AAPM Newsletter March/April 2012 Vol. 37 No. 2 by AAPM Docs

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 Presidentâ&#x20AC;&#x2122;s 37 NO. 2

MARCH/APRIL 2012

AAPM Presidentâ&#x20AC;&#x2122;s Column Gary A. Ezzell, Mayo Clinic Scottsdale

s I write this column we are five weeks out from AAPM's inaugural Spring Clinical Meeting. David Hintenlang has led the program development, along with Bob Pooley, Joann Prisciandaro, Jessica Clements, Brian Wang, and Bill Geiser. The meeting offers a number of opportunities for continuing education, including thirteen SAMS sessions, and is really focused on serving the needs of practicing clinical physicists. The organizers have put together an excellent program that accomplishes that goal, and I look forward to being there. I will be particularly interested in the Saturday morning symposium on Patient Safety & Medical Error Prevention presented by David Hintenlang and Chris Serago. Our profession has been deepening its understanding of how to prevent errors by identifying and responding to early warnings of systems and behaviors that make errors more likely. It is important for all of us to put these lessons into practice in our own clinics, learning and adapting as we go along. My department initiated a "practice improvement" process last year that captures events in which something went wrong (or almost went wrong), but did not lead to an Included in this issue: actual error in patient treatment. We have changed our procedures in several instances as a result, and are Chair of the Board p. 2 better for it. We are moving now from a paper reporting President Elect p. 4 system to an electronic one that will be easier to use Executive Director p. 5 and analyze. None of this is new stuff; Sasa Mutic and Editor p. 6 p. 7 others have written and presented about such systems for Professional Council p. 10 years. But it takes time and dedicated commitment for E & R Fund Education Council p. 11 changes in practice and culture to become widespread, p. 14 and we medical physicists are often the key leaders to ACR Accreditation Leg. & Reg. Affairs p. 17 make such changes happen. Specialty Meetings I happen to be in Japan this week and have felt the Oversight Subcommittee p. 21 ground shake a couple of times. It was eleven months ABR Trustees Report p. 23 ago that the major quake and tsunami hit, so these little Radiology Safety Case tremblors are reminders to be prepared - big things can of the Fortnight p. 24 happen. This could be a metaphor for the need to pay UNYAAPM Chapter Report p. 25 attention to recurrent small disruptions in the clinic; they Persons in the News p. 27 could be precursors to the "Big One" if left unattended.

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March/April 2012

AAPM Chair of the Board’s Column J. Anthony Seibert, UC Davis Medical Center Diagnostic Physics Scope of Work

n adhoc committee was initiated prior to the Annual Meeting on the issues of what the responsibilities of a qualified medical physicist (QMP) are for diagnostic medical physics. I must admit to the readership that as chair of the committee, I have let things slip through the holiday season and beyond. Things will be gearing up again for a quick turn around of a report by the ad hoc committee prior to the annual meeting. The charge of the committee is as described: The Qualified Medical Physicist (QMP) is defined by the AAPM in (Professional Policy) PP1. Furthermore the Scope of Practice of Medical Physics is elucidated in PP-17, and the AAPM Position Statement on the Role of Medical Physicists in Providing Quality Medical Care is described in PP-22-B. Significant efforts over many years have been put forth in the establishment of the QMP for Diagnostic and Therapy Medical Physics. However, for the Diagnostic Imaging Medical Physicist, the current lack of CAMPEP-accredited Diagnostic Medical Physics Residency positions and the varying requirements/ definitions of who can do medical physics work are potentially creating a situation where there might be an insufficient number of QMPs to meet the projected manpower needs beyond 2014, with equally undesirable global consequences for patient care/safety and the profession of medical physics. Recent email threads have brought the issues forward, and one clear message is the lack of consistency on what the details regarding the scope of practice of a QMP in Diagnostic Imaging actually are (or should be). Therefore, the charge of this committee, to be completed within a 2- to 3-month time period from inception, is to Determine what procedures and tasks the Diagnostic (Dx) QMP needs to personally perform in terms of clinical practice. Determine “allowable” procedures and tasks performed under the supervision of the Dx QMP. The level of supervision, direct or general, for each task not performed by the QMP must be explicitly described. Define types of supervision for different circumstances and tasks. Members of the task group include Jessica Clement, Don Frey, Per Halvorsen, Mike Herman, Melissa Martin, Doug Pfeiffer, Bob Pizzutiello, Beth Schueler, and Jeff Shepard. Lynne Fairobent is providing headquarter's support, John Hazle is attending as President-Elect. At the Annual Meeting, materials provided to the committee for consideration included current guidance for the Supervision of Temporary Licensees in the State of Texas (http://www.dshs.state.tx.us/mp_ guidance.shtm), and definition of practice of medical physics in New York (http://www.op.nysed. gov/prof/medphys/article166.htm) These documents and others will be used to assist in the development of the ad hoc committee report. General discussion at the meeting in Vancouver focused on 1. The need to define two types of individuals: those with an advanced medical physics degree (e.g., a QMP-track individual), and those without (e.g., a technical staff/track individual). 2. The need to address the criteria that define tasks and procedures that are based on judgment/ experience versus outcome-based measurements. 3. The need to define types of procedures and measurements appropriate for Dx QMP general supervision of technical staff technologists, assistants, or medical physics residents, such as periodic measurements and data collecting. 4. A core list of tasks that require direct or personal supervision by a Dx QMP, including (a) protocol review; (b) interpretation of image quality; (c) interventional radiology / cardiology; (d) and “advanced” image modalities including computed tomography, positron emission tomography, magnetic resonance; (e) mammography. 5. Allowance for professional judgment and responsibility of the Dx QMP to determine an appropriate level of initial training of technical assistants, length of training with personally supervised surveys,

AAPM Newsletter

March/April 2012

continued - AAPM Chair of the Board’s Column a checklist for competency verification with documentation that would allow a trainee to perform surveys under direct and/or general supervision at a later time that is consistent with other training requirements. 6. The number of individuals that a Dx QMP can supervise at the same time (for instance, State of Texas guidance indicates 2 individuals only). 7. The magnetic resonance certified scientist and the Dx QMP relationship in overseeing MRI-related physics services. 8. The issue of Nuclear Medical Physics being separate or a subset of Diagnostic Medical Physics. The American Board of Radiology (ABR) is seeking advice on whether the diagnostic scope of practice should be formally expanded to include nuclear medical physics, or keep it separate with its own certification (as is now the case). TG-207, Medical Nuclear Physics in Diagnostic Imaging under the Education Council is underway, and will provide input to the ad hoc committee. The deliverables from this ad hoc committee will be a document outlining a list of tasks, procedures and guidance regarding supervision that can supplement the Scope of Practice for the Dx QMP. Consistency in this message should help better define the manpower needs of Dx QMPs to meet the expected demands beyond 2014. Also, as required accreditation of advanced imaging modalities is fast approaching, it is important to provide direction to the AAPM liaisons to the accrediting bodies (ACR, IAC [all subgroups], and TJC) to continue and further focus the dialog regarding a common base for medical physicist qualifications and to lobby that the participation of a Dx QMP be required in order for a practice to obtain accreditation. The goals of the ad hoc are to produce a consensus document that represents a majority of the voices of medical physicists working in clinical diagnostic medical physics. Comments and suggestions are certainly welcome by the membership of the AAPM. Please forward to jaseibert@ucdavis.edu for consideration by the committee.

