AAPM Newsletter November/December 2016 Vol. 41 No. 6

AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

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

IN THIS ISSUE: ▶ Chair of the Board’s Report

▶ Research Spotlight

▶ Education Council Report

▶ TG-100 Report

▶ NMQAAC Meeting Summary

▶ Life and Career Balance ▶ ACBSROBMPS 2016, Bangladesh Report and more...

JUL 30–AUG 3

AAPM 2017 DATES TO REMEMBER December 2016

2017 Annual Meeting website activated. View the site for the most up-to-date meeting and abstract submission information. www.aapm.org/meetings/2017AM/

January 18

Website activated to receive electronic abstract submissions.

March 9 at 8PM Eastern, 5PM 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 22

Meeting Housing and Registration available online.

By April 18

Authors notified of presentation disposition.

By May 9

Annual Meeting Program available online.

June 21

Deadline to receive Discounted Registration Fees.

CONTENTS ARTICLES IN THIS ISSUE 5 7 11 13 15 17 23 25 29 31 33 36 37 40

Chair of the Board’s Report Executive Director’s Column Treasurer’s Report Education Council Report Website Editor’s Report ABR News Health Policy & Economic Issues ACR Accreditation Legislative & Regulatory Affairs NMQAAC Meeting Summary Research Spotlight TG-100 Report Life and Career Balance ACBSROBMPS-Bangladesh, 2016

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

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

EVENTS/ANNOUNCEMENTS 2 AAPM 2017 Important Dates 4 DREAM 10 AAPM 2017 Spring Clinical Meeting 10 AAPM 2017 Summer School 11 AAPM Reception at RSNA 2016 21 Condolences ­— AAPM Deceased Member 22 Wiley Publishing 32 SUFP

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 Tap the arrows at the bottom of the page to go to the next or previous page.

PUBLISHING SCHEDULE The AAPM Newsletter is produced bi-monthly.

Next issue: January/February Submission Deadline: December 9, 2016 Posted Online: Week of January 1, 2017

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.

CONNECT WITH US!

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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: gaf.aapm.org

AWARD DURATION: MAY 1, 2017 – SEPTEMBER 1, 2017 • APPLICATION DEADLINE: FEBRUARY 9, 2017 PROGRAM CONTACT: Jacqueline Ogburn, jackie@aapm.org or (571) 298-1228 AD: Sponsored by the AAPM Education Council through the AAPM Education and Research Fund

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

CHAIR OF THE BOARD’S REPORT John M. Boone, PhD, Sacramento, CA

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APM is an amazing organization that serves the needs of the medical physics community in a wide-ranging manner by using a number of different mechanisms. The AAPM (task group) Report series and the Medical Physics Practice Guidelines provide valuable recommendations and guidance for the professional, educational, and scientific practice of medical physics, both in radiation oncology and diagnostic imaging. The Annual Meetings in the spring (Spring Clinical Meeting), summer (AAPM Annual Meeting) and fall (joint with the RSNA) provide well-orchestrated, targeted forums for networking with colleagues, obtaining important continuing medical education credits, viewing emerging research trends, and providing an opportunity to meet with vendors.

Our two journals, Medical Physics and the Journal of Applied Clinical Medical Physics, appeal to a broad spectrum of readers from in-the-trench clinical medical physicists to highly cited research scientists. The hierarchy of our volunteer-driven association allows younger medical physicists to initially tip-toe into national collaboration, rise to lead a task group or subcommittee of AAPM, perhaps work their way up to sit on a council, and in some cases earn elective office on the Executive Committee or on the Board of Directors. This opportunity to lead is available to those volunteers who work hard and earn the respect of their peers, regardless of their educational level or whether they are clinical practitioners or academic scientists.

I know that the above comments are true because I have grown up in the AAPM family since age 28; four different jobs and 34 years later, I have seen and done many of those things mentioned above. And since this is my last opportunity to address AAPM members as a leader of the Association, forgive me for taking this opportunity to share with you some of the recent accomplishments of our association that I have witnessed: You, the members of AAPM, purchased a building in Alexandria, Virginia last year. Our beautiful Headquarters building is a state-of-the-art office space designed to facilitate the needs of our organization, serve as a base of operation for our staff, and provide a high-tech environment for AAPM committees and other groups to meet — just two Metro stops away from a major airport, across the street from a brand-new hotel, and surrounded by dozens of great eateries. In addition to 1631 Prince Street being our new Headquarters, it represents a fiscally prudent asset that will continue to grow in monetary value throughout your career in medical physics.

In recent years, AAPM has added significant value to its members by offering free access to reports from the International Commission on Radiation Units and Measurement (ICRU) and the National Council for Radiation Protection (NCRP). This trove of documents, in many cases, defines the core scientific principles of our field, and refines our understanding of emerging issues that impact our profession. And, they are only an internet connection away. This new benefit has allowed me to clear out three bookshelves in my office, replaced now with great pictures of my kids.

Just this year, AAPM has contracted with a new publisher to unify the publishing platform for our awesome journals, Medical Physics and JACMP. This move will allow our association to go forward into the murky future of scientific publication with a strong business partner to manage both of our journal interests. These journals offer our members the traditional publishing platform of Medical Physics in addition to the open access model of JACMP.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Chair of the Board, cont.

AAPM has enjoyed increased recognition as a scientific organization in recent years and, as an association, we are routinely consulted by other societies, governmental agencies, and other organizations for our input on scientific and public policy matters. Last year, Roderic Pettigrew, PhD, MD, the Director of the National Institute of Biomedical Imaging and Bioengineering (NIBIB) addressed the Association in Anaheim on the topics of innovation and discovery.

This year, Doug Lowy, MD, the acting director of the National Cancer Institute addressed the Association in Washington, DC about the Cancer Moonshot project. Last month, AAPM members met in Kyoto with a committee of the International Electrotechnical Commission (IEC) to help steward concepts developed in an AAPM task group report into IEC regulations that will be implemented into devices worldwide. As I write this, AAPM leaders are scheduled to meet next week in Senator Feinstein’s office to discuss the importance of keeping specific nuclear material legally available in the commercial sector for radiation therapy applications. From basic and translational research, to international regulations, intersociety interaction, and federal and state policy decisions, AAPM — through its staff and volunteers — is engaged in making an impact in the public arena which extends far beyond the fields of medical physics, radiation oncology, or medical imaging.

Despite the enormous success that AAPM has realized across our entire mission space in recent years, we are challenged by an outdated organizational structure that has grown unrealistically large due to unforeseen mandates of our founding legal documents. While many hundreds of active AAPM volunteers provide the energy and gravitas that have led to the advancement of our association, the de facto decision-making is mostly executed by the five elected AAPM members who sit on the Executive Committee (“EXCOM”) — the President-Elect, President, Chair of the Board, Secretary, and Treasurer. How do I know this? I have held three of these positions in the last three years. Why is decision-making so concentrated? Because a Board of Directors encompassing 38 voting members is simply too large to act as a cohesive and timely decision-making body (period). With expert consultants, AAPM President Bruce Curran, MEng has championed a comprehensive process to educate the current Board to better understand how our association might be reorganized to allow more distributed yet nimble leadership. The AAPM membership — YOU — will be voting on various aspects of this reorganization in the coming 18 months.

I leave you with the dirty little secret that virtually all current and former members of EXCOM eventually learn: there is strong sentiment amongst our members that the current 38-member board of directors provides geographic representation from our 21 regional chapters. While this may look good on paper, nothing could be further from the truth. If you want broader democratic decision making action in AAPM, I urge you to vote in favor of a new trimmeddown organizational structure (the final details of which are emerging). You will hear many arguments on both sides of this issue, but there are two things that I can share with you as I end my term of office: (1) I will never be in AAPM leadership again, so I have nothing to lose or gain personally from this issue, and (2) if the vote for reorganization does not pass and the status quo remains, the five members of EXCOM will continue to make most of the actual decisions affecting the Association — certainly for the rest of my career as a medical physicist, and probably for the rest of yours as well. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

EXECUTIVE DIRECTOR’S REPORT Angela R. Keyser, Alexandria, VA

AAPM events during RSNA 2016

REMINDER! AAPM’s Headquarters during the RSNA meeting will be located at: The Hyatt Regency Chicago located at 151 E. Upper Wacker Drive.

AAPM Committee meetings and Annual Reception will be held at the Hyatt.

Make plans to join your colleagues on Tuesday, November 29 from 6:00 PM – 8:00 PM for the annual AAPM Reception. Special thanks to Landauer and Versant Medical Physics and Radiation Safety for their financial contributions to offset the costs for this event.

Visit AAPM at Booth 1109 in McCormick Place — South Building — Hall A to charge your mobile devices! Pick up information on Association programs, the current list of AAPM publications, and complimentary copies of Medical Physics and check out the recent advancements in the AAPM Virtual Library.

The most up-to-date schedule for AAPM meetings during the RSNA meeting is available online.

