AAPM Newsletter May/June 2011 Vol. 36 No. 3

Newsletter

AME RIC AN AS S O C I ATI O N O F P H Y S I C I S TS I N M E D I CI N E We advance the science, education and professional practice of medical physics

AAPM Column VOLUME President’s 36 NO. 3

MAY/JUNE 2011

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

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he crisis and devastation in Japan following the March 11 earthquake and tsunami continue, and as with any natural disaster of this magnitude, healing will be neither simple nor immediate. Our thoughts and hearts are with the Japanese people and with their many loved ones. We stand in support and solidarity of our medical physicist colleagues who are in the middle of an unfathomable situation.

Inevitably, the disaster in Japan will fall from the headlines, but we need to reach out with assistance to those who are in distress, and especially in respect for our medical physics connections to Japan. There is much to do, and if you wish, you can also help, too. Please visit this link for a variety of charities aiding the Japanese people: http://www.charitynavigator.org/index.cfm?bay=content.view&cpid=1221 As President, I am reaching out with the membership of the AAPM to offer our condolences and heartfelt feelings in these times of difficulty, for I am sure they would do the same if the circumstances were reversed. We all hope for a rapid recovery and return to prosperity for those afflicted by this event.

After a busy winter, spring has sprung, and before you know it, summer will be here along with the Annual Meeting in Vancouver at the end of July. I am looking forward to an outstanding educational, scientific, and professional program, in conjunction with COMP, the Canadian Organization of Medical Physicists.

As final arrangements for the meeting are being implemented, the scientific program chair, Jeff Siewerdsen, reports that submissions are up significantly, by 20% over last year. I’m confident you will hear more about the annual meeting offerings and opportunities in the coming months in the Newsletter and the Medical Physics pre-meeting publication. An excellent education program, under the direction of Matthew Podgorsak is also well under way. In addition to Jeff and Matt, the directors and codirectors who have put many volunteer hours into organizing the offerings include Indrin Chetty and Harald Paganette for the therapy scientific program; Mitch Gootsitt and Mike McNittGray for the imaging scientific program; Paul Carson for the ultrasound scientific program; Kyle Jones and Eric Gingold for the education imaging program; Todd Pawlicki and Bulent Aydogan for the education therapy program, and Chris Serago for the professional program. We all will benefit from their efforts as we partake in the scientific, educational, and professional opportunities and offerings. The combined COMP/AAPM annual meeting is sure to be as outstanding as the inviting location in Vancouver.

Included in this issue: Chair of the Board p. 3 President-Elect p. 4 Executive Director p. 5 Editor p. 9 Education Council p. 10 Professional Council p. 12 Leg. & Reg. Affairs p. 13 2011 Awards & Honors p. 18 ACR Accreditation p. 20 Education & Training Topics p. 21 Health Policy/Econ Issues p. 23 Working Group on Prevention of Errors Report p. 25 New Professionals SC Report p. 26 NRC Workshops Report p. 28 European Affairs SC News p. 29 Chapter News p. 31 Obituaries p. 33

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continued - President's Column The President’s Symposium, entitled “The Future of Medical Physics – challenges and opportunities” under the organization, guidance, and assistance of Bill Hendee, will feature five leaders of the AAPM: John Boone, Rebecca Fahrig, David Rogers, George Starkschall, and Per Halvorsen, who will be presenting their views and insight on the issues of research in Medical Physics, the past glory and the present challenges and opportunities that we all must face in the coming years resulting from a sea of change with respect to our profession. Look forward to a very informative program and lively discussion. I am deeply indebted to Bill Hendee for his willingness to organize this symposium and for his deep knowledge and sage advice regarding the issues.

Regarding your attendance at the annual meeting, for all non-Canadian citizens, make sure to apply for a passport immediately if you do not have one, and if you do have one, check the expiration date to ensure its validity for the duration of annual meeting …..otherwise you WILL NOT be able to enter Canada. Birth certificates or other non-passport forms of identification are no longer accepted. Do not be disappointed at the border, so check NOW. Finally, over the last two months I had the opportunity to participate in the AAPM Strategic Planning committee proceedings in Tucson on March 17-18, and visited the spring meetings of the Southwest Chapter of the AAPM in Dallas, Texas on April 2, and the Southeast Chapter of the AAPM on April 7 in Myrtle Beach, South Carolina.

The new strategic plan, which will set the direction of the AAPM and get the Board of Directors more involved in future planning of the association, is being refined by the ad hoc group for strategic planning, under the guidance and leadership of Mike Herman and Gary Ezzell. See Mike’s column for more details and progress that is being made.

The themes of the SWAAPM and SEAAPM chapter meetings were focused on safety in imaging and therapy, and developing a safety culture in the workplace. Each chapter had young investigators’ symposia and poster sessions, showcasing the future leaders of our profession. I was very impressed with the excellent speaker presentations and the organizational skills of the chapters in putting together truly outstanding events. Congratulations!

As always, please contact me at jaseibert@ucdavis.edu for any issues, concerns and comments related to the AAPM or the medical physics profession that you may have.

2011 Professional Program • • • • • • • • • •

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Professional Council Symposium - Preparing for Radiation Oncology ACR/ASTRO accreditation ABR 2014: Trained for Competence Preparing for Diagnostic ACR accreditation Women’s Professional SC Panel: Successful Career Strategies in Medical Physics The Role of Voluntary versus Mandatory Regulatory Standards Meet the Experts – Young Member Symposium Medical Physics in Africa Preparing for ABR Board Exams Economic Focus: Practical Aspects Role of Medical Physics in Federal and State Government

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2011 Therapy SAMs

SAM Session 1: Breathing-Induced Motion Management in Radiation Therapy SAM Session 2: Imaging Acquisition, Processing and Display for Guiding and Adapting Radiotherapy SAM Session 3: Quality Management Systems in Radiotherapy SAM Session 4: SBRT

In order to receive SAMs credits, you must rent an audience response unit while registering for the Annual Meeting. You will not be able to register for SAMs after July 6 (there will be no on-site registration.) If you have already registered for the meeting, but did not register for SAMs, you can still add SAMs by calling the registration call center at 1-508-743-8511.

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AAPM Chair of the Board’s Column Michael G. Herman, Mayo Clinic Strategic Plan

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he second incarnation of the AAPM Ad hoc Strategic Planning Committee met recently to complete a final draft of our Strategic Plan.

This document brings each objective and its respective strategies into focus and defines deliverables for each set of strategies. The objectives and strategies provide the mechanism for achieving the goals of the AAPM Mission. Each objective or strategy is assigned to a specific AAPM committee or group for accountable action. This plan is being finalized for review and approval by the AAPM BOD while you are reading this newsletter. In addition, the ad hoc committee was charged with proposing a process for monitoring, managing and guiding the ongoing strategic plan and process. A subcommittee of the board is being proposed to carry out this charge. This proposal will also be brought to the BOD for approval with the strategic plan.

Together, these should provide focus and continuity to our longer term planning and assist with prioritizing initiatives.

Consistent qualifications for clinical practice remain a critical focus. We continue to move toward the 2012 and 2014 dates, where CAMPEP accredited education will be mandated to sit for ABR certification. Residency program reviews continue to grow to meet supply needs. AAPM is working with RSNA to focus attention on the special need for imaging physics residency programs. For those of you who are carrying out clinical training please consider working toward accreditation, alone or partnering with other groups/programs. Assistance in obtaining accreditation is available. This is part of the larger effort toward guaranteeing that only qualified medical physicists participate clinical practice to provide the best patient care. Please see the Government and Regulatory Affairs column on page 13 for additional information on the CARE bill and the new QMP registry with the CRCPD. 2011 Annual Meeting

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any of you have already made plans to attend the Annual Meeting this year, which will be held in cooperation with COMP in Vancouver. Once again a very strong science program will be augmented by excellent educational and professional sessions, with SAMs and CME credit abundantly available.

Please make sure you take time to attend and get involved in committee meetings of interest. Also plan to join in the Town Hall and Business meeting.

AAPM functions well and is successful because of the energy and commitment of each of you. I also encourage you to consider signing up for the AAPM service project on Saturday afternoon to work at the Greater Vancouver Food Bank.

2011 Practical Medical Physics Track Highlights: • • • • • • • • • •

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Joint AAPM - CCPM educational session Writing/ reviewing papers for Medical Physics Going paperless in a radiation oncology clinic Clinically focused physics education Practical contouring: prostate and H&N anatomies Overview of accreditation programs for radiation oncology: ACR and ACRO Practical tips for VMAT implementation Practical concerns with airport whole-body scanners Review of radiation detectors for diagnostic radiology applications The new ACR CT accreditation program: phantom submission process

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President-Elect’s Column Gary A. Ezzell, Mayo Clinic Scottsdale

Living in the real world

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y experience of the “real world” was broadened recently. This past March 31 I represented AAPM at a Congressional briefing about radiation oncology, along with speakers from ASTRO, ASRT, and a patient advocacy group. A primary purpose was to advocate for the CARE bill, which would require states to ensure that all members of the radiation therapy team have adequate credentials. At this point, a number of states have no minimum qualifications for performing basic medical physics work, such as calibrating treatment units. The session was sponsored by Representatives Sue Myrick (R-NC) and Lois Capps (D-CA) and attended by staff from about 14 different House and Senate offices. Passage of the CARE bill has long been an AAPM goal, and we continue to plug away at the process of making law. “Governmental affairs” has not been one of my particular interests or strengths, but moving into the presidential sequence is allowing me to understand the depth and persistence of the work done on our behalf by volunteers and staff who have that expertise. Having an effect in the world depends on such people making sure we work effectively with other organizations on matters of common interest. AAPM was not originally included; Lynne Fairobent at HQ got us a seat at the table.

In mid May I will be among several physicists presenting talks at the annual meeting of the Council of Radiation Control Program Directors (CRCPD), the state radiation regulators, which is another lever we have on the world. I have been assigned the topic “Role of Regulations in Promoting Safety and Quality in Radiation Therapy.” This poses a dilemma. In my conception of the way the world ought to be, there should be no reason to single out the quality of radiation medicine for regulatory control. A prostate treated with radiation is subject to regulatory scrutiny that the same prostate treated with hormones or surgery is not. This offends my sense of symmetry, which for a physicist is a substantial insult. However, if we accept the premise that there is and should be such regulation (and in all honesty patients are better off for it), then what should be said? At this point, I am thinking of three main messages: (1) AAPM is developing minimum practice guidelines to support practice accreditation; these guidelines will be better guides for regulation than tables of recommendations in task group reports.

