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MEDICAL PHYSICS
THE OTTAWA HOSPITAL
CANCER CENTRE
ANNUAL REPORT
2008
Annual Report 2008
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 Oncology 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 2008, the radiation
therapy program treated 3,492 patients, delivering a total of 66,849 treatments. Dr. Ian
Cameron provides support to the Magnetic Resonance Imaging Unit in the Department of
Diagnostic Imaging at The Ottawa Hospital.
The most significant event of 2008 for the TOHCC Medical Physics group was the discovery
of an error in the dose rate tables for the low energy (orthovoltage) treatment unit at the
Civic Campus, in clinical use for a period of 3 years. Extensive investigation revealed that
this error had resulted in underdosing to more than 300 patients treated on this unit with
curative intent for skin cancer. As the professional group responsible for the accuracy of
radiation treatments in the centre, this was a severe blow to the group. The experience of
dealing with this discovery has provided us with many opportunities to learn how to improve
the service we provide to the Radiation Oncology Program.
There were several major equipment changes during 2008. In early April, we began patient
treatments in our newly commissioned portable bunker, a temporary installation enabling us
to increase our treatment capacity during construction of our expanded facilites currently
underway. The fall saw the installation of a micro-multileaf collimator with associated
treatment planning software plus a kilovolt X-ray image-guidance system to upgrade our
stereotactic radiosurgery program. A 14 year old Siemens Mevatron at the Civic campus
and the cobalt Theratron 780 at the General campus were both decommissioned and
removed. Our treatment capacity was reduced for the last 4 months of the year when one
of our accelerators failed catastrophically and the repair took much longer than expected.
In preparation for the construction of a new brachytherapy suite at the site of the physics
office area at the General, we relocated our offices temporarily into the basement of the
Critical Care Wing in October. After renovation on the 2nd floor of the Cancer Centre
scheduled for early in 2010, we will be moving again into newly configured office space.
In addition to clinical service, the group was active in research and development, publishing
19 peer reviewed articles and presenting 26 papers at national and international
conferences. Two of our masters graduate students completed their theses this year.
Teaching this year included lectures to Carleton University physics graduate students and
University of Ottawa Radiology and Radiation Oncology medical residents.
This year we celebrated the successful clinical certification of four of our medical physicists,
Crystal Angers, Lesley Buckley, Gosia Niedbala and Ryan Studinski, all of whom completed
their clinical training in-house. The certification consists of both a written and an oral
examination administered by the Canadian College of Physicists in Medicine (CCPM) and is
considered to be very challenging. This 100% examination success rate is a testimony to
the excellence of the clinical training offered by our group.
We successfully filled all open positions this year recruiting three Medical Physicists, Katie
Lekx-Toniolo, Gosia Niedbala and Ryan Studinski, two Physics Residents Gérard Lagmago
Kamta and Eric Vandervoort, two Physics Technologists, Tyler Punkari and Andrew
Richardson and one Radiotherapy Service Technologist, Richard Webb. Only two departures
this year, Ryan McCabe, Physics Technologist, and Dong Vo, Computing Specialist.
Report prepared by Brenda Clark, Chief, Medical Physics, TOHCC
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
TABLE OF CONTENTS
Executive Summary ............................................................ 2
Staff List............................................................................ 4
Administration .................................................................... 5
Radiation Safety ................................................................. 6
Orthovoltage Incident.......................................................... 8
Clinical Activities............................................................... 10
Development ...................................................................... 10
Equipment.......................................................................... 10
Treatment Planning ............................................................. 10
Stereotactic Radiosurgery..................................................... 12
Brachytherapy .................................................................... 12
Technical Services ............................................................... 12
MR Imaging........................................................................ 14
Academic Activities ........................................................... 16
Representation on External Committees ............................... 18
Research ......................................................................... 19
1 Peer Reviewed Publications ............................................... 19
2 Books / Chapters ............................................................. 20
3 Invited Presentations ....................................................... 20
4 Oral Presentations at National & International Conferences .... 21
5 Poster Presentations at National & International Conferences . 21
6 Research Funding ............................................................ 23
7 Research & Development Projects ...................................... 23
National/International Conference Representation ................. 30
Profile of Physicists ........................................................... 31
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Annual Report 2008
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 (50%)
Lesley Buckley, Ph.D., MCCPM (maternity leave, April 2008-March 2009)
Elizabeth Henderson, Ph.D., MCCPM
Chun-Bun Kwok, Ph.D., MCCPM
Katie Lekx-Toniolo, Ph.D. (maternity leave October 2008-May 2009)
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM
Balazs Nyiri, Ph.D., MCCPM
Ryan Studinski, Ph.D., MCCPM
Medical Physics “Elekta” Fellow
Jason Bélec, M.Sc., MCCPM (50%)
Administrative Support
Janice Fish
Doris Vieira
Physics Technologists
Chris Lambert
Silvia Neuteboom
Julie-Maude Leblanc
Tyler Punkari
Medical Physics Residents
Gérard Lagmago Kamta, Ph.D.
Robert Mahon
Ryan McCabe
Andrew Richardson
Nicolas Ploquin, Ph.D.
Eric Vandervoort, Ph.D.
Physics Computer Support
Dong Vo
Graduate Students (Supported by Research Grants and Fellowships)
Amanda Cherpak
Maria Lourdes Garcia
Elena Gill
Jared Strydhorst
Tara Murphy
Elizabeth Orton
Summer Students (Supported by Harold E. Johns Scholarships)
Kiara Govia
Technical Services (Electronics/Machine Shop)
Senior Radiotherapy Service Technician
Electronics
Farhoud Abbassian
Georges Gohier
Don Lesway
Najib Nassar
Richard Webb
Machine Shop
Bernie Lavigne
Page 4/46
Don Petzold
Gaetan Belanger
Tony Magee
Ron Romain
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
ADMINISTRATION
•
Appointment of Jason Bélec as the second TOHCC Elekta Fellow, with 50% FTE funding
for research from Elekta.
•
Initiation of TomoTherapy research agreement specifying 5 clinical projects over 5 years,
research to be done in collaboration with TOHCC radiation therapists and radiation
oncologists.
•
Recruitment of Katie Lekx-Toniolo, PhD, into a physicist position. After completing her
PhD on “Myocardial blood flow, function, metabolism and viability imaging using MRI,
SPECT and PET” working with Frank Prato at UWO, followed by a 2 year post-doctoral
fellowship, Katie comes to us from the physics residency program at McMaster.
•
Recruitment of Eric Vandervoort, PhD, into a physics residency position. Eric joined us
from Vancouver on competion of his PhD on “Development of an analytical scatter
correction for singles-mode transmission scanning in PET imaging” working with Vesna
Sossi at UBC.
•
Recruitment of Gérard Lagmago Kamta, PhD, into a physics residency position. Gérard
is a native of Cameroon and comes to Ottawa with a considerable range of experience
including a PhD in Theoretical Atomic Physics from Bénin, associated research
apppointments in Louvain, Belgium, Nebraska, USA, and Sherbrooke, Quebec, and most
recently a masters degree in Medical Physics from McGill University.
•
Recruitment of Tyler Punkari, BSc, a graduate of the Carleton University physics
undergraduate program and Andrew Richardson, MSc, from New Brunswick into physics
technologist positions.
•
Recruitment of Richard Webb, BSc, into a radiotherapy service technologist position.
Richard has over 9 years experience in linear accelerator maintenance, predominantly
with Varian equipment, and came to us from Lincoln, England.
•
Selection of major equipment for the Capital Expansion Queensway Carleton site in the
form of 4 Elekta Synergy accelerators, two with 6 and 15 MV photon beams and micromultileaf collimators for the General campus, two with 6, 10 and 15 MV photon beams
and 6, 9, 12 and 15 MeV electron beams for QCH and all units with kV conebeam CT.
•
Support for NavCanada fundraising efforts for the TOHCC Capital Expansion.
•
Application to Cancer Care Ontario for major capital equipment items, this year totalling
$2.43m. Funding approval was obtained and we subsequently installed a $1.77m
upgrade for our stereotactic radiosurgery program, couch upgrades for our tomotherapy
units, assorted brachytherapy items and 5 additional treatment planning licenses for our
external beam planning software.
•
Preparation and submission of the budget for the Physics Department.