New AAPM Report Available Report No. 175 - Acceptance Testing and Quality Control of Dental Imaging Equipment (2016)

RFP — Future AAPM Summer Schools The AAPM Summer School Subcommittee has issued an RFP for future Summer School programs. The 2018 AAPM Annual Meeting will be held in downtown Nashville July 29 – August 2. The plan is for the AAPM 2018 Summer School to be a 2.5-day event held at Vanderbilt University immediately preceding or immediately following the Annual Meeting.

Therefore, the Summer School SC is particularly interested in a “short” school topic. Preference will be given to imaging related topics, however, all proposals will be reviewed for consideration. To submit an application click here. Deadline for proposals is November 16.

Your Online Member Profile This is a reminder to keep your AAPM Membership Profile information up to date by going to the AAPM Member Profile Page and making any changes necessary. Please upload your picture if you have not already done so.

Remember to review the “Conflict of Interest” area of the Member Profile to self-report conflicts per the AAPM Conflict of Interest Policy.

2017 Dues Renewal 2017 dues renewal notices were distributed in early October. You may pay your dues online or easily print out an invoice and mail in your payment. I am pleased to report that all twenty-one AAPM Chapters have elected to have HQ collect chapter dues. We hope that you will appreciate the convenience of paying your national and chapter dues with one transaction!

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Executive Director, cont.

APSIT Benefits for AAPM Members Each year, AAPM members are offered a range of insurance products through the American Physical Society Insurance Trust (APSIT) because of AAPM’s affiliation with the American Institute of Physics (AIP). APSIT was established in 1969 by the American Physical Society (APS) to provide members with a convenient source of quality and affordable insurance.

The trust began by offering Group Term Life Insurance in February of 1970, and has since greatly expanded their product selection.

APSIT plans are underwritten by market-leader New York Life Insurance Company, established in 1845. New York Life regularly earns the highest ratings for its financial strength from leading rating services.

Plan premiums are regularly more affordable than what’s available through competitors, thanks to the power of group purchasing. Since AIP society members usually have higher education levels and tend to live more conservative lives, APSIT group rates are very competitive in the market.

APSIT’s governing board, charged with making decisions about which plans to provide, is comprised of representatives from participating member societies. This means every decision is made based on an understanding of what AIP society members find important. I’ve been fortunate enough to serve on the APSIT board since 2009.

In 2014, APSIT selected Pearl Insurance as its exclusive program administrator for life and health insurance offerings.

With over 60 years of industry experience, Pearl Insurance is a nationally recognized third-party organization, and is responsible for the brokerage, administration, and marketing of APSIT’s group insurance program. This strategic partnership will lead to additional coverage options and enhanced services as we continue to work toward expanding our benefit offerings. Pearl Insurance’s team can be reached Monday through Friday, from 7 AM – 7 PM CST, at 800-272-1637.

Currently, members of any AIP society are eligible to purchase the following plans through APSIT: •

Group Term Life § Benefit amounts of up to $1,500,000 § Spouse/domestic partner coverage available

•

Group 10-Year Level Term Life § Rates locked in for a decade § Benefit amounts of up to $1,000,000

•

Group Disability Income § Benefit amounts of up to $5,000 per month § Benefits paid up to age 70

•

Group Accidental Death and Dismemberment § Benefit amounts of up to $300,000 § Spouse/domestic partner and dependent child coverage available

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Executive Director, cont.

•

Long-Term Care § Provides financial assistance for long-term medical treatment § Special discounted member rates

•

GoodRx § Saves money on your prescriptions through discounts, coupons, and price comparisons

While it remains your decision as to whether any of these insurance products fit your own needs, I encourage everyone to take advantage of the plans that are right for you. Visit apsitinsurance.com for more information on each plan.

Staff News

Matt Lind is the newest member of the HQ Team, joining us in September as the new Front End Developer. Matt will work closely with Farhana Khan and Website Editor George Kagadis, PhD as he generates and maintains the interface for AAPM and other related websites. With the addition of Matt to the team, Rohan Tapiyawala has transitioned from this position to Applications Developer, responsible for the design and implementation of new and existing database programs.

Who does what on the AAPM HQ Team? See a list with contact information and brief descriptions of responsibilities online. An Organization Chart is also provided.

Congratulations go out to AAPM’s Controller Robert McKoy on his recent engagement to Denise Fagan. Robert recently shared the news with his HQ family and I know our members join us in wishing the couple all the best!

AAPM’s Headquarters Team I firmly believe that part of the success of AAPM HQ operations is our ability to attract and retain an excellent team of high performing association management professionals. The years of service documented below is very telling; the AAPM HQ team is very committed to serving the AAPM membership. The following AAPM team members have celebrated an AAPM anniversary in the last half of 2016. I want to publicly thank them and acknowledge their efforts.

Lisa Rose Sullivan

23 years of service

Jackie Ogburn

9 years of service

Michael Woodward

20 years of service

Janet Harris

4 years of service

Farhana Khan

18 years of service

Abby Pardes

3 years of service

Yan-Hong Xing

10 years of service

Phyllis Doak

1 year of service

Tammy Conquest

9 years of service

Rohan Tapiyawala

1 year of service

Corbi Foster

9 years of service

Nick Wingreen

1 year of service

The AAPM Headquarters office will be closed Thursday, November 24 – Friday, November 25, Monday, December 26 and Monday, January 2. I wish you and your loved ones all the joys of the season and happiness throughout the coming year. n

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Online YIS and Poster Abstract Submission Now Open! www.aapm.org/meetings/2017SCM/

SAVE THE DATE! MARCH 18–21, 2017 Hilton New Orleans Riverside New Orleans, LA

Registration and Housing Available Online: February 15

In conjunction with the American Brachytherapy Society The course will provide an intense experience to cover the state-of-the-art for clinical brachytherapy physics. Presentations will include the experiences from experts as well as discussion and dialog with course attendees. Workshops will provide practical hands-on opportunities for attendees to gain experience on nine key aspects of clinical brachytherapy physics, with

opportunities for feedback from the faculty. The course textbook will archive the contents of the presentations and workshops, provide example forms and workflows, and include practical problems and explanative solutions. Course attendees will learn up-to-date methods for the responsibilities associated with clinical brachytherapy physics. *This event is not endorsed or sponsored by Lewis & Clark

www.aapm.org/meetings/2017SS/

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

TREASURER’S REPORT Mahadevappa Mahesh, PhD, Baltimore, MD

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s the final Treasurer’s Report for 2016, I’m writing to share my thoughts on the recent Finance Committee (FINCOM) meeting I chaired during the week of October 16, 2016. One of the primary roles of FINCOM is to review and approve a fiscally responsible budget that will be able to support all of AAPM’s activities in the upcoming year. The lengthy budget process typically starts around/after the Annual Meeting and involves many AAPM members.

Nearly 26% of the AAPM membership is involved in committee activities and the AAPM staff work closely with those committee chairs to compile all the necessary data to create the various budgets. Committees then submit their budget requests through the respective council tree, which are then finally compiled by the Accounting staff. Along with council requests, budget requests for other activities such as meetings, publications, membership, headquarters staff expenses, etc., are all compiled to arrive at the draft budget. The draft budget is then reviewed at the FINCOM meeting each year. This year was no different; the draft budget was then reviewed along with council chairs and their staff liaisons. The day-long process (FINCOM meeting) happened this year at AAPM Headquarters (for the first time) and included lengthy discussions on the various budget items. Both revenues and expenses were carefully evaluated and at the end of the day, FINCOM unanimously approved the 2017 draft budget that will be sent to the AAPM board. FINCOM will meet again via conference call early November to review one final time (to process any budget appeals) before submitting the budget to the AAPM board. The AAPM Board will then vote at the next board meeting (during RSNA meeting in Chicago, IL). My first column next year will go over the approved budget for the year 2017. I want to thank all the members of FINCOM and the council chairs and their respective staff liaisons for a very constructive budget meeting this year that eventually led to the unanimous approval of the draft budget. Finally, I would like to thank Robert McKoy, Controller, for all his work on the budget and helping me throughout this year on finances and other related topics. Since this is the last column for 2016, I wish all of you very Happy Holidays and a Happy New Year. n

THE AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE

cordially invites you to attend the AAPM Tuesday Evening Reception at RSNA during the 2016 AAPM / RSNA Meeting Tuesday, November 29, 2016 • 6:00 pm – 8:00 pm Crystal Ballroom BC, Hyatt Regency Chicago • Chicago, Illinois

light hors d’oeuvres AAPM gratefully acknowledges the following sponsors for their contribution to this reception:

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

EDUCATION COUNCIL REPORT Jim Dobbins, PhD, Durham, NC

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s the year comes to a close, I am pleased to report on the activities of Education Council during 2016. There are several items that deserve particular mention.

First, we as a field have made substantial progress in increasing the number of CAMPEP-accredited residency slots. Back in 2008, AAPM convened a series of summit meetings to discern the effort needed to prepare for upcoming changes in 2012 and 2014 on the requirements for board eligibility. These changes mandated that residencies would be a required part of board eligibility beginning in 2014. In 2008, we had about 25 residency slots per year, which was considerably short of the 175 slots per year estimated to be needed SUGGESTION BOX to meet workforce demands. I am pleased to report that as of this year, if all of the programs currently under review at CAMPEP are accredited, we will have approximately 160 residency slots per year. So, we are coming very close to meeting our anticipated need. One of the activities of Education Council this year will be to collect data to determine how many additional residencies will be needed to complete the full set required based on current employment patterns.

