medical physics department -...

MEDICAL PHYSICS

ANNUAL REPORT

2012

including

IMAGING PHYSICS and

RADIATION ONCOLOGY PHYSICS

Annual Report 2012 Medical Physics The Ottawa Hospital

EXECUTIVE SUMMARY This report addresses the medical physics professional practice at TOH and also summarises the operational activities of the radiation oncology medical physics group.

Imaging Physicists at TOH are specialized in nuclear medicine, nuclear cardiology and magnetic resonance imaging, providing clinical and research support to The Ottawa Hospital and Heart Institute: Ian Cameron and Rebecca Thornhill to Magnetic Resonance Imaging, Department of Medical Imaging, and Robert deKemp and Glenn Wells to the Department of Cardiac Imaging at the University of Ottawa Heart Institute (UOHI). In 2012, the Cardiac Imaging program at the heart institute performed approximately 5,500 cardiac SPECT and 1,500 cardiac PET scans for the diagnosis and management of patients with ischemic heart disease. Approximately 35,000 MRI exams were performed at TOH in 2012.

The focus for Cardiac Imaging Physics at UOHI in 2012 has been the reduction of radiation exposure in nuclear cardiology procedures and development of the cardiac MRI program. In nuclear cardiology (SPECT) imaging, half-dose protocols were introduced for myocardial perfusion imaging with technetium-99m. The cardiac PET program at UOHI, leading the Canadian multi-centre trial ‘Rubidium-82 Alternative Radiopharmaceutical for Myocardial Imaging’ by Dr. deKemp, completed enrolment of over 5000 patients at 6 participating clinical imaging centres.

The Radiation Oncology Physics group at The Ottawa Hospital Cancer Centre provides scientific and technical support to the Radiation Medicine Program, relating in general terms to the calibration and ongoing verification of the accuracy of the radiation dose delivered to radiation therapy patients. In 2012, the Radiation Medicine Program treated 4,060 patients through a total of 75,790 individual treatments, an increase of 5.0% over 2011.

The focus of the radiation oncology physics group this year has been the improvement of the safety and efficiency of various aspects of radiation treatment and included the development of customised software to record, track and analyse routine quality control measurements and a failure modes and effect analysis applied to two clinical processes. The new quality control tracking software has generated considerable excitement in the radiation treatment community with several requests for collaboration.

A focus for all groups this year was the development of a document describing the professional practice of medical physics in general and the practice at TOH in particular.

In addition to clinical service, the group published 14 peer reviewed articles, gave 15 invited presentations and presented an additional 53 papers at national and international conferences. Members of the group supervised 13 graduate students, 1 post doctoral fellow and 4 summer students, and delivered clinical imaging physics lectures to medical residents and research fellows in the University of Ottawa Radiology, Radiation Oncology and Cardiac Imaging residency programs and to the Nuclear Medicine Fellowship Programs at UOHI. Our radiation oncology physics residency program was awarded reaccreditation for 5 years.

Joanna Cygler, Senior Medical Physicist with the group since August 1986, achieved the rank of Full Professor in the Department of Radiology, Faculty of Medicine at the University of Ottawa this year. This is a significant achievement and recognises Joanna’s international reputation for her research into electron beam and in-vivo dosimetry, as well as her clinical, teaching and mentoring skills. Congratulations also to Jason Bélec who completed his doctoral thesis this year working part time and aided by a grant from Elekta. During 2012, Lee Gerig retired after 31 years of service, Nicolas Ploquin moved to a University of Calgary position and Richard Webb accepted a position with Elekta. We recruited Claire Foottit to the radiation oncology physics group on completion of her residency training.

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TABLE OF CONTENTS Executive Summary ............................................................. 2

Staff List ............................................................................ 4

Administration .................................................................... 5

Radiation Safety .................................................................. 6

Clinical Activities – Radiation Oncology .................................. 7

Development ......................................................................... 7 Treatment Unit Quality Assurance ............................................. 8 Treatment Planning ................................................................ 8 Tomotherapy ......................................................................... 9 Stereotactic Ablative Radiotherapy (SABR) .............................. 10 Brachytherapy ..................................................................... 12 Technical Services ................................................................ 12

Clinical Activities – Imaging ................................................. 15

MR Imaging ......................................................................... 15 Cardiac and Nuclear Medicine Imaging .................................... 15

Academic Activities ............................................................. 17

Representation on External Committees ................................ 21

Research ........................................................................... 22

1 Peer Reviewed Publications ................................................ 22 2 Books / Chapters / Other ................................................... 23 3 Invited Presentations ........................................................ 23 4 Oral Presentations at National & International Conferences .... 24 5 Poster Presentations at National & International Conferences . 25 6 Internal Presentations ....................................................... 28 7 Research Funding ............................................................. 30 8 Research & Development Projects ....................................... 31 9 Graduate Theses Completed this Year ................................. 35 10 Projects Completed this Year ............................................ 35 11 National/International Conference Representation ............... 36

Profile of Physicists ............................................................. 37

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STAFF LIST Medical Physics Professional Practice Chief

Brenda G. Clark, Ph.D., FCCPM, FAAPM Imaging Physicists (Cardiology and Radiology)

Robert A. deKemp, Ph.D., P.Eng., P.Phys Head Physicist, Cardiac Imaging, UOHI R. Glenn Wells, Ph.D., FCCPM. Imaging Physicist, Cardiac Imaging, UOHI Ian G. Cameron, Ph.D., FCCPM. Senior Medical Physicist, MRI Unit, TOH Rebecca Thornhill, Ph.D, Cardiac MRI Physicist, TOH and UOHI

Radiation Safety Officer (TOH Cancer Centre) David E. Wilkins, Ph.D., FCCPM

Senior Medical Physicists (Radiation Oncology) Joanna E. Cygler, Ph.D., FCCPM, FAAPM Lee H. Gerig, Ph.D., FCCPM Elizabeth Henderson, Ph.D., FCCPM Janos Szanto, Ph.D., FCCPM

Medical Physicists (Radiation Oncology) Crystal Angers, M.Sc., MCCPM Jason Bélec, Ph.D., MCCPM Lesley Buckley, Ph.D., MCCPM (maternity leave, June 2012-June 2013) Claire Foottit, Ph.D. (from October 2012) Danielle Fraser, Ph.D., MCCPM Chun-Bun Kwok, Ph.D., MCCPM Daniel La Russa, Ph.D., MCCPM Katie Lekx-Toniolo, Ph.D., MCCPM (maternity leave, June 2011-June 2012) Malgorzata Niedbala, Ph.D., MCCPM Balazs Nyiri, Ph.D., MCCPM Nicolas Ploquin, Ph.D., MCCPM Ryan Studinski, Ph.D., MCCPM Eric Vandervoort, Ph.D. MCCPM

Medical Physics “Elekta” Fellow Jason Bélec, Ph.D., MCCPM (50%)

Imaging Physics “Ernest and Margaret Ford Cardiology Endowed Research” Fellow Etienne Croteau, Ph.D.

Administrative Support Kirsten Berry Doris Vieira

Medical Physics Associates Janet Hendry, M.Sc. Randle Taylor, M.Sc.

Medical Physics Technologists Chris Lambert, B.Sc. Julie-Maude Leblanc, B.Sc. Silvia Neuteboom, B.Sc. Andrew Richardson, M.Sc. Justin Sutherland, M.Sc. Miro Vujicic, M.Sc.

Medical Physics Residents Andrew Alexander, Ph.D. Elsayed Ali, Ph.D. Amanda Cherpak, Ph.D. Claire Foottit, Ph.D. Michael Roumeliotis, Ph.D.

Technical Services (Electronics/Machine Shop) Senior Radiotherapy Service Technologist Don Petzold Electronics Farhoud Abbassian Georges Gohier Don Lesway

Dylan Loose Tony Magee Richard Webb Machine Shop Bernie Lavigne Ron Romain

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ADMINISTRATION • Recruitment of Claire Foottit, Ph.D,. into a medical physicist position in October following

her successful completion of our CAMPEP accredited physics residency training program

• Recruitment of Michael Roumeliotis, Ph.D., into a physics residency position in January after completion of his doctoral degree at the University of Western Ontario under the supervision of Jeffrey Carson on the design, synthesis and characterization of a hemispherical, sparse detector array to produce photoacoustic images

• Recruitment of Elsayed Ali, Ph.D. into a physics residency position in September after completion of his doctoral degree at Carleton University under the supervision of David W. O. Rogers on the topic of “A novel physics-based approach for unfolding clinical photon spectra from transmission measurements and depth-dose curves”

• Recruitment of Justin Sutherland, M.Sc. and Miro Vujicic, M.Sc. into temporary Physics Technologist positions in January

• Preparation and submission to CAMPEP of an application for reaccreditation of our medical physics residency program

• Preparation and publication of a report summarising the results generated by the consistent use of a radiation specific incident learning system over the past 5 years

• Attendance at two TOH Leadership Development Institutes numbers 8 and 9 at the Hampton Inn, 9-10 February and 14-15 June

• Preparation and submission to Cancer Care Ontario of a request for capital equipment totalling approximately $7.8m and including the following 8 prioritised requests:

1. Replacement of a Siemens Primus accelerator

2. Upgrade of existing TomoTherapy unit

3. Upgrade of existing treatment planning hardware

4. VMAT licenses for 2 Elekta accelerators

5. Upgrade for 2 CT scanners

6. Brachytherapy upgrade for HDR prostate treatments

7. Additional treatment planning licences for IMRT

8. MLC Upgrade for 2 Elekta Synergy accelerators

Funding for items 3, 6 and 7 was approved in February and funding for a replacement Siemens accelerator (item #1) approved in January 2013, together with additional funding for the radiation oncology information system maintenance, to bring the total funding for the year to approximately $7m.

• Preparation and submission of the annual budget for the Medical Physics department and the capital equipment requests for the Radiation Medicine Program which included a 4 items totalling $571k at priority #1 (required by legislation or essential for patient care/service delivery/safety) and 4 items totalling $282k at priority #2 (Equipment would significantly and demonstrably improve patient care/service delivery/safety)

• Preparation and publication of this Annual Report summarising the activities of the Medical Physics Department

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RADIATION SAFETY The Radiation Safety Program at The Ottawa Hospital Cancer Centre continues to contribute to safe operation of the Radiation Medicine Program, with very low staff doses and one reportable incident in 2012. Radiation safety activities this year included:

• Inspections of all Cancer Centre radiation areas, performed by DW and Lamri Cheriet of the Radiation Safety and Health Physics Department (RSHP);

• Notification to the CNSC of the change in Applicant Authority and Designated Supervising Physician, and associated licence amendment requests;

• Update of room numbering, and associated licence amendment requests; • Change of the Annual Compliance Reporting period and the personal dosimeter

period to synchronize with the calendar year; • Investigation and reporting to the CNSC of one anomalous high staff dosimeter

reading; • Installation of mirrors at CyberKnife to improve Last Person Out room visibility; • Implementation of TLD monitoring of perimeter doses on CyberKnife to collect data

for CNSC licensing; • Radiation surveys of both tomotherapy units; • Visit CNSC offices to discuss licensing of CyberKnife and tomotherapy units; • Submission of request for CNSC approval of core drilling of Unit 4 shielded wall for

concrete testing, with surveys before and after drilling; • Visit CNSC offices to do user testing of pilot on-line Annual Compliance Reporting

software. • Radiation safety training provided for all staff in the Radiation Medicine Program,

consisting of 24 sessions on 4 different topics, with a total of 166 participants.

Ministry of Health and Long-Term Care Advisory Workshop: Ensuring Quality and Safety of Medical Imaging in Ontario, 12 December 2012, Toronto:

The Healing Arts Radiation Protection Act and regulations in the X-Ray Safety Code govern the use of medical X-Rays in Ontario. The act and regulations are outdated and need revision. The MoHLTC convened a panel of 20 experts for a consultative workshop to seek advice on governance and oversight of the medical imaging system in Ontario. Participants included radiologists, medical physicists, medical radiation technologists, radiation oncologists, cardiologists, health physicists, and regulators. David Wilkins of The Ottawa Hospital was one of 3 medical physicists invited to this workshop.

The success of the Radiation Safety Program depends on fostering a positive safety culture to encourage staff to use safe practices in their daily activities. We are fortunate in the Radiation Medicine Program to have an excellent safety culture. I am grateful for the support offered by the Radiation Safety and Health Physics Department, in particular Michèle Légaré, Jon Aro, Leah Shuparski, Lamri Cheriet, Jodi Ploquin, and Hung Tan. David Wilkins Radiation Safety Officer

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CLINICAL ACTIVITIES – RADIATION ONCOLOGY

Development • Design and development of software (QATrack+) designed to consolidate the collection,

storage, analysis and trending of quality control test data. It was developed in-house using a modern software platform and has been made available to the greater Medical Physics community as an open source web-based application. This software tool has already generated considerable excitement in the radiation oncology physics community and our development group, led by Crystal Angers and Randle Taylor, has received considerable kudos, not only from other Canadian centres but also from industry.

• The application of Failure Modes and Effect Analysis to two clinical processes: out-of-hours emergency treatments and tomotherapy. This is a standard tool used in the manufacturing industry but has rarely been applied to existing processes, rather it is generally used during the manufacture of a new product. We have applied this technique to two routine clinical processes to quantify risk and identify measures to reduce risk in these specific processes. For each process, a multidisciplinary team led by a medical physicist was convened to identify potential failure modes for each step in the process, together with severity, frequency of occurrence and detectability. The results of these analyses were presented at the annual meeting of the Canadian Association of Radiation Oncology meeting in Ottawa in September and have been used to identify measures to increase the safety of these clinical processes.

• Completion of a study to determine precise output factors for the very small fields used by the CyberKnife treatment unit resulting in an adjustment enhancing the accuracy of these treatments by up to 5%.

• Design and development of a solid-water bullet phantom for CyberKnife to improve the accuracy of patient-specific quality assurance.

• Development of a fiducial implant method for CyberKnife using the conventional simulator in the brachytherapy suite

• Development of a SABR technique for the treatment of prostate cancer

• Rationalisation and streamlining of routine tomotherapy QC, details given later in the report

• Development of a customised QC program for VMAT. This included the development and implementation of 4 new routine QC tests: cumulative sliding window, absolute sliding window, gantry speed and dose rate and leaf gap assessment.

• Rationalisation of the Elekta image guidance clinical process which reduced the imaging dose to the patient by ~60%, reduced the X-ray tube heat load thereby extending the life of this expensive part and also substantially reduced each occurrence of use of the cone-beam CT imager, thereby increasing patient throughput on all our Elekta accelerators

• Development and implementation of a high precision CT scale verification device and analysis technique

• Development of a wide field array calibration procedure for large diode detector arrays

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Treatment Unit Quality Assurance • Routine monitoring of QA compliance by the physics infrastructure group with issues

being tracked by the Radiation Equipment Review Committee (RERC) until completion

• Implementation of QATrack+ for daily and monthly QC test results

• Verification of Volumetric Modulated Arc Therapy (VMAT) on Elekta Synergy and Synergy S units. This effort spanned almost 2 years and involved input from many members of the physics team including electronics, physics technologists, physics residents and medical physicists. VMAT treatments involve gantry rotation in addition to beam shaping while the beam is on and are significantly more complex to plan and deliver than conventional intensity modulated treatments. Our first patient was treated with VMAT in June on Unit 23 and four units are currently commissioned for this treatment, Units 8, 9, 22 and 23. A substantial amount of time and effort was expended into attempts to commission Unit 6 but problems with the dose rate stability, which do not affect traditional treatments, have to date prevented clinical release of this unit for VMAT treatments. Further details of this commissioning effort are described in the commissioning report, available on request.

Treatment Planning • Supervision of treatment planning and computer data management for external beam

therapy and brachytherapy

• Quality assurance of treatment plans – all computerised treatment plans generated at the centre are independently checked by medical physicists prior to use for patient treatments.

• A total of 4,596 treatment plans (computerised dose distributions) were generated in 2012, 3% fewer than the 4,722 recorded in 2011. The plot of monthly activity shows the usual considerable fluctuation throughout the year with an average of 383 plans generated per month or 88.4 per week.

