AAPM Newsletter July/August 2017 Vol. 42 No. 4 by AAPM Docs

AMERICAN ASSOCIATION of PHYSICISTS IN MEDICINE

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

IN THIS ISSUE: ▶ President’s Report ▶ Education Council Report ▶ Website Editor’s Report

▶ Health Policy & Economic Issues ▶ TGI 100 Report

▶ NGR Medical Physics Subcommittee Report ▶ IROC Report

▶ Chapter News

and more...

JUL 30–AUG 3

AAPM 2017 DATES TO REMEMBER •

Housing reservation deadline

•

Deadline to cancel housing reservation without a $25 cancellation fee

•

Fees for registration will be refunded in full if written notice of cancellation is received by July 5, 2017

•

Deadline to complete the online evaluation in order to receive

July 5

September 6 11:59 PM ET September 13

CAMPEP Credit (equivalent to CME category 1), SAMs Credit (equivalent to SA-CME), MDCB and RLI Credits •

Credits released for meeting attendees

This Year at AAPM: • Interact with vendors and learn about the latest technology. Evaluate new equipment to inform purchasing decisions. • Earn continuing education credit by attending scientific, educational, and professional presentations. • Pick the sessions you want to attend and get the credit you need — AAPM is scheduling more sessions that offer SAM. • Share knowledge and solutions, catch up with colleagues, and compare notes on similar clinical issues.

For the most up-to-date meeting and abstract submission information, visit www.aapm.org/meetings/2017AM/

CONTENTS ARTICLES IN THIS ISSUE 5 7 13 19 21 23 27 29 31 33 36 37 39 41 45 47 51

President’s Report Educational Council Report Executive Director’s Report Treasurer’s Report Website Editor’s Report ABR News Legislative & Regulatory Affairs Report ACR Accreditation: FAQs for Medical Physicists Health Policy & Economic Issues Imaging Practice Accreditation Subcommittee Report TG 100 Report Ohio River Valley Chapter Report Southern California Chapter Report Upstate New York Chapter Report NRG Medical Physics Subcommittee Report IROC Report Person in the News

EVENTS/ANNOUNCEMENTS 2 4 8 20 22 25 26 28 34 35 38 46 48 49 52

AAPM 2017 Annual Meeting & Exhibition Dates to Remember AAPM 2017 E&R Fund Donors’ Lounge AAPM 2017 Annual Meeting & Exhibition Program Information Condolences— AAPM Deceased Members AAPM 2017 Career Expo Career Services AAPM 2017 Expanding Horizons Travel Grant 2017 RSNA 2017 Proposed Ammendments to AAPM By-Laws AAPM 2017 Annual Meeting & Exhibition — New Member Symposium AAPM 2017 Call for Nominations AAPM Certificate of Completion Course AAPM 2017 Elections MedPys 3.0 AAPM 2018 Spring Clinical Meeting

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

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

NAVIGATION HELP Previous/Next Article

PUBLISHING SCHEDULE The AAPM Newsletter is produced bi-monthly. Next issue: September/October Submission Deadline: August 11, 2017 Posted Online: Week of September 3, 2017 CONNECT WITH US!

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

www.aapm.org www.aapm.org

focus on our future

Visit the AAPM E&R Fund Donorsâ&#x20AC;&#x2122; Lounge Exhibit Hall A Entrance, Level 2, Convention Center To Donate During AAPM 2017 in Denver, CO July 30 â&#x20AC;&#x201C; August 3, 2017 The AAPM Education & Research Fund supports the development of our great profession via the provision of seed money for research, fellowships for PhD students, fellowships for undergraduate students, and grants to support Imaging Physics residencies. Without contributions from our generous members we would never have been able to provide the now over 100 grants, fellowships, and residencies since the inception of the Fund 22 years ago. All contributions are tax deductible. Larger donations may be designated for specific fellowships, residencies, travel awards, research, or other suitable purposes.

Give to the AAPM Education & Research Fund Donate Now: www.aapm.org/education/edfundintro.asp

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

AAPM PRESIDENT’S REPORT Melissa C. Martin, MS, Gardena, CA

his is truly an exciting time of the year for AAPM. Our Annual Meeting is within a few weeks and there are many members and staff that have spent numerous hours planning our sessions to cover the latest in scientific developments, clinical applications, continuing education sessions and professional development. One of the major developments for this year’s meeting is the significant increase in the number of SAM sessions being offered. For those members who need to track their CEU’s and SAM credits, this year’s meeting is designed to offer you a wide range of sessions to attend in order to achieve this requirement. I am very excited for the 2017 Presidential Symposium on Monday morning, July 31, with the three outstanding speakers who are slated to particpate. We will hear from Jim Borgstede, MD, FACR, Past President of the RSNA, presenting the role of the medical physicist in Diagnostic Imaging, followed by Brian Kavanagh, MD, MPH, FASTRO, President of ASTRO, presenting the role of the medical physicist in Radiation Oncology, and Paul Naine, MSc, MIPEM, Sr. Manager, Clinical Operations for Elekta presenting the role of the medical physicist in industry. The overall theme of the symposium is the strength and rewards of the various roles of the medical physicist and our colleagues working in unity to achieve our goals. My sincere thanks go out to the entire Meeting Coordination Committee who have worked so hard to put this outstanding meeting together. The Program Directors (Kristy Brock, Scientific Program, Robin Stern, Educational Program, Jeff Limmer, Professional Program) have done a fantastic job with the presentations. The Headquarters staff have put countless hours into organizing the many aspects of this year’s meeting, as they do every year. We have again received great support from our vendors for this upcoming Annual Meeting. Please make time in your schedule to visit with them in the Exhibit Hall. I sincerely hope to see as many of you as possible at the meeting in Denver. If you have the time and opportunity to bring your family with you to the meeting, there are many places to vacation in the Rocky Mountains. We have already had two very successful meetings this year: the Spring Clinical Meeting and the Summer School on Brachytherapy. Both boasted attendance higher than last year and each had very useful and practical sessions. Thanks go to the directors for these meetings: Bruce Thomadsen, Mark Rivard, and Luc Breulieu for the Summer School and Jessica Clements, Michael Howard, Kyle Antes, Jean Moran, Annie Hsu, Brent Parker, Matthew Meineke, Jeff Moirano, Bill Sensakovic, and Austin Hadley for the Spring Clinical Meeting. Our vendors were very supportive of the Spring Clinical Meeting this year for which we are deeply grateful. Both the Professional Council (Dan Pavord, Chair) and Education Council (Jim Dobbins, Chair) have held their annual retreats at Headquarters to work on the many projects and challenges confronting our members at this time. The Professional Council members have spent many hours working on the updated version of our Scope of Practice for Clinical Medical Physicists which will be published soon at the next MPPG. This document is required to be approved by our Board of Directors before the next document on the roles of the Medical Physicists Assistants can be developed. It is necessary to document and outline exactly what tasks must be performed by the Qualified Medical Physicist in both Imaging and Therapy. With several states trying to define the required roles of the QMP, it is of utmost importance that the AAPM define our roles and not have them defined by outside agencies. Another ongoing activity that is gaining momentum is the project headed by Jatinder Palta and our Headquarters staff to develop a Corporate Council. This initiative will provide our vendors with the opportunity to work with our members

www.aapm.org | 5

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

President, cont. in a more cohesive manner developing a closer working relationship between the two. As an organization, we need to develop an identity that our members bring to the vendors which is not available from any other organization. These nominations will be approved at the next Board of Directors’ meeting. In May, AAPM held a successful training day at the CRCPD meeting. Training on CR/DR was held in the morning and CBCT in the afternoon. Additional training was presented on Error Prevention in Radiation Therapy later in the week. This followed two intense days of Mammography Training organized by the CRCPD, FDA, ACR and AAPM. We had many participants in this training program and the relationships with the CRCPD have been strengthened. These presentations are available in our Virtual Library for those that are interested and would like to see what the inspectors have been trained to ask on their next visit! Presentations on CR/DR were made by Kyle Jones and Tony Seibert while CBCT was presented by Bob Pizzutiello and Brett Mauro. The Errors Prevention Session was presented by Bruce Thomadsen, Gary Ezzell, and Debbie Gilley. Physicists participating in the Mammography Training were Eric Berns, Penny Butler, Doug Pfeiffer, Tyler Fisher, and myself. As you can see in addition to the Governance project, there is a lot of activity going on so stay tuned and participate in your local chapter as well as many of these national activities as possible. I hope to see you soon. n

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6 | www.aapm.org

AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

EDUCATION COUNCIL REPORT Jim Dobbins, PhD, Durham, NC

he Education Council recently held its annual retreat, and I am pleased to offer this brief summary of items looking back over the past year and ahead to high priority items for our efforts in the coming year. We reviewed the key challenges and opportunities for each of our major committees and subcommittees, and I will mention just a few items of note for each group. The Public Education Committee is investing substantial effort in identifying common questions of interest regarding medical physics topics for the general public. Forty such questions have been identified and materials appropriate for a general audience will be produced and disseminated. The Medical Physics Education of Allied Health Professionals Committee is looking at ways to highlight to fellow societies the value provided by medical SUGGESTION BOX physicists, and is evaluating how to appropriately choose liaisons with those societies. The Committee on Medical Physicists as Educators is planning a summer workshop in the near future to revisit important contemporary approaches to education. The Medical Physics Education of Physicians Committee provided feedback to ACGME encouraging the involvement of medical physicists in residency training curricula, and has revamped the format of the Saturday physics sessions at RSNA. The Continuing Professional Development Committee is working on a business plan for improved utilization of our available online educational resources and is looking at ways to enhance the role of the MOC subcommittee beyond approving SAMs questions. The Education and Training of Medical Physicists Committee is looking at standardizing characteristics of DMP programs and is working on improving the funding support for summer undergraduate fellowships and diversity fellowships. The International Educational Activities Committee is working on prioritizing international education efforts and coordinating education and training with other organizations and societies. The Subcommittee on the Oversight of MedPhys Match is working on ways to incentivize programs to use the match and on identifying ways in which MedPhys Match and the Medical Physics Residency Application Program process (MP-RAP) can be better integrated. In short, our many committees and subcommittees have accomplished a lot this past year and have identified important work for the year ahead. We also continued our efforts at three of our major themes: (1) collecting data to assess the number of graduates and residents completing CAMPEP accredited programs relative to the perceived workforce demand, (2) determining how many additional residency slots are required, and (3) working on ways to address the educational implications of medical physics of the future. We also discussed several specific items, including the evaluation of trial educational modules for use in radiation oncology training. A set of such modules has been produced and is being evaluated to see if there is sufficient interest and value to warrant the expense of producing additional ones. The Council also addressed a concern raised at the spring Board of Directorsâ&#x20AC;&#x2122; meeting regarding a perception that some graduates of CAMPEP accredited graduate programs lack adequate preparation when applying to residency programs. We assigned individuals to collect data to explore this perception and how prevalent it might be and we discussed means to better harmonize expectations for clinical training between graduate programs and residency programs. In summary, the retreat reminded us of the considerable work done by many in AAPM to support high standards of education and training across many types of learners. I am particularly grateful to the chairs and vice-chairs of our many committees and subcommittees who put in considerable effort to advance education in medical physics. We would welcome any thoughts or suggestions you would have to help us further enhance our value to AAPM and its members. n

www.aapm.org | 7

he theme for AAPM's 2017 Annual Meeting is “Connecting Our Pathways. Unifying Our Profession.” As many of us have observed in recent times, our profession of medical physics that had been functioning in fairly discrete segments not that long ago is now moving together at a rapid pace: Imaging with dual mode capabilities such as PET/CT or PET/MR and Therapeutic Modalities incorporating MR or X-ray localization immediately prior to energizing the treatment beam to ensure accurate placement of the treatment dose. Imaging is now an integral part of a radiation oncology department to the extent that radiation oncology physicists must be thoroughly familiar with all types of imaging modalities. The accuracy of treatment planning is totally dependent on the accuracy of the imaging information available for the patient. How we integrate the training of each of the current disciplines in medical physics is crucial to the success of our field in the future.