The heavily-overhauled and feature-rich AAPM Career Services online job site just celebrated its first anniversary! Have you tried it yet? http://www.aapm.org/careers Whether you’re looking to hire or be hired, AAPM Career Services is your ideal recruitment resource. Post your medical physics job openings and place your organization front-and-center with talented AAPM members, or upload your resume and search dozens of exciting new employment opportunities each month…all while supporting AAPM! QUESTIONS? Please email careers@mail.aapm.org or call 301-209-3187

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AAPM President-Elect's Column John D. Hazle, UT MD Anderson Cancer Center

reetings fellow medical physicists! As I was preparing to write this first article as President-elect, I looked back at Gary Ezzell’s comments in his first Newsletter last year and found his words to ring very true. The six months between the elections and taking office are a whirlwind of trying to get up to speed on all the activities of the association and it presents quite a challenge. I want to thank Gary, Tony, Mike and Angela for the crash course on AAPM!!! They have been very patient as I worked my way through all the meetings, often interrupting the discussion to ask about background on various topics. While the scope of the Association is broad, I think it is important to have a focus or goal that you want to accomplish during the relatively brief time that you are in this role. Minutes after the election results were posted, Steve Goetsch invited me to attend the Southern California Chapter meeting in January. Apparently, the SoCal chapter has been inviting President-elects for some time to make that meeting our first official function and I wasn’t about to break that trend! Steve gave me the charge of talking about whatever I thought was important to me as a member of the AAPM leadership team. As stated in my position statement during the election, my focus will be on the changing state of cancer research and how to best position the AAPM for the future. To that end I will be working with the exceptionally bright and talented members of Science Council, the Research Committee and the Work Group on the Future of Research and Academic Medical Physics. While the Work Group name implies that the impact of research is limited to Academic Medical Physics, I will argue that in the long run, the research of today will become the practice of tomorrow and is, therefore, important to all members of the association. Developing a more robust strategic plan for research will be a focus of my leadership tenure in AAPM and an ongoing topic for my Newsletter articles. On other fronts, progress continues to be made in our capacity to educate and train medical physicists. The 2012 and 2014 initiatives are on us. As expected, the 2012 changes had relatively modest impact. The ABR did experience an escalation of applications to examine over the past few years, but those numbers are expected to fall back to a more normal rate now that the 2012 requirements are behind us. The number of graduates from CAMPEP accredited graduate programs is likely to be close, if not adequate, for meeting current manpower needs. The AAPM continues to watch this situation carefully. However, the 2014 deadline is just around the corner and the AAPM is actively working with CAMPEP to promote the development of new residency programs in both therapy and imaging. In November, I attended the RSNA Leadership with Tony Seibert and one of the most lively discussions was about the need to develop more residencies in imaging. Taking the RSNA leadership advice, I will be attending the Society of Chairs of Academic Radiology Departments in March to advocate for their support in developing new residencies in imaging. We will continue to monitor this situation closely, but at this time we seem to be on track with many new residencies in the queue for CAMPEP accreditation. Somewhat along these lines, as we go into the future, it will be important for the AAPM to develop a manpower needs model which will allow us to predict how many Qualified Medical Physicists, those that provide the clinical medical physics services, will be required to meet patient therapy and safety concerns. Now that residencies are required for becoming a QMP, we also need to include in our model the manpower needs of those medical physicists that don’t practice clinically to meet research, development and regulatory needs. I believe this will require us to somewhat rethink our graduate educational programs where we have focused on making sure that the background knowledge to practice clinical medical physics is obtained in preparation for residency clinical training, leaving open the option for individuals interested in research as a career to obtain graduate degrees along side those who plan to practice more clinical medical physics. I will be working with Science and Education Councils to develop strategies on how to prepare the next generation of research faculty. In closing, I look forward to working with the AAPM leadership and our members to further the profession of medical physics. We have the privilege of working in an exciting area of healthcare that improves the

AAPM Newsletter

March/April 2012

AAPM Executive Director’s Column Angela R. Keyser, College Park, MD 2012 Spring Clinical Meeting March 17 – 20 – Dallas, TX

everal AAPM groups plan to meet during the inaugural Spring Clinical Meeting. A list of AAPM activities is available online. Please make time during the meeting to visit the vendors and thank them for their support of AAPM and the medical physics profession. 2012 Summer School Medical Imaging Using Ionizing Radiation: Optimization of Dose and Image Quality June 24 – 29 -- University of California, San Diego, CA Course Directors, Cynthia McCollough and Diana Cody have put together an excellent faculty to deal with this important topic. Take a moment to review the program which is designed to provide up-to-date and clinically relevant education regarding: • safe uses of constantly evolving imaging technologies, • best methods to test image quality and dose performance, and • changes in technology and how they affect regulatory / accreditation requirements. Additionally, two Self Assessment Modules (SAMs) are planned for Wednesday at no extra fee! Registration for the Summer School will open on March 21. 54th AAPM Annual Meeting July 29 – August 2 -- Charlotte, NC You can expect an outstanding program at the 2012 AAPM Annual Meeting. Make sure to note the expanded SAMS offerings and new session formats, including debates and panel discussions. Registration will open on March 21, with the meeting program posted on May 11. This year's program will be held in the Charlotte Convention Center. Charlotte, the Queen City, is both a charming, walkable town and a cosmopolitan, financial epicenter with unique cultural offerings and entertainment. With its diverse restaurants plus the Levine cultural campus with four new museums just 1 block from the convention center, Charlotte will surprise you. You can’t visit Charlotte without experiencing the NASCAR Hall of Fame, the site of the AAPM Night Out on Tuesday, July 31. I know this may not sound like a typical “medical physicist type” venue, but I think you will be pleasantly surprised! The museum is adjacent to the Charlotte Convention Center; a convenient walk down a hallway from where sessions will take place. Enjoy dinner and conversation with colleagues in the Crown Ballroom of the Convention Center, then make your way to the interactive museum with its 150,000 square feet of history, 50 hands-on exhibits and nearly 1,000 artifacts. No need to be a hard-core NASCAR fan to appreciate the 31 meticulously maintained automobiles spanning seven decades, or to discover how down force and drag impact the car and driver. Reminder - Funding Opportunities Deadlines are approaching! AAPM Fellowship for Graduate Study in Medical Physics is awarded for the first two years of graduate study leading to a doctoral degree in Medical Physics from a program accredited by the Commission on Accreditation of Medical Physics Education Programs, Inc. (CAMPEP). Additional information on CAMPEP-accredited programs can be found at http://www.campep.org. Application Deadline: April 17. $33,500 in matching support will be made to institutions for a full-time Clinical Residency in Imaging Medical Physics. Application Deadline: April 20.

