SCOPE | CONTENTS

THIS ISSUE

52 COVER FEATURE MEDICAL PHYSICIST IN MRI ART Professor John Mallard has been honoured and immortalised in a work of MRI art, and generously donated his honours as a gift

08 RELIABILITY ENGINEERING The second part of the feature on reliability engineering, this time with a case study on syringe drivers using Weibull analysis

14 THE CASE FOR REVALIDATION The Science Council’s perspective on the revalidation issue for their Chartered Scientist programme

06 TUTORIAL 18 SIMPLE LINEAR REGRESSION Predicing values of variables

MEETING REPORTS 24 COMPUTING THE ODDS IN VEGAS Lisa Rowley 26 2009 RADIATION PROTECTION ADVISERS UPDATE MEETING Elizabeth Larkin 27 SOUTH WEST TRAINEE AND SUPERVISOR MEETING Alex Morris 08 29 A RADIOTHERAPY LEARNING EXPERIENCE Eva Rutkowska and Mekala Chandrasekaran 32 CODES OF PRACTICE STUDY DAY Chris Hasler 33 MEDICAL PHYSICS AND ENGINEERING CONFERENCE Azzam Taktak 38 INTERNATIONAL CONTINENCE SOCIETY MEETING, ICS 2009 Becky Clarkson 43 48TH PARTICLE THERAPY CO-OPERATIVE GROUP MEETING Daniel Kirby

14 REGULARS 03 PRESIDENT’S LETTER Producing the right results 05 EDITORIAL Art and science 06 NEWS Stories in the media from Christie McComb 47 INTERNATIONAL NEWS Diary of meetings and teaching resources 49 MEMBERS’ NEWS Including a welcome to new members 53 BOOK REVIEWS Two book reviews and details of some just published books

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04 | MARCH 2010 | SCOPE Reliability engineering Part 2: case study of syringe drivers

Dr Peter Clowes (NHS Grampian, Aberdeen) provides the second part of his feature on reliability engineering with a case study of syringe drivers using Weibull analysis

ollowing on from the M Infusions must and tabulated, and conclusions made installation; these entries were discussions in Part 1 be accurate, both as to the reliability of each. ignored, and only true equipment with respect to (Some Fundamentals of Additionally, it is shown that Weibull failures, i.e. un-scheduled removals rate-of-delivery Reliability Engineering), and in the total analysis can be used on small data- from service, were logged. For the results of a case study amount of sets, and that reasonable predictions equipment that has not yet failed, the of syringe drivers using solution of reliability can still be made, despite survival time (days) is logged. FWeibull analysis are presented. delivered. the small sample size. Syringe drivers are much used and THE RELIABILITIES OF FOUR very valuable pieces of medical DATA-SOURCE AND METHOD OF TYPES OF SYRINGE DRIVER electronic equipment. They are used DATA-EXTRACTION USING WEIBULL ANALYSIS to intravenously infuse a great range Data used in this analysis is either Figure 1 shows the Weibull plot for of solutions, often containing from the NHS Grampian Medical the estimate of probability of failure ) powerful drugs. For reasons of safety, Electronics Equipment Dbase or with function for the IVAC P3000 such infusions must be accurate, both kind permission from the NHS syringe driver; similar plots were with respect to rate-of-delivery and in Tayside Database. Table 1 provides a made for the other three syringe the total amount of solution summary of the syringe driver entries drivers, and the Weibull parameters delivered. Often syringe drivers are in the NHS Grampian Dbase. For each are all tabulated in table 2. Having the used on critically-ill patients and item on the Dbase the time-to-first- Weibull parameters for all four great reliance is put on their failure (days) was calculated by syringe drivers altogether makes functioning properly. examining the Repair Log. In some comparisons easier. The Weibull parameters for four cases equipment was modified or For best reliability, the syringe driver models are derived, received software upgrades following characteristic life parameter η should

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be large, as this is the expected time for two-thirds of the equipment to fail; and the shape parameter β TABLE 1 should be small, as this describes the deterioration of equipment with age, β Syringe driver: Review Earliest date in use at a lower value of indicating less manufacturer / type quantity NHS Grampian deterioration with age. However, values of β < 1 can indicate ‘burn-in’ failures, possibly showing that the IVAC / P1000 146 01/01/1994 product has not been properly cycled before being issued. IVAC / P3000 36 08/03/1996 From table 2, it can be seen that the earlier models of syringe driver, the Cardinal (Alaris) / Asena 169 04/05/2006 IVAC P1000 and the IVAC P3000, GH have significantly longer characteristic BBraun / Perfusor 31 29/08/2008 lives, i.e. the time at which 63.2 per 8713030

cent of units fail, than those of the later models, the Asena GH and the M TABLE 1. NHS Grampian syringe drivers: manufacturer, models, quantities and periods of use. BBraun Perfusor. The shape parameters of the older models are also smaller than those of the newer models, indicating better ageing performance. Some possible explanations for the apparent differences in reliability are offered below. The earlier simple syringe drivers were robustly engineered, with a metal housing and a well-supported screw mechanism. They were also electronically simple and easier to use. Admittedly they lacked the sophistication of the modern devices, but in most cases provided adequate functionality. The two modern syringe drivers are functionally complex, and have options that offer desirable features such as a ‘drugs-library’; however, it is not the introduction of more electronic sophistication that has made these models less reliable, but inherent mechanical problems. Most of the first-time failures in the modern syringe drivers were due to mechanics, and not electronics. The shift to ‘plastics’, and, in both models, a design of drive-mechanism that now sits to the side of the main unit, have resulted in a more flimsy construction. The long-term effects of ultra-violet rays on the plastic possibly weaken it; and the drive mechanism to the side of the main unit allows an increased incidence of collision with other obstacles. The process of loading of the syringe into the later models is also more difficult. All these factors may have had detrimental effects on the reliability of the more modern syringe drivers. One final consideration is that the present demands on the Health

Service mean that equipment is more M

heavily used than a decade ago, and FIGURE 1. An example of plotted data: the IVAC P3000 syringe driver. M

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M this may well account for some of the apparent decline in reliability of the TABLE 2 modern equipment over the older. The following section discusses mean time to failure values (MTTFs) Syringe driver: Review Scale Shape Weibull obtained from failed units only and Quantity manufacturer / type quantity parameter parameter distribution shows how Weibull analysis provides failed (k) (analysis performed) (N) (η) (days) (β) function F(t) a better estimate of reliability than calculations based on failed-data alone.

MTTF DATA AND WEIBULL IVAC / P1000 1 – exp The characteristic life η is related to 146 129 2,620 1.35 1.35 (multi-censored) (–t/2620) the mean time to fail (MTTF) by the following relationship:

(1)1 IVAC / P3000 1 – exp 36 32 2,120 1.22 1.22 (singly-censored) (–t/2120) where:

is the gamma function defined Cardinal (Alaris) / by: Asena GH 1 – exp 169 101 1,370 1.55 1.55 (multi-censored) (–t/1370) ;

with z = 1+1/β. BBraun / Perfusor 8713030 1 – exp The gamma function can easily be 31 5 560 2.10 2.1 (singly-censored) (–t/560) evaluated using MATLAB ® or similar software. The values of MTTF

calculated using the gamma function M TABLE 2. Weibull parameters derived from: time-to-first-failure and total-run-time data. are shown in column 6 of table 3. If instead of adopting the methods of forming the estimation of probability of failure using either TABLE 3 Auth’s method1 or Benard’s ) equation2 , and MTTF Weibull- previously explained in Part 1, Review derived using failed Syringe driver: Weibull parameters section 4, the MTTF value is quantit Quantity MTTF data only: manufacturer / calculated using failed-data only in y failed (k) the equation: MTTF = , type Characteristic Shape µ η Г β (N) life parameter = * ( ) then an under-estimate of MTTF (η) (β) results. This can clearly be seen in column 7 of table 3, where the MTTF estimates using MTTF = IVAC / P1000 146 129 2,620 1.35 2,402 1,976 all show significantly lower values than the Weibull-derived values (shown in column 6). The BBraun data from NHS Grampian is from a small sample, so IVAC / P3000 36 32 2,120 1.22 1,985 1,579 the accuracy of the prediction of the MTTF is questionable; however, Weibull is noted for its accuracy in these cases. In the next section, the predictions of MTTF from the NHS Cardinal (Alaris) 169 101 1,370 1.55 1,232 810 Grampian data are presented / Asena GH alongside additional data obtained from NHS Tayside.

BBraun / THE WEIBULL PREDICTIONS Perfusor 31 5 560 2.10 496 162 FOR SMALL SAMPLES (NHS Grampian) Weibull is extensively used in predicting aircraft reliabilities. Such

an industry thankfully has very few M

TABLE 3. The Weibull-derived values presented alongside the failed-units MTTF values. catastrophic failures; nevertheless, the M

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M few catastrophic failures that do occur give valuable information. It has been TABLE 4 found from many studies on aircraft failures that Weibull is a good Data source Review Weibull Weibull predictor of reliability, despite the Manufacturer / Qty Scale Shape quantit estimate distribution sparse data available. type Failed parameter parameter y of MTTF function In the case of the NHS Grampian (analysis (k) (η) (days) (β) (N) (µ) F(t) BBraun syringe-driver analysis using performed) only five failures, the Weibull η β NHS Grampian parameters, scale and slope 1 – exp BBraun / Perfusor 31 5 560 2.10 496 indicated poorer reliability when (–t/560)2.1 (singly-censored) compared to the other syringe driver models. In order to offer confidence in NHS Tayside the predictions made from the small 1 – exp BBraun / Perfusor 81 50 730 1.60 654 sample, Medical Physics at Ninewells (–t/730)1.6 (multi-censored) Hospital, Dundee, were asked to

provide their first-time-to-fail data, M and their survival-time data on their TABLE 4. Weibull parameters for the BBraun syringe driver: NHS Grampian and NHS Tayside. BBraun syringe drivers. Thanks to the help of Dr George Corner, Head of Instrumentation, and Mr Robert McKinnes, Senior Medical Electronics Technologist, a comparison between the results of the short data set (NHS Grampian) with the large data set (NHS Tayside, Dundee) can be presented; see table 4. Figure 2 shows the Weibull plots for the singly-censored small sample data from NHS Grampian and the multi- censored large sample from NHS Tayside. The NHS Grampian small sample data gave: η = 560 days and µ (MTTF) = 496 days, and that of the NHS Tayside data gave: η = 730 days and µ (MTTF) = 654 days. The characteristic life value from the small sample was a 20 per cent under-estimate of that of the large sample, and the MTTF of the small sample was a 24 per cent under- estimate of the larger sample. Despite the small sample size of the NHS Grampian data, a reasonably good estimate of characteristic life and MTTF has been made.

CONCLUSIONS The methods of failure-statistics analysis shown here use all the observed data available. The methods presented (that of determining the ) estimate-of-failure function using either Benard’s equation for singly- censored data or using Auth’s equation for multi-censored data), coupled with the use of Weibull graph plotting techniques, provide a better method of predicting reliability than using failed-data only. To demonstrate the superiority of

the combined methods of estimate of M FIGURE 2. Weibull plots for the BBraun syringe drivers: the singly-censored small sample data failure and Weibull analysis over the from NHS Grampian and the multi-censored large sample from NHS Tayside. simpler failure-only method, the

12 | MARCH 2010 | SCOPE BBraun syringe driver results are reviewed. REFERENCES The MTTF values derived from the ABOUT THE AUTHOR failures only are: 216 days (NHS DR PETER CLOWES Tayside) and 162 days(NHS Grampian). 1 Abernethy RB. The New Weibull Handbook, 5th Dr Peter Clowes, Clinical Bearing in mind that the MTTF edn. Florida, USA: Robert Abernethy, 2008: Scientist, MIPEM, C.Eng., joined value is the time in which almost two- 2–7. NHS Grampian, Aberdeen, in thirds of the units (63.2 per cent March 2004 to work in Medical 2 actually) are expected to fail, clearly Benard A, Equipment Management, where the non-Weibull predictions are Bos- he has special responsibilities Levenbach EC. inaccurate; examination of the larger for: infusion devices, patient- The plotting of data-set (Dundee) showed that only monitoring equipment and results on 11 units out of 81 units failed at 216 medical equipment strategies, probability days or less. including reliability analysis. Prior paper. Statistica to joining the NHS, he had worked The Weibull-derived MTTF 1973; 1: 163–73. (Dundee) gives the value of 654 days, in the oil and gas sector, and was at which 40 units had failed and 41 primarily involved with design and units non-failed. This is still not at the development of sub-sea control two-thirds level; however, many of systems. His last post was with Ocean Resource Limited, the syringe drivers are fairly new and CORRECTION NOTE Chepstow, where he held the dual have only run for a short period of responsibilities of Chief Control time, less than 730 days characteristic Systems Engineer and Chief life period, thus distorting the VOLUME 18, ISSUE 4, DECEMBER 2009 Reliability Engineer. It is his expected number of failures. Page 12, middle column: interest in reliability analysis and Nevertheless the observed number of 2. Rank: this is simply the row number, starting at 1, up to n; n = 169 in his present involvement with failures of 40 units out of 81 is this example. medical electronic equipment significantly nearer to reality than the SHOULD READ: that have spurred the production 11 failures predicted using only 2. Rank: this is simply the row number, starting at 1, up to n; n = 11 in table 5. of this paper. failed-data. I

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SCOPE | MARCH 2010 | 13 THE CASE FOR REVALIDATION

Mary Arbuthnot (Science Council) sat down recently with the HOW DID THIS ALL BEGIN? Science Council’s Chief The Science Council was established recently interviewed the Science Executive Diana Garnham and by Royal Charter in 2003 with the Council’s Diana Garnham and Deputy Registrar Alisdair Orr objective to advance science and its Alisdair Orr to ask for their views to get their perspective on the applications for public benefit. revalidation issue as it pertains Under Diana Garnham’s leadership, on revalidation Ito their Chartered Scientist (CSci) the Council sees its core remit as programme. The full picture, as I helping to build public trust in found out, is a complex and multi- science and scientists. Garnham, faceted one. The following article is a along with her Deputy Registrar Ali summary of the most salient points – Orr, believe their Chartered both macro and micro – that I took Scientist designation (CSci) is away from our conversation. central to that goal.

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contentious – whether swine flu, their careers by requiring them to climate change, an ageing practise and record a variety of population, the list goes on… – the ‘continuing professional Science Council offers their CSci development’, commonly referred to designation to scientists as an anchor as CPD. in an often stormy sea of conflicting The Science Council defines CPD agendas and public mistrust. At as ‘the means by which professionals CSci’s heart – arguably the lifeblood maintain, improve and broaden their that keeps it relevant – is the concept knowledge and skills, and develop of ongoing revalidation. the personal qualities required in their working lives’. What qualifies as PROFESSIONALISM AND CPD is virtually limitless and falls TRUST roughly into five broad categories, ‘CSci and revalidation are part of the including: (1) work-based learning; process of addressing public concern (2) professional activity; (3) in the integrity of science and formal/educational; (4) self-directed gaining the trust and respect of your learning; and (5) other, i.e. voluntary scientific peers,’ says Garnham. work. ‘How can you ask the public to trust A little known but surprising piece scientists without this? The qualities of trivia is that the NHS is the largest of a professional scientist are employer of scientists in the UK. embedded in what CSci is – a mark Acknowledging their prominence in of current competence and the regulatory agenda, the Science commitment to codes of professional Council maintains a regulatory conduct and ethics.’ interface with the related Health Public trust for most things is in Professions Council, who alone short supply. Just ask Viki Cooke, regulates in excess of 200,000 Chair of Opinion Leader, who ran a professionals. While accurate recent seminar entitled Has Trust numbers don’t exist to show the total Gone Bust? ‘We’ve moved from an number of UK professionals involved age of deference to reference, where in some form of ongoing regulation people are more likely to trust the (CPD, revalidation etc.), looking at advice of their friends and family HPC’s figures combined with the versus that of experts,’ says Cooke. multitude of other UK professional ‘There is a toxic debt of trust and bodies it seems reasonable to sense of lack of accountability… speculate this number could easily be people are seen to get away with over a million. things.’ Garnham agrees and wants The Science Council’s synergistic professional bodies to be more relationship with HPC has resulted in outward-facing. ‘What do the public their modelling CSci’s new 2008 CPD need from scientists?’, Garnham standards on HPC’s existing asks, implying it’s a question not guidelines. These five requirements asked enough. ‘Some people think state that all registrants must: you can tell the public, “we’re clever, I maintain a continuous, up-to-date trust us”, but behind trust are and accurate record of their CPD; transparency and accountability.’ I demonstrate that their CPD activities are a mixture of learning REVALIDATION: THE BASICS activities relevant to current or Garnham and Orr believe the Science future practice; Council’s Chartered Scientist I seek to ensure that their CPD has qualification (CSci) – launched in benefited the quality of their

2003 and currently approaching practice, and As part of its modern forward- M Being a 15,000 registrants across 21 Licensed I benefited the users of their work; looking outlook, the Science Council scientist Bodies – is a significant step towards I present a written profile containing believes its community of Chartered involves more winning back public confidence in evidence of their CPD on request. Scientists should not be (or be than just the UK’s thousands of science In addition to these standards, perceived as) a cosy, closed research. professionals. CSci also outlines five broad areas of community of academics. Instead, A key component of the competencies that Chartered CSci strives to be as inclusive as Chartered Scientist status has always Scientists are expected to demonstrate possible across the scientific been mandatory revalidation, or the through a combination of their disciplines, continually challenging process by which a regulated knowledge and experience. These the public’s perception of what it professional periodically has to include skills like the ability to deal means to be a scientist. demonstrate that he or she remains with complex scientific issues and to At a time when science issues are fit to practise. This ensures exercise self-direction and originality

increasingly urgent and often professionals don’t become static in in solving problems. M

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built around points earned for hours invested attending industry conferences or reading journals, which while useful has its limitations. But now there is a more reflective “output-based CPD” which is about measuring the benefits of CPD to your practice in a much broader way. For example, if you’re a psychologist who goes on a statistics course, you can demonstrate how you’ve used what you’ve learned to benefit your practice, even though statistics isn’t directly related to your field.’

