101
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Summers P, Ibbott G, Moyers M, Grant R, Followill D. MO-D-BRB-03: Comparison of Proton Therapy Institutional Data Collected by the RPC. Med Phys 2012; 39:3866. [DOI: 10.1118/1.4735784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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102
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Klein E, Ibbott G, Bayouth J. MO-E-211-01: ABR 2014: Trained for Competence. Med Phys 2012; 39:3870. [PMID: 28518226 DOI: 10.1118/1.4735802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Medical physicists are the only non-physician professionals recognized by the American Board of Medical Specialties through certification by the American Board of Radiology (ABR). The ABR has always set high standards of clinical competency and now with the endorsement of the AAPM, is able to raise these standards by mandating that in 2014, to sit as a candidate for board certification, enrollment in an accredited physics residency program is required. This is an enormous step to elevate our profession, as now we have the means to specify only one method for achieving board certification that is through an accredited residency program, which leads to an increase of clinical competency. This will have a positive impact on our profession's recognition. Most challenges have been met, namely the number of residency positions has increased exponentially to meet the manpower needs. In addition, funding mechanisms are being sought for government support of such training programs. However, we have to ensure that pathways for a residency and certification do not eliminate strong scientists; if for example, they do not have the prior educational pre-requisite. Our profession has always, and must continue to breed strong scientists who have clinical expertise though may not be seeking a clinical career. This requires developing skill sets that prepare scientists to be researchers or residents who can perform research. We will discuss the benefits of the 2014 mandate along with the challenges that still exist. LEARNING OBJECTIVES 1. The ABR requirements c2014: Why they're needed and how they were established 2. Physics Residency Programs: Importance for our profession and methods to fund 3. Essential elements for competency: didactic, scientific and clinical.
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103
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Johnson J, Brown K, Ibbott G, Pawlicki T. MO-F-211-01: Methods for Completing Practice Quality Improvement (PQI). Med Phys 2012; 39:3871. [PMID: 28518242 DOI: 10.1118/1.4735805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Practice Quality Improvement (PQI) is becoming an expected part of routine practice in healthcare as an approach to provide more efficient, effective and high quality care. Additionally, as part of the ABR's Maintenance of Certification (MOC) pathway, medical physicists are now expected to complete a PQI project. This session will describe the history behind and benefits of the ABR's MOC program, provide details of quality improvement methods and how to successfully complete a PQI project. PQI methods include various commonly used engineering and management tools. The Plan-Do-Study-Act (PDSA) cycle will be presented as one project planning and implementation tool. Other PQI analysis instruments such as flowcharts, Pareto charts, process control charts and fishbone diagrams will also be explained with examples. Cause analysis, solution development and implementation, and post-implementation measurement will be presented. Project identification and definition as well as appropriate measurement tool selection will be offered. Methods to choose key quality metrics (key quality indicators) will also be addressed. Several sample PQI projects and templates available through the AAPM and other organizations will be described. At least three examples of completed PQI projects will be shared. LEARNING OBJECTIVES 1. Identify and define a PQI project 2. Identify and select measurement methods/techniques for use with the PQI project 3. Describe example(s) of completed projects.
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104
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Thomadsen B, DeWerd L, Ibbott G, Meigooni A, Mitch M, Rivard M, Stump K, Venselaar J. 93 TG-138 REPORT: UNCERTAINTIES IN PHOTON EMITTING BRACHYTHERAPY SOURCE DOSIMETRY. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)72060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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105
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Zietman A, Ibbott G. A clinical approach to technology assessment: how do we and how should we choose the right treatment? Semin Radiat Oncol 2012; 22:11-7. [PMID: 22177874 DOI: 10.1016/j.semradonc.2011.09.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The evidence required to support the use of new technology in medicine differs from that required for new drugs. On one extreme, very little may be required for small devices, but on the other strong evidence is required to support the use of truly novel, potentially dangerous, and high-cost machines. The randomized controlled trial is built into the evaluation of drugs and suits them well. It is not so well suited to the evaluation of major devices in which installation costs and return on investment are important. We discuss where the randomized controlled trial may still play a role and what alternatives may exist when this is not possible. We also discuss the role that independent bodies may have in determining whether or not a new device is not only safe but also adds to the medical landscape in a way that justifies its cost.
