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Irene Joliot-Curie is the daughter of Marie Curie, a double Nobel Prize-winner. In 1925, Irene Curie became Doctor of Science.In 1926, Irene married her colleague Frederic Joliot, an assistant at the Radium Institute. With him, she continued experiments with various chemical elements. In some of these experiments, Irene and Frederic performed bombardment of boron, and aluminium with alpha particles, thereby producing new chemical elements. These new elements were radioactive: aluminum became radioactive phosphorus, while boron became a radioactive isotope of nitrogen. Within a short time, Joliot-Curie created many new radioactive elements. In 1935, Irene and Frederic Joliot-Curie were jointly awarded the Nobel Prize for Chemistry for their artificial creation of new radioactive elements Working with uranium in the late 1930s, Irene Joliot-Curie made several important discoveries and came close to the discovery of uranium decay, when bombarded with neutrons.Jean Frederic Joliot was born in Paris, in the family of a prosperous merchant Henri Joliot and Emilia (Roederer) Joliot, who came from a wealthy Protestant family from Alsace.Frederic obtained his Doctor of Science degree in 1930 for a thesis on the electrochemistry of radioactive polonium. Having received the Nobel Prize in 1935 together with his wife, 35-year-old Frederick still remains the youngest Nobel Laureate in Chemistry.The discoveries and achievements of the Joliot-Curie family laid the foundation for further research in nuclear physics, chemistry, and nuclear medicine. Without their discoveries, it is impossible to imagine modern science and everyday life.

Purpose This study aims to review the outcome of an institution in multicatheter/interstitial accelerated partial breast irradiation (MC-APBI) for treatment of patients with breast cancer, either with strong criteria for APBI or unable to be treated with whole-breast irradiation. The outcomes were also stratified by the American Society for Radiation Oncology, American Brachytherapy Society, and Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology patient selection criteria. Methods The study includes 118 patients and 120 MC-APBI treatments, treated in a single tertiary center, between November 2003 and August 2016. The analysis is focused on the clinical baseline characteristics, local control, relapse-free survival, disease-specific survival (DSS), and overall survival. Results In accordance to the American Society for Radiation Oncology, American Brachytherapy Society, and Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology, 17.1% were “unsuitable,” 19.2% were “unacceptable,” and 19.5% were “high risk,” respectively. The main reasons why high-risk patients were submitted to MC-APBI were as follows: cardiopathy (n = 7), social difficulties (n = 4), and mobility limitations (n = 4). At the median followup period of 86.5 months, ipsilateral breast tumor recurrence was observed in one (0.8%) patient. The 3-year and 5-year relapse-free survival were 100% and 99.1%, respectively. DSS was 100%. Conclusions This study demonstrated excellent control rates, DFS, and DSS of MC-APBI, rendering APBI as an excellent treatment for patients with breast cancer, even those who are not necessarily eligible for this treatment approach. The selection criteria for ABPI diverge according to different guidelines and are based on studies with discrepancies, making extremely possible that these recommendations could be changed.

The Working Group of the Gynecological Tumor Committee of the Japanese Radiation Oncology Study Group (JROSG) published recommendations for contouring high-risk clinical target volumes (HR-CTV) on CT for 3-dimentional image-guided brachytherapy for cervical cancer. The purpose of this study was to compare HR-CTV delineated on CT, referencing recommendations from JROSG, with HR-CTV delineated on MRI, referencing consensus guidelines from the Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC ESTRO). Fourteen patients were evaluated. After the insertion of the CT/MR applicator into the patient, CT and MRI were performed. HR-CTVMR was delineated on MRI for clinical examination and HR-CTVCT was delineated on CT retrospectively referencing the MRI just before brachytherapy within a week. The volume and dosimetry of HR-CTV based on a 6 Gy dose of the Manchester system were evaluated. The median volumes of HR-CTVMR and HR-CTVCT were 24.4 ml (range, 13.6–50.4 ml) and 29.9 ml (range, 13.2–49.2 ml), respectively. Median D90 of HR-CTVMR and HR-CTVCT were 6.7 Gy (range, 5.8–10.1 Gy) and 6.8 Gy (range, 5.1–10.4 Gy), respectively. Somewhat difference could be seen between HR-CTVMR and HR-CTVCT.

