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The questionnaire survey was conducted in 2020 to investigate the working conditions of qualified medical physicists in Japan. We developed a web-based system for administering the questionnaire and surveyed 1,228 qualified medical physicists. The number of received responses was 405. We summarized the results of the survey by job category. The obtained results showed that most of the people working as certified medical physicists met the following conditions: (1) position of healthcare occupation, (2) direct supervisor is a medical doctor or a medical physicist, (3) licensed or passed an examination for a Class I Radiation Protection Supervisor, (4) without the license of professional radiotherapy technologist, (5) master's or doctor's degree, (6) being assigned to the section that is different from the radiological technologist section. The average annual salary was approximately 600,000 yen higher for those employed as medical physicists than for those employed as radiotherapy technologists. The percentage of work performed by a certified medical physicist in radiation therapy greatly varies depending on whether the physicist is dedicated to treatment planning and equipment quality control. Alternatively, the proportion of the true duties of medical physicists in charge of radiation therapy, as considered by qualified medical physicists in radiation therapy, was the same regardless of whether they were working full-time or not. The results of this survey updated the working status of certified medical physicists in Japan. We will continue to conduct the survey periodically and update the information to contribute to the improvement of the working conditions of medical physicists and policy recommendations.

In 2016, the American Association of Physicists in Medicine (AAPM) has published a report of task group (TG) 100 with a completely new concept, entitled "application of risk analysis methods to radiation therapy quality management." TG-100 proposed implementation of risk analysis in radiotherapy to prevent harmful radiotherapy accidents. In addition, it enables us to conduct efficient and effective quality management in not only advanced radiotherapy such as intensity-modulated radiotherapy and image-guided radiotherapy but also new technology in radiotherapy. It should be noted that treatment process in modern radiotherapy is absolutely more complex and it needs skillful staff and adequate resources. TG-100 methodology could identify weakness in radiotherapy procedure through assessment of failure modes that could occur in overall treatment processes. All staff in radiotherapy have to explore quality management in radiotherapy safety.

We have developed an Electron-Tracking Compton Camera (ETCC) for medical imaging due to its wide energy dynamic range (200-1,500keV) and wide field of view (FOV, 3 str). This camera has a potential of developing the new reagents. We have carried out several imaging reagent studies as examples; (1) 18F-FDG and 131I-MIBG simultaneous imaging for double clinical tracer imaging, (2) imaging of some minerals (Mn-54, Zn-65, Fe-59) in mouse and plants. In addition, ETCC has a potential of real-time monitoring of the Bragg peak location by imaging prompt gamma rays for the beam therapy. We carried out the water phantom experiment using 140MeV proton beam, and obtained the images of both 511 keV and high energy gamma rays (800-2,000keV). Here better correlation of the latter image to the Bragg peak has been observed. Another potential of ETCC is to reconstruct the 3D image using only one-head camera without rotations of both the target and camera. Good 3D images of the thyroid grant phantom and the mouse with tumor were observed. In order to advance those features to the practical use, we are improving the all components and then construct the multi-head ETCC system.