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TU-A-304-00: Imaging, Treatment Planning, and QA for Stereotactic Body Radiation Therapy (SBRT)

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-A-304-01: Introduction and Workflow of Image-Guided SBRT

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-A-304-02: Treatment Simulation, Planning and Delivery for SBRT

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

TU-A-304-03: Quality Assurance, Safety, and Other Practical Aspects of SBRT

Increased use of SBRT and hypo fractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide updated knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT or IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional (3D and 4D) and multi-modality (CT, beam-level X-ray imaging, pre- and on-treatment 3D/4D MRI, PET, robotic ultrasound, etc.) for reliable guidance of SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. Discuss treatment planning and quality assurance issues specific to SBRT. Research grant from Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

WE-B-207-00: CT Lung Cancer Screening Part 1

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.

60 APPLIED LIFE SCIENCES↗

WE-B-207-01: CT Lung Cancer Screening and the Medical Physicist: Background, Findings and Participant Dosimetry Summary of the National Lung Screening Trial (NLST)

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.

60 APPLIED LIFE SCIENCES↗

WE-B-207-02: CT Lung Cancer Screening and the Medical Physicist: A Dosimetry Summary of CT Participants in the National Lung Cancer Screening Trial (NLST)

The US National Lung Screening Trial (NLST) was a multi-center randomized, controlled trial comparing a low-dose CT (LDCT) to posterior-anterior (PA) chest x-ray (CXR) in screening older, current and former heavy smokers for early detection of lung cancer. Recruitment was launched in September 2002 and ended in April 2004 when 53,454 participants had been randomized at 33 screening sites in equal proportions. Funded by the National Cancer Institute this trial demonstrated that LDCT screening reduced lung cancer mortality. The US Preventive Services Task Force (USPSTF) cited NLST findings and conclusions in its deliberations and analysis of lung cancer screening. Under the 2010 Patient Protection and Affordable Care Act, the USPSTF favorable recommendation regarding lung cancer CT screening assisted in obtaining third-party payers coverage for screening. The objective of this session is to provide an introduction to the NLST and the trial findings, in addition to a comprehensive review of the dosimetry investigations and assessments completed using individual NLST participant CT and CXR examinations. Session presentations will review and discuss the findings of two independent assessments, a CXR assessment and the findings of a CT investigation calculating individual organ dosimetry values. The CXR assessment reviewed a total of 73,733 chest x-ray exams that were performed on 92 chest imaging systems of which 66,157 participant examinations were used. The CT organ dosimetry investigation collected scan parameters from 23,773 CT examinations; a subset of the 75,133 CT examinations performed using 97 multi-detector CT scanners. Organ dose conversion coefficients were calculated using a Monte Carlo code. An experimentally-validated CT scanner simulation was coupled with 193 adult hybrid computational phantoms representing the height and weight of the current U.S. population. The dose to selected organs was calculated using the organ dose library and the abstracted scan parameters. This session will review the results and summarize the individualized doses to major organs and the mean effective dose and CTDIvol estimate for 66,157 PA chest and 23,773 CT examinations respectively, using size-dependent computational phantoms coupled with Monte Carlo calculations. Learning Objectives: Review and summarize relevant NLST findings and conclusions. Understand the scope and scale of the NLST specific to participant dosimetry. Provide a comprehensive review of NLST participant dosimetry assessments. Summarize the results of an investigation providing individualized organ dose estimates for NLST participant cohorts.