The year 2020 marks the 80th anniversary of the Society of Surgical Oncology (SSO), so it is appropriate to celebrate the vision and leadership of Dr. William MacComb, who led the formation of the James Ewing Society as an alumni organization of the Memorial Hospital in New York City. The Ewing Society was later renamed and reorganized as the SSO in 1975. Dr. MacComb was elected as the first and second President of the James Ewing Society from 1940 to 1942. He was elected onto the Executive Council when it first formed in 1947 as the Secretary/Treasurer from 1947 to 1948, as Vice-President from 1948 to 1949, and then continued as a member of the Executive Council for 3 years until 1952. He was elected again as Vice President from 1958 to 1959, as President-elect from 1959 to 1960, as President for a third time from 1960 to 1961, and then as Chair of the Executive Committee from 1961 to 1962. No other person in the history of the SSO was President for multiple terms and also was one of the founding leaders. For these reasons, it would be a fitting accolade to refer to Dr. William MacComb as "the Father of the Society of Surgical Oncology" (founded as the James Ewing Society). Dr. MacComb also served as President of both the American Radium Society (1950) and the Society of Head and Neck Surgery (1969). He one of the first surgical oncologist trained in head and neck surgery, and, uniquely, one of the first physicians to be Board Certified in Radiology because of his training and publications in therapeutic radiology. Dr. MacComb made important contributions in the field of Head and Neck surgery, as a pioneer in the development of radiation therapy and radiation physics, and for advancing the use of combined surgery and radiation therapy for head and neck cancers.

The European Society for Therapeutic Radiology and Oncology Advisory Committee in Radiation Oncology Practice (ESTRO-ACROP) recently released new contouring guidelines for postmastectomy radiation therapy (PMRT) after implant-based reconstruction (IBR). As compared to prior ESTRO guidelines, the new guidelines primarily redefined the chest wall (CW) target to exclude the breast prosthesis. In this study, we assessed the impact of these changes on treatment planning and dosimetric outcomes using volumetric-modulated arc therapy (VMAT) and proton pencil-beam scanning (PBS) therapy.We performed a treatment planning study of 10 women with left-sided breast cancer who underwent PMRT after IBR. All target structures were delineated first using standard (ESTRO) breast contouring guidelines and then separately using the new (ESTRO-ACROP) guidelines. Standard organs-at-risk (OARs) and cardiac substructures were contoured. Four sets of plans were generated: (1) VMAT using standard ESTRO contours, (2) VMAT using new ESTRO-ACROP contours, (3) PBS using standard contours, and (4) PBS using new contours.VMAT plans using the new ESTRO-ACROP guidelines resulted in modest sparing of the left anterior descending coronary artery (LAD) (mean dose: 6.99 Gy standard ESTRO vs. 6.08 Gy new ESTRO-ACROP,PMRT after IBR using the new ESTRO-ACROP contouring guidelines with both VMAT and PBS therapy is associated with significant changes in exposure to several cardiopulmonary structures.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. Approved by AAPM’s Executive Committee May 28, 2019

Interstitial brachytherapy (IBT) is often utilized to treat women with bulky endometrial or cervical cancers not amendable to intracavitary treatments. A modern trend in IBT is the utilization of magnetic resonance imaging (MRI) with a high dose rate (HDR) afterloader for conformal 3D image‐based treatments. The challenging part of this procedure is to properly complete many sequenced and co‐related physics preparations. We presented the physics preparations and clinical workflow required for implementing MRI‐based HDR IBT (MRI‐HDR‐IBT) of gynecologic cancer patients in a high‐volume brachytherapy center. The present document is designed to focus on the clinical steps required from a physicist’s standpoint. Those steps include: (a) testing IBT equipment with MRI scanner, (b) preparation of templates and catheters, (c) preparation of MRI line markers, (d) acquisition, importation and registration of MRI images, (e) development of treatment plans and (f) treatment evaluation and documentation. The checklists of imaging acquisition, registration and plan development are also presented. Based on the TG‐100 recommendations, a workflow chart, a fault tree analysis and an error‐solution table listing the speculated errors and solutions of each step are provided. Our workflow and practice indicated the MRI‐HDR‐IBT is achievable in most radiation oncology clinics if the following equipment is available: MRI scanner, CT (computed tomography) scanner, MRI/CT compatible templates and applicators, MRI line markers, HDR afterloader and a brachytherapy treatment planning system capable of utilizing MRI images. The OR/procedure room availability and anesthesiology support are also important. The techniques and approaches adopted from the GEC‐ESTRO (Groupe Européen de Curiethérapie ‐ European Society for Therapeutic Radiology and Oncology) recommendations and other publications are proven to be feasible. The MRI‐HDR‐IBT program can be developed over time and progressively validated through clinical experience, this document is expected to serve as a reference workflow guideline for implementing and performing the procedure.