(2) Regulators should not try to keep prescriptive regulations up to date with technology; instead they should look for evidence of quality systems and continuous quality improvement practices.

(3) Many significant errors are the result of commissioning mistakes that affect many patients.

Regulators should require external peer review of new systems before they are used to treat patients.

This last point will need careful elucidation: which new systems and what kind of peer review? But the real world would be safer if we checked each other’s work, and that is more likely to happen if such were a regulatory mandate. Would you agree? How might such a regulation be crafted? More generally, what type of regulatory structure would best balance rigor and flexibility? Let me know what you think: ezzell.gary@ mayo.edu.

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AAPM 2011 Summer School Uncertainties in External Beam Radiation Therapy

August 4-9, 2011 immediately following the AAPM Annual Meeting Simon Fraser University, Burnaby, BC http://www.aapm.org/ meetings/2011SS/ Save $$ and register prior to the June 1 deadline Program Directors: Jatinder R. Palta, PhD, University of Florida T. Rock Mackie, PhD, University of Wisconsin

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AAPM Executive Director’s Column Angela R. Keyser, College Park, MD FYI…

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APM has added a feature to the Member Directory results page that allows members with a Smartphone to easily import directory information. The feature is called a QR code and you will need a Smartphone with a camera and a barcode reader/scanner app (many of which can be found for free).

Scan the code of the person you wish to import and your phone should recognize the Name, Department, Institution, Address, Phone and Email address. We have tested this with Barcode Scanner v3.53 for Android and it gives you the option to automatically import, show the contact on a map, dial their phone or send them an email. We only show the QR code for members who have opted to show contact information.

AAPM has made it easier to understand where your printed journal will be delivered. From the Member Profile screen, click on Journal . If you are subscribed to the print journal, it will show the address where your journal will be delivered. If you need to change the address, it tells you which address to change and allows you to verify once the change is made.

New AAPM Reports The report of AAPM Task Group 154: Quality assurance of U.S.-guided external beam radiotherapy for prostate cancer is now available online at: http://aapm.org/pubs/reports/RPT_154.pdf AAPM Report #100, Acceptance Testing and Quality Assurance Procedures for Magnetic Resonance Imaging Facilities, the report of MR Subcommittee Task Group 1 is available online at: http:// aapm.org/pubs/reports/RPT_100.pdf Election Process online only this year!

Elections for the 2012 Officers and Board Members-At-Large will open on June 22 and will run through July 13. Again this year AAPM will use the Bulletin Board System (BBS) during the election process to allow members to discuss issues of concern with the candidates and the election in general. The election process will be online only so be alert for email announcements.

Upcoming AAPM Meetings Looking for a way to engage with medical physicists in your local area? Consider attending a local chapter meeting. Many chapter meetings offer MPCECs for participating. For a list of meetings, go to: http://www.aapm.org/meetings/chaptermeetings.asp The Joint AAPM/COMP meeting will be held July 31 – August 4 in Vancouver, British Columbia.

Abstract submissions were up significantly for the upcoming meeting and attendance is expected to be at an all time high. Remember, the program organizers have planned a “dawn-to-dusk" program (8:00 AM – 6:00 PM) of Educational, Professional and Scientific Programs to allow more sessions in areas of particular interest with less parallel track overlap. The full meeting program will be available online by May 12. Make sure to register by June 8 to receive discounted registration fees.

Important information regarding passports and visas: United States Visitors to Canada, when re-entering the U.S., must show a passport or other travel documents as approved by the Department of Homeland Security. Please do not leave the U.S. without your passport or other approved travel documents.

International visitors to Canada (not US citizens or US permanent residents) must carry a valid passport and, if required, a visa. Citizens from the United Kingdom, France, Germany, Japan, the Republic of Korea, Australia and some other countries do not require a visa to enter Canada.

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continued - Executive Director's Column Visit the Citizenship and Immigration Canada website for a complete list of countries whose citizens require visas to enter Canada.

All other visitors should contact their Canadian embassy or consulate to learn what documents are required. Contact information for Canadian embassies around the world can be found at the Foreign Affairs Canada website.

Visitors are advised that if they are travelling through a third country, they may also need visas or other documents for that country.

For further information, please visit travel.state.gov.

Interested in sharing costs with a roommate in Vancouver? Sharing a hotel room at the conference can stretch your budget and make your travel expense more affordable. Check out the AAPM/ COMP Roommate Search Bulletin Board for a potential hotel roommate to save on hotel costs.

While AAPM will monitor content on the Roommate Search BBS, AAPM is not ultimately responsible

Special Ultrasound Symposium – Advances in Therapeutic and Diagnostic Ultrasound August 1 – 4, 2011 Monday, August 1 – US Education and Diagnosis, Tuesday, August 2 – US Diagnosis, Wednesday, August 3 – US Therapy Thursday Morning, August 4 – Diagnosis and Guidance of Interventions US Education Courses (and organizers) include: • Hands-On Workshop (Sandra Larson, Zheng-Feng Lu) • Current state, future directions and challenges of US (Thaddeus Wilson) Diagnostic symposia (P Carson, X Wang) include: • Contrast and Interventional Agents (US and optical), and Small Animal Imaging (Brian Fowlkes, Michael Kolios) • Advanced Systems, Components, Signal/Image Processing & Display (Robert Entrekin, Robert Rohling) • Photoacoustic Imaging (Xueding Wang, Robert Kruger, Peter Kaczkowski) • Breast, Other Applications, Guidance of Interventions (Michael Andre, Aaron Fenster) • Quantitative Imaging & Measures (James Zagzebski, Russell Witte) • US Image Guidance in Radiation Therapy (Frank Verhaegen, Bill Salter) Therapy symposia (Chris Diederich with include: • Clinical Systems and Applications (Joo Ha Hwang, David Schlesinger) • Image Guidance and Assessment (Kayvan Farahani, Nathan McDannold) • Advanced Technology and Implementation (Larry Crum, Kim Butts Pauly) • Novel Technologies & Therapeutic Strategies (Cyril Lafon, Kullervo Hynynen) • Treatment Planning, Control & Assessment (Eduardo Moros, Jason Stafford)

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continued - Executive Director's Column for content posted by others, or for decisions individuals make based on the content. Please use prudence.

More information on the Joint AAPM/COMP meeting is available online at: http://www.aapm. org/meetings/2011AM/ .

The 2011 AAPM Summer School, Uncertainties in External Beam Radiotherapy, will immediately follow the Annual Meeting, from August 4-9 at Simon Fraser University in Burnaby, British Columbia. Make sure to register by June 1 to receive discounted registration fees.

AAPM offers scholarships in the form of a waiver of tuition for the Summer School. This year, there were 13 applications. Congratulations to the five 2011 recipients: Mandar Bhagwat, Esmaeel Ghasroddashti, Wu Li, Nicolas Ploquin and Christina Skourou. In addition, Capintec sponsors two $500 grants to assist with other expenses related to the Summer School.

Capintec established these grants to honor the memory of Arata Suzuki, Ph.D., who was part of Capintec for more than 20 years. Wu Li and Nicolas Ploquin are the recipients of the 2011 Suzuki grants.

For details, go to: http://www.aapm.org/meetings/2011SS/ .

AAPM is hosting the 2011 CT Dose Summit: Interdisciplinary Program on Scan Parameter Optimization for Imaging Physicians, Technologists and Physicists, October 7-8 in Denver, CO. Program Directors Cynthia McCollough and Diana Cody have put together an outstanding faculty with the goal to provide practical information for users that will help them operate their CT scanners wisely, improving the quality and usefulness of CT images while reducing the radiation dose to patients. Registration for the 2011 event will open on May 11. Do not delay in registering as 2010 event sold out in record time. For more information, go to: http://aapm. org/meetings/2011CTS/.

AAPM HQ Team‌at your service!

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he AAPM Accounting Team is hard at work supporting the activities of the Association. Like the IS team, profiled in the last issue, the valuable work of the Accounting team takes place primarily behind the scenes.

Peggy Compton joined the Accounting team in October 2004 as the Accounting Assistant. As a result of her willingness and eagerness to take on a higher level of responsibility, she was promoted to Senior Accounting Assistant at the end of 2007. Peggy processes dues renewals and other cash receipts, records accounts payable, prepares checks and does the invoicing.

Melissa Liverpool, the newest member of the HQ team, joined the staff in January of this year as the Staff Accountant. Melissa has responsibility for daily and monthly accounting functions, including management of general ledger functions, production of financial reports, management of cash and reconciliation of accounts.

The team together is responsible for handling the receipt and disbursement of over $7 million annually, including hundreds of transactions monthly. Thousands of dues payments are processed annually, along with meeting registrations and exhibitor payments for the various meetings managed by HQ. Coming next issue‌.group profile of the AAPM Legislative and Regulatory Affairs team.

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TG-142 QA Made Easy Streamline the integration of TG-142 procedures into your workflow by consolidating a multitude of QA tests into a single application.

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Monthly MV and kV imaging tests

Spatial resolution, contrast-to-noise, overall noise

Monthly mechanical and imaging QA procedures

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Light/radiation field coincidence & crosshair alignment, jaw positioning, scaling – MV & kV imaging

Star shot analysis for annual mechanical procedures

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Collimator rotation isocenter, gantry rotation isocenter, couch rotation isocenter

Automatic CATPHAN analysis for monthly CBCT QA tests

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Geometric distortion, spatial resolution, HU constancy, contrast, noise

Stereotactic QA

1281-25, 08/10

Automatically analyze EPID images of Winston-Lutz ball marker

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Editor's Column Mahadevappa Mahesh, Baltimore, MD

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elcome to the 3rd issue of the 2011 Newsletter. As reflected in the President’s column, it is quite heartbreaking to read the news regarding the crisis and devastation that has occurred in Japan.

As a result, the nuclear reactor’s disaster and the continued radiation emissions from it are putting all of us in the medical physics field, and others, in situations where we are expected to immediately provide accurate information and a well placed perspective.

In addition to regular columns, this issue contains updates on the upcoming annual meeting along with AAPM awards information and other reports including local chapter news. Also featured in this issue is the obituary of two AAPM stalwarts namely Dr. Suresh Agarwal and Dr. Joseph Sayeg. I am privileged to have known Dr. Agarwal well through the activities of the Mid-Atlantic Chapter of AAPM. He was a nice man who was always liked by everyone.

Finally, I would like to congratulate all the recipients of the 2011 AAPM Awards and Honors (pages 18-19). I am looking forward to the Awards Ceremony and Reception in Vancouver.

