is also survived by 3 grandchildren, Evan, Kelly and Sydney. Steve is dearly missed by those who knew and worked with him.

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American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740-3846

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

PRINT SCHEDULE • The AAPM Newsletter is produced bimonthly.

• Next issue: September/October • Submission Deadline: August 12, 2010 • Posted On-Line: week of September 1, 2010