Journal of Medical Physics
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ABSTRACTS
Year : 2017  |  Volume : 42  |  Issue : 5  |  Page : 38-45
 

IDMP



Date of Web Publication24-Oct-2017

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How to cite this article:
. IDMP. J Med Phys 2017;42, Suppl S1:38-45

How to cite this URL:
. IDMP. J Med Phys [serial online] 2017 [cited 2020 Jun 2];42, Suppl S1:38-45. Available from: http://www.jmp.org.in/text.asp?2017/42/5/38/217109





   IDMP-1: History of Medical Physics: A New Iomp Project Top


Slavik Tabakov

President, International Organisation for Medical Physics (IOMP), Department of Medical Engineering and Physics, King's College London, UK. E-mail: slavik.tabakov@kcl.ac.uk

Medical Physics is relatively young profession and very dynamic profession. This creates a need for a reference source showing the development of the profession and the progression of ideas. Such source is naturally a project describing the history of the profession. Recently IOMP launched such project aiming to show the creation and the evolution of different equipment and methods, as well as their clinical application; the overall development of the profession and the main contributors in the various topics in medical physics.

The project will create a Compendium of independent Volumes/Parts, which will reflect the main areas of development of medical physics, including: Diagnostic Radiology (X-ray) Imaging; Computed Tomography; Radiotherapy (External beam); Radiotherapy (Brachytherapy); Nuclear Medicine Imaging; Ultrasound Imaging; Magnetic Resonance Imaging; Optical Systems and NIR in Medicine; Medical Informatics; Radiation Measurement and Protection in Medicine; Professional Development; Education&Training Development. Other fields can also be added during the development of this large project, which is expected to attract a large international team and to take several years.

Each Volume of the Compendium will be relatively independent and will have its own Leads/Editors, who will prepare the internal structure of the Volume (its Chapters/Sub-chapters) and will invite colleagues to write these Chapters. Each Chapter will refer to specific types of equipment and/or method(s). The methodology of the projects will roughly follow the methodology of development of the Encyclopedia of Medical Physics project (www.emitel2.eu). The project volumes will be printed as Annex to the issues of the free online Journal of IOMP Medical Physics International (MPI).

The project results will be a very useful source of information for future new developments and will provide a canvas for future updates. Very importantly, the project results will be a written proof of the significant role played by medical physicists in contemporary medicine.


   IDMP-2: Medical Physics Education & Profession perspective in AFOMP Region Top


Tae Suk Suh, Ph.D.

Department of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul, South Korea. Email: suhsanta@catholic.ac.kr

Asia-Oceania has a diverse cultural, social, educational, and economical background. Around 60% of the world's population resides in Asia and Oceania and speak hundreds of languages and dialects. Geographically, Asia comprises five sub-regions: North East, South East, Central, South, and Middle East.

There is a shortage of medical physicists worldwide, especially in the Asia region. The reason for this is there are fewer education and training programs for medical physicists in Asia. The most difficult part of medical physics is in the area of clinical training. Therefore, there are fewer qualified medical physicists and more transfer of qualified medical physicists to advanced countries.The lack of recognition of medical physics standards of practice is a common issue in many Asian countries. Most of the Asian countries do not have accreditation or certification systems for medical physicists.The IAEA data for Asian countries with education, clinical training, and proper accreditation process in the field of medical physics show that most parts of Asia do not have clinical trainings or accreditation programs.

Education in medical physics in the Asian region has been supported by the IAEA or the IOMP.Most clinical centers in the Asian region cannot afford the time and investment in the clinical training of physicists. A joint approach with regional professional bodies has fostered clinical and scientific meetings to encourage clinical practice and to transfer skills and maintain communication among professionals. An example of was the UNDP project supported by the Korean FDA. The UNDP project provided a one-month clinical training opportunity in Korea for medical physicists in developing countries in Asia. The IAEA also provided many clinical training programs for medical physicists in Asia through various projects.

The role and status of medical physicists in the AFOMP region has gradually improved as can be seen by its increasing recognition in societies. However, neither the governments nor the public has yet recognized the importance of medical physics and the necessity for accreditation. A well-prepared strategy and a strong action plan are crucial for the AFOMP to move forward.