REVALIDATION: BIG BROTHER? Understandably, increased scrutiny over the auditing period, as well as disciplinary complaints (peers reporting the infractions of their colleagues), can make many Chartered Scientists nervous. But Orr stresses that the auditing process is not intended to catch hard- working scientists out, but instead to maintain CSci’s integrity and highly regarded reputation. ‘I want to reassure people that if they’re still in employment it’s probably because they’re valuable and doing CPD without even realising it,’ he says. Registrants should be aware that the audit will be peer-reviewed: assessors will always be Chartered Scientists like themselves, not some

REVALIDATION: THE FUTURE revalidation online, streamlining the M The scheme is highly-paid consultant without any The 2008 Science Council review of process, making it paperless and not intended to knowledge of the field. Once the CPD requirements led not only to new much less cumbersome than years feel like a ‘Big revalidation transition is complete, a Brother’ CPD standards, but also, significantly, past. sample audit of 2.5 per cent of experience. a move from a five-year revalidation registrant’s returns will be scrutinised requirement to annual revalidation REVALIDATION: THE by a minimum of two trained phased in by 2011. This means moving CONTROVERSY assessors. They will ask questions forward Chartered Scientists must But CPD and revalidation are not like: ‘Has your CPD been a mixture of keep an accurate record of their CPD without controversy. Perhaps different learning activities? Have you achievements for submission each unsurprisingly, there has been shown the benefits to your work? Has year, subject to scrutiny by auditors, in resistance to change, and a backlash the CPD improved the quality of your order to remain active on the Register. against revalidation amongst some practice?’ This significant policy change is the members of the CSci community who Thankfully for those Chartered result of a general consensus by the perceive it as time-consuming, Scientists required to submit their Science Council’s Licensed Bodies that ineffective, prone to dishonesty and CPD log to another registration body, a five-year gap for revalidation is too condescending. the Science Council has signed up to long and causes scientists to While acknowledging the validity the Hampton Regulations, which procrastinate recording their CPD of their concerns, Orr hopes to slowly mean CSci’s don’t have to double up until the last minute. Garnham and win over hearts and minds. ‘There are on paperwork. The Hampton Orr hope that a two-year transition to misconceptions about CPD, which is principles also stipulate that any annual revalidation will reduce this evolving,’ he says. Orr wants regulatory audit should be responsive bottle-neck effect and be ample time to Chartered Scientists to develop a to risk and increased only if a sample make regular CPD recording both more reflective practice through group is worse than expected. It will habit-forming and hassle-free. engagement in CPD, which he then be up to individual Licensed Reassuringly for those who fear a believes most scientists do on a daily Bodies to decide if a poor audit is paperwork nightmare ahead, basis without even realising it. ‘There worthy of an internal review. sophisticated technology now exists is a technical and conceptual side to While there might be a tendency to and is being developed for the revalidation and CPD,’ he explains. focus on the negative perceptions of professional market which enables ‘The old CPD system relied heavily revalidation, Orr believes the positive registrants to manage their CPD and on the technical “input-based CPD” benefits to the individual far

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outweigh any potential burden. A century business world. This comes ultimately means greater job 2007 government white paper for the at a time when increasingly the satisfaction and a deeper NHS echoes this thinking, stating science sector is finding ‘T-shaped commitment to one’s company and professional regulation ‘…should be professionals’ in short supply. In this colleagues. On an individual level, as much about sustaining, improving analogy, the stem of the letter ‘T’ regular tracking of one’s CPD and assuring the professional represents a deep knowledge in a progress isn’t just for revalidation – standards of the overwhelming home discipline (whether it be chances are most scientists will use majority of health professionals as it is chemistry, mathematics, biology, etc.) this data to enhance and keep their about identifying and addressing while the horizontal top of the ‘T’ CVs, bios and websites up-to-date poor practice or bad behaviour in the represents a broad set of too. small minority’. And in a speech to transferrable skills, or individuals Another benefit of CSci is its the Science Council Licensed Bodies, capable of interacting with and transferability. Increasingly scientists Dame Carol Black noted that the role understanding specialists from a are involved in interdisciplinary of scientists is not always visible to wide range of disciplines and work and don’t identify themselves the public, yet the need for functional areas. T-shaped with just one body of professionals professionalism within science is as professionals are the 21st-century (i.e. engineers, chemists or great as in any field. On the subject of equivalents of well-educated and biologists). Unlike most other revalidation, she suggested that well-rounded persons of the chartered designations, if scientists reflective practice is crucial to Renaissance. They are numerate and decide to transfer between license maintaining professionalism and adept at technology even as they are bodies their status doesn’t change; stressed that a good professional good managers, entrepreneurs, they simply take their CSci with wants to continue to be one and is problem-solvers and them. CSci is the scientific equivalent willing to attest to that fact [through communicators. of the Euro, a currency of the process of revalidation]. In the big picture, CPD helps professional recognition that professionals understand the transcends the borders of any one REVALIDATION: WHAT’S IN IT objectives they are working towards discipline and empowers scientists FOR ME? and take ownership of their career to be collaborative instead of CPD as part of the revalidation progression, which in turn improves shutting them in their box… process diversifies a scientist’s skill- their productivity and creativity. whether they are a biologist, food set to meet the challenges of the 21st- Keeping up-to-date in one’s field scientist, engineer or psychologist. I

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SCOPE | MARCH 2010 | 17 SIMPLE LINEAR REGRESSION: PREDICTING VALUES OF VARIABLES Dr Jenny Freeman and Dr Tracey Young use simple linear regression to quantify continuous variables and predict the values of them from other known ones

IN THE PREVIOUS TUTORIAL we case of height and weight, as height EXAMPLE: SIMPLE LINEAR looked at using correlation to assess determines weight, to an extent, and No REGRESSION OF WEIGHT the strength of the linear relationship not the other way around, a AGAINST HEIGHT FOR TEN between two continuous variables. scatterplot of weight against height distinction ELDERLY MEN The correlation coefficient simply would be plotted with height on the is drawn Figure 1 shows the height and weight measures the strength of the linear horizontal axis and weight on the “between values for 10 elderly men. The data are association as a single number. No vertical axis. given in Table 1. distinction is drawn between the two the two Thus the regression equation for variables and no causation is implied. SIMPLE LINEAR REGRESSION variables these data is: However, it is often of interest to In the technique of simple linear and no quantify the relationship between two regression a straight-line equation is weight = −82.25 + 0.9051 * height continuous variables, and given the used to model the relationship causation value of one variable for an individual, between the predictor variable and the is implied From this it can be seen that the slope to predict the value of the other response variable. The equation of the coefficient was 0.9051, indicating that for variable. This is achieved using the regression line is given by: y = a + bx every 1 cm increase in height there was technique known as simple linear where: an increase in weight of 0.9051 kg. Note regression. One variable is regarded I x = independent / predictor / that the value of the intercept is −82.25. as a response to the other predictor explanatory variable: variable that Thus when height is zero, weight is (explanatory) variable and the value of is used to predict the values of the ” −82.25 kg. Clearly this is nonsense and the predictor variable is used to response variable. This is plotted illustrates an important principle for predict what the response would be. on the horizontal axis of a scatter regression analyses: they should never plot. be used to predict values outside of the SCATTER PLOTS I y = dependent / response / range of observations. However, within As stated in the previous tutorial, outcome variable: variable being the range of the data the regression when undertaking either a correlation predicted by the model. This is equation can be used to predict the or simple linear regression analysis it plotted on the vertical axis of a values of the y variable for particular is important to construct a scatter plot scatterplot. values of the x variable. For example the of the data. The values of one variable I a = intercept. This is the point at estimated weight for an elderly man who are plotted on the horizontal axis which the regression line crosses was 180 cm tall is calculated as follows: (known as the x-axis) and the values of the vertical (Y) axis. Strictly another are plotted on the vertical axis speaking this gives the value of the weight = −82.25 + 0.9051 * 180 = 80.67 kg (y-axis). By drawing a scatter plot it is Y variable (dependent variable) possible to see whether or not there is when the X variable (independent ASSUMPTIONS AND MODEL FIT any visual evidence of a straight line or variable) is zero. Three important assumptions underlie a linear association between the two I b = regression coefficient. It is also simple linear regression analysis as variables. It is possible for there to be known as the slope and it shows outlined in Box 1 and as with any a relationship between two variables the average change in the Y statistical analysis it is important to but for that relationship to not be variable (outcome) for a unit check that they are valid and that the linear. In this case, correlation or change in the X variable model fits the data adequately. The first simple linear regression analysis may (predictor/explanatory variable). assumption can be checked by not be the most appropriate methods constructing a scatter plot of the data to use. In addition a scatterplot a and b are calculated as follows: (figure 1). provides a good way of examining the The final two assumptions can be data and checking for outliers or odd checked by examining the residuals from values. the fitted model. Each y observation has If it is known (or suspected) that a residual associated with it; this is the the value of one variable (known as difference between the actual observed y the independent variable) influences value (yobs) and the y value predicted by the value of the other variable (known the model (known as the fitted value as the dependent variable), it is usual (yfit)) (see table 2). In figure 1 for each to plot the independent variable on the point the residual is given by the vertical horizontal axis and the dependent distance between that point and the variable on the vertical axis. In the fitted regression line. For example, for

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FIGURE 1. Scatter plot of weight against height together with the regression line.

TABLE 1

Subject

1 173 –3.5 12.25 65 –12.5 156.25 43.75 2 165 –11.5 132.25 57 –20.5 420.25 235.75 3 174 –2.5 6.25 77 –0.5 0.25 1.25 4 183 6.5 42.25 89 11.5 132.25 74.75 5 178 1.5 2.25 93 15.5 240.25 23.25 6 188 11.5 132.25 73 –4.5 20.25 –51.75 7 180 3.5 12.25 83 5.5 30.25 19.25 8 182 5.5 30.25 86 8.5 72.25 46.75 9 163 –13.5 182.25 70 –7.5 56.25 101.25 10 179 2.5 6.25 82 4.5 20.25 11.25 Total 1,765 0.0 558.50 775 0.0 1,148.50 505.50

TABLE 1. Calculation of regression equation for regression of weight on height of 10 elderly men. 1765 / 10 = 176.5 cm =775 / 10 = 77.5 kg b = 505.5 / 558.5 = 0.9051 a = 77.5 – 0.905103 * 176.5 = −82.25

BOX 1: Assumptions

1 The relationship between the two variables should be linear. 2 The value of the response variable, y, should have a Normal distribution for each value of the explanatory variable x. 3 The variance (or standard deviation) of y should be the same at each value of x, i.e. there should be no evidence that as the value of y changes, the spread of the x values changes. M

SCOPE | MARCH 2010 | 19 SCOPE | TUTORIAL M the first observation in table 1, the actual A weight is 65 kg and the predicted weight is TABLE 2 74.33 kg, thus the residual is given by 65 − well- 74.33 = −9.33 kg. fitting In order for assumption 2 to be valid Predicted “model will the residuals should be Normally Actual height Actual weight value = Residual distributed. This is most easily checked by (m) (kg) –82.25 + (yobs – yfit) have a constructing a histogram of the residuals 2 height * 0.9051 high r and to check that this is approximately Normal a badly- (figure 2). With only 10 individuals it is difficult to definitively conclude that the 173 65 74.33 –9.33 fitting residuals are Normally distributed, but model will given that they are spread out around a 165 57 67.09 –10.09 have a low central peak it would appear to be value of R2 reasonable to accept this assumption as 174 77 75.24 1.76 being valid. In order to check assumption 3 it is necessary to do a scatter plot of the residuals against the predicted values. 183 89 83.38 5.62 This should show a good spread with no obvious patterns (i.e. it looks random) as 178 93 78.86 14.14 ” in figure 3. R2 188 73 87.91 –14.91 The value of r2 is often quoted in published articles and indicates the proportion 180 83 80.67 2.33 (sometimes expressed as a percentage) of the total variability of the outcome variable 182 86 82.48 3.52 that is explained by the regression model fitted. A well-fitting model will have a high r2 and a badly-fitting model will have a low 163 70 65.28 4.72 value of R2. It is calculated as follows:

179 83 79.76 2.24

TABLE 2. Calculation of residuals from the fitted model.

Note that this is also the square of the correlation coefficient:

)

For the current example the value of r2 is 0.398. Thus 39.8 per cent of the total variability in weight for the 10 men is explained by their heights.

MORE THAN ONE EXPLANATORY VARIABLE Simple linear regression as described above involves the investigation of the effect of a single explanatory variable on the outcome of interest. However, there is usually more than one possible explanatory variable influencing the values of the outcome variable and the method of regression can be extended to investigate the influence of more than one explanatory variable on the outcome of FIGURE 2. Histogram of the residuals from the fitted model. interest. In this case it is referred to as

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multiple regression, and the influence of If it is several explanatory variables can be investigated simultaneously. This is sensible to beyond the scope of the current tutorial assume and will be covered in a subsequent “that one tutorial. variable SUMMARY: REGRESSION OR may be CORRELATION? causing a Regression and correlation are related methods (note that the r2 coefficient is response simply the square of the correlation in the coefficient!). As they are often presented other then together it is easy to get the impression that they are inseparable. In fact, they regression have distinct purposes and it is relatively analysis rare that one is genuinely interested in should be performing both analyses on the same set of data. Regression is more used informative than correlation. Correlation simply quantifies the degree of linear association (or not) between two variables. However, it is often more useful to describe the relationship ” between the two variables, or even predict a value of one variable for a given value of the other and this is done using regression. If it is sensible to assume that one variable may be causing a response in the other then regression analysis FIGURE 3. Plot of the residuals from the model against the predicted values. should be used.

Ad

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COMPUTING THE ODDS IN VEGAS (INTRODUCTION TO MCNP USING THE MCNP/MCNPX VISUAL EDITOR) LISA ROWLEY Christie NHS Foundation Trust

LAS VEGAS 11th–15th May 2009

THE MONTE CARLO N-PARTICLE (MCNP) code was those involved gain an understanding of the basics of developed at the Los Alamos National Laboratory and MCNP and how the editor worked. Students were also can be used for modelling neutron, photon and electron free to bring in their own problems and discuss and transport. Consequently it can be used as a powerful tool develop them with Randy Schwarz (founder of VEC). in medical physics in areas such as radiation protection The first few days focused primarily on setting up the and dosimetry. The Visual Editor Consultants (VEC), geometry of the shielding, before developing into based in the US, developed a visual editor for use with sources, tallies, universes and lattices. MCNP, funded by NASA. The software allows For those new to MCNP, the editor is a very useful visualisation of 3D structures as they are created and learning tool, allowing the user to create geometries very includes wizards for defining cells, sources and material easily, use the wizards and watch the code appear in an definitions. I was asked to investigate the use of MCNP input box on screen. This helped me familiarise myself for PET shielding calculations as part of my higher with the MCNP code and, as I got more experienced, training. The VEC offer training courses on using MCNP allowed me to easily edit or write my own code into the with the editor and so I attended this recent course held in input box directly. There were, however, some parts of Las Vegas, with the flights funded through an IPEM MCNP that were only briefly addressed and I found bursary. myself getting a bit lost at times. Since returning from The course was a week long, computers were provided the course and trying to do problems by myself, I have with the code and example problems installed (figures 1 had to go back to basics and refer to the MCNP manual and 2). A prior knowledge of MCNP was not required for (provided by Los Alamos National Laboratory) with the class. We were provided with manuals covering regards to tallies and sources in particular. When I MCNP theory, how the visual editor worked and two mentioned this on my course evaluation form, Randy problem books. A CD with the notes, code (for the contacted me to say that if I have any questions or code example problems) and latest version of the visual editor that I have problems with, to email them to him for help. were also handed out. The examples were heavily When I did, he replied the following day answering my weighted towards the nuclear power sector, but helped questions with useful examples.

M FIGURE 1. Doing examples in the class: the head on the main screen was just for show, but demonstrates the complex geometries that can be created by MCNP and visualised in the editor.

24 | MARCH 2010 | SCOPE MEETING REPORTS | SCOPE

M FIGURE 2. A screenshot of the visual editor. The images show a container for transporting nuclear waste. The yellow box shows the input file which can be edited and updated directly rather than using the editor.

For current users of MCNP, the ability to immediately M FIGURE 3. The canals in the visualise the geometry of designs as they are inputted Venetian Hotel. will, I think, prove very useful and aid in the task of spotting errors early on in the design process. There is also a useful feature that lets you plot the particle tracks so you can see potential weaknesses in shielding and if you have programmed your source correctly. Another feature is the option to import CAD files, which would vastly simplify the development stage when looking at room shielding problems. While it has the potential to save a lot of time plotting geometries, the system frequently crashes, usually when the geometry is not quite right. This has been very frustrating initially; however, as I have gained more experience with the editor and its quirks it is running much more smoothly, although I would advise people to save their work frequently. The course venue was a pleasant hotel just off the main Strip in Vegas. If you like casinos, drinking, shows, general excess and a lot of tack, the Strip is the place to go. It is, however, all about money, which you need in order to see the more glamorous side of the city (figure 3). If you ever find yourself in the area though, forget the rest – the Grand Canyon is an absolute, amazing, spectacular must. Overall the course offered a good introduction to MCNP and in particular the visual editor, certainly partnered with the development team at Los Alamos to enough to get me going on looking at shielding problems, deliver training workshops, including some to be held in although more MCNP theory would be beneficial. Europe in 2010, again charged at $2,000 (if booked early). If people are interested in taking an MCNP/Visual These may cover tallies and sources in more detail. A Editor course (beginner, intermediate or advanced), copy of the code is required before attendance however, Randy will (and is quite keen to) come across to the UK. and this can be obtained from the Nuclear Energy Agency He needs a class of at least 6 people ($2,000 each for a (NEA) who distribute the code in Europe. You can also week’s course). For more information and contact details book the European courses through the NEA for 2,000 see http://www.mcnpvised.com/. He has also recently euros, so check the exchange rates first! I

SCOPE | MARCH 2010 | 25 SCOPE | MEETING REPORTS

2009 RADIATION PROTECTION ADVISERS UPDATE MEETING ELIZABETH LARKIN Queen Elizabeth Hospital, Birmingham

AUSTIN COURT, BIRMINGHAM 16th June 2009

THE ANNUAL RPA UPDATE MEETING, organised by the suitable Radiation Protection Advisers (RPA) in respect of Institute of Physics in Engineering and Medicine (IPEM) the items listed in Schedule 5 of the Ionising Radiations Radiation Protection Special Interest Group, was held on Regulations 1999 (IRR99). He also reminded us of the 16th June at Austin Court in Birmingham. additional RPA ‘tasks’ in Regulations 8 (restriction of Eddy Rafiqi (Queen Elizabeth Hospital, Birmingham) exposure), 10 (maintenance and examination of opened the day by welcoming everyone to Birmingham, engineering controls and personal protective equipment) explaining that the programme included topics requested and 31 (duties of manufacturers of articles for use in work by IPEM members. with ionising radiation). Gareth briefly described the stages taken in planning a new CT room, a simple method for MORTALITY AND CANCER RISKS FOLLOWING checking the level of protection and any discontinuities OCCUPATIONAL RADIATION EXPOSURE: 3RD (‘hotspots’), and the solutions to problems found. In ANALYSIS OF THE UK NATIONAL REGISTRY FOR summary, it is important to check the shielding, to measure RADIATION WORKERS (NRRW) the dose rate through barriers as a visual check will not The NRRW was set up in 1976 in order to obtain data on identify all the deficiencies, and to state the design the risks from protracted or low dose radiation exposures. conditions and dose constraints early and worry about The organisations that participate in the NRRW are in the every other room that has not been checked in this way! nuclear, research and industrial sectors. Colin Muirhead (Health Protection Agency, Didcot) presented the results of X-RAY HANDOVER FORM the third analysis, which, funded by the Health and Safety Michael Nettleton (Health and Safety Executive [HSE], Executive, provides the most precise estimates to date of Bootle) reported that his colleague, David Orr, has been mortality and cancer risks following occupational radiation liaising with the Association of X-ray Equipment exposure and strengthens the evidence for raised risks from Manufacturers (AXrEM) to try to improve the these exposures. The results show the cancer risk estimates arrangements for handing over equipment and controlled to be consistent with values used to set radiation protection areas after service or repair. AXrEM have produced a draft standards, both for leukaemia and for all other cancers handover form for consideration by hospital sector combined, and exclude the possibility of radiation risks employers and the professional bodies of relevant staff being more than a few times higher than existing estimates. groups. The use of this form should result in a more Further details of the analysis can be found at: consistent approach to handover throughout the UK; this www.nature.com/bjc. approach is fully supported by HSE.

