EFOMP MP CoVID-19 Forum
In order to increase exchange of CoVID-19 information between medical physicists in Europe, EFOMP has set up a special MP CoVID-19 Forum. This is a moderated forum to be used by all medical physicists in Europe. Every contributor to the forum has his or her own responsibility for what is written. The following rules apply for use of the forum:
- All contributions to the forum must have to do with practical CoVID-19 situations in the hospital.
- Be brief.
- Be careful in what you write and use your scientific background.
- Share your own experience, especially positive experience.
- Practical advice is welcome.
- Advertisements for products or services are not permitted.
- Posts based on fake or falsified information are not permitted.
- Do not contradict others or governmental guidelines. In case of a possible misunderstanding, contact one of EFOMP’s officers.
- Do not scaremonger or engender chaos.
- An EFOMP moderator will examine the content of submitted posts and will thereafter approve or deny publication in the forum; it may take some hours before a post is published.
- The EFOMP moderator’s decision is final; EFOMP will not enter into any communication regarding posts for which publication has been denied.
- EFOMP reserves the right to edit submitted posts, to deny publication of a post, to remove a post after publication, or to close the forum as it sees fit.
The European Surface-Guided Radiotherapy Meeting will be held online at 12 noon on each Friday in November (6th, 13th 20th and 27th Nov).
The online conference will include a COVID19 related lecture on the 13th of November 2020: “Introducing hypo-fractionated breast radiotherapy during COVID-19 using Align-RT”, University Hospital Galway, Ireland.
Registration is FREE and available online at: Link
The session "DIBH AND MARKERLESS TREATMENTS" on Friday 13th, November, CET has been accredited by EBAMP as CPD event for Medical Physicists at EQF Level 7 and awarded 10 CPD credit points.
Dear colleagues,EFOMP and IAPM are inviting you to attend the 7th lockdown webinar.CT screening for lung disease has advantages and disadvantages. Advantages include early diagnosis of disease whereas an obvious disadvantage is the radiation dose to the asymtomatic patient. Ireland, like many other countries, has no National Screening Program for CT lung screening but considering lung cancer is a leading cause of death is there a need for CT lung screening? In light of COVID should CT lung screening be performed to identify positive cases faster than a lab test? Can a national program be set out while following the regulations set out in the Basic Safety Standards? What effective dose is received from screening CT?This EFOMP-IAPM lockdown webinar workshop aims to discuss these issues.The aim of the lockdown talks was to bring Medical Physicists closer together during the Covid-19 time and discuss new working arrangements and challenges in diagnosis and treatment, issues arising in our working environments, novel strategies applied and lessons learned that may improve our practices and services in the future.
IAEA webinar and article on Chest CT practice and protocols for COVID-19
by Jenia Vassileva, on 2020-08-04 09:34:11An article based on the pre-webinar survey and the IAEA webinar on CT practice and protocol optimization for COVID-19 has been just published in the journal European Radiology and is freely available under the Public Health Emergency COVID-19 Initiative:The webinar recording is also available from the RPOP webpage: https://www.iaea.org/resources/webinar/covid-19-and-chest-ct-protocol-and-dose-optimization
Mobile Chest X-Rays Through Glass - ACPSEM press release and publication
by David Lurie, on 2020-07-21 11:40:19X-RAYS THROUGH GLASS - A TECHNIQUE TO MINIMISE INFECTION WHILE TREATING COVID-19An innovative technique for performing mobile chest x-rays through glass has been outlined in a new study by Australian medical physicists in ACPSEM’s journal “Physical and Engineering Sciences in Medicine”. The ‘through glass’ method will help speed-up treatment rates and minimise infections during the COVID-19 pandemic.Chest x-rays are key in diagnosing and managing COVID-19 patients with respiratory symptoms. The ‘through glass’ method adds an extra layer of protection by allowing x-ray images to be taken through glass from outside a patient’s room. The evidence-based technique has recently been implemented at The Alfred and Sandringham Hospitals and has the potential to improve safety in medical facilities around the world.The study ‘Technique, radiation safety and image quality for chest X-ray imaging through glass and in mobile settings during the COVID-19 pandemic’ reveals that the time taken to perform a chest x-ray for COVID-19 patients is significantly reduced by avoiding a full disinfection of the x-ray unit, adding instantly and safely to available surge capacity in our hospitals.The risk to radiographers of infection is also halved by the ‘through glass’ technique. Instead of two radiographers being in the room with the infected patient, only one is required.While x-rays through glass have been used elsewhere, this study is the first to comprehensively review all the technical and safety aspects. “X-rays through glass provide acceptable image quality, maintain low radiation doses and minimise the amount of personal protective equipment (PPE) required,” said lead author and Alfred Health Chief Imaging Physicist, Dr Zoe Brady.The study also acts as a comprehensive ‘how to’ guide for others who want to implement the ‘through glass’ method into clinical practice. “We provide evidence on all aspects including image quality, technique and radiation safety,” Dr Brady said. “Our parameters will help other hospitals and facilities introduce the technique safely to help