Method to assess the need for re-planning HDR brachytherapy tandem and ring treatments

High dose rate (HDR) brachytherapy procedures for cervical cancer require multiple applicator insertions for multiple (typically 5) fractions of a single plan, which carries a risk for variability in applicator position between fractions. Due to applicator displacement relative to patient anatomy, the dose to nearby organs-at-risk (OARs) may vary significantly from one fraction to the next. The purpose of this study was to evaluate the effect of changes in HDR tandem and ring (T&R) applicator position on doses to nearby OARs and to present a quick and simple method to estimate doses to OARs inter-fractionally without having to perform a re-plan. Ninety CT image sets for 20 patients, ages 44 to 86, undergoing T&R-based HDR for cervical cancer were used retrospectively for this study. Measures of applicator positional and angular changes relative to the bony anatomy were obtained using image fusion in MIM software, between the planning CT (plan CT) and the CT on the treatment day (CT-TX). Dosimetric data were determined, also using MIM software, using the original (first fraction) dose distribution applied to organs at risk (rectum and bladder), transferred via rigid registration from the plan CT to each CT-TX. Bladder and rectum contours were also transferred from each plan CT to each CT-TX and were tweaked manually to match anatomy on each CT-TX and examined visually for appropriateness. Differences in translation and rotation of the T&R applicator between the planning CT and subsequent individual fractions were recorded and plotted against dose differences between each fraction of treatment and the original (first) fraction. Absolute dose (D2cc) and volume (V50) differences vs positional shifts were calculated and plotted, and the Pearson Product-Moment correlation coefficient between dose parameters and measured positional shifts was determined. Average dosimetric differences between planned dose and subsequent fractional doses obtained through rigid registration were 1.48 ± 1.92 Gy, 14.91 ± 11.92 cm3, 0.56 ± 0.93 Gy, and 1.77 ± 2.18 cm3 for Bladder D2cc, Bladder V50, Rectum D2cc, and Rectum V50, respectively. Correlation between Bladder V50 and sagittal plane rotation gave an r2 of 0.4, showing the most correlation of all parameters studied. Bladder dose and volume increased by a maximum of about 2.7 Gy and 50 cm3 overall for Bladder D2cc and Bladder V50, respectively. Bladder V50 was most sensitive to T&R applicator displacements. We have quantified the effects of applicator positional changes on dose changes for the bladder and rectum. Even large changes in applicator position between fractions did not result in significant changes in dose to these normal tissues, indicating that adaptive re-planning is not necessary.

Navigating the 2021 ACPSEM ROMP workforce model: insights from a single institution

Workforce modelling for Radiation Oncology Medical Physicists (ROMPs) is evolving and challenging, prompting the development of the 2021 Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) ROMP Workforce (ARW) Model. In the exploration of this model at Sir Charles Gairdner Hospital, a comprehensive productivity exercise was conducted to obtain a detailed breakdown of ROMP time at a granular level. The results provide valuable insights into ROMP activities and enabled an evaluation of ARW Model calculations. The findings also capture the changing ROMP role as evidenced by an increasing involvement in consultation and advisory tasks with other professionals in the field. They also suggest that CyberKnife QA time requirements in the data utilised by the model may need to be revised. This study emphasises features inherent in the model, that need to be understood if the model is to be applied correctly.

If you can make it, you can share it - Perspectives on the first DIY-fair at the European congress of medical physics (ECMP, DUBLIN 2022)

The medical physics and engineering community is known for being active in conjuring do-it-yourself (DIY) -solutions to support their clinical and research work. To facilitate the exchange of solutions and ideas, a DIY-fair was held for the first time at the European Congress of Medical Physics (ECMP) in August 2022 in Dublin, Ireland. Altogether 32 contributions were presented, consisting of software, scripts, 3D-printed customized solutions, devices, gadgets and phantoms. All contributions were published in video format on a dedicated YouTube channel, and most were also presented in person at the conference. The fair demonstrated that there is an unmet need for sharing and distributing information on self-created solutions in the medical physics community. The authors propose the creation of a dedicated platform for sharing such content within our community, as well as a continuity of DIY-fairs at future ECMP meetings.

Benchmark of the PenRed Monte Carlo framework for HDR brachytherapy

PURPOSE

The purpose of this study is to validate the PenRed Monte Carlo framework for clinical applications in brachytherapy. PenRed is a C++ version of Penelope Monte Carlo code with additional tallies and utilities.

METHODS AND MATERIALS

Six benchmarking scenarios are explored to validate the use of PenRed and its improved bachytherapy-oriented capabilities for HDR brachytherapy. A new tally allowing the evaluation of collisional kerma for any material using the track length kerma estimator and the possibility to obtain the seed positions, weights and directions processing directly the DICOM file are now implemented in the PenRed distribution. The four non-clinical test cases developed by the Joint AAPM-ESTRO-ABG-ABS WG-DCAB were evaluated by comparing local and global absorbed dose differences with respect to established reference datasets. A prostate and a palliative lung cases, were also studied. For them, absorbed dose ratios, global absorbed dose differences, and cumulative dose-volume histograms were obtained and discussed.

RESULTS

The air-kerma strength and the dose rate constant corresponding to the two sources agree with the reference datatests within 0.3% (Sk) and 0.1% (Λ). With respect to the first three WG-DCAB test cases, more than 99.8% of the voxels present local (global) differences within ±1%(±0.1%) of the reference datasets. For test Case 4 reference dataset, more than 94.9%(97.5%) of voxels show an agreement within ±1%(±0.1%), better than similar benchmarking calculations in the literature. The track length kerma estimator scorer implemented increases the numerical efficiency of brachytherapy calculations two orders of magnitude, while the specific brachytherapy source allows the user to avoid the use of error-prone intermediate steps to translate the DICOM information into the simulation. In both clinical cases, only minor absorbed dose differences arise in the low-dose isodoses. 99.8% and 100% of the voxels have a global absorbed dose difference ratio within ±0.2% for the prostate and lung cases, respectively. The role played by the different segmentation and composition material in the bone structures was discussed, obtaining negligible absorbed dose differences. Dose-volume histograms were in agreement with the reference data.

CONCLUSIONS

PenRed incorporates new tallies and utilities and has been validated for its use for detailed and precise high-dose-rate brachytherapy simulations.

Perception and Recognition of Clinical Medical Physicist Roles and Responsibilities by Specialist Physician Staff: The First Mexican Survey

Introduction

Although medical physics as a profession is recognized as part of the health-care professional workforce by the International Labor Organization, in the Mexican context, the figure of the medical physicist (MP) is often inappropriately associated solely with technical work, leading to perception, recognition, and salary implications. The aim of this study was to explore the perception of medical specialists regarding the role and responsibilities of MPs in clinical practice in Mexico.

Methods

A national survey was answered by medical personnel, ranging from residents to qualified specialists in November 2019. The questionnaire consisted of ten questions related to perception of MPs. The survey was open to all medical specialists regardless of their involvement in the use of ionizing radiations or otherwise.

