AAPM Newsletter January/February 2016 Vol. 41 No. 1

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AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE

AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

AAPM NEWSLETTER Advancing the Science, Education and Professional Practice of Medical Physics

“I’M VERY INTERESTED in increasing usage of the content across multiple platforms as well as allowing a mechanism for readers to give feedback and interact with each other.”

— Jessica Clements AAPM Newsletter Editor

IN THIS ISSUE: ▶ President’s Report

▶ Research Spotlight

▶ Treasurer’s Report

▶ Impacting the Safety and Quality of Cancer Care in the Global Setting

▶ Imaging Physics Curricula Subcommittee Report and more...


2016 AAPM/SNMMI

NUCLEAR MEDICINE RESIDENCY GRANT Eligibility The goal is to provide matching grant support for residency training programs that will be CAMPEPaccredited in nuclear medicine by the time the resident completes his/her training. The following scenarios are acceptable: • Programs

that have submitted an application for accreditation in nuclear medicine physics.

• Programs

that will commit to submitting an application for CAMPEP accreditation in a timely fashion so that CAMPEP may review the application before the first resident completes the program. Programs should allow 6-9 months for CAMPEP review.

• These

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he AAPM Board of Directors has approved the expenditure of $70,000 (25% support) over the next 2 years to fund 2 new nuclear medicine residency programs in collaboration with the Society of Nuclear Medicine and Molecular Imaging (SNMMI). SNMMI will provide $70,000 (25% support) in funding. Each funded institution will provide $140,000 (50% support). This could be a 2+1 program.

Sponsored by the AAPM Education Council through the AAPM Education & Research Fund. A list of Award Recipients can be found here. Application Deadline: 2/1/2016

scenarios need not be in place at the time of the application but are required to receive the award.

The funding is granted to the institution. An individual need not be named at the time of application.

The funds are held by AAPM until the institution has an individual to fill the training position.

Review Criteria •

Commitment to nuclear medicine training.

Adequate staff resources.

Facilities relative to nuclear medicine training.

Quality of the training program based upon the description of the training rotations, didactic content and quality of training partner if used.

Recipients Notified by: 3/04/2016

FOR MORE DETAILS, VISIT: www.aapm.org/education/GrantsFellowships.asp


ARTICLES IN THIS ISSUE 5 7 13 15 17 19 21 25 29 33 34 37 41 42 45 46 47 54 56 59

President’s Report From the Editor’s Desk Executive Director’s Column Professional Council Report Education Council Report Science Council Report Treasurer’s Report ABR News Legislative & Regulatory Affairs Report ACR Accreditation: FAQs For Medical Physicists Health Policy & Economic Issues Research Spotlight AAPM Practice Accreditation Subcommittees’ Report Impacting the Safety and Quality of Cancer Care in the Global Setting Person in the News Imaging Physics Curricula Subcommittee Report News From the Medical Physics Editors’ Desk IOMP News The Findings of the AAPM/SNMMI Joint Task Force Expanding Global Access to Radiation Therapy by 2035

EVENTS/ANNOUNCEMENTS 2 4 6 8 15 16 24 28 32 45 53 63

2016 AAPM/SNMMI Nuclear Medicine Residency Grant AAPM DREAM Program AAPM Spring Clinical Meeting 2016 AAPM 58th Annual Meeting & Exhibition The Radiomics Workshop 2015 AAPM Research Seed Funding Grant Career Services AAPM 2016 Graduate Fellowship AAPM Summer Undergraduate Fellowship AAPM’s Working Group on Standardization of CT Nomenclature & Protocols AAPM Summer School 2016 AAPM Funding Opportunities

AAPM NEWSLETTER The AAPM NEWSLETTER is published by the American Association of Physicists in Medicine on a bi-monthly schedule. AAPM is located at 1631 Prince Street, Alexandria, VA 22314-2818

EDITORIAL BOARD Editor Jessica B Clements, MS Kaiser Permanente E-mail: JessicaClements@gmail.com Phone: 818-502-5180 John M. Boone, PhD Robert Jeraj, PhD George C. Kagadis, PhD E. Ishmael Parsai, PhD Charles R. Wilson, PhD SUBMISSION INFORMATION Please send submissions (with pictures when possible) to: E-mail: nvazquez@aapm.org AAPM Headquarters Attn: Nancy Vazquez 1631 Prince Street Alexandria, VA 22314 Phone: (571) 298-1300

NAVIGATION HELP Previous/Next Article

PUBLISHING SCHEDULE The AAPM Newsletter is produced bi-monthly. Next issue: March/April Submission Deadline: February 12, 2016 Posted Online: Week of February 29, 2016

Tap the arrows at the bottom of the page to go to the next or previous page. EDITOR’S NOTE I welcome all readers to send me any suggestions or comments on any of the articles or new features to make this a more effective and engaging publication and to enhance the overall readership experience. Thank you.

www.aapm.org

CONNECT WITH US!

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CONTENTS

AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016


AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE

DREAM

Diversity Recruitment through Education And Mentoring

THE DREAM PROGRAM is a 10 week summer program designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics.

ELIGIBILITY •

Undergraduate Juniors and Seniors majoring in Physics, Engineering, or other science degrees

U.S. Citizens, Canadian Citizens, or Permanent Citizens of the U.S.

HOW TO APPLY •

Complete application

Official transcript

2 Letters of recommendation

Self statement

FOR MORE DETAILS, VISIT: www.aapm.org/education/GrantsFellowships.asp

PROGRAM CONTACT: Jacqueline Ogburn, jackie@aapm.org or 301-209-3394 AD: Sponsored by the AAPM Education Council through the AAPM Education and Research Fund


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

AAPM PRESIDENT’S REPORT Bruce H. Curran, Richmond, VA

A

s I write this first column of 2016 I am returning (morning train from Alexandria to Richmond) from the winter meeting of the AAPM MidAtlantic Chapter. This is noteworthy for two reasons. First, the excellent presentation by Bruce Libby of the University of Virginia on Breast IORT, an area of research/clinical treatment that I was not well-versed on, and second, the first meeting held in our new Headquarters facility in Alexandria, Virginia. With marvelous assistance from HQ staffers Karen McFarland, Lisa RoseSullivan, and Farhana Khan, the Mid-Atlantic meeting went flawlessly amazing as AAPM moved into the building only three days earlier (many thanks to the planning and efforts of all of our staff, but particularly Angela Keyser, Michael Woodward, and, of course, Lisa Schober for keeping them organized). The new building is beautiful, if not quite complete (the inevitable punch lists are still ongoing), and the Chapter was treated to a tour of the new space prior to their meeting. My thanks to John Hazle and the members of the Ad Hoc Committee that had the foresight to suggest AAPM was ready to make this step. This is also my first column as President (even though I’m still three weeks away as I write this). I will miss the camaraderie and advice of John Bayouth and Matt Podgorsak, who leave the Executive Committee in 2016, but look forward to the presence of Melissa Martin (President-Elect) and Mahadevappa Mahesh (Treasurer) as they take on their leadership roles and join John Boone, Todd Pawlicki, and myself on the 2016 Executive Committee. 2016 will be a busy year for AAPM if the actions taken by the AAPM Board of Directors at their December meeting are any indication. In addition to the usual activities of approving a budget and committee appointments for the coming year, six changes to our rules of Governance were approved for discussion at the 2016 Annual Business Meeting and subsequent membership vote. These include a new structure for the Nominating Committee, some clarifications to the roles of Board Members, and updating the name of our organization (more on that elsewhere in this issue). There are two items that I would like to discuss in a little more depth. Shortly after ACMP voted to cease operations and AAPM agreed to take on several of its activities, an Ad Hoc Committee, chaired by Ken Hogstrom, looked at improving the relationship between Medical Physics and the Journal of Applied Clinical Medical Physics (JACMP). Their recommendations included identifying a single editorial and single publishing platform for both journals to facilitate author and reader ease of use and consistency in user interface. For the past year an Ad Hoc committee, chaired by John Hazle, has been considering this transition and it recently issued an RFP to several publishers (including the two current publishers) for such a combined operation. The Ad Hoc committee is currently reviewing the responses to that RFP and expects to make a recommendation this coming March, with the first issues from the new publisher starting in January 2017. Several publishers have put forth new concepts that the Committee is discussing as well. I expect that the results of this effort and the Board’s decision will be announced in the May/June issue of the Newsletter. The second topic for discussion is an assessment of the current AAPM governance structure and how it could be improved. I proposed this to the Strategic Planning Committee (SPC) last May and the Board in July and both groups approved the undertaking. An Ad Hoc committee was formed and Quantum Governance, L3C, a consulting

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

President, cont.

group specializing in non-profit governance, was contracted to assist in the process. As of this writing, the group has accomplished a number of tasks, including two surveys of AAPM members in leadership roles (Board, Committee Chairs…) and interviews with leaders and selected HQ staff to better define issues addressed in the survey. I have also held discussions with several chapters as part of the usual presidential talks at chapter meetings. Quantum will be presenting their observations to the Ad Hoc Committee and the SPC in mid-January, and to the Board in early March. Several changes in Board operations have already been instituted to improve our compliance with required practices of non-profit boards. The goal of this effort is to propose changes to the governance structure at the March and July Board meetings for Board approval, and then re-structured governance documents to the Board for approval in December 2016. The changes would then be presented to the membership for review at the 2017 Annual Business Meeting and subsequent membership vote. Finally, I’d like to welcome Jessica Clements as our new Newsletter Editor and thank Mahesh for his service as Editor for the past nine years. As a previous Editor, I know this is a significant effort and want to recognize both Mahesh and Jessica for their willingness to take on this important task. n

MEETING PROGRAM NOW AVAILABLE Deadline to Receive Discounted Registration Fees: January 27th NEW THIS YEAR: Bring a Friend Discount! Find out more here.

2016

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

FROM THE EDITOR’S DESK Jessica Clements, Los Angeles, CA

H

appy New Year! I am very excited to accept the offer to serve as the next Newsletter Editor. When the call for a new editor was published, I was instantly interested. I have been a longtime reader and have previous experience working for my hometown newspaper and undergraduate university newspaper. In both positions, I wrote news briefs, edited pages prior to print or web publication, and sold advertising. I would like to thank Martin Weinhous and the Electronic Media Coordinating Committee for making the recommendation to our President, Bruce Curran, and the Board of Directors to serve as your next Newsletter Editor! Our former Editor, Mahadevappa Mahesh, has left some large shoes to fill! When Dr. Mahesh first took over as Editor, a major change went into effect— AAPM Headquarters staff Nancy Vazquez began to manage the Newsletter. I look forward to continuing the partnership with Nancy and many other headquarters’ staff. I’m also very interested in increasing usage of the content across multiple platforms, including social media, and giving readers the opportunity to interact with content in a timely manner. While these enhancements develop, please check out all that this first issue of 2016 has to offer. Please feel free to drop me a line if you have any comments or suggestions for the Newsletter. Thank you again for this opportunity!

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T

he theme for 2016 and the AAPM Annual Meeting is “Communicating our Value. Improving our Future.” I have observed over recent years that the importance of the Medical Physicist to both the imaging and treatment processes has lessened in many institutions. We are losing/have lost our place as key players on the diagnosis and treatment teams, often relegated to the role of technicians in the eyes of our colleagues and administrators. This is true in academic/research arenas as well, where grant opportunities for improvements in technology and process, areas in which we are major players, have been on the decline. We need to reverse these trends in order to survive and thrive. AAPM can help medical physicists achieve better recognition by providing tools and guidance in promoting our value to our institutions and colleagues. Medical Physics 3.0, the Medical Physics Leadership Academy and the 2016 Summer School on Leadership are all venues that have this goal (among others). Our Annual Meeting provides opportunities for sharing/improving your scientific knowledge, clinical skills, and professional leadership. Involvement in AAPM committees and task groups enables you to help shape our future, clinically, scientifically, and professionally. These opportunities, however, are only of value if you take advantage of them and work to incorporate them into your research, clinical practice, or interactions with your colleagues. I echo John Boone’s words from 2015; “I invite you — indeed I challenge you — to take advantage of the outstanding opportunities offered at this summer’s meeting to reinvigorate your professional, [clinical, and scientific] excellence.” —Bruce H. Curran, AAPM President

THIS YEAR… • Special 2-Day Program on Radiomics (Monday – Tuesday,

August 1–2). • The Science Council Session — Imaging for Particle Therapy

(see below). • NEW Submission Types:

 Science Council Junior Investigator Award — An award recognizing outstanding scientific research by Junior Investigators has been established by the AAPM Science Council. The award is based on abstracts submitted to the Scientific Program of the AAPM Annual Meeting, judged according to criteria of significance, innovation, and the potential for major scientific impact in an area of cutting edge interest in medical physics. The award carries a monetary prize and is announced at the Awards & Honors Ceremony at the Annual Meeting. Select Junior Investigator Submission type.  SPS Undergraduate Research & Outreach — The Society of Physics Students (SPS) Undergraduate Research & Outreach poster session highlights the work of undergraduate students with an interest in medical physics. The first author (and presenter) of all posters in this session must be an undergraduate at the time of submission. Posters should reflect either research related to medical physics or outreach to promote the importance of and relationship between physics in medicine. All joint SPS-AAPM undergraduate members are invited to submit.

• 2016 Certificate Course — A day-long track on the

Application of Risk Analysis Methods to Radiotherapy Quality Management: TG 100 Recommendations (see following pages). • Joint Scientific Symposium with the World Molecular Imaging

Society — Metabolic Imaging of Cancer • Joint Scientific Symposium with ESTRO — AAPM Symposium:

Advances in Experimental Medical Physics • Distinguished Lectureships:

 Carson-Zagzebski Distinguished Lectureship — In the spirit of education and science, this year’s session will feature an overview of shear wave imaging utilizing ultrasound and an update on the progress being made by the RSNA Quantitative Biomarkers Alliance ultrasound committee on the use of Shear Wave Speed.  The Anne and Donald Herbert Distinguished Lectureship in Modern Statistical Modeling • Major expansion of SAMs offerings in Education, Professional, Practical, and Scientific Programs. • Dedicated time in the meeting program for Visit the Vendors. • NEW Guided Tours on the Exhibit Floor. SAMs credit will be

offered. Stay tuned for further details. • Partners in Solutions — an exciting venue on the exhibit floor (see following pages).


All sessions and technical exhibits will take place in the Walter E. Washington Convention Center, 801 Mt Vernon Pl NW, Washington, DC. The education program and professional program will offer a significant opportunity to gain practical knowledge on emerging technical and professional issues. This year, the scientific program will also offer a special twoday track on Radiomics.

Application of Risk Analysis Methods to Radiotherapy Quality Management, TG 100 Recommendations: Mini-Track and 2016 Certificate Course Wednesday of the meeting (August 3) will include a daylong “Mini-Track” on the topic of Application of Risk Analysis Methods to Radiotherapy Quality Management, TG 100 Recommendations. This mini-track, open to all registrants, will focus on describing a structured methodology of TG 100 for analyzing clinical processes and for developing clinic - and site - specific quality management programs that more effectively and efficiently address work practices in individual clinics. The mini-track will consist of 6 sessions (including educational and scientific sessions, and proffered papers) which provide basic education as well as a survey of emerging and advanced concepts. All those who register for the AAPM meeting (weekly or Wednesday daily) will have access to these sessions as usual.

The mini-track will also serve as the certificate course at this year’s meeting, which provides an in-depth review of a particular topic with verification of learning objectives through on-line homework. Attendees may enroll in the certificate program for an additional fee. Enrollment in the program entitles participants to dedicated seating in the mini-track sessions as well as additional online materials. Following the meeting, certificate program participants will be required to take an on-line examination which covers the material presented throughout the day-long mini-track. Enrollees who demonstrate satisfactory attendance at the course and successful completion of the on-line examination (available after the meeting) will receive a framed certificate of completion for this course.