deal with a second wave of COVID-19.” This has led to substantial attention from the medical community, with thousands of downloads of the paper and international interest immediately following publication.Development and implementation of ‘through glass’ chest x-rays has been a multi-disciplinary effort by medical physicists, radiographers, radiologists and research staff all keen to make a difference. “As a medical physicist, I have a role to play in the pandemic,” said Dr Brady, “I am not a frontline healthcare worker, but by enabling the use of this technique I can ensure the quality of chest x-rays for COVID-19 patients and help keep my colleagues safe.”This story about accelerated, pandemic-driven innovation; through the dedicated work of medical professionals, and including the low profile but indispensable medical physicist, is good news in challenging times.The ACPSEM is the professional body supporting medical physicists, scientists and engineers in Australia and New Zealand.For comment and further information contact:Dr Zoe Brady, Chief Physicist, Alfred Radiology and Nuclear Medicine Department and Radiation Safety Officer, Alfred HealthPh: +61 (3) 9076 2368Z.Brady@alfred.org.auSharon Flynn, CEO, ACPSEMPh: +61 (2) 8305 3909Mob: +61 0408463469Sharon.Flynn@acpsem.org.auwww.acpsem.org.auRead the full paper here:Brady, Z., Scoullar, H., Grinsted, B. et al. Technique, radiation safety and image quality for chest X-ray imaging through glass and in mobile settings during the COVID-19 pandemic. Phys Eng Sci Med (2020) https://link.springer.com/article/10.1007/s13246-020-00899-8
Lessons learned in radiotherapy physics during the Covid-19 pandemic
by Catharine Clark, on 2020-06-29 23:08:39Dear colleagues,
The ESTRO Physics committee invites you to take part in a survey to gather the lessons learned in radiotherapy physics during the Covid-19 pandemic of 2020. The results will be used for a symposium at ESTRO 2021 in Madrid, where the experiences and solutions which have come out of the pandemic, in terms of how radiotherapy physics coped, will be discussed.
We would like to gather all experiences (both good and poorer) from all physicists working in radiation oncology, so multiple physicists may answer from the same institution and the responses will be anonymous.
It would be helpful if you can answer the questions as fully as possible, however no question is mandatory. The questions have been divided into sections on demographics, organisation of the department, changes in practice, morale and mental health and impact for the future. There are 39 questions in total and most are tick box responses and we estimate that it takes 20 minutes to answer all the questions.
The survey will be open until 12th July. Click on the link below to take part in the survey.
Thank you for your participation in this survey and stay safe
The ESTRO Physics Committee
Dear Colleague,Re: GENDER AND WORK FROM HOME DURING COVID19 SURVEYWe invite you to participate in a survey that aims to collect data about the main issues that biomedical engineers and medical physicists (academics and professionals) and other related STEM professionals are facing when working from home in the current pandemic COVID-19 situation.The survey is being conducted by the Women in Medical Physics and Biomedical Engineering task group of International Union for Physical and Engineering Sciences in Medicine (IUPESM). We strongly encourage you to complete the questionnaire so that we can identify how our workforce has been affected by the working from home situation. Every response will help maximize the statistical power of the study. The data collected will be non-identifiable. Our intention is to publish the results as well as present at relevant conferences. It will take you ~10-15 minutes to complete the survey.Analyzed data will be presented at relevant professional conferences and in a publication.This research has been cleared by Carleton University Research Ethics Board-B (CUREB-B Clearance #112898), under the study title: GENDER AND WORK FROM HOME DURING COVID19 SURVEY.All medical physicists, biomedical engineers and other STEM scientists in academia or clinics over the age of 18 are eligible to participate. Participation is completely voluntary and there is no remuneration offered for your time.We at IUPESM care about your privacy and are committed to protecting your personal information in accordance with fair information practices and applicable data privacy laws. The privacy notice is included in the survey’s introduction.As part of this survey, data is only visible to the survey administrator and all records are anonymized during collection. Please note that we are not asking for your personal contact details.The non-personal data will be aggregated to provide broad demographic information, such as the geographic location of participants. Collecting this type of information allows us to analyze trends and statistics and provide better service and security.If interested, please use this link to participate, or use the QR code:Welcome and thank youWinMPBME task group
Change of time for final lock down lecture: "The new normal for medical physics keeping yourself and your patients safe now 12 PM CET/11 am GMT
by paddy gilligan, on 2020-06-25 15:54:24Apologies we have had to move this lecture one hour earlierEFOMP/IAPM are delighted to announce the final lockdown webinarWhen: Jun 30, 2020 11:00 AM London, 12 PM CET
Topic: The new normal for medical physics keeping yourself and your patients safeProf Martin Cormican (Professor of Bacteriology @NUI Galway)
Consultant Microbiologist National Clinical Lead for HCAI and AMR.Register in advance for this webinar:
Meeting ID: 934 2643 3758
After registering, you will receive a confirmation email containing information about joining the webinar.