In 1903, on the basis of Morozov Institute of the Moscow Imperial University (currently, P. Herzen Moscow Oncology Research Center, a branch of the National Medical Research Radiological Center, Ministry of Health of the Russian Federation), the first specialized unit in Russia was opened – department of radiation therapy of oncological diseases, in which scientific research in the field of medical radiology was officially launched in our country for the first time. The first studies in the field of radiation therapy can be attributed to this period.The article presents a brief summary of the historical development of radiotherapy in the world and in Russia; provides information on the achievements of global importance, fundamental for this scientific field. The activities of leading Russian organizations in the field of radiation therapy are reviewed; names of scientists, doctors and other specialists who have made a significant contribution to its development are provided. The main literature sources relevant to the field are given.The data in this article may be of interest and be useful for biomedical scientists, practicing radiologists and radiotherapists, oncologists, medical and graduate students, interns and other specialists.

This study aimed at assessing occupational radiation doses in different diagnostic, interventional and therapeutic services. Personal dose equivalent, Hp(10), of 116 medical radiation workers, all with 3 y of dose records (2015–18), were collected from the TLD dosimetry service at the Sultan Qaboos University Hospital—a 700-bed tertiary care teaching hospital in Oman. The doses were measured using calibrated thermo-luminescence dosemeters (TLD-100 (LiF:Mg,Ti)). Five occupational groups, diagnostic radiology, interventional radiology, nuclear medicine, medical physicists and nurses, were considered. Average, maximum and median cumulative doses were estimated and compared against the annual dose limit (20 mSv per y) and the local dose investigation level (DIL) (6 mSv per y). Personal doses (average:maximum:median) for diagnostic radiology, interventional radiology, nuclear medicine, medical physicists and nurses group were found to be 0.05:0.90:0.00, 0.05:0.50:0.00, 1.20:7.40:0.40, 0.16:1.40:0.00 and 0.10:2.10:0.00 mSv, respectively. The findings of this study suggest, at the exception of nuclear medicine, lower DILs for all occupational groups.

Purpose Prostate cancer has a low mortality rate and requires persistent treatment; however, treatment decisions are challenging. Because prostate cancer is complex, the outcomes warrant thorough follow-up evaluation for appropriate treatment. Electronic health records (EHRs) do not present intuitive information. This study aimed to develop a Clinical Decision Support System (CDSS) for prognosis management of radical prostatectomy. Methods We used data from 5,199 prostate cancer patients from three hospitals’ EHRs in South Korea, comprising laboratory results, surgery, medication, and radiation therapy. We used open source R for data preprocessing and development of web-based visualization system. We also used R for automatic calculation functionalities of two factors to visualize the data, e.g., Prostate-Specific Antigen Doubling Time (PSADT), and four Biochemical Recurrence (BCR) definitions: American Society of Therapeutic Radiology and Oncology (ASTRO), Phoenix, consecutive PSA > 0.2 ng/mL, and PSA > 0.2 ng/mL. Results We developed the Prostate Cancer Trajectory Map (PCT-Map) as a CDSS for intuitive visualization of serial data of PSA, testosterone, surgery, medication, radiation therapy, BCR, and PSADT. Conclusions The PCT-Map comprises functionalities for BCR and PSADT and calculates and visualizes the newly added patient data automatically in a PCT-Map data format, thus optimizing the visualization of patient data and allowing clinicians to promptly access patient data to decide the appropriate treatment.