The Presidential Symposium this year will feature leading physicians speaking on the integration of each of the three branches of medical physics: diagnostic imaging physics, nuclear medical physics and radiation oncology physics, into their practice. Their outlook concerning future developments that may be occurring as we speak with other modalities, particularly with the incorporation of the immunological therapy agents and genomic sequencing, will provide us valuable insights into our potential future work. The radiology profession has already incorporated Imaging 3.0 into their practice as we incorporate Medical Physics 3.0 into ours. This year’s Annual Meeting in the Mile-High City of Denver will provide the perfect opportunity to showcase the highlights of our profession, which requires that all of us work together to bring into the clinic those exciting and significant developments being made by our researchers. Only when we utilize all of the talents of our multi-faceted profession will true success be obtained in providing the best possible diagnosis and treatment of our patients. Our Annual Meeting provides unique opportunities for you to share your scientific and clinical knowledge and skills. Ensure your professional development for the sake of our future in the field of Medical Physics by attending this year’s Annual Meeting in the Mile-High City. —Melissa C. Martin, 2017 AAPM President

NEW AND EXCITING FEATURES THIS YEAR… • New Symposium Structure and Special Joint Symposium at

this Year’s Annual Meeting Each year the Professional Council and Education Council host symposia at the annual meeting on timely topics of interest to the membership. This year, the chairs of the four councils (Professional, Education, Science, and Administrative) are joining forces to have a coordinated set of symposia on the general theme of new trends in medical physics. There will be three symposia on Sunday morning, starting with the Professional Council Symposium on "Communicating with Patients: A Vital Skill for a Medical Physicist,” followed by a Joint Symposium co-sponsored by all four councils on the topic of “New Opportunities for Medical Physics.” The morning session will conclude with the Education Council Symposium on “Future Trends in Medical Physics Education.” The joint symposium will include talks about new research horizons, the important new skills needed for medical physicists across all work environments, and a look at the challenges and opportunities of medical physics around the world. We encourage members to attend these three symposia to get a broad view of new directions in the many facets of medical physics.

• Special 3-Day Program on Ultrasound covering advances

in ultrasound guided radiotherapy, therapeutic ultrasound, and diagnostic imaging (Monday – Wednesday, July 31 – August 2, 2017) • NEW and IMPROVED General ePoster Discussions

In addition to the moderated ePosters in the ePoster Theater, we will expand our ePoster capabilities and include ePoster stations throughout the lounge areas in the Exhibit Hall. General ePosters include a select group of high-scoring posters identified by the Program Directors to be of special interest to attendees of the scientific program. This is an alternative to the hardcopy general poster to allow the authors to present their general poster electronically at a large screen display, dedicated to only their poster during a specifically assigned 30-minute timeslot. These General ePoster presentations will occur in the ePoster Theater and throughout the Exhibit Hall promoting lively discussion and scientific exchange.

All sessions and technical exhibits will take place in the Colorado Convention Center, 700 14th St, Denver, CO. The education program and professional program will offer a significant opportunity to gain practical knowledge on emerging technical and professional issues. This year, the scientific program will also offer a special three-day track on Ultrasound.

New and Exciting Features (continued) • 2017 Certificate Course — A day-long track on Advanced

Imaging for Clinical Trials and Advanced Practice (see below) • Joint Scientific Symposium with the World Molecular Imaging

Society — Imaging Hypoxia • Joint Scientific Symposium with ESTRO – AAPM Symposium:

From Bench to Bedside via Veterinary Radiation Oncology • Distinguished Lectureships:

§ The Carson/Zagzebski Distinguished Lecture on Medical Ultrasound — Lihong Wang, Gene K. Beare Distinguished Professor of Biomedical Engineering at Washington University in St. Louis, will present Photoacoustic Tomography: Multiscale Imaging from Organelles to Patients by Ultrasonically Beating Optical Diffusion. This presentation will be held during the diagnostic ultrasound imaging sessions within the Special 3-day Ultrasound Track. § The Anne and Donald Herbert Distinguished Lectureship in Modern Statistical Modeling — Daniel Krewski, PhD, MHA, Natural Sciences and Engineering Research Council of Canada Chair in Risk Science, Professor and Director, McLaughlin Centre for Population Health Risk Assessment, University of Ottawa will discuss the statistical modeling involved in making conclusions from analysis of accumulated data on the effects of radiation at low doses.

• MR-in-RT Mini-Series: MR-in-RT is a multi-part course on

the role of MRI in radiation therapy, intended to offer comprehensive and focused education to both imaging and therapy physicists, including those who may have missed the MRgRT certificate course offered previously. Coordinated sessions will be held in the Imaging Education, Therapy Education, Professional, and Practical programs. • MPLA Leadership Session (Pre-registration required)

Tuesday, August 1, 2017 | 1:45-3:45 In the symposium, Leading from the Middle, experts in the field of Leadership Effectiveness will focus on methods to enhance and grow your current leadership skills focusing on networks and interactions to maximize performance and outcomes. Participation by each attendee is expected; space is limited for this interactive program. • Attend sessions aligned with your interest and get SAM

Credit: Similar to last year, with only a few exceptions, most of the invited sessions in the Education, Science, Professional, and Practical Tracks will offer SAMs. SAMs questions can be answered on your own following the completion of the session. Attendance is verified using a participation device on your badge. Registration for the Participation Device is required for the SAM Program. • Dedicated time in the meeting program for Visit the

Vendors. • Guided Tours on the Exhibit Floor. SAM credit will be offered.

Pre-registration required. See below. • Partners in Solutions — an exciting venue on the exhibit floor

(see below).

www.aapm.org/meetings/2017AM

CERTIFICATE COURSE — Beyond Clinical Imaging: The Role of the Medical Physicist in Clinical Trials and Response Assessment This year’s Certificate Course will be on Wednesday of the meeting (August 2) on the topic of “Beyond Clinical Imaging: The Role of the Medical Physicist in Clinical Trials and Response Assessment”. This course will be open to all registrants and will focus on the important roles that medical physicists — both diagnostic and therapeutic — play in clinical trials and in clinical practice where the assessment of patient response to treatment is being evaluated. This course will consist of 4 sessions: (a) an education session that will focus on clinical trials — both those using radiation therapy and those that involve diagnostic imaging — and on the roles that medical physicists may play in each; (b) an education session on advanced technologies such as MR-PET and MR/RT that are being used for trials and response assessment; (c) a scientific session with proffered talks on these topics and (d) a session that will describe several active clinical trial settings and the roles that medical physicists are playing now and in the future. All sessions aim to be relevant to both diagnostic and therapeutic medical physicists, will seek to identify the unique requirements

of trials compared to clinical practice and seeks to increase the communication between physicists in these important activities. All those who register for the AAPM meeting (weekly or Wednesday daily) will have access to these sessions as usual. The mini-track will also serve as the certificate course at this year’s meeting, which provides an in-depth review of a particular topic with verification of learning objectives through on-line homework. Attendees may enroll in the certificate program for an additional fee. Enrollment in the program entitles participants to dedicated seating in the mini-track sessions as well as additional online materials. Following the meeting, certificate program participants will be required to take an online examination which covers the material presented throughout the day-long mini-track. Enrollees who demonstrate satisfactory attendance at the course and successful completion of the online examination (available after the meeting) will receive a framed certificate of completion for this course.

SCIENTIFIC PROGRAM A symposium is a topical session focusing on a current topic related to pioneering or state-of-the-art research and development of medical physics. The symposia often include multiple, invited speakers to share their expertise on the topic. Some symposia will include a panel discussion aiming to define the current state of the field and to distill the thinking of the experts.

Joint Imaging/Therapy Track

Therapy Track

• Design for Care [SAM]

• Microscopic Monte Carlo Simulations for Radiobiology • • • • • • •

Modeling: Advances and Challenges [SAM] QA for Modern Radiation Therapy [SAM] Joint Scientific Symposium with ESTRO: From Bench to Bedside via Veterinary Radiation Oncology [SAM] In Memoriam of John "Jack" F. Fowler: The Mathematics of Dose-fractionation Effects [SAM] The Role of Physics in Long Term Epidemiological Studies of Pediatric Radiotherapy Patients [SAM] Quantitative Imaging Guided Adaptive Radiotherapy [SAM] Recent Advances in Brachytherapy [SAM] Joint Symposium of AAPM and ASTRO: Normal Tissue Dosevolume Effects of Head/Neck and Liver/GI SBRT [SAM]]

Imaging Track • Deep Learning and Applications in Medical Imaging [SAM]] • 2017 ICRU Gray Medal: Presentation of the Medal and

Lectures by the Pioneers [SAM] • Photon Counting Detectors and Their Applications in

Medical Imaging [SAM] • Non-conventional Multi-Source X-Ray Imaging: Cardiac,

Breast Imaging and Cone Beam CT [SAM] • Emerging and New Generation PET: Instrumentation,

Technology, Characteristics and Clinical Practice [SAM] • Low Dose CT: Where Do We Stand Now? [SAM]

• In Memoriam of Michael Sharpe: The Future of Precision in RT

[SAM] • Machine Learning Role in Radiomics and Radiogenomics

[SAM] • Nanoparticles for Imaging and Therapy [SAM] • Radiomics for Lung Cancer [SAM] • Roles of In-vivo Dose Verification in Radiation Therapy [SAM] • MR-guided Radiotherapy [SAM] • Optical Image-guided Surgery [SAM] • Research Funding [SAM] • ROC: A New Method in Radiotherapy QA [SAM] • Auto-segmentation for Thoracic Radiation Treatment

Planning: A Grand Challenge [SAM] • Advancements in MRI and MR-Guided Interventions [SAM] • FUTURE: Provocative Questions in Medical Physics

Ultrasound (Special 3 Day Program) This track highlights recent advances in ultrasound for diagnostic imaging, ultrasound for guidance and control of radiation therapy, and therapeutic ultrasound such as MR guided HIFU. These ultrasound symposia and scientific sessions have been allocated as a three-day track to be held on Monday, July 31, through Wednesday, August 2. Day 1 will highlight advances of ultrasound imaging technology applied to guiding and planning external beam radiation therapy and brachytherapy. Day 2 covers image guided therapeutic ultrasound, with clinical sessions covering HIFU in oncology and neurology, treatment planning, therapy monitoring, and innovative directions of therapeutic ultrasound for hyperthermia, thermal ablation, enhanced radiotherapy, targeted drug delivery, and immunotherapies.

Ultrasound (Special 3 Day Program, Cont. Day 3 brings together advances in diagnostic imaging, innovations in ultrasound monitoring of treatment and response, elastography, contrast agents, and theranostics. Day 3 also includes the Carson-Zagzebski Distinguished Lectureship on Medical Ultrasound: Dr. Lihong Wang will present “Photoacoustic Tomography: Multiscale Imaging from Organelles to Patients by Ultrasonically Beating Optical diffusion.” A selection of proffered abstracts is incorporated within these sessions, and within a SNAP oral session to be held on Sunday, July 30th. Each daily track begins with an Educational Session related to the subsequent scientific sessions: a two-hour hands-on ultrasound workshop to highlight ultrasound imaging and therapy systems; a primer on the potential role of therapeutic ultrasound and immunotherapies; and a primer on QA for diagnostic ultrasound. The Ultrasound Track was supported in part by the generous donations from the Focused Ultrasound Foundation and Sensus Healthcare.