LESSONS LEARNT FROM EXCEEDING A DOSE CO-OPERATION BETWEEN EMPLOYERS IN THE LIMIT IN THE CATH LAB HEALTH SERVICE Matthew Dunn (Nottingham University Hospitals NHS In today’s NHS culture, ‘employers’ within different Trust, Nottingham) reported on the lessons learnt when a organisations are required to work together, e.g. those Senior Consultant Radiologist performing hepato-biliary within NHS Trusts, Primary Care Trusts, Independent interventional procedures exceeded a dose limit. His doses Sector Treatment Centres, Service Contractors, and so on. were erratic, occasionally very high and annually well In her presentation, Claire-Louise Chapple (Newcastle above the classification level of 150mSv. Although his doses General Hospital, Newcastle) focused on the ‘radiation were higher than those of his colleague undertaking similar employer’, i.e. the main duty holder, as required by the procedures and did not correlate well with his workload, Ionising Radiations Regulations 1999 (IRR99) and the he was unable to offer any explanation! In 2001, the dose to Ionising Radiation (Medical Exposure) Regulations 2000 his left hand exceeded 500mSv, the Health and Safety (IR[ME]R2000). Is the ‘radiation employer’ the owner of the Executive (HSE) were notified and an action plan was premises, the owner of the equipment, the employer of the drawn up. Matt’s conclusion emphasised the need for staff member operating the equipment, the employer proper risk assessments to be undertaken and the need to controlling the equipment, the employer providing the ‘monitor’ any monitoring arrangements which are in place service or is it all of these people? Perhaps we should ask (no-one should be overexposed). He also indicated that ‘who is responsible’ for notification of work with ionising intervention by the Radiation Protection Adviser at an early radiation, carrying out risk assessments, providing local stage can dramatically reduce doses. Finally, the Radiation rules, organising QA, providing the employer’s IR(ME)R Employer has overall responsibility for compliance with the procedures, investigating/reporting ‘exposures much regulations and should be reminded of this obligation. greater than intended’ and for things going wrong? Claire- Louise provided a number of examples and ended with a DEFICIENCES IN BARRIER SHIELDING plea for more definitive guidance on the interpretation of Gareth Iball (Leeds General Infirmary, Leeds) reminded us ‘employer’ and the requirements for ‘co-operation’ in that the Radiation Employer must contact one or more today’s NHS culture.

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RISK ASSESSMENTS – A REFRESHER increase transparency and flexibility in ways that will Michael Nettleton indicated that when HSE carry out hopefully lighten the burden on the medical sector, without inspections, the two regulations most commonly used are reducing the environmental standards and outcomes. They Regulation 7 (Prior Risk Assessment) and Regulation 8 will also help the UK develop its strategic approach to (Restriction of Exposure). The regulations say that there radioactive waste management in the long term. We should must be a ‘suitable and sufficient assessment of the risk to read the consultation documents for EPP2 and exemption any employee …‘, that ‘all hazards with the potential to order review, consider how the proposals will affect us and cause a radiation accident have been identified’ and that pass on our comments to the Department of Energy and ‘the nature and magnitude of the risks to employees … Climate Change (DECC). have been evaluated’. During inspections, he has found risk assessments which are ‘suitable and sufficient’, those REQUIREMENTS OF THE TRANSPORT that have been ‘done (mentally), but not recorded’ and REGULATIONS (INCLUDING THE ROLE OF THE those which haven’t been done at all! He concluded by DANGEROUS GOODS SAFETY ADVISOR) saying that a risk assessment must be undertaken (and David Rowe (Department for Transport, London) reported documented), any control measures must be implemented that the Carriage of Dangerous Goods and Use of and it must be reviewed! NB: risk assessments are also Transportable Pressure Equipment Regulations 2009 (CDG required under the Management of Health and Safety at 2009) came into force on 1st July 2009 (Statutory Instruments Work Regulations 1999 (Regulation 3)! 2009/1348). Carriage must be undertaken in accordance with the European Agreement Concerning the International ETHICS APPLICATIONS – THE PROBLEMS AND ONE Carriage of Dangerous Goods by Road 2009 (ADR 2009). No SOLUTION further changes to CDG are proposed, but the ADR will Giles Morrison (Sheffield Teaching Hospitals, Sheffield) continue to be subject to a 2-year review. David outlined the reported that specific requirements for the use of radiation derogations relating to fire extinguishers, the alternative to sources have been included in the Integrated Research the orange plates and the crossing of public roads. He went Application System (IRAS) online ethics application form. on to talk about Labelling (ADR Chapter 3.2), Emergency The publication of revised guidance for ‘approval of Arrangements (CDR: Regulation 24 and Schedule 2, and research involving ionising radiation’ in 2008 has resulted ADR 2009: Section 5.4), Certification of Expired Type A in a general improvement of Multi-Centre Research Ethics Containers (ADR Chapter 6.4), Renewal of Special Form Committees (MREC) applications and a greater confidence Material Certificates, Security Provisions (ADR Sections in local compliance with IR(ME)R 2000 for research. 1.10.1 and 1.10.2), Dangerous Good Safety Advisers (CDG However, the requirements of local research departments 2007, Regulation 43 and ADR 2009), Vehicle Equipment for corporate governance, and the demands of national and (ADR Chapter 8.1), Quality Assurance and Training (ADR international research organisations, continue to throw up Section 1.7.3), Training (ADR Sections 1.3.2.1, 1.3.2.2, 1.3.2.3, problems. Chief and principal investigators, clinical 1.3.3 and 1.7.2.5) and Compliance Assurance. At the end of radiation and medical physics experts are still learning their his presentation, David identified current problems relating roles within the guidance! James Harries (Oxford Radcliffe to incomplete consignment notes and vehicle equipment, Hospitals, Oxford) went on to describe the use of local the lack of emergency arrangements, incorrect marking and computer software for calculating the doses and risks labelling of packages, inadequate justification of package associated with each application. design approval and package contents/activity and counterfeit packages/spare parts. Finally, to round off the AN UPDATE ON THE REQUIRMENTS OF THE presentations, David asked for completed Department for RADIOACTIVE SUBSTANCES ACT Transport questionnaires to be returned at the earliest Chris Englefield (Environment Agency, Warrington) opportunity. reported that significant changes are imminent to the Radioactive Substances Act 1993. New Environmental THANKS TO THE FOLLOWING SPONSORS OF THE Permitting Regulations (EPP2) are likely to replace 95 per MEETING cent of the requirements of the primary legislation and the The meeting was sponsored by Mirion Technologies long-awaited review of exemption arrangements by Dosimetry Services Division, Pycko Scientific Ltd, Qados government is nearing completion. The regulations will and Southern Scientific Ltd. I SOUTH WEST TRAINEE AND SUPERVISOR MEETING ALEX MORRIS Part I Trainee, Plymouth Hospitals NHS Trust

SALISBURY DISTRICT HOSPITAL 9th July 2009

THIS YEAR, THE TRAINEES and supervisors from MORNING SESSION the South West Region met in Salisbury (figure 1) to An early start for most called for some strong coffee and a share experiences and improve their own training general catch up between the various mentors and schemes by determining the ‘best practices’ across the supervisors. There was a strong turnout from all centres

region. which leant for a friendly atmosphere. Following a warm M

SCOPE | MARCH 2010 | 27 SCOPE | MEETING REPORTS M welcome from organiser Tom Lister, Paul White contained too much textbook material. It was (Chairman of the IPEM Accreditation and Training commented that this reflects the format of the viva voce Committee) started things off with an introduction and examinations. Delegates felt that the Part I portfolio overview to all parts of the training scheme. After an structure would benefit from being more like a series of extensive amount of questions from trainees and reports. In contrast, people were happy with the mentors alike it was time to move on to the scientific structure of the Part II portfolios. presentations from Part I trainees. There was a general consensus that more should be Francis Gibbons (Gloucestershire Hospitals NHS done to encourage Part I trainees to write up their Foundation Trust, Cheltenham) opened the presentations portfolios throughout the placements, rather than with a critical analysis on the use of ‘MOSFET detectors leaving much of the work until the end. Suggestions for in vivo patient dosimetry’, a project undertaken by were made to achieve this, including a performance Francis during his Part I training placement in appraisal at the end of each of the three placements. radiotherapy. Ruth Ruddlesden (current second year This would perhaps require an assessment of portfolio Part I trainee, Bristol) followed Francis with an in-depth standard to decide whether or not to transfer the process of ‘Developing a system to use HDR trainee from the current placement to the next. Also, brachytherapy surface moulds to treat superficial lesions trainees and supervisors felt that a mock viva after the of the hand’. The presentations were brought to an end first placement would be helpful for assessing the by Tejal Mistry (Bath trainee) who discussed ‘The use of quality of the portfolio. This would be in addition to SPECT in lung ventilation and perfusion imaging’. the current mock viva format in the South West region. Written feedback from the day suggested that AFTERNOON SESSION centres may look for a more structured approach to the After a well laid out lunch, caffeine fix and a lot of Part I training they provide, in particular with the ‘bonding’ the group was split into four smaller clusters management of portfolios. during a breakout session. The groups were mixed between centres, Part I and II trainees and Contrasts between Part I and Part II training supervisors/mentors, with the aim of discussing three Delegates felt that Part I trainees are more limited in pertinent topics. Afterwards, the groups reconvened to what they can do, although this was appropriate due to share their conclusions and discuss the topics further, the experience of the trainees. It was mentioned that chaired by Duncan Wood (Salisbury co-ordinator). The there is a large gap between Part I and Part II training, following is a summary of this discussion. with Part I’s following a relatively strict curriculum and Part II’s having much more flexibility, with much Managing portfolios less guidance. The discussion was focused on Part I portfolios and It was mentioned that the clarity of supervisory highlighted pressures on trainees with regard to this. roles was greater for Part I trainees. Delegates It was decided unanimously that the majority of discussed the role of mentors for Part II trainees and portfolio writing should be done within working hours. supervisors. They felt that mentors can be useful but it The general feeling was that this should be supported is important to find the right person. Trainees have with protected time External Training Advisors who can take a similar role M FIGURE 1. for portfolio to mentors, although it seems they are not used very [LEFT] writing during the much. Salisbury placements and at We discussed the six monthly reports for Part II Cathedral. the end of the three trainees and delegates felt that they could benefit by placements. It was combining these short reports with their trust appraisal suggested that the scheme. time should be flexible to fit in Managing extra-curricular activities with the nature of When discussing attendance of meetings and training performing presentations, delegates felt that this opportunities, should not be thought of as ‘extra’ curricular but is which may arise at instead essential to the training. Furthermore, delegates any time or day of felt that trainees would benefit from making more of the week. The the meetings held within the South West region. proportion of time There was a very positive feel about the prospect of to be protected for getting involved with the community, in particular portfolio writing with school science days. Also, delegates discussed the was discussed, with benefits of seeing other departments. It was mentioned suggestions that Special Interest Groups were useful to join but it is ranging from 20 per difficult to get accepted into one. The group concluded cent to 50 per cent. that networking, both within the hospital and further The general afield, was a critical part of the training scheme. structure of the portfolio was Other points discussed. It was The MSc courses in Surrey were discussed. Differing felt that the current opinions were viewed on the advantages and format often disadvantages of having a broad curriculum. It was

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mentioned that the physics course has undergone personally that I gained a lot from this experience and many changes in the last 2 years, the most recent would like to thank Tom Lister and Dr Duncan Wood at changes of which were beneficial (although further Salisbury for their warm hospitality and smooth improvement would be encouraged). In contrast, recent organisation. changes to the engineering course were perceived as detrimental. Delegates also mentioned recent (minor) NOTE FROM TOM LISTER (PART II TRAINEE, organisational issues on the physics course. SALISBURY DISTRICT HOSPITAL; ORGANISER) All in all this proved to be a very worthy session Written feedback was very positive and the organisers with many lengthy discussions concerning the most would like to thank those who were able to attend the efficient way to manage the training experience and day. I would especially like to thank Dr Paul White for many new outlooks gained on the training process. his fantastic talk and interest in the day, and Dr Duncan To summarise, the trainee bonding day was Wood for help with the overall organisation and for designed to give new Part I trainees insight into the running the afternoon session. I would also like to training pathway, share training practices from centre thank Dr Mohamed Mirghany and Mr Dominic Nolan to centre as well as sharing experiences between for their involvement in organising all aspects of the trainees (i.e. start writing your portfolio NOW!). On day and Dr Francis Gibbons for his help with the this basis I think it proved to be a huge success. I know morning session. I

A RADIOTHERAPY LEARNING EXPERIENCE: 9TH MAYNEORD–PHILLIPS SUMMER SCHOOL EVA RUTKOWSKA University of Liverpool MEKALA CHANDRASEKARAN Clatterbridge Centre for Oncology

ST EDMUND’S HALL, UNIVERSITY OF OXFORD 6th–10th July 2009

THE MAYNEORD–PHILLIPS SUMMER SCHOOL is a normal tissue complication probability models by John biennial residential course designed to accommodate a Fenwick. Catherine West (University of Manchester) small group of PhD students and medical physics pointed out the necessity to change the radiobiological researchers early in their career. This year’s school, the modelling framework to include the influence of first to focus on radiotherapy, was entitled ‘21st chemotherapy on local tumour control. Century Radiotherapy: State-of-the-art and Predicting On a different note, Alan McKenzie (Bristol the Future’ (see figure 1). Oncology Centre) presented practical principles for cost-benefit management of resources in the HIGHLIGHTS FROM DAYS 1 AND 2 radiotherapy department, with a judgment grown from The meeting began with a welcome and overview given much experience. by Colin Baker (University of Liverpool), the organiser of this year’s meeting. Next up was Steve Webb KNOWLEDGE UPDATE (Institute of Cancer Research, Royal Marsden NHS The third and fourth days covered a wide range of Foundation Trust, Sutton), who outlined the evolution stimulating topics. Marcel van Herk intriguingly of intensity-modulated radiation therapy and pointed illustrated the necessity to manage errors in out challenges encountered in radiotherapy that need to radiotherapy – both due to set-up inaccuracies and be addressed in the near future. organ motion – in order to ensure tumour coverage Two of these challenges, organ motion and target and sparing of critical structures. He also presented delineation, were discussed in detail later in the day, the possible solutions; for example, treatment planning on former by Dan Low (Washington University School of a CT series with the tumour in an average position Medicine, St Louis, MO, USA) who looked at 4D CT, over the breathing cycle, chosen from a 4D scan. and the latter by Marcel van Herk (Netherlands Cancer Similarly, Rock Mackie (University of Wisconsin, Institute, Amsterdam, The Netherlands) who Madison, WI, USA; TomoTherapy, Madison; figure 2) concentrated on different imaging modalities, image emphasised the importance of image guidance for registration and fusion. conformal treatments and explained the techniques of Lectures on the second day focused largely on tomotherapy. Mackie also presented details of a radiobiology, which kicked off with a talk on classical dielectric wall accelerator for proton therapy, which he radiobiology from John Fenwick (Clatterbridge Centre and his colleagues are currently developing. for Oncology, Wirral) and followed by Bleddyn Jones Those who thought boron neutron capture therapy (University of Oxford), who examined radiobiology for (BNCT) a thing of the past learned differently when neutrons, protons and light ions. Stuart Green (University of Birmingham) presented Afternoon sessions examined radiobiological new developments in this area. Green argued that modelling, currently a captivating research issue. BNCT is a modality that can bridge the visibility gap Tumour control probability models were reviewed by between chemotherapy and radiotherapy when it

Marco Carlone (University of Toronto, Canada) and comes to locally-spread disease. M

SCOPE | MARCH 2010 | 29 SCOPE | MEETING REPORTS M A taste of the future was provided by Rob Edgecock and which enabled the students to visualise their (Particle Physics Department, Rutherford Appleton research in a wider perspective, as well as gain greater Laboratory, Didcot) who talked about the fixed field understanding in related areas. alternating gradient accelerator, and David Neely The involved discussions that followed each lecture (Central Laser Facility, Rutherford Appleton were only too short, with most lecturers struggling to Laboratory) who discussed laser plasma-based fit what they wanted to say within their allocated time accelerators that could be used to accelerate many slot. However, most of the faculty stayed at the college different kinds of particles and deliver extremely high for the full week, providing a great opportunity for the dose rates. students to converse with them and gain feedback on On the concluding day of the school, Glenn Flux their own research. (Institute of Cancer Research, Royal Marsden NHS The school also included tutorial sessions, in which Foundation Trust, Sutton) provided an update on students were given the opportunity to present on their developments of dosimetry for radionuclide therapy. areas of research and receive feedback from other Markus Alber (University Clinic for Radiooncology, students and the teaching faculty. Tübingen, Germany) then spoke about physical and Inspiring lectures, discussions and the opportunity biological optimisation and presented a recipe for to meet other researchers are a great motivation as a quantifying intuitive dose–volume constraints for contrast to the often lonely every-day life of the PhD normal tissues. The influence of temporal modulation student (figure 3). As such, the next summer school in on treatment outcome was considered by John Fenwick, two years’ time is highly recommended to all. who is using delay differential equations to model the development of early complications during I The full programme from the 2009 Summer School, radiotherapy. including links to most of the presentations, is The summer school ended as it started, with a available on the Mayneord–Phillips Trust website at captivating lecture from Steve Webb, this time focusing www.m-pss.org. Details of previous Summer on the likely areas in which radiotherapy will develop Schools can also be found on the Mayneord–Phillips in the future. Trust site.

HIGHLY RECOMMENDED ABOUT THE AUTHORS The Mayneord–Phillips summer school delivered Eva Rutkowska and Mekala Chandrasekaran are PhD exactly what it promised: lectures encompassing the full students in radiotherapy physics at the University of range of radiotherapy, presented at just the right depth Liverpool and Clatterbridge Centre for Oncology. I

M FIGURE 1. Class of 2009.

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M FIGURE 2. Networking opportunity with Rock Mackie (second from right).

M FIGURE 3. Drinks reception at St Edmunds Hall.