Results

It was shown that approximately two-thirds of specialists know and recognize the medical physics profession in hospitals and the roles and responsibilities of MPs. However, 19% of medical specialists considered the standard of service as inadequate.

Conclusion

MPs must exert greater efforts to promote their status and enhance the recognition of their contribution to health care. The low level of recognition in diagnostic and interventional radiology and in nuclear medicine in Mexico might be related to nonexistent or unclear documentation and inadequate regulations, policies, or directives promoted by the health-care authorities.

Cine MRI-based analysis of intrafractional motion in radiation treatment planning of head and neck cancer patients

PURPOSE/OBJECTIVE(S)

To investigate intrafraction motion of (HN) target volumes and to determine patient-specific planning target volume (PTV) margins.

MATERIALS/METHODS

MR-cine imaging was performed for radiation treatment planning in HN cancer patients treated with definitive EBRT (n = 62) or SBRT (n = 4) on a 1.5 T MRI between 2017-2019. Dynamic MRI scans (sagittal orientation, 2 × 82 × 7 mm3 resolution), ranging from 3-5 min and 900-1500 images, were acquired. The position of the maximum tumor displacement along each direction in the anterior/posterior (A/P) and superior/inferior (S/I) position was recorded and analyzed to determine average PTV margins.

RESULTS

Primary tumor sites (n = 66) were oropharynx (n = 39), larynx (n = 24) and hypopharynx (n = 3). PTV margins for A/P/S/I positions were 4.1/4.4/5.0/6.2 mm and 4.9/4.3/6.7/7.7 mm for oropharyngeal and laryngeal/hypopharyngeal cancers when accounting for all motion. V100 for PTV was calculated and compared to the original plans. The mean drop in PTV coverage was in most cases under 5%. For a subset of patients with 3 mm plans available, V100 for PTV had more substantial decreases in coverage averaging 8.2% - and 14.3% for oropharyngeal and laryngeal/hypopharynx plans, respectively.

CONCLUSION

The use of MR-cine in treatment planning allows for quantification of tumor motion during swallow and resting periods and should be accounted for during treatment planning. With motion considered, the derived margins may exceed the commonly used 3-5 mm PTV margins. Quantification and analysis of tumor and patient-specific PTV margins is a step towards real-time MRI guidance adaptive radiotherapy.

Dynamic nanoassemblies derived from small-molecule homodimeric prodrugs for in situ drug activation and safe osteosarcoma treatment

Supramolecular prodrug self-assembly is a cost-effective and powerful approach for creating injectable anticancer nanoassemblies. Herein, we describe the self-assembly of small-molecule prodrug nanotherapeutics for tumor-restricted pharmacology that can be self-activated and independent of the exogenous stimuli. Covalent dimerization of the anticancer agent cabazitaxel via reactive oxygen species (ROS)- and esterase-activatable linkages produced the homodimeric prodrug diCTX, which was further coassembled with an ROS generator, dimeric dihydroartemisinin (diDHA). The coassembled nanoparticles were further refined in an amphiphilic matrix, making them suitable for in vivo administration. The ROS obtained from the coassembled diDHA synergized with intracellular esterase to activate the neighboring diCTX, which in turn induced potent cytotoxicity. In a preclinical orthotopic model of human osteosarcomas, nanoparticle administration exhibited durable antitumor efficacy. Furthermore, this smart, dual-responsive nanotherapeutic exhibited lower toxicity in animals than those of free drug combinations. We predict that this platform has great potential for further clinical translation.

Current status and development of neutron radiation for biophysical applications in Colombia

In Colombia, medical physics started formally about 3 decades ago. Two master's programs in medical physics initiated activities at two different universities. In particular, the master's program at the Pontificia Universidad Javeriana has been underway since 2012, and taking into account its projections, a team was established in 2015 in collaboration with the Universidad Distrital Francisco José de Caldas to conduct basic research on cancer treatment using neutron capture therapy (NCT). The primary goal of our initiative is to create the infrastructure required to adapt new technologies in our universities in the future. The long-term objective is to use neutron radiation to study not only NCT but also biomolecules, membranes, and materials. This will require the commissioning of an actual nuclear facility. Our group has been exclusively focused on carrying out calculations with GEANT4 because of its characteristics as open-source software, its accessibility, and its ample worldwide use and validation in the particle physics, nuclear physics, and medical physics communities. In this work, we present some results of our preliminary design for the ion accelerator column of a compact neutron generator. Also, we present the characterization of the kinematical and dose distributions of boron neutron capture processes using Geant4.

Clinician's guide to the basic principles of MRI

MRI is an important and widely used imaging modality for clinical diagnosis. This article provides a concise discussion of the basic principles of MRI physics for non-radiology clinicians, with a general explanation of the fundamentals of signal generation and image contrast mechanisms. Common pulse sequences, tissue suppression techniques and use of gadolinium contrast with relevant clinical applications are presented. Knowledge of these concepts would provide an appreciation of how MR images are acquired and interpreted to facilitate interdisciplinary understanding between radiologists and referring clinicians.

Hospital-based proton therapy implementation during the COVID pandemic: early clinical and research experience in a European academic institution

INTRODUCTION

A rapid deploy of unexpected early impact of the COVID pandemic in Spain was described in 2020. Oncology practice was revised to facilitate decision-making regarding multimodal therapy for prevalent cancer types amenable to multidisciplinary treatment in which the radiotherapy component searched more efficient options in the setting of the COVID-19 pandemic, minimizing the risks to patients whilst aiming to guarantee cancer outcomes.

METHODS

A novel Proton Beam Therapy (PBT), Unit activity was analyzed in the period of March 2020 to March 2021. Institutional urgent, strict and mandatory clinical care standards for early diagnosis and treatment of COVID-19 infection were stablished in the hospital following national health-authorities' recommendations. The temporary trends of patients care and research projects proposals were registered.

RESULTS

3 out of 14 members of the professional staff involved in the PBR intra-hospital process had a positive test for COVID infection. Also, 4 out of 100 patients had positive tests before initiating PBT, and 7 out of 100 developed positive tests along the weekly mandatory special checkup performed during PBT to all patients. An update of clinical performance at the PBT Unit at CUN Madrid in the initial 500 patients treated with PBT in the period from March 2020 to November 2022 registers a distribution of 131 (26%) pediatric patients, 63 (12%) head and neck cancer and central nervous system neoplasms and 123 (24%) re-irradiation indications. In November 2022, the activity reached a plateau in terms of patients under treatment and the impact of COVID pandemic became sporadic and controlled by minor medical actions. At present, the clinical data are consistent with an academic practice prospectively (NCT05151952). Research projects and scientific production was adapted to the pandemic evolution and its influence upon professional time availability. Seven research projects based in public funding were activated in this period and preliminary data on molecular imaging guided proton therapy in brain tumors and post-irradiation patterns of blood biomarkers are reported.

CONCLUSIONS

Hospital-based PBT in European academic institutions was impacted by COVID-19 pandemic, although clinical and research activities were developed and sustained. In the post-pandemic era, the benefits of online learning will shape the future of proton therapy education.

