Download MASTER`S PROGRAMME IN MEDICAL PHYSICS

MASTER’SPROGRAMMEINMEDICALPHYSICS
JointlyorganisedbyICTPandTriesteUniversity
(ver10/12/2016)
TheMasterisaddressedtostudentswithaMScinPhysics(orequivalentacademicdegree).
Thecourse,takingintoaccountIAEAandIOMPrecommendations,isorganisedintwoyearsofactivities:
-
AfirstyearofacademiccoursesandpracticalexercisesinMedicalPhysics
AsecondyearofsupervisedClinicalTraining
AftertheMaster,therecommendationistofollowother1-2yearsofClinicalTraininginordertoberecognised
asClinicallyQualifiedMedicalPhysicist(CQMP)oradifferentpathaccordingtotherequirementsofthe
competentauthoritiesintheCountry.TheCertification/RegistrationasClinicallyQualifiedMedicalPhysicist
(CQMP)hastofollowexistingStateregistrationrules.IAEAandIOMParerecommendingthatthecompetences
havetobemaintainedwithaCPD(ContinuousProfessionalDevelopment)programme.
MedicalPhysicsMaster-Year1
Theacademiceducationofthefirstyeariscoveringalltherelevantspecialtiesofmedicalphysicstoprepare
thestudenttoenterinaformalclinicalmedicalphysicsresidency(secondyear).Itwillalsoprovidethestudent
withthebasicknowledgeneededtoembarkonacareerintheregulatory,industry,metrology,researchand
developmentorinnovationthroughresearchsectors,forinstance.
Themajoroutcomeoftheacademicprogrammewouldbetoprovidestudentswithathoroughgroundingin
thephysiologicalbasis,analyticalmethodsandfundamentalaspectsofmedicalphysicsandinstilanattitudeof
integrity,professionalism,critical-thinkingandscientificrigor.
Teachingisprovidedbothbyfulltimeacademicstaffandbyclinicalmedicalphysicistsandotherhealthcare
professionals,likeradiobiologists,cliniciansandregulators.
COREMODULES
Thecoremodulesareprovidedbelow,includinganoutlineoftheircontent:
Code
No.hours
oflectures
ECTS*
or
supervised
exercises
Nameofcourseorpracticals
L1
Typeof
activity
Examination
type
lesson
Oral
L2
AnatomyandPhysiologyasappliedtoMedical
Physics
Radiobiology
L3
RadiationPhysics
4
32
lesson
Oral
L4
RadiationDosimetry
4
32
lesson
Oral
4
32
1
8
lesson
Oral
L5
MedicalImagingFundamentals
24
lesson
Oral
1
8
lesson
Oral
PhysicsofNuclearMedicine
PhysicsofDiagnosticandInterventional
RadiologywithX-ray1
PhysicsofDiagnosticandInterventional
RadiologywithX-ray2
3
24
lesson
Oral
2
16
lesson
Oral
2
16
lesson
Oral
L10
PhysicsofDiagnosticRadiologywithUSandMR
4
32
lesson
Oral
L11
PhysicsofRadiationOncology1
4
32
lesson
Oral
L12
PhysicsofRadiationOncology2
4
32
lesson
Oral
L13
RadiationProtection1
2
16
lesson
Oral
L14
RadiationProtection2
TechnologyofInformationTechnologyfor
MedicalPhysics
1
8
lesson
Oral
2
16
lesson
Oral
L6
PhysicsofImagingDetectors
L7
L8
L9
L15
3
Guidedexercisesandpracticals(228h):
P1
Athospitalinradiology,nuclearmedicine,
radiotherapyandmedicalphysicsdepts
3
36
P2
Radiology
3
P3
Nuclearmedicine
P4
laboratory
written
36
laboratory
written
2
24
laboratory
written
Radiationoncology
8
96
laboratory
written
P5.1
Informationtechnologyandsoftwaretools:
exerciseswithImageJ
1
12
laboratory
written
P5.2
Statisticsformedicine
1
12
laboratory
written
Montecarlosimulationmethods
1
12
laboratory
written
60
556
P6
TOTALECTSANDHOURS
European Credit Transfer and Accumulation System(ECTS) is a standard for comparing the study attainment and
performance of students ofhigher educationacross theEuropean Unionand other collaborating European countries. For
successfully completed studies, ECTS credits are awarded. One academic year corresponds to 60ECTS-creditsthat are
equivalentto1500–1800hoursofstudyinallcountriesirrespectiveofstandardorqualificationtypeandisusedtofacilitate
transferandprogressionthroughouttheUnion.Typically,aECTSisequivalentto25-30hoursofstudy.