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Editor's Column

Mahadevappa Mahesh, Baltimore, MD

elcome to the second issue of the Newsletter for this year. It has been a fairly mild winter so far here in the mid-Atlantic region. This issue contains articles from our regular contributors providing updates on various issues related to our profession. In addition to the regular columns, this issue includes articles from AAPM local chapter (UNYAAPM), Persons in the News, an Invitation to participate in the Radiology Safety Case of the Fortnight, along with the 54th AAPM Annual Meeting Scientific Program announcement. Finally, I would like to draw your attention to two items – pertaining to the American Board of Radiology (ABR) - the ABR Physics Trustees report and announcement about reporting MOC status of diplomates. I welcome all readers to send me any suggestions or comments on any of the articles or about the Newsletter itself. ABMS to publicly report MOC status of diplomates; ABR to provide online clarification for lifetime certificate holders Beginning August 1, 2012, the American Board of Medical Specialties (ABMS) will begin reporting on its public website, www.certificationmatters.org, whether or not diplomates certified by any of the 24 ABMS Member Boards are meeting Maintenance of Certification (MOC) requirements. This includes ABR board-certified diagnostic radiologists, radiation oncologists, and medical physicists. This reporting standard was implemented by seven ABMS Member Boards in October 2011. Concerning the ABMS move, President and CEO Kevin Weiss offered the following: “We’re honoring our pledge of increased transparency to the public by providing easy access to important information about individual physicians. The ABMS MOC program is being incorporated into the credentialing process and is recognized as an important quality marker by insurers, hospitals, quality and credentialing organizations, the federal government, and the public.” While complying with the new ABMS standard, the ABR is determined to make it perfectly clear to anyone researching the certification status of its diplomates online that those certified before the MOC program started are NOT required to participate in MOC. The ABMS decided to report only two statuses (meeting requirements of MOC and not meeting requirements of MOC), and to deal with other statuses only by providing a link to each Member Board's website. The ABR realized the confusion this would cause and subsequently took two actions to mitigate the impact on ABR diplomates: 1) requested and received an ABMS deferral for one year to prepare for and communicate the reporting system to ABR diplomates (from August 2011 to August 2012), and 2) accelerated the planned introduction of ABR website information on diplomate statuses. While a launch of the ABR's online verification system was originally scheduled for 2013, the date was moved to August 1, 2012, coinciding with the launch of the ABMS reporting system so it would be immediately available to provide clarifying information for all ABR diplomates. Here is how the public reporting will work: ABR diplomates enrolled in MOC and meeting MOC requirements will be able to direct individuals and organizations to the ABMS website as proof of their MOC status. The ABR website will contain individual information for each diplomate, clearly stating the status of lifetime-certified individuals as "certified, not required to participate in MOC." Website users will be instructed to access the ABR’s new database or contact the ABR directly for information regarding whether a specific physician is required to participate in MOC. This will enable the ABR to clearly explain to all interested parties that physicians with lifetime certification status need not “meet the requirements” of MOC to retain their valid ABR certification. This information cannot be displayed on the ABMS website because of limitations placed by the ABMS. This initiative reflects ABR’s vigorous efforts on behalf of its diplomates to render the mandated ABMS reporting process clear, fair and consistent with our commitment to those with ABR lifetime certifications.

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Professional Council Report Per Halvorsen, Newton, MA

Current surveys s you may be aware, the Ethics Committee recently launched a survey on ethics and professionalism in medical physics. The responses, which will of course be kept entirely anonymous, will help the committee to prioritize their work in support of our members’ needs. I would encourage you to complete the brief survey if you haven’t already done so. The link can be found on the AAPM home page, or you may go to http://www. aapm.org/announcements/EthicsSurvey.asp.

ASTRO is currently conducting a survey of most professional groups in radiation oncology, including therapists, dosimetrists and physicists. They provided a draft of the survey instrument to the AAPM for review, and Michael Mills and Yan Yu (Chair and Vice Chair of the Workforce Assessment Committee) reviewed the draft survey on behalf of the AAPM. Based on this review, the AAPM has agreed to support ASTRO in this effort, and I would encourage you to participate if you are contacted. While we recently conducted a thorough workforce study of the medical physics profession, ASTRO’s survey is focused on factors in the practice environment rather than on “hard data” related to workforce supply and demand. We hope their study can provide information that complements our own supply and demand data. Economics Committee provides reimbursement webinars On January 10th and 11th, Economics Committee Chair Jim Goodwin and consultant Wendy Smith Fuss presented webinars for our members on the 2012 final rules by the Centers for Medicare and Medicaid Services (CMS) for the Medicare Physician Fee Schedule (physicians and outpatient centers) and the Hospital Outpatient Prospective Payment System (hospital-based centers). Many thanks to all who helped prepare these webinars. The slide presentations are available for download from the AAPM website at http://www.aapm.org/meetings/default.asp?tab=5#MeetingsPanel. Should you have any questions or requests for future presentations, feel free to contact Jim Goodwin, or Lynne Fairobent at AAPM HQ (lynne@mail.aapm.org). Spring Clinical Meeting The AAPM Spring Clinical Meeting will be held from March 17th to 20th at the Westin Galleria Hotel in Dallas, TX. Thanks to the tireless efforts of many of your colleagues who have volunteered their time, the program should have something for everyone who is active in clinical medical physics, including more than a dozen SAM sessions covering therapy, imaging, and mammography topics. See http://www.aapm.org/meetings/2012SCM/ for more information. We hope you can join us! Professional Services Committee events at the Annual Meeting The Women's Professional Subcommittee will again host a women's luncheon at the summer meeting. This year, they have requested that the option to participate be listed with meeting registration – the cost will be $10. Also, the New Professionals Subcommittee is organizing the New Member Symposium, which will again involve a drawing for free registration to the next meeting as well as a “Meet the Experts” social/drink ticket. Information to be provided at the symposium includes a talk by Michael Mills on residencies and workforce, as well as an introduction to the AAPM and a “How To” presentation on navigating the AAPM website. The Placement Service Subcommittee, with the help of AAPM HQ, has recently published the following information on the summer meeting website: http://www.aapm.org/meetings/2012AM/CareerServices.asp.

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Therapy Program • Scientific Symposia Accuracy of Proton Dose Computation Algorithms and Need for Improvement Automatic Planning in Radiation Therapy Decision Support for Radiation Therapy Biophysical Modeling for High-Dose Hypofractionated Radiotherapy Implementation and Precautions for Unflattened Beam Radiotherapy Predicting Complication Probabilities Beyond the Dosevolume Histogram Will Proton Therapy Gradually Replace Photon Therapy?

Proffered Abstract Submissions • Patient Simulation Imaging for Planning • Treatment Planning • Treatment Delivery and Verification • Dosimetry Techniques, Specifically Patient Safety and Quality Assurance Procedures • Outcome Modeling and Assessment • Basic Radiobiology • Informatics • Small Animal Studies • Radiation Protection and Shielding • Targeted Radionuclide Therapies

New for 2012!! (13) INTERACTIVE SESSIONS will be offered this year which will require an audience response unit (ARU) to participate. To participate interactively you will need to rent the ARU through the registration process.

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March/April 2012

Imaging Program • Scientific Symposia State of the Art in Quantitative Imaging in CT, PET and MRI Advanced Angiographic Imaging Techniques Assessment of Image Quality for the New CT Limits of Dose Reduction in CT: Where are they and how will we know when we get there? Where Molecular Imaging is Taking Us CAD: Can we get from promise to clinic? Quantitative Imaging and Contrast Agents in Ultrasound

Proffered Abstract Submissions • Radiography • • Mammography • • Fluoroscopy • • Rotational • Angiography • • Helical CT • • Dual Energy CT • • Dynamic Contrast • Enhanced CT • • Cone Beam CT • • Nuclear Medicine and PET

MRI DCE-MRI DWI-MRI MR Spectroscopy Optical Ultrasound Novel Modalities Multi-Modality Imaging Modality Independent Display

(ARU) INTERACTIVE SESSION TITLES Volumetric Modulated Arc Therapy State of the Art in Quantitative Imaging in CT, PET and MRI Linac-based IMRT/VMAT Commissioning and QA Program Development Personalizing Medicine: Adapting to the Individual Medical Physics Ethics in Action Where Molecular Imaging is Taking Us Assessment of Image Quality for the New CT Will Proton Therapy Gradually Replace Photon Therapy? Transitioning from 3D IMRT to 4D IMRT and Role of Image-Guidance Deformable Registration in the Clinic: From Commissioning to Advanced Applications Imaging Dose to Patients and Inclusion of Imaging Dose in Radiation Therapy Treatment Planning Dosimetry of Small Fields Advanced Imaging Applications and Contrast Agents in Ultrasound Imaging

AAPM Newsletter

Joint Imaging/Therapy Program • Scientific Symposia • Treatment Assessment of Radiation Therapy Using MR Functional Imaging • The Future of Physics in Cancer Therapy and Imaging • Advances in Image-Guided Oncologic Surgery • Personalizing Medicine: Adapting to the Individual • Image Guided Adaptive Brachytherapy (IGABT) for Cervical Cancer • Risks and Realities of Radiation Dose in Medical Imaging • Real-time Volumetric Soft Tissues Guidance Technologies for External Beam Radiotherapy