Training for the future: Introducing foundational skills necessary to promote patient-centered care practice in medical physics graduate programs

Current medical physics graduate training in the United States seldom explicitly includes education on foundational skills necessary to produce Patient-Centered Care (PCC)-focused healthcare providers. Such abilities include effective communication, critical reflection, and ethical decision-making. In this article, we present examples of curricula used to purposefully introduce these skills into graduate training to fill this gap. Presented didactic activities include an introduction to patient communication, ethics in medical physics, and a primer in health disparities for medical physicists. Although development of new curricula is resource-intensive when left to individual programs, we here propose resource-sharing and interprofessional collaboration to overcome these barriers.

[Clinical research in radiation oncology: how to move from the laboratory to the patient?]

Translational research in radiation oncology is undergoing intense development. An increasingly rapid transfer is taking place from the laboratory to the patients, both in the selection of patients who can benefit from radiotherapy and in the development of innovative irradiation strategies or the development of combinations with drugs. Accelerating the passage of discoveries from the laboratory to the clinic represents the ideal of any translational research program but requires taking into account the multiple obstacles that can slow this progress. The ambition of the RadioTransNet network, a project to structure preclinical research in radiation oncology in France, is precisely to promote scientific and clinical interactions at the interface of radiotherapy and radiobiology, in its preclinical positioning, in order to identify priorities for strategic research dedicated to innovation in radiotherapy. The multidisciplinary radiotherapy teams with experts in biology, medicine, medical physics, mathematics and engineering sciences are able to meet these new challenges which will allow these advances to be made available to patients as quickly as possible.

Effects of mobile-based mindfulness meditation for mental health of nurses: a protocol for systematic review and meta-analysis

INTRODUCTION

Existing studies have shown that mobile-based mindfulness meditation (MMM) can have a certain impact on nurses' mental health problems, but its specific effect and the effect on specific mental health problems such as stress, anxiety, depression, mindfulness, well-being and resilience are not clear.

METHODS AND ANALYSIS

This study protocol follows the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols guidelines. Electronic search through PubMed, Web of Science, EBSCO, Cochrane Library, CINAHL, PsycINFO, ERIC, Embase and three Chinese databases namely CNKI, Wan Fang and Chinese Biology Medicine disc. The inclusion criteria follow the PICO principle, which is defined translate the question into a searchable and answerable question . P (patient/population): clinical characteristics of patients; I (intervention or exposure): treatment measures or exposure factors of concern; C (comparison): control measure.; O (outcome): outcome indicator of concern. Registered nurses, preregistered nurses, midwives and nursing students will all be included, studies using MMM as intervention to improve mental health of nurses, compared with waitlist controls or traditional methods groups, outcomes assessment of stress, anxiety, depression, mindfulness, well-being and resilience will meet the inclusion criteria. Studies designed randomised controlled trails (RCTs) of quasiexperimental and written in English or Chinese will be eligible. Search time was from inception of each database to July 2022. Two reviewers screen and assess studies for inclusion and extract data independently; any dispute will be settled through discussion. If the discussion still fails, the third author will make a decision. For RCT, risk of bias will be assessed using Cochrane risk-of-bias tool for randomised trials (RoB 2), and for non-RCT studies, risk of bias in non-randomised studies of interventions (ROBINS-I) tool will be performed. Meta-analysis will be performed using RevMan software if sufficient number of comparable studies are retrieved.

ETHICS AND DISSEMINATION

This is a study protocol of meta-analysis; no primary data will be collected, and no ethics assessment is required. The study results will be presented in a peer-reviewed scientific publication.

PROSPERO REGISTRATION NUMBER

CRD42021277932.

Use of a novel anthropomorphic prostate simulator in a prostate brachytherapy transrectal ultrasound imaging workshop for medical physicists

PURPOSE

Ultrasound imaging training is not required as part of radiation oncology training programs nor does any objective competency measure exist to independently assess performance. Physical simulation training can provide a structured approach to this training but only if suitably challenging training simulators exist. This study describes the design and preliminary evaluation of a simulation-based transrectal ultrasound (TRUS) imaging training workshop developed for medical physicists involved in low-dose-rate (LDR) prostate brachytherapy (PBT).

METHODS

The study incorporated novel high-fidelity anthropomorphic PBT TRUS training simulators and a TRUS imaging module with a blended-learning pedagogical approach, to address TRUS image optimisation and managing image quality.

RESULTS

Results demonstrated a significant improvement in knowledge, with an average increase in multiple choice question score of 61% (P < 0.0002), and that there was a 46% (P < 0.0001) average increase in the participants perceived understanding of TRUS scanner operation, and an increase of 36% (P < 0.001) in participants readiness to optimise image quality and mitigate image artefacts. Focus group data explored participants' experiences, perceptions and challenges with TRUS LDR PBT.

CONCLUSIONS

This study suggests a benefit in offering a simulation training workshop to medical physicists and the potential benefit to other healthcare professionals involved in prostate brachytherapy, by incorporating novel high-fidelity anthropomorphic PBT TRUS training simulators, in a simulated environment to practice ultrasound image optimisation for PBT image guidance. This approach to training would enable competency-based skill acquisition and continued proficiency or health professionals in the TRUS PBT procedure, outside of the surgical environment without direct exposure to patients.

A Brief History of Nuclear Medicine Physics, Instrumentation, and Data Sciences in Korea

We review the history of nuclear medicine physics, instrumentation, and data sciences in Korea to commemorate the 60^th anniversary of the Korean Society of Nuclear Medicine. In the 1970s and 1980s, the development of SPECT, nuclear stethoscope, and bone densitometry systems, as well as kidney and cardiac image analysis technology, marked the beginning of nuclear medicine physics and engineering in Korea. With the introduction of PET and cyclotron in Korea in 1994, nuclear medicine imaging research was further activated. With the support of large-scale government projects, the development of gamma camera, SPECT, and PET systems was carried out. Exploiting the use of PET scanners in conjunction with cyclotrons, extensive studies on myocardial blood flow quantification and brain image analysis were also actively pursued. In 2005, Korea's first domestic cyclotron succeeded in producing radioactive isotopes, and the cyclotron was provided to six universities and university hospitals, thereby facilitating the nationwide supply of PET radiopharmaceuticals. Since the late 2000s, research on PET/MRI has been actively conducted, and the advanced research results of Korean scientists in the fields of silicon photomultiplier PET and simultaneous PET/MRI have attracted significant attention from the academic community. Currently, Korean researchers are actively involved in endeavors to solve a variety of complex problems in nuclear medicine using artificial intelligence and deep learning technologies.

Report of the ACPSEM radiation oncology medical physics workforce modelling project task group

The ACPSEM radiation oncology medical physics workforce modelling project task group was formed to acquire a snapshot of practices in Australia and New Zealand and to develop an activity-based workforce model. To achieve this, two surveys were carried out, capturing the work practices of 98 radiation oncology departments and 182 college members. The member survey provided a snapshot of the current workforce: their demographics, work conditions, professional recognition, and future plans. The facility survey provided an Australian and New Zealand contextualisation of the volume-based activities defined in the International Atomic Energy Agency activity-based radiation oncology staffing model at a granular level. An ACPSEM ROMP workforce model was developed to be a modelling tool applicable at both the facility and sector levels.