•
Preparation and publication of this Annual Report summarising the activities of the
Physics Department.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
RADIATION SAFETY
Initiatives:
•
Radiation safety binders compiled and placed on all treatment machines
•
E-mail notification of TLD personal dosimeter readings to all staff in Radiation Oncology
Program
•
Radiation safety inspections conducted of all treatment machines
License Applications and Amendments:
Application for decommissioning licence
•
12710-27-13.0 Decommission CMD2 linear accelerator at Civic
•
12710-28-13.0 General cobalt decommissioning
21 Feb 2008
24 Jul 2008
Request to amend accelerator operating licence
•
12710-17-29.9 Add accelerator Unit 20
•
12710-17-29.9 Remove CMD2 accelerator
20 Mar 2008
23 Jul 2008
Request to revoke commissioning licence
•
12710-26-13.0 Unit 20 commissioning complete
3 Apr 2008
•
12710-27-13.0 CMD2 decommissioning
23 Jul 2008
Licence renewal application
•
12710-10-13.0 Cobalt teletherapy
9 Apr 2008
•
12710-12-13.0 Manual Brachytherapy
Application for amalgamated licence for radiation therapy operation & service
•
12710-17-29.9 Linac Accelerator Operating
•
12710-18-09.3 HDR Brachytherapy
•
12710-13-12.0 Service Class II Prescribed Equipment
16 Apr 2008
1 Aug 2008
Notification to transfer source
•
12710-28-13.0 General cobalt decommissioning
•
Decommissioning report, request to revoke decommissioning licence
•
12710-28-13.0 General cobalt decommissioning
18 Sep 2008
20 Oct 2008
Request to amend operating licence
•
12710-10-13.0 Cobalt
20 Oct 2008
Letter re addition of BrainLAB X-ray system to Unit 7
•
12710-17-29.9 Modification of licensed equipment
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19 Dec 2008
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Annual Compliance Reports
10 Sep 2008
•
12710-12-08.3 Manual Brachytherapy
•
12710-10-08.3 Cobalt Teletherapy
•
12710-13-12.0 Service
•
12710-17-29.9 Accelerator operating
•
12710-18-09.3 HDR Brachytherapy
•
12710-25-13.0 Construction Licence for General bunkers
•
12710-24-13.0 Construction Licence for HDR suite
X-ray Inspection Service, MOH submission
•
Shielding approval for Accelerator Unit 16
•
Approval of Unit 20 XVI system
20 Jun 2008
11 Jul 2008
Request to Ministry of Health, CT letter of designation
17 Sep 2008
Radiation Safety Training:
•
18 training sessions, 142 attendees
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
ORTHOVOLTAGE INCIDENT
In late November of 2007, an error was found in the beam data tables issued by the physics
group for beam time calculations for the orthovoltage unit at the Civic campus. These data
tables had been in clinical use since the unit was commissioned after relocation from the
General to the Civic in late 2004. This error remained undetected despite regular quality
assurance testing until a full technical review of the unit was undertaken in the fall of 2007
during implementation of a new annual quality assurance regime. This broader scope of
testing which, for the first time incorporated measurements of field sizes other than the 10
cm x 10 cm square, was one of a series of recommendations on quality assurance in
radiation therapy drafted by a group of Canadian medical physicists under the auspices of
the Canadian Association of Provincial Cancer Agencies (CAPCA). The data tables were
corrected immediately after the error was confirmed by independent measurement, but it
was not until January 2008 that a full internal investigation was complete and the
dosimetric effect of the error fully understood.
The source of the error was a failure to appropriately account for variations in the
measurement-to-dose conversion with radiation field size, leading to an error in treatment
dose calculation that varied with field size of treatment. For some patients with larger areas
treated, the errors were zero or small; for patients with the smallest areas treated, the
errors were higher. During the time the unit was operating with this error undetected, 1019
treatments were delivered: 378 of these treatments (delivered to 326 patients) have been
estimated to have a potential for clinically significant underdosing. No patients were
subjected to an overdose.
Immediately on receipt of confirmation of accepted dose tolerances for these category of
radiation treatments, obtained from an external consultant radiation oncologist, the patients
who had received an underdose deemed to be potentially clinically significant were
contacted individually and, at the same time, a program of public disclosure implemented.
At this point, The Ottawa Hospital senior management requested an external review of the
physics commissioning process for this unit and the hospital adverse incident management,
to be coordinated by Cancer Care Ontario. A panel of three experts from the Alberta Cancer
Board was identified to carry out this review and subsequently spent several days at TOHCC
conducting interviews of relevant personnel and examining documentation. Among other
factors, the panel discovered that medical physics staffing at The Ottawa Hospital Cancer
Centre had been experiencing extreme resource limitations prior to and around the time the
error occurred. Although a direct causal relationship between medical physics staffing
shortages and the specific calibration error cannot be established with certainty, it was
definitely, in the opinion of the panel, a significant contributory factor. The full text of their
report, received in October, is available from the TOH website.
The recommendations set out in this report focus on adoption, adherence and monitoring of
specific nationally recognized protocols for commissioning and quality assurance of radiation
treatment equipment including orthovoltage units. They also recommend that attention
should be paid to matching the scope and intensity of radiation therapy equipment
installation and upgrading to available medical physics staffing with commensurate
reduction of the radiotherapy service to be instituted in the event of extreme shortages of
medical physics personnel, to maintain the safety and quality of the clinical program.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Of note, the reviewers specifically commended the hospital on their response to the error,
stating that “Upon discovery of the problem, TOH responded in an appropriate and
conscientious manner.”
Since the discovery of this error, the TOHCC medical physics group has taken several
specific actions aimed to prevent occurrences of this nature. Specifically, we have:
1. Remeasured, reviewed and retabulated all beam data for the orthovoltage unit.
2. Independently verified all orthovoltage beam data.
3. Reviewed and revised all machine quality assurance and quality control procedures.
4. Developed an implementation plan to bring the treatment unit quality assurance
program
into
compliance
with
CAPCA
recommendations,
where
these
recommendations are appropriate.
5. Added a specific requirement for an independent check of all beam commissioning
data prior to clinical release. (Although this requirement was in place at the time of
this incident, it had not been formalised in a written policy.)
6. Formalised a policy requiring two physicists to work together for clinically critical
procedures.
7. Reviewed and improved specification of accountability and scope for the more
routine clinical assignments such as commissioning and independent calibration of
beams.
Finally, the experience has emphasised the value of local robust and comprehensive adverse
incident policies and procedures. We were in the fortunate position of having implemented,
in September of 2006, a rigorous Incident Learning System specifically tailored to our
radiation treatment program which proved invaluable during this period.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
CLINICAL ACTIVITIES
Development
•
Ongoing development of policies and procedures covering all aspects of our quality
assurance activites including development of a substantially revised policy for the
treatment of patients with a pacemaker
•
Development and implementation of a Stereotactic Body Radiation Therapy (SBRT)
technique for the hypofractionated treatment of small lung lesions.
•
Development of a gafchromic film based dosimetry QA system (calibration, delivery,
image analysis procedures & macros, training etc.), initial implementation for daily
gafchromic film based Delivery QA for tomotherapy
•
Development of light field vs radiation field size and coincidence QA and MLC QA
gafchromic film process for weekly QA testing
•
Development and implementation of a secondary monitor unit calculation software
module and procedure for scan-plan-treat (StatRT) helical tomotherapy
•
Development and implementation of a morning QA IGRT test procedure (Pentaguide)
with tracking software
•
Development of DVH data extraction from XiO and processing & visualization software
for statistical analysis for clinical study RTOG 01-01
•
Installation, acceptance and commissioning of the first temporary radiotherapy bunker in
Canada housing the centre’s third Elekta Synergy accelerator, funded by CCO to provide
an increase in our treatment capacity during construction and commissioning of our
expansion facilities.
•
Decommissioning and removal of the Siemens CMD2 linear accelerator and the Siemens
MevaSim at the Civic Campus.
•
Installation and commissioning of the Siemens Primus linear accelerator relocated from
the General campus to the Civic to make room for the second TomoTherapy unit.
•
Decommissioning and removal of the G780 cobalt unit at the General Campus.
•
Installation and commissioning of a BrainLAB ExacTrac orthogonal kilovolt X-ray imageguidance system on Unit 7.
•
Installation and commissioning of a BrainLAB m3 micro-multileaf collimator providing
additional beam shaping on Unit 7.
•
Installation of two new TomoTherapy couches for Units 1 and 2. These couches offer
streamlined patient handling and have provided substantial improvement in patient
throughput.
Treatment Planning
•
Supervision of treatment planning and computer data management for external beam
therapy and brachytherapy.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
•
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 4753 treatment plans (computerised dose distributions) were generated,
compared to 4,721 in 2007, indicating considerable consistency. The plot of monthly
activity shows considerable fluctuation throughout the year with an average of just
under 400 plans generated per month. This plot also clearly shows a reduction in
planning activity during the last 5 months of the year, most likely due to the reduction in
treatment capacity resulting from extensive repairs on Unit 7.
2008 Treatment Planning Activity
600
# Plans
500
502
465
405
400
416
410
389
416
320
340
372
386
332
300
200
100
0
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Month
•
The CMS treatment planning system was upgraded twice during the year, and 5
additional CMS XiO workstations and servers were installed with funding supplied by
CCO.
•
An independent audit of the beam models for all treatment machines in the CMS
treatment planning system was performed.
•
The care plans for all site groups were revised and re-formatted.
•
On-call and Sim&Treat treatment planning was migrated from Philips ACQSim
(VoxelQ) workstations to CMS Focal, and a filmless/paperless process developed.
•
Total Body Irradiation (TBI) treatment planning was migrated to the CMS treatment
planning system, and a filmless/paperless process developed.
•
ORCC patient ID numbers were converted to TOH patient ID numbers (ICP
Integration).
