Maintenance of Certification for Medical Physics

Examples of SDEPs

 

Example 1: Education

Title: Develop a Lecture on CT/PET in Radiation Oncology for Medical Residents
Category: Education
Date Initiated:
Date Completed:
  1. Significance
    Physicists are responsible for the radiation physics training of medical students, residents, and allied health personnel. In this case, I will develop a specific lecture on the use of CT/PET in radiation oncology as an educational tool.
  2. Approach
    I will prepare a one-hour lecture, utilizing appropriate task group reports and reference data, to be delivered to medical residents in radiation oncology. It will be developed at the appropriate level using appropriate references. I will create a PowerPoint presentation to cover my objectives for the self-directed education project:
    • Familiarize myself with PET/CT.
    • Discuss the basics of PET, CT and PET/CT scanners.
    • Discuss the purpose of PET/CT in oncology.
    • Address limitations.
    • Observe the clinical use of PET/CT.
    • Conduct an experiment for measuring the resolution in a PET scanner.
    • Build a phantom for measuring the resolution of hot sources on a cold background.
    • Use 18 FDG to measure the resolution of the GE Advance Pet Scanner in the department.
  3. Evaluation of Achievement
    1. Prospective Statement (provided when SDEP is initiated)
      Upon completion of the project, I will create a PowerPoint lecture for radiation oncology residents on CT/PET use in radiation oncology. I will deliver the lecture to the residents in the department, and I will compile their evaluations to assess the success of the project.
    2. Final Statement (provided when SDEP is completed)
      The project has resulted in creation of an educational lecture on PET/CT. A slide presentation is available for use by members of the department. Specific learning objectives have been documented. Following the presentation, evaluation by the residents showed a favorable response to fulfilling the learning objectives and furthering their understanding of PET/CT technology and its clinical utility.
  4. Impact on Practice/Outcome Statement
    1. Prospective Statement (provided when SDEP is initiated)
      Medical imaging is an essential tool in radiation therapy. Computed tomography (CT) and positron emission tomography (PET) are image modalities that have been used in diagnosis and staging of diseases and in monitoring the effects of therapy. The high-resolution anatomical imaging ability of CT and the accurate localization of functional abnormalities with PET provide valuable information for patient management. The biological information from a PET/CT image can aid oncologists in assessing tumor hypoxia and potential doubling time.
    2. Final Statement (provided when SDEP is completed)
      The implementation of the SDEP on CT/PET has benefited the institution in achieving a full understanding of the consequences of implementing the modality. It has aided in understanding the advantages of multimodality imaging application in radiation oncology, and it provides detailed step-by-step process implementation tools.
 

Example 2: Clinical

Title: Using the TG-51 Protocol for Calibration Dosimetry
Category: Clinical Practice
Date Initiated:
Date Completed:
  1. Significance
    During the last decade, radiation therapy high-energy accelerator beams have been calibrated following the TG-21 recommended protocol. AAPM’s TG-51 protocol for clinical reference dosimetry of high-energy photon and electron beams is an improved and significantly revised protocol. It is strongly recommended by the Radiologic Physics Center and the Therapy Committee of the AAPM. The objective of this SDEP is to fully understand and implement all aspects of the TG-51 protocol.
  2. Approach
    I will write a step-by-step guide to calibration of a linac’s photon and electron beams using the TG-51 protocol. A medical physicist who is not yet familiar with this protocol could use the guide to gain experience. A calibrated ion chamber, a water tank phantom, a calibrated electrometer, a lead foil for filtering electron contamination from a photon beam of 10 MV or greater, and temperature and pressure-measuring devices are also required. Emphasis will be placed on explaining the definitions and the advantage and simplicity of using dose-based calibration, as opposed to the exposure-based calibration and cavity theory relationships used in the TG-21 protocol.
    The formalism and dosimetry procedures recommended for TG-51 are based on the use of an ionization chamber calibrated in terms of absorbed dose to water in an Accredited Dosimetry Calibration Laboratory (ADCL), using a reference 60 Co gamma ray beam. This is different from the recommendations given in the AAPM TG-21 protocol, which are based on an exposure calibration factor of an ionization chamber in a 60 Co beam.
    I will provide step-by-step information on the following topics:
    • Measurement of percent depth-ionization and depth-dose curves for photon and electron beams, using cylindrical and plane-parallel ionization chambers
    • Determination of the beam quality conversion factor k Q for photon beams and the electron beam quality conversion factor k’ R50 for electron beams
    • Measurement of various correction factors to the charge reading
    • Determination of dose at the depth of dose-maximum from measurements made at the reference depth for both photon and electron beams
    • Measurements needed to compare the recommendations of the TG-51 protocol with those of the TG-21 protocol
    • Clarification of potential sources of confusion in the clinical implementation of TG-51
  3. Evaluation of Achievement
    1. Prospective Statement (provided when SDEP is initiated)
      Upon completion of the project, I will have prepared a guide and posted it on a university website for use by any person who wants to learn about TG-51.
    2. Final Statement (provided when SDEP is completed)
      I have prepared a report concerning TG-51 that documents the above activities, date of completion, and data for all relevant findings. That report is available on the web to serve as a teaching guide.
  4. Impact on Practice/Outcome Statement
    1. Prospective Statement (provided when SDEP is initiated)
      Completion of the guide to TG-51 will require a thorough understanding of the protocol and will provide a useful resource for any medical physicist who wants to become familiar with TG-51.
    2. Final Statement (provided when SDEP is completed)
      The implementation of the TG-51 protocol has benefited the institution in achieving a full understanding of the consequences of implementing the new protocol. It has aided in complying with the recommendations of the Radiologic Physics Center and, consequently, in achieving better standardization of the dosimetry. The comparative evaluation of patients entered in national clinical trials through study groups such as RTOG is also placed on better scientific foundations.

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