IntroductionThe optimal dose-fractionation schedule of palliative radiotherapy has been debated in patients with bone metastases. Our objective is to comprehensively compare multiple fraction schedules with single fraction radiotherapy in terms of efficacy and toxicities by performing a systematic review and network meta-analysis.Methods and analysisElectronic searches of titles/abstracts of palliative radiotherapy for bone metastases will be performed, using PubMed, Cochrane Library, Embase,clinical trials, American Society for Therapeutic Radiology and Oncology and European Society of Radiotherapy and Oncology. The primary outcome of interest is the incidence of skeletal-related event following palliative radiotherapy for bone metastases in prospective studies. The risk of bias and quality of evidence will be evaluated based on Cochrane Collaboration’s tool and Grades of Recommendation, Assessment, Development and Evaluation in the network meta-analysis. We will conduct subgroup analysis and sensitivity analysis regardless of heterogeneity estimates.Ethics and disseminationThis study will synthesise the evidence regarding dose-fractionation schedule of palliative radiotherapy in patients with bone metastases. We hope the findings from this study will help clinicians and patients select optimum palliative radiotherapy by identifying the optimal dose-fractionation schedule of palliative radiotherapy with the most value in terms of patient-important outcomes. The evidence obtained from network meta-analysis will help to guide head-to-head research in the future. The results will be disseminated through international conference reports and peer-reviewed manuscripts. Ethics review board is not required for this network meta-analysis.PROSPERO registration numberCRD42019135195.

Stereotactic radiosurgery (SRS), given in a single or few fractions (2–5), is the recommended treatment for patients with a limited number of brain metastases. Both single-fraction and multi-fraction SRS are effective treatment options for patients with brain metastases, with a relative risk of neurological complications. The end points typically used for assessing radiation-induced complications in the brain are the development of brain radiation necrosis, which is associated with the presence of different degrees of neurological deficits, and neurocognitive deterioration. In general, normal tissue toxicity during SRS appears to be a function of radiation dose, volume, and proximity to eloquent sensitive brain structures. For single-fraction SRS, a clear correlation has been demonstrated between the target volume and the risk of brain necrosis, with most of these data reported by the “Quantitative Analysis of Normal Tissue Effects in the Clinic” or QUANTEC papers published in 2010 by a joint American Association of Physics in Medicine (AAPM) and American Society of Therapeutic Radiology and Oncology (ASTRO) committee. For large lesions or those in close proximity to critical structures, multi-fraction SRS is usually utilized when high-dose single-fraction SRS would result in unacceptable risks of severe neurological toxicity; however, there is little systematic reporting on normal tissue dose constraints and risk of long-term toxicity. Future prospective studies would provide robust data on normal brain constraints, including dose-volume information for different SRS schedules, evaluation of neurocognitive status through formal testing, and toxicity of combined SRS and systemic treatments. This chapter summarizes the dose tolerance limits of normal tissues for patients receiving SRS treatments to the brain.

Concurrent chemotherapy and radiotherapy (CCRT) followed by durvalumab immune therapy in appropriate patients is considered to be the standard of care in most fit stage III non-small-cell lung cancer (NSCLC) patients. However, CCRT is a toxic treatment that affects all organ systems and may cause acute and permanent side effects, some of which may be lethal. Supportive care is therefore of utmost importance in this clinical setting. A group of experts from the European Society for Therapeutic Radiology and Oncology (ESTRO) and the European Society of Medical Oncology (ESMO) identified the following items of importance for further improvement of supportive care: smoking cessation; nutrition before and during CCRT (including treatment and prevention of anorexia); physical exercise before and during CCRT; prevention and treatment of acute esophagitis and dysphagia; treatment of cough and dyspnea; treatment of skin reactions; treatment of fatigue; prophylaxis of nausea and emesis; prevention, diagnosis, and treatment of cardiac disease and damage; and optimization of radiotherapy techniques and chemotherapy adjustments to reduce toxicity in the era of immune therapy. The resulting recommendations are summarized in this manuscript and knowledge gaps identified, in which future investments are needed to improve supportive care and hence quality of life and survival for our stage III NSCLC patients. ispartof: ANNALS OF ONCOLOGY vol:31 issue:1 pages:41-49 ispartof: location:England status: published

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education, and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances. Approved by AAPM Professional Council 3-31-2017 and Executive Committee 4-4-2017.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: •Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. •Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