•
The quality assurance activities involving treatment planning and radiation therapy
delivery were reviewed and reconciled. Electronic checklists for all work areas were
developed. The checklists are to be implemented next year and are expected to
improve efficiency and accuracy of the treatment planning and delivery process.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Stereotactic Radiosurgery
•
84 patients were treated with stereotactic radiosurgery
•
20 patients were treated with stereotactic radiotherapy, 203 fractions
•
Implementation of extranial stereotactic treatments for lung cancer using an Elekta
Synergy accelerator and the CMS XiO treatment planning system
Brachytherapy
Physics support to this program consists of 4 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 2008:
•
38 patients received I-125 permanent prostate implants
•
16 patients received Ir-192 interstitial Low Dose Rate implants
•
321 treatments were delivered to 100 patients using High dose Rate brachytherapy
Initiatives this year include:
•
Reviewing and rewriting all brachytherapy policies and procedures
•
Development of a new process for ordering and measuring Ir-192 brachytherapy
seeds, to reduce waste and cost
•
Accepted and commissioned a new ultrasound and planning system for prostate
brachytherapy (SPOT), developed an intraoperative planning process
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.
In 2008, the list of major equipment requiring support included 2 TomoTherapy units, 3
Elekta Synergy accelerators with kilovolt x-ray imaging, 5 Siemens accelerators (4 Primus,
1 Mevatron), 1 Cobalt unit, 1 Orthovoltage unit, 2 Philips CT Simulators and 1 Varian Acuity
simulator in the HDR brachytherapy suite.
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. The table below lists the repair and
maintenance activity for each treatment unit for 2008.
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Summary of Repair and Maintenance from 1 January to 31 December 2008
Name
Model
Unit 1
Unit 2
Unit 3
Unit 4
Unit 5
Unit 6
Unit 7
Unit 14
CMD2
Unit 16
Unit 17
Unit 18
Unit 19
Unit 20
TomoTherapy
TomoTherapy
Theratron 780
Siemens Primus K
Elekta Synergy
Elekta Synergy
Siemens Primus K
Theratron 780C
Mevatron MD2
Siemens Primus M
Mevatron KD2
Siemens Primus M
Therapax 300
Elekta Synergy
Totals:
Potential
Time Hrs
2241
2000
520
2720
2720
2720
2621
400
1034
1313
2720
2720
1500
1875
27104
# Repairs
Minor
23
16
1
26
32
38
28
0
6
35
57
36
7
30
335
Repair Hrs
Minor
18
21
0
29
22
26
41
0
12
45
39
37
4
38
331
# Repairs
Extensive
30
34
4
19
44
40
32
2
5
11
32
13
3
17
286
Repair Hrs
Extensive
314
248
7
80
113
60
493
6
12
20
80
22
9
32
1494
Service
Time Hrs
332
268
7
109
134
86
534
6
24
66
119
59
14
70
1826
PM Time
Hrs
57
67
2
21
12
22
13
6
7
12
26
28
5
8
283
Downtime
Hrs
156
139
2
37
51
52
923
0
14
15
65
29
2
29
1515
The graph below shows the percentage time during clinical hours that the machines were
available for patient treatments, excluding scheduled maintenance and repair. The two
TomoTherapy units maintained a lower availability than the conventional accelerators at
93% and also required more service time. This is a concern and our team is working with
representatives from TomoTherapy Inc. to improve this record. The reason for the lower
reliability is that these units consist of a megavolt linear accelerator mounted on a ring
gantry providing helical fan-beam radiation delivery with integrated CT image-guidance,
representing completely new technology compared to the conventional gantry mounted
units. We understand that several of the major components prone to failure will be
redesigned to improve reliability over the next few years.
The conventional accelerators, with the exception of Unit 7, were available almost
consistently more that 98% of the time required, an excellent record which helps to
maintain patient throughput and prevent treatment cancellations due to machine failure.
Unit 17, at 97.6% availability, is a Siemens Mevatron (klystron) unit and with 12 years
clinical service, is now the oldest unit in our inventory.
2008 Treatment Unit Availability
100
% Up-Time
98.6
90
93.1
98.1
98.8
98.1
97.6
98.9
98.4
18
20
93.3
80
70
64.8
60
1
2
4
5
6
7
16
17
Treatment Unit Number
Page 13/46
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Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Early in September, the waveguide on Unit 7 developed a leak, a catastrophic failure. This
waveguide was installed 2 years ago and on average, this part is expected to last for 10
years. Locating a replacement part, the Siemens personnel to install it and the rental
equipment required took a week or so. However, after installation of this part, it was found
to be faulty, requiring a second waveguide to be located. Unfortunately, after installation of
this second new waveguide, another major component was determined to be non-functional
and the klystron was replaced. After this additional major component replacement, the
radiation output was fluctuating, requiring further troubleshooting and several minor
component replacements. After the repairs were finally complete, the beams required
recommissioning prior to clinical release. In total, this unit was under repair for 4 months,
resulting in a major negative impact on our treatment capacity for the year. The only
positive aspect of this stressful time was the installation of a kilovolt X-ray image guidance
system, work that was scheduled prior to the machine breakdown and although requiring 2
weeks construction work in the vault, was managed in between repair tasks.
During 2008, 3 items of major equipment were decommissioned and removed from the
Clinic, one from the General campus and two from the Civic. At the General Campus, the
Cobalt unit, Theratron 780 s/n 271, in clinical use since installation in 1980, was removed to
make space for the consolidation of treatment capacity in our capital expansion. The vault
is too small for a conventional accelerator and after renovation will house a new
orthovoltage unit. At the Civic campus, the Siemens Mevatron s/n 2427, installed in 1994,
and a Siemens Mevasim s/n 1158, installed in 1992, had both reached the end of their
useful life and were decomissioned.
During 2008, members of our electronics staff attended and successfully completed the
following off-site training courses:
•
Tomo T-DAT, Madison, WI, USA Gaetan Belanger, 25 – 27 February
•
Varian Acuity, Las Vegas, NV, USA Don Petzold, 31 March – 11 April
•
Elekta 2nd Line, Atlanta, GA, USA Georges Gohier, 31- March – 18 April
•
Tomo Level 1, Madison, WI, USA Tony Magee, 21 April – 2 May
•
Elekta Table, Iview, London, UK Tony Magee, 2 - 13 June
•
Elekta 1st Line, Atlanta, GA, USA Don Petzold, 9 – 13 June
•
Philips, CT, Cleveland, Ohio, USA Gaetan Belanger, 27 October – 21 November
MR Imaging
The Ottawa Hospital purchased a new 3 Tesla MR scanner in 2007. Dr Ian Cameron was
involved with all aspects of this project. In 2008, he was heavily involved with addressing
siting issues for the new scanner which was installed in December. Dr Cameron also
performed acceptance testing on the new scanner.
The 1.5 T MR scanner at the General Campus underwent a major upgrade in 2008. Dr
Cameron was heavily involved in the negotiations for the upgrade, coordinating work and
performing acceptance testing.
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 was
extended in 2008 but further expansion is still required. In the meantime, Dr Cameron
continues to monitor system performance.
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Dr Cameron interacts regularly with TOH Biomedical Engineering personnel that repair and
maintain the scanners.
In 2008, there were several instances where Dr Cameron’s
expertise was required to deal with diagnosing the source of system performance problems
and image artificacts (e.g. chemical shift artifacts one EPI sequences).
Three MRI protocols developed by the MRI research team at The Ottawa Hospital are being
used in clinical trails. All three have been approved by the hospital ethics committee.
