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Introduction/Objective Left breast cancer patients undergoing radiotherapy are at higher risk of cardiovascular diseases (CVD), as a partial volume of the heart is anatomically close to target volume. This may cause CVD in the years following cancer treatment. The aim of this work was to develop a scoring system which identifies patients with increased risk of development of CVD, as a consequence of the left breast irradiation. Methods The patients followed up in this study were treated during 2009. Eight years later, they were invited to participate in a study where they underwent a cardiology evaluation. Their current condition was statistically correlated to the doses received by their heart and left anterior descendant artery (LAD). Results Out of 114 patients, 31 women were evaluable for cardiology assessment. Out of these 31 subjects, six women were with a history of CVD before cancer treatment. Four women never developed any kind of heart associated disease, while in the other 27, newly onset CVD were diagnosed ranging from hypertension to myocardial infarction, strongly positively correlated to doses to heart and LAD (p = 0.003). Severity of developed cardiovascular toxicity was formulated through the correlation of mean heart and mean LAD doses with CVD developed in the form of a scoring system. Conclusion The doses to critical organs depend on patient anatomy and technique of irradiation. The cardiovascular complications are proven as consequence of radiotherapy. Scoring system based on doses received by heart and LAD is a reliable tool in predicting CVD.

In the case of dynamic radiotherapy plans, the fractionation schemes can have dosimetric effects. Our goal was to define the effect of the fraction dose on the plan quality and the beam delivery.

The aim of the study was to dosimetrically compare multicatheter interstitial brachytherapy (MIBT) and stereotactic radiotherapy with CyberKnife (CK) for accelerated partial breast irradiation (APBI) especially concerning the dose of organs at risk (OAR-s).

The purpose of the study was to compare the results of gamma value based film analysis according to the used type of self-developer film and software product.

The aim of the study was to evaluate and compare four different external beam radiotherapy techniques of accelerated partial breast irradiation (APBI) considering target coverage, dose to organs at risk and overall plan quality. The investigated techniques were three dimensional conformal radiotherapy (3D-CRT), “step and shoot” (SS) and “sliding window” (SW) intensity-modulated radiotherapy (IMRT), intensity-modulated arc therapy (RA).

The aim of the study was to present dosimetric comparison of image guided high-dose-rate brachytherapy (IGBT) with volumetric modulated arc therapy (VMAT) for head and neck cancer regarding conformity of dose distribution to planning target volume (PTV) and doses to organs at risk (OARs).

Medical physics is a health profession where principles of applied physics are mostly directed towards the application of ionizing radiation in medicine. The key role of the medical physics expert in safe and effective use of ionizing radiation in medicine was widely recognized in recent European reference documents like the European Union Council Directive 2013/59/EURATOM (2014), and European Commission Radiation Protection No. 174, European Guidelines on Medical Physics Expert (2014). Also the International Atomic Energy Agency (IAEA) has been outspoken in supporting and fostering the status of medical physics in radiation medicine through multiple initiatives as technical and cooperation projects and important documents like IAEA Human Health Series No. 25, Roles and Responsibilities, and Education and Training Requirements for Clinically Qualified Medical Physicists (2013) and the International Basic Safety Standards, General Safety Requirements Part 3 (2014). The significance of these documents and the recognition of the present insufficient fulfilment of the requirements and recommendations in many European countries have led the IAEA to organize in 2015 the Regional Meeting on Medical Physics in Europe, where major issues in medical physics in Europe were discussed. Most important outcomes of the meeting were the recommendations addressed to European member states and the survey on medical physics status in Europe conducted by the IAEA and European Federation of Organizations for Medical Physics.

Background/Objectives : Radiography is an essential and low-cost diagnostic method in pulmonary medicine that is used for the early detection and monitoring of lung diseases. An adequate and consistent image quality (IQ) is crucial to ensure accurate diagnosis and effective patient management. This pilot study evaluates the feasibility and effectiveness of the International Atomic Energy Agency (IAEA)'s remote and automated quality control (QC) methodology, which has been tested in multiple imaging centers. Methods : The data, collected between April and December 2022, included 47 longitudinal data sets from 22 digital radiographic units. Participants submitted metadata on the radiography setup, exposure parameters, and imaging modes. The database comprised 968 exposures, each representing multiple image quality parameters and metadata of image acquisition parameters. Python scripts were developed to collate, analyze, and visualize image quality data. Results : The pilot survey identified several critical issues affecting the future implementation of the IAEA method, as follows: (1) difficulty in accessing raw images due to manufacturer restrictions, (2) variability in IQ parameters even among identical X-ray systems and image acquisitions, (3) inconsistencies in phantom construction affecting IQ values, (4) vendor-dependent DICOM tag reporting, and (5) large variability in SNR values compared to other IQ metrics, making SNR less reliable for image quality assessment. Conclusions : Cross-comparisons among radiography systems must be taken with cautious because of the dependence on phantom construction and acquisition mode variations. Awareness of these factors will generate reliable and standardized quality control programs, which are crucial for accurate and fair evaluations, especially in high-frequency chest imaging.

