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At least 145 records · Page 8

SU-B-213-02: Development of CAMPEP Standards

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-213-03: Evaluation of Graduate Programs

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-213-04: Evaluation of Residency Programs

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-213-05: Development of ABR Certification Standards

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-213-06: Development of ABR Examination Questions

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-213-07: Panel Discussion

The North American medical physics community validates the education received by medical physicists and the clinical qualifications for medical physicists through accreditation of educational programs and certification of medical physicists. Medical physics educational programs (graduate education and residency education) are accredited by the Commission on Accreditation of Medical Physics Education Programs (CAMPEP), whereas medical physicists are certified by several organizations, the most familiar of which is the American Board of Radiology (ABR). In order for an educational program to become accredited or a medical physicist to become certified, the applicant must meet certain specified standards set by the appropriate organization. In this Symposium, representatives from both CAMPEP and the ABR will describe the process by which standards are established as well as the process by which qualifications of candidates for accreditation or certification are shown to be compliant with these standards. The Symposium will conclude with a panel discussion. Learning Objectives: Recognize the difference between accreditation of an educational program and certification of an individual Identify the two organizations primarily responsible for these tasks Describe the development of educational standards Describe the process by which examination questions are developed GS is Executive Secretary of CAMPEP.

61 RADIATION PROTECTION AND DOSIMETRY↗

TU-G-213-01: IEC and US Committee Activities and Organizational Structure

The International Electrotechnical Commission (IEC) writes standards that manufacturers of electrical equipment must comply with. Medical electrical equipment, such as medical imaging, radiation therapy, and radiation dosimetry devices, fall under Technical Committee 62. Of particular interest to medical physicists are the standards developed within Subcommittees (SC) 62B, which addresses diagnostic radiological imaging equipment, and 62C, which addresses equipment for radiation therapy, nuclear medicine and dosimetry. For example, a Working Group of SC 62B is responsible for safety and quality assurance standards for CT scanners and a Working Group of SC 62C is responsible for standards that set requirements for dosimetric safety and accuracy of linacs and proton accelerators. IEC standards thus have an impact on every aspect of a medical physicist’s job, including equipment testing, shielding design, room layout, and workflow. Consequently, it is imperative that US medical physicists know about existing standards, as well as have input on those under development or undergoing revision. The structure of the IEC and current standards development work will be described in detail. The presentation will explain how US medical physicists can learn about IEC standards and contribute to their development. Learning Objectives: Learn about the structure of the IEC and the influence that IEC standards have on the design of equipment for radiology and radiation therapy. Learn about the mechanisms by which the US participates in the development and revision of standards. Understand the specific requirements of several standards having direct relevance to diagnostic and radiation therapy physicists.

60 APPLIED LIFE SCIENCES↗

TU-G-213-02: IEC Subcommittee 62B (Diagnostic Imaging Equipment): Recent and Active Projects

The International Electrotechnical Commission (IEC) writes standards that manufacturers of electrical equipment must comply with. Medical electrical equipment, such as medical imaging, radiation therapy, and radiation dosimetry devices, fall under Technical Committee 62. Of particular interest to medical physicists are the standards developed within Subcommittees (SC) 62B, which addresses diagnostic radiological imaging equipment, and 62C, which addresses equipment for radiation therapy, nuclear medicine and dosimetry. For example, a Working Group of SC 62B is responsible for safety and quality assurance standards for CT scanners and a Working Group of SC 62C is responsible for standards that set requirements for dosimetric safety and accuracy of linacs and proton accelerators. IEC standards thus have an impact on every aspect of a medical physicist’s job, including equipment testing, shielding design, room layout, and workflow. Consequently, it is imperative that US medical physicists know about existing standards, as well as have input on those under development or undergoing revision. The structure of the IEC and current standards development work will be described in detail. The presentation will explain how US medical physicists can learn about IEC standards and contribute to their development. Learning Objectives: Learn about the structure of the IEC and the influence that IEC standards have on the design of equipment for radiology and radiation therapy. Learn about the mechanisms by which the US participates in the development and revision of standards. Understand the specific requirements of several standards having direct relevance to diagnostic and radiation therapy physicists.