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ACADEMIC ACTIVITIES
CARLETON UNIVERSITY GRADUATE STUDENT SUPERVISION
PHD PROGRAM
Name
Entry
Est. Fin
Supervisor
Topic
Sorina Truica
Jan 2003
Aug 2009
I.G. Cameron
Abdominal Perfusion Measurements
using non-contrast MRI
Elena Olariu
May 2003
Aug 2009
I.G. Cameron
Diffusion Decay as
Diffusion Tensor MRI
Claire Foottit
Sep 2004
Dec 2009
I.G. Cameron
Quantitative Perfusion MRI in the Brain
and in Tumours
L. Maria Garcia
Sep 2005
Aug 2009
D.E. Wilkins
Amanda Cherpak
Sep 2007
Apr 2010
J.E. Cygler
4D in-vivo dosimetry
Elizabeth Orton
Sep 2008
Aug 2012
B.G. Clark
Biological target definition for radiation
therapy
using
positron
emission
tomography imaging
E Henderson
it
Relates
to
Radiobiological Modeling of IMRT
MSC PROGRAM
Name
Entry
Est. Fin
Supervisor
Tara Murphy
Sep 2006
Aug 2008
J.E. Cygler
Jared Strydhorst
Sep 2006
Aug 2008
M.S. MacPherson
Elena Gill
Sep 2007
Aug 2009
J.E. Cygler
Topic
An evaluation of treatment planning
for the inhomogeneity conditions of
laryngeal cancer
Tomotherapy for Breast Treatment
Dose-to-water
vs
dose-to-medium
calculations for electron beams
ADDITIONAL SUPERVISION
•
Supervision by Ian Cameron of Greg Cron, a Senior Research Associate at the Ottawa
Health Research Institute
•
Supervision by Balazs Nyiri of Kiara Govia, a McMaster University Health Physics
undergraduate co-op student
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UNIVERSITY LECTURES DELIVERED
•
PHYS 5208 Radiation Safety – Carleton University graduate physics course in radiation
safety, coordinated and taught by D Wilkins at TOHCC (Jan – April 2008)
•
PHYS 5209 Medical Physics Practicum – Carleton University graduate physics course,
three modules on radiation therapy physics, Jan – Apr 2008
•
PHYS 5204 Physics of Medical Imaging - Carleton University graduate physics course, a
series of 6 lectures on MRI Physics
•
Coordination of the Radiobiology for Radiation Oncology Residents Course
•
Coordination and delivery of the Medical Physics for Radiation Oncology Residents
Course, Sep 2007 – Apr 2008
•
A series of 8 lectures on Imaging Physics for the Radiology Residents
VISITS HOSTED
•
8 April and 16 November – Bog Jarosz and Carleton University undergraduate Modern
Physics class, tour
•
1 May 2008 – CNSC administrators (3), courtesy visit
•
17 June 2008 – Carleton University Modern Physics class tour (7 participants)
•
30 June – 4 July –COMP/BEST Medical Developing Country – Resident Travel Awardee,
Surendra B Chand, Medical Physicist, B.P. Koirala Memorial Cancer Hospital, Bharatpur,
Chitwan, Nepal
•
15 July 2008 – Health Canada Medical Devices Bureau, 6 visitors, presentation and tour
•
31 October – 16 November 2008 – Flavia Teixeira, Physicist CNEN/CGMI/DIAMP, Rio de
Janiero, Brazil, visit funded by IAEA
OTHER ACTIVITIES
•
Medical Physics workshop delivered as part of the 13th Annual Canadian Radiation
Oncology Resident Refresher Course
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REPRESENTATION ON EXTERNAL COMMITTEES
•
AAPM (American Association of Physicists in Medicine) – International Affairs Committee
JE Cygler, Vice-Chair
•
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
•
CAMRT (Canadian Association of Medical Radiation Technologists) Strategic Planning
Committee
DE Wilkins
•
CCPM (The Canadian College of Physicists in Medicine)
DE Wilkins, Vice President
•
CCPM (Canadian College of Physicists in Medicine) Examination Committee
BG Clark and DE Wilkins
•
CMA (Canadian Medical Association) Conjoint Accreditation Services Team – Radiological
Technology
IG Cameron
•
COMP (Canadian Organization of Medical Physicists) Conference Committee
DE Wilkins
•
COMP (Canadian Organization of Medical Physicists) Joint Finance Committee
DE Wilkins
•
COMP (Canadian Organization of Medical Physicists) Professional Affairs Committee
DE Wilkins
•
CPAC (Canadian Partnership Against Cancer) Human Resources Action Group
DE Wilkins
•
IAEA (International Atomic Energy Agency) Committee on In-vivo dosimetry
JE Cygler
•
IEC (International Electrical Commission) - Canadian Standards Team – SC62C WSG1
Equipment for radioatherapy, nuclear medicine and radiation dosimetry
LH Gerig (2006 – present)
•
OMPI (Ottawa Medical Physics Institute) Executive Committee
BG Clark
•
Polish Journal of Medical Physics and Engineering Editorial Board
JE Cygler
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RESEARCH
1 Peer Reviewed Publications
1.1
Benedict SH, Bova FJ, Clark B, Goetsch SJ, Hinson WH, Leavitt DD, et al.
Anniversary Paper: the role of medical physicists in developing stereotactic
radiosurgery. Med Phys 2008 Sep;35(9):4262-77.
1.2
Cardenas-Blanco A, Tejos C, Irarrazaval P, Cameron IG. Noise in Magnitude
Magnetic Resonance Images. Concepts in Magn. Reson. 32A(6), 409-416 (2008).
1.3
Caudrelier J-M, Morgan SC, Montgomery L, Lacelle M, Nyiri N, MacPherson, M.
Helical tomotherapy for locoregional irradiation including the internal mammary
chain in left-sided breast cancer:
Dosimetric evaluation.
Radiaiotherapy and
Oncology, Volume 90, Issue 1, January 2009, 99-105 (Accepted 7 September 2008,
Available online 1 November 2008).
1.4
Caudrelier J-M, Vermandel M, Betrouni N, Nyiri B, Cameron IG, Rousseau J.
Towards an Accurate and Robust Method Based on Fuzzy Logic Principles for the
Reconstructions and Quatification of Large Volumes from MR and CT Images. Br. J.
of Radiology, 82 (2009), 228-234 (Published online 11 November 2008).
1.5
Cherpak A, Studinski RCN, Cygler JE. MOSFET detectors in quality assurance of
tomotherapy treatments. Radiother. Oncol., 86, 242-250, 2008.
1.6
Clark BG, Candish C, Vollans E, Gete E, Lee R, Martin M, et al. Optimization of
stereotactic
radiotherapy
treatment
delivery
technique
for
base-of-skull
meningiomas. Med Dosim 2008;33(3):239-47.
1.7
Gomez-Laberge C, Adler A, Cameron IG, Nguyen T, Hogan MJ. Selection Criteria
for the Analysis of Data-driven Clusters in Cerebral fMRI. IEE Trans. On Biomed.
Engineering 55(10), 2372-2380 (2008).
1.8
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 Apr;87(1):116-8.
1.9
Montgomery L, Macpherson M, Gerig LH, Carty K, Fox G, Esche B, et al.
Simultaneous treatment of multiple basal cell carcinoma lesions. Br J Radiol 2008
Dec;81(972):e290-e292.
1.10
Ploquin NP, Dunscombe PB. The cost of radiation therapy. Radiother Oncol 2008
Feb;86(2):217-23.
1.11
Rangel A, Ploquin NP, Kay I, Dunscombe P. Evaluation of linear accelerator
performance standards using an outcome oriented approach. Med Phys 2008
Jun;35(6):2513-8.
1.12
Samant R, Gerig LH, Montgomery L, MacRae R, Fox G, Nyiri B, et al. Hightechnology palliative radiotherapy using image-guided intensity-modulated
radiotherapy. Clin Oncol (R Coll Radiol ) 2008 Nov;20(9):718-20.
1.13
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 (1) 51-57 (2008).
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The Ottawa Hospital Cancer Centre
1.14
Tsai E, Alkherayf F, Olariu E, Berthiaume A, Nguyen T, Santos M, Benoit B, Cameron
IG. Clinical Value of Tractography in the Spinal Cord. J Neurotrauma 25(7), 854854 (2009).
1.15
Vandervoort E, Sossi V. An analytical scatter correction for singles-mode
transmission data in PET. IEEE Trans Med Imaging 2008 Mar;27(3):402-12.
1.16
Vandervoort E, Sossi V. Impact of contamination from scattered photons in singlesmode transmission data on quantitative small-animal PET imaging. J Nucl Med 2008
Nov;49(11):1852-61.
1.17
Viamonte A, Da Rosa L A R, Buckley L, Cherpak A, Cygler JE. Radiotherapy
dosimetry using a commercial OSL system. Med. Phys. 35, 1261-1266, 2008.
1.18
Wang M, Rohling R, Duzenli C, Clark BG, Archip N. Evaluation of targeting errors in
ultrasound-assisted radiotherapy. Ultrasound Med Biol 2008 Dec;34(12):1944-56.
2 Books / Chapters
2.1
A Sohrabi, AM Smith, R West, IG Cameron. Uncertainty, Risk and Illusion in
Reward Prediction: Evidence from fMRI. In B Hardy-Vallee, ed. Cognitive Decisionmaking: Empirical and Foundation Issues. Cambridge: Cambridge Scholars Press
Ltd.
2.2
MS Anscher, H Saleh, M Murphy, JE Cygler, GP Beyer, CW Scarantino, M Wiesmeyer. Future Developments II: On-line Dosimetric Verification with Fiducial Dosimeter Planning and Verification. In Prostate Cancer: Principle Practices of Imageguided Radiation Therapy, RK Valicenti, AP Dicker, DA Jaffray, Editors, Informa
Healthcare, Inc., LLC 270 Madison Avenue, New York, New York, 2008.
3 Invited Presentations
3.1
BG Clark: Two Years of Clinical Tomotherapy: The Ottawa Experience - International
Conference on Novel Techniques in Clinical Oncology & Radiation Physics, Dr. Ida B
Scudder Cancer Centre, Christian Medical College, Vellore, Tamil Nadu, India, 7-9
February 2008
3.2
LH Gerig:
Varian Workshop on Image Guided Motion Management.
