Category: Medical Physics

01 Jun 2022
diagnostic imaging procedure

Diagnostic Medical Physics in Medicine: Why It’s Important

Many are unfamiliar with the important role that diagnostic medical physics plays in medicine, particularly in the diagnosis and treatment of diseases like cancer.

At Versant Physics, we provide a wide range of diagnostic medical physics services that help healthcare facilities safely and effectively execute procedures for the health and well-being of their patients. Our goal is to help facilities ensure their patients are protected from excessive levels of radiation and that diagnostic equipment is working appropriately, all while maintaining compliance with state and federal regulations.

In this blog post, we’ll break down what diagnostic imaging is, how and why physics principles are applied to diagnostic medicine, and the various roles of a diagnostic medical physicist to help clarify the importance of this profession.

What is Diagnostic Imaging?

Diagnostic Imaging is a range of techniques and equipment used to look inside the body. The purpose of this is to help physicians identify injuries and illnesses, and to help make an accurate diagnosis and treatment plan. This can include a variety of procedures, from simple X-rays for broken bones to more complex procedures involving the brain, heart, or lungs.

Diagnostic imaging procedures are usually painless and noninvasive. However, depending on the test being performed, some patients may be exposed to small amounts of radiation.

diagnostic medical physics

CT scans are a common example of a diagnostic imaging test that emits radiation. In a CT scan, the patient is exposed to a series of X-rays from a variety of angles which are then processed via a computer. The computer creates cross-sectional images of the inside of the body. CT scans are higher-quality images than a normal X-ray and allow physicians to view both hard and soft tissues in the body. They can check for stroke, internal bleeding, chest abnormalities, enlarged lymph nodes, abdominal or pelvic pain, tumors, and more. It is also used to monitor existing diseases such as heart disease and cancer. 

Other common diagnostic imaging procedures include mammography, which helps detect and diagnose breast cancer, fluoroscopy, magnetic resonance imaging (MRI), and ultrasounds.  

Diagnostic Physics and Medicine

Medical physics as a field is divided into five categories, including:

  • nuclear medicine
  • therapeutic medical physics,
  • medical health physics,
  • magnetic resonance imaging physics, and
  • diagnostic imaging.

Diagnostic medical physicists are responsible for ensuring the safe and effective application of radiation used in medical treatments. Specifically, radiology procedures. They work as a member of a patient’s care team, which typically includes physicians, dosimetrists, and radiologic technologists among others.

Equipment Evaluation and Compliance

One of the main roles of a diagnostic medical physicist is to ensure the safe operation of radiation-producing machines and diagnostic radiation detectors. This can include developing imaging equipment specifications, measuring the radiation produced by a piece of equipment prior to clinical use, and proving that the equipment is compliant with regulatory and accreditation requirements.

This also includes assessing all the software, algorithms, data, and computer systems associated with the radiation-producing equipment for accuracy and performance.

Acceptance Testing

Any unit that is used in a diagnostic setting must be periodically reviewed to ensure not only that the image quality is maintained, but that the unit is operating in compliance with the manufacturer’s specifications.

Most states require that a newly installed piece of diagnostic imaging equipment, whether it is brand new or used, be tested by a qualified medical physicist prior to first clinical use. This extremely thorough survey confirms that the unit was installed and set up correctly and ensures that it meets vendor and industry performance standards. It is also an opportunity to identify any potential issues with the unit before it is used on patients.

mammography unit

Typical units that require acceptance testing include fluoroscopic x-rays, radiographic x-rays, PET and PET/CT units, mammography equipment, C-arms, CTs, SPECT cameras, and PACS workstations.

Commissioning

The commissioning process for diagnostic radiation therapy machines such as Linear Accelerators involves testing the unit’s functionality and verifying that dose calculation algorithms work appropriately to produce measured dose calculations.  

Radiation-producing equipment like a LINAC is highly technical and specific. There are many requirements and protocols that detail how this unit should work, from how much energy it produces to the shape and direction of the beam. Diagnostic medical physicists are trained to measure, assess, and implement the optimal baseline values for a unit during the commissioning process.

Patient safety is the end goal of all diagnostic physics commissioning work.

Shielding

Another important aspect of diagnostic physics includes the planning and placement of shielding in areas that use radiation. In the United States, 35+ states require specific shielding designs in any room that houses radiation-producing equipment.

A diagnostic medical physicist can evaluate any shielding that is installed to determine if it will adequately protect workers, patients, and the public from the radiation outside of the scope of a specific treatment. This includes planning for material thickness as well as appropriate placement.

Versant Physics physicists are experienced with a range of equipment shielding requirements, including dental units, Cone-beam CTs, mobile c-arms, high-energy LINACS, Proton Therapy units, and Cyclotrons.

Our team is also experienced with different types of shielding materials, including non-lead materials, which are guaranteed to meet regulatory guidelines and ALARA principles.

Patient Dose & Treatment

Part of a diagnostic physicist’s job is also to ensure the safety of medical imaging modalities being applied in the treatment of individual patients.