While we have made substantial progress overall in increasing the number of residencies, there continue to be fewer in the imaging and nuclear medicine arena than needed. AAPM has supported a couple of initiatives in the last few years to promote the establishment of additional imaging residencies and imaging residencies with a strong nuclear medicine component. In collaboration with SNMMI, AAPM provided support for two imaging residencies that are adding a nuclear medicine focus. This dovetails with recent efforts by AAPM to provide funding support for 8 additional imaging residencies. We will continue to monitor the number of residency slots needed and work toward completing our goal of a full complement of accredited programs, both in therapy and imaging.

There are two other items of note regarding residencies: namely, the MedPhys Match and the Medical Physics Residency Application Program (MP-RAP). The match has completed its second year and had 209 applicants who completed their materials to participate in the match, with 106 applicants being matched to programs. This number represents substantial participation by residency programs and applicants, though we will continue to look at reasons behind the disparity between the number of applicants applying and matched positions. The match program has been considered a great success to date. It will change its fee structure this coming year so that AAPM and SDAMPP will cover about half of the costs of the program, which is down from full support by AAPM/SDAMPP during the initial roll out of the program.

Education Council held a retreat this past July and there were several points of emphasis for the coming year. We have three major themes for the year, including (1) collecting data on the relative production of graduate and residency programs compared with estimated workforce needs, (2) meeting the remaining need for residency slots, and (3) determining the educational needs to address future evolutions in the field of medical physics. The council also recognized the following needs for attention in the coming year: continuing efforts to better serve a broad range of educational constituents, including physicians, allied health professionals, international colleagues, and the public;

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Education Council, cont.

enhancing the understanding of non-clinical career options for our students; improving liaison with industry, including developing internships; educating healthcare executives to understand better the value of medical physics to the healthcare enterprise; addressing increasing need for IT support to meet the demands for the growing amount of online educational opportunities; understanding the best coordinated means for addressing international educational needs; and looking at how to best incorporate alternative pathways into the educational ecosystem.

Education Council appreciates the efforts of our many colleagues who work in various capacities to meet the need for quality training of our many constituent learners. Please contact us if you have an idea, comment, or question about how EC can best serve AAPM. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

WEBSITE EDITOR’S REPORT George C. Kagadis, PhD, Rion, Greece

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he majority of us are getting prepared for the 102nd RSNA Annual Meeting which is going to take place in Chicago, Illinois (November 27 – December 2).

I would like to take the opportunity and give you an update on our society’s Virtual Library content, and our social media presences. We are currently on Facebook, LinkedIn, Twitter, and Flickr.

The AAPM Virtual Library now has 3293 videos available (as of October 31, 2016) to our membership. All the educational material is concurrently available in AAPM’s AWS (Amazon Web Services) and Vimeo. When somebody tries to access a video he/she is first connected to Vimeo and if, due to institution’s policy cannot access Vimeo, he/she is then transferred to view it on our AWS. We currently have all past meetings material uploaded in our Virtual Library back to 2001. More recently the material from the 2016 Annual Meeting was uploaded to the AAPM VL. Our Twitter regularly highlights new job listings from the AAPM Career Services, interesting articles from Medical Physics and Journal of Applied Clinical Medical Physics, as well as aapm.org What’s New items. All these tweets are automated by our Information Services (IS) staff, while we intervene to tweet or retweet interesting material from other groups ad hoc.

AAPM IS staff again implemented the use of the hashtag (#AAPM2016) for our Annual Meeting that took place in Washington, DC. The aim of a discrete hashtag for every meeting is to facilitate searching for all tweets relating to that specific meeting. During this year’s Annual Meeting our tweets earned 48.3K impressions. (Impressions are number of times users saw the Tweet on Twitter.) Impressions spiked as meeting-related Medical Physics articles/abstracts were posted. As of October 31, 2016 we have 5,365 followers on Twitter.

Our Facebook page doesn’t have the character limitation of Twitter. We thus have the opportunity to post there more material with regard to a specific issue we consider of interest to our members. Regular posts include the monthly covers of Medical Physics and JACMP, new AAPM Reports, meeting information, as well as other information of note. As of October 31, 2016 we have 4,968 likes on Facebook.

Our LinkedIn page is used for more professional material such as new member benefits, press releases, etc. As of October 31, 2016 we have 9,813 members on our LinkedIn Group.

We use our Flickr account in order to upload meeting photos from our Annual Meeting, Spring Clinical Meeting, Summer School, etc. As of October 31, 2016 we have 41,825 photos available on our Flickr.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Website Editor, cont.

The figures below provide a glimpse of our Twitter, Facebook and Vimeo stats for June, July and August.

I would like to bring to your attention once again the AAPM Social Media Policy. This Policy aims to ensure that all AAPM-related content on social media sites is consistent with the organization’s mission and objectives.

Our Social Media presence spans from our site, to presences on Facebook, Twitter, Flickr, LinkedIn, and our BBS. Before posting anything please review the policy itself as well as the Good Pratice Guidelines (available in the July – August 2016 Website Editor Report) about the appropriatness of the content you wish to post on any of our pages before posting. We will thus avoid any redundant, inappropriate information, etc. being posted.

The Website Editorial Board will meet during RSNA 2016 on Monday, November 28 from 12:00 – 2:00 pm in the Picasso Room (Bronze Level / West) of the Headquarters Hotel (Hyatt Regency Chicago). There is always space for members interested in knowing what we do firsthand or possibly want to join. Please stop by!

I am looking forward to seeing as many of you as possible next month in Chicago! I hope you find the AAPM website useful, visit it often and send me your feedback. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ABR NEWS Geoffrey Ibbott, PhD, ABR Board of Governors and Jerry Allison, PhD, J. Anthony Seibert, PhD, and Michael Herman, PhD, ABR Trustees

Results from Recent ABR Examinations Reliability and Stability of the Exams

The ABR medical physics exams must accurately reflect the performance of candidates and remain stable over time. The content of the exams changes little from year to year, and each exam contains some items from previous years.

The reliability of exams also is examined. Reliability is a psychometric statistical concept related to the overall consistency of a measure. The measure, in this case the passing score, is said to have a high reliability if it produces similar results under consistent conditions. We check the reliability of each of our exams, and if the value begins to drift downward, we modify the exam. An example is the recent increase in the number of items on the Part 1 Clinical Exam. Another example is the pending replacement of three-point complex items with several one-point, case-based items on the Part 2 exams.

The percentage of candidates who answer an item correctly is also important because items that too many or too few examinees answer correctly are of no value in evaluating candidates. Items that are too easy or too hard may be removed from an exam and the item pool as well. In a similar fashion, the Board checks the correlation of each item, because the overall high performers on an exam should do better on an item than the overall low performers. Items that have a low or negative correlation also may be removed from an exam and the item pool.

ABR exams are criterion based, which means the Board is only interested in how well a candidate does compared to an ideal standard. In principle, everyone could pass or fail an exam. In practice, the number who pass is similar from year to year when there are sufficient candidates, but it may vary quite a bit for small groups.

Determining the Passing Score A psychometric technique, called the Angoff process, is used in determining the passing score. In the language of testing, the individual test elements are called “items.” This is because not all elements are in the form of a question.

However, informally items and questions are the same thing. Each item is evaluated by a panel of board-certified medical physicists. The panels contain both PhD and MS medical physicists, medical physicists from both private practice and academic practice, as well as medical physicists who are diverse by geographic location and gender. Panels evaluate each item on an exam by asking, “Would the minimally competent candidate get this item right?” We emphasize that the basis of the Angoff process is the minimally competent candidate, not the superstar. We also emphasize “would get it right” as opposed to “should get it right.” The results of the Angoff process are similar from year to year.

By ensuring the stability of the exam over time, ensuring the reliability of the exam, and using the Angoff process to validate individual items and the exam as a whole, we are confident of the quality of the examinations.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ABR, cont.

Results — Part 1 The number of first-time takers for the Part 1 General Exam rose sharply in 2013, and we assume this was due to the upcoming change in ABR requirements for 2014. The number fell sharply in 2014 and has been slowly increasing since then.

The results in recent years show a distinct decrease in performance by the candidates. Note that these are first-time candidates; the results for repeat candidates are poorer. The ABR has reviewed the exam statistics extensively and is convinced that the exam has not changed. The first-time taker pass rates are as shown below.

Part 1 – General First-time Takers Enrolled in a CAMPEP Program % Fail

% Pass

Total

2013

14%

86%

384

2014

30%

70%

152

2015

27%

73%

192

2016

35%

65%

232

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Exam

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ABR, cont.

The results for the Part 1 Clinical Exam have been more stable than those for the Part 1 General Exam, but they too show a slight decline in pass rates.

