Download Medical Physics Department

MEDICAL PHYSICS
THE OTTAWA HOSPITAL
CANCER CENTRE
ANNUAL REPORT
2010
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
EXECUTIVE SUMMARY
The Medical Physics group at The Ottawa Hospital Cancer Centre provides scientific and
technical support to the Radiation Medicine Program. This support relates in general terms
to the calibration and ongoing verification of the accuracy of all aspects of the high-energy
radiation dose delivered to patients treated with radiation therapy. In 2010, the Radiation
Medicine Program treated 3,727 patients, delivering a total of 69,566 treatments, an
increase of 5% over 2009. Dr. Ian Cameron provides support to the Magnetic Resonance
Imaging Unit in the Department of Diagnostic Imaging at The Ottawa Hospital.
2010 saw the completion of our capital expansion facilities which represented a tremendous
temporary increase in clinical workload for the entire physics group required to commission
three treatment units, a CT scanner and treatment planning facilities at the IGFCC, a new
orthovoltge unit at the General Campus and to facilitate relocation of the brachytherapy
suite from the Civic to the General Campus. All the new treatment facilities were ready for
patient treatments on schedule due to the tremendous efforts of both the physicists directly
responsible for commissioning and also those responsible for maintaining the clinical
operations during the commissioning process. The dedication and hard work that made this
possible was inspiring. Of particular note was the collaborative teamwork among the group
in covering gaps in clinical coverage with so many physicists, physics and electronics
technologists and machinists working on the commissioning of the new facilities.
In addition to this effort, a third vault in the new General Campus annexe underwent
extensive remodeling during the early months of 2010 for a CyberKnife unit which was
installed in August and ready for patient treatments in September. The installation of this
unit positions the Radiation Medicine Program at The Ottawa Hospital Cancer Centre at the
leading edge in terms of technology available for radiation treatment in Canada. With our
inventory of a CyberKnife, 2 TomoTherapy units, 7 Elekta Synergy units with full imageguidance capability and a full service brachytherapy suite, we can offer our patients stateof-the-art treatment for a full range of disease sites.
The research activities of the group were unavoidably limited during this very busy year, no
new students were recruited but, despite the high clinical workload, 7 peer reviewed articles
were published, 1 patent was lodged, 30 presentations made throughout the year and 3
graduate theses completed by students in the Carleton University Medical Physics graduate
program. Additionally, 3 new research grants were obtained totaling $780,000.
Due to the pressure to accredit residency programs and the limitations of operating a
comprehensive progam in a smaller centre, our residency program was augmented this year
with the affiliation of the programs at Kingston and Sudbury. Eric Vandervoort successfully
completed his physics residency training in May and was promoted to physicist effective 1
June. Gérard Lagmago Kamta also successfully completed the program in October and left
to take a medical physicist position in Charles Lemoyne Hospital Cancer Centre, Longueuil,
Quebec. Claire Foottit was recruited into the vacated physics resident position in September
on completion of her PhD under the supervision of Ian Cameron. Four physicists sat the
clinical certification CCPM examinations this year and all were successful: Nicolas Ploquin,
Marija Popovic, Katie Lekx-Toniolo, and Eric Vandervoort.
We were fortunate to have Marija Popovic, PhD, join the physicist team in February to help
out during the expansion work, in between completing her residency in Hamilton and taking
a permanent position at McGill in November. Dylan Loose was recruited into an electronics
position in July.
Report prepared by Brenda Clark, Chief, Medical Physics, TOHCC
Page 2/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
TABLE OF CONTENTS
Executive Summary ............................................................ 2
Staff List............................................................................ 4
Administration .................................................................... 5
Capital Expansion ............................................................... 6
Radiation Safety ................................................................. 7
Clinical Activities................................................................. 8
Development ........................................................................ 8
Major Equipment Changes ...................................................... 8
Treatment Unit Quality Assurance............................................ 8
Treatment Planning ............................................................. 10
Stereotactic Ablative Radiotherapy......................................... 10
Brachytherapy .................................................................... 11
Technical Services ............................................................... 11
MR Imaging........................................................................ 13
Academic Activities ........................................................... 14
Representation on External Committees ............................... 16
Research ......................................................................... 17
1 Peer Reviewed Publications ............................................... 17
2 Patent ............................................................................ 17
3 Invited Presentations ....................................................... 17
4 Oral Presentations at National & International Conferences .... 18
5 Poster Presentations at National & International Conferences . 19
6 Research Funding ............................................................ 20
7 Research & Development Projects ...................................... 20
8 Graduate Theses Completed this Year................................. 24
9 Projects Completed this Year ............................................. 24
10 Departmental Presentations ............................................ 25
11 National/International Conference Representation .............. 27
Profile of Physicists ........................................................... 28
Page 3/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
STAFF LIST
Chief, Medical Physics Department
Brenda G. Clark, Ph.D., FCCPM, FAAPM
Radiation Safety Officer
David E. Wilkins, Ph.D., FCCPM
Senior Medical Physicists
Ian G. Cameron, Ph.D., FCCPM (MRI Unit, The Ottawa Hospital)
Joanna E. Cygler, Ph.D., FCCPM
Lee H. Gerig, Ph.D., FCCPM
Janos Szanto, Ph.D., FCCPM
Medical Physicists
Crystal Angers, M.Sc., MCCPM
Jason Bélec, M.Sc., MCCPM
Lesley Buckley, Ph.D., MCCPM (maternity leave, February 2010-March 2011)
Elizabeth Henderson, Ph.D., MCCPM
Chun-Bun Kwok, Ph.D., MCCPM
Katie Lekx-Toniolo, Ph.D., MCCPM
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM
Balazs Nyiri, Ph.D., MCCPM
Nicolas Ploquin, Ph.D., MCCPM
Marija Popovic, Ph.D., MCCPM (February to October)
Ryan Studinski, Ph.D., MCCPM
Eric Vandervoort, Ph.D. MCCPM
Medical Physics “Elekta” Fellow
Jason Bélec, M.Sc., MCCPM (50%)
Post Doc Fellow (funded by OCAIRO project)
Daron Owen, Ph.D.
Administrative Support
Janice Fish (50%)
Doris Vieira
Physics Technologists
Chris Lambert
Tyler Punkari
Julie-Maude Leblanc
Andrew Richardson
Medical Physics Residents
Gérard Lagmago Kamta, Ph.D.
Danielle Fraser, Ph.D.
Silvia Neuteboom
Claire Foottit, Ph.D.
Daniel La Russa, Ph.D.
Eric Vandervoort, Ph.D.
Graduate Students (Supported by Research Grants and Fellowships)
Amanda Cherpak
Maria Lourdes Garcia
Elizabeth Orton
Summer Students (Supported by Harold E. Johns Scholarships)
Ekaterina Tchistiakova
Technical Services (Electronics/Machine Shop)
Senior Radiotherapy Service Technician
Electronics
Farhoud Abbassian
Don Lesway
Tony Magee
Machine Shop
Bernie Lavigne
Page 4/45
Don Petzold
Georges Gohier
Dylan Loose
Richard Webb
Ron Romain
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
ADMINISTRATION
•
Recruitment of Eric Vandervoort, PhD, into a physicist position on 1 June. Eric joined
our group as a physics resident in February 2008 after completing his PhD at the
University of British Columbia under the supervision of Vesna Sossi on the topic of PET
imaging. He successfully completed the residency program requirements in May.
•
Recruitment of Claire Foottit, PhD, into a physics residency position. Claire joined us in
September on completion of her PhD on MR imaging under the supervision of Ian
Cameron.
•
Recruitment of Dylan Loose into a Radiotherapy Service Technologist position in July.
Dylan has 6 years of experience in repair and maintenance of airport CT systems.
•
Recruitment of Daron Owen into a Post Doctoral Fellowship position with funding from
the OCAIRO project. Daron joined us in November on completion of his PhD at UWO on
MR imaging under the supervision of Frank Prato
•
Management of Capital Expansion project, including the development of a detailed
equipment commissioning plan, monitoring of progress and directing remaining physics
effort at appropriate clinical priorities.
•
Facilitation of installation, training and commissioning of CyberKnife unit including
presentation of proposal to TOH Board of Governors, 3 February and a visit to the
CyberKnife group at CHUM Hôpital Notre Dame with Elizabeth Henderson and Julie
Gratton on 3 June.
•
Attendance at 3 TOH Leadership Development Institutes #2, Ottawa Hunt and Golf Club,
4-5 February and #s 3 and 4 at Hampton Inn, 20-21 May and 7-8 October
•
Participation in the search committee for new Head of Radiation Oncology
•
Facilitation of the Huda Radiology Resident Physics Review Course, Ottawa, 16-18 July
•
Participation in the implementation of TOH Patient Safety Learning System as one of a
small number of initial users. This required working closely with the TOH consultants to
configure the PSLS for migration of our program Incident Learning System.
•
Attendance at a Canadian chapter of the International System Safety Society lectures on
“Patient Safety in Canada”, Laurel Taylor, 25 March and “An Approach to Providing
Human Resource Solutions to SMS Implementation Challenges”, Robert Donald 21 Oct.
•
Attendance at TOH Patient Safety Conference, Hampton Inn, 4 November
•
Application to Cancer Care Ontario for major capital equipment items, this year totalling
$7.63m. Funding approval was obtained for two replacement accelerators for the QCH
totalling $5.92m. Funding was rejected for HDR prostate brachytherapy on the grounds
of eligibility, the system requiring the upgrade was purchased last year. Requests for
functionality upgrades for 2 accelerators (VMAT, 4D CBCT), treatment planning system
and oncology PACS upgrades were deferred awaiting additional MoH funding.
•
Preparation and submission of the budget for the Physics Department
•
Preparation and publication of this Annual Report summarising the activities of the
Physics Department
Page 5/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
CAPITAL EXPANSION
Our capital expansion efforts culminated during 2010 with the opening of a new cancer
centre at the Queensway Carleton Hospital in western Ottawa and a new building with 4
bunkers at the NE end of the existing cancer centre at the General Campus. These
extensive new facilities occupied considerable physics effort from mid 2009 to the end of
2010. Two Elekta Synergy S units installed in the new building at the north end of the
existing cancer centre at the General Campus were fully commissioned and ready for patient
treatments in January 2010. A new brachytherapy suite with a full operating room and a
smaller procedure room, radioactive seed storage and handling facilities and treatment
planning space was constructed and commissioned at the site of the old physics
department. Finally, a new orthovoltage unit was installed in the old Cobalt vault in the
original radiation treatment area next to the tomotherapy units. This expansion at the
General Campus replaced our treatment capacity at the Civic Campus and these out-dated
facilities were decommissioned during the year as the space was vacated.
The new Irving Greenberg Family Cancer Centre at QCH has 3 new vaults, a CT scanner and
full treatment planning facilities. Two new Elekta Synergy units were installed in the fall of
2009 and early in 2010, the Elekta Synergy unit installed in the portable bunker at the Civic
campus was relocated to the third vault with an MLC upgrade and new flattening filters to
match the photon beams on the two new units. Commissioning on these 3 units started in
early January 2010 and was completed on time for the official opening of the centre in April.
The effort required for this successful project was extensive: the beam commissioning by
Lee Gerig, Dan La Russa, Danielle Fraser and Balazs Nyiri with help from Chris Lambert,
Andrew Richardson and Silvia Neuteboom; the photon beam modeling by Jason Bélec and
Katie Lekx-Toniolo; the imaging systems (Elekta CBCT and Philips CT scanner)
commissioning by Lesley Buckley and CB Kwok; the orthovoltage unit commissioning by
Jason Bélec, Nicolas Ploquin and Gérard Lagmago Kamta and the brachytherapy relocation
by Joanna Cygler. And last, but certainly not least, the work required to satisfy CNSC
licensing requirements has kept David Wilkins busy for at least 2 years.
Fractions (Thousands)
In addition to the effort listed above, the remainder of the physics group was working
overtime to ensure routine clinical operations were maintained, the success of which is
illustrated in the plot below. During a year with so many major equipment changes, the
number of treatments delivered increased by 5% over 2009, an outstanding achievement!
20
Megavolt Fractions Delivered per Quarter
19
2005
2006
2007
2008
2009
2010
18
17
16
15
Jan-Mar
Apr-Jun
Jul-Sep
Page 6/45
Oct-Dec
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
RADIATION SAFETY
The Cancer Centre Capital Expansion project resulted in a very busy year for Radiation
Safety, due to the licensing and training associated with installing and commissioning new
radiotherapy equipment in new facilities, moving equipment from the Civic to the Irving
Greenberg Family Cancer Centre and the General campus, and decommissioning facilities at
the Civic campus.
Four license applications were submitted to the Canadian Nuclear Safety Commission in
2010, for: an operating license for 3 linear accelerators at the IGFCC; a decommissioning
license for an accelerator at the Civic; a commissioning license for the new Brachytherapy
Suite at the General; and an operating license for HDR patient treatments. In addition, 6
submissions were made to the X-Ray Inspection Service of MOHLTC, for approval of a CT
simulator, Acuity simulator, XVI units, orthovoltage and Cyberknife.
Commissioning of new radiotherapy facilities and equipment necessitated detailed radiation
surveys and safety systems testing of 8 new locations. Decommissioning of radiotherapy
facilities at the Civic resulted in the disposal of 2122 radiation sources totaling 12.141
gigaBequerels of activity, and decommissioning surveys of 4 Civic locations.