   IDMP-3: Medical Physics Education: Indian Scenario Top


S. D. Sharma

Radiological Physics and Advisory Division, Bhabha Atomic Research Centre, CT and CRS, Mumbai, Maharashtra, India. E-mail: sdsbarc@gmail.com

Medical Physics is a new and important discipline of science which deals with the application of physical principles and methods to the diagnosis and treatment of diseases. About three decades ago, medical physics activities were restricted primarily to the dosimetry of ionizing radiation. In the recent past, this concept has changed considerably and now the medical physicists are involved in all the aspects of medical application of radiation including radiation safety and play vital roles both in diagnosis and therapy diseases. Foreseeing the requirements of medical physicists and radiation safety officers (RSOs) well in advance, the Radiological Physics and Advisory Division (erstwhile Division of Radiological Protection), Bhabha Atomic Research Centre (BARC) started a regular training programme in Radiological Physics in 1962, in collaboration with World Health Organization. This course was later converted as Diploma in Radiological Physics (DipRP). The DipRP course of BARC is a prestigious multidisciplinary education and training programme which is well recognised both in India and abroad.

Considering the increased demand of medical physicists/RSOs in the country, a few universities/institutions also started education and training programme in medical physics. Currently, fourteen universities/institutions are conducting courses in medical physics in India. As far as course modality is concerned, two different types of medical physics courses are conducted in India, namely (i) Post MSc Diploma in Radiological/Medical Physics (DipRP/DipMP), and (ii) MSc Degree in Medical Physics [MSc (Medical Physics)]. In DipRP/DipMP course, the entry level qualification of the candidate is MSc Degree in Physics whereas in MSc (MedicalPhysics) course the entry level qualification is Bachelor of Science Degree majoring in physics. As most of the medical physicists trained in India work in the discipline of radiation oncology medical physics (ROMP), the entry level qualifications are based on the eligibility criteria prescribed by the Atomic Energy Regulatory Board (AERB) for medical physicist and RSO. The curriculum of the DipRP course, conducted by BARC, has been adopted by the AERB indicating it to be one of the best courses in the country with its well-organized modality.

A qualified medical physicist is a professional with education and specialist training who is competent to practice unsupervised in one or more subfields of medical physics. An ROMP is involved in many clinical activities including performance evaluation of imaging and therapy equipment, physical and patient dosimetry, treatment planning, research and development, and teaching related to medical use of ionizing radiation and associated radiation protection and safety. Advanced technology therapy and imaging equipments are now-a-days commonly used for treating the cancer patients by highly advanced clinical techniques such as intensity modulated radiotherapy, image guided radiotherapy, stereotactic radiosurgery/radiotherapy, and volumetric modulation arc therapy. Providing physics support in these high precision and highly conformal clinical techniques are also the routine responsibilities of the medical physicists. It will be challenging for a medical physicist without supervised clinical experience to provide physics support in such cases. Due to the complexity of recent radiotherapy equipment and clinical techniques and to ensure the effective and safe treatment for the patient, medical physics internship at a well-equipped radiotherapy centre for at least one year duration on successful completion of academic component has recently been incorporated in the medical physics education in India. A structured competency based medical physics internship programme was developed and implemented from July 2013. As on today, more than 100 radiotherapy centres are conducting medical physics internship in India.

In addition, efforts were made to harmonize academic part of the medical physics programme. In this context, a process of assessment of medical physics courses were initiated to ensure that the syllabus and infrastructure are adequate to conduct the programme effectively. Further, competency certification process of clinical medical physicists has also been started way back in 2009 and by now about 50 candidates has been certified by the College of Medical Physics of India. Competency testing and certification for RSOs are also conducted since early days of medical physics programme in India. Now, this process has been revised and re-structured with effect from 2007.

In summary, medical physics education in India is well-structured. However, there is always scope of improving the quality of teaching and training which is being initiated by incorporating training for trainers. Now, it is required to initiate the process of revalidation of certification both for clinical competency and radiological safety.


   IDMP-4: Pioneer Women Medical Physicists from Mefomp Countries Top


Huda M. Al Naemi

Chief Medical Physicist & RSO, Hamad Medical Corporation, Doha, Qatar. E-mail: halnaomi@hamad.qa

Establishment of Middle East Federation of Medical Physics (MEFOMP) in 2009 was part of the International Organization for Medical Physics (IOMP) efforts to organize regional medical physics societies under its umbrella and to further enhance and improve the status of medical physics across the Globe.

The main Goals of MEFOMP are; to Promote advancement of medical physics in the Middle East (ME), Educate and train local society members on new procedures and technologies, Encourage exchange of expertise and information among societies and to organize regional conferences and symposia.

