Institutional Strategies to Maintain and Grow Imaging Research During the COVID-19 Pandemic

Understanding imaging research experiences, challenges, and strategies for academic radiology departments during and after COVID-19 is critical to prepare for future disruptive events. We summarize key insights and programmatic initiatives at major academic hospitals across the world, based on literature review and meetings of the Radiological Society of North America Vice Chairs of Research (RSNA VCR) group. Through expert discussion and case studies, we provide suggested guidelines to maintain and grow radiology research in the postpandemic era

Investigating magnetic field dose effects in small animals: a Monte Carlo study

Purpose: In MRI-linac treatments, radiation dose distributions are affected by magnetic fields, especially at high-density/low-density interfaces. Radiobiological consequences of magnetic field dose effects are presently unknown and preclinical studies are desirable. This study investigates the optimal combination of beam energy and magnetic field strength needed for preclinical murine studies.Methods: The Monte Carlo code MCNP6 was used to simulate the effects of a magnetic field when irradiating a mouse lung phantom with a 1.0 cm × 1.0 cm photon beam. Magnetic field dose effects were examined using various beam energies (225 kVp, 662 keV [Cs-137], and 1.25MeV [Co-60]) and magnetic field strengths (0.75 T, 1.5 T, and 3 T). The resulting dose distributions were compared to Monte Carlo results for humans with various field sizes and patient geometries using a 6MV/1.5T MRI-linac.Results: In human simulations, the addition of a 1.5 T magnetic field causes an average dose increase of 49% (range: 36% - 60%) to lung at the soft tissue-lung interface and an average dose decrease of 30% (range: 25% - 36%) at the lung-soft tissue interface. In mouse simulations, no magnetic field dose effects were seen with the 225 kVp beam. The dose increase for the Cs-137 beam was 12%, 33%, and 49% for 0.75 T, 1.5 T, and 3.0 T magnetic fields, respectively while the dose decrease was 7%, 23%, and 33%. For the Co-60 beam the dose increase was 14%, 45%, and 41%, and the dose decrease was 18%, 35%, and 35%.Conclusion: The magnetic field dose effects observed in mouse phantoms using a Co-60 beam with 1.5 T or 3 T fields or a Cs-137 beam with a 3T field fall within the range seen in humans treated with an MRI-linac. These irradiator/magnet combinations are therefore suitable for preclinical studies investigating potential biological effects of delivering radiation therapy in the presence of a magnetic field.---------------------------Cite this article as: Rubinstein A, Guindani M, Hazle JD, Court LE. Investigating magnetic field dose effects in small animals: a Monte Carlo study. Int J Cancer Ther Oncol 2014; 2(2):020233. DOI: 10.14319/ijcto.0202.3

Aapm Report 373: The Content, Structure, and Value of the Professional Doctorate in Medical Physics (DMP)

The Professional Doctorate in Medical Physics (DMP) was originally conceived as a solution to the shortage of medical physics residency training positions. While this shortage has now been largely satisfied through conventional residency training positions, the DMP has expanded to multiple institutions and grown into an educational pathway that provides specialized clinical training and extends well beyond the creation of additional training spots. As such, it is important to reevaluate the purpose and the value of the DMP. Additionally, it is important to outline the defining characteristics of the DMP to assure that all existing and future programs provide this anticipated value. Since the formation and subsequent accreditation of the first DMP program in 2009-2010, four additional programs have been created and accredited. However, no guidelines have yet been recommended by the American Association of Physicists in Medicine. CAMPEP accreditation of these programs has thus far been based only on the respective graduate and residency program standards. This allows the development and operation of DMP programs which contain only the requisite Master of Science (MS) coursework and a 2-year clinical training program. Since the MS plus 2-year residency pathway already exists, this form of DMP does not provide added value, and one may question why this existing pathway should be considered a doctorate. Not only do we, as a profession, need to outline the defining characteristics of the DMP, we need to carefully evaluate the potential advantages and disadvantages of this pathway within our education and training infrastructure. The aims of this report from the Working Group on the Professional Doctorate Degree for Medical Physicists (WGPDMP) are to (1) describe the current state of the DMP within the profession, (2) make recommendations on the structure and content of the DMP for existing and new DMP programs, and (3) evaluate the value of the DMP to the profession of medical physics