Therapy Physics Educational Courses

2011 Imaging SAMs •

The Therapy Physics Educational Courses will feature courses on therapy physics practices including TG-51 calibration, QA/Safety, and sitespecific treatment strategies (pelvis and head/ neck) as well as special clinical procedures including Stereotactic Body Radiotherapy (SBRT), motion management, and non-ionizing imaging, data flow and management, Monte Carlo for planning, dosimetry of small fields, proton therapy, and radiobiology for radiotherapy among others. Our goal this year was to create an overall learning opportunity directed toward the junior physicists, student, and physics resident while the SAM sessions go into depth on an advanced or novel topic and therefore should also be suitable for more experience physicists.

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In order to receive SAMs credits, you must rent an audience response unit while registering for the Annual Meeting. You will not be able to register for SAMs after July 6 (there will be no on-site registration.) If you have already registered for the meeting, but did not register for SAMs, you can still add SAMs by calling the registration call center at 1-508-743-8511.

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SAM Session 1: Breast tomosynthesis Principles of breast tomosynthesis acquisition and reconstruction, and Role of the medical physicist in clinical implementation of breast tomosynthesis; SAM Session 2: Estimating patient dose at CT and estimating patient dose resulting from fluoroscopically-guided interventions SAM Session 3: Physics of MRI safety and clinical MRI safety SAM Session 4: Yttrium-90 microsphere therapy planning and dose calculation;Absorbed dose estimation for radiopharmaceuticals

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Education Council Report George Starkschall, Houston, TX

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everal months ago I introduced you to the International Educational Activities Committee, one of the committees that make up the AAPM Education Council. This month I asked Mark Rzeszotarski, Chair of the Medical Physics Education of Physicians Committee to describe to you the activities of his committee.

The Medical Physics Education of Physicians Committee Mark Rzeszotarski, PhD The Medical Physics Education of Physicians (MPEP) Committee is one of the committees overseen by the Education Council of the AAPM. Its charge is to facilitate the development of medical physics educational resources for physicians. A few years ago, the committee changed its name from the Training of Radiologists Committee to the Medical Physics Education of Physicians Committee, reflecting the broader need for medical physics education for radiologists, radiation oncologists, cardiologists and other practitioners who utilize radiologic equipment in the healing arts. The MPEP Committee meets at AAPM and RSNA each year as do many of the standing AAPM committees. MPEP currently has six subcommittees and one task group. Much of the work accomplished by this committee is through its subcommittees, which are described below.

Two of the subcommittees are joint AAPM/RSNA subcommittees charged with developing educational materials for presentation at the RSNA annual meeting on the Saturday afternoon at the start of the RSNA meeting. An equipment selection tutorial and a tutorial on medical physics for radiology residents are presented each year. The physics tutorial lectures are frequently converted into Radiographics articles in their AAPM/RSNA Physics Tutorial for Residents series and are useful for medical physics education. A list of these articles can be found on the RSNA web site at http:// www.rsna.org/Education/archive/aapm.cfm Another subcommittee of MPEP is the Imaging Physics Curricula Subcommittee. This group developed a recommended medical physics curriculum for diagnostic radiology residents, available at http://www.aapm.org/education/documents/Curriculum.pdf The subcommittee is currently pursuing the development of additional educational resources for radiology residents as well as an ongoing review of the curriculum to keep it current.

A similar subcommittee, the Curriculum for Radiation Oncology Medical Residents Subcommittee, is a joint AAPM/ASTRO subcommittee that developed a recommended medical physics curriculum for radiation oncology residents, which can be found at http://www.aapm.org/education/ documents/ASTROAAPMDetailedCurrwObjectives0605Release.pdf This SC is currently updating their curriculum.

The Physics Education Task Force Subcommittee is charged with the development of web-based medical physics educational modules targeting the diagnostic radiology resident. Over the past several years, this subcommittee has spearheaded this major joint AAPM/RSNA project to develop on-line medical physics education. Currently, 40 education modules are on-line with several more in development. Phases I and II of this project are now nearly completed. Phase III will commence in the near future, consisting of a revision of all modules based on feedback from users as well as updates due to technology advances, etc. Each web module includes a quiz at the end with the awarding of a certificate upon successful completion. The intent is to assign some of the materials for resident review during clinical rotations or they can be used in didactic lectures. These modules are image-rich and were jointly written by teams of medical physicists and radiologists. The modules are also useful for medical physicist and radiation oncology resident education. They

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continued - Education Council Report are available free of charge to all AAPM and RSNA members. Note that radiology residents can join RSNA for free. If you have not seen them, have a look at: http://www.aapm.org/education/ webbasedmodules.asp In March of this year, the MPEP Committee approved the formation of a new subcommittee, the Radiation Oncology Medical Physics Education Subcommittee. Its charge is to develop web-based medical physics educational materials for radiation oncology residents in training, similar to the diagnostic radiology resident modules developed by the AAPM and RSNA. This subcommittee is currently exploring funding and affiliation opportunities. It plans to meet in Vancouver this summer for the first time. When completed, these modules should also be useful for medical physicist resident education.

The MPEP Committee has one active task group, TG 124, Guide for Establishing a Fluoroscopy Credentialing Program for Physicians. This is becoming an increasingly important task often delegated to medical physicists for implementation. The aim of the task group is to provide guidance in instituting a fluoroscopy credentialing process in the hospital setting. The task group work is nearing completion and it will complement the recently published NCRP Report 168: Radiation Dose Management for Fluoroscopically-Guided Interventional Medical Procedures.

The MPEP committee has recently devoted considerable time and effort discussing medical physics education of diagnostic radiology residents. This has been brought on by the American Board of Radiology’s decision to change their examination process for diagnostic radiology residents. Currently, residents sit for three examinations: medical physics, clinical written and oral boards. Residents frequently cram for the medical physics examination and then forget most of what they have learned before they graduate. Starting in 2013, diagnostic radiology residents will take two computer-based exams, one at the end of their third year of training and another 15 months after completion of their residency. There will no longer be an oral exam. Medical physics AAPM New Member Symposium content will be incorporated into both examinations.

Tuesday, August 2 • 4:30pm - 6:00pm The hope is to stimulate long-term retention of medical physics knowledge so that radiologists use Room 224,Vancouver Convention Centre this expertise in their clinical practice. This mastery Welcome: J. Anthony Seibert, PhD of technology is one of the skills that differentiates Professional Etiquette: George Sherouse, PhD Panel Discussion: Rocky Barra, Michael Mills, PhD a radiologist from other practitioners who utilize John Swanson, PhD, Eric Klein, PhD radiologic equipment. Because the timing and clinical focus of the examination process are different from Calling all AAPM New Members (who have joined since 2008) what it was in the past, medical physics education will need to adapt to satisfy the constraints imposed Grab a beer and meet the committee chairs from 4 AAPM Councils: Science, Education, Professional on the resident to master all modalities by the end and Administrative. of their third year of training. A number of recent articles have been published that describe different New AAPM members registered for the 2011 Joint suggested methods for medical physics education.

AAPM/COMP Meeting -- RSVP now so we know you are coming!

The MPEP Committee hopes to assemble some “best practice” examples which others can use to develop All new AAPM members who RSVP will receive their medical physics educational offerings. a raffle ticket (enter to win a complimentary registration for the 2012 Annual Meeting in The MPEP Committee is also working with the Charlotte!)

Education Council to develop an Educator’s Resource In addition, all new members who RSVP will receive Guide, identifying useful resources for medical physics a drink ticket, good for one complimentary beer education. We plan to assemble lists of useful web served at the New Member Symposium. sites, identify good textbooks, articles, videos, blogs, wikis and other materials that can facilitate medical RSVP: http://www.aapm.org/meetings/2011AM/ NewMemberSymposium.asp physics education of physicians. Please share your Deadline to RSVP (tickets will be included with your ideas for useful materials with the MPEP Committee. badge onsite) is July 13.

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Professional Council Report Per Halvorsen, Newton, MA

ACMP and AAPM: Moving forward as one. s most of you know, the ACMP and AAPM Boards voted last November to combine into one organization by the end of 2011. We are now in the implementation phase, and it appears that everything is on track to a unified structure by the end of the year.

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At the end of April, the Professional Council will meet in Chattanooga in connection with the ACMP Annual Meeting, where we will hold a joint session with ACMP leadership to determine how to change the Professional Council’s structure to ensure that ACMP and AAPM contributions are properly represented.

The ACMP Annual Meeting has always been a highly regarded conference for clinically practicing medical physicists, and starting in 2012 it will be relabeled as the AAPM Spring Clinical Meeting – with the same great team of organizers and program directors.

Medical physics workforce study and Salary Survey validation report – ready for distribution.

The Center for Healthcare Workforce Studies at SUNY has completed the workforce study that the AAPM contracted for, as well as the validation of the AAPM’s salary survey methodology and findings. Their reports have now been approved by the Professional Services Committee as well as the Professional Council. Both reports are available on-line.

Medical Physicist named to the Medicare (CMS) advisory committee The Centers for Medicare and Medicaid Services (CMS) has named AAPM member Michael Mills to serve a two-year term on the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). His term begins June 1, 2011, and ends May 31, 2013. As many of you know, Michael is uniquely qualified for this role, with his multiple board certifications, crucial role in the Abt studies, extensive work on procedural and manpower issues in our profession, and his leadership role within the AAPM (past Vice Chair of the Professional Council and current Chair of the Professional Services Committee). We are fortunate to be represented at MEDCAC by one of our colleagues, and MEDCAC will benefit from his broad and deep expertise.

Updates to the Qualified Medical Physicist and Scope of Practice policy statements With the ACMP and AAPM unifying, and with increased interest in accreditation of imaging and radiotherapy programs, this is an appropriate time to re-assess our policy statements on the scope of practice in clinical medical physics and the appropriate qualifications for a clinical medical physicist to practice independently. The Professional Council recently presented a revised definition of Qualified Medical Physicist to the Board, and based on their input we will further refine the definition in coming months.

At the same time, we are reviewing and updating the Scope of Practice policy statement to ensure that both documents are current The 2011 AAPM election will open for online and synergistic. We hope voting on June 22, 2011. All Membership to have final versions of votes will be accomplished via electronic both documents ready for ballot and paper ballots will not be mailed out. the Board’s consideration at the Annual Meeting.

The deadline to submit your vote electronically

AAPM 2011 ELECTIONS

or by paper ballot will be July 13, 2011.

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Legislative and Regulatory Affairs Lynne Fairobent, College Park, MD

President-elect Ezzell Participates in Educational Briefing to Congressional Staff on Value of Radiation Oncology

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n March 31, 2001, The American Association of Physicists in Medicine (AAPM), the American Society for Radiation Oncology (ASTRO), and the American Society of Radiologic Technologists (ASRT) held an educational briefing for congressional representatives, especially those serving their first term, about the value of radiation oncology as a cancer treatment, new technologies and significant advances in patient care, and community cancer treatment centers' focus on patient safety.