The number of Female medical physicists obtained from the MEFOMP countries medical physicssocieties (in Lebanon, Syria, Jordan, Iraq, Palestine, King Saudi Arabia (KSA), United Arab Emirates (UAE), Kuwait, Qatar, Bahrain, Oman and Yemen) was found to be 243. Whereas the total number of medical physicists in these countries is 700 working in radiology, oncology, nuclear medicine and all other medical physics fields. This means that 35% of the medical physicists in the Middle East are women. The highest number of female medical physicists was found to be in Kingdom of Saudi Arabia 84 (35 % of the total MEFOMP females). The highest percentage of the female medical physicist in MEFOMP counties is in the UAE as 70% of medical physicists are females.

Some of the women in MEFOMP countries are pioneers in their field, their creativity and achievements have contributed to medical physics and that is sure to inspire a new generation of young women to pursue their highest ambitions in medical physics and other fields.


   IDMP-5: Medical Physicists Certification Process and Examination in the Middle East Top


Ibrahim Duhaini

Chief Medical Physicist and RSO, Rafik Hariri University Hospital, Beirut, Lebanon. E-mail: duhaini@yahoo.com

Certifying medical physics is becoming an essential part in recruiting medical physicists in hospitals across the Middle East region. Due to the lack of a comprehensive post graduate programs in MP in most of ME countries; hospitals find it very difficult to hire MP without the proper credentials and clinical experiences. Also, MP in the region find it very difficult to apply and travel for certification in Europe or North America due to visa and other related issues. So, if these certifying bodies are welling to cooperate with MEFOMP and/or similar organizations in the ME region so that certifications will be offered in the region for the region in a way to ease the process and save efforts and resources from the burdens of MP.

Certifying Medical Physicist requires an individual to obtain a university degree at the level of Master degree in Medical Physics, this is followed with at least a one year of clinical residency program in the Medical Physics fields applied in a Hospital.

The existing local/national certifying organization exam models are utilized as reference to design the final exam structure which can be customized for the medical physicists that will be working in the Middle East.

Three Exam Model proposals will be discussed here, all of which aim to evaluate the competencies of the individual medical physicist knowledge and skills by following various examination approaches.


   IDMP-6: Introductory Talk on Idmp Top


John Damilakis

Department of Medical Physics, Faculty of Medicine, University of Crete, Heraklion, Greece. E-mail: john.damilakis@med.uoc.gr

The International Organization for Medical Physics (IOMP) celebrates every year the International Day for Medical Physics (IDMP) on November the 7th. The day was chosen by IOMP in recognition of the pioneering research work on radioactivity of Marie Sklodowska-Curie who, on that day in 1867, was born in Poland. This year we celebrate the 150th birthday of Marie Sklodowska-Curie and the theme is 'Medical Physics: Providing a Holistic Approach to Women Patients and Women Staff Safety in Radiation Medicine'. IDMP is an excellent opportunity to promote the role of medical physicists in the worldwide medical scene.

Medical Physics enables healthier lives for women. There are health problems that are more prevalent in women than in men such as breast cancer and osteoporosis. Medical physicists not only develop methods to diagnose and treat breast cancer but also play a fundamental role in their application ensuring the quality of procedures while minimizing radiation risks to women patients. X-ray mammography was developed in the 60s. In 1965, Charles Gros, a French medical physicist developed the first X-ray unit dedicated to mammography called 'Sonographe'. X-ray mammography has been considered as a 'gold standard' for screening of asymptomatic women. Dedicated CT systems have also been developed by medical physicists for the three-dimensional high-resolution imaging of the breast. In 1963, J. Cameron and James Sorenson, medical physicists from the USA developed the first non-invasive technique to assess bone mineral. They introduced single photon absorptiometry to measure peripheral bone mineral density. This had tremendous implications in healthcare, especially for the early diagnosis of osteoporosis.

Globally, women have fewer opportunities than men and less representation in the workplace. Increasing the number of women medical physicists should be a priority for our profession. IDMP 2017 is an excellent opportunity to discuss and try to address work challenges for women medical physicists. IOMP 'Women Subcommittee' is working with IOMP national member organizations to address gender inequality and empower women medical physicists. I would like to congratulate the Subcommittee for these activities.