60 APPLIED LIFE SCIENCES↗

WE-G-213-01: Roentgen and the Birth of Modern Medical Physics

Roentgen and the Birth of Modern Medical Physics – Perry Sprawls Wilhelm Roentgen is well known for his discovery of x-radiation. What is less known and appreciated is his intensive research following the discovery to determine the characteristics of the “new kind of radiation” and demonstrate its great value for medical purposes. In this presentation we will imagine ourselves in Roentgen’s mind and follow his thinking, including questions and doubts, as he designs and conducts a series of innovative experiments that provided the foundation for the rapid growth of medical physics. Learning Objectives: Become familiar with the personal characteristics and work of Prof. Roentgen that establishes him as an inspiring model for the medical physics profession. Observe the thought process and experiments that determined and demonstrated the comprehensive characteristics of x-radiation. The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who were they and what did they do? – Lawrence N. Rothenberg William David Coolidge (1873–1975) William Coolidge was born in Hudson, NY in 1873. He obtained his BS at the Massacusetts Institute of Technology in 1896. Coolidge then went to the University of Leipzig, Germany for graduate study with physicists Paul Drude and Gustave Wiedemann and received a Ph.D. in 1899. While in Germany he met Wilhelm Roentgen. Coolidge returned to the US to teach at MIT where he was associated with Arthur A. Noyes of the Chemistry Department, working on the electrical conductivity of aqueous solutions. Willis R. Whitney, under whom Coolidge had worked before going to Germany, became head of the newly formed General Electric Research Laboratory and he invited Coolidge to work with him. In 1905, Coolidge joined the staff of the GE laboratory and was associated with it for the remainder of his life. He developed ductile tungsten filaments to replace fragile carbon filaments as the material for electric light bulb filaments. Until that innovation light bulbs had a notoriously short life. He later incorporated the ductile tungsten as a filament material for a hot cathode, fully evacuated x-ray tube, first described in 1912, which allowed higher current and x-ray output, and greater reliability than had previously been possible. These “Coolidge x-ray tubes” were far superior to the cold cathode, partial pressure gas x-ray tubes that had been in use since Roentgen’s discovery of x-rays in 1895. The Coolidge tube with incremental developments is now the key component for x-ray production in all of our modern x-ray imaging devices, such as CT scanners, interventional radiology systems, and mammography units. Coolidge was also involved in the development of sectional x-ray tubes for research and treatment that were initially designed to reach 800 kV. Additional improvements led to 1 MV and 2 MV devices. In 1932 Coolidge became director of the General Electric Research Laboratory, and in 1940, was made Vice-President and Director of Research. In 1945 he retired and was named Director Emeritus of the laboratory. Coolidge held 83 patents and was recognized for these and many other achievements by election to the National Academy of Engineers, a place in the Engineering Hall of Fame and the National Inventor’s Hall of Fame. The AAPM’s highest honor, the Coolidge Award, was named after him. He accepted Honorary Membership in the AAPM and was the first recipient of the AAPM Coolidge Award, which was presented to him in a special ceremony in Schenectady, NY in 1972 when he was 100 years old. Edith Hinckley Quimby (1891–1982) Edith Quimby was born in Rockford, IL in 1891. She graduated from Whitman College in Walla Walla, WA with a B.S. in 1913, and then obtained a masters degree from the University of California at Berkeley. Later in her career, after many significant achievements, Quimby was awarded honorary doctorates by Whitman College and Rutgers University. Edith Quimby was hired by Giacchino Failla as a radiation physicist at Memorial Hospital for Cancer in New York City. Failla had studied with Madame Curie and obtained his doctoral degree in her laboratory. After many groundbreaking medical physics studies from 1919 until 1942, they both moved to Columbia University. Dr. Quimby developed a widely employed dosimetry system for single plane implants with radium and radon seeds, and a dosimetry methodology for internal radionuclides. She was author of more than 75 scientific publications, and of significant textbooks including the first comprehensive physics textbook for radiologists “Physical Foundations of Radiology”, which was co-authored with Otto Glasser, Lauriston Taylor and James Weatherwax in the first edition, with Russell Morgan added for the second edition and Paul Goodwin for the fourth edition. With Sergei Feitelberg, M.D. she published two editions of “Radioactive Isotopes in Medicine and Biology: Basic Physics and Instrumentation”. Quimby became a renowned examiner for the American Board of Radiology when the third ABR examination, given in 1936, added physics. She served as President of the American Radium Society, received the RSNA Gold Medal, and also numerous prestigious awards given to women in science. Edith Quimby was a Charter Member of AAPM. The AAPM Lifetime Achievement Award was renamed the Edith H. Quimby Lifetime Achievement Award in her honor in 2011. Marvin Martin Dixon Williams (1902–1981) Marvin Williams was born in Walla Walla, WA in 1902, and attended the same college as Edith Quimby, graduating from Whitman College in 1926. He was greatly influenced to go into medical physics by her accomplishments. During his early career, Williams worked with James Weatherwax in Philadelphia while he was working toward an M.S. from the University of Pennsylvania. In 1931 Williams was awarded a Ph.D. in Biophysics from the University of Minnesota, with the work actually performed at the Mayo Clinic Graduate School of the University. While completing his Ph.D. studies, Marvin met Dr. Paul Hodges who had returned from the Peiping Union Medical College in Peiping (now Beijing), China. Hodges suggested that a physicist be sent to Peiping to install x-ray therapy equipment and a radon plant. Williams accepted the position and, in 1931, he and his wife Orpha left for China. Before going to China, Williams had spent time with the physics group at Memorial Hospital to learn about the operation of a radon plant. In China, he constructed the radon plant, employing 0.25 g of radium, and also installed the x-ray therapy unit. Williams and his wife returned to the US in 1935, and he accepted a research position at the Mayo Clinic. In 1950, he became Professor of Biophysics at Mayo, where he taught physics and biophysics until his retirement in 1967. Williams was also very active in the American Board of Radiology where, from 1944 through 1977, he examined over 3000 radiologists and 250 physicists. Marvin Williams was a Charter member of AAPM, served as the fourth President of AAPM in 1963, and was the fourth recipient the AAPM Coolidge Award in 1975. The Marvin Williams Award was originally established as the highest award of the American College of Medical Physics. When various functions of the ACMP were absorbed into the AAPM in 2012, the Marvin M D Williams Professional Achievement Award became one of the AAPM’s highest honors. Learning Objectives: Become familiar with the persons in whose honor the three major AAPM Award are named Learn about the achievements and activities which influenced the AAPM to name these awards in their honor.

