EFOMP Working Groups

'The role of the Medical Physicists and Medical Physics Experts in the management of medical laser sources' - Policy Statement 21

The WG is ready to operate under the EFOMP Professional Matters Committee from July 2024 to July 2026. The chair of the WG is Mani Manivannan (United Kingdom).

The rationale of the WG: Medical Physics Experts working within the hospitals are often appointed as Laser Safety Experts for the lasers used in medical applications. Their role is to contribute to maintaining a safe, effective and optimised use of laser-based devices for patients, staff and visitors. In particular, it comprises quality controls, risk management (designation of laser-controlled areas, definition of protection provisions, including protective equipment, signs, etc.), staff and user training, optimisation and safety of the practices.

'Volumetric Modulated Arc Therapy - Breast'

The WG will operate under Science Committee from March 2023 to December 2024. The chair of the WG is Tuomas Koivumäki (Finland).

The rationale of the WG: In many scientific papers, the VMAT technique has shown to improve the target coverage and reduce the unwanted dose to critical organs. The techniques used with VMAT seems to alter from center to center. Still it is unknown how many centers in European level use VMAT in breast radiotherapy treatments.

Joint Working Groups

Joint AAPM-EANM-SNMMI-EFOMP 'DICOM QSPECT MRT'

The WG is ready to operate under the EFOMP Science Committee from November 2024 to November 2026. The chair of the WG is Jaroslav Ptáček (CZ).

The rationale behind this WG is to bring together key stakeholders to identify the way in which a future MRT-DICOM standard should be implemented. The identification of pre-existing tags, or tags that could be used for this purpose, will be carried out and then translated into a joint recommendation.

Joint ESR-EFOMP 'Medical Physics Experts working in Radiology'

This WG will meet and carry out their work online. The WG is ready to operate under the EFOMP Education and Training Committee from September 2024 and is expected to be completed by December 2025. The chair of the WG is Mika Kortesniemi (FIN).

The rationale of this WG is to update and adapt the core curriculum (CC) for Medical Physics Experts working in Radiology to the current and future needs of our profession. Recent advances in medical imaging, such as automation, big data analysis, artificial intelligence and personalised practices support the need for a further revision and development of a competence based Radiology CC. This revision is not only necessary to keep up with the rapidly-evolving field and to reinforce the scientific role of Medical Physicists but also to be in line with the European Commission (EC) guidelines on Medical Physics Experts (MPE). The WG also includes an ESR representative as a consultant. Once the Radiology Curriculum will be completed, EFOMP, in collaboration with the NMOs and affiliated organisations will investigate the possibility of developing a single combined curriculum for all MPE specialties.

Joint ESTRO-ESR-EANM-EFOMP 'Software as a Medical Device in Medical Physics'

The WG is ready to operate under the EFOMP Science Committee from November 2024 to November 2026. The chair of the WG is Christina Zacharatou (IRL).

The rationale behind this WG is that not many publications have appeared so far in the literature on the implementation of EU MDR 2017/745 in clinical practice. The Regulation is not always clear to interpret and many grey areas remain. European guidelines are needed to facilitate its clinical integration. EFOMP can help users by creating awareness and proposing the homogenisation of current practice and national recommendations.

Joint EANM-EFOMP

'Core curriculum revision for Medical Physics Experts working in Nuclear Medicine'.

The WG will operate from April 2022 to April 2024. The rationale of the WG is to update the latest core curriculum.

Read Core Curricula for Medical Physics Experts here: https://www.efomp.org/index.php?r=fc&id=core-curricula

'Quality controls in conventional and solid state detector gamma cameras'

The WG will operate under Science Committee from September 2023 to September 2025. The chair of the WG is Laetitia Imbert (France).

The rationale of the WG: The literature on routine Quality Controls procedures for conventional gamma cameras is out-of-date or no more valid. No quality control guidelines even exists for solid state gamma cameras (both dedicated cardiac cameras and more recently introduced general purpose cameras), which need a specific and dedicated approach in the definition of routine quality control tests. Thus, there is a demanding need for guidelines that identify a set of routine quality controls to perform on both up-to-date conventional and solid state detector gamma cameras. The set of quality controls devised should have the characteristics of being simple and easy to realize. Reference and tolerance values will also be defined. The execution of these QC would guarantee the operation of conventional and solid state detector gamma cameras under optimal conditions ensuring the best performance in routine clinical tasks.

Joint AAPM-EFOMP

AAPM/EFOMP 'Fetal Dose Considerations in Radiation Therapy' (TG36B).

EFOMP members: Michalis Mazonakis (GR) and Laura Shields (IR).

The rationale of this WG is to:

Provide an update on recommended methods of measurement or calculating fetal dose estimates.
Provide an update to literature review on fetal risks by gestational age and estimated dose levels.
Provide recommendations for medical physicists on the management of a pregnant patient related to RT treatment.

AAPM/EFOMP 'Radiation Oncology Contingency Plan Against Cyberattacks' (TG393).

Chair: Baoshe Zhang (AAPM) Vice chair Brendan McClean (EFOMP).

The charges support the implementation of contingency plan for a radiation therapy clinic to resume patient treatments within a reasonable timeframe, following a cyberattack that leaves institutional computing and network services compromised and/or unavailable.