0

100

200

300

400

500

600

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

371343

456401

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360395

328 337

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# P

lans

Month

Average 383 plans/month

2012 Treatment Planning Activity

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• Since 2005, we have seen an overall 12% increase in number of treatments (fractions)

delivered, with a temporary reduction in 2008-2009 during our capital expansion but a steady increase over the last 4 years.

• A major program improvement this year was the introduction of a comprehensive 3 week treatment planning course developed by the treatment planner group to provide a basic introduction to treatment planning for radiation oncology residents, medical physics residents and radiation therapists. This course was first given in September and repeated in November and has been very well received, filling a need that has been apparent for some time.

60,000

65,000

70,000

75,000

80,000

2005 2006 2007 2008 2009 2010 2011 2012

Frac

tions

Del

iver

ed

Year • Installation and commissioning of a software package for platform-independent image

fusion and dose summation (Velocity)

• Coordination of two major upgrades to our primary treatment planning software suite: CMS XiO, Focal and Monaco from Elekta

• Increase in capacity of IMRT treatment planning through the addition of four new CMS Monaco servers and the upgrading the existing six servers to faster hardware

• Hardware upgrade to the XiO servers and XiO Multivue workstations

• Development of several scripts to monitor the consistency of our beam models

• Development of a process for treatment planner accreditation

Tomotherapy The tomotherapy program makes use of two helical accelerators to deliver intensity modulated radiation treatments. Tomotherapy is advantageous for the irradiation of patients with extensive disease, e.g., multiple myeloma, mesothelioma or sarcoma, and/or disease requiring a large amount of radiation modulation to spare normal surrounding tissues, e.g., head and neck cancer, breast cancer including nodal involvement or anal cancer. The tomotherapy physics group consists of 5 medical physicists and 5 physics technologists. On a daily basis, physics support is assigned to 2 medical physicists (equipment quality assurance, treatment planning consultation, treatment plan verification, project

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development) and 1 physics technologist (patient dose delivery verification). In calendar year 2012, the tomotherapy physics group has undertaken the following work:

• Re-implementation of the adaptive software This software facilitates the calculation of the treatment dose received by the patients based on the positioning scan acquired before each treatment. This dose may also be compared with the treatment plan to determine whether treatment modifications are required.

• Implementation of a major software upgrade This upgrade includes dose calculation accuracy improvements for low modulation treatments of disease located at a position away from the machine axis of rotation.

• Development of a Monte Carlo calculation algorithm to improve the accuracy of dose delivered to lung cancer patients. This algorithm is used to verify and improve the dose calculation by accounting for the continuous motion of the accelerator and the continuous deformation of the patient anatomy during treatments.

• Lung treatment time reduction Transfer of inverse-planned lung SABR treatments from tomotherapy to a conventional linear accelerator using volumetric modulated arc therapy. The treatment time (including scan, positioning, delivery) was reduced from about 45 minutes to less than 20 minutes.

• Quality assurance tests rationalization and improvements to allow a more rapid identification of faulty or mis-calibrated machine components (jaws, MLC, focal spot, output, beam energy) causing differences between expected and measured treatment dose distributions. The new tests were used to fix recurrent problems observed on the machine in the last few years.

• Retrospective analysis of head and neck cancer recurrence A total of 15 head and neck cancer patient with recurrence were analysed. Post treatment scans were registered with delivered dose distributions using rigid and/or deformable image registration. The majority of tumor recurrences were unexpectedly found to be located in anatomy receiving full prescription dose.

• Development of an in-vivo radio-chromic film dosimetry method to verify skin dose in two dimensions for extensive scalp treatments.

• Retrospective analysis of superficial (skin) dose for head and neck cancer (ongoing). Monte Carlo simulation is used to calculate the dose received by the various superficial skin layers. This dose is not well modeled by the clinical planning system. This information will be used to improve guidelines on the use of bolus and flash.

• Improvements in patient specific dose verification Development of a method to analyse and understand causes of failed pre-treatment dose verification measurements (ongoing). Out-of-tolerance measurement values (from the Delta4 detector) are projected onto the planned MLC sinogram and also compared with the on-board imaging detector data acquired during the measurements.

Stereotactic Ablative Radiotherapy (SABR) Stereotactic ablative radiotherapy refers to the high precision treatment of relatively small targets with a high dose of radiation delivered in a low (generally 1-5) number of treatments or fractions. At TOHCC, the main technique for the delivery of SABR treatments is our CyberKnife unit, installed in August 2010.

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Highlights of the 2012 CyberKnife program:

• CyberKnife Symposium We hosted a half-day CyberKnife symposium, held immediately after the annual scientific meeting of the Canadian Association of Radiation Oncologists (CARO) in Ottawa in September. This symposium included invited speakers from the Montreal and Hamilton CyberKnife centers and attendees from across Canada.

• Adjustment of circular field output factors A major focus of our physics research work on CyberKnife has been to verify proposed correction factors to CyberKnife output factor measurements which are very challenging to measure due to the small size of the CyberKnife radiation beam relative to our measurement devices. This work generated several conference presentations and a useful collaboration with a CyberKnife center in Vincenza, Italy. The 2012 change in the CyberKnife output factors used at TOHCC has resulted in up to a 5% increase in the accuracy of CyberKnife dose, the precise value dependent on the patient specific parameters.

• Major System Upgrades A major treatment planning hardware and software upgrade and treatment delivery software upgrade that has allowed us to reduce planning and treatment times

• Clinical Trial Accreditation The treatment of five prostate patients and subsequent accreditation for the RTOG clinical trial 0938 to investigate the efficacy of this new radiation therapy technique

• Completion of Monte Carlo radiation beam model commissioning This calculation algorithm provides increased accuracy in the determination of radiation dose in heterogeneous media, e.g., close to lung, and is a useful independent check of the pencil beam radiation beam model.

• Development of advanced image guidance for fiducial placement The feasibility of implanting fiducial markers in the brachytherapy suite was established using image guidance from both ultrasound and the conventional (Acuity) simulator. This technique results in optimal positioning of the fiducial markers for CyberKnife treatment, something that is difficult to achieve under ultrasound guidance alone.

Treatments by Site, 1 Jan – 31 Dec 2012 Site (Diagnosis) # Treatments # Prescriptions

Brain 278 o Metastases 226 o Primary Brain 182 o Acoustic 86 o AVM 6 o Trigeminal Neuralgia 12 o Other Intracranial 92

Spine 62 24 Liver 70 16 Lung 3 1 Kidney 10 3 Pancreas 3 1 Prostate 26 5 Other 59 10

Total 837 338

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During the 2012 calendar year on CyberKnife:

o A total of 338 prescriptions were issued for 200 patients and a total of 839 fractions delivered, with an average of 3.4 fractions treated per day. This is very similar to the 2011 numbers: 332 prescriptions, 210 patients and 784 fractions delivered, with an average of 3.4 fractions treated per day

o 19% of these patients were treated for benign disease, i.e., AVM, acoustic neuroma and trigeminal neuralgia

o 29% of treatments were delivered with the iris variable collimator, the remainder with circular collimators

Brachytherapy Physics support for the brachytherapy 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 calendar year 2012:

• 23 patients received I-125 permanent prostate implants;

• 4 patients received Ir-192 interstitial low dose rate implants

• 345 treatments were delivered to 120 patients with High Dose Rate brachytherapy;

• 1 patient was treated with a permanent Pd-103 implant for breast.

In April, the manual interstitial low dose rate brachytherapy technique using Ir-192 was discontinued.

A new planning system, Oncentra Prostate HDR, has been acquired. The first training has been received. The treatment planning system and the treatment procedure are being commissioned.

Technical Services Physics Technical Services (Radiotherapy Service Technologists and Mechanical Technologists) provide support for both the IGFCC and General Campus divisions of The Ottawa Hospital Cancer Centre. The primary function of the electronics group is to provide electrical and electronic support to the Radiation Medicine 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 2012, the list of major equipment requiring support included 1 CyberKnife, 2 TomoTherapy units, 7 Elekta Synergy accelerators with kilovoltage x-ray imaging, 2 Siemens Primus accelerators, 1 Orthovoltage unit, 3 Philips CT Simulators and 1 Varian Acuity simulator located in the HDR brachytherapy suite.

Clinical hours of operation are 09:00 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 maximize patient treatment capacity.

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Summary of Repair and Maintenance from 1 January to 31 December 2012

Name Model Potential Time Hrs

# Repairs Minor

Repair Hrs Minor

# Repairs Extensive

Repair Hrs Extensive

Service Time Hrs

PM Time Hrs

Downtime Hrs

Unit 1 TomoTherapy 1988 34 13.2 41 138.2 151.4 34.1 49Unit 2 TomoTherapy 2490 43 17.3 50 247.7 264.9 49.1 189Unit 3 Gulmay D3300 1488 13 9.7 9 5.7 15.3 12.0 2Unit 4 Siemens Primus K 2728 78 54.8 28 32.8 87.6 30.1 22Unit 5 Elekta Synergy 2775 79 33.7 65 210.0 243.7 32.9 118Unit 6 Elekta Synergy 2775 85 46.8 50 77.1 123.8 27.8 32Unit 7 Siemens Primus K 2739 55 27.5 16 26.0 53.5 26.1 14Unit 8 Elekta Synergy S 2728 73 28.1 32 57.3 85.4 31.5 28Unit 9 Elekta Synergy S 2717 63 35.7 31 41.3 76.9 40.1 13

Unit 11 Accuray CyberKnife 1976 42 34.6 25 181.3 215.9 26.5 110Unit 21 Elekta Synergy 2279.5 39 13.8 3 4.1 17.8 16.0 3Unit 22 Elekta Synergy 2278.5 46 19.4 6 17.9 37.3 17.6 14Unit 23 Elekta Synergy 2278.5 72 40.0 16 49.2 89.1 14.9 18

Totals: 31240.5 722 374 372 1088 1463 359 613

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100

1 2 4 5 6 7 8 9 11 21 22 23

97.5

92.4

99.2

95.8

98.999.5

99.099.5

94.4

99.999.4 99.2

% U

p-Ti

me

Treatment Unit Number Treatment Unit Availability for 2012

The overall average up-time for our treatment units was 98.0% in 2012, up from 97.0% in 2011. This increase is predominantly due to the increased stability of the newer of our tomotherapy units (Unit 1) where the up-time rose to 97.5% from 88.1% in 2011 as a result of extensive work done on this unit during 2011. The other tomotherapy unit recorded a consistent 92.4% for both years and did not benefit significantly from the equivalent work done. Consideration will be given in 2013 to replacing this unit if funding is available.

In October, Unit 5, one of our original Elekta units installed in 2006, suffered an obscure breakdown of the modulator which took considerable time to troubleshoot, resulting in a downtime of approximately one week.

The down-time on the CyberKnife (Unit 11) was caused by a failure of the magnetron, resulting in a major repair occurring over the Christmas holiday period. The process of

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ordering this part encountered several difficulties: the TOH purchasing process proved very cumbersome for this amount ($165,000) and Accuray were not able to immediately supply the part. As a result, the unit was out of clinical service for 2 weeks.

During 2012, our Electronics staff attended and successfully completed the following training course: Elekta EOE2, Atlanta, GA – Dylan Loose, 16 Jan – 3 Feb

Also during 2012, the electronics laboratory at the General campus was renovated to add 3 purpose built work areas and a separate office for the Senior Electronics Technologist.

In addition to routine maintenance and repair of treatment equipment and alignment lasers, machine shop projects include the design and manufacture of:

o Modifications to Delta4: PMMA insert with chamber holes, a 3 point levelling pad o A high resolution phantom for the standard Catphan 503 phantom o A solid water phantom for commissioning of non-coplanar SABR treatments o Monthly output and profile consistency QA phantom for the orthovoltage unit o A TG61 absolute dosimetry calibration jig for the orthovoltage unit o A respiratory motion phantom o A CyberKnife laser alignment jig and film scanner template o Brachytherapy rectal templates o Carbon fibre headrests o A TBI table and lung shield tray o An abdominal compression device o A high precision prostate slicer o A VMAT gantry speed chamber o A rotational stability jig for tomotherapy o Mould templates for Elekta electron shields o A radiation shield for infusion pumps o A 45º holder for QC kV phantom o Table height indicators

50%

18%

15%

12%

5% 1%

1%Physics

Rad Therapy

Electronics

Cyberknife

Machine Shop

TOH

Brachytherapy

Source of Machine Shop Requests and Approximate Time Spent

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CLINICAL ACTIVITIES – IMAGING

MR Imaging

In December 2011, The Ottawa Hospital accepted delivery of a new 3 Tesla MR scanner; the first patient was scanned in mid January 2012. Dr. Ian Cameron performed acceptance testing for the new scanner prior to the first patient being scanned.

Dr. Cameron is working with Biomedical Engineering to develop an extensive Quality Assurance program for the new MR scanner. He continues to monitor system performance for all four MR scanners. Dr. Cameron also interacts regularly with the Biomedical Engineering personnel that repair and maintain the MR systems.

There is growing concern about the safety of MRI scanning for patients who have implanted medical devices, e.g., stents. Many of these devices are rated as MRI Conditional by the manufacturer which means that they are considered safe for some, but not all, MRI scanners and procedures. The determination of whether it is safe to scan a given patient is made by the MRI technologists but often they require the expertise of the MR Physicist in making their decision. Dr. Cameron is regularly consulted to assist in the process. He has also written a 10 page guide to help the technologists.

Cardiac and Nuclear Medicine Imaging

Nuclear Medicine at the Ottawa Hospital

Dr. Wells has continued to provide emergency physics support to the Nuclear Medicine departments at the Civic, Riverside and General campuses. This support includes assistance with the resolution of image artifacts and processing problems. He has also assisted in work to enable a transition to SPECT lung scanning from planar lung scanning. He has assisted with the development of a Quality Assurance study to assess the quality and consistency of the clinical evaluation of bone scans in the department. Finally, he has assisted with the nuclear medicine residency program by teaching the physics course to the residents (2 hrs / wk from Aug 2011 – May 2012) and supervising resident research projects.

Cardiac Imaging at the University of Ottawa Heart Institute

Dr. deKemp is Head Imaging Physicist in the Department of Cardiac Imaging. He provides imaging physics support primarily to the cardiac PET program. This includes the supervision of scanner selection, installation, commissioning and quality assurance for 3 state-of-the-art PET-CT scanners installed since 2007. Significant contributions to clinical care at the Heart Institute include the development and introduction of routine quantification of myocardial blood flow for the improved detection and management of ischemic heart disease using the PET tracers Rubidium-82 and Nitrogen-13-ammonia. He leads the Canadian ‘Rb-ARMI’ multi-centre imaging trial for the use of Rb-82 PET as an alternative to Tc-99m for myocardial perfusion imaging.

Dr. Wells provides physics support to nuclear cardiology (SPECT imaging) at the Heart Institute. This includes protocol optimization, evaluation of novel software and hardware, acceptance testing of new equipment, oversight of the Quality Assurance program, and

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resolution of image artifacts and processing problems. Dr. Wells also participates regularly in the monthly city-wide Nuclear Medicine rounds and presented rounds on Apr 26, 2012.

A significant achievement of 2012 was the implementation of dose reduction protocols for perfusion imaging with the Infinia and NM530c gamma cameras. Following the evaluation studies done on the Evolution software package for the Infinia and the comparison studies of image quality on the new NM530c dedicated cardiac camera, we have altered our standard clinical protocol. For all studies being done on these cameras after Feb 2012, patient doses have been reduced to 50%, reducing the average patient effective dose from 11mSv to 5mSv for this test. Results of this change were presented at UOHI Grand Rounds in Oct 2012.