Collaborative networking and support for medical physics development in low and middle income (LMI) countries

Medical physics is one of the key aspects of contemporary medicine, primarily focused on the safe and effective use of medical imaging and radiotherapy equipment. The number of medical physicists and their activities are directly related to the national/regional healthcare provision. The distribution of the medical physics workforce however is still very uneven-more than 70% of all medical physicists are in North America and Europe, serving the healthcare provision of about 1 billion people. The remaining 30% of medical physicists serve the healthcare provision of the rest of the world-serving about 6.5 billion people. A number of activities were taken by various teams and organisations to address this issue. The increase of quality of healthcare and the effectiveness of medical technology usage, lie in adequate education and training for medical physicists and engineers, who are the front-liners when it comes to dealing with technology in healthcare. To help LMI countries professional growth in the field of medical physics and technology, we developed an education and capacity building strategy, based on the revolutionary application of digital resources combined with experience sharing through large international network.

Comparison of low-contrast detectability between uniform and anatomically realistic phantoms-influences on CT image quality assessment

Objectives

To evaluate the effects of anatomical phantom structure on task-based image quality assessment compared with a uniform phantom background.

Methods

Two neck phantom types of identical shape were investigated: a uniform type containing 10-mm lesions with 4, 9, 18, 30, and 38 HU contrast to the surrounding area and an anatomically realistic type containing lesions of the same size and location with 10, 18, 30, and 38 HU contrast. Phantom images were acquired at two dose levels (CTDIvol of 1.4 and 5.6 mGy) and reconstructed using filtered back projection (FBP) and adaptive iterative dose reduction 3D (AIDR 3D). Detection accuracy was evaluated by seven radiologists in a 4-alternative forced choice experiment.

Results

Anatomical phantom structure impaired lesion detection at all lesion contrasts (p < 0.01). Detectability in the anatomical phantom at 30 HU contrast was similar to 9 HU contrast in uniform images (91.1% vs. 89.5%). Detection accuracy decreased from 83.6% at 5.6 mGy to 55.4% at 1.4 mGy in uniform FBP images (p < 0.001), whereas AIDR 3D preserved detectability at 1.4 mGy (80.7% vs. 85% at 5.6 mGy, p = 0.375) and was superior to FBP (p < 0.001). In the assessment of anatomical images, superiority of AIDR 3D was not confirmed and dose reduction moderately affected detectability (74.6% vs. 68.2%, p = 0.027 for FBP and 81.1% vs. 73%, p = 0.018 for AIDR 3D).

Conclusions

A lesion contrast increase from 9 to 30 HU is necessary for similar detectability in anatomical and uniform neck phantom images. Anatomical phantom structure influences task-based assessment of iterative reconstruction and dose effects.

Key Points

• A lesion contrast increase from 9 to 30 HU is necessary for similar low-contrast detectability in anatomical and uniform neck phantom images.

• Phantom background structure influences task-based assessment of iterative reconstruction and dose effects.

• Transferability of CT assessment to clinical imaging can be expected to improve as the realism of the test environment increases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00330-021-08248-3.

RadioTransNet: Preclinical research network coordinated at the SFRO and SFPM

The RadioTransNet programme launched under the auspices of French societies for radiation oncology (SFRO) and medical physics (SFPM) was approved by the French national cancer institute (INCa) in December 2018 and is dedicated to proposing a relevant national and transversal structure for preclinical research including translational research in radiation oncology with well-defined priority areas of research. Its activities, coordinated by a scientific committee that includes radiation oncologists, medical physicists, academic biologists, are structured around several main areas, i.e.: target volume definition, interaction of radiation with normal tissues, combined treatments and modern dose calculation approaches. Four work packages have been created in these areas and are associated with other objectives pertaining to fundamental radiobiology, early implementation of new drugs in a preclinical setting, contribution of imaging in this task, research in medical physics including transversal components such as medical oncology, radiology, nuclear medicine and also cost/efficiency evaluation. All these tasks will be included in a national network that uses the complementary expertise provided by partners involved in the scheme. Calls for proposals will be selected by the scientific council to be submitted to INCa and the various academic associations to obtain funding for the human and technical resources required to conduct under optimal conditions projects in preclinical and translational research in radiation-oncology.

Health management during COVID-19 pandemic-contribution of women health informaticians, medical physicists and veterinarians from Bangladesh and Malaysia during the world crisis

This article aims to highlight some of the contributions from Bangladeshi and Malaysian women scientists in the fields of health informatics, medical physics and biomedical engineering, and veterinary science in combating the COVID-19 world crisis. The status of COVID-19 situations in Bangladesh and Malaysia in respect to global scenario, some relevant government policies, lessons learnt from previous pandemics, socio-economic impacts of COVID-19, the impact on healthcare system and health management approaches taken by individual/institutional research group led by women scientists during the COVID-19 pandemic have been discussed and demonstrated in this article. These promising activities and initiatives will eventually motivate other women in science and extend their roles from laboratory to society in more aspects.

The perceptions of medical physicists towards relevance and impact of artificial intelligence

Artificial intelligence (AI) is an innovative tool with the potential to impact medical physicists' clinical practices, research, and the profession. The relevance of AI and its impact on the clinical practice and routine of professionals in medical physics were evaluated by medical physicists and researchers in this field. An online survey questionnaire was designed for distribution to professionals and students in medical physics around the world. In addition to demographics questions, we surveyed opinions on the role of AI in medical physicists' practices, the possibility of AI threatening/disrupting the medical physicists' practices and career, the need for medical physicists to acquire knowledge on AI, and the need for teaching AI in postgraduate medical physics programmes. The level of knowledge of medical physicists on AI was also consulted. A total of 1019 respondents from 94 countries participated. More than 85% of the respondents agreed that AI would play an essential role in medical physicists' practices. AI should be taught in the postgraduate medical physics programmes, and that more applications such as quality control (QC), treatment planning would be performed by AI. Half of the respondents thought AI would not threaten/disrupt the medical physicists' practices. AI knowledge was mainly acquired through self-taught and work-related activities. Nonetheless, many (40%) reported that they have no skill in AI. The general perception of medical physicists was that AI is here to stay, influencing our practices. Medical physicists should be prepared with education and training for this new reality.

The status of medical physics in radiotherapy in China

PURPOSE

To present an overview of the status of medical physics in radiotherapy in China, including facilities and devices, occupation, education, research, etc. MATERIALS AND METHODS: The information about medical physics in clinics was obtained from the 9-th nationwide survey conducted by the China Society for Radiation Oncology in 2019. The data of medical physics in education and research was collected from the publications of the official and professional organizations.

RESULTS

By 2019, there were 1463 hospitals or institutes registered to practice radiotherapy and the number of accelerators per million population was 1.5. There were 4172 medical physicists working in clinics of radiation oncology. The ratio between the numbers of radiation oncologists and medical physicists is 3.51. Approximately, 95% of medical physicists have an undergraduate or graduate degrees in nuclear physics and biomedical engineering. 86% of medical physicists have certificates issued by the Chinese Society of Medical Physics. There has been a fast growth of publications by authors from mainland of China in the top international medical physics and radiotherapy journals since 2018.