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106
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Ibbott G. Oncology Scan - Physics. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/s0360-3016(12)00268-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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107
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Grant R, Ibbott G, Zhu X, Adamovics J, Oldham M, Followill D. Investigation of Proton Beam Dose Distributions with 3D Dosimetry. Int J Radiat Oncol Biol Phys 2011. [DOI: 10.1016/j.ijrobp.2011.06.1584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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108
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Tonigan J, Kry S, Dong L, Purdie T, White R, Ibbott G, Followill D. WE-C-BRB-01: Does IMRT Treatment Plan Complexity or Mismatched Dosimetry Data Contribute to Dose Delivery Errors Detected Using an IMRT H&N Quality Assurance Phantom? Med Phys 2011. [DOI: 10.1118/1.3613320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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109
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Aguirre J, Alvarez P, Ibbott G, Followill D. SU-E-T-126: Analysis of Uncertainties for the RPC Remote Dosimetry Using Optically Stimulated Light Dosimetry (OSDL). Med Phys 2011. [DOI: 10.1118/1.3612077] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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110
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Grant R, Ibbott G, Zhu X, Carroll M, Adamovics J, Oldham M, Followill D. SU-E-T-363: Investigation of PRESAGE® Dosimeters for Proton Therapy. Med Phys 2011. [DOI: 10.1118/1.3612317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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111
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Kerns J, Kry S, Sahoo N, Followill D, Ibbott G. SU-E-T-134: Angular Dependence of the NanoDot Dosimeter. Med Phys 2011. [DOI: 10.1118/1.3612085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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112
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Molineu A, Hernandez N, Alvarez P, Ibbott G, Galvin J, Followill D. WE-C-BRB-05: Results from 1005 IMRT Irradiations of an Anthropomorphic Head and Neck Phantom. Med Phys 2011. [DOI: 10.1118/1.3613324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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113
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Faught A, Kry S, Luo D, Molineu A, Galvin J, Drzymala R, Timmerman R, Sheehan J, Gillin M, Ibbott G, Followill D. SU-E-T-173: Design, Development, and Evaluation of a Modified, Anthropomorphic, Head and Neck, Quality Assurance Phantom for Use in Stereotactic Radiosurgery. Med Phys 2011. [DOI: 10.1118/1.3612123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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114
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Cho J, Alvarez P, Followill D, Gillin M, Ibbott G. SU-E-T-153: Proton Linearity and Energy Dependence Studies of Optically Stimulated Luminescent Detectors for Remote Audits of Proton Beam Calibrations by the Radiological Physics Center. Med Phys 2011. [DOI: 10.1118/1.3612103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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115
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Followill D, Alvarez P, Molineu A, Gillin M, Ibbott G. SU-E-T-542: Evaluation of Lung Treatment Deliveries Using the Radiological Physics Centerˈs (RPC) Thorax Phantom: Monte Carlo Heterogeneity Correction Algorithms vs. All Other Modern Heterogeneity Correction Algorithms. Med Phys 2011. [DOI: 10.1118/1.3612504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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116
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Ibbott G, Oldham M, Mijnheer B, Zhu T. TU-E-BRA-02: How Should We Verify Complex Radiation Therapy Treatments ? Med Phys 2011. [DOI: 10.1118/1.3613176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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117
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Blatnica A, Ibbott G, Zhu X, Balter P, White R, Followill D. SU-E-T-169: Modification and Implementation of the RPC Heterogeneous Thorax Phantom for Verification of Proton Therapy Treatment Procedures. Med Phys 2011. [DOI: 10.1118/1.3612119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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118
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Cho J, Mawlawi O, Gillin M, Titt U, Gonzalez-Lepera C, Ibbott G. WE-G-214-07: Proton Beam Range Verification with PET: Comparison of O-18, O-16 and C-12 Activation. Med Phys 2011. [DOI: 10.1118/1.3613428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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119
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Klein E, Ibbott G, Bayouth J. MO-D-224-01: ABR 2014: Trained for Competence. Med Phys 2011. [DOI: 10.1118/1.3612904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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120
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Summers P, Followill D, Sahoo N, Poenisch F, Tucker S, Gillin M, Riley B, Ibbott G. SU-E-T-357: Development of An Anthropomorphic Head Phantom for the Assessment of Proton Therapy Treatment Procedures. Med Phys 2011. [DOI: 10.1118/1.3612311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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121
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Wang Z, Thomas A, Newton J, Ibbott G, Deasy J, Oldham M. Dose Verification of Stereotactic Radiosurgery Treatment for Trigeminal Neuralgia with Presage 3D Dosimetry System. ACTA ACUST UNITED AC 2010; 250. [PMID: 21218143 DOI: 10.1088/1742-6596/250/1/012058] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Achieving adequate verification and quality-assurance (QA) for radiosurgery treatment of trigeminal-neuralgia (TGN) is particularly challenging because of the combination of very small fields, very high doses, and complex irradiation geometries (multiple gantry and couch combinations). TGN treatments have extreme requirements for dosimetry tools and QA techniques, to ensure adequate verification. In this work we evaluate the potential of Presage/Optical-CT dosimetry system as a tool for the verification of TGN distributions in high-resolution and in 3D. A TGN treatment was planned and delivered to a Presage 3D dosimeter positioned inside the Radiological-Physics-Center (RPC) head and neck IMRT credentialing phantom. A 6-arc treatment plan was created using the iPlan system, and a maximum dose of 80Gy was delivered with a Varian Trilogy machine. The delivered dose to Presage was determined by optical-CT scanning using the Duke Large field-of-view Optical-CT Scanner (DLOS) in 3D, with isotropic resolution of 0.7mm(3). DLOS scanning and reconstruction took about 20minutes. 3D dose comparisons were made with the planning system. Good agreement was observed between the planned and measured 3D dose distributions, and this work provides strong support for the viability of Presage/Optical-CT as a highly useful new approach for verification of this complex technique.