60 APPLIED LIFE SCIENCES↗

WE-G-213-00: History Symposium: Radiological Physics Pioneers: Roentgen and the AAPM Award Eponyms - William Coolidge, Edith Quimby, and Marvin Williams - Who Were They and What Did They Do?

Roentgen and the Birth of Modern Medical Physics – Perry Sprawls Wilhelm Roentgen is well known for his discovery of x-radiation. What is less known and appreciated is his intensive research following the discovery to determine the characteristics of the “new kind of radiation” and demonstrate its great value for medical purposes. In this presentation we will imagine ourselves in Roentgen’s mind and follow his thinking, including questions and doubts, as he designs and conducts a series of innovative experiments that provided the foundation for the rapid growth of medical physics. Learning Objectives: Become familiar with the personal characteristics and work of Prof. Roentgen that establishes him as an inspiring model for the medical physics profession. Observe the thought process and experiments that determined and demonstrated the comprehensive characteristics of x-radiation. The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who were they and what did they do? – Lawrence N. Rothenberg William David Coolidge (1873–1975) William Coolidge was born in Hudson, NY in 1873. He obtained his BS at the Massacusetts Institute of Technology in 1896. Coolidge then went to the University of Leipzig, Germany for graduate study with physicists Paul Drude and Gustave Wiedemann and received a Ph.D. in 1899. While in Germany he met Wilhelm Roentgen. Coolidge returned to the US to teach at MIT where he was associated with Arthur A. Noyes of the Chemistry Department, working on the electrical conductivity of aqueous solutions. Willis R. Whitney, under whom Coolidge had worked before going to Germany, became head of the newly formed General Electric Research Laboratory and he invited Coolidge to work with him. In 1905, Coolidge joined the staff of the GE laboratory and was associated with it for the remainder of his life. He developed ductile tungsten filaments to replace fragile carbon filaments as the material for electric light bulb filaments. Until that innovation light bulbs had a notoriously short life. He later incorporated the ductile tungsten as a filament material for a hot cathode, fully evacuated x-ray tube, first described in 1912, which allowed higher current and x-ray output, and greater reliability than had previously been possible. These “Coolidge x-ray tubes” were far superior to the cold cathode, partial pressure gas x-ray tubes that had been in use since Roentgen’s discovery of x-rays in 1895. The Coolidge tube with incremental developments is now the key component for x-ray production in all of our modern x-ray imaging devices, such as CT scanners, interventional radiology systems, and mammography units. Coolidge was also involved in the development of sectional x-ray tubes for research and treatment that were initially designed to reach 800 kV. Additional improvements led to 1 MV and 2 MV devices. In 1932 Coolidge became director of the General Electric Research Laboratory, and in 1940, was made Vice-President and Director of Research. In 1945 he retired and was named Director Emeritus of the laboratory. Coolidge held 83 patents and was recognized for these and many other achievements by election to the National Academy of Engineers, a place in the Engineering Hall of Fame and the National Inventor’s Hall of Fame. The AAPM’s highest honor, the Coolidge Award, was named after him. He accepted Honorary Membership in the AAPM and was the first recipient of the AAPM Coolidge Award, which was presented to him in a special ceremony in Schenectady, NY in 1972 when he was 100 years old. Edith Hinckley Quimby (1891–1982) Edith Quimby was born in Rockford, IL in 1891. She graduated from Whitman College in Walla Walla, WA with a B.S. in 1913, and then obtained a masters degree from the