Prof. Martin Cormican, Professor of Bacteriology at NUI Galway, Consultant Microbiologist and member of NPHET’s Expert Advisory Group is the HSE National Clinical Lead for Infection Prevention and Control. The Irish Government is basing decisions on COVID-19 crisis management on the advice of the National Public Health Emergency Team (NPHET) of which Prof Cormican is a key member.
after 13th June 2020 Lockdown lectures recordings may only be available through EFOMP educational platform
by Paddy Gilligan, on 2020-06-11 11:38:03Dear All, for licencing reasons the goto recordings link may expire on the 13/6/2020 so after that date the recordings may only be available through the EFOMP educational platform . To access the platform you will need to become an individual associate member you will find details here :stay safe
Question on cleaning/disinfection of hand-foot-monitor
by Evangelia Dimovasili, on 2020-06-09 18:01:06Dear All,Is there anyone who might be able to provide instructions on how to clean and disinfect hand-foot radiation monitors? Information about BERTHOLD and/or SAPHYMO models in particular, would be highly appreciated!Many thanks and best regards,Evangelia
3D printing of face shields for the COVID-19 emergency in Serbia. A practical support from the medical physicists of the radiotherapy department in the Oncology Institute Vojvodina, Sremska Kamenica, Serbia. Read the article
Influence of the pandemic dissemination of COVID-19 on radiotherapy practice
by Ralf Mueller-Polyzou, on 2020-05-22 07:35:16Dear all, we would like to share our paper just published at PLOS ONE (open access):Influence of the pandemic dissemination of COVID-19 on radiotherapy practice: A flash survey in Germany, Austria and Switzerland
EURADOS (European Dosimetry Group) has issued recommendations as a guide for the operation of Individual Monitoring Services (IMS), Calibration Laboratories and other stakeholders involved in dosimetry during the COVID -19 pandemic.It is recognized that the situation is different in each country ant that the situation will evolve at different rates for the stakeholders over the next months.Recommendations
IAPM EFOMP Lockdown Lecture 5: Implementing a system for automated, remote quality assurance in CT, Radiography and Mammography
by Paddy Gilligan, on 2020-05-06 15:17:14Lockdown lecture 5:Implementing a system for automated, remote quality assurance in CT, Radiography and Mammography: Erik Teselaar, Linköping University Hospital, Sweden.Irish Experience of Remote Centralised Monitoring in Screening Mammography, Liz Keavey, Irish Breast Screening Servicein combination with the International Medical Physics Week by IOMP, 11th-15th May, 2020 .
Recording now available :Lock Down Lecture 4 :Radiotherapy Physics during the pandemic: Short term changes and longer term possibilities.
by Paddy Gilligan, on 2020-05-06 13:17:13
Prof Brendan Mc Lean and Prof Holger WirtzThe recording is now available at this link and it will be available for EFOMP individual associate members on the Educational platform
IAPM/EFOMP Lock Down Lecture 4 :Radiotherapy Physics during the pandemic: Short term changes and longer term possibilities.
by Paddy Gilligan, on 2020-04-29 15:52:36Dear all, Hope you are safe and well , please join us for:IAPM/EFOMP Lock Down Lecture 4 :Radiotherapy Physics during the pandemic: Short term changes and longer term possibilities.Join us for a webinar on Tuesday May 05, 2020 at 11:00 AM IST. 12:00 pm CETProf .Brendan McClean , Director of Physics at St Luke’s Radiation Oncology Network in Dublin, Ireland and Vice Chair of EFOMP scientific committee..After registering, you will receive a confirmation email containing information about joining the webinar.
Recording of IAPM/EFOMP Lockdown lecture 3: SAR vs SARS, MRI and PPE in the time of Covid now available
by Paddy Gilligan, on 2020-04-28 15:05:00Dear All,A Recording of IAPM/EFOMP Lockdown lecture 3: SAR vs SARS, MRI and PPE in the time of Covid is now available at this link:and also will be available on the EFOMP elearning platform for Individual Associate Members
A preprint publication on UVC disinfection as an effective, safe and scalable method for reuse of surgical facemask and respirators.If you have UV-C desinfection capabilities and a shortage of mask/respirators this might be of interest to you.