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CODES OF PRACTICE STUDY DAY: REVIEW AND IMPLEMENTATION CHRIS HASLER The Beacon Centre, Musgrove Park Hospital, Taunton

NATIONAL PHYSICAL LABORATORY, TEDDINGTON 14th July 2009

THE PURPOSE OF THIS study day was to review the considerations and practical tips for performing MV dose theoretical background and practical implementation of measurements. the Radiotherapy Dosimetry Codes of Practice (CoP). The Russell Thomas (NPL) gave a very pragmatic talk on CoP recommends procedures both for measuring the important topic ‘Maintenance of secondary standard radiation output from a linac or 60Co unit, and also for and field instruments’. Delivered in his own inimitable calibrating field instruments using a secondary standard style, Russ began with the provocative declaration: This is calibrated by the National Physical Laboratory (NPL). without doubt the most important lecture that you will be given Hugo Palman (NPL) began the day with a useful during this course… you may be the best physicist in the world refresher on the theory, equations and symbols used in but if the equipment you are using does not work correctly then dosimetry. Subsequent talks alternated and contrasted the any measurements that you make will be worthless. perspectives of members of the NPL calibration service Based on years of work with the NPL calibration with those of clinical physicists responsible for service, his talk could have been sub-titled ‘Look after implementing kV photons, MV photons, electrons and your equipment and your equipment will look after you’, HDR brachytherapy in UK oncology departments. and featured many photographs, radiographs and stories Perhaps reflecting the dominant frequency of clinical of what happens if you don’t (figure 2). usage, one of the key presentations was ‘MV photon We all know that our measurement chambers and dosimetry in the clinic’ by Andrew Williams (Norfolk & dosemeters are crucial pieces of kit; expensive to Norwich University Hospital NHS Trust, Norwich). In his purchase, calibrate and commission, and fundamental to talk, he said the CoP tells us how and what to do, but not the QA chain in every radiotherapy department. Yet Russ who should do the calibration (figure 1), the level of shared many horror stories of equipment negligence experience required, when to do it or even to double- witnessed during hospital visits. check the results. He said the CoP does not even tell us to Russ even had a scare story for those of us who treat write down all the measurements! Guidance on these our equipment with paranoid reverence: ‘don’t forget matters is instead contained in IPEM 81. Dr Williams your phantom’. He said that although PFI contracts continued his witty presentation with important guarantee a dust-free environment during building work,

M FIGURE 1. Only one of these men could calibrate your linac (top: Albert Einstein, bottom: Andrew Williams).

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any dust that does escape (heaven forbid) will settle on their clinic. Only about two-thirds have adopted the 2003 every exposed surface. This includes any solid phantoms code with about one-third still using the 1996 code. left on a shelf and hence into the chamber insertion holes. Surprisingly, one centre is still using previous guidance, From there dust can enter the chamber’s vent hole and which stunned the speaker and the audience. impair function and reliability. In summary, more than 70 delegates from all over the Mark Bailey (NPL) delivered an interesting UK attended this very informative meeting. Alternating presentation on ‘Electron dosimetry at NPL’, referring to talks between the NPL staff and clinical physicists for each the advances made in the 2003 CoP compared to the 1996 modality was a very useful structure. Many in-depth code. In his talk, he discussed some of the subtleties and discussions ensued during the breaks between the complications of electron dosimetry. Near the end of his speakers and audience members. Armed with a deeper talk, Mark asked the audience which code they used in understanding of the codes, now is the time to practice. I

M FIGURE 2. Equipment negligence.

MEDICAL PHYSICS AND ENGINEERING CONFERENCE AZZAM TAKTAK Organising Committee Chair, Royal Liverpool University Hospital

LIVERPOOL 14th–16th September 2009

THE IPEM’S 15TH ANNUAL MEDICAL PHYSICS and city centre by coaches after a short tour of some of the Engineering Conference (MPEC) and AGM (figures 1 and historic sites of the city. Delegates were then free to 2) were held at Liverpool Hope University. Delegates were explore the city centre for few hours before being offered on-campus residences, right next to the lecture transferred back to the university campus. The theatres, and the refectory which was extremely conference dinner was held on Tuesday at the Liverpool advantageous considering the tight schedule of the Maritime Museum in the famous Albert Docks, and programme. Around 250 delegates attended this delegates got the chance to visit parts of the museum. conference over 3 days. There were 99 proffered papers, 15 The theme for the conference was cancer. The opening keynote lectures and 12 exhibitors. address was delivered by The Very Reverend Justin A buffet dinner was organised on the Sunday evening Welby (Dean of Liverpool) who talked about his at the venue itself. This provided a good opportunity to experience managing conflict and bringing hope in network and make new acquaintanceships. On the difficult situations, an aspect that most medical

Monday evening, delegates were transferred to Liverpool researchers are familiar with. This was M

SCOPE | MARCH 2010 | 33 SCOPE | MEETING REPORTS M followed by a keynote lecture from Derek Gould (Royal our understanding of subsequent papers involving this Liverpool University Hospital). Later on the same day, technique. Other optical topics included the metrology an eponymous lecture was sponsored by the Hospital of optical coherence tomography and a new use for Physicists Association and the speaker was Surgeon Raman spectroscopy which holds promise to solve the Rear Admiral Lionel Jarvis (Ministry of Defence) who technical problems encountered in endoscopic talked about globalisation and delivering medical care surveillance of the oesophagous. ‘Regulations and in the battle field. The Institute’s Woolmer memorial guidelines’ might be thought of as rather a dry topic lecture was in the afternoon on day 1 and the speaker but it was brought to life by our speakers. Tim was Martin Birchall (University College London), a Beaumont (Health and Safety Executive (HSE), Bootle) leading ENT surgeon, who talked about new challenges gave an overview of how the HSE develops its policies and new hopes in regenerative medicine. and guidance, especially with reference to the EMF and The Institute of Physics organised a small meeting Optical Radiation Directives which are due to be within this conference on novel imaging detectors with introduced in the UK. The next two papers dealt with five keynote lectures and six proffered papers. In a new surveys of occupational exposure to the radiations departure for the Institute, a public session organised by referred to in these directives. Sense about Science took place on day 2 (figures 3–5). Once my chairing duties were finished I could relax The topic was full-body MRI scanning. Speakers and appreciate the ‘wider dimension’, vividly included Stephen Keevil (Guy’s and St Thomas’ NHS illustrated in the eponymous lecture delivered by Foundation Trust, London), Laura Parkes (University of Surgeon Rear Admiral Lionel Jarvis entitled ‘The global Manchester), Michael Fitzpatrick (a GP from Hackney, use of medical devices in military scenarios’. I hardly London) and Peter Mace (BUPA Wellness), and was expected someone from the Assistant Chief of Defence followed by a panel debate with questions. Staff to say much about the technical aspects of these A number of teaching sessions were organised devices but he had a very well illustrated slide show including a scientific computing session on day 2 demonstrating the surprising extent to which the organised by the Informatics and Computing Special world’s population is concentrated in coastal areas and Interest Group, and a leadership session on day 3 which what might happen to this population if current was addressed by Sue Hill (Chief Scientific Officer, meteorological trends continue. Social and political Department of Health, London) and other leading instability are obvious military concerns. Switching figures. Also on day 3 was a special session on from possible scenarios to the present day, we were registration and CPD matters and speakers included shown slides of the field hospitals in Afghanistan and I Iain Chambers (James Cook University Hospital, was impressed by how well organised it seemed and Middlesbrough), myself and Justin McCarthy (ClinEng struck by how little we see of this in the press or on TV. Consulting Ltd, Cardiff). Other presentations which I enjoyed were about Personally, I found the whole experience of hosting survivorship in cancer and a public session on MRI. this event extremely enjoyable and worthwhile, Survivorship is concerned with ‘Living with, or although it was hard work at times and not without beyond, cancer’ according to Nicola Cook (Macmillan some last minutes hiccups which (hopefully) went Cancer Support, London), who explained how this unnoticed. I would like to express my sincere thanks to affects the two million people in the UK currently the support from the IPEM office personnel and living with cancer and the financial and emotional members of the Science Board and organising issues they face. Originally Macmillan was associated committee who helped with the programme. with palliative care but now wishes its 4,000 Here are some reports from delegates and session professionals (50 per cent nurses, 50 per cent therapists organisers related to sessions that they attended. etc.) to be better known for their supportive work. The public session sponsored by Sense about Science MICHAEL LYNN (FORMER UNIR SIG CHAIR, was a new venture for IPEM. There were three ROYAL BERKSHIRE NHS FT, READING) presentations on MRI followed by a panel discussion I was fortunate to be able to attend all 3 days of the and debate. The principles of MRI and the importance conference. I expected it to be a great opportunity for of functional MRI were explained at the right level for a networking (which it was) and hopefully to attend public session, appropriately illustrated with slides. interesting scientific presentations. The opening speech This was followed by a personal view from Michael on the first morning set the scene with a thought- Fitzpatrick, a GP from Hackney, who also contributes provoking address by the Dean of Liverpool, the host to medical journals. He spoke fluently, eloquently and city. The Very Reverend Justin Welby described his work entertainingly without slides, only pausing when he in Africa before taking up his present incumbency and made the best (entirely unintentional!) joke of the encouraged us to apply our efforts in physics and conference. He had been in full flow about the demand engineering for the greater good. The Woolmer Lecture for screening for all sorts of conditions when he continued this theme with practical examples from declared: ‘It now seems to me that screening for regenerative medicine, presented by Martin Birchall. prostate cancer is being introduced by the back door’. The scientific sessions then got under way. I had the When his audience recovered he carried on unabashed. pleasure to jointly chair two of these sessions, in It was a really impressive performance. ‘Optical measurement’ and ‘Regulations and Another innovation was the three sessions on guidelines’, both of which were very well attended. The ‘Leadership and innovation’ with views from within audience for ‘Optical measurement’ was firstly given a and outside of the NHS. Some had heard it all before review of photoplethysmography by John Allen but I think the majority of attendees benefited. (Freeman Hospital, Newcastle upon Tyne) which helped I look forward to MPEC 2010.

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M FIGURE 1. [TOP LEFT] Dr Diane Crawford at the AGM.

M FIGURE 2. [TOP RIGHT] Dr Chris Gibson’s first address as an IPEM President during the AGM.

M FIGURE 3. [MIDDLE LEFT] Dr Michael Fitzpatrick, GP, at the public session.

M FIGURE 4. [MIDDLE RIGHT] Dr Peter Mace, BUPA, at the public session.

M FIGURE 5. The public session panel. From left to right: Dr Peter Mace, Dr Laura Parkes, Dr Stephen Keevil and Dr Michael Fitzpatrick. M

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M LEADERSHIP AND INNOVATION SESSIONS: capacity to adopt. He discussed how knowledge plays an STEVE LAKE (ROYAL LIVERPOOL UNIVERSITY important part in disseminating and adopting innovation HOSPITAL) and made recommendations on what Trusts can do to The leadership sessions were opened by Keith Ison who take advantage of innovation in the future. invited Sue Hill to give the first keynote lecture. Professor Hill discussed the QIPP (quality, innovation, JOHN PICKETT (FORMER PMSIG CHAIR) productivity and prevention) agenda and set out the The session on optical measurements kicked off with a importance of physical sciences to the future of comprehensive review of the clinical applications of healthcare. Clinical leadership was discussed along with photoplethysmography from John Allen. Following on how managerial and clinical priorities need to be from this, he went on to describe work investigating the addressed. The responses received to Modernising use of photoplethysmography to assess coronary heart Scientific Careers were discussed including how disease by examining the reactive hyperaemia response. disappointing it was to find that the patient was The third presentation, from Jonathan Ashmore (Barts mentioned so little. It was noted that a great many of the and The London NHS Trust, London), addressed the use responses had been inwardly focused on departmental of continuous arteriovenous oximetry to examine the staffing rather than outwardly on how departments ‘fit reactive hyperaemia response in patients undergoing in’ with the rest of healthcare. cardiopulmonary bypass surgery. Catherine Kendall The next keynote speaker was Beverly Alimo- (Gloucestershire Hospitals NHS Foundation Trust, Metcalfe (Bradford University School of Management, Gloucester) outlined the development and assessment of Bradford) who gave a lively talk on what a new Raman probe for use in endoscopic assessment of transformational leadership is about and why it is oesophageal disease. This in vitro work demonstrated the needed. Gone are the days of ‘Rambo in pinstripes’ and potential of the system to acquire useful spectra in a incoming are requirements to invest in staff. Professor clinically practical timeframe. Peter Tomlins (National Alimo-Metcalfe states how the private sector is better at Physical Laboratory, Teddington) then described the the ‘soft stuff’ but notes we are a caring profession. We development of test phantoms to determine the should be better at celebrating our achievements. Job sensitivity, resolution and contrast of optical coherence satisfaction can lead to motivation, commitment and tomography instruments, before Michelle Hickey (City then ‘engagement’ which are described as the new University, London) presented preliminary targets for transformational leaders. Are the new measurements using a new fibre-optic sensor to collect competency frameworks relevant to the NHS of photoplethysmographic signals from human splanchnic tomorrow? Professor Alimo-Metcalfe presented results organs. from the largest leadership survey carried out in the Ian McCarthy (Royal National Orthopaedic Hospital, NHS and discussed the links between leadership, Stanmore) opened the physiological measurement effectiveness and wellbeing. session, describing the measurement of regenerate bone The second leadership session was chaired by Liz stiffness in distraction osteogenesis of the tibia. Two Dymond (North Bristol NHS Trust, Bristol) who invited presentations from City University, London, then Geoff Meads (University of Warwick, Coventry) to give followed; Shafique Muhammad on the design of a new a keynote lecture on ‘Inter-professional collaboration’. trans-reflectance photoplethysmograph probe and Professor Meads discussed the various relationships Kamran Shafqat on wavelet analysis of heart rate formed during work within our profession, with other variability. David Simpson (University of Southampton) professionals, government, the public and the patient. described a novel test for the detection of auditory How the understanding of participation had changed in brainstem evoked potentials, with the potential for the new NHS to become more collaborative was reducing the number of stimulations required to detect explained. A revealing exercise was carried out by the evoked potential and hence reduce the examination surveying what kind of team members of the audience time. The clinical evaluation of a new subcutaneous perceived they operated in, drawing on models from the cardioverter defibrillator was the subject of the next sporting world of cricket, soccer, tennis, rugby and presentation, from Stephen O’Connor (Cameron Health, basketball. Professor Meads discussed how working in San Clemente, CA, USA), and the session was rounded teams gave a ‘collaborative advantage’ along with off by a paper from Hazel Boyd (Bath Institute of examples of where this had significantly improved Medical Engineering, Bath) detailing a potential performance. We were finally left with the advice that assessment technique for identifying elderly people at going solo is no longer an option, being interprofessional risk of suffering falls. is being professional, engaging in policy development, negotiating a shared learning approach in the public APEN SESSIONS AND ACTIVITIES interest and trading for real reciprocal patient exchange. Rosemary Eaton (Guy’s & St Thomas’ Hospitals, London) The final leadership session was chaired by Steve Sarah Higgins (University Hospitals Coventry and Lake (Royal Liverpool University Hospital) who invited Warwickshire, Coventry) Alastair Mitchell-Baker (Tricordant Ltd, Worcester) to Nicola Kent (Newcastle General Hospital, Newcastle) give a keynote lecture on ‘Innovation in the NHS’. Alan McWilliam (Christie Hospital, Manchester) Alastair focused his talk on the adoption stage of the The aim of the three ‘trainee sessions’ was to provide a innovation life-cycle. The myriad of organisations forum for trainees to present work carried out during involved in supporting innovation were explored along their placements or MSc to an audience of peers, in a with the need for a map to guide which to use and friendly and non-threatening environment. All of the when. Alastair concluded by looking at the barriers to talks were of a high standard, in both quality of research adoption and how organisations can increase their and quality of presentation.

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The first trainee session covered various topics in department that have opportunity to carry out much- engineering and MRI. Talks of particular note include a needed development work to commission new description of measurements of fat and muscle volumes techniques and equipment. There was a particularly by MRI in the legs of ambulant spastic cerebral palsy enthusiastic and supportive audience at all three sufferers from Andrew Lewis (King’s College Hospital sessions, who were keen to hear what trainees in their [KCH], London). The realisation that patients may have own and other centres had been doing. high levels of fat could lead to changes in physiotherapy There were many stalls to visit at the MPEC, treatment. Robert Batty (Salisbury District Hospital) including one run by the Associate Physicists and described a technique for deducing foot orientation by Engineers Network (APEN). The APEN stall provided using data collected by a force-measuring device in the trainees with a chance to meet some of the APEN panel, shoe. This has applications for those suffering from drop and ask them any questions they had about the training foot, where data could be fed back to control a scheme. There were also sample portfolios from functional electrical simulation device. In the final talk of previous trainees to browse through. These proved to be the session Stephen Wastling (KCH) described the need particularly popular, as they demonstrated the typical to rotate the b-matrix during the reconstruction of layout and content of a portfolio and provided diffusion tensor MRI images, if there has been reassurance to a number of tense trainees. significant movement of the head during scanning. On Monday evening the APEN panel invited all All presentations in the second session were about trainees to join them at La Tasca for a tapas meal. There projects carried out as part of radiotherapy training was an amazing turnout, as 80 people descended on the placements. The topics covered included the restaurant to enjoy a night of Spanish food and a glass of development of planning techniques for the breast wine (or two!). It was a great opportunity to meet other (Justine Calvert (KCH)) and the lung (Carolyn Furlong trainees, and relax after a long day of talks. (Royal Liverpool University Hospital)). There were three talks on brachytherapy: optimising the fractionation COMPUTING TRAINING SESSIONS schedule of an HDR brachytherapy treatment using Ed McDonagh (Former ICSIG Chair) radiobiological modelling (Tracey Underwood (KCH)); Dom Withers (Current ICSIG Chair) commissioning a 3D image-guided brachytherapy David Carpenter (Former ICSIG Secretary) procedure (Joanna Barraclough (Addenbrooke’s In an innovative session for the annual IPEM conference, Hospital, Cambridge), and the dosimetric analysis of the Informatics and Computing Special Interest Group prostate I-125 brachytherapy plans which resulted in of the IPEM ran a series of hands-on sessions in the urethral strictures (James Earley (Royal Surrey County university’s computing lab, where the delegates were Hospital, Guildford). There was just one talk on able to try out the various software and techniques that radiotherapy equipment by Alan McWilliam (Christie were being discussed. The need for such training was NHS Foundation Trust, Manchester) which described a highlighted by the range of delegates who signed up: project looking at optimising MLC calibration to ensure attendees ranged from Part I trainees to Band 8c the accuracy of head and neck IMRT delivery. A more physicists and engineers. unusual project on the effect of irradiation on bovine The day started with ‘Departmental intranet pericardium tissue was presented by Elaine Woods applications using a wiki’, where the delegates were (Royal Free Hampstead NHS Trust, London). A scanning shown how to make use of a pre-configured wiki for electron microscope was used to look at the nano- various tasks that they could then take away to use in structure, and mechanical testing was also carried out. their departments by use of a virtual machine. This was The first half of the final session was focused on followed by a session on ‘Automated image analysis for nuclear medicine, with talks describing left ventricular QA’, with the delegates being shown how to use the ejection fraction in PET/CT (Matthew Gray (University IQWorks package for various QA tasks. Due to the College Hospital, London)) and comparison of nature of the session, the delegates could direct the SPECT/CT reconstruction techniques (Jennifer Gregson subject matter to the types of analysis they needed. (Royal Liverpool University Hospital)). An interesting A session on ‘Networking’ took the delegates through talk by Bruno Rojas Fisher (University College the basics and some more advanced concepts in Hospital) on small angle x-ray scattering system for networking, using the computers in the lab to try out characterising various samples bridged the gap to a some of the trouble-shooting techniques being taught. selection of magnetic resonance imaging presentations. This was followed by a session concentrating on The session was finished with a complete change of ‘DICOM’, extending the networking trouble-shooting subject with a radiotherapy talk by Rachel Hollingdale skills learnt in the session before to DICOM networking, (Guy’s and St Thomas’ NHS Foundation Trust, London) as well as teaching more about the principles and comparing ionisation chambers and TLDs for measuring terminology that is required. After lunch the session small field output factors. These talks sparked probing ‘Tools and teamwork for higher quality programs’ questions from the audience with debates that promised demonstrated an entire tool chain to aid the creation of to continue after the session had finished. high-quality software through the entire project life- The wide variety of presentations in the trainee cycle. Finally, there was an ‘Open session’ where sessions highlights the true breadth of our field. No delegates were able to discuss topics of particular other sessions had this diversity and this is where the interest, with demonstrations individually or in small real strength of the trainee sessions lies. The sessions groups. The sessions were all well attended, and because also showcased the fantastic work that trainees are the software used in the sessions was open source involved in and the contribution that they make to the software, it could either be taken away on CD or subject. For example, it is often the trainees within a downloaded from the internet. I

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INTERNATIONAL CONTINENCE SOCIETY MEETING, ICS2009 BECKY CLARKSON Freeman Hospital, Newcastle-upon-Tyne

SAN FRANCISCO, USA 29th September – 3rd October 2009

THE INTERNATIONAL CONTINENCE SOCIETY (ICS) image that adorned the lecterns in front of many speakers is an international membership society for medical at the meeting! The week consisted of 2 days of professionals concerned with furthering education, educational courses and workshops and 3 days for the scientific research, clinical practice and removing the scientific programme – in total 284 presentations from stigma of incontinence. Each year, their annual conference centres around the world. The topics ranged from brings together eminent professionals from a variety of pregnancy and childbirth to basic pharmacology and backgrounds, both medical and scientific, to discuss key from quality of life to neurourology, in as many as four issues regarding both urinary and faecal disorders and concurrent sessions. how to improve and sustain patients’ care and quality of My first task, after overcoming jet-lag and finding the life. I am currently coming towards the end of a PhD in correct building in the sprawling Moscone Center, was to bladder contractility within Freeman Hospital Medical be chief note-taker in the workshop entitled ‘Urodynamic Physics department. This year, being my last, I submitted equipment – limitations and challenges’, hosted by two abstracts which were accepted as a discussion poster Andrew Gammie (Bristol Urological Institute). The (poster display plus short presentation) and a non- webcast of this session, along with many others, is discussion poster. available at http://webcasts.prous.com/ICS2009. The I was lucky enough to be granted an IPEM travel aim of this gathering was to bring together clinicians, award which allowed me to jet off to the much sunnier researchers and manufacturers to provoke discussion on climes of San Francisco in late September (figure 1). I was the shortcomings and requirements of urodynamic thrilled to hear that this time of year had the lowest equipment, and the need for guidelines and standards. chance of fog and was therefore able to take numerous The range of people attending the meeting made for photos of the fabled Golden Gate Bridge (figure 2). These, interesting discussion and highlighted the differing in my humble opinion, much outdid the rather gloomy opinions of clinicians, manufacturers and researchers, and

M FIGURE 1. San Francisco tram and the Star Trek building!