Rep. Sue Myrick (R-NC), a breast cancer survivor who underwent radiation therapy, and Rep. Lois Capps (D-CA), a registered nurse and advocate for patient safety, not only sponsored the briefing but also attended it and made opening remarks. Dr. Anthony L. Zietman, chair of the American Society for Radiation Oncology (ASTRO) served as the facilitator for the briefing. "The radiation oncology community's highest priority is ensuring that patients receive the safest, most effective treatments available," Zietman said.

Rep. Sue Myrick (R-NC)*

"As a cancer survivor myself who has undergone radiation therapy, I can personally attest to the value of this cancer treatment," Rep. Myrick said. "Radiation therapy technology has become more precise and state of the art compared to just a decade ago. It is important that cancer patients have access to this critical therapy. It allowed me to continue my normal routine while undergoing treatment. I credit my speedy recovery in large part to radiation therapy, and the caring expertise of my doctors."

"I applaud this community for coming together to raise awareness about the benefits of advanced radiation therapy services in cancer care," added Rep. Capps. "As a nurse, I remain committed to working with the medical community, and my fellow lawmakers, to build on the important protections for individuals with cancer in the Affordable Care Act and protect access to potentially life-saving treatments upon which so many patients depend."

Rep. Lois Capps (D-CA)*

The briefing was a mix of the medical community and patient advocates speaking on the important role radiation oncology plays in treating cancer.

Dr. Gary Ezzell stated: "Radiation therapy has become much more complex, both in technology and procedures. We are able to better control the shape and location of the radiation dose.

AAPM supports efforts to further improve these potentially life-saving therapies for patients."

The most moving presentation was by Nancy DavenportEnnis, a cancer survivor and founder and CEO of the Patient Advocate Foundation. She spoke of her experience with her own cancer and told a story about a man who woke one day AAPM President-Elect, Gary Ezzell*

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continued - Legislative and Regulatory Affairs with a simple earache only to learn that he had extensive head and neck cancer. In her comments she mentioned the important role of his medical physicists at Duke. The man she spoke of is her husband, who five years later is doing well. She discussed the importance of access to cancer care for all patients battling this devastating disease.

"It is vital for everyone here today members of Congress, patient advocates, and all members of the cancer community to work together to continue to fight the war on cancer, to continue the pursuit of innovative treatments that hold even greater promise for a cure, and to ensure that each patient diagnosed with cancer has access to the treatment prescribed by their physician to manage their disease," added Nancy Davenport-Ennis.

All participating organizations called for passage of the Consistency, Accuracy, Responsibility and Excellence (CARE) in Medical Imaging and Radiation Therapy Act, which will soon be introduced

by Rep. Ed Whitfield (R-KY), as a positive policy solution to ensuring patient safety through the establishment of national educational and certification standards for health care professionals and radiologic personnel who administer radiation therapy treatments. Supporters of the CARE Act emphasized that this legislation is a necessary first step in improving patient care and protecting patients from unnecessary exposure to radiation.

NRC - ACMUI meeting April 11-12, 2011 – by Herbert Mower, Chair GRAC and Lynne Fairobent, Manager of Legislative and Regulatory Affairs, AAPM The Advisory Committee on the Medical Use of Isotopes [ACMUI] held a meeting on April 11 and 12, 2011 at the NRC headquarters in Rockville, MD. This group reviews items of concern to the NRC relative to medical isotopes and the safe use thereof. Support or promotion of a proposal by the ACMUI does not automatically result in adoption of the concept by the NRC staff. Frequently the NRC staff has gone in the opposite direction. For this meeting, the agenda included: • Written directives and medical event reporting for permanent implant brachytherapy • Amending preceptor attestation requirements • Extending grandfathering to certain certified individuals regarding training and experience requirements [Petition for Rulemaking (RPM 35-20, Ritenour Petition)] • Dose limits to members of the public [per year versus per treatment] from patients who have been administered radioiodine Although the NRC staff referred to this meeting as the first ‘public workshop’ relative to these items, it was really not stated that way in the Federal Register. In addition, with only about two weeks public notice in a ‘not-so-obvious posting, there was no real participation by the public.

The ACMUI forwarded to the NRC staff the recommendation that future workshops have at least 3-months notice. This will not affect already scheduled Part 35 workshops as the next two in this series are presently scheduled. The first workshop will be held June 20 -21 in New York City.

Initially both workshops were being scheduled for June. However, based on concerns raised by AAPM to the ACMUI and NRC staff regarding the short notice for these workshops, the NRC staff did move the second workshops to August. The final dates for the August workshop were not set at the time of writing this article but are tentatively being scheduled for the week of August 8 -11, 2011 in Houston, TX. In the opening session there was a report of the medical events subcommittee, which noted that for the previous year there was a very low incidence of reported medical events. The incidence was well below 1% being closer to 0.004% and that these posed no safety problems, only that there might be the potential for harm.

The next agenda item addressed written directives for permanent implant brachytherapy, what is a medical event related to and the implications thereof. The NRC staff looked at the original intent of the procedure as the written directive rather than the adjustments thereto at the time of the procedure. Thus, the resultant implant, although meeting the clinical needs as evaluated at the time of the implant may not agree with the earlier intent. Thus, the delivered dose is as clinically required though it still may need to be reported as a medical event, causing much concern on the part of the patient when there is no clinical problem. The American Society

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continued - Legislative and Regulatory Affairs for Radiation Oncology (ASTRO) proposed, and the ACMUI supported the recommendation that the ‘written directive refer to the total source strength implanted after administration but before the patient leaves the post-treatment recovery area rather than an arbitrary pre-implantation written directive.’ There was also strong support for post-implant dosimetry including a CT scan performed immediately after the procedure. The full text of the ASTRO letter can be found at: http://pbadupws.nrc.gov/docs/ML1110/ML111010724.pdf.

Next the committee moved on to the ‘Ritenour Petition’ which expressed concerns over the grandfathering clauses for recognition of board certified individuals boarded prior to the date of implementation of the recent complete overhaul of part 10CFR35 in 2005 and as amended in 2008.

The NRC staff, after reviewing the petition, decided to keep the attestation requirement for those earlier diplomats. They noted that this probably affected about 10,000 people. The ACMUI voted to eliminate the attestation requirement for those boarded by a recognized board, regardless of the date of certification. Although this is a positive step by the ACMUI, it is uncertain how this would help individuals certified by boards before the recognized effective dates of acceptance by the NRC. AAPM will analyze this issue prior to the upcoming Part 35 workshops to determine if this would resolve the grandfathering concerns raised in the Ritenour Petition or simply eliminate the need for the preceptor attestation but still require individuals certified by a recognized board prior to their listed date of recognition to apply under 10 CFR § 35.50 and 10 CFR §35.51 via the alternate pathway. Board certifications and dates of acceptance are found at: http://www.nrc.gov/materials/miau/med-use-toolkit/spec-board-cert.html.

The last agenda item pertained to the release of patients with a therapeutic body burden of radioactive material in accordance 10 CFR §35.75. The concern was noted as the safety of the general public and that, if a patient received more than one administration within a year, there might be a public dose problem. Prior interpretations, and even direct statements in earlier regulations, referred to the exposure values from a single therapeutic administration and not integrated over the year. The problems with the present interpretation is that it assumes the more than one administration are given to only one patient and that they only interact with the same individuals in the public. Obviously a member of the public may be in contact with more than one patient in the year and there is no way to know this from the licensee’s perspective. Thus, although the NRC staff are promoting an annual exposure limit, the ACMUI’s recommendation was that NRC pursue rulemaking to clarify the criteria and endorse a per episode limit.

These items will be on the agenda for the upcoming 10 CFR Part 35 workshops in June and August in NYC and Houston, respectively. Updates on the workshops will be noted on the AAPM website.

The full agenda for the April ACMUI meeting can be found at: http://pbadupws.nrc.gov/ docs/ML1108/ML11088A014.pdf. The slides from the meeting are posted at: http://www. nrc.gov/reading-rm/doc-collections/acmui/meeting-slides/. The full meeting summary will be available at: http://www.nrc.gov/reading-rm/doc-collections/acmui/meetingsummaries/.

A National Registry for Qualified Medical Physicists (QMP) The goal of the QMP Registry supported by the AAPM and the Conference of Radiation Control Program Directors (CRCPD) will be an electronic database comprised of all professional certifications granted by the American Board of Radiology (ABR), the American Board of Medical Physics (ABMP), the American Board of Health Physics (ABHP), the American Board of Science in Nuclear Medicine (ABSNM) and the Canadian College of Physicists in Medicine (CCPM). Each of the certifying boards on a yearly basis will submit date-specific lists of individuals who are currently boarded and their specialties (diagnostic, therapy, etc.). The database will be open to the public to verify an individual medical physicist’s board certification(s) and/or license(s).

The individual’s credentials will not be independently verified as accurate nor will there be any processes established to remove an individual from the registry unless the certifying board/state removes the individual certification and/or the license is revoked. However, verification of the data upload will be performed to ensure that the information transferred correctly.

Also there is currently no law or regulation in place that compels an employer to hire an individual who is listed on the registry. The QMP registry is a tool that can be used by regulatory agencies and employers to independently verify that the individual has successfully passed a

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continued - Legislative and Regulatory Affairs recognized examination in their specialty.

It will prevent fraudulent activities with counterfeit certifications similar to what happened in some states several years ago. In addition, in institutionalizes the definition of a Qualified Medical Physicists making it easier to develop regulations and licensure. It’s limitation is that all information comes from the board who certifies the individuals and only if the board certification is revoked will the individual’s name be removed from the registry.

AAPM Career Services http://www.aapm.org/careers careers@mail.aapm.org or 301.209.3187

Running in circles looking for a great medical physics job or hire? Save your breath - try the allnew AAPM Career Services site:

The registry will be demonstrated at the American College of Medical Physics and the CRCPD’s meeting in May with a goal of a July 1st launch. By waiting until July 1st to launch the registry, the 2011 diplomates should be included in the registry.

Upload your resume and apply-for the latest job opportunities… click here

…or post jobs and search thousands of relevant resumes!

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AAPM Newsletter

May/June 2011

Congratulations to the recipients of the following awards, achievements and honors in 2011!