Second MPWB sponsored webinar: International Medical Physics Guidelines for COVID-19
by David Lurie, on 2020-04-23 10:11:22The first COVID-related webinar sponsored by Medical Physics for World Benefit (MPWB) was entitled “COVID-19-Related Issues: A Medical Physics Perspective from Italy” and was presented by Antonella del Vecchio from the Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy. The webinar was extremely well received with nearly 700 attendees. The video recording remains available through www.mpwb.org. In the post-webinar survey, 95% of the respondents indicated that they would be interested in a follow-up webinar. To this end, MPWB is hosting a second webinar entitled “International Medical Physics Guidelines for COVID-19.” The Asia-Oceania Federation of Medical Physics (AFOMP) has developed guidelines on Radiation Oncology Operation during COVID-19. These can be found here:http://afomp.org/wp-content/uploads/2020/04/AFOMP-RT-guideline-COVID-April4.pdf. The Australasians have also developed guidelines that can be found here:https://link.springer.com/article/10.1007/s13246-020-00869-0.Two main contributors to these reports will present an overview of Medical Physics considerations for dealing with the COVID-19 pandemic: (1) Dr. Xiance Jin, PhD, Chief Physicist and Vice Director, Wenzhou Medical University First Hospital, Wenzhou, China, and (2) Tomas Kron, PhD, Director of Physical Sciences, Peter MacCallum Cancer Institute, Melbourne, Australia. The session will be moderated by Parminder Basran, Director of Communications for MPWB. The time for this webinar will be more friendly towards the eastern world but, of course, everyone is invited to attend:Date: Wednesday 29 April 2020.Time: 7:00 am Eastern Daylight time (11:00 am UTC; 1:00 pm Central European time; 2:00 pm Asia Standard time; 4:30 pm India Standard time; 7:00 pm China Standard time; 9:00 pm Australian Eastern Standard time; 4:00 am Pacific Daylight time) The registration link for the webinar is here: https://attendee.gotowebinar.com/register/7910895308807531278Once registered, an automatic e-mail will be sent from “AAPM Webinar” providing a direct connection to the webinar. Questions can be submitted in advance here: firstname.lastname@example.orgThe webinar will be video recorded with a link provided on the www.mpwb.org website._________________Thank you for your consideration!JakeJacob (Jake) Van Dyk, MSc, FCCPM, FAAPM, FCOMP, DSc(hon)Professor EmeritusDepartments of Oncology and Medical BiophysicsWestern UniversityLondon, Ontario, Canada
RECORDING OF LOCKDOWN LECTURE 2 ,Webinar IAPM /EFOMP “ A primer on ventilators and organ support systems for medical physicists during the COVID crisis”
by Paddy Gilligan, on 2020-04-22 13:48:32The recording for Webinar IAPM /EFOMP “ A primer on ventilators and organ support systems for medical physicists during the COVID crisis” is now available on the EFOMP elearning plaform :and directly from goto webinar:regardsPaddy
IAPM/EFOMP Lockdown lecture 3: SAR vs SARS, MRI and PPE in the time of Covid,
by Paddy Gilligan, on 2020-04-22 13:26:59Dear All, as most of us are still locked down we are running the next lecture in our series next tuesday Apr 28, 2020 at 11:00 AM BST.IAPM/EFOMP Lockdown lecture 3: SAR vs SARS, MRI and PPE in the time of CovidJoin us for a webinar on Apr 28, 2020 at 11:00 AM IST.IAPM/EFOMP Lockdown lecture 3: SAR vs SARS, MRI and PPE in the time of Covid, Dr. Nigel Davies,
Lead MRI Physicist at University Hospitals Birmingham NHS , UK,
Dr. Niall Colgan, NUI Galway IrelandAfter registering, you will receive a confirmation email containing information about joining the webinar.
