ACPSEM QLD BRANCH NEWSLETTER

DECEMBER 2013

NOTE FROM THE EDITOR Welcome to the first edition of the new ACPSEM QLD Branch newsletter. Many moons have passed since the last newsletter was produced, and the branch committee has decided the time was right to bring it back as a way to increase communication with the members. This first edition is quite hefty as the news section from each department span a long timeframe. The next edition will be much shorter in this regards, but may be bigger on “features”. Speaking of which, I invite all members to submit whatever the heck they want for future newsletters. It WILL get published no matter how irrelevant and non-sensible it is (the only line being prejudicial articles). Apart from centre news you will also see in this edition some exciting baby news, a report from the Chairman (also exciting), reviews of recent QLD events, member presentations at EPSM, awards, and a competition to guess the ACPSEM QLD member in the photo. The first two people to guess correctly will receive a free drink personally from the ACPSEM QLD Branch chairman (upper limit of $10, some people have been known to take advantage of these offers….you know who you are). In the next edition there may be more content – particularly if you contribute to it – so please do. In the meantime enjoy this edition.

IMPORTANT DATES Friday the 6

th of December, 6pm, the Plough Inn: ACPSEM QLD Branch AGM and social (includes the awarding

of the inaugural Bob Fitchew Member of the Year award)

TABLE OF CONTENTS

Note from the Editor .............................................................................................................................................. 1

Important Dates ..................................................................................................................................................... 1

Chairman’s report .................................................................................................................................................. 3

Baby news .............................................................................................................................................................. 4

News from around the state ................................................................................................................................. 5

RBWH RO ............................................................................................................................................................ 5

PAH RO................................................................................................................................................................ 5

Townsville RO ..................................................................................................................................................... 5

Radiation Oncology Queensland ........................................................................................................................ 5

Premion .............................................................................................................................................................. 6

Nuclear Medicine ................................................................................................................................................ 6

BTS ...................................................................................................................................................................... 7

CT ‘Skyshine’ ................................................................................................................................................... 7

BreastScreen Digital Project ........................................................................................................................... 7

New Starters ................................................................................................................................................... 7

Radiation Health ................................................................................................................................................. 7

Recent Incident ............................................................................................................................................... 7

Business Improvements .................................................................................................................................. 8

The rest ............................................................................................................................................................... 8

Event Reviews ........................................................................................................................................................ 9

2013 ACPSEM QLD Branch State Symposium, QUT ............................................................................................ 9

PRIMPS 11, Wesley Radiation Oncology, August .............................................................................................. 10

EPSM 2013 ............................................................................................................................................................ 10

Oral presentations ............................................................................................................................................ 10

Poster presentations ........................................................................................................................................ 11

EPSM Awards .................................................................................................................................................... 11

Certifications ........................................................................................................................................................ 12

Guess who?? ........................................................................................................................................................ 12

CHAIRMAN’S REPORT Dear Colleagues,

I am very excited, thrilled if you will, to be putting fingers to keyboard for the revamp of the ACPSEM QLD

branch newsletter. The branch has been aiming to bring the medical physics and engineering community

together through a variety of means including the membership drive, PRIMPS, the symposium, and now this as

the latest edition. We hope that it provides some enjoyment to you and welcome any feedback you may have.

I thought I would take this opportunity to also highlight some of the bigger things that have been happening

within the ACPSEM. For those of you who attended the symposium this year, you would have seen my action

packed presentation, for those who did not attend, I’m sure you will have heard about it – as well as all the

other great presentations that were given on the day.

The biggest project on the ACPSEM books at present is RO-STAMP and although it is fast drawing to a close,

much has been achieved including the TEAP CTG review and revamp, sustainability and international panel

reviews, revamp of the CPD program, the launch of the E-learning platform with comprehensive online

resources now available via the ACPSEM website, progression with mutual recognition and professional

registration including our TEAP programs being officially recognised by CAMPEP, and let’s not forget the 56

TEAP graduates and 195 ARECQA graduates! RO-STAMP funding ceases in early 2014, however the ACPSEM

will be continuing the programs until July 2014 whilst new funding is sourced and secured.