Purpose For selected early breast cancers, intraoperative radiation therapy (IORT) at the time of lumpectomy can be an efficient alternative to fractionated whole breast radiation therapy (WBRT). However, some patients are later recommended WBRT after IORT due to surgical pathologic findings. To understand risk factor identification rates triggering WBRT recommendation, we analyzed adverse prognostic features based on multiple international criteria for suitability for accelerated partial breast irradiation. Methods and Materials We performed a single-institution retrospective review of all 200 nonrecurrent invasive breast carcinomas that received IORT in 20 Gy to the tumor cavity using a 50 kV photon applicator between January 2011 and December 2015. IORT eligibility was based on the 2009 accelerated partial breast irradiation Consensus Statement from the American Society for Radiation Oncology (ASTRO). IORT was offered as the sole radiation modality to patients meeting 0–1 “cautionary” and no “unsuitable” criteria before lumpectomy. WBRT was recommended after IORT when 2+ cautionary and/or 1+ unsuitable criteria were met after accounting for resection pathology. We recalculated WBRT recommendation rates using initial and reresection margins for ASTRO consensus, Groupe Europeen de Curietherapie–European Society for Therapeutic Radiology and Oncology recommendations, and TARGeted Intraoperative radioTherapy vs. Postoperative Radiotherapy trial “prepathology” stratum protocol. Results Depending on the selection criteria chosen, rates of WBRT recommendation can vary from 4.5% to 33%. Conclusions WBRT recommendation rates of 30–33% after lumpectomy and IORT are observed when the WBRT indication is a single ASTRO cautionary/unsuitable, Groupe Europeen de Curietherapie–European Society for Therapeutic Radiology and Oncology intermediate/high-risk criterion, or TARGeted Intraoperative radioTherapy vs. postoperative radiotherapy trial protocol recommendation. Alternatively, allowing for re-excision to clear margins and accepting one ASTRO cautionary factor lowered the rate of WBRT recommendation to 9.5%.

Purpose: This study explores the effectiveness of remote contouring training for therapeutic radiology in three Sub-Saharan African countries (Nigeria, Tanzania, Cameroon) using a web-based platform (ProKnow). Methods and Materials: A 2-hour real-time video didactic lecture and demonstration of the left parotid tumor contouring on axial CT images was delivered using the ProKnow system and a video conferencing software. Participants were granted week-long access to practice contouring of the left parotid volume after the session. Effectiveness of the remote training was evaluated with a self-assessment questionnaire administered before and after the training. Areas of competence assessed included: (i) ability to identify anatomic structure on axial CT; (ii) ability to contour a parotid volume; (iii) ability to delineate tissues; (iv) dose-volume histogram evaluation (DVH); (v) plan evaluation; (vi) port film evaluation; (vii) cone-beam CT evaluation (CBCT). A comparative statistical analysis was undertaken to evaluate for significant changes in the average self-competence score for the various competency areas before and after intervention. The post-class survey also contained questions to determine the acceptability of the ProKnow system for training and image-guided radiotherapy planning among the participants and their access to the necessary internet services. Results: There was statistically significant improvement in all skill parameters needed to contour parotid volumes on axial CT scan. Percent improvement in average self-competency scores ranged from +14.3% for DVH evaluation to +32.8% for treatment plan evaluation. Although in varying degree, 95% of participants indicated the remote training session was relevant to their clinical practice and training. Also, in varying degrees, all indicated that the web-based tool will be helpful to their professional development; that the web-based platform (ProKnow) was easy to navigate and use; and that they would recommend the resource. Most respondents (84%) had access to strong or moderate internet connectivity to integrate the web-based tools into their clinical practice and training. Conclusion: Web-based interactive contouring atlases have utility in global health, as they can serve as self-directed and remote training tools for oncology and radiology staff, which could improve the accuracy of their treatment planning and ultimately impact the quality of therapeutic radiology.

Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

After the results obtained in the two randomized clinical trial, the ELIOT trial and the TARGIT-A trial, a heated debate is going on concerning the question of applying intraoperative radiotherapy (IORT) instead of postoperative whole breast irradiation (WBI) after breast conservative treatment. Currently, many centers are applying the IORT following the strict selection criteria dictated by the working groups American Society for Radiation Oncology (ASTRO) and Groupe Européen de Curiethérapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) and monitoring the oncological outcome together with radiation toxicity on breast tissue. The clinical experience of the Geneva University Hospital regarding the use of the Intrabeam system is evaluated and compared with current evidences.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines:• Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline.• Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

The American Association of Physicists in Medicine (AAPM) is a nonprofit professional society whose primary purposes are to advance the science, education and professional practice of medical physics. The AAPM has more than 8,000 members and is the principal organization of medical physicists in the United States. The AAPM will periodically define new practice guidelines for medical physics practice to help advance the science of medical physics and to improve the quality of service to patients throughout the United States. Existing medical physics practice guidelines will be reviewed for the purpose of revision or renewal, as appropriate, on their fifth anniversary or sooner. Each medical physics practice guideline represents a policy statement by the AAPM, has undergone a thorough consensus process in which it has been subjected to extensive review, and requires the approval of the Professional Council. The medical physics practice guidelines recognize that the safe and effective use of diagnostic and therapeutic radiology requires specific training, skills, and techniques, as described in each document. Reproduction or modification of the published practice guidelines and technical standards by those entities not providing these services is not authorized. The following terms are used in the AAPM practice guidelines: Must and Must Not: Used to indicate that adherence to the recommendation is considered necessary to conform to this practice guideline. Should and Should Not: Used to indicate a prudent practice to which exceptions may occasionally be made in appropriate circumstances.