CONCLUSIONS

Demand for medical physicists in radiotherapy increased quickly in the past decade. The distribution of radiotherapy facilities in China became more balanced. High quality continuing education and training programs for medical physicists are deficient in most areas. The role of medical physicists in the clinic has not been clearly defined and their contributions have not been fully recognized by the community.

Current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy

Artificial intelligence (AI) has seen tremendous growth over the past decade and stands to disrupts the medical industry. In medicine, this has been applied in medical imaging and other digitised medical disciplines, but in more traditional fields like medical physics, the adoption of AI is still at an early stage. Though AI is anticipated to be better than human in certain tasks, with the rapid growth of AI, there is increasing concerns for its usage. The focus of this paper is on the current landscape and potential future applications of artificial intelligence in medical physics and radiotherapy. Topics on AI for image acquisition, image segmentation, treatment delivery, quality assurance and outcome prediction will be explored as well as the interaction between human and AI. This will give insights into how we should approach and use the technology for enhancing the quality of clinical practice.

140 years of medical physics in Romania

In 2020 the Romanian College of Medical Physicists celebrated 140 years of medical physics in Romania. The article presents a short historical perspective of medical physics teaching and education in the country, focusing on the current situation and challenges that we are facing in regards to staffing, training and accreditation. While certain aspects concerning the procurement of radiotherapy / medical imaging devices and staffing are improving over the years, others, related to clinical training and education, as well as the national recognition of the profession continue to pose a challenge.

Integration of Gross Anatomy Laboratory Sessions into Medical Physics Curriculum

BACKGROUND

Gross anatomy laboratory sessions with hands-on activities using specimens are essential for teaching anatomy in the medical field. However, they are not seen in medical physics programs. The objective of this pilot study at McGill University was to explore the educational potential of integrated gross anatomy laboratory sessions tailored to the medical physics curriculum.

METHODS

The study included 21 medical physics and 11 radiation oncology participants. It was conducted over four 2-h laboratory sessions on pelvic, thoracic, and head and neck anatomy. A radiotherapy applicator device and augmented reality tools were brought in to focus on radiological anatomy and radiation therapy. Students' lab experiences were evaluated through post-laboratory surveys using a mixed methodology. Qualitative data from short-answer questions were analyzed using an inductive coding approach. Quantitative data from Likert scale questions were analyzed with descriptive statistics.

RESULTS

All participants reported gross anatomy laboratory sessions as a superior method of learning anatomy compared with a single didactic course (mean Likert: 4.38; median = 5; SD = 0.74). Participants also expressed greater comfort with radiological anatomy and the lab environment with gradual exposure from pelvic prosections to full-body cadavers. Lastly, all participants showed enthusiasm for multidisciplinary activities.

CONCLUSION

Carefully designed gross anatomy laboratory sessions were very well received by medical physics students as they transition into a clinical role in healthcare. This pilot study serves as a foundation for future studies exploring anatomical education in medical physics. These sessions will continue to be offered at our school and could be adopted also by other medical physics departments in their courses.

Medical physics graduate education in Mexico and its relation to the advances in radiation oncology

Aim

To evaluate the state of graduate education in medical physics and progress in radiation oncology (RO) equipment in Mexico since 2000, when conferring degrees from two master's-degree programs in Medical Physics began.

Background

Medical physics is a Health Profession and there are international recommendations for education, training, and certification. Both programs follow these education guidelines. The most common clinical occupation of graduates is in RO services. Techniques in Mexican RO include traditional and high-precision procedures.

Methods

Academic and occupational information about the programs and their graduates were obtained from official websites. Graduates were invited to respond to a survey that requested information about their present job. We obtained data on RO equipment and human resources from public databases and estimated staffing requirements of medical physicists (MPs).

Results

Medical physics programs have graduated a total of 225 MPs. Half of them work in a clinical environment and, of these, about 90 work in RO services. MPs with M.Sc. degrees constitute 36% of the current MP workforce in RO, estimated to be 250 individuals. Survey responses pointed out the main merits and limitations of the programs. The number of MPs in RO has increased fivefold and the number of linacs sixfold in 15 years. The present number of MPs is insufficient, according to published guidelines.

Conclusion

All MPs in RO services with advanced modalities must be trained following international recommendations for graduate education and post-graduation clinical training. Education and health institutions must find incentives to create more graduate programs and clinical residencies.

Assessment of carboxyhemoglobin content in the blood with high accuracy: wavelength range optimization for nonlinear curve fitting of optical spectra

The impact of carbon monoxide (CO) gas on the human organism is very dangerous. The affinity of CO to hemoglobin is considerably higher than that of oxygen. Thus, the interaction of CO with the blood results in a higher content of carboxyhemoglobin (HbCO) in red blood cells (RBCs) and correspondingly in tissue hypoxia. The disruption in the organism depends on the HbCO content in the blood. To assess any complications in the body at a given moment due to CO exposure and predict future consequences, it is necessary to measure the dynamics of hemoglobin derivative concentrations simultaneously. However, measuring HbCO and other derivatives in RBCs without hemolysis accurately is complicated due to the strong intercollinearity between the molar absorptivities of hemoglobin derivatives and superposition of absorption and scattering spectra. In the present study, to quantitatively assess the contents of the hemoglobin derivatives in the blood after exposure to CO, improved accuracy is achieved by optimizing the wavelength range used for the nonlinear curve fitting of optical spectra. Experimental spectra were measured in the wavelength range Δλ=500−700nm. For each experimental curve, it was established the value of optimal interval Δλopt for which the correlation coefficient between experimental data and corresponding points of the theoretical fitting curve was the maximum in the wavelength range Δλtyp=535−580nm, which contains the typical absorption peaks for HbO2, Hb, and HbCO. The concentrations obtained based on such fitting curves were considered to be highly accurate. The quantitative assessment enabled the determination of theHbCO nonlinear increase with the time of CO exposure in the in vitro experiment and the study of the dynamics of hemoglobin derivative transformations during blood incubation.

Leadership and mentoring in medical physics: The experience of a medical physics international mentoring program

Mentoring aims to improve careers and create benefits for the participants' personal and professional lives. Mentoring can be an individual or a shared experience for a group, while the mentor's role remains the same in both models. Mentors should increase confidence, teach, inspire, and set examples, helping the mentees to mould their path, contributing to the pursuit of their personal and professional goals. This study aims to report on the experience of early-career medical physics professionals and postgraduate students participating in a global mentoring program and to assess the impact of this activity on their professional development. The objectives of this mentoring program are to develop leadership roles among young medical physicists and to provide guidance and support. An online questionnaire was administered to the mentee participants. The analysis of their responses is reported in this work and the current status of the programme was examined using a SWOT analysis. In general, the mentoring experience had a positive impact on the mentees. The mentors were found especially helpful in the decision-making situations and in other conflicts that may arise with career development. Additionally, the mentees felt that mentoring contributed to the development of leadership skills required for the job market and assist in personal development. This paper concludes that participation of young medical physicists in a mentoring group program is beneficial to their career and therefore should be encouraged.