Radiation safety training associated with the capital expansion, as well as routine refresher
training of Radiation Medicine Program staff, was accomplished through 24 training sessions
held throughout 2010, on 8 different topics, with a total of 183 attendees. Annual
Compliance Reports were submitted to the CNSC in August for the two primary licenses held
by The Ottawa Hospital Cancer Centre. A new process for receiving replacement HDR
sources was developed, and enhancements were made to provisions for the security of
radioactive materials in the Cancer Centre.
The substantial volume radiation safety work in 2010 could not have been accomplished
without the considerable assistance of staff of the Radiation Safety and Health Physics
Department of The Ottawa Hospital, in particular Michèle Légaré-Vézina, Jodi Ploquin, Jon
Aro and Marc Lamoureux. This team has helped to ensure that the Radiation Medicine
Program has an excellent radiation safety program that ensures safe operation and very low
radiation doses for staff and visitors in the Cancer Centre.
Dave Wilkins, PhD, FCCPM
Radiation Safety Officer
The Ottawa Hospital Cancer Centre.
Page 7/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
CLINICAL ACTIVITIES
Development
•
Development of our stereotactic radiosurgery (SRS) program to include CyberKnife
treatment. This program has now been renamed, consistent with relevant literature, to
SABR, or Stereotactic Ablative Radiotherapy.
•
Implementation of intensity modulated radiation therapy treatments on Elekta Synergy
accelerators using the Monaco Monte Carlo simulation treatment planning software
•
Development, installation and testing of a novel safety interlock system for a two-room
high dose rate brachytherapy unit by Georges Gohier
•
Independent validation of a novel electron beam Monte Carlo dose calculation algorithm
developed by Elekta requiring extensive beam characterisation measurements
Major Equipment Changes
•
Installation and commissioning of two new Elekta Synergy units at the Irving Greenberg
Family Cancer Centre at the Queensway Carleton Hospital
•
Relocation and commissioning of the Elekta Synergy unit from the portable bunker at
the Civic Campus to the Greenberg centre
•
Replacement and relocation of the orthvoltage unit from the Civic to the General
•
Installation and commissioning of a CyberKnife unit at the General Campus
Treatment Unit Quality Assurance
2010 was a period of significant transition for the treatment unit quality assurance program
due to the major equipment changes resulting from the capital expansion project and the
introduction of new technology. During the year, our accelerator inventory moved from
predominantly Siemens (3 Siemens units were decommissioned, only 2 remain) to
predominantly Elekta, (4 new Elekta units began clinical operations bringing our total to 7).
The QA program changed significantly throughout the year to address the needs of the new
equipment. The physics policies and procedure document detailing the QA procedures was
re-issued fifteen times with each new issue incorporating numerous test modifications,
additions and deletions. The major events are listed below.
•
Over the past year the number of infrastructure team members grew to include 10
physicists (two thirds of the Medical Physicist group). The infrastructure team is
responsible for developing and maintaining the Quality Assurance (QA) program for all of
our radiotherapy equipment with the exception of CyberKnife. Specific infrastructure
tasks include immediate response to machine issues, daily review and reporting of
machine quality control (QC) testing, scheduled evening work and annual quality control
testing.
•
Our QA program was extended to include two new Elekta Synergy S (beam modulator)
units (designated units 8 and 9) which began clinical operations early in 2010.
•
Our QA program was extended to include units 21 and 22, two new Elekta Synergy units
which began clinical operations in the late spring of 2010.
Page 8/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
The iba StarTrack device was implemented on units 8, 9, 21, 22 and 23, primarily for
profile constancy testing.
Initial implementation also included radiation light
coincidence, backup diaphragm and jaw junction tests, but these tests were moved to
eQA when this new software became available later in the year.
•
The StarTrack device was also initially used to test electron profile constancy and energy
on our IGFCC Elekta units. These tests were subsequently suspended when the Elekta
electron beams were removed from clinical use due to low operational requirements.
•
During the first few months of use, the StarTrack devices were found to have inadequate
resolution for profile constancy. A full report was prepared and submitted to iba for
resolution. A replacement profile constancy test is currently under development using
the Profiler II device.
•
New software from Modus Medical (eQA) offering EPID testing for several routine
measurements was purchased and implemented on all Elekta Linacs. This software
replaces our film based testing for MLC and jaw position accuracy. The implementation
of eQA has allowed us to maintain MLC leaf position accuracy to within 1 mm on our
Elekta units - a clear benefit for our IMRT and VMAT programs.
•
A GafChromic film process was implemented on our Siemens units to replace radiographic film based testing of MLC and jaw position accuracy.
•
The last remaining hospital film processor was decommissioned in December.
Radiographic film is no longer used for routine QA.
•
Our in-house QA tracking software (Total QC) was decommissioned and replaced by a
directory hierarchy on the Medical Physics common drive. All machine QA data is now
stored in electronic files.
•
A software inventory has been established and is being maintained on seven laptops
specified for QA use.
•
Wireless access to the network has been established for each QA laptop. Network
access allows measured data (databases) and device specific calibration files to be
stored on the Medical Physics common drive (machine QA/QA data directories). Access
to data and calibration files is now independent of hardware and geographic location.
•
The Daily QA3 device was evaluated for use in daily dose verification but proved to be
more cumbersome and to present a higher operational risk than our existing Sun
Nuclear CheckMate devices and therefore was not implemented.
•
A new TLD system was implemented with updated operational policies and procedures.
•
An Imaging Lead Physicist position has been identified for the Infrastructure team and
expectations for this role have been established.
•
Annual CTDI test procedures were developed and implemented for the Acuity, all CT
simulators and the Elekta XVI systems.
•
A Reference Dosimetry program has been initiated. This program will monitor and
maintain equipment and processes for absolute dose calibration including cross
calibrated (tertiary) equipment.
•
Patient specific QA testing has been developed and implemented for LINAC IMRT using
the MapCheck II device.
Page 9/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
A new process of monitoring of Routine QA compliance has been established where
issues raised are tracked until completion. Due to this strict monitoring an audit for QA
compliance is no longer required.
•
A standardized dynamic dose test was implemented on our TomoTherapy units to assess
output accuracy under conditions of rotating gantry and moving couch.
•
The TomoTherapy patient-specific QA process was transferred from film and ion
chamber to a diode array device known as the Delta4. Commissioning of the device has
led to some insight into the functioning of diode arrays.
Treatment Planning
•
Supervision of treatment planning and computer data management for external beam
therapy and brachytherapy.
•
Quality assurance of treatment plans – all computerized treatment plans generated at
the centre are independently checked by medical physicists prior to use for patient
treatments.
•
A total of 4,906 treatment plans (computerised dose distributions) were generated in
2010, an increase of 9% compared to 4,501 in 2009. The plot of monthly activity shows
considerable fluctuation throughout the year with an average of 409 plans generated per
month or 94.3 per week.
•
During the last 5 years, the number of plans generated annually has increased by 6%
(4617 to 4906) whereas the number of patients who have had plans generated has
increased by 28% (2099 to 2935), reflecting a change in practice where a higher
proportion of patients are treated with fewer phases of treatment thus requiring fewer
plans per patient.
2010 Treatment Planning Activity
500
# Plans
400
462
373
469
448
420
401
395
413
412
353
375
385
Nov
Dec
300
200
100
0
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Month
Stereotactic Ablative Radiotherapy
A CyberKnife treatment unit was installed and clinically implemented in 2010.
Two
physicists received the physics training on the CyberKnife provided by Accuray, Inc.
(Sunnyvale CA). The Unit 11 treatment room and console area were renovated between
Page 10/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
March and August 2010.
Our CyberKnife unit arrived 18 May 2010, was installed 2-16
August 2010 and the unit was accepted on 16 August 2010. The CyberKnife program
(treatment unit, planning system and processes) was commissioned in 4 weeks (23 August
– 17 September 2010) and the first patient was treated on the TOHCC CyberKnife on 23
September 2010. In 2010, 47 patients were treated in 112 fractions (see table).
Site Treated
# Patients
Brain
38
Spine
6
Lung
2
Nasopharynx
1
Pelvis
1
Total
47
Prior to implementation of the CyberKnife system, the BrainLAB system was used 72
patients, giving a total patient count for SABR in 2010 of 119.
Brachytherapy
Physics support to this program consists of 5 physicists, 5 treatment planners, and 2
physics technologists who provide regular support for HDR, LDR and the permanent
prostate implant programs. This support consists of quality assurance, treatment planning,
treatment delivery, regulatory support and process development. In calendar year 2010,
•
•
•
38 patients received I-125 permanent prostate implants
17 patients received Ir-192 interstitial low dose rate implants
421 treatments were delivered to 131 patients using High Dose Rate brachytherapy
Technical Services
Physics Technical Services (Electronics and Machinists) provide support for both the Civic
and General divisions of The Ottawa Hospital Cancer Centre. The primary function of the
Electronics group is to provide electrical and electronic support to the Radiation Oncology
Program in terms of repair and maintenance of all major equipment. The Machinists provide
mechanical expertise to assist in maintenance and repair of the radiation therapy equipment
and the design and development of machine accessories.
Clinical hours of operation are 07:00 to 18:00, five days per week, with coverage on
weekends for emergency/urgent repairs and maintenance. Unless there is a major failure,
almost all machine maintenance is scheduled outside clinical hours during evenings or
weekends, to maximise patient treatment capacity.
In 2010, the list of major equipment requiring support included 2 TomoTherapy units, 7
Elekta Synergy accelerators with kilovolt x-ray imaging, 2 Siemens accelerators (Primus), 1
Orthovoltage unit, 3 Philips CT Simulators, 1 Varian Acuity simulator in the HDR
brachytherapy suite and 1 Accuray CyberKnife unit.
In the early months of 2010 we began providing support for 3 Elekta Synergy units and a
Philips CT Simulator at the Queensway Carlton Hospital. Support for the Civic Hospital was
concluded in March with the decommissioning of two Siemens Primus units (serial numbers
4063 and 4111).
Page 11/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Summary of Repair and Maintenance from 1 January to 31 December 2010
Name
Unit 1
Unit 2
Unit 3
Unit 4
Unit 5
Unit 6
Unit 7
Unit 8
Unit 9
Unit 11
Unit 16
Unit 18
Unit 19
Unit 21
Unit 22
Unit 23
Model
TomoTherapy
TomoTherapy
Gulmay D3300
Siemens Primus K
Elekta Synergy
Elekta Synergy
Siemens Primus K
Elekta Synergy S
Elekta Synergy S
Accuray CyberKnife
Siemens Primus M
Siemens Primus M
Therapax 300
Elekta Synergy
Elekta Synergy
Elekta Synergy
Totals:
Potential
Time Hrs
2490
1998
922.5
2773
2743
2743
2743
2473
2433
544
682
628
512
988
1460
1500
27632.5
# Repairs
Minor
55
33
18
61
99
76
90
96
76
2
8
10
6
38
40
43
751
Repair Hrs
Minor
94.5
29.8
12.6
23.5
45.6
55.7
72.1
46.8
44.8
2.0
3.8
5.0
0.8
21.2
16.6
17.2
492
# Repairs
Extensive
45
58
4
34
41
33
46
23
39
0
5
7
3
37
13
14
402
Repair Hrs
Extensive
395.1
280.6
46.1
100.5
76.8
54.7
112.8
36.1
67.7
0.0
8.8
9.5
3.5
132.4
23.1
17.2
1365
Service
Time Hrs
489.6
310.4
58.7
124.0
122.3
110.3
184.9
82.8
112.4
2.0
12.6
14.5
4.3
153.6
39.7
34.3
1856
PM Time Downtime
Hrs
Hrs
30.8
187
27.8
110
8.0
1
28.3
85
34.5
25
25.3
19
29.3
74
29.3
30
32.8
37
5.0
0
2.5
4
7.5
12
6.0
3
8.8
33
14.7
19
11.0
10
302
649
2010 Treatment Unit Availability
100
% Up-Time
98
96
94
92
90
1
2
3
4
5
6
7
8
9
11
16
17
18
21
22
23
Treatment Unit Number
The average up-time for all units was 98.0%. The two TomoTherapy units were the least
reliable at 92.5% and 94.5%; however, this represented a slight improvement over last
year when the numbers were 92.4% and 91.7% respectively. Units 4 and 7 are Siemens
Primus units which, at 5 and 7 years old are now the oldest units in our inventory, are
somewhat less reliable than the Elekta units, with the exception of Unit 21 which required a
new bending magnet assembly soon after installation.
During 2010, our electronics staff attended and successfully completed the following on/offsite training courses:
•
Elekta EOE1, Atlanta, Richard Webb, 8-19 February
Page 12/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
Elekta EOE1, Atlanta, Don Lesway, 8-26 February
•
Elekta EOE2, Crawley, UK, Richard Webb 8-26 November
•
Elekta XVI, IView, Generator, Atlanta, Don Petzold, 12-23 April
•
TomoTherapy, Madison, Richard Webb, 12 July – 20 August
•
TomoTherapy, Updates, Madison, Georges Gohier, 13-17 September
•
Orthovoltage, Birmingham, UK, Farhoud Abbassian, 12-16 July
•
Philips CT, Cleveland, Tony Magee, 4-28 May
•
Philips CT, Cleveland, Dylan Loose, 2-19 November
MR Imaging
Dr. Cameron is working with Biomedical Engineering to develop a more extensive Quality
Assurance program for the three MR scanners at The Ottawa Hospital. The QA program has
been expanded but further expansion is still required. In the meantime, Dr. Cameron
continues to monitor system performance. Dr. Cameron also interacts regularly with the
Biomedical Engineering personnel that repair and maintain the scanner.