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ACADEMIC ACTIVITIES

CARLETON UNIVERSITY GRADUATE STUDENT SUPERVISION

PHD PROGRAM

Name Entry Est. Fin Supervisor Topic

Jason Bélec Sep 2007 Aug 2012 BG Clark Monte Carlo simulation of motion in radiation treatment

Jared Strydhorst Sep 2008 Aug 2013 RG Wells Micro-SPECT/CT

Chad Hunter Sep 2010 Aug 2014 R deKemp Patient Motion Correction for cardiac PET perfusion imaging

Michel Lalonde Sep 2010 Aug 2013 RG Wells Wall-motion Analysis of SPECT Radionuclide Angiography

Amir Pourmoghaddas

Jan 2010 Aug 2014 RG Wells Quantitative Flow measurement with a dedicated cardiac SPECT

camera

Elizabeth Orton Sep 2011 Aug 2014 RG Wells Extra-cardiac Interference in 82Rb PET imaging

Sarah Cuddy Sep 2012 Aug 2017 RG Wells Characterization of a novel CZT-based cardiac SPECT camera

MSC PROGRAM

Name Entry Est. Fin Supervisor Topic

Matthew Efseaff Sep 2010 Sep 2012 R deKemp Test-retest repeatability of rubidium-82 PET myocardial blood flow imaging

Rachel Timmins Sep 2010 Aug 2012 RG Wells Cross-Talk Corrections for Multi-Isotope Small-Animal SPECT/CT

Stéphanie Chiasson

Sep 2010 May 2013 RG Wells Cross-talk correction with a Dedicated Cardiac SPECT camera

Brandon Zanette Sep 2011 Aug 2013 IG Cameron Use of Signal Phase in Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Gliomas

Paul Prior Sep 2012 Aug 2014 RG Wells Multi-isotope cross-talk correction in micro-SPECT/CT

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ADDITIONAL SUPERVISION • Mentorship by Elizabeth Henderson, Eric Vandervoort and Janos Szanto, of SABR Fellows

radiation oncologists Anoop Haridass and Vimoj Nair

• Supervision during the summer months by Joanna Cygler and Eric Vandervoort of Junior Akunzi, visiting medical physics graduate student from France

• Supervision during the summer months by Nicolas Ploquin and Eric Vandervoort of Ismail Ait El Kadir, visiting medical physics graduate student from France

• Supervision during the summer months by Eric Vandervoort of Harold Johns Studentship recipient Eric Christiansen, McGill University physics undergraduate student

• Supervision during the summer months by Ryan Studinski of Andrew Fleck, University of Ottawa physics undergraduate student

• Supervision during the summer months by R deKemp of Tyler Kaster, University of Ottawa undergraduate summer student.

• Supervision during the summer months by RG Wells and R Clackdoyle of Michael Zhao, Queens University undergraduate summer student.

UNIVERSITY LECTURES DELIVERED Carleton University

• PHYS 5208 Radiation Protection, Course instructor David Wilkins

• PHYS 5209 Medical Physics Practicum

o HDR brachytherapy module - Joanna E Cygler

o IMRT module – Dan La Russa, Katie Lekx-Toniolo

o SPECT module - R. Glenn Wells

o PET module - Robert deKemp

o MRI module – Ian Cameron

University of Ottawa

• Radiology Residents Physics Course

o MRI Physics, Ian G Cameron

o Radiology Fellows lectures

o MRI Physics, 4 lectures, Ian G Cameron

• Radiation Oncology Residents Physics Course

o Coordination: Joanna E Cygler

o Lectures: Lesley Buckley, Ian Cameron, Brenda Clark, Joanna E Cygler, Danielle Fraser, Lee Gerig, Elizabeth Henderson, Dan La Russa, Gosia Niedbala, Balazs Nyiri, Nicolas Ploquin, Ryan Studinski, Eric Vandervoort, David Wilkins, R Glenn Wells

• Department of Cellular and Molecular Medicine

o MRI Physics to graduate students, 1 lecture, Ian G Cameron

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o Imaging in Animal Models of Cardiovascular Disease, 1 lecture, R deKemp

• Psychology Department, MRI Physics to graduate students, 1 lecture, Ian G Cameron

• Nuclear Medicine Residents Physics course

o 2hrs / week, Aug 2011 – May 2012, R Glenn Wells

• Cardiology Residents / Fellows Core Lectures

o 4hrs, R Glenn Wells: Basics of SPECT, CT, image reconstruction, AC/SC

o 4hrs, R deKemp: PET artifacts, SPECT and PET quality assurance, Tracer kinetics

• BPS 4103 – Medical Imaging

o 3 hrs, SPECT imaging, R. Glenn Wells

o 3 hrs, Cardiac Molecular imaging, R. deKemp

VISITS HOSTED • Kasia Broda and Angel Licea, CNSC inspectors, CyberKnife tour, hosted by David

Wilkins, 19 January

• Dave Whitby, CNSC inspector, Cancer Centre tour hosted by David Wilkins, 25 January

• Professor Julia Wallace and Carleton PHYS 3606 class, Cancer Centre tour, hosted by David Wilkins and Michael Roumeliotis, 21 March

• Kyu Hwan Jung, Korea Institute of Nuclear Safety, Cancer Centre tour hosted by David Wilkins, 22 March

• Dr. Peter Dunscombe, Professor and Chief of Medical Physics, University of Calgary and Dr. Bruce Gerbi, Professor, University of Minnesota, site visit for reaccreditation of our residency program, 7 September

• Eugene Wong, Associate Professor, Department of Physics and Astronomy, University of Western Ontario, 11 September

• Cancer Care Ontario Physics Review A Examining Committee, hosted by Brenda Clark, 20 September

• PCL Company, Cancer Centre tour hosted by Frank Medwenitsch and David Wilkins, 27 September

• Dr. Louis Archambault, Medical Physicist, CHUQ – Hôtel Dieu de Québec, 1 October

• Georges Bendavid, Joel Bohadana, Nathalie Ohayan, Jewish General Hospital, Cancer Centre tour hosted by David Wilkins and Don Petzold, 3 October

• Professor Paul Johns and Carleton University PHYS 5203 class, Cancer Centre tour hosted by Claire Foottit and David Wilkins, 26 November

OTHER ACADEMIC ACTIVITIES • TOHCC Research, Medical Physics Unit, McGill University, BG Clark, 15 March

• Participation in the Carleton University Medical Physics Ph.D. comprehensive examination, May 2012, David Wilkins

• OMPI Seminar, Ottawa, 18 October 2012, Radiation Safety Then and Now, DE Wilkins

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• Participation in the setting and marking of the MRI specialty examinations of the

Canadian College of Physicists in Medicine, Ian Cameron

• Chair of the Canadian Medical Association accreditation survey team to evaluate the MRI technologist training program at Red River College in Winnipeg, Ian Cameron

• Participation in the Carleton University search committee for two faculty positions in Medical Physics, Ian Cameron

• Participation in the TOH Medical Imaging Department search committee to fill a vacant MR Physicist position, Ian Cameron

• Participation in the University of Ottawa, Faculty of Medicine search committee to fill a new faculty position in Medical Physics, Ian Cameron

• Grant fund application review, Cancer Care Manitoba Foundation, BG Clark

• CAMPEP accreditation review of the Seoul National University Graduate Program in Medical Physics, Seoul, N Korea, 27-28 February 2012

• Career lecture presented to grade 11 and 12 students at Canterbury High School, Ottawa, ON, Lesley Buckley, 9 May 2012

• Moderator: M08 -- Simulation and Modeling of Medical Imaging Systems at the 2012 IEEE Medical Imaging Conference, Anaheim, USA, Nov 2012, R Glenn Wells

• 2012 Judge: Young Investigator Competition at the 2012 IEEE Medical Imaging Conference, Anaheim, USA , Nov 2012, R Glenn Wells

• 2012 Organizer / Moderator: SPECT and PET: Evaluating the Artifacts at the 2012 Society of Nuclear Medicine Annual Meeting, Miami Beach, USA, June 2012, R Glenn Wells

• Radiation Safety Committee Member, The Ottawa Hospital, R deKemp

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REPRESENTATION ON EXTERNAL COMMITTEES • AAPM (American Association of Physicists in Medicine) Working Group on the Prevention of

Errors – BG Clark • AAPM – International Affairs Committee - JE Cygler, Vice-Chair, European Subcommittee • AAPM Partners in Physics Committee – JE Cygler • AAPM Summer School Scholarship Committee – JE Cygler • AAPM – TG 105 Clinical Implementation of Monte Carlo based treatment planning systems, JE

Cygler • AAPM – TG 176 for Dosimetric Effects of Immobilization Devices - LH Gerig • AAPM – TG 191 on Clinical Use of Luminescent Dosimeters - JE Cygler • AAPM – TG 195 on Monte Carlo Reference Data Sets for Imaging Research – E. Ali • CAMPEP (Commission on Accreditation of Medical Physics Educational Programs), Graduate

Education Program Review Committee (GEPRC) - BG Clark • Canadian Institute of Health Information, Advisory Group on minimum data requirements for

health human resources – DE Wilkins • CCO (Cancer Care Ontario) Physics Provincial Advisory Committee (PPAC) - BG Clark • CCO Radiation Incident and Safety Committee (RISC), Chair – BG Clark • CCO Head and Neck Community of Practice Working Group – L Buckley, K Lekx-Toniolo • CCO GYNE Community of Practice Working Group – D Fraser • CCN (Cardiac Care Network of Ontario) PET Imaging Advisory Committee – R deKemp • CCPM (The Canadian College of Physicists in Medicine) - DE Wilkins, President; RG Wells.

Secretary/Treasurer • CCPM Examination Committee - I Cameron, D Wilkins, RG Wells • CCPM Nominating Committee - BG Clark, Chair • CMA (Canadian Medical Association) Committee on Program Accreditation – IG Cameron • CMA Conjoint Accreditation Services Team – Radiological Technology, MRI - IG Cameron • COMP (Canadian Organization of Medical Physicists) Board Member - DE Wilkins • CQA (Collaborative Quality Assurance) Advisory Committee – K Lekx-Toniolo, L Buckley • Heart and Stroke Foundation of Canada, Scientific Review Committee II – R deKemp • IAEA Committee on In-vivo dosimetry, JE Cygler, Consultant • IEC (International Electrical Commission) - Canadian Standards Team – SC62C WSG1

Equipment for radiotherapy, nuclear medicine and radiation dosimetry, LH Gerig • IEEE Nuclear and Medical Imaging Sciences Council - RG Wells • Journal of Nuclear Cardiology Editorial Board Member – R deKemp • OMPI (Ottawa Medical Physics Institute) Executive Committee - BG Clark • OMPI (Ottawa Medical Physics Institute) Executive Committee Past-Director – R deKemp • National Research Council of Canada Dose Registry and Radiation Exposure Monitoring

Project, Expert Advisory Group, DE Wilkins • Polish Journal of Medical Physics and Engineering Editorial Board - JE Cygler • Reports of Practical Oncology and Radiotherapy Editorial Board – JE Cygler • Society of Nuclear Medicine, CardioVascular Council – R deKemp • Workgroup on Implementation of Cooperative Agreements between the AAPM and other

National and International Medical Physics Organizations – JE Cygler

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RESEARCH

1 Peer Reviewed Publications 1.1 Battista JJ, Clark BG, Patterson MS, Beaulieu L, Sharpe MB, Schreiner LJ,

MacPherson MS, Van Dyk J: Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada. J App. Cl Med Phys, 13 (1), 93-110, 2012

1.2 Cherpak AJ, Cygler JE, Andrusyk S, Pantarotto J, MacRae R, Perry G: Clinical use of a novel in vivo 4D monitoring system for simultaneous patient motion and dose measurements. Radiother. Oncol, 102, 290-296, 2012

1.3 Clark BG, Brown RJ, Ploquin J, Dunscombe PD: Patient safety improvements in radiation treatment through 5 years of incident learning. Practical Radiation Oncology, 2012 DOI http://dx.doi.org/10.1016/j.prro.2012.08.001

1.4 Malone S, Croke J, Roustan-Delatour N, Belanger E, Avruch L, Malone C, Morash C, Kayser C, Underhill K, Li Y, Malone K, Nyiri BJ, Spaans J: Postoperative radiotherapy for prostate cancer: a comparison of four consensus guidelines and dosimetric evaluation of 3D-CRT versus tomotherapy IMRT. Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):725-32. Epub 22 Mar 2012.

1.5 Nguyen TB, Cron GO, Mercier JF, Foottit C, Torres CH, Chakraborty S, Woulfe J, Caudrelier JM, Sinclair J, Hogan MJ, Thornhill RE, Cameron IG: Diagnostic Accuracy of Dynamic Contrast-Enhanced MR Imaging Using a Phase-Derived Vascular Input Function in the Preoperative Grading of Gliomas. Am J Neuroradiology, 33(8), 1539-1545, 2012

1.6 Nyiri BJ, Smale JR, Gerig LH: Two self-referencing methods for the measurement of beam spot position. Med Phys.; 39(12):7635-43, Dec 2012

1.7 Omotayo A, Cygler JE, Sawakuchi GO: The effect of different bleaching wavelengths on the sensitivity of Al2O3:C optically stimulated luminescence detectors (OSLDs) exposed to 6 MV photon beams, Med. Phys. 39, 5457-5468, 2012

1.8 Rakhra KS, Lattanzio PJ, Cardenas-Blanco A, Cameron IG, Beaule PE: Can T1ρ MRI Detect Acetabular Cartilage Degeneration in Femoroacetabular Impingement? – A Pilot Study. Bone and Joint Surgery, 04-B(9), 1187-1102, 2012.

1.9 Smith AM, Walker L, Freedman MS, Berrigan L, St. Pierre J, Hogan M, Cameron IG: Activation Patterns in Multiple Sclerosis on the Computerized Tests and Information Processing. J of Neuro. Sci., 312(1-2), 131-137, 2012.

1.10 Trudel G, Coletta E, Cameron IG, Belavy D, Lecompte M, Armbrecht G, Felsenberg D, Uhthoff H: Resistive Exercises, With and Without Whole Body Vibrations, Prevent Vertebral Marrow Fat Accumulation During 60 Days of Head-down Tilt Bed Rest in Men. J Appl Physiol., 112(11), 1824-31, 2012.

1.11 R.G.Wells, K. Soueidan, K. Vanderwerf, T.D. Ruddy, .Comparing slow- versus high-speed CT for attenuation correction of cardiac SPECT perfusion studies.. J. Nucl. Cardiol. 19, 719-726 (2012).

1.12 G. Dwivedi, R.G. Wells, B.J. Chow, .Cardiovascular magnetic resonance for diagnosis of coronary artery disease: quo vadis?.. Expert Rev. Med. Devices 9, 219-224 (2012).

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http://dx.doi.org/10.1016/j.prro.2012.08.001


2 Books / Chapters / Other 2.1 JE Cygler, K Tanderup, S Beddar, J Perez-Calatayud, “In Vivo Dosimetry in

Brachytherapy”, in Comprehensive Brachytherapy: Physical and Clinical Aspects, ISBN-10:1439844984, Taylor & Francis (CRC PressINC) Boca Raton 2012, p. 379-396.

2.2 GO Sawakuchi, L Archambault, A Scullion, JE Cygler, “Results of a survey to assess the current status of in-vivo dosimetry in Canada”, InterACTIONS: The Canadian Medical Physics Newsletter, 58(1), 13-18, 2012

3 Invited Presentations 3.1 C Angers, Experience at the Front Lines: Ottawa and Industry Perspectives,

Quality & Safety in Radiation Therapy Education Course, UHN-PMH Accelerated Education Program, February 22-24, 2012

3.2 D Wilkins, Radiation Protection & Radiation Biology, lectures to Radiology Residents, Memorial University, Newfoundland 2 April,

3.3 JE Cygler, In vivo dosimetry in brachytherapy: detectors, techniques and possible clinical applications, Pre-meeting course, Recent advances in brachytherapy, ESTRO 31, May 9-13, 2012, Barcelona, Spain

3.4 DE Wilkins, The Canadian College of Physicists in Medicine, Student Council meeting, Canadian Organization of Medical Physicists Annual Scientific Meeting, July 12, 2012, Halifax, NS

3.5 BG Clark, Implementation of An Incident Learning System in a Multidisciplinary Environment: a Leadership Opportunity for Medical Physicists Practice Management Session, AAPM Annual Scientific Meeting, Charlotte, NC, 31 Jul 2012

3.6 E Henderson, Technical Issues: CyberKnife central nervous system treatments, Ottawa CyberKnife Symposium, September 15, 2012

3.7 JE Cygler, Clinical electron beams in the era of commercial Monte Carlo based treatment planning systems, Annual meeting of Swiss Medical Society, 15-16 November 2012, Biel-Bienne, Switzerland

3.8 RG Wells, Reducing Patient Exposure in Nuclear Cardiology. Presented at the University of Ottawa Heart Institute Grand Rounds, Ottawa, ON, on Oct. 22, 2012.