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Proffered Abstract Submissions • John S. Laughlin / Science Council Research Symposium: Imaging for Therapy Assessment • Image Registration and Fusion • Therapy Assessment • Image Guidance and Localization at Therapy • Image Segmentation for Planning or Therapy • Image Visualization at Planning or Therapy • Motion Assessment/Management at Planning or Therapy • Simulation for Planning • Targeted Radionuclide Therapies • Patient Immobilization • Uncertainty Assessment/Management (e.g. adaptive RT & Margins)

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Professional Program Professional Council Symposium Medical Physics Practice Guidelines ABR 2014: Trained for Competence Economic Topics Methods in Completing Practice Quality Improvement (PQI) Medical Physics Ethics in Action Practice Management Training ACR Accreditation: Radiation Therapy How You Can Be the Speaker and Communicator Everyone Wants You to Be JMPSLC Update Establishing Multidisciplinary Research as a Medical Physicist Workforce Survey Update New Members Symposium Controlling Your Stress and Your Stuff International Medical Physics Symposium Preparing for the ABR Therapy Exam Preparing for the ABR Diagnostic Exam Medical Physics in Federal and State Governments The Evolving Landscape of Scientific Publishing AAPM-SEFM-AMPR How to Be a Journal Referee Economics of Light Ion Therapy Memorial Symposium in Honor of Rosalyn Yalow

Practical Medical Physics Program • • • • • • • • •

CT QC Testing Professional Practice Accreditation Medical Imaging Education Accidents and Misadministration Writing and Reviewing Papers in Medical Physics Implanted Cardiac Devices Multivendor SBRT/IGRT Radiation Therapy Contouring PET/CT QA and Acceptance Testing

More than 50 hours of educational courses in medical imaging and radiation therapy physics will be offered. This will include SAMS courses for diagnostic, medical nuclear, and radiation therapy physicists. www.aapm.org/meetings/2012AM

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AAPM wishes to acknowledge and thank the following individuals for their 2011 contributions: Education and Research Fund:

Armando Acha B. (Wally) Ahluwalia Hassaan Alkhatib Amiaz (Ami) Altman Michael P. Andre John A. Antolak David M. Applebaum Samuel G. Armato Ben A. Arnold Alfred E. Asprinio Glaister G. Ayr Michael J. Bailey John P. Balog Morris I. Bank Gary T. Barnes J. Ed Barnes Jerry J. Battista Ishtiaq H. Bercha Carl E. Bergsagel Michael O Bligh Frank Bloe Arthur L. Boyer Ajit Brindhaban Harry S Bushe Stewart C. Bushong Carlos A Caballero Desmi Campbell James E. Carey David J Carlson Elena Castle Maria F Chan Sha X Chang Paule M Charland Jean Jacques Chavaudra Zhe (Jay) Chen Stéphanie B Corde Kevin W. Corrigan Richard J. Crilly Phillip E. Cubbage Wesley S. Culberson Joanna E. Cygler Edmund P. Cytacki Maximian Felix D’Souza Jerome G. Dare Indra J. Das Domenico Delli Carpini Jun Deng Colleen M. Desrosiers Anonymous Donor Anton Eagle Ravimeher L. Errabolu Carlos Esquivel Bruce A. Faddegon Lynne Fairobent Tony Falco Karl J Farrey Doracy P. Fontenla Martin W. Fraser D. Jay Freedman G. Donald Frey Steven Anthony Gasiecki William R. Geisler Bruce J. Gerbi John P. Gibbons

Maryellen L. Giger Steven J. Goetsch David Lloyd Goff Bennett S. Greenspan Suzanne A. Gronemeyer Madhup Gupta Nilendu Gupta Per H. Halvorsen Homayoun Hamidian Russell J. Hamilton Oliver D. Hanson Peter A. Hardy John D. Hazle Chris M. Hearn Joseph P. Hellman Frank William Hensley Michael G. Herman James M. Hevezi Jung T. Ho Randall William Holt Kristina E. Huffman Tobin C. Hyman Gulkan Isin Leo E. Jablonski Edward F. Jackson Zheng Jin Haejin Kang Timothy R. Keys Angela R. Keyser Steven A. Kirkpatrick Assen S. Kirov Michael E Kowalok Lena S. Lamel Donald W Laury Edwin M. Leidholdt David A. Lightfoot Dale W. Litzenberg Eugene Mah Lesley Ann Malone Sivasubramanian Manoharan Alexander Markovic Christopher H. Marshall Mary K. Martel Rafael Martin Martha M. Matuszak Cynthia H. McCollough James E. McDonough Sharon K. McMillan Michael F. McNitt-Gray Matthew A Meineke Jeffrey G. Messinger Tariq A. Mian Richard E. Michaels Ira D. Miller Michael G. Mitch George Mitev Raj K. Mitra Mary E. Moore Jose A Morales Monzon Lee T. Myers David M. Nelson Robert M. Nishikawa James H. O’Rear Sachio Ogawa Olabode Thomas Ogunleye Arthur J. Olch Sandra L. Paige

Norris J. Parks E. Ishmael Parsai Daniel C. Pavord Shashi A Perera Joseph Perl Paula L. Petti Douglas E. Pfeiffer Bhaskaran K. Pillai Robert J. Pizzutiello Robert A. Praeder Nicole T. Ranger Prema Rassiah-Szegedi Chester S. Reft Miguel A. Rios Mark J. Rivard Daniel G Robertson Lawrence N. Rothenberg Narayan Sahoo James S Sample George A. Sandison Vikren Sarkar L. John Schreiner Alexander W. Scott Shakil Bin Shafique Anil Kumar Sharma S. Jeff Shepard Nikul S. Sheth Hemant I Shukla Deborah J. Shumaker Melvin P. Siedband Michael D. Silver Guy H. Simmons Douglas J. Simpkin Larry D. Simpson John P. Skrobola Jerry Soen Donna M. Stevens Palmer G. Steward Crowe Suzaine Kazumichi Suzuki David J Swanberg John W. Sweet Martin Szegedi Raymond L. Tanner Russell B. Tarver Michael Tassotto David D. Taylor James A. Terry Peter J Thirunelli Bruce R. Thomadsen Stephen R. Thomas Earl A. Trestrail Sugata Tripathi Erik J. Tryggestad John C. Upton Jaime Urribarri Stephen A Vastagh Steven J. Wang Dongxu Wang John T. Washington Michelle C. Wells Marilyn C. Wexler Gerald A. White John D. Willins Robert John Wilson John W. Winston Charles Wissuchek

Margaret A. Wolf John W. Wong Ching-Chong Jack Yang Ellen D. Yorke Ning J. Yue James A. Zagzebski Pengpeng Zhang Qinghui Zhang Timothy C. Zhu Jeananne M. Zink

John R. Cameron Memorial Fund:

Michael J. Bailey Harry S Bushe Ray Capestrain Jean Jacques Chavaudra Edmund P. Cytacki Maximian Felix D’Souza William R. Geisler Cynthia H. McCollough Lawrence N. Rothenberg David P. Spencer

Hy Glasser Memorial Fund Jerome G. Dare Lawrence N. Rothenberg

John Hale Memorial Fund

Mary E. Moore

Doug Jones Memorial Fund

Robert A. Praeder David P. Spencer John T. Washington

Jack S. Krohmer Memorial Fund

Jerome G. Dare James H. Goodwin Edwin M. Leidholdt Mary E. Moore David P. Spencer