Page 13/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
ACADEMIC ACTIVITIES
Carleton University Graduate Student Supervision
PhD Program
Name
Entry
Est. Fin
Supervisor
L. Maria Garcia
Sep 2005
Jan 2010
D.E. Wilkins
Amanda Cherpak
Sep 2007
Aug 2011
J.E. Cygler
Sorina Truica
Jan 2003
Dec 2010
I.G. Cameron
Diffusion Weighted Magnetic
Resonance Imaging Assessment of
Blood Flow in the Microvasculature of
Abdominal Organs
Claire Foottit
Sep 2004
Sep 2010
I.G. Cameron
The Use of Signal Phase in Dynamic
Contrast-Enhanced magnetic
Resonance Imaging
Elizabeth Orton
Sep 2008
Aug 2012
B.G. Clark
E Henderson
Topic
Total Marrow Irradiation Using Helical
Tomotherapy
4D in-vivo dosimetry
Biological target definition for
radiation therapy using positron
emission tomography imaging
Additional Supervision
•
Supervision by Joanna Cygler and Eric Vandervoort of Ekaterina Tchistiakova, an H. E.
Johns summer scholarship student
University Lectures Delivered
Carleton University PHYS 5208 Radiation Protection – Dave Wilkins
Carleton University PHYS 5204 Physics of Medical Imaging
•
MRI Physics (6 lectures) – Ian Cameron
Carleton University PHYS 5209 Medical Physics Practicum
•
Brachytherapy module – Joanna Cygler
•
MRI module - Ian Cameron
University of Ottawa Radiology Residents Physics Course, 17 May – 1 June
•
MRI Physics (4 lectures) – Ian Cameron
•
Radiation Protection (1 lecture) – Dave Wilkins
•
Computed Tomography (2 lectures) – Katie Lekx-Toniolo and Ryan Studinski
Page 14/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
Fluoroscopy and Angiography (1 lecture) – Balazs Nyiri
University of Ottawa Radiation Oncology Residents Physics Course – lectures delivered by
several individual physicists throughout the year.
Visits Hosted
•
Canadian Nuclear Safety Commission human factors experts Alice Salway and Mark
Brodeur, 3 June – Dave Wilkins
•
Canadian Organization of Medical Physicists Annual Scientific Meeting delegates, 19 June
o
•
•
B.Clark, D.Wilkins, E. Vandervoort, G. Niedbala
Carleton University Modern Physics undergraduate class
o
Professor J. Wallace and 8 students, 22 March - Dave Wilkins
o
Professor J. Wallace and 4 students, 8 June – Dave Wilkins
Carleton University graduate Medical Physics class
o
Professor P. Johns and 11 students, 6 December – Dave Wilkins
Other Academic Activities
•
Revision of MRI sections of the Canadian College of Physicists in Medicine certification
examination - - Ian Cameron
•
Canadian Medical Association accreditation review of the Radiological Technology
program at Red River College in Winnipeg - Ian Cameron
•
Development and participation in the CCO sponsored “IMRT Ontario Physics Meeting”, 13
February – Brenda Clark
•
North American Medical Physics Leadership Meeting, AAPM, ABR, CAMPEP, CCPM,
SDAMPP, Philadelphia, 19 July - Dave Wilkins
•
Quality Assurance Review of the Radiation Oncology Program, UCSF Helen Diller Family
Comprehensive Cancer Centre, San Francisco, CA, 27-29 September – Brenda Clark
•
CAMPEP accreditation review of the University of Western Ontario graduate program in
Medical Biophysics, London, ON, 8-9 June 2010 - Brenda Clark
•
CAMPEP accreditation review of the Georgia Institute of Technology graduate program in
Medical Physics, Atlanta, GA, 2-3 October 2010 - Brenda Clark
Page 15/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
REPRESENTATION ON EXTERNAL COMMITTEES
•
AAPM (American Association of Physicists in Medicine) – International Affairs Committee
JE Cygler, Vice-Chair of European Sub-Committee
•
AAPM (American Association of Physicists in Medicine) - Partners in Physics Committee
JE Cygler (2009-present)
•
AAPM (American Association of Physicists in Medicine) - Summer School Scholarship Committee
JE Cygler (2010-present)
•
AAPM (American Association of Physicists in Medicine) – Task Group 191 on Clinical Use of
Luminescent Dosimeters - JE Cygler
•
AAPM (American Association of Physicists in Medicine) – Task Group 105 for Clinical
Implementation of Monte Carlo based treatment planning systems
JE Cygler (2003 - present)
•
AAPM (American Association of Physicists in Medicine) – Task Group 176 for Dosimetric Effects of
Immobilization Devices - LH Gerig (2008 – present)
•
CAMPEP (Commission on Accreditation of Medical Physics Educational Programs), Graduate
Education Program Review Committee (GEPRC) - BG Clark
•
CCO (Cancer Care Ontario) Physics Provincial Advisory Committee (PPAC) Chair, BG Clark
•
CCO (Cancer Care Ontario) Provincial Radiation Treatment Program Committee - BG Clark
•
National Research Council of Canada Dose Registry and Radiation Exposure Monitoring Project,
Expert Advisory Group, D. Wilkins
•
Canadian Nuclear Safety Commission, On-line Annual Compliance Report Project, Expert Advisory
Group, D. Wilkins
•
CCPM (The Canadian College of Physicists in Medicine) – D. Wilkins, President
•
CCPM (The Canadian College of Physicists in Medicine) / COMP (Canadian Organization of Medical
Physicists) Joint Finance Committee – D. Wilkins
•
CCPM (Canadian College of Physicists in Medicine) Examination Committee
I Cameron, BG Clark, D. Wilkins
•
CCPM (Canadian College of Physicists in Medicine) Nominating Committee, BG Clark, Chair
•
CMA (Canadian Medical Association) Conjoint Accreditation Services Team – Radiological
Technology - IG Cameron
•
COMP (Canadian Organization of Medical Physicists) Conference Committee - D. Wilkins
•
COMP (Canadian Organization of Medical Physicists) - D Wilkins, Board Member
•
COMP (Canadian Organization of Medical Physicists) LAC (Local Affairs Committee) for COMP 2010
C Plume Angers
•
COMP (Canadian Organization of Medical Physicists) LAC (Local Affairs Committee) for COMP 2010
L Buckley
•
COMP (Canadian Organization of Medical Physicists) Professional Affairs Committee
D. Wilkins
•
IAEA (International Atomic Energy Agency) Committee on In-vivo dosimetry
JE Cygler, Consultant
•
IEC (International Electrical Commission) - Canadian Standards Team – SC62C WSG1 Equipment
for radiotherapy, nuclear medicine and radiation dosimetry - LH Gerig (2006 – present)
•
CCSRI (Canadian Cancer Society Research Institute) Grant Funding Panel E - BG Clark
•
OMPI (Ottawa Medical Physics Institute) Executive Committee - BG Clark
•
Polish Journal of Medical Physics and Engineering Editorial Board - JE Cygler
Page 16/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
RESEARCH
1 Peer Reviewed Publications
1.1
AM Smith, CA Longo, PA Fried, MJ Hogan, IG Cameron, Effects of Marijuana on
Visuospatial
Working
Memory:
An
fMRI
Study
in
Young
Adults,
Psychopharmacology 210(3), 429-438, 2010
1.2
BG Clark, RJ Brown, JL Ploquin, AL Kind, LG Grimard: The management of
radiation treatment error through incident learning. Radiother Oncol 95, 344-349,
2010
1.3
J Crook, J Jezioranski, JE Cygler, Penile brachytherapy: Technical aspects and
postimplant issues, Brachytherapy 9, 151-158, 2010
1.4
C Foottit, GO Cron, MJ Hogan, T Nguyen, IG Cameron, Determination of the
Venous Output Function from MR Signal Phase: Feasibility for Quantitative DCEMRI in Human Brain, Magn. Reson. Med, 63, 772-781, 2010
1.5
LM Garcia, LH Gerig, GP Raaphorst, DE Wilkins, Junctioning longitudinally
adjacent PTVs with helical tomotherapy. Journal of Applied Clinical Medical
Physics 11(2):62-80, 2010.
1.6
R Samant, LH Gerig, L Montgomery, M MacPherson, G Fox, R MacRae, K Carty, S
Andrusyk, P Genest, B Nyiri, "Rapid palliative radiotherapy: comparing IG-IMRT
with more conventional approaches", Journal of Radiotherapy in Practice, 9, 143148, 2010
1.7
LH Gerig, M Niedbala, BJ Nyiri Dose perturbations by two carbon fiber
treatment couches and the ability of a commercial treatment planning system to
predict these effects. Med Phys Jan;37:322-8 2010
2 Patent
A Saoudi, JE Cygler, R Ashton, US Patent 7831016 Radiation dosimetry apparatus and
method and dosimeter for use therein, 9 November 2010
3 Invited Presentations
3.1
JE Cygler, 4D radiotherapy and the RADPOS system, Annual OAMRT Meeting,
Ottawa, May
3.2
JE Cygler, Clinical implementation and application of Monte Carlo in
electron dose calculation, AAPM Annual Meeting, 18-22 July, Philadelphia, PA
3.3
D. Wilkins, Debate on Medical Physics Training CARO Annual Meeting,
Vancouver 22 September
3.4
BG Clark, Patient Safety Improvement in Radiation Oncology. UCSF Helen
Diller Family Comprehensive Cancer Centre, San Francisco, CA, 29 September
3.5
IG Cameron, Diffusion MRI, Ottawa Carleton Institute for Physics, December
3.6
JE Cygler, Clinical implementation and application of Monte Carlo methods
in electron beam dose calculation, Dosimetry Symposium, Christian medical
College, Vellore, India, 18 December
Page 17/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
3.7
JE Cygler, MOSFET dosimetry in radiotherapy, Dosimetry Symposium,
Christian medical College, Vellore, India, 18 December
3.8
JE Cygler, OSL dosimetry in radiotherapy, Dosimetry Symposium, Christian
medical College, Vellore, India, 18 December
4 Oral Presentations at National & International Conferences
56th COMP Annual Scientific Meeting, 16-19 June, Ottawa
4.1
Determination of contrast agent concentration in tortuous blood vessels using
measured MRI phase changes and Fourier-based field inhomogeneity
equations, CB Foottit, GO Cron, MJ Hogan, TB Nguyen, IG Cameron,
4.2
Evaluation of a New Commercial Monte-Carlo treatment planning system for
electrons, EJ Vandervoort, JE Cygler
4.3
Monitoring the Breathing Patterns of Lung Patients throughout the course of
treatment – Preliminary Experience with the RADPOS System, AJ Cherpak,
JE Cygler, S Andrusyk, J Pantarotto, R MacRae, G Perry
4.4
Position – Probability – Sampled Monte Carlo Calculation of VMAT, 3DCRT
Step – Shoot IMRT and Helical Tomotherapy Dose Distributions using
BEAMnrc / DOSXYZnrc, J Belec, N Ploquin, D La Russa, BG Clark
4.5
Total Marrow Irradiation Using Helical Tomotherapy in Treating a Multiple
Myeloma Patient: A Case Study, M Niedbala, H Atkins, L Gerig, K Carty, L
Montgomery, B Nyiri, R Samant
52nd AAPM Annual Meeting, 18-22 July, Philadelphia, PA
4.6
Initial Results of Real-Time External Surface Motion and Dose Monitoring
Study for Lung Patients, AJ Cherpak, JE Cygler, S Andrusyk, J Pantarotto, R
MacRae, G Perry
4.7
Clinical implementation and application of Monte Carlo in photon and electron
dose calculation, J DeMarco, JE Cygler
Other Meetings
4.8
Dosimetric Comparison of the Paris System and the RTOG Method of
Prescripition for Interstitial Brachytherapy of the Breast. R Studinski, M
Villeneuve, M Chelfi, L Grimard, 24th CARO Annual Meeting, Sept 22-25,
Vancouver, Canada
4.9
Improvement in Patient Safety in a Large Academic Radiation Therapy
Program Through Incident Learning: Three Years Results, L Grimard, BG
Clark, R Brown, J Ploquin, A Kind, RANZCR Perth 2010, 61st Annual Scientific
Meeting, Perth, Western Australia, 14-17 October
4.10
Ktrans Kurtosis: A Potential Surrogate for Biological Aggressiveness Suitable
for Multi-institutional Musculoskeletal Trials, GO Cron, AM Sheikh, IG
Cameron, ME Schweitzer, J Zhang, XG Cheng, J Werier, G DiPrimio, RSNA,
Chicago, November
Page 18/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
5 Poster Presentations at National & International Conferences
5.1
Assessment of Placental Blood Flow using a Navigator Echo Respiratory Gated
Parallel Imaging Technique at 1.5 T, LS Truica, IG Cameron, LI Avruch A
Gruslin, International Society of Magnetic Resonance in Medicine, Stockholm, May
5.2
Effects of Low Level Alcohol Consumption on Selective Attention in Young Adults
using fMRI, AM Smith, R Halchuk, IG Cameron, PA Fried, MJ Hogan, Canadian
Association for Neuroscience, Ottawa, May
5.3
Effects of Prenatal Nicotine on Visuospatial Working Memory: An fMRI Study, CA
Longo, AM Smith, PA Fried, MJ Hogan, IG Cameron, Canadian Association of
Neuroscience, Ottawa, May
5.4
Improved Venous Output Function using MR Signal Phase for Quantitative 2D
DCE-MRI in Human Brain, CB Foottit, GO Cron, TB Nguyen, MJ Hogan, IG
Cameron, International Society of Magnetic Resonance in Medicine, Stockholm,
May
5.5
Monitoring the Breathing Patterns of Lung Patients throughout the Course of
Treatment – Preliminary Expeience with RADPOS System, AJ Cherpak, JE
Cygler, S Andrusyk, J Pantarotto, R MacRae, G Perry, 56th COMP Annual Meeting,
16 – 19 June, Ottawa
5.6
Clinical evaluation of an Atlas-Based Auto-Segmentation application for autocontouring pelvic targets and OARs, G Lagmago Kamta, LA Buckley, E
Henderson, 56th COMP Annual Meeting, 16 – 19 June, Ottawa
5.7
Optimum Frequency of Spatial Registration in Image Guided Radiation Therapy
for TMI, LM Garcia, DE Wilkins, LH Gerig, B Nyiri, GP Raaphorst, 56th COMP
Annual Meeting, 16 – 19 June, Ottawa
5.8
Prospective Study of Accelerated Radiation Therapy with Tomotherapy
Simultaneous Integrated Boost with Concomitant and Adjuvant Temozolomide
Chemotherapy in the Treatment of Glioblastoma Multiforme: Dosimetric Data, H
AlHussain, S Malone, O Agboola, T N’Guyen, J Belec, K Carty, J Bahm, L