3.9 RG Wells, The Physics of Dose Reduction in Nuclear Medicine.. The McGill Health Sciences Centre Medical Physics seminar series, Montreal, QC, on Sept 14, 2012.

3.10 RG Wells, Ultra Low Dose Imaging - New Protocols and Equipment.. The 17th Annual Scientific Session of the American Society of Nuclear Cardiology at Baltimore, MD, on Sept. 8, 2012.

3.11 RG Wells, MUGA: Planar and SPECT Artifacts and Issues.. The 17th Annual Scientific Session of the American Society of Nuclear Cardiology at Baltimore, MD, on Sept. 7, 2012.

3.12 RG Wells, The Art of Artifact Identification and Explanation.. The 17th Annual Scientific Session of the American Society of Nuclear Cardiology at Baltimore, MD, on Sept. 7, 2012.

3.13 RG Wells, Fundamentals of SPECT and Technical Advances.. Molecular Function and Imaging Symposium: Bringing Cardiovascular Imaging and Therapy to Life at Ottawa, ON, on June 21, 2012.

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3.14 RG Wells, Hardware: New PET and SPECT Cameras.. Society of Nuclear Medicine

Annual Meeting at Miami Beach, FL, on June 9, 2012. 3.15 RG Wells, The Physics Behind CZT.. Joint Canadian Association of Nuclear

Medicine / Eastern Great Lakes – Society of Nuclear Medicine Annual Scientific Meeting at Ottawa, ON, on May 3, 2012.

4 Oral Presentations at National & International Conferences 4.1 S. Neuteboom, C. Angers, D. Wilkins, Everyone on the Same Page: Evolution

of a QC Program, Canadian Organizaiton of Medical Physicists Winter School, Whistler, British Columbia, January 29 - February 2

4.2 JE Cygler, In vivo dosimetry in brachytherapy: detectors, techniques and possible clinical applications, Pre-Meeting Course, Recent advances in brachytherapy, ESTRO 31, Barcelona, Spain, May 9-13

4.3 N Ploquin, G Kertzscher, E Vandervoort, CE Anderson, JE Cygler, P Francescon, Small field dosimetry using optical-fiber radioluminescence and RADPOS dosimetry systems, Radiotherapy and Oncology, 103, Supplement 1, S208, 2012, ESTRO 31, Barcelona Spain, May 9-13

4.4 JE Cygler, A Cherpak, R MacRae, J Pantarotto, G Perry, Clinical use of RADPOS 4D in vivo dosimetry system, 2012 World Congress of Medical Physics and Biomedical Engineering, Beijing, China, May 26-31

4.5 JE Cygler, E Vandervoort, Clinical use of commercial Monte Carlo-based-dose-calculations-systems for electron beams, 2012 World Congress of Medical Physics and Biomedical Engineering, Beijing, China, May 26-31

4.6 N Ploquin, G Kertzscher, E Vandervoort, CE Anderson, JE Cygler, P Francescon, Small field dosimetry using optical-fiber radioluminescence and RADPOS dosimetry systems, 2012 World Congress of Medical Physics and Biomedical Engineering, Beijing, China, May 26-31

4.7 E Vandervoort, DJ La Russa, N Ploquin, I Ait El Kadir, J Szanto, E Henderson, Improved dosimetric accuracy for patient specific quality assurance using a dual-detector measurement method for CyberKnife output factors, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, 11-14 July

4.8 N Ploquin, G Kertzscher, E Vandervoort, JE Cygler, CE Anderson, P Francescon, CyberKnife relative output factor measurements using fiber-coupled luminescence, MOSFET and RADPOS dosimetry systems, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

4.9 B Nyiri, L Gerig, A generalized solution to the wide field array calibration method, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, 11-14 July

4.10 C Angers, J Renaud, BG Clark, Identifying and Mitigating Risk In After Hours Radiation Treatment Delivery, Oral presentation at the Canadian Association of Radiation Oncologists Annual Scientific Meeting, Ottawa, September 12-15

4.11 J Bahm, R Studinski, DJ La Russa, K Carty, D Fraser, L Buckley, C Angers, BG Clark, Does the application of failure mode and effects analysis identify and reduce risk for a TomoTherapy treatment process?, Canadian Association of Radiation Oncologists Annual Scientific Meeting, Ottawa, September 12–15

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4.12 A Haridass, S Chakraborty, R.Chatelain, J Szanto, C Lum, S Malone, J Sinclair,

Technique For Using Dynamic CT Angiography (dCTA) For Frameless Stereotactic Radiosurgical (SRS) Planning Of Intracranial Arterio Venous Malformations (AVM) Canadian Association of Radiation Oncologists Annual Scientific Meeting, Ottawa, September 12–15

4.13 A Haridass, E Vandervoort, J Szanto, J Sinclair, J Gratton, K Malone, S Malone, Customised MoldCare® head rests reduce patient movement for intracranial Cyberknife RadioSurgery. 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) 28 – 31 October, Boston

4.14 JE Cygler, Clinical electron beams in the era of commercial Monte Carlo based treatment planning systems, Annual Meeting of Swiss Medical Society, Biel-Bienne, Switzerland, November 15-16

4.15 R Studinski, A Fleck, A Alexander, DJ La Russa, Comparison planning of breast and anal canal: TomoTherapy vs SharePlan, Accuray users meeting: Advancing Radiation Oncology: A Collaborative Forum, Dallas TX, 28–30 Nov

4.16 DJ La Russa, J Bahm, R Studinski, K Carty, C Angers, BG Clark, A comparative risk assessment of TomoTherapy and conventional IMRT with image guidance using failure mode and effects analysis, Accuray users meeting: “Advancing Radiation Oncology: A Collaborative Forum”, Dallas, TX, 28–30 Nov

4.17 E Vandervoort, DJ La Russa, N Ploquin, J Szanto, E Henderson, Improved dosimetric accuracy for patient specific quality assurance using a dual-detector measurement method for CyberKnife output factors, Oral presentation at the Accuray users meeting: Advancing Radiation Oncology: A Collaborative Forum, Dallas, TX, November 28–30

4.18 R.G. Wells, J. Lockwood, L. Wei, D. Duan, P. Fernando, C. Bensimon, T.D. Ruddy. .Serial Estimation of Cross-talk for Correction in Dual-isotope Imaging with Dynamic Tracers.. Oral presentation at the Candian Organization of Medical Physics Annual Meeting in Halifax, NS, July, 2012. Med. Phys. 39, 4642 (2012) [Abstract].

4.19 R.S. Thing, E Mainegra-Hing, G.Wells, I Kawrakow, C. Brink. .CBCT image quality improved by scatter subtraction calculated by Monte Carlo Simulations.. European Society for Radiotherapy and Oncology Meeting (2012). Oral Presentation.

4.20 PG Burgon, SL Thorn, G Wells, RA deKemp, JN DaSilva, RS Beanlands. .Muscle enriched A-type Lamin Interacting Protein (MLIP) regulates Cardiac Metabolism, Growth and Function.. Oral presentation at the American Heart Association annual meeting, 2012. Circulation 126 Suppl., A13249 (2012) [Abstract].

5 Poster Presentations at National & International Conferences 5.1 A Cardenas-Blanco, A Speirs, K Rakhra, H Frei, IG Cameron, ME Schweitzer, PE

Beaule, How Do Subchondral Bone Changes Affect Cartilage in FAI?, American Academy of Orthopaedic Surgeons, Scientific Exhibit, San Francisco, California, February

5.2 A Cardenas-Blanco, ME Schweitzer, K Rakhra, IG Cameron, PE Beaule, Femoroacetabular Impingement: Is Cartilage Degeneration a Continuum? Orthopedic Research Society, San Francisco, California, February

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5.3 A Cardenas-Blanco, K Rakhra, A Speirs, IG Cameron, ME Schweitzer, PE Beaule,

Noncontrast Cartilage Assessment (T1ρ) of the Hip in Femoroacetabular Impingement: Can We Predict Early Changes?, International Society of Magnetic Resonance in Medicine, Melbourne, Australia, p. 3307, May

5.4 GO Cron, M El-Maadawy, J Werier, RE Thornhill, R Chatelain, E Henderson, C Foottit, IG Cameron, AM Sheikh, G DiPrimio, M Sampaio, ME Schweitzer, A Comparison of Quantitative Dynamic Contrast-Enhanced CT and MRI in Musculoskeletal Tumors, International Society of Magnetic Resonance in Medicine, Melbourne, Australia, May

5.5 GO Cron, TB Nguyen, RE Thornhill, JF Mercier, C Foottit, CH Torres, S Chakraborty, J Woulfe, JM Caudrelier, J Sinclair, MJ Hogan, IG Cameron, ME Schweitzer, Phase-derived Vascular Input Functions for 2D DCE#-MRI of Cerebral Gliomas: Reproducibility and Diagnositc Value, International Society of Magnetic Resonance in Medicine, Melbourne, Australia, May

5.6 JE Cygler, E Vandervoort, Clinical Implementation and QA of Monte Carlo-based dose calculation algorithms for electron beams, ESTRO 31, Barcelona, Spain, May 9-13

5.7 S Samiee, M Lacelle, B Nyiri, N Ploquin, JM Caudrelier: Implementation and early evaluation of Linac IMRT for the post operative logo-regional radiation of breast cancer. Radiother Oncol vol. ESTRO 2012 Barcelona, Spain, May 9-13

5.8 S Malone, J Croke, E Belanger, K Malone, L Avruch, C Malone, C Morash, Y Li, B Nyiri: Use of pre-op MRI and «3D prostate cancer maps» to improve CTV definition for post-operative radiation. Estro 2012 Barcelona, Spain, May 9-13

5.9 J Szanto, E Henderson, E Vandervoort, Optimized Output Factor Measurement Method for CyberKnife Collimators, ESTRO 31, Barcelona, Spain, May 9-13

5.10 A Cardenas-Blanco, KS Rakhra, ME Schweitzer, IG Cameron, PE Beaule, Non-Contrast Quantitative MR Imaging (T1-Rho) of the Hip in Asymptomatic and Symptomatic CAM FAI, Canadian Orthopaedic Association 67th Annual Meeting, Ottawa, June

5.11 AJ Cherpak, G Kertzscher, JE Cygler, Applications of RADPOS In Vivo Dosimetry for QA of High Dose Rate Brachytherapy, Med. Phys. 39, 3968 (2012), Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

5.12 AJ Cherpak, JE Cygler, G Kertzscher, CE, G Perry, LDR to HDR : RADPOS applications in brachytherapy, Med. Phys. 39, 4624 (2012), Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

5.13 A Omotayo, JE Cygler, G Sawakuchi, The Effect of Bleaching Wavelengths on the Regeneration of the Optically Stimulated Luminescence Signal of NanoDot Dosimeters Pre-Exposed to High-Doses, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

5.14 A Omotayo, JE Cygler, G Sawakuchi, Investigation of Different Bleaching Wavelengths on Absorbed-Dose Sensitivity of NanoDot OSLDs Exposed to 6 MV X-ray Beams, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

5.15 C Angers, R Studinski, DJ La Russa, J Bahm, J Renaud, BG Clark, Risk Assessment of Clinical Radiation Processes using Failure Modes and Effect Analysis, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

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5.16 R Studinski, A Alexander, DJ La Russa, Conversion of helical TomoTherapy

plans into clinically favourable step-and-shoot IMRT plans deliverable on a c-arm linac, Canadian Organization of Medical Physicists Annual Meeting, Halifax, NS, July 11-14

5.17 V Janardanan Nair, J Szanto, E Vandervoort, E Henderson, L Avruch, S Malone, J Pantarotto, Feasibility, Detectability and Experience with Platinum Seed Internal Fiducial Markers for CT-MRI Fusion and Real-time Tumor Tracking During Stereotactic Ablative Radiotherapy, Annual Scientific Meeting of the Canadian Association of Radiation Oncology (CARO), September

5.18 AJ Cherpak, JE Cygler, C E, G Perry, Impact of transrectal ultrasound probe on prostate position and dose distribution during permanent seed implantation, 26th Annual Scientific Meeting of the Canadian Association of Radiation Oncology (CARO), Ottawa, 12-15 September

5.19 VJ Nair, N Ploquin, R MacRae, BG Clark, J Pantarotto, A practical and objective scoring method for dosimetric comparison of individual stereotactic ablative radiotherapy treatment plans, 26th Annual Scientific Meeting of the Canadian Association of Radiation Oncology (CARO), Ottawa, 12-15 September

5.20 J Belec, BG Clark, 4D Monte Carlo Calculations of VMAT and Helical TomoTherapy Dose Distributions of Lung Stereotactic Treatments with Intra-Fraction Motion 26th Annual Scientific Meeting of the Canadian Association of Radiation Oncology (CARO), Ottawa, 12-15 September

5.21 V Janardanan Nair, J Szanto, E Vandervoort, E Henderson, L Avruch, S Malone, J Pantarotto, Feasibility, Detectability and Experience with Platinum Seed Internal Fiducial Markers for CT-MRI Fusion and Real-time Tumor Tracking During Stereotactic Ablative Radiotherapy, Annual Meeting of the American Society for Radiation Oncology (ASTRO), October

5.22 GO Cron, KS Rakhra, PE Beaule, I Catelas, A Cardenas-Blanco, ME Schweitzer, IG Cameron, MRI perfusion measurements in patients who have undergone total hip replacement, RSNA, Chicago, Illinois, November

5.23 GO Cron, WM Shabana, RE Thornhill, IG Cameron, ME Schweitzer, Towards more uniform follow-up of rectal cancer treatment: Improved reproducibility of MRI perfusional measurements using Bookend T1 measurements, RSNA, Chicago, Illinois, November

5.24 JM Croke, B Nyiri, L Avruch, E Belanger, S Malone: Impact of Radical Prostatectomy on Rectal Position and Implications for CTV Definition for Postoperative Prostate Radiation Therapy, ASTRO Boston, MA

5.25 RG Wells, K Soueidan and TD Ruddy. .Position dependent attenuation artifacts with multi-pinhole dedicated cardiac camera.. 2012 IEEE Nuclear Science Symposium Conference Record, 2515-2518, 2012

5.26 P. Burgon, J. Lockwood, G. Wells, and A. Blais. .Haploinsuf_ciency of Muscle enriched A-type Lamin Interacting Protein (MLIP) manifests as enlarged dilated hearts.. Poster presentation at the American Heart Association Basic Cardiovascular Sciences Meeting, 2012. Circ. Res. 111, A250 (2012) [Abstract].

5.27 M Cocker, G Dwivedi, B Marvin, M Poirier, C Dennie, G Wells, K Chan, R Roberts, A Dick, TD Ruddy. .Integrin Imaging of Hypertrophic Cardiomyopathy Identi_es Diffuse Cardiac Fibrosis: Direct Comparison with Cardiovascular Magnetic Resonance Imaging The SCAR Study.. Oral presentation at the 2012 Canadian Cardiovascular Congress. Can. J. Cardiol. 28 Supp., S139 (2012) [Abstract].

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5.28 J.S. Gill, M. Cocker, G. Dwivedi, D. Dowlatshahi, M. Bussiere, F. Momoli,

G.Wells, J. DaSilva, R. Glikstein, R. DeKemp, R. Beanlands, G. Stotts, M. Hogan, M. Sharma, T. Ruddy. .Assessment of Aortic Plaque In_ammation and its Relationship with Aortic Dilatation by FDG PET/CT Hybrid Imaging.. Poster presentation at the 2012 Canadian Cardiovascular Congress. Can. J. Cardiol. 28 Supp., S376-S377 (2012) [Abstract].

5.29 S. Chiasson, TD Ruddy and RG Wells. .Tc-99m/Tl-201 crosstalk correction on a dedicated cardiac CZT SPECT camera.. 2012 IEEE Nuclear Science Symposium and Medical Imaging Conference Abstract Book, 397 (2012). [Abstract] Poster presentation.

5.30 M. Lalonde, D. Birnie, T.D. Ruddy, R. Wassenaar, R.G. Wells. .Comparison of SPECT RNA phase analysis amplitude values and left ventricular lateral wall scar size.. J. Nucl. Med. 53 Supp 1, 422P (2012) [Abstract].