COVID-19 associated pulmonary infiltrates observed on CBCT
by Mirjana Josipovic, on 2020-04-17 15:51:04
Webinar IAPM /EFOMP “ A primer on ventilators and organ support systems for medical physicists during the COVID crisis”
by Paddy Gilligan, on 2020-04-17 14:42:31After over four hundred registrations for our first event IAPM / EFOMP are pleased to announce our second lockdown lecture, “ A primer on ventilators and organ support systems for medical physicists during the COVID crisis” given by Fran Hegarty Chief technical officer , new children’s hospital , Dublin Ireland. The lecture will take place on Tuesday 21st, April at 11am BST .Registration on goto webinarThe lecture will be recorded and made available via the efomp website after the event
The German Society for Medical Physics has published a collection of information on COVID-19 topics related to medical physics on their homepage:Although much of the information is in German, there is a link to an English article published in Radiation Oncology entitled "First statement on preparation for the COVID-19 pandemic in large German Speaking University-based radiation oncology departments" by Combs et al.:https://ro-journal.biomedcentral.com/track/pdf/10.1186/s13014-020-01527-1
Mark Ladd, President of the German Society for Medical Physics (DGMP)
IAPM-EFOMP webinar on “Risk Assessment for Mobile Radiography Outside Intensive Care Units”
by Efi Koutsouveli, on 2020-04-16 07:30:36The webinar was the first of a series of talks to bring Medical Physicists closer together during this COVID19 pandemic. EFOMP invites National Member Organisations to participate and contribute to the discussions by sharing their practices.A link of the joint IAPM-EFOMP informative webinar recording held on Tuesday 14th of April is accessible here: View the recordingTo access the video recording, please complete the registration process and you will then be immediately directed to the video.Please send your comments and suggestions to email@example.comPaddy Gilligan, Efi Koutsouveli, David Lurie
COVID-19-Related Issues: A Medical Physics Perspective from Italy
by Efi Koutsouveli, on 2020-04-14 22:33:57Medical Physics for World Benefit is hosting a webinar on COVID-19 related issues on 15 April 2020, 15:00 CET.The webinar will enable participants to learn from the experience of the Medical Physics Department in Milan, Italy. The discussion will be led by Antonella de Vecchio from the Department of Medical Physics, San Raffaele Scientific Institute, Milan, Italy and chaired by Parminder Basran, MPWB.Registration link: https://lnkd.in/gcPCC3a.
This might be of interest to some EFOMP members.COVID-19 Pandemic: Guidance for Nuclear Medicine Departments
IAPM lockdown lecture available via goto webinar to EFOMP members
by Paddy Gilligan, on 2020-04-09 09:53:41we have been able to put this talk on Goto webinar so we have opened this Lockdown Lecture up to EFOMP members. See Details below:Please register for Risk Assessment for Mobile Radiography Outside ICU- Dr. Lynn Gaynor, Beaumont Hospital, Dublin Ireland on Apr 14, 2020 11:00 AM IST/ 12:00 pm CET at:After registering, you will receive a confirmation email containing information about joining the webinar.Thanks to Shane Foley, UCD and EFRS colleague for helping me with thiskeep well and safePaddyBrought to you by GoToWebinar®Webinars Made Easy®
IAPM are about to trial our first lock down lecture in Ireland by Dr. Lynn Gaynor from Beaumont Hospital on "Mobile Radiography Risk Assessment outside the icu on the 14th April at 11 am via the zoom app. it will also give us the chance to get in touch through this crisis and see what others have in place. It looks like we have a good response already. This is something worth thinking about for other NMOs and if successful at EFOMP level.
Here is some CoVID-19 information found on IOMP's website:https://www.iomp.org/who-medical-devices-april-2020-newsletter/
Words of appreciation for the contribution of medical physicists are spoken in Scottish Parliament by Scottish First Minister Nicola Sturgeon [see https://www.youtube.com/
watch?v=hNYzTakw9yw4’48”]. The following words (translated in English) can be found in a recently (30 March 2020) published formal document by the Dutch Ministry of Health: “I very much appreciate the involvement of these parties. Experts (intensivists, medical physicists and medical technologists) assess whether the equipment offered is (or can be made) suitable for use in the IC beds.” In both countries the number of beds in the Intensive Care Units for COVID19 patients has been tripled with the help of medical physicists who have worked non stop to make this happen.
IAEA webinar on COVID-19 and chest CT (protocol & dose optimization)
by Efi Koutsouveli, on 2020-04-02 20:27:55People affected by COVID-19 may need to undergo multiple chest CT scans. In the webinar best practices for chest CT, including scan parameters and related radiation doses will be presented on April 9, 2020.
IPEM have published a special page on their web site, containing a wide range of information:https://www.ipem.ac.uk/ScientificJournalsPublications/IPEMStatementsandNotices.aspx?f24_pid=4cd42711-5182-4596-8486-427a05fc6afe&utm_campaign=All%20Member%20email&utm_source=force24&utm_medium=email&utm_content=textlink
Dear Bart we have looked at a few facemasks.