60 APPLIED LIFE SCIENCES↗

TU-G-213-03: IEC Subcommittee 62C (Equipment for Radiotherapy, Nuclear Medicine and Radiation Dosimetry): Recent and Active Projects

The International Electrotechnical Commission (IEC) writes standards that manufacturers of electrical equipment must comply with. Medical electrical equipment, such as medical imaging, radiation therapy, and radiation dosimetry devices, fall under Technical Committee 62. Of particular interest to medical physicists are the standards developed within Subcommittees (SC) 62B, which addresses diagnostic radiological imaging equipment, and 62C, which addresses equipment for radiation therapy, nuclear medicine and dosimetry. For example, a Working Group of SC 62B is responsible for safety and quality assurance standards for CT scanners and a Working Group of SC 62C is responsible for standards that set requirements for dosimetric safety and accuracy of linacs and proton accelerators. IEC standards thus have an impact on every aspect of a medical physicist’s job, including equipment testing, shielding design, room layout, and workflow. Consequently, it is imperative that US medical physicists know about existing standards, as well as have input on those under development or undergoing revision. The structure of the IEC and current standards development work will be described in detail. The presentation will explain how US medical physicists can learn about IEC standards and contribute to their development. Learning Objectives: Learn about the structure of the IEC and the influence that IEC standards have on the design of equipment for radiology and radiation therapy. Learn about the mechanisms by which the US participates in the development and revision of standards. Understand the specific requirements of several standards having direct relevance to diagnostic and radiation therapy physicists.

60 APPLIED LIFE SCIENCES↗

SU-G-TeP4-09: Development of a Plan Data Aggregator for Time Efficient Physics Second-Checks of Machine Parameters for External Beam Treatment Plans

Purpose: Physics second-checks for external beam radiation therapy are performed, in-part, to verify that the machine parameters in the Record-and-Verify (R&V) system that will ultimately be sent to the LINAC exactly match the values initially calculated by the Treatment Planning System (TPS). While performing the second-check, a large portion of the physicists’ time is spent navigating and arranging display windows to locate and compare the relevant numerical values (MLC position, collimator rotation, field size, MU, etc.). Here, we describe the development of a software tool that guides the physicist by aggregating and succinctly displaying machine parameter data relevant to the physics second-check process. Methods: A data retrieval software tool was developed using Python to aggregate data and generate a list of machine parameters that are commonly verified during the physics second-check process. This software tool imported values from (i) the TPS RT Plan DICOM file and (ii) the MOSAIQ (R&V) Structured Query Language (SQL) database. The machine parameters aggregated for this study included: MLC positions, X&Y jaw positions, collimator rotation, gantry rotation, MU, dose rate, wedges and accessories, cumulative dose, energy, machine name, couch angle, and more. Results: A GUI interface was developed to generate a side-by-side display of the aggregated machine parameter values for each field, and presented to the physicist for direct visual comparison. This software tool was tested for 3D conformal, static IMRT, sliding window IMRT, and VMAT treatment plans. Conclusion: This software tool facilitated the data collection process needed in order for the physicist to conduct a second-check, thus yielding an optimized second-check workflow that was both more user friendly and time-efficient. Utilizing this software tool, the physicist was able to spend less time searching through the TPS PDF plan document and the R&V system and focus the second-check efforts on assessing the patient-specific plan-quality.