William D. Coolidge Award is present to: Richard L. Morin, PhD Honorary Membership is presented to: Salvatore Trofi

Edith H. Quimby Lifetime Achievement Award is presented to: Joel E. Gray, and Martin S. Weinhous, PhD

The following are named Fellows in 2011 for their distinguished contributions to the AAPM: Jay W. Burmeister, PhD

Donald J. Peck, PhD

Frederic H. Fahey, DSc

Robert A. Price Jr., PhD

Mary F. Fox, MS

Mark J. Rivard, PhD

James R. Halama, PhD

Peter J. Rosemark, PhD

Michael F. McNitt-Gray, PhD

Narayan Sahoo, PhD

Andrzej Niemierko, PhD

George A. Sandison, PhD

Xiaochuan Pan, PhD

Terry T.Yoshizumi, PhD

E. Ishmael Parsai, PhD

All of the award, achievement and honor recipients will be recognized during the 2011 AAPM Annual Meeting in Vancouver, BC, Canada at the Awards and Honors Ceremony and Reception.

Please join us in congratulating all of the recipients: DATE: Monday, August 1, 2011 TIME: 6:30 PM PLACE: Ballroom A

Vancouver Convention Centre

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Farrington Daniels Paper Award (dosimetry) is given for: “Monte Carlo calculations of kQ’ the beam quality conversion factor” by Bryan Muir and David Rogers Medical Physics 37, Number 11/5939-5950

May/June 2011

Sylvia Sorkin Greenfield Paper Award (non-dosimetry) is given for: “Noninvasive mapping of spontaneous fluctuations in tumor oxygenation using 19F MRI” by: Bernard Gallez, Julie Magat, Benedicte Jordan and Greg Cron Medical Physics 37, Number 10/5434-5441

AAPM-IPEM Medical Physics Travel Grant is presented to: Jun Deng, PhD

AAPM Regrets to announce that the following members have passed away since our last Annual Meeting: Suresh Agarwal, PhD - Charlottesville,VA L. Stephen Graham, PhD - North Hills, CA Kwangyoul Park, PhD- Dallas, TX Robert Rohrer, PhD - Tucker, GA Mircea Sabau, PhD - Bolingbrook, IL Joseph Sayeg, PhD - Lexington, KY If you have information on the passing of members not listed above, please inform HQ ASAP so these members can be remembered during the Awards and Honors Ceremony at our upcoming Annual Meeting. We respectfully request the notification via e-mail to: 2011.aapm@aapm.org Please include supporting information so that we can take the appropriate steps.

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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.

The ACR launched its newest accreditation program, the Breast MRI Accreditation Program, in May 2010. The following questions are actual ones received by the ACR regarding this new program. To see more FAQs on this topic, please visit the ACR website.

Q. We did not pass accreditation on our first attempt. The ACR reviewers pointed that there may be performance problems associated with the equipment or our choice of protocol.

What should we do?

A. You should contact medical physicist/MR scientist for assistance. When ACR reviewers report image quality problems on cases submitted for accreditation. It is not always possible to exactly identify the cause of the deficiencies. Reviewers will provide “possible” causes to help direct the facility in correcting the problem. Your medical physicist/MR scientist can be invaluable in helping you identify and eliminate problems that are technical in nature by reviewing your protocols and/or conducting focused tests on the equipment.

Q. My out-patient facility is already accredited by the ACR in MRI. Are we also required to be accredited in Breast MRI in order to be reimbursed by CMS for breast MRI exams?

A. Yes. CMS mandates that ACR transmit to CMS separate data elements for each MRI sub-modality that an accredited facility performs. For example, if your facility is currently ACR accredited in Cardiac or MSK MRI, and you begin performing breast MRI, that service must also be accredited ACR will be required to submit breast MRI separately to CMS for you to receive reimbursement.

Q. We currently run an Ax T2 fat-sat instead of a routine Ax T2 for fluid. Is this an acceptable sequence to run? (I did not see any fat-sat sequences specifically listed in the ACR documentation.)

A. Yes, it is acceptable -- and desirable. The Breast MRI Accreditation Committee decided not to specify the type of pulse sequences required and leave the selection to the discretion of the imaging facility. For the T2W/bright fluid series, the ACR specifies that the sequence should demonstrate fluid as sufficiently bright to be considered a true bright fluid sequence. With a T2 fat-sat (or STIR) the fat is suppressed (i.e., becomes dark) and the bright fluid is much easier to see. Please review the Clinical Image Quality Guide for more information on the image characteristics evaluated by ACR reviewers for the T2W/bright fluid series.

Q. We have an Aurora Dedicated Breast MRI System that acquires a pre-contrast T-1 weighted series that is also a T2-weighted/bright fluid series. Consequently, we cannot submit the 4 required sequences? May we only submit 3 sequences for accreditation review?

A. Yes. If the pre-contrast series is sufficiently T2-weighted, it can be evaluated as both the T2weighted/bright fluid series and the pre-contrast T1-weighted series. In this case, enter the acquisition parameters under “Pre-Contrast T1” on the Test Image Data form; in the “Sequence name/ type” space under “T2-Weighted/Bright Fluid Series,” check “see pre-contrast T1W.” Do not fill out the remaining parameters for the T2-weighted/bright fluid series.

Q. The Aurora EDGE software uses a distinctly different acquisition time for the pre-contrast series compared with that of the post-contrast series. Is this difference acceptable?

A. Yes.

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Education and Training Topics A Post-Doctoral Certificate in Radiation Oncology Physics – A Practical Alternative Pathway by: Wendy Smith, Derek Brown and Peter Dunscombe

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he Department of Physics and Astronomy, Radiation Oncology Physics specialization, at the University of Calgary in Alberta, Canada, offers both CAMPEP-accredited graduate and residency programs. Fewer than a quarter of applicants for recent residency openings had PhDs from CAMPEP-accredited graduate programs. Our policy is to give a strong preference to applicants who have a comprehensive didactic background in radiation oncology physics before entering the residency. The experience and policies of many other residency programs echo our own. The ABR will soon require a CAMPEP-accredited residency as a prerequisite for admission to their certificate examination, and CAMPEP is becoming stricter on the number of ‘make-up’ courses that can be taken during the two-year residency itself.

So what is a nuclear physicist with dreams of becoming a medical physicist to do? Often, such physicists apply to our MSc program, but, to be frank, little is gained by them doing a third thesis.

The question of how we can facilitate entry to the field of medical physics for people with doctoral degrees in other specialities has been raised in several recent publications, including TG-133 and in this newsletter in Nov-Dec 2010. Clearly, the first step is to provide the missing didactic components, (Charge 3 for TG-133).

To this end, our department has developed a Post-Doctoral Certificate in Radiation Oncology Physics. For the past two years, we have been navigating through a series of University committees. In March, we also submitted an application for CAMPEP approval.

The Post-Doctoral Certificate in Radiation Oncology Physics is a two-term program designed to prepare individuals with a Ph.D. in physics or related subject, but insufficient didactic background in radiation oncology physics, for acceptance into a Radiation Oncology Physics Residency. The 18 credit hour curriculum encompasses all the didactic components identified by the American Association of Physicists in Medicine (Report No. 197S) required of students making the transition into Radiation Oncology Physics. The courses are offered at an accelerated Call for Applications pace, mostly in a traditional classroom Associate Executive Director, Medical Physics (AED-MP) format, supplemented with laboratories,

This part-time position (40-50%) does not require relocation to Tucson, Arizona practica and clinical observation (although desirable), though regular travel is required. It is anticipated that the rotations. The program is based at a new AED-MP will work alongside the current AED-MP in late 2011, and assume fully equipped tertiary cancer treatment full responsibility in early 2012. facility, delivering approximately 3000 courses of radiation therapy per The AED-MP reports to the Executive Director and works closely with the year. Students are expected to take executive team to coordinate and operationalize the strategic plan and policy advantage of the other educational decisions made by the Board of Trustees. The AED-MP also works with the staff opportunities available in the cancer Directors of Certification Services, Information Technologies, Standards (including Communications, Psychometrics, and Digital Imaging), Board Affairs, and centre setting, including Grand Rounds, Financial Services on operational matters, systems analysis, and quality and Radiation Therapy Rounds.

Upon completion of this certificate, the student will be well-grounded in the theoretical aspects of radiation oncology physics and therefore well-prepared to enter a residency in radiation oncology physics.

For more information, please email: wendy.smith@ albertahealthservices.ca

improvement. He/she also works with the executive team to coordinate policy and the specifics of implementation across disciplines. The AED-MP participates as a recognized ABR leader and spokesperson in various public forums. He/she also participates in ABR research activities and authors/co-authors ABR publications.

Parties interested in exploring candidacy for this position should contact the Executive Director or the Director of Board Affairs by phone, email, or U.S. mail before May 8, 2011.

For further information, please visit our website at: http://www.theabr.org/about/careers.html.

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Health Policy/Economic Issues James Goodwin, Burlington, VT

Medical Physics Procedure Billing - Getting It Right

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his is the first in a series of articles provided by the AAPM Professional Economics Committee that reviews the use of physics related CPT codes. These articles will be published in the newsletter periodically.

CPT© 77336 Continuing medical physics consultation, including assessment of treatment parameters, quality assurance of dose delivery, and review of patient treatment documentation in support of the radiation oncologist, reported per week of therapy is one of the most frequently used of all the physics/dosimetry codes. 77336 and 77370 Special medical radiation physics consultation are the two codes that are most directly attributable to the work that therapy physicists perform on a regular basis. Both codes have technical components only; they provide no professional reimbursement for the radiation oncologist’s work.

77336 covers the ongoing support that we provide for each patient while they are receiving radiation therapy. It is often misunderstood that 77336 covers only the work associated with weekly chart reviews. While these checks are an important component of 77336, this code covers a wide range of tasks that are performed (or which should be performed) to support on-treatment patients. These tasks include but are not limited to: • Pre-treatment chart/treatment plan review • Discussion of patient plans in daily treatment planning conferences and departmental chart rounds • Review and analysis of medical physics aspects of changes to the treatment regime • Consultation with and direction to therapists on patient setup and treatment modifications, verification of dose calculation data, • Physicist review of accuracy of the current data record, including review of patient-specific therapist treatment and technical notes • Consultation with radiation oncologists on patient planning and treatment • Supervision/review of image guided radiation therapy (IGRT) activities • Review of specific radiation safety issues Some tasks such as in-vivo dosimetry review, calculation second checks and review of isodose plans are covered by their own associated CPT codes.

The treatment of a particular patient may require physics work that is more involved and time consuming than normal. The design of customized beam modification devices, the dosimetric analysis of previously treated treatment fields and image fusion are all examples of tasks that go beyond 77336 and which may justify the billing of a special physics consult using 77370. In these cases, a written request from the radiation oncologist and a signed, written physics report are necessary.