• Hands-on Workshop for Diagnostic Ultrasound Imaging

• • • • • • • • • • • •

Quality Control, High Intensity Focused Ultrasound Therapy and Ultrasound-guided Therapy US Guidance for RT Interventions [SAM] US Guided Systems for Brachytherapy [SAM] Therapeutic Ultrasound and Immunotherapy: A Primer [SAM] HIFU in Oncology Advanced Novel Technologies & Delivery Strategies in HIFU Therapeutic Strategies and Image Guidance in HIFU [SAM] HIFU Treatment Planning, Modeling, and Dose Advances in Ultrasound Contrast Agents and Elastography [SAM] Advances in Ultrasound Imaging Technology Performance Evaluation of Ultrasound Systems: Advanced Methods and Applications Ultrasound in Monitoring Treatment and Response The Carson/Zagzebski Distinguished Lecture on Medical Ultrasound

EDUCATIONAL PROGRAM Therapy Track The 2017 Therapy Education Program will feature a total of 35 hours of educational sessions designed to meet the diverse interests of our membership, with the majority designated as SAM sessions. New this year are 6 hours of Joint Imaging/ Therapy Education sessions that bridge professional specialties. This year's joint-track topics are MedPhys 3.0 and Radiation Protection Programs. The program will also include topics in electronic charting and EMR integration, big data, incident reporting system findings, brachytherapy for gyn, brachytherapy treatment verification, proton therapy pencil beam scanning, machine learning, advances in inverse optimization, electron beam therapy, EPID-based quality assurance, intra-operative RT for breast, new plan checks, contour QA, reference dosimetry updates, SRS/SBRT small volume dose limits, and IGRT-based margins. Highlighted this year is a series of related "MR in RT" sessions across multiple Education and Scientific tracks that are intended to offer MRfocused education to both imaging and therapy physicists. The MR in RT session scheduled in the Therapy Education program will focus on MR image processing, registration and motion management that is commonly utilized in radiotherapy planning of brain, abdominal, and gynecological cancers. • In Memoriam of Michael Goitein: Milestones in Treatment

Planning, Biophysical Modeling, and Delivery of Proton Therapy [SAM] • In Memoriam of Bob Gorson: Radiation Programs in Medical Centers [SAM] • MR in RT: MR Image Processing, Registration and Planning in Radiation Therapy [SAM] • Clinical Implementation of Pencil Beam Scanning (PBS) Proton Therapy

• Personalized Electron Beam Therapy using Custom Treatment

Devices • Medical Physics 3.0 in Design & in Practice (Joint Therapy &

Imaging Session) [SAM] • Big Data in Radiation Oncology: Current Resources,

Technology & Emerging Strategies [SAM] • Electronic Charting in Radiation Oncology and Integration • • • • • • • • • • •

with Hospital EMR [SAM] Best Practices for Physics Plan and Chart Review: Report of AAPM Task Group 275 [SAM] Strategies for Quality Improvement Based on RO-ILS Information [SAM] Contour Quality Assurance & Decision Support (Primer for the Auto-Segmentation Grand Challenge) [SAM] Machine Learning in Medical Physics Changing paradigms for linac QA using EPIDS [SAM] Intra-Operative Radiotherapy (IORT): Breast and Beyond [SAM] HDR Brachytherapy: Interstitial Treatments for GYN (Panel Discussion) & Methods of Treatment Verification [SAM] Developments in Clinical Reference Dosimetry [SAM] SRS/SBRT: Clinical Implementation and Small Volume Dose Limits for Intra-cranial and Spine [SAM] Inverse Optimization Meets High Performance Computing [SAM] Clinical IGRT: In-room Technologies, Image Processing for Patient Alignment, IGRT Protocol Considerations and Informed Margins [SAM]

www.aapm.org/meetings/2017AM

Imaging Track

Practical Medical Physics

New this year are 6 hours of Joint Imaging / Therapy Education sessions that bridge professional specialties. This year's jointtrack topics are MedPhys 3.0 and Radiation Protection Programs.

The Practical Medical Physics Track offers presentations of use and interest to the practicing medical physicist.

• Multi-modality 4D Imaging: From Principles to Applications

• Statistical Failings that Keep Us in the Dark & Practical

• MR in RT: MR Pulse Sequences and Image Acquisition • • • • • • •

• • • •

(Including Radiation Therapy Applications) [SAM] EI DI Oh! Implementation and interpretation of the Exposure Indicator for Digital Radiography [SAM] A Concise Introduction to MRI [SAM] Best Practices in Pediatric Imaging [SAM] Anne and Donald Herbert Distinguished Lecture in Modern Statistical Modeling ALARA Debate General Nuclear Medicine [SAM] Advanced Breast Imaging: Stereotactic Breast Biopsy Updates and Contrast Enhanced Spectral Mammography [SAM] Implementation of the 2016 ACR Digital Mammography Quality Control Manual [SAM] Quantitative Multi-Energy Computed Tomography: Imaging and Therapy Advancements [SAM] How to select and evaluate a PET auto-segmentation (PETAS) tool - insights from AAPM TG211 [SAM] Computed Tomography Imaging: From the Order to Dose Monitoring and Review [SAM]

• Tailoring CT Protocols to the Patient's Age, Size, and Clinical

Scenario Statistics [SAM] • From the Trenches: Implementing the Changes of the New

MR QA Manual [SAM] • Identifying Image Artifacts, Their Causes, and Solutions [SAM] • MR in RT: Implementation in RT Planning and Delivery [SAM] • Compliance with AAPM, ACR, TJC Guidelines on CT Clinical

Practice [SAM] • An Interactive Safety Session for New Brachytherapy

Practitioners [SAM] • Good, Bad and Ugly of Patient Exposure and Dose Tracking

[SAM] • Perspectives in MRI Safety for Medical Physicists [SAM] • Improving Dose Prescriptions for Safety, Reporting, and

Clinical Guideline Consistency [SAM] • Management of Radiotherapy Patients with Cardiac

Implantable Electronic Devices [SAM] • DBT Quality Assurance: Medical Physicists Role, From

Equipment Evaluation to Soft Copy Image Display [SAM]

www.aapm.org/meetings/2017AM

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

AAPM Professional Survey The 2016 Professional Survey is available online. You can download a PDF from the web or have the document emailed to you. If you have any problems, please contact HQ.

Election Process Online Only! Elections for the 2018 Officers and Board Members-At-Large are now in process and will run through July 12. The election process will be online only so be alert for email announcements.

Did You Know……

AAPM Reports Authored Included in Membership Directory Listing Ever want to find an AAPM Report, don’t remember all the details, but remember the name of one of the authors? AAPM now includes “AAPM Reports Authored” in the AAPM Membership Directory listing of each AAPM Member. Log in and check it out!

AAPM Has an Audit Committee and Has an Independent Audit Performed Yearly AAPM created an Audit Committee that reports to the Board of Directors over 10 years ago in an effort to foster a governance structure of accountability. The primary function of this group is to monitor the integrity of AAPM’s financial reporting process, the appropriateness of the organization’s accounting policies and internal controls, and the independence and performance of the independent auditors. AAPM’s Audit Committee, chaired by Jennifer Johnson, met at AAPM HQ on June 6 and will provide a report to the Board at the August 3 Board of Director’s meeting in Denver. AAPM audit reports going back to 1992 are available online.

Career Services AAPM offers webinars geared towards assisting scientists in their career development. Please see below a list of upcoming events as well as links to the recorded versions of previous webinars.

Upcoming Webinars

July 20, 2017: A Mid-Career Change? No Problems, Only Opportunities Changing course in the middle of your career may be a bit scary, but it can also be strategic. Whether you are shifting employers, taking on new tasks, moving to a new city, or changing careers altogether, there are a number of steps you can take to ensure that you achieve your goals in an efficient and satisfactory manner. The webinar will focus on developing the strategy and employing the tactics to find an opportunity that is right for you, go after it, complete a smooth transition, and maintain a stellar reputation in and after the process. Let’s prepare you for your new adventure! Continued, page 15

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PROFESSIONAL PROGRAM The Professional program is devoted to the professional aspects of the Medical Physics Career and is highlighted by a leadership session entitled “Leading from the Middle.” Other symposia cover topics include medical physicist assistants, legal issues for medical physicists, economics, training, and ethics. The international symposium highlights advanced training techniques beyond North America. For those who are new to the profession of Medical Physics there is a new member symposium and sessions on navigating the board certification process. • Advanced Training of Medical Physicists Beyond North • • • • •

America Recent Medical Physics Practice Guidelines and Your Delivery Path [SAM] Recent Changes to the ABR MOC Process Physicists’ Roles and Workload for NCTN (National Clinical Trials Network) Clinical Trials [SAM] MR in RT: Professional Requirements for Physicists in MRI Guided Radiation Therapy [SAM] What to Do: Medical Physicist Assistants

• Leading from the Middle [SAM] • New Member Symposium • Code of Ethics: Practicing Our Values [SAM]] • Economic Issues in Medical Physics • History Symposium – Radionuclide Therapy: Dr. Saul Hertz to

Present • Diagnostic Workforce Study Report • Adult Learning (Andragogy) Techniques for Medical Physics

[SAM] • In Memoriam of Ann Wright: Panel Discussion – Promoting

Diversity Through Active Mentoring • Session in Memory of Alex Turner: Medical Physics Journal

Workshop • Panel Discussion: Mentor and Mentee Roles [SAM]] • Question Writer Workshop • Intellectual Property Law for the Medical Physicist • How to Prepare for and Navigate the Board Certification

Process in Diagnostic and Nuclear Imaging • Navigating the Board Certification Process: Therapy Physics

PARTNERS IN SOLUTIONS This is the 3rd year that the joint AAPM-exhibitor program, Partners in Solutions (PinS), has been held at the Annual Meeting. PinS continues to offer a unique way for AAPM members to interact with and learn from our exhibitors by providing an exhibitor led, physics-level applications training session in a specially design lecture room on the exhibit floor. In these topic-specific sessions, exhibitors will provide a

“marketing free” but practical “how it works” presentation on their latest, commercially available technology. This year’s imaging topic is Metal Artifact Reduction and the therapy topic is In Vivo/Transmission Detection Systems. CE Credits will be offered. Come and experience this great series!!

EXHIBIT HALL GUIDED TOURS The Educational Topic Specific Guided Tours, which are held in the Exhibit Hall, offers a new way for you, the attendee, to interact with our exhibitors and earn (1.0-1.5hrs) of SAM credit in the process. First, you attend a short introduction by an AAPM-member Tour Leader on the selected topic – Secondary Dose Calculation Programs for Therapy or Quality Assurance Phantoms for Diagnostic Imaging. Then you follow a AAPM-

member Tour Guide to the participating exhibitors’ booths, where the exhibitor will present detailed information about the solution(s) they offer. It’s an interesting and fun way to get a comprehensive overview of the products available on the market to address the clinical needs of your facility. Please note – Pre-Registration is required.

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Executive Director, cont.

October 19, 2017: Bounce Back from a Career Challenge Registration for this event will open in late September 2017. We all face challenges at some points in our careers, whether we have been laid off, need to leave our current position due to either positive or negative stimuli, are looking for a promotion, or are eager to work in a completely different field or profession. But no matter the challenge, scientists have the competitive advantage to manage, survive and thrive because of their innate problem solving skills. This webinar will address how to manage a career challenge and tackle it using strengths. The webinar will also explore options for handling especially challenging situations, like zombie bosses (who steal your work or malign your reputation) or a desire to make a mid-career change, and chart a strategic course to achieve your goals.

Recorded Webinars Successfully Navigating the International Job Search Outstanding Oral Presentations Presenting a Winning Poster Transitioning Your Career Beyond Academia Identifying and Seizing Value from Conference Participation I Am About to Graduate – What on Earth Do I Do Now? Beyond the Residency Match: Options and Strategies for Next Steps The Interview: What You Need to Do Before, During, and After to Get the Job Network Yourself to a Great Career

New AAPM Publications

Two new Medical Physics Practice Guidelines are available online: •

AAPM Medical Physics Practice Guideline 6.a.: Performance characteristics of radiation dose index monitoring systems; and,

•

AAPM Medical Physics Practice Guideline 8.a.: Linear accelerator performance tests

New AAPM Report: •

An Updated Description of the Professional Practice of Diagnostic and Imaging Medical Physics: The Report of AAPM Diagnostic Work and Workforce Study Subcommittee is now available on the AAPM Reports list.