38 | MARCH 2010 | SCOPE MEETING REPORTS | SCOPE

M FIGURE 2. The Golden Gate Bridge.

M FIGURE 3. City Hall. M

SCOPE | MARCH 2010 | 39 SCOPE | MEETING REPORTS M also the fundamental differences between healthcare chairs were provided in the venue, except in meeting systems. Most were in agreement that there should be rooms, the main hall was not the flurry of discussion, standards and guidelines in place for urodynamic chatting and networking that it has been in the past. equipment and tests, but the main issues are who will Among the sea of landscape A0s was my non- implement them and how they will be enforced. discussion poster (figure 4), which tested Derek Currently, only when these are enforced will this market Griffiths’ (University of Pittsburgh, PA, USA) theoretical pull encourage manufacturers to comply, so it is bladder models using a penile cuff to gradually reduce important to ensure all parties have a say. The financial flow. Unfortunately, it did not attract the attention of the aspect of imposing these standards also provoked debate, man himself – he was unable to make it – but I was with particular reference to the US healthcare system, but sought out by one reader for discussion, and so I with increasing relevance to the system in the UK. presumed that there must have been many more who had Despite the equipment focus of the workshop, it was similarly enjoyed the read! evident that one of the main issues is standardisation of A number of ‘state of the art’ lectures peppered the training of those carrying out urodynamics. conference, with guest speakers invited to give 30 minute After the workshops and educational courses had talks on topics judged to be ‘à la mode’. The first was an finished, a welcome reception was held to mark the interesting update on imaging and modelling of the beginning of the meeting proper. It was held in the regal pelvic floor by John DeLancey (University of Michigan, San Francisco City Hall (reminiscent of 17th-century MI, USA). He spoke about methods to determine the French architecture yet built in 1915, figure 3) with a structural deficiency in the pelvic floor which cause range of buffet contents chosen to represent the city’s prolapse, and presented a 3D finite element model of the inhabitants. Although the sushi appeared to be anterior vaginal wall, and the addition of other structures approached with some caution, the wine was enjoyed by to model and simulate prolapse under increasing most, and the event proved a good opportunity to make abdominal pressure. This aids identification of the cause new contacts and catch up with older ones. of pelvic organ prolapse. A lecture by Jack Winters (New The scientific programme kicked off the following day, Orleans, USA) picked up on the hot topic from the back at Moscone West, with the opening ceremony. The workshop I had attended, describing education and main hall consisted of a display of just shy of 600 posters training of urodynamics studies. He too supported to keep us occupied during coffee breaks, along with a comprehensive training, and suggested using a number of stalls from equipment manufacturers and standardised, interactive multimedia course, and pharmaceutical companies showcasing their wares and subsequent proficiency testing of those carrying out playing rather graphic videos of surgical techniques to urodynamic tests. How this training and standardisation unsuspecting lunchers! Unfortunately, as no tables or may be implemented was not discussed. Kate Lloyd

M FIGURE 4. Experimental and theoretical bladder output relation.

40 | MARCH 2010 | SCOPE MEETING REPORTS | SCOPE

M FIGURE 5. My presentation.

M FIGURE 6. The first method of continuous and non-invasive bladder pressure measurement. M

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M (pharmaceutical consultant, UK) raised a number of often the case in these sessions. Any discussions of interesting points about the relationship between interest could easily be revived after the session. healthcare professionals and the pharmaceutical industry, By far the most nerve racking was the last session: specifically with regard to education. She discussed the urodynamic techniques and bladder outlet obstruction. impact of the RCP working party suggestion to wean Chaired by Werner Schaefer (University of Pittsburgh), doctors off training support from the pharmaceutical and at the last minute Clive Griffiths (Newcastle industry, and its effect on industry funding. Her University), this was to be the stage for my 2 whole interactive show of delegates attending with no influence minutes of fame, the culmination of my 3 years of PhD from pharmaceutical funding was interesting – those left work (figure 5). I took my post (figure 6) and answered standing were few! She described the mistrust of some initial questions before the session began, then sat industry’s influence, and predicted that change would be nervously on the front row to wait my turn. I barely had a slow process but the relationship would eventually time to draw breath before my 5 minutes on the podium become more productive. was over! The audience had been kind, projecting I mostly attended the sessions with presentations in interest and asking good, but not difficult, questions. neurourology, gerontology and benign prostatic I had presented what I billed as ‘The first method of hypertrophy, as this is where my interests lie. The continuously and non-invasively measuring bladder neurourology sessions included stressing of rats to assess pressure’. As part of my PhD work I have been testing a changes in bladder behaviour, pudendal versus sacral new device which uses an inflatable penile cuff in men nerve stimulation, the effect of botox on neurogenic to restrict urine flow to a constant low rate. At this detrusor overactivity and the effect of prostate size on meeting I presented the practical work I had done to urodynamic results. The prize for best clinical abstract support our hypothesis that, when controlling the was split between two in the neurourology category, pressure in the cuff to keep the flow at a constant rate, using functional MRI studies to map the brain responses the pressure in the cuff should be equal to the pressure to bladder filling in women with urinary retention and in in the bladder, thus being a measurement of bladder patients with urge urinary incontinence. Both were pressure. By performing this technique on men who interesting, well presented and provoked some discussion were having simultaneous invasive bladder pressure in the meeting hall. The poster presentation sessions were measurements made, this hypothesis could be tested. An somewhat frenzied, with 2-minute speeches which example is shown (figure 7) with cuff pressure in red, inevitably overran, and 3-minute question slots which following the invasively measured vesical pressure in sometimes culminated in a battle of wills between the blue. The corresponding flow trace is shown in green chairperson and the questioner. However, the nature of and the root mean square difference between the two the presentations allowed the listener to gain an overview measurements during controlled flow was less than of a number of different research projects without being 5cmH2O. I found that in a number of men this technique lost in the fine detail, and thus these sessions were ideal worked extremely well, and used the initial study to for delegates sampling a slightly foreign subject, as is suggest ways that the technique could be improved. The

M FIGURE 7. Example result.

42 | MARCH 2010 | SCOPE work was received well and I got some encouraging

M FIGURE 8. Big Sur, the comments after the session. southern I left the lecture hall and breathed a sigh of relief. I Californian coast. walked out of the Moscone Center and hit the road, poster tube in hand (Bazooka? Tube of Smarties? It seems airport security has gained a sense of humour!), to explore the delights of southern California (figure 8). I’d like to thank IPEM for giving me the chance to travel to this immensely useful conference. I’d also like to thank my supervisory team: Clive Griffiths, Rob Pickard, Michael Drinnan and Frank McArdle for their support and encouragement, and Wendy Robson for the hours she’s spent helping me get my data, without which there would be no poster or presentation! I 48TH PARTICLE THERAPY CO- OPERATIVE GROUP MEETING DANIEL KIRBY Medical Physics, University of Birmingham

HEIDELBERG 28th September – 3rd October 2009

THE END OF SEPTEMBER saw the 48th meeting of the Germany) (figure 2). They reiterated that while carbon Particle Therapy Co-Operative Group (PTCOG), in the ions and protons behave similarly in patients, they vary historical university town of Heidelberg, Germany (figure greatly in their relative biological effect (RBE) and 1). This year’s meeting drew around 700 medical accounting for this when planning with carbon ions is physicists, oncologists, students and researchers and the much more complex than for protons where the RBE is rapid growth of its members mirrors that of the ion beam assumed to be constant with depth. Dr Scholz described therapy (IBT) modality itself. The congress was split into a how RBE for carbons is highly dependent on energy, LET 2½-day educational session and a 3-day scientific session, (linear energy transfer), dose per fraction, cell type and and included a welcome party, conference meal at the biological end-point, and introduced the local effect Heidelberg Castle and a tour of the new Heidelberg Ion model (LEM) which HIT has adopted for carbon ion Therapy (HIT) centre in all of its 600-ton, ion gantry treatment planning (figure 3). Later that morning, Thilo splendour. I felt honoured to be accepted for a poster Elsässer (GSI, Darmstadt, Germany) elaborated on the presentation, and was fortunate to receive a bursary award LEM and how it is based on the premise that the local from IPEM to help fund my attendance. effect due to ions is the same as that of photons, because the majority of damage is still carried about by secondary EDUCATIONAL SESSION (PHYSICS/BIOLOGY) electrons (or δ-rays). He ended by saying that the latest The session was structured with physics and biology talks version (IV) of the LEM is in preparation for publication. in the mornings and clinical talks in the afternoons. Marco Treatment planning techniques were a recurrent theme Schippers (Paul Scherrer Institut, Swizterland) and (and also later in the scientific session), as well as how to Thomas Haberer (HIT, Germany) presented the relative cope with range uncertainties and inter- and intra- merits and limitations of using cyclotrons or synchrotrons fractional motion. Tony Lomax (Paul Scherrer Institut, for producing a clinical ion beam. Cyclotrons offer a Switzerland) described several different scanning beam smaller footprint and a continuous, fixed-energy beam algorithms for achieving highly conformal proton which has to be degraded mechanically, while therapy: optimisation of each treatment field (single-field synchrotrons can vary energy between ‘spills’ to give the uniform dose), distal edge tracking, and optimisation of exact penetration required, but the beam is highly pulsed. all Bragg peaks from all directions, all of which gave Markus Roth (GSI, Darmstadt, Germany) then described identical final plans. Professor Lomax went on to show new accelerator concepts like the dielectric wall that introducing deliberate range variations into these accelerator, and in more detail the idea of laser-plasma plans resulted in very different dose–volume histograms acceleration, which is in the relatively early stages of for each algorithm, with varying degrees of overdosing investigation by many (highly competitive!) research to organs at risk. By choosing the most robust plan, groups around the world. I found this particularly of misplaced dose due to movement could be significantly interest, as my PhD research is part of the UK laser-ion reduced. research consortium Laser Induced Beams of Radiation Christoph Bert (GSI, Darmstadt, Germany) also and their Applications (LIBRA) and it was interesting to discussed the well-known interplay effect with scanned see how other groups were progressing. beams and organ motion, which results in a ‘patchy’ dose Tuesday morning started with an overview of field with hot and cold spots in the tumour. He also radiobiology from Michael Scholz (GSI, Darmstadt, explained the concept of an internal target volume (ITV) Germany) and its clinical implementation from Peter used by many radiotherapy departments to incorporate

Peschke (German Cancer Research Center, Heidelberg, the changing clinical target volume (CTV) at M

SCOPE | MARCH 2010 | 43 SCOPE | MEETING REPORTS

M different points of motion, but illustrated how that didn’t Professor Tsuji also said that the low α/β ratio for solve the problem for scanned beams. His suggested prostates means it can be safely treated with a very short solutions were fast rescanning (around 15 times), beam course, and that 51.6 GyE in 12 fractions had been found gating and increased pencil beam overlap. to have the best anti-tumour effect with least toxicity.

EDUCATIONAL SESSION (CLINICAL) SCIENTIFIC SESSION Of interest in the clinical session were the talks given by On Thursday, the session began with six talks from Jean-Louis Habrand (Centre de Protonthérapie d’Orsay, centres in Houston, Boston, Jacksonville, Loma Linda (all France) and Stephanie Combs (University of Heidelberg, USA), Heidelberg and Chiba (Japan), each outlining their Germany) on paediatric malignancies. Professor Habrand experiences and perspectives on particle therapy. To noted that tumours in children are quite different to those summarise this session briefly, Al Smith (MD Anderson, of adults, and there is an even higher emphasis on quickly Houston, USA) explained that their centre was slightly responding with treatment and keeping integral dose to isolated with it being ¾ mile from the hospital. This normal tissues as low as possible. His view was that the perhaps explained the surprising statistic that 69 per cent role of protons should be mainly to escalate doses of of their patients are self/directly referred to them, with selected radio- and chemo-resistant tumours and to just the remaining 31 per cent coming from the hospital. improve quality of life, and highlighted the importance of Hirohiko Tsuji (NIRS, Chiba, Japan) reiterated their spot scanning to reduce secondary cancer probability Dr strategy of hypofractionation, which enabled a much Combs focused on the applicability of carbon ions, noting lower cost per treatment, putting the cost on a par with that generally they are not talked about in conjunction surgery and chemotherapy. He also mentioned the plans 1 with treating children. She showed many cases of children at Gunma University to develop a compact accelerator, ⁄3 whose faces had grown asymmetrically in the years the size of the HIMAC accelerator used at NIRS. Jürgen following conventional treatment. She identified Debus (HIT, Germany) enthusiastically stated the chordomas, low grade chondrosarcomas and intention at Heidelberg to use their new multiple-ion osteosarcomas as possible carbon ion candidates and gantry to do the first blind-patient phase I and II trials of presented excellent results of 94 per cent local control in 5 protons versus carbon ions, using the same standards and years for skull base osteosarcoma, with excellent cosmetic beam delivery techniques. This will be of particular outcome on the longest followed-up patient. importance to the future of both treatment modalities. Hirohiko Tsuji (National Institute of Radiological For much of the day onwards, clinical and physics Sciences, Chiba, Japan) presented clinical data of workshop sessions were run in parallel. Being primarily a hypofractionation with carbon ions. He described how physicist, I attended the latter in the very ornate giving larger dose per fractions can actually improve the Chambermusic Hall on the 2nd floor. Marco Pullia (Pavia, therapeutic ratio, and gave examples of excellent local Italy) gave some interesting and innovative proposals for control of hepatocellular carcinoma with treatment improving ion gantries, among them: rotating only 180° regimes between 32–39 GyE in just two fractions. instead of 360°, along with a rotatable couch to reduce

M FIGURE 1. The Heidelberg Convention Centre.

44 | MARCH 2010 | SCOPE MEETING REPORTS | SCOPE

room size; field patching, by moving the couch to fill the display, no more than 1½ hours (including lunch) was whole field which reduces the bending magnet aperture; dedicated to viewing with authors present. The afternoon having a mobile rather than fixed iso-centre thus reducing was full of intensive clinical talks, and so I took the the radius of the gantry, and even going as far as moving opportunity for a break from the conference in order to see the patient between floors! the sights of Heidelberg. The views from the castle grounds Friday morning began with a split session regarding and platform that straddles the Neckar river were fantastic, image-guided proton therapy (IGPT), with talks first on and it was well worth the visit. Heidelberg also has many inter-fractional and then intra-fractional motion. Håkan interesting old university buildings, amongst which is the Nyström (Skandion Clinic, Uppsala, Sweden) stressed that student prison, a two-storey house used to detain students for protons, the lung problem is not solved by selecting for usually minor infringements. Over the centuries, the non-moving tumours, changing margins, audio coaching walls (and ceilings!) have become completely covered in and not even 4D CT as taking an average breathing pattern artwork and scribblings, usually involving the names and on one or two occasions is not good enough. Instead, he silhouette impressions of those who served time there. In suggested a combination of repeated (possibly daily) more recent times, it was regarded as almost a rite of imaging, adaptive planning, advanced audio-visual passage to spend time there whilst studying. coaching, gating (or breath holding) and possibly even Saturday started with more clinical talks on brain and apnea during anaesthesia. Marcel van Herck (Netherlands skull base tumours, followed by ‘free communication’ Cancer Institute, Amsterdam, Netherlands) followed this sessions. Herman Suit (Massachusetts General Hospital, by outlining correction concepts for motion. He warned of Boston, US) aired his strong desire for phase III trials to baseline shifts between fractions, and suggested a path for compare protons with carbon ions, by keeping variables adaptive RT: starting with a conventional 10 mm plan for 5 such as fractionation and delivery equipment the same, days with cone beam CT carried out daily, then replanning and investigating others such as the effect of different LET every week with a 7 mm margin. His future vision for from the two ion species. His talk on the whole was quite optimal procedures was to combine on-line shift corrections profound and his message clear – that we need to be with off-line replanning, and he noted that protons require guided not by what we think, but by what we know from larger margins for movement than x-rays and electrons as clinical data. their shallower lateral dose fall-off is more forgiving. Marc Münter (HIT, Germany) presented some results on Lunchtime saw the opportunity for poster viewing combining ~ 56 Gy IMRT with a 20 GyE carbon ion boost (figure 4), and after quickly downing my food I tethered for inoperable adenoid cystic carcinomas, namely acute myself to my poster entitled ‘GafChromic film spectroscopy toxicity at the grade III level in only a small minority of of a laser-proton source’. With laser-plasma acceleration patients, with the rest experiencing a more tolerable grade being one of the exciting fields of physics research talked II or lower and no incidence whatsoever of grade III or IV about at this meeting, I wasn’t short of interest and had late toxicities. His future proposals included weighting several fruitful discussions mainly with other physicists. It more of the dose towards carbon ions, and also combining

was unfortunate however that with over 150 posters on the chemotherapy agent Erbitux®. M

M FIGURE 2. Radiobiology experiments with laser accelerated particles.