5.31 R.G. Wells, K. Soueidan, P. Fernando, J. Lockwood, B. Marvin, L. Wei, D. Duan, C. Bensimon, T.D. Ruddy. Radiodosimetry of 123I-CMICE-013, a Novel SPECT Myocardial Perfusion Imaging Tracer, using a pig model.. J. Nucl. Med. 53 Supp 1, 328P (2012) [Abstract].

5.32 L. Wei, C. Bensimon, X. Yan, P. Fernando, J. Lockwood, D. Duan, G. Wells, T. Ruddy. .Synthesis and Evaluation of 123I-CMICE-013: a Novel SPECT Myocardial Perfusion Agent.. J. Nucl. Med. 53 Supp 1, 354P (2012) [Abstract].

5.33 R. Timmins, R.G. Wells. .Cross-talk correction in dual isotope 111In/99mTc small-animal cardiac SPECT imaging.. Proceedings of the 10th ImNO Symposium, p. 165 (2012) [abstract]. Poster presentation. J. Nucl. Med. 53 Supp 1, 574P-575P (2012) [Abstract].

6 Internal Presentations • Elekta machine design for VMAT, Physics Research Rounds, January 12, J Smale • Image Noise and Iterative Reconstruction – Part II of II, Physics Research Rounds,

January 20, B Nyiri • Introduction to Neoplasia, Physics Research Rounds, January 27, Dr Mary Senterman • COMP Winter School 2012 Summary, Physics Research Rounds, February 10, DE

Wilkins & S Neuteboom • VMAT machine QA newest developments/updates, Physics Research Rounds,

February 24, G Niedbala • Experience at the Front Lines: Ottawa and Industry Perspectives, Physics Research

Rounds, March 9, C Angers • Photon Dose Calculations, Physics Research Rounds, March 30, A Alexander, A

Cherpak, C Foottit • Calibration of MatriXX: Error Propagation, Measurement Strategy, and Generalized

Wide Field Calibration Algorithm, Physics Research Rounds, May 11, B Nyiri • Comprehensive and Automated Quality Control for Radiotherapy: The AQUA System,

Physics Research Rounds, May 18, Daniel Letourneau (invited speaker) • 3D cancer maps for improved targeting, Physics Research Rounds, June 1, B Nyiri

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• E Vandervoort, Improved dosimetric accuracy for patient treatments on the

CyberKnife robotic radiosurgery system using dual-detector measurement method for the measurement of relative output factors, University of Ottawa, Radiology Research Day, June 7, 2012

• Lung SBRT Intra Fraction Dose Calculation, Radiation Medicine Program Rounds, June 15, J Belec

• Imaging Program Update, Physics Research Rounds, June 22, L Buckley • COMP conference presentation, Physics Research Rounds, June 22, A Alexander • Implementation and validation of the DoseLabPro software for patient specific quality

assurance and its application to Volumetric Modulated Arc Therapy (VMAT) and CyberKnife treatments, Physics Research Rounds, August 10, I Ait El Kadir

• Validation of XiO Elekta Monte Carlo planning system for electron beams, Physics Research Rounds, August 10, J Akunzi

• Investigation of Spinal Re-treatments Using Different Planning CT’s on CyberKnife, Physics Research Rounds, August 17, E Christiansen

• SharePlan© versus conventional Linear Accelerator planning for challenging breast and chest wall patients, Physics Research Rounds, August 17, A Fleck

• SBRT Journal Club, Physics Research Rounds, August 24, C Foottit • Radiation Incidents, Physics Research Rounds, August 31, C Foottit • E Henderson, CyberKnife Treatment Planning, Ottawa Treatment Planning Training

Course (2 sessions), September and November 2012 • CARO presentations, Physics Research Rounds, September 7, C Angers, J Bahm • ESTRO conference summary, Physics Research Rounds, September 14, J Szanto • CARO conference summary, Physics Research Rounds, September 21, C Angers, A

Cherpak, J Hendry • Radiation Safety, Patient Safety and Quality Assurance, Radiation Oncology/Physics

Rounds, September 26, DE Wilkins • An update on the development and implementation of QATrack+, Physics Research

Rounds, September 28, D La Russa • Medical Physics Professional Practice Models - Part I, Physics Research Rounds,

October 12, BG Clark • Orthovoltage QA, Physics Research Rounds, October 19, A Alexander • Radiotherapy for Prostate Cancer: are the modern ways “to skin the cat”

complementary or competitive? Radiation Medicine Program Rounds, 24 October, JE Cygler

• VelocityAI dose summation bug – Did the patch work?, Physics Research Rounds, October 26, E Vandervoort

• Medical Physics Professional Practice Models - Part II, Physics Research Rounds, November 2, BG Clark

• Is image-guided radiotherapy overvalued as a clinical tool?, Physics Research Rounds, November 23, A Cherpak

• Radiation Safety Update, Physics Research Rounds, November 30, DE Wilkins • Lung SABR VMAT, Physics Research Rounds, December 7, J Belec • Summary of Accuray Users Meeting, Physics Research Rounds, December 14, E

Henderson, D La Russa

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7 Research Funding • CIHR $116,356/yr (2009-2014)

P Beaule, IG Cameron, H Frie, M Lamontagne, K Rakhra, M Schweitzer Femoroacetabular Impingement: Correlating Hip Morphology to Changes in Cartilage and Subchontral Bone

• TomoTherapy Inc. $390,000 (2008-2013) BG Clark, Clinical TomoTherapy Process Improvement

• Elekta Technology Research Grant $50,000 (2010-2012) JE Cygler and E Vandervoort Evaluation of a new commercial Monte Carlo dose calculation algorithm for electron beam treatment planning in CMS

• Elekta Technology Research Grant $265,000 (2010-2012) BG Clark and JE Cygler Implementation of advanced 4D treatment planning and dose delivery techniques.

• ORF (Ontario Research Fund) $465,000 (2010-2015) BG Clark, Adaptive Techniques for Rapid Radiation Therapy as part of the Ontario Consortium for Adaptive Interventions in Radiation Oncology (OCAIRO), PI D Jaffray

• Canadian Institutes of Health Research $1,105,000 (2009-12) RA deKemp, RSB Beanlands, GA Wells. Rubidium-82 Alternative Radiopharmaceutical for Myocardial Imaging (Rb-ARMI) Canadian Multi-centre Trial

• Natural Science and Engineering Research Council $140,000 (2011-2016) RG Wells, Improving Accuracy in Small-Animal Cardiac SPECT/CT Imaging

• Heart and Stroke Foundation of Ontario $140,787 (2010-2012) RG Wells, RA deKemp. Respiratory Motion Compensation in Coronary Flow Reserve Measurements with CZT Dedicated Cardiac Single-Photon Emission Computed Tomography

• Natural Science and Engineering Research Council $1,040,388 (2012-2015) RG Wells (Co-Investigator) Development of a Therapeutic Oncolytic Poxvirus with Enhanced Stability and Potency (PI: J. Bell)

• Ministry of Research and Innovation. Ontario Research Fund $574,333 (for UOHI) (2009-2015) RG Wells (co-investigator) Ontario Preclinical Imaging Consortium (PI S Foster)

• Ministry of Research and Innovation. Ontario Research Fund $1,604,000 (for UOHI) (2008-2014)

• RG Wells (co-investigator) Imaging for Cardiovascular Therapeutics (PI G Wright)

RA deKemp (uOHI site-leader and co-investigator)

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8 Research & Development Projects

RADIATION TREATMENT VALIDATION • Characterization of OSL nanoDot detectors in 6 MV photon beam

A Omotayo, G Sawakuchi, JE Cygler

Al2O3:C nanoDots, optically stimulated luminescence detectors, and microStar system have been recently acquired by our department. This in vivo dosimetry system can complement our TLD and MOSFET systems for special clinical applications. OSL detectors are more efficient to use than TLDs and can provide faster information about the dose delivered to the patients. Manufacturer sells nanoDots as single-use-detectors. However, they could be re-used after careful bleaching is applied, resulting in savings to the hospital. The purpose of this project is to determine the effect of different bleaching wavelengths on the luminescence response of Al2O3:C optically stimulated luminescence detectors (OSLDs) exposed to accumulated doses of 6 MV photon beams. A paper was presented at AAPM/COMP Joint Meeting. A manuscript has been published (Med. Phys. 39, 5457-5468 (2012)).

• Motion study for lung patients using RADPOS system JE Cygler, A Cherpak, S Andrusyk, G Perry, R MacRae, C Lochrin, J Pantarotto

This is an on-going clinical trial that aims to evaluate the potential of the RADPOS system for applications in external beam treatments for lung cancer patients. Measurements are performed at the time of each patient’s 4DCT and throughout the course of treatment. Three RADPOS sensors were positioned and marked points on the patient’s chest and abdomen while a fourth detector was placed on the CT or treatment couch for reference. Data analyzed in terms of inter- and intra-fraction reproducibility of patients breathing patterns and received dose. The paper has been published (Radiother. Oncol. 102, 290-296, 2012)

• RADPOS for post-implant QA of permanent prostate implants A Cherpak, JE Cygler, C E, G Perry

This project is part of ongoing development of the RADPOS 4D in vivo dosimetry system. The study explored the use of a modified version of the position and dose monitoring detector during permanent seed implant procedures for prostate brachytherapy. The detector was positioned in the urethra and displacement of the prostate was recorded throughout the implantation procedure. A dose profile along the urethra was also measured after all seeds were placed both before and after the removal of a transrectal ultrasound probe to compare deviations in the dose. Real-time dosimetry of such procedures can provide valuable information and potentially allow for additional placement of seeds or medical care if lower or higher doses than expected are detected. The study was presented at a conference and the manuscript is in preparation.

• Use of real-time RL Al2O3:C and RADPOS for Brachytherapy QA G Kertzscher, A Cherpak, JE Cygler, C Anderson

This project is in collaboration with Risø National laboratory in Denmark. Gustavo Kertzscher, a visiting PhD student from Denmark, worked with us during the summer

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months. Gustavo brought with him a novel radioluminescence based dosimetry system. Summer was spent on exploring possible clinical applications of the Risø system and comparing it with RADPOS. The purpose of this project is to evaluate a dose-verification protocol for HDR Brachytherapy based on in vivo time-resolved 1 s time resolution of Risø and RADPOS systems. The preliminary measurements have been completed. An abstract has been presented at a conference.

• Use of real-time RL Al2O3:C and RADPOS for VMAT QA G Kertzscher, M Rodrigues, A Cherpak, N Ploquin, JE Cygler, C Anderson

This project is also in collaboration with Risø National laboratory in Denmark. It explores the possibility of using Risø and RADPOS systems for patient specific QAA of breast treatment delivery using VMAT. Preliminary measurements show a good promise for usefulness of both systems. The data analysis is in progress.

• Use of real-time RL Al2O3:C, RADPOS, MOSFET, and Gafchromic film systems for measurement of relative output factors for Cyberknife cones and patient specific QA N Ploquin, G Kertzscher, E Vandervoort, JE Cygler, C Anderson

This project is another collaboration with Risø National laboratory in Denmark using the Radioluminescent (RL) Al2O3:C dosimetry system. In this project we compare RL, RADPOS, MOSFET, and Gafchromic film systems for measurement of relative output factors for Cyberknife cones. The accurate determination of output factors for small fields is challenging and can lead to large dose errors in patient treatments if corrections for detector effects (e.g. detector size, scatter from high-Z material) are not applied to these measurements. This is a novel application for Risø and RADPOS systems. The results from different detectors agree very well, provided that appropriate correction factors are applied. An abstract has been submitted to an international conference (European Society for Radiotherapy and Oncology). We also carried out preliminary measurements of patient specific QA using static and moving (Quasar) phantoms. RADPOS shows a particular promise here, since this system can simultaneously measure both the spatial position and dose. The study was presented at a conference and the manuscript is in preparation.

RADIATION DOSE CALCULATION • Investigation of software to generate conventional accelerator IMRT fluence

from TomoTherapy fluence - SharePlan R Studinski, A Alexander, D La Russa

SharePlan is novel planning software solution that takes dose distributions generated on a TomoTherapy planning station for a helical TomoTherapy treatment and creates a step-and-shoot IMRT plan for a C-arm linac. The linac plan is optimized on the dose distribution from the TomoTherapy, which is imported directly from the TomoTherapy planning system, and generated within the space of a few minutes. This product has significant clinical potential since we can quickly create back-up TomoTherapy plans for linacs. A beam model was constructed on SharePlan for our Elekta Beam Modulator units using existing commissioning data. Treatment plans for several anal canal patients and several breast patients were generated on both TomoTherapy and SharePlan systems with the aim of comparing several metrics, including target coverage, organ-at-risk

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(OAR) sparing, and treatment time. The impact of target/OAR weighting and number of beams on SharePlan plan quality was also investigated. The results were presented at the Accuray users meeting in Dallas, Texas (Nov 28-30, 2012) and at the annual meeting of the Canadian Organization of Medical Physicists in Halifx, NS (Jul 11-14, 2012).

IMPROVEMENT OF TREATMENT UNIT QUALITY ASSURANCE • TomoTherapy Quality Assurance and Optimization of MVCT HU

R Studinski, D La Russa, J Belec

The MVCT of the TomoTherapy system has substantial potential as a planning tool in the clinic due to its ability to image high-Z material(s) without artifacts common with conventional CT simulators. This system may also be integrated into adaptive planning techniques on TomoTherapy since it is used daily to capture changes in patient anatomy and physiology. However, the HU of a TomoTherapy unit have been shown to be unstable and requires extensive QA to monitor changes. Some changes in HUs have been shown to be related to energy, and our own analysis of the imaging beam has shown that the jaw setting for the imaging beam may play a role as well. Whatever the cause, we are developing novel techniques to overcome the instability of HUs measured with the TomoTherapy imaging beam using scripts that automatically compare TomoTherapy MVCT scans with kVCT scans from our simulators. These scripts use the kVCT scans to correct the intensity-value-to-density table (IVDT) needed by TomoTherapy systems to calculate HU values, thereby enabling the use of MVCT scans for treatment planning.

MAGNETIC RESONANCE IMAGING • Characterization of Proteoglycan Depletion in Femoroacetabular Impingement

with T1ρ MRI. PJ Lattanzio, P Beaule, A Cardenas-Blanco, G Cron, IG Cameron, K Rakhra, M Schweitzer

The goal of this study is to demonstrate the feasibility of T1ρ MRI in the evaluation of hip cartilage. The T1ρ relaxation values of hyaline cartilage in asymptomatic control patients will be compared to those in patients with clinically proven FAI. The correlation between T1ρ values and proteoglycan content of hip cartilage, as determined by histopathology, will be determined.

• The Effects of Water Diffusion on MR Image Contrast 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 these motions at a very basic level so that the contrast obtained in diffusion weighted MR imaging can be better understood.

• Placental Perfusion Measurements to Assess Fetal Growth Restriction L Avruch, A Gruslin, 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 techniques for measuring blood flow in the

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placenta without the use of contrast agents. Such techniques would all us to distinguish intrauterine growth restricted fetuses from those that are small but healthy.

• Rician Bias Reduction 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 cerebra perfusion. These methods are very useful for many clinical indications; however, for other conditions quantitative measurements of perfusion 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.

• Quantitative Perfusion MRI in Tumours L Avruch, C Foottit, G Cron, T Nguyen, M Hogan, IG Cameron

MRI perfusion measurement techniques are being developed which will allow us to measure perfusion in tumours. In particular, it is expected that we will be able to accurately measure the permeability surface area product for vessels in tumours to assess the “leakiness” of the vessels.

NUCLEAR MEDICINE IMAGING

• Quantitative Myocardial Flow Measurement with SPECT

RG Wells, R deKemp, TD Ruddy, A Celler, T Farncombe

Development of absolute myocardial blood flow measurements using the dedicated cardiac SPECT camera. Traditional SPECT measures only relative uptake of tracer and thus misses 50% of multi-vessel disease leading to underdiagnosis of disease severity. Absolute flow measurement may be possible with the new dedicated cardiac SPECT technology that is available.

• Quantitative Small-Animal SPECT imaging.

RG Wells

Small-animal imaging with nuclear medicine is a valuable tool for development of new diagnostic and therapeutic agents. Capitalizing on this potential requires accurate images. We are developing techniques for improving the accuracy and precision of measurements of cardiac function and perfusion in rodent models of heart disease.