Switzerland, 25-26 February 2008
3.3
JE Cygler: Clinical Implementation and Use of Electron Monte Carlo Based Treatment
Planning Systems. 2008 SEAAPM Symposium, Birmingham, Alabama, 26-28 March
2008
3.4
JE Cygler: In Vivo Dosimetry in Brachytherapy. Instituto de Radioprotecao e
Dosimetria Comissao Nacional de Energia Nuclear, Rio de Janeiro, Brazil, 14 April 2008
3.5
JE Cygler: Clinical Implementation and Use of Electron Monte Carlo Based Treatment
Planning System for electron beams. INCA Hospital, Rio de Janeiro, Brazil, 16 April
2008
3.6
JE Cygler: Clinical Implementation and Use of Electron Monte Carlo Based Treatment
Planning System for electron beams.
Instituto de Radioprotecao e Dosimetria
Comissao Nacional de Energia Nuclear, Rio de Janeiro, Brazil, 18 April 2008
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3.7
BG Clark: Tomotherapy: A Physics Toy or the Optimal IG-IMRT Tool? Radiological
Physics Rounds, Institute of Cancer Research/Royal Marsden Hospital, Sutton,
England, 16 May 2008
3.8
DE Wilkins: A temporary Bunker for Radiation Therapy in Ottawa. Cancer Diseases
Hospital, Lusaka, Zambia, 18 August 2008
3.9
IG Cameron: Towards Quantitative Diffusion MRI.
Symposium, Toronto, September 2008
Imaging Network Ontario
3.10 BG Clark: Tomotherapy for BC: Coals to Newcastle or Snow to Eskimos? Radiation
Program Rounds, BC Cancer Agency, Vancouver, BC, 12 Dec 2008
3.11 JE Cygler: Monte Carlo systems in pre-clinical and clinical treatment planning. RSNA,
Chicago, IL, December 2008
4 Oral Presentations at National & International Conferences
4.1
Construction of a Temporary Bunker in Ottawa. DE Wilkins.
Radiation Medicine Conference, Kingsbridge, 27 April 2008
Fifth Annual Toronto
4.2
Dose-Position Verification of 4D Radiotherapy Using the RADPOS System in a
Deformable Lung Phantom. A Cherpak, M Serban, J Seuntjens, JE Cygler. AAPM
50th Annual Meeting, Houston, Texas, 27 – 31 July 2008, Medical Physics, Vol. 35, No.
6, 2994, 2008
4.3
Saving Trees and Improving Workflow. C Angers, J Renaud, MS MacPherson, BG
Clark. Med. Phys. 35(7):3413, (2008) presented at the 54th Canadian Organization
of Medical Physicists annual meeting, Quebec City, Quebec, 25 – 28 June 2008
4.4
Verification of a Monte Carlo based treatment planning system in a homogeneous
water phantom. O Nairz, JE Cygler, BG Clark. Med. Phys. 35,3413(2008), presented
at the 54th Canadian Organization of Medical Physicists annual meeting, Quebec City,
Quebec, 25 – 28 June 2008
4.5
One Year of Learning from Incidents B.G. Clark, R. Brown, A. Kind, D. Wilkins, L.
Grimard Med. Phys. 35,3400,2008, presented at the 54th Canadian Organization of
Medical Physicists Annual Meeting, Québec, 25-28 Jun 2008
4.6
On-line adaptive radiation therapy based on the intra-fractional digital tomosynthesis
images. A. Mestrovic, A. Nichol, B. Clark, K. Otto Med. Phys. 35, 3411, 2008,
presented at the 54th Canadian Organization of Medical Physicists Annual Meeting,
Québec City, Québec, 25-28 Jun 2008
5 Poster Presentations at National & International Conferences
5.1
Analysis of dosimetric differences between dose-to-water vs. dose-to-medium
calculations for electron beams. . E Gil, BG Clark, JE Cygler. 54th Canadian
Organization of Medical Physicists annual meeting, Quebec City, Quebec, 25 – 28 June
2008, Med. Phys. 35, 3405 (2008)
5.2
Analysis of the Noise Corrected Diffusion Decay of Human Brain. E Olariu, A CardenasBlanco, IG Cameron. International Society of Magnetic Resonance in Medicine,
Toronto, May 2008
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The Ottawa Hospital Cancer Centre
5.3
Bayesian Hierarchial Modelling of Clustered Cerebral BOLD Images. C Gomez-Laberge,
A Adler, IG Cameron, MJ Hogan. Imaging Network Ontario Symposium, Toronto,
September 2008
5.4
Comparing Rapid Palliative IG-IMRT with more Conventional Simulation-and-Treatment
Approaches. R Samant, LH Gerig, L Montgomery, M MacPherson, G Fox, R MacRae, K
Carty, S Andrusyk, P Genest. 2008 Americal Society for Radiation Oncology Annual
Meeting, Boston, Mass., 21-25 September
5.5
Dose Errors Related to the Treatment Couch. M Niedbala, B Nyiri, LH Gerig. 54th
Canadian Organization of Medical Physicists Annual Meeting, Med. Phys. Volume 35,
Issue 7, pp. 3407 (July 2008), Québec City, Québec, June 2008
5.6
Investigation of a Patient Immobilization System for Breast Tomotherapy.
JH
Strydhorst, J-M Caudrelier, LA Montgomery, BG Clark, MS MacPherson, Med.
Phys. 35, 3407, 2008, presented at the 54th Canadian Organization of Medical
Physicists Annual Meeting, Québec City , Québec, 25-28 Jun 2008
5.7
Effects of Current Alcomhol Use on Executive Functioning in Young Adults Using fMRI.
RE Halchuk, AM Smith, N Wallis, IG Cameron, PA Fried, MJ Hogan. Imaging Network
Ontario Symposium, Toronto, September 2008
5.8
Effects of Current Marijuana Use on Visuospatial Working Memory: An fMRI Study. CA
Longo, AM Smith, PA Fried, MJ Hogan, IG Cameron. Imaging Network Ontario
Symposium, Toronto, September 2008
5.9
Evaluation of a novel 4D in-vivo dosimetry system. A Cherpak, A Hallil, W Ding, JE
Cygler. American Association of Physicists in Medicine 50th Annual Meeting, Houston,
Texas, 27 – 31 July, 2008, Medical Physics, Vol. 35, No. 6, 2789, 2008
5.10 Feasibility of Using Phase to Measure the Venolus Output Function for a Quantitative
DCE-MRI in the Human Brain. C Goottit, GO Cron, MJ Hogan, T Nguyen, IG Cameron.
Imaging Network Ontario Symposium, Toronto, September 2008
5.11 Feasibility study of longitudinal field junctioning with helical tomotherapy. LM Garcia,
LH Gerig, GP Raaphorst, DE Wilkins. American Association of Physicists in Medicine
50th Annual Meeting, Houston, Texas, 27 – 31 July, 2008
5.12 Interaction of Prenatal and Current Marijuana Exposure on Working Memory using
fMRI. RE Schnare, AM Smith, MJ Hogan, IG Cameron. Canadian Psychological
Association Annual Meeting, 2008
5.13 In-vivo dosimetry in radiotherapy: an IAEA coordinated research project. T Bokulic,
AM Campos de Araujo, JE Cygler, P Kukolowicz, S Luo, P Mayles, J Izewska. 27th
ESTRO Annual Meeting, 14 – 18 September, 2008, Goteborg, Sweden, Radiotherapy &
Oncology, 88, Sup 2, S386, 2008
5.14 New Brain Diffusion Analysis Method: White Matter Grey Matter Disassociation. A
Cardenas-Blanco, E Olariu, IG Cameron. 54th Canadian Organization of Medical
Physicists Annual Meeting, Québec City, Québec , June 2008, poster 28
5.15 Performance of the radpos dose-position verification system in 4D radiotherapy using a
deformable lung phantom. JE Cygler, A Cherpak, M Serban, J Seuntjens. 27th
ESTRO Annual Meeting, 14 – 18 September, 2008, Goteborg, Sweden, Radiotherapy &
Oncology, 88, Sup 2, S35, 2008
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5.16 The Use of Phase to Measure the Arterial Input Function for Quantitative T1-weighted
DCE-MRI in Human Brain Tumours. C Foottit, GO Cron, M Hogan, T Nguyen, IG
Cameron. International Society of Magnetic Resonance in Medicine, Toronto, May
2008
5.17 Tractography: A novel Technique to Image Fiber Tracts of the Spinal Cord. F
Alkherayf, A Alali, B Benoit, J Sinclair, A Berthiaume, E Olairu, IG Cameron, E Tsai.
National Neurotrauma Symposium 2008, Orlando, Florida, 2008
6 Research Funding
•
Elekta $83,000/yr (2006-2009)
BG Clark, JE Cygler, MS MacPherson, various topics in IGRT using an Elekta Synergy
accelerator
•
HTX $207,000
JE Cygler, in support of development of a 4D dosimeter system
•
ORCC Foundation $20,000
JE Cygler and A Cherpak, in support of development and clinical evaluation of a 4D
dosimetry system
•
ORDCF $150,000/yr (2002-2008)
IG Cameron (part of a province wide neuroimaging research network) Behaviour
Research and Imaging Network (BRAIN): Revealing the Machinery of the Mind
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. Our results indicate that RADPOS
combined with deformable lung phantom can be a useful tool for quality assurance in 4D
treatment delivery. Papers were presented at AAPM and ESTRO Annual Meetings.
