Index of content:
Volume 34, Issue 6, June 2007
- Professional Symposium: Room M100A
- Performance Specification for New Equipment Purchases
34(2007); http://dx.doi.org/10.1118/1.2761761View Description Hide Description
Every cancer treatment facility is involved in the purchase of new equipment. While the purchase process will vary from one institution to another, there are certain generic considerations that are addressed either overtly or indirectly. These considerations include: (1) clinical needs assessment, (2) definition of specifications, selection and purchase process, (3) installation, (4) acceptance testing, (5) commissioning, (6) training, (7) clinical use, and (8) periodic quality control (QC). Medical physicists generally are involved in all of these considerations. For many technologies, committees or task groups have developed recommendations on acceptance testing, commissioning and QC. However, relatively little has been presented or published on what should be done before the purchase. The purpose of this Professional Symposium is to provide guidance to Medical Physicists on factors that they should consider in the specification and purchase of new technologies within a radiation therapy department. This presentation will provide a generic overview for any technology in radiation therapy of the clinical needs assessment, the definition of specifications and the purchase process. Other presenters in this symposium will address similar considerations but specifically for: (1) CT‐simulators and PET/CT, (2) radiation treatment planning systems, and (3) image guidance systems such as tomotherapy and linear accelerator with cone beam CT.
1. To describe the development of performance specifications of any new equipment to be purchased in a radiation therapy facility.
2. To describe issues to consider in the purchase of any new equipment for radiation therapy.
34(2007); http://dx.doi.org/10.1118/1.2761762View Description Hide Description
Imaging equipment for radiation therapy (RT) has undergone significant changes during the past decade. Historically, imaging equipment has been designed almost exclusively for diagnostic radiology. Computed tomography(CT) and positron emission tomography(PET)scanners did not have any features which were specifically indented for imaging of RT patients. These scanners were used for radiationimaging often with modifications and largely were not suited well for the task.
Today, the situation is different and all major scanner manufacturers offer devices which are designed specifically for RT imaging or which have features designed for RT. This paradigm change in how scanner manufacturers view RT imaging needs has resulted in significant increase in imaging equipment choices available to RT departments. The change in scanner manufacturer approach towards RT is mainly driven by the increased need for CT and multimodality imaging(PET, MR, SPECT) in RT. The vast majority of radiationoncology departments have a CTscanner, some have more than one, and many have PETCTscanners. The scanners found in radiationoncology are also no longer predominantly low end models but more commonly state of the art scanners capable of diagnostic quality imaging.
For CTscanners, there are several gantry aperture sizes available with varying number of detector configurations. All manufacturers offer solutions for respiratory correlated imaging. Similarly, PET/CT scanners are indented to be used for RT treatment planningimaging and there are multiple options available on the market for this equipment as well.
Understanding features of CT and PET/CT scanners that are available for RT imaging and selecting the scanner which best suits the needs and workflow of an individual department can significantly affect treatment planning and radiation delivery process. This presentation is designed to address features of CT and PET/CT scanners which are important for RT imaging and which are commercially available. The presentation will also address typical needs of individual radiationoncology facilities and how modern CT and PET/CT scanners are meeting these needs.
1. Describe features available on commercial CTscanner (simulators).
2. Describe features available on commercial PET/CT scanners (simulators).
3. Describe how available CT and PET/CT scanner features can meet the needs of modern radiationoncology practice.
34(2007); http://dx.doi.org/10.1118/1.2761763View Description Hide Description
Prior to the advent of 3D treatment planning, a radiation therapytreatment planning system (RTPS) operated in near isolation. There were few, if any, interconnections between the planning system and other information systems in the institution. Today, the RTPS operates as one node in a continuum of information systems and processes that can include imaging systems and archives, information systems, other RTPS nodes and systems, and delivery and delivery verification systems. In order to integrate a new RTPS into the departmental process, the planning for purchase of an RTPS must go far beyond the traditional comparisons of contouring, dose calculation algorithms, and dose evaluation tools.
This presentation will attempt to guide the medical physicist in planning the purchase of a new RTPS. Issues such as system infrastructure, network architecture, integration planning, and continuing training will be discussed. The medical physicist must consider the changes planned at their institution, such as 4D delivery,adaptive radiation therapy, and new treatment techniques. Each of these will influence the direction that the RTPS purchase should take. RTPS features can also force changes in the treatment planning process, as differences in areas such as image registration, plan normalization, and optimization may require technique and quality assurance changes in order to effect an orderly and safe transition. Finally, an upgrade strategy should be included in the purchase decision, so that future improvements in the RTPS can be effectively integrated into the overall treatment planning and delivery process.
1. To describe the overall planning process for the purchase of a radiation therapy planning system.
2. To identify key steps in the purchase process for a radiation therapy planning system under the aegis of the medical physicist.
34(2007); http://dx.doi.org/10.1118/1.2761764View Description Hide Description
Pre‐treatment cone beam CTimage guidance combined with linear accelerator based intensity‐modulated radiotherapy(IMRT) is compared to and contrasted with tomotherapy an alternative commercially available IMRT planning and delivery system. The underlying rationale of the two different IMRT approaches are discussed and their methods pre‐treatment image guidance and modes of treatment delivery are described. Differences between dose‐distributions delivered using tomotherapy and conventional linear accelerators are outlined. Because conventional linear accelerator design has been refined over many decades, innovative design enhancement of one aspect of system performance often limits another facet of system capability. Consequently the two IGRT/IMRT delivery systems may prove optimal for different types of treatment, proving advantageous for certain disease sites while being of almost equal utility in others.
1. Understand the differences and similarities in pre‐treatment image guidance for the two systems discussed.
2. Understand the differences and similarities in treatment delivery for the two systems discussed.
- What Does it Mean to Sign Attestation Statements?
34(2007); http://dx.doi.org/10.1118/1.2761719View Description Hide Description
There are a number of situations where medical physicists must make statements attesting to the credentials of individuals or training programs. The U.S. Nuclear Regulatory Commission (NRC) recently revised its regulations in 10 CFR Part 35 for the training and experience (T&E) of an authorized user, an authorized medical physicist, and a radiation safety officer in the medical use of radioactive materials. The T&E regulations require an attestation by individuals on signed preceptor statements in order to be authorized/listed on a license to use radioactive materials. The attestation is a new, added requirement. What are the expectations of the individual who signs the attestation? Are there legal implications?
In order to acquire CAMPEP accreditation for either GraduateMedical Physics programs or Medical Physics Residency programs requires that the program submits a self study document stating explicitly what must be done to complete the program and showing documentation that these requirement have been met. After review of this self study, a survey team conducts an on‐site visit to verify that the program is operating in a manner consistent with what is described in the self study. If successful, accreditation is granted for a period of 5 years. Renewal requires submission of an updated self study. What happens to the individuals attesting to the validity of the program if graduates are involved in medical events? Is there liability for the institution or the individuals? This session will generate discussion on these topics.
Ralph Lieto, M.S., FAAPM — Implications of NRC Part 35 and Preceptor Statements — an AAPM Perspective.
Francis (Chip) Cameron, J.D. — Implications of NRC Part 35 and Preceptor Statements — an NRC Perspective.
Bruce Gerbi, Ph.D., FAAPM — CAMPEP Accreditation: stating expectations and verifying performance.