Montgomery, J-M Caudrelier, ASTRO Annual Meeting, SandDiego, CA
5.9
Quantitative DCE-MRI of Cerebral Gliomas is Feasible with 2D Multi-slice Imaging,
CB Foottit, GO.Cron, J-F Mercier, J Woulfe, J Sinclair, TB Nguyen, MJ Hogan, IG
Cameron, Brain Health Research Day, University of Ottawa, June
5.10
Total Marrow Irradiation (TMI) and Autologous Stem Cell Transplantation (ASCT)
for the Treatment of Multiple Myeloma, H Atkins, L Montgomery, K Carty, G
Niedbala, B Nyiri, G Fox, D Wilkins, L Huebsch, ML Garcia, L Gerig, R Samant,
Canadian Bone Marrow Transplant Group Meeting, 2010
5.11
Interstitial breast brachytherapy coverage homogeneity constraints: comparing
RTOG guidelines and Paris System, L Grimard, R Studinski, M Chelfi, M
Villeneuve, RANZCR Perth 2010, 61st Annual Scientific Meeting, Perth, Western
Australia, 14-17 Oct 2010
5.12
Functional Tendon Imaging: A Post-orthopedic Surgery Rabbit Study, A
Cárdenas-Blanco, AM Sheikh, IG Cameron, G Trudel, P Lapner, ME Schweitzer,
RSNA, Nov 2010
Page 19/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
6 Research Funding
•
Elekta Technology Research Grant $250,000 (2007-2010)
BG Clark
Verification of XVMC Monte Carlo dose calculation engine as implemented in Precise Plan
•
TomoTherapy Inc. $390,000 (2008-2013)
BG Clark
Clinical TomoTherapy Process Improvement
•
CIHR $116,356/yr (2009-2014)
P Beaule (PI), IG Cameron, H Frei, M Lamontagne, K Rakhra, M Schweitzer
Femoroacetabular Impingment: Correlating Hip Morphology to Changes in Cartilage and
Subchontral Bone
•
Elekta Technology Research Grant $50,000 (2010-2012)
JE Cygler, E. Vandervoort
Evaluation of a new commercial Monte Carlo dose calculation algorithm
•
Elekta Technology Research Grant $265,000 (2010-2012)
BG Clark
Implementation of advanced 4D treatment planning and dose delivery techniques.
•
ORF (Ontario Research Fund) $465,000 (2010-2015)
BG Clark
Adaptive Techniques for Rapid Radiation Therapy as part of the Ontario Consortium for
Adaptive Interventions in Radiation Oncology (OCAIRO), PI D Jaffray
7 Research & Development Projects
Treatment Validation
•
Dose-Position Verification in 4D Radiotherapy Using a Deformable Lung and
RADPOS System
JE Cygler, A Cherpak, M Serban, J Seuntjens
This is a collaborative project with McGill University and Montreal General Hospital. Two
novel systems are used in this project: RADPOS (Ottawa) and deformable lung phantom
(Montreal). The purpose of our work is to use the dose-position measuring system,
RADPOS, in conjunction with a deformable lung phantom to quantitatively verify
planning and delivery stages of 4D radiotherapy. Treatment plans for free breathing and
gated dose delivery were calculated with Varian, XiO and Monte Carlo planning systems.
Our results indicate that RADPOS combined with deformable lung phantom can be a
useful tool for quality assurance in 4D treatment delivery. The manuscript is in
preparation.
•
Development of a new 4D dosimetry system
JE Cygler, A Cherpak, W Ding, A Hallil (BEST Medical Canada)
The new dosimetry system is being developed in collaboration with Thomson-Nielsen
Electronics. It will consist of a computer controlled miniature probe capable of
simultaneous measurement of the dose and spatial coordinates of the measurement
point as a function of time so that the new product justly deserves the title of a 4D
dosimetry system. Up to date two different prototypes have been built. Preliminary
tests were performed. Early software version has been written and tested. Grant
Page 20/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
application has been submitted to HXT to fund this project. Subsequetly, JE Cygler was
a successful recipient of a $207,000 grant from HXT. Preliminary tests in phantoms
have been completed and a manuscript has been published (Med. Phys.).
•
Motion study for lung patients using RADPOS system
JE Cygler, A Cherpak, S Andrusyk, G Perry, R MacRae, C Lochrin, J Pantarotto
This is an on-going clinical trail that aims to evaluate the potential of the RADPOS
system for applications in external beam treatments for lung cancer patients.
Measurements are performed at the time of each patient’s 4D CT and throughout the
course of treatment. Three RADPOS sensors were positioned and marked points on the
patient’s chest and abdoment while a fourth detector was placed on the CT or treatment
couch for reference. Data is analyzed in terms of inter- and intra- fraction
reproducibility of patients breathing patterns and received dose. The manuscript is in
preparation.
Dose Calculation
•
Commissioning of CMS Monte Carlo Dose Calculation Module for electron beams
JE Cygler and E Vandervoort
Recently CMS released a new Monte Carlo based dose calculation module for electron
beams. We have finished collecting the required experimental data to model the beams.
Up to date all beam energies for Siemens linac have been modeled. For these beams we
are now evaluating the calculation accuracy for homogeneous and heterogeneous
phantoms. Effects of simulation parameters on accuracy and speed of calculations has
been also studied.
•
External Photon Beam Treatment Technique Comparison
J Belec, D La Russa, N Ploquin, BG Clark
The development of a platform to automatically analyze patient data (scan, contours,
inter/intra fraction motion patterns) to aid decision of which external beam treatment
technique is the most appropriate for the individual treatment and thus to improve the
comparisons between different external photon beam treatment techniques. The
techniques under consideration are VMAT Monaco, Step&Shoot IMRT Monaco, 3DCRT
CyberKnife or Helical TomoTherapy. Elekta conventional accelerator configuration
includes the Beam Modulator MLC and the standard MLC. This tool will thus predict
treatment quality for each technique based on initial patient data using metrics under
development to characterize different components of the treatment process. The aim is
to establish a correlation between realistic treatment quality and initial patient data.
The correlations could then be used to build a simple model to further improve our
understanding of the techniques (limitations, comparative advantages, etc.). This
knowledge is currently lacking and would greatly facilitate clinical implementation of
many complementary technologies by providing tools to aid i) equipment selection (in
terms of a cost-benefit analysis) based on a representative subset of patients typically
treated and ii) selection of the most appropriate technology for individual patient
treatment based on the initial patient data (and thereby avoiding the time consuming
task of multiple planning for several techniques/technology). Finally, this tool will offer
the possibility to look at the “big picture” and document the impact of current margins,
machine constraint and machine QA tolerance on patient treatment. The first part of
this project includes accelerator, treatment delivery and patient motion modeling using
Monte Carlo techniques. It was completed in 2010 and published in Medical Physics. The
second part of this project is ongoing.
Page 21/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
Application of historical brachytherapy planning to modern dose protocols
RCN Studinski, L Grimard, M Chelfi
Modern brachytherapy protocols often require 3D reconstruction of catheters and inverse
planning to achieve dose coverage and homogeneity goals. By applying modern
brachytherapy planning systems to historical methods (e.g., the Paris system) it can be
determined if these simpler techniques may be used to achieve those goals
Improvement of Treatment Unit Quality Assurance
•
Measurement of the photon beam spot source
L H Gerig, B Nyiri, J Smale
Existing methods for measuring beam spot position are labour intensive and not always
precise. These methods, including foil activation (LaRiviere) and beam spot cameras
(Munro, Rawlinson, Lutz)) all share a common drawback in that they are not self
referencing to the Collimator Axis Of Rotation (CAOR) and hence all measurements
require a separate and apriori knowledge of their own position with respect to the
CAOR. The split beam block method of Lutz is self referencing to the CAOR, but is quite
labour intensive and relies on the use of radiographic film. This method was employed
at TOHCC for many years, but is difficult to use now that film is no longer readily
available. The work we are undertaking is a collaborative project with Elekta (Jason
Smale) for the development of several methods for beam spot measurement which are
inherently self referencing to the CAOR. Three methods are presently under
development and testing. These include a co-rotational ½ block method, a co-rotational
60 degree wedge test and an image based test using the linac EPID.
•
Development of a Robust method for calibrating diode arrays such as Profiler
II, Delta 4 and TOMOdose
L H Gerig, B Nyiri, C Footit
Diode arrays are commonly used to measure radiation beam profiles for machine QA and
return to service. They are also used to measure dose distributions as part of the
delivery QA process incorporated into an IMRT program. Most commercial diode devices
are supplied with software to perform in-house calibration of the device in the beam
which is to be measured. Unfortunately these methods only perform well near the
central axis of the beam. Measurements at distances of 10 or 15 cm from the central
axis over estimate the dose by amounts ranging from 2 to 6%. In this work we are
characterizing the nature of this over response and developing calibration methodologies
which will allow the diode array devices to report the same dose profile that would be
measured in a large water tank with an ion chamber.
•
Improving the Accuracy of Patient-Specific QA Measurements of Helical
TomoTherapy Treatments Using a Bi-Planar Diode Array
D. La Russa, C. Foottit, R. Studinski
Due to a movement away from the use of film at TOH, our department has acquired two
Delta4 bi-planar diode arrays (http://www.scandidos.com) for performing patientspecific IMRT QA measurements of VMAT and helical TomoTherapy treatments.
Although the Delta4 consists solely of diodes, it is used to measure both relative and
absolute dose. Previous reports on this device, as well as our own experiments, indicate
the Delta4 is well suited for measurements of relative dose distributions, but there is
little discussion in the literature about the accuracy of absolute dose measurements over
the full range of clinical situations. Since diodes are prone to over respond at large field
sizes due to a build-up of low-energy photons, we have elected investigate the
Page 22/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
dosimetric consequences of using the Delta4 for absolute dose measurements of IMRT
treatments, where the field sizes often differ substantially from the field size used at the
time of calibration. Experiments we have designed for this investigation have shown
that measurements of absolute dose with the Delta4 can differ from measurements with
a calibrated ion chamber by as much as 4%. However, we have found that these
discrepancies can be accounted with correction factors determined, in part, on the basis
of field/target size. Other dosimetric properties of the Delta4 not previously discussed in
the literature were also investigated, and the results were submitted to the joint
COMP/AAPM Annual Meeting in Vancouver.
Development of Electronic Incident Learning System
•
Implementation and Design Optimisation of an Incident Learning System for a
Radiation Treatment Program
P Dunscombe, BG Clark, J Ploquin
Collaboration with the Tom Baker Cancer Centre (P Dunscombe, et al.) in the
development of software to enable multi-site participation working towards a national
database for incident reporting, funded by the CSNC.
Magnetic Resonance Imaging
•
The Effects of Water Diffusion on MR Image Contrast
E Olariu, A Cardenas-Blanco, IG Cameron
One source of contrast for MR Images is the microscopic motion of water molecules,
diffusion in tissues and perfusion in blood vessels. The goal of this research project is to
gain a better understanding of water diffusion in tissues at a very basic level so that the
contrast obtained in diffusion weighted imaging can be better understood. We are also
working to extend this research to MR Tractography which is a method for mapping
individual nerve tracts in the brain and the spinal cord.
•
Quantitative Cerebral Perfusion MRI
C Foottit, G Cron, IG Cameron, T Nguyen, M Hogan
Various MRI methods exist for the qualitative monitoring of cerebral perfusion. These
methods are very useful for many clinical indications; however, for other situations
quantitative perfusion measurements are desirable. We are investigating several ways
of doing quantitative perfusion MRI including serial measurements of the first pass of a
bolus of Gd-DTPA and arterial spin labeling.
