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Medical physics the current status, problems, the way of development. Innovation technologies Workshop proceedings June 06 07, 2013, Kyiv, Ukraine UDC 3; 009; 33; 37; 159.9; 664; ...

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III International Workshop

Medical physics the current status,

problems, the way of development.

Innovation technologies

Workshop proceedings

June 06 07, 2013, Kyiv, Ukraine

UDC 3; 009; 33; 37; 159.9; 664; 624; 61; 007; 52; 504; 800; 002; 51; 53; 57.

Medical physics the current status, problems, the way of development. Innovation

technologies. Proceedings of 3rd International Workshop, June 06 07, 2013, Kyiv, Taras

Shevchenko National University of Kyiv, 2013. 186 p.

The published proceedings are speakers and participants papers of 3rd International Workshop Medical physics the current status, problems, the way of development. Innovation technologies.

Proceedings are reflecting the scientific, methodical and practical results of scientific researches.

Results are directed to improve the way of medical physics development in post-Soviet countries and further promotion of innovation technologies in the market of medical services.

The workshop is held by initiative of Taras Shevchenko National University of Kyiv and Swedish radiation safety authority (SSM) with the participation of specialists of leading institutions of higher education, medical and scientific organizations, authorities from EC countries, Belarus, Russia, Ukraine, and also representatives of Ministry of Education and Science of Ukraine, Ministry of Public Health of Ukraine, State Nuclear Regulatory Inspectorate of Ukraine, National Academy of Medical Science of Ukraine, The National Institute for Strategic Studies. The workshop aim is cooperation of international community in the area of enlightenment, science, public health and nuclear regulation for effective training of specialists in medical physics.

Organizers of workshop:

Taras Shevchenko National University of Kyiv (KNU);

Training-Research Center for Radiation Safety of Taras Shevchenko National University of Kyiv;

Swedish radiation safety authority (SSM).

The workshop is holding by support of Swedish radiation safety authority in the frame of the project Support to development of quality assurance and quality control in medical radiology, phase 2.

Organizing committee:

Chairman Hubersky L., Academician of NAS of Ukraine, Rector International Izewska J., Head, Dosimetry Laboratory, International Atomic Energy Agency, Austria Chernyaev A., Pro-rector, M.V. Lomonosov Moscow State University, Russia Mattsson S., Professor, Lund University at Malm, Sweden Tarutin I., Chief Scientist, N.N. Alexandrov National Cancer Centre, Belarus KNU Anisimov I., Dean, Radiophysics Fuculty Aslamova L., Director, TRC for Radiation Safety Bulavin L., Academician of NAS of Ukraine, Head of Department of Molecular Physics, Physics Fuculty Makarets M., Dean, Physics Fuculty

   

The proceedings are reproduced from the original manuscripts given and edited by authors.

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Education and training of medical physicists

   

Abstract. Medical physics is a branch of applied physics. It uses concepts and methods of physics to help identify and treat human disease. Medical physics plays an essential role in medical imaging, radiation therapy and in radiation protection.




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Medical imaging, which is a prerequisite for all modern hospital and health care, is today one of the fastest growing areas in medicine, exemplified by CT-, MR- and PET-imaging for anatomical, functional and molecular information.

Radiation therapy is unique among the cancer treatment modalities because it can be modulated in space and in time (4D). Spatial modulation will be facilitated by recent technological advances in image guided treatment planning and delivery to be optimised for the individual patient.

Radiation protection involves the protection of patients as well as of occupationally exposed persons in all areas of society, as well as of the general public.

The future progress of medical physics depends on future groundbreaking innovations in physics and technology. It is also highly related to the future of medicine and its research challenges in the new explosive fields of genetics, molecular and cellular biology. Organisation of medical physics education, basic research, translational research and clinical work and how these fields are cooperating - will have the highest impact on future progress in the field.

Key words: medical physics, development, future, imaging, radiation therapy, radiation protection, multidisciplinary work, research, education, organisation.