Professional quality of life and burnout among medical physicists working in radiation oncology: The role of alexithymia and empathy

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Burnout is critical for oncology professionals, affecting quality of life and performance at work.

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Alexithymia and empathy are personality traits influencing the capacity to cope with stress.

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Alexithymia increases burnout among medical physicists with a negative impact at work.

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Higher level of empathy are correlated to a better professional quality of life.

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This data may help identifying subjects at risk to implement preventive strategies.

Background and purpose

The professional quality of life of radiation oncology professionals can be influenced by different contributing factors, including personality traits. Alexithymia involves deficits in emotion processing and awareness. Empathy is the ability to understand another’s ‘state of mind/emotion’. We investigated professional quality of life, including burnout, in radiation oncology, exploring the role of alexithymia and empathy and targeting the population of medical physicists (MPs), since this professional category is usually underrepresented in surveys exploring professional well-being in radiation oncology and MPs may experience professional distress given the increasing complexity of multimodal cancer care.

Material and methods

An online survey was addressed to ESTRO members. Participants filled out three questionnaires to evaluate alexithymia, empathy and professional quality of life: a) Toronto Alexithymia Scale (TAS-20); b) Interpersonal Reactivity Index (IRI); c) Professional Quality of Life Scale (ProQoL). Professional quality of life as per ProQoL was considered as dependent variable. The three domains of the ProQoL, namely compassion satisfaction (CS), secondary traumatic stress (STS) and burnout were correlated with alexithymia (as per TAS-20) and empathy (as per IRI with three subcategories: empathic concern, perspective taking and personal distress) and demographic/professional characteristics as independent variables. Generalized linear modeling was used. Significant covariates on univariate linear regression analysis were included in the multivariate linear regression model.

Results

A total of 308 medical physicists completed all questionnaires. Alexithymia as per TAS-20 was correlated to decreased CS (β = −0.25, p < 0 0.001), increased likelihood for STS (β = 0.26, p < 0 0.001) and burnout (β = 0.47, p < 0 0.001). With respect to empathy, the ‘Empatic Concern’ subscale of the IRI was found to be a significant predictor for increased CS (β = 0.19, p = 0 0.001) and increased STS (β = 0.19, p < 0 0.001), without significant correlation with burnout. The individual’s perception of being valued by own’s supervisor was correlated to increased CS (β = 0.23, p < 0.001), and decreased burnout (β = −0.29, p < 0.001).

Conclusions

Alexithymic personality trait increased the likelihood to develop burnout, with less professional satisfaction amongst MPs working in radiation oncology. Empathy results in higher professional fulfilment. These results may be used to benchmark preventing strategies, including peer support, debriefing sessions, leadership initiatives and work-load limitation strategies.

Applications of MCNP simulation in treatment planning: a comparative study

Monte Carlo codes have been used for approximately 80 years to solve various problems in medical physics. In this paper, the importance of the MCNPX code in treatment planning is highlighted. As illustrative examples of the role of MCNPX in this field, some dosimetric parameters, isodose distribution curves, and figures of merit (FOMs) were considered for photon beams of various energies. To the best of the authors' knowledge, such a systematic study has not been done before. Tissue-air ratio values were obtained as a function of depth in tissue as well as field size. The results of the simulations were in agreement within 3.5% with experimental results reported in the literature. Backscatter factor values were calculated as a function of beam energy, and found to be in agreement with published experimental values within 5.9%. The isodose curves for different conditions and beam arrangements were also simulated. Besides, FOMs were calculated for different radiation energies. All the results were in agreement with related data in the literature. It is concluded that the MCNPX code and the models developed in the present study can be used in different conditions where these parameters are involved, improving individualized treatment planning for individual patients.

Comparison of fetal heart rate variability by symbolic dynamics at the third trimester of pregnancy and low-risk parturition

Fetal heart rate variability (fHRV) is an essential source of information to monitor fetal well-being during pregnancy. This study aimed to apply a nonlinear approach, known as symbolic dynamics (SD), for comparing human fHRV in the third trimester of pregnancy during active fetal state (TT) and active labor at term (P). We performed a longitudinal, prospective, descriptive, and comparative study composed of 42 longitudinal recordings of 5-minutes of fetal heartbeat interval series. Recordings were collected from 21 low-risk, healthy, pregnant women attending the Maternal and Child Research Center (CIMIGen), Mexico City. We calculated relevant linear parameters of fHRV between TT and P stages, such as the percentage of differences between adjacent RR intervals >5 ms (PRR5, related to vagal modulations) and other SD parameters such as the percentage of no variations between three successive symbols (%0V, reflects sympathetic modulations) and the probability of low variability with a threshold of 4 ms (POLVAR4, associated with a low variability). We identified statistical differences for PRR5 between TT and P (37.13% [28.47-47.60%] vs. 28.84% [19.36-36.76%], p = 0.03), respectively. Also, for 0V% (65.66% [59.01-71.80%] vs. 71.14% [65.94-75.87%], p = 0.03) and for POLVAR4 values (0.06 [0.04-0.11] vs. 0.15 [0.09-0.24], p = 0.002), respectively. Our results indicate that during parturition, the short-term fetal fHRV is decreased, showing a decreased vagal modulations and higher adrenergic response of the heart. These autonomic modifications may result from the fetal response to the stressful inflammatory challenge of labor. We thus confirmed that the analysis of the SD applied to fHRV time series could be a potential clinical biomarker to differentiate the fetal autonomic cardiac condition at different stages of pregnancy.

Implementation of a simple clinical linear accelerator beam model in MCNP6 and comparison with measured beam characteristics

Monte Carlo N-Particle 6 (MCNP6) is the latest version of Los Alamos National Laboratory's powerful Monte Carlo software designed to compute general photon, neutron, and electron transport using stochastic algorithms. Here we provide a case study of modeling the photon beam of a Varian 600C Clinical Linear Accelerator (linac), which is used to deliver radiation therapy, along with a comparison to experimentally measured beam characteristics. The source definition parameters in MCNP6, including the energy spectrum and angular spectrum of the photons, secondary and tertiary collimators, and a water phantom that tallied dose delivered at different points along the phantom are included. The experimental data for comparison was in the form of a percent depth dose curve as well as crossline and inline beam profiles. Experimental depth dose curve and beam profiles were acquired using a standard 0.125 cc ion chamber within a water phantom. In the computational model, the simulated depth dose curve was computed by tallying the total energy deposited in a stack of vertical slices down the depth of the phantom for percent depth dose curves. The simulated beam profiles were computed in a similar fashion, by tallying the energy deposited in a horizontal row, both in the x- and y-directions of cubic cells located at various depths. For the percent depth dose curve, a mean absolute percentage difference of 1.02%, 1.07%, and 1.94% were calculated for field sizes of 5 × 5 cm², 10 × 10 cm² and 20 × 20 cm², respectively, between the model and experimental measurements were calculated. We present our model as an example to guide other MCNP6 users in the medical physics community to create similar beam models for biomedical dose estimation and research calculations for predicting dose to newly developed phantoms.