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9 Graduate Theses Completed this Year • Monte Carlo calculation of volumetric modulated arc therapy and helical tomotherapy

dose distributions for stereotactic ablative radiotherapy lung treatments Jason Bélec, Carleton University, supervisor BG Clark

• Cross-Talk Corrections for Multi-Isotope Small-Animal SPECT/CT Rachel Timmins, Carleton University, supervisor RG Wells

• Test-retest Repeatability of Rubidium-82 PET myocardial blood flow imaging, Matthew Efseaff, Carleton University, supervisor RA deKemp

10 Projects Completed this Year • Commissioning of CMS Monte Carlo Dose Calculation Module for electron beams

JE Cygler, E Vandervoort

Recently CMS released a new Monte Carlo based dose calculation module for electron beams. We have finished collecting the required experimental data to model the beams for Siemens Primus (5 energies). To date all beam energies for Siemens linac have been modeled and fully validated. We evaluated the calculation accuracy for homogeneous and heterogeneous phantoms. Effects of simulation parameters on accuracy and speed of calculations was also studied. Our results indicated a need for the model improvement for the 13 MeV electron beam. This was communicated to CMS and we worked with them to improve this beam model. The clinical procedures have been written and in December 2011 the system was released for clinical use for Siemens linacs. A manuscript is in preparation. The Elekta electron beams have been installed in XiO and the validation of the TPS is in progress.

• Commissioning and Clinical Implementation of the Monte Carlo Dose Calculation Method for Cyberknife Multiplan Treatment Planning Software J Szanto, E Henderson N Ploquin and E Vandervoort

The Multiplan treatment planning system has recently released a new module for beam modeling and commissioning of the Monte-Carlo calculation algorithm. This algorithm provides the most accurate dose-computation method for extra cranial treatments especially in highly heterogeneous tissues such as lung. All of the necessary beam data has been collected and the modeling process has been completed for all fixed cones and for the iris variable aperture. Clinical validation of the algorithm has been performed using gafchromic film, ion chambers and diodes measurements performed within slabs of simulated tissue materials and using an in-house anthropomorphic lung phantom.

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11 National/International Conference Representation AAPM (American Association of Physicists in Medicine Annual Scientific Meeting, Charlotte,

NC, 28 July – 3 August, 2012 BG Clark, JE Cygler, CB Kwok

ARO: Accuray User’s group meeting, Dallas, Texas, 29 – 30 November 2012 E Henderson, DJ La Russa

Cancer Care Ontario Winter Meeting, Advanced Imaging Applications: IMRT and Brachytherapy, Toronto, ON, 15 February, 2012 A Cherpak, JE Cygler, C Foottit, D Fraser, E Henderson, DJ La Russa

CARO (Canadian Association of Radiation Oncology) Annual Scientific Meeting, Ottawa, ON, 13 - 14 September 2012 C Angers, A Cherpak, BG Clark, J Hendry

COMP (Canadian Organization of Medical Physicists) Annual Scientific Meeting, Halifax, NS, 11 – 14 July, 2012, A Cherpak, A Alexander, C Angers, BG Clark, C Foottit, BJ Nyiri, N Ploquin, M Roumeliotis, R Studinski, E Vandervoort, DE Wilkins

COMP Winter School, Whistler, BC, 29 January – 2 February, 2012, DE Wilkins, S Neuteboom

ESTRO (European Society for Radiotherapy & Oncology) 12th Biennial Meeting, Barcelona, Spain, 6 – 13 May, 2012 JE Cygler, J Szanto

ISMRM (International Society for Magnetic Resonance in Medicine) Annual Scientific Meeting, Melbourne, Australia, May 2012

IG Cameron SNM (Society of Nuclear Medicine Annual Meeting), West Beach, FL, June 2012 RA deKemp, RG Wells SRS/SBRT (The Radiosurgery Society) Conference, Carlsbad, CA, 22 – 26 February, 2012

E Vandervoort Swiss Medical Physics Society Meeting, Switzerland, 12 - 19 November, 2012

JE Cygler World Congress of Medical Physics Conference, Beijing, China, 23 May – 31 May, 2012 JE Cygler

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PROFILE OF PHYSICISTS

Crystal Plume Angers, M.Sc., MCCPM .................................... 38

Jason Bélec, Ph.D., MCCPM ................................................. 39

Lesley Buckley, Ph.D., MCCPM ............................................. 40

Ian G. Cameron, Ph.D., FCCPM ............................................ 41

Brenda G. Clark, Ph.D., FCCPM, FAAPM ................................. 42

Joanna E. Cygler, Ph.D., FCCPM, FAAPM ................................ 43

Robert deKemp, Ph.D., P.Eng, P.Phys. .................................. 44

Danielle Fraser, Ph.D., MCCPM ............................................. 45

Lee H. Gerig, Ph.D., FCCPM ................................................. 46

Elizabeth Henderson, Ph.D., FCCPM ...................................... 47

Chun-Bun Kwok, Ph.D., MCCPM ........................................... 48

Daniel La Russa, Ph.D., MCCPM ............................................ 49

Katie S. Lekx-Toniolo, Ph.D., MCCPM .................................... 50

Malgorzata (Gosia) Niedbala, Ph.D., MCCPM .......................... 51

Balazs Nyiri, Ph.D., MCCPM ................................................. 52

Nicolas Ploquin, Ph.D., MCCPM ............................................. 53

Ryan Studinski, Ph.D., MCCPM ............................................. 54

Janos Szanto, PhD., FCCPM ................................................. 55

Rebecca E. Thornhill, Ph.D. .................................................. 56

Eric Vandervoort, PhD., MCCPM ........................................... 57

R. Glenn Wells, Ph.D., FCCPM .............................................. 58

David E. Wilkins, Ph.D., FCCPM ............................................ 59

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Crystal Plume Angers, M.Sc., MCCPM

Medical Physicist, The Ottawa Hospital Cancer Centre

Professional Certification:

2008 Canadian College of Physicists in Medicine, member (MCCPM)

Research Interests:

• Development and implementation of new measurement devices for routine linac quality assurance. New test methods and devices (such as ion chamber arrays and diode arrays) are required to replace traditional film based test methods.

• The application of quality tools and process control to routine linac quality assurance testing.

Publications and Presentations:

2 peer reviewed articles, 6 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*, R Studinski, D La Russa, J Bahm, J Renaud, B G Clark, Risk Assessment of Clinical Radiation Processes using Failure Modes and Effect Analysis, Med. Phys. 39, 4628 (2012), Poster presentation at the Canadian Organization of Medical Physicists Annual Meeting, Halifax, Nova Scotia, July 11-14, 2012

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

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Jason Bélec, Ph.D., MCCPM




Research Interests:

• Comparative studies of realistic optimal solution space offered by several treatment techniques (Tomotherapy, VMAT, step & shoot IMRT, CyberKnife, etc…)

• Use of Monte Carlo calculations to study the impact of dynamic jaws on treatment time for tomotherapy treatment

• Realistic Monte Carlo calculations of dose distribution for dynamic radiation treatments (lung motion, VMAT, Tomotherapy, etc…)

• Monte Carlo calculations of detector perturbation factors for dynamic treatments • Use of Monte Carlo calculations to reconstructing 3D dose distributions from two

orthogonal 2D detector arrays for dynamic treatments

Publications and Presentations: 2 peer reviewed articles, 8 published abstracts

Publications:

J. Belec, N. Ploquin, D. J. La Russa, B. G. Clark: Position-probability-sampled Monte Carlo calculation of VMAT, 3DCRT, step-shoot IMRT, and helical tomotherapy dose distributions using BEAMnrc/DOSXYZnrc Med. Phys. 38, 948 (2011)

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.


D Owen, A Cherpak, J Cygler, J Belec and B Clark Patient‐Specific Evaluation of the Need for Adaptive Therapy in Lung SBRT Med. Phys. 38, 3716, 2011, Presented at the 2011 Joint AAPM/COMP Annual Scientific Meeting, Vancouver, 31July-4 August 2011 N Ploquin, J Belec, JM Caudrelier and B G Clark, Med Phys 38, 3680, 2011 Accuracy of Low Doses in Lung for Locoregional Breast Irradiation with TomoTherapy and VMAT J Belec, N Ploquin, and BG Clark Monte Carlo Calculation of Breathing Interplay Effect and Dose Calculation Discretization Error for VMAT and TomoTherapy Stereotactic Lung Treatments Med. Phys. 38, 3870 (2011) N Ploquin, J Belec, B Clark, IMRT dosimetry for prostate, breast and head-and-neck: comparing biologically based step-and-shoot IMRT with dynamic helical tomotherapy, Presented at COMP Annual Meeting, Quebec, Quebec, 2009. 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 and (in French) at the 72nd Annual Meeting of the ACFAS, Montreal, Québec, 2004.

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http://link.aip.org/link/mphya6/v38/i2/p948/s1









Lesley Buckley, Ph.D., MCCPM




Research Interests:

• Improvements in IGRT

• Biases within the treatment planning process




A. Viamonte, LAR da Rosa, LA Buckley, A Cherpak and JE Cygler. Radiotherapy dosimetry using a commercial OSL system. Med. Phys. 35, 1261 (2008)

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)

Selected Abstracts:

G. Lagmago Kamta, L.A. Buckley, E Henderson, Clinical evaluation of an Atlas-Based Auto-Segmentation application for auto-contouring pelvic targets and OARs, COMP Annual meeting, Ottawa, ON, June 2010

A Viamonte Marin, L Ribeiro da Rosa, L Buckley, A Cherpak and J Cygler. Evaluation ofa commercial OSL system for dosimetry measurements in radiotherapy beams. Presented at the AAPM annual meeting, 2007

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

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Ian G. Cameron, Ph.D., FCCPM

Senior Medical Physicist, MRI Unit, The Ottawa Hospital Adjunct Professor, Department of Physics, Carleton University Assistant Professor, Department of Radiological Sciences, University of Ottawa Clinical Investigator, Ottawa Hospital Research Institute Member, Ottawa Medical Physics Institute (OMPI)


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 non-invasively. The signals from which these MR images are made are induced 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. This work will be done on the MR scanners at The Ottawa Hospital.

• Contrast between tissues in an MR image is a result of differences in inherent tissue parameters such as MR relaxation times or water diffusion coefficients (D) between tissues: however, the physics of exactly how these processes contribute to the contrast is often unclear. MR diffusion measurements are rich in information about the microscopic environment of the cells. The challenge is to extract this information and display it in a meaningful way. Currently our focus is on separating the intracellular behaviour from extracelluar dynamics for human brain white matter in vivo and to study the exchange of water between these two environments.


36 peer reviewed articles, 82 presentations at national / international conferences


AM Smith, L Walker, MS Freedman, L Berrigan, J St. Pierre, M Hogan, IG Cameron, Activation Patterns in Multiple Sclerosis on the Computerized Tests and Information Processing, J of Neuro. Sci., 312(1-2), 131-137 (2012)

KS Rakhra, PJ Lattanzio, A Cardenas-Blanco, IG Cameron, PE Beaule, Can T1ρ MRI Detect Acetabular Cartilage Degeneration in Femoroacetabular Impingement? – A Pilot Study, Bone and Joint Surgery, 94-B(9), 1187-1192 (2012)

C Gomez-Laberge, A Adler, IG Cameron, T Nguyen, MJ Hogan, A Bayesian Hierarchical Correlation Model for fMRI Cluster Analysis, IEEE Trans. On Biomed. Engineering 58 (7), 1067-1976 (2011).

C Foottit, G.O. Cron, M.J. Hogan, T Nguyen and I.G. Cameron, Feasibility of using Phase to Measure the Venous Output Function for Quantitative DCE-MRI in the Human Brain, Magn. Reson. Med, 63, 772-781 (2010).

AM Smith, LAS Walker, M Freedman, C DeMeulemeester, M Hogan, IG Cameron. fMRI Investigation of Disinhibition in Cognitively Impaired Patients with Multiple Sclerosis, J Neurological Sciences, 281, 58-63 (2009).

J-M Caudrelier, M Vermandel, N Betrouni, B Nyiri, IG Cameron, J Rousseau, Towards an Accurate and Robust Method Based on Fuzzy Logic Principles for the Reconstruction and Quantification of Large Volumes from MR and CT Images, Br. J. Radiol. 82, 228-34 (2009).

A Cardenas-Blanco, C Tejos, P Irarrazaval, IG Cameron, Noise in Magnituded Magnetic Resonance Images, Concepts in Magn. Reson. 32A(6), 409-416 (2008).

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Brenda G. Clark, Ph.D., FCCPM, FAAPM

Chief, Medical Physics, The Ottawa Hospital Cancer Centre Professor, Department of Radiology, University of Ottawa Adjunct Research Professor, Department of Physics, Carleton University Clinical Investigator, Ottawa Hospital Research Institute Member, Ottawa Medical Physics Institute (OMPI)


1995 Canadian College of Physicists in Medicine, fellow, (FCCPM) 1989 Canadian College of Physicists in Medicine, member, (MCCPM)

Research Interests:

• The management of error in radiation treatment through the use of incident learning systems and failure modes and effect analysis

• Stereotactic Radiosurgery and IMRT treatment planning Publications and Presentations:

57 peer reviewed articles, 27 invited presentations, 148 presentations at national / international conferences, 3 patents

Selected Recent Publications:

J.J. Battista, B.G. Clark, M.S. Patterson, L. Beaulieu, M.B. Sharpe, L.J. Schreiner, M.S. MacPherson, J. Van Dyk: Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada J App. Cl Med Phys, 13(1), 93-110, 2012 BG Clark, RJ Brown, J Ploquin, PD Dunscombe: Patient safety improvements in radiation treatment through 5 years of incident learning Practical Radiation Oncology, 2012 DOI http://dx.doi.org/10.1016/j.prro.2012.08.001 J Belec, N Ploquin, DJ La Russa, BG Clark: Position-probability-sampled Monte Carlo calculation of VMAT, 3DCRT, step-shoot IMRT, and helical tomotherapy dose distributions using BEAMnrc/DOSXYZnrc Med. Phys. 38, 948, 2011 BG Clark, RJ Brown, JL Ploquin, AL Kind, L Grimard: The management of radiation treatment error through incident learning. Radiother Oncol 95, 344-349, 2010 B McCurdy, L Duggan, S Howlett, BG Clark: A comparison of medical physics training and education programs – Canada and Australia Aus Phys & Eng Sci in Med 32,251-260, 2009 A Mestrovic, A Nichol, BG Clark, K Otto: Integration of on-line imaging, plan adaptation and radiation delivery: proof of concept using digital tomosynthesis. Phys Med Biol 54,3803-3819, 2009 BG Clark, C Candish, E Vollans, E Gete, R Lee, M Martin, R Ma, M McKenzie: Optimization of stereotactic radiotherapy treatment delivery technique for base-of-skull meningiomas. Med Dosim; 33(3): 239-247, 2008 SH Benedict, FJ Bova, BG Clark, SJ Goetsch, WH Hinson, DD Leavitt, DJ Schlesinger, KM Yenice: 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 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

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http://dx.doi.org/10.1016/j.prro.2012.08.001





Joanna E. Cygler, Ph.D., FCCPM, FAAPM

Senior Medical Physicist, The Ottawa Hospital Cancer Centre Professor, Department of Radiology, University of Ottawa Hospital Adjunct Research Professor, Department of Physics, Carleton University Clinical Investigator, Ottawa Health Research Institute (OHRI) Member, Ottawa Medical Physics Institute (OMPI)

Professional Certification: 1994 Canadian College of Physicists in Medicine, fellow, (FCCPM) 1994 Canadian College of Physicists in Medicine, member, (MCCPM)

Awards: 2007 Fellow, American Association of Physicists in Medicine, (FAAPM)

Research Interests: Main research interests: dosimetry (with emphasis on electron beams), brachytherapy, development of new in-vivo dosimeter methods and detectors, 4D dosimetry, image guided radiotherapy, radiobiology, adaptive radiotherapy, Monte Carlo dose calculations, radiobiology.

Publications and Presentations: 1 book (co-editor), 5 book chapters, 52 peer reviewed articles, >135 published abstracts, over 45 invited presentations, 1 CAPCA technical report, 2 other Selected Publications: A Cherpak, M Serban, J Seuntjens, JE Cygler. 4D dose-position verification in radiation therapy using the RADPOS system in a deformable lung phantom, Med. Phys. 38, 179-187, 2011.