University of California at Berkeley. Later in her career, after many significant achievements, Quimby was awarded honorary doctorates by Whitman College and Rutgers University. Edith Quimby was hired by Giacchino Failla as a radiation physicist at Memorial Hospital for Cancer in New York City. Failla had studied with Madame Curie and obtained his doctoral degree in her laboratory. After many groundbreaking medical physics studies from 1919 until 1942, they both moved to Columbia University. Dr. Quimby developed a widely employed dosimetry system for single plane implants with radium and radon seeds, and a dosimetry methodology for internal radionuclides. She was author of more than 75 scientific publications, and of significant textbooks including the first comprehensive physics textbook for radiologists “Physical Foundations of Radiology”, which was co-authored with Otto Glasser, Lauriston Taylor and James Weatherwax in the first edition, with Russell Morgan added for the second edition and Paul Goodwin for the fourth edition. With Sergei Feitelberg, M.D. she published two editions of “Radioactive Isotopes in Medicine and Biology: Basic Physics and Instrumentation”. Quimby became a renowned examiner for the American Board of Radiology when the third ABR examination, given in 1936, added physics. She served as President of the American Radium Society, received the RSNA Gold Medal, and also numerous prestigious awards given to women in science. Edith Quimby was a Charter Member of AAPM. The AAPM Lifetime Achievement Award was renamed the Edith H. Quimby Lifetime Achievement Award in her honor in 2011. Marvin Martin Dixon Williams (1902–1981) Marvin Williams was born in Walla Walla, WA in 1902, and attended the same college as Edith Quimby, graduating from Whitman College in 1926. He was greatly influenced to go into medical physics by her accomplishments. During his early career, Williams worked with James Weatherwax in Philadelphia while he was working toward an M.S. from the University of Pennsylvania. In 1931 Williams was awarded a Ph.D. in Biophysics from the University of Minnesota, with the work actually performed at the Mayo Clinic Graduate School of the University. While completing his Ph.D. studies, Marvin met Dr. Paul Hodges who had returned from the Peiping Union Medical College in Peiping (now Beijing), China. Hodges suggested that a physicist be sent to Peiping to install x-ray therapy equipment and a radon plant. Williams accepted the position and, in 1931, he and his wife Orpha left for China. Before going to China, Williams had spent time with the physics group at Memorial Hospital to learn about the operation of a radon plant. In China, he constructed the radon plant, employing 0.25 g of radium, and also installed the x-ray therapy unit. Williams and his wife returned to the US in 1935, and he accepted a research position at the Mayo Clinic. In 1950, he became Professor of Biophysics at Mayo, where he taught physics and biophysics until his retirement in 1967. Williams was also very active in the American Board of Radiology where, from 1944 through 1977, he examined over 3000 radiologists and 250 physicists. Marvin Williams was a Charter member of AAPM, served as the fourth President of AAPM in 1963, and was the fourth recipient the AAPM Coolidge Award in 1975. The Marvin Williams Award was originally established as the highest award of the American College of Medical Physics. When various functions of the ACMP were absorbed into the AAPM in 2012, the Marvin M D Williams Professional Achievement Award became one of the AAPM’s highest honors. Learning Objectives: Become familiar with the persons in whose honor the three major AAPM Award are named Learn about the achievements and activities which influenced the AAPM to name these awards in their honor.

60 APPLIED LIFE SCIENCES↗

WE-G-213-02: The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who Were They and What Did They Do?