They are responsible for determining the exact radiation dose a patient will receive in accordance with the radiation oncologist’s prescription before the patient begins treatment. Creating this therapy plan can take a few hours or multiple days, depending on the complexity of the illness. They also ensure radiation protection guidelines are in place, develop QA tools that ensure optimal image quality, and make sure that all operators are trained in the use of the best imaging techniques.

A diagnostic medical physicist may also monitor the dose of the patient throughout the course of their treatment.

Patients rarely interact directly with the medical physicist on their care team; however, they are a vital part of a safe and effective treatment process.

Versant Physics Diagnostic Support

Our board-certified physicists are able to handle diagnostic physics support for a variety of facilities, including hospitals, clinics, dental offices, and university health systems. With decades of experience, top-of-the-line equipment, and a passion for patient safety, our team is the best choice to assist with your diagnostic medical physics needs.

Contact us for a quote or to learn more about our medical physics support services.

12 Aug 2021

A Step-by-Step Guide to Implementing a Radiation Safety Program

Implementing a radiation safety program is the best way to protect radiation workers and maintain safe radiological conditions in your clinic or university. If you are a new facility starting from scratch, implementing a radiation safety program can be an overwhelming task. We have put together a step-by-step guide to help clarify areas you will need to address.

Who Regulates What?

It is important for any new radiation safety program to understand which regulations to follow. The U.S. Nuclear Regulatory Commission (NRC) is responsible for regulating radioactive materials in the United States. However, they do not regulate radioactive material in any of the 37 Agreement States. These Agreement States have signed agreements with the state’s governor and the chair of the NRC that declare they take responsibility for all radioactive material regulation within the state. Agreement States can set their own rules for how radiation is monitored, handled, and used if they are at least as strict as the NRC.

Each state regulates the use of ionizing radiation generating equipment within the state. It is very important to research your individual state regulations.

For a list of individual state radiation control programs and their specific rules and regulations, we recommend visiting the Conference of Radiation Control Program Directors (CRCPD) website.

Step 1: Identify a Radiation Safety Officer

A Radiation Safety Officer is a required element of a radiation safety program.

According to AAPM Report 160, the RSO in a radiation safety program “is responsible for the implementation, coordination, and day-to-day oversight of the radiation protection program.” An RSO enforces policies and procedures regarding radiation safety and ensures the facility’s use of ionizing radiation is compliant with regulatory requirements, whether that be state or federal. These individuals are required to meet certain education, training, and experience requirements to assume the role.

The responsibilities of the RSO are many. In addition to managing the radiation safety program, this person will:

  • Provide advice and assistance on radiological safety matters,
  • Ensure safe use of radioactive materials,
  • Ensure compliance with regulatory and license requirements,
  • Identify radiation safety problems and correct them,
  • Ensure ALARA practices are enforced,
  • Perform audits and surveys of work areas as necessary,
  • Dose monitoring,
  • Instrument calibration,
  • And more.

Step 2: Get Copies of State and Federal Regulations

Federal regulations can be found on the NRC website. As mentioned above, most states have their own regulatory body. This may also be a good time to contact your state regulator and introduce yourself.

Step 3: Set-up Administrative Documents & QA Program

You will want to lay out the various roles in your radiation safety program in an organization chart. This includes management, IT, radiation safety resources, and additional radiation modalities and departments.

It will also be helpful to create a Standard Operating Procedure Manual on radiation protection that describes emergency procedures, training policies, and credentialing all radiation workers should be familiar with.

Step 4: Establish a Radiation Safety Committee

A radiation safety committee is typically made up of:

  • The RSO,
  • An authorized user of each type of use permitted by the license,
  • A nursing representative, and
  • A representative who is neither an authorized user nor the RSO.

Many universities and larger clinics find an RSC helpful for efficient radiation safety program management. However, they are not always mandatory depending on your use of radiation. You may find a radiation safety committee is not necessary for your facility.

Step 5: X-ray Room Shielding

Radiation Worker Behind Shielding

Facilities that utilize radiation are required to have a shielding plan developed by a qualified expert, such as a medical physicist. Most states also require the shielding plan to be submitted to the state before the equipment can be used.  

When setting up a radiation safety program, it will be necessary to contact an appropriate QE to put together the shielding plan. You will work with them to implement the appropriate materials and signage throughout your facility. Afterward, integrity and regulatory surveys must be performed to ensure compliance with area dose limits.

Step 6: Registration of Radiation Machines & RAM License Application

A new facility with new X-ray equipment must register each unit with the state, typically within 30 days of acquiring the unit. The use of X-ray-producing equipment is regulated on a state-by-state basis. The appropriate forms and required supporting documentation can be found on your state’s regulatory website or by contacting your regulator.

A new facility intending to use radioactive material must apply to either their Agreement State or the NRC for approval. In preparation for submitting the application, all the previous steps should be completed. Many of the items above will be reviewed along with the license application to determine approval status.

Note that some states may require radiation-producing machines to be inspected regularly by state-approved qualified experts to maintain a registration.

Step 7: Set-up a Personnel Monitoring Program

Licensees/Registrants are required to monitor radiation exposure of radiation workers to remain in compliance with occupational dose limits.