Part 1 – Clinical First Time Takers Enrolled in a CAMPEP Program Exam

% Fail

% Pass

Total

2013

23%

77%

379

2014

25%

75%

151

2015

27%

73%

192

2016

29%

71%

231

Part 2 Results The Part 2 exam is given in each of the medical physics subspecialties, including Therapeutic (TMP), Diagnostic (DMP) and Nuclear (NMP). In 2016, the majority of the candidates were in TMP. This has historically been true.

Specialty

Part 2 – First Time Takers

DMP

38

21%

NMP

5

3%

TMP

140

77%

The pass rate for the Part 2 exams has been stable for the last four years.

Part 2 – First-time Takers % Fail

% Pass

Total

2013

22%

78%

49

2014

25%

75%

63

2015

20%

80%

183

2016

18%

83%

183

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Exam

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ABR, cont.

Part 3 (Oral) Exam Results There are three possible results for the oral exam: One can pass, condition (fail one of the five categories), or fail (fail two or more of the five categories). First-time takers who condition the exam have a high pass rate when they take the conditioned exam. The number of oral exam candidates is similar to the number of Part 2 Exam candidates.

Oral Exam Candidates 2016 Specialty

Number

DMP

48

19%

NMP

9

4%

TMP

197

78%

The global results for the last few years are:

Oral Exam First-time Takers Exam

Percent Conditioned

Percent Failed

Percent Passed

Total

2014

12%

22%

65%

242

2015

13%

12%

74%

195

2016

12%

27%

60%

254

This year, almost half of the oral exam candidates had graduated from a CAMPEP-accredited residency. The performance of the CAMPEP residency graduates remains much stronger than those who do not have a residency.

Oral Exam

Percent Conditioned

Percent Failed

Percent Passed

Total

First-time Takers

12%

27%

61%

254

CAMPEP Residency

8%

20%

71%

119

No Residency

16%

33%

51%

135

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ABR, cont.

Summary This year’s exam statistics show decreased performance on the Part 1 General Exam despite evidence that the exam has remained essentially unchanged in recent years. The reason for this is unknown but should be considered by AAPM, CAMPEP, and SDAMPP. Performance on the Part 1 Clinical Exam declined slightly, and performance on the Part 2 exams is stable within the statistics of the examination. On the oral exam, CAMPEP residency graduates now make up about one-half of the candidates, and they perform better than the candidates without a residency. The performance of the CAMPEP residency graduates provides support for the decision of almost a decade ago to require a residency as the standard pathway to practicing clinical medical physics. n

Our Condolences James S. Sample, MS — Cordova, IL

Our deepest sympathies go out to his family. We will all feel the loss in the medical physics community.

If you have information on the passing of members, please inform HQ ASAP so that these members can be remembered appropriately. We respectfully request the notification via e-mail to: 2016.aapm@aapm.org Please include supporting information so that we can take appropriate steps.

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AAPM journals now

publishing with Wiley AVAILABLE ONLINE—See http://www.medphys.org

September 2016

Volume 43, Number 9

The International Journal of Medical Physics Research and Practice

Volume 17, Number 5

2D maps of a microdiamond (MD) dosimeter (PTW model 60019) response measured by scanning a 200 µm diameter soft x-ray microbeam over the 3 mm diameter active detector element. The left panel illustrates the response distribution (color wash) obtained by scanning (a) perpendicular to the diamond plate (dotted white lines) and (b) parallel to the detector axis where the solid white lines indicate the external surface of the MD dosimeter. The right panel shows normalized response maps of 10 different PTW MD detectors.

[Figures 3 and 6 from Marinelli, Prestopino, Verona, and Verona-Rinati, “Experimental determination of the PTW 60019 microDiamond dosimeter active area and volume,” Med. Phys. 43, 5205-5212 (2016)].

Published by the American Association of Physicists in Medicine (AAPM) with the association of the Canadian Organization of Medical Physicists (COMP), the Canadian College of Physicists in Medicine (CCPM), and the International Organization for Medical Physics (IOMP) through the AIP Publishing LLC. Medical Physics is an ofcial science journal of the AAPM and of the COMP/CCPM/IOMP. Medical Physics is a hybrid gold open-access journal.

We are delighted to announce that beginning in 2017 our prestigious journals, Medical Physics and Journal of Applied Clinical Medical Physics, will be published in partnership with Wiley.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

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

AAPM Submits Comments on 2017 Medicare Proposed Rules AAPM recently submitted comments to the Centers for Medicare and Medicaid Services (CMS) regarding the 2017 Medicare proposed rules for payments to hospital outpatient departments, freestanding cancer centers and physicians.

CMS will address public comments in the 2017 final rules, which will be published on the first of November. AAPM’s full comments to CMS can be found here.

Medicare Hospital Outpatient Prospective Payment System AAPM provided written comments to CMS regarding the 2017 Medicare Hospital Outpatient Prospective Payment System (HOPPS) proposed rule, which provides facility payments to hospital outpatient departments.

In the 2017 Medicare hospital outpatient proposed rule, CMS proposes to continue the existing Comprehensive APC (C-APC) methodology and create 25 new C-APCs. The proposed C-APC policy applies to surgical services provided during brachytherapy treatment delivery for multiple types of cancer.

CMS defines a Comprehensive APC as a classification for the provision of a primary service and all adjunctive services and supplies provided to support the delivery of the primary service. Under this policy, CMS calculates a single payment for the entire hospital stay, defined by a single claim, regardless of the date of service span.

The AAPM noted that since the inception of the Comprehensive APC methodology, the Association has commented on concerns around the accuracy of claims data, as there is a great deal of discrepancy around how hospitals submit these claims. The AAPM also stressed uncertainty as to whether the rates associated with C-APCs adequately or accurately reflect all of the procedures and costs associated with those APCs. This is of particular concern as CMS continues to expand the number of packaged and bundled services. Preliminary claims data analysis suggests that the comprehensive APCs may result in significant Medicare payment reductions for complex radiation oncology treatments.

The AAPM advised that if CMS plans to expand the use of Comprehensive APC payment for radiation oncology services, they must revise the current methodology to adequately capture appropriately coded claims. CMS could introduce code edits to both include and exclude procedures from rate setting in an effort to mitigate major distortions in the claims data. The Agency would also need to expand the list of radiation oncology planning and preparation codes, and other codes reflected in the process of care, for Comprehensive APC payment exclusion to ensure appropriate separate payment.

In addition, CMS proposes to reduce the number of clinical APCs for Therapeutic Radiation Treatment Preparation from 4 to 3 levels by consolidating Level 1 & Level 2 treatment preparation codes into clinical APC 5611 Level 1 Therapeutic Radiation Treatment Preparation. CMS proposes to reassign the special medical radiation physics consultation code (CPT 77370) from current APC 5612 to APC 5611, which results in a significant payment decrease of more than 30%.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Health Policy, cont.

AAPM noted that special medical physics consultation ensures that patients with the most complex clinical situations receive safe and effective care and is significantly more effort and intensity than the continuing medical physics consultation code (CPT 77336). Both medical physics codes do not belong in the same clinical APC. AAPM recommends that CMS maintain CPT 77370 Special medical radiation physics consultation code in APC 5612 Level 2 Therapeutic Radiation Treatment Preparation in 2017.

Medicare Physician Fee Schedule AAPM also provided written comments to CMS regarding the 2017 Medicare Physician Fee Schedule (MPFS) proposed rule, which impacts physician payment and payments to freestanding radiation oncology centers.

AAPM notes that 2017 CMS proposals have minimum impact to radiation oncology procedures and services. The Association did comment on several radiation oncology codes where CMS did not accept the RUC recommendations and made recommendations for lower relative value units (RVUs).

•

•

•

Oppose the CMS proposed work RVU reductions for treatment device codes and request that CMS implement the RUC approved values of 0.54, 0.84 and 1.24 for CPT 77332, 77333 and 77334, respectively, which are supported by the RUC survey data.

Urge CMS to finalize the physician work RVU of 2.03 and practice expense inputs for CPT 77470. In addition, the AAPM opposes the development of new HCPCS G-codes to describe a Special Radiation Treatment Procedure (77470).

Reinstate the RUC approved work RVU of 8.78 for interstitial low-dose rate brachytherapy code 77778.

Maintain the current work RVUs for HDR breast brachytherapy catheter placement code 19298, Cobalt-60 stereotactic radiosurgery treatment delivery code 77371 and hyperthermia codes 77600, 77605, 77610 and 77615 and not implement a 0.25 work RVU reduction, as these codes were never valued with inherent moderate sedation. n

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The next and necessary evolution of the secondary dose calculation process will require verification of all patient dose distribution points (i.e., the full patient dose volume) to adequately account for the myriad variations inside the treatment fields as generated for IMRT, VMAT, and other complex modern treatment techniques.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

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

D

oes your facility need help on applying for accreditation? In each issue of this newsletter, I’ll present frequently asked questions (FAQs) of particular importance for medical physicists. You may also check out the ACR’s accreditation web site portal for more FAQs, accreditation application information and QC forms.