ViewRay is a novel MR‐guided radiotherapy system capable of imaging in near real‐time at four frames per second during treatment using 0.35T field strength. It allows for improved gating techniques and adaptive radiotherapy. Three cobalt‐60 sources (∼15,000 Curies) permit multiple‐beam, intensity‐modulated radiation therapy. The primary aim of this study is to assess the imaging stability, accuracy, and automatic segmentation algorithm capability to track motion in simulated and in vivo targets. Magnetic resonance imaging (MRI) characteristics of the system were assessed using the American College of Radiology (ACR)‐recommended phantom and accreditation protocol. Images of the ACR phantom were acquired using a head coil following the ACR scanning instructions. ACR recommended T1‐ and T2‐weighted sequences were evaluated. Nine measurements were performed over a period of seven months, on just over a monthly basis, to establish consistency. A silicon dielectric gel target was attached to the motor via a rod. 40 mm total amplitude was used with cycles of 3 to 9 s in length in a sinusoidal trajectory. Trajectories of six moving clinical targets in four canine patients were quantified and tracked. ACR phantom images were analyzed, and the results were compared with the ACR acceptance levels. Measured slice thickness accuracies were within the acceptance limits. In the 0.35 T system, the image intensity uniformity was also within the ACR acceptance limit. Over the range of cycle lengths, representing a wide range of breathing rates in patients imaged at four frames/s, excellent agreement was observed between the expected and measured target trajectories. In vivo canine targets, including the gross target volume (GTV), as well as other abdominal soft tissue structures, were visualized with inherent MR contrast, allowing for preliminary results of target tracking. PACS number: 87.61.Tg

Many people lack awareness and good knowledge about radiation and its uses in medicine as it has been figured out that significant segments of the public society have a wrong idea and abnormal fear from unwarr anted irradiation. For these reasons, a population in the Middle East was surveyed by means of a short questionnaire that was designed to assess the level of general knowledge of radiation and focus on the most important reasons behind their fear from dealing with radiation in order to improve their point of view about medical diagnostic and therapeutic radiology alike. The questionnaire is built upon the foundations and rules of scientific court as it was divided into two essential specialized classifications to describe different criteria, apart from other personal

BackgroundBrachytherapy is an integral component of the definitive treatment of locally advanced cancer cervix. Cervical Brachytherapy has evolved from the time when dose prescription was largely empirical, to the image based conformal brachytherapy advocated by Groupe Europeen de Curie Therapie-European society for therapeutic radiology and oncology (GEC-ESTRO) and American brachytherapy society (ABS).ObjectivesTo explore the feasibility of transabdominal ultrasound (USG) as an imaging modality for conformal brachytherapy (intracavitary) in locally advanced cancer cervix.MethodsTwenty-five patients with locally advanced cervix cancer (FIGO 2009 IB2 to IIIB) treated with definitive chemoradiation and brachytherapy were included in this study. Two plans were generated for each patient at each brachytherapy session – 1) standard orthogonal X-Ray plan with dose presciption to Point A and 2) plan based on USG imaging and clinical assessment. The two plans were compared with respect to doses received at point A, international commission on radiation units and measurements (ICRU) 38 urinary bladder and rectal points. Actual Brachytherapy doses were prescribed to the USG (and clinically) delineated target and patients followed up to 15 months minimum for assessing local control and late toxicity.ResultsUSG based planning resulted in statistically significant reduction of doses received at organs at risk (OAR) i.e. ICRU 38 bladder (PConclusionsConsidering the ease of availability, inexpensiveness, quick and good soft tissue imaging offered by ultrasound, this modality’s potential for conformal brachytherapy should be further explored, especially in limited resource settings and where the disease burden is high.

A research report submitted to the Faculty of Health Sciences, University of the of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Diagnostic Radiology.