Comparison of failure modes and effects analyses and time for brachytherapy ring and tandem applicator digitization between manual and solid applicator source placement methods.

Ring and tandem (R&T) applicator digitization is currently performed at our institution by manually defining the extent of the applicators. Digitization can also be achieved using solid applicators: predefined, 3D models with geometric constraints. This study compares R&T digitization using manual and solid applicator methods through Failure Modes and Effects Analyses (FMEAs) and comparative time studies.

Exploring the Use of Contour-Based Intrafraction Motion Review for Spine Stereotactic Body Radiation Therapy Treatments.

Purpose: Patient motion during radiation therapy treatment is a concern, especially for spine stereotactic body radiation therapy cases where the sharper dose gradient presents a toxicity threat to the spinal cord. Intrafraction motion review (IMR) is an application used to monitor patient position during treatment. The presence of spinal fixation hardware presents an opportunity for motion tracking to manually pause the beam.

Multi-phase failure modes and effects analysis for low dose bilateral whole lung irradiation of COVID-19 positive patients requiring respiratory ventilation.

Purpose: To identify high-priority risks in a clinical trial investigating the use of radiation to alleviate COVID-19 pneumonia using a multi-phase failure modes and effects analysis (FMEA).

Methods: A comprehensive FMEA survey of 133 possible causes of failure was developed for the clinical trial workflow (Phase I). The occurrence, severity, and detection risk of each possible cause of failure was scored by three medical physicists.

Technical note: Commissioning of a linear accelerator producing ultra-high dose rate electrons.

Background: Ultra-high dose rate radiation (UHDR) is being explored by researchers in promise of advancing radiation therapy treatments.

Purpose: This work presents the commissioning of Varian's Flash Extension for research (FLEX) conversion of a Clinac to deliver UHDR electrons.

Methods: A Varian Clinac iX with the FLEX conversion was commissioned for non-clinical research use with 16 MeV UHDR (16H) energy.

Medical Physics Leadership Academy Journal Club (Leadership Club) program: Two-year review in building a community of leaders.

The American Association of Physicists in Medicine began the Medical Physics Leadership Academy Journal Club in the fall of 2020. The initiative was launched to provide a forum for medical physicists to learn about leadership topics using published material, discuss and reflect on the material, and consider incorporating the discussed skills into their professional practice. This report presents the framework for the MPLA Journal Club program, describes the lessons learned over the last 2 years, summarizes the data collected from attendees, and highlights the roadmap for the program moving forward.

Introduction to concept inventories for medical physics education.

Concept inventories are multiple choice exams designed with the intention to test core concepts on specific subjects and evaluate common misconceptions. These tests serve as a useful tool in the classroom to assess value added by the instructor's educational methods and to better understand how students learn. They can provide educators with a method to evaluate their current teaching strategies and to make modifications that enhance student learning and ultimately elevate the quality of medical physics education.

Novel Intrafraction Motion Tracking During Postoperative Spine Stereotactic Irradiation for a Patient With Carbon Fiber Fixation Hardware.

Carbon-fiber reinforced (CFR) polyetheretherketone hardware is an alternative to traditional metal hardware used for spinal fixation surgeries before postoperative radiation therapy for patients with spinal metastases. CFR hardware's radiolucency decreases metal artifact, improving visualization and accuracy of treatment planning. We present the first clinical use and proof of principle of CFR spinal hardware with tantalum markers used for successful tracking of intrafraction motion (IM) using Varian TrueBeam IMR (Intrafraction Motion Review) software module during postoperative spine stereotactic radiation.

Blinding of Residency Applications in Medical Physics: Promises and Pitfalls.

Purpose: The feasibility of blinding applications for a medical physics residency program has yet to be demonstrated in the literature. We explore the application of an automated approach with human review and intervention to blind applications during the annual medical physics residency review cycle.

Methods And Materials: Applications were blinded using an automated process and used for the first phase of residency review in the program.

Implementation of triggered kilovoltage imaging for stereotactic radiotherapy of the spine for patients with spinal fixation hardware.

Background And Purpose: Mitigation of intrafraction motion (IM) is valuable in stereotactic radiotherapy (SRT) radiotherapy where submillimeter accuracy is desired. The purpose of this study was to investigate the application of triggered kilovoltage (kV) imaging for spine SRT patients with hardware by correlating kV imaging with patient motion and summarizing implications of tolerance for IM based on calculated dose.

Materials And Methods: Ten plans (33 fractions) were studied, correlating kV imaging during treatment with pre- and post-treatment cone beam computed tomography (CBCT).

The lifetime of a linac monitor unit ion chamber.

This study is the first to report the clinical lifetime of Varian Kapton sealed ion chambers as a retrospective review. The data have been analyzed using ion chamber gain values, daily quality assurance results, monthly quality assurance results, and delivered treatment field data were analyzed to comprehensively review trends. The data show the average lifetimes of the ion chambers from our institution, so other physicists can prepare for replacement.

Model for implementation of a modern journal club in medical physics residency programs.

Journal clubs are a common educational experience for medical physics residents as a forum to discuss current research within the field. While journal clubs are valued by educational programs and accrediting bodies, there are a wide variety of ways in which these sessions are conducted. Unfortunately, there are currently few studies that have assessed the effectiveness of this educational method.

Commissioning of a motion system to investigate dosimetric consequences due to variability of respiratory waveforms.

A commercially available six-dimensional (6D) motion system was assessed for accuracy and clinical use in our department. Positional accuracy and respiratory waveform reproducibility were evaluated for the motion system. The system was then used to investigate the dosimetric consequences of respiratory waveform variation when an internal target volume (ITV) approach is used for motion management.

Implementation of an in-house visual feedback system for motion management during radiation therapy.

In this Technical Note, we describe an in-house video goggles feedback system assembled using several commercially available products. This goggle video feed-back system is currently being used at University of Louisville and Mayo Clinic for both CT simulation and linac treatment delivery. The setup details, including specific recommendations, are provided, along with an alternative option for using the video goggles system.

Site-specific tolerance tables and indexing device to improve patient setup reproducibility.

While the implementation of tools such as image-guidance and immobilization devices have helped to prevent geometric misses in radiation therapy, many treatments remain prone to error if these items are not available, not utilized for every fraction, or are misused. The purpose of this project is to design a set of site-specific treatment tolerance tables to be applied to the treatment couch for use in a record and verify (R&V) system that will insure accurate patient setup with minimal workflow interruption. This project also called for the construction of a simple indexing device to help insure reproducible patient setup for patients that could not be indexed with existing equipment.