•
Quantitative Perfusion MRI in Tumours
L Avruch, C Foottit, G Cron, T Nguyen, M Hogan, IG Cameron
MRI perfusion measurement techniques are being developed which will allow us to
measure perfusion in tumours. In particular, it is expected that we will be able to
accurately measure the permeability surface area product for vessels in tumours to
assess the “leakiness” of the vessels.
•
Placental Perfusion Measurements to Assess Fetal Growth Restriction
L Avruch, A Gruslin, S Truica, IG Cameron
Abnormally small third trimester fetuses are often a consequence of malnutrition
secondary to placental dysfunction. When this is the case early delivery may be
required. We are working on developing MRI technique for measuring blood perfusion in
the placenta without the use of contrast agents. Such a technique would allow us to
distinguish intrauterine growth restricted fetuses from those that are small but healthy.
Page 23/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
Characterization of Proteoglycan Depletion in Femoroacetabular Impingement
with T1ρ MRI
PJ Lattanzio, P Beaule, A Cardenas-Blanco, G Cron, IG Cameron, K Rakhra, M Schweitzer
The goal of this study is to demonstrate the feasibility of T1ρ MRI in the evaluation of
hip cartilage. The T1ρ relaxation values of hyaline cartilage in asymptomatic control
patients will be compared to those in patients with clinically proven FAI. The correlation
between T1ρ values and proteoglycan content of hip cartilage, as determined by
histopathology, will be determined.
•
Rician Bias Reduction
E Olariu, S Truica, C Foottit, G Cron, A Cardenas-Blanco, IG Cameron
Obtaining quantitatively accurate values for the MR signal strength from the images is
hampered, for low intensity signals, by a bias introduced by rectification of the noise on
the signal when the magnitude is computed during the image reconstruction process.
This is known as Rician Bias. An algorithm for reducing this bias to acceptable levels has
been developed and is being validated on phantoms. We are also extending this theory
to phased array rf coils.
Participation in Clinical Trials
•
OTT 05-01 Randomized Phase III trial of Conventional Radiotherapy versus Helical
Tomotherapy IMRT in the Palliative Treatment of Spine Metastases
R MacRae, O Agboola, JM Caudrelier, P Cross, C E, L Eapen, S El-Sayed, B Esche, E
Fitzgibbon, W Kendal, P Genest, LH Gerig, A Girard, L Grimard, C Lochrin, S Malone, J
Meng, B Nair, J Pantarotto, G Perry, R Samant, J Spaans
•
A Dose Escalation Study of Total Marrow Irradiation (TMI) And Autologous Stem Cell
Transplantation (ASCT) For The Treatment Of Relapsed Or Refractory Multiple Myeloma
(MM)R Samant, L Gerig, H Atkins, P Cross, L Huebsch, G Fox, LM Garcia, M MacPherson,
L Montgomery, P Raaphorst, D Wilkins.
8 Graduate Theses Completed this Year
•
Diffusion Weighted Magnetic Resonance Imaging Assessment of Blood Flow in the
Microvasculature of Abdominal Organs
Sorina Truica, supervisor Ian Cameron
•
The Use of Signal Phase in Dynamic Contrast-Enhanced magnetic Resonance Imaging
Claire Foottit, supervisor Ian Cameron
•
Total Marrow Irradiation Using Helical Tomotherapy
Lourdes Maria Garcia-Fernandez, supervisor David E Wilkins
9 Projects Completed this Year
•
Investigations of a Total Marrow Irradiation treatment technique for multiple myeloma
using Helical Tomotherapy
LM Garcia, DE Wilkins, LH Gerig, R Samant, GP Raaphorst
Page 24/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
10 Departmental Presentations
•
Presentation of Auto-contouring and Deformable Image Registration Software
MIMvista Group, 15 January 2010
•
Quality Control in Clinical Bone Mineral Density Programs: The Physicist’s Role
G. Peter Raaphorst, 22 January 2010
•
TOMO v4.0.1
Ryan Studinski, 29 January 2010
•
Physics Workload Management
Brenda G. Clark, 5 February 2010
•
TG-142 Compliance Report
Lelsey Buckley, 12 February 2010
•
Quality and Safety in Radiation Oncology: Lessons from Banff
David Wilkins, 19 February 2010
•
Journal Club - Out of field doses for linac-based radiotherapy with BrainLab’s mMLCs
Gerard Lagmago Kamta, 26 February 2010
•
General Research Discussion
Brenda G. Clark, 23 April 2010
•
Journal Club - 30 April 2010
Quantitative Analyses of Normal Tissue Effects in Clinic (QUANTEC), Eric
Vandervoort and Radiation dose-volume effects of the lung, Dan La Russa
•
CyberKnife Mania
Janos Szanto, 14 May 2010
•
Journal Club - Quantitative Analyses of Normal Tissue Effects in Clinic (QUANTEC)
Danielle Fraser & Gerard Lagmago Kamta, 21 May 2010
•
Commissioning at the QCH
Danielle Fraser & Dan La Russa, 28 May 2010
•
The use of signal phase in dynamic contrast-enhanced MRI
Claire Foottit, 4 June 2010
•
Radiology Research Day Practice Talks
11 June 2010
•
Clinical Experience of RapidArc
Emily Vollans, 7 July 2010
•
IGRT
•
Evaluation of treatment planning system for electron beams
Ekaterina Tchistiakova, 27 August 2010
•
Making sense out of quality assurance in IGRT and IMRT
Kyle Malkowske, 3 September 2010
•
QA Implementation
Crystal Plume Angers, 10 September 2010
•
Evaluation of the Delta4 detector array for Tomotherapy and IMRT delivery QA
Gerard Lagmago Kamta, 10 September 2010
•
Investigation into Multifleaf Collimator Performance and Failure
Michael Tassotto, 17 September 2010
Danielle Fraser, Dan La Russa, & Gerard Lagmago Kamta, 30 July 2010
Page 25/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
•
Daily QA3 Implementation
Marija Popovic, 22 October 2010
•
A little bubbly – Ultrasound Microbubble Contrast
Danielle Fraser, 29 October 2010
•
Orthovoltage clinical issues
Lee Gerig, 5 November 2010
•
TLD’s
•
Stopping power ratios
Dan La Russa, 26 November 2010
•
Delta4 Digging Deeper
Ryan Studinski, 3 December 2010
•
Elekta Beam Spot Analysis
Balazs Nyiri, 10 December 2010
Danielle Fraser, 19 November 2010
Other Presentations
•
RADPOS - 4D in vivo dosimetry system
JE Cygler, CCO sponsored “IMRT Ontario Physics Meeting”, 13 February
•
Clinical Applications of Monte Carlo Based Treatment Planning – New Concepts and
Considerations
JE Cygler, Radiation Oncology Physics Rounds, 6 October
•
Clinical Application of Electron Beams
JE Cygler, In-service lecture for therapists, 4 October
Page 26/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
11 National/International Conference Representation
AAPM (American Association of Physicists in Medicine) Annual Scientific Meeting,
Philadelphia, PA, 20-23 July 2010
Brenda G Clark, Joanna Cygler, Nicolas Ploquin, David E Wilkins
AAPM/ASTRO Meeeting on Safety in Radiation Therapy, Miami, FL, 24-25 June 2010
Brenda G Clark
CARO (Canadian Association of Radiation Oncology) Annual Meeting, Vancouver, 22-25 Sep
Brenda G Clark, Ryan Studinski, David E Wilkins
COMP (Canadian Organization of Medical Physicists) Annual Meeting, Ottawa, 17-19 June
Crystal Angers, Jason Bélec, Lesley Buckley, Brenda G Clark, Joanna Cygler, Gosia
Niedbala, Balazs Nyiri, Eric Vandervoort, David E Wilkins
COMP (Canadian Organization of Medical Physicists) Winter School on Quality and Safety in
Radiation Therapy, 24-28 January, Banff
D. Wilkins
ISMRM (Intenational Society for Magnetic Resonance in Medicine) Annual Scientific Meeting,
Stockholm, Sweden, 1-7 May
Ian Cameron
RSNA (Radiological Society of North America) Annual Meeting, Chicago, IL, 28 Nov – 3 Dec
Ian Cameron
Page 27/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
PROFILE OF PHYSICISTS
Crystal Plume Angers, M.Sc., MCCPM................................... 29
Jason Bélec, M.Sc., MCCPM ................................................ 30
Lesley Buckley, Ph.D., MCCPM ............................................ 31
Ian G. Cameron, Ph.D., FCCPM ........................................... 32
Brenda G. Clark, Ph.D., FCCPM, FAAPM ................................ 33
Joanna E. Cygler, Ph.D., FCCPM, FAAPM............................... 34
Lee H. Gerig, Ph.D., FCCPM ................................................ 34
Elizabeth Henderson, Ph.D., MCCPM .................................... 36
Chun-Bun Kwok, Ph.D., MCCPM .......................................... 37
Katie S. Lekx-Toniolo, Ph.D., MCCPM ................................... 38
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM ......................... 39
Balazs Nyiri, Ph.D., MCCPM ................................................ 40
Nicolas Ploquin, Ph.D., MCCPM............................................ 41
Ryan Studinski, Ph.D., MCCPM ............................................ 42
Janos Szanto, PhD., FCCPM ................................................ 43
Eric Vandervoort, PhD., MCCPM .......................................... 44
David E. Wilkins, Ph.D., FCCPM ........................................... 45
Page 28/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Crystal Plume Angers, M.Sc., MCCPM
Medical Physicist
The Ottawa Hospital Cancer Centre
Professional Certification:
2008
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
Development and implementation of new measurement devices for routine LINAC
quality assurance. New test methods and devices (such as ion chamber arrays and
diode arrays) are required to replace traditional film based test methods.
•
The application of process control to routine LINAC quality assurance testing.
Publications and Presentations:
2 peer reviewed articles, 7 published abstracts
Selected Publications:
J.J. Battista, R.B. Barnett, D.L.D. Mason, C.A. Plume, M.S. MacPherson, B. Fisher, A.T.
Porter, New radioactive isotope developed in Canada for cancer brachytherapy,
Current Onco. 2: 6-13, 1995.
C.A. Plume, S.E. Daly, A.T. Porter, R.B. Barnett, J.J. Battista, The Relative Biological
Effectiveness of Ytterbium-169 for Low Dose Rate Irradiation of Cultured
Mammalian Cell, Int. J. Radiat. Oncol. Biol. Phys. 25(5): 835-840, 1993.
Published Abstracts:
C. Angers, J. Renaud, M. MacPherson, B. Clark, Saving Trees and Improving Workflow,
Med. Phys. 35(7): 3413, presented at the Canadian Organization of Medical Physicists
annual meeting, Quebec City, Quebec, June 25 - 28, 2008.
C. Angers and J.E. Cygler, Beam Characterization of the Equinox Cobalt-60
Treatment Unit, Med. Phys. 34(6), 2422, presented at the American Association of
Physicists in Medicine, Minneapolis, Minnesota, July 22 - 26, 2007.
J. Battista, D. Mason, M. MacPherson, C.A. Plume, R. Barnett, G. Lazarescu, B. Fisher, A.
Porter, Ytterbium-169 Seeds for Brachytherapy: from the Laboratory to the
Operating Room, International Symposium on the Technical Basis for a Brachytherapy
System in Korea, Seoul Korea, October 17, 2002.
J.E. Cygler, B. Esche, C. Angers, L. Eapen, M. Labinaz, J.F. Marquis, Endovascular
brachytherapy strategies for treatment of coronary restenosis at sites of arterial
bifurcation, Radiotherapy and Oncology 64 (S1), S228, 21st Annual ESTRO Meeting,
Prague, Czech Republic, September 17-21, 2002.
J.E. Cygler, C. Angers, L. Eapen, M. Labinaz and J.F. Marquis, Use of THERAPLAN Plus
treatment planning system in endovascular brachytherapy, Radiotherapy & Oncology
61 (S1), S80 , ESTRO 6th biennial meeting of physics in clinical radiotherapy, Sevilla,
Spain, September 15-20, 2001.
Page 29/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Jason Bélec, M.Sc., MCCPM
Medical Physicist, The Ottawa Hospital Cancer Centre
Professional Certification:
2007
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
Comparative studies of realistic optimal solution space offered by several treatment
techniques (Tomotherapy, VMAT, step&shoot IMRT, CyberKnife, etc…).
•
Use of Monte Carlo calculations to study the impact of dynamic jaws on treatment time
for tomotherapy treatment.
•
Realistic Monte Carlo calculations of dose distribution for dynamic radiation treatments
(lung motion, VMAT, Tomotherapy, etc…)
•
Monte Carlo calculations of detector perturbation factors for dynamic treatments.
•
Use of Monte Carlo calculations to reconstructing 3D dose distributions from two
orthogonal 2D dectector arrays for dynamic treatments.
