Trends in Medical Physics

During the recent American Association of Physicists in Medicine (AAPM) conference in Anaheim, Calif., I had the opportunity to meet with John Boone, Ph.D., FAAPM, president of AAPM, and discuss some of the current trends in medical physics.

One of the more exciting trends he is seeing is the movement toward magnetic resonance (MR)-guided radiation therapy. “Radiation therapy has always been image guided for the last 20, even 30 years — it started with the radiographic systems, moving into computed tomography (CT) and now we are seeing a trend toward MR-guided radiation therapy,” he explained. “It’s very exciting, and there are both tomotherapy and linear accelerated systems. Imagine just sitting there and steering the beam with the resolution of MR. You have no additional radiation with MR compared with CT and radiography, so it really is a step forward in radiation therapy application.”

In diagnostic radiology for diagnostic medical physicists, Boone said that CT dose is still a big issue, as is CT dose reporting, which became law in California on July 1, 2012, and has since become law in other states as well, with the Joint Commission even adding some of the elements of this law in order to strengthen its accreditation requirements related to radiation safety and to ensure that accreditation continues to meet with the intent of this law.

We also talked a bit about the future and what Boone sees looming on the horizon. “Currently, the future holds change,” he stressed. “We are seeing it with the Affordable Care Act going into law now, and are seeing fast changes both in radiation oncology and radiology. And what we are seeing is the bundling of procedure-based medicine in both radiation oncology and radiology, our procedure-based modalities.”

He explained that radiology has gone to a value-based proposition instead of a volume-based way of thinking, and this has led to Radiology Imaging 3.0, which is also being talked about by radiology colleagues at the Radiological Society of North American (RSNA) and elsewhere. “With respect to that, the AAPM is very active in trying to adapt to these changes,” Boone said. “Our physician colleagues are going to have to adapt; there are payment schemes that we need to accommodate and medical physicists both in radiology and radiation oncology both need to adapt with these changes as well.” 

AAPM is rolling out what they currently are calling Medical Physics 2.0, and the idea, for example, on the diagnostics side, “is to get our heads out of the CT scanners and mammography machines to take a step back,” said Boone. “Sure, we have to do the normal things that we have to do, but we also have to take a step back and look at protocols and talk with the technologists, talk to the radiologists and sometimes talk to the patients and really see what values we can add to the clinical evaluation of our hospitals. There is so much that medical physicists can do, and right now we have the knowledge, but we don’t interface well with our peers in the clinical setting, and what we hope to do with the Medical Physics 2.0 project is develop tools to train people how to interact with their administrations, with the technologists, the therapists and the radiation oncologists, certainly the radiologists, working with protocols for the betterment of patient care.”

To learn about other AAPM initiatives and hear from other industry experts on the topic of medical physics, be sure to stop by ITN’s newly redesigned, responsive website: www.itnonline.com/videos/category/conference-videos/1251