Progression has been made with the BARO survey which has been established and completed by about 25

chief physicists, a DIMP TEAC has been appointed with department accreditations and TEAP enrolments

currently being finalised, and the ACPSEM has welcomed radiopharmaceutical scientists to our membership.

The ACPSEM is also committed to improving communication with updates to the website coming,

enhancements to the membership database, and more information being passed onto members both directly

and via social media. So, indeed, there is a lot happening.

November 7 this year was the inaugural launch of the “International day of medical physics”. The day is quite

symbolic in that it is the birth date of arguably the most significant contributor to medical physics – Marie

Curie. To coincide with this, the ACPSEM has launched a new facebook page, so for those of you who have

facebook accounts, please check it out and spread the word to raise awareness for what we all do and enjoy.

www.facebook.com/Acpsem.medicine

As the year draws to a close, so too does my time as QLD chairman. As I’m sure any past chairman will agree,

it is a lot of work, but nonetheless an enjoyable and rewarding role, as it has been for the past two and a bit

years. I have enjoyed working with the branch committee in 2013 and look forward to handing over the reins

to the incoming chairman elect, Paul Charles.

I invite you all to attend the upcoming AGM (yet to be announced) which will be combined with a social get

together and the inaugural presentation of the Bob Fitchew Member of the Year Award, so keep an eye out for

the details of this to come. If you aren’t coming to the AGM, then I would like to wish you a Merry Christmas

and a safe new year in 2014.

Best wishes

Trent Aland

ACPSEM QLD chairman

BABY NEWS

Congratulations to members Rebecca Moylan (Premion) and Eva Liu (RO PAH) on the recent expansions to their families. Bec’s boy, Christian James Moylan (left with Bec), was born on August 21st, weighing in at 3.33 Kg. Eva’s son, Jacob Yin Wawrzakwas was born on April 9th, weighing in at 2.4 Kg. Though much bigger now in the recent photo below!

If any member would like to share exciting news about new family members (or anything really), please contact any member of ACPSEM QLD branch committee for inclusion in the next newsletter.

NEWS FROM AROUND THE STATE This section provides a news update from the different centres around Queensland.

RBWH RO

In July we had two Cadets start with us (Rachael and Kirby). Both have recently completed their MSc (Medical Physics) at QUT. They are now both settled in and focused on TEAP. Recently two physicists were recipients of the inaugural RBWH Cancer Care Grants. These small grants will allow the purchase of a 3D printer, for the development of printing brachy moulds, and the purchase of a PC Kinect, for the development of a patient positioning and dose calculation (Monte Carlo) system for TSET treatments. Recently another grant has allowed for RBWH to start a 3D gel dosimetry program. Chris Poole (our research physicist) has recently come back from Europe where he presented at a couple of conferences: the 16

th International Symposium of Micro Dosimetry, and the Geant4 International Users

Conference. Some of the interesting topics discussed were some new and rather perplexing results with bystander effect. Also Chris is now a member of Geant4 - DNA collaboration. A lot of work associated with replacement of 3 linacs and upgrades to the 2 Tomotherapy units is happening at present. More news about this in the next newsletter (perhaps).

PAH RO

The PAH has been kept busy this year with linac upgrades and the implementation of a stereotactic program. Each of which has resulted in the requirement of new treatment planning systems. Our first Elekta Agility was completed and clinical in June 2013 with the second installation underway and due to come online Feb 2014. Since the current TPS Eclipse is not compatible with the 160 MLC Agility head, the department has chosen to transition to the Pinnacle TPS. The stereo program has resulted in the introduction of the BrainLab iPlan TPS, and the installation of ExacTrac IGRT system on the Elekta Axesse. So far nine patients have been treated. A second Toshiba Aquilion CT scanner also came online Aug 2013. With such an expansion, the department participated in a Level 1 and 2 ACDS dosimetry audit this year and passed. Two physicists also successfully completed and passed their TEAP theory exam this year. We also look forward to introducing our new Director in the new year.

TOWNSVILLE RO

1. The ACPSEM college has granted TCC Provisional Accreditation to Townsville Hospital for a period of two years, effective from 25 October 2013.

2. Monaco TPS was commissioned and it was released for clinical used sincefrom May 2013. 3. The first SBRT patient (lung) was treated in August 2013 in the Elekta Axesse

TM with Agility Head.