The 3M FFP3 1863 , Kolmi FFP2 and FFP3 masks showed torque and artefacts. The Kolmi FFP2 and FFP3 and were associated with considerable artefact on GRE images. Like yourselves the Halyard FFP2 mask did not exhibit evidence of ferromagnetism and produced
only minimal artefact on GRE imaging. The standard disposable Dalhousie surgical mask, which has some aluminum showed no signs of ferromagnetism with minimal local artefact. A number of physicists in other departments have looked at these too (particularly in the U.K. on the MRI physics disucssion group ) and may add to the list.RegardsPaddy Gilligan
Hello,Is there any information about MRI compatible masks (IIR/FFP2/FFP3), concerning artifacts, forces, and heating?In our deparntment we tested 2 two types ourselves and concluded:
Kind regards,Bart VermolenHospital Gelderse Vallei, The Netherlands
- Halyard PFR P2, 62408 (FFP2)
- No artifacts detected, no noticeable forces and no noticeable warming
- Halyard Fluidshield 2, 62115 (IIR)
- Artifacts are detected
Fast track individual patient ventilation for protection of medical workers in a Covid-19 crisis scenario
by Jim Patel, on 2020-03-29 18:58:36Strategy to protect medical workers from airborne virus. Individual ventilated hoods for hospital beds. Extracted air purified by passage through a HEPA filter. Details here.
Hi All,These documents are information I have found through the IPEM communities (UK) which may be useful to other hospitals.BNMS guidancehttps://cdn.ymaws.com/www.bnms.org.uk/resource/resmgr/news_&_press_office/news/26-03-2020_nuclear_medicine_.pdfNM preparations article:https://journals.lww.com/nuclearmedicinecomm/Fulltext/2020/04000/COVID19__Nuclear_Medicine_Departments,_be.1.aspxLetter Re: Techngeashttps://higherlogicdownload.s3-external-1.amazonaws.com/IPEM/Technegas%20and%20COVID-19%20letter%20(NM).pdf?AWSAccessKeyId=AKIAVRDO7IEREB57R7MT&Expires=1585237433&Signature=EsvP73p%2BHvcffUg9LwcRjyPImug%3Dand this post Re: RAI18/03/2020
Thyroid Cancer: Radioactive Iodine Treatment during COVID19 pandemic
In these unprecedented times we have been considering how to optimally manage our patients with differentiated thyroid cancer. We have put together the following guidance taking in to account both the risk patients face from cancer and from infection.
We recommend that all radioactive iodine treatments be halted during the COVID 19 pandemic based on the following rationale:
Low risk patients: (adjuvant setting)
- A delay in RAI is not expected to alter prognosis from DTC.
- This cohort of patients are expected to be cured and should they fall ill with severe COVID19 infection whilst radioactive their care and subsequent prognosis may be compromised.
- Once the COVID19 situation resolves, some of the patients who have had their treatment delayed may be suitable for 1.1GBq as an outpatient, thereby taking some demand off inpatient isotope facilities.
High risk patients (metastatic disease):
- The risk/benefit scenario in these clinical situations are harder to determine.
- This cohort are likely to have longer radiation protection restrictions following RAI and are also at higher risk for COVID19 infection. If a patient in this situation was to fall ill with COVID19 whilst radioactive their immediate care may be detrimentally affected.
We must also take in to account the service delivery aspects of patient care.
Resources (Staffing, room availability, supply chain):
- Most centres have limited numbers of clinical scientists able to administer, monitor, scan and calculate radiation protection restrictions. With likely imminent reduced staff levels it may not be safe to administer radioactive substances.
- With widespread travel restrictions and the potential for staff shortages affecting drug manufacture, it is uncertain if our RAI supply chain will be affected.
The recommendations have taken in to account discussions amongst UK thyroid cancer clinicians as well as general COVID19 oncological advice at local and national levels.
Recommendations will be kept under review.
Professor Jon Wadsley, Consultant Clinical Oncologist, Weston Park, Sheffield. Chair NCRI Thyroid Cancer Subgroup
Dr Laura Moss, Consultant Clinical Oncologist, Velindre Cancer Centre, Cardiff. Thyroid Cancer Forum-UK Director
Strategy for handling treatment gaps during COVID-19 - Herlev Hospital (DK)
by Eva Samsøe & Jens Edmund, on 2020-03-26 12:37:30Thank you for sharing your strategy for treatment gaps, Colin Kelly. Our local strategy for handling long treatment gaps during COVID-19 very much resemples yours with the addition of Table 3 in Gay et al. Practial Radiation Oncology (2019) 9, 305-321. This paper - also referenced by ESTRO - descripes the handling of the crisis during the hurricane Maria in Puerto Rico 2007. Currently, we are collecting a document describing the use of hypofractionated regimes, where it makes sense, categorized according to level of crisis (percentage of staff left). Here are our references in the document concerning long treatment interruptions (I will link if/when the document is online - it will, however, be in Danish):
 Gay et al. Practical Radiation Oncology (2019) 9, 305-321
 Higgins et al. “The timely delivery of radical radiotherapy: guidelines for the management of unscheduled treatment interruptions”, 4th edition, The Royal College of Radiologists (2019)
 Dale et al. Clinical Oncology (2002) 14, 382-393
 “Basic Clinical Radiobiology”, 4th edition (2009), M. Joiner and A. van der Kogel (editors).