   IDMP-7: Medical Physics Contribution to Women'S Health and Radiation Safety Considerations in Medical Physics Towards Women'S Health and Radiation Safety Top


Hasin Anupama Azhari

Department of Medical Physics and Biomedical Engineering, Gono Bishwabidyalay, Savar, Bangladesh. E-mail: ahasinanupama@gmail.com

The discovery of X-rays, natural radioactivity and ionizing radiation has played an important role in numerous fields in modern scientific and technological developments radically influencing the entire modern civilization spanning fields like atomic and nuclear physics, agriculture, industry and in medicine providing an impetus for development of radiology and radiotherapy as medical specialties and medical physics. In this article contributions of medical physics for the occupational workers especially for women's health in terms of radiation safety have been described. Continuous technological advancements in all areas of medical physics are significantly increasing the risk of potential exposure to ionizing radiation. General acceptance of risks of radiation is a matter of consensus, and therefore, international safety standards are needed to provide the justification of the use of any radiation with standardization, optimization and limitation of exposure. International consensus was achieved for the IAEA safety standards (BSS) through the IAEA SAFETY SERIES, which adopted and documented for medical public and occupational exposures as well as the special needs for the safety of women medical physicists with child bearing incidence. Participants of these initiatives are six major relevant international organizations: FAO, IAEA, ILO, the OECD Nuclear Energy Agency (OECD/NEA), Pan American Health Organization (PAHO) and WHO. The purpose of the standards is to establish basic requirements for protection against the risks associated with exposure to ionizing radiation and for the safety from the radiation sources.

Radiation sources and installations should be provided with the best available protection and safety measures under the prevailing circumstances, so that the magnitudes and likelihood of exposures and the numbers of individuals exposed should be As Low As Reasonably Achievable (ALARA). For the establishment of dose limitation (DLs), the National Council on Radiation Protection and Measurements (NCRP) assessed risk on the basis of data from reports of the National Academy of Sciences (Biologic Effects of Ionizing Radiation [BEIR]. NCRP 116 and ICRP 60 recommend a limit of radiation exposure to a member of the general public as 1 mSv per year and the limit for the fetus of an occupationally exposed individual to 0.5 mSv per month (NCRP) and 2 mSv during the gestation period (ICRP).

When a radiologic worker becomes pregnant, she should notify her supervisor. The main risk is that of abortion if the radiation exposure results in death of the conceptus. Response of fetus to radiation is non threshold in nature and ten times more susceptible than maximum permissible dose (MPD) and thus special considerations are required. It requires a foetal dose of more than 100 mGy for this to occur. Based on this, it was suggested to do away with the 10-day rule and replace it with a 28-day rule postulated by ICRP for woman of reproductive age. The pregnant worker should be provided with a second personnel monitoring device at waist level as well as counseling. No alteration in work schedule is required normally.

A safety culture should be developed that governs the attitudes and behavior in relation to protection and safety of all individuals and organizations dealing with sources of radiation with special consideration to pregnant women. In-depth defensive measures should be incorporated into the design and operating procedures for radiation sources to compensate for potential failures in protection or safety measures; and also protection and safety should be ensured by sound management and good engineering, quality assurance, training and qualification of personnel, comprehensive safety assessments and attention to lessons learned from experience and research.


   IDMP-8: IOMP Women Survey Data Top


Virginia Tsapaki

Department of Medical Physics, Konstantopoulio General Hospital, Athens, Greece. E-mail: virginia@otenet.gr

According to the latest International Organization for Medical physics (IOMP) survey, which was published in the year 2015, women represent approximately 28% of the total medical physicist (MP) workforce globally (4807 women out of the 17024 medical physicists). In more detail, women percentages in different regions of the world are 47% in Europe, 21% in USA, 33% in Africa, 35% in Asia and 50% in Middle East. Despite the fact that the number of women MP is increasing over the years, surveys in Australia and Canada showed that they still are under-represented in leadership roles. A European survey concluded in 2012 concluded that women researchers constituted less than 40% in most countries of European Union. The European Commission makes a great effort to identify and quantify the remaining inequalities between the two genders, as gender equality is a fundamental value for the European Union. Many European policies have been introduced in the attempt to reach this gender balance. Although long-term gender equality trends seem to be encouraging, there are still steps to do. As reported in the recent literature, USA data suggest that around one quarter of deans and department heads are women; in science this drops to nearly 1 in 20. Part of this problem of under representation stems from the population pool: only 33% of science and engineering doctorate holders employed in academia are women. Other issues include well known problems of women's participation in science, technology, engineering, and mathematics (STEM) fields such as 1) lack of role models, 2) unconscious biases, 3) discrimination 4) unwelcoming climates, etc.