4. SRT is being commissioning in the Elekta AxesseTM

with Agility Head and with the APEX add-on MLC. 5. 4D-CT scanner Toshiba is being commissioning. 6. Two new Elekta Infinity

TM Linacs will be arriving in Townsville Hospital in February 2014 and after

installation and acceptance tests , they will be commissioned.

RADIATION ONCOLOGY QUEENSLAND

Exciting things have been happening recently across ROQ. Our centre at Cairns base hospital has recently

celebrated a second birthday and the centre is humming along nicely with Sam Towns permanently based at

the centre along with support in the form of regular visits from team members based at the southern sites. In

Toowoomba, expansions including new bunker and planning room were completed this year. A third linac,

"Gamma" has since been commissioned and went clinical in August.

Having recently won the tender for the Gold Coast University Hospital Radiotherapy service, ROQ physicists

are currently working toward a clinical date of January 2014. GCUH will add two new linacs, "Apollo" and

"Gemini" to the ROQ network. The centre features two linacs and dedicated CT with room for expansion.

The next ROQ site has just recently broken ground in Springfield, with an expectation that building and

commissioning will ramp up swiftly in 2014.

This rapid growth has been supported by an expanded physics team with new registrars (Talia Jarema & Dean

Wallace), senior physicists (Guy Godwin & Emmanuel Baveas) joining us, as well as work experience

placements (Simon Biggs) and students.

ROQ continues to be an expanding enterprise, with what appears to be limitless possibilities on the horizon,

and it is safe to say that the whole team is looking forward to an exciting future with new centres and new

staff helping guide clinical development and research.

PREMION

Premion has recently celebrated the graduation of its 4th and 5th TEAP registrars - Tanya Kairn and Rebecca Moylan. Congratulations to them both. Rebecca has also featured in the latest edition of the APESM journal with her publication on the use of Gafchromic film for in-vivo dosimetry. This brings the total publication from the Premion physics group to 7 for 2013 (another 4 are currently ‘in press’). Premion is also in the process of alpha testing the TADA (treatment and dose assessor) program created by Scott Crowe. It is envisaged that this will enable us to not only collect patient data retrospectively, but also be used at a pre-treatment / plan quality tool for all our treatments. Finally, this year marks 25 years of operation for Premion (formerly Wesley Cancer Care Centre). The event was marked with an organisation wide dinner held in the CBD.

NUCLEAR MEDICINE

The big new in Nuclear Medicine at the moment would have to be HIRF. The Herston Imaging Research Facility to be built near the RBWH is a joint venture between The University of Queensland (UQ), Royal Brisbane & Women's Hospital (RBWH), Queensland University of Technology (QUT) and the Queensland Institute of Medical Research (QIMR), with Siemens as the industry supporter. HIRF will house Queensland (?Australia’s) first simultaneous PET/MR, with an adjoining 3T MR and PET/CT. This is a site worth watching over the next couple of year and I will look forward to seeing the work come out of it. Nuclear Medicine at the RBWH is currently ramping up radiopharmaceutical development with a number of new PET tracers coming on board. Currently the Lab provides a number of sites with FDG which we all know as the work horse of PET, along with 18F-DOPA and 68Ga-DOTATATE. Within the next 6 to 12 months we should see 68Ga-DOTANOC, 18F-MISO, a 68Ga labelled PSMA ligand and a 68Ga labelled cyclic peptide CPCR4-2 which is used to image the CXCR4 receptor status. Finally the RBWH had a world first recently with the installation of a Siemens Biograph mCT Flow, the first in a clinical setting. There is nothing new about this scanner except one new feature, the bed continually moves turning the PET acquisition. Think of it like a really slow CT which takes 20 minutes. Traditionally PET has acquired images with a step and shoot method, imaging a section of the body for 2-3 minutes before moving about 15cm and imaging the next section. This new continual bed motion should be more comfortable for the patient but otherwise produce the same great PET images we know and love.

BTS

CT ‘SKYSHINE’ Stephen Edwards, a Diagnostic Imaging Medical Physicist with Biomedical Technology Services (BTS) from the PA Hospital, has developed a robust and empirically validated method of calculating shielding requirement for CT installations. During his MSc, Stephen found that skyshine alone could potentially be responsible for annual dose rates above legal limits. Developing on his MSc work, Stephen has incorporated Tertiary air kerma rates from radiation scattered off the ceiling slab (Skyshine) into his shielding design work and released it to be used by BTS across the state. This new shielding model is a great step forward for radiology physics, and for putting QLD physicists on a national and international stage.