Robert Loevinger Memorial Fund

Harry S. Bushe Edwin M. Leidholdt

John S. Laughlin Memorial Fund

Jerome G. Dare Anonymous Donor Edwin M. Leidholdt Radhe Mohan Mary E. Moore Lawrence N. Rothenberg Larry D. Simpson Qinghui Zhang

Edward Webster Memorial Fund

Ben A. Arnold Jerome G. Dare

AAPM Newsletter

March/April 2012

Education Council Report George Starkschall, Houston, TX

his month’s report is another in the series of reports to describe to you the activities of the committees that make up the AAPM Education Council. We have already had reports from the International Educational Activities Committee, the Medical Physics Education of Physicians Committee, and the Continuing Professional Development Committee. This month I asked Doug Pfeiffer, Chair of the Medical Physics Education of Allied Health Professionals Committee, to describe to you the activities of his committee. The Medical Physics Education of Allied Health Professionals Committee Doug Pfeiffer, Boulder, CO What does this committee do? A relatively recent (1995) definition of “Allied Health” stated that Allied Health is “a large cluster of health-related personnel who fulfill necessary roles in the healthcare system, including assisting, facilitating, and complementing the work of physicians and other healthcare specialists"(CAHEA, 1995).” Another definition specifically excludes nursing. However, the Allied Health Committee (for short) has a broader purview than this. We are tasked with the medical physics education of most groups other than Medical Physicists, Radiologists, and Radiation Oncologists. So, our umbrella covers more than the formal definition of Allied Health. Steve de Boer is Chair of the Training and Practice of Medical Dosimetry Subcommittee (TPMD). We’ve always had a close relationship with our dosimetrist colleagues, and Steve is working hard to maintain that relationship, along with Mike Taylor, who is our liaison to the Medical Dosimetrist

The first annual AAPM Spring Clinical Meeting will include practical information designed to help medical physicists integrate emerging technologies into the clinical environment, keep abreast of regulatory and accreditation related issues, and provide a forum for the exchange of ideas in support of practice quality improvement It’s not too late to Register! The AAPM Spring Clinical Meeting has been approved by the Commission on Accreditation of Medical Physics Education Programs, Inc. (CAMPEP) for continuing education credit hours. AAPM has applied to the ABR for Self-Assessment Modules (SAMs) which allow for interactive learning and self-assessment of knowledge gained during these sessions. We anticipate offering as many as 13 SAMs sessions - exact number to be disclosed after ABR approval. For more information www.aapm.org/meetings/2012SCM/

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AAPM Newsletter

March/April 2012

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AAPM Newsletter

March/April 2012

continued - Education Council Report Certification Board. Among many activities of the TPMD, one highlight from Steve is his efforts on the AAMD curriculum guide. One of the standing tasks of the Allied Health Committee is to make arrangements for the RSNA/AAPM Basic Physics Lecture for Radiologic Technologists. For years, the Committee determined the topics and arranged the speakers. I noticed, however, that it seemed we were missing our intended audience at RSNA, and attendance seemed to be lower than it should be. I have begun working with a representative of the American Society of Radiologic Technologists (ASRT) to ensure that the topics are indeed meeting the needs of the RT society. Further, we’ll be working more closely with RSNA to take advantage of resources available to advertise the lecture. Our relationship with the ASRT is being strengthened by the efforts of Phil Heinz. We work closely with the American Registry of Radiologic Technologists, identifying medical physicists to serve on their exam committees. These committees have a vital role in ensuring that the registry exams are correct and pertinent. We regularly have about 10 liaison appointments to the ARRT. With the increase in radiation safety awareness, it is more important than ever for medical physicists to be providing radiation safety training to hospital staff who might not have received it regularly in the past. This is where the definition of Allied Health becomes somewhat broadened. The Allied Health Committee will be establishing a Subcommittee or Working Group to develop and maintain radiation safety training modules for a diverse set of groups. Nurses, ER physicians, surgeons, and cardiologists all need appropriate training. We will be establishing contact with organizations for these groups, developing the training modules, and getting them on line. The goal is to make these a source of income for our society. All of these activities are consistent with the AAPM Strategic Plan (http://aapm.org/org/ TheAAPMStrategicPlan-2011_Full_Version_final.pdf), under Goal 3, Objective 3 and Goal 5, Objectives 1-3. My apologies go to those who serve in other capacities for Allied Health, whom I haven’t specifically mentioned or have overlooked. While small in the AAPM hierarchy, the Allied Health Committee will be growing and becoming more active to meet these goals and objectives. It’s an exciting time, and I am honored to chair this committee.

Who Should Attend?

Any medical physicist who uses imaging technology as part of their practice.

Why Attend?

Whether you are new to the use of diagnostic cone-beam CT in the neurovascular lab, or new to the use of cone-beam CT as part of your radiation therapy treatment planning and delivery verification processes, you need to know about new imaging technologies. • How will they benefit your practice? • How will they integrate with existing imaging capabilities and information technology infrastructure? • What do you need to know to bring these technologies into your practice and adequately test and turn them over for clinical use? Join our faculty of experts in beautiful San Diego to learn the answer to these questions and more. Particular focus will be given on how to maximize the benefit to risk ratio associated with the use of medical imaging. Additionally, two Self Assessment Modules (SAMs) will be included in Wednesday’s program (no extra fee) • •

MAY 9 JUNE 8

Deadline to receive early registration fees Deadline to reserve campus housing

http://www.aapm.org/meetings/2012SS/

*2012 AAPM Summer School is not sponsored by the University of California

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AAPM Newsletter

March/April 2012

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. Q. Should I follow the laser printer manufacturer’s QC manual when performing QC on the laser printer in order to comply with the FDA regulations? A. Possibly. It depends on the instructions provided in the FFDM unit manufacturer’s QC manual. FDA regulations require the quality assurance program at FFDM facilities to be substantially the same as the quality assurance program recommended by the image receptor manufacturer (e.g., GE, Lorad, etc.). Some FFDM QC manuals provide specific instructions on performing QC of the laser printer used with their systems; others instruct the user to follow the QC manual of the laser printer manufacturer. The following table summarizes the laser printer QC (at the time this question was written). Check with your FFDM manufacturer for the most current instructions. FDA-Required Laser Printer QC FFDM Mfr

Model

Carestream

Directview CR

Fischer

SenoScan

Fuji

FCRm

General Electric Lorad

Senographe 2000D, DS and Essential Selenia

Philips (Sectra)

MicroDose L30

Planmed

Nuance and Nuance Excel

Siemens

Mammomat Novation DR

Laser Printer QC Follow the laser printer manufacturer’s QC manual Follow the laser printer manufacturer’s QC manual Follow the laser printer manufacturer’s QC manual Follow the laser printer manufacturer’s QC manual Follow the Lorad Selenia QC Manual Follow the laser printer manufacturer’s QC manual Follow the laser printer manufacturer’s QC manual Follow the laser printer manufacturer’s QC manual (but conduct QC every day that images are printed)

Q. The FFDM unit manufacturer’s QC manual specifies that the laser printer QC must be performed weekly. However, my facility only prints hard-copy mammograms to give to patients once or twice a month. Do we need to perform QC on the laser printer during weeks no printing occurs?

A. No. The following serves to clarify FDA's position on laser printer testing, as of January 4, 2011: Facilities are required to follow the testing requirements for laser printers as outlined in the FFDM manufacturer's (or laser manufacturer's if more appropriate) QC manual but only on those days or weeks when they are actually printing out images. In the case of a facility that performs its final interpretations using softcopy, the facility would only have to test the laser printer on those days or weeks when producing clinical hardcopy images for patients or healthcare providers or for retention purposes. Q. Is there a list that shows the laser printers that have been cleared for mammography by the FDA? If not, how can I determine if FDA has cleared a given laser printer for mammography use? A. No. Although FDA has cleared many printers for FFDM use through the 510(k) process, FDA does not keep a list of cleared printers, other than what is available in FDA’s 510(k) database at http://www.fda.gov/cdrh/510khome.html#database. You can search this database by product code, device name, applicant name, decision date, and other elements, including a simple word search. Another way to find out whether a particular printer has been cleared for FFDM use is to check the device’s labeling or to have the printer manufacturer provide you with written documentation showing that the printer has been cleared by FDA for FFDM.