SCIENTIFIC PROGRAM Joint Imaging-Therapy Track

Therapy Track

The 2016 Joint Imaging-Therapy Track will feature exciting topics highlighting the latest science incorporating imaging for improving therapeutic interventions. In addition to over 30 hours of proffered sessions, this track will include invited symposia covering the following topics: the joint symposium with World Molecular Imaging Society on the metabolism of cancer, image-guided interventions; advances in imageguided brachytherapy; deformable registration; CT ventilation; dual-energy CT; new applications of electronic portal imaging; medical physics advances for low-resource settings; and a debate on the future of the ITV. As in all of the other tracks, several of the scientific symposia are expected to offer SAM credits for those participating in the ABR’s MOC program who don’t want to miss out on hearing the latest science in imaging and therapy.

The 2016 Therapy Track will showcase several current hot topics in therapy physics including emerging fields that present unique opportunities for medical physicists. Invited symposia will be presented on the following topics: radioimmunotherapy, real-time 3D dosimetry, radiation countermeasures, computational biology, advances in experimental medical physics, digital linear accelerators, and motion management and RBE prediction in particle therapy. At this year’s meeting several symposia will be presented in coordination with the educational program. That is, back-toback invited sessions which first present the well-established aspects of a topic (education) followed by new emerging advancements (science). As usual, this year’s scientific program will also include fantastic cutting edge research presented in more than 27 proffered sessions in the therapy scientific track alone.

www.aapm.org/meetings/2016AM


SCIENTIFIC PROGRAM (CONTINUED) Imaging Track The 2016 Imaging Track highlights ongoing research and advances in Imaging in Medical Physics. In addition to proffered sessions, this track will include scientific symposia on Imaging-Radiomics Joint session on the low dose CT grand challenge (www.aapm.org/GrandChallenge/LowDoseCT/), radiation and cancer, model observer design and its validation for digital breast tomosynthesis, quantitative performance assessment of CT systems employing iterative reconstruction algorithms, advances in image-guided neurointerventions, advances in dedicated breast CT, and advances in preclinical imaging. Several of the scientific symposia are expected to offer SAM credits. The scientific symposia and the proffered scientific sessions will explore the state of the art and also new frontiers in imaging. Radiomics Track (Special 2 Day Program) “Radiomics” is the name given to the growing effort to extract and utilize the data inherent in medical images in order to quantify medically relevant characteristics (e.g., phenotypes of cancerous tumors.) The field continues to evolve, building upon quantitative image analysis methods from computeraided diagnosis and machine learning. Various radiomic studies are attempting to further understand the biology of cancer (for example, druggable mutations), as well as the role of tumor heterogeneity in metastatic disease. Medical physicists have taken a leading role in radiomics and thus, this track will include proffered and invited talks over several days addressing multiple key areas of radiomics, including quantitative imaging foundations and best practices, new applications and results across modalities, new software tools

and processes, and driving biological questions. Important challenges, such as the dependence of radiomic features on databases, technology, and methodology, will be examined in detail to help point a way forward in this exciting area. Science Council Session: Imaging for Particle Therapy The Science Council Session includes proffered abstracts on a topic at the cutting-edge of medical physics research, presented in a special, high-visibility proffered oral session. For the 2016 Annual Meeting, the Scientific Program invites abstract submissions on “Imaging for Particle Therapy,” emphasizing research in imaging for treatment planning, dose calculations, image guidance, and verification of treatment. Example areas of research include (but are not limited to): • Innovation in imaging for particle therapy treatment

planning and adaptation, including, but not limited to, the use of imaging for range uncertainty reduction, robust optimization, and motion assessment. • Development and implementation of novel in-room

image guidance systems (e.g. proton radiography and tomography) for particle therapy to ensure accurate delivery of treatment plan and assess the need for adaptation. • Novel methods to verify the delivery and efficacy of particle

therapy. Criteria for abstract evaluation include the novelty of the research, the emphasis on innovation in the application for particle therapy, and the potential impact/significance in therapy.

EDUCATIONAL PROGRAM Educational Course Therapy Track The 2016 Therapy Education track will feature a total of 35 hours of educational sessions designed to meet the diverse interests of our membership, with the majority of sessions being SAM sessions. The program will include topics in SRS/ SBRT, IGRT, brachytherapy, proton therapy, quality assurance, motion management, and safety. Highlighted topics for this year include a series of SBRT Case Study Panel Discussions of different treatment sites (lung, liver, and spine), two sessions on Statistical Considerations for RT, and a session on Big Data in Rad Onc. A few sessions on the updates of AAPM TG reports (TG-167, TG-180, TG-191, TG-199, etc.) will be presented. Returning popular topics will include small-field dosimetry,

adaptive treatment planning, and proton therapy. Continuing the tradition from the last several meetings, there will be a live point-counter point debate; this year the comparison between proton and photon radiation therapy will be the focus. Educational Course Imaging Track The 2016 Imaging Education Track will feature a total of seventeen educational sessions, including over 22 hours of CME with most being SAM sessions. The program will be focused on meeting the continuing education requirements of our membership at various stages of professional development, with several sessions featuring coupled “basics-to-advanced” topics, including nuclear medicine

www.aapm.org/meetings/2016AM


EDUCATIONAL PROGRAM (CONTINUED) and MR. CT, Ultrasound, and Informatics. Several crossmodality sessions will be offered, including pediatric imaging, body tomosynthesis, and radiation dose monitoring. Special attention this year was given to coordinating educational requirements with the scientific program and the Partners in Solutions to meet FDA requirements for digital breast tomosynthesis including cross training from the vendors of approved systems on features specific to their machines while obtaining the additional DBT hours of training in the two tracks.

Practical Medical Physics Track The Practical Medical Physics Track offers presentations of use and interest to the practicing medical physicist. Topics for 2016 include: commissioning and QA for treatment planning systems; practical statistics; motion management techniques for Lung SBRT and Breast Radiation Therapy; Planning and Delivering HDR APBI Treatments; Performing Radiation Safety Surveys; Identifying and Correcting Image Artifacts; and a special presentation on the basics of Proton Therapy.

PARTNERS IN SOLUTIONS Partners in Solutions continues to offer a unique way for physicists to interact with and learn from our vendors, with vendors providing physics-level applications training classes in a special-purpose lecture room located on the exhibit floor. These are not sales pitches, but practical information for the clinical physicist from the people who know their systems in depth. Topics for this year are: • Imaging: Digital Breast Tomosynthesis. The three PinS

sessions will cover the manufacturer- and model-specific features and requirements of the DBT systems currently approved by FDA. Together with other sessions offered during the Annual Meeting program, these will allow attendees to meet the FDA initial training requirements for DBT (8 hours of training including manufacturer-specific features of each approved system).

• Therapy: MR Simulation. MRI techniques are becoming

increasingly used in treatment planning, image-guided radiation therapy, and treatment evaluation, and it is important that medical physicists understand the underlying processes of the systems they are using. Presentations from three manufacturers will feature details of their fast MR imaging techniques, functional MR imaging techniques, and MRI distortion correction and quality assurance techniques, including their pros and cons. An increased awareness of how MRI simulation tools work will allow attendees to better understand and apply their results. Look for the Partners In Solutions sessions on the meeting program. CE credit will be offered. Come learn with us!

PROFESSIONAL PROGRAM Professional Track

Key sessions or tracks:

The Professional Track will be offering sessions designed to keep our members abreast of the latest profession-related developments. Topics this year include clinical, publishing, educating, diversity in the workplace, compliance, international, and other aspects of our profession. International content will cover material from NCRP, ICRP, contributing to the developing world, and updates on dose reduction efforts across the globe. Plans for SAMs credit as well. The Professional Track will again have a proffered paper session in 2016.

• Publishing; Journal Options, Financial Implications,

Preparations • ABR Prep, Therapy and Diagnostic • ABR MOC Update • Regulatory; CDRH/FDA Process • Radiation Protection • Education; Funding, Frants, Residencies, etc.


58th Annual Meeting & Exhibition Walter E. Washington Convention Center

JULY 31–AUGUST 4 | WASHINGTON, DC AAPM 2016 DATES TO REMEMBER January 20

Website activated to receive electronic abstract submissions.

March 10 at 5PM Eastern, 8PM Pacific Time

Deadline for receipt of 300 word abstracts and supporting data. This deadline recognizes other conference schedules. There will be NO EXTENSION OF THIS DEADLINE. Authors must submit their abstracts by this time to be considered for review.

March 23

Meeting Housing and Registration available online.

By April 18

Authors notified of presentation disposition.

By May 10

Annual Meeting Program available online.

June 22

Deadline to receive Discounted Registration Fees.

WWW.AAPM.ORG/MEETINGS/2016AM


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

EXECUTIVE DIRECTOR’S COLUMN Angela Keyser, Alexandria, VA

Prince Street in Progress — Your New AAPM Headquarters

I am pleased to report that the new AAPM HQ officially opened on Tuesday, December 8. While the contractors are still with us working through the punch list, the HQ Team is getting settled into our new Alexandria, Virginia home. The move from College Park, Maryland went very smoothly due in large part to the tireless efforts of the HQ team. One major feature of the building refurbishment will not be completed until early spring. The multi-story building is served by a central staircase that will ultimately have glass walls on two sides. Delays in the permitting process were further compounded by the long lead time for the firerated glass. At this time, I expect the stairwell will be finished in March. A highlight of the new space is AAPM’s ability to host larger and concurrent in-house meetings. The new space includes a Large Conference Room that seats 24 comfortably in a hollow square configuration, with extra seating capacity around the perimeter. There is also an Executive Conference Room that seats 10 around a conference table, with plenty of extra seating space. There are also two breakout rooms with a conference table for six people and three other meeting areas that offer more “conversational” settings. It is the goal that AAPM councils and committees that meet outside of the traditional AAPM Annual or RSNA meetings with hold their meeting at the new HQ. The Mid-Atlantic Chapter holds the title of the first group to meet at the new HQ. They were brave enough to meet at the new facility on the third day after our opening! Thankfully the meeting went well and indications are that our members liked what they saw! I hope you are pleased with what you see in the pictures included here and on social media and that you will visit should your travels bring you to the area.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Executive Director, cont.

2016 Dues Payments 2016 renewal notices have been sent several times since October, with payments due by March 1. If you have an email address on file, the invoice was sent electronically in an effort to make it more convenient for you to pay your dues and to reduce administrative costs. There is a mechanism provided to print a copy of the invoice if you wish to mail your payment. Please go to the AAPM Homepage, log in and click on “Pay Your 2016 Dues Online.” Remember, you can pay Chapter dues with your AAPM dues for any Chapter of which you are already a member! The AAPM Rules are very specific regarding the cancellation of membership if dues are not paid by the deadline and the fees required for reinstatement. As the administrative staff of AAPM, we must consistently enforce the rules of the organization. It would be very difficult to make exceptions for some members and enforce such fees on others. If you need any assistance or have any questions about the dues process, please contact Janet Harris at 571-298-1216.

Staff News

I am pleased to announce that Lisa “G” Schober has been promoted to the position of Executive Office Manager. With the move to our new HQ building, Lisa will manage the team that will be providing “office services” support. While she will remain my right hand, this promotion acknowledges her increased level of responsibility in project management relating to association governance and as staff liaison to the Administrative Council. I am also pleased to announce Tammy Conquest’s promotion to Senior Applications Developer. Tammy joined the AAPM HQ team back in 2007 and has been instrumental in the online abstract submission process, the services we provide under contract to CAMPEP and many other Information Services projects. n

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

PROFESSIONAL COUNCIL REPORT James Goodwin, Burlington, VT

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y best wishes to all for a Happy New Year. I hope that everyone was able to find time to spend with family, relax and recharge. By the time that you read this, we will be into 2016 and changes in committee assignments will have taken effect. I am very happy to report that Dan Pavord will have taken over the reigns as Professional Chair and I will have returned to my original position as Vice Chair. I wanted to provide you with two updates, one concerning the Medical Physics Leadership Academy (MPLA) and the other about Medical Physics Practice Guidelines progress. At the end of December, the Subcommittee had chosen a consulting firm, Impact Learning and Development, Inc. (Impact), to help design leadership and development curriculum for both the MPLA and this year’s Summer School which will serve as the kickoff for this new, ongoing program. Impact will also provide facilitators who will augment AAPM member Summer School faculty. We are very excited about both MPLA and the Summer School. Providing the membership with resources for learning leadership and management skills has been a vision of AAPM for many years. We hope that the MPLA will provide the knowledge that members can use to expand their roles and increase their effectiveness both at their home institutions as well as in leadership positions within the Association. I’m very pleased to report that three new MPPG’s have been recently published: Medical Physics Practice Guideline 3.a Levels of Supervision for Medical Physicists in Clinical Training, Medical Physics Practice Guideline 4.a Development, Implementation, Use and Maintenance of Safety Checklists and Medical Physics Practice Guideline 5.a Commissioning and QA of Treatment Planning Dose Calculations — Megavoltage Photon and Electron Beams. The ABR has officially recognized MPPG 3.a in their supervision requirements when registering for Part 2 exams in medical physics. The MPPG on Performance Criteria for a Radiation Dose Index System is nearing completion and the MPPG on Medical Physicist Assistants is in progress. Four other guidelines have been selected and are working their way through the approval process for writing committee formation. n

The Radiomics Workshop 2015 Took Place on October 26–27 in Clearwater Beach, FL This was the 6th annual and most attended workshop thus far, and it had a great mix of plenary speakers, researchers’ lectures and student presentations. Drs. Robert J. Gillies (Moffitt Cancer Center) and Sandy Napel (Stanford University), Chairs, prepared a report of the workshop which is available HERE.

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2016 RESEARCH SEED FUNDING GRANT T

hree $25,000 grants will be awarded to provide funds to develop exciting investigator-initiated concepts, which will hopefully lead to successful longer term project funding from the NIH or equivalent funding sources. Funding for grant recipients will begin on July 1 of the award year. Research results will be submitted for presentation at future AAPM meetings. The award is not intended to provide salary support for the applicant, however any other research-related expenses, including travel to scientific meetings, will be supported. Travel expense should be included in the submitted budget. At the end of the 12-month period a report must be forwarded to the AAPM, along with itemized expenses. The award will not support indirect costs. Any unspent funds should be returned to the AAPM. Sponsored by the AAPM Science Council through the AAPM Education and Research Fund.

Application Requirements: a) Five-page description of research project (including figures and tables), separated as follows: b) Specific aims c) Background and significance d) Preliminary results e) Research plan f) Literature cited g) Budget h) Letter of support from division/department chair demonstrating support for the project and authorization of time and resources to complete the proposed research. i) CV (no more than 4 pages). Note that sections (e) and (f) do not count towards the five-page limit. As the competition for the seed grant is high, eligible applicants are encouraged to also submit their applications for other awards, e.g. www.cancer.gov/researchandfunding/training/. Review Criteria 50% Scientific merit of proposal (significance, innovation, environment, and soundness of approach) 25% Potential for project to develop into a major project fundable by NIH, DOE, DOD, etc.

A list of Award Recipients can be found at: www.aapm.org/education/edfund.asp.

25% Background of investigator

Eligibility:

Award duration: July 1, 2016 – August 30, 2017

• 5 years or less since awarding of Ph.D.

(All supporting documents are due by the application deadline.)

• Must be a member of the AAPM at the time

of application. (any membership category) Pending membership status not eligible. • No previous grants >$50,000 as principle investigator. • Previously funded projects are ineligible. • Prior Seed Grant recipients are ineligible.