AAPM and ASTRO Leaders Meet Members of AAPM’s Executive Committee and ASTRO Board of Directors met on May 2 to discuss matters of mutual interest. Highlights include an update on the Radiation Oncology Incident Learning System (RO-ILS), details on the transition of staff support of Integrating Healthcare Enterprise - Radiation Oncology (IHE-RO) from ASTRO to AAPM, concerns about radiation oncology funding and opportunities for collaboration with IAEA. This yearly meeting of AAPM and ASTRO leaders acknowledges the complimentary missions of the organizations, reflecting the close professional relationship between medical physicists and radiation oncologists.

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Executive Director, cont.

#AAPM2017 — Annual Meeting News Connecting Our Pathways. Unifying our Profession.

Get your attendance approved now with the Attendee Justification Toolkit! Find supportive information to give to your supervisor and share our prewritten letter with all the benefits. Print and share with the individual who authorizes your travel. Tuesday, August 1 from 9:30 AM – 11:00 AM is dedicated time to Visit the Vendors. No sessions are scheduled to conflict during this time so make sure to visit the Exhibit Hall. An online Buyers Guide is available, with information about the exhibiting companies. Exhibit hours are: •

Sunday, July 30 – 12:30 – 5:00 PM

•

Monday, July 31 – 9:00 AM – 5:00 PM

•

Tuesday, August 1 – 9:00 AM – 5:00 PM

•

Wednesday, August 2 – 9:00 AM – 2:00 PM

Make plans to attend the 2017 Annual Business and Town Hall Meeting on Wednesday, August 2 from 6:15 PM – 7:30 PM in the Four Season 2 room of the Colorado Convention Center. The Governance Quality Improvement Project and proposed changes to AAPM’s By-Laws will be discussed. AAPM's President and Treasurer will report on the status of the organization. What should AAPM be working on? How can the organization better serve you? Members of the AAPM Board of Directors want to hear directly from the membership. Here's your chance to be heard. Taking a lesson from the successful format of the 2016 Night Out, the 2017 Night Out will not be a dinner event. Instead, you are encouraged to meet your colleagues at the venue for limited light snacks and then make your way to one of the many restaurants in the area for dinner. Or, dine first and make your way to the event for a bite of something sweet at the end of the evening! AAPM will take over the entire Denver Art Museum, with 70,000 works of art divided between 10 permanent collections including African, American Indian, Asian, European and American, modern and contemporary, pre-Columbian, photography, Spanish Colonial, textile, and western American art. For those who like to dance, head to Ponti Hall to hear classic rock covers by the Kory Brunson Band. Each adult Night Out ticket will include 1 drink ticket, good for beer or a glass of wine. Again, you will be disappointed if you come to the Night Out expecting a meal. Please make your plans in advance and dine at a restaurant of your choice and favorite cuisine! We have compiled a list of restaurants and encourage you to either make reservations on your own, or with help from the restaurant desk at the Convention Center.

RSNA 2017 — Explore. Invent. Transform. Register now for the RSNA 103rd Scientific Assembly and Annual Meeting, November 26 – December 1. Reminder AAPM’s Headquarters Hotel is the Hyatt Regency Chicago located at 151 E. Wacker Drive.

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Executive Director, cont.

AAPM HQ Team…at Your Service! While all the members of the AAPM HQ team play an important role in the meetings and programs processes, the Meetings and Programs Department are the leads in many of the major responsibilities. As we prepare for the 2017 Annual Meeting, I wanted to introduce you to the association management professionals supporting the effort. Lisa Rose Sullivan will celebrate her 24th Anniversary as a member of the AAPM team later this year. She joined the staff in November 1993 as Projects Coordinator and was one of the original five Maryland staff members hired when the AAPM HQ offices relocated from NYC to College Park, Maryland. Lisa was promoted to Exhibits and Scientific Program Manager in 1998 and then to the management team as Director, Meetings and Programs in 2005. Lisa oversees the meetings and programs operations and manages the 8-person team. She also serves as the staff liaison to the Education Council. Nancy Vazquez joined the HQ Pictured top row, left to right: Jaime Hoza, Phyllis Doak, Nancy Vazquez, Karen MacFarland, team as the 6th staff person in 1996, Corbi Foster; bottom row, left to right: Rachel Smiroldo, Laurie Allen, Jackie Ogburn, serving as the Receptionist. She was Lisa Rose Sullivan promoted to Programs Manager in 1998 and took on the responsibility of managing the registration processes for the various AAPM-managed meetings. In 2007, the production of the AAPM newsletter was brought in house, with Nancy working directly with Editor Clements to produce the bi-monthly publication. Nancy is also the staff liaison to the Awards and Honors Committee, manages the Awards and Honors nomination process and plans the yearly Awards and Honors Ceremony and Reception. Earlier this year, Nancy took on the program management for AAPM’s report process. Karen MacFarland, Senior Meetings and Programs Manager, joined the team in 2003. Karen handles the meeting negotiations and logistics for many of the association meetings scheduled throughout the year, including the Annual Meeting and the Summer School. In 2007, she passed the Convention Council Industry exam to become a Certified Meeting Planner (CMP). Corbi Foster joined AAPM in 2007 as Meetings and Programs Manager. She handles the meeting negotiations and logistics for the Spring Clinical Meeting. Corbi is also responsible for the arrangements for AAPM committee meetings at the Annual Meeting and during RSNA and ASTRO. Along with Karen, Corbi shares the responsibility for overseeing specialty meetings.

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Executive Director, cont.

Laurie Allen joined the team 2007 as the Customer Service Representative. Later that same year, she was promoted to the newly created position of Programs Assistant, overseeing the meeting program development and abstract submission processes for the Annual Meeting, Spring Clinical Meeting and specialty meetings. In 2014, Laurie was promoted to Programs Manager in recognition of her increased level of responsibility in the overall meeting program management process. When Laurie was promoted in 2007, Jackie Ogburn was hired to fill our Customer Service Representative position. In 2008, Jackie was promoted to the newly created position of Education Assistant and in 2011 was promoted to the position of Education Manager. Jackie oversees the operational aspects of the Associationâ&#x20AC;&#x2122;s educational activities, including the Online Learning, SAMs and Virtual Library programs. She also manages the AAPM grants and funding opportunities and provides staff support to CAMPEP. Rachel Smiroldo started as a summer intern with the AAPM in 2010. Upon her graduation from college in 2011, she joined our staff as the Exhibits and Meetings Assistant. Rachel coordinates the exhibit programs for both the Annual and Spring Clinical meetings and assists with the registration processes for all meetings. Phyllis Doak was hired in 2015 to develop and implement a Corporate Partnership Program for the AAPM. In her role as Corporate Relations Manager, Phyllis is building strong constituencies through sound outreach, establishing cultivation efforts and solid program management. She oversees the delivery of partnership benefits and tracking satisfaction levels. Jaime Hoza, Meetings and Programs Assistant, celebrated her 1-year anniversary as an AAPM team member in January. Besides assisting with planning processes of the Annual Meeting, Summer School, and Spring Clinical meetings, Jaime coordinates logistics for the numerous in- house meetings at the HQ office.

Headquarters News

Aaron Rudd joined the AAPM HQ team in May as the Office Services Assistant. Aaron hails from Mississippi but traveled the world during his 8-year service in the US Navy where he served in administrative roles.

Staff Recognition 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 following AAPM team members celebrated an AAPM anniversary in the first half of 2017. I want to publicly thank them and acknowledge their efforts. n Nancy Vazquez........................... 21 years of service Jennifer Hudson......................... 16 years of service Zailu Gao.................................... 16 years of service Karen MacFarland...................... 14 years of service Lisa Schober............................... 12 years of service Laurie Allen................................. 10 years of service Viv Dennis................................... 7 years of service

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Melissa Liverpool........................ 6 years of service Rachel Smiroldo.......................... 6 years of service Shayna Knazik............................. 3 years of service Richard Martin............................. 2 years of service Robert McKoy............................. 3 years of service Jaime Hoza................................. 1 year of service

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

s I pass the mid-way term as your Treasurer, I want to share (in my 10th column) information about the type of budget and the budget process that AAPM undertakes each year. As committee members are gearing up for the Annual Meeting, many are also beginning to develop budget requests for their corresponding committee activities for the following year. The AAPM budget process starts with requests from various committees, submitted through their chairs to their respective councils, and eventually tabulated by the Finance staff for preparation of a tentative budget. The contingent budget is submitted to the AAPM Finance Committee to finalize the eventual budget. The Finance Committee is chaired by the Treasurer and includes voting and non-voting members as well as AAPM staff members. Non-voting members include all the council chairs and committee members and is supported by the AAPM staff (Executive Director and Director of Finance). The AAPM Finance Committee meets in mid-October to review and generate the following year’s budget that is then presented to the Board of Directors for approval. AAPM’s budget is historically a deficit budget based on the explanation outlined below. In addition, reasons for having a deficit and other budget types are discussed below.

Why a Deficit Budget? One of the key components of sound fiscal planning is an organization’s operating budget. The budget facilitates planning and control in an organization by detailing the planned revenues and expenses of an organization for the year. The budget also serves as an effective evaluation tool as management monitors its actual progress during the course of the year against budgeted plans. Once a budget is complete, there are different approaches to budgeting. Three types of budget are:

(1) Balanced Budget

Budgeted Revenues = Budgeted Expenses

In a balanced budget scenario, budgeted revenues equal budgeted expenses. Therefore, from a budgeting perspective, no change is planned in Net Assets for the year. Some organizations, based on their operating guidelines, are required to have a balanced budget. While other organizations use a balanced budget approach as it is very “mission friendly.” All mission related revenue is spent on mission expenditures without building up reserves nor dipping into operating reserves.

(2) Surplus Budget

Budgeted Revenues > Budgeted Expenses

In a surplus budget scenario, budgeted revenues exceed budgeted expenses. The surplus creates an increase in Net Assets and is often used by organizations seeking to build its reserves.

(3) Deficit Budget

Budgeted Expenses > Budgeted Revenues

In a deficit budget scenario, budgeted expenses exceed budgeted revenues. When an organization operates on a budget deficit it must dip into its reserves or use credit to cover expenditures not covered by revenues. Therefore,

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Treasurer, cont.

operating in a budget deficit is not a long-term strategy. However, it can effectively be used in the short-term to address a short-term reduction in revenue while still meeting mission objectives, expending funds under a grant where the revenue was recognized in a previous period and to address a specific plan of increased costs to achieve certain mission objectives. On an annual basis, AAPM prepares a deficit budget. However, AAPM is in a very unique situation in that it does not prepare a deficit budget for the reasons previously outlined. In fact, AAPM prepares a deficit budget with the express intent of achieving a break-even status where actual expenses equal revenue at year-end (as is demonstrated by the final AAPM financial statements over the past years). Included in the AAPM annual budget are many programs and initiatives. As a volunteer-driven organization, AAPM relies upon the efforts of its volunteers to achieve its mission objectives. If not for the deficit budget, many of the programs/ activities proposed by the AAPM volunteers could not be accommodated. Frequently, for a variety of circumstances, some of these planned initiatives are not completed and as a result, funds allocated towards the project are not spent. The AAPM budgeted deficit is not merely a shot-in-the-dark. AAPM’s Finance Department has prepared a statistical model that analyzes historical data of AAPM’s budgeted revenues and expenses vs. actual revenues and expenses. Based upon historical differences between the budgeted vs. actual results from operations, the model identifies a targeted deficit that will allow AAPM to break-even for the year. The targeted deficit is modified to take into consideration the loan covenants financed the building purchase through the bank. The goal of the AAPM budget deficit is to budget for as large of a deficit as possible in order to maximize mission expenditures, achieving mission objectives while still being fiscally conservative. This meets both organizational fiscal objectives and the loan covenants established by the bank that has financed the Headquarters. For the reasons listed above, AAPM generates a deficit budget for the operational activities of the organization. If you have any questions related to this column please feel free to reach out to me by email, Twitter, or call me at 410-955-5115. [I would like to thank Robert A. McKoy, AAPM Director of Finance, for his contribution of the subject matter to this column.] n

Our Condolences Helmar S. Janee, MS • Constantine (CJ) J. Maletskos, PhD • Yu Chen, PhD • James Kereiakes

Our deepest sympathies go out to their families. 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: 2017.aapm@aapm.org Please include supporting information so that we can take appropriate steps.