•
Flaws in IMRT Verification
B Nyiri, M Niedbala, LH Gerig
Investigation of dose errors in the planning system(s) for MVCT and KVCT RED curves
and the development of phantoms using non traditional materials, e.g., PMMA.
•
Investigation of attenuation by a carbon fibre tabletop
M Niedbala, B Nyiri, DE Wilkins, LH Gerig
Investigation of feasibility of routine incorporation of the treatment tabletop into patient
treatment planning dose calculations.
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The Ottawa Hospital Cancer Centre
PATIENT POSITIONING
•
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 and consists of a computer controlled miniature probe capable of
simultaneous measurement of dose and spatial coordinates of the measurement point as
a function of time. Two different prototypes have been built, preliminary tests in
phantom have been completed and a manuscript has been submitted for publication.
DOSE RECALCULATION
•
Analysis of dosimetric differences between dose-to-water vs. dose-to-medium
calculations for electron beams
JE Cygler, E Gil, BG Clark
With the advent of commercial Monte Carlo based treatment planning systems (TPS)
typically calculating dose-to-medium, Dm, as opposed to dose-to-water, Dw, calculated
by conventional TPS, a thorough analysis of differences between these treatment plans
is required. Such an analysis has not yet been carried out. The purpose of our study
was to evaluate dosimetric differences between such plans generated with a commercial
MC based TPS. Preliminary results were presented at the COMP Annual Meeting.
IMPROVEMENT OF PLANNING/IMAGING TECHNIQUES
•
Application of historical brachytherapy planning to modern dose protocols
RCN Studinski, L Grimard, M Chelfi
•
MVCT for Prostate Brachytherapy
MS MacPherson, G Perry, JE Cygler
Quantification of advantages of MVCT for post-implant dosimetry.
•
Clinical Implementation of Tomotherapy for Rapid Palliation
R Samant, R MaCrae, L Montgomery, G Fox, L Gerig, B Nyiri
28 patients treated to date, structured clinical implementation strategy to be developed.
BASIC DOSIMETRY
•
In-vivo dosimetry in high gradient radiation fields
JE Cygler, RCN Studinski, A Cherpak
The purpose of this work was to investigate the use of metal oxide semiconductor fieldeffect transistors (MOSFETs) for quality assurance in high dose gradient fields. Most of
the work was carried out on Tomotherapy Hi-Art Unit. High sensitivity and standard
sensitivity MOSFETs were calibrated and tested for reproducibility, field size,
dependence, and accuracy of measuring surface dose in 6 MV beam as well as in
Tomotherapy Hi-Art Unit. In-vivo measurements were made on both a RANDO phantom
and several head and neck cancer patients treated with Tomotherapy. The results were
compared to TLD measurements and treatment plan doses. Our results indicate that
MOSFETs are suitable detectors for surface dose measurements in both conventional
beam and Tomotherapy treatments - manuscript in press.
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RADIOBIOLOGICAL MODELING
•
Infrared Thermal Imaging in Patients Undergoing Early Stage Breast Cancer Treatment
Q Ishaq, DE Wilkins, D Wilkinson, J-M Caudrelier
•
Investigations of a Total Marrow Irradiation treatment technique for multiple myeloma
using Helical Tomotherapy
LM Garcia, DE Wilkins, LH Gerig, MS MacPherson, R Samant, GP Raaphorst
DEVELOPMENT OF INCIDENT LEARNING SYSTEM
•
Implementation and Design Optimisation of an Incident Learning System for a Radiation
Treatment Program
BG Clark, R Brown, DE Wilkins, J Ploquin
Includes collaboration with staff at 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
•
Characterization of Proteoglycan Depletion in Femoroacetabular Impingement with T1ρ
MRI
P-J Lattanzio, P Beaule, A Cardenas-Blanco, G Cron, IG Cameron, K Rakhra
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.
•
fMRI of Young Adults Exposed Prenatally to Marijuana
M Hogan, IG Cameron, A Smith (U of O), P Fried (Carleton University)
Dr. Peter Fried of the Psychology Department at Carleton University has been following
the development of a group of subjects, some of whom were exposed to marijuana
smoking prenatally, since they were born. These subjects are now in their early
twenties. Over this time he has applied a large number of psychological tests to try to
determine if their prenatal exposure to marijuana smoking has affected them in any
way. He has determined that subjects exposed to marijuana do not perform as well on
a certain class of decision-making tasks related to executive functioning skills. In the
present project this same group of subjects will be studied using functional MRI. This is
a technique that can determine which areas of the brain are used to perform a given
task. Our goal is to see which parts of the brain are used by the subjects in performing
a battery of decision making tasks and to see if there is any statistical difference in the
performance of those who were prenatally exposed to marijuana and the control
subjects. Initial experiments have been completed and two papers have been published
from this study. Analysis of the results continues and future experiments are planned.
•
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
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The Ottawa Hospital Cancer Centre
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.
•
Rician Bias Reduction
M Nezamzadeh, 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.
•
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, E Henderson, 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.
•
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.
PARTICIPATION IN CLINICAL TRIALS
•
ER 08-06 OHREB #2008XXX-01HOTT Tomo-PAL: Assessing the feasibility and use of
IG-IMRT for palliation in the management of cancer patients and comparing it with other
approache
R Samant, R MacRae, LH Gerig
•
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
•
OTT 05-02 Randomized Phase III Trial of 3D Conformal Radiotherapy versus Helical
Tomotherapy IMRT in High-Risk Prostate Cancer
Page 26/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
S Malone, L Eapen, G Perry, C E, R Samant, R MacRae, W Kendall, J Spaans, C Kennedy,
LH Gerig, J Szanto, C Morash, I Cagiannos
•
OTT 05-03 Phase II Trial to Evaluate the Potential for Helical Thomotherapy IMRT to
Improve Bladder Cancer Chemoradiation
L Eapen, C E, C Canil, W Kendal, N Reaume, R MacRae, R Segal, S Malone, G Perry, R
Samant, LH Gerig, I Cagiannos, MS MacPherson, C Morash
•
OTT 05-06 Helical Tomotherapy Intensity Modulated Radiotherapy: A phase I/II pilot
study to determine the toxicity profile, pattern of failures and quality of life of patients
with squamous cell carcinoma of the Head and Neck
S El-Sayed, L Eapen, B Esche, L Grimard, S Andrusyk, J Spaans, H Vanasse, N Page, A
Lamothe, E Henderson
•
RTOG 0320 A Phase III Trial Comparing Whole Brain Radiation and Stereotactic
Radiosurgery Alone vs. Temozolomide or Erlotinib in Patients with Non Small Cell Lung
Cancer and 1 – 3 Brain Metastases
G Perry, J Szanto, P Cross, B Esche, C Lochrin, R MacRae, S Malone, JM Caudrelier, C
Canil, S Dent, S Gertler, R Goel, G Goss, S Laurie, G Nicholas, N Reaume
GRADUATE THESES COMPLETED THIS YEAR
•
Breast Cancer Tomotherapy: the Impact of Intrafraction Motion and Shallow Depth Dose
Profiles on the Choice of PTV Depth
J Strydhorst, supervisors M MacPherson and BG Clark
•
Evaluation of Dose Calculation Accuracy for Laryngeal Cancer Radiation Therapy
Treatment Plans
Tara Murphy, supervisor J Cygler
PROJECTS COMPLETED THIS YEAR
•
Verification of XVMC Monte Carlo dose calculation engine as implemented in PrecisePlan
O Nairz, JE Cygler, BG Clark, DWO Rogers
•
Analysis of Prostate Positioning during Treatment
MS MacPherson, LH Gerig
•
Tomotherapy for Adaptive Radiotherapy of Bladder Cancer
MS MacPherson, S Malone, L Eapen, R MacRae, L Montgomery, G Fox, K Carty, LH Gerig
•
Feasibility of rapid palliation using TomoTherapy
MS MacPherson, L Montgomery, G Fox, K Carty, LH Gerig, R MacRae, R Samant
•
Implementation of Multi-catheter Partial Breast Brachytherapy
LA Buckley, JE Cygler
•
Investigation of breast radiotherapy using helical tomotherapy
J Strydhorst, BG Clark, L Montgomery, J-M Caudrelier, MS MacPherson
•
On-line 3D Image and Planning for Tomotherapy
MS MacPherson, LH Gerig, L Montgomery, G Fox, K Carty, S Malone, L Eapen, R MacRae
Page 27/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
•
Evaluation of OSL detectors for dosimetry in radiotherapy
JE Cygler, LA Buckley, A Cherpak, A Viamonte Marin, L-A Ribeiro da Rosa
DEPARTMENTAL PRESENTATIONS
•
A quality assurance program for linear accelerators
Michael Evans, MUHC, invited speaker, 10 October 2008
•
Billiards with photons, atoms and light molecules
Alexandre Trottier, 26 March 2008
•
Bringing Monaco to Ottawa
Nicolas Ploquin, 12 December 2008
•
CT Imaging in Cervical Cancer: Determination of Dose Delivered to Critical Organs in
Intracavitary Brachytherapy
Katie Lekx-Toniolo, 7 March 2008
•
Dose errors related to the treatment couch
Malgorzata Niedbala, 24 October 2008
•
Dose Position Verification in 4D Radiation Therapy
Amanda Cherpak, 23 July 2008
•
Evaluation of a commercial OSL system
Lesley Buckley, 11 January 2008
•
Field Junctions with Tomotherapy
Lourdes Maria Garcia, 25 April 2008
•
GafChromic Film
Kiara Govia, 22 August 2008
•
IGRT Updates
Chun-Bunk Kwok, 26 September 2008
•
Improving Tomotherapy Efficiency and Versatility
Emilie Soisson, 22 February 2008
•
Introduction to Monaco
Jason Belec, 12 September 2008
•
Low-field MRI’s
Silvia Neuteboom, 11 April 2008
•
Matrixx and Compass systems from IBA
Jesse Kruser, IBA Dosimetry, invited speaker, 7 November 2008
•
muCheck Implementation
Crystal Angers, 3 October 2008
•
Our GafChromic film scanner and software – initial experience
Elena Gil, 4 April 2008
•
Overview of HDR cervix implementation
Lesley Buckley, 15 February 2008
•
Probing molecular structure and dynamics with intense femto-second laser pulses &
Evaluation of the Monted Carlo dose calculation in Eclipse for electron beams
Gerard Lagmago Kamta, 30 May 2008
Page 28/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
•
QA Program
Lee H Gerig, 6 June 2008
•
Radiation Therapy in Zambia
David E Wilkins, 5 September 2008
•
Reference dosimetry: the next steps
Malcolm McEwen, NRC, invited speaker, 28 November 2008
•
Tomotherapy QA: What would CAPCA do?