Publications and Presentations: 2 peer reviewed article, 9 published abstracts
Selected Publications:
J Bélec, N Ploquin, D La Russa, BG Clark: Position‐Probability‐Sampled Monte Carlo
Calculation of VMAT, 3DCRT, Step-Shoot IMRT and Helical Tomotherapy Dose
Distributions using BEAMnrc /DOSXYZnrc. Medical Physics 2011:38:948-960
J Bélec, HJ Patrocinio, F Verhaegen: Development of a Monte Carlo model for the
Brainlab microMLC. Physics in Medicine and Biology 2005:50:787-799
Published Abstracts:
H Al Hussain, S Malone, O Agboola, T N’Guyen, J Belec, K Carty, J Bahm, L Montgomery, JM Caudrelier, Prospective Study of Accelerated Radiation Therapy with
Tomotherapy Simultaneous Integrated Boost with Concomitant and Adjuvant
Temozolomide Chemotherapy in the Treatment of Glioblastoma Multiforme:
Dosimetric Data, ASTRO Annual Meeting, San Diego, CA, 2010
J Belec, N Ploquin, Daniel La Russa, B Clark, Position‐Probability‐Sampled Monte
Carlo Calculation of VMAT, 3DCRT, Step‐Shoot IMRT and Helical Tomotherapy
Dose Distributions using BEAMnrc /DOSXYZnrc, Presented at COMP Annual Meeting,
Ottawa, Ontario, 2010
A Haddad, S El-Sayed, R Zohr, J Belec, L Eapen, B Esche, L Grimard: A Prospective Trial
of Helical Tomotherapy (HT) in Patients with Head and Neck Cancer (HNC):
Results
of
Dosimetric
Comparisons
with
Three-Dimentional
Conformal
Radiotherapy (3D-CRT), Presented at ASTRO Annual Meeting, Chicago, IL, 2009
N Ploquin, J Belec, B Clark, Dosimetric comparison between helical tomotherapy and
biologically based IMRT treatment planning system for selected cases, Presented at
World Congress on Medical Physics and Biomedical Engineering, Munich, Germany, 2009
N Ploquin, J Belec, B Clark, IMRT dosimetry for prostate, breast and head-and-neck:
comparing biologically based step-and-shoot IMRT with dynamic helical
tomotherapy, Presented at COMP Annual Meeting, Quebec, Quebec, 2009
Page 30/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Lesley Buckley, Ph.D., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
Professional Certification:
2008
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
•
Monte Carlo simulation
Treatment planning algorithms
Publications and Presentations:
5 peer reviewed articles, 9 published abstracts
Selected Publications:
Lesley A. Buckley and D. W. O. Rogers. Wall correction factors, Pwall, for parallel-plate
ionization chambers. Med. Phys. 33, 1788-1796 (2006)
Lesley A. Buckley and D. W. O. Rogers. Wall correction factors, Pwall, for thimble
ionization chambers. Med. Phys. 33, 455-464 (2006)
Lesley A. Buckley, I. Kawrakow and D. W. O. Rogers. CSnrc: Correlated sampling Monte
Carlo calculations using EGSnrc. Med. Phys. 31, 3425-3435 (2004)
Lesley A. Buckley, I. Kawrakow and D. W. O. Rogers. An EGSnrc investigation of cavity
theory for ion chambers measuring air kerma. Med. Phys. 30, 1211-1218 (2003)
Lesley A. Buckley, Bruce R. Thomadsen and Larry A. DeWerd. The water equivalence of
phantom materials for 90Sr/90Y beta particles. Med. Phys. 28, 1010-1015 (2001)
Selected Abstracts:
G. Lagmago Kamta, L.A. Buckley, E Henderson, Clinical evaluation of an Atlas-Based
Auto-Segmentation application for auto-contouring pelvic targets and OARs, COMP
Annual meeting, Ottawa, ON, June 2010
L.A. Buckley and D.W.O. Rogers. Calculated Pwall values in clinical electron beams.
Presented at the AAPM annual meeting, Seattle WA, 2005.
L.A. Buckley and D.W.O. Rogers. Calculated Pwall values in clinical photon beams.
Presented at the COMP annual meeting, Hamilton ON, 2005.
L.A. Buckley, D.W.O. Rogers, M. Aznar and J. Medin. Monte Carlo calculated dose to
Al2O3 per unit dose to water in photon beams compared to measured OSL
response per unit dose to water. Presented at the AAPM annual meeting, Pittsburgh,
PA, 2004.
L.A. Buckley, I. Kawrakow and D.W.O. Rogers. A correlated sampling user code for the
EGSnrc system. Presented at the COMP annual meeting, Winnipeg MB, 2004.
Page 31/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Ian G. Cameron, Ph.D., FCCPM
Senior Medical Physicist, MRI Unit
The Ottawa Hospital
Adjunct Professor
Department of Physics, Carleton University
Associate Professor
Department of Radiology, University of Ottawa
Clinical Investigator
Ottawa Hospital Research Institute
Member
Ottawa Medical Physics Institute
Professional Certification:
2005
Canadian Collect of Physicists in Medicine, fellow, (FCCPM)
2003
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
With Magnetic Resonance Imaging (MRI), "pictures" of the inside of the body are obtained
noninvasively. The signals from which these MR images are made are generated mainly by 1H
nuclei of water. MRI has become a vital part of diagnostic medicine, especially for head, spine and
joint imaging. Two areas of MRI research, which, are available for graduate student involvement,
are diffusion MRI and perfusion MRI. Most of this work will be done on the MR scanners at the
Ottawa Hospital.
•
Contrast between tissues in an MR image is a result of differences in inherent tissue parameters
such as MR relaxation times or water diffusion coefficients (D) between tissues, however, the
physics of exactly how these processes contribute to the contrast is often unclear. MR diffusion
measurements are rich in information about the microscopic environment of the cells. The
challenge is to extract this information and display it in a meaningful way. Currently our focus is
on separating the intracellular behaviour from extracelluar dynamics for human brain white matter
in vivo and to study the exchange of water between these two environments.
Publications and Presentations:
30 peer reviewed articles, 63 presentations at national / international conferences
Selected Publications:
C Foottit, G.O. Cron, M.J. Hogan, T Nguyen and I.G. Cameron, Feasibility of using Phase to
Measure the Venous Output Function for Quantitative DCE-MRI in the Human Brain, Magn.
Reson. Med, 63, 772-781 (2010).
AM Smith, LAS Walker, M Freedman, C DeMeulemeester, M Hogan, IG Cameron. fMRI Investigation
of Disinhibition in Cognitively Impaired Patients with Multiple Sclerosis, J Neurological
Sciences, 281, 58-63 (2009).
J-M Caudrelier, M Vermandel, N Betrouni, B Nyiri, IG Cameron, J Rousseau, Towards an Accurate
and Robust Method Based on Fuzzy Logic Principles for the Reconstruction and
Quantification of Large Volumes from MR and CT Images, Br. J. Radiol. 82, 228-34 (2009)
A Cardenas-Blanco, C Tejos, P Irarrazaval, IG Cameron, Noise in Magnituded Magnetic Resonance
Images, Concepts in Magn. Reson. 32A(6), 409-416 (2008).
C. Gomez-Laberge, A Adler, IG Cameron, T Nguyen, MJ Hogan, Selection Criteria for the Analysis
of Data-driven Clusters in Cerebral fMRI, IEEE Trans. On Biomed. Engineering, 55(10), 23722380 (2008).
Page 32/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Brenda G. Clark, Ph.D., FCCPM, FAAPM
Chief, Medical Physics, The Ottawa Hospital Cancer Centre
Adjunct Research Professor, Department of Physics, Carleton University
Associate Professor, Department of Radiology, University of Ottawa
Adjunct Professor, Department of Physics and Astronomy, University of British Columbia
Clinical Investigator, Ottawa Hospital Research Institute
Member, Ottawa Medical Physics Institute (OMPI)
Professional Certification:
1995
Canadian College of Physicists in Medicine, fellow, (FCCPM).
1989
Canadian College of Physicists in Medicine, member, (MCCPM).
Research Interests:
•
Stereotactic Radiosurgery is the ablation of small lesions in the brain with a single dose
of high energy radiation. Dosimetric studies ensure optimisation of the parameters of
the treatment delivery process to achieve this goal.
•
Stereotactic Radiotherapy is the irradiation of small lesions in the brain with a
tumouricidal dose of high energy radiation delivered over a period of several days or
weeks with the aim of sparing healthy tissue close to the treatment volume. We are
studying various aspects of this treatment including the reproducibility of the patient
positioning system to verify the precision of dose placement.
•
The use of learning systems to improve patient safety and radiation processes.
Publications and Presentations:
55 peer reviewed articles, 23 invited presentations, >130 presentations at national /
international conferences, 3 patents
Selected Recent Publications:
B.G. Clark, R.J. Brown, J.L. Ploquin, A.L. Kind, L. Grimard: The management of radiation
treatment error through incident learning. Radiother Oncol 95 (2010) 344-349
A. Mestrovic, A Nichol, B. G. Clark, K Otto: Integration of on-line imaging, plan adaptation and
radiation delivery: proof of concept using digital tomosynthesis. Phys Med Biol 54,3803-3819,
2009
B. McCurdy, L.Duggan, S. Howlett, B. G. Clark: A comparison of medical physics training and
education programs – Canada and Australia Aus Phys & Eng Sci in Med 32 (4),251-260, 2009
Clark BG, Candish C, Vollans E, Gete E, Lee R, Martin M, Ma R, McKenzie M.: Optimization of
stereotactic radiotherapy treatment delivery technique for base-of-skull meningiomas. Med
Dosim; 33(3): 239-247, 2008
Benedict SH, Bova FJ, Clark BG, Goetsch SJ, Hinson WH, Leavitt DD, Schlesinger DJ, Yenice KM.: The
role of medical physicists in developing stereotactic radiosurgery Med. Phys. 35, 4262, 2008
Mestrovic A, Milette MP, Nichol A, Clark B.G., Otto K. Direct aperture optimization for online
adaptive radiation therapy. Med Phys 34 (5):1631-46; 2007
Page 33/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Joanna E. Cygler, Ph.D., FCCPM, FAAPM
Senior Medical Physicist, The Ottawa Hospital Cancer Centre
Adjunct Research Professor, Department of Physics, Carleton University
Associate Professor, Department of Radiology, University of Ottawa Hospital
Clinical Investigator, Ottawa Health Research Institute (OHRI)
Member, Ottawa Medical Physics Institute (OMPI)
Professional Certification:
1994 Canadian College of Physicists in Medicine, fellow, (FCCPM)
1994 Canadian College of Physicists in Medicine, member, (MCCPM)
Awards:
2007
Fellow, American Association of Physicists in Medicine, (FAAPM)
Research Interests:
Main research interests: dosimetry (with emphasis on electron beams), brachytherapy, development
of new in-vivo dosimeter methods and detectors, 4D dosimetry, image guided radiotherapy, adaptive
radiotherapy, Monte Carlo dose calculations, radiobiology.
Publications and Presentations:
1 book (co-editor), 5 book chapters, 50 peer reviewed articles, >130 published abstracts, over 40
invited presentations, 1 CAPCA technical report, 1 other
Selected Publications:
J. Crook, J. Jezioranski, J. E. Cygler, Penile brachytherapy: Technical aspects and postimplant
issues, Brachytherapy 9, 151-158, 2010
A. Cherpak, W. Ding, A. Hallil, JE. Cygler, Evaluation of a novel 4D in vivo dosimetry system,
Med. Phys. 36, 1672-1679, 2009
L. A.R. Viamonte, L.A. da Rosa, L. Buckley, A. Cherpak and J. E. Cygler, Radiotherapy dosimetry
using a commercial OSL system, Med. Phys. 35, 1261-1266, 2008
A. Cherpak, R. C.N. Studinski, J. E. Cygler,MOSFET detectors in quality assurance of
tomotherapy treatments, Radiother. Oncol., 86, 242–250, 2008
I. Chetty, B. Curran, J.E. Cygler et al. Report of the AAPM Task Group No. 105: Issues associated
with clinical implementation of Monte Carlo-based photon and electron external beam
treatment planning. Med Phys 34, 4818-4853; 2007.
L. Grimard, B. Esche, A. Lamothe, J. Cygler, J. Spaans: Interstitial low-dose-rate brachytherapy
in the treatment of recurrent head and neck malignancies: Head & Neck 28: 888-895, 2006
B.A. Faddegon, J.E. Cygler. Use of Monte Carlo Method in Accelerator Head Simulation and
Modelling for Electron Beams, Integrating New Technologies into Clinic: Monte Carlo and
Image-Guided Radiation Therapy. AAPM Monograph No. 32, edited by B.H. Curran, J.M. Balter,
I.J. Chetty, Medical Physics Publishing (Madison, WI, 2006), p.51-69.
J.E. Cygler, A. Saoudi, G. Perry, C. Morash, C. E. Feasibility study of using MOSFET detectors for
in vivo Dosimetry during permanent low-dose-rate prostate implants. Radiotherapy and
Oncology, 80: 296-301, 2006.
J.E. Cygler, E. Heather, G.X. Ding, J.P. Seuntjens. Monte Carlo Systems in Preclinical and
Clinical Treatment Planning: Pitfalls and Triumphs. AAPM Monograph No. 32, edited by B.H.
Curran, J.M. Balter, I.J. Chetty, Medical Physics Publishing (Madison, WI, 2006), p.199-232.
J.E. Cygler, G.M. Daskalov, G.H. Chan, G.X. Ding: Evaluation of the first commercial Monte Carlo
dose calculation engine for electron beams treatment planning, Med. Phys. 31:142-153, 2004.