SCOPE | MARCH 2010 | 45 SCOPE | MEETING REPORTS M M FIGURE 3. The Heidelberg ion therapy gantry. M On a different topic, Stefan Schmidt (ACCEL, Bergisch FIGURE 4. Gladbach, Germany) discussed technical commissioning Poster being a cost driver in particle therapy and related to his presentation. experience at the new Rinecker Proton Therapy Centre (RPTC) coming online in Munich. He pointed out that with 20 different energy steps between 70 and 250 MeV, 24 gantry angles and two spot sizes, the number of sample points grows to around 1,000 before you even include range shifters and/or ripple filters. This led to his notion that the developing of automation is critical to capping the cost of commissioning, and one example of this at RPTC is a new amorphous silicon panel detector, which feeds a 20 Hz data stream directly into a database while the computer controls the beam and gantry. After the lunch break, the topic once again focused on IMPT and treatment planning issues. Tony Lomax added to his earlier contributions by showing a humorous but in fact important case of ‘the wrong underwear’ – two scans of the same patient on different days revealed that wearing much tighter underwear (or trousers) can have a Hownsfield units to tissue composition and density. He significant impact on the path-length in the patient to the indicated that the latter is more important to get right as tumour site, giving rise to yet another source of proton the stopping powers are more sensitive to changes in range uncertainty. density, and he described the benefits of using a dual Towards the end of the session, Katia Parodi (HIT, energy CT system to separate information about density Germany) and Frank Verhaegen (Maastricht University, from atomic number. Netherlands) presented the role and obstacles of Monte The closing remarks followed the end of the session, Carlo treatment planning (MCTP) for particle therapy. Dr after which the new PTCOG president, Dr Alejandro Parodi emphasised the ability of MCTP to fully simulate Mazal thanked Dr Debus and Dr Combs in particular for nuclear fragments in carbon ion beams, and showed all their hard work in coordinating the conference, which excellent agreement between depth dose curves with the was a great success. As well as the highly informative FLUKA code and a standard treatment planning system talks, I had the opportunity to talk to many other people (TPS) after tweaking the I-value for water in FLUKA to in the field of particle therapy and establish some new match the range given by the TPS. Dr Verhaegen focused research contacts. I would like to sincerely thank IPEM, on the method of importing CT data into a Monte Carlo the Institute of Physics, and the LIBRA consortium for simulation – essentially a problem of going from funding my costs for this meeting. I

46 | MARCH 2010 | SCOPE PRESIDENT’S LETTER | SCOPE

PRODUCING THE RIGHT RESULTS

cience lies at the heart of organisation of scientific meetings, past is a near guarantee of missed all the many and both the programme of individual opportunities and declining activity. diverse activities which specialist meetings and also our Formulating a strategy is not a well- are undertaken by IPEM contributions to major national events defined process, it is necessarily members. It is all too such as UKRC, UKRO, and especially abstract and imaginative rather than easy to overlook this, our annual Medical Physics and detailed and prescriptive. Some of the Swhen faced with economic pressures Engineering Conference (MPEC). themes which have already been (the recession, implications for public Planning for the next series of MPECs proposed for consideration include: sector spending, cost improvement Chris Gibson is well advanced, and we can look I What is our identity (professional programmes…) and operational President forward to collaboration with the UK body, learned society, or both)? pressures (18-week targets, research Bioengineering Society in I How might we support research assessment exercises, recruitment Nottingham in 2010, and the potential and innovation? difficulties…). It can be good to step for international collaboration with I How might we support and back, take a different perspective, and two Irish Societies and EFOMP in sustain training for scientists and reflect on the wider contributions 2011. Beyond that, IPEM has also technologists, given the likely made by scientists to healthcare. The been invited to host the International changes defined by Modernising Chief Scientific Officer’s annual Conference for Medical Physics in the Scientific Careers? conferences have now been running UK in 2013, as part of the celebration I How should we make best use of for 6 years, and have developed into of the 50th anniversary of the our financial reserves? just such an opportunity. During each founding of IOMP. This will be an I would encourage all IPEM of the last two conferences there were opportunity to bring a major members to take an active part in this clear messages, from both the Chief scientific meeting to the UK and also process, either through Regional Executive and the Medical Director of to strengthen the international Chairs, or specialist groups, or by the NHS, that science and innovation reputation of the Institute. direct comment to the IPEM office. are crucial to the success of healthcare Looking ahead over a 5-year Your input will ensure that a wide organisations, and that scientists have period, or even further, what lies in range of views are represented, and a key role in ensuring the quality of store for IPEM? Crystal ball gazing is the collective wisdom of IPEM services. Indeed, the NHS definition never easy, but changes will certainly members will give us the greatest of quality is that care should be happen, and history suggests that potential for insight and analysis. I ‘clinically effective, personal, and successful organisations are those cannot resist another quotation from safe’. All scientists will be able to which can adapt and develop. To Churchill, which seems to me contribute to the first and last of these help guide these developments, the particularly apt for physicists and dimensions, many will contribute to Trustees are currently reviewing the engineers: ‘However beautiful the all three, and this definition of quality IPEM strategy. Why do we need one? strategy, you should occasionally look maps readily onto the areas and ways Well, although we can be justly proud at the results’. It reminds us to apply in which IPEM members work. of the many achievements of the the same standards of empiricism The Healthcare Scientist Awards, Institute, historical momentum is a and evidential rigour to our instigated by Professor Sue Hill and poor strategic plan. To do in the professional activities as we do to our presented at the Chief Scientific future only what we have done in the scientific work. Officer’s Annual Conference, also provide an opportunity to recognise excellence in the different dimensions of scientific activity. It was particularly pleasing to see IPEM members so well represented amongst recent prizewinners. As well as the HCS awards for innovation (Professor Andy Beavis, Hull) and for research (Professor Nick Stone, Gloucester), Dr Alan Mackenzie (recently retired from Bristol) received a lifetime achievement award. All the winners, and indeed all those who

were nominated, have set standards of excellence which are an inspiration M IPEM COUNCIL 2009-2010: [Standing from left to right] Dr Chris Callicott, Mr Matthew Tallboys, Mr to us all. Geoff Cusick, Dr Liz Parvin, Mr Justin McCarthy, Ms Alyte Podvoiskis, Mr Paul Robbins, Professor Nick A major part of IPEM’s Stone, Professor Jeff Hand, Dr Steve Keevil, Dr Paul White, Mr Phil Harrison, Mr Alan Thompson. [Seated contribution to the development of from left to right] Ms Laura Sawyer, Dr Chris Gibson (President), Dr Peter Jarritt. The following members scientific excellence is the of Council are not on the photograph: Dr Neil Lewis, Dr Bill Vennart, Dr Liz Dymond, Dr Andy Nevill

SCOPE | MARCH 2010 | 03 COMMENT | SCOPE Scope is the quarterly Cancer Center, 1840 Old magazine of the Institute of Spanish Trail,Houston, Physics and Engineering in Texas 77054, U.S.A. Medicine T + 1 713 563 6894 IPEM Fairmount House, F + 1 713 563 1521 230 Tadcaster Road, E richamos@mdanderson. York, YO24 1ES org T 01904 610821 F 01904 612279 ART AND SCIENCE E [email protected] INTERNATIONAL EDITOR W www.ipem.ac.uk Ryan D. Lewis Department of Medical ou may not realise, but Scope Physics and Clinical is prepared several months EDITOR-IN-CHIEF Engineering, Abertawe Bro Marc E. Miquel Morgannwg University in advance. Hopefully this Department of Clinical NHS Trust, Singleton Physics, The Royal Hospital, Swansea, issue will greet you on a London Hospital, Wales, SA2 8QA 56–76 Ashfield Street, T +44(0)179 220 5666 warm spring day, but I’m London, E1 2BL extension 6438 writing this welcome, my T +44 (0)207 601 8232 E ryan.lewis@swansea- F +44 (0)207 377 7100 tr.wales.nhs.uk first Scope editorial, with E [email protected] frost-bitten fingers in a drafty London Published on behalf of Y ASSISTANT EDITOR the Institute of Physics hospital on Christmas Eve. Our Editor-in- Gemma Whitelaw and Engineering in Radiotherapy Physics, St. Medicine by Chief, Marc, handed the Scope reins for this Bartholomew’s Hospital, CENTURY ONE 25 Bartholomew Close, PUBLISHING LTD. issue to me as he prepared for a Joyeux Noël West Smithfield, Arquen House, in France, but unfortunately a whole 3 mm London, EC1A 7BE 4–6 Spicer Street, E gemma.whitelaw@barts St Albans, of snow was enough to ground his andthelondon.nhs.uk Herts, AL3 4PQ T 01727 893 894 aeroplane, forcing him to swap Père Noël for F 01727 893 895 Originally MEETING REPORTS E enquiries@centuryone good old Saint Nick instead. EDITOR publishing.ltd.uk ‘science’ and ‘art’ Angela Cotton W If the weather turns foul he may think of Head of Non-Ionising www.centuryone Radiation Support, publishing.ltd.uk were considered to taking his family along to The Wellcome Medical Physics & Bioengineering, “be two sides of the Collection in London where they showcase CHIEF EXECUTIVE Southampton General Nick Simpson many collaborations between art and Hospital, Southampton, T 01727 893 894 same coin SO16 3DR E nick@centuryone science. Originally ‘science’ and ‘art’ were E angela.cotton@suht. publishing.ltd.uk swest.nhs.uk considered to be two sides of the same coin ADVERTISING MANAGER and artists have often drawn upon the NEWS EDITOR Oliver Kirkman Christie McComb T 01727 739 184 sciences for inspiration when their muse MRI/SPECT, Institute of E ollie@centuryone ” eludes them. Neurological Science, publishing.ltd.uk Southern General Hospital, There is now an emerging new school 1345 Govan Road, Glasgow, G51 4TF SUB EDITOR known as ‘MRI art’ and in this issue we T 0141 201 2120 Karen Mclaren E [email protected] T 01727 739 187 focus on a large installation recently erected E karen@centuryone publishing.ltd.uk at the University of Aberdeen Medical BOOK REVIEW EDITORS Marium Naeem School on page 52. I’m sure you’ll share my Department of Radiotherapy DESIGN & PRODUCTION Physics, St Thomas' Heena Gudka hope that this may herald a new era of Hospital, London, SE1 7EH T 01727 739 185 E marium.naeem@ E studio@centuryone collaboration between the Arts Council and gstt.nhs.uk publishing.ltd.uk IPEM, or maybe not. Usman I. Lula Department of PRINTED BY For the less culturally aware amongst us, Radiotherapy, Poole Century One Publishing Ltd Hospital, Longfleet Road, we still have a diverse range of other Poole, BH15 2JB E [email protected] Scope is published features; Peter Clowes brings us the second quarterly by the Institute of part of his Weibull analysis article. Our Physics and Engineering in ENGINEERING & Medicine but the views regular contributor Jenny Freeman leads us ACADEMIC EDITOR expressed are not Constantinos Zervides, necessarily the official through simple linear regression and Mary E [email protected] views of the Institute. Arbuthnot discusses the Chartered MEMBERS NEWS EDITOR Authors instructions and Scientists programme with the Chief Matt Gwilliam copyright agreement can Cancer Research UK be found on the IPEM Executive and Deputy Registrar of the Clinical MR Research website. Group, Institute of Cancer Science Council. Research and Royal Articles should be sent to Marsden NHS Foundation the appropriate member of Usman and Marium have also put Trust, Sutton the editorial team. By together another excellent book review SM2 5PT submitting to Scope, you E [email protected] agree to transfer copyright section, Azzam Taktak gives us feedback on to IPEM. what happened at IPEM’s 15th Annual INTERNATIONAL EDITOR We reserve the right to edit (Developing countries) your article. Proofs are not Medical Physics and Engineering Andrew Gammie sent to contributors. The Clinical Engineer, integrity of advertising Conference and Christie McComb reports Bristol Urological Institute, material cannot be BS10 5NB guaranteed. on a new device that may allow us to curtail T +44(0)117 950 5050 extension 2448 or 5184 all that hand washing in hospitals. E [email protected] Copyright Reproduction in whole or I hope that you enjoy this issue, next time part by any means without Marc will be back at the helm and INTERNATIONAL EDITOR written permission of the (North America) publisher is strictly everything will be back to normal. Richard A. Amos forbidden. © IPEM 2009 Department of Radiation Physics, The University of Texas M.D. Anderson ISSN 0964-9565 GEMMA WHITELAW ASSISTANT EDITOR

SCOPE | MARCH 2010 | 05 SCOPE | NEWS BY CHRISTIE MCCOMB

Stone Pancreatic cancer screening imaging using optical spectroscopy In current clinical practice, it is possible to differentiate between uric acid kidney stones and non- uric acid kidney stones. However, there are in fact many different types of kidney stones, and more accurate classification could lead to improved management of patients. Results of a prospective phantom study which investigated the non-invasive assessment and classification of kidney stones were recently presented. The research was carried out using a dual-source CT system which operated at 80 and 140 kV, with a tin filter added to the 140 kV tube to provide increased energy separation between the two spectra. Sixty human renal stones of ten different types, whose true composition was determined using micro CT and infrared spectroscopy, were embedded in porcine kidneys and placed into a water phantom with a cadaver spine. Images were obtained using the low and high energy settings, and the CT numbers for the stones calculated for each image. The dual energy ratio (DER), which is the ratio of the low Optical techniques can be used to detect pancreatic tumours to high CT numbers, was then calculated and used to The 5-year survival rate for The Reflectance and reflectance and intrinsic characterise stone type. pancreatic cancer is very low, Fluorescence Lifetime fluorescence to allow The researchers found that it mainly due to the fact that no Spectrometer (RFLS), developed interpretation of the differences was possible to separate the ten reliable diagnostic procedure at the University of Michigan, was in spectra for different tissue types of stones into four primary has been developed for detection used to obtain reflectance and types. They found that the groups, a significant improvement of early stage disease. The fluorescence measurements reflectance model was most from the two-class discrimination current diagnostic standard is from freshly-excised human useful for discriminating between technique currently used. While endoscopic ultrasound-guided pancreatic tissue from two pancreatic cancer and chronic some types of stone are amenable fine needle aspiration (EUS- patients. Histological samples pancreatitis, while the to lithotripsy, other types are very FNA), which only has a 54 per from one patient revealed fluorescence model was more difficult to break up non-invasively cent sensitivity for cancer in the pancreatitis in some areas and effective at distinguishing and require surgical intervention presence of pancreatitis. normal pancreatic tissue in between all three tissue types. and the information provided by Previous studies in animals have others, and samples from the Combining reflectance this technique could therefore demonstrated that the use of other patient showed the spectroscopy and fluorescence assist in the triage of patients. optical techniques such as presence of pancreatic cancer in spectroscopy may offer a This story was reported on fluorescence spectroscopy can all areas. The reflectance and diagnostic advantage over using Aunt Minnie on 4th January, and be used to quantitatively fluorescence spectra obtained just one of these modalities to further information can be found at: distinguish between different from the three tissue types were detect pancreatic cancer. http://www.auntminnie.com/index tumour regions, and a research noticeably different, and This story was reported on .asp?Sec=sup&Sub=cto&Pag=dis team at the University of therefore could potentially be Medical Physics Web on 27th &ItemId=88958 Michigan have now carried out a used as a diagnostic indicator for October, and further information http://rsna2009.rsna.org/search/s similar study in human pancreatic cancer. can be found using the following earch.cfm?action=add&filter=Aut pancreatic tissue (Opt Express The researchers developed link:http://medicalphysicsweb.or hor&value=66378 (abstract 6) 2009; 17(20): 17502–16). mathematical models of g/cws/article/research/40779

06 | MARCH 2010 | SCOPE NEWS BY CHRISTIE MCCOMB | SCOPE

Plasma dispenser for IN BRIEF

PANCREATIC hospital disinfection CANCER SCREEN Optical techniques such as to mechanical, chemical and stainless steel wire mesh fluorescence spectroscopy possibly allergic irritations to the electrode. Two electrodes are have been trialled in skin. positioned with a separation of human pancreatic tissue to Sterilisation of equipment 4 cm, and when a voltage is detect tumours. Reflectance and fluorescence using plasmas, which are gases applied to the copper electrode, measurements were of ions and free electrons, is a plasma is produced in the obtained from samples and

Prof. Gregor Morfill, Max-Planck Institute for Extraterrestrial Physics well-established technology in squares between the wires of the the different spectra could medicine. Plasma sterilisation mesh electrode. Interactions potentially be used as a devices work at the between the plasma and water diagnostic indictor for HandPlaSter device atomic/molecular level and are vapour in the air produce reactive pancreatic cancer. therefore able to reach surfaces oxygen and nitrogen species, Disinfection and sterilisation in which are not accessible to fluid including ozone, nitrogen oxide PLASMA HAND hospitals is of increasing disinfectants. The design of such and hydrogen peroxide, which STERILISER concern due to the rise in devices has previously made together kill bacteria. A team of researchers have described the development hospital-acquired infections them unsuitable for use on the The team have demonstrated of a new atmospheric such as MRSA and C. Diff., and human body, but a team of that the device operates far plasma dispenser. the increase of antibiotic- researchers at the Max-Planck below the WHO safety levels for Sterilisation using resistant bacteria. The current Institute of Extraterrestrial UV, toxicity and plasmas, gases of ions and method of bacterial containment Physics in Garching have electromagnetics, and they free electrons, has been involves the use of liquid published a paper describing the suggest that devices of this type used on equipment and the disinfectant by hospital visitors development of a new could become a major weapon in new design is specifically for disinfection of large and staff. However, the issue of atmospheric plasma dispenser the fight against hospital- areas such as hands. This hand disinfection can be which is specifically designed for acquired bacterial infections in could be a major daunting – on a typical working disinfection of large areas e.g. the future. breakthough in the fight day around 60 to 100 the hands (New J Phys 2009; 11: This story was reported on against hospital-acquired disinfections are required in 115019). Physics World on 26th infections and antibiotic- principle, each of which should The plasma dispenser November, and further resistant bacteria. take 3 minutes, which means a contains a new design of information can be found using total of 3 to 5 hours spent on electrode, which consists of the following link: DUAL-SOURCE disinfection. In addition, there three layers – a copper sheet http://physicsworld.com/cws/art CT IMAGING are a number of side effects due electrode, a Teflon plate and a icle/news/41072 There are many different types of kidney stones, and dual-source CT can be used non-invasively to assess and classify Alliance for MRI update for 2010 different types. Images were obtained using a The EU Physical Agents community who are seeking to is well understood amongst key dual-source CT system 2004/40/EC (EMF) was created to avert the threat to the future of decision-makers in the European with high and low energy settings, and calculations provide minimum health and MRI and to ensure that patients in Commission, European of the dual energy ratio safety requirements relating to Europe will not be precluded Parliament and the member were made to determine the exposure of workers to EMFs. from state-of-the-art healthcare states. Towards this end, the the stone type. However, there is concern that services. Alliance for MRI held a very the proposed legislation will The European Commission is successful annual meeting and ALLIANCE FOR severely curtail the clinical and preparing its proposal to amend reception in the European MRI UPDATE research use of magnetic Directive 2004/40/EC, and the parliament on 13th October 2009, The Alliance for MRI aims resonance imaging (MRI), proposal is expected to be which was hosted by two leading to safeguard the future use particularly in interventional adopted by the College of MEPs. of MRI in Europe through applications and in imaging Commissioners by April 2010. Further information, including an EU-wide exemption for vulnerable patients and children There is still a widespread lack of press releases, related to this the medical use of MRI and related research from any where closer patient contact is understanding regarding the story can be found on the Alliance exposure limit values set. A required. implications of the EU legislation for MRI website: successful recent meeting The Alliance for MRI is a on the use of MRI, and therefore http://www.alliance-for- started their 2010 coalition of European in 2010 the Alliance for MRI will mri.org/cms/website.php?id=/en/ campaign to highlight Parlimentarians, patient groups, be working with all its members eu_affairs_research/alliance_for_ these issues. scientists and the medical to ensure that the potential threat mri.htm

SCOPE | MARCH 2010 | 07 INTERNATIONAL NEWS | SCOPE

DIARY OF MEETINGS 2010

Meeting Dates Venue

16th UK Monte Carlo User Group 12th–13th April National Physical Laboratory (NPL), UK Meeting (MCNEG 2010) Further information regarding this meeting, details of registration and submission of abstracts, and preliminary programmes can be found on the website at: www.npl.co.uk/events/12-+-13-apr-mcneg-2010

11th International Workshop on 7th–8th June Leuven Belgium Electronic Portal Imaging This year with the added focus on in-treatment verification. Your contribution can be submitted using the submission form on the website: http://www.epi2kx.org

The website of course also holds more information on the conference.