AAPM Newsletter continued - ACR Accreditation Q. Can a manufacturer hook up a printer or monitor to its FFDM unit if the printer or monitor were not part of its original PreMarket Approval (PMA)?

AAPM New Member Symposium Tuesday, July 31 • 4:30pm - 6:00pm Charlotte Convention Center Are you a new AAPM member (joined in the last 3 years)? Don't forget to select the ticket option for the New Member Symposium when you register for the AAPM Annual Meeting in Charlotte.

A. Manufacturers will need to check the exact wording of their PMA to see if this is allowed. However, the facility is not restricted by the PMA and may hook up and use printers and monitors other than those approved by FDA for use with the manufacturer’s FFDM unit as long as they meet the requirements specified in “Can a facility use printers and monitors that were not specifically approved as part of its FFDM unit?”.

T H E

W A T E R

March/April 2012

Following an introduction from the AAPM President, Michael Woodward of the AAPM staff will provide a crash course on the AAPM structure and organization, as well as some pointers on navigating the website. Next will be Dr. Michael Mills presenting on the current state of the U.S. Medical Physics Workforce and Residencies. Registered attendees will receive a raffle ticket -enter to win a complimentary registration for the 2013 Annual Meeting in Indianapolis! In addition, all new members who register for the Symposium will receive a drink ticket, good for one complimentary beer served at the New Member Symposium during the social with committee chairs from the 4 AAPM Councils: Science, Education, Professional and Administrative.

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AAPM Newsletter

March/April 2012

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AAPM Newsletter

March/April 2012

Legislative and Regulatory Affairs Lynne Fairobent, College Park, MD

DICOM WG-28 “Physics Strategy” Established n December 2011, the DICOM Standards Committee (DSC) approved the establishment of Working Group (WG) 28, on Physics Strategy. This is the first time that there is a WG focused on medical physics issues. In order to maximize reaching out to medical physicists, it was decided to have two co-chairs – one from the US and one from Europe and two secretaries. The co-chairs are: Donald Peck, AAPM and Annalisa Trianni, European Federation of Organizations of Medical Physics (EFOMP). Alberto Torresin, EFOMP, serves as the European Secretary and I serve as the US Secretary. The inaugural meeting of WG-28 was on February 6, 2011 in San Diego, CA.

The Scope of WG-28 is to: • Develop or consult on Correction Proposals (CP) and Supplements requiring detailed expertise on physics and/or the needs and work of medical physicists. • Serve as a liaison body to facilitate including data relevant to the physics community in DICOM objects. If you are interested in becoming involved with WG-28, you are invited to join WG-28 as “Members” or “Observers”. The application process is described in the complete text of the DICOM Procedures: http://medical.nema.org/DICOM/Geninfo/Procedures.pdf WG-28 intends to accomplish most of its work through e-mail and telephone conference communications on an as needed basis. Annually, in–person meetings are planned generally once in the United States and once outside of the United States, in conjunction with appropriate professional society meetings. If you are interested in WG-28, please contact me at lynne@aapm.org. NRC – ACMUI Permanent Implant Brachytherapy Subcommittee Report Issues Final Recommendations The NRC Advisory Committee on the Medical Uses of Isotopes (ACMUI) Permanent Implant Brachytherapy Subcommittee Report as it relates to the implementation of the medical regulations in Title 10, Code of Federal Regulations (CFR) Part 35, “Medical Use of Byproduct Material” met via conference call on February 7, 2012 to review the revised report by the Subcommittee on Brachytherapy. The Draft ACMUI Permanent Implant Brachytherapy Subcommittee Report modified January 2012, (ADAMS Accession #ML12019A196,) was approved by the ACMUI with the three changes noted above and one opposing vote. Dr. Thomadsen voted against the current report and stated his continued support for the October 18, 2011 version (ADAMS Accession #ML11292A139). Dr. Thomadsen’s comments are summarized in the “Minority Report” section of the current report dated February 7, 2012 (ADAMS Accession #ML12038A279). The summary of the ACMUI conference call can be found at: http:// pbadupws.nrc.gov/docs/ML1203/ML12038A280.pdf Final Recommendations of the ACMUI Permanent Implant Brachytherapy Subcommittee Report: A. Proposed Definition for Medical Event for Macroscopic Permanent Implants 1. For the target, greater than 20% of the sources fall outside of the treatment site (not resulting from patient-related causes such as edema or source migration after placement); OR 2. For normal-tissue structures, a. For neighboring structures (such as the bladder or rectum in prostate implants as an example), the dose to at least 5 contiguous cm3 exceeds 150% of the dose prescribed to the CTV or PTV; OR b. For intra-target structures (such as the urethra in prostate implants as an example), the

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AAPM Newsletter

March/April 2012

continued - Legislative and Regulatory Affairs dose to at least 5 contiguous cm3 exceeds 150% of that structure’s expected dose based on the approved pre-implant, dose distribution. Or, 3. A treatment is executed a. Using the wrong radionuclide; b. Using the wrong activity or source strength (+/- 20%) as specified in the Written Directive; c. Delivered to the wrong patient; d. Delivered directly to the wrong site or body part, with the exceptions of seed migration, edema and other patient-related factors or source displacement following placement, as long as the criteria in 1. is not violated; e. Delivered using the wrong modality or f. Using leaking sources, B. Written Directive Completion After implantation but before the patient is released from the Authorized User’s control, the Authorized User shall complete the Written Directive to include the radionuclide, treatment site, number of sources, and the total source strength permanently implanted in accordance with 10 CFR 35.40(b)(6). Unusual aspects of the procedure, including patient-related limitations should be documented in this Written Directive completion. The Authorized User should provide a statement in this Written Directive Completion attesting that the permanently implanted sources have been placed in accordance with the final planned distribution. The permanent implant procedure shall be considered complete once the patient is released from the Authorized User’s control. Terminology • Gross Tumor Volume, GTV – The volume of the tumor proper as detected on imaging, visual observation or manual palpation on physical examination. • Clinical Target Volume, CTV – The volume containing the gross tumor and a margin that may contain malignant cells from the tumor. In the case of prostate implants, this usually is the whole prostate but can be more if there is “extracapsular extension” of disease. • Planning Target Volume, PTV – The volume within which the sources are placed to deliver the prescribed dose to the CTV. This would include the CTV plus any additional margin used to assure y adequate coverage. • D90 – The dose to 90% of the CTV • Treatment site – The anatomical description of the tissue intended to receive a radiation dose, as described in a written directive [10 CFR 35.2]. The Subcommittee recommends the description include the concept of GTV, CTV, or PTV.

The above recommendations will be considered by the NRC staff in its continuing effort to make 10 CFR Part 35 more useful, practical, and not overly burdensome on licensees, while maintaining public health and safety.