In order to investigate if all this is actually true in the medical physics filed, IOMP decided to run a detailed survey. It was thought that the results of the survey could provide an opportunity for countries as well as IOMP, for a more in-depth analysis and deliberate on further actions. An online questionnaire was created, prepared as a Google Forms survey asking the country a number of simple questions relating not only on the total number of MPs and women MPs, but also on issues related to leadership or high level professional or scientific roles. The questionnaire was sent to all national member organizations of IOMP. In the attempt to have as much data as possible, even non-IOMP member countries were included in the survey. The results will be presented.


   IDMP-9: MP Education, Proffession and as Acareer for Women in Bangladesh: Problems and Perspective Top


K. T. Afrin, N. Karmaker, H. A. Anupama

Department of Medical Physics and Biomedical Engineering, Gono Bishwabidyalay, Savar, Bangladesh. E-mail: towmimzaman@gmail.com

Introduction: Medical physics is among the fastest progressing scientific and practical areas in Bangladesh. Historically women had played an important role in the field of physics, contributing to the leading achievements in the area. Our world is dominated by men but women have made significant contributions to the development of medical physics study and practice. According to survey of IOMP 2015, Sixty-six countries answered the survey, with 52% of responses provided by women. The total number of medical physicists cited was 17024, representing more than three quarters of the worldwide medical physics workforce. This included 4807 women – just 28% of the total.

Objectives: The main objective of this study is to find out the educational, career and professionals status of medical physics for women in Bangladesh existing or opportunity.

In Bangladesh three universitiesare offering M.Sc program in medical physics (MP); Gono Bishwabidyalay (University) is the pioneer one, offering degree since 2001, Dhaka University and Khwaja Yunus Ali University, offering since 2014. Female students areonly 20% in these universities, due to challenge of balancing family life, childcare support, gender inequality, social class, caste, religion, ethnicity, early marriage and house hold work. Also for economical constraint, normally after bachelor course, the femalestudents are unable to admit in M.Sc course as educations in private University areexpensive for poor students. Another reason is traditionally women are underrepresented in those fields based on mathematics and physical science.

Medical physics study is a new subject with a little exposure to common people so our people are unawareabout itsprospective career. Lack of job availability, dreadful of radiation hazards for the females discontinues their careers. Also in Bangladesh jobs are available after four years honors' program. In this field for career in medical physics minimum requirement is M.Sc in MP, which is one of cause for discontinuing to develop career in this field. Most of the female students in science are always pressurized from their family for early marriage. It seems tobe difficult to succeed as a medical physicist.

As a profession medical physics in Bangladesh is now at the beginning stage because of the lack of governmental position in hospital. Bangladesh Medical Physics Society (BMPS) is working with the government for recruitment rules for the MP. On the other hand private hospitals are recruiting MP with the advent of diagnostic and therapeutic treatment modalities based on medical physics.

Discussion and Conclusion: According to WHO report, we need total 160 radiotherapycenters, 320 LINACS, 640 Medical Physicists only in cancer treatment. Bangladesh government is purchasing recent updated technology for radiotherapy and radiology. The importance and necessity of this manpower is needed to be circulated in media and newspapers for public awareness. In the mean time, BMPS is working hard to popularize this subject, make awareness in public sector and to create position in the hospitals and continuous professional development for the graduates. The experiment to establish a department in Gono University is a successful story. Through German collaboration since its inception and help of other countries like India and China, Gono University is trying hard to maintain international standard. IOMP is working towards strengthening of the role of the women in our professional society.

Two years training program for certificationwill be started through national and international collaboration. BMPSalso trying best to involvefemale participants specially in AAPM, IAEA, AFOMP, IOMP conference for their career. A step towards achieving this objective is the formation of IOMP-W (IOMP women medical physics group). We certainly believe this group will encourage our Female medical physics community in education, profession and career.


   IDMP-10: Contribution of Women to Medical Physics and Status of Women Medical Physicists an Indian Perspective Top


Shobha Jayaprakash

Chief Medical Physicist & RSO, B.Y.L. Nair Ch. Hospital, Mumbai, Maharashtra, India. E-mail: shobhajp@hotmail.com

Today Medical Physics is among the fastest progressing in scientific and medical areas. Historically women played an important role in the creation, advancement and application of medical physics. In the last World Congress of Medical Physics and Bio medical engineering at Toronto, they had a special session for discussing problems faced by Women Physicists as well as their achievements. There has also been some discussion on the gender issues in Medical Physics community in the recent past. It is not always easy being a woman and a professional, as they have to balance between the family life and professional duties, but women have been proven to excel in multitasking.