J Crook, J Jezioranski, JE Cygler. Penile brachytherapy: Technical aspects and post implant issues, Brachytherapy 9, 151-158, 2010.

A Cherpak, W Ding, A Hallil, JE Cygler. Evaluation of a novel 4D in vivo dosimetry system, Med. Phys. 36, 1672-1679, 2009.

LAR Viamonte, LA da Rosa, L Buckley, A Cherpak, JE Cygler. Radiotherapy dosimetry using commercial OSL system, Med. Phys. 35, 1261-1266, 2008.

A Cherpak, RCN Studinski, JE Cygler. MOSFET detectors in quality assurance of tomotherapy treatments, Radiother. Oncol., 86, 242-250, 2008.

I Chetty, B Curran, JE Cygler et al. Report of the AAPM Task Group No. 105: Issues associated with clinical implementation of Monte Carlo-based photon and electron external beam treatment planning. Med. Phys. 34, 4818-4853, 2007.

BA Faddegon, JE 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 BH Curran, JM Balter, IJ Cherry, Medical Physics Publishing (Madison, WI, 2006), p.51-69.

JE Cygler, GM Daskalov, GH Chan, GX Ding. Evaluation of the first commercial Monte Carlo dose calculation engine for electron beams treatment planning, Med. Phys. 31, 142-153, 2004.

JE 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.

JE Cygler, E Heather, GX Ding, JP Seuntjens. Monte Carlo Systems in Preclinical and Clinical Treatment Planning: Pitfalls and Triumphs. AAPM Monograph No. 32, edited by BH Curran, JM Balter, IJ Cherry, Medical Physics Publishing (Madison, WI, 2006), p.199-232.

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Robert deKemp, Ph.D., P.Eng, P.Phys.

Head Imaging Physicist, Cardiac Imaging, University of Ottawa Heart Institute Associate Professor, Medicine (Cardiology), University of Ottawa Cross-appointment, Engineering (EECS), University of Ottawa Adjunct Professor, Department of Physics, Carleton University Past-Director, Ottawa Medical Physics Institute (OMPI), Carleton University


1994 P.Eng. Professional Engineer

2003 P.Phys. Professional Physicist

Research Interests:

• Multi-modality and hybrid imaging technology development and application to cardiovascular medicine

Publications (lifetime total):

113 peer-reviewed papers, 34 conference proceedings, 13 book chapters, 250+ abstracts

Selected Publications (2012):

Book Chapters: DaSilva JN, Valadiva AC, Mylonas I, Hadizad T, deKemp RA, Beanlands RSB. “PET Radiopharmaceuticals”, Chapter 13 in Handbook of Nuclear Cardiology: Cardiac SPECT and Cardiac PET. Heller GV, Hendel RC (Eds). Springer 2012. Renaud J, Beanlands RSB, deKemp RA. “PET Instrumentation”, Chapter 14 in Handbook of Nuclear Cardiology: Cardiac SPECT and Cardiac PET. Heller GV, Hendel RC (Eds). Springer 2012.

Peer-Reviewed Papers: deKemp RA, Declerck J, Klein R, Pan X-B, Nakazato R, Tonge C, Arumugam P, Berman DS, Germano G, Beanlands RS, Slomka PJ. Reproducibility of Stress and Rest Myocardial Blood Flow Assessed with 3D dynamic PET-CT and a one-tissue-compartment model of 82Rb kinetics. J Nucl Med. 2013. Ohira H, McArdle B, Cocker MS, deKemp RA, DaSilva JN, Beanlands RS. Current and Future Clinical Applications of Cardiac Positron Emission Tomography. Circulation J. 2013. Croteau E, Renaud JR, deKemp RA. Cardiac Micro-PET-CT. Curr Cardiovasc Imaging Reports 2013 [Review]. Liu Y, Ghosh N, Dwivedi G, Chow BJ, deKemp RA, DaSilva J, Guo A, Garrard L, Beanlands RSB, Ruddy TD. Identification of Inflamed Aortic Plaque in Conventional FDG-PET Myocardial Viability Studies. Can J Cardiol 2012. Renaud JR, DaSilva JN, Beanlands RS, deKemp RA. Characterizing the Normal Range of Myocardial Blood Flow with 82Rubidium and 13N-Ammonia PET Imaging. J Nucl Cardiol 2013 S.L. Thorn, R.A. deKemp, T. Dumouchel, R. Klein, J.M. Renaud, R.G.Wells, M. Gollob, R.S. Beanlands, J.N. DaSilva, Repeatable Non-Invasive Imaging of FDG PET in the Mouse Myocardium: Evaluation of Tracer Kinetics in a Type 1 Diabetes Model. [in-press]. A. Pourmoghaddas, R. Klein, R.A. deKemp, R.G. Wells .Respiratory phase alignment improves blood-flow quantification in Rb82 PET myocardial perfusion imaging.. Med. Phys. 40, 022503 (11 pages) [in-press].

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Danielle Fraser, Ph.D., MCCPM



2012 Canadian College of Physicists in Medicine, member, (MCCPM)

Research Interests:

• Image guided radiation therapy, implications for treatment planning through to patient alignment, derivation of margins, decision making process

• Dosimetry, dose measurement in non-standard fields




Fraser DJ, Chen Y, Poon E, et al. Dosimetric consequences of misalignment and realignment in prostate 3DCRT using intramodality ultrasound image guidance. Med Phys 2010;37: 2787-2795.

Fraser DJ, Wong P, Sultanem K, Verhaegen F. Dosimetric evolution of the breast electron boost target using 3D ultrasound imaging. Radiother Oncol 2010;96: 185-191.

Fraser D, Parker W, Seuntjens J. Characterization of cylindrical ionization chambers for patient specific IMRT QA. J Appl Clin Med Phys 2009;10:241-251.

Fraser D, Mark C, Cury F, et al. Comparison of conventional and Monte Carlo dose calculations for prostate treatments. J Phys Conf Ser 2008;102:012010.

Fraser D, Fava P, Cury F, et al. Evaluation of a prototype 3D ultrasound system for multimodality imaging of cervical nodes for adaptive radiation therapy. Proc of SPIE 2007;6509:1605-7422/07.

Selected Abstracts:

Fraser DJ, Nyiri B, Gerig LH. Investigation of target motion for serially delivered TMI treatments. 53rd Joint AAPM/COMP meeting, Vancouver, July 31- August 4 2011.

Fraser D, Wong P, Verhaegen F. Electron Monte Carlo dose calculations for breast treatments. ESTRO 28, Maastricht, the Netherlands, August 30 - September 3 2009.

Verhaegen F, Fraser D, Falco T. Complementary information from 3D ultrasound in image-guided radiotherapy. Fourth International Conference on Translational Research and Pre-Clinical Strategies in Radiation Oncology, Geneva Switzerland, March 11-13 2009.

D Fraser, F Cury, C Mark, G Shenouda, M Duclo, T Falco, F Verghaegen, Integration of 3D ultrasound image-guidance in Monte Carlo dose calculations. 3rd annual McGill Workshop on Monte Carlo Techniques in Radiotherapy Delivery and Verification, McGill University, Montreal QC, May 29-June 1 2007.

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Lee H. Gerig, Ph.D., FCCPM

Senior Medical Physicist, The Ottawa Hospital Cancer Centre

Assistant Professor, Department of Radiology, University of Ottawa

Adjunct Professor, Department of Physics, Carleton University

Clinical Investigator, Ottawa Health Research Institute (OHRI)

Member, Ottawa Medical Physics Institute (OMPI)


1992 Canadian College of Physicists in Medicine, fellow, (FCCPM)


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.


46 peer reviewed articles, 56 published abstracts, 3 technical reports


Nyiri BJ, Smale JR, Gerig LH: Two self-referencing methods for the measurement of beam spot position. Med Phys.; 39(12):7635-43, Dec 2012 R Samant, LH Gerig, L Montgomery, M MacPherson, G Fox, R MacRae, K Carty, S Andrusyk, P Genest, B Nyiri, Rapid palliative radiotherapy: comparing IG-IMRT with more conventional approaches", Journal of Radiotherapy in Practice, 9, 143-148, 2010 LH Gerig, M Niedbala, BJ Nyiri, Dose perturbations by two carbon fiber treatment couches and the ability of a commercial treatment planning system to predict these effects. Med Phys;37:322-8 2010

M MacPherson, L Montgomery, G Fox, K Carty, LH Gerig, R MacRae, et al. On-line rapid palliation using helical tomotherapy: a prospective feasibility study. Radiother Oncol 2008 Apr;87(1):116-8.

Z Gao, DE Wilkins, L Eapen, C Morash, Y Wassef, LH Gerig, A Study of Prostate Delineation Referenced Against a Gold Standard Created from the Visible Human Data, Radiotherapy and Oncology 85(2):239-46 2007

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Elizabeth Henderson, Ph.D., FCCPM





2011 Canadian College of Physicists in Medicine, fellow, (FCCPM)


Research Interests:

Small field dosimetry




M.A. Haider, M. Milosevic, A. Fyles, I. Sitartchouk, I. Yeung, E. Henderson, G. Lockwood, T-Y. 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. A dual detector method for determining CyberKnife Total Scatter Factors (TSF), J Szanto, E Henderson. Presented at the International Stereotactic Radiosurgery Society (ISRS), Paris, France, May 2011 (Poster) Use of the SRS Profiler for CyberKnife Patient Specific Quality Assurance (PSQA), Henderson, J Szanto. Presented at the International Stereotactic Radiosurgery Society (ISRS), Paris, France, May 2011 (Poster) A Dual Detector Method for Determining CyberKnife Total Scatter Factors (TSF), J Szanto, E Henderson, 2011 Joint AAPM/COMP Meeting, Vancouver, BC, 31 Jul – 4Aug2011 (Poster)

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Chun-Bun Kwok, Ph.D., MCCPM





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 accelerators - The aim of this studying was to eliminate the use of x-ray film in the quality assurance of radiation treatment units. The work involved investigation and evaluation of currently available, non x-ray film based treatment machine quality assurance (non x-ray film based machine QA) techniques. In addition, investigation of appropriate non x-ray film based machine QA techniques for implementation at The Ottawa Hospital Cancer Centre (TOHCC).




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.

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Daniel La Russa, Ph.D., MCCPM




Research Interests:

Quality and Safety in Radiation Therapy:

• QC management, failure mode and effects analysis, and statistical process control techniques

TomoTherapy:

• Adaptive planning techniques

• Investigating the quality and role of novel new techniques for converting helical TomoTherapy plans into step-and-shoot and arc-type IMRT plans deliverable on a C-arm linac.

Cavity theory/ion chamber dosimetry

• Investigating new stopping-power ratio formalisms to improve the accuracy of cavity theory over a larger range of energies and cavity sizes.

Monte Carlo methods

• Beam modeling and independent verification of dose distributions for clinical IMRT plans using the EGSnrc Monte Carlo code system.




J. Belec, N. Ploquin, D. J. La Russa, B. R. Clark, Position-probability-sampled Monte Carlo calculation of VMAT, 3DCRT, step-and-shoot imrt, and helical tomotherapy dose distributions using BEAMnrc/DOSXYZnrc, Med Phys 38 (2), 948 - 960, 2011 D. J. La Russa, D. W. O. Rogers, Accuracy of Spencer-Attix cavity theory and calculations of fluence correction factors for the air kerma formalism, Medical Physics, 36 (9), 4173 - 4183, 2009 D. J. La Russa, D. W. O. Rogers, Accuracy of EGSnrc calculations at 60Co energies for the response of ion cambers configured with various wall materials and cavity dimensions, Medical Physics, 35 (12), 5629 - 5640, 2008 D. J. La Russa, M. McEwen, D. W. O. Rogers, An experimental and computational investigation of the standard temperature-pressure correction factor for ion cambers in kilovoltage x rays, Medical Physics, 34 (12), 4690 - 4699, 2007 D. J. La Russa, D. W. O. Rogers, An EGSnrc investigation of the PTP correction factor for ion cambers in kilovoltage x rays, Medical Physics, 33 (12), 4590 - 4599, 2006

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Katie S. Lekx-Toniolo, Ph.D., MCCPM





Research Interests:

• Stereotactic radiosurgery and radiotherapy techniques

• Advancing treatment planning techniques in radiation therapy

• MRI, SPECT, PET/CT, and clinical radiotherapy physics

• Myocardial blood flow, function, metabolism and viability imaging using MRI, SPECT and PET


6 peer reviewed articles, 17 published abstracts, 4 invited presentations


Lekx KS, deKemp RA, Beanlands RS, Wisenberg G, Wells RG, Lortie M, Klein R, Zabel P, Kovacs MS, Sykes J, Prato FS. 3D vs. 2D dynamic 82Rb myocardial blood flow imaging in a canine model of stunned and infarcted myocardium. Nucl Med Commun. Jan;31(1):75-81, 2010.

Lekx KS, deKemp RA, Beanlands RS, Wisenberg G, Wells RG, Lortie M, Klein R, Zabel P, Kovacs MS, Sykes J, Prato FS. Quantification of Regional Myocardial Blood Flow in a Canine Model of Stunned and Infarcted Myocardium: Comparison of 82Rb PET with Microspheres. Nucl Med Commun. Jan;31(1):67-74, 2010.

Wisenberg G, Lekx K, Zabel P, Kong H, Mann R, Zeman PR, Datta S, Culshaw CN, Merrifield P, Bureau Y, Wells G, Sykes J, Prato FS. Cell tracking and therapy evaluation of bone marrow monocytes and stromal cells using SPECT and CMR in a canine model of myocardial infarction. J Cardiovasc Magn Reson Apr 27;11(1):11, 2009.

Lekx KS, Fathimani M, Bureau Y, Wisenberg G, Sykes J, Prato FS. Comparison of the detection of subtle changes in myocardial regional systolic function using qualitative and semi-quantitative techniques. J Cardiovasc Magn Reson 8(5):731-739, 2006.

Lekx KS, Prato FS, Sykes J, Wisenberg G. The partition coefficient of Gd-DTPA reflects maintained tissue viability in a canine model of chronic critical coronary stenosis using MRI. JCMR 6(1):35-44, 2004.

Pereira RS, Prato FS, Lekx K, Sykes J, Wisenberg G. Contrast-enhanced MRI for the assessment of myocardial viability after permanent coronary artery occlusion. Magn Reson Med 44: 309-316, 2000.

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Malgorzata (Gosia) Niedbala, Ph.D., MCCPM





Research Interests:

• Image guidance for breast treatment

• OSLD NanoDots in-vivo dosimetry applied to total body irradiation and total marrow irradiation




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 Low-Dose-Rate Irradiation in Tumor and Normal Cell Lines. Radiation Research. 155:297-303, 2001


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.

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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:


Research Interests: General techniques: Mathematical-physics/modeling; imaging, image processing and analysis; statistical analysis

Specific applications: Image Guided Radiotherapy/Imaging Improvements: Using model phantom MTF measurements, image analysis and manipulation techniques we are exploring the limits of our XVI/CBCT imaging equipment and techniques. The objective is to aggressively reduce imaging time and patient dose (50 and 70% resp.) and to increase equipment life, without compromising targeting accuracy. We also adapt to special treatment techniques e.g. VMAT and large patients. Conventional CT QA: The development of sub-pixel accuracy measurements is critical for meaningful quality assurance of conventional CT's, viz. our clinical geometric tolerances are the same order of magnitude as the voxel size. One example introduced, still promising further applications, is a hole-row phantom, the image of which is Fourier analyzed, including aliasing effects to achieve said goals. Linacs and Dosimetry: The numerical techniques of large scale linear systems, minimization methods, and error propagation analysis combined with practical dosimetric experiments are key techniques of understanding, evaluating and developing various wide field array calibration procedures for our MatriXX devices. Properly calibrated (0.1-0.3%) these enable us to have accurate and efficient, true 2D QA and analysis of our clinical beam profiles. Treatment planning/targeting: To improved prostate CA CTV definition we create pathology based 3D prostate cancer maps and fuse these to planning CT. Beyond the proof of concept phase we are working on the improvement of various steps of the process: from actual pathology processing, through image analysis to integration with the planning system. Improved OAR definition requires the statistical analysis of pt anatomy. An example is the study of the impact of prostatectomy on rectal position using pre-op and post-op image sets.