Page 34/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Lee H. Gerig, Ph.D., FCCPM
Senior Medical Physicist, The Ottawa Hospital Cancer Centre
Adjunct Professor, Department of Physics, Carleton University
Associate Professor, Department of Radiology, University of Ottawa
Clinical Investigator, Ottawa Health Research Institute (OHRI)
Member, Ottawa Medical Physics Institute (OMPI)
Professional Certification:
1992
Canadian College of Physicists in Medicine, fellow, (FCCPM)
1992
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
We are developing a model by which we can examine the entire radiation cancer treatment process,
including staging, imaging, prescription, treatment planning and finally treatment delivery. The model
treats the radiation therapy process as a linear chain, in that information is collected and passed from
one stage of patient care to the next. The output of one stage acts as the input for the next. As a
simple example, staging is determined based on the results of many tests including biochemistry,
imaging and physical examination. Thus the output of the testing acts as the input for determination
of the target volume. This chain continues and culminates in the delivery of treatment. As a result of
the temporal and spatial dose actually delivered the patient experiences an outcome (product). Thus,
any weakness or error in any part of the chain will contribute to a reduced probability of a favourable
outcome. In order to achieve optimal improvement in the system with finite resources the weakest
links in the chain must be identified. The model is coupled to a biological response in order to predict
outcome. We have chosen for this model the linear quadratic model with a repair term and
Gompertzian growth kinetics and we will use Normal Tissue Complication Probability (NTCP) and
Tumour Control Probability (TCP) as our endpoints. Combining all of these elements we hope to
develop a model which would help predict the impact of various changes of practice and the
introduction of new technologies. Integrating this with estimates on the cost (negative or positive) of
the changes one can then make a predictive cost benefit analysis.
Publications and Presentations:
46 peer reviewed articles, 56 published abstracts, 3 technical reports
Selected Publications:
LH Gerig, M Niedbala, BJ Nyiri Dose perturbations by two carbon fiber treatment couches and the
ability of a commercial treatment planning system to predict these effects. Med Phys Jan;37:322-8
2010
LM Garcia, LH Gerig, GP Raaphorst, DE Wilkins, Junctioning longitudinally adjacent PTVs with
helical tomotherapy. Journal of Applied Clinical Medical Physics 11(2):62-80, 2010
R Samant, LH Gerig, L Montgomery, M MacPherson, G Fox, R MacRae, K Carty, S Andrusyk, P Genest,
B Nyiri, "Rapid palliative radiotherapy: comparing IG-IMRT with more conventional
approaches", Journal of Radiotherapy in Practice, 9, 143-148, 2010
Macpherson M, Montgomery L, Fox G, Carty K, Gerig LH, MacRae R, et al. On-line rapid palliation
using helical tomotherapy: a prospective feasibility study. Radiother Oncol 2008;87(1):116-8
WK Myint, M Niedbala, D Wilkins, LH. Gerig Investigating treatment dose error due to beam
attenuation by a carbon fiber tabletop, J. Applied Clin. Med Phys, 7(3), 2006
Page 35/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Elizabeth Henderson, Ph.D., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
Assistant Professor
Department of Radiology, University of Ottawa
Member
Ottawa Medical Physics Institute (OMPI)
Professional Certification:
2003 Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
The development of dynamic, contrast-enhanced DT and MR techniques for imaging
tumour physiology. In these techniques, CT or MR imaging in which a tracer kinetic
model is fit to the data from a dynamic contrast-enhanced CT study, giving
measurements of physiological parameters such as tissue perfusion, capillary
permeability, and blood volume. Measurements of these physiological parameters
may be useful for determining cancer patient prognosis, predicting response to
various therapies, or in defining biological target volumes for radiation therapy.
Publications and Presentations:
7 peer reviewed articles, 21 published abstracts
Selected Publications:
M.A. Haider, M. Milosevic, A. Fyles, I. Sitartchouk, I. Yeung, E. Henderson, G. Lockwood, TY. Lee, T.P.L. Roberts Assessment of the tumor microenvironment in cervix cancer
using dynamic contrast enhanced CT, interstitial fluid pressure and oxygen
measurements. Int. J.Rad.Onc.Biol.Phys.62: 1100-7, 2005.
E. Henderson, M.F. Milosevic, M.A. Haider, I.W.T. Yeung Functional CT imaging of
prostate cancer. Physics in Medicine and Biology 48: 3085-3100, 2003.
T.G. Purdie, E. Henderson, T.-Y. Lee Functional CT imaging of angiogenesis in rabbit
VX2 soft tissue tumour. Physics in Medicine and Biology 46: 3161-75, 2001.
E. Henderson, J. Sykes, D. Drost, M.K. Welch, H.-J. Weinmann, B.K. Rutt, T.-Y. Lee MR
measurement oftracer kinetic parameters in a spontaneous canine breast tumour
model: a comparison between two MR contrast agents.
Journal of Magnetic
Resonance Imaging 12: 991-1003, 2000.
P.S. Tofts, G. Brix, D. Buckley, J.L. Eveloch, E. Henderson, M. Knopp, H.B.W. Larsson, T.-Y.
Lee, G.J.Parker, R.E. Port, J. Taylor, R.M. Weisskoff Estimating kinetic parameters from
dynamic contrast-enhanced T1-weighted MRI of a diffusible tracer: a common
global language for standardised quantities and symbols. Journal of Magnetic
Resonance Imaging 10: 223-232, 1999.
Page 36/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Chun-Bun Kwok, Ph.D., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
Assistant Professor,
Department of Radiology, University of Ottawa
Professional Certification:
2001
Canadian College of Physicists in Medicine, member, (MCCPM)
2000
Review A for Medical Physics of Cancer Care Ontario
Research Interests:
Two areas of special research interests: IGRT research and non x-ray film based quality
assurance (QA) of treatment accelerator.
Image-Guided Radiation Therapy - The IGRT research focuses on assuring the
congruence between imaging and radiation therapy. In the case of x-ray based IGRT (kV
CBCT, MVCT, etc. imaging), the congruence investigation is done by means of determining
the respective imaging/therapy beam focal spots and beam geometries.
Non x-ray film based quality assurance (QA) of treatment accelerator - The aim of
this studying was to reduce and eventually eliminate the use of x-ray film in the quality
assurance of radiation treatment unit. The proposed was to investigate and evaluate
currently available, non x-ray film based treatment machine quality assurance (non x-ray
film based machine QA) techniques. In addition, it was proposed to adopt appropriate non
x-ray film based machine QA techniques at The Ottawa Hospital Cancer Centre (TOHCC).
Publications and Presentations:
10 peer reviewed articles, 31 published abstracts
Selected Publications:
C.B. Kwok, G. Lam, and S. El-Sayed, Suitability of using multi-leaf collimator (MLC)
for photon field matching, Medical Dosimetry 29:184-195, 2004.
G.X. Ding, J.E. Cygler, and C.B. Kwok, Clinical reference dosimetry: Comparison
between AAPM TG-21 and TG-51 protocols, Med. Phys. 27:1217-1225, 2000.
R. Rathee, C.B. Kwok, C. MacGillivray and M. Mirzaei, Commissioning, Clinical
Implementation and Quality Assurance of Siemens’ Virtual WedgeTM, Medical
Dosimetry, Vol. 24(2):145-153, 1999.
C.B. Kwok, M.S. Mathur and J.S.C. McKee, Photoconductivity Improvement in H+
implanted a-Si:H thin film, Materials Letters, 10:457-460, 1991.
M.S. Mathur, C.B. Kwok and J.S.C. McKee, Energetic H2+ assisted Deposition of Thin
Films of Ag and Au, J. Phys. D: Appl. Phys. 22:1228-1230, 1989.
Page 37/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Katie S. Lekx-Toniolo, Ph.D., MCCPM
Medical Physicist
The Ottawa Hospital Cancer Centre
Assistant Professor,
Department of Radiology, University of Ottawa
Research Interests:
•
MRI, SPECT, PET/CT, and clinical radiotherapy physics
•
Validation of 82Rubidium PET perfusion
pharmacologically induced hyperemia
•
Myocardial blood flow, function, metabolism & viability imaging using MRI, SPECT & PET
•
The assessment of myocardial viability using MRI with Gd-DTPA
measurements
at
rest
and
during
Publications and Presentations:
6 peer reviewed articles, 17 published abstracts, 4 invited presentations
Selected Publications:
Lekx KS, deKemp RA, Beanlands RS, Wisenberg G, Wells RG, Lortie M, Klein R, Zabel P,
Kovacs MS, Sykes J, Prato FS. 3D vs. 2D dynamic 82Rb myocardial blood flow imaging
in a canine model of stunned and infarcted myocardium. Nucl Med Commun.
Jan;31(1):75-81, 2010.
Lekx KS, deKemp RA, Beanlands RS, Wisenberg G, Wells RG, Lortie M, Klein R, Zabel P,
Kovacs MS, Sykes J, Prato FS. Quantification of Regional Myocardial Blood Flow in a
Canine Model of Stunned and Infarcted Myocardium: Comparison of 82Rb PET with
Microspheres. Nucl Med Commun. Jan;31(1):67-74, 2010.
Wisenberg G, Lekx K, Zabel P, Kong H, Mann R, Zeman PR, Datta S, Culshaw CN, Merrifield
P, Bureau Y, Wells G, Sykes J, Prato FS. Cell tracking and therapy evaluation of bone
marrow monocytes and stromal cells using SPECT and CMR in a canine model of
myocardial infarction. J Cardiovasc Magn Reson Apr 27;11(1):11, 2009.
Lekx KS, Fathimani M, Bureau Y, Wisenberg G, Sykes J, Prato FS. Comparison of the
detection of subtle changes in myocardial regional systolic function using
qualitative and semi-quantitative techniques. J Cardiovasc Magn Reson 8(5):731-739,
2006.
Lekx KS, Prato FS, Sykes J, Wisenberg G. The partition coefficient of Gd-DTPA reflects
maintained tissue viability in a canine model of chronic critical coronary stenosis
using MRI. JCMR 6(1):35-44, 2004.
Pereira RS, Prato FS, Lekx K, Sykes J, Wisenberg G. Contrast-enhanced MRI for the
assessment of myocardial viability after permanent coronary artery occlusion.
Magn Reson Med 44: 309-316, 2000.
Page 38/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
Assistant Professor,
Department of Radiology, University of Ottawa
Professional Certification:
2008
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
Tomotherapy Adaptive Planning
•
Dose perturbation due to elements between the beam and the patient.
Publications and Presentations:
6 peer reviewed articles, 7 published abstracts
Selected Publications:
WK Myint, M Niedbala DE Wilkins, LH Gerig. Investigating treatment dose error due to
beam attenuation by a carbon fiber tabletop. J Appl Clin Med Phys. 2006 Aug
24:7(3):21-7.
M Niedbala, JP McNamee, GP Raaphorst. Response to pulsed dose rate and low dose
rate irradiation with and without mild hyperthermia using human breast
carcinoma cell lines. Int J Hyperthermia. 2006 Feb;22(1):61-75.
GP Raaphorst, DP Yang, G Niedbala. Is DNA polymerase beta important in thermal
radiosensitization? Int J Hyperthermia. 2004 Mar;20(2):140-3.
M Niedbala, CE Ng, GP Raaphorst. Response to pulsed dose rate irradiation with and
without mild hyperthermia using tumour and normal cell lines. Int. J.
Hyperthermia. 17:536-544, 2001
M Niedbala, G Alsbeih, CE Ng, GP Raaphorst. Equivalence of Pulsed-Dose-Rate to LowDose-Rate Irradiation in Tumor and Normal Cell Lines. Radiation Research. 155:297303, 2001
Published Abstracts:
M Niedbala, B Nyiri, LH Gerig. Dose Errors Related to the Treatment Couch. Canadian
Organization of Medical Physicists Annual Meeting, Quebec City, Quebec City, June 2008.
M Niedbala, J Belec, B Nyiri, MS MacPherson, LH Gerig. On the use of non water
equivalent phantoms for IMRT QA. Canadian Organization of Medical Physicists Annual
Meeting, Toronto, Ontario, October 2007.
K Myint, M Niedbala, D E Wilkins, L.H Gerig. An evaluation of treatment dose error due
to beam attenuation from a carbon fiber table top. Canadian Organization of Medical
Physicists Annual Meeting, Hamilton, Ontario, June 2005, Medical Physics 32, July 2005.
Page 39/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Balazs Nyiri, Ph.D., MCCPM
Medical Physicist, The Ottawa Hospital Cancer Centre
Assistant Professor, Department of Radiology, University of Ottawa
Member, Ottawa Medical Physics Institute (OMPI)
Professional Certification:
2006
Canadian College of Physicists in Medicine, member (MCCPM)
2003
Review A for Medical Physics of Cancer Care Ontario
Research Interests:
Mathematical Physics & Modeling, Statistical analysis, Image processing and analysis, Linear
accelerator QA; IMRT/IMRT delivery, Stereotactic Radiosurgery/Radiotherapy
Current interests
Linac beam spot physics: ionchamber and diode array based co-rotational dosimetry
combined with image based geometric approaches to develop efficient measurement
techniques, to understand its effect on the accuracy of QA techniques and treatment beam.
Image processing & analysis and 3D synthesis in general and applied to
- Gafchromic film and Epid image based QA, dosimetry and automated geometric analysis
- Motion and feature analysis from 4DCT techniques and applied to breast IMRT planning
Total Marrow Irradiation with Helical Tomotherapy
- CT and Dose image operations for treatment planning, plan evaluation and analysis
- Patient Motion studies and statistical analysis for margin optimization
Dosimetric effect of Treatment Couch on radiotherapy planning, delivery & delivery QA.