The following questions are for the new ACR Digital Mammography Quality Control Manual. Please feel free to contact us if you have questions about radiation mammography accreditation.

Q. Are the technologist and medical physicist forms available online?

A. Yes. Both the technologist and the medical physicist forms are available as downloadable Excel files. Visit the new ACR Digital Mammography QC Manual Resources webpage.

Q. Will the ACR provide training on how to use the new ACR Digital Mammography QC Manual?

A. Yes. The ACR Subcommittee on Quality Assurance is currently working on a series of webinars on how to use the new QC manual for technologists and medical physicists. Check the ACR Digital Mammography QC Manual Resources webpage for announcements.

Q. Where do I obtain the new ACR Digital Mammography Phantoms?

A. The ACR posts the name and contact information for approved vendors of the new ACR Digital Mammography Phantom on the ACR Digital Mammography QC Manual Resources webpage. In order for a manufacturer to sell the new phantom, they must have it reviewed and approved by the ACR.

Q. How does the new ACR Digital Mammography Phantom differ from the old one?

A. The main differences are as follows: • The

new phantom is large enough to cover most of the detector. This enables artifact evaluation to be done the same time as the phantom image quality is evaluated.

• The

largest test objects have been removed and smaller ones have been added. The gradations between test objects are also smaller so that the phantom is more sensitive to changes.

• The

filter has been included under the wax insert so that the signal throughout the phantom is much more uniform.

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• A

tolerances for test object size and location are much tighter ensuring minimal phantom-to-phantom variation.

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ACR, cont.

Q. How does the scoring of the new ACR Digital Mammography Phantom compare to that of the old ACR mammography phantom?

A. See the table:

# of Test Objects That Must Be Visible to Pass Test Object

Old ACR Mammography Phantom

New ACR Digital Mammography Phantom

Fibers

4

2

Speck Groups

3

3

Masses

3

2

Q. How do the test object sizes of the new ACR Digital Mammography Phantom compare to those of the old ACR mammography phantom?

A. See the table:

Old and New ACR Phantom Test Object Visual Equivalency (Green are Passing) Fiber (mm) Old

Speck Groups (mm) New

Old

New

Masses (mm) Old

New

1.56 1.12

0.54

2.00 1.00

1.00

0.33

0.75

0.75

0.28

0.50

0.50

0.89

0.89

0.40

0.75

0.75

0.32

0.61 0.54

0.54

0.40

0.40 0.30

0.24

0.23 0.20

0.16

0.17 0.14

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0.38 0.25

0.25 0.20

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

ACR, cont.

Q. When will the ACR start accepting technologist QC and medical physicist reports using the new ACR Digital Mammography QC Manual for accreditation purposes?

A. The new ACR Digital Mammography QC Manual will go into effect in July 2017 for those facilities that choose to use the new manual for QC. This means that you will not be able to submit QC testing results for ACR accreditation using the new manual until July 2017. However the ACR encourages you to become familiar with the changes by using the new manual alongside existing manufacturer QC. Q. When will the ACR start accepting images from the new ACR Digital Mammography Phantom for mammography accreditation?

A. At this time we expect to be able to start accepting images from the new phantom for accreditation in July 2017.

Q. Will the ACR update the Digital Mammography QC Manual to include tests for tomosynthesis?

A. Yes. The ACR Subcommittee on Quality Assurance is currently working on an appendix for technologist and medical physicist tests of tomosynthesis features. Once completed, the appendix will be reviewed by tomosynthesis equipment manufacturers for applicability. The ACR draft must be reviewed and approved by the FDA before it becomes final. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

LEGISLATIVE & REGULATORY AFFAIRS REPORT Lynne Fairobent, Alexandria, VA

Summary of AAPM Meeting with Senator Feinstein on Source Security

On Tuesday, October 18, 2016, President Elect Melissa Martin, MS and Chairman of the Board John Boone, PhD, accompanied by Lynne Fairobent, Senior Manager of Government Relations and Matt Reiter, Capitol Associates, Inc. (CAI) met with Trevor Higgins, Legislative Assistant to Senator Feinstein.

Trevor handles Nuclear Regulatory Commission (NRC) issues for Senator Feinstein.

Background AAPM has been engaged with Congress on legislative efforts to introduce new source security legislation that would likely result in a greater regulatory burden on licensees in possession of Category 1 and 2 source materials, such as hospitals. This effort is mainly being promoted under the argument of preventing terrorists from acquiring these materials to build a “dirty bomb.” AAPM, along with a coalition of other organizations that wish to preserve the use of source materials for industrial use called the Source Security Working Group (SSWG) have successfully been able to prevent any real action being taken on this proposed legislation. Additionally, the SSWG has been proactively engaged in changing the language in draft legislation while also trying to build allies in Congress who would oppose a bill that is unsatisfactory to the SSWG. AAPM sits on the SSWG Steering Committee and has taken the lead on developing the organization’s positions and talking points.

In addition to this legislative source security effort, a recent Government Accountability Office (GAO) “sting” operation resulted in the GAO successfully receiving a license to obtain enough Category 3 material to aggregate into a Category 2 source using a falsified license. This operation was a follow-up to a similar operation conducted in 2008.

The GAO recommended that the NRC require all Category 3 material be tracked by the National Source Tracking System (NSTS). Following the GAO report, Senators Feinstein and Schumer sent letters to the NRC requesting NRC to re-evaluate including Category 3 material in NSTS. NRC has responded to Senator Feinstein and is in process of responding to Senator Schumer.

Meeting Summary

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Chair of the Board, Dr. John Boone and President-Elect, Ms. Melissa Martin, standing outside of Senator Feinstein’s office during a recent visit.

Senator Feinstein is very supportive of non-proliferation and is a main backer of source security legislative efforts. Trevor was therefore very familiar with the issue but was relatively

AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Legislative, cont.

unfamiliar with AAPM and the medical physics profession. AAPM used this opportunity to educate him about both the organization and the profession. We also emphasized our mutual interest in the secure use of radiological sources in medical applications.

Trevor was interested in our thoughts on the GAO “sting” operation. AAPM expressed our perspective that the existing regulatory structure is effective. We also expressed our position that expanding the NSTS to Category 3 materials would be operationally challenging. Additionally, NRC and the Agreement States only recently finished implementing increased controls for Category 1 and 2 materials under 10 CFR Part 37. AAPM believes that there has been insufficient time to determine the effectiveness of these regulations AAPM outlined many of the operational challenges to including Category 3 materials in the NSTS in great detail. For example, we discussed the challenges to states like California and the lack of resources and staff to effectively handle the increased volume of sources in the NSTS as an example.

AAPM capitalized on an opportunity to establish itself as honest brokers of information. When asked by Trevor how much of a burden tracking Category 3 materials in the NSTS would be for our members, we answered that it would present some difficulties and would likely require the hiring of additional staff. Rather than complain about the difficulties tracking Category 3 materials would impose, we expressed our view as source security experts on how expanded tracking may not be the most effective or efficient way to improve security. We expressed concern that we may be changing one threat for another, that being an increased risk from cybersecurity. This needs to be carefully researched before expanding the existing NSTS to determine whether the expanded capability exists in the systems, the regulatory burden to all licensees with Category 3 material, and the burden and cost to NRC and Agreement States to implement. All of this must be analyzed against existing regulatory structure that is safe and effective.

Conclusion AAPM was successful in helping her staff understand the realities of operationalizing the expansion of the NSTS to Category 3 sources and the reasons behind the results of the GAO operation. We also highlighted the effectiveness of the existing regulatory structure for source security.

It is unclear if Senator Feinstein will change her position in favor of expanded tracking as a result of this one meeting.

She has been a staunch supporter of source security efforts but this does not mean her office is not open to changing at least some aspects of their position. AAPM and the SSWG will continue to engage with Senator Feinstein and other Congressional offices on this issue.

Most importantly, AAPM positioned itself as a resource to her office going forward. AAPM presented our members as experts in our field who are dedicated to the secure use of source materials. We expressed our willingness to facilitate a site visit for the Senator and her staff with an AAPM member to help her office learn more about our profession and the safe environment in which medical physicists provide lifesaving medical procedures to patients. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

LEGISLATIVE & REGULATORY AFFAIRS REPORT, Continued Richard Martin, Alexandria, VA

NMQAAC Meeting Summary On September 15, 2016, the National Mammography Quality Assurance Advisory Committee (NMQAAC) met. Effective February 17, 2016, alternative Standard #24 allows for the use by mammography facilities of the ACR digital mammography quality control manual as an alternative to the quality assurance program recommended by the image receptor manufacturer. The advisory committee discussed the ACR Digital Mammography QC manual, noting its comprehensive approach, including most legacy tests, most current manufacturer tests, and accommodating manufacturer specific tests where appropriate. The advisory committee also addressed the of ACR DM phantom prototype benefits of prototype phantom design.