Weekly chart checks shall be performed by physicists. The medical physicist shall provide a dated signature in the chart each week to document that he or she has reviewed the chart. Any supplementary chart reviews performed by the dosimetry staff should be done with physics supervision. Specific documentation requirements for chart checks vary from payer to payer. All payers require the signing and dating of the review (either hard copy or electronic). Many require the use of a check list of specific items reviewed during each check. It is always good practice to document any tasks performed in support of patients under treatment, not just chart checks.

Because chart checks are performed once a week but other tasks under 77336 tend to be

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continued - Health Policy/Economic Issues ongoing, there is often confusion regarding the actual billing of 77336. As outlined in the ASTRO/ ACR Guide to Radiation Oncology Coding 2010, 77336 can be billed once every five fractions for external beam treatment. If a patient’s treatment course extends beyond the last group of five fractions by three or four fractions, an additional 77336 may be charged. BID treatments can count as two fractions. Treatment courses of less than five fractions can receive a single 77336. In the case of implant patients, high dose rate (HDR) treatments are counted the same as external beam fractions. Non-HDR brachytherapy treatments may be billed once per calendar week in which they occur.

It should be noted that end of treatment chart checks performed after the last fraction has been delivered do not justify an additional 77336 charge. As chart checks are only a part of the activities performed within 77336, the date of the weekly billing of 77336 does not need to coincide with the date that the chart check was performed. Most payers do not require that the billing for 77336 be dated exactly on the patient’s fifth (and multiple thereof) treatment; only that there is one billing per five fractions. However, automatic charge generation on the fifth fraction (and at the end of each subsequent multiple) is a convenient way to set up charge capture within a record and verify system. Each department should check with its payer(s) for specific documentation and billing requirements.

The current reimbursement for 77336 is $104.48 under the Hospital Outpatient Payment System (HOPPS) for hospital-based departments and $52.32 under the Medicare Physician Fee Schedule (MPFS), which covers freestanding centers. Freestanding center reimbursement under the MPFS has decreased in recent years due to the phasing in of new reimbursement formulas. The AAPM is currently evaluating whether it may be possible to seek revaluation of the work performed under 77336, especially in light of new treatment technologies and the increased complexity of associated tasks that must be performed.

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Working Group on Prevention of Errors Report Peter Dunscombe, Calgary , AB, CANADA Eric Ford, Baltimore, MD

Two day workshop on Incident Reporting, Analysis and Learning: defining the structure

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earning from errors and near misses is recognized as a valuable tool for improving the quality and safety of radiation treatments. The successful employment of this approach requires a systematic structure for codifying and analyzing the many incidents that occur in the course of normal clinical operations. The AAPM Working Group on Prevention of Errors (WGPE) has been engaged in a project to provide recommendations for such a structure. These recommendations will be key to the design of any incident learning system either within an institution or nationally.

The project began at the AAPM Philadelphia meeting of the Working Group on the Prevention of Errors (WGPE) in 2010. Teams were identified to focus on five key project components: definitions, process maps, severity metrics, causal taxonomies, and data elements. The project, now in its final phases, was the subject of a recent Workshop held in Washington, DC on April 14 & 15, 2011 with principal funding from the AAPM and held under the auspices of the WGPE. The goal of the Workshop was to consolidate and move towards finalizing the project.

The core group of the Workshop, fully sponsored by the AAPM, was Peter Dunscombe, Luis Fong de Los Santos, Eric Ford, Anne Greener, Jennifer Johnson, Ajay Kapur, Janaki Krishnamoorthy, Sasa Mutic, Todd Pawlicki, Steven Sutlief, Stephanie Terezakis MD, Bruce Thomadsen (unable to attend).

To maximize consultation, participation was invited from organizations identified as having a strong interest in the purpose of the Workshop. These participants were: Jean-Pierre Bissonnette (COMP), Jim Deye (NIH), Rachel Hackett (AAMD), Sandra Hayden (ASRT), James Hevezi (ACR), Ola Holmberg (IAEA), Jatinder Palta (ASTRO), Emily Wilson (ASTRO). The CRCPD and FDA were also invited to nominate participants.

The Workshop included presentations by six participants on their practical experience with developing and implementing error reporting/incident learning systems, as well as two invited background presentations: Stephanie Terezakis, MD. speaking on “Attitudes to error reporting: a multi-institutional study” and Jatinder Palta, PhD speaking on “Update on the National Radiation Oncology Registry initiative and link to reporting systems.”

Overviews of the progress to date on the five components of the project were presented, followed by a breakout session of smaller groups for continued in-depth discussion on the content and structure of these five components with reports back to the whole Workshop. Following further tweaking of the five components the Workshop then moved into a validation phase. This consisted of attempting to use the structures developed to report, analyze and learn from published (IAEA) descriptions of the Michigan Gammaknife incident, the New York MLC incident and a fabricated incident.

The Workshop was an important step in finalizing the reporting structure project. Final recommendations are expected by July and will be presented as part of a special symposium at this year’s AAPM Annual Meeting in Vancouver. A presentation has been submitted to ASTRO as well.

The proposed data structures are a key foundation for error and near-miss incident learning. A number of clinics are already implementing incident learning systems and this project is expected to facilitate these efforts. On the national scale, a repository of information on errors and near misses in radiotherapy has been recognized as a potentially valuable tool by many organizations including the AAPM and ASTRO. Although it is as yet unclear what agency would host such a database, it is timely to undertake the necessary preparatory work of defining the structure of such a tool.

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New Professionals Subcommittee Report From the Members of the New Professionals Subcommittee

How To Get Involved With the AAPM

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s a new professional or a physicist at any stage in your career, you may decide to volunteer your time to a professional organization. This is a great way to participate in the decision making process of the organization—you can really make a difference! Volunteering also builds professional networks and forms life-long relationships. One of the simplest ways to volunteer is to write the chair or a member of the committee or subcommittee. You can also attend committee meetings preceding the national meeting each summer and volunteer in person. The AAPM is a volunteer organization, meaning much of the work is done by members in their free time.

This means that there are many opportunities to help, and your offer to help is generally quite welcome! The members of the New Professionals Subcommittee would like to each share their story for how they started their work with the AAPM. Minsong Cao The AAPM annual conference offers great opportunities for volunteering in the organization. While attending the 50th Annual AAPM meeting in Houston in 2008, I had the opportunity to meet several physicists after one of the professional sessions and discussed the idea to have a subcommittee devoted to new professionals in medical physics. After the meeting, I was involved in the initiation of the New Professionals Subcommittee. Another important path to volunteer for the AAPM is through the local chapters. I started to attend local chapter meetings when I was in graduate school and got involved as a chapter officer after a few years. There are plenty of opportunities for new professionals to get involved in local AAPM chapters.

Jessica Clements My first involvement with the AAPM was working as a “volunteer” for the Joint Medical Physics Licensure Subcommittee. I simply wrote to the chair at the time and offered to help. There was a long list of areas to work on, so I chose a few and did my best to complete the work. I joined the SC during their meeting in Houston (July, 2008)—it was a great experience. During one of the professional sessions at the annual meeting that year, several audience members gave recommendations for things that AAPM should do. The moderator, George Sherouse, essentially told each commenter something along the lines of “that’s a good suggestion; you should do something about it!” A few of those making similar comments and I talked extensively after the session and decided to accept the George’s challenge and the New Professionals Subcommittee was born! Since that time, my involvement has continued to include many additional groups.

Jeffrey Fiedler As part of preparations for setting up a new Gamma Knife department where I would be the sole physicist, I helped assemble a department budget in which the newly-acquired treatment device was amortized (and reloaded once) over an expected seven year life span. One of the by-products of this project ended up being a proposed billing scheme for treatments of different complexity: The nurse manager and I putting together this budget plan literally had to analyze and predict exactly how much the hospital would have to charge (based on equipment, anticipated supply, staffing, etc. costs) in order for the department to be financially self-sustaining. I learned a lot about reimbursement issues through my involvement in this project, and was later invited to deliver a presentation about the financial and budgeting aspects of setting up a new Gamma Knife department at a meeting of the SROA (Society of Radiation Oncology Administrators). Not long after this, I was appointed to the AAPM Economics Committee, and have learned even more about reimbursement issues, trying to contribute to the work of this committee, and later the New Professionals Subcommittee as well, ever since.

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continued - New Professionals Subcommittee Report Justin Keener The way I got involved with the NPSC and AAPM was really very simple. I was interested in doing something, but as a fresh graduate didn't feel like I possessed the experience or technical expertise to join a TG report type of subcommittee. My mentor was very active in the AAPM and had heard about a new AAPM subcommittee for new professionals and suggested I contact Jessica.

In talking with her it sounded like a good fit and a fun opportunity, so I asked to be involved. Hopefully I'm able to contribute half a much as I've learned and gained from the other members and from the experience.

Michael Olex Find an area which you have special interest in. Each of us has some special skill set which we can utilize towards helping our fellow members of the AAPM. Find something which you are extremely interested in whether it's scientific, professional, or some other avenue. Contact the committee chair and let them know why you're motivated to join, how you can help, and what you think you can bring to their work. Don't despair if you don't immediately don't hear back from them. As you know already, we are all rather busy; however, this doesn't mean that your opinion & skill set are any less valuable. I had gotten involved whilst I was working with Jessica in Texas and we began formulating what kind of things we had questions about which weren't addressed to New Professionals which began the formation of this sub-committee.

Russell Tarver My story is much like others. For years I benefited from the vast collection of work that the AAPM has created in the form of TG reports and other publications.

I finally decided it was time to start giving back. I had been involved at the chapter level for several years (which, by the way, is another great avenue to start giving), and wanted to move to the national level. I submitted my name to several postings, but was never selected.

I tried to be selective in my submission; not choosing technical working groups or task groups that I felt I was unlikely to be chosen for. Even that didn't seem to help. Then I changed REGISTRATION OPENS MAY 11 my tactics and focused on committees Rapid developments in CT scanner technology over the last that were related strictly to professional matters. Again, no luck there for a year or decade have yielded new clinical capabilities and substantial so. Then, to my delight, I was selected to improvements in patient care. The greater complexity several committees within a few months of of today’s CT scanners, however, creates considerable each other. I guess persistence pays.

Jeffrey Wyler In the military, you basically do the job for which you want to be officially promoted.

So I looked at what the Senior Physicists that I considered role models were doing and took steps to copy them. After getting started in this vein, I realized that the bottom line is about giving back.

challenges for CT users, who must master a wide range of equipment features and clinical applications.