Objective . In this multicentric collaborative study, we aimed to verify whether the selected radiation detectors satisfy the requirements of TRS-483 Code of Practice for relative small field dosimetry in megavoltage photon beams used in radiotherapy, by investigating four dosimetric characteristics. Furthermore, we intended to analyze and complement the recommendations given in TRS-483. Approach . Short-term stability, dose linearity, dose-rate dependence, and leakage were determined for 17 models of detectors considered suitable for small field dosimetry. Altogether, 47 detectors were used in this study across ten institutions. Photon beams with 6 and 10 MV, with and without flattening filters, generated by Elekta Versa HD TM or Varian TrueBeam TM linear accelerators, were used. Main results . The tolerance level of 0.1% for stability was fulfilled by 70% of the data points. For the determination of dose linearity, two methods were considered. Results from the use of a stricter method show that the guideline of 0.1% for dose linearity is not attainable for most of the detectors used in the study. Following the second approach (squared Pearson's correlation coefficient r 2 ), it was found that 100% of the data fulfill the criteria r 2 > 0.999 (0.1% guideline for tolerance). Less than 50% of all data points satisfied the published tolerance of 0.1% for dose-rate dependence. Almost all data points (98.2%) satisfied the 0.1% criterion for leakage. Significance . For short-term stability (repeatability), it was found that the 0.1% guideline could not be met. Therefore, a less rigorous criterion of 0.25% is proposed. For dose linearity, our recommendation is to adopt a simple and clear methodology and to define an achievable tolerance based on the experimental data. For dose-rate dependence, a realistic criterion of 1% is proposed instead of the present 0.1%. Agreement was found with published guidelines for background signal (leakage)., (Creative Commons Attribution license.)

Although Medical Physics educators have historically contributed to the education of the non-physics healthcare professions, their role was not studied in a systematic manner. In 2009, EFOMP set up a group to research the issue. In their first paper, the group carried out an extensive literature review regarding physics teaching for the non-physics healthcare professions. Their second paper reported the results of a pan-European survey of physics curricula delivered to the healthcare professions and a Strengths-Weaknesses-Opportunities-Threats (SWOT) audit of the role. The group's third paper presented a strategic development model for the role, based on the SWOT data. A comprehensive curriculum development model was subsequently published, whilst plans were laid to develop the present policy statement. This policy statement presents mission and vision statements for Medical Physicists teaching non-physics users of medical devices and physical agents, best practices for teaching non-physics healthcare professionals, a stepwise process for curriculum development (content, method of delivery and assessment), and summary recommendations based on the aforementioned research studies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Associazione Italiana di Fisica Medica e Sanitaria. All rights reserved.)

This EFOMP Policy Statement is an update of Policy Statement No. 6 first published in 1994. The present version takes into account the European Union Parliament and Council Directive 2013/55/EU that amends Directive 2005/36/EU on the recognition of professional qualifications and the European Union Council Directive 2013/59/EURATOM laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation. The European Commission Radiation Protection Report No. 174, Guidelines on Medical Physics Expert and the EFOMP Policy Statement No. 12.1, Recommendations on Medical Physics Education and Training in Europe 2014, are also taken into consideration. The EFOMP National Member Organisations are encouraged to update their Medical Physics registration schemes where these exist or to develop registration schemes taking into account the present version of this EFOMP Policy Statement (Policy Statement No. 6.1"Recommended Guidelines on National Registration Schemes for Medical Physicists")., (Copyright © 2016. Published by Elsevier Ltd.)

Continuing Professional Development (CPD) is vital to the medical physics profession if it is to embrace the pace of change occurring in medical practice. As CPD is the planned acquisition of knowledge, experience and skills required for professional practice throughout one's working life it promotes excellence and protects the profession and public against incompetence. Furthermore, CPD is a recommended prerequisite of registration schemes (Caruana et al. 2014) and is implied in the Council Directive 2013/59/EURATOM (EU BSS) and the International Basic Safety Standards (BSS). It is to be noted that currently not all national registration schemes require CPD to maintain the registration status necessary to practise medical physics. Such schemes should consider adopting CPD as a prerequisite for renewing registration after a set period of time. This EFOMP Policy Statement, which is an amalgamation and an update of the EFOMP Policy Statements No. 8 and No. 10, presents guidelines for the establishment of national schemes for CPD and activities that should be considered for CPD., (Copyright © 2016. Published by Elsevier Ltd.)

Background and Purpose: One of the newer audit modalities operated by the International Atomic Energy Agency (IAEA) involves audits of treatment planning systems (TPS) in radiotherapy. The main focus of the audit is the dosimetry verification of the delivery of a radiation treatment plan for three-dimensional (3D) conformal radiotherapy using high energy photon beams. The audit has been carried out in eight European countries - Estonia, Hungary, Latvia, Lithuania, Serbia, Slovakia, Poland and Portugal. The corresponding results are presented., Material and Methods: The TPS audit reviews the dosimetry, treatment planning and radiotherapy delivery processes using the 'end-to-end' approach, i.e. following the pathway similar to that of the patient, through imaging, treatment planning and dose delivery. The audit is implemented at the national level with IAEA assistance. The national counterparts conduct the TPS audit at local radiotherapy centres through on-site visits. TPS calculated doses are compared with ion chamber measurements performed in an anthropomorphic phantom for eight test cases per algorithm/beam. A set of pre-defined agreement criteria is used to analyse the performance of TPSs., Results: TPS audit was carried out in 60 radiotherapy centres. In total, 190 data sets (combination of algorithm and beam quality) have been collected and reviewed. Dosimetry problems requiring interventions were discovered in about 10% of datasets. In addition, suboptimal beam modelling in TPSs was discovered in a number of cases., Conclusions: The TPS audit project using the IAEA methodology has verified the treatment planning system calculations for 3D conformal radiotherapy in a group of radiotherapy centres in Europe. It contributed to achieving better understanding of the performance of TPSs and helped to resolve issues related to imaging, dosimetry and treatment planning.