Helen Barr, MD, Director Division of Mammography Quality Standards, FDA, introduced a new inspection program called “EQUIP: Enhancing Quality Using the Inspection Program.” The goal of this program is to equip facilities to address image quality on a continuing basis and emphasize the lead interpreting physician(LIP) and Interpreting physician (IP) responsibilities. Images will not be looked at during inspections. Rather the facility’s processes for ensuring image quality will be inspected. The inspection process will include questions related to quality assurance part of the inspection procedures and there will be citations for inadequate or missing quality processes. EQUIP will be phased in. First inspections using new questions will begin before the end of calendar year 2017. There will be no equipment violations for the first year. The advisory committee’s reactions to whether the program has potential to improve image quality were mixed but generally supportive.

In addition, the advisory committee addressed the issue of giving notification to mammography patients regarding dense breast issue. David L. Lerner, MD, talked about breast tissue density cancer risk and state patient notification laws. He looked at definitions of breast density and the importance of a breast tissue density determination. He noted that 27 states now have laws mandating patient notification of density, and most require a prescribed text, but texts vary from state to state. He also addressed proposed federal legislation (HR 716 and S370, Breast Density and Mammography Reporting Act of 2015), which would amend MQSA. That legislation proposes that patients be told information about breast density, and the effect of density in masking cancer based on the patient’s breast density, and advise the patient to speak with her physician regarding whether they would benefit from additional tests. The advisory committee discussed how facilities, referring health care providers, and patients are responding in states that have density notification requirements. Advisory committee members were supportive of the notice requirement as well as greater uniformity in the text of that notice. The general consensus was that that patients are entitled to know their medical information and risk factors, and density notification promotes informed and shared decision-making. Members, however, posited that the issue was complex, and the patient’s recommended course of action upon receiving notice varied widely, depending on other individual risk factors. They noted, too, that some patients may benefit from supplemental screening, but supplemental screening incurs added costs to patient and health care system and may result in false positives. n

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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!

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Fellowships are offered for 10 weeks during the summer (May through September) and available to students not in their final year.

Application Deadline: February 2, 2017 For more details, visit: www.aapm.org/education/GrantsFellowships.asp

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Pushing and Pulling — the Evolving Role of Preclinical Imaging Highlights From Today’s Cutting Edge Medical Physics Research The Research Spotlight highlights projects, people, and emerging science in medical physics.

Dr. Taly Gilat Schmidt, PhD, Milwaukee, WI on behalf of the AAPM Research Committee

Research Spotlight

R

ecent progress in 3 areas — basic science research, human clinical research, and small animal imaging technology — has led to an expanding role for preclinical imaging.

Preclinical imaging is now being used in research involving oncology, cardiology, inflammatory diseases, infection, and the neurosciences. It is also being applied in a broad range of ways:

• • • • •

Analysis of organ function and metabolism in a variety of pathological contexts1 Detection of and characterization of biological targets, particularly in oncology1,2,3 Assessment of biomarkers and bio-distribution patterns2,3 Monitoring of treatment responses2,3 Characterization of drug pharmacological, pharmacokinetic, and pharmacodynamic profiles (including safety and validation studies)1

What is Preclinical imaging?

According to John D. Hazle, PhD (Professor and Bernard W. Biedenharn Chair in Cancer Research, Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas), “Preclinical imaging is the use of imaging in any animal model for understanding biology or response to therapy, and it is typically [but not exclusively] restricted to in vivo imaging of whole living animals.” Preclinical imaging utilizes noninvasive means and yields quantitative as well as spatially and temporally indexed information on normal and diseased tissues.1,4 According to Dr. Hazle, most of the work in the field focuses on small animals, with “98 or 99% of preclinical imaging using mouse models.”

Pushing and Pulling The use of small-animal models has become a foundation for many research and development strategies, representing a bridge between discoveries at the molecular level and implementation at the human clinical level.1 Rather than just a bridge, however, Dr. Hazle sees small-animal imaging as being part of a “circular process”, in which human clinical problems derived from imaging are pushed down into the preclinical space, where there is more latitude to delve more deeply into the inquiry. Subsequently, the knowledge gleaned from the preclinical work is then pushed back up, or translated, to the human clinical space. Others see a similar process occurring with basic science research, in which there are opportunities for in vitro research questions to be pulled up into the preclinical space, where they can be explored in living organisms, and then pulled back down into the basic science realm for further analysis.4 Dr. Hazle also sees this trend occurring with the evolution of co-clinical trials. These are trials in which tumors with specific genetic or phenotypic characteristics are used to generate both clinical and preclinical data in parallel. Some of the work uses so-called patient-derived xenographs (PDX), in which parts of the tumor from a patient are simultaneously studied in a mouse model, so that complimentary data can be accumulated.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

Research Spotlight, cont.

Imaging Modalities The most suitable modalities for small-animal in vivo imaging are based on magnetic resonance imaging (MRI), nuclear medicine techniques (positron emission tomography [PET] and single photon emission computed tomography [SPECT]), computed tomography (CT), magnetic resonance spectroscopic imaging (MRSI), ultrasound, and optical imaging (OI).

The specific preclinical applications of these techniques include micro-MRI, micro-PET, micro-SPECT, micro-CT, and microultrasound.2 More recently, aiming to overcome some of the inherent limitations of each of these imaging modalities, the idea of using multimodality combinations of highly sensitive functional modalities (PET and SPECT) and highly anatomical and morphological techniques (CT and MRI) has been gaining traction.1 This approach permits the evaluation of different aspects of function, anatomy, gene expression, and phenotype using software algorithms or, more recently, hybrid instruments.5 Dr. Hazle explains that of the more sophisticated imaging methods, MRI is used preferentially for preclinical imaging.

However, he also observes that optical imaging (both bioluminescence and biofluorescence) is used more often, largely because it is less expensive. Yet, while it does provide some functional information, optical imaging has significant anatomical limitations that make it less translatable to humans.

Development of Preclinical Imaging According to Dr. Hazle, one of the early drivers of the use of preclinical imaging as a significant tool in cancer therapy was Duke University’s G. Allan Johnson, PhD, in the mid-1990’s. Back then, before devices dedicated to small animals were commercially available, small animal imaging was performed with human clinical instrumentation. Over time and with the advent of better imaging software and hardware, specific instrumentation has been developed that has addressed the need for improved equipment performance (namely, better spatial resolution, sensitivity, and tissue contrast).1 The push-pull metaphor has also surfaced in the development of preclinical imaging techniques. For example, many small animal imaging instruments were developed as a result of pushing human-scale devices into the preclinical environment.

Conversely, optical imaging (with biofluorescent and bioluminescent tracer technology) originated in single-cell in vitro studies, and it was then scaled or pulled up to whole-body animal imaging.5 Dr. Hazle identifies several other reasons for the more recent progress of preclinical imaging, including improvements in: • • • •

basic science knowledge animal models of disease (more closely mimicking human clinical disease) parallel imaging of disease models in animals (co-clinical trials) levels of confidence in obtained results

Preclinical Imaging Today Preclinical imaging provides researchers with a unique opportunity for studying disease quantitatively, in real time and in a non-destructive, noninvasive manner. It affords investigators the ability to repeatedly monitor disease progression or response to treatment, at multiple time points over a wide timescale (longitudinally) and at multiple levels (from cellular and molecular to organ and entire organism). Furthermore, the use of small animal imaging offers scientists other advantages, including the reduction of biological variability (each animal works as its own control) and the opportunity to acquire, in continuity, an impressive amount of unique information (without interfering with the biological process under study) in distinct forms, modulated as needed, along with a substantial reduction in the number of animals required.1

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Research Spotlight, cont.

Perhaps most importantly, as most small-animal imaging techniques are now similar to those used in the human clinical setting, results from this type of research are often translatable to humans.1 Dr. Hazle again cites the emerging role of co-clinical trials in this process. He notes that the goal of these types of trials, which are designed to use imaging to study the effects of therapies on mice and humans at the same time, is to “look at how we can optimize those different imaging approaches so that the data at the end can be harmonized and analyzed collectively.”

Finally, since preclinical imaging allows the development of diagnostic and therapeutic agents on nearly identical molecular synthesis platforms, drug discovery can be linked to the development of imaging tracers. This powerful paradigm, now known as diagnostic-therapeutic pairing, or theranostics, is already familiar to many with the use of I-123 for thyroid diagnosis and I-131 for therapy of benign and malignant thyroid conditions.5

Future Role of Preclinical Imaging Progress with hardware and software will broaden the range of applications and quality of images in preclinical imaging.1 In addition, more theranostic agents are likely to emerge, including nanoparticles, aptamers, peptides, and antibodies for a variety of imaging devices in animals, with subsequent translation to human use.5 Preclinical imaging will also continue to play roles in analyzing and manipulating living tissue at the cellular and molecular levels and in integrating imaging techniques with therapy, so that diseased tissues can be identified and therapies can be directed at specific target sites.6 And even though the sophisticated animal models, drugs, and pathology being used in preclinical imaging research are expensive, Dr. Hazle emphasizes that “any disease you can imagine that has developed animal models, we can push that down and have analogous approaches in the preclinical space, so we can study these processes in animals.”