60 APPLIED LIFE SCIENCES↗

The Smallest Drops of the Hottest Matter? New Investigations at the Relativistic Heavy Ion Collider (493rd Brookhaven Lecture)

Pool sharks at the billiards hall know that sometimes you aim to rocket the cue ball for a head-on collision, and other times, a mere glance will do. Physicists need to know more than a thing or two about collision geometry too, as they sift through data from the billions of ions that smash together at the Relativistic Heavy Ion Collider (RHIC). Determining whether ions crash head-on or just glance is crucial for the physicists analyzing data to study quark-gluon plasma—the ultra-hot, "perfect" liquid of quarks and gluons that existed more than 13 billion years ago, before the first protons and neutrons formed. For these physicists, collision geometry data provides insights about quark-gluon plasma's extremely low viscosity and other unusual properties, which are essential for understanding more about the "strong force" that holds together the nucleus, protons, and neutrons of every atom in the universe. Dr. Sickles explains how physicists use data collected at house-sized detectors like PHENIX and STAR to determine what happens before, during, and after individual particle collisions among billions at RHIC. She also explains how the ability to collide different "species" of nuclei at RHIC—including protons and gold ions today and possibly more with a proposed future electron-ion collider upgrade (eRHIC)—enables physicists to probe deeper into the mysteries of quark-gluon plasma and the strong force.

43 PARTICLE ACCELERATORS↗

Quantum computing for finance

Quantum computers are expected to surpass the computational capabilities of classical computers and have a transformative impact on numerous industry sectors. Here, we present a comprehensive summary of the state of the art of quantum computing for financial applications, with particular emphasis on stochastic modelling, optimization and machine learning. This Review is aimed at physicists, so it outlines the classical techniques used by the financial industry and discusses the potential advantages and limitations of quantum techniques. Finally, we look at the challenges that physicists could help tackle. Quantum computers are expected to surpass classical computers and transform industries. This Review focuses on quantum computing for financial applications and provides a summary for physicists on potential advantages and limitations of quantum techniques, as well as challenges that physicists could help tackle.

97 MATHEMATICS AND COMPUTING↗

A computer aided treatment event recognition system in radiation therapy

Purpose: To develop an automated system to safeguard radiation therapy treatments by analyzing electronic treatment records and reporting treatment events. Methods: CATERS (Computer Aided Treatment Event Recognition System) was developed to detect treatment events by retrieving and analyzing electronic treatment records. CATERS is designed to make the treatment monitoring process more efficient by automating the search of the electronic record for possible deviations from physician's intention, such as logical inconsistencies as well as aberrant treatment parameters (e.g., beam energy, dose, table position, prescription change, treatment overrides, etc). Over a 5 month period (July 2012–November 2012), physicists were assisted by the CATERS software in conducting normal weekly chart checks with the aims of (a) determining the relative frequency of particular events in the authors’ clinic and (b) incorporating these checks into the CATERS. During this study period, 491 patients were treated at the University of Iowa Hospitals and Clinics for a total of 7692 fractions. Results: All treatment records from the 5 month analysis period were evaluated using all the checks incorporated into CATERS after the training period. About 553 events were detected as being exceptions, although none of them had significant dosimetric impact on patient treatments. These events included every known event type that was discovered during the trial period. A frequency analysis of the events showed that the top three types of detected events were couch position override (3.2%), extra cone beam imaging (1.85%), and significant couch position deviation (1.31%). The significant couch deviation is defined as the number of treatments where couch vertical exceeded two times standard deviation of all couch verticals, or couch lateral/longitudinal exceeded three times standard deviation of all couch laterals and longitudinals. On average, the application takes about 1 s per patient when executed on either a desktop computer or a mobile device. Conclusions: CATERS offers an effective tool to detect and report treatment events. Automation and rapid processing enables electronic record interrogation daily, alerting the medical physicist of deviations potentially days prior to performing weekly check. The output of CATERS could also be utilized as an important input to failure mode and effects analysis.

62 RADIOLOGY AND NUCLEAR MEDICINE↗

ITAR: A modified TAR method to determine depth dose distribution for an ophthalmic device that performs kilovoltage x-ray pencil-beam stereotaxy