Roentgen and the Birth of Modern Medical Physics – Perry Sprawls Wilhelm Roentgen is well known for his discovery of x-radiation. What is less known and appreciated is his intensive research following the discovery to determine the characteristics of the “new kind of radiation” and demonstrate its great value for medical purposes. In this presentation we will imagine ourselves in Roentgen’s mind and follow his thinking, including questions and doubts, as he designs and conducts a series of innovative experiments that provided the foundation for the rapid growth of medical physics. Learning Objectives: Become familiar with the personal characteristics and work of Prof. Roentgen that establishes him as an inspiring model for the medical physics profession. Observe the thought process and experiments that determined and demonstrated the comprehensive characteristics of x-radiation. The AAPM Award Eponyms: William D. Coolidge, Edith H. Quimby, and Marvin M.D. Williams - Who were they and what did they do? – Lawrence N. Rothenberg William David Coolidge (1873–1975) William Coolidge was born in Hudson, NY in 1873. He obtained his BS at the Massacusetts Institute of Technology in 1896. Coolidge then went to the University of Leipzig, Germany for graduate study with physicists Paul Drude and Gustave Wiedemann and received a Ph.D. in 1899. While in Germany he met Wilhelm Roentgen. Coolidge returned to the US to teach at MIT where he was associated with Arthur A. Noyes of the Chemistry Department, working on the electrical conductivity of aqueous solutions. Willis R. Whitney, under whom Coolidge had worked before going to Germany, became head of the newly formed General Electric Research Laboratory and he invited Coolidge to work with him. In 1905, Coolidge joined the staff of the GE laboratory and was associated with it for the remainder of his life. He developed ductile tungsten filaments to replace fragile carbon filaments as the material for electric light bulb filaments. Until that innovation light bulbs had a notoriously short life. He later incorporated the ductile tungsten as a filament material for a hot cathode, fully evacuated x-ray tube, first described in 1912, which allowed higher current and x-ray output, and greater reliability than had previously been possible. These “Coolidge x-ray tubes” were far superior to the cold cathode, partial pressure gas x-ray tubes that had been in use since Roentgen’s discovery of x-rays in 1895. The Coolidge tube with incremental developments is now the key component for x-ray production in all of our modern x-ray imaging devices, such as CT scanners, interventional radiology systems, and mammography units. Coolidge was also involved in the development of sectional x-ray tubes for research and treatment that were initially designed to reach 800 kV. Additional improvements led to 1 MV and 2 MV devices. In 1932 Coolidge became director of the General Electric Research Laboratory, and in 1940, was made Vice-President and Director of Research. In 1945 he retired and was named Director Emeritus of the laboratory. Coolidge held 83 patents and was recognized for these and many other achievements by election to the National Academy of Engineers, a place in the Engineering Hall of Fame and the National Inventor’s Hall of Fame. The AAPM’s highest honor, the Coolidge Award, was named after him. He accepted Honorary Membership in the AAPM and was the first recipient of the AAPM Coolidge Award, which was presented to him in a special ceremony in Schenectady, NY in 1972 when he was 100 years old. Edith Hinckley Quimby (1891–1982) Edith Quimby was born in Rockford, IL in 1891. She graduated from Whitman College in Walla Walla, WA with a B.S. in 1913, and then obtained a masters degree from the University of California at Berkeley. Later in her career, after many significant achievements, Quimby was awarded honorary doctorates by Whitman College and Rutgers University. Edith Quimby was hired by Giacchino Failla as a radiation physicist at Memorial Hospital for Cancer in New York City. Failla had studied with Madame Curie and obtained his doctoral degree in her laboratory. After many groundbreaking medical physics studies from 1919 until 1942, they both moved to Columbia University. Dr. Quimby developed a widely employed dosimetry system for single plane implants with radium and radon seeds, and a dosimetry methodology for internal radionuclides. She was author of more than 75 scientific publications, and of significant textbooks including the first comprehensive physics textbook for radiologists “Physical Foundations of Radiology”, which was co-authored with Otto Glasser, Lauriston Taylor and James Weatherwax in the first edition, with Russell Morgan added for the second edition and Paul Goodwin for the fourth edition. With Sergei Feitelberg, M.D. she published two editions of “Radioactive Isotopes in Medicine and Biology: Basic Physics and Instrumentation”. Quimby became a renowned examiner for the American Board of Radiology when the third ABR examination, given in 1936, added physics. She served as President of the American Radium Society, received the RSNA Gold Medal, and also numerous prestigious awards given to women in science. Edith Quimby was a Charter Member of AAPM. The AAPM Lifetime Achievement Award was renamed the Edith H. Quimby Lifetime Achievement Award in her honor in 2011. Marvin Martin Dixon Williams (1902–1981) Marvin Williams was born in Walla Walla, WA in 1902, and attended the same college as Edith Quimby, graduating from Whitman College in 1926. He was greatly influenced to go into medical physics by her accomplishments. During his early career, Williams worked with James Weatherwax in Philadelphia while he was working toward an M.S. from the University of Pennsylvania. In 1931 Williams was awarded a Ph.D. in Biophysics from the University of Minnesota, with the work actually performed at the Mayo Clinic Graduate School of the University. While completing his Ph.D. studies, Marvin met Dr. Paul Hodges who had returned from the Peiping Union Medical College in Peiping (now Beijing), China. Hodges suggested that a physicist be sent to Peiping to install x-ray therapy equipment and a radon plant. Williams accepted the position and, in 1931, he and his wife Orpha left for China. Before going to China, Williams had spent time with the physics group at Memorial Hospital to learn about the operation of a radon plant. In China, he constructed the radon plant, employing 0.25 g of radium, and also installed the x-ray therapy unit. Williams and his wife returned to the US in 1935, and he accepted a research position at the Mayo Clinic. In 1950, he became Professor of Biophysics at Mayo, where he taught physics and biophysics until his retirement in 1967. Williams was also very active in the American Board of Radiology where, from 1944 through 1977, he examined over 3000 radiologists and 250 physicists. Marvin Williams was a Charter member of AAPM, served as the fourth President of AAPM in 1963, and was the fourth recipient the AAPM Coolidge Award in 1975. The Marvin Williams Award was originally established as the highest award of the American College of Medical Physics. When various functions of the ACMP were absorbed into the AAPM in 2012, the Marvin M D Williams Professional Achievement Award became one of the AAPM’s highest honors. Learning Objectives: Become familiar with the persons in whose honor the three major AAPM Award are named Learn about the achievements and activities which influenced the AAPM to name these awards in their honor.