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

his issue of the Newsletter is being published just before the AAPM 2017 Annual Meeting which takes place July 30 – August 3, 2017 in Denver, CO. All of us are getting prepared for this event, and I am sure we are going to have an interesting week, full of presentations and meetings advancing our science, education, and professionalism. This event is advertised by our website, as well as our various Social Media presences, especially our Twitter presence. The AAPM Information Services (IS) staff has created a channel in Twitter with the hashtag #AAPM2017. It is recommended to use this hashtag when posting conference’s related content to social media sites. The aim of a discrete hashtag every year is to facilitate searching for all tweets related to the Annual Meeting. IS staff will post information about interesting events, talks, information for the Annual Meeting, so please stay tuned for useful updates. Many of our Association’s Committees, Subcommittees, Task Groups and Working Groups will meet during the Annual Meeting in Denver, CO, and will work together for the advancement of their groups. The Website Editorial Board will meet during AAPM 2017 on Saturday, July 29 4:00 – 6:00 PM in the Granite A room on the third Floor of the Hyatt Regency Denver at Colorado Convention Center. There is always space for members interested in knowing what we do firsthand or who possibly want to join. Please stop by! With regard to our Social Media presence, I am pleased to report that as of June 6th, 2017 we have 41,905 images posted to AAPM’s flickr, 5,881 likes on Facebook, 9,997 members on LinkedIn, 4,161 followers on Twitter and 104 followers on Instagram. Please, do not hesitate to contact us should you need any further clarification about the policy and the guidelines for posting any material in the AAPM social media pages. I hope you find the AAPM website useful, visit it often, and send me your feedback. n

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The Student and Traineeâ&#x20AC;&#x2122;s Subcommittee and the Working Group to Promote Non-Clinical Career Paths for Medical Physicists (WGNCMP) present the

2 ANNUAL CAREER EXPO ND

Student Day July 30, 2017 | 11:30 amâ&#x20AC;&#x201C;1:00 pm This event brings students, trainees, and new medical physicists together with physicists who are currently employed within a non-clinical setting. We are looking to gather employers who regularly hire medical physicists for positions within industry, regulation, and research in one convenient location. Our aim is to to help connect employers with students and trainees to discuss the wide range of careers and opportunities available within non-clinical medical physics. There is no fee to register and

employers may bring as many representatives (physicists ideally) as you would prefer. To register your company, please fill out this Google Form as soon as possible as space is limited. For more information, please e-mail Humza Nusrat or Kurt Van Delinder. (Lunch will be provided for employer representatives.)

We look forward to seeing you in Denver!

FOR MORE INFORMATION, VISIT: www.aapm.org/meetings/2017AM/AssociationMtgs.asp

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

ABR NEWS Geoffrey Ibbott, PhD, ABR Board of Governors, Jerry Allison, PhD, J. Anthony Seibert, PhD, and Matthew B. Podgorsak, PhD, FAAPM, ABR Trustees

ABR Trustees’ Opinion: The Value of MOC for Medical Physicists The American Board of Medical Specialties (ABMS) was formed in 1933, in part to support the professional development of physicians by setting standards that define competency in clinical care and to verify through the board certification process that individual specialists meet these standards. A secondary but also important role for the ABMS was to provide information to the general public concerning the certification status of individual practitioners. The vast majority of medical professionals today agree that board certification is an important step in the professional development of any practitioner who will be involved in patient care. Indeed, AAPM defines a “qualified medical physicist” as one who, among other criteria, holds board certification in the subfield in which he or she practices clinically (Professional Policy 1-H, “Definition of a Qualified Medical Physicist.” By design, the board certification process that leads to initial certification confirms that a certified individual meets minimal standards that define safe and meaningful delivery of clinical care. Clearly, these standards evolve as a result of technological advances and improvements in the knowledge base associated with a medical specialty. This is especially true for those specialties, like medical physics, that are highly technologically driven. Therefore, documenting minimal competence at the time of initial certification may not be a good indicator of one’s continued competence with new technologies developed many years later. For board certification to continue to indicate minimal competence throughout a practitioner’s career, some sort of ongoing evaluation of competence is needed. ABMS officially recognized this in 2000 when it mandated that all of its 24 member boards stop issuing “lifetime” certificates. In parallel, ABMS directed member boards to implement Maintenance of Certification (MOC) programs that enable continued evaluation of the six competencies associated with initial certification: medical knowledge, patient care and procedural skills, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice and The Six Compentencies for Medical Physics. The ABR last issued lifetime certificates in 2001, and, starting in 2002, certificates were valid for 10 years only. During this time, the ABR began the process of developing an MOC program as a pathway for board-certified medical physicists to remain certified throughout their careers. In 2012, 10-year certificates were discontinued, and the ABR moved instead to “Continuous Certification,” where ongoing validity of certification depends on meeting the requirements of the MOC Program. To be a meaningful indicator of continued competency in clinical care and thus bring value to the general public, an MOC program should, at a minimum, allow ongoing verification that a practitioner has command of the current treatment techniques and technologies associated with contemporary standards of care. The required level of competency should be on par with the standards that those attempting initial certification at that point in time need to meet. Moreover, a well-structured MOC program should bring value to diplomates by providing a means whereby they can continue professional development throughout their careers. The ABR’s MOC Program was designed to satisfy both

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ABR, cont.

goals above. It comprises a four-part framework that evaluates on a continuous basis the six competencies mentioned above, which define clinical practice:

Part 1: Professionalism and Professional Standing Part 2: Lifelong Learning and Self-Assessment Part 3: Assessment of Knowledge, Judgment, and Skills Part 4: Improvement in Medical Practice

To meet the requirements of the ABR MOC Program, a medical physicist must document: • • •

current practice in the subfield in which he or she is certified (Part 1), familiarity with contemporary practice through continuing education and evaluation (Parts 2 and 3), and commitment to improving patient care (Part 4).

Meeting the ABR MOC requirements, therefore, provides ongoing evaluation and documentation of a medical physicist’s command of contemporary techniques and technologies. Furthermore, participating diplomates receive feedback regarding their expertise with state-of-the-art technology, and any deficiencies can be addressed through focused selfstudy and follow-up evaluation. It is not possible to know for certain whether or not an MOC program improves clinical care. In fact, some of our clinical colleagues, mostly in other medical specialties, have proposed arguments to suggest that at best, there is no value, and at worst, participating in an MOC program may actually distract specialists from providing quality care. To the contrary, we believe that based on its careful design, the ABR MOC Program is meaningful and enhances the quality of care provided by participating medical physicists. While many ABR diplomates with lifetime certificates who do not participate in MOC nonetheless engage in various continuing education activities throughout their careers, there is no systematic methodology or uniformly enforced professional obligation for them to do so. Therefore, there are likely practicing medical physicists who base their qualifications on board certification awarded many years or decades earlier, but who have not remained current with their skills and knowledge. On the other hand, a medical physicist who is meeting the requirements of the ABR MOC Program is very likely to be knowledgeable about state-of-the-art imaging, as well treatment techniques and associated technologies, given that contemporary cognitive expertise and lifelong learning are explicitly evaluated through the ABR MOC Program. Most would agree that a medical physicist meeting MOC requirements has the potential to make more effective contributions to patient care than a medical physicist who has not remained current. This fact alone suggests very strongly that over time, the ABR MOC Program will enhance clinical care since the proportion of medical physicists who participate in the program will increase over time. The value of the ABR MOC Program, however, is not defined solely through fewer “non-current” medical physicists practicing as a result of attrition of lifetime certificate holders. One could argue that simply completing some quantity of CME activities annually would be sufficient to enable maintenance of competency and knowledge of contemporary technologies. While lifelong learning and self-assessment are one component of the MOC framework, it is not possible to evaluate all aspects of professional clinical practice through simple CME. It is necessary to more rigorously evaluate cognitive expertise throughout one’s career by providing useful feedback to the diplomate on his or her knowledge and skills, enabling focused continued learning on those topics identified as problem areas. The ABR MOC Program is designed to provide this feedback, thus enhancing the professional development of diplomates and giving them the best possible chance to provide high-quality care throughout their careers.

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ABR, cont.

Finally, in order to remain current and meaningful into the future, the ABR MOC Program undergoes continual review and revision by the ABR Board of Governors and the ABR Board of Trustees. Recent results of this self-study process include: (1) simplified attestation of Professional Standing; (2) simplified attestation of Lifelong Learning and Self-Assessment; (3) replacement of the written decennial MOC exam associated with Part 3 of the framework by a more continual evaluation of cognitive expertise (Online Longitudinal Assessment, or OLA), which provides meaningful and direct feedback to diplomates; and (4) implementation of an increase in the scope of how medical physicists can meet requirements for Part 4 of the framework (Participatory Quality Improvement Activities). As professional standards and societal expectations regarding the competence of healthcare providers continue to evolve, we anticipate further enhancements will be made to the ABR MOC Program to enable it to continue to meet the needs of our patients and diplomates into the future. n

LOOKING FOR A NEW JOB? LOOKING FOR A NEW HIRE?

n addition to attending the many sessions and social events, the Annual Meeting offers an on-site Career Services recruitment connection to job seekers and employers alike, including paper resume and job posting boards and a convenient interview room. Be sure to stop by the Career Services area outside the entrance to Exhibit Hall A in the Denver Convention Center.

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www.aapm.org/careers

And, as always, visit the online Career Services site for the latest job postings and career resources available to members!

THE AAPM EXPANDING HORIZONS

Travel Grant

TYPE: Grant OPEN: 5/1/17 DEADLINE: 9/1/17 NOTIFICATION: 10/6/17 APPLICATION MATERIALS TO BE SUBMITTED • Personal statement describing long term career goals, motivation to attend the selected meeting, and expected scientific value of attendance on the applicant’s dissertation project or future research (2 pages maximum). •

Curriculum Vitae.

•

Letter of recommendation from the applicant’s supervisor or department head confirming that additional travel expenses will be covered.

•

Budget indicating expected expenses.

THE AAPM EXPANDING HORIZONS TRAVEL GRANT will award up to fifteen $1,000 travel grants per year for the purpose of providing additional support for student and trainee travel to conferences that are not specifically geared toward medical physics. The travel grant program is designed to provide an opportunity to broaden the scope of scientific meetings attended in order to introduce students and trainees to new topics which may be of relevance to medical physics research and which may subsequently be incorporated into future research in order to progress the field in new directions. ELIGIBILITY CRITERIA • Must be a member of AAPM in good standing at the time of application •

Must be a current graduate student, post-doctoral candidate, or resident

•

Proposed meeting must not be specifically-related to medical physics

•

Examples of ineligible conferences include: • AAPM Annual Meeting • AAPM Spring Clinical Meeting • AAPM Chapter Meetings • American Society for Radiation Oncology (ASTRO) Annual Meeting • Radiological Society of North America (RSNA) Annual Meeting • Any meeting that the applicant’s group is regularly attending, this will be judged on a case-by-case basis.