AAPM Webinar The process of using preclinical imaging techniques to impact basic science and clinical research will continue to require close collaboration between clinicians, imagers, engineers, statisticians, basic scientists, and physicists. Dr. Hazle hopes that his upcoming Webinar for AAPM, on December 8, 2016, will serve as a broad scientific overview of the field of preclinical imaging as well as a window into how others in the AAPM community might participate in this field in the future. n References: 1. Cunha L, Horvath I, Ferreira S, et al. Preclinical imaging: an essential ally in modern biosciences. Mol Diagn Ther. 2014;18:153-173.

2. PR Newswire. Small animal imaging (in-vivo) market is expected to reach $2.1 billion globally by 2020 - Allied market research.

http://www.prnewswire.com/news-releases/small-animal-imaging-in-vivo-market-is-expected-to-reach-21-billion-globallyby-2020---allied-market-research-290768881.html. Published February 4, 2015. Accessed September 30, 2016.

3. Grand View Research. Small animal imaging (in-vivo) market worth $2.7 billion by 2022. https://www.grandviewresearch.com/ press-release/global-small-animal-imaging-in-vivo-market. Published December 2015. Accessed September 30, 2016.

4. Zanzonico, P. Small animal imaging. In: Kiessling F, Pichler B, ed. Noninvasive Imaging for Supporting Basic Research. BerlinHeidelberg, Germany: Springer; 2011;3-16.

5. Koba W, Kim K, Lipton M, et al. Imaging devices for use in small animals. Sem Nucl Med. 2011; 41(3):151-165.

6. NIH Research Portfolio Online Reporting Tools (RePORT). Optical imaging. https://report.nih.gov/nihfactsheets/ViewFactSheet. aspx?csid=105. Published March 29, 2013. Accessed October 1, 2016.

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

TG 100 REPORT Saiful Huq, PhD, Pittsburgh, PA Peter Dunscombe, PhD, Calgary, AB, Canada Co-Chairs for the Work Group on the Implementation of TG 100

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he establishment of this Work Group was approved by AAPM in January 2016. By the time all members had agreed to serve it was March before the first teleconference was held. The Work Group is fortunate in having acquired the services of several seasoned campaigners in the area of quality and safety as well as several younger members of the Association who are already active in the field. The mandate of the Work Group is to develop educational materials and an implementation guide to facilitate adoption of the TG-100 methodology and to establish liaisons with other organizations in the radiation oncology field. The liaison issue is particularly important as, to be successful, quality and safety improvement initiatives, in our field, have to be multidisciplinary not just in name but also in fact. The Work Group has met eight times by teleconference and continues to meet monthly.

Progress is being made on all fronts. A repository of TG-100 related PowerPoint presentations delivered by members of the Work Group has been established and is being used as the basis for the development of generic slide sets. These slide sets are intended to ensure that coherent and consistent messages on TG 100 are shared. The slide sets in the repository have been used in a variety of venues including the recent Certificate Course at the Annual Meeting as well as TG-100 workshops presented at the Southwest and Penn-Ohio Chapters of AAPM. The successful multidisciplinary TG100 Workshop offered by the Penn-Ohio Chapter was highlighted in the July-August edition of this Newsletter. Planning has also begun on a proposed specialty meeting immediately prior to the 2017 Spring Clinical Meeting in New Orleans to present risk analysis techniques to members of radiation therapy treatment teams, not physicists alone.

The development of a TG-100 implementation guide along with software to facilitate the integration of prospective risk management into routine clinic operations is under discussion. Letters inviting active participation by related organizations, and regulators, are currently being distributed. These liaisons will be pursued vigorously as participation by these other organizations is essential to the success of the TG-100 initiative to enhance the quality and safety of treatment of radiotherapy patients.

The Work Group has recently submitted a budget to support activities in 2017. We are optimistic about obtaining funding to partially support the presentation of workshops in conjunction with Chapter meetings as well as in other venues. Apart from the educational aspect of these workshops they offer a unique opportunity to network with colleagues across radiation oncology and, with multidisciplinary participation, to coalesce into teams with the patient’s interest front and center. n

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

LIFE AND CAREER BALANCE: CHILDCARE AT CONFERENCES Kristi Hendrickson, PhD, Seattle, WA Thanks and acknowledgements to Jean Moran, PhD, Holly Lincoln, MS, Sonja Dieterich, PhD, Charles Bloch, PhD, Susan Richardson, PhD, Laura Cervino, PhD, Nicole Ranger, MSc, James Balter, PhD and others.

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ttendance at AAPM meetings such as the Annual and Spring Clinical Meetings, Summer School, etc. are invaluable to medical physicists as opportunities to earn required continuing education credits, to present and share their research, to network with other medical physicists, to keep abreast of new technology offerings and interact with vendors, and to meet faceto-face with long distant collaborators. Often national committees, working groups, task groups, and other affiliated medical physics groups also use these gatherings to hold in-person conferences.

Unfortunately, many challenges exist that prevent AAPM members from fully participating in these key professional activities. Among these are the challenges associated with family responsibilities, especially childcare. This is particularly true for members with young children; how can a parent, particularly a dual-career family or single parent, travel for an overnight or multi-day conference with young children?

Many professional and scientific societies who sponsor and organize national meetings for their members recognize that having young children can present an impediment to attendance at conferences and hence to career advancement.

To better serve their membership and to increase the participation rate at conferences and thereby attract and retain talented individuals in their fields, increasingly these organizations are offering solutions to the conference-childcare problem. No single solution will meet the needs of every parent medical physicist, but in this article we will explore the practical issues facing AAPM members and some of the solutions that are working for other professional societies.

Some Real Examples From AAPM Members AAPM members have sought their individual solutions, and we can learn from their stories. Some bring their spouse and children to the meeting location and juggle between attending key sessions during the day and additional evening events while needing to take over childcare responsibilities at times. This often involves compromise and the reality that some events or sessions will be missed. Occasionally the spouse is also a Medical Physicist and AAPM member. Then juggling childcare responsibilities is less feasible, and a family member or nanny might be asked to travel with the family to care for and entertain the children. The care of children left at home may incur additional costs. Expenses for these solutions add up quickly and can be prohibitive, especially for younger members or trainees.

Members who are parents note that children are not allowed in the vendor hall, with the consequence that without childcare their interactions with vendors are limited and access to complimentary snacks and lunches (a member benefit) is also effectively cut off.

One prominent AAPM parent recounted that she was almost late to receive her Fellowship award during the Awards Ceremony because her nanny needed a required break. She also had to immediately walk off the stage and out the door because her nanny had reached her daily work hour limit; consequently, she missed the rest of the ceremony and could not join in the celebratory atmosphere of the event.

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Childcare, cont.

Another member noted she would have been unable to be part of the Summer School organizing committee, a session moderator, and a session speaker if she had not been permitted to bring her sleepy 7-week-old baby to the Summer School and into some sessions. Not being able to participate and to contribute her expertise on the Summer School topic would have been a missed opportunity and consequential to her academic record and in her career advancement.

Solutions That Already Exist From Other Societies One of the solutions that several conference organizers and professional societies have developed is onsite childcare.

•

The Radiological Society of North America (RSNA) has offered onsite child care at the McCormick Place Convention Center through “Camp RSNA” every year since 1998 for children aged 6 months to 12 years old. They contract with a national company called ACCENT on Children’s Arrangements, Inc.--one of several companies whose sole business plan is to arrange full service child care at the site of the conference for corporations and professional societies. RSNA pays a management fee to ACCENT to offset expenses and to keep fees affordable and provides a secure room within the conference center. ACCENT provides similar services to other medical professional meetings. They provide a customized, creative schedule of events and age-appropriate toys, active games, fun equipment, storytelling, music and more to create an engaging and stimulating, educational and fun experience.

•

The American Chemical Society (ACS) provides onsite childcare for ages 2 to 16 years old at “Camp ACS.” This program has been fully funded for the past six years by the society for its members.

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The American Physical Society (APS) offers childcare grants of up to $400 to parent participants at its meetings.

•

The Nuclear & Plasma Sciences Society (NPSS) offers a child care reimbursement grant up to $400 per family to assist conference attendees who incur additional expenses as a result of attending an NPSS conference.

The impact of childcare on professional meeting participation is not just a problem being recognized and addressed in the United States. The Society for Molecular Biology and Evolution at their recent annual conference July 3-7, 2016, in Australia provided accredited child care through a “Kids Club” facility for all children over 2 years of age at no additional cost to the participants. In addition, there were approximately 50 awards (chosen from applications) of up to $1000 (Australian) available to members with children to cover a wide range of eligible extra expenses related to attending the meeting with children (for example, airfare for the child, airfare for an additional caregiver) or for care of children left at home (for example, airfare to fly in a relative to care for the child at home).

Full package solutions offered—depending on the organization and situation— include reasonable babe-in-arms policies. Professionals and scientists attending these meetings are sufficiently wise to know when a baby is being disruptive and are adept at making quick exits.