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Technical Note: Validation of halo modeling for proton pencil beam spot scanning using a quality assurance test pattern

Purpose: The purpose of this paper is to demonstrate the utility of a comprehensive test pattern in validating calculation models that include the halo component (low-dose tails) of proton pencil beam scanning (PBS) spots. Such a pattern has been used previously for quality assurance purposes to assess spot shape, position, and dose. Methods: In this study, a scintillation detector was used to measure the test pattern in air at isocenter for two proton beam energies (115 and 225 MeV) of two IBA universal nozzles (UN #1 and UN #2). Planar measurements were compared with calculated dose distributions based on the weighted superposition of location-independent (UN #1) or location-dependent (UN #2) spot profiles, previously measured using a pair-magnification method and between two nozzles. Results: Including the halo component below 1% of the central dose is shown to improve the gamma-map comparison between calculation and measurement from 94.9% to 98.4% using 2 mm/2% criteria for the 115 MeV proton beam of UN #1. In contrast, including the halo component below 1% of the central dose does not improve the gamma agreement for the 115 MeV proton beam of UN #2, due to the cutoff of the halo component at off-axis locations. When location-dependent spot profiles are used for calculation instead of spot profiles at central axis, the gamma agreement is improved from 98.0% to 99.5% using 2 mm/2% criteria. The two nozzles clearly have different characteristics, as a direct comparison of measured data shows a passing rate of 89.7% for the 115 MeV proton beam. At 225 MeV, the corresponding gamma comparisons agree better between measurement and calculation, and between measurements in the two nozzles. Conclusions: In addition to confirming the primary component of individual PBS spot profiles, a comprehensive test pattern is useful for the validation of the halo component at off-axis locations, especially for low energy protons.

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SU-G-201-01: An Automated Treatment Plan Quality Assurance Program for High-Dose Rate (HDR) Brachytherapy with a VaginalCylinder Applicator

Purpose: Plan specific quality assurance (QA) is an important step in high dose rate (HDR) brachytherapy to ensure the integrity of a treatment plan. The conventional approach is to assemble a set of plan screen-captures in a document and have an independent plan-checker to verify it. Not only is this approach cumbersome and time-consuming, using a document also limits the items that can be verified, hindering plan quality and patient safety. We have initiated efforts to develop a web-based HDR brachytherapy QA system called AutoBrachy QA, for comprehensive and efficient QA. This abstract reports a new plugin in this system for the QA of a cylinder HDR brachytherapy treatment. Methods: A cylinder plan QA module was developed using Python. It was plugged into our AutoBrachy QA system. This module extracted information from CT images and treatment plan. Image processing techniques were employed to obtain geometric parameters, e.g. cylinder diameter. A comprehensive set of eight geometrical and eight dosimetric features of the plan were validated against user specified planning parameter, such as prescription value, treatment depth and length, etc. A PDF document was generated, consisting of a summary QA sheet with all the QA results, as well as images showing plan details. Results: The cylinder QA program has been implemented in our clinic. To date, it has been used in 11 patient cases and was able to successfully perform QA tests in all of them. The QA program reduced the average plan QA time from 7 min using conventional manual approach to 0.5 min. Conclusion: Being a new module in our AutoBrachy QA system, an automated treatment plan QA module for cylinder HDR brachytherapy has been successfully developed and clinically implemented. This module improved clinical workflow and plan integrity compared to the conventional manual approach.

