Expanding the medical physicist curricular and professional programme to include Artificial Intelligence.

PURPOSE: To provide a guideline curriculum related to Artificial Intelligence (AI), for the education and training of European Medical Physicists (MPs). MATERIALS AND METHODS: The proposed curriculum consists of two levels: Basic (introducing MPs to the pillars of knowledge, development and applications of AI, in the context of medical imaging and radiation therapy) and Advanced. Both are common to the subspecialties (diagnostic and interventional radiology, nuclear medicine, and radiation oncology). The learning outcomes of the training are presented as knowledge, skills and competences (KSC approach). RESULTS: For the Basic section, KSCs were stratified in four subsections: (1) Medical imaging analysis and AI Basics; (2) Implementation of AI applications in clinical practice; (3) Big data and enterprise imaging, and (4) Quality, Regulatory and Ethical Issues of AI processes. For the Advanced section instead, a common block was proposed to be further elaborated by each subspecialty core curriculum. The learning outcomes were also translated into a syllabus of a more traditional format, including practical applications. CONCLUSIONS: This AI curriculum is the first attempt to create a guideline expanding the current educational framework for Medical Physicists in Europe. It should be considered as a document to top the sub-specialties' curriculums and adapted by national training and regulatory bodies. The proposed educational program can be implemented via the European School of Medical Physics Expert (ESMPE) course modules and - to some extent - also by the national competent EFOMP organizations, to reach widely the medical physicist community in Europe.

Dosimetric comparison between the microSelectron HDR (192)Ir v2 source and the BEBIG (60)Co source for HDR brachytherapy using the EGSnrc Monte Carlo transport code.

Manufacturing of miniaturized high activity (192)Ir sources have been made a market preference in modern brachytherapy. The smaller dimensions of the sources are flexible for smaller diameter of the applicators and it is also suitable for interstitial implants. Presently, miniaturized (60)Co HDR sources have been made available with identical dimensions to those of (192)Ir sources. (60)Co sources have an advantage of longer half life while comparing with (192)Ir source. High dose rate brachytherapy sources with longer half life are logically pragmatic solution for developing country in economic point of view. This study is aimed to compare the TG-43U1 dosimetric parameters for new BEBIG (60)Co HDR and new microSelectron (192)Ir HDR sources. Dosimetric parameters are calculated using EGSnrc-based Monte Carlo simulation code accordance with the AAPM TG-43 formalism for microSlectron HDR (192)Ir v2 and new BEBIG (60)Co HDR sources. Air-kerma strength per unit source activity, calculated in dry air are 9.698×10(-8) ± 0.55% U Bq(-1) and 3.039×10(-7) ± 0.41% U Bq(-1) for the above mentioned two sources, respectively. The calculated dose rate constants per unit air-kerma strength in water medium are 1.116±0.12% cGy h(-1)U(-1) and 1.097±0.12% cGy h(-1)U(-1), respectively, for the two sources. The values of radial dose function for distances up to 1 cm and more than 22 cm for BEBIG (60)Co HDR source are higher than that of other source. The anisotropic values are sharply increased to the longitudinal sides of the BEBIG (60)Co source and the rise is comparatively sharper than that of the other source. Tissue dependence of the absorbed dose has been investigated with vacuum phantom for breast, compact bone, blood, lung, thyroid, soft tissue, testis, and muscle. No significant variation is noted at 5 cm of radial distance in this regard while comparing the two sources except for lung tissues. The true dose rates are calculated with considering photon as well as electron transport using appropriate cut-off energy. No significant advantages or disadvantages are found in dosimetric aspect comparing with two sources.

SU-E-T-313: Probe-Type Experimental Dosimetry in Terms of Absorbed Dose to Water in Photon-Brachytherapy a Proposal for a Radiation-Quality Index.