Survey of postgraduate medical physics programmes in the Asia-Oceania region

The increased use of medical imaging and radiation therapies has resulted in a high demand for medical physicists. Although medical physics programmes are well established in advanced countries, the same cannot be said for many low- and medium-income countries. In some countries, there may be huge variations in the graduates' skill and quality, which pose a problem in ensuring patient safety, providing quality assurance in treatments, optimisation of protocols and standardisation of quality. It also makes any yet-to-be-established regional peer recognition efforts problematic. In order to understand the depth of this problem, a survey was carried out as part of the home-based assignment under the RAS 6088 IAEA programme. A large diversity in terms of course content, duration, clinical training and student profile could be observed across the Asia-Oceania universities surveyed. Out of 25 programmes, only six received recognition from professional bodies, and they were mostly in Australia and New Zealand. Hence, to ensure quality education, a regional curriculum model needs to be developed to harmonise standards. And there is still a long way to go towards standardizing medical physics education and clinical training in the region.

[RadioTransNet, the French network for preclinical research in oncological radiotherapy]

The ambition of the RADIOTRANSNET network, launched by the INCa at the end of 2018, is to create a French research consortium dedicated to preclinical radiotherapy to foster scientific and clinical interactions at the interface of radiotherapy and radiobiology, and to identify research priorities dedicated to innovation in radiotherapy. The activities of the network are organized around four major axes that are target definition, normal tissue, combined treatments and dose modelling. Under the supervision of the Scientific Council, headed by a coordinator designated by the SFRO and a co-coordinator designated by the SFPM, three leaders coordinate each axis: a radiation-oncologist, a medical physicist and a biologist, who are responsible for organizing a scientific meeting based on the consensus conference methodology to identify priority issues. The selected themes will be the basis for the establishment of a strategic research agenda and a roadmap to help coordinate national basic and translational research efforts in oncological radiotherapy. This work will be published and will be transmitted to the funding institutions and bodies with the aim of opening dedicated calls to finance the necessary human and technical resources. Structuration of a preclinical research network will allow coordinating the efforts of all the actors in the field and thus promoting innovation in radiotherapy.

Lausanne checklist for safe stereotactic radiosurgery

INTRODUCTION

Stereotactic radiosurgery (SRS) is increasingly used as a minimally invasive alternative in many neurosurgical conditions, including benign and malignant tumors, vascular malformations, and functional procedures. As for any surgical procedure, strict safety guidelines and checklists are necessary to avoid errors and the inherent unnecessary complications. With regard to the former, other groups have already reported human and/or technical errors. We describe our safety checklist for Gamma Knife radiosurgical procedures.

METHODS

We describe our checklist protocol after an experience gained over 1500 radiosurgical procedures, using Gamma Knife radiosurgery, performed over a period of 8 years, while employing the same list of items. Minor implementation has been performed over time to address some safety issues that could be improved.

RESULTS

Two types of checklist are displayed. One is related to the indications when a specific tissue volume is irradiated, including tumors or vascular disorders. The second corresponds to functional disorders, such as when the dose is prescribed to one specific point. Using these checklists, no human error had been reported during the past 8 years of practice in our institution.

CONCLUSION

The use of a safety checklist for SRS procedures promotes a zero-tolerance attitude for errors. This can lower the complications and is of major help in promoting multidisciplinary cooperation. We highly recommend the use of such tool, especially in the context of the increased use of SRS in the neurosurgical field.

Practicality and importance of selected endothelial dysfunction measurement techniques: review

The measurement of endothelial dysfunction (ED) has importance in that it indicates the presence of coronary artery disease (Kuvin et al. in J Am Coll Cardiol 38(7):1843-1849, 2001) in addition to acting as a predictor of future adverse events (Halcox et al. in Circulation 106:653-658, 2002). Various tools, methods, and metrics exist that can provide an indicator of endothelial dysfunction. Given the significance of ED, it is of utmost importance to find a measurement technique that is reliable, while defining a metric providing a framework for an overall system that is practical, accurate, and repeatable. Success would provide a tool for the early detection of cardiovascular disease not only moving patients that are currently classified as asymptomatic to symptomatic, but also providing a method to monitor the efficacy of treatments.

AFOMP policy number 6: code of ethics for medical physicists in AFOMP Countries

This policy statement, which is the sixth of a series of documents prepared by the Asia-Oceania Federation of Organizations for Medical Physics (AFOMP) Professional Development Committee, gives guidance on how medical physicists in AFOMP countries should conduct themselves in an ethical manner in their professional practice (Ng et al. in Australas Phys Eng Sci Med 32:175-179, 2009; Round et al. in Australas Phys Eng Sci Med 33:7-10, 2010; Round et al. in Australas Phys Eng Sci Med 34:303-307, 2011; Round et al. in Australas Phys Eng Sci Med 35:393-398, 2012; Round et al. in Australas Phys Eng Sci Med 38:217-221, 2015). It was developed after the ethics policies and codes of conducts of several medical physics societies and other professional organisations were studied. The policy was adopted at the Annual General Meeting of AFOMP held in Jaipur, India, in November 2017.

Future forum, Hobart, October 29, 2017: examining the role of medical physics in cancer research

This commentary reports on a forum held in October 2017 in Hobart, Tasmania, attended by 20 Australasian medical physicists, to consider the future role of medical physics, as well as non-medical physics and allied disciplines, in oncology research. Attendees identified important areas of oncology research which physicists can be contributing to, with these evaluated in the context of a set of "Provocative Questions" recently generated by the American Association of Physicists in Medicine. Primary perceived barriers to participation in research were identified, including a "lack of knowledge of cancer science", together with potential solutions. Mechanisms were considered for engagement with the broader scientific community, consumers, advocates and policy makers. In considering future opportunities in oncology research for medical physicists, it was noted that a professional need to focus on the safety and accuracy of current treatments applied to patients, encouraging risk-aversion, is somewhat in competition with the role of physical scientists in the exploration and discovery of new concepts and understandings.

Editorial: The role of medical physics in lung SBRT

Stereotactic body radiation therapy (SBRT) has become a standard treatment for non-operable patients with early stage non-small cell lung cancer (NSCLC). In this context, medical physics community has largely helped in the starting and the growth of this technique. In fact, SBRT requires the convergence of many different features for delivering large doses in few fractions to small moving target in an heterogeneous medium. The special issue of last month, was focused on the different physics challenges in lung SBRT. Eleven reviews were presented, covering: imaging for treatment planning and for treatment assessment; dosimetry and planning optimization; treatment delivery possibilities; image guidance during delivery; radiobiology. The current cutting edge role of medical physics was reported. We aimed to give a complete overview of different aspects of lung SBRT that would be of interest to both physicists implementing this technique in their institutions and more experienced physicists that would be inspired to start research projects in areas that still need further developments. We also feel that the role that medical physicists have played in the development and safe implementation of SBRT, particularly in lung region, can be taken as an excellent example to be translated to other areas, not only in Radiation Oncology but also in other health sectors.