The rationale of this WG is to:

Provide guidance in analyzing each clinical sub-system’s weaknesses and specifying clinical priority or impact of each clinical sub-system.
Provide recommendations and perspective to review and to determine the readiness of the clinical systems against cyberattacks and to prepare for readiness of contingency plan for each clinical subsystem.
Identify the nature and the severity of attacks and provide the minimum dataset to be prepared and recommendations on appropriate time period (hours or days) to recover from the attack per the levels of the attacks.
Provide the data backup strategies for contingency plan of each clinical subsystem.
Provide recommendations and strategy in rebuilding temporary clinical systems in case of cyberattacks and using the temporarily-rebuilt subsystems to resume radiotherapy treatment.
Provide guidance and strategy to verify corrupted clinical system and to recover corrupted clinical data.
Provide recommendations on how to restore patient data back to the main clinical system after restoration of institutional computation and network services.
Provide guidance to individual clinical practices in designing their own site-specific contingency plan from minimal to comprehensive.

AAPM/EFOMP 'Comprehensive quantification and dissemination of patient-model-based organ and effective dose estimations and their associated uncertainties for CT examinations' (TG430).

Chair Kai Yang (AAPM)

The rationale of this WG is to perform a comprehensive evaluation of organ dose and effective dose from CT utilizing a wide range of Monte Carlo simulation engines and whole-body CT data from real patients. Calculate the conversion factor (“k” factor) from dose-length-product (DLP) to effective dose using these realistic patient data and estimate the associated uncertainties. Make recommendations on a set of standard “k” factors, and their associated uncertainties, which can be used to calculate patient-model-based effective dose.

AAPM-EFOMP 'Technical Guidelines for the Use of Proton Therapy in Clinical Trials' (TG427).

Chair Stella Flampouri (AAPM) Vice chair Christian Rønn Hansen (EFOMP)

The rationale of the WG:

Outline physicist responsibilities to ensure compliance with study requirements
Provide proton practice trial recommendations to ensure minimum standards for treatment quality and parity between co-existent proton delivery modes
Recognize bias in multimodality trials and suggest mitigations
Propose standards for dosimetric and imaging data collection to maximize their value
Discuss the integration of emerging proton therapy technologies in future clinical trials.

AAPM-EFOMP 'Development of a new breast dosimetry phantom' (TG 323).

Chair Ioannis Sechopoulos (AAPM) Vice chair Ruben van Engen (EFOMP)

The rationale of the WG: To develop a new breast phantom that adequately queries the response of the automatic exposure control (AEC) mechanisms of digital mammography, breast tomosynthesis and contrast-enhanced digital mammography systems in a clinically realistic fashion.

AAPM-ESTRO-EFOMP 'FLASH (ultra-high dose rate) radiation dosimetry' (TG359).

Chair Dimitris Mihailidis (AAPM) Vice chair Yolanda Prezado (EFOMP)

The WG will review the uncertainty in determining the dose and need for standardization in dosimetry for FLASH beams to be used in experiments, research and potentially in pre-clinical applications.

Assess the factors that would affect the beam dosimetric characteristics in FLASH mode, compared to standard delivery.
Assess the suitability of radiation measurement equipment (ion chambers, film, diodes, Faraday cap, etc) for FLASH mode.
Provide general guidelines on calibration, dosimetry and reporting of beams in FLASH mode.

AAPM-EFOMP 'Invasive Cardiovascular X-ray Imaging' (TG389).

Chair Ken Fetterly (AAPM) Vice chair Hilde Bosmans (EFOMP)

X-ray angiography systems are used to diagnose and treat cardiovascular (CV) disease in adult and pediatric patients. Disease conditions commonly encountered in the invasive CV practice include arrhythmia, atrial fibrillation, chronic and acute coronary artery stenosis, and adult and pediatric structural heart disease. When imaging the vessels and devices within and near the heart, cardiac motion and rapid blood flow contribute to unique X-ray imaging conditions. Further, cardiovascular disease is treated with a variety of devices ranging in size from small to large compared to the spatial resolution properties of the X-ray systems. The purpose of this TG is to generate a Report describing imaging conditions unique to diagnosis and treatment of cardiovascular disease; technical considerations for X-ray angiography and fluoroscopy imaging; and recommendations to optimize relationship between image quality and patient radiation dose.

AAPM-EFOMP 'Recommendations for the safe clinical use of respiratory-correlated four-dimensional magnetic resonance imaging in radiotherapy' (TG391).

Chair Martin Fast (EFOMP), Vice chair Eric Paulson (AAPM)

Define the (minimum) requirements for the use of respiratory-correlated 4D-MRI acquisitions in radiotherapy, including considerations for scanner hardware, sequence parameterization, motion surrogate, and personnel and their roles.
Provide practical clinical implementation guidelines for 4D-MRI, including general and organ-specific protocol optimization and workflow recommendations.
Outline recommended RT-specific acceptance, commissioning, and periodic QA for 4DMRI on MR-sim and MR-linac based on early user experience.
Discuss potential future developments in 4D-MRI and their relevance to the RT workflow.

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