L1.AnatomyandPhysiologyasappliedtoMedicalPhysics
o AnatomicalNomenclature
§ Originofanatomicalnames
§ Prefixesandsuffixes
§ Anatomicalpositionandbodyplaneterminology
o Structure,Physiology,Pathology,andRadiographicappearance(x-ray,CT,MRIand
nuclearmedicineimaging)of:
§ BonesandBoneMarrow
§ BrainandCNS
§ Thorax
§ Abdomen
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§
§
Pelvis
Respiratory,Digestive,Urinary,Reproductive,Circulatory,Lymphatic,
EndocrineSystems
L2.Radiobiology
o ClassificationofRadiationinradiobiology
o Cell-Cycleandcelldeath
o Effectofcellularradiation,oxygeneffect
o Typeofradiationdamage
o Cellsurvivalcurve
o Dose-responsecurve
o Earlyandlateeffectsofradiation
o Modelling,LinearQuadraticModel,α/βRatio
o Fractionation,EQD2Gy
o DoseRateEffect
o TumourControlProbability(TCP),NormalTissueComplicationProbability(NTCP),
EquivalentUniformDose(EUD)
o ToleranceDosesandVolumes,QuantitativeAnalysisofNormalTissueEffectsinthe
Clinic(QUANTEC)[10]
o Normalandtumourcelltherapeuticratio
o Radio-sensitizers,Protectors
L3.RadiationPhysics
o Briefreviewofquantummechanicsandmodernphysics
o X-raysradiology-introduction
o Passageoftheradiationthoughmatter;microscopictreatment
§ coherentandincoherentscatteringonatoms
§ photoelectriceffect
§ characteristicx-rays
o Passageofx-raysthroughmatter:macroscopictreatment
§ Filtering
§ X-raysinstrumentation
§ Contrastandscatteredradiation
o X-raysdetectors
§ Imageintensifiers
§ Imagescreens
§ Digitaldetectors:computedradiography;thef-centers,directradiography,
indirectconversionmethods,directconversionmethods
§ Otherdigital detectors
L4.RadiationDosimetry
o QuantitiesandUnits
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o
o
o
o
o
o
o
o
o
o
o
o
o
Stochastic,non-stochasticquantities
Fluence,Exposure,KERMA,Absorbeddose
Radiation,chargedparticleequilibrium
NeutronInteractions
Multiplescatteringtheories
StoppingPower
§ Restricted,Unrestricted
§ LinearEnergyTransfer(LET)
TransportEquation
§ ChargedParticleslowingdown § ContinuousSlowingDownApproximation(CSDA)
Fanotheorem
CavityTheory
§ Large,smallcavity
RadiationDosimetersandinstrumentation
RadiationStandards
CalibrationChain
AbsolutedosimetryprotocolsandIAEAcodesofpractice
L5.MedicalImagingFundamentals
o MathematicalMethods
o TomographicReconstructionTechniques
o LinearSystems
o Acquisition,formation,processinganddisplayofmedicalimages
o Perception
o EvaluationofImageQuality
L6.PhysicsofImagingDetectors
o Basics:IntroductiontoPoissonstatistics
o Physicsofgenericphotondetectors
§ Quantumefficiency
• Directconversiondetectors
o Chargegenerationandchargecollection
• Indirectconversiondetectors
o Scintillators
§ Integratingdetectors
§ Countingdetectors
§ Spectroscopicdetectors
o Sampling
§ Space
§ Time
o Noiseconsiderations
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§ Signaltonoiseratio
o Photontransfercurve
o Conceptofspatialfrequencydependingdetectivequantumefficiency
§ Integratingdetectors
§ Countingdetectors
L7.PhysicsofNuclearMedicine
o Shortelementsofnucleardecays
o Radioisotopeimaginggeneralities
o Imagesfromradioisotopes
o Radioisotopesproduction
§ Batemanequations
o Radionuclidesadministration
o Themostfrequentyusedradioisotopes
o ImagingInstrumentation
§ Planar,Whole-body
§ SPECT
§ PET
§ HybridImaging
o Medicalapplicationsofspectandpet
o ImageQualityandnoise
o Non-imagingInstrumentation
§ Dosecalibrators,Wellcounters
§ Probes
o InternalDosimetry
o QuantitativeImaging
o RadionuclideTherapy
o Acceptancetestingandcommissioning
o QualitymanagementofNuclearMedicine
L8-L9.PhysicsofDiagnosticandInterventionalRadiologywithX-Ray
o OverviewofImagingModalities(ionizingandnon-ionizing)
o XrayImaging
§ Generationofx-rays,x-rayspectra
§ Detectors
§ ImageParameters
§ Imagequality,Noise,contrast,resolution
§ Radiographic,Mammography,Fluoroscopic,
§ CT,DECT,Tomosynthesis
§ InterventionalRadiology
§ Dualenergyimagingandabsorptiometry
§ Patientdoseandsystemoptimization
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o
o
DualandMulti-modalityImaging
QualityManagementofDiagnosticandInterventionalRadiology
L10.PhysicsofDiagnosticRadiologywithUSandMR
o UltrasoundImaging
§ Acousticpropertiesofbiologicaltissues
§ Wave,motionandpropagation,acousticpower
§ ModesofScanning
§ Transducers
§ Doppler
§ Safety
o MagneticResonanceImaging(MRI)
§ PhysicsofMagneticResonance
§ MRImageformation
§ MRInstrumentation
§ MRImethods
§ MRcontrastandimagequality
§ Clinicalapplicationsandartefacts
§ Safety
L11-L12.PhysicsofRadiationOncology
o Overviewofclinicalradiotherapy
o Radiationtherapyequipment(accelerators,cobalt60,cyclotrons,kVgenerators)
o Basicphotonradiationtherapy(dosimetricfunctions,etc.)