Purpose: New technology has been developed to treat age-related macular degeneration (AMD) using 100 kVp pencil-beams that enter the patient through the radio-resistant sclera with a depth of interest between 1.6 and 2.6 cm. Measurement of reference and relative dose in a kilovoltage x-ray beam with a 0.42 cm diameter field size and a 15 cm source to axis distance (SAD) is a challenge that is not fully addressed in current guidelines to medical physicists. AAPM's TG-61 gives dosimetry recommendations for low and medium energy x-rays, but not all of them are feasible to follow for this modality. Methods: An investigation was conducted to select appropriate equipment for the application. PTW's Type 34013 Soft X-Ray Chamber (Freiburg, Germany) and CIRS's Plastic Water LR (Norfolk, VA) were found to be the best available options. Attenuation curves were measured with minimal scatter contribution and thus called Low Scatter Tissue Air Ratio (LSTAR). A scatter conversion coefficient (C{sub scat}) was derived through Monte Carlo radiation transport simulation using MCNPX (LANL, Los Alamos, NM) to quantify the difference between a traditional TAR curve and the LSTAR curve. A material conversion coefficient (C{sub mat}) was determined through experimentation to evaluate the difference in attenuation properties between water and Plastic Water LR. Validity of performing direct dosimetry measurements with a source to detector distance other than the treatment distance, and therefore a different field size due to a fixed collimator, was explored. A method—Integrated Tissue Air Ratio (ITAR)—has been developed that isolates each of the three main radiological effects (distance from source, attenuation, and scatter) during measurement, and integrates them to determine the dose rate to the macula during treatment. Results: LSTAR curves were determined to be field size independent within the range explored, indicating that direct dosimetry measurements may be performed with a source to detector distance of 20 cm even though the SAD is 15 cm during treatment. C{sub scat} varied from 1.102 to 1.106 within the range of depths of interest. The experimental variance among repeated measurements of C{sub mat} was larger than depth dependence, so C{sub mat} was estimated as1.019 for all depths of interest. Conclusions: Equipment selection, measurement techniques, and formalism for the determination of dose rate to the macula during stereotaxy for AMD have been determined and are strongly recommended by the authors of this paper to be used by clinical medical physicists.

61 RADIATION PROTECTION AND DOSIMETRY↗

SU-B-BRF-01: Professional Council Symposium: The Evolving US Healthcare Delivery Model, How Will the Medical Physics Profession Be Impacted and How Should We Respond?

The United States' healthcare delivery model is undergoing significant change. Insurance and reimbursement models are rapidly evolving, federal allocations are shifting from specialty services to preventive and generalpractice services, and Accountable Care Organizations are gaining in prominence. One area of focus is on the perceived over-utilization of expensive services such as advanced imaging and, in some cases, radiation therapy. Reimbursement incentives are increasingly aimed at quality metrics, leading to an increased interest in the core concepts of High Reliability Organizations. With the shift in federal resources away from specialty services and the increasing prominence of Accountable Care Organizations, we will likely be challenged to re-assess our traditional model for delivering medical physics services. Medical physicists have a unique combination of education and training in physics principles, radiation physics applications in medicine, human anatomy, as well as safety analysis and quality control methods. An effective medical physicist recognizes that to advance the institution's mission, the medical physicist must join other professional leaders within the institution to provide clear direction and perspective for the entire team. To do that, we must first recognize the macro changes in our healthcare delivery system and candidly assess how the medical physics practice model can evolve in a prudent way to support the institution's objectives while maintaining the traditionally high level of quality and safety. This year's Professional Council Symposium will explore the many facets of the changing healthcare system and its potential impact on medical physics. Dr. Shine will provide an overview of the developing healthcare delivery and reimbursement models, with a focus on how the physician community has adapted to the changing objectives. Mr. White will describe recent changes in the reimbursement patterns for both imaging and radiation therapy services, the underlying imperatives that will influence additional changes in the near-term future, and the broader changes in the medical physics workforce that may arise due to many (often conflicting) directives and incentives both internal and external to the profession. Maintaining the integrity of the medical physics profession and the high quality of medical physics services will require a shared understanding of the changing practice environment and a firm commitment to protecting the key priorities of clinical medical physics as the healthcare system transitions to a new and very different model. To be effective as medical physicists, we must learn how to provide leadership in our respective institutions. Learning Objectives: Understand the macro changes occurring in the US healthcare delivery system. Understand the likely near-term, and possible longer-term, impact on the medical physics profession. Understand some strategies for providing leadership during this period of significant change.