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Shop Talk by Frank Santos (page 1) You\u27ve Come a Long Way, Lawn-Mower Pusher by Alan B. Albin (2) In The Eyes of the Laymen by Eugene P. Elcik (2) The Importance of Water Management by Fred V. Grau (A-1) Automatic Irrigation Systems Integrated with Pumping Systems by Michael O. Mattwell (A-5) Installation of a Complete Water Source and Automatic System by Richard C. Blake (A-19) How the Soil Conservation Service Can Help in Golf Course Management by Christopher G. Mousitakis (A-22) Our Shrinking Environment by Haim B. Gunner (A-24) Pesticides\u27 Dilemma - Emotion vs. Science by Allen H. Morgan (A-28) Effects of Turf Grasses and Trees in Neutralizing Waste Water by William E. Sopper (A-34) Unsolved and New Problems Developing in Golf Course Management by Alexander M. Radko (A-44) Coming of the Conglomerate Director of Golf Courses by Edmund B. Ault (A-48) Aquatic Weed Control by John E. Gallagher (A-52) What Project Apollo Has Done for Golf and Golf Course Architecture by Mal Purdy (A-54) Maintenance of Grass Tennis Courts by Wayne Zoppo (A-59) Diseases of Ornametnals Growing in Turf Areas by R.E. Partyka (A-62) Control of Turf Insects by John C. Schread (A-65) Lime for Turf by Henry W. Indyk (A-68) How to Stop Guessing When You Buy Seed by Dale Kern (A-71) Broad Aspects of Turf Grass Culture Other Than Golf Courses by Geoffrey S. Cornish (A-79) Establishing and Maintaining Turf int he national Capitol Parks by Alton E. Rabbitt (A-81) Preventive Maintenance on Small One Cylinder Air Cooled Engine by F. W. Hazle (A-85) Top Fairway Mower Performance by James R. Maloney (A-95) Grinding Reel Type Mowers by Ray Christopherson (A-99

Synthetic PET From CT Improves Diagnosis and Prognosis for Lung Cancer: Proof of Concept

[18F]Fluorodeoxyglucose positron emission tomography (FDG-PET) and computed tomography (CT) are indispensable components in modern medicine. Although PET can provide additional diagnostic value, it is costly and not universally accessible, particularly in low-income countries. To bridge this gap, we have developed a conditional generative adversarial network pipeline that can produce FDG-PET from diagnostic CT scans based on multi-center multi-modal lung cancer datasets (n = 1,478). Synthetic PET images are validated across imaging, biological, and clinical aspects. Radiologists confirm comparable imaging quality and tumor contrast between synthetic and actual PET scans. Radiogenomics analysis further proves that the dysregulated cancer hallmark pathways of synthetic PET are consistent with actual PET. We also demonstrate the clinical values of synthetic PET in improving lung cancer diagnosis, staging, risk prediction, and prognosis. Taken together, this proof-of-concept study testifies to the feasibility of applying deep learning to obtain high-fidelity PET translated from CT

Predicting Benefit From Immune Checkpoint Inhibitors in Patients With Non-Small-Cell Lung Cancer by CT-Based Ensemble Deep Learning: A Retrospective Study

BACKGROUND: Only around 20-30% of patients with non-small-cell lung cancer (NCSLC) have durable benefit from immune-checkpoint inhibitors. Although tissue-based biomarkers (eg, PD-L1) are limited by suboptimal performance, tissue availability, and tumour heterogeneity, radiographic images might holistically capture the underlying cancer biology. We aimed to investigate the application of deep learning on chest CT scans to derive an imaging signature of response to immune checkpoint inhibitors and evaluate its added value in the clinical context. METHODS: In this retrospective modelling study, 976 patients with metastatic, EGFR/ALK negative NSCLC treated with immune checkpoint inhibitors at MD Anderson and Stanford were enrolled from Jan 1, 2014, to Feb 29, 2020. We built and tested an ensemble deep learning model on pretreatment CTs (Deep-CT) to predict overall survival and progression-free survival after treatment with immune checkpoint inhibitors. We also evaluated the added predictive value of the Deep-CT model in the context of existing clinicopathological and radiological metrics. FINDINGS: Our Deep-CT model demonstrated robust stratification of patient survival of the MD Anderson testing set, which was validated in the external Stanford set. The performance of the Deep-CT model remained significant on subgroup analyses stratified by PD-L1, histology, age, sex, and race. In univariate analysis, Deep-CT outperformed the conventional risk factors, including histology, smoking status, and PD-L1 expression, and remained an independent predictor after multivariate adjustment. Integrating the Deep-CT model with conventional risk factors demonstrated significantly improved prediction performance, with overall survival C-index increases from 0·70 (clinical model) to 0·75 (composite model) during testing. On the other hand, the deep learning risk scores correlated with some radiomics features, but radiomics alone could not reach the performance level of deep learning, indicating that the deep learning model effectively captured additional imaging patterns beyond known radiomics features. INTERPRETATION: This proof-of-concept study shows that automated profiling of radiographic scans through deep learning can provide orthogonal information independent of existing clinicopathological biomarkers, bringing the goal of precision immunotherapy for patients with NSCLC closer