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AAPM Newsletter

March/April 2012

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continued - Legislative and Regulatory Affairs Reports from ACMUI on Permanent Implant Brachytherapy • Permanent Implant Brachytherapy Rulemaking Final Report (2012) can be found on NRC’s public website under “Related Information”: http://pbadupws.nrc.gov/docs/ML1203/ ML12038A279.pdf • Permanent Implant Brachytherapy Rulemaking Final Report (2011) can be found on NRC’s public website under “Related Information”: http://pbadupws.nrc.gov/docs/ML1129/ ML11292A139.pdf • Permanent Implant Brachytherapy Rulemaking Final Report (2010) can be found on NRC’s public website under “Related Information”: http://pbadupws.nrc.gov/docs/ML1035/ ML103540385.pdf • Permanent Implant Brachytherapy Rulemaking Final Report (2008) can be found on NRC’s public website under “Related Information”: http://pbadupws.nrc.gov/docs/ML0922/ ML092220766.pdf ACMUI documents: • Full transcripts of the ACMUI meeting can be found on NRC’s public website: http://www.nrc. gov/reading-rm/doc-collections/acmui/tr/ • Handouts from the ACMUI meeting can be found on NRC’s public website: http://www.nrc. gov/reading-rm/doc-collections/acmui/meeting-slides/ If you have comments on the above recommendations, please provide them to me at lynne@aapm. org.

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AAPM Newsletter

March/April 2012

National Symposium

Quality, Safety, and Compliance

How to address the triple challenge of modern imaging and therapy Atlanta, Georgia, April 18-‐20, 2012 www.seaapm.org

Symposium Features

1) Basics of quality and safety – the “what” 2) Achieving and maintaining accreditation – the “how” 3) Effectiveness and limitations of clinical implementations – the “why”

Followed by the Southeast Chapter Scientific Meeting, April 20-‐21, 2012 Night-‐out at Georgia Aquarium CME: CAMPEP credit

Symposium Faculty

Co-‐chairs: Ehsan Samei, PhD, Duke University Medical Center Lawrence Marks, MD, University of North Carolina Todd Pawlicki, PhD, University of California Theresa Branham, BSRS, ACR Donald Peck, PhD, Henry Ford Medical Group Benedick Fraass, PhD, Cedars-‐Sinai Douglas Pfeiffer, MS, Boulder Community Hospital Mannudeep Kalra, MD, Mass General H. Ronald Price, PhD, Vanderbilt University Carolyn MacFarlane, MS, ACR P. Tripuraneni, MD, Scripps Clinic Torrey Pines Brian Monzon, MBA, ACR

AAPM Newsletter

March/April 2012

AAPM Specialty Meetings Oversight Subcommittee Bret H. Heintz, Southlake, TX

AAPM Specialty Meetings

s Chair of the Specialty Meetings Oversight Subcommittee, I’d like to bring to your attention the opportunity to suggest, organize and host an AAPM Specialty Meeting.

In addition to the Annual and Summer School meetings, we have added the AAPM Spring Clinical Meeting to our yearly conference offerings. But we recognize that one size does not fit all. AAPM offers Specialty Meetings as one more option to those members with limited travel/time out of the office looking for a shorter 1- or 2-day course on a specific topic. We realize the need to keep up with new scientific technologies, as well as educational and professional development requirements and now invite the membership to get involved…host a meeting. Individuals wishing to organize an AAPM Specialty Meeting are asked to complete the Specialty Meeting Request Form and submit accordingly. Details regarding the process can be found on the AAPM Meetings website under the ‘Specialty’ meeting tab: http://www.aapm.org/meetings Please note you’ll have the full support of our headquarters staff to assist with every step of the process and for organizing a meeting. Please contact me or HQ with questions. We look forward to hearing from you.

Previous AAPM Specialty Meetings include:

• 2011: AAPM CT Dose Summit: Interdisciplinary Program on Scan Parameter Optimization October 7 – 8 Denver, CO

• 2010: Safety in Radiation Therapy – A Call to Action June 24 – 25 Miami, FL

• 2010: Imaging for Treatment Assessment in Radiation Therapy (ITART) June 21 – 22 National Harbor, MD

• 2010: AAPM CT Dose Summit: Scan Parameter Optimization April 29 – 30 Atlanta, GA

• 2009: AAPM Residency Training Program Workshop - Organization and Completion of CAMPEP Self-Study August 28 - 29 Minneapolis, MN

• 2009: Symposium on the Promises and Perils of Proton Radiotherapy May 8 – 9 Baltimore, MD

• 2009: AAPM Residency Training Program Workshop - Organization and Completion of CAMPEP Self-Study February 6 – 7 Dallas, TX

• 2008: Becoming a Better Teacher of Medical Physics July 31 - August 3 League City, TX

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AAPM Newsletter

March/April 2012

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AAPM Newsletter

March/April 2012

ABR Trustees Report

Jerry Allsion, Geoffrey Ibbott, Richard Morin

or many years, individuals have used the term “board eligible” to indicate that they are eligible to take the ABR examination. This could be important to an individual for purposes of obtaining or holding a job or for credentialing by his or her employer. The use of this term has taken place in spite of the fact that the board itself did not recognize the status of “board eligible.” To the ABR, one was either “in-process” or “certified.” To correct this situation, the ABR recently adopted the term “board eligible” to designate candidates who are progressing toward full certification.

Board Eligible

Candidates now may describe themselves as “board eligible” once they have been approved to take Part 2 of the ABR Medical Physics Examination.

We hope that candidates in the ABR examination process will benefit from their ability to describe themselves as “board eligible.” This status indicates that they have completed their training and are well along the road to being fully certified.

As part of its procedure to improve the certification process, the ABR has also replaced the three “opportunities” to take each part of the examination with time limits. This will give candidates more flexibility in their ability to manage the examination process. These limits are generally 5 years for the Part 1 examination and 6 years for the Part 2 and Oral examinations. (These six years comprise the “boardeligible” period.)

Part 1 Examination – Time Limit

After candidates have been approved for Part 1, they have five years to pass the Part 1 examination. If they have not passed after five years, they are required to take additional training at a CAMPEP-accredited educational program. This training must include, at a minimum, successful completion of at least five medical physics courses (15 credit hours total). The candidate does not have to be matriculated in a degree program, but the successful completion of the five courses must be demonstrated either on a college transcript or through an official report. The report must be prepared and signed by the course instructor and co-signed by the program director, attesting that the candidate completed all assigned work and exams, and received passing grades. The clock for the Part 2 and Oral examination starts either when one is approved for Part 2 or when one completes a CAMPEP-accredited residency (the earlier of the two dates is used). Like all ABR policies, if an individual has special circumstances that keep him or her from completing the process, the ABR will consider each situation on an individual basis. These might include major illness or military deployment. The ABR treats these cases with compassion and sensitivity. These time limits were put into effect after the ABR reviewed the histories of several candidates who had been in the physics certification process for 20 years or more. It was felt that there should be a time limit on candidates’ being able to describe themselves as board eligible and that after some point, additional training was necessary. We believe that candidates in the ABR examination process will benefit from their ability to describe themselves as “board eligible,” indicating that they have completed their training and are well along the road to being fully certified. What happens if I am already in the process? If you have been approved to take Part 1, you now have until January 1, 2017, to pass Part 1. You may take the Part 1 exam each year until that date. If you do not pass Part 1 by that date, you will be required to take additional didactic training. You will not be allowed to take Part 2 until you pass Part 1. If you have been approved to take Part 1, Part 2 or Part 3 (Oral) you have until January 1, 2017, to pass Part 2 and Part 3 (Oral). You must pass Part 1 before you take Part 2, and you must pass Part 2 before you take the Oral examination. Once in the Oral examination process you can take the Conditioned exam as necessary. However, you must complete the entire process prior to January 1, 2017.