 Marks et al., IJROBP (2010) 76(3), S10-S19 (QUANTEC)
 Ray et al. Clin. Oncol. (R Coll Radiol) (2015) 27(7), 420-6
 Whelan et al Semin Radiat Oncol (2008) 257-64
 Brenner et al. IJROBP (2002) 52(1), 6-13
 DAHANCA radiotherapy guidelines (2019) https://www.dahanca.oncology.dk/assets/files/GUID_DAHANCA%20Radiotherapy%20Guidelines%202019.pdf/ES, JME 20-03-2020
Clinical guide for the management of cancer patients during the coronavirus pandemic
by Chryssa Paraskevopoulou, on 2020-03-25 16:37:41
Other useful (pre proof) publications on covid-19 and radiotherapy
by Albert Lisbona, on 2020-03-25 15:28:58
The impact of Coronavirus (COVID-19) on head and neck cancer patients’ care
by Albert Lisbona, on 2020-03-25 14:19:09
See there part of the response from ESTRO
Dear ForumI am just wondering is there any consensus emerging concerning COVID 19 patients returning for radiotherapy after gaps of 1-3 weeks for either testing or treatment.Here we are using the UK RCR guidelines form 2008 with some amendments as follows:
1a1b2a2b3SCC Head&NeckHead&Neck (non SCC)BrainProstatePalliativesCervixGravesStereoPaediatricsMedulla blastomaLungTBIPNETBreastPre-op OesOes post opCBURectumPre-Op RectumBladderSCC’sExtremitiesRepop Factor K0.90.70.70.058Repopul Time28252534I would appreciate any comments either on or off the list.
- Use the conventional formula to calculate BED i.e. )
- Discuss with RO whether they want to match normal tissue toxicity for a particular OAR or original treatment prescribed dose
- Determine salvage course which will probably involve bi-dailies and/or weekend treatments
- We have decided not to change the dose per fraction but to stick with that of the original treatment intent
- For the time facto K and the repopulation time we are using the values set out below.
RE: For your information: Fast volume chest CT protocol used in HUS Finland
by Mika Kortesniemi, on 2020-03-25 09:41:43Due to some further questions which I have received on the fast volume chest CT protocol, here are some remarks which might be useful:
- Overall context: There are various CT scan protocols and imaging options which can be used for this patient group (=poorly or non-co-operative intensive care patients in chest CT scan) but this is what we chose to use primarily in this case. Other indications and co-operative patients are typically examined with other protocols and imaging methods.
- Patient orientation: Feet first was used to facilitate the patient access and scan preparations with intensive care patients with related instruments and tubings, and also to facilitate possible further contrast enhanced scan if that is needed for overall clinical status and indications.
- Radiation exposure: We have seen CTDIvol typically within a range of 3 to 9 mGy (depending on patient size & attenuation, we also tested the protocol with anthropomorphic phantom). The scan length is typically about 30 cm (again, varying a lot depending of the patient anatomy) which indicates a DLP ranging from about 100 to 300 mGycm. In terms of effective dose, this indicates that the exposure should be well below 5 mSv, typically 2-4 mSv.
- Scan parameters: It is important to notice that optimal scan parameters may (and will) vary between different vendors and scanner models. Furthermore, in each imaging organisation, the clinical image quality must be adjusted to satisfy radiologists preferences and requirements on each site. Thus, optimal scan parameters may involve:
- different reconstruction options (including anatomical DFOV options, selection of kernels and levels of iterative reconstruction - or more recently, deep-learning based reconstruction)
- application of organ-dose-modulation
- spectral optimisation (e.g. use of tin-filtration if applicable)
- ultra-fast scanning with dual-source or wider detector scanner models
- different number of localiser radiographs (1 or 2 scouts/topograms) and their order and projection angle (effecting ATCM and helping patient centering)
- ...and other scanner specific technical optimisation tools.
Italian experience of a running radiation oncology during the Coronavirus pandemic
by David Lurie, on 2020-03-23 12:22:06The following article has just been published in Advances in Radiation Oncology by Krengli, Ferrara, Mastroleo, Brambilla and Ricardi:"Running a Radiation Oncology Department at the time of coronavirus: an Italian experience"The article, which is Open Access, can be found at: https://doi.org/10.1016/j.adro.2020.03.003
For your information: Fast volume chest CT protocol used in HUS Finland
by Mika Kortesniemi, on 2020-03-23 10:38:41For your information, we prepared the following modification of the volume HRCT protocol to enable fast lung scan for non-co-operative patients, primarily now thinking of covid intensive care cases (mainly for our Siemens Definition Edge/Flash/AS scanners, but also GE is referenced):
Please, note that this only for information of our local protocol. I will gladly receive comments or suggestions for improvements on this.Best regards, stay healthy,Mika
- no IV contrast used in this scan.