Closing remarks: Without solutions like those above, AAPM members who are also parents are less able to attend meetings and to accept volunteer opportunities such as participating in committee work, moderating sessions, and other important activities at national AAPM meetings. In the meeting evaluation survey to participants of the 2016 Summer School, out of 145 respondents, 25% answered yes to the question “Would onsite childcare have made it easier for you to attend this meeting?” In the Annual Meeting 2016 evaluation survey, out of 1434 respondents, 27% answered yes to the same question. Furthermore, out of 375 respondents at the Annual Meeting, 30% answered yes to the statement “Within the last three years, I have not been able to attend this annual meeting due to difficulty in arranging for childcare

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Childcare, cont.

at home.” These survey questions have thus far only reached AAPM members who have been able to attend the meetings. A survey of the general AAPM membership on this topic is forthcoming. The results and suggestions from the survey will assess the needs of the membership and inform process changes at the AAPM. I am confident that an organization devoted to improving care to patients can produce solutions to the childcare problem for its members.

Afterward: To facilitate informal exchange about topics related to childcare within our profession, a “Medical Physics Parents” Facebook Group (closed for privacy) has been created. Please join us there! n References: RSNA Meetings Website (August 2016) Retrieved from https://www.rsna.org/Childcare.aspx ACCENT Company Website (August 2016) Retrieved from http://www.accentoca.com/site33.html SMBE Meetings Website (August 2016) Retrieved from http://smbe2016.org/child-care-award/ IEEE-NPSS Conference Awards Website (August 2016) Retrieved from http://ieee-npss.org/awards/conference-awards/ APS Programs Website (August 2016) Retrieved from http://www.aps.org/programs/women/workshops/childcare.cfm

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AAPM Newsletter • Volume 41 No. 6 NOVEMBER | DECEMBER 2016

REPORT ON ACBSROBMPS-2016, BANGLADESH Nupur Karmaker, MSc1, Abu Saif1, Hasin Anupama Azhari, PhD1, Golam Abu Zakaria, PhD1,2 1 Dept. of Medical Physics and Biomedical Engineering, Gono University, Dhaka, Bangladesh; 2Dept. of Medical Radiation Physics, Gummersbach Hospital, Academic Teaching Hospital of the University of Cologne, Germany

Introduction Regarding development and improvement of the status of Medical Physics, Bangladesh Medical Physics Society (BMPS) has continuously performed different activities throughout the year since its inception 2009.

As Medical Physics is a new era in our country, BMPS is playing various important roles such as post creation in the hospital, organization of different national and international scientific conferences, workshop with collaboration with different institutions, societies, etc. BMPS arranges executive committee meetings (every month), quarterly meetings (every three months), annual conferences (ACBMPS), and the International Conference in Radiation Oncology and Imaging (ICMPROI), which already occurred in 2011 and 2014 (every three years). In addition, BMPS celebrates 7 November in each year by publishing an e-newsletter (Voice of BMPS).

In the near future, BMPS will accomplish the goals of the infrastructure, requirements and examination procedures for the certification of medical physicists in accordance with the requirements of the International Organization of Medical Physics (IOMP) guidelines with association of other societies.

Recently, BMPS has organized a two-day annual conference “Annual Conference of Bangladesh Society of Radiation Oncologist (BSRO) & Bangladesh Medical Physics Society (BMPS) (ACBSROBMPS-2016)” on 24-25 September, 2016 at Bangladesh Institute of Administration and Management (BIAM) auditorium.

Co-organizers In this conference the co-organizers are Department of Radiotherapy, Dhaka Medical College Hospital (DMCH); Department of Medical Physics & Biomedical Engineering (MPBME), Gono Bishwabidyalay; Institute of Nuclear Medical Physics Project, Bangladesh Atomic Energy Commission (INMP, BAEC); Institute of Nuclear Medicine and Allied Sciences (INMAS), Dhaka Medical College Campus; Institute of Nuclear Medicine and Allied Science’s (INMAS), Dhaka Medical College Campus and Military Institute of Science and Technology (MIST).

Participants About 300 participants from different universities, hospitals, industries and foreign delegates from India, China, Nepal, and Germany attended this program and exchanged their views, knowledge, experience and ideas.

This two-day-long program comprises of an inaugural ceremony, vendor presentations, scientific parallel sessions, poster session, annual general meeting (AGM) of BMPS, award ceremony, training program on TPS & quality control of imaging and closing ceremony.

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ACBSROBMPS-2016, cont.

First Day

Inaugural Ceremony

It was held on Saturday, 24 September 2016 in BIAM Auditorium and inaugurated by the Prof. Dr. Gowher Rizvi, Adviser for International Affairs & Special Representative of the honourable Prime Minister of Bangladesh, who was present to grace the occasion as the Chief Guest. Prof. Dr. M. Iqbal Arslan, Dean, Faculty of Basic Science & Para Clinical Science, Syndicate Member, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dr. Gauranga Chandra Mohonta, Project Director, (Additional Secretary), Higher Education Quality Enhancement Project (HEQEP), University Grant Commission (UGC) were present as special guests. Dr. Martina Treiber, Head of the Radiooncology Department, Caritas Klinikum Saarbruecken, Germany was present as guest of honor. Prof. Dr. Golam Abu Zakaria, Germany was present as the keynote speaker and Prof. Dr. M. A. Hai was the patron of the conference. The session was presided over by Prof. Dr. Sheikh Golam Mostafa, Vice President of BSRO and Dr. Kumaresh Chandra Paul, President of BMPS.

Scientific Sessions

Fig. 1: Respected guests in the inaugural ceremony

It was split into the keynote speech, invited lectures, and oral (22), poster (33), and vendor presentations.

Poster Session and Award Ceremony Thirty-three posters were displayed in the gallery and judges of three members selected three posters out of them for first, second and third prizes. The titles of first, second and third posters were “Design and Construction of Linear Variable Differential Transformer (LVDT)” by Fazlul Haque Rana, “Deep Inspiration Breath Hold Technique with Homemade LPT System For Left Breast Cancer Comparison between 3DCRT and IMRT” by Mokhlesur Rahman and “Deep Inspiration Breath Hold Technique with Homemade LPT system For Left Breast Cancer Using 3DCRT” by Md. Hafizur Rahman.

Fig. 2: Poster presentation and Three winner poster presenters with judges

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ACBSROBMPS-2016, cont.

Annual General Meeting(AGM) of BMPS

Fig. 3: Annual General Meeting of BMPS-2016

All categories of BMPS members were present in the AGM. The President, joint secretary, treasurer have discussed the activities and related issues of the last one year. The honorary members and founder members have expressed the future activities and their implementation in AGM. Some new proposals from EC are unanimously accepted by general members.

Second Day

Training Program on TPS (Eclipse) The training program on TPS was conducted by three groups from Bangladesh. In each group one radiation oncologist (RO) and one medical physicist (MP) from Bangladesh discussed our planning process and goals for different types of carcinoma (breast, cervical, prostaste and laryngeal carcinoma).

German experts Dr. Martina Treiber, RO and Ms. Renate Walter, MP discussed all casses individually with the participants as well as with the planner. It was a very interactive learning session between oncologists and medical physicists.

Fig. 4: Training program on TPS

Quality Control of Imaging

Still now there no established QC protocols in Bangladesh for imaging. On the basis of this, BMPS emphasized in the conference the training on ‘Quality Control of Imaging training on Radiography, Fluoroscopy, Mammography and Computed Tomography (CT)’ which is conducted by two German experts: Mr. Daniel Boedeker and Prof. Dr. G A. Zakaria in Padma Diagnostic Center.

This is the first time in Bangladesh BMPS has started training program on this issue and consequently it will take necessary steps to establish QC protocols in hospitals through cooperation with the Bangladesh Atomic Energy Commission (BAEC) and Bangladesh Atomic Energy Regulatory Authority (BAERA) and Bangladesh Society of Radiology and Imaging (BSRI).

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ACBSROBMPS-2016, cont.

Fig. 2: Poster presentation and three winner poster presenters with judges

Fig. 6: Practical secession in training program, at Padma Diagnostic Center

Closing Ceremony

The closing ceremony was presided over by the president of BMPS (Dr. Kumaresh Chandra Paul). Then the founder president of BMPS (Prof. Dr. Hasin Anupama Azhari) and the father of Medical Physics in Bangladesh (Prof. Dr. Golam Abu Zakaria) discussed the overall progress of the situation of medical physics and the results of ACBSROBMPS-2016 followed by closing speech of the president of BMPS. Finally, the importance was noted of the fact that national and international cooperation and advice is necessary for the upgrowing further development of this subject which is now main concern of BMPS.

Fig. 7: Large number of male and female Participants of ACBSROBMPS-2016

Acknowledgement We are thankful to our colleagues, contributors, abstract reviewers, organizing committee, co-organizers, sponsors, scientists, students and all other people who provided expertise for their assistance in the conference. Special thanks to Varian for their markable contribution to holding the conference successfully. n

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UPCOMING AAPM MEETINGS: March 18–21, 2017 AAPM 2017 Spring Clinical Meeting New Orleans, LA June 10–14, 2017 AAPM 2017 Summer School Clinical Brachytherapy Physics Portland, OR July 30–August 3, 2017 AAPM 59th Annual Meeting & Exhibition Denver, CO

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