Publications and Presentations: Total: 20 peer reviewed articles, 42 conference presentations, 2 invited lectures, 8 patents

Recent Peer Reviewed Papers: • Nyiri BJ, Smale JR, Gerig LH: Two self-referencing methods for the measurement of beam spot

position. Med Phys. 2012 Dec; 39(12):7635-43. • Malone S, Croke J, Roustan-Delatour N, Belanger E, Avruch L, Malone C, Morash C, Kayser C, Underhill

K, Li Y, Malone K, Nyiri B, Spaans J: Postoperative radiotherapy for prostate cancer: a comparison of four consensus guidelines and dosimetric evaluation of 3D-CRT versus tomotherapy IMRT. Int J Radiat Oncol Biol Phys. 2012 Nov 1;84(3):725-32. Epub 2012 Mar 22.

Recent Conference Presentations, Posters, Abstracts: • B Nyiri, L Gerig: A generalized solution to the wide field array calibration method. Med. Phys. 39,

4643 (2012); COMP 2012 Halifax • S Malone, J Croke, E Belanger, K Malone, L Avruch, C Malone, C Morash, Y Li, B Nyiri: Use of pre-op MRI

and «3D prostate cancer maps» to improve CTV definition for post-operative radiation. Radiaother Oncol vol 103 suppl. 1 (2012) ESTRO 2012 Barcelona

• JM Croke, B Nyiri, L Avruch, E Belanger, S Malone: Impact of Radical Prostatectomy on Rectal Position and Implications for CTV Definition for Postoperative Prostate Radiation Therapy, Int J Radiat Oncol Biol Phys. vol. 84, Issue 3, suppl. 1 Nov 2012, Page S371; ASTRO 2012 Boston

• S Samiee, M Lacelle, B Nyiri, N Ploquin, JM Caudrelier: Implementation and early evaluation of Linac IMRT for the post-operative loco-regional radiation of breast cancer. Radiother Oncol vol. 103, suppl. 1, S551 (2012) ESTRO 2012 Barcelona

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Nicolas Ploquin, Ph.D., MCCPM

Medical Physicist, The Ottawa Hospital Cancer Centre Assistant Professor, Department of Radiology, University of Ottawa Member, Ottawa Medical Physics Institute (OMPI)

Professional Certification: 2010 Canadian College of Physicists in Medicine, member (MCCPM)

Research Interests: Implementation, evaluation and comparison of Volumetric Arc Therapy with current state-of-the-art IMRT techniques (step-and-shoot, sliding window, tomotherapy)

Clinical and Economic Evaluation of current radiation therapy modalities

Stereotactic Radiosurgery

Publications and Presentations: 10 peer reviewed articles, 13 published abstracts

Selected Publications: W. Smith, G. Menon, N. Wolfe, N. Ploquin, T. Trotter, D. Pudney. IMRT for breast: a comparison of planning techniques. Phys. Med. Biol. 55, 1231-41, 2010 N. Ploquin, P. Dunscombe. A Cost-Outcome Analysis of Image Guided Patient Repositioning in the Radiation Treatment of Cancer of the Prostate. Radiother. Oncol., 93, 25-31, 2009 N. Ploquin, A. Rangel, P. Dunscombe. Phantom evaluation of a commercially available three modality Image Guided Radiation Therapy system. Med. Phys.; 35(12): 5303-11, 2008 N. Ploquin, P. Dunscombe. The cost of radiation therapy. Radiother. Oncol., 86, 217-223, 2008 A. Rangel, N. Ploquin, I. Kay, P. Dunscombe. Evaluation of linear accelerator performance standards using an outcome oriented approach. Med Phys.; 35(6):2513-8, 2008. A. Rangel, N. Ploquin, I. Kay, P. Dunscombe. Towards an objective evaluation of tolerances for beam modeling in a treatment planning system. Phys Med Biol. 7; 52(19):6011-25, 2007. P. Dunscombe, S. Iftody, N. Ploquin, E. Ekaette, R. Lee. The Equivalent Uniform Dose as a Severity Metric for Radiation Treatment Incidents. Radiother. Oncol. 84 64-66, 2007 N. Ploquin, I. Kay, A. Rangel, H. Lau, P. Dunscombe. A comparison of techniques for simulating set-up error and uncertainty in head and neck IMRT. Med. Phys. 33 (9), 3213-19, 2006 N. Ploquin, W. Song, H. Lau, P. Dunscombe. Intensity Modulated Radiation Therapy for oropharyngeal cancer: the sensitivity of plan objectives and constraints to set-up uncertainty. Phys. Med. Biol. 50 3515-33, 2005

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Ryan Studinski, Ph.D., MCCPM




Research Interests:

• SharePlan SharePlan is an interesting variation on conventional IMRT planning software. It takes dose distributions generated on a TomoTherapy planning station for a helical TomoTherapy treatment and creates a step-and-shoot IMRT plan for a C-arm linac. The linac plan is optimized on the dose distribution from the TomoTherapy, which is imported directly from the TomoTherapy planning system, and generated within the space of a few minutes. This product has significant clinical potential since we can quickly create back-up TomoTherapy plans for linacs. Several research opportunities exist to investigate the advantages of the TomoTherapy planning system independent of the TomoTherapy beam delivery system. It could also help settle which disease sites benefit the most from being on TomoTherapy rather than on a conventional linear accelerator.

• TomoTherapy Quality Assurance and Optimization of MVCT HU The MVCT of the TomoTherapy system has substantial potential as a planning tool in the clinic due to its ability to image high-Z material(s) without artifacts common with conventional CT simulators. This system may also be integrated into adaptive planning techniques on TomoTherapy since it is used daily to capture changes in patient anatomy and physiology. However, the HU of a TomoTherapy unit have been shown to be unstable and requires extensive QA to monitor changes. Some changes in HUs have been shown to be related to energy, but our preliminary results show that the jaw




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)

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Janos Szanto, PhD., FCCPM




Clinical Investigator, Ottawa Health Research Institute (OHRI)


1994 Canadian College of Physicists in Medicine, fellow (FCCPM)


Research Interests:

• 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.

• Optimized output factor measurements for CyberKnife® robotic radiosurgery collimators

• Accurate dosimetry for patient specific quality assurance using CyberKnife® radiosurgery

• Platinum based fiducial markers for CT-MRI fusion and real-time tumor tracking during CyberKnife® radiosurgery

• Method for dynamic CT angiography (dCTA) for stereotactic frameless stereotactic radiosurgical (SRS) planning of intracranial Arterio Venous Malformations (AVM)




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, G.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): 49-55, 2001

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Rebecca E. Thornhill, Ph.D.

Cardiac MRI Physicist, Imaging Scientist, The Ottawa Hospital and The University of Ottawa Heart Institute

Assistant Professor, Department of Radiology, University of Ottawa Clinical Investigator, Ottawa Hospital Research Institute Member, Ottawa Medical Physics Institute (OMPI)

Research Interests:

• MRI is a highly versatile imaging modality, capable of producing images with strong soft-tissue contrast. In MR, we can exploit prior knowledge of tissue composition, eg, how ‘watery’ or ‘fatty’ we expect a lesion or normal organ to be in order to make certain structures more conspicuous. However, sometimes the discrepancy between the pathology and normal tissue is too weak to enable a confident distinction. One key area of MR research is the development of techniques to exaggerate the inherent differences between lesion and healthy tissue by dynamic contrast-enhanced imaging. By tracking contrast-related changes in MRI signal over time, we can estimate the concentration of contrast-agent. This is potentially useful, since we can apply mathematical models to estimate physiologically meaningful parameters like blood flow or vascular ‘leakiness,’ which in turn may enable us to characterize tumour aggressiveness, as well as certain forms of heart failure.

• In addition to blood flow and related information, my research interests are largely concerned with how quantitative image texture and lesion morphology can be used to identify “signature” patterns associated with various pathologies. Current applications include delineation of malignant from benign lymph nodes on rectal MRI and lung CT images, as well as identification of biologically aggressive musculoskeletal and breast tumours. We are also investigating quantitative MRI texture features for characterizing heart failure, particularly those sub-types for which conventional visual assessment lacks diagnostic accuracy.


18 peer reviewed articles, 39 presentations at national / international conferences Selected Publications:

1. Thornhill RE, Chen S, Rammo W, Mikulis DJ, Kassner A. Contrast-enhanced MRI in acute ischemic stroke: T2* measures of blood-brain barrier permeability and their relationship to T1 estimates and hemorrhagic transformation. AJNR Am J Neuroradiol 2010;31:1015-1022.

2. Kassner A, Thornhill RE. Texture Analysis: a Review of Neurologic MR Imaging Applications. AJNR Am J Neuroradiol 2010;31:809-816.

3. Thornhill RE, Prato FS, Wisenberg G, White JA, Nowell J, Sauer A. Feasibility of the single bolus strategy for measuring the partition-coefficient of Gd-DTPA in patients with myocardial infarction: independence of image delay time and maturity of scar. Magn Reson Med 2006;55:780-789.

4. Thornhill RE, Prato FS, Wisenberg G. The assessment of myocardial viability: a review of current diagnostic imaging approaches. J Cardiovasc Magn Reson 2002;4:381-410.

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Eric Vandervoort, PhD., MCCPM

Medical Physicist, The Ottawa Hospital Cancer Centre Assistant Professor, Department of Radiology, University of Ottawa Member, Ottawa Medical Physics Institute (OMPI)



Research Interests:

My graduate research involved the development of attenuation and Compton scatter correction methods for quantitative imaging in PET and SPECT imaging. Since starting at The Ottawa Hospital Cancer Centre, my research has focused on the implementation and commissioning of a Monte-Carlo treatment planning system for electrons. I have also used radiochromic film to measure relative output factors for different sized apertures on CyberKnife and, in collaboration with colleagues, compared to other detector types (microMOSFET, radioluminescent dosimeters, diodes and microchambers). Another project under investigation will characterize the accuracy of clinical dose calculation algorithms under conditions of electronic disequilibrium using a plastic scintillator and film. We will evaluate the sensitivity of the dose calculation to clinically realistic uncertainties in treatment delivery, small changes in electron density, miscalibrations of the position and speed of the multileaf collimators and gantry, and changes in the patient anatomy due to tumour shrinkage, growth, and tumour movement during the respiratory cycle.

Peer-Reviewed Articles:

• Groman SM, Lee B, London ED, Mandelkern MA, James AS, Feiler K, Rivera R, Dahlbom M, Sossi V, Vandervoort E, Jentsch JD, and J. Jentsch (2011) Dorsal Striatal D2-Like Receptor Availability Co-varies with Sensitivity to Positive Reinforcement during Discrimination Learning, J. Neurosci., 31(20): 7291-7299.

• Vandervoort E and Sossi V (2008) Impact of contamination from scattered photons in singles-mode transmission data on quantitative small-animal PET imaging, J. Nucl. Med., 49(11): 1852-1861.

• Vandervoort E and Sossi V (2008) An analytical scatter correction for singles-mode transmission data in PET, IEEE Trans. Med. Imaging 27(3):402-412.

• Vandervoort E, Camborde M-L, Jan S and Sossi V (2007) Monte-Carlo modeling of singles-mode transmission data for small animal PET scanners, Phys. Med. Biol. 52(11): 3169-3184.

Published abstracts:

• Vandervoort EJ, La Russa DJ, Ploquin N, Szanto, J, Henderson E, Improved dosimetric accuracy for patient specific quality assurance using a dual-detector measurement method for CyberKnife output factors, COMP annual meeting 2012, Halifax, NS

• Vandervoort EJ, La Russa DJ and Cygler JE Clinical Implementation of a Commercial Monte Carlo Treatment Planning System for Electron Beams, Joint AAPM/COMP annual meeting 2011 Vancouver, Canada

• Vandervoort E and Cygler JE (2010) Evaluation of a New Commercial Monte-Carlo Treatment Planning System for Electrons, 56th Annual Meeting of the Canadian Organization of Medical Physicists and the Canadian College of Physicists in Medicine.

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R. Glenn Wells, Ph.D., FCCPM

Medical Physicist, Cardiac Imaging, University of Ottawa Heart Institute Associate Professor, Medicine (Cardiology), University of Ottawa Adjunct Professor, Department of Physics, Carleton University Member, Ottawa Medical Physics Institute (OMPI)


2008 Canadian College of Physicists in Medicine, fellow (FCCPM) 2002 Canadian College of Physicists in Medicine, member (MCCPM)

Research Interests:

Tthe physics of multi-modality imaging with nuclear medicine: the combination of multi-slice X-ray computed tomography (CT) with single-photon emission computed tomography (SPECT) and positron emission tomography (PET). The research focuses on image reconstruction, multi-isotope and dynamic imaging with application in the fields of small-animal SPECT/CT and dedicated cardiac clinical SPECT.


34 peer reviewed articles, 4 book chapters, 137 presentations at national / international conferences


S.L. Thorn, R.A. deKemp, T. Dumouchel, R. Klein, J.M. Renaud, R.G.Wells, M. Gollob, R.S. Beanlands, J.N. DaSilva, . Repeatable Non-Invasive Imaging of FDG PET in the Mouse Myocardium: Evaluation of Tracer Kinetics in a Type 1 Diabetes Model.. [Accepted]

R.G. Wells, B Marvin, G. Kovalski, T.D. Ruddy. .Planar radionuclide angiography with a dedicated cardiac SPECT camera.. J. Nucl. Cardiol. (2013). Epub 22 Feb 2013, doi:10.1007/s12350-013-9674-6.

A. Pourmoghaddas, R. Klein, R.A. deKemp, R.G. Wells .Respiratory phase alignment improves blood-flow quantification in Rb82 PET myocardial perfusion imaging.. Med. Phys. 40, 022503 (11 pages), (2013).

R.G.Wells, K. Soueidan, K. Vanderwerf, T.D. Ruddy, .Comparing slow- versus high-speed CT for attenuation correction of cardiac SPECT perfusion studies.. J. Nucl. Cardiol. 19, 719-726 (2012).

G. Dwivedi, R.G. Wells, B.J. Chow, .Cardiovascular magnetic resonance for diagnosis of coronary artery disease: quo vadis?.. Expert Rev. Med. Devices 9, 219-224 (2012).

J. Strydhorst, F. Leenen, T.D. Ruddy, R.G.Wells, .Reproducibility of serial left ventricular perfusion, volume, and ejection fraction measurements using multiplexed multi-pinhole SPECT in normal rats and following myocardial infarction.. J. Nucl. Med. 52, 1285-1292 (2011).

Y. Xu, S. Hayes, I. Ali, T.D. Ruddy, R.G. Wells, D.S. Berman, G. Germano, and P.J. Slomka, .Automatic and visual reproducibility of perfusion and function measures for myocardial perfusion SPECT.. J. Nucl. Cardiol. 17, 1050-1057 (2010).

R.G.Wells, T.D. Ruddy, R.A.deKemp, J.N.DaSilva, and R.S. Beanlands, .Respiratory Motion Correction using Phase-Specific Alignment of Single-Phase CT in Cardiac PET/CT .. J. Nucl. Med. 51, 1182-1190 (2010).

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David E. Wilkins, Ph.D., FCCPM

Senior Medical Physicist, The Ottawa Hospital Cancer Centre Radiation Safety Officer, The Ottawa Hospital Cancer Centre Adjunct Professor, Department of Physics, Carleton University Assistant Professor, Department of Radiology, University of Ottawa Clinical Investigator, Ottawa Health Research Institute (OHRI) President, Canadian College of Physicists in Medicine

Profession Certification:

1999 Canadian College of Physicists in Medicine, fellow (FCCPM)


Research Interests: Biological modeling of emerging radiation treatment strategies, altered fractionation, tumour proliferation.

Statistical analysis of clinical and experimental data to determine meaningful parameters for radiobiological modeling, and to explore the limitations of existing models.

Publications and Presentation: 25 peer reviewed articles, 61 published abstracts

Selected Publications: Lourdes M. Garcia, Lee H. Gerig, G.P. Raaphorst, D. Wilkins. Junctioning longitudinally adjacent PTVs with helical tomotherapy. Journal of Applied Clinical Medical Physics, accepted May 2009.

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 51:2813-2823, 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.

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