FOR MORE DETAILS, VISIT:

Application Deadline: March 25, 2016

Recipients notified by: May 15, 2016

www.aapm.org/education/GrantsFellowships.asp


AAPM Newsletter • Volume 40 No. 6 NOVEMBER | DECEMBER 2015

EDUCATION COUNCIL REPORT George Starkschall, Houston, TX

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n the previous issue of the AAPM Newsletter, I provided a summary of the accomplishments of the Education Council during my term of office as Chair. As I conclude my term of office (my term will have concluded by the time you read this), I would like to share with you some of my thoughts on where Education Council should be heading. Please note that everything you read here is my personal opinion; Education Council may think otherwise. One of Education Council’s highest priorities over the past several years has been to ensure that our residency programs are producing a sufficient number of graduates to fill clinical employment needs. We need to continually assess these needs, and then make sure we have a sufficient number of clinical training opportunities (residency programs, professional doctorate programs) to meet these needs. We need to remove barriers that hinder clinical practices from providing accredited clinical medical physics training, whether these barriers be administrative or financial.

One issue that we have had to confront is that more individuals are graduating from medical physics graduate programs than there are available clinical training positions in residency programs. As a consequence, a significant number of medical physics graduates will not be able to become qualified for clinical careers in medical physics. These individuals may have to work in research, industry, or regulatory activities. We need to extend non-clinical educational opportunities for medical physicists through such activities as industrial internships, programs in federal and state government such as Congressional internships, etc. Continuing education is an important issue for our members, whether it be participation in a Maintenance of Certification program, requirements for license renewal, or simply a desire to keep up with a rapidly-changing discipline. Not only do we need to provide more continuing education for our members, but we can leverage our expertise to develop additional continuing education activities for non-members as a source of funding for our organization. AAPM needs to increase its revenue stream from non-dues sources, and providing continuing education programs in medical physics to non-medical physicists may be a way to achieve additional revenue, while improving the quality of healthcare. Because our field is rapidly changing, we must continually review our graduate curriculum to ensure our graduates are adequately prepared for careers in research and in the clinic. We need to identify new fields that may be of relevance to the education of a medical physicist, for example, nanomedicine, the set of “-omics”, such as radiomics, genomics, proteomics, etc. In addition, we need to examine the “soft” skills that a successful medical physicist needs to develop, such as leadership, interpersonal relations, and the like, and determine how best to provide such training in the medical physics curriculum, whether it be in the graduate program, the clinical training program, the continuing education program, or all three. We also teach physics to physicians and allied health personnel, and need to examine the development of educational materials for these populations. One example of this would be the development of online educational modules for radiation oncology residents, along the line of the AAPM/RSNA modules for radiology residents. Obtaining the resources, not only to produce these modules, but to maintain these modules, without placing an undue financial burden on our members, will prove to be a real challenge.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Education Council, cont.

Additionally, we need to reinvigorate the Public Education Committee. It has been rather quiescent for the past few years and now needs to take a more active role in educating the public about medical physics. So that’s my “to do” list for Education Council. As I rotate off Education Council, I leave it in the good hands of Jim Dobbins. He will be responsible for guiding the Council in a pathway for the next several years. I shall be looking forward to seeing where Education Council goes. Finally, I wish to thank Jim, the various Committee Chairs, and the at-Large members of Education Council for the great support I have been given these past six years. A special thank you goes to Lisa Rose Sullivan, who has been our primary Staff Support individual, as well as the other Headquarters Staff assigned to Education Council. Their presence makes Education Council work. Happy New Year! n

IRREGULAR

ECR

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

SCIENCE COUNCIL REPORT Jeffrey H. Siewerdsen, Baltimore, MD

“If you want something NEW, you have to stop doing something old.” —Peter F. Drucker

A

New Year opens before us – 2016 – full of promise, peril, and opportunity: the Summer Olympics will be held in Rio de Janeiro; NASA will launch a probe to retrieve a sample of an asteroid; Frankenstein turns 200 years old; the world marks the 400th anniversary of Shakespeare’s death; and AAPM may make a new name for itself. It is a pleasure to remark on some of WHAT’S NEW in the year ahead for our Association.

NEW Council Chair First and foremost — WELCOME — with sincere appreciation to Dr. Benedick Fraass, who will take the Chair of Science Council in January 2016. Dick has been a giant in the field for three decades, playing a central role in creating the modern era of radiation therapy through his work in computerization, 3D treatment planning, image guidance, and novel treatment methods — earning our Association’s highest recognition in the 2013 Coolidge Award. Dick is now Professor and Director of Medical Physics and Vice Chair for Research at Cedars-Sinai Medical Center in Los Angeles. He has served extensively on Therapy Physics and Research Committees as well as Science Council and the Board, and offers a commanding perspective for AAPM Science as he assumes the Council Chair.

NEW Award for Junior Investigators Recognizing the growing quality and quantity of scientific abstracts submitted to the AAPM Annual Meeting, we are pleased to announce the inaugural Science Council Junior Investigator Award to be awarded at the 2016 Annual Meeting in Washington DC. The award carries a prestigious distinction and cash award and is based on scientific quality, innovation, and impact as judged by the Chair and Directors of the Scientific Program Subcommittee.

NEW Editor for the Research Spotlight Last year saw the launch of the Research Spotlight article appearing in each Newsletter to highlight an emerging topic, research program, and researchers at the cutting edge of medical physics. This issue sees the article now under the charge of Dr. Taly Schmidt, who will serve as editor on behalf of the Research Committee. Thank you, Taly, for seeing the program forward and elevating the profile and dissemination of medical physics research.

NEW Opportunities for Early-Career AAPM Researchers Two programs promoting early-career AAPM researchers will continue in 2016: the Science Council Associates Mentorship Program (SCAMP) will launch a call for competitive applications in Spring; and the Expanding Horizons Travel Award program will seek applications for medical physicists interested in attending scientific conferences on topics at the horizons of our field. In 2015, we inaugurated eight SCAMP awardees and nearly 20 Expanding Horizons awardees, and 2016 will continue to grow that cadre further. Watch this space!

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Science Council, cont.

NEW Name for the CT Alliance The Alliance for Quality Computed Tomography extends the outstanding work of the WGCTNP under the leadership of Dr. Cynthia McCollough and Dr. Dianna Cody. The Alliance continues the charge to disseminate reference CT protocols, develop educational materials, and other activities recognized with a 2013 Director’s Special Citation Award from the FDA and advances such activity to the long-term mission of ensuring safe and effective use of CT.

NEW Forum for Medical Physics Research Got science? This year sees the launch of the online series Research Webinar. Each Webinar will feature an invited scientific presentation on a topic of cutting edge interest in medical physics research, with real-time Q&A at the click of a mouse. Thanks to Dr. Joe Deasy and the AAPM Research Committee for creating this exciting new venue for AAPM science. Finally, I would like to thank the members of the AAPM Science Council and the outstanding AAPM Directors and Staff for the opportunity to serve the scientific mission of our Association. AAPM has opened countless opportunities for me, and I owe a still unpaid debt of gratitude and service in return. I encourage physicists of all ilk to direct their passion for science to AAPM, its journals, conferences, and scientific mission. There is no better place for science than in the privileged domain of the medical physicist, and the investment of one’s time, expertise, and vision pays immeasurable return. n

This is why we do QA.

PerFRACTION™ 3D — A New Day For Patient Safety Efficiency without compromise. That’s the idea behind PerFRACTION 3D, which automates the capture and analysis of radiation measurement QA for pre-treatment verification and per-fraction in-vivo monitoring. With actionable insights delivered directly to you, you can easily see the source of QA failures, quantify the impact to clinical goals, and still have time to do something about it. Visit sunnuclear.com/PerFRACTION to learn more.

© 2016 Sun Nuclear Corporation. All rights reserved.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

TREASURER’S REPORT Mahadevappa Mahesh, Baltimore, MD

I

want to sincerely thank the AAPM membership for the trust you all have placed in me by electing me to the position of the Treasurer. Most of you have known me as the Newsletter Editor all these years and have continuously supported me through your encouragement and timely advice. I hope to receive similar support and encouragement from all of you as I step into this new position. For the past few months, I have been observing the work of the outgoing Treasurer, FINCOM, Budget Subcommittee and the AAPM staff to learn the intricacies of the AAPM finances. Especially now that the Association has purchased a building, and starting from 2016 onwards, we all have additional fiduciary responsibilities, which, in a way, are going to guide/restrict us on how we spend and maintain our finances. With this in mind, I take this position very seriously and hope to provide sufficient information regarding AAPM finances. Before presenting more details about next year’s budget, I would like to take this opportunity to thank the outgoing Treasurer, Dr. Matthew Podgorsak, a good friend from graduate school days. He had a challenging role working with different AAPM financial teams during his tenure, which he did remarkably well. I would also like to thank the members of FINCOM and the Budget Subcommittee who served the association admirably.

Financial Position and Estimates for 2015 As of mid-December, we anticipate that AAPM will finish the year close to break-even, perhaps with a modest surplus or deficit from operations. While conservative reports submitted at the board meeting in December held in Chicago indicate that we will complete the year with a deficit from operations, when factoring in a reduced spending pattern within the Councils and Committees through the end of the year and historical spending in the last two months of the year, it is estimated that the Association will see a surplus from operations as well as an increase in reserves. The 2015 budget, as approved by the Board of Directors, was once again developed using a statistical model to project revenue and expenses based on historical spending trends. As you will see in the accompanying reports, revenue and expenses are estimated at $9.16 million and $10.71 million respectively compared to approved budgeted revenue of $9.34 million and expenses of $10.58 million for the year 2015. AAPM experienced a better than anticipated revenues from the Annual Meeting and the Medical Physics Journal, contributing to the better than anticipated revenue in 2015. On the expense side, the decision to purchase the new HQ building was made after the budget process, therefore unbudgeted expenses for this acquisition contributed to the $135,997 increase in expenses compared to budget. At present, AAPM’s investment portfolio gained substantially during the early part of 2015 and then tumbled during the third quarter. Assuming the market continues to advance through the fourth quarter, our reserves at the end of the year may exceed $13 million.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Treasurer, cont.

2016 Budget We would once again like to thank the Council and Committee Chairs with their liaisons who worked extremely hard together in developing their budgets. Attention was focused on meeting the goals of the Strategic Plan. The Budget Subcommittee, Finance Committee and the Board approved the 2016 budget. The 2016 budget summary is included with this report. Revenue projections total $9.5 million and expenses total $10.9 million, with a budgeted deficit of $1,384,396. The finance team developed a new statistical model, which was tested against the old model. According to this model, it predicts a deficit of $825,912. However, since AAPM purchased the new building, for the first time we have to comply with financial covenants established by TD Bank, the mortgage holder for the new HQ building. Factoring in the requirements for the Debt-Service Coverage Ratio covenant, the model predicted a deficit of $730,369. Given our normal spending patterns, we typically under-spend by a factor of $400,000 to $500,000, therefore the Budget Subcommittee felt this additional allowance was warranted and would still allow the Association to finish the year at or near break-even from Operations. AAPM’s Budget Subcommittee, Finance Committee, Strategic Planning Committee and Board carefully weighed the risks of a potential covenant violation against the impact of significantly reducing programs in order to align with the statistical model. It was determined that the potential risk of violating the covenant was mitigated by the following factors: •

AAPM’s effective management of the banking relationship; and,

AAPM’s investments/debt ratio reduces the risk of drastic action on their part if a covenant is violated.

Included you will find a copy of the approved budget along with a comparison of the 2015 vs. 2016 budgets as well as a graphical presentation of the 2016 budgeted revenues and expenses by category. In closing, I look forward to serving AAPM as your Treasurer and hope to communicate with the membership on a regular basis. I also look forward to receiving your suggestions, questions, comments and advice via email. n

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Treasurer, cont. 2015-2016 Budget Comparison Membership Dues— increase plus no longer allocating a portion of dues to the journal.

$542,616.00

Governance — Additional spending in 2015 to develop a communications strategy for AAPM.

$174,460.00

Councils & Committees - Increased revenue Mailing list, 2015 included increased funding for 3 Postdoc Grants for TG100.

$144,593.00

Education & Professional Development— net budget

$(235,096.00)

Publications— No longer allocating dues to the Journal, decline in ad, consortia sales and overall subscriptions. JACMP assumes an increase in ad revenue offset by increased expenses.

$(316,111.00)

Administrative — Insurance assume flat in 2016.

$490.00

Other Income/Expense — Interest earned on reserves moved out of operations

$94,445.00

Headquarters, hiring 4 (net) additional staff, depreciation on building, Prince St. operating costs.

$(546,539.00)

AAPM Education and Research Fund - net budget

$(22,735.00)

Total Difference 2015 vs. 2016 Budget

$(163,877.00)

AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE Did you know that AAPM has co-sponsored five CAREER DEVELOPMENT WEBINARS for its members? VISIT: www.aapm.org/careers/jobseekers/resources/webinars/ to access recorded versions of them, with topics including interviewing, networking, and how to attend a scientific conference.

CHECK BACK SOON FOR TOPICS, DATES, AND REGISTRATION INFORMATION FOR OUR 2016 EVENTS!

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

ABR NEWS Jerry D. Allison, Geoffrey S. Ibbott, J. Anthony Seibert and Michael Herman, ABR Medical Physics Trustees

Changes to the Organization of the American Board of Radiology

Geoffrey Ibbott, Board of Governors Jerry Allison, Board of Trustees Michael Herman, Board of Trustees J. Anthony Seibert, Board of Trustees

Reorganization The American Board of Radiology (ABR) recently reorganized its governance. The impetus for reorganization was based on an 80-year-old structure that had not changed while mandates had gained in size, number, and complexity, such that the method of governance was no longer sufficient. Under the new model, there is a small Board of Governors (BOG) and a larger Board of Trustees (BOT). The reorganization allows greater flexibility in dealing with management, finance, mission, goals, objectives, and strategic planning issues by the BOG and retention of the familiar ABR BOT examination body connected to volunteers, with greater attention to certification and recertification processes for each of the represented disciplines. The new structure is illustrated in Figure 1.

Figure 1. Reorganized structure of the ABR

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

ABR News, cont.

The BOG consists of up to nine members, each with a specific portolio and duties to ensure proper function of the American Board of Radiology, as shown in Figure 2. The term of a member of the BOG is two years, renewable once. There are seven committees of the BOG, as listed in Table 1. The BOT governance structure is organized as illustrated in Figure 3. The leadership of the BOT consists of a Chair (two-year term) and a ViceChair for each discipline. The Associate Executive Director (AED) positions assist each of the disciplines in their responsibilities and functions and report back to the Executive Director. Each discipline nominates Trustees, who are elected by the BOT and

Figure 2. Reporting structure of the BOG members

Table 1. The Board of Governors 7–9 members

COMMITTEES of the BOT

(Each member has a specific portfolio as described in Figure 2.)

• • • • • • •

Finance Bylaws Audit Review Professionalism Hearing Strategic Planning Certification Policy

approved by the BOG. Newly elected Trustees serve for three years, with a two-term limit. Members of the BOT who have demonstrated leadership may be elected to serve on the BOG (up to a total of 10 years on the BOT and BOG combined). The discipline breakout committees are preserved, with numbers of members and committee structures of the BOT listed in Table 2.

Figure 3. Board of Trustees structure

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

ABR News, cont.

