AFOMP Policy No 5: career progression for clinical medical physicists in AFOMP countries.

This policy statement, which is the fifth of a series of documents being prepared by the Asia-Oceania Federation of Organizations for Medical Physics Professional Development Committee, gives guidance on how clinical medical physicists' careers should progress from their initial training to career end. It is not intended to be prescriptive as in some AFOMP countries career structures are already essentially defined by employment awards and because such matters will vary considerably from country to country depending on local culture, employment practices and legislation. It is intended to be advisory and set out options for member countries and employers of clinical medical physicists to develop suitable career structures.

Radiation exposure to caregivers from patients undergoing common radionuclide therapies: a review.

The contribution of radionuclide therapies (RNTs) to effective patient treatment is widely appreciated. The administration of high doses has necessitated investigating the potential radiation hazard to caregivers from patients undergoing RNTs. This work aimed to review the literature regarding measured effective doses to caregivers from such patients. The main selection criterion was the presence of real radiation exposure measurements. The results were categorised according to the treatment protocol and dose parameters. Analysis of the collected data demonstrated that the measured effective dose values were within the dose constraints defined by the International Commission on Radiological Protection, provided that the radiation protection instructions were followed by both patients and caregivers. In conclusion, the radiation risk for caregivers was almost negligible. In this context, treatments could be administered more often on an outpatient basis, once cost-effectiveness criteria were established and radiation protection training and procedures were appropriately applied.

Patient-specific dosimetry in peptide receptor radionuclide therapy: a clinical review.

Neuroendocrine tumours (NETs) belong to a relatively rare class of neoplasms. Nonetheless, their prevalence has increased significantly during the last decades. Peptide receptor radionuclide therapy (PRRT) is a relatively new treatment approach for inoperable or metastasised NETs. The therapeutic effect is based on the binding of radiolabelled somatostatin analogue peptides with NETs' somatostatin receptors, resulting in internal irradiation of tumours. Pre-therapeutic patient-specific dosimetry is essential to ensure that a treatment course has high levels of safety and efficacy. This paper reviews the methods applied for PRRT dosimetry, as well as the dosimetric results presented in the literature. Focus is given on data concerning the therapeutic somatostatin analogue radiopeptides (111)In-[DTPA(0),D-Phe(1)]-octreotide ((111)In-DTPA-octreotide), (90)Y-[DOTA(0),Tyr(3)]-octreotide ((90)Y-DOTATOC) and (177)Lu-[DOTA(0),Tyr(3),Thr(8)]-octreotide ((177)Lu-DOTATATE). Following the Medical Internal Radiation Dose (MIRD) Committee formalism, dosimetric analysis demonstrates large interpatient variability in tumour and organ uptake, with kidneys and bone marrow being the critical organs. The results are dependent on the image acquisition and processing protocol, as well as the dosimetric imaging radiopharmaceutical.

The education and training of clinical medical physicists in 25 European, 2 North American and 2 Australasian countries: similarities and differences.

PURPOSE: The clinical medical physicist is part of a team responsible for safe and competent provision of radiation-based diagnostic examinations and therapeutic practices. To ensure that the physicist can provide an adequate service, sufficient education and training is indispensable. The aim of this study is to provide a structured description of the present status of the clinical medical physicist education and training framework in 25 European, 2 North American and 2 Australasian countries. METHODS: For this study, data collection was based on a questionnaire prepared by the European Federation of Organizations in Medical Physics (EFOMP) and filled-in either by the corresponding scientific societies-organizations or by the authors. RESULTS: In the majority of cases, a qualified medical physicist should have an MSc in medical physics and 1-3 years of clinical experience. Education and training takes place in both universities and hospitals and the total duration of the programs ranges from 2.5 to 9 years. In 56% of all European countries, it is mandatory to hold a diploma or license to work as a medical physicist, the situation being similar in Australasian and 4 states of USA. Generally, there are national registers of medical physicists with inclusion on the register being voluntary. There are renewal mechanisms in the registers usually based on a Continuing Professional Development (CPD) system. CONCLUSIONS: In conclusion, a common policy is followed in general, on topics concerning education and training as well as the practice of the medical physicist profession, notwithstanding the presence of a few differences.

Quantifying image quality at breast periphery vs mammary gland in mammography using wavelet analysis.

Use of high contrast film-screen systems in mammography, in combination with the fact that exposure parameters are selected to ensure good visualization of the mammary gland, results in overexposure of the film area corresponding to the breast periphery, therefore decreasing image quality. The aim of this work was to provide a quantitative evaluation of image quality at the breast periphery compared with the mammary gland. To deal with the difficulties in quantification of image quality introduced by low contrast encountered at the breast periphery, wavelet analysis has been used for derivation of a contrast indicator (CI) and a noise indicator (NI), taking into account local grey level variations. Gradient magnitude coefficients corresponding to region of interest (ROI) grey level values are the basis of CI definition. Mammary gland and breast periphery were sampled by equally spaced ROIs, the quantity of which was determined by a heuristic method. For NI definition, the power values of gradient magnitude coefficients corresponding to the ROI were utilized. Image quality at the breast periphery compared with the mammary gland was evaluated using 150 craniocaudal images from the Digital Database for Screening Mammography. Measurements were carried out using a tool developed in our department. A 50% contrast decrease at the breast periphery was observed, while noise decreased by approximately 2%.

A digital density equalization technique to improve visualization of breast periphery in mammography.

In mammographic imaging, the film area corresponding to the breast periphery is overexposed, resulting in high optical density and degraded contrast in this region. A digital, model-driven density equalization technique was designed and developed to overcome this overexposure problem, taking into account the non-linear characteristic curve of the film-digitizer system. The method is based on several image processing and analysis techniques, such as thresholding, which is used to segment the pixels of the mammogram belonging to the breast region from the background, and wavelet-based fusion, which is used to equalize the pixels of breast periphery selectively while leaving the remaining breast region unaffected. Initial application of the method resulted in density-equalized mammographic images, characterized by improved contrast at the breast periphery.