•

Examples of eligible conferences include: • American Physical Society (APS) Annual Meeting • Biophysics Society (BPS) Annual Meeting • Physical Sciences in Oncology Centers (PSOC) Annual Meeting • Radiation Research Society (RRS) Annual Meeting • World Molecular Imaging Conference (WMIC)

APPLICATION PROCESS • APPLY AT: gaf.aapm.org • DIRECT INQUIRIES: exhg@aapm.org

American Association of Physicists in Medicine | www.aapm.org

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

he Nuclear Regulatory Commission Advisory Committee on the Medical Uses of Isotopes (ACMUI) held their Spring meeting on April 26-27, 2017, at NRC headquarters in Rockville, Maryland. Items discussed included physical presence requirements for the Leksell Gamma Knife® IconTM, Category 3 source security and accountability evaluation initiatives, and training and experience requirements for authorized individuals. Elekta requested the ACMUI to consider recommending changing physical presence requirements for the newest Gamma Knife model to allow the authorized user to leave the console after initiation of treatment, but remain immediately available in the department. Under the Elekta proposal, the authorized medical physicist would remain at the console for the entire duration of treatment. Elekta reasoned that this change could be made without adverse safety consequences because of the new model’s high level of automation, built-in redundancy for safety, and motion management tracking system. The ACMUI is considering this request. The Subcommittee on Training and Experience Requirements for all Modalities presented a report outlining a methodology for periodically reviewing training and experience requirements. The subcommittee proposed to assess each modality by looking at medical events, radiation safety events and patient access to treatment. In addition, review would assess competencies required for provider to consistently administer safe, reliable care. The ACMUI also explored how medical event reporting may impact medical licensee patient safety culture. The subcommittee addressing that issue will present a report at the Fall meeting identifying specific options the NRC may take to encourage a licensee’s patient safety culture while maintaining its regulatory authority to protect patients. Additional information about this meeting is here. n

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PLANNING TO ATTEND

RSNA 2017?

Be Sure to Book Your Room at the AAPM Headquarters Hotel:

The Hyatt Regency Chicago 151 E. Wacker Drive AAPM Meetings and Annual Reception will be held at the Hyatt Regency Chicago RSNA 103rd Scientific Assembly and Annual Meeting November 26 â&#x20AC;&#x201C; December 1, 2017 Chicago, IL

July 18: Online Program Opens!

AMERICAN ASSOCIATION OF PHYSICISTS IN MEDICINE | WWW.AAPM.ORG

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

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 Protecting Access to Medicare Act (PAMA) included requirements that health care providers comply with the National Electrical Manufacturers Association (NEMA) XR-29 Standard Attributes on CT Equipment Related to Dose Optimization and Management, also known as MITA Smart Dose. The Centers for Medicare and Medicaid Services (CMS) is responsible for implementing the law and their regulations went into effect on January 1, 2016. The following questions discuss the ACR’s most recent guidance on this topic. See the ACR’s NEMA XR-29 (MITA Smart Dose) Standard: Frequently Asked Questions for more information. Q. What is XR-29? A. The NEMA XR-29 standard (MITA Smart Dose) specifies four attributes of CT scanners that “contribute to or help perform optimization and or management of doses of ionizing radiation while still enabling the system to deliver the diagnostic image quality needed by the physician.” CT scanners meeting the XR-29 Standard have the following: •

DICOM-compliant radiation dose structured reporting. See NEMA XR 29-2013 (Standard Attributes on CT Equipment Related to Dose Optimization and Management) and the DICOM website.

•

Dose check features. See NEMA XR 25-2010 (Computed Tomography Dose Check).

•

Automatic exposure control. See NEMA XR-28-2013 (Supplemental Requirements for User Information and System Function Related to Dose in CT).

•

Reference adult and pediatric protocols. See NEMA XR-28-2013 (Supplemental Requirements for User Information and System Function Related to Dose in CT).

Q. How will noncompliance with XR-29 standards be verified? A. According to the Medicare Claims Processing Manual, Chapter 12 – Physician/Nonphysician Practitioners, (issue 1-616) 20.4.7: “The statutory provision requires that information be provided and attested to by a supplier and a hospital outpatient department that indicates whether an applicable CT service was furnished that was not consistent with the NEMA CT equipment standard...The statutory provision also provides that such information shall be verified, as appropriate, as part of the periodic accreditation of suppliers under SSA section 1834(e) and hospitals under SSA section 1865(a).” (See CMS Transmittal #3402, section 20.4.7.)

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

ACR Accreditation, cont.

Q. Our facility is accredited in CT with the ACR. How will ACR verify that our CT scanners do or do not comply with the XR-29 standards? A. The statutory provision for XR-29 provides that “such information shall be verified, as appropriate, as part of the periodic accreditation of suppliers under SSA section 1834(e) and hospitals under SSA section 1865(a).” (See CMS Transmittal #3402, section 20.4.7.) The ACR is currently asking its accredited facilities for a copy of each CT unit’s Certificate of NEMA XR-29 Compliance. Going forward, the ACR will request copies of Certificates of NEMA XR-29 Compliance for each unit as part of the routine accreditation application and renewal process. Once CMS provides accrediting organizations with final criteria and procedures to verify and report CT system compliance with XR-29, the ACR will share that information with our accredited facilities. Q. Are there published requirements for who may prepare certificates of NEMA XR-29 Compliance? A. No. If you have questions regarding certificate compliance, please contact CMS. Q. Our CT scanner meets some but not all of the four XR-29 provisions. Must our scanner meet all of the XR-29 provisions in order to obtain full reimbursement? A. Yes, your scanner must meet all of the following XR-29 provisions in order to obtain full reimbursement. •

DICOM-compliant radiation dose structured reporting.

•

Dose check features.

•

Automatic exposure control.

•

Reference adult and pediatric protocols.

Q. Our CT scanner manufacturer has informed us that they are unable to upgrade our scanner so that it is compliant with XR-29. May we modify our CT scanner with a commercial 3rd party solution to meet XR-29 compliance? A. Possibly. Please contact CMS to discuss. n

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AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

HEALTH POLICY & ECONOMIC ISSUES Blake Dirksen, MS, Coralville, IA

roperly coding the work performed in radiation oncology is very complicated. It is impossible to cover every clinical scenario or treatment approach in a series of CPT procedure codes. However, it is important that we endeavor to comply with coding rules to ensure fair and stable reimbursement of our services. AAPM works with ACR and ASTRO to manage the CPT code descriptors and assist members on coding issues, including fielding member questions. The AAPM Professional Economics Committee felt it would be beneficial to share some of the frequently asked coding questions and our answers. Often, clinical situations present themselves that are not perfectly described by the existing CPT code set or are subject to payment policies of regional and local payers. In these gray areas, department leadership should evaluate their individual situation to determine department policy. 1.

What date should an isodose plan charge be reported? The work of developing a treatment plan includes multiple steps and multiple individuals and is typically performed over multiple days. It is not practical or required that the work be performed and documented on the same day. It is common within many practices that there will be one date on the document, the medical physicist will sign on another date, and the physician will potentially sign on a third date. It is ASTRO's recommendation (not a requirement) that the charge should be submitted on the date the plan is signed by the physician but what is most important is that the department leadership determine a policy and consistently follow it. For example, medical physics plan review or patient specific IMRT quality assurance (QA), do not have to fall on the day the planning charges are billed. Also, physics plan review and patient specific IMRT QA do not require the direct supervision of a physician. It is important that you have a consistent policy developed by your leadership team that puts patient safety first when developing workflows. If you encounter issues with this topic please reach out the AAPM Professional Economics Committee and we will try to assist.

We perform diode checks or EPID in vivo dosimetry on the first day of treatment to verify the treatment delivery and machine output. For the calculation associated with this check can we bill a basic radiation dosimetry calculation (CPT 77300) or special dosimetry (77331)? If not, what code would be recommended for this check? Measurements obtained for quality assurance purposes are not separately reportable. A special dosimetry charge (CPT 77331) can be used if there is a specific clinical reason other than routine quality assurance for a particular patient case. What day should we bill the weekly chart check? The day of the 5th fraction or the date we complete the chart check? Do we have to perform the chart check during clinical hours? Billing the chart check either weekly or every fifth fraction is acceptable, but it is important to be consistent. For the continuing medical physics consultation (CPT 77336) it is important to note that the work involved covers much more than the weekly chart review. This means that the work performed occurs throughout the week. Therefore, the billing

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AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

Health Policy, cont.

of CPT 77336 is not required to occur on the day of the chart review but can be if that is your department policy. The continuing medical physics consultation charge covers a series of up to five fractions and at least three fractions are required to bill one CPT 77336 code. For example, if a patient has a total of 18 fractions, a maximum of four CPT 77336 codes may be reported. If a patient has 16 fractions, a maximum of three CPT 77336 codes may be reported because the fourth series of treatments includes only one fraction. The work of CPT 77336 includes consultation with the physician and communication with the clinical team. The medical physicist should have significant physical presence in the department during the week and ideally when performing the chart review to facilitate communication of issues found or to follow up with questions. It is important that you have a consistent policy developed by your leadership team that puts patient safety first when developing chart review workflows. 4.

Can you bill for complex simulation if the patient is getting IMRT treatment? The same question applies to SRS/SBRT. You cannot bill a complex simulation code (CPT 77290) as part of the simulation and planning for a course of IMRT treatment. The work of a complex simulation (CPT 77290) is included in the work of the IMRT planning code (CPT 77301). You may bill a complex simulation (CPT 77290) for SRS or SBRT if it meets all the criteria of a complex simulation and IMRT planning is not utilized.

Can you bill for image fusion? Yes, if a medical physicist is directly involved with the image fusion and generates a custom report for each patient case then you may report a special medical radiation physics consultation (CPT 77370). An article outlining what is required to bill a special medical physics consultation code for image fusion was published in the Nov/Dec 2008 AAPM Newsletter.

Is a medical physicist required to be present at the treatment console during an SBRT or SRS procedure? Yes, there are direct practice expense (PE) inputs for medical physics time in the CPT codes for SBRT and SRS treatments, which means the payment rates for SBRT and SRS in the Medicare Physician Fee Schedule include dedicated time from the medical physicist during the procedure.

Can you use IMRT for SRS or SBRT planning? Yes, the treatment planning codes reported are independent of the treatment delivery codes reported. The treatment planning code that best describes the work performed should be utilized. The same rules for determining if a treatment plan is IMRT or 3D apply regardless of if the technique is SRS, SBRT, or traditional fractionation. n

The opinions referenced are those of members of the AAPM Professional Economics Committee based on their coding experience and they are provided, without charge, as a service to the profession. They are based on the commonly used codes in radiation oncology, which are not all inclusive. Always check with your local insurance carriers, as policies vary by region. The final decision for coding of any procedure must be made by the physician and/or facility, considering regulations of insurance carriers and any local, state or federal laws that apply to the facility and physiciansâ&#x20AC;&#x2122; practice. Neither AAPM nor any of its officers, directors, agents, employees, committee members or other representatives shall have any liability for any claim, whether founded or unfounded, of any kind whatsoever, including but not limited to any claim for costs and legal fees, arising from the use of these opinions.