07 ISOTOPE AND RADIATION SOURCES↗

TH-E-9A-01: Medical Physics 1.0 to 2.0, Session 4: Computed Tomography, Ultrasound and Nuclear Medicine

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidencebased medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below. CT 2.0: CT has been undergoing a dramatic transition in the last few decades. While the changes in the technology merits discussions of their own, an important question is how clinical medical physicists are expected to effectively engage with the new realities of CT technology and practice. Consistent with the upcoming paradigm of Medical Physics 2.0, this CT presentation aims to provide definitions and demonstration of the components of the new clinical medical physics practice pertaining CT. The topics covered include physics metrics and analytics that aim to provide higher order clinicallyrelevant quantification of system performance as pertains to new (and not so new) technologies. That will include the new radiation and dose metrics (SSDE, organ dose, risk indices), image quality metrology (MTF/NPS/d’), task-based phantoms, and the effect of patient size. That will follow with a discussion of the testing implication of new CT hardware (detectors, tubes), acquisition methods (innovative helical geometries, AEC, wide beam CT, dual energy, inverse geometry, application specialties), and image processing and analysis (iterative reconstructions, quantitative CT, advanced renditions). The presentation will conclude with a discussion of clinical and operational aspects of Medical Physics 2.0 including training and communication, use optimization (dose and technique factors), automated analysis and data management (automated QC methods, protocol tracking, dose monitoring, issue tracking), and meaningful QC considerations. US 2.0: Ultrasound imaging is evolving at a rapid pace, adding new imaging functions and modes that continue to enhance its clinical utility and benefits to patients. The ultrasound talk will look ahead 10–15 years and consider how medical physicists can bring maximal value to the clinical ultrasound practices of the future. The roles of physics in accreditation and regulatory compliance, image quality and exam optimization, clinical innovation, and education of staff and trainees will all be considered. A detailed examination of expected technology evolution and impact on image quality metrics will be presented. Clinical implementation of comprehensive physics services will also be discussed. Nuclear Medicine 2.0: Although the basic science of nuclear imaging has remained relatively unchanged since its inception, advances in instrumentation continue to advance the field into new territories. With a great number of these advances occurring over the past decade, the role and testing strategies of clinical nuclear medicine physicists must evolve in parallel. The Nuclear Medicine 2.0 presentation is designed to highlight some of the recent advances from a clinical medical physicist perspective and provide ideas and motivation for designing better evaluation strategies. Topics include improvement of traditional physics metrics and analytics, testing implications of hybrid imaging and advanced detector technologies, and strategies for effective implementation into the clinic. Learning Objectives: Become familiar with new physics metrics and analytics in nuclear medicine, CT, and ultrasound. To become familiar with the major new developments of clinical physics support. To understand the physics testing implications of new technologies, hardware, software, and applications. Identify approaches for implementing comprehensive medical physics services in future imaging practices.

60 APPLIED LIFE SCIENCES↗

SU-E-E-07: An Adaptable Approach for Education On Medical Physics at Undergraduate and Postgraduate Levels