Note this workshop is being organised in co-operation with the conference on the use of computers in radiation therapy (ICCR 2010: http://www.iccr2010.org ) which is to be held a week beforehand in Amsterdam, The Netherlands. This is about a 2 hour drive away from Leuven.

6th IET International Seminar on 13th May IET, Savoy Place, London Appropriate Healthcare Speaker: Sir Liam Donaldson, Chair WHO Patient Safety Technologies for Developing Countries (AHT 2010) The format of this year’s event differs from previous years. The launch of the event will take the shape of an evening meeting. Those unable to attend will have the opportunity to submit a paper/presentation which will be accessible from the event website. Discussion will then be held electronically using the Listserv INFRATECH (http://listserv.paho.org/archives/infratech.html). This will enable participation by field workers all over the world.

On the evening itself, following the keynote address from Sir Liam Donaldson there will be a platform to exhibit posters allowing presenters and researchers to view one another’s work.

The event will be held in collaboration with WHO Patient Satefy and IPEM

For more information, and to register for the event, visit: www.theiet.org/aht2010

First Global Forum on Medical 15th–17th September Thailand Devices, linked with the Global http://www.who.int/medical_devices/events/en/index.html Initiative on Healthcare Technologies The aim of this conference is to raise awareness on the role of medical devices in health, to share knowledge on available resources, tools, guidelines and their use and to foster interdisciplinary partnerships.

There are some places still available on the MEIGaN course taking place on 22nd and 23rd February at the Trans-Euro Engineering Training Centre. For full details and a booking form please go to: www.trans-euro.co.uk M

SCOPE | MARCH 2010 | 47 SCOPE | INTERNATIONAL NEWS M TEACHING RESOURCES

SOME TEACHING RESOURCES AVAILABLE ONLINE:

URL Details

http://www.insidestory.iop.org/insidestory_flash1.html Explains radiotherapy to a class of 10–11 year olds. It's good fun. Should get them enthused.

http://www.teachingmedicalphysics.org.uk/ Includes interactive planning of RT, also PET, functional MRI and colonoscopy!

http://ehealthlearning.org.uk/arena/index.cfm An e-learning package from the HPA covering major incidents. It’s useful to see what other agencies will be doing when planning your own response. http://www.sciencedump.com/content/wc- r%C3%B6ntgen-and-x-rays Roentgen re-enactment.

For general information on policies, recommendations and guidelines on Healthcare Technology Management, see the new WHO e-documentation website: http://infocooperation.org/healthtechdocs

CLASSIFIEDS

A free medical physics classifieds website has recently been launched: www.medphysclassifieds.com

The hope is that it will provide a central location for buying and selling new/used medical physics equipment among other things (wanted, services, education, etc.). If anything, it might help clear out the physics storage room!

(Note: for used medical equipment, there exists a service at http://www.biomedea.org/HTTTG/donations.htm under the aegis of the IFMBE. This aims to provide advice on the suitability of offered medical equipment to the environment proposed.)

FOOTBALL WORLD CUP

As some of you may be aware, South Africa is hosting the 2010 soccer world cup. The final draw has been made and all soccer enthusiasts are rushing to get tickets and finalise their travel arrangements. Our local medical physics community sees this as an ideal opportunity to build up relations between like-minded medical physicists.

I am therefore inviting any medical physicist / soccer lover who is thinking of visiting our beautiful country to contact me. There are a number of levels in which we can get involved in making your stay here more memorable.

These are:

1. We can arrange guest lecture(s) at our training institutions, the trip can then become a business trip with associated tax perks!

2. We can help with accommodation and travel arrangements even if it is simply advice when making a choice.

3. We can give you contact details of colleagues in the city(or cities) where you will be staying so that there is a support base for you to fall back on in case of a vehicle breakdown or if you simply want to know where to get the best pizza.

4. We will gladly field your questions on any concerns you may have.

We see this as an ideal opportunity to extract more value for all out of this huge event.

Professor Ado J van Rensburg Director: Medical Physics Steve Biko Hospital (formerly Pretoria Academic Hospital) [email protected]

PS There used to be a Scope magazine in South Africa. It was the only magazine with half nudes (appropriately covered with censor's stars) but did cover some real news events as well. I include a few covers I could find.

48 | MARCH 2010 | SCOPE MEMBERS’ NEWS | SCOPE

Obituary: Aled Evans Dave Wyper and Donald Smith look back on the full life of an inspiring colleague

and with considerable respect. word means. He translated many ultraviolet phototherapy cabinets’, Being in his company was always of his publications into the Welsh ‘An instrument for testing a warm experience. You felt language. This was more to do external cardiac pacemakers’, ‘A relaxed, but also stimulated by with his proud patriotism than an method for testing volumetric his thought and perception. He attempt to increase his pumps’ and ‘Microprocessor- would seldom argue with you. publication list. He had no need to controlled signal generator for Instead, the look in his eye told do that. From an NHS setting, he the functional testing of you that he did not completely produced an impressive range of electrocardiographs’. The approve of your proposal. That products and publications. medical devices that he was enough. We all had great As head of the Medical developed range from the respect for his judgement. Electronics Development Service Easicom, developed for elderly For someone who joined the within the department, Aled’s patients in hospitals with hearing department as an expert in forte was instrumentation deficits, to the Pocket Speech Aid radiation physics, Aled, in software. With his customary for clients with communication response to demand, rapidly sound judgement he recognised impairment, the Ultratimer to Aled Evans lived life to the full. developed expertise in medical that his small section could not assess movement, and, most electronics. From this setting, be world experts in everything recently, the SightSim project Aled Evans worked in the Aled helped to develop not only and so he focused the work of his developed along with colleagues Department of Clinical Physics electronic instruments, but also team on two niche areas. The at Yorkhill for carers of children and Bioengineering in Glasgow the careers of trainee scientists team was pro-active in the with visual impairment for 38 years. Aled had always and technologists. He set about development of test equipment (www.sight-sim.co.uk). been healthy and active and so it training with knowledge and for medical devices and also It is sad that Aled did not live to was a surprise and a shock to all conviction, teaching and reactive in responding to specific enjoy a period of retirement. He his friends and colleagues when organising several courses. projects brought by clinicians who did, however, enjoy many happy he was diagnosed with a brain Aled loved Scotland – almost identified the needs of patients in years with his family and friends tumour over 2 years ago. He as much as he loved being various settings. and a very fulfilling professional survived far longer than Welsh. The message on his The test instruments produced career that has benefited predicted, and did so with dignity, answer machine was in Welsh, in this setting have been well countless patients and colleagues fortitude and good humour. and why not. They all say the described in several publications: in clinical physics. Our thoughts All of us who worked with Aled same thing and so it doesn’t ‘An instrument for scanning the are with Aled’s wife Joan and his will remember him with affection matter if we know what each angular variation of irradiance in children Charel and Gareth.

IPEM FORTHCOMING CONFERENCES 2010

Conference Dates and venue More information

Experiences and Optimisation of 26th March 2010 Multicentre MRI is an increasingly popular approach for acquiring large Multicentre MRI Research Studies Edinburgh Training and datasets from diverse geographical populations, yet technical issues in Conference Venue combining data from multiple sites need to be addressed. At this meeting, practical approaches to these problems will be discussed in addition to results from existing clinical and research multicentre studies.

30th April 2010 Technical advances in radiotherapy such as IMRT and IGRT, along with Head and Neck Cancer: Advances in The Geological Society, new chemo-radiation regimes, are providing greater ability to preserve Radiation Treatment London organs, increase survival rates and improve patients’ quality of life. This meeting provides the opportunity to discuss developments and future directions in the treatment of head and neck cancer.

6th May 2010 One of the challenges to scientists and engineers working in movement New Analytical Tools in Clinical Gait Fairmount House, York analysis is to make the data they receive more meaningful to clinicians. Analysis for Better Patient Outcomes This event will provide an opportunity for scientists, engineers, doctors and physiotherapists to exchange ideas and present new results. The aim is to encourage dialogue between professionals from different backgrounds in this multidisciplinary area of research and practice.

Further details of all forthcoming conferences can be found at www.ipem.ac.uk M

SCOPE | MARCH 2010 | 49 SCOPE | MEMBERS’ NEWS M NEW MEMBERS AND TRANSFERS 2010

Name Title Affiliation City Jason Richard Searle Clinical Scientist St Mary's Hospital Portsmouth Alan Effraim Nahum Head of Physics Research Clatterbridge Centre for Oncology Bebington Alison Mackie Head of Nuclear Medicine Service & RPA University Hospital of North Durham Durham Carl Graham Rowbottom Consultant Clinical Scientist Christie Hospital Manchester David James Gow Head of SMART Services Astley Ainslie Hospital Edinburgh Philip George Hillel Consultant Clinical Scientist in Nuclear Medicine Royal Hallamshire Hospital Sheffield Ranald MacKay Radiotherapy Physics Group Leader Christie Hospital Manchester Terence Michael Kehoe Head of Section & Acting Head of Department Edinburgh Cancer Centre, Western General Hospital Edinburgh Aaron Hucke Trainee Clinical Scientist Leeds General Infirmary Leeds Bethany Baker Howard Trainee Clinical Scientist Addenbrooke's Hospital Cambridge Jose Sanchez Trainee Clinical Scientist Addenbrooke's Hospital Cambridge Philippa Sturt Trainee Clinical Scientist King's College Hospital London Stacey Elizabeth McGowan Trainee Clinical Scientist Northampton General Hospital Northampton Thomas Leonard Hague Trainee Medical Physicist St George's Hospital London Timothy Clark Trainee Clinical Scientist Leeds General Infirmary Leeds Antonio Eleuteri Computer Scientist Royal Liverpool & Broadgreen University Hospital Trust Liverpool David Randall Trainee Clinical Scientist Royal Hallamshire Hospital Sheffield Jamie Wright Trainee Clinical Scientist Aberdeen Royal Infirmary Aberdeen Joshua Naylor Trainee Clinical Scientist Christie Hospital Manchester Martin Cox Principal Bioengineer Southern General Hospital Glasgow Alastair Mitchell Plank Product Specialist for Anaesthetics & Ventilation Dolby Medical Stirling Alexander James Smout Trainee Clinical Scientist Royal Surrey County Hospital Guildford Alys Bryony Potter Trainee Clinical Scientist Nottingham University Hospital Nottingham Andrew James Patterson Research Associate Addenbrooke's Hospital Cambridge Andrew Peter Aitken Trainee Clinical Scientist King's College Hospital London Andrew Simon Perkinson Trainee Medical Physicist Leeds General Infirmary Leeds Antony John Carver Trainee Clinical Scientist Royal Liverpool University Hospital Liverpool Benjamin Kelvin Rowberry Trainee Clinical Scientist Derriford Hospital Plymouth Ceri Leisa Williams Trainee Clinical Scientist Christie Hospital Manchester Clara Andrea Navarro Ibarra Trainee Clinical Scientist Royal Berkshire Hospital Reading Colin Martin Mair Trainee Bio-medical Engineer Aberdeen University Aberdeen Daniel Johnson Trainee Clinical Scientist Christie Hospital Manchester Deborah Saunders Trainee Medical Physicist Southampton General Hospital Southampton Delphine Darios Trainee Clinical Scientist King's College Hospital London Dylan Nalinda Bandara Yatigammana Trainee Medical Physicist Queen Alexandra Hospital Portsmouth Earl Merson Trainee Clinical Scientist St George's Hospital London Emily Field Trainee Clinical Scientist University Hospital of Wales Cardiff Emily Jane Howes Trainee Clinical Scientist King's College Hospital London Emma Louise Birch Trainee Medical Physicist Leicester Royal Infirmary Leicester Emma Whitehead Trainee Medical Physicist Royal Surrey County Hospital Guildford Emmanuel Adeoluwa Akinluyi Trainee Clinical Engineer King's College Hospital London Gary Barfield Trainee Clinical Scientist Lincoln County Hospital Lincoln Ilyas Amir Zatout Trainee Clinical Scientist King's College Hospital London Joanna Katarzyna Baginska Trainee Clinical Scientist Royal Hallamshire Hospital Sheffield John Kenneth James Archer Trainee Clinical Scientist Christie Hospital Manchester Jonathan Paine Trainee Clinical Scientist Queen Elizabeth Hospital Birmingham Joseph Stephen Wood Trainee Clinical Scientist Christie Hospital Manchester Julian Jianhua Liu Trainee Clinical Scientist Royal Sussex County Hospital Brighton Julie Wooldridge Trainee Medical Physicist Leicester Royal Infirmary Leicester Karen Ann McKay Trainee Clinical Scientist Royal United Hospital Bath Kimberley Jo-anne Quinn Trainee Clinical Scientist Royal Liverpool University Hospital Liverpool Louise Susan Helen Bendall Trainee Clinical Scientist Christie Hospital Manchester Malamatenia Argoulea Trainee Clinical Scientist Royal Liverpool University Hospital Liverpool Mark Gannon Trainee Clinical Scientist Leeds General Infirmary Leeds Martin Bruno Rojas Fisher Trainee Clinical Scientist Royal Free Hospital London Matthew Bolt Trainee Clinical Scientist Royal Surrey County Hospital Guildford Matthew Firth Trainee Clinical Scientist Royal Hallamshire Hospital Sheffield Matthew Jones Trainee Clinical Scientist Christie Hospital Manchester Matthew Lewis Lee Medical Physics Trainee Kent & Canterbury Hospital Canterbury Matthew Lowe Trainee Clinical Scientist Christie Hospital Manchester Michael Chu Trainee Clinical Scientist University Hospital of Wales Cardiff Naomi Helena Mary Hogg Trainee Clinical Scientist King's College Hospital London Nicholas Harding Trainee Clinical Scientist Royal Sussex County Hospital Brighton Peter Mould Radiation Physics Technician Glan Clwyd Hospital Bodelwyddan Rakesh Shukla Rehabilitation Engineer Croydon Wheelchair Service Croydon Rebecca Ellen Rose Artschan Trainee Clinical Scientist Leeds General Infirmary Leeds Robert James Behan Trainee Clinical Scientist Addenbrooke's Hospital Cambridge Robert Richardson Trainee Clinical Scientist Hull Royal Infirmary Hull Robert Ross Trainee Medical Physicist Royal Cornwall Hospitals Truro Ruth Hanley Trainee Clinical Scientist Royal Sussex County Hospital Brighton Ruth Monica Parker Trainee Clinical Scientist Royal Devon & Exeter Hospital Exeter Stephanie Prince Trainee Clinical Scientist Hull Royal Infirmary Hull Stephen David Gregory Trainee Clinical Scientist Singleton Hospital Swansea Susan Blair Turnbull Trainee Medical Physicist Aberdeen Royal Infirmary Aberdeen William John Beasley Trainee Clinical Scientist Christie Hospital Manchester Zoe Adey Trainee Clinical Scientist University Hospital Coventry & Warwickshire Coventry