o Basictreatmentplanning
o Simulation,virtualsimulation,DRR’s,imageregistration
o Patientsetup,includingpositioningandimmobilization
o ICRUReports50,62and83
o Basicelectronradiationtherapy,ICRUReport71
o Kilovoltageradiotherapy
o Dosecalculationalgorithmsandheterogeneitycorrections
o Brachytherapy,ICRUReport38,AAPMTG43formalism
§ HDR/LDR,Equipment,TreatmentPlanning
o InversePlanning,optimization,IMRT
o Smallfielddosimetry(fundamentalaspects,protocols)
o Small-fieldradiotherapyequipmentandtechniques(StereotacticRadiotherapyand
Radiosurgery,StereotacticBodyRadiotherapy,IntensityModulatedRadiotherapy,
TomotherapyTM,CyberknifeTM,GammaknifeTM,etc.)
o Imageguidanceandverificationinradiotherapy(ConebeamCT,ultrasound,Portal
imaging,in-vivodosimetry,imageregistration)
o Radiationtherapyinformationsystems
o Acceptancetestingandcommissioning
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o
Qualitymanagementofradiotherapy
L13-L14.RadiationProtection
o SourcesofRadiation
o Activity,half-life,exponentialattenuation,half-valuelayer(HVL),inversesquarelaw,
tenth-valuelayer(TVL)
o BiologicalEffectsofRadiation
o RadiationQualityfactor,Equivalentdose,Effectivedose
o Legalframeworkforradiationprotection(BSS)
o Aslowasreasonablyachievable(ALARA)concept
o Occupational,publicexposureandannuallimits
o Radiationprotectiondetectors(Ionizationchambers,Geiger-Mueller,Proportional
counters,Scintillators,ThermoluninescentDosimeters(TLDs),neutrondetectors)
o Personalandenvironmentaldosimetry
o Shieldingcalculation
o Radioactivetransportandwastemanagement
o Emergencyprocedures
o Radiationprotectionprogrammedesign,implementationandmanagementinthe
medicalsector
L15.TechnologyofInformationTechnologyforMedicalPhysics
o Internationalstandards
§ IEC,DICOM,IHE
o HIS/RIS/PACS
o RadiotherapyR&Vsystems
o Navigationsystems
o Registration,segmentation
Seminarscoveringfollowingtopics:
• ICTPandICTP/IAEAtrainingcourses
• ProfessionalandScientificDevelopment
o Ethics,professionalism
• PresentationSkills
o ScientificCommunication
o TechniquesofInstruction
PRACTICALSESSIONS
P1.Practicalsessionswithahospitalfacilities
3hourssessionstobeheldattheTriesteHospitalfacilities.