Infection Prevention and Control Guideline for Cystic Fibrosis: 2013 Update

The 2013 Infection Prevention and Control (IP&C) Guideline for Cystic Fibrosis (CF) was commissioned by the CF Foundation as an update of the 2003 Infection Control Guideline for CF. During the past decade, new knowledge and new challenges provided the following rationale to develop updated IP&C strategies for this unique population: 1. The need to integrate relevant recommendations from evidence-based guidelines published since 2003 into IP&C practices for CF . These included guidelines from the Centers for Disease Control and Prevention (CDC)/Healthcare Infection Control Practices Advisory Committee (HICPAC), the World Health Organization (WHO), and key professional societies, including the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA). During the past decade, new evidence has led to a renewed emphasis on source containment of potential pathogens and the role played by the contaminated healthcare environment in the transmission of infectious agents. Furthermore, an increased understanding of the importance of the application of implementation science, monitoring adherence, and feedback principles has been shown to increase the effectiveness of IP&C guideline recommendations. 2. Experience with emerging pathogens in the non-CF population has expanded our understanding of droplet transmission of respiratory pathogens and can inform IP&C strategies for CF . These pathogens include severe acute respiratory syndrome coronavirus and the 2009 influenza A H1N1. Lessons learned about preventing transmission of methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant gram-negative pathogens in non-CF patient populations also can inform IP&C strategies for CF

In vivo magnetic resonance studies of experimental liver disease: Carbon tetrachloride hepatotoxicity and alcohol-induced fatty liver in rat

Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) were used to non-invasively determine if cirrhosis induced by carbon tetrachloride (CCl\sb4) and phospholipase-D (PLD) could be distinguished from fatty infiltration in rat. MRS localization and water suppression methods were developed, implemented and evaluated in terms of their application to in vivo proton NMR studies of experimental liver disease. MRS studies were also performed to quantitate fatty infiltration resulting from carbon tetrachloride (CCl\sb4) or alcohol (ethanol) administration and the MRS results were confirmed using biochemical total lipid analysis and histology. \rm T\sb1 weighted MR images acquired weekly, 48 hours post administration, demonstrated only a slight increase in overall liver intensity with CCl\sb4 or alcohol administration, which is consistent with previously reported results. The MR images were able to detect nodules resulting from CCl\sb4+PLD induced cirrhosis as hypointense regions, also consistent with previous reports. Localized in vivo water and lipid proton \rm T\sb1 relaxation time measurements were performed and demonstrated no statistically significant trends for either agent. In vivo proton spectra were also acquired using stimulated echo techniques to quantitatively follow the changes in liver lipid content. The changes in liver lipid content observed using MRS were verified by total lipid analysis using the Folch technique and histology. The in vivo \rm T\sb1 and lipid quantification data str inconsistent with the previous hypothesis that the changes in \rm T\sb1 weighted images were the result of increased free water content and, therefore, increased water \rm T\sb1 relaxation times. These data indicate that the long term changes are more likely the result of changes in lipid content. The data are also shown to agree with the accepted hypothesis that the time course and mechanism of fatty infiltration are different for CCl\sb4 and alcohol. The hypothesis that the lipids resulting from either protocol are from the same lipid fraction(s), presumably triglycerides, is also supported. And lastly, on the basis of MR images and quantitative MRS lipid information, it was shown that cirrhosis could be distinguished from fatty infiltration