Radiation dose associated with CT-guided drain placement for pediatric patients

BACKGROUND

To date, there are limited radiation dose data on CT-guided procedures in pediatric patients.

OBJECTIVE

Our goal was to quantify the radiation dose associated with pediatric CT-guided drain placement and follow-up drain evaluations in order to estimate effective dose.

MATERIALS AND METHODS

We searched the electronic medical record and picture archiving and communication system (PACS) to identify all pediatric (<18 years old) CT-guided drain placements performed between January 2008 and December 2013 at our institution. We compiled patient data and radiation dose information from CT-guided drain placements as well as pre-procedural diagnostic CTs and post-procedural follow-up fluoroscopic abscess catheter injections (sinograms). Then we converted dose-length product, fluoroscopy time and number of acquisitions to effective doses using Monte Carlo simulations and age-appropriate conversion factors based on annual quality-control testing.

RESULTS

Fifty-two drainages were identified with mean patient age of 11.0 years (5 weeks to 17 years). Most children had diagnoses of appendicitis (n=23) or inflammatory bowel disease (n=11). Forty-seven patients had diagnostic CTs, with a mean effective dose of 7.3 mSv (range 1.1-25.5 mSv). Drains remained in place for an average of 16.9 days (range 0-75 days), with an average of 0.9 (0-5) sinograms per patient in follow-up. The mean effective dose for all drainages and follow-up exams was 5.3 mSv (0.7-17.1) and 62% (32/52) of the children had effective doses less than 5 mSv.

CONCLUSION

The majority of pediatric patients who have undergone CT-guided drain placements at our institution have received total radiation doses on par with diagnostic ranges. This information could be useful when describing the dose of radiation to parents and providers when CT-guided drain placement is necessary.

Web of Science, Scopus, and Google Scholar citation rates: a case study of medical physics and biomedical engineering: what gets cited and what doesn't?

There are often differences in a publication's citation count, depending on the database accessed. Here, aspects of citation counts for medical physics and biomedical engineering papers are studied using papers published in the journal Australasian physical and engineering sciences in medicine. Comparison is made between the Web of Science, Scopus, and Google Scholar. Papers are categorised into subject matter, and citation trends are examined. It is shown that review papers as a group tend to receive more citations on average; however the highest cited individual papers are more likely to be research papers.

The role of medical physics in prostate cancer radiation therapy

Medical physics, both as a scientific discipline and clinical service, hugely contributed and still contributes to the advances in the radiotherapy of prostate cancer. The traditional translational role in developing and safely implementing new technology and methods for better optimizing, delivering and monitoring the treatment is rapidly expanding to include new fields such as quantitative morphological and functional imaging and the possibility of individually predicting outcome and toxicity. The pivotal position of medical physicists in treatment personalization probably represents the main challenge of current and next years and needs a gradual change of vision and training, without losing the traditional and fundamental role of physicists to guarantee a high quality of the treatment. The current focus issue is intended to cover traditional and new fields of investigation in prostate cancer radiation therapy with the aim to provide up-to-date reference material to medical physicists daily working to cure prostate cancer patients. The papers presented in this focus issue touch upon present and upcoming challenges that need to be met in order to further advance prostate cancer radiation therapy. We suggest that there is a smart future for medical physicists willing to perform research and innovate, while they continue to provide high-quality clinical service. However, physicists are increasingly expected to actively integrate their implicitly translational, flexible and high-level skills within multi-disciplinary teams including many clinical figures (first of all radiation oncologists) as well as scientists from other disciplines.

Women in medical physics: a preliminary analysis of workforce and research participation in Australia and New Zealand

Although the participation of women within the science, technology, engineering and mathematics workforces has been widely discussed over recent decades, the recording and analysis of data pertaining to the gender balance of medical physicists in Australia and New Zealand remains rare. This study aimed to provide a baseline for evaluating future changes in workforce demographics by quantifying the current level of representation of women in the Australasian medical physics workforce and providing an indication of the relative contribution made by those women to the local research environment. The 2015 Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM) member directory and list of chief physicists at ACPSEM-accredited radiation oncology and diagnostic imaging training centres were interrogated to identify the gender balance of medical physicists working in Australia and New Zealand. A specific investigation of the employment levels of all medical physicists in Queensland was undertaken to provide an example of the gender balance at different levels of seniority in one large Australian state. Lists of authors of medical physics presentations at ACPSEM annual conferences and authors of publications in the ACPSEM's official journal, were used to provide an indication of the gender balance in published research within Australia and New Zealand. The results of this study showed that women currently constitute approximately 28 % of the medical physics workforce in Australia and New Zealand, distributed disproportionally in junior roles; there is a decrease in female participation in the field with increasing levels of seniority, which is particularly apparent in the stratified data obtained for the Queensland workforce. Comparisons with older data suggest that this situation has changed little since 2008. Examination of ACPSEM conference presentations suggested that there are similar disparities between the gender-balance of proffered and invited or keynote speakers (28 % and 13 % from female authors) and the gender balance of certified and chief physicists (28 % and 21 % female). The representation of women in the ACPSEM journal does not differ substantially between authorship of proffered versus invited work (22 % and 19 % from female authors). While this work was limited to evaluating the membership, annual conference and official journal of the ACPSEM (rather than evaluating the entire medical physics workforce and the contributions of male and female physicists to international conferences and publications), this study nonetheless led to the following recommendations: that a longitudinal study analysing correlations between age, period of service, seniority and gender should be undertaken and that future ACPSEM workforce surveys should include analyses of gender representation.

Medical physics in radiotherapy: The importance of preserving clinical responsibilities and expanding the profession's role in research, education, and quality control

Medical physicists have long had an integral role in radiotherapy. In recent decades, medical physicists have slowly but surely stepped back from direct clinical responsibilities in planning radiotherapy treatments while medical dosimetrists have assumed more responsibility. In this article, I argue against this gradual withdrawal from routine therapy planning. It is essential that physicists be involved, at least to some extent, in treatment planning and clinical dosimetry for each and every patient; otherwise, physicists can no longer be considered clinical specialists. More importantly, this withdrawal could negatively impact treatment quality and patient safety. Medical physicists must have a sound understanding of human anatomy and physiology in order to be competent partners to radiation oncologists. In addition, they must possess a thorough knowledge of the physics of radiation as it interacts with body tissues, and also understand the limitations of the algorithms used in radiotherapy. Medical physicists should also take the lead in evaluating emerging challenges in quality and safety of radiotherapy. In this sense, the input of physicists in clinical audits and risk assessment is crucial. The way forward is to proactively take the necessary steps to maintain and advance our important role in clinical medicine.

Correction Techniques in Emission Tomography

Correction Techniques in Emission Tomography., Dawood M., Jiang X., Schäfers K., CRC Press, Taylor & Francis Group, Boca Raton, FL, 2012. 287 pp. Price: $119.95. ISBN: 9781439812983 (hardcover). © 2013 Doody's Review Service. Doody's Review Service.