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122
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Newton J, Thomas A, Ibbott G, Oldham M. Preliminary commissioning investigations with the DMOS-RPC optical-CT Scanner. ACTA ACUST UNITED AC 2010; 250:12078. [PMID: 21218171 DOI: 10.1088/1742-6596/250/1/012078] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
A midsized broad beam Optical-CT scanner is being developed for collaborative research between Duke and the Radiological Physics Center (RPC). The Duke Midsized Optical-CT Scanner (DMOS-RPC) is designed to be compatible with several of the RPC phantoms, including the head and neck, stereotactic SRS, and lung phantoms. Preliminary data investigating the basic performance of the scanner is described. Two 10 cm PRESAGE cylinders were irradiated with simple test plans. Projections of ~80 μm resolution of each dosimeter were collected at 1 degree intervals over a full 360 degrees both before and after irradiation. 3 dimensional reconstructions of attenuation coefficients throughout the dosimeter were computed with 1 mm(3) resolution. Scans were normalized to the calculated dose distribution and a 3D comparison was made with a commissioned treatment planning system. Initial results indicate DMOS-RPC can produce accurate relative dose distributions with high spatial resolution (up to 1 mm(3) in 3D) in less than 30 minutes (acquisition and reconstruction). A maximum dose of ~3.6Gy was delivered in these tests, and observed noise was ~2% for 1 mm(3) reconstructions. Good agreement is observed with the planning system in these simple distributions, indicating promising potential for this scanner.
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123
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Hsu IC, Bae K, Shinohara K, Pouliot J, Purdy J, Ibbott G, Speight J, Vigneault E, Ivker R, Sandler H. Phase II trial of combined high-dose-rate brachytherapy and external beam radiotherapy for adenocarcinoma of the prostate: preliminary results of RTOG 0321. Int J Radiat Oncol Biol Phys 2010; 78:751-8. [PMID: 20207506 PMCID: PMC2946454 DOI: 10.1016/j.ijrobp.2009.08.048] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2009] [Revised: 07/29/2009] [Accepted: 08/21/2009] [Indexed: 10/19/2022]
Abstract
PURPOSE To estimate the rate of late Grade 3 or greater genitourinary (GU) and gastrointestinal (GI) adverse events (AEs) after treatment with external beam radiotherapy and prostate high-dose-rate (HDR) brachytherapy. METHODS AND MATERIALS Each participating institution submitted computed tomography-based HDR brachytherapy dosimetry data electronically for credentialing and for each study patient. Patients with locally confined Stage T1c-T3b prostate cancer were eligible for the present study. All patients were treated with 45 Gy in 25 fractions using external beam radiotherapy and one HDR implant delivering 19 Gy in two fractions. All AEs were graded according to the Common Terminology Criteria for Adverse Events, version 3.0. Late GU/GI AEs were defined as those occurring >9 months from the start of the protocol treatment, in patients with ≥18 months of potential follow-up. RESULTS A total of 129 patients from 14 institutions were enrolled in the present study. Of the 129 patients, 125 were eligible, and AE data were available for 112 patients at analysis. The pretreatment characteristics of the patients were as follows: Stage T1c-T2c, 91%; Stage T3a-T3b, 9%; prostate-specific antigen level ≤10 ng/mL, 70%; prostate-specific antigen level >10 but ≤20 ng/mL, 30%; and Gleason score 2-6, 10%; Gleason score 7, 72%; and Gleason score 8-10, 18%. At a median follow-up of 29.6 months, three acute and four late Grade 3 GU/GI AEs were reported. The estimated rate of late Grade 3-5 GU and GI AEs at 18 months was 2.56%. CONCLUSION This is the first prospective, multi-institutional trial of computed tomography-based HDR brachytherapy and external beam radiotherapy. The technique and doses used in the present study resulted in acceptable levels of AEs.
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124
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Aguirre J, Alvarez P, Amador C, Tailor A, Followill D, Ibbott G. WE-D-BRB-08: Validation of the Commissioning of an Optically Stimulated Luminescence (OSL) System for Remote Dosimetry Audits. Med Phys 2010. [DOI: 10.1118/1.3469396] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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125
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Kerns J, Ibbott G, Johnson V, Kry S, Sahoo N, Followill D. TH-C-BRB-01: Characterization of Optically-Stimulated Luminescent Detectors (OSLDs) in Photon & Proton Beams. Med Phys 2010. [DOI: 10.1118/1.3469485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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