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MO-D-BRB-00: SBRT Workflow Overview

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

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MO-D-BRB-01: Fundamental Aspects of SBRT

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

MO-D-BRB-02: SBRT Treatment Planning and Delivery

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

MO-D-BRB-03: Quality Assurance of SBRT

Increased use of SBRT and hypofractionation in radiation oncology practice has posted a number of challenges to medical physicist, ranging from planning, image-guided patient setup and on-treatment monitoring, to quality assurance (QA) and dose delivery. This symposium is designed to provide current knowledge necessary for the safe and efficient implementation of SBRT in various linac platforms, including the emerging digital linacs equipped with high dose rate FFF beams. Issues related to 4D CT, PET and MRI simulations, 3D/4D CBCT guided patient setup, real-time image guidance during SBRT dose delivery using gated/un-gated VMAT/IMRT, and technical advancements in QA of SBRT (in particular, strategies dealing with high dose rate FFF beams) will be addressed. The symposium will help the attendees to gain a comprehensive understanding of the SBRT workflow and facilitate their clinical implementation of the state-of-art imaging and planning techniques. Learning Objectives: Present background knowledge of SBRT, describe essential requirements for safe implementation of SBRT, and discuss issues specific to SBRT treatment planning and QA. Update on the use of multi-dimensional and multi-modality imaging for reliable guidance of SBRT. Discuss treatment planning and QA issues specific to SBRT. Provide a comprehensive overview of emerging digital linacs and summarize the key geometric and dosimetric features of the new generation of linacs for substantially improved SBRT. NIH/NCI; Varian Medical Systems; F. Yin, Duke University has a research agreement with Varian Medical Systems. In addition to research grant, I had a technology license agreement with Varian Medical Systems.

60 APPLIED LIFE SCIENCES↗

WE-H-BRA-04: Biological Geometries for the Monte Carlo Simulation Toolkit TOPASNBio

Purpose: New advances in radiation therapy are most likely to come from the complex interface of physics, chemistry and biology. Computational simulations offer a powerful tool for quantitatively investigating radiation interactions with biological tissue and can thus help bridge the gap between physics and biology. The aim of TOPAS-nBio is to provide a comprehensive tool to generate advanced radiobiology simulations. Methods: TOPAS wraps and extends the Geant4 Monte Carlo (MC) simulation toolkit. TOPAS-nBio is an extension to TOPAS which utilizes the physics processes in Geant4-DNA to model biological damage from very low energy secondary electrons. Specialized cell, organelle and molecular geometries were designed for the toolkit. Results: TOPAS-nBio gives the user the capability of simulating biological geometries, ranging from the micron-scale (e.g. cells and organelles) to complex nano-scale geometries (e.g. DNA and proteins). The user interacts with TOPAS-nBio through easy-to-use input parameter files. For example, in a simple cell simulation the user can specify the cell type and size as well as the type, number and size of included organelles. For more detailed nuclear simulations, the user can specify chromosome territories containing chromatin fiber loops, the later comprised of nucleosomes on a double helix. The chromatin fibers can be arranged in simple rigid geometries or within factual globules, mimicking realistic chromosome territories. TOPAS-nBio also provides users with the capability of reading protein data bank 3D structural files to simulate radiation damage to proteins or nucleic acids e.g. histones or RNA. TOPAS-nBio has been validated by comparing results to other track structure simulation software and published experimental measurements. Conclusion: TOPAS-nBio provides users with a comprehensive MC simulation tool for radiobiological simulations, giving users without advanced programming skills the ability to design and run complex simulations.

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TH-C-204-00: Medical Physics Workshop: An Update On the Journal’s Improvement Activities and Guidance On Writing and Reviewing Papers