This summit will demonstrate how scan acquisition and image reconstruction parameters should be selected and managed to improve image quality and reduce radiation dose. Faculty members will explain the essential criteria for specific diagnostic tasks, and participants will have an opportunity to practice the selection of optimum scan protocols. The goal of the summit is to provide practical information for users that will help them operate their CT scanners wisely, improving the quality and usefulness of CT images while reducing the radiation dose to patients.

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NRC Workshops Report Herbert Mower, GRAC Chair

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t the recent Advisory Committee on the Medical Use of Isotopes meeting it was announced that the meeting was the first of three scheduled workshops open to stakeholders and the public to discuss: • Written directives and medical event reporting for permanent implant

brachytherapy • Amending preceptor attestation requirements • Extending grandfathering to certain certified individuals regarding training and experience requirements [Petition for a Rulemaking {RPM

35-20, Ritenour Petition} • Dose limits to members of the public {per year versus per treatment} form patients who have been administered radioiodine Notice for this first workshop was very short, less than two weeks, and not well publicized.

Presently the second workshop is being planned sometime in the third week of June and possibly in New York City. With our strong input, the third workshop will probably now be at the end of the second week of August and in the western half of the US. This is an excellent opportunity for your input into this very important process. Even if you are in an agreement state, the actions on these items by the NRC will end up being implemented in the agreement state programs.

As soon as we know the dates and locations of these workshops, we will post them on the AAPM website. Please check there for updates or contact our regulatory affairs personnel at headquarters.

JOB POSTING BY THE NATIONAL COUNCIL ON RADIATION PROTECTION AND MEASUREMENTS (April 31, 2011)

National Council on Radiation Protection and Measurements (NCRP), 7910 Woodmont Avenue, Suite 400, Bethesda, MD 20814-3095 Attn.: Dr. Thomas S. Tenforde, NCRP President (tenforde@NCRPonline.org) Description: Executive Director of the National Council on Radiation Protection and Measurements (NCRP). The NCRP is seeking candidates for the full-time position of Executive Director. The successful candidate will be hired in 2011 and serve on an interim basis as a Deputy Executive Director under the current Executive Director, Dr. David A. Schauer, with the expectation of becoming the Executive Director on February 1, 2012. The Executive Director’s responsibilities include financial management, working with the Office Manager to provide oversight of office operations, working with the President in the preparation of grant and contract proposals and in providing assistance in meeting NCRP’s reporting requirements to its sponsors and ensuring the high quality of NCRP publications. Prospective candidates should have a master’s degree or doctorate in either the physical sciences or life sciences. Demonstrated experience in scientific and financial management and expertise in health physics or medical physics are desirable qualifications. It is expected that the successful candidate will have at least 10 years of relevant experience, and be willing to reside in the Washington, DC metropolitan area. Compensation will be competitive with current market levels for comparable positions. The NCRP is an equal opportunity employer that offers an excellent benefits package. Interested candidates should submit a CV, including a complete description of prior job titles and experience and a list of publications. This information should be submitted to Dr. Thomas S. Tenforde, NCRP President, 7910 Woodmont Avenue, Suite 400, Bethesda, MD 20814-3095 (fax: 301-907-8768; email: tenforde@NCRPonline.org). Applications must be submitted no later than July 1, 2011.

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European Affairs Subcommittee News Eugene Lief, Pelham, NY

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his article addresses some new developments in European medical physics.

1. EMBRACE (www.embracestudy.dk) is an international, multi-center prospective observational phase 4 brachytherapy study with the primary goal of implementing 3D QA MRI-based IGABT in locally advanced cervical cancer. It will introduce MRI-based brachytherapy in a multi-center setting to correlate the outcome with image-based DVH parameters for the clinical target volume and organs at risk. These results will enable development of prognostic and predictive statistical models for clinical outcomes including volumetric, dosimetric, clinical, and biological risk factors as well as radiobiological parameter estimates. The models will allow precise risk assessment for individual patients and development of new treatment protocols.

The main study office is based at the Vienna Medical University. It is responsible for quality and completeness of the individual centers’ data as well as coordination of 3D QA and the quality of life sub-study.

EMBRACE was started in July 2008. Currently, there are over 400 patients registered from 20 participating institutions (15 in Europe, 2 in Asia and 3 in North America). It is estimated that over 600 patients will be registered by the end of the enrollment period. Each prospective center participation is contingent upon completion of a detailed review of its contouring, planning, and reporting guidelines, to ensure the uniform approach to the study protocol. The patient inclusion criteria are definitive chemo-radiotherapy with a curative intent and MRI-guided brachytherapy for at least one fraction. The choice of the applicator, implant procedures, target dose, and DVH constraints follow each individual department guidelines. Uniform reporting in a prospective clinical setting with a variety of dose levels and techniques applied will allow detailed correlation analyses to address some existing issues in GYN brachytherapy.

2. This year the AAPM ISEP Diagnostic Physics course will take place at the University of Patras (Greece) on June 17-20, mostly attended by physicists from European Union and the US. Department of Medical Physics of Patras University organizes this course under the guidance and sponsorship of AAPM ISEP. This course will present cutting edge Diagnostic Physics and Technology not only to Medical Physicists but also allied professionals (Radiologists, Technologists, and Dosimetrists). The organizing committee has prepared a stimulating scientific program. Sessions will cover a variety of topics on image formation, digital imaging, image quality, flat panel detectors, MDCT, Digital Mammography, MRI, SPECT, PET-CT, patient dose, Radiation Safety, etc. The organizers are confident that the course will be a venue for exchanging and sharing ideas of the most recent developments in the Physics of Diagnostic Radiology and that it will have a great impact to the participants’ knowledge.

In the course’s web site (http://aapm2011.upatras.gr) one can watch the latest updates on the Summer School Program, get the information on registration, accommodation, and transportation. The advance registration has started and will be open until June 10. After that, the participants can register on site. The Organizing Committee (Drs. Mahadevappa Mahesh, George C. Kagadis, and George C. Nikiforidis) are inviting physicists and allied professionals to attend the Course and are looking forward to welcoming you in Greece!

3. A new society of Euro-American Medical Physicists (SEAMP) has been formed last year under the leadership of the AAPM member Victor Gurvich, PhD The society unites medical physicists of

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continued - European Affairs Subcommittee News the European origin and also includes interested members from other parts of the globe. SEAMP's mission is to promote cooperation between medical physicists from various countries. Many more details could be found on their website http://seamp.org. On July 20, 2010 more than a hundred medical physicists, researchers, developers, and manufacturers of medical equipment from the United States, Canada, Russia, and Europe, as well as guests from Asia and Latin America, attended the first SEAMP party, held at Moriarty’s Restaurant in Philadelphia during the Annual AAPM meeting. The event was attended by many well-known medical physicists and industrial sponsors. Prof. Dr. Fridtjof Nüsslin, President of the International Organization for Medical Physics, Dr. Anthony Seibert, President-Elect of AAPM, and Dr. William Hendee, Editor of the journal Medical Physics as well as Presidents and top managers of the industrial sponsors made welcoming presentations. We wish all the best to the new Society.

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AAPM Newsletter

May/June 2011

Chapter News

Michael S. Gossman: ORVC President - Ashland, KY

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he Ohio River Valley Chapter of the AAPM held its Spring Educational Symposium on the Campus of the University of Cincinnati at the Kingsgate Marriott Conference Center during the weekend of March 4-5, 2011. The meeting was highlighted by planned Night Out dinner cruise event on the Belle of Cincinnati riverboat docked in the harbor on the Ohio River.

The social venue included a poster session on 15 different current topics of interest in medical physics. The Chapter again, successfully exceeded its recorded marks in all areas at the Night Out with 80 participants, as well as for the Symposium with 121 Night Out on the Belle of Cincinnati Riverboat participants and 31 exhibitors.

Stanley H. Benedict of the University of Virginia Health Systems provided the Honorary James G. Kereiakes Keynote Lecture. The talk entitled “A review of Stereotactic Body Radiation Therapy Developments, Technology and Recommendations” was a thorough lesson on the history and advancement of SBRT in medical physics, powered by the guidance, efforts and recommendations of years of research and AAPM Task Groups.

His colloquium was followed by a seminar competition on selected research topics from 11 of our Chapter’s esteemed medical physics students and residents. In prior, the ORVC Officers appointed a Panel of Judges tasked to rate each speaker individually on their topic and presentation. The Panel included Guy H. Simmons, Jr., of Bluegrass Radiological Physics, Inc., Howard R. Elson of the University of Cincinnati, and Chee-Wai Cheng Indiana University. The first place recipient was Bhoj R. Gautam from the University of Toledo for his talk on “Advantages of implementation of a self-regulating thermobrachytherapy seed in treatment of solid tumors”. The second place award went to Li Zhao of Indiana University for her talk on “Towards Symposium Panel of Judges (Top: C. understanding the uncertainty in range and dose in presence Cheng, G. Simmons, H. Elson) and of high-Z materials in proton therapy”. Finally, third place was Winners (Bottom: B. Gautam, L. Zhao, A. Panda) awarded to Anshuman Panda of Purdue University for his talk on “Clinical challenges in implementing P-31 MR spectroscopy of focal liver lesions”.

Symposium Keynote Speaker Award: M. Gossman, M. Cao, R. Richardson and S. Benedict

The Symposium concluded with our Chapter Business Meeting. With the recent revisions to our By-Laws voted to be active in early 2010, we are now permitted as a Chapter to influence legislation towards licensure in support of the Association’s interest. We have been leading the charge to communicate with state regulatory authorities in Indiana, Kentucky and Ohio in request for revisions to radiation regulations, while seeking to influence the inclusion of licensure for the Qualified Medical Physicist. Along this same track, we have been aiming to provide a means for assisting each State Radiological Health Branch by establishing or restructuring an Advisory Council or Licensing Board, each consisting of board certified medical physicists. We have invited

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continued - Chapter News the Midwest Chapter for communications about Indiana, and invited the Penn-Ohio Chapter for communications on Ohio, since these two states have divided AAPM Chapter lines. Much of the charged efforts have been well received already. With the State of Kentucky covered solely by the Ohio River Valley Chapter, its State Health Branch is already considering our proposed changes. As action items, we continue to move in a positive direction with our adjacent Chapters for hopeful bi-lateral agreement regarding Indiana and Ohio in the same regard.

Although these efforts have taken an enormous Symposium Audience amount of energy and time, we are pleased to be taking the lead in promoting the interest of the AAPM and ORVC for these efforts.