Ryan Studinski, 31 October 2008
•
Tomo Treatment Planning
Lynn Montgomery, 23 May 2008
•
Updates on the commissioning of the new Elekta linac in the portable bunker
Nicolas Ploquin & Eric Vandervoort, 18 April 2008
•
Verifying monitor unit calculations for tangential whole-breast fields
Ian Kay, 29 February 2008
•
XiO Dose Calculation Accurancy
Jason Belec, 5 December 2008
OTHER PRESENTATIONS
•
Electron beams
JE Cygler. 13th Radiation Oncology. Refresher Course, January 12, 2008
•
Independent Monitro Unit Calculation for a Class of Helical Tomotherap
B Nyiri, Ottawa Medical Physics Institute (OMPI), 17 April 2008
•
Notes from Rio
JE Cygler, Radiation Oncology and Physics Rounds, 30 April 2008
•
Image Guided Micro-MLC Precision Therapy is coming soon to a Bunker Near You!
BG Clark, RT In-Service, 16 June 2008
•
The Use of MRI for Radiation Therapy Treatment Planning
E Henderson, Radiation Oncology and Physics Rounds, 29 October 2008
•
Radiation Therapy in Zambia.
DE Wilkins, Ottawa Medical Physics Institute (OMPI), 20 November 2008
•
Treatment Plan Verification for Single Fraction Scan, Plan 7 Treat Tomotherapy
B Nyiri, Radiation Oncology and Physics Rounds, 20 February 2008
Page 29/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
NATIONAL/INTERNATIONAL CONFERENCE
REPRESENTATION
AAPM (American Association of Physicists in Medicine) Annual Scientific Meeting, Boston,
MA, USA, 21 – 25 July 2008
Joanna E Cygler
COMP (Canadian Organization of Physicists in Medicine) Annual Meeting, Quebec City,
Quebec, 25 – 28 June 2008
Crystal Plume Angers
Brenda G Clark
Malgorzata Niedbala
Balazs Nyiri
David E Wilkins
ESTRO (European Society of Therapeutic Radiation Oncology) Annual Scientific Meeting,
Goteberg, Sweden, 14 – 17 September 2008
Joanna E Cygler
Lee H Gerig
Janos Szanto
IAEA (International Atomic Energy Agency) June 2008
Joanna E Cygler
ISMRM (International Society of Physicists in Medicine
Ian G Cameron
RSNA (Radiology Society of North America) Annual Scientific Meeting Chicago, IL, USA, 30
November – 5 December, 2008
Joanna E Cygler
SEAAPM (Southeast Chapter of the American Association of Physicists in Medicine)
Symposium, Birmingham, Alabama, USA, 26 – 28 March, 2008
Joanna E Cygler
Page 30/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
PROFILE OF PHYSICISTS
Crystal Plume Angers, M.Sc., MCCPM................................... 32
Jason Bélec, M.Sc., MCCPM ................................................ 33
Lesley Buckley, Ph.D., MCCPM ............................................ 34
Ian G. Cameron, Ph.D., FCCPM ........................................... 35
Brenda G. Clark, Ph.D., FCCPM, FAAPM ................................ 36
Joanna E. Cygler, Ph.D., FCCPM, FAAPM............................... 37
Lee H. Gerig, Ph.D., FCCPM ................................................ 38
Elizabeth Henderson, Ph.D., MCCPM .................................... 39
Chun-Bun Kwok, Ph.D., MCCPM .......................................... 40
Katie S. Lekx-Toniolo, Ph.D. ............................................... 41
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM ......................... 41
Balazs Nyiri, Ph.D., MCCPM ................................................ 43
Ryan Studinski, Ph.D., MCCPM ............................................ 44
Janos Szanto, Ph.D., FCCPM ............................................... 45
David E. Wilkins, Ph.D., FCCPM ........................................... 46
Page 31/46
BGC/June 2009
Annual Report 2008
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:
•
Clinical development of High Dose Rate Brachytherapy Cervix program
•
Clinical development of High Dose Rate Brachytherapy Partial Breast program.
•
Clinical implementation of the ExacTrac patient positioning system
•
Clinical implementation of the BrainLab stereotactic radiotherapy system
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 32/46
BGC/June 2009
Annual Report 2008
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:
•
Evaluation of dose calculation algorithms and measurement perturbation factors
for radiosurgery and highly modulated fields (IMRT, Tomotherapy).
•
Monte Carlo simulations of Synergy Elekta linear accelerator and cone beam
imaging system.
•
Clinical evaluation of a biological optimization algorithm for inverse IMRT.
Publications and Presentations:
1 peer reviewed article, 5 published abstracts
Selected Publications:
J. Bélec, H. J. Patrocinio, F. Verhaegen: Development of a Monte Carlo model for
the Brainlab microMLC. Physics in Medicine and Biology 2005:50:787-799.
Published Abstracts:
J. Belec: Procédures de Dosimétrie au CHVO. Presented at the AQPMC Annual
Meeting, Montréal, Québec, 2005.
J. Belec, H. J. Patrocinio, F. Verhaegen: Development of a Monte Carlo
component model for a micro multileaf collimator used for conformal beam
stereotactic radiosurgery treatment. Proceedings of Current Topics in Monte
Carlo Treatment Planning Advanced Workshop, Montreal, Quebec, 2004.
J. Belec, H. J. Patrocinio, F. Verhaegen: A Monte Carlo approach to the
validation of a pencil beam algorithm used in treatment planning for static
conformal beam radiosurgery. Presented at the Young Investigator Symposium
of the AAPM annual Meeting, Pittsburg, Pennsylvania, 2004.
J. Belec, H. J. Patrocinio, F. Verhaegen: Une approche Monte Carlo pour la
validation d’un algorithme de faisceaux étroits utilisé pour la planification
de traitements en radiochirurgie avec champs conformes statiques.
Presented at the 72nd Annual Meeting of the ACFAS, Montreal, Québec, 2004.
J. Belec: Procédures de contrôle de qualité des accélérateurs au CHVO.
Presented at the AQPMC Annual Meeting, Montréal, Québec, 2004.
Page 33/46
BGC/June 2009
Annual Report 2008
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, 7 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)
Published Abstracts:
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.
L.A. Buckley and D.W.O. Rogers. EGSnrc calculations of a dag-coated aluminumwalled thimble chamber. Presented at the AAPM annual meeting, Montreal PQ, 2002.
L.A. Buckley, L.A. DeWerd and B.R. Thomadsen. Characterization of the waterequivalence of phantom materials for 90Sr/90Y beta particles using the Novoste
Beta-CathTM system. Presented at the AAPM annual meeting, Salt Lake City UT, 2001.
Page 34/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Ian G. Cameron, Ph.D., FCCPM
Medical Physicist, MRI Unit
The Ottawa Hospital
Adjunct Professor
Department of Physics, Carleton University
Associate Professor
Department of Radiology, University of Ottawa
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 NMR 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:
23 peer reviewed articles, 51 presentations at national / international conferences
Selected Publications:
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), 2372-2380, 2008.
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.
of Radiology 33222418v2, pulished online 11 November 2008.
A.M. Smith, P.A. Fried, M.J. Hogan, I.G. Cameron, Effects of Prenatal Marijuana on
Visuospatial Working Memory: An fMRI Study in Young Adults. Neurotoxicology and
Teratology, 28(2), 286-295, 2006.