BREASTSCREEN DIGITAL PROJECT October 2012 saw the final touches being made on the 6 year road to triumph for Michael Bleazard and the BreastScreen QLD team. Michael has been leading the technical team responsible for transitioning BreastScreen QLD to the digital age, where reporting from film screen has been replaced by a state-wide PACS reporting and resource sharing system and cassette driven mammography acquisition has been replaced with integrated digital systems. This has allowed for state-wide pooling of expertise and resources, expected improvement in patient outcomes and workflow efficiency, reduction in patient dose, and the potential for implementation of exciting new procedures like digital breast tomosynthesis to improve detection rates, and gridless image acquisition to reduce patient dose further. Michael and the BreastScreen QLD team received the Australia Day Achievement Award in January 2012 in acknowledgement acknowledged for their hard work and dedication to this project.

NEW STARTERS While BTS regrets the loss of a number of staff over the past few years, it has been great to gain international experience and expertise from the likes of; Peter Barnes: Diagnostic Imaging Medical Physicist (Radiology) from the UK. Peter has taken a lead role in the BreastScreen QLD physics team, mentoring junior physicists and offering expert consultancy interstate as required; Deborah Tout: Diagnostic Imaging Medical Physicist (Nuclear Medicine) from the UK. Deb now has oversight of the new Nuclear Medicine and Radiology Services delivered from the Gold Coast University Hospital and; George McGill: Diagnostic Imaging Medical Physicist from the UK. George has taken a senior role in Radiology currently at the Royal Brisbane and Women’s Hospital. George continues to take a mentoring role over junior physicists and shares his wealth of experience in Radiology, Nuclear Medicine, and Radiation Protection physics

RADIATION HEALTH

RECENT INCIDENT

One of the roles of Radiation Health is to investigate radiation incidents and report them to the Australian Radiation Incident Register. An example of a recent incident involved the fracture of a vial containing FDG sometime during its transport from Sydney to a nuclear medicine practise in Brisbane. Following an investigation it was concluded the most likely cause of the incident was damage to the vial during preparation for transport, possibly as a result of a the lead shielding lid colliding with the glass vial during lid placement. However there was a very small possibility that the vial may have fractured during transport. It was also found that the shielded container and Type A transport package was in poor condition and may not have

meet the requirements of the Code of Practice for the Safe Transport of Radioactive Material (2008 Edition), specifically: Section 639 - "The design shall include a containment system securely closed by a positive fastening device which cannot be opened unintentionally or by a pressure which may arise within the package". Section 641 - "If the containment system forms a separate unit of the package, it shall be capable of being securely closed by a positive fastening device which is independent of any other part of the packaging." - It appears the lid of the shielding container came loose during transport or was not initially placed on securely; and Section 648 - "A Type A package designed to contain liquid radioactive material shall, in addition: (a) Be adequate to meet the conditions specified in para. 646(a) if the package is subjected to the tests specified in para. 725; and (b) Either (i) Be provided with sufficient absorbent material to absorb twice the volume of the liquid contents. Such absorbent material must be suitably positioned so as to contain the liquid in the event of leakage; or (ii) Be provided with a containment system composed of primary inner and secondary outer containment components designed to ensure retention of the liquid contents, within the secondary outer containment components, even if the primary inner components leak." - It appears the package had an insufficient amount of absorbent material or an inadequate secondary containment component. This may be of interest to those medical physicists involved with the transport of radioactive substances. The take home message is “care must be taken when placing heavy lids on containers holding radioactive substances in glass vials, and Type A transport packages must be verified to comply with Code of Practice for the Safe Transport of Radioactive Material (2008 Edition) before being used to transport radioactive substances”.