I am thankful for the tremendous work of my colleagues, Minsong Cao of Indiana University (ORVC President-Elect), Rebecca F. Richardson of Louisville Radiation Oncology Center (ORVC Secretary/Treasurer), and Indra J. Das of Indiana University (ORVC Chapter Board Representative), for their support and dedication to the success and growth of the Chapter as Officers. Finally, I would like to thank the following sponsors for their generous contributions and attendance at the symposium: Platinum Sponsors:

Varian Medical Systems

Gold Sponsors:

Philips Healthcare

Silver Sponsors:

Siemens, Elekta, Accuray, Tomotherapy, Nucletron, iCAD-Xoft, Best-CNMC, Brainlab, PTW New York, iba Dosimetry, Standard Imaging, Sun Nuclear, ISP, RadiaDyne, ScandiDos, MultiData, RIT, Landauer, LACO, LAP Laser, Q-Fix Systems (WQFR), CIVCO, IsoAid, BrachySciences, NELCO, Theragenics, Core Oncology

Bronze Sponsors:

GE Healthcare, Oncology Tech

2011 Steven A. Leibel Memorial Lecture

2011 Practical Diagnostic Imaging Educational Courses

Dr. Steven Leibel MD was an inspiring leader in radiation oncology. The Leibel Memorial symposium honors his memory and his collegial relationships with medical physicists at Memorial-Sloan Kettering Cancer Center, Stanford University, and the American Board of Radiology. Dr. Leibel was a major innovative force in development and application of IntensityModulated Radiation Therapy (IMRT), and his vision and energy were instrumental in national and international adoption of this disruptive technology in radiation therapy. In this memorial symposium, three distinguished medical physicists will examine the current state of IMRT and provide their vision for its future, including considerations of biologicallyadaptive IMRT, tumor modeling integrated into IMRT, and advanced technical IMRT features.

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The program will include 32 Educational Courses in Diagnostic Imaging Physics and Technology. The courses will include: image reconstruction, radiation dose, breast imaging, radionuclide imaging, MRI, radiography, radiation safety and risk, multimodality imaging, medical informatics, and teaching physics to radiology residents.

Six hours of mammography CE will be available in the breast imaging, radionuclide imaging, and MRI courses.

Also new this year is our improved dawn-to-dusk program. Less parallel education content means you can earn more CE credits and attend more sessions that interest you.

AAPM Newsletter

May/June 2011

Obituary

Suresh K. Agarwal, Ph.D.

by Shiv P. Srivastava

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t is with extreme sadness that we announce the passing of Dr. Suresh K. Agarwal on March 10, 2011 while visiting his home town in India. We have lost a great teacher. Suresh was born in 1931 in India. He received his PhD degree from Lucknow University in 1966 while working at prestigious King George’s Medical College in Lucknow.

He was a lecturer till 1969. During a sabbatical from 1957-1958, Suresh was awarded the Rockefeller Foundation fellowship to be a Clinical Fellow in Medical Physics at Memorial Sloan Kettering Cancer Hospital in New York City, NY. He moved to University of Virginia in Charlottesville where he became Director of Radiological Physics in the Department of Radiology in 1970. He was board certified in both Diagnostic Radiology and Radiation Therapy Physics. He was instrumental in the development of a strong MS program in Medical Physics.

Even though he had administrative responsibilities, his real love was teaching. He helped train numerous physicists, residents and staff in Diagnostic Radiology, Nuclear Medicine, and Radiation Oncology. He was a Fellow of the AAPM, ACR and ACMP. Dr. Agarwal was elected Professor Emeritus in 2004. Later that year he retired but continued to help residents, physicists and technologists pass their board exams due to his devotion to teaching.

Apart from his high professional achievements with many awards and publications; he remained a simple and an incredible human being with Dade Moeller great passion for helping the less fortunate.

Gaithersburg MD He founded a school in rural India to provide Radiation Safety Las Vegas NV quality education to underprivileged children.

Academy For many years he was the sole supporter of the educational trust to India, where he traveled regularly.

Dr. Agrawal was a devoted family man and a fierce bridge competitor. After the passing of his wife, Mithlesh Agarwal, of 50 years in 1999, Dr. Agarwal revived his passion for bridge. He documented his own 'bidding strategy' and won many tournaments and finally making to Nationals as district champions last year.

He is survived by 4 daughters, 7 grandchildren and 2 great grandchildren. He will be missed dearly.

Medical Radiation Safety Officer Training Course Are you a Medical Physicist, RSO, assistant RSO, or Authorized User responsible for radioactive materials and radiation-producing machines in your hospital?

To help keep you current with new techniques and procedures, Dade Moeller Radiation Safety Academy offers this course for those managing or working with radioactive material and radiation sources in a medical environment.

For 5 days, you will receive practical information on a variety of topics including discussions of real-world experiences:

Medical licensing Fluoroscopy safety PET/CT programs Brachytherapy Nuclear medicine

Regulatory inspections/audits Instruments Safety program management Emergency response DOT shipping/receiving

This course is approved by CAMPEP for 40.25 MPCEC for qualified Medical Physicists.

Visit: www.moellerinc.com/academy for a detailed course agenda.

Register online or call 800-871-7930

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Obituary

Joseph A. Sayeg, Ph.D.

compiled by Ralph Christensen

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oseph A. Sayeg, a long-term member of the Health Physics Society and the American Association of Physicists in Medicine, died in Lexington, KY on 31 March 2011 at age 85. He had battled leukemia for a number of years, had been bedridden for the past 18 months, and was under Hospice care for much of that time.

Joe is perhaps best remembered by many as a tall, black-haired man carrying a large camera one-handed as he walked around annual meetings taking pictures for the History Committee. From early childhood he had a short leg and a withered hand, but did not let that hold him back. If you ever wondered why he only wore clip-on bow ties, think about trying to tie a tie with one hand! He was an active participant in service activities in both the HPS and the AAPM, including several years as examiner for the ABR. He was a member of the American Board of Health Physics and its Examination Committee. He chaired the Medical Physics Academic Program Directors group from 1982-84. He also served as President and as Secretary-Treasurer of the Bluegrass Chapter of the Health Physics Society.

Joe had a lighter side; he loved to annually invite friends and students to his back yard to have lamb shish-ka-bob. He took pride in his cooking and hosting, along with his gracious wife Margaret. Also, in the seventies and early eighties the Bluegrass Chapter, with Joe hosting, biannually would have a Casino Night at UK’s Spindletop Hall, using printed bills with photographic likenesses of various chapter members. A good time was always had by all!

Professionally, Joe was probably best-remembered as the founding father of the medical physics and health physics academic (M.S.) programs begun in 1968 at the University of Kentucky.

However, he had a very significant career in dose research and measurement, especially with regard to densely ionizing radiations, for many years prior to that point.

He attended the University of California at Berkeley, earning an A.B. in physics (1947) and a Ph.D. in biophysics (1954). His Ph.D. thesis was printed as a UCRL Report “The Effect of Highly Ionizing Radiations in Cell Survival”, and resulted in a publication in Volume 1 of Radiation Research (1954). Between 1954 and 1961 he worked at Los Alamos National Laboratory, making radiation measurements for the Biomedical Research Group under Wright Langham, authoring and co-authoring twenty LASL Reports, most of which involved neutron and other densely ionizing radiation dosimetry. It was also in Los Alamos that he and his beloved wife Margaret adopted two babies. Jim and Janine, their spouses, and their six children were with Joe at the time of his death; Margaret had died eleven years ago.

Between 1961 and 1966 Joe worked as a Scientific Specialist for Edgerton, Germeshausen, and Grier, Inc. in Santa Barbara, performing dosimetry research and authoring several more in-house reports. He then moved to the University of Pittsburgh as Associate Professor of Health Physics and Associate Director of the Whole Body Counting Facility. There, he evaluated with his students, and published results of the internal dose evaluations of, some of Niel Wald’s patients who had inhaled fission products in accidents at the early nuclear installations in Western Pennsylvania.

In 1968 he accepted the position of Associate Professor in Radiation Medicine at the University of Kentucky, and remained there until retirement in 1994, serving as an academic medical physicist and academic program director. By 1968, he had seventeen refereed publications in addition to all the in-house reports referenced above. Joe was Board-certified by the ABHP in 1967 and by the American Board of Radiology, in radiological physics, in 1969. He was a diligent scholar as well as revered teacher of dosimetry. He studied for his ABR examinations even on airplanes during professional trips, and passed the ABR exams the first time in all specialties. He was so meticulous in his scholarship, teaching, and writing in dosimetry that he was recruited to be co-

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author and write the more rigorous discussion of the Bragg-Gray Principle in his final publication, Chapter 15, “Radiation Dosimetry,” in M.F. L’Annunziatta, Editor, Handbook of Radioactivity, Second Edition, Academic Press, New York, 2003.

At Kentucky, Joe designed, developed, and directed a three-track academic sequence leading to an M.S. in health physics, an M.S. in therapeutic medical physics, or an M.S. in radiation biology.

The only active track today is the CAMPEP-accredited one in medical physics, which is highly regarded in the medical physics community. Joe personally recruited and taught nearly one hundred students, two of whom later became President of the American Association of Physicists in Medicine, and all of whom have been highly competent practitioners. In the classroom, Joe was a teacher with very high expectations, always demanding knowledge of the theoretical underpinnings underlying actual practice. He was a kind and helpful mentor to students and colleagues, and would always have good suggestions about how to address issues that arose. He will be sorely missed by his family, friends, and colleagues.

Workshop on Optimisation and Justification in Radiology and Radiotherapy August 31, 2011, Trinity College, Dublin Jointly organized by European Federation of Organizations of Medical Physics and the American Association of Physicists in Medicine Introduction Traditionally, medical physicists, radiologists and radiation oncologists have placed a considerable emphasis on the quality of the examination or treatment. Recently the extent of the use of radiology and high technology radiotherapy has become a matter of concern. Several highly publicized events culminated in a hearing in U.S. Congress and similarly, the European Commission has expressed concern. All this is leading to an appraisal of optimal use of radiation technology and justification of the procedures. The aim of this Workshop is to introduce current issues related to the justification of medical procedures to medical physicists and to provide a state of the art overview of optimization in medical imaging including assessment of risk.

Aim of the Workshop : • Provide an overview of the importance of justification • Highlight the importance of communication in radiation protection • Provide state-of-the-art overview of optimization in radiology • Provide an introduction to new EU standards for Criteria for Acceptability of Imaging and Therapy Equipment Registration details, information on location, local accommodations, fees etc. can be found at: www.empec.ie.

Note that the workshop immediately precedes the European Medical Physics and Engineering Conference and conference delegates benefit from a reduced fee for the workshop.

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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, Eileen Cirino, 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: July/August • Submission Deadline: June 15 2011 • Posted On-Line: week of July 5, 2011