medical physics, medical physicists, and the aapm:...

Medical Physics,Medical Physicists,and the AAPM:

From Quarks to Cancer

Medical Physics,Medical Physicists,and the AAPM:

From Quarks to Cancer

Jeff Siewerdsen, Ph.D.Associate Professor

Department of Biomedical EngineeringDepartment of Computer Science

Department of RadiologyJohns Hopkins University

AAPM Science Council (Member)AAPM Annual Meeting Science Program (Chair)

Imaging Physics Committee (Co-Chair)AAPM Liaison to the RSNA

Dr. Jeff Siewerdsen (Johns Hopkins University)

See Acknowledgments Slide for Contributing Support January 7, 2011 (American Center for Physics)

Physics in Medicine



Physics Asks…What is the nature of matter?



What is the nature of energy?Physics Asks…

Electricity + Magnetism

Electro-Magnetic Energy



How do matter and energy interact?Physics Asks…

• Do nothing at all

• Scatter, reflect, refract

• Absorb

• Excite (e.g., glow or spin)

• Impart molecular change



How can we apply our knowledge

of energy and matter against disease?

Medical Physics Asks…

Imaging

Therapy



Imaging

Therapy



Medical Imaging

• Imaging Modalities- X-ray Radiography- Computed Tomography (CT)

- Ultrasound

- Magnetic Resonance (MRI)

- Nuclear Medicine (PET, SPECT)

- Optical (OCT)

• Imaging Applications- Screening … Diagnosis …

- Staging / Prognostication …

- Planning and guidance of intervention

- Monitoring of treatment response



Medical Imaging

• Imaging Modalities- X-ray Radiography

- Computed Tomography (CT)- Ultrasound



- Optical (OCT)







Medical Imaging


- Computed Tomography (CT)

- Ultrasound- Magnetic Resonance (MRI)


- Optical (OCT)







Medical Imaging



- Ultrasound

- Magnetic Resonance (MRI)- Nuclear Medicine (PET, SPECT)

- Optical (OCT)







Medical Imaging



- Ultrasound


- Nuclear Medicine (PET, SPECT)- Optical (OCT)









- Ultrasound



- Optical (OCT)





Medical Imaging



Imaging

Therapy



Medical Linear AcceleratorsFor Example: Radiation Therapy

Role of PhysicsAccelerator physicsDose calculationTreatment planningTreatment deliveryQA / verification… and more



Surgery and Interventional Radiology

Role of PhysicsRobotics / toolsTracking / navigationPlanning / modelingImaging / registration… and more

For example: Minimally Invasive Surgery



Imaging

TherapyScie

nce

Pro

fess

ion

al

Pra

ctic

e



ResearchNew Imaging Methods

A PET scanner… inside an MRI

Ultrasound… with a laser!

Turning a C‐arm… into a CT

A CT scanner….you can stand in!

MRI, PET, CT, etc… of a mouse!



ResearchNew Treatment Methods

A linear accelerator… around an MRI

Surgery… by wire

Treating cancer…

… with heavy ions

Killing breast tumors…… with sound.



ResearchFundamental Basis of Disease Progression / Response



Clinical Medical PhysicsBasic ResponsibilitiesAssure the safe and effective delivery of radiation to achieve a diagnostic or therapeutic result

Protect the patient and others from harmful or excessive radiation

Advance procedures to ensure image quality and precise delivery of therapeutic radiation

Develop and direct quality assurance programs

Assist other healthcare professionals in the balance of beneficial and deleterious effects of radiation

Professional QualificationsCertification by the American Board of Medical Physics (ABMP), the American Board of Radiology (ABR), and/or the American Board of Health Physics (ABHP)

Diagnostic and/or Therapy Physicswww.aapm.org



Clinical Medical PhysicsA Day in the Life…Procedures for evaluating imaging and therapy equipment and radiation detectors

Compliance of equipment / methods with regulations

Acceptance testing and commissioning of imaging and therapy equipment

Review / verification of dosimetry in patient records

QA Program to monitor and evaluate imaging and therapy processes

Radiation safety program

Radiation shielding requirements and planning

Consultation on patient dose and associated risks

Training for medical practitioners

… and morewww.aapm.org



The AAPMMissionAdvance the science, education, and professional practice of medical physics

Goals1. Promote the highest quality medical physics services for patients.