1. Introduction Medical physics is a branch of applied physics. It uses concepts and methods of physics to help diagnose, treat and prevent disease [1]. Medical physicists and engineers have played a crucial role in the development of new technologies that have revolutionized the way medicine is practiced today. They have contributed with technological innovations including computed tomography (CT), positron emission tomography (PET), the compact linear accelerator, magnetic resonance imaging (MRI) and many other developments. Some medical physicists generate new ideas and develop new technologies in their laboratories, while most of them are clinically working professionals who apply these technologies in the clinic for the diagnostic and treatment of diseases. They also ensure the safety of a large number of patients, occupationally exposed persons and the general public.

2. Medical imaging Medical imaging together with molecular medicine is among the fastest growing areas within medicine. It covers a number of techniques such as computed tomography (CT), magnetic resonance imaging (MRI), ultrasound (US), nuclear medicine (NM) including positron emission tomography (PET) and single photon tomography (SPECT) and several methods in optical imaging.

Traditionally, and most often also today, medical imaging is used for noninvasive mapping of anatomy and for detection and localisation of a disease. Hybrid imaging techniques (PET/CT, SPECT/CT, and PET/MRI) reveal important biological information about physiology, organ function, biochemistry, metabolism, molecular biology and even functional genomics. These new methods combine the ability to measure and quantify biological processes with the ability to localise the measured parameter in a high quality anatomical image [2]. Furthermore, advanced imaging techniques have developed into essential parts of advanced methods for treatment as an alternative to surgery: e.g. coronary angioplasty, and treatment of aortic and cerebral aneurysms.

The important and exciting progress in biotechnology, nanomedicine and new innovative therapies is highly dependent on integration with medical imaging for successful application into clinical practice [2].

3. Radiation therapy Accurate target delineation and image guidance are essential for the precise radiation therapy.

Despite the tumour target volume and the amount of radiation needed to treat is known, the delineation of normal tissue and the reliable prediction of normal tissue complication probabilities (NTCP) in each organ is important.

Developments in multimodality and 4D imaging techniques, as described above, provide opportunities to improve tumour localisation as well as improved tumour and normal tissue delineation. The imaging techniques, especially CT, are extremely helpful in dose planning and contribute to the reduction of set up variations and treatment margins. Proper use of imaging technologies can provide sparing dose to normal tissue and permit safer escalation of tumour doses [3].

Technical developments in the form of inverse treatment planning and dynamic multi-leaf collimation systems have given radiotherapy the ability to deliver conformal and intensitymodulated radiotherapy (IMRT). Linac based CT systems and applications of megavoltage (MV) imaging systems have opened new possibilities for image-guided radiation therapy (IGRT). Other examples are the so-called volumetric modulated arc therapy (VMAT) technique, involving IMRT delivery during gantry rotations, the Rapid Arc TM technique and the helical TomoTherapy.

Stereotactic treatment techniques as well as improved patient immobilization techniques are other examples of important improvements.

For targets in the thoracic and abdominal regions, the organ motion due to breathing limits the precision of radiotherapy. Field sizes must be sufficiently large to include tumour motion and this means a limitation in the dose that can be delivered. Respiratory-gated beam delivery is intended to limit the irradiation to selected parts of the respiratory cycle, and thereby enable reduction of the required treatment field margins. Treatments of breast cancer, lung and liver tumours are examples where respiratory gating is an advantage. It is also essential to adapt to changes that happen slowly over the course of treatment, e.g. due to tumour shrinkage and weight loss.

The major advantage of proton (and heavier particle) treatment over conventional radiation therapy is that the energy of protons can be directed and deposited in tumour volumes in a threedimensional pattern from each beam used. In this way the absorbed dose to the tumour can be increased while reducing the dose to surrounding normal tissues. The ultimate goal is to do fully automated pencil beam scanning and three-dimensional intensity modulated proton therapy (IMPT).



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