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AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

REPORT FROM THE IMAGING PRACTICE ACCREDITATION SUBCOMMITTEE Patrick Byrne, MS, Carmel, IN and Tyler Fisher, MS, Gardena, CA

Accreditation of Non-Traditional Nuclear Medicine Systems For many decades, Nuclear Medicine was limited to large sodium iodide detectors coupled to photomultiplier tubes. In recent years, the field has seen the introduction and development of a variety of non-traditional, specialized imaging systems. Typically, these systems are intended to image individual organs such as the heart and breast. As their focus is limited, they have been able to optimize their capabilities through the use of unique radiation detectors and proprietary reconstruction methods. These systems are not able to function in the same manner as traditional gamma cameras, so many of the tests described in NEMA NU 1-2012 Performance Measurements of Gamma Cameras are not even possible, if relevant at all. Nevertheless, the American College of Radiology Nuclear Medicine Accreditation Program does provide accreditation coverage of these systems. Non-traditional Nuclear Medicine breast imaging systems include the GE NM750b, the Dilon 6800, and the Gamma Medica LumaGEM. These systems feature small detectors that are capable of planar imaging only. The NM750b and LumaGEM are cadmium zinc telluride (CZT) based and the 6800 utilizes thousands of individual sodium iodide crystals whose scintillation light is detected by an array of position sensitive photomultiplier tubes. While the ACR NMAP program requirements do not mention breast imaging units, the ACR will accredit them. A facility accrediting one of these systems should contact the ACR for guidance. The physics portion of testing requires the submission of a uniformity image as well as a resolution image. For resolution, the ACR allows the submission of either a four-quadrant bar phantom or a planar image of the ACR SPECT phantom. Generally, due to geometric limitations, imaging of the SPECT phantom is not practical. Therefore, imaging of a four-quadrant bar phantom is the most likely method for resolution evaluation. Breast imaging systems are generally not capable of performing all the recommended ACR recommended Nuclear Medicine performance tests. However, some of the tests are able to be performed and each system has built-in quality control routines. Many of the manufacturers have developed documents that provide guidance on the tests that can be performed as well as specifications for normal/abnormal operation. Performance of these tests by the qualified medical physicist or an individual under their direction should be conducted annually in place of the tests detailed in the Nuclear Medicine accreditation program requirements. An even wider array of systems has been developed to image the heart. Some of these systems are traditional gamma cameras, albeit with smaller field of view (FOV) detectors. Systems in this category include the Siemens C.Cam, the Philips CardioMD, and the GE Ventri. All use sodium iodide scintillators coupled to photomultiplier tubes. These systems are able to perform both planar and SPECT imaging and therefore all the annual Nuclear Medicine performance tests can be conducted on them. Due to their limited FOV, the Deluxe ACR SPECT phantom cannot be fully imaged. The ACR recommends the use of the Data Spectrum Small SPECT phantom for limited FOV systems. This phantom has a diameter of 14 centimeters instead of 20.4 centimeters and will completely fit within the FOV while imaging.

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

Imaging Practice Accreditation, cont.

Non-traditional cardiac imaging systems use a variety of detectors, collimators, and reconstruction algorithms. The most commonly encountered non-traditional cardiac systems include the Digirad Cardius, the GE Discovery NM530c, and the Spectrum Dynamics D-SPECT. Digirad systems utilize solid state cesium iodide crystals coupled to a silicon photodiode. These systems also use traditional collimators, with parallel-hole being the most common. The Discovery NM530c and D-SPECT are CZT based systems, with integrated, non-removable collimators. These systems are designed to only perform SPECT imaging of the heart and are not able to perform planar imaging at all. Each has a modified daily quality control procedure, whose method and specifications are described by the manufacturer. The ACR Accreditation Program allows either the Small SPECT phantom or the Deluxe SPECT phantom to be used on these systems. The Spectrum Dynamics D-SPECT includes a special holding plate for the phantom that shows the correct orientation of it in relation to the scanner. The plate and orientation guide are designed for the Deluxe SPECT phantom, so its use rather than the Small SPECT phantom is recommended. An important note when scanning the SPECT phantom on dedicated cardiac cameras is to recognize that the acquisitions are limited to 180 degrees. Because of this, the setup of the phantom, both internally and in relation to the scanner, is absolutely key in achieving an optimal study. From an internal standpoint, the rods and spheres in the phantom must be coordinated. That is, the largest spheres must be placed over the largest rods and the smallest spheres likewise placed over the smallest rods. Otherwise, you will visualize one (rods/spheres) well but not the other since you’re not scanning completely around the phantom. Setup of the phantom in relation to the scanner is also key as you want the largest rods and spheres to be closest to detectors so that they may be best visualized. Performance of the rest of the specified annual performance tests vary system to system. Each non-traditional imaging system poses unique testing issues to the qualified medical physicist. Consultations with the manufacturer, service engineer, and ACR accreditation staff will yield great assistance in ensuring a robust testing and quality control program is designed and executed. n

AAPM 2017 ELECTIONS The Proposed Amendments to AAPM’s By-Laws will open for online voting on August 23, 2017. Deadline to submit your vote electronically: September 13, 2017

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NEW MEMBER SYMPOSIUM Tuesday, August 1 • 4:30 pm – 6:00 pm • Room 108, Street Level, Convention Center

s a new member of AAPM, it is easy to feel overwhelmed by the size and complexity of the association and to be unaware of the benefits and opportunities available to members. At this year’s AAPM Annual Meeting in Denver, CO, we will host a New Member Symposium where you can learn more about the organization, member resources, opportunities to get involved, and about topics of particular interest to new professionals. We encourage you to take advantage of this great opportunity to learn valuable information and to grow your professional network.

Registered attendees will receive a raffle ticket. Enter to win a complimentary registration for the 2018 Annual Meeting in Nashville, TN!! In addition, all new members who register for the Symposium will receive a drink ticket, good for one complimentary soda or beer served after the New Member Symposium during the social with committee chairs from four AAPM Councils: Science, Education, Professional and Administrative.

Get Your Picture Taken. There will be a photographer there to take pictures for your profile in the AAPM directory.

www.aapm.org/meetings/2017AM/

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

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

he Work Group on the Implementation of TG 100 continues to meet regularly by teleconference. Amongst our activities is organizing TG 100 Workshops which recently included a full day event immediately preceding the Spring Clinical Meeting in New Orleans and a second Workshop as part of the Florida Chapter’s Spring Meeting. From the evaluations we have received so far, participants have found the experience valuable and particularly enjoyed the handson exercise and discussion components which together make up more than half of the Workshop. While we have been successful at attracting physicists to our Workshops, try as we may, we have been unable to attract our colleagues from radiation oncology, dosimetry, therapy and other key disciplines in any significant numbers. However, we are reaching out to other organizations in an attempt to enlist their support for this initiative. Just recently we have been in touch with the ASTRO leadership with one aim being a higher profile for TG 100 in the re-write of Safety is No Accident which is currently underway. We are also starting communications with accrediting bodies, such as ASTRO’s APeX, with a view to having prospective risk and quality management acknowledged as one trait of a high quality clinical program. The Working Group is well aware of the challenges entailed in implementing this radically new approach to providing safe, high-quality care to patients exposed to radiation for diagnostic or therapeutic purposes. To that end the Working Group is actively discussing not only an on-line implementation guide but also a repository of completed process maps, failure modes and effects analyses and fault tree analyses. As many groups within the AAPM have similar or overlapping needs, the organization is actively discussing a more structured approach to content management in general. Once we have figured out the design specifications and a preliminary budget, we will contribute our thoughts to what a new Content Management System might look like. At this time, we don’t really know what the uptake of TG-100’s methodology is across the community so we will be approaching participants at previous Workshops to find out whether or not they have been able to implement the tools and, importantly, what the impediments have been. Finally, the Working Group does have a modest budget to support Workshops held in conjunction with Chapter meetings. AAPM will support travel for one of two or more speakers if the Chapter can cover other expenses. n

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

OHIO RIVER VALLEY CHAPTER REPORT Ashley Cetnar, MS, Columbus, OH

T Griffin Gate Marriott April 2017 in Lexington Kentucky

he Ohio River Valley Chapter hosted our Spring Educational Symposium on April 14th and 15th in Lexington, KY. The Friday events started off by holding the chapter’s second annual mock oral event. This year we were happy to see sixteen participants converge at the Griffin Gate Marriott to practice conveying their knowledge of medical physics to volunteer examiners.

The official meeting events started Friday night with a poster session and Meet and Greet where physicists, students, residents, and vendors were able to able to catch up with colleagues, network with new people, and discuss current research within the chapter. The social opportunities continued to the sponsored night out event held at Shakespeare and Co.

Night out event with chapter Members at Shakespeare and Co. in Lexington, KY

On Saturday the event was started by a TG-281 presentation by AAPM Secretary, Todd Pawlicki to discuss the current government assessment project. Guest speakers included Bill Salter presenting motion management considerations for lung SBRT, Janelle Molloy sharing her experience with educational economics and the evolution of medical physics education, and Brent Parker with helpful information on a physicist’s role in supervision in the clinic.

Saturday meeting with Dr. Bill Salter presenting SBRT lung data

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The afternoon was filled with insightful research from students and residents within our chapter. This year there was a wide variety of topics presented among the thirteen presenters

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

Ohio River Valley Chapter, cont.

from across our region. The winner of this year’s competition was Elijah Martin of the University of Louisville with his investigation of a source model for use with a new electronic brachytherapy tandem using film measurements. Second place was awarded to Eric Miller of the University of Kentucky, and third place to Spenser Murphy of the University of Kentucky. We would like to thank all of the vendors that made this event possible. We appreciate all of the guest speakers and students who shared their research for the symposium. Finally, we would like to thank the volunteer examiners who helped make the mock oral possible and all of the hard work of the chapter officers for another successful meeting. n Left: President Dr. Wei Luo with winner of the student research awards, Elijah Martin, Eric Miller, and Spenser Murphy Right: Current and past officers at the conclusion of the meeting. Ashley Cetnar (Secretary/Treasurer), Peter Sandwall (President-Elect), Nicholas Sperling (Past-President), Chris Allgower (former President), Michael Gossman (Board Representative and former President), and Wei Luo (President)

Call for Nominations

Nominations are now being accepted for the following AAPM Awards: • William D. Coolidge Gold Medal Award Marvin M.D. Williams Professional Achievement Award • Edith H. Quimby Lifetime Achievement Award John S. Laughlin Young Scientist Award • AAPM Fellows • Honorary Membership •

•

All nominations are due by September 15, 2017 and are to be done through the online nomination system. Applicants will be notified of decisions by March, 2018. Recipients will be honored at the AAPM Awards and Honors Ceremony and Reception during the 60th Annual Meeting & Exhibition in Nashville, TN in the year 2018.

awards.aapm.org

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

SOUTHERN CALIFORNIA CHAPTER REPORT Steven Goetsch, PhD, San Diego, CA

he AAPM Southern California Chapter held its annual Norm Baily Awards dinner for graduate students, residents and postdoctoral fellows at the JD Morgan Athletic Center at UCLA on May 9, 2017. A total of seven awards were given out with 19 excellent abstracts submitted. The top three awardees each gave a 15 minute talk on their work. Angelia Landers (a graduate student at UCLA Department of Radiation Oncology) gave a talk on “Bayesian Optimization for Automatic 4 PI Planning.” Her advisor is Professor Ke Sheng. Du Dongsu (a resident at UCLA Medical Center) gave a talk titled “Initial investigation of four-dimensional (4D) dose calculation based on 4D-MRI.” Du works with Professor Minsong Cao. Fei Han (UCLA Department of Radiology) gave a talk titled “Respiratory Motion-Resolved, Self-Gated 4D-MRI Using Rotating Cartesian K-Space (ROCK): Initial Clinical Experience on an MRI-Guided Radiotherapy System.” Fei works with Professor Peng Hu. Other winners were: Geraldine Chee and Kamal Singhrao (UCLA Medical Center), Tze Lim, Ana Medina and Niclas Pettersson (University of California San Diego Medical Center). Left to right: Kamal Singhrao, Fei Han, Dongsu Du, Angelia Landers, Ana Medina, Geraldine Chee, Chapter President Mike Campbell, Tze Lim, Education Chair Steve Goetsch

Medical Physics for World Benefit

edical Physics for World Benefit (MPWB) has a mission of

In addition, MPWB will be holding information/membership

supporting medical physics activities, especially in low-

meetings at both the COMP and AAPM annual scientific

to-middle income countries. The Board of Directors of MPWB

meetings.

has formalized its membership process as of 15 June 2017. If

COMP: Thursday 13 July 2017 at 5:30 pm in ‘Confederation I’

go to www.mpwb.org. There you will also find a description of why one would consider becoming a member and the formalities of the membership process.

of the Westin Hotel in Ottawa.