50 | MARCH 2010 | SCOPE MEMBERS’ NEWS | SCOPE

Qualifications Entry Type Date MSci Physics, Bristol / MSc Medical Physics, Surrey New applicant Corporate 2 Oct 09 BA (Hons) Physics, Oxford / PhD, Edinburgh New applicant Fellowship 14 Oct 09 BSc (Hons) Biophysics, York / MSc Medical Physics, Aberdeen / PhD, Edinburgh Transfer Fellowship 14 Oct 09 BSc Mathematics & Physics, Manchester / MSc Radiation & Environmental Protection, Surrey / PhD Radiotherapy Physics, London Transfer Fellowship 14 Oct 09 BSc (Hons) Engineering Science, Edinburgh New applicantt Fellowship 14 Oct 09 BSc (Hons) Physics, Birmingham / MSc Medical Physics, Leeds Transfer Fellowship 14 Oct 09 BSc (Hons) Physics, Newcastle / M.Med.Sci Medical Physics, Sheffield / PhD Physics, Manchester Transfer Corporate 14 Oct 09 BSc (Tech) Physics & Electronics, Wales / MSc Medical Physics, Surrey Transfer Associate 23 Oct 09 MPhys Physics with Medical Physics, Sheffield Transfer Associate 27 Oct 09 MPhys Physics with Medical Physics, Sheffield Transfer Associate 27 Oct 09 BSc Physics/Chemistry, Valencia Transfer Associate 27 Oct 09 MPhys Physics with Medical Physics, Sheffield New applicant Associate 27 Oct 09 BSc Physics with Particle Physics, Birmingham Transfer Associate 27 Oct 09 MSci (Hons) Mathematical Physics, Nottingham Transfer Associate 27 Oct 09 BSc (Hons) Physics, Leeds Transfer Corporate 27 Oct 09 MSc (equivalent) Computer Science, Italy / PhD (equivalent) Applied Mathematics & Computer Science, Italy New applicant Associate 11 Nov 09 MPhys Physics, York / MSc Medical Physics, Leeds Transfer Associate 13 Nov 09 MSci Physics & Astronomy, Glasgow Transfer Associate 13 Nov 09 BSc Physics, Manchester / MSc Physics & Computing in Medicine & Biology, Manchester Transfer Associate 13 Nov 09 BEng (Hons) Mechanical Engineering, Glasgow / MSc Mechanical Engineering, Glasgow / Mars Biomedical Engineering, Strathclyde Transfer Associate 13 Nov 09 New applicant Associate 16 Nov 09 BSc (Hons) Physics with Medical Applications, London New applicant Associate 16 Nov 09 MEng Biomedical Engineering, Sheffield New applicant Associate 16 Nov 09 BEng Mechanical Engineering, Wales / MSc Computational Methods in Computer Aided Engineering, Cranfield / PhD Analysis of Retinal Images in Glaucoma, Nottingham New applicant Associate 16 Nov 09 MEng Engineering Science, Oxford New applicant Associate 16 Nov 09 BSc (Hons) Chemical Physics, Sheffield / MSc Medical Physics, Leeds New applicant Associate 16 Nov 09 MPhys Physics, Bath New applicant Associate 16 Nov 09 BSc Mathematics & Physics, Sheffield / MSc Medical Physics, Surrey New applicant Associate 16 Nov 09 BSc Physics with Medical Physics, Cardiff / MSc Physics & Computing in Medicine & Biology, Manchester New applicant Associate 16 Nov 09 MSc Medical Physics, London New applicant Associate 16 Nov 09 MEng Product Design Engineering, Strathclyde New applicant Associate 16 Nov 09 MPhys Physics, Manchester New applicant Associate 16 Nov 09 BSc (Hons) Diagnostic Radiography, London / MSc Radiation Physics (Medical Applications), London New applicant Associate 16 Nov 09 MSc Applied Physics, Orleans / PhD Laser Physics, London New applicant Associate 16 Nov 09 MPhys Physics, Manchester New applicant Associate 16 Nov 09 MEng Engineering, Cambridge New applicant Associate 16 Nov 09 BSc (Hons) Physics, Bath New applicant Associate 16 Nov 09 BSc Mathematical Physics, Nottingham New applicant Associate 16 Nov 09 MPhys Physics with Astronomy, Leicester / MSc Medical Physics, Leeds New applicant Associate 16 Nov 09 BSc (Hons) Physics, Southampton New applicant Associate 16 Nov 09 BA Engineering (Mechanical), Cambridge / MEng Engineering, Cambridge New applicant Associate 16 Nov 09 BSc (Hons) Physics with Astrophysics, Leicester / MSc Medical Physics, Leeds New applicant Associate 16 Nov 09 BEng (Hons) Biomedical Engineering, London New applicant Associate 16 Nov 09 BSc Physics, Mathematics, Medical Physics, Poland / MSc Physics, Mathematics, Medical Physics, Poland New applicant Associate 16 Nov 09 MPhys Astrophysics, Liverpool / PhD Optical Diagnostics, Liverpool New applicant Associate 16 Nov 09 MPhys Physics, Bath New applicant Associate 16 Nov 09 MPhys (Hons) Physics with Business & Management, Manchester New applicant Associate 16 Nov 09 BSc Mathematics, Heilongjiang /MSc Applied Mathematics, Harbin / PhD Electrical & Electronic Engineering, Shanghai New applicant Associate 16 Nov 09 MSci (Hons) Mathematical Physics, Nottingham New applicant Associate 16 Nov 09 MSci Physics, London New applicant Associate 16 Nov 09 BSc Physics with Biomedical Physics, Nottingham / MSc Physics, Durham New applicant Associate 16 Nov 09 BSc Physics, Sheffield / MSc Medical & Radiation Physics, Birmingham New applicant Associate 16 Nov 09 MPhys Physics, Manchester / PhD Experimental Nuclear Physics, Manchester New applicant Associate 16 Nov 09 BSc Physics & Astrophysics, Galway / MSc Medical Physics, Galway New applicant Associate 16 Nov 09 MPhys Physics, Warwick / MSc Radiation Physics, London New applicant Associate 16 Nov 09 MPhys (Hons) Physics, Southampton New applicant Associate 16 Nov 09 BSc Physics with Medical Physics, Sheffield / MSc Medical Physics, Leeds New applicant Associate 16 Nov 09 MSc Mathematics &Physics, Durham New applicant Associate 16 Nov 09 BSc Physics, York New applicant Associate 16 Nov 09 MPhys Physics, Durham New applicant Associate 16 Nov 09 MSci Physics & Astrophysics, Birmingham New applicant Associate 16 Nov 09 MSci Chemistry & Physics, Durham New applicant Associate 16 Nov 09 BA (Hons) Experimental & Theoretical Physics, Cambridge / MSci Experimental & Theoretical Physics, Cambridge New applicant Associate 16 Nov 09 BSc (Hons) Physics, Leeds New applicant Associate 16 Nov 09 BSc (Hons) Engineering with Medical Application, London / MSc Biomedical Engineering with Medical Imaging, London New applicant Associate 16 Nov 09 BSc Physics, Durham New applicant Associate 16 Nov 09 BAI Mechanical Engineering Mathematics, Dublin / MSc Biomedical Engineering, Oxford New applicant Associate 16 Nov 09 BSc (Hons) Physics with Medical Technology, Hull New applicant Associate 16 Nov 09 BSc (Hons) Physical Science, OU / MSc Medical Physics Computing, Aberdeen New applicant Associate 16 Nov 09 BE (Hons) Mechanical Engineering, Dublin / MSc Engineering & Physical Science in Medicine, London New applicant Associate 16 Nov 09 MPhys (Hons) Physics, Durham New applicant Associate 16 Nov 09 MEng Mechanical Engineering, Leeds New applicant Associate 16 Nov 09 MPhys Physics, Durham New applicant Associate 16 Nov 09 MSci Physics, Strathclyde / PhD Solid State Physics, Glasgow New applicant Associate 16 Nov 09 MPhys Physics, Warwick New applicant Associate 16 Nov 09 MPhys Physics, Warwick New applicant Associate 16 Nov 09 M

SCOPE | MARCH 2010 | 51 SCOPE | MEMBERS’ NEWS

M Medical physicist becomes a work of art and gives away his honours J. R. Mallard describes some incredible artwork and a very generous donation

In case you hadn’t realised that John presented all 30 of his people’s memories. MRI could have anything to do with Honours – medals, awards and So Fiona and I hope that the art, the installation consists of a plaques – to the President of the medals and awards, which have large number of acrylic sheets Aberdeen Medical-Chirurgical been given to me, will serve as a suspended on stainless steel wires, Society as a gift in perpetuity. The permanent reminder of the terrific each sheet imprinted with an MRI Society, which promotes medical stir and excitement which that transverse section – using a education and hosts many work caused at the time, in the modified IR sequence – across the scientific meetings in its rooms scientific and medical worlds. The bodies of John Mallard, and a Mr adjacent to the Medical School, medals are just symbols of the Suttie who made a very generous was founded in 1789 and is one of recognition given to that work, donation towards the cost of the the oldest medical societies in the when its significance was realised.’ building, as shown in the world: it has a collection of The 30 awards include: two Gold photograph. A 3D effect is created portraits, medical artefacts and Medals, 1984 and 1990, from the showing John reaching down from archives, which is of national Royal Society (London); the Royal the top to touch Mr Suttie reaching importance. When making the Gold Medal of the Royal Society of up from the bottom, rather presentation, John paid tribute to Edinburgh, 2002; the Gold Medal of reminiscent of Michelangelo’s God the dedicated teams of people who the Royal College of Radiologists, creating Adam in the Sistine had carried out the work, some of 2004; the OBE, 1992; two medical Chapel. Not that I am suggesting whom were present at the from the BIR., 1981 and 1991; two that John be deified! In fact the ceremony and he added, ‘It is very plaques from USA, both 1982; the The artwork on display. whole structure is meant to provide natural that Fiona, my wife, and I Dunottar Silver Medal of the Royal Professor John Mallard, emeritus a permanent reminder of the work should wish to leave, with the Med- Scottish Society of Arts, 1996; three Professor of Medical Physics at carried out on the site by medical Chi here at Foresterhill, some real awards from Europe (including the Aberdeen University, has been physicists who pioneered MRI. evidence of the pioneering work, George van Hevesy Medal, 1984, honoured in a unique and most Creating the work was less than towards the creation of modern and the EFOMP Medal, 2004), and appropriate way. The atrium of the straightforward as it proved medical imaging, which was three international awards, new Centre for Teaching and difficult to get John’s bent back into carried out here at Foresterhill, including one from Japan. Learning in Healthcare, on the site the 3T imager. The first set of from 1965 onwards. I think that In accepting the awards, the of the Aberdeen Royal Infirmary images showed him without a head nuclear medicine imaging of President of the Med-Chi said that and University of Aberdeen so a second session had to be patients, and magnetic resonance it was planned that they would be Medical School, has as its arranged to put his head back on imaging (MRI), are here to stay in exhibited in the Centre for Teaching centrepiece a large piece of MRI again! He claims to be the first medicine, but, already, the vital and Learning in Healthcare, art, some 19 metres high, created person to survive beheading! contributions made here in together with other items from by Marilene Oliver. Also, at a special ceremony, Aberdeen are beginning to fade in their archives.

IPEM EXAM RESULTS CLINICAL TECHNOLOGISTS

IPEM EXAM RESULTS

Congratulations to the following who have recently been successful in the IPEM Viva Voce examinations for the Clinical Technologist Diploma of IPEM DipIPEM(T).

Name Training centre Result

Richard Bergman Freeman Hospital, Newcastle Pass John Breen Singleton Hospital, Swansea Pass with Merit Caroline Lewis Rotherham District Hospital Pass with Distinction Maxine Mitchell West Cumberland Hospital Pass with Merit Aidan Murray Royal Victoria Hospital, Belfast Pass with Merit Pamela Plumb Darlington Memorial Hospital Pass with Merit Joyjit Sarkar West Midlands Rehabilitation Centre Pass with Distinction Lisa Scallan Northampton General Hospital Pass Laura Williams Singleton Hospital, Swansea Pass with Merit

52 | MARCH 2010 | SCOPE BOOK REVIEWS | SCOPE

n this first issue of Scope this an important concept in modern linac year, there are two book reviews; design, especially at the higher energies. one by Malcolm Sperrin and Chapters 4, 5 and 6 are particularly another by myself. Malcolm useful in that they discuss protection, Sperrin examines ‘Topics in monitoring and shielding of high-energy Accelerator Health Physics’ beams which includes energies found in whilst I uncover an therapeutic applications and isotope Iinterdisciplinary text on ‘Cancer creation. These chapters provide insight Mortality and Morbidity Patterns in the into the design and monitoring U.S. Population’. arrangements for facilities using high The ‘News’ section covers some new radiation fields but there are sections such publications issued by the IAEA during as how to manage ducts and penetrations 2009. The ‘Just Published’ section which clearly are of relevance either to contains several ‘medical imaging’ texts, new build or modification to established some to be published over the coming facilities. In addition to the expected Cancer Mortality and months. attenuation calculations, information on If you are interested in reviewing any managing abnormal operating conditions Morbidity Patterns in of these texts or have a burning desire to and the practicalities of dose limitation are the U.S. Population: review a text of your choice, please covered although with some comments contact the book review editors. relating to legislation that are clearly An Interdisciplinary Alternatively, send us an email if you intended for the American markets. Approach would like to join the new Chapters 8 and 9 are, however, more ‘SCOPEBookReviews’ Space at likely to be of primary interest to the This is an excellent text authored by three http://UbiDesk.com. Once registered, practicing medical physicist in that they specialists from different disciplines – users will be notified of any new texts concentrate on medical application of demography, theoretical and mathematical available for review. therapy or isotope manufacture. They physics and internal diseases/biochemistry. include discussion on QA, documentation, The opening chapter introduces the reader Marium Naeem traceability and dosimetry all based on the to a short historical timeline of cancer: ([email protected]) concepts established in previous chapters. origins, discoveries, the first oncologist and Usman I. Lula The final two chapters are interesting the first cancer hospital as well as more ([email protected]) in their own right since they present recent developments. The following chapter analysis of the interaction of radiation considers the cellular aspects of cancer, beams with solids and also some case theories and models of carcinogenesis studies with analysis of faults and (including hallmarks of cancer) and incidents which are useful to study in the heterogeneous population models as well as light of the UK framework of control. In limitations of study types and analyses. fact it is a useful exercise to case study the Chapters 4 and 5 cover stochastic and non- presented incidents with an eye on how stochastic methods of analysing mortality they would be addressed in the UK. and morbidity data and provide a basis for Overall, this book can be heavy going mathematical analysis. Chapters 3 and 6–9 since it is derived from a specialist cover cancer risk factors, in-depth site- professional development course but specific trends in the USA, modelling age nevertheless is recommended as a means patterns of cancer histotypes, risk factor of extending current knowledge. Anyone intervention and cancer prevention. The without a working knowledge of linacs or authors provide an excellent insight into Topics in Accelerator cyclotrons would find it a bit indigestible controllable and non-controllable cancer risk Health Physics and it is certainly not one for trainees factors. They put emphasis on adopting a unless for insight into the finer workings microsimulation model to aid cancer First impressions of this text are that it of beam control. The only real criticism is prevention in addition to advocating that has only peripheral relevance to the that the quality of the non-text elements is ultimate success can be achieved through medical physics community; however, poor; some of the graphs are almost interdisciplinary team work. A number of closer inspection reveals it to be a impossible to read and some of the images solutions are provided that would steer valuable addition to a departmental have not been reproduced well enough to current research and might result in book-list, albeit a highly specialised one. be of use. One for the central medical breakthroughs. Cancer prevention strategies The first chapter on beam physics and physics library. cover factors such as smoking, obesity, diet, accelerator architecture has both physical exercise and alcohol consumption. qualitative and quantitative analyses of Malcolm Sperrin, Director of Medical This really is a marvellous piece of work, beam control which would be relevant to Physics at the Royal Berkshire Hospital which should provide scientists with key linac and cyclotron physicists where a strategies that will lead to successful research deeper understanding of device design TOPICS IN ACCELERATOR HEALTH PHYSICS outcomes and the much-needed ultimate J. DONALD COSSAIRT, VASHEK VYLET AND could be important but is most likely to JOHN W. EDWARDS. breakthrough in cancer. It is a very highly appeal to research applications. Chapter 2 Publisher: Medical Physics Publishing recommended text for any professional discusses the production of radiation Corporation (December 2008) associated with the field of cancer. ISBN: 978-1930524378 fields in accelerators and includes an Pages: 309 Republished (in part) from: Cancer Mortality

analysis of neutron production which is List price (from Amazon): £26.06 and Morbidity Patterns in the U.S. M

SCOPE | MARCH 2010 | 53 SCOPE | BOOK REVIEWS M Population: An Interdisciplinary Approach, Fundamentals of Medical Imaging (2nd reviewed by Usman I. Lula; Significance edition) by Paul Suetens (Cambridge University REVIEWERS Journal (The Royal Statistical Society), 6(4) Press) is an invaluable technical introduction WANTED! (copyright © December 2009), published by to each imaging modality, explaining Wiley-Blackwell. mathematical and physical principles, image acquisition and interpretation. Individual Usman I. Lula chapters on each modality review the physics of the signal, image formation/ CANCER MORTALITY AND MORBIDITY reconstruction, image quality and equipment, PATTERNS IN THE U.S. POPULATION: AN INTERDISCIPLINARY APPROACH clinical applications, biological effects and KENNETH G. MANTON, IGOR AKUSHEVICH AND safety issues. JULIA KRAVCHENKO Published by: Springer Science & Business Media (2009) Statistics of Medical Imaging by Tianhu Lei ISBN: 978-0-387-78192-1 (Taylor & Francis Ltd) fills the gap in the 455 pages literature to provide a unified framework of List price: £51.00 study. It presents a complete look at medical imaging and statistics, from the statistical News aspects of imaging technology to the Some useful IAEA publications for the year statistical analysis of images. It provides 2009 (accessible electronically via technicians and students with the statistical http://www.iaea.org/Publications/index. principles that underlay medical imaging and Being a Scope book review editor is a funny html) are listed as follows: offers reference material for researchers old business. One minute you have no involved in the design of new technology. books on your desk and you’re worrying I Dose Reduction in CT while Maintaining about where your next copy is coming from. Next minute there is an avalanche; you Diagnostic Confidence: A The Physics of Medical Imaging (2nd receive a package of books every day and Feasibility/Demonstration Study; IAEA revised edition) by Steve Webb (Taylor & the tower on your desk becomes higher and TECDOC Series No. 1621, 2009 Francis Ltd) reviews the scientific basis and higher. I Quality Assurance for SPECT Systems; physical principles underpinning imaging in A way to make the whole process a bit IAEA Human Health Series No. 6 medicine. The major imaging methods of x- easier is to have a good group of reviewers STI/PUB/1394, 2009 rays, nuclear medicine, ultrasound and ready and waiting. We have recently been in I Release of Patients After Radionuclide nuclear magnetic resonance are covered. consultation with the IPEM special interest Therapy; Safety Reports Series No. 63; Following these reviews are several groups, and they are willing to help us create STI/PUB/1417, 2009 mathematic chapters which cover the maths a group of keen reviewers who we may refer I Security of Radioactive Sources; IAEA of medical imaging, image perception, books on to. Nuclear Security Series No. 11, 2009 computational requirements and techniques. We need more than this however and this I Calibration of Reference Dosimeters for is where you come in. If you have seen a External Beam Radiotherapy; Technical Radiation Protection in Medical book in Just Published! that you might like to Reports Series No. 469, 2009 Radiography (6th revised edition) by Mary review, please drop us a line and we will try Alice Statkiewicz-Sherer, Paula J. Visconti and E. and get a copy for you, likewise with any Russell Ritenour (Elsevier Health Sciences recent book in print. You may also decide Just Published! Mosby) provides vital information on that you would like to be a reviewer but are radiation protection and biology in a clear, unsure what to review. Please contact us Get Through First FRCR: MCQs for the concise and easy-to-understand manner. and we could match you with a book. Either Physics Module by Grant Mair, Andrew Baird Building from basic to more complex way, as a thank you, you get to keep the and Andrew Nisbet (The Royal Society of concepts, this book also presents radiation book. We don’t operate short deadlines, therefore allowing you to review at your own Medicine Press Limited) is the essential revision physics, cell structure, effects of radiation on pace. tool for all First FRCR candidates preparing humans at the cellular and systemic levels, Popular Science is our newly launched for the newly-revised examination. Over 200 regulatory and advisory limits for human column, and again we are on the lookout for five-part true/false MCQs are presented exposure to radiation, and the reviewers. This time we cannot call on the according to syllabus topics, accurately implementation of patient and personnel SIGs for help so this is where volunteers like reflecting the content, style and level of radiation protection practices. you are especially needed. Popular Science difficulty of the actual examination questions. books are generally shorter and easier to SPECT Basic Science and Clinical read in one go, making them ideal for time- Basic Health Physics: Problems and Applications by Dale L. Bailey and Steven R. short reviewers, and again you would get to Solutions by Joseph John Bevelacqua (John Wiley Meikle (Springer London Ltd) is claimed to be keep the book. and Sons Ltd) is designed to prepare the most complete book on single photon There are advantages to doing book candidates for the American Board of Health emission computed tomography (SPECT) reviews for Scope; in addition to increasing Physics Comprehensive examination (Part I) fundamentals published to date. It brings your library, it counts towards valuable CPD, and other certification examinations. It together the theory, physics, instrumentation, and as a more junior member of IPEM it may introduces readers to radiation protection image processing and quality assurance be a good addition to your CV. principles and their practical application in aspects necessary to understand and perform So please, we ask you to consider routine and emergency situations. It features high quality SPECT. The text is suitable for becoming a Scope book reviewer, it takes more than 650 worked examples illustrating radiologists, physicists, engineers and little time, there are clear benefits and it concepts under discussion along with in- technologists working with SPECT would make our lives easier! depth coverage of numerous areas. technology.

54 | MARCH 2010 | SCOPE