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Session1
Session2
Session3
Session4
Session5
Session6
Interventionaland
Diagnostic
Radiology
Interventionaland
Diagnostic
Radiology
Interventionaland
Diagnostic
Radiology
Interventionaland
Diagnostic
Radiology
NuclearMedicine
NuclearMedicine
Conventional
radiography
Mammography
Interventional
Radiology
Computed
Tomography
Non-imaging
InstrumentationQC
Imaging
Instrumentation
(SPECT)QC
Session7
Session8
Session9
Session10
Session11
Session12
RadiationDosimetry
Radiation
Protection
RadiochromicFilm
Dosimetry
RadiationOncology RadiationOncology RadiationOncology RadiationOncology
WaterTank
RadiationSurveyof
ScanningofPhotons
aclinicalinstallation
clinicalbeams
WaterTank
Scanningof
Electronsclinical
beams
QConLinac
QConMLC
P2.Radiology
• Generalradiology:QA,patientdosimetry(softwaretools)
• Interventionalradiology:
o EquipmentQA
o Procedureoptimisation:DRLs,equipmentset-up,protocoloptimisation
o Preventionofskinburns:skindosimetry,triggerlevel,protocoloptimisation,clinical
follow-upofhighdosepatients
• IntroductionanduseofIDLtoolsforimageanalysis
P3.NuclearMedicine
• Imagequalityassessment
• QCofnuclmedicineinstrumentation
• Patientinternaldosimetry(useofsoftwaretools)
P4.RadiationOncology
• CommissioningandbasicQC
o Linac(AAPMTG106and142)
o Simulators(AAPMRPT83)
o Epid
o kVImager,R&V
• MUcalculation(ESTRO)
• QAofaTPS(AAPMTG43)
• Externalbeamphotontherapyplanning(ICRU50&62)
• Electronbeamelectrontherapyplanning(ICRU71)
• 3DCRTplanning
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•
•
•
•
•
IMRT/VMAT:Planning(ICRU83)andQA(includedAAPMTG142)
Simulation,virtualsimulation,DRR’s,imageregistration,patientsetup,includingpositioning
andimmobilization
Imageguidanceandverificationinradiotherapy:conebeamCT,ultrasound,portalimaging,
(AAPMTG179and95)
Multimodality:imageregistration,motionmanagement
BrachytherapyplanningandQA
P5.1Informationtechnologyandsoftwaretoolsformedicalphysics
• ProgrammingwithImageJ:quantitativeimagequalityassessment
P5.2StatisticsforMedicine:Statisticsasausefulandnecessarytoolforthehealthprofessions.
• Descriptivestatistics:
o Charts /tables, box-plot, measures of central tendency, measures of dispersion and
their'critical'use.ExamplesandexerciseswithRinthefieldofbio-medical.
o Elementsofprobabilitytheory:definitionsandproblems,theconditionalprobability.
o DiagnostictestsandROCcurve:ExamplesandexerciseswithR
o PopulationsofGaussiandataandtheirproperties.
• Elementsofstatisticalinference:
o Pointestimates,estimatesofintervals,the'confidenceintervals'.Estimationofthe
meanofapopulationofGaussiandata.ExamplesandexerciseswithR;
o Statisticaltests:thechi-squaretest,Fisher'sexacttest,thettestStudent,MannWhitneytestandtheWilcoxontest.ExamplesandexerciseswithR
o Riskmeasures:relativerisk(RR)andoddsratio(OR)
o Linearregression:ExamplesandexerciseswithR
• Criticalreadingofascientificarticle
P6.MonteCarlosimulationmethodsformedicalphysics
• GeneralIntroductiontoMonteCarlomethods
• UseofMonteCarlomethodsinMedicalPhysics
• BasicofMonteCarlosimulationwithintheGeant4framework
• PracticalsessionofGeant4simulation
• BasicinformationaboutotherMCtools
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MedicalPhysicsMaster-Year2
Year2isdevotedtoasupervisedfulltimeclinicaltrainingtobeperformedinoneaccreditated
hospitals.
Thestudentshould\practicescoveringmainlyaspecificareaofmedicalphysics(medicalphysicsfor
diagnosticimagingormedicalphysicsforradiationtherapy.
Activitiestoperform,assessmentoftheskillsandcompetencesacquiredineachfieldareadapted
fromtheIAEAandAFRAclinicaltrainingofmedicalphysicistsguidelines.
ECTS*
MinimumNo.Of
hours
Clinicaltraininginahospitalofthenetwork
55
1200
Finalthesis
5
125
60
1325
Activitytype
TOTALECTSANDHOURS
Theassignmenttohospitalswillbenotleesthan45weeks(about1700hours)thatincludesthework
forthedevelopmentofthethesiswork.
Clinicaltrainingcontentandassessmentagreement
Twoprogrammesareidentified:
• thefirstforthetraininginradiotherapy,
• thesecondfordiagnosticradiologyandnuclearmedicine.
Thecontentanddurationoftheclinicaltrainingwillbetailoredtothebackgroundandknowledgeof
theResidenttakingintoaccountthefollowingtables.