Table 2. The Board of Trustees 18-24 members

COMMITTEES of the BOT • • •

Examination Coordinating Volunteerism Subspecialty

Responsibilities of the BOT and BOG overlap in several areas that are pertinent to diplomate initial and continuous certification processes, as shown in Figure 4. As part of the reorganization, Dr. Geoffrey Ibbott became a member of the Board of Governors. He serves as Secretary-Treasurer for the ABR. Dr. Michael Herman joined the Board as a trustee for the specialty of Therapeutic Medical Physics. Table 3 lists ABR Representatives for Medical Physics. In summary, the reorganization of the ABR is expected to result in improvements in governance and in certification and recertification processes. Medical Physics is now represented on the ABR by four members as Trustees or Governors, and is ably assisted by the Associate Executive Director for Medical Physics, Don Frey. n

Figure 4. Shared responsibilities of the BOT and BOG

Table 3. Medical Physics Representation on the American Board of Radiology Board of Governors Secretary-Treasurer

Dr. Jerry Allison

Board of Trustees Vice-Chair for Medical Physics Trustee for Nuclear Medical Physics

Dr. J. Anthony Seibert

Board of Trustees Trustee for Diagnostic Medical Physics

Dr. Michael Herman

Board of Trustees Trustee for Therapeutic Medical Physics

Dr. G. Donald Frey

Associate Executive Director, Medical Physics

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Dr. Geoffrey Ibbott


2016 AAPM GRADUATE FELLOWSHIP T

he fellowship is awarded for the first two years of graduate study leading to a doctoral degree in Medical Physics. Both BSc. and MS holders are eligible to apply. A stipend of $13,000 per year, plus tuition support not exceeding $5,000 per year is assigned to the recipient. The amount of tuition support granted will be at the discretion of the AAPM. The award will be paid to the recipient’s institution and distributed in accordance with the institution’s disbursement procedures. It is AAPM’s policy that none of the funds may be diverted to the institution’s “facilities”, “administrative”, or other overhead categories and the full $13,000 stipend must be provided to the recipient. Sponsored by the AAPM Education and Research Fund.

on a 4.0). Each applicant must have submitted an application for graduate study to one of the accredited programs with subsequent acceptance. Required Supporting Documentation: •

All post-secondary study transcripts (Official Transcripts Only)

Copy of Graduate Record Exam results (If applicable)

TWO Reference Letters

Acceptance letter from intended CAMPEP Accredited Program

CV including GPAs and Publications (Use CV Template)

Merge all files into one PDF and upload the complete application (PDF). Send supporting documentation to: American Association of Physicists in Medicine One Physics Ellipse College Park, MD 20740 ATTN: Jacqueline Ogburn Application Deadline: April 29, 2016

A list of Award Recipients can be found at: www.aapm.org/education/edfund.asp.

(All supporting documents are due by the application deadline.)

Each applicant must be a graduate of an undergraduate program in physics or equivalent majors (e.g. engineeringphysics, math-physics, or nuclear engineering or applied physics) from an accredited university or college in North America. The undergraduate grade point average must be greater than 3.5 (Based

Recipient Notified on: June 2, 2016

FOR MORE DETAILS, VISIT: www.aapm.org/education/GrantsFellowships.asp


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

LEGISLATIVE & REGULATORY AFFAIRS REPORT Lynne Fairobent, Alexandria, VA

CRCPD Announces Availability of NEXT CT Survey Results The Conference of Radiation Control Program Directors (CRCPD) is pleased to announce that E-15-3 Nationwide Evaluation of X-Ray Trends (NEXT), Tabulation and Graphical Summary of the 2005-2006 Survey of Computed Tomography document has been posted to the CRCPD website. You may access the document by clicking here.

NRC Announces January 21, 2016 Patient Release Information Collection Public Workshop/Patient Release Dialog

Purpose: The NRC is holding a public workshop/patient release dialog based on NRC’s information collection request published November 16, 2015, in the Federal Register, “Sodium Iodine I-131 Patient Release Information Collection” (80 FR 70843-70846). NRC held a public meeting on December 14, 2015 to answer questions on the information presented in the November 16, 2015 Federal Register Notice. If you missed the December 14th webinar go here and then scroll down to find the archived meeting and select the format for watching on line. Date(s) and Time(s):

January 21, 2016, 9:00 AM–4:00 PM

Local Attendance Location:

NRC Two White Flint North, T2B1 11545 Rockville Pike Rockville, MD

Note: If snow or ice in the Washington D.C. area adversely affects the open status of the Federal Government, driving, or local attendance, the onsite meeting and webcast may not be available. However, the meeting will still be held via the telephone conference bridge line. Remote Attendance: •

Telephone Teleconference Number: (800) 857-6712 Passcode: 3817522

Webcast: The meeting will be webcast live at video.nrc.gov. However, the audio portion of the webcast will be carried over the telephone conference number provided above.

The January 21, 2016 meeting will differ in that the amount of time allocated to each of the four components of the information collection will be longer and, while the public can still ask questions, the focus will be on dialog between participants on each part of the information collection.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Legislative and Regulatory Affairs, cont.

January 21, 2016 Agenda – Times indicated are Eastern 9:00 Introduction 9:15

Web Site Information

10:30 Patient/Licensee Acknowledgement Form and Best Practices in Making Informed Decisions on Releasing Patients Treated With I–131 Based on Radiation Exposure Considerations 12:00 Break for Lunch 1:00

Guidance for Released Patients

2:30

Brochure for Nationwide Use

3:45 Conclusion Note: The times are approximate – the discussion on some topics may finish sooner and some may go longer. If you only want to participate in one topic, it is recommended that you check frequently to see if the meeting is behind or ahead of schedule. If you have question of NRC Contact: Donna-Beth Howe at 301-415-7848 or via email. Background: In the November 16, 2015 Federal Register, the Nuclear Regulatory Commission (NRC) announced a 90day request for information on issues associated with medical treatment of patients with sodium iodide I-131. Specifically, the NRC would like input on patient concerns about medical treatment involving the use of I-131, information that physicians use to make decisions on when it is safe to release I-131 patients based on radiation exposure concerns, radiation safety information used by I-131patients after their release, and the availability of a radiation safety informational guidance brochure for I-131 patients that can be distributed nationwide. The information collected will be used to develop a website to provide patients with clear and consistent information about radioactive iodine treatments and to revise NRC patient release guidance. The focus of this information gathering effort is to obtain: •

Information that patients believe will help them understand the I-131 treatment (also referred to as Radioactive Iodine (RAI) procedures,

The physician’s or licensee’s best practices when making informed decisions on releasing RAI treatment patients, and

Information provided to patients on how to reduce radiation doses to others.

The NRC is also interested in learning if patient advocacy, medical professional organizations, licensees, or other individuals have brochures that already contain the information requested.

A 2014 memo to the full commission from then Chairman MacFarlane and Commissioner Magwood questioned whether patients receiving I-131 treatments are given consistent and useful information from medical facilities and whether patients can correctly follow those instructions. Anecdotal data from patients and patient advocacy groups indicated that while instructions are provided, the quality of the instructions varies significantly, and that some patients are provided with instructions that the patient and the medical facility know will be impractical to follow.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Legislative and Regulatory Affairs, cont.

A subsequent Staff Requirements memo directed the NRC staff to develop a website that provides patients with clear and concise information and links to relevant medical and patient advocacy websites about I-131 treatments, to revise NRC guidance to specify guidelines for patient instructions and information including a voluntary model patient/licensee acknowledgement form documenting the patient/licensee dialog leading to the licensee’s decision of when to safely release the patient from its control based on radiation exposure concerns, and to develop a standard set of guidelines that licensees can use to provide instructions to released I-131 patients. The Commission also directed the NRC staff to consider whether the guidance information provided to the patients can be made into an NRC brochure, or whether a medical organization already has, or would produce, a brochure for nationwide distribution. The NRC is considering establishing a website that provides potential patients with information on Radioactive Iodine (RAI) treatment procedures so that patients will understand the reason for the procedures, the process, and how to reduce radiation exposure to others. Some of this is medical information that is outside the NRC’s field of expertise. The NRC would like to be able to provide links to other sites providing this medical information. The NRC may develop the basic radiation safety information itself, but could provide links if established sites already have this information. The NRC is also looking for best practices used by individual physicians and licensees that focus on enhancing the ability to make informed radiation safety decisions on the release of individual patients from their radiation safety control under the patient release criteria in the NRC’s medical use regulations. Specifically, NRC is requesting copies of guidance documents that stakeholders distribute that they believe provide clear instructions to released patients. This announcement in the Federal Register, can be viewed in its entirety online. Comments to NRC must be submitted by February 16, 2016. Comments can be submitted online and must reference Docket ID NRC-2015-0020. Comments can also be submitted in writing. If you have comments that you wish AAPM to consider, please contact Richard Martin, AAPM’s Government Relations Specialist or Lynne Fairobent, AAPM’s Senior Manager for Government Relations.

Review of Image Gently — The Alliance for Radiation Safety in Pediatric Imaging In 2007 The Alliance for Radiation Safety in Pediatric Imaging was formed by four societies: the Society for Pediatric Radiology, the American College of Radiology (ACR), the American Society of Radiologic Technologists (ASRT) and the AAPM. The Alliance is a coalition of health care organizations dedicated to providing safe, high quality pediatric imaging worldwide. The primary objective of the Alliance is to raise awareness in the imaging community of the need to adjust radiation dose when imaging children. The ultimate goal of the Alliance is to change practice. The current chair of the Alliance is Donald Frush, MD and the vice-chair is AAPM’s own Keith Strauss, MSc. In the first few years, the number of affiliated organizations grew from 13, and now comprises nearly 100, representing over 1,000,000 professional members, which include scientists (e.g. medical and health physicists), radiologists, dentists and dental surgeons, radiologic and dental technologists, pediatric surgeons, and pediatricians. The number of international alliance members based outside North America currently totals 35. Recently a review of the Alliance was published in the Medical Physics International Journal, vol.3, No.2, 2015. Additional information can be found here.

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AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE Interested in applying your physics or engineering knowledge in medicine? Want to make a clinical impact this summer?

Then the SUMMER UNDERGRADUATE FELLOWSHIP PROGRAM is for you!

We provide opportunities for excellent undergraduates to gain experience in medical physics at leading clinical and research institutions. A large menu of mentordefined projects is available and Fellows select their mentor according to their mutual interests. Fellowships are offered for 10 weeks during the summer (May through September) and available to students not in their final year. For more details, visit: www.aapm.org/education/GrantsFellowships.asp

Sponsored by the AAPM Educational Council through the AAPM Education and Research Fund


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

ACR ACCREDITATION: FAQS FOR MEDICAL PHYSICISTS Priscilla F. Butler, MS, Senior Director and Medical Physicist ACR Quality and Safety

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oes your facility need help with 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 website portal (click “Accreditation”) for more FAQs, accreditation applications, and QC forms. The following questions are for the AACR Mammography Accreditation Program. Please feel free to contact us if you have questions about stereotactic breast biopsy accreditation.

Q. Does the ACR Mammography Accreditation Program or the FDA require mammography facilities with digital mammography units to have the ability to print hard-copy images? A. No. Having access to a hard copy printer for printing of digital images is no longer required for the ACR Mammography Accreditation Program or by the FDA. On November 18, 2015, the FDA clarified their requirements on their website, saying “in today’s world, the option to maintain a printer and/or the ability to print hard-copy images is a decision left to each individual facility.” They further outlined that “If a facility chooses to maintain a printer, it must follow all the quality control requirements that are prescribed by the manufacturer of the printer and mammographic unit. The manufacturer’s quality control program benefits the facility that wants to provide the best possible quality in any hard copy mammography images it prints. Although the FDA’s MQSA inspection program has removed printer QC questions from its inspection procedures, if a facility decides to maintain a printer, medical physicists must continue to include that printer QC in the Mammography Equipment Evaluation upon installation, after a major repair, and annually, if required by the printer’s or image receptor’s manufacture quality control program.” The FDA also changed their requirements for Certification Extension review to allow for either hard copy or soft copy submission of digital breast tomosynthesis phantom images.

You can find the complete FDA announcement here. The ACR has revised its Mammography Accreditation Program’s requirements to be consistent with these changes. Q. I had heard that the ACR no longer requires that a dosimeter be exposed during the production of the phantom image as part of the Mammography Accreditation process. Is this true? A. Yes. In order to eliminate redundant testing (medical physicists are required to evaluate radiation dose in mammography annually) we decided to eliminate the dosimeter component of phantom image quality evaluation for accreditation. This was done in consultation with and the approval of the FDA. At this time, dosimeters are still required as part of the stereotactic breast biopsy accreditation process.

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The new ACR Accreditation microsite

Q. I sometimes have trouble finding what I need for accreditation on the ACR website. Can the ACR make it easier to find accreditation instructions and documents? A. Yes! The ACR launched a new microsite for accreditation on November 25, 2015 to help facilities find information on all ACR Accreditation programs. You can find it here. You can also still access ACR Accreditation through the main ACR website www.acr.org, and click on accreditation. n


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

HEALTH POLICY & ECONOMIC ISSUES Wendy Smith Fuss, MPH, AAPM Health Policy Consultant

CMS Delays Implementation of the Radiation Therapy Code Set for Physician and Freestanding Cancer Center Medicare Services

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MS released the 2016 Medicare Physician Fee Schedule (MPFS) final rule. All payments and policies became effective on January 1, 2016. The MPFS specifies payment rates to physicians and other providers, including freestanding radiation therapy centers. It does not apply to hospital-based facilities. Facility payment to hospital outpatient departments is covered under a separate rule and those changes are described in a separate article to follow.

In 2012, CMS identified multiple radiation therapy codes as potentially misvalued. Through the Relative Value Update Committee (RUC), the AMA provided recommended values for new codes issued in 2015, including changes to the assumed number of services that are furnished using capital equipment. Based on a review of public comments, CMS did not finalize the proposal to implement the new code set for payment of radiation therapy treatment under the MPFS in 2015 or 2016, which includes conventional EBRT delivery, IMRT delivery, and image guidance. CMS will continue to address the radiation therapy codes and pricing in future years. Physicians and freestanding radiation therapy centers will continue to use the HCPCS G-codes created in 2015 when reporting Medicare services in 2016. However, CMS is finalizing the proposed change in the utilization rate assumption for linear accelerators, which is used to determine per minute cost for use of capital equipment used to deliver radiation therapy. Final assumptions adopted in this final rule are that the equipment is used for 35 hours per week (a 70 percent utilization rate) instead of 25 hours per week (a 50 percent utilization rate). CMS will implement this change over two years. CMS is also seeking comment on additional sources of accurate data regarding the price of the linear accelerators used in radiation therapy and how often the machines are in use. Other 2016 policies that impact radiation oncology payments include: •

Beginning January 1st, CMS will package radiation source loading and handling (CPT 77790) into the complex interstitial LDR brachytherapy code 77778. The global payment for 77778 will decrease 10% but the technical component payment will increase by 28% due to new equipment inputs. Physician work associated with this code is significantly reduced (-29%) as CMS disagreed with the recommended physician work RVUs.

CMS implemented the new HDR brachytherapy codes (CPT 77767-77772), which became effective January 1, 2016. The codes for interstitial/intracavitary HDR brachytherapy (77770-77772) have significant global payment increases of between 17% and 35% and include the cost of a HDR brachytherapy treatment vault.

The new category III codes for electronic HDR brachytherapy (0394T & 0395T) are not assigned relative value units (RVUs) under the MPFS. These codes are carrier priced.

CMS reports the final rule’s impact on radiation oncologists as a 2.0 percent reduction, with a 1.0 percent reduction for freestanding radiation oncology centers. This is an improvement over the proposed rule. To read a complete summary of the final and to review impact tables, go here.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Health Policy, cont.