Instadose+ Dosimeter

It is important to set up a personnel monitoring program for radiation workers who regularly work with or could encounter radiation while on the job. These programs require personnel to wear a dosimeter badge which measures their total received exposure. RSO’s periodically review the personnel exposures.

There are a variety of dosimeter options available including TLDs, ring badges, and badges that provide on-demand dose reads.

Step 8: Recordkeeping

Implementing a radiation safety program means there will not be existing inspection reports, previous audits, or correspondence with regulators on file to familiarize yourself with. However, as the RSO, you will be responsible for maintaining all records regarding personnel exposure, exposure levels to the public, surveys, calibrations, and any maintenance completed on the facility’s X-ray equipment moving forward. Consult your state regulations to determine how long individual records need to be kept.

Conclusion

While there are many moving parts to setting up a radiation safety program, it is an important aspect of a safe workplace. Following these steps will have you well on your way to leading a successful program.

Our experienced radiation safety officers, health physicists, and medical physicists can help you implement a radiation safety program. Contact sales@versantphysics.com to be connected with a physicist or visit our regulatory page for more information.

Interested in becoming a Radiation Safety Officer yourself? Versant Physics offers a 20-hour online Medical Radiation Safety Officer course that teaches how to implement a successful, compliant radiation safety program. It will help you gain a practical understanding of regulations governing the safe use of radiation-emitting machines and radioactive materials, as well as responsibilities for managing radiation safety in a medical setting.

11 May 2020

International Medical Physics Week

This year, medical physicists around the world celebrate the first ever International Medical Physics Week (IMPW). As some of you may already know, medical physicists also celebrate an International Day of Medical Physics (IDMP) on November 7th. The International Organization for Medical Physics (IOMP) organizes and promotes both, with the intention of enhancing the field’s importance, increasing awareness about the role medical physicists play in the lives of patients, and increasing implementation of programs. In honor of the first ever IMPW there are planned activities around the world, including virtual educational sessions, social media chats and campaigns, and a daily webinar on topics ranging from diagnostic imaging and nuclear medicine to Monte Carlo modeling.

As I reflect on what it means to be a part of the global community of medical physicists, I am truly humbled by the spectrum of expertise that we have. Just by glancing at the topics covered in the webinars, it is abundantly clear that the medical physics contribution to the healthcare field is much larger than what each of us do on a daily basis. In part, this week is important because it gives us an opportunity to connect with and learn from one another. The fact that we all have a unique and valuable perspective to offer one another has been the single most important takeaway from my time as a resident medical physicist.

Cynthia McCullough, President of the AAPM, and guest speaker Amy Lynch covered this topic well in the President’s Symposium at the 2019 AAPM Annual Meeting. They both spoke about the importance of diversity, though not only in the most common ways you may expect. Amy Lynch specifically covered the topic of generational diversity, and said, “we have to step up and work with generational intelligence and intellectual humility in order to come up with the very best ideas.” Easier said than done!

Despite the challenge, I think that this concept can be applied even more broadly in the context of medical physics. Recent articles in Medical Physics and the Journal of Applied Clinical Medical Physics feature discussions among physicists who see our roles changing drastically in the coming years. Advances in automation will likely challenge us to work more closely with software engineers and IT professionals. Changes in reimbursement models have the potential to allow us to work more closely with physicians. How are we to handle this? I hope that we can take it in stride and adapt, recognizing that the collection of different perspectives will move the field of medical physics forward.

Perhaps, at the very least, this week will give us an opportunity to tell yet another family member or friend what a medical physicist does. Or, we could look at our first IMPW as a challenge to continue developing this great field we are a part of, by connecting with one another. I encourage us all to seek out a new interest in the broader discipline of medical physics, take an online course, listen to a webinar you might not usually join, or maybe simply ask for a fresh opinion on a process you’ve always done a certain way. Happy IMPW!

For more information about IMPW or a list of activities and participants, visit https://www.iomp.org/impw/.
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Forum Article "Radiopharmaceutical Extravasation: Pragmatic Radiation Protection" published ahead of print

An article written by Versant team members Dr. Darrell R. Fisher, Ph.D. and Misty Liverett, M.S., CNMT was recently published ahead of print in Health Physics. The article provides an unbiased, scientific assessment of pragmatic and reasonable health physics actions that should be taken in response to inadvertent extravasation events. Click the link below to view the article.

Permits

THE PERMISSION SYSTEM FOR INVENTORY TRACKING, MACHINE MANAGEMENT & EQUIPMENT CATALOG MODULES

Permit Profile

Each permit has a dedicated profile of information that includes authorized personnel, radioactive material, machines, and devices. Permit conditions, completed audits, and forms are also found on this profile.

Authorized Condition Database

Create and view authorized conditions included on permits. Previously created authorized conditions are listed with their code, category, and description.

Permit Enforcement

Information specified on a permit not only serves as a record of that permit, but also controls what can be added to other modules. The location, owner and type of radioactive materials, machines, and equipment can be enforced by permits.

Permit Audits

Perform permit audits, mail the results to relevant personnel, and track responses to non-compliances.