Marie Curie, a pioneer in the field of radioactivity was the first woman to be awarded two Nobel Prizes in different sciences (Physics and Chemistry). One of Marie Curie's most famous citations: “We must have perseverance and above all confidence in ourselves. We must believe that we are gifted for something and that this thing must be attained”. Marie Curie had opened the doors of her lab to many women for which she was an icon and represented an example to follow. Large number of women was found to be working her scientific research laboratory.

First international study on number of women Medical Physicists globally was performed by IOMP in 2013. 66 countries had participated and the survey results showed that out of the total number of Medical Physicists only 28% were females. The latest study on Women in Medical Physics performed in Australia/New Zealand and published in 2016 showed a considerable increase in the number of Women Medical Physicists. The rising number was contributed to women both deserving and passionate in their chosen fields

A survey was conducted in order to document the total number of Medical Physicists in India and the percentage of Women Medical Physicists. The data collection was done with the help of all the AMPI Chapters, AERB, seniors and colleagues. This is the first survey carried out in India. (1) To document the number and percentage of Women Medical Physicists. (2) Their contribution to Medical Physics -Status of Women Medical Physicists. The total number of Registered Medical Physicists in India as of today is 1042. This includes 361 women – which is just 35% of the total (which is slightly below the target (40% female) set by European countries. We have many female Physicists in faculty positions, involved in teaching and research. Many of them have national and international publications to their credit and also represent the country in International conferences. Even though not many Women Physicists are occupying eminent positions in various national and international forums and associations, they have still made significant impact wherever they have been chosen to officiate.

In India, many female Physicists face employment issues, as most of the hospitals are not in favour of employing female physicists, the reason provided was the late working hours which many Employers felt women were not capable of. Facilities such as formation of online group of Women Medical Physicists of India are a step towards recognition and help required by such individuals. This is an easy means to discuss and ask for advice without any inhibitions. Hence we have started an Online Indian Womens' Medical Physicist Group to discuss common issues and problems. The initial response has been overwhelming. It's really encouraging to see the camaraderie among our co-workers who have mailed their valuable opinions and suggestions. This has been an eye opener which needs to be addressed and dealt with. The facility can be made more accessible by forming Zonal Groups with a Zonal Representative who can co-ordinate with the Central Body.

It is also planned to organize, on a regular basis, seminars, workshops, refresher courses including hands on training etc. which will be beneficial for working Physicists and trainees to enhance and improve their working skills. A concept like this will bring to forefront the profession of Medical Physics among women thus increasing the sorry percentile of the Women Physicist statistics. Overall this will also help us to popularize the role of women in medical physics and encourage Female medical physicists to advance in the profession.


   IDMP-11: Women and Men in the Australasian College of Physical Scientists and Engineers in Medicine: Workforce Survey Top


Eva Bezak1,2, Roksolana Suchowerska3, Elizabeth Claridge Mackonis4, Heath Pillen5, Anna Ralston6, Annette Haworth7, Natalka Suchowerska4,7

1Sansom Institute for Health Research and the School of Health Sciences, University of South Australia, 2School of Physical Sciences, University of Adelaide, Adelaide, 3Centre for Social Impact, Swinburne University, Melbourne, Victoria, 4Chris O'Brien Lifehouse, 6St George Hospital Cancer Care Centre, 7Faculty of Science, University of Sydney, New South Wales, 5International Centre for Allied Health Evidence, UniSA , Australia. E-mail: eva.bezak@adelaide.edu.au

Introduction: A survey was designed to determine the aspirations, motivations and workplace experiences of members of the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM). The survey collected both quantitate and qualitative data, including open ended questions. This presentation reports the survey's qualitative results. The qualitative data analysis was in part funded by the ACPSEM.

Methods: The research was approved by Ethics at University of South Australia and endorsed by ACPSEM.

All 205 female members (30% of total membership) and 440 males were invited to complete the survey online.