CMS Restructures Radiation Oncology APCs CMS published the 2016 Hospital Outpatient Prospective Payment System (HOPPS) final rule. All hospital outpatient payments and policies become effective on January 1, 2016. CMS conducted a comprehensive review of all of the HOPPS clinical ambulatory payment classifications (APCs). They restructured and consolidated many APCs, resulting in fewer APCs overall. CMS deleted several radiation oncology APCs specific to treatment modalities (e.g. brachytherapy, protons, stereotactic radiosurgery) and established seven APCs for Radiation Therapy, which are each more broad. Significant increases and decreases in 2016 payments are due to APC restructuring and reassignment of procedures to different clinical APCs from 2015 to 2016 (see table on next page). For 2016, CMS maintains the comprehensive APC payment policy, which applies to intraoperative radiation therapy (IORT), breast brachytherapy catheter placement and single session cranial stereotactic radiosurgery (SRS) procedures. Under this policy, CMS designates each service described by a HCPCS code assigned to a comprehensive APC (C-APC) as the primary service and, with few exceptions, considers all other services reported on a hospital claim to be related to the delivery of the primary service. CMS calculates a single payment, defined by a single claim, regardless of the dates of service. CMS finalized the proposal to revise payment for comprehensive APC 5627 Level 7 Radiation Therapy by removing planning and preparation services (CPT 70551, 70552, 70553, 77011, 77014, 77280, 77285, 77290, 77295) and the medical physics consultation code 77336 from the C-APC geometric mean calculation for 2016 and 2017. CMS provides separate payment for these services during 2016 and 2017. CMS will collect data through the use of a HCPCS modifier on all services related to a C-APC primary procedure that are reported on the same or a separate hospital outpatient claim. The purpose of this data collection is to assess the costs of all adjunctive services related to C-APC services, even when they are reported on a separate claim. Other key provisions in the 2016 HOPPS final rule include: •

CMS maintains the medical physics consultation code 77336 in APC 5611 Level 1 Therapeutic Radiation Treatment Prep with a payment of $107.40, which is a 5% decrease over the 2015 payment.

CMS reassigns the special medical physics consultation code 77370 to higher level APC 5612 Level 2 Therapeutic Radiation Treatment Prep, which results in a 47% increase from 2015 payment.

CMS reassigns the teletherapy isodose plan codes 77306 and 77307 to higher level APCs resulting in 47% and 158% payment increases from 2015, respectively.

CMS reassigns the LDR brachytherapy codes 77761, 77762 and 77763 to higher level APCs resulting in significant payment increases in 2016.

CMS implements 5 new HDR remote afterloading brachytherapy codes (77767, 77768, 77770, 77771, 77772) and 2 electronic HDR codes (0394T, 0395T) effective January 1, 2016.

CMS assigns the new HDR brachytherapy skin surfaces codes (77767, 77768, 0394T) to APC 5622 Level 2 Radiation Therapy with a payment of $194.35.

CMS assigns HDR brachytherapy interstitial or intracavitary codes (77770, 77771, 77772, 0395T) to APC 5624 Level 6 Radiation Therapy with a payment of $696.21.

A complete summary of the final rule and impact tables is on the AAPM website.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Health Policy, cont.

Summary of 2016 Radiation Oncology HOPPS Payments APC

Description

CPT Codes

2016 Payment

5093*

Level 3 Breast/ Lymphatic Surgery and Related Procedures

19296,19298, 77424, 77425 & other breast surgery codes

$7,557.75

5611

Level 1 Therapeutic Radiation Treatment Preparation

77299, 77300, 77316, 77331, 77332, 77336, 77399

$107.40

5612

Level 2 Therapeutic Radiation Treatment Preparation

77280, 77306, 77333, 77370

$166.65

5613

Level 3 Therapeutic Radiation Treatment Preparation

77285, 77290, 77307, 77317, 77318, 77321, 77334, 77338

$291.77

5614

Level 4 Therapeutic Radiation Treatment Preparation

32553, 49411, 55876, 77295, 77301, C9728

$1,026.81

5621

Level 1 Radiation Therapy

77401, 77402, 77407, 77789, 77799

$110.34

5622

Level 2 Radiation Therapy

77412, 77422, 77600, 77750, 77767, 77768, 0394T

$194.35

5623

Level 3 Radiation Therapy

77385, 77386, 77423, 77470, 77520, 77610, 77615, 77620, 77761, 77762,

$505.51

5624

Level 4 Radiation Therapy

77605, 77763, 77770, 77771, 77772, 77778, 0395T

$696.21

5625

Level 5 Radiation Therapy

77522, 77523, 77525,

$1,150.69

5626

Level 6 Radiation Therapy

77373

$1,671.91

5627*

Level 7 Radiation Therapy

77371, 77372

$7,300.24

8001

LDR Prostate Brachytherapy Composite

55875+77778

$3,385.44

*Comprehensive APC in 2016

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

DEFORMABLE IMAGE REGISTRATION FOR PERSONALIZED TREATMENT PLANNING Highlights From Today’s Cutting Edge Medical Physics Research

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adiation oncology wrestles with a fundamental challenge, in that the planning and delivery of a particular treatment demands both acute and accurate imaging capabilities. If both of those criteria aren’t satisfied, precision medicine is nearly impossible.

Research Spotlight

Deformable registration attempts to solve both of those problems — to be sensitive and specific — by combining multiple image sources to accurately construct a complete and comprehensive model of the patient, including anatomical, functional, and physiological information1. “Where 15 years ago we were only getting one CT scan,” says Kristy Brock (University of Michigan), now radiation oncologists are being presented with multi-parametric MR images, functional images such as PET, and images that reveal physiologic motion, such as 4D CT. Precisely integrating these images into the treatment planning process remains challenging due to the geometric variations that exist in the patient position and physiological state during the acquisition of each image, which occurs between hours to days apart. The incorporation of deformable image registration into the treatment planning process enables the development of a highly precise model of the patient for localization of radiotherapy through the utilization of these images. Deformable registration is also useful in ensuring a given treatment is accurately delivered for an individual patient. Periodic images obtained throughout the treatment process can reveal information about the therapy’s effectiveness over time that might otherwise be invisible or ambiguous using less sophisticated techniques2. Earlier this year, Brock and colleagues demonstrated, for the first time, that the accumulated dose, using deformable registration, is a stronger predictor for clinical outcomes than the planned dose in stereotactic body radiation therapy for liver metastases3. “[Deformable dose accumulation] allows us to monitor and detect anatomical changes of the patient over the course of the treatment,” Brock says. Medical physicists can then convert the geometric differences observed in the images obtained at the time of treatment to dosimetric differences that may impact the successful treatment of the patient.

Overlay of longitudinal lung CT images

Morfeus: Biomechanical deformable image registration

Overlay of the registered images

Image courtesy of Guillaume Cazoulat and Kristy Brock, University of Michigan

In that way, the planning process becomes adaptive, Brock says. “When treatment planning is performed, there are competing goals: to deliver the prescription dose to the tumor, but also to limit the dose to the

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Longitudinal lung CT images overlay


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Research Spotlight, cont.

normal tissue to avoid or reduce the chance of toxicity for the patient. However, when the patient’s anatomy is changing substantially over the course of treatment, we can’t be sure we’re maintaining that balance of an effective dose to the tumor and an acceptable risk to the normal tissue. Dose accumulation with deformable registration, helps us to track the delivered dose and ensure a safe treatment of the patient.” The importance of the application of deformable registration and dose accumulation extends beyond only ensuring the planned dose is delivered. Researchers are now focused on not only adapting to the anatomical changes of the patient, but also adapting to the functional changes and response over the course of treatment – both for the tumor and the normal tissues4. This opens the door to a new level of personalized medicine, which can tailor the individual’s response to radiation into the treatment design and delivery. It also enables an improved understanding of toxicity models. When dose accumulation is linked with patient outcomes, radiation response can be better understood. This research is ongoing and still fraught with specific challenges, most notably closing the window of uncertainty in making image-guided decisions. While the deformable registration model works well for simpler geometric alignments, being adaptive in how patients are treated requires much more innovation within the field. Complicating all of this is the fact that the patients’ needs vary on an individual basis, which means the uncertainties can also vary just as frequently. Deformable registration is always based on a model of the true changes in the patient, which is spatially variable and very complex. Regardless of which registration technique is utilized, there is always a level of uncertainty. “It’s always a struggle to make sure we understand the uncertainties in the use of these models as they are applied to individual patients,” Brock says. AAPM Task Group 132 was formed in response to those growing challenges. The task group, chaired by Brock, focused on developing guidelines for commissioning deformable registration software to the medical physics community atlarge. The soon to be released Task Group 132 Report provides recommendations for validation, verification, and quality assurance of image registration and fusion software. As part of this report, users will be able to download entire data sets to aid in their commissioning process and to better understand the algorithms used in their software, Brock says. The task group provides recommendations for commissioning the registration algorithm, which includes an understanding of the fundamental components of the algorithm and end to end tests. Once the overall system is understood, site-specific commissioning must be performed, including evaluating the registration algorithm on example clinical datasets. Given the inherent variations in patient anatomy and the images acquired, the task group also recommends a patient-specific QA program be established, analogous to the processes developed for patient specific IMRT QA, to ensure that the patient specific uncertainties are addressed. 1. Brock KK. Image registration in intensity- modulated, image-guided and stereotactic body radiation therapy. Front Radiat Ther Oncol. 2007;40:94-115. 2. Jaffray DA, Lindsay PE, Brock KK, Deasy JO, Tomé WA. Accurate accumulation of dose for improved understanding of radiation effects in normal tissue. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S135-9. 3. Swaminath A, Massy C, Brierley JD, Dinniwell R, Wong R, Kim JJ, Velec M, Brock KK, Dawson LA. Accumulated Delivered Dose Response of Stereotactic Body Radiation Therapy for Liver Metastases. Int J Radiat Oncol Biol Phys. 2015 Nov 1;93(3):639-48. 4. Heukelom J, Hamming O, Bartelink H, Hoebers F, Giralt J, Herlestam T, Verheij M, van den Brekel M, Vogel W, Slevin N, Deutsch E, Sonke JJ, Lambin P, Rasch C, Adaptive and innovative Radiation Treatment FOR improving Cancer treatment outcomE (ARTFORCE); a randomized controlled phase II trial for individualized treatment of head and neck cancer., BMC Cancer. 2013 Feb 22;13:84. doi: 10.1186/1471-2407-13-84.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

PRINCE STREET PROGRESS AAPM Headquarters Has Moved! Contact us at: 1631 Prince Street, Alexandria, VA 22314 Phone: 571-298-1300 • Fax: 571-298-1301 Staff contact info: www.aapm.org/org/contactinfo.asp

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Penn’s Medical Physics Programs Penn’s Medical Physics Programs integrate theory, application and medical ethics training to prepare the medical physics leaders of tomorrow. Our innovative courses feature: • CAMPEP-accredited master’s degree and post-grad certificate programs • World-class imaging and therapy facilities • Research opportunities at the University of Pennsylvania The Medical Physics Programs seek students with a strong background in physics or a physical science and a passion for the advancement of therapeutic medicine through technology. If you know a student, employee or colleague who is ready for this rigorous course of study, visit:

www.upenn.edu/mpp


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

REPORT FROM THE AAPM PRACTICE ACCREDITATION SUBCOMMITTEES Tyler Fisher, Costa Mesa, CA and Steven de Boer, Buffalo, NY

An Introduction to AAPM Practice Accreditation Subcommittees

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s part of an ongoing effort to build synergy between AAPM and the various accreditation bodies, Professional Council, under the leadership of the Clinical Practice Committee, has established two subcommittees: the Therapy Practice Accreditation and Imaging Practice Accreditation Subcommittees. Chaired by Steven de Boer and Tyler Fisher respectively, these subcommittees have been hard at work trying to build relationships and foster collaboration with the accreditation bodies. Thus far, the Imaging Practice Accreditation Subcommittee has worked with the ACR to help improve the visibility of new documents and requirements to their accreditation programs. We have worked closely with the Joint Commission to refine their initial imaging accreditation standards into a more feasible and practical program. We have collaborated with the Intersocietal Accreditation Commission to help define their standards, improve their personnel requirements, and help establish their vision going forward. The Therapy Practice Accreditation Subcommittee has been working to outline practice guidelines by referencing AAPM Reports, Task Groups, Medical Physics Practice Guidelines and other AAPM publications. We then intend to compare these guidelines with the current recommendations from the three therapy accreditation bodies and, through our liaisons, share this information to promote adaptation of AAPM recommendations in the therapy practice accreditation process. To help improve communication to the members, we are going to be launching a new article in the bi-monthly AAPM Newsletter that deals with accreditation questions. The Newsletter currently features a FAQ regarding the ACR Accreditation Programs that is very informative, but we would like to expand the scope to include the various other accreditation bodies. To help focus our questions, we are inviting members to submit their questions regarding the various accreditation programs to the Subcommittee Chairs. Each Newsletter, we will try to answer some of these questions with verified responses from official representatives to the accreditation programs. For questions regarding imaging accreditation, please email Tyler Fisher and for questions regarding therapy accreditation, please email Steven de Boer. We look forward to working with the membership to make this regular feature in the Newsletter as informative and helpful as possible. n

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

IMPACTING THE SAFETY AND QUALITY OF CANCER CARE IN THE GLOBAL SETTING: AAPM AND THE ASSOCIATION OF MEDICAL PHYSICISTS IN RUSSIA Eric Ford, Seattle, WA and Emilie Soisson, Montreal, Quebec, CA “In your life you occasionally have an opportunity where an enormously complicated problem is put on your doorstep and if you don’t take advantage of that opportunity your window may close.” — Dr. Norm Coleman, Addressing the role of medical physicists in addressing the global gap in cancer care1, AAPM Annual Meeting 2015

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n October we travelled to Moscow to participate in a week-long training program for medical physicists sponsored by AAPM and the AMPR (Association for Medical Physicists in Russia). The activity is part of the educational efforts of the WGNIMP workgroup within AAPM (for more information on the workgroup and its activities see the sidebar below). For the last two years AAPM physicists have been participating in this program: Yakov Pipman in 2013, and Dan Bourland and Charles Mayo in 2014. It was our privilege to participate this year.

These training activities serve an important role in improving the safety and quality of care in developing regions. In the remote regions of Russia and neighboring countries access to cancer care is a major challenge. In fact, in resource limited settings, cancer has now become the major killer due in part to the large reductions in the burden of communicable diseases (think Bill and Melinda Gates Foundation). The enormous gap in cancer care at the global level was highlighted by Dr. Coleman’s AAPM presentation (quoted above and available online1) and also a recent report from the Global Task Force on Radiotherapy for Cancer Control5. The AAPM/AMPR course is one concrete effort to improve access to quality radiotherapy care. The AMPR training program draws medical physicists from all over the Commonwealth of Independent States (former Soviet Republics) for a four week course on the technical aspects of radiotherapy. The course is hosted by the N.N. Blokhin Russia Cancer Research Center (RCRC) in Moscow, Russia. Additional courses are offered along with the IAEA. Blokhin is the largest cancer center in Russia and home base for the AMPR main offices. Our contribution to this course consisted of a week of lectures focusing on IMRT and IGRT techniques. Our lectures were presented in the final week of the course where we contributed two thirds of the lectures (17 lectures in total with live translation into Russian) and the rest was delivered by members of the faculty at the Blokhin training center. The lectures were coupled to a practical training component organized by the faculty at Blokhin. We were interested to note the value that the Russian faculty place on the educational offerings provided by AAPM. There were numerous references throughout the week to AAPM task group reports, several of which have been translated to Russian. Students came mainly from remote areas of Russia, Tajikistan, Armenia, Uzbekistan and other countries. Many radiotherapy centers in these regions are going through a period of extremely rapid modernization. We met several students who were working at centers with Cobalt machines and taking the course in preparation for an influx of modern

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Impacting the Safety and Quality of Cancer Care in the Global Setting, cont.