PURPOSE: In photon-brachytherapy (BT), all data for clinical dosimetry (e.g., the dose-rate constant) are not measured in water, but calculated, based on MC-simulation. To enable the measurement of absorbed dose to water, DW, in the vicinity of a source, the complex energy-dependence and other influence quantities must be considered. METHODS: The detectors response, R=M/D, is understood as product of a detector-material dependent 'absorbed dose response', Ren, and Rin, the 'intrinsic response'. Ren is described by the Burlin-theory and because of dissimilarities between the detector-material and water, will have energy dependent correction factors which convert Ren into the clinically relevant DW,Qo=MQo × ND,W,Qo. To characterize BT- source-types, we propose a new 'radiation-quality index' QBT=Dprim(2cm)/Dprim(1cm), the ratio of the primary-dose to water at r=2cm to that at the reference distance r=1cm, similar to external beam dosimetry. Although QBT cannot be measured directly, it can be derived from primary and scatter separated dose-data, published as consensus data e.g., in the Carlton AAPM-TG-43-database. RESULTS: Mean QBT-values are: for nine HDR and four PDR 192Ir-sources: 0.2258±0.5%; one 169Yb- source: 0.2142; and one 125I-source: 0.1544. CONCLUSIONS: The main benefit of this new QBT-concept is that a type of BT-dosimetry-detector needs to be calibrated only for one reference radiation-quality, e.g., for Q0=192Ir. To measure the dose for different source-types, DW can be determined using calculated radiation-quality conversion factors kQ,QoBT, to be included in the AAPM-database and to be provided by the manufacturer for each detector-type. Typical BT-dosimetry-detectors are plastic scintillation detectors, radiochromic film, thermoluminescence detectors, optically stimulated detectors, and small volume ionization chambers. Recently, different DW(1cm)-primary standards have been developed in several European NMIs, enabling to calibrate BT-radiation- sources and BT-dosimetry-detectors and allowing to verify MC-calculated dose-rate constant values. The proposed definition of QBT has to be discussed internationally to find broad consensus.

A modified formula for defining tissue phantom ratio of photon beams.

Tissue phantom ratio (TPR), for square fields of various dimensions has been determined at varying depths in water. The dose in water has been measured at a fixed source-to-surface distance (SSD) of 100 cm and reference depth of 5 cm for 6 MV photon beam of Siemens Linear Accelerator Primus 11 in German Cancer Research Center (DKFZ), Heidelberg, Germany. A modified formula has been developed to calculate the TPR value for isocentric treatment. The present article describes the conversion of the measured data values into a comprehensive and consistent data set by the modified formula, that gives the TPR from Percentage Depth Dose (PDD) with depth as a function of field sizes from 10 mm x 10 mm upto 300 mm x 300 mm) and depth (from 0 mm to 300 mm).

[Use of electrons above 20 MeV for reduction of radiation exposure]. / Elektronenanwendungen oberhalb 20 MeV zur Verringerung der Strahlenbelastung.

After many years of clinical application of a 42 MeV betatron, the following indications were found for deep therapy with electrons above 20 MeV: tumors situated in the brain, mediastinum, kidney, liver, bladder, rectum, as well as peripheral tumors situated in different body regions. For eight different cases, the total body exposure and the radiation exposure of some risk organs was calculated for an irradiation with electrons alone, a combination of electrons and photons, an irradiation with 42 MeV X-rays and with Co-60 gamma rays alone. All these calculations were based on a most favorable irradiation technique. The results showed that electrons up to 40 MeV can spare more than 30% of the total body dose; a combination of electrons and photons allows a reduction of the total dose of about 15% as against that of photons alone, which makes possible a better conservation of skin. This total dose reduction corresponds to that achieved by the substitution of ultrahard X-radiation for Co-60 gamma radiation in deep therapy. The radiation exposure of risk organs can often be reduced by the use of electrons, too. Thus electron deep therapy shows to be justified for the mentioned tumor cases. This is also confirmed by clinical experience.