- Patient in feet first supine position.
- Two topograms: 1st craniocaudal lat, 2nd caudocranial top, followed by craniocaudal spiral scan.
- DFOV limited tightly to bony chest.
- Rotation time: 0.28-0.33 s or based on scanner model; as fast rotation as feasible considering tube limits.
- Tube-voltage: 120 kV (140 kV only with very obese patients) to keep it simple
- ATCM (mA-modulation): Siemens QRefmAs 110-140 depending on model (QRefmAs 110 with new Stellar detector scanners. With GE scanners: NI 30 HU (set for 0.625 mm primary recon).
- Pitch: Siemens 1.2; GE 1.0. Aiming to fast scan but considering tube limits.
- In this scan, we are quite conservative with iterative recon, but of course that's according to radiologists preferences.
- Archived images:
- Lung window images: Siemens kernel = B50f medium sharp; GE kernel = Bone Plus: axial, sagittal, coronal images with 1 mm thickness (or thinner) with same interval.
- Mediastinum window images: Siemens kernel = B30f medium smooth; GE kernel = Standard: 3 mm thick axial images with same interval
Global challenge for the fast development of ventilators to treat COVID-19
by ennomotive, on 2020-03-20 12:32:51Ennomotive has launched a non-profit online competition for the ideation of low-cost, easy-to-build solutions. The goal is to speed up the availability of ventilators in hospitals everywhere to help patients with coronavirus.The number of people affected by the pandemic doubles every three days in many countries. Since 20% of patients are hospitalized and 5% need to be admitted to an ICU, the demand for ventilators is sky-high.Ennomotive has joined other international initiatives for the development of easy-to-build ventilators and makes its global community of 20,000 engineers available to face the challenge.Based on its experience, ennomotive has chosen to focus on solutions that can adapt or reuse widely used standard industrial components or that use other easy-to-access and universal everyday-life elements.This online challenge is open worldwide to any engineering professional, company, tech center, maker or scholar from different industries and technical backgrounds that want to propose a solution for this challenge. The final goal is to make a key contribution to the fight against the COVID-19 pandemic.The solutions resulting from this challenge will be open to the public and ennomotive will fund the development of the best prototypes in the next round. Given the urgency, the first deadline for submissions is the 25th of March.
Red journal preview article from Italy concerning radiotherapy
by Albert Lisbona, on 2020-03-20 10:27:55
To consider the Belgian therapeutic treatment for the new CKV virus that causes Covid 19, which was published yesterday on 16-3-2020, containing recommendations from Italy, Sweden and the Netherlands. This reference is the most important:
ACR published recommendations concerning the use of CT to screen or diagnose COVID-19 infection: https://www.acr.org/Advocacy-a
nd-Economics/ACR-Position-Stat ements/Recommendations-for- Chest-Radiography-and-CT-for- Suspected-COVID19-Infection
Webinar concerning COVID-19 related infrastructural problems in Dutch hospitals
by Ad J.J. Maas, on 2020-03-17 17:50:19Tuesday 17 March, a webinar was held among 100 MPEs working in hospitals in the Netherlands. Dutch MPEs have a responsibility concerning the availability and quality of medical equipment. The influx of seriously ill COVID-19 patients causes problems for the capacity of IC wards. This capacity is mainly limited by the availability of ventilators and hemodialysis or CVVH equipment. Several solutions were given how to increase the availability of these apparatus in order to increase IC capacity.The main warning was: be prepared and take your measures now!
Recommendations published by the French Society of Radiation Oncology (SFRO), the National Union of Radiation Oncologists (SNRO) and the French Society of Medical Physics (SFPM) for use by professionals working in the Radiation Oncology field.You can find the guidelines (in French) at the website of SFPM:
Read the message of the President of EFOMP, Dr. Marco Brambilla, about the COVID-19 virus.
EFOMP has set up this forum in order to facilitate information exchange between medical physicists concerning the CoVID-19 crisis. In view of the speed of communication exchange, EFOMP refrains from directly checking the published information. None of the information shared in the forum is the responsibility of EFOMP, nor does it reflect the views of EFOMP or its Officers. EFOMP reserves the right to remove posts that do not follow the posting rules or which may be considered as aggressive, racist or insulting to an individual or to a group of people.