We had many lively and interesting discussions with the students, stimulated by the lecture material. The students expressed a keen interest in image-guidance techniques. Some of these we might not have anticipated. For example, we fielded many questions about the clinical use of in-room ultrasound which is arguably a thing of the past in many centers here, but may be reasonable choice in an environment where on-board imaging is not yet available. On the opposite end of the spectrum there was an active interest in emerging technologies like Adaptive Radiotherapy and MR-guided Radiotherapy. The students valued the opportunity to learn about these techniques and anticipate how they might be incorporated into clinical practice. On the practical end, students had many questions related to QA techniques: What EPID-based solutions are available for IMRT QA? What are the best practices for the QA of 4D-CT devices? How can the accuracy of a linac isocenter be verified? These questions are, of course, crucial to safe and effective care. And the choice of QA devices is especially critical in a resource-constrained environment given the expenses involved. A final aspect of the course was education on quality improvement techniques. This included Failure Mode and Effects Analysis, à la AAPM Task Group 100, and other techniques. Students gained experience with these techniques through a half-day hands-on workshop which was very well received. While at the training center we had the pleasure of meeting Dr. Valeriy Kostylev, one of Russia’s most well-known Medical Physicists and one of the leaders behind the AMPR training program. Dr. Kostylev founded the AMPR in 1993 and in 2013 was recognized by the International Association of Medical Physicists, IOMP, as one of “50 Outstanding Medical Physicists in the last 50 years”. He is particularly proud of the AMPR’s joint courses with both the IAEA and AAPM and their outreach to physicists throughout the region. We were honored to have the opportunity to meet with him and hear some of his experiences.

Activities and Structure of AAPM Work Group (WGNIMP) Education Council International Education Activities Committee Workgroup on Implementation of Cooperative Agreements Between AAPM and Other International Medical Physics Organizations (WGNIMP) The organizational structure of the Cooperative Agreements Work Group is shown above. WGNIMP has been collaborating with the AMPR (Association for Medical Physicists in Russia) since 2010 when a formal educational exchange agreement between the two societies was signed. Previous events involved two Joint Workshops at the 2012 and 2014 AAPM Annual Meetings (“Medical Physics Challenges for Implementation of New Technologies in External Beam Radiotherapy”2 and “Education of Radiotherapy Physicists”3,4, respectively) and the participation of AAPM members in AAPM/AMPR radiotherapy physics courses. Workshops at the AAPM meetings have also been held in conjunction with the Spanish Medical Physics Society with whom the AAPM also signed a formal educational collaboration agreement. Details of the WGNIMP activities can be found on the AAPM website.

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radiotherapy equipment with state of the art image guidance and IMRT. Two students were working at a center with a single cobalt machine with only 2D planning (wire contours) and plan to move directly to modern state-of-the-art linear accelerators in the coming years. If you think about this, most of us rolled out these features gradually over a few decades, it would be quite daunting to introduce linear accelerators, MLCs, IMRT, VMAT, image guidance, etc. all at the same time. In this setting, education plays a key role.


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Impacting the Safety and Quality of Cancer Care in the Global Setting, cont.

Overall, the course required a substantial effort but was an extremely rewarding experience for both of us. Despite the language barrier, students were interested and engaged throughout the course. We were treated extremely well by our Russian hosts and were thanked many times for our contributions to the course material and our willingness to come to Russia as educators. Students were enthusiastic in accompanying us sightseeing after class and introduced us to Russian culture and cuisine. We both developed a taste for borscht! We look forward to seeing the relationship between AAPM and AMPR thrive. AAPM has a role to play in supporting this organization in its continued efforts to develop and promote quality radiotherapy throughout Russia and the region.

Global Oncology: How to Contribute There are a number of structured programs focused on global oncology where medical physicists can contribute in meaningful ways. Opportunities are available both in therapy and diagnostic physics. Below is a list of a few specific organizations. Most of these are newly-formed and volunteer run. Contribute to these organizations either by signing up as a volunteer expert, donating time and/or money, or simply by becoming more aware of the needs at an international level. •

International Cancer Experts Core. This US-based NGO has the goal of developing a mentoring network of professionals. The model is core of mentors who team up with centers in developing countries through a program of structured mentorship. This is organized through a system of regional hubs both domestically and internationally. For more information see: iceccancer.org

Radiating Hope. This nonprofit 501(c)(3) organization seeks to partner with local clinics, provide donated equipment and develop expertise through training and mentorship. It combines mountaineering with global oncology action in a unique way. For more information see: radiatinghope.org

Medical Physicists Without Borders. The mission of this newly-formed organization is to support activities which will yield effective and safe use of physics and technologies especially in low- and middle-income countries. Being very new, it is now incorporated in Canada and seeking incorporation in the US. Formal application for status as a non-profit, charitable organization in both Canada and the US is in progress. It has developed a memorandum of understanding with the AAPM largely to clarify communication and cooperation strategies. Various potential projects are under discussion. Soon it will send out a call for memberships. For more information see: mpwb.org. n

1. Dr. Coleman’s presentation at AAPM 2015 is available on the virtual library at: aapm.org/education/VL/vl.asp?id=4408 2. C Borrás et al. “Medical Physics Challenges for Implementation of New Technologies in External Beam Radiotherapy”. Med Phys, 39, 3955. (2012). 3. M Mahesh et al. “Education of Radiotherapy Physicists”. Med. Phys. 41, 454 (2014) 4. Cari Borrás. Joint AAPM/SEFM/AMPR Educational Workshop on “Education of Radiotherapy Physicists”. AAPM Newsletter, Volume 39 No. 6, November/December 2014, 48-49 5. R. Atun, D. A. Jaffray, M. B. Barton, F. Bray, M. Baumann, B. Vikram, T. P. Hanna, F. M. Knaul, Y. Lievens, T. Y. Lui, M. Milosevic, B. O’Sullivan, D. L. Rodin, E. Rosenblatt, J. Van Dyk, M. L. Yap, E. Zubizarreta and M. Gospodarowicz. 2015. Expanding global access to radiotherapy. Lancet Oncol 16 (10), 1153-1186

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

PERSON IN THE NEWS Dianna Cody, Houston, TX

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r. Dianna Cody, professor and deputy chair in the Department of Imaging Physics, was honored with the 2015 Alumni Merit Award from the Department of Biomedical Engineering at the University of Michigan. The award is given each year to recognize alumni who have made a difference in their field. Dr. Cody was honored for her work in CT physics and implementing new technology into a high-volume clinical operation. Dr. Cody is also a recognized national expert in radiation dose issues relevant to diagnostic exams. She received the award October 9, 2015 at the Alumni Awards Ceremony, part of the University of Michigan Homecoming Weekend, which included two tickets to the university’s homecoming football game. The Wolverines dominated Northwestern 38-0. n

AAPM’s Working Group on Standardization of CT Nomenclature and Protocols is now the Alliance for Quality Computed Tomography manufacturers, and liaisons from the American College of Radiology, American Society of Radiology Technologists, and the Food and Drug Administration. The “Alliance” name better represents the composition of the working group, as well as the scope of the activities which is to promote the highest level of quality in CT imaging. Click here for more information on the Alliance for Quality Computed Tomography and CT Protocols, the CT Lexicon and Dose-Check.

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Nov. 10, 2015 — The American Association of Physicists in Medicine’s (AAPM) multiorganizational Working Group on Standardization of CT Nomenclature and Protocols has a new name: the Alliance for Quality Computed Tomography (AQCT). The working group was formed in 2010 to provide information to CT users that enhances the quality of their CT practice. The membership includes academic and consulting medical physicists who specialize in CT imaging, representatives of each of the major CT scanner


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

IMAGING PHYSICS CURRICULA SUBCOMMITTEE REPORT Kalpana Kanal, Seattle, WA

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he AAPM Imaging Physics Curricula Subcommittee first published the Diagnostic Radiology Residents Physics Curriculum in 2009 followed by an update in November 2013 which included Q&A for each module The purpose of this curriculum is to outline the breadth and depth of scientific knowledge underlying the practice of diagnostic radiology that will aid a practicing radiologist in understanding the strengths and limitations of the tools in his/her practice.

This curriculum contains 15 modules covering imaging physics. The first seven modules cover basic radiation physics and biology, and the remaining eight modules utilize this base information to examine clinical applications of physics to each modality. Each module presents its content in two sections: (1) learning objectives, and (2) curriculum. The question and answer sets for each module in the updated curriculum are still being prepared and will be uploaded separately to the AAPM website when completed. We are pleased to announce that the Imaging Physics Curricula Subcommittee has completed the task of updating the curriculum over the past one year to include topics (e.g., dual energy and tomosynthesis) and remove content on obsolete technology such as film. Our goal was to keep the curriculum geared towards radiology residents and streamline the curriculum as much as possible. We hope that this is a step in the right direction and that residents and educators find the document to be useful for their education. We plan to continue updating and improving the curriculum periodically. I want to thank the Imaging Physics Curricula Committee members for their hard work on this document and congratulate them on this achievement. The updated curriculum can be found here. n

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

NEWS FROM THE MEDICAL PHYSICS EDITORS’ DESKS Jeffrey Williamson, Editor-in-Chief, Shiva Das, Therapy Physics Editor and Mitchell Goodsitt, Imaging Physics Editor

Overview It’s hard to believe that it has been two years since our editorial team stepped into the big shoes left behind by retiring long-time Editor-in-Chief, Bill Hendee. All three of us have found the experience of collectively reading and overseeing evaluation of nearly 1500 new manuscripts annually to be a daunting but very intellectually stimulating and challenging activity, providing us with a unique overview of the trends in medical physics research. As Bill Hendee remarked to us, “the Journal never sleeps.” In this Newsletter article, we would like to review the major improvements and changes that have been put in place during the last two years.

Editorial Office Changes We were inspired and saddened by Journal Manager Penny Slattery’s courageous struggle with recurrent cancer during 2014 and her untimely death in March 2015.1 Penny was the public face of Medical Physics for nearly 20 years, serving as the Journal Manager under three editors. She was the principal journal contact for countless authors and reviewers. Thanks to the outstanding efforts of AAPM’s Viv Dennis and our publisher, the American Institute of Physics Publishing (AIPP), we were able to make a fairly seamless transition to a new Editorial front office. Starting in April 2015, our manuscript receipt and processing have been staffed by Origin Editorial, LLC. Our Editorial Assistant, Ms. Ania Bukowski, has done an outstanding job of supporting and interacting with authors, referees, Associate Editors, and Editors to ensure prompt submission, review, and editorial decisions for Medical Physics manuscripts. Please do not hesitate to contact Ania if you have any questions regarding the status of your manuscript or need assistance in navigating through our PeerX-Press (PXP) manuscript processing system. Journal management services, which include marketing, data analysis, production supervision, and workflow design, are ably provided to us by AIPP’s Jennifer Simmerer, PhD.

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Medical Physics Editors, cont.

New Editorial Model and Team The astute reader will have noted that there are now three Editors2 rather than one, a tribute to editorial and management skills of Bill Hendee, who was able to handle the job alone. Because the Editor’s position had grown into a full-time job, the AAPM leadership and Journals Business Management Committee (JBMC) made the decision to support one full-time equivalent position, split among 2 or 3 editors whose primary employers agree to allocate the necessary effort. Editor-in-Chief, Jeff Williamson, supports the Journal with a 50% time commitment while Therapy Physics Editor, Shiva Das, and Imaging Physics Editor, Mitch Goodsitt, are each committed to 25% effort. Jeff assigns each new manuscript to one of the three editors, who in turn supervise the review of the manuscript and make editorial decisions. The Editors are much more involved in coordinating Journal operations through our weekly or biweekly meetings with Ania Bukowski, Viv Dennis, Jennifer Simmerer, and other AIPP/Origin production and marketing staff as needed.

Changes in Editorial Board and Review Processes We have restructured the Editorial Board (EB) and revised its mission. Under previous editors, the Board was quite large (50-60 members). In addition to providing editorial oversight and guidance, its main function was to provide a permanent pool of Associate Editors. In this approach, about 30% of the manuscripts were managed by a Board member and 70% by Guest Associate Editors, who were recruited by the Editor on a submission-by-submission basis. We have reduced the EB from 60 members to 30, with the idea that members will be active in developing and implementing initiatives to improve Journal operations and quality. In addition to their advisory and editorial functions, most EB members serve on one of the following Working Groups or Subcommittees: a. Working Group 1 (WG-1): Improving review process efficiency, quality, and selectivity (Jeff Williamson and Mitch Goodsitt, co-Chairs) b. Working Group 2 (WG-2): Improving the reader experience by enhancing accessibility and readability, and marketing impact of Journal (Sam Armato, Chair) c. Working Group 3 (WG-3): Data mining and evaluation of Journal quality (George Kagadis, Chair) d. Working Group 4 (WG-4): Outreach and Marketing to related scientific and clinical communities (Shiva Das and Andrew Karellas, Co-Chairs) e. Scientific Integrity Subcommittee: Maintenance of code of scientific ethics and adjudication of alleged instances of scientific misconduct (Mark Rivard, Chair) Some of the accomplishments of these groups include: 1. Creation of a Board of Associate Editors (BAE) and Senior Associate Editor (SAE) positions, which are now official AAPM service positions with three year terms. Altogether, we have 145 EB, BAE, and SAE members. Currently, 75% of submitted manuscripts are managed by in-house Associate Editors, which has significantly improved the quality and uniformity of review. 2. A structured template for guiding referees through the required components of a review, e.g., impact/novelty, methods, data presentation, etc., with referee reports in HTML format that preserves complex formatting. This includes new nine point rating scales for New Science, Good Science, Overall Importance, and Readability. The new review template will be implemented in early 2016.

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Medical Physics Editors, cont.

3. The medphys.org website has been given a major facelift, thanks to Farhana Khan, Michael Woodward, and WG-2 members. In addition, WG-2 is now interviewing applicants for newly created Review Editor positions in therapy and imaging physics. These volunteer service positions will be similar to the Point/Counterpoint and Book Review Editor positions on the EB. These individuals will be responsible for prospectively soliciting Review and Vision 20/20 articles in timely areas of medical physics research and clinical practice and will manage these articles as Associate Editors. 4. WG-3 has performed an extensive machine learning “big data” analysis to identify those features of published articles that are associated with high rates of download and citation. The data sources examined include SCOPUS citation data; PXP referee scores and metadata; keywords mined from abstracts; and download data collected by our web hosting platform, Scitation, for all articles published from 2008 to 2014. 5. WG-1 has developed a new hierarchically-structured expertise taxonomy for classifying the review expertise of all BAE, SAE, and EB members and worked with AIPP to enable PXP to perform searches for potential AEs based upon these categories. Once it is working well for Associate Editors, we will expand this taxonomy to all active referees in our database. 6. A new article type, the Medical Physics Dataset Article (MPDA), has been developed. It is scheduled for launch in early 2016. MPDA’s describe archived, publically accessible datasets (including data acquisition, validation, and formats as well as potential applications) that are of interest to investigators in related fields. 7. WG-4 has successfully produced a Special Issue on CT Image Reconstruction. They are currently working on a Special Issue on Charged Particle Therapy Physics for publication in 2016. WG-4 hopes to produce one or two special issues on high interest topics annually.

A New Look for Medical Physics and a Refocused Mission Statement Perhaps the most visible change to Medical Physics is the revised Table of Contents (ToC) and article classifications that will make its first debut in the January 2016 issue. The table below and summary remarks are taken from a forthcoming Editorial3. While manuscripts on radiation therapy and x-ray imaging applications still constitute a majority of our portfolio, it is clear to us that submissions addressing non-ionizing radiation therapeutic interventions, e.g., MRI and ultrasound imageguided vascular and surgical interventions, are increasing, as well as manuscripts on magnetic resonance, ultrasound, and optical imaging. It is also evident that image registration, segmentation, and restoration, rather than dose calculation, now dominate the computational research agenda. Finally, medical physics research has become far more interdisciplinary, with more of our corresponding and contributing authors drawn from engineering and computer science departments than ever before. To accommodate these shifts in the medical physics research enterprise, we have introduced a new and modernized Table of Contents (ToC) for topically classifying and highlighting our scientific publications in a coherent fashion. The new approach reduces the number of topical categories from 13 to 6 and modernizes the terminology to reflect current medical physics research emphases. While diagnostic and therapeutic radiological physics constitutes the majority of our portfolio, we felt it important to communicate the importance of non-ionizing radiation research to medicine and the Journal’s openness to such research. Hence, we have dropped the word “radiation” from our

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Medical Physics Editors, cont.