The data for the qualitative analysis were responses to open-ended questions within the Survey. The data was thematically analysed by twice. First, by the survey authors and secondly by a single researcher, who was a male allied health researcher not involved in the development of the survey or data collection. Open codes were assigned to key categories in the data on a first reading of the survey responses and refined to 24 codes on a second reading. Codes were arranged into themes inductively by examining the relationship between them. Analysis of responses continued until no new themes emerged from the data, despite further analysis. Since the number of females in a senior managerial role was limited, further analysis was performed for this subgroup to account for any relevant variations in the data.

Results: 102 female and 150 male completed surveys were received, with 66 surveys analysed, before data saturation was reached.

The survey revealed a number of themes that reflect concerns and opportunities identifying the direction for improving work-life balance and gender equity within the medical physics profession in Australasia. Issues around managing challenging workloads and professional development were amplified for women with children and child-rearing responsibilities, directly contributing to a reduction in work capacity and a reorientation of work-life priorities. Some evidence of gender inequities in the professional context were reported. Female respondents, in particular those assuming a carers role, perceived these inequities to be the entrenched attitudes and structures that act to favour one group over another. For some women, this gender bias meant that it was difficult to engage fully in the profession when indicators of success (e.g. meeting the inflexible needs of organisations through working long hours, work hour flexibility and travel) favoured those without carer responsibilities. Inefficient management practices contributed to an environment where unreasonable time demands are placed on staff with carer responsibilities, limiting opportunities to engage in career development activities. In contrast, male (and some female) respondents perceived the workplace to offer equal treatment of individuals irrespective of gender and that individuals are responsible for their own success and advancement within the profession.

Conclusions: The survey provides direction for strategies to improve work-life balance and enable equitable engagement in the profession. The first is to identify and develop role models that actively model successful work-life balance and flexibility in gender roles and in professional conduct. The second is to improve the management skills of current and emerging administrators, advocating for improved work conditions for medical physics professionals at an organisation level. Finally, efforts need to be made to establish flexible professional development and career progression opportunities amongst those that are unable to commit to large workloads, which is common for those with child-rearing responsibilities. The realisation of these strategic goals will reduce the identified barriers to full female participation in the workforce, and shift gender-based subcultures within the workplace.


   IDMP-12: Radiation Safety Aspects Pertaining to Female Patients and Staff Top


Nidhi Patni

Department of Radiation Oncology, BMCHRC, Jaipur, Rajasthan, India. E-mail: nidhionco@gmail.com

Many organizations in the world are committed to gender parity. Increasing number of women is working in the fields of radiation medicine and in industries dealing with radiation. Women patients may be exposed to radiation in radiology, radiation oncology, nuclear medicine, interventional cardiology, dentistry etc. Radiation safety of women staff and women patients is different from their male counterparts because of conception and pregnancy. So, fetal health is a matter of concern in the above. Also, the excess relative risk of radiation induced cancers in females relates to higher risk of thyroid cancer and high radiosensitivity as compared to males.

With the advances in technology radiation equipment are safer than ever. Highly sophisticated radiation safety, QA and measurement gadgets are a norm. Strict personal radiation exposure monitoring is being done on a regular basis. According to the latest recommendations from Atomic Energy Regulatory Board (AERB), the maximum permissible effective dose for radiation workers 20 mSv annually averaged over five consecutive years. For pregnant radiation workers, the dose to embryo or fetus should not exceed 1 mSv, after declaration of pregnancy.

Best possible measures are taken to achieve ALARA. “Rule of ten” is a safe practice while going for an elective radiological investigation in a female in reproductive age group. Fetus is most sensitive to radiation effects between 8 and 15 weeks of pregnancy. If the mother has been given a radioisotope, depending upon its half life, breast feeding should be avoided. In a multidisciplinary approach, lesser amount of radiation dose is required and lesser volume of tissue is irradiated, especially since more effective systemic therapy is available now. Same stands true for patients undergoing radiation therapy. Modern radiation treatment has reduced the irradiated volumes on one hand but high precision treatments like IMRT, IGRT and SBRT have increased the integral dose. The stochastic effects of integral dose are of concern. Radiations safety of women staff and women patients needs special consideration.


   IDMP-13: Dose Management of Pregnant Patients in Radiology Top


John Damilakis

Department of Medical Physics, Faculty of Medicine, University of Crete, Heraklion, Greece. E-mail: john.damilakis@med.uoc.gr

Conceptus dose and risk assessment is of great importance whenever a diagnostic or interventional X-ray examination of a pregnant patient is necessary. Estimation of conceptus radiation dose and associated risks is also needed in cases of accidental exposure of pregnant patients from X-ray procedures. This presentation will provide information about methods to estimate radiation dose absorbed by the unborn child from x-ray examinations and strategies to manage pregnant patients so that radiation doses to the mother and child are kept as low as reasonably achievable.