BUSINESS IMPROVEMENTS In recent times Radiation Health has been reviewing all of it licensing processes. This included development of new forms that can be filled in electronically and providing radiation source and purpose categories that more closely relate to the types of radiation sources used, and reason why they are used, within Queensland’s radiation practices. As part of this process, use licence authorities given to fully trained and qualified medical physicists have been broadened to fully cater for the full range of purposes medical physicists may use radiation sources for in their work place. This will hopefully reduce the need to amend medical physicist’s use licences and allow greater flexibility to use radiation sources for purposes for which they are appropriately trained and qualified. Look out for the new look forms and authorities on new licences.

THE REST

We did not manage to get a complete list of news from all centres in this edition. If a willing volunteer from

each centre could contact a ACPSEM Branch committee member stating that they would like to contribute

news to the next newsletter, it would be much appreciated.

“Charismatic speaker”: Pete Bridge delivers a far more

interesting speech than this image depicts.

“Collaboration is the future”: Andrew Fielding delivers

a topical and strong presentation.

EVENT REVIEWS

2013 ACPSEM QLD BRANCH STATE SYMPOSIUM, QUT

By Ben Harris (RO Medical Physics Cadet, PAH) The annual symposium is always both reflecting on the year past and looking forward to the future and what it brings. This year, it was all about research, collaboration, and imaging. The mood was set with the first keynote speaker of the day, Professor Paul Keall from the University of Sydney. His research group’s projects spanned the entire treatment spectrum, from the MRI-linac (potentially game-changing treatment imaging), to motion tracking (for treatment monitoring and adaptive planning) and the Nano-X (a low cost linac to improve global access to radiotherapy). Just as expansive was the work currently overseen by Professor Graham Galloway, the director of the Centre for Advanced Imaging at UQ. They are now implementing Australia’s first 7T whole-body MRI, allowing faster and higher resolution MRI scans. And in his role as director of the National Imaging Facility, he showed how collaborating between different centres spread across the country, each with different specialties, could open new research pathways. What was interesting was how current clinical research, such as that done by Professor Keall’s group, was being reflected in improvements in the current linac manufacturers. In a presentation for Varian (one of the symposium’s sponsors), Natalie Fimmell showed how the next linac improvements would include not only improved delivery, but also greater imaging facilities, like kV imaging during treatment, and panel upgrades to

develop better images. Collaboration was brought to the fore in the two talks from QUT. Pete Bridge showed how a simple survey of clinical work processes could help shape what skills were taught to radiotherapy students. On the research side, Andrew Fielding emphasised that most projects are multi-disciplinary, and how medical physicists can play an important role in many ostensibly oncologist- and radiotherapist-led projects. The presentations spanned a wide variety of topics, from the new imaging facilities in the Gold Coast University Hospital, through to CT diagnostic

reference levels and OSLD audits for linacs. Alas, while space forbids any detailed discussion, special mention must be made of the two prizewinning presentations of the day.

Both presenters used current technology to create new image types. Tim Markwell presented a method for obtaining MV cone-beam CT images from a standard Varian linac, and Deborah Tout showed how a single PET image could be rebinned to display and account for respiratory motion. Congratulations to them both. Many thanks go to all presenters at this year’s symposium for their talks, and to the organisers, sponsors (Nucletron, Elekta and Varian), and Queensland branch of the ACPSEM for a successful day. If this symposium was any indication, the future in Queensland is looking bright, sharp, and in 4D.

PRIMPS 11, WESLEY RADIATION ONCOLOGY, AUGUST

By Trent Aland

The latest PRIMPS event was held at the Wesley Research Institute on Friday 30 August. The afternoon was

well attended with members and QUT medical physics students/researchers. Topics ranged from a technical

issue with measuring routine off axis factors to updates from centres to a collation of IMRT / VMAT plan

acceptance criteria across all centres who treat IMRT or VMAT. Following on from this, a demonstration of the

EPID based quality assurance software, EpiQA, was given at Premion – Wesley. Fun was had by all!

EPSM 2013 Congratulations to the following members for presenting at EPSM 2013 in Perth. It was fantastic to see such a

large Queensland contingent this year.