AnindividualPortfoliowillbedevelopedbytheClinicalMedicalPhysicistSupervisortailoredtothe
Residentbackgroundandknowledgebeforethebeginningoftheclinicaltraining.
Radiotherapy
Module
Duration(weeks)
Range
(weeks)
Clinicalenvironmentinradiotherapy
Entireprogramme46weeks
Externalbeamradiotherapy(EBRT)referencedosimetry
4
2-6
EBRTrelativedosimetry
7
4-10
Imagingequipment
3
2-4
EBRT
17
14-20
Brachytherapy
2.5
1-4
3
2-4
Radiationprotectionandsafety
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Equipmentspecificationandacquisition
Qualitymanagement
Professionalethics
1.5
1-2
8
6-10
Entireprogramme46weeks
46
Totalweeks
Diagnosticandinterventionalradiology&nuclearmedicine
Module
Duration(weeks)
Clinicalawareness
Priorities
Entireprogramme23wks
Radiationprotectionandsafety
3
Dosimetryinstrumentationandcalibration
1
Performancetestingofimagingequipment
13
1
Patientdoseaudit
2
4
Technologymanagementofimagingequipment
1
2
Optimisationofclinicalprocedure
3
3
Entireprogramme23wks
23
Professionalethics
Totalweeks
(Thetrainingcanbeexpandedupto36wksincludingangiographyunitsandMRIimagingandsafety.The
remaining10weekswillbedevotedtoperformancetestingmodulesofnuclearmedicineequipment)–
Priorities:1basic–4highestcompetences
Module
Duration(weeks)
Clinicalawareness
Priorities
Entireprogramme23wks
Radiationprotectionandsafety
4
4*
TechnologymanagementinNM
2
Radioactivitymeasurementandinternaldosimetry
3
PerformancetestingofNNMequipment
7
1
Preparationandqualitycontrolofradiopharmaceuticals
1
Radionuclidetherapyusingunsealedsources
2
3
Optimisationinclinicalapplication
4
2
Entireprogramme23wks
23
Professionalethics
Totalweeks
(Thetrainingcanbeexpandedupto36wksincludingalsoPET/CT.Theremaining10weekswillbe
devotedtoperformancetestingmodulesofdiagnosticradiologyequipment)–Priorities:1basic–4
highestcompetences
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(*)designoftheNMDpt
Fordiagnosticandinterventionalradiology&nuclearmedicineitisstatedthatthe2subprogrammescanshareequallythetimeor,inthecaseofspecificresidenttrainingneeds,asubprogrammecanbeenlargedmaintainingsomemodulesofthesecondprogrammethathastobe
includedfollowingtheindicatedpriorities(priority1indicatethemandatorymodule)
Thestudents,attheendofthefirstyearoftheCoursewillbeassignedtoahospitaloftheNetwork
ofaccreditedhospitals.
HeadoftheMedicalPhysicsDepartmentsandHospitalsoftheNetworkofHospitalsfortheClinicalTraining
HeadMPDpt
Hospitalname
Town
StefaniaMaggi
Az.OspedalieroUniversitariaOspedaliRiuniti
Ancona
ElviraCapra
CentrodiRiferimentoOncologico
Aviano
AndreoliStefano
Az.OspedalieraPapaGiovanniXXIII
Bergamo
AlessandroTurra
Az.OspedalieroUniversitaria“ArcispedaleSant’Anna”
Ferrara
BusoniSimone
Az.OspedalieraCareggi
Firenze
AlbertoTorresin
OspedaleNiguardaCa'Granda
Milano
GabrieleGuidi
Az.Ospedaliero-Universitaria di Modena
Modena
AndreaCrespi
Az.OspedalieraS.Gerardo
Monza
MarcoBrambilla
Az.OspedalieroUniversitariaOsp.MaggioredellaCarità Novara
MartaPaiusco
IstitutoOncologicoVeneto
Padova
AntonioTraino
Az.OspedalieroUniversitariaPisana
Pisa
LidiaStrigari
Ist.NazionaleTumoriReginaElena
Roma
RobertoRopolo
A.O.U.CittadellaSaluteedellaScienza
Torino
AldoValentini
OspedaleS.Chiara
Trento
MarioDeDenaro
Az.OspedlaieroUniversitariaOspedaliRiuniti
Trieste
MariaRosaMalisan
Az.OspedalieroUniversitariaS.MariadellaMisericordia Udine
CarloCavedon
Az.OspedalieroUniversitariaIntegrata
Verona
PaoloFrancescon
ULSS6Vicenza,OspedaleSanBortolo
Vicenza
HrvojeHrsak
UniversityHospitalCentreZagreb(KBC)
Zagreb
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