Purpose: To contribute to the professional profile of future medical physicists, technologists and physicians, and implement an adaptable educational strategy at both undergraduate and postgraduate levels. Methods: The Medical Physics Block of Electives (MPBE) designed was adapted to the Program of B.S. in Physics. The conferences and practical activities were developed with participatory methods, with interdisciplinary collaboration from research institutions and hospitals engaged on projects of Research, Development and Innovation (RDI). The scientific education was implemented by means of critical analysis of scientific papers and seminars where students debated on solutions for real research problems faced by medical physicists. This approach included courses for graduates not associated to educational programs of Medical Physics (MP). Results: The implementation of the MPBE began in September 2014, with the electives of Radiation MP and Introduction to Nuclear Magnetic Resonance. The students of second year received an Introduction to MP. This initiative was validated by the departmental Methodological Workshop, which promoted the full implementation of the MPBE. Both postgraduated and undergraduate trainees participated in practices with our DICOM viewer system, a local prototype for photoplethysmography and a home-made interface for ROC analysis, built with MATLAB. All these tools were designed and constructed in previous RDI projects. The collaborative supervision of University’s researchers with clinical medical physicists will allow to overcome the limitations of residency in hospitals, to reduce the workload for clinical supervisors and develop appropriate educational activities. Conclusion: We demonstrated the feasibility of adaptable educational strategies, considering available resources. This provides an innovative way for prospective medical physicists, technologists and radiation oncologists. This strategy can be implemented in several regions without formal programs of MP, like most of developing countries. Starting with undergraduate students would allow to reach appropriate certification faster than most of traditional or alternative approaches for education on MP. The authors acknowledge Radiation Consulting Group, LLC, an Arizona Corporation which promotes the use of ionizing radiation in the healing arts, for the “Oscar Luis Caballero” travel grant. The authors thanks to professors Meisbel Daudinot, David Adame and Alexander Pascau for the practices through imagis, imageROC and ANGIODIN PD3000 respectively.

60 APPLIED LIFE SCIENCES↗

MO-D-BRB-00: Pediatric Radiation Therapy Planning, Treatment, and Late Effects

Most Medical Physicists working in radiotherapy departments see few pediatric patients. This is because, fortunately, children get cancer at a rate nearly 100 times lower than adults. Children have not smoked, abused alcohol, or been exposed to environmental carcinogens for decades, and of course, have not fallen victim to the aging process. Children get very different cancers than adults. Breast or prostate cancers, typical in adults, are rarely seen in children but instead a variety of tumors occur in children that are rarely seen in adults; examples are germinomas, ependymomas and primitive neuroectodermal tumors, which require treatment of the child’s brain or neuroblastoma, requiring treatment in the abdomen. The treatment of children with cancer using radiation therapy is one of the most challenging planning and delivery problems facing the physicist. This is because bones, brain, breast tissue, and other organs are more sensitive to radiation in children than in adults. Because most therapy departments treat mostly adults, when the rare 8 year-old patient comes to the department for treatment, the physicist may not understand the clinical issues of his disease which drive the planning and delivery decisions. Additionally, children are more prone than adults to developing secondary cancers after radiation. For bilateral retinoblastoma for example, an irradiated child has a 40% chance of developing a second cancer by age 50. The dosimetric tradeoffs made during the planning process are complex and require careful consideration for children treated with radiotherapy. In the first presentation, an overview of childhood cancers and their corresponding treatment techniques will be given. These can be some of the most complex treatments that are delivered in the radiation therapy department. These cancers include leukemia treated with total body irradiation, medulloblastoma, treated with craniospinal irradiation plus a conformal boost to the posterior fossa, neuroblastoma, requiring focal abdominal irradiation to avoid kidney, liver, and vertebral body damage, retinoblastoma, requiring treatment to an eye while minimizing dose to surrounding tissues, and a variety of other tumors which occur anywhere in the body. Case studies will be presented showing the treatment technique and resulting dosimetry, highlighting the objectives for tumor coverage and organ-at-risk sparing. Practical issues that have to be faced when treating children will also be discussed such as daily sedation and immobilization. Late effects based on the current understanding of dose-volume response in normal tissues will be discussed. In the second presentation, specific focus will be on pediatric proton therapy. We will review literature publications on dosimetric comparison of proton versus photon plans, common pediatric tumors treated with protons, and available clinical outcomes. We will describe simulation technique, treatment planning, image guidance for setup verification, and proton beam delivery unique to pediatric and adolescent patients. Finally, we will discuss desired improvements, outlook, and opportunities for medical physicists in pediatric proton therapy. Learning Objectives: Improve understanding about childhood cancer and treatment with radiation Understand treatment planning and delivery issues and associated late effects specific to children Become aware of specific treatment methods for the most challenging pediatric cancers Know the current status, techniques, and desired improvements for pediatric proton therapy.

60 APPLIED LIFE SCIENCES↗