Table 1: Old and New Table of Contents. The second column gives the text descriptors of the six new topical categories that will serve as section (major) headings in the new Table of Contents. Each major heading will have subheadings demarcating the manuscript types listed in the fourth column. The other manuscript types, e.g., Review Articles, Task Group Reports, etc., will continue to have their own section headings. The first column shows the approximate correspondence of old to new categories, while the third column gives the new classification criteria.

Old Section Headings

Section Heading (Content Category)

• Radiation Therapy Physics

THERAPEUTIC INTERVENTIONS

• Thermotherapy Physics • Radiation Protection Physics

Criteria for New Section Headings • Research and development for all radiation therapy, animal treatments, image guided surgery, SFUS, thermal therapy, endovascular interventions, radiopharmaceutical therapy modalities in current clinical use • Device development, QA/QC, image guidance, motion management, IMRT planning, virtual clinical trials excluding sectional headings below • Therapy-related health physics, safety, and error mitigation

• Radiation Imaging Physics • Optical Physics • Ultrasound Physics • Infrared and Microwave Imaging

DIAGNOSTIC IMAGING (IONIZING AND NONIONIZING)

• Image quality, QC, detector development, image reconstruction, and other topics excluding sectional headings below • Observer studies and methodologies, Virtual clinical trials

• Radiation Protection Physics

• Incudes small animal and histopathology • Diagnostic imaging-related health physics, safety, and error mitigation

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• Medical Physics Letters

• Imaging research for ionizing radiation (CT, • Research Articles x-ray, charged particle, etc., PET, SPECT) and non-ionizing (US, MRI, electrical • Technical Notes impedance, optical) modalities in current clinical use.

• Magnetic Resonance Physics • Nuclear Medicine Physics

Subsection Headings (Article Type)


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Medical Physics Editors, cont.

Old Section Headings

Section Heading (Content Category)

Criteria for New Section Headings

Subsection Headings (Article Type)

• Post-acquisition image processing, image restoration and enhancement • Secondary feature extraction • Radiomics and biomarkers QUANTITATIVE • Segmentation, rigid and deformable IMAGING AND IMAGE image registration PROCESSING • CAD/Quantitative imaging, decision support, staging, treatment response/ prognosis/risk prediction, • Imaging research that is neither therapeutic nor diagnostic

EMERGING IMAGING AND THERAPY MODALITIES

COMPUTATIONAL AND EXPERIMENTAL DOSIMETRY

• Anatomy and Physiology • Radiation Protection Physics

• Testing and/or experimental clinical evaluation of emerging modalities or combinations of existing modalities

• Technical Notes

• Research Articles

• Monte Carlo, deterministic algorithm and dosimeter development and measurements, for both ionizing and nonionizing radiation • Radiation exposure risk analysis

• Radiation Biology • Tissue Measurements

• Medical Physics Letters

BIOLOGICAL PHYSICS AND RESPONSE PREDICTION

• Outcome and response prediction (LQ, TCP) • Tissue and cell models; microscopy • Molecular and radiation biology • Physiology and biophysics

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• Radiation Measurement Physics

• Emerging diagnostic (e.g., microwave, x-ray phase contrast) or treatment modalities that have not yet been translated into clinical use (e.g., microbeam and nanoparticle-mediated therapies)


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Medical Physics Editors, cont.

taxonomy. We continue to solicit and encourage submission of cutting-edge medical physics science in all areas of diagnostics and therapeutics including ultrasound, magnetic resonance, optical, and electromagnetic modalities as well as our core emphasis on ionizing radiation imaging and radiation therapy innovations. Finally, the new taxonomy signals the Journal’s intent to welcome all authors, regardless of departmental affiliation or professional identity, who utilize physics concepts and methodologies to improve healthcare outcomes. To this end, none of our headings use the word “physics” compared with 9 of 13 headings in the old taxonomy. Given the close relationship between our topical categories and the mission of Medical Physics, we would like to reproduce our statement of editorial vision for Medical Physics (see our recent Editorial for more details3), so that authors will have a better feel for what types of articles should be submitted to Medical Physics. Broadly speaking, our mission is to publish the very best science that propels medical physics forward and improves our contribution to patient care. “Medical physics science” is understood to be application of physics concepts and methods to diagnosis and treatment of disease. We interpret “physics concepts and methods” broadly to include a wide range of applied mathematics, engineering, computer science, biostatistical, and chemical physics methodologies needed to solve problems in medical physics. A focus on improving therapeutic and diagnostic clinical outcomes distinguishes medical physics research from engineering, applied mathematics, or imaging science research that is better suited for non-medical journals supported by those disciplines. Once again, we interpret this emphasis on translational research clinical outcomes broadly to include basic medical physics research that enables new or improved medical interventions. It also includes investigations that support preclinical research (e.g., small animal imaging innovations) or translational biological research (e.g., labeling and segmentation of microscopy images). Finally, modeling of biological or physical processes relevant to prediction of response to therapy or diagnostic accuracy is a suitable topic for Medical Physics papers. The following is a summary of our editorial policy, as informed by the above mission statement: 1. Medical Physics articles must describe a novel research study that uses medical physics research methodologies to address an important issue in treatment or diagnosis of disease. Medical Physics articles should contain generalizable scientific data or conclusions and should be of interest to a defined subset of our readership. 2. Medical Physics articles must make an original contribution to the literature or to clinical practice. Such articles include: a. Novel basic scientific developments with potential for improving patient care b. Clinical translation and validation of previously published scientific innovations c. High-impact clinical physics innovations addressing a significant problem of broad interest to our readership. d. Articles that address a narrow clinical physics problem, e.g., evaluation of a specific quality-assurance commercial product, are likely not suitable for Medical Physics and should be submitted to more clinically-oriented physics venues, e.g., Journal of Applied Clinical Medical Physics. However, articles proposing generalizable solutions to common clinical problems that could be implemented on many commercial products would be of interest. Similarly, image processing innovations, e.g., automated segmentation/labeling tools, without demonstrated impact in medical imaging are better suited for image-processing journals. 3. Generally, Research Articles and Medical Physics Letters articulate and validate a scientific hypothesis. Technical Notes describe new scientific instruments, computational tools, or processes but need not be hypothesis-driven.

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We hope that our new topical classifiers and ToC organization clarifies the Editorial mission of Medical Physics. We look forward to serving both traditional medical physics and other biomedical science authors to disseminate the highest impact medical physics research to our worldwide clinical and scientific readership. n

References W. Hendee, A. Keyser, C. Orton, and J. Williamson, “Tribute to Penny Slattery (1962–2015),” Medical physics 42 (4), 1473-1473 (2015). 2 J. F. Williamson, S. K. Das, and M. M. Goodsitt, “Message from the editors: Changing of the guard,” Medical physics 41 (1), 010401 (2014). 3 J. F. Williamson, S. K. Das, and M. M. Goodsitt, “A new look for Medical Physics and refocused editorial vision,” Medical physics 43 (In Press) (2016). 1

Medical Physics Leadership Academy June 12 –16, 2016 | Chantilly, VA

Leadership in Visioning Leadership with People • Leadership in Projects • Leadership in Finance • Leadership in Communication • Leadership in a Constrained Environment • Leadership in Practice • •

Immerse yourself in a focused and hands-on environment for leadership and management skill development interwoven into the context of medical physics. In addition to individual registrations, medical physics departments and consulting groups are invited to bring a group of leaders and emerging leaders. Save on registration fees by registering a group of three or four!

www.aapm.org/meetings/2016SS/

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This is a 4.5 Day Program with Lectures/Exercises in These Key Areas:


AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

IOMP NEWS Magdalena Stoeva, Editor of Medical Physics World

The International Day of Medical Physics (IDMP)

Better Medical Physics = Better Cancer Care in Radiation Oncology To raise awareness about the role medical physicists play for the benefit of patients, the International Organization for Medical Physics (IOMP) organizes annually the International Day of Medical Physics (IDMP) on November 7, an important date in the history of medical physics. On that day in 1867, Marie Sklodowska-Curie, known for her pioneering research on radioactivity, was born in Poland. At the end of 2012, the IOMP Education and Training Committee undertook the responsibility to develop a strategy to promote the International Day of Medical Physics (IDMP) and support IDMP activities of national member organizations. On November 7, 2014. On November 7, 2015 IOMP celebrated the third International Day of Medical Physics focused on the role of the Medical Physicist for Patient care in Radiation Oncology. Numerous events and activities took place on and around IDMP 2015 all around the world: •

The main event was organized in Doha, Qatar — The Hamad Medical Corporation in collaboration with the Middle East Federation of Medical Physics (MEFOMP) and the European Federation of Organizations of Medical Physics (EFOMP) organized a workshop which was initiated by the International Organization for Medical Physics (IOMP).

The Italian Association of Medical Physics (AIFM) celebrated the International Day with a discussion panel on the risks and benefits of ionizing radiation examinations performed in children.

A scientific conference dedicated to the IDMP was organized in Plovdiv.

To celebrate IDMP, the Canadian Organization of Medical Physicists (COMP) has hosted a contest.

The Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) for the first time celebrated IDMP at its 15th Asia-Oceania Congress of Medical Physics (AOCMP) held in the historical city of Xi’an, China (6-8th November 2015).

The Bangladesh Medical Physics Association (BMPA) organized a seminar and press conference in Dhaka and published the 3rd issue of its e-Newsletter.

A lecture entitled ‘Back to the Future: some synergies between physics and medicine from history to horizon’ has been given in Australia.

A scientific meeting was held at the atomic campus of the University of Ghana in.

This IOMP activity now gained a fantastic momentum, and is an excellent way to increase the visibility of our profession, and to raise the awareness of it among our medical colleagues, general public and media. IOMP thanks all the colleagues who have actively participated in the celebration of IDMP 2015. More information about IDMP activities can be found here.

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Upcoming Events ECMP 2016

European Congress of Medical Physics 2016 September 1-4 2016, Athens, Greece The congress is organized by EFOMP, HAMP and the Eugenides Foundation. ECMP’s major role in the international Medical Physics community is to gather colleagues from all over Europe and beyond and to offer them an inspiring environment to define common goals. ECMP provides a unique opportunity for all participants to exchange ideas and share their knowledge and experience. Besides our scientific programme, you will enjoy the sunny weather, the sightseeing and archaeological sites in Athens. View ECMP 2016 Website

ICMP 2016 International Conference on Medical Physics 2016 December 9-12, 2016, Bangkok, Thailand Medical physics propelling global health. The Conference is hosted by the cooperation of IOMP, AFOMP, EFOMP, MEFOMP, SEAFOMP, JSRT, TMPS and TCEB. It is the first time that Thailand hosts the International Conference on Medical Physics (ICMP) in Bangkok, the ‘City of Angels’ and the ‘Venice of the East’ which you can enjoy the Asian culture of the gorgeous temples and Grand Palace along the Chao Phya River with the fantastic world famous Thai food. The Scientific and Commercial Exhibition Committee are preparing for the highest scientific and educational quality through lectures, symposium, workshop, proffered papers, e-posters together with the radiological products of advanced technology from every corners of the world. View ICMP 2016 Website n

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

THE CURRENT STATE OF NUCLEAR MEDICINE PHYSICS TRAINING: THE FINDINGS OF THE AAPM/SNMMI JOINT TASK FORCE Beth A. Harkness, Detroit, MI and Frederic H. Fahey, Boston, MA

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n the spring of 2012, the American Association of Physicists in Medicine (AAPM) and the Society of Nuclear Medicine and Molecular Imaging (SNMMI) decided to form a joint task force to evaluate then state of nuclear medicine physics training and to assess the need to explore pathways for the improvement of nuclear medicine physics training opportunities in the future. The mission of this task force was to assemble a representative group of stakeholders in nuclear medicine and medical physics to: •

Estimate the demand for board-certified nuclear medicine physicists in the next 5–10 years,

Identify the critical issues related to supplying an adequate number of physicists who have received the appropriate level of training in nuclear medicine physics, and

Identify approaches that may be considered to facilitate the training of nuclear medicine physicists.

The task force was chaired by an active member of both organizations and included representatives from AAPM, SNMMI, the American Board of Radiology (ABR), the American Board of Science in Nuclear Medicine (ABSNM), and the Commission for the Accreditation of Medical Physics Educational Programs (CAMPEP). The task force had its initial faceto-face meeting at the AAPM Annual Meeting in Charlotte in July 2012 and continued to communicate both face-to-face and by conference calls for the next 2 years. In the summer of 2014, the task force delivered a final report that was subsequently approved by the Boards of Directors of both organizations. This report has recently been published as a white paper in the Journal of Applied Clinical Medical Physics.1 Although the findings of the report will be briefly summarized in this commentary, it is recommended that readers refer to the previous citation for the full report. The physicist has been an integral member of the nuclear medicine team since the earliest days of the field, more than 60 years ago. The development of counting and imaging instrumentation as well as clinical protocols involved a strong partnership between the physician and the physicist. The nuclear medicine physicist is typically responsible for the development and maintenance of an appropriate quality assurance program for all nuclear medicine equipment including hybrid devices that involve computed tomography and magnetic resonance instrumentation. Due to the functional nature of nuclear medicine, the nuclear medicine physicist should also have a basic understanding of physiology and molecular processes as well as anatomy. The nuclear medicine physicist must also understand the essential aspects of therapeutic nuclear medicine as well as diagnostic. The diagnostic medical physicist has a basic understanding of nuclear medicine and there is a substantial overlap of the skill sets of the two types of physicist. However, there remain areas of knowledge that are unique and essential to nuclear medicine physics that are not routinely covered within diagnostic imaging training.

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AAPM/SNMMI Joint Task Force, cont.

The Task Force evaluated the current workforce of nuclear medicine physicists within the US. A variety of data sources were reviewed including the database maintained by the Conference of Radiation Control Program Directors (CRCPD), the SNMMI membership database and the results of the AAPM Professional Survey for 2012. This review indicated that nuclear medicine physicists comprise a small fraction of the total number of qualified medical physicists. The total number of nuclear medicine physicists is probably in the range of 350 to 450, slightly less than 10% of the total number of medical physicists in the US. In the US, there are currently two organizations that certify nuclear medicine physicists, the American Board of Radiology (ABR) and the American Board of Science in Nuclear Medicine (ABSNM). The ABR requires the passing of a 3-part examination. Prior to allowing a candidate to sit for the exam, the ABR determines whether applicants have proper training and experience. Since 2014, this training has included a considerable clinical component which involves completion of a medical physics residency program. In addition the ABR requires the participation in a Maintenance of Certification (MOC) program. Thirty-seven medical physicists were granted certification in Nuclear Medical Physics by the ABR between 2010 and 2014. The ABSNM requires the passing of a 2-part examination for certification in Nuclear Physics and Instrumentation. The ABSNM also has certain training and experience requirements that applicants must meet prior to being allowed to sit the exam. At the present time, the ABSNM does not require the completion of a nuclear medical physics residency in their educational requirements. The ABSNM approved an MOC policy that went into effect on January 1, 2015. Thirty-four physicists were granted certification in Nuclear Physics and Instrumentation by the ABSNM between 2010 and 2014. There is a critical need for medical physics residency programs accredited by CAMPEP that can provide clinical training in nuclear medicine physics given the small number and average age of the existing pool of nuclear medicine physicists. There are several models of residency training including a two-year program in nuclear medicine physics, an additional year in nuclear medicine physics following the completion of a residency of an imaging medical physics residency and the completion of a doctor of medical physics (DMP) degree program. The “Hub and Spoke” model is also available where there is a central “Hub” site that manages the administrative aspects of the program while a number of affiliated, “Spoke” sites provide a variety of educational opportunities to the residents. As of the spring of 2015, 11 imaging medical physics residency programs were listed on the CAMPEP website providing 10-15 residency slots within North America. Although there are no specific nuclear medicine physics residencies, several programs allow residents to choose after their first year of a two-year program to concentrate in their second year in nuclear medicine making them eligible to sit for the ABR certification in nuclear medical physics. In an effort to encourage new or existing imaging residencies to include nuclear medicine physics training within their programs, the SNMMI awarded 2 nuclear medicine physics residency training grants in 2104 and 2015, each of which supported the training of a nuclear medicine physics resident. Based on the success of this program, AAPM and SNMMI are partnering in a joint nuclear medicine training residency program in 2016 that will support two programs for two years. Details of this joint venture are available on the AAPM and SNMMI websites. The Joint AAPM-SNMMI Task Force evaluated the training needs for nuclear medicine physicists. As a result of this evaluation, the recommendations of the Joint AAPM-SNMMI Task Force are:

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AAPM/SNMMI Joint Task Force, cont.