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AAPM Newsletter

March/April 2012

Radiology Safety Case of the Fortnight William Hendee, Rochester, MN Donald Peck, Detroit, MI

mage Wisely is preparing a new series for its website. The series, called Radiology Safety Case of the Fortnight, will present brief scenarios with questions and images depicting quality and dose issues from radiologic procedures (radiography, fluoroscopy, interventional radiology, computed tomography, nuclear medicine). A new case will be offered every other week. Eventually, physicians and radiologic technologists who study the case and take a brief test after reviewing the case will be eligible to receive CME or Category 1 credit respectively. CAMPEP credit for persons preparing cases is also being pursued. The cases will be similar to the ACR’s Case in Point (3s.ACR.org/CIP/). Multiple authors of a Case of the Fortnight are acceptable. Each case is peer-reviewed, and most require modest revision before they can be accepted. Because they are peer-reviewed, they can be included on the author’s CV. Preparing a Case of the Fortnight is an excellent opportunity for medical physics students, residents and fellows working under the supervision of a mentor. You may request the template for submitting a Case of the Fortnight presentation by contacting Wil Creech at the American College of Radiology (wcreech@acr.org) We encourage medical physicists, including students, residents and fellows to prepare one or more Cases of the Fortnight. All cases should be sent to Wil Creech. Further questions should be directed to Donald J. Peck, PHD (donaldp@rad.hfh.edu), incoming AAPM Representative to Image Wisely.

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AAPM Newsletter

March/April 2012

UNYAAPM Chapter Report Iris Wang, Immediate Past President Buffalo, NY

Thomas R. Mackie Honored at UNYAPM Fall Meeting

n October 18th, 2011, the Upstate New York Association of Physicists in Medicine held its semiannual meeting at the Zebro Family Conference Center, Roswell Park Cancer Institute, Buffalo, NY. The highlight of the meeting was the presentation of the annual UNYAAPM Lifetime Achievement Award honoring Thomas R. Mackie this year. The award recognizes the exemplary and legendary contributions that Dr. Mackie has made to radiation therapy during his Dr. Mackie receiving the Life Time Achievement career thus Award from the UNYAPM executive members. From far. As part left to right: Dinko Plenkovich, Iris Wang, Thomas Mackie and Michael Schell. of the award ceremony, Dr. Mackie presented a keynote lecture entitled “Cancer Imaging for Radiotherapy”, which emphasized the increasing importance of imaging in radiotherapy. After a brief history review, Dr. Mackie presented the application of CT, as well as the new roles of some other medical imaging modalities, such as MRI and PET in modern radiotherapy. He concluded that “It is highly likely that the number of years patients Discussion at break: Matthew Podgorsak (left) survive with a high quality of life will steadily increase and Thomas Mackie (right) over the next 25 years as imaging for cancer becomes less expensive and even more capable.” Dr. Mackie’s enlightening messages and scientific insights were very well received by the audience. In addition to Dr. Mackie’s presentation, the meeting program was comprised of some other presentations given by graduate students and clinical physicists from various universities/centers. From the Toshiba Stroke Research Center (TSRC), University at Buffalo, Brendan Loughran presented “Investigating the Usability of BIM (Brain Imaging Material) as a Water Equivalent Material in Neurovascular Imaging Studies.” Also representing the TSRC, Sandesh Gupta presented their research on “Increasing x-ray tube Sandesh Gupta, TSRC, output while maintaining the small effective focal spot Univeristy at Buffalo Jonathan Schmitt, RPCI for the Microangiographic Fluoroscope (MAF) System.” and University of Buffalo From Roswell Park Cancer Institute (RPCI), Jonathan Schmitt presented the results of his research entitled “The Optimization of Stereotactic Body Radiation Therapy

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continued - UNYAAPM Chapter Report (SBRT) from a Simple Field Order Rearrangement.” It was then followed by Setlur Nagesh’s presentation on “Dose Reduction technique for Image Guided Neurovascular Intervention,” also from the TSRC. The proffered paper session was concluded with a professional talk by Daniel Pavord, Chief Medical Physicist, Vassar Brothers Hospital, who presented a very informational talk on “Competency and Credentialing: Current AAPM Initiatives.”

Daniel Pavord, Vassar Brothers Hospital

The two vendors’ presentations were from PTW and Accuray. There were eight other vendors who also participated in the exhibits to demonstrate their products to the attendees, including: VARIAN, ELEKTA, Upstate Linac Services, LACO Inc., TomoTherapy, Velocity, SUN Nuclear, VisionRT, BARD, and ScandiDos. The UNYAPM would like to thank the vendors for their continuous sponsorship and participation in the chapter meetings.

The next semi-annual UNYAPM meeting is scheduled for May 2nd, 2012, to be held at the Bone and Joint Center, SUNY Upstate Medical University, East Syracuse, NY. As always, nonmembers are also welcome to attend. Details can be obtained from the chapter secretary, Dr. Daryl Nazareth (Daryl.Nazareth@RoswellPark.org) and the chapter web site (www. UNYAPM.org).

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AAPM Newsletter

March/April 2012

Persons in the News Norbert Pelc elected to National Academy of Engineering

orbert Pelc entered the field of Medical Physics as an undergraduate at the University of Wisconsin. He received his doctorate degree in Medical Radiological Physics from Harvard in 1979 where he conducted research on Computed Tomography and also PET. He worked at GE Medical Systems from 1978 until 1990 where he contributed to all the major imaging modalities but especially in CT, MRI, and digital radiography. Dr. Pelc joined Stanford University in 1990 and is now a Professor, and the Associate Chair for Research of the Radiology Department. Dr. Pelc attended his first AAPM meeting 35 years ago and has been a member since 1978, serving on task groups, the Imaging Physics Committee, and Science Council. He is also a long-time member of the RSNA and the ISMRM. He has served as reviewer for funding organizations including NIH, and was a member of the first Advisory Council of NIBIB. He is a Fellow of the AAPM, Fellow of the ISMRM, and Fellow of AIMBE. He is especially proud of the honors received by his trainees, including 5 RSNA Research Fellow Awards and two ISMRM Young Investigator Awards. His current research interests are in advanced CT system design, including system geometries and reconstruction methods.

Muthana Al-Ghazi; Ph.D. was the recipient of the Association of Residents in Radiation Oncology (ARRO) “Educator of the Year Award” in 2011

uthana Al-Ghazi is a Clinical Professor & Director of Medical Physics at the Department of Radiation Oncology, University of California, Irvine. Amongst his responsibilities is the physics instruction of radiation oncology residents. He also directs a CAMPEPaccredited therapy physics residency program. Dr. Al-Ghazi is board certified by the ABR & ABMP in therapy physics. He is a fellow of the Canadian College of Physicists in Medicine (CCPM) and AAPM. He is author/co-author of 56 journal and conference papers, book chapters, and reports, 81 abstracts and 77 invited and contributed presentations at regional, national and international conferences. He has served on several AAPM committees, mainly in the area of international affairs and continues to do so. He has co-directed, and was faculty at several AAPM/IOMP International Scientific Exchange Programs (ISEP). He helped establish the Middle East Federation of Medical Physics (MEFOMP), the Middle East chapter of IOMP.

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AAPM Online Learning Center Need medical physics continuing education credits? ABR certified and need Maintenance of Certification (MOC) credits? Sign up for access to the AAPM Online Learning Center Members have the opportunity to earn CAMPEP-approved Medical Physics Continuing Education Credit (MPCEC) and Self-Assessment Modules (SAMs) Credit for successfully passing quizzes associated with informational sources such as journal articles, AAPM Virtual Library presentations, task group reports, and other publications. • The annual fee is $65. • Credits are transferred to CAMPEP on a daily basis. • Register with the CME Gateway and your MPCEC and SAM credits can be transferred to the ABR daily. For listings of available CAMPEP-approved quizzes and ABR-approved SAMs offerings, visit the: AAPM Online Learning Center http://www.aapm.org/education/ce/info.asp

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: May/June • Submission Deadline: April 5, 2012 • Posted On-Line: week of May 1, 2012