2. Encourage research and development to advance the discipline.

3. Disseminate scientific and technical information in the discipline.

4. Foster the education and professional development of medical physicists.

5. Support the medical physics education of physicians and other medical professionals.

6. Promote standards for the practice of medical physics.

7. Govern and manage the Association in an effective, efficient, and fiscally responsible manner.

A Quick Plug: Our annual meeting (late July)Vancouver – Charlotte – Indianapolis – Austin – Baltimore (?)High School students welcome! (contact [email protected])



The AAPMDemographics*Membership:

Full Members:International:Junior / Resident:Student:

Diagnostic Physics:Therapy Physics:

Mean Age (Full):Male:Female:

PhD:MSc:BSc:

*Errors and omissions are the responsibility of the author (not the AAPM)

7,572

5,147124298758

1,6694,101

465,9521,547

3,1992,778210



Paths to Medical Physics



Paths to Medical PhysicsThe Path of Benevolence

Jean

Love of math, physics, and biology

Family member dies of cancer

BS / MS in Nuclear Engineering

PhD in Radiological Health Program

PostdocOn‐the‐job trainingABMP Certification Junior Faculty

FacultyAAPM BoD



Paths to Medical PhysicsThe Inter‐Disciplinarian

John

Indecision

Recognition of biology and physics

Desire for “unification” Biophysics

PhD in Biophysics

Junior Faculty Radiological Sciences Program

ABR CertificationFacultyAAPM Science Council Chair



Paths to Medical PhysicsThe Accidental Medical Physicist

Kyle

Physics andAstrophysics

Detectors (particle physics) Imaging (telescopes)

Job prospects?

Opportunity knocksInternship in hospital medical physics program

Junior FacultyABR Certification

PhD in Astrophysics

FacultyTraining ProgramAAPM Ed Program



Paths to Medical PhysicsThe Student In‐The‐Know

Nick

BSc Medical Physics

MSc Medical Biophysics

PhysicsResidencyCertification

ClinicalPhysics



Paths to Medical PhysicsIn short, there is no fixed path to a career in Medical PhysicsStudents should be aware that Medical Physics exists as a field of physics with rich opportunities in research, education, and professional / clinical practice

Formal DEPARTMENTS of Medical Physics can be rare, but other departments and programs may provide appropriate training, for example:

Biophysics Radiological Health Nuclear EngineeringBiomedical Engineering Computer Science Physics

Students should look deep into curricula, faculty, and research projects to find appropriate medical physics programs and research opportunities

ABR and ABMP certification require training in an accredited Medical Physics Residency Training Program.

Things are changing fast. Medical Physics training quickly becoming formalized.



e-

e+

A Final Thought

Paul A. M. Dirac

Theorized the existence of anti-matter (observed 1 year later)

Bra-ket notation for quantum physics

Dirac delta function…



Paul A. M. Dirac

“The fundamental problems in physics awaiting solution:

… the nature of atomic nuclei…

… to be followed by more difficult ones such as the problem of life.”

(1931)

A Final Thought



Acknowledgments

Jean MoranUniversity of Michigan

John BooneUC Davis

A. Kyle JonesMD Anderson

Nick ShkumatCleveland Clinic

E. I. ParsaiUniversity of Toledo

Funding Support and Disclosures for Dr. SiewerdsenNational Institutes of HealthSiemens HealthcareElekta Oncology SystemsCarestream Health

Contributions and Personal Communication



Acknowledgments

W. TomeUniversity of Wisconsin

C. LevinStanford University

Alex Vitkin, Ontario Cancer Institute

GE, GammaMedica, and NatureMedicine

Keissling et al.Nature Medicine 2004

Ferenc JoleszMass General Hospital

www.aapm.org www.aapm.org



medical physics, medical physicists, and the aapm:...

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