Publications and Presentations:
20 peer reviewed articles, 36 published abstracts, 2 invited/landmark lectures, 8/4
patents/inventions.
Selected Recent Publications:
R Samant, L Gerig, L Montgomery, M MacPherson, G Fox, R MacRae, K Carty, S Andrusyk, P
Genest, B Nyiri. Rapid palliative radiotherapy: comparing IG-IMRT with more
conventional approaches. Journal of Radiotherapy in Practice (2010) 9, 143-148
Atkins H, Montgomery L, Carty K, Niedbala G, Nyiri B, Fox G, Wilkins D, Huebsch L, Garcia
ML, Gerig L, Samant R. Total Marrow Irradiation and Autologous Stem Cell
Transplantation for the Treatment of Multiple Myeloma. 12th Canadian Blood and
Marrow Transplant Group Meeting April 7-10, (2010)
M Niedbala, H Atkins, L Gerig, C Karty, L Montgomery, B Nyiri, R Samant. Total Marrow
Irradiation Using Helical Tomotherapy in Treating a Multiple Myeloma Patient: A
Case Study Med. Phys. 37 7, 3905 (2010) 56th annual COMP
L Gerig, M Niedbala, and B Nyiri: Dose perturbations by two carbon fiber treatment
couches and the ability of a commercial treatment planning system to predict
these effects. Med Phys 2010 37(1):322-8; #1 in category @BioMedLib 7Mar2011
LM Garcia, DE Wilkins, LH Gerig, B Nyiri, GP Raaphorst, Optimum Frequency of Spatial
Registration in Image Guided Radiation Therapy for TMI, 56th COMP Annual Meeting,
June 16 – June 19, (2010), Ottawa, Canada
Page 40/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Nicolas Ploquin, Ph.D., MCCPM
Medical Physicist, The Ottawa Hospital Cancer Centre
Assistant Professor, Department of Radiology, University of Ottawa
Member, Ottawa Medical Physics Institute (OMPI)
Research Interests:
Implementation, evaluation and comparison of Volumetric Arc Therapy with current
state-of-the-art IMRT techniques (step-and-shoot, sliding window, tomotherapy)
Clinical and Economic Evaluation of current radiation therapy modalities
Stereotactic Radiosurgery
Publications and Presentations: 10 peer reviewed articles, 13 published abstracts
Selected Publications:
W. Smith, G. Menon, N. Wolfe, N. Ploquin, T. Trotter, D. Pudney. IMRT for breast: a
comparison of planning techniques. Phys. Med. Biol. 55, 1231-41, 2010
N. Ploquin, P. Dunscombe. A Cost-Outcome Analysis of Image Guided Patient
Repositioning in the Radiation Treatment of Cancer of the Prostate. Radiother.
Oncol., 93, 25-31, 2009
N. Ploquin, A. Rangel, P. Dunscombe. Phantom evaluation of a commercially available
three modality Image Guided Radiation Therapy system. Med. Phys.; 35(12): 530311, 2008
N. Ploquin, P. Dunscombe. The cost of radiation therapy. Radiother. Oncol., 86, 217223, 2008
A. Rangel, N. Ploquin, I. Kay, P. Dunscombe. Evaluation of linear accelerator
performance standards using an outcome oriented approach. Med Phys.;
35(6):2513-8, 2008.
A. Rangel, N. Ploquin, I. Kay, P. Dunscombe. Towards an objective evaluation of
tolerances for beam modeling in a treatment planning system. Phys Med Biol. 7;
52(19):6011-25, 2007.
P. Dunscombe, S. Iftody, N. Ploquin, E. Ekaette, R. Lee. The Equivalent Uniform Dose as
a Severity Metric for Radiation Treatment Incidents. Radiother. Oncol. 84 64-66, 2007
N. Ploquin, I. Kay, A. Rangel, H. Lau, P. Dunscombe. A comparison of techniques for
simulating set-up error and uncertainty in head and neck IMRT. Med. Phys. 33 (9),
3213-19, 2006
N. Ploquin, W. Song, H. Lau, P. Dunscombe. Intensity Modulated Radiation Therapy for
oropharyngeal cancer: the sensitivity of plan objectives and constraints to set-up
uncertainty. Phys. Med. Biol. 50 3515-33, 2005
Page 41/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Ryan Studinski, Ph.D., MCCPM
Medical Physicist
The Ottawa Hospital Cancer Centre
Professional Certification:
2008
Canadian College of Physicists in Medicine, member, (MCCPM)
2007
Review A for Medical Physics of Cancer Care Ontario
Research Interests:
•
Development and implementation of quality assurance procedures for
image guided conformal radiotherapy and tomotherapy units. Advances
in radiation therapy are changing the way treatment is delivered, relying on
supplemental imaging equipment and complex intrafraction machine motion.
Local standards need to be developed as technology is implements even as
National standards are still in development in many cases.
•
Application of historical brachytherapy planning to modern dose
protocols. The Paris System is a relatively simple methodology of planning
high dose rate brachytherapy for treatment of breast cancer. Can a relatively
simple method of planning meet complex dose distribution requirements such as
those set out by the RTOG? This can be determined by doing dosimetric studies
on past breast patients to look for relationships between their plans and the
dosimetric criterion.
Publications and Presentations:
7 peer reviewed articles, 8 published abstracts
Selected Publications:
Studinski R, O’Meara J, McNeill F. The feasibility of in vivo measurement of arsenic and
silver by x-ray fluorescence. X-Ray Spectrom 37 51-57 (2008)
Cherpak A, Studinski RCN, Cygler JE MOSFET Detectors in Quality Assurance of
Tomotherapy Treatments. Radiother Oncol 86 242-250 (2007)
Studinski RC, McNeill FE, O'Meara JM, Chettle DR. A method detection limit for potential in
vivo arsenic measurements with a 50 W x-ray tube. Phys Med Biol. 51 N381-7 (2006)
Studinski R C N, McNeill F E, Chettle D R and O'Meara J M. Estimation of a Method
Detection Limit for an in vivo XRF Arsenic Detection System. Phys Med Biol 50 521-530
(2005).
Studinski R C N, McNeill F E, Chettle D R and O'Meara J M. XRF analysis of arsenic-doped
skin phantoms. X-Ray Spectrom 33 285-288 (2004)
Page 42/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Janos Szanto, PhD., FCCPM
Senior Medical Physicist,
The Ottawa Hospital Cancer Centre
Associate Professor
Department of Radiology, University of Ottawa
Member
Ottawa Medical Physics Institute (OMPI)
Clinical Investigator
Ottawa Health Research Institute (OHRI)
Professional Certification:
1994
Canadian College of Physicists in Medicine, fellow (FCCPM)
1993
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
•
Design and Dosimetry of a Fractionated Stereotactic Radiotherapy System.
•
At the Ottawa Cancer Centre we have developed a unique system for the delivery of
fractionated stereotactic radiotherapy. Patients are immobilized in a very accurate,
stable, reproducible, non-invasive, relocatable stereotactic frame which is based on a
custom made Cobalt-Chrome bite-block that locks into the undercuts of the teeth with
an accuracy of ± 1mm.
•
The dosimetry of small, high energy X-ray beams has been investigated both
experimentally and by Monte-Carlo calculations. Some difficulty arises from the lack of
lateral electronic equilibrium and the detectors' relatively large sizes.
Publications and Presentations:
22 peer reviewed articles, 55 published abstracts
Selected Publications:
Z. Gao, J. Szanto, L. H. Gerig: Using MLC Inter-Leaf Leakage to Extract Absolute
Spatial Information from EPID Images. Journal of Applied Clinical Medical Physics, Vol
8, No 1 (2007)
S. Malone, J. Szanto, G. Alsbeih, E. Szumacher, L. Souhami, R. Gray, A. Girard,
P.Raaphorst, L. Grimard: Radiation sensitivity testing and late neurological
complications following radiosurgery for AVM: the use of SF2 from fibroblasts as a
predictive factor. Cancer/Radiotherapie 7(4): 225-230, 2003.
S. Malone, J. Szanto, G. Alsbeih, E. Szumacher, L. Souhami, R. Gray, A. Girard, G.P.
Raaphorst, l. Grimard: Radiosensibilité et séquelles neurologiques tardives suite à la
radiochirurgie de malformation artérioveineuse: le SF2 comme nouveau facteur
prédictif. Cancer Radiotherapie 7: 225-230, 2003
S. Malone, R. Donker, S. Dahrouge, L. Eapen, I Aref, G. Perry, J. Szanto: Treatment
planning aids in prostate cancer: friend or foe? Int. J. Rad. Onc. Biol. Phys. 51(1): 4955, 2001.
Page 43/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
Eric Vandervoort, PhD., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
Associate Professor
Department of Radiology, University of Ottawa
Member
Ottawa Medical Physics Institute (OMPI)
Professional Certification:
2010
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
My graduate research involved the development of attenuation and Compton scatter
correction methods for quantititaive imaging in PET and SPECT imaging. Since starting at
the Ottawa hospital cancer centre, my research has focused on the implementation and
commissioning of a Monte-Carlo treatment planning system for electrons. I am also
developing patient specific QA processes using gafchromic film and volumetric dose
comparison methods for treatment modalities with high spatial dose gradients in 3dimensions (e.g., cyberknife, electron treatments, VMAT and brachytherapy).
Publications and Presentations:
Peer-Reviewed Articles:
•
•
•
•
•
S. Groman, B. Lee, E. London, M. Mandelkern, A. James, K. Feiler, R. Rivera, M.
Dahlbom, V. Sossi, E. Vandervoort, and J. Jentsch (2011) "Dorsal Striatal D2-Like
Receptor Availability Co-varies with Sensitivity to Positive Reinforcement during
Discrimination Learning" accepted for publication in the Journal of Neuroscience.
Vandervoort E. and Sossi V. (2008) “Impact of contamination from scattered photons
in singles-mode transmission data on quantitative small-animal PET imaging”. J. Nucl.
Med., 49(11): 1852-1861.
Vandervoort E. and Sossi V. (2008) “An analytical scatter correction for singles-mode
transmission data in PET”. IEEE Trans. Med. Imaging 27(3):402-412.
Vandervoort E., Camborde M.-L., Jan S. and Sossi, V. (2007) “Monte-Carlo modeling
of singles-mode transmission data for small animal PET scanners”. Phys. Med. Biol.
52(11): 3169-3184.
Vandervoort E., Celler A. and Harrop R. (2007) “Implementation of an iterative
scatter correction, the influence of attenuation map quality and their effect on absolute
quantitation in SPECT”. Phys. Med. Biol. 52(5): 1527-1545.
Published abstracts:
•
•
Vandervoort E. and Cygler J.E. (2010) ““Evaluation of a New Commercial Monte-Carlo
Treatment Planning System for Electrons”, 56th Annual Meeting of the Canadian
Organization of Medical Physicists and the Canadian College of Physicists in Medicine.
Gil E., Vandervoort E., Clark B. and Cygler J.E. (2009) “Impact of Dose-to-Water
Versus Dose-to-Medium in Electron Beam Monte Carlo Based Treatment Planning for
Breast”, AAPM 51st Annual Meeting, Anaheim, USA
Page 44/45
BGC/April 2011
Annual Report 2010
Medical Physics
The Ottawa Hospital Cancer Centre
David E. Wilkins, Ph.D., FCCPM
Senior Medical Physicist, Medical Physics
The Ottawa Hospital Cancer Centre
Radiation Safety Officer
The Ottawa Hospital Cancer Centre
Adjunct Professor
Department of Physics, Carleton University
Assistant Professor
Department of Radiology, University of Ottawa Hospital
Clinical Investigator
Ottawa Health Research Institute (OHRI)
President, Canadian College of Physicists in Medicine
Profession Certification:
1999
Canadian College of Physicists in Medicine, fellow, (FCCPM).
1997
Canadian College of Physicists in Medicine, member, (MCCPM)
Research Interests:
Biological modeling of emerging radiation treatment strategies, altered fractionation,
tumour proliferation.
Statistical analysis of clinical and experimental data to determine meaningful parameters for
radiobiological modeling, and to explore the limitations of existing models.
Publications and Presentation:
25 peer reviewed articles, 58 published abstracts
Selected Publications:
Loudes M. Garcia, Lee H. Gerig, G.P. Raaphorst, D. Wilkins. Junctioning longitudinally
adjacent PTVs with helical tomotherapy.
Journal of Applied Clinical Medical Physics,
11(2):62-80, 2010.
L.M. Garcia, J. Leblanc, D. Wilkins, GP Raaphorst. Fitting the linear quadratic model to
detailed data sets for different dose ranges. Physics in Medicine and Biology 51:28132823, 2006.
Kenji Myint, Gosia Niedbala, David Wilkins, Lee Gerig. Investigating treatment dose
error due to beam attenuation by a carbon fiber tabletop. Journal of Applied Clinical
Medical Physics, accepted for publication April 2006.
M. Carlone, D. E. Wilkins, G. P. Raaphorst: Radiobiological parameters suitable for
modeling individual outcomes cannot be obtained by analyzing heterogeneous
population data with homogeneous tumour control model: In regard to D’Souza et
al. Int J Radiat Oncol Biol Phys 58: 1540-1548, 2004. Letter to the Editor, International
Journal of Radiation Oncology Biology Physics 62: 298-299, May 2005.
Page 45/45
BGC/April 2011