ORAL PRESENTATIONS

Katrina Biggerstaff: INTEGRATION OF BRAINLAB EXACTRAC WITH ELEKTA IGUIDE FOR STEREOTACTIC RADIOTHERAPY/RADIOSURGERY

Katrina Biggerstaff: BRAINLAB IPLAN TREATMENT PLANNING SYSTEM FOR ELEKTA AXESSE

Dianna Binny: TSET - TOTAL SKIN ELECTRON THERAPY, A CASE STUDY USING OPTICALLY STIMULATED LUMINESCENCE DETECTORS AND ITS BENEFITS

Paul Charles - A PRACTICAL AND THEORETICAL DEFINITION OF 'SMALL FIELD'

Paul Charles - A DIODE FOR CORRECTION-LESS SMALL FIELD OUTPUT FACTOR MEASUREMENTS

Andrew Fielding - VERIFICATION OF RADIOTHERAPY TREATMENTS INVOLVING THE ENHANCED DYNAMIC WEDGE: EPID MEASUREMENT AND MONTE-CARLO SIMULATION Talia Jarema - EYE PLAQUE DOSE VERIFICATION USING SOLID STATE DETECTORS

Tanya Kairn - THE IMPORTANCE OF ACCURATE BEAM DATA MEASUREMENT FOR SRT/SRS TREATMENT

PLANNING

Tanya Kairn - EFFECTS OF SMALL FIELD OUTPUT FACTORS ON IMRT OPTIMISATION AND DOSE CALCULATION

Tanya Kairn - PROSTATE RADIOTHERAPY TREATMENT PLAN QUALITY: EFFECTS OF HIP PROSTHESES

John Kenny - ACDS LEVEL IB AUDIT: OUTCOMES FROM THREE YEARS OF OPERATION

Daniel Schick - APPLYING NOISE REDUCTION CHARACTERISTICS OF SIEMENS STELLAR CT DETECTOR TO DOSE OPTIMISATION

Ian Smith - USE OF A STANDARDISED OUTPUT RATIO TO COMPARE CARDIAC IMAGING SYSTEMS

Ian Smith - RADIATION RISK REDUCTION IN CARDIAC ELECTROPHYSIOLOGY THROUGH USE OF A GRIDLESS IMAGING TECHNIQUE.

George Warr - STATUS OF THE ACPSEM RADIATION ONCOLOGY MEDICAL PHYSICS TRAINING EDUCATION AND ASSESSMENT PROGRAM

Mark West - REFLECTIVE PRACTICE TO ASSESS THE IMPLEMENTATION OF A RADIATION THERAPY CLINICAL ORIENTATION PROGRAM FOR TRAINEE RADIATION ONCOLOGY MEDICAL PHYSICISTS

Poster presentations

Tim Ireland - RECOMMENDATIONS FOR A DIGITAL RADIOGRAPHIC DETECTOR QUALITY ASSURANCE PROGRAM

Ben Keir - ASSESSING DYNAMIC FLUOROSCOPIC IMAGE QUALITY IN TELEHEALTH APPLICATIONS: ADAPTATION OF THE NEMA XR 21 CARDIOVASULAR FLUOROSCOPIC BENCHMARKING

Ricardo Simeoni - RESPONSE COMPARISON OF DIGITAL HEARING AIDS

Ricardo Simeoni - THE THERMODYNAMICS OF INGESTION BODY COOLING REGIMES WHEN EXERCISING IN THE HEAT

Nancy Yu - COMMISSIONING LANDAUER INLIGHTTM OPTICALLY STIMULATED LUMINESCENCE DOSIMETERS FOR IN-VIVO PATIENT DOSIMETRY

EPSM AWARDS

Congratulations to the following two ACPSEM QLD Members who received awards for EPSM 2013:

Talia Jarema – Richards Bates Travel Award

Paul Charles – John Black Award (best student presentation)

CERTIFICATIONS Very warm congratulations to the following ACPSEM QLD Branch members who recently enjoyed success in their training. It’s always big news around here! Sincere apologies if we’ve left anyone out. Rebecca Meldrum, Premion (RO)

Tanya Kairn, Premion (RO)

John Baines, Mater (RO)

Josh Boyd, Mater (RO)

Zoe Baldwin, RBWH [passed her practical and oral exams] (RO)

Ben Harris , PAH [passed his written exam] (RO)

GUESS WHO?? Guess the ACPSEM QLD member pointed to in the photo. The first 2 people to send the correct answer to

paulcharles111@gmail.com will receive a free drink from the ACPSEM QLD Branch Chairman personally (up to

$10).