Page 35/46
BGC/June 2009
Annual Report 2008
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.
•
Implementation of Image Guidance Techniques to ensure appropriate treated volumes.
Publications and Presentations:
50 peer reviewed articles, 19 invited presentations, >130 presentations at national /
international conferences, 3 patents
Selected Recent Publications:
Macpherson M, Montgomery L, Fox G, Carty K, Gerig L, Macrae R, Grimard L, Clark BG, Samant R:
On-line rapid palliation using helical tomotherapy: A prospective feasibility study. Radiother
Oncol. Apr;87(1):116-8, 2008
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
Montgomery L, Macpherson M, Gerig L, Carty K, Fox G, Esche B, Clark BG: Simultaneous
treatment of multiple basal cell carcinoma lesions. Br J Radiol.81(972):e290-2, 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
Clark B, McKenzie M, Robar J, Vollans E, Candish C, Toyota B, Lee A, Ma R, Goddard K, Erridge S.
Does intensity modulation improve healthy tissue sparing in stereotactic radiosurgery of
complex arteriovenous malformations? Med Dosim; 32(3): 172-80, 2007
Page 36/46
BGC/June 2009
Annual Report 2008
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
Clinical Investigator, Ottawa Health Research Institute (OHRI)
Member, Ottawa Medical Physics Institute (OMPI)
Professional Certification:
Award:
1994
Canadian College of Physicists in Medicine, fellow, (FCCPM)
1994
Canadian College of Physicists in Medicine, member, (MCCPM)
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, image guided radiotherapy, radiobiology.
Dose calculations for electron beams present a serious technical difficulty. Until recently in commercial
treatment planning systems approximate algorithms have been implemented. Approximations cause
different levels of discrepancies between calculated and measured dose distributions. I designed special
phantoms, carried on the experiments and explained the physical reasons for the discrepancies found
between the calculated and measured dose distributions. These phantoms have become a common
standard in testing of electron dose calculations. I collaborated on the OMEGA project (funded by NIH)
with scientists from NRC and University of Wisconsin, USA on development of Monte Carlo based
treatment planning system for electron beams. Recently I have implemented clinically the first
commercial Monte Carlo based system for electron beams. I have been also involved in development
of new dosimetry methods and devices. For number of years I have been involved in collaboration
with Thomson – Nielsen on development of new MOSFET detectors. In collaboration with the NRC
scientists (Dr. N.Klassen) a new technique of using the GafChromic film was developed. This
technique has been successfully applied in external high energy beams, brachytherapy and recently in
measurements of back-scatter factors in low energy X-ray beams.
Publications and Presentations:
3 book chapters, 45 peer reviewed articles, >100 published abstracts, 37 invited
presentations, 1 CAPCA technical report
Selected Publications:
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. Cherry, Medical Physics Publishing (Madison, WI, 2006), p.51-69.
G.X. Ding, D.M. Duggan, C.W. Coffey, P. Shokrani, J.E. Cygler. First Macro Monte Carlo based
commercial dose calculation module for electron beam treatment planning: new issues for
clinical consideration. Physics in Medicine and Biology, 51: 2781-2799, 2006.
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. Cherry, Medical Physics Publishing (Madison, WI, 2006), p.199-232.
Page 37/46
BGC/June 2009
Annual Report 2008
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:
Montgomery L, MacPherson M, Gerig LH, Carty K, Fox G, Esche B, Clark BG. Simultaneous
treatment of multiple basal cell carcinoma lesions.
The British Journal of Radiology
81(972):e290-2 2008.
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
Apr;87(1):116-8.
Samant R, Gerig LH, Montgomery L, MacRae R, Fox G, Nyiri B, et al. High-technology palliative
radiotherapy using image-guided intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol )
2008 Nov;20(9):718-20.
Gao Z, Wilkins DE, Eapen L, Morash C, Wassef Y, Gerig LH. A Study of Prostate Delineation
Referenced Against a Gold Standard Created from the Visible Human Data. Radiotherapy and
Oncology 85(2):239-46 2007
Gao Z, Szanto J, Gerig LH. Using MLC Inter-Leaf Leakage to Extract Absolute Spatial
Information from EPID Images. Journal of applied clinical medical physics, 8(1):1-9 2007
Page 38/46
BGC/June 2009
Annual Report 2008
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 39/46
BGC/June 2009
Annual Report 2008
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 40/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Katie S. Lekx-Toniolo, Ph.D.
Medical Physicist
The Ottawa Hospital Cancer Centre
Research Interests:
•
Organ at-risk doses during high dose rate brachytherapy for the treatment of cancer of
the cervix
•
MRI, SPECT, PET/CT, and clinical radiotherapy physics
•
Validation of 82Rubidium PET perfusion
pharmacologically induced hyperemia
•
Myocardial blood flow, function, metabolism and viability imaging using MRI, SPECT and
PET
measurements
at
rest
and
during
Publications and Presentations:
4 peer reviewed articles, 17 published abstracts, 4 invited presentations
Selected Publications:
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.
Selected Abstracts:
Lekx KS, Patel M, Voruganti S, Hunter R, Farrell T, Dhamanaskar K. CT imaging in cervical
cancer: Determination of dose delivered to bladder and rectum during intracavitary
brachytherapy.
Lekx KS, Wisenberg G, Wells RG, Sykes J, Prato FS. Perfusion reserve ratio, regional
contractile wall motion and glucose uptake measurements in a canine model of coronary
artery stenosis.
Page 41/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Malgorzata (Gosia) Niedbala, Ph.D., MCCPM
Medical Physicist,
The Ottawa Hospital Cancer Centre
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(7), P40, July
2005.
Page 42/46
BGC/June 2009
Annual Report 2008
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 Modeling; Statiscial analysis; IMRT/IMRT delivery; Image processing and
analysis; Stereotactic Radiosurgery/Radiotherapy.
Currently I am interested in GafChromic film based film dosimetry and image processing
and analysis for linac QA, IMRT treatment DQA. Image analysis for the dosimetric effect of
the treatment couch on radiotherapy planning and delivery.
Publications and Presentations:
18 peer reviewed articles, 32 presentations at national / international conferences, 2 invited
/ landmark lectures, 8 (4) patents (inventions)
Selected Recent Publications:
JM Caudrelier, SC Morgan, L Montgomery, M Lacelle, B Nyiri, M MacPherson. Helical
tomotherapy for locoregional irradiation including the internal mammary chain in
left-sided breast cancer: Dosimetric evaluation. Radiotherapy and Oncology, Volume
90, Issue 1, January 2009, Pages 99-105 (Accepted 7 September 2008, Available online 1
November 2008)
JM Caudrelier, M Vermandel, N Betrouni, B Nyiri, I Cameron, J Rousseau. An accurate and
robust method based on fuzzy logic principles for the reconstruction and
quantification of large volume from MR and CT images. Br. J. of Radiology, 82
(2009), 228-234 (Published online 11 November 2008).
R Samant, LH Gerig, L Montgomery, R Macrae, G Fox, B Nyiri, K Carty, M MacPherson.
High-technology Palliative Radiotherapy using Image-guided Intensity-modulated
Radiotherapy. Clinical Oncology, volume 20, Issue 9, November 2008, pages 718-720
M Carlone, DE Wilkins, B Nyiri, GP Raaphorst. Comparison of α/β Estimates from
Homogeneous (Individual) and Heterogeneous (Population) Tumor Control Models
for early Stage Prostate Cancer Med. Phys. 30 (10), October 2003
Z Donko and B Nyiri. Molecular dynamics calculation of the thermal conductivity and
shear viscosity of the classical one-component plasma. Phys. Plasmas (USA) 7 (Jan.
2000) 45-50
B Nyiri and P Van. Hamilton Formalism and Variational Principle Construction
Annalen der Physik (Leipzig) 8/4, (1999), p331-354
Z Donko, B Nyiri, L Szalai, and S Hollo. Thermal Conductivity of the Classical Electron
One-Component Plasma. Phys. Rev. Lett. 81, 1622-1625 (1998)
Page 43/46
BGC/June 2009
Annual Report 2008
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 44/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
Janos Szanto, Ph.D., 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 45/46
BGC/June 2009
Annual Report 2008
Medical Physics
The Ottawa Hospital Cancer Centre
David E. Wilkins, Ph.D., FCCPM
Senior Medical Physicist, Medical Physics
The Ottawa Hospital Cancer Centre
Adjunct Professor
Department of Physics, Carleton University
Assistant Professor
Department of Radiology, University of Ottawa
Clinical Investigator
Ottawa Health Research Institute (OHRI)
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.
Computer simulations of linear accelerator head leakage for evaluation of shielding
materials and radiotherapy bunker design.
Publications and Presentation:
24 peer reviewed articles, 55 published abstracts
Selected Publications:
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.
M. Carlone, D. E. Wilkins, G. P. Raaphorst. The modified linear quadratic model of
Guerrero and Li can be derived from a mechanistic basis and exhibits linearquadratic-linear behaviour. Letter to the Editor, Physics in Medicine and Biology 50: L915, 2005.
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BGC/June 2009