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Medical Physics 1.0 to 2.0, Session 4: Computed Tomography, Ultrasound and Nuclear Medicine

E Samei

N Hangiandreou
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J Nelson

E Samei1*, N Hangiandreou2*, J Nelson3*, (1) Duke University Medical Center, Durham, NC, (2) Mayo Clinic, Rochester, MN, (3) Duke University Medical Center, Durham, NC


TH-E-9A-1 Thursday 1:00PM - 2:50PM Room: 9A

Medical Physics 2.0 is a bold vision for an existential transition of clinical imaging physics in face of the new realities of value-based and evidence-based medicine, comparative effectiveness, and meaningful use. It speaks to how clinical imaging physics can expand beyond traditional insular models of inspection and acceptance testing, oriented toward compliance, towards team-based models of operational engagement, prospective definition and assurance of effective use, and retrospective evaluation of clinical performance. Organized into four sessions of the AAPM, this particular session focuses on three specific modalities as outlined below.

CT 2.0:
CT has been undergoing a dramatic transition in the last few decades. While the changes in the technology merits discussions of their own, an important question is how clinical medical physicists are expected to effectively engage with the new realities of CT technology and practice. Consistent with the upcoming paradigm of Medical Physics 2.0, this CT presentation aims to provide definitions and demonstration of the components of the new clinical medical physics practice pertaining CT. The topics covered include physics metrics and analytics that aim to provide higher order clinically-relevant quantification of system performance as pertains to new (and not so new) technologies. That will include the new radiation and dose metrics (SSDE, organ dose, risk indices), image quality metrology (MTF/NPS/d’), task-based phantoms, and the effect of patient size. That will follow with a discussion of the testing implication of new CT hardware (detectors, tubes), acquisition methods (innovative helical geometries, AEC, wide beam CT, dual energy, inverse geometry, application specialties), and image processing and analysis (iterative reconstructions, quantitative CT, advanced renditions). The presentation will conclude with a discussion of clinical and operational aspects of Medical Physics 2.0 including training and communication, use optimization (dose and technique factors), automated analysis and data management (automated QC methods, protocol tracking, dose monitoring, issue tracking), and meaningful QC considerations.

US 2.0:
Ultrasound imaging is evolving at a rapid pace, adding new imaging functions and modes that continue to enhance its clinical utility and benefits to patients. The ultrasound talk will look ahead 10-15 years and consider how medical physicists can bring maximal value to the clinical ultrasound practices of the future. The roles of physics in accreditation and regulatory compliance, image quality and exam optimization, clinical innovation, and education of staff and trainees will all be considered. A detailed examination of expected technology evolution and impact on image quality metrics will be presented. Clinical implementation of comprehensive physics services will also be discussed.

Nuclear Medicine 2.0:
Although the basic science of nuclear imaging has remained relatively unchanged since its inception, advances in instrumentation continue to advance the field into new territories. With a great number of these advances occurring over the past decade, the role and testing strategies of clinical nuclear medicine physicists must evolve in parallel. The Nuclear Medicine 2.0 presentation is designed to highlight some of the recent advances from a clinical medical physicist perspective and provide ideas and motivation for designing better evaluation strategies. Topics include improvement of traditional physics metrics and analytics, testing implications of hybrid imaging and advanced detector technologies, and strategies for effective implementation into the clinic.

Learning Objectives:
1. Become familiar with new physics metrics and analytics in nuclear medicine, CT, and ultrasound.
2. To become familiar with the major new developments of clinical physics support.
3. To understand the physics testing implications of new technologies, hardware, software, and applications.
4. To understand the need and components of the operational engagement of clinical physics in CT, NM and US practice.
5. Identify approaches for implementing comprehensive medical physics services in future imaging practices.


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