When the uterus is remote from the directly exposed anatomical area, the embryo/fetus is exposed to scattered radiation and its dose is negligible (dose lower than 1 mGy). Normally, a detailed embryo/fetus dose evaluation is not needed for such studies. Radiologic examinations involving the abdomen and/or pelvis may deliver relatively high radiation dose to the unborn child. For abdominal examinations, maternal body size and uterus position should be taken into consideration to obtain accurate dose estimation. Patient-specific Monte Carlo simulations have been used to accurately estimate radiation dose from an abdominal CT examination. A standard CT examination for appendicitis or ureteral stones performed on the mother would result in an embryo/fetus dose of about 10-25 mGy. Multi-phase abdominal CT examinations may deliver relatively high doses to the unborn child. Doses to the unborn child below 100 mGy should not be considered a reason for therapeutic abortion.

The risk to the embryo/fetus for stochastic effects is assessed on the basis of radiation dose using appropriate risk factors. CoDE (Conceptus Dose Estimation) online software tool allows a) calculation of conceptus radiation dose and associated risk from X-ray examinations performed on the expectant mother and b) anticipation of conceptus dose for the pregnant employee who participates in fluoroscopically-guided interventional procedures. CoDE is available free of charge. For more information please visitembryodose.med.uoc.gr


   IDMP-14: Segmentation of Breast Masses Using Active Contour Modelling Top


W. I. D. Rae, S. N. Acho

Department of Medical Physics, University of the Free State, Bloemfontein, South Africa. E-mail: raewid@ufs.ac.za

Introduction: Breast disease is widespread and is a major cause of morbidity and mortality worldwide. Imaging of the breast is a widely used standard for assessment of pathology and screening of asymptomatic people who may have some increased risk of cancer, or in some countries screening if available to all women over some predefined age (usually 40 years). Imaged tumours often infiltrate surrounding normal tissues and thus delineation of the tumour to define a focal area for treatment, or to assess change in the tumour over time, is difficult and often not unanimous. Reliable and reproducible metrics describing the tumour morphology are thus difficult to obtain and to quantify. To achieve reliable quantitative measures of lesions within the breast it is necessary to have a reliable segmentation method to define objects seen in the image. Active contours are useful in defining boundaries around masses by defining a contour which expands and contracts over the edge of a mass until it reaches a minimum energy state dependent upon the statistical information inherent in the digital image. It has been shown that segmentation outcomes for active contours which are driven by local statistical information depend upon the placement of the initial level set contour. This is limiting. A more robust and generalised method to determine mass specific boundaries would facilitate the automated or assisted analysis of mammograms to allow wider utilisation in computer aided diagnostic and detection systems.

Aim: To develop a mass segmentation technique which is reliable and can lead to more meaningful segmentation of breast pathology by providing a mass-specific threshold value, which requires minimal intervention from the user, and which minimises the energy functional of the segmentation contour for individual masses.

Materials and Methods: Problems with segmentation using convex active contour model masses have all sizes, shapes, locations and more often embedded in the complex matrix of the breast parenchyma tissue therefore a single threshold value for a database of masses is not practical, therefore we propose a mass-specific threshold value for convex energy functional of each massdriven by global stats. Images were smoothed prior to segmentation. This mathematical method is applied to a series of test masses with a range of pathologies as a proof of concept.

Results: The proposed model performed well when compared to other standard techniques of mass segmentation and was independent of the initial position of the initial contour.

Discussion: Each mass lesion is unique and using a smoothed image was shown to be useful in defining its best representation. Using the probability matrix (interactive process) derived from random walk algorithm acted as a confidence map to guide the segmentation process. Such stable boundaries can be useful as they define the “inside” and “outside” of masses thus effectively using statistical measures to see how the mass characteristics change over the area of overlap of, or invasion by, the mass and the surrounding normal tissues. This may be able to give insight into the behaviour of masses at their boundary and allow modelling of masses according to their pathological origin.

Conclusion: Active contour modelling isa reliable segmentation method. The results are independent of the initial level set contours and require a minimal level of intervention from the user. It allows interrogation of the statistical character of the junction between masses and their surrounds, thus potentially allowing better characterisation of imaged tumours.




 

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