In this presentation, the Editors will outline our vision for the future of Medical Physics and review recent work-in-progress initiatives to implement this vision. Finally, we will close with guidance to authors on how to write a good Medical Physics paper. A major focus will be the transition to a new publisher in 2017 following a more than 40-year association with American Institute of Physics Publishing (AIPP). Vision for Medical Physics and status of current initiatives: Jeff Williamson, Editor-in-Chief The broad vision of Medical Physics is “to continue the Journal’s tradition of publishing the very best science that propels our discipline forward and improves our contribution to patient care.” More concretely, the Journal should be the preeminent forum for exchange of cutting edge medical physics science. We seek to identify the best contributions in (a) high impact clinical physics innovations; (b) clinical translation and validation of basic science innovations; and (c) cutting edge basic science developments with potential for patient care improvements. Among the challenges and opportunities, we face are: electronic-only and open access publishing; competition from new radiological science journals; trends towards more interactive, social-media based scientific communities; and diversification of the medical physics research, authorship, and readership domains, including clinical applications quite foreign to core ABR clinical competencies. Recently implemented and ongoing initiatives include: Revised Table of Contents (TOC) and more contemporary topical submission categories Structured review template in HTML format Comprehensive hierarchical taxonomy for identifying reviewer expertise Formal process for soliciting high quality and impact Review and Vision 20/20 Articles We have recruited four Review Article Co-editors: John Rowlands and Ingrid Reiser (imaging physics) and Joao Seco and Tim Zhu (therapy physics). The Co-Editors will identify timely topics and solicit high profile authors to submit review manuscripts. To submit an article, authors will need to work with an assigned Co-Editor to develop a mutually acceptable outline and abstract. 5) A new and exciting class of articles: Medical Physics Dataset Articles (MPDAs) MPDAs describe scientifically or clinically valuable open-access datasets with high potential for contributing to the research of medical physicists working on related problems. In contrast to Research Articles, MPDAs should not include hypothesis testing; or data analyses supporting generalizable conclusions. The publically accessible dataset must be permanently archived before the MPDA can be published. This initiative is being led by Joe Deasy. Update on new publisher transition: The transition of AAPM scientific publishing operations to a major publishing house is a major opportunity to expand Medical Physics readership and its scholarly impact. The advantages include: (a) common manuscript management and web hosting platforms for Medical Physics and its sister journal, JACMP; (b) greater than 4-fold expansion of subscribing institutions; and (c) resources to mount data-driven, highly targeted marketing campaigns to enhance citation and download rates. A transition update of this epochal development, which has only begun as of this writing (3/31/16), will be given. Improving manuscript quality via structured reviews, enhanced scientific category taxonomy, and outreach: Shiva Das, Therapy Physics Editor Medical Physics is committed to continuous improvement with the ultimate goal of improving the potential impact of accepted manuscripts. In order to do so, Medical Physics must be able to tap into important/emerging areas and be able to select high quality contributions consistently via discerning reviews. Improving the quality of reviews is crucial to selecting high quality manuscripts and also to improving manuscript impact via feedback in the review process. With this in mind, Medical Physics is in the process of: (a) fostering outreach to important areas that are currently underrepresented in Medical Physics; (b) implementing a structured template review form; and (c) implementing a comprehensive scientific category taxonomy to identify reviewers who are best suited to an article. Outreach efforts have begun to various scientific areas. Strategies to increase submissions from these areas will be discussed. As a consequence of this effort, a special issue on particle therapy is under development. A review template was implemented in late 2014 on a limited test basis. Based on reviewer feedback, the template was restructured and shortened to capture essential review elements. The restructured template is due to be released shortly. The new scientific category taxonomy is in the process of being deployed to reviewers and associate editors. Salient aspects of the structured review template and scientific category taxonomy will be discussed in this talk. Writing good scientific papers and responding to critiques: Mitch Goodsitt, Imaging Physics Editor The essential components of the abstract, introduction, methods, discussion and conclusion sections of manuscripts, as well as the desired writing style and style of the figures and tables will be reviewed. Publishable Medical Physics manuscripts must include clear and concise statements of the novelty and clinical and/or scientific importance of the authors’ work. Examples of novelty include: new technical solution to an important clinical problem; new generalizable knowledge; and first demonstration that an existing engineering solution solves a clinical problem. Please note that we encourage authors of recently published conference proceedings (e.g., SPIE, IEEE) papers on novel medical physics related work to submit more substantial versions of that work to our journal. All submissions must include: sufficient background information and rationale; enough detail for others to reproduce the authors’ work; sufficient statistical analysis to refute or validate the authors’ hypotheses; a description of how the present work compares to, is distinct from, and improves upon others’ work; and sections devoted to the limitations of the study and future directions. Writing should be polished. Poor wording, grammar and composition frustrate the review process. Our journal does not have copyeditors for revising manuscripts. When authors receive critiques from the referees and associate editor, the authors should provide a detailed point-by-point response to each comment. The authors’ rebuttal should include the text of the original criticism, the authors’ response, and a pasted copy of the modified text along with the line numbers in the revised article. The new text should be highlighted in a different font color in the revised submission. Following these recommendations will improve submissions and facilitate the review process.

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