1. This report should be provided as a guidance document for future efforts. At a minimum, this report should be distributed to the relevant professional societies (AAPM, SNMMI, COMP) as well as certifying (ABR, ABSNM, CAMPEP, ABMP, CCPM) and accreditation bodies (ACR, IAC, Joint Commission). 2. This report should also be made widely available to interested individuals, perhaps through the websites of the above professional organizations. 3. All nuclear medicine physics certifying bodies should incorporate formal residency training as a requirement for board certification as well as maintenance of qualification program. 4. The Joint Task Force reviewed current data regarding the state of the field, but was not able to provide an evaluation of future needs. Therefore, a nuclear medicine physics work force committee should be formed to evaluate future needs in the field, perhaps under the AAPM Work Force Assessment Committee. 5. Relevant professional organizations should continue to fund residency training in nuclear medicine physics to encourage new and established imaging residency programs to incorporate nuclear medicine physics training into their programs. The above recommendations are based on a combination of several factors: a. the high median age of qualified nuclear medicine physicists b. the poorly understood training and certification processes c. the shortage of formal training programs Professional organizations such as the AAPM and the SNMMI, as well as others, must continue to support the training of nuclear medicine physicists and continue to evaluate the needs of the field in a changing clinical and professional environment. To remain a vital and progressive field, nuclear medicine needs well-trained medical physicists to meet the complex requirements of quality patient care and to advance the field. If there are not enough qualified nuclear medicine physicists, nuclear medicine as a whole will see a negative impact.   References Harkness BA, Allison JD, Clements JB et al. AAPM/SNMMI Joint Task Force: report on the current state of nuclear medicine physics training. J Applied Clin Med Phys. 2015;16(5):3-13.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

EXPANDING GLOBAL ACCESS TO RADIATION THERAPY BY 20351 Jacob (Jake) Van Dyk, London, Ontario, Canada

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n 2011, the United Nations highlighted the growing burden of noncommunicable diseases (NCDs) and acknowledged cancer as being a major component [1]. Cancer kills more people in low-to-middle income countries (LMICs) than HIV/AIDS, malaria and tuberculosis combined [2]. In September 2015, the new UN Development Goals called for a reduction by 1/3 in premature mortality from non-communicable diseases, including cancer, by 2030 [3]. In the summer of 2013, the Union for International Cancer Control (UICC), under the leadership of Dr. Mary Gospodarowicz, from the Princess Margaret Cancer Centre, Toronto, developed a Global Task Force on Radiotherapy for Cancer Control (GTFRCC). The GTFRCC was charged to clarify the challenge, identify opportunities, and quantify the investment needed to provide equity in global access to radiation therapy, i.e., what will it cost to close the gap between what exists today and reasonable access to radiotherapy globally by the year 2035? The time line for the GTFRCC was to provide a report at the World Cancer Congress in December 2014 (~15 months). The GTFRCC was composed of cancer leaders including radiotherapy professionals, industry partners, cancer control organizations, patient groups, economists, and enablers of healthcare change. The honorary chair of the GTFRCC was Dr. Tabaré Vázquez, a Radiation Oncologist and the president of Uruguay. Dr. David Jaffray, Head of Radiation Physics at Princess Margaret Cancer Centre, was the head of the Secretariat. Since the UICC is a non-governmental, membership-driven association, it approached the Canadian Organization of Medical Physicists (COMP) to nominate delegates to participate in the GTFRCC. It was my privilege to have been nominated to represent COMP on the GTFRCC. The activities of the GTFRCC were divided into 2 main work groups: (1) Work Group 1 (WG1) dealt with the global burden of cancer over the next 20 years on a per country basis, i.e., cancer incidence, the number of patients needing radiation therapy, the number of fractions per patient and the projected benefit in terms of lives saved with radiotherapy being available globally. This group was led by Dr. Michael Barton, Professor of Radiation Oncology at the University of New South Wales, Sydney, Australia and Research Director of Collaboration for Cancer Outcomes Research and Evaluation (CCORE). He had a number of PhD students working on generating the appropriate data for the GTFRCC. (2) Work Group 2 (WG2) dealt with the core investments needed over the next 20 years to treat the patients described by WG1 including facilities, equipment and personnel. This work group was headed by me but had tremendous support from the other participants, especially Dr. Eduardo Zubizarreta, a Radiation Oncologist who has been at the International Atomic Energy Agency (IAEA) for the last 6 years. Through several consultants’ groups at the IAEA, a radiation therapy cost calculator had been developed as well as a staffing estimator. Dr. Zubizarreta combined and updated these calculators to fit the needs of the Task Force. This modified calculator allowed the determination of infrastructure costs for a variety of scenarios in different income settings. This article is adapted from an article written for InterActions, the newsletter of the Canadian Organization of Medical Physicists (COMP).

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Expanding Global Access, cont.

In parallel, with WG1 and WG2, another group looked at outcomes benefit and economic impact using Health Systems analysis methodologies. This activity was directed by Dr. Rifat Atun, Professor of Global Health Systems at Harvard University, and the Director of Global Health Systems Cluster. Through this analysis, the potential economic benefits of investing in radiation therapy were determined. The outcome of this work was presented at several national and international conferences and was published a September 2015 issue of Lancet Oncology as a Commission report [4]. The report is extensive with 33 journal pages, in addition to several commentaries. Only a few key points can be presented here, especially those that are relevant to the Medical Physics community. For further details, interested individuals should review the full report [4]. Key points are summarized here: •

Cancer incidence varies significantly around the globe and is dependent on the level of the Human Development Index (HDI), which is a measure of education, life expectancy and income level. In 2012, 56% of new cancer cases occurred in high or very high HDI countries, while these account for only one-third of the world population.

As levels of socio-economic development increase, cancer emerges as a major source of morbidity and mortality. Cancer is now the leading cause of death world-wide. The incidence of cancer is increasing at a significantly higher rate in the lower HDI countries.

Based on cancer incidence by disease type, the number of patients requiring radiation therapy was determined and the corresponding number of treatment fractions was calculated. Using information on existing resources, the additional resources required to treat these patients could be determined. Worldwide, 204 million fractions of radiotherapy will be needed to treat the 12 million cancer patients who could benefit from treatment in 2035.

Radiotherapy cost estimates were divided into 2 components: (1) upfront costs to develop a new facility including building, equipment and training of new staff, and (2) operating costs once the facility is established.

An activity-based costing model was used to estimate the human resources needed for all steps of the radiation therapy process [5] and capital needs (buildings and equipment) were determined for different levels of treatment capacity. The capital and operating costs were estimated at four different regional income levels based on the WorldBank defined regions of low-income (LI), lower-middle income (LMI), upper-middle income (UMI) and High income (HI).

The operating costs per fraction were found to range between US$ 60 for LI settings to US$ 235 for HI settings while the upfront costs per fraction for the first year of operation ranged between US$ 352 to US$ 803. This cost per fraction is highly cost-effective and very low compared to the high price of many new cancer drugs.

The relative costs for salaries, buildings and equipment ranged from 10%, 9%, and 81%, respectively, in LI settings to 64%, 6%, and 30% in HI settings.

Nearly 13,000 megavoltage therapy machines and 6,500 CT scanners will be required by 2035 in LMICs.

Approximately 22,000 Radiation Oncology Medical Physicists will be required by 2035 in LMICs.

Full access to radiotherapy could be achieved for all patients in need in LMICs by 2035 for as little as US$ 97 billion, with potential health benefits of 27 million life years saved, and economic benefits ranging from US$ 278 billion to US$ 365 billion over the next 20 years.

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AAPM Newsletter • Volume 41 No. 1 JANUARY | FEBRUARY 2016

Expanding Global Access, cont.

The report ends with the following five “Calls for Action” with corresponding targets: 1. All countries should have population based comprehensive cancer plans.

Target: By 2020, 80% of the countries should have cancer plans that include radiotherapy.

2. Immediate action to establish additional radiotherapy capacity by creating at least one cancer centre in each LMIC by 2020. These centres should be used to train the radiotherapy workforce to enable further radiotherapy expansion.

Target: An increase of 25% in the 2015 radiotherapy treatment capacity by 2025.

3. A call for new approaches to train radiotherapy professionals globally, with the creation of new core curriculums, innovative learning methods, and international credentialing to expand the radiotherapy workforce.

Target: 7,500 radiation oncologists, 20,000 radiation technologists, and 6,000 medical physicists to be trained in LMICs by 2025.

4. Develop sustainable financing to expand access to radiotherapy through domestic and international financing.

Target: $46 billion of investment by 2025 to establish radiotherapy infrastructure and training in LMICs.

5. A call for alignment of radiotherapy access with universal health coverage. 6. Target: 80% of LMICs to include radiotherapy services as part of their universal health coverage by 2020. In summary, the report provides compelling evidence that investment in radiotherapy not only enables treatment of large numbers of cancer cases to save lives, but also brings positive economic benefits. Acknowledgement: COMP provided travel support to some of the key meetings associated with developing the Lancet Oncology Commission report.

References [1] UNITED NATIONS GENERAL ASSEMBLY. Political Declaration of the High-level Meeting of the General Assembly on the Prevention and Control of Non-communicable Diseases. http://www.un.org/ga/search/view_doc.asp?symbol=A/66/L.1 (Accessed 2015-10-21), United Nations . 2011. [2] MOTEN A., SCHAFER D., FARMER P., KIM J., FERRARI M. Redefining global health priorities: Improving cancer care in developing settings, J.Glob.Health, 4, (2014) 010304. [3] UNITED NATIONS GENERAL ASSEMBLY. Transforming our world: the 2030 Agenda for Sustainable Development.

http://www.un.org/ga/search/view_doc.asp?symbol=A/70/L.1&Lang=E (Accessed 2015-10-21), United Nations . 2015. [4] ATUN R., JAFFRAY D.A., BARTON M.B., BRAY F., BAUMANN M., VIKRAM B., HANNA T.P., KNAUL F.M., LIEVENS Y., LUI T.Y., MILOSEVIC M., O’SULLIVAN B., RODIN D.L., ROSENBLATT E., VAN DYK J., YAP M.L., ZUBIZARRETA E., GOSPODAROWICZ M. Expanding global access to radiotherapy, Lancet Oncol, 16, (2015) 1153-1186. [5] LIEVENS Y., VAN DEN BOGAERT W., KESTELOOT K. Activity-based costing: a practical model for cost calculation in radiotherapy, Int J Radiat Oncol Biol Phys, 57, (2003) 522-535.

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February 1-3, 2016 3FOBJTTBODF "VTUJO )PUFM JO "VTUJO 59

Medical Physicist & Health Physicist Training Courses: X-Ray Quality Assurance, Mammography, and Medical Internal Radiation Dosimetry

Registration for the HPS Midyear Meeting can be found at www.hps.org

X-Ray Quality Assurance

Registration for Courses:

Mammography Quality Standards Act (MQSA) Medical Physicist Testing of Mammography Units

*All Participants must be registered at the Midyear Meeting of the Health Physics Society. These courses are pending CAMPEP credit and AAHP credit 'FFT $PVSTF $PVSTF $PVSTF $PVSTF

More info: www.hps.org Dade Moeller Health Group 1835 Terminal Dr., Suite 201, Richland, WA 99354

Phone: 1-888-316-3644 E-mail: traininginfo@dmhg.net Website: www.dmhg.net

Course 1 Part 1: Monday PM - 4 Hours, February 1 Course 1 Part 2: Tuesday AM - 4 Hours, February 2 Frederic Mis, PhD

Course 2: Tuesday PM - 3 Hours, February 2 David Conover, MS, LMP

Cone Beam Breast CT: Technology, Clinical Images, Quality Control Course 3: Tuesday PM - 1 Hour, February 2 David Conover, MS, LMP

Fundamentals of Medical Internal Radiation Dosimetry Course 4: Wednesday AM - 3 Hours, February 3 Darrell Fisher, PhD


AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE

2016 AAPM FUNDING OPPORTUNITIES GRANTS

FELLOWSHIPS

The Research Seed Funding Grant

AAPM Fellowship for the Training of a Doctoral Candidate in the Field of Medical Physics

Three $25,000 grants will be awarded to provide funds to develop exciting investigator-initiated concepts, which will hopefully lead to successful longer term project funding from the NIH or equivalent funding sources. Funding for grant recipients will begin on July 1 of the award year. Research results will be submitted for presentation at future AAPM meetings. Must be a member of AAPM at time of application (any membership category). Pending membership status not accepted. **No Exceptions**

APPLY: www.aapm.org/education/ GrantsFellowships.asp

The AAPM Fellowship for the training of a doctoral candidate in the field of Medical Physics is awarded for first two years of graduate study leading to a doctoral degree in Medical Physics. Both BSc. and MS holders are eligible to apply. A stipend of $13,000 per year, plus tuition support not exceeding $5,000 per year will be assigned to the recipient. Graduate study must be undertaken in a Medical Physics Doctoral Degree program accredited by the Commission on Accreditation of Medical Physics Education Programs, Inc, (CAMPEP).

Summer Undergraduate Fellowship Program The American Association of Physicists in Medicine Summer Undergraduate Fellowship Program is designed to provide opportunities for undergraduate university students to gain experience in medical physics by performing research in a medical physics laboratory or assisting with clinical service at a clinical facility. In this program, AAPM serves as a

clearinghouse to match exceptional students with exceptional medical physicists, many who are faculty at leading research centers. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be an AAPM summer fellow. Each summer fellow receives a $5,000 stipend from AAPM.

Diversity Recruitment through Education and Mentoring Program (DREAM) The American Association of Physicists in Medicine Diversity Recruitment through Education and Mentoring Program (DREAM) is a 10 week summer program designed to increase the number of underrepresented groups in medical physics by creating new opportunities, outreach and mentoring geared towards diversity recruitment of undergraduate students in the field of medical physics. Students participating in the program are placed into summer positions that are consistent with their interest. Students are selected for the program on a competitive basis to be a DREAM fellow. Each DREAM fellow receives a $5,000 stipend from AAPM.


UPCOMING AAPM MEETINGS: March 5–8, 2016 AAPM Spring Clinical Meeting Salt Lake City, UT June 12–16, 2016 AAPM Summer School Medical Physics Leadership Academy Chantilly, VA July 31–August 4, 2016 AAPM 58th Annual Meeting & Exhibition Washington, DC

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