AAPM: Tuesday 1 August 2017 at 12:15 pm in ‘Mineral Hall A’ of the Hyatt Regency Denver (see AAPM Committees and Activities Schedule).

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interested in its mission, vision, objectives and values, please

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

UPSTATE NEW YORK ASSOCIATION OF PHYSICIST IN MEDICINE (UNYAPM) CHAPTER REPORT Lalith K. Kumaraswamy, PhD, Buffalo, NY

he Upstate New York chapter of the AAPM (UNYAPM) held its semi-annual meeting on April 21st, 2017 at the SWIFT Auditorium, Buffalo General Hospital, Buffalo, NY. The UNYAMP consists of members from all across the upstate New York region, from Buffalo to Albany. The meeting started with an invited presentation by Paul Naine from Elekta. As radiation therapy continues to evolve, image guidance plays a crucial role in targeting tumors precisely to maximize tumor kill while protecting surrounding healthy tissue. Mr. Naine talked about the emergence of MR IGRT and the future of image guided radiotherapy, which drew much interest from both therapeutic and diagnostic physicists in the audience. The Ninth Annual Young Investigators Competition was then held, with eight students from Roswell Park Cancer Institute, Toshiba Stroke and Vascular Research Center, and the University at Albany participating. The clinical and research work presented by the young investigators were excellent with good impact in the field of Medical Physics. The first prize was awarded to Alexander Podgorsak, who was selected by four faculty judges for his impressive presentation on “Implementation of basis material decomposition in neurovascular intervention.” Dr. Laila Hassan received the second prize for presenting her work titled “Coherent scatter imaging Monte Carlo simulation.” The third price was awarded to Tianjun Ma for his work on “Fiducial marker detectability improvement in EPID during radiation therapy treatment.” Dr. Lalith Kumaraswamy, President of UNYAPM, presented the awards to the winners of the Young investigator competition. The closing session was an invited talk by Dr. Matthew Podgorsak, who is the current Trustee of the American Board of Radiology for the Therapy Medical Physics. Dr. Podgorsak outlined the new ABR MOC process including the new Online Longitudinal Assessment (OLA) program. His talk was well received, as was evident from several key discussions initiated by the audience during his presentation. The next chapter meeting is scheduled for October 2017 and non-members are welcome to attend. Details can be obtained from the Chapter Secretary, Vikas Patel and the chapter website. n UNYAPM executive committee with the winners of the Young Investigator awards. From left to right: President Lalith Kumaraswamy, Secretary Vikas Patel, Second prize winner Laila Hasan, First prize winner Alexander Podgorsak, Third prize winner Tianjun Ma, and President-elect Mubin Shaikh.

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Dr. Matthew Podgorsak, who is the Trustee of the ABR for the Therapy Medical Physics, giving an update on the new ABR MOC process including the new OLA program.

Fill in the missing pieces. LinacView™ analyzes machine performance before the patient even leaves the couch. Adaptivo™ provides in-depth patient dosimetry data, so you can review and adjust before their next visit. Together, these essential QA software products can help you improve patient care — for every patient, every fraction, automatically. When every piece counts, get the whole picture with LinacView and Adaptivo.

S U T VISI PM AA 051 AT H 4 OT BO

1388-24, 3/17

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

FEARFUL FOR THE FUTURE OF SCIENCE? Stay informed with FYI: Science Policy News from AIP

our membership with AAPM makes it possible for AIP to provide accurate, objective, and comprehensive updates on science policy and funding.

FYI has been a trusted source of science policy news for more than two decades. Readers learn about legislative and executive branch policy developments important to the physical sciences community, and follow agency appointments, funding, and priorities advanced by policymakers and science organizations. In the coming months, FYI will deliver detailed coverage of the fiscal year 2018 budget process and of degree to which Congress acts upon the President’s budget request that propose deep cuts in research funding across several science agencies. Sign up for free. There are several options to meet your needs, including depth policy reporting and analysis in the FYI Bulletin and FYI This Week, a new weekly newsletter that provides a panoramic picture of what to expect in the week ahead, and a summary of the past week in science policy. Also see FYI tracker, a set of three online resources that provide up-to-date, curated information on federal science budgets, policymakers, and legislation: •

Budget Tracker — the current status of budget negotiations for research-focused agencies and budget tables that detail the proposed and final funding amounts for science programs.

•

Leadership Tracker — an index of high-level federal officials that have responsibility for appropriating funds, setting policy, or managing science programs-updated as presidential appointees make their way through the Senate confirmation process and as other leaders in the Legislative and Executive Branches are announced.

•

Bill Tracker (coming soon) — current status of major science-related legislation being considered by Congress.

As a member of AAS, AIP invites you to take advantage of these resources. By staying informed about policy developments, we can better shape the future of science.

aip.org/fyi

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AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

NRG MEDICAL PHYSICS SUBCOMMITTEE REPORT Yongsook Cecilia Lee, PhD, Tucson, AZ, Ying Xiao, PhD, Philadelphia, PA and Stanley B. Benedict, PhD, Sacramento, CA

NRG Protocol Radiation Therapy Template for Gynecological (cervix or uterine cervix) Cancers The Center for Innovation in Radiation Oncology (CIRO) of NRG Oncology was established to provide expertise and resources in radiation therapy technology for National Cancer Institute (NCI)â&#x20AC;&#x2122;s clinical trial network. One of the main efforts lies in protocol development support. NRG Medical Physics Subcommittee and NRG Radiation Oncology Committee within the CIRO have standardized the radiation therapy section in NRG protocols for various disease sites to provide the principal investigator (PI) and the Co-PI with standardized radiation therapy section templates. These templates help the PI(s) and Co-PI(s) facilitate the writing of the radiation therapy section. In the templates, details for treatment technology, immobilization and simulation, imaging, definitions of targets and critical structures from the NRG structure name library, dose prescription, compliance criteria, treatment planning instructions, patient specific QA and daily treatment localization are provided. The templates are available from the NRG Oncology website. In an effort to standardize, the NRG Radiation Therapy template for Gynecological (cervix or uterine cervix) cancers was created/reviewed by CIRO members, NCI experts and can be downloaded in NRG Oncology > Scientific Program > Center for Innovation in Radiation Oncology > Gynecologic (as shown in the screen capture below). The downloaded template can be modified by PI(s) and Co-PI(s) for their GYN protocol. n

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Certificate Course: Beyond Clinical Imaging: The Role of the Medical Physicist in Clinical Trials and Response Assessment Wednesday, August 2 • 7:30 am – 6:00 pm

Following the meeting, certificate of completion program participants will be required to take an online examination, which covers the material presented throughout the day-long mini-track. Enrollees who demonstrate satisfactory attendance at the course and successful completion of the online examination (available after the meeting) will receive a certificate of completion for this course. AAPM member attendees may enroll in the certificate of completion program for an additional fee. Enrollment in the program entitles participants to dedicated seating in the mini-track sessions as well as additional online materials. Course Registration includes: Reserved seating • USB stick and downloadable file. For more information and to register, click here.

AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

IROC REPORT Andrea Molineu, MS, Houston, TX IROC-Houston handles credentialing for clinical trials in the NCI’s National Clinical Trials Network (NCTN). Many institutions have satellite treatment sites or are part of larger group of connected institutions. We are often asked how credentialing works for these sites. Does every location have to perform every credentialing step? The answer to this question depends on the protocol. There are some protocols that do require every site in a group to perform each credentialing task. However the majority of protocols allow phantom irradiations from a connected institution to cover a group of 5 centers or fewer if certain criteria are met. See below for the specifics of how this works.

Facility Questionnaire (FQ) Each site must have an updated FQ. This is how we know what machines are at the site and ensure that they are covered by our annual OSLD service. If the password isn’t known, our office can send a link to the specific questionnaire. Please contact us to request the link.

Credentialing Status Inquiry (CSI) This form lets us know that a site wants to be credentialed for a certain protocol and must be filled out for each site that wishes to be credentialed. It can be found here. CSI forms are normally responded to within two business days.

IGRT This credentialing is site specific so must be done by each location.

Phantoms For many protocols H&N and lung phantom irradiations within hospital groups can be shared if the following criteria are met by the group: • • • • • •

The same physician group covers the sites. The same physics group covers the sites. The sites have the same machine manufacturer (ie all Varian or all Elekta). The sites use the same planning system. The algorithm and motion management (for lung phantoms is the same). The irradiation was done at the first site within the last 5 years.

Benchmarks Some benchmarks can be shared between institutions if the sites have the same dosimetry group in addition to the above requirements. For any site, unique delivery machines such as CyberKnife or TomoTherapy must be credentialed separately from the traditional c-arm linacs. Remember that whether you are part of a group of institutions or not, you can always check our website to find requirement for the specific trial you are interested in. n

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2017 AAPM ELECTIONS Open for Online Voting: JUNE 21

VOTE Deadline to Submit Your Vote Electronically: JULY 12 vc AAPM Clr Ad 6.75x4.75_17Jun9.pdf

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AAPM Newsletter â&#x20AC;˘ Volume 42 No. 4 JULY | AUGUST 2017

PERSON IN THE NEWS Mahadevappa Mahesh, PhD, Baltimore, MD Mahadevappa Mahesh, MS, PhD was elected as President of the Maryland Radiological Society (MRS) for a two-year term starting June 2017. MRS is the state chapter of the American College of Radiology with more than 693 members. Less than 10% of MRS membership is made up of medical physicists and being elected, as the President of a local radiological society is a true recognition of the contribution of medical physics members. Dr. Mahesh is the second only medical physicist in the nation to become the president of a local chapter of the American College of Radiology. Dr. Mahesh is a Professor of Radiology and Cardiology at Johns Hopkins University School of Medicine and is the Chief Physicist at the Johns Hopkins Hospital. Dr. Mahesh is currently the Treasurer of AAPM.

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AAPM Newsletter • Volume 42 No. 4 JULY | AUGUST 2017

Press Release The International Atomic Energy Agency (IAEA) launched today an online tool for strengthening the safety of workers who risk exposure to ionizing radiation in the fields of medicine and industry. The Information System on Occupational Exposure in Medicine, Industry and Research (ISEMIR) collects and evaluates occupational exposure data from two areas where radiation protection of workers can be a challenge - interventional cardiology (IC) and industrial radiography (IR). IC facilities performing cardiac X-ray procedures and non-destructive testing (NDT) companies using radiation to test structures for faults or defects, are invited to take part in the system. “Workers in these two areas are typical examples of occupationally exposed workers in non-nuclear energy sectors,” said Miroslav Pinak, Head of Radiation Safety and Monitoring Section at the IAEA. “We hope that many medical facilities and NDT companies will participate in ISEMIR. This will help to ensure and advance occupational radiation protection in interventional cardiology and industrial radiography.” Interventional cardiology procedures may result in higher occupational exposure as medical practitioners must stay close to patients when imaging X-rays are used. Industrial radiography, on the other hand, is often carried out under difficult working conditions outside the facilities. As a result, accidents and overexposures may occur more frequently. ISEMIR will gather occupational exposure data received through selected coordinators at participating companies and facilities. After verification by the IAEA, participants will be able to review trends and analyze performance against others in their region and around the world. “ISEMIR allows participating IC facilities and IR companies to benchmark the occupational radiation dose per procedure received by individual workers,” said Sandra Gabriel, a Radiation Safety Specialist at the IAEA. “By comparing this information with doses received by workers with similar characteristics at other facilities, participants can identify areas for improvement and corrective actions to increase radiation protection.” To access ISEMIR, users are requested to create an account with NUCLEUS, the IAEA’s web portal for scientific, technical and regulatory resources. For more information, please see here.

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