EFOMP policy statement 16: The role and competences of medical physicists and medical physics experts under 2013/59/EURATOM

Caruana, Carmel J.; Tsapaki, Virginia; Damilakis, John; Brambilla, Marco; Martin, Graham D.; Dimov, A.; Bosmans, Hilde; Egan, Gillian; Bacher, Klaus; McClean, Brendan

doi:10.1016/j.ejmp.2018.03.001

Cited by 25 publications

(22 citation statements)

References 9 publications

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“…The involvement of the medical physics expert (MPE) in standardized therapies entails mostly quality control of the treatment protocol, equipment used and radiation protection responsibility. Recommendations have been formalized by the European Federation of Organizations for Medical Physics (EFOMP) on the involvement of MPEs in radiation therapy; in the practice of standardized therapy, the MPE should monitor this practice regularly and be available on call at all times [7]. We recommend, however, that the MPE is closely involved in the initiation of a new radionuclide therapy for a clinical centre until sufficient routine is gained.…”

Section: Standardized and Non-standardized Nuclear Medicine Therapymentioning

confidence: 99%

“…For non-standardized therapies, a medical physics expert should be closely involved meaning to be member of the team that give advice on the therapy for the activity needed (either based on dosimetry or following a fixed activity prescription) and verification of the absorbed doses given in order to avoid acute cases of insufficient dose-coverage or excessive healthy tissue damage. According to the EFOMP [7], an MPE must be present at all times during the entire patient pathway, which does not always seem realistic in clinical practice. However, the MPE does need to be closely involved in the prescription and verification at initial and follow-up non-standardized nuclear medicine therapies.…”

Section: Standardized and Non-standardized Nuclear Medicine Therapymentioning

confidence: 99%

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EANM position paper on article 56 of the Council Directive 2013/59/Euratom (basic safety standards) for nuclear medicine therapy

Konijnenberg

Herrmann

Kobe

et al. 2020

Eur J Nucl Med Mol Imaging

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Executive Summary The EC Directive 2013/59/Euratom states in article 56 that exposures of target volumes in nuclear medicine treatments shall be individually planned and their delivery appropriately verified. The Directive also mentions that medical physics experts should always be appropriately involved in those treatments. Although it is obvious that, in nuclear medicine practice, every nuclear medicine physician and physicist should follow national rules and legislation, the EANM considered it necessary to provide guidance on how to interpret the Directive statements for nuclear medicine treatments. For this purpose, the EANM proposes to distinguish three levels in compliance to the optimization principle in the directive, inspired by the indication of levels in prescribing, recording and reporting of absorbed doses after radiotherapy defined by the International Commission on Radiation Units and Measurements (ICRU): Most nuclear medicine treatments currently applied in Europe are standardized. The minimum requirement for those treatments is ICRU level 1 (“activity-based prescription and patient-averaged dosimetry”), which is defined by administering the activity within 10% of the intended activity, typically according to the package insert or to the respective EANM guidelines, followed by verification of the therapy delivery, if applicable. Non-standardized treatments are essentially those in developmental phase or approved radiopharmaceuticals being used off-label with significantly (> 25% more than in the label) higher activities. These treatments should comply with ICRU level 2 (“activity-based prescription and patient-specific dosimetry”), which implies recording and reporting of the absorbed dose to organs at risk and optionally the absorbed dose to treatment regions. The EANM strongly encourages to foster research that eventually leads to treatment planning according to ICRU level 3 (“dosimetry-guided patient-specific prescription and verification”), whenever possible and relevant. Evidence for superiority of therapy prescription on basis of patient-specific dosimetry has not been obtained. However, the authors believe that a better understanding of therapy dosimetry, i.e. how much and where the energy is delivered, and radiobiology, i.e. radiation-related processes in tissues, are keys to the long-term improvement of our treatments.

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Section: Standardized and Non-standardized Nuclear Medicine Therapymentioning

confidence: 99%

Section: Standardized and Non-standardized Nuclear Medicine Therapymentioning

confidence: 99%

EANM position paper on article 56 of the Council Directive 2013/59/Euratom (basic safety standards) for nuclear medicine therapy

Konijnenberg

Herrmann

Kobe

et al. 2020

Eur J Nucl Med Mol Imaging

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“…Medical physicists across the world provide supporting roles in RT including administration, direct clinical services, equipment performance evaluation, quality assurance, safety, informatics, education and training, research, and service development [28,29]. In order to execute these tasks safely and efficiently, they have to operate in teams, supervise staff, provide consultation and in some activities face-to-face patient interactions.…”

mentioning

confidence: 99%

Evolution of clinical radiotherapy physics practice under COVID-19 constraints

Khan

Darafsheh

Goharian

et al. 2020

Radiotherapy and Oncology

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“…Practical experience has shown however that even if installation engineers and/or application specialists are willing to assist, they are not responsible for optimization tools applied to everyday clinical practice [23,84]. As the optimization process relies on a complex combination of equipment performance, protocol modification and staff behaviour, the role as well as knowledge and skills of the clinically qualified medical physicist becomes more crucial in this process and requires active engagement in the routine daily clinical environment [85][86][87]. As stated in the recent European Federation of Organizations for Medical Physics (EFOMP) statement, the diagnostic radiology medical physicist clinical activities should be to carry out, participate in and supervise everyday activities related to patient safety and quality to ensure on-going effective and optimised use of medical devices, including patient specific optimization, prevention of unintended or accidental exposures and patient follow-up [86].…”

Section: Discussionmentioning

confidence: 99%

Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives

Tsapaki

2020

Physica Medica

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The medical radiological imaging technological evolution and wide availability has resulted in the exponential increase in utilization. Evidence for a risk of cancer arising from radiation doses of lower than 100 mSv is still limited. There is a need for patient dose optimization. A literature review was conducted to identify the reasons why optimization is important and the steps to be followed for a successful optimization process in digital radiology, Computed Tomography, interventional radiology and mammography.Based on recent literature, 5 steps for a dose optimization process are proposed. These steps are: 1) establishment of a quality assurance programme; a mistake, misuse or malfunction of an X-ray machine can potentially affect the health or life of thousands of people, 2) establishment of a dose optimization team consisting of a radiologist, medical physicist and radiation technologist, 3) determination of baseline dose levels and image quality as well as comparisons with benchmarks to decide which exam protocols should be optimized, 4) modification of protocols by the medical physicist and 5) evaluation of the optimization process and its effect on patient dose and image quality.The optimization process should include joint efforts focused on 1) equipment performance 2) exam protocol customization and 3) staff behaviour. Manufacturers should provide detailed descriptions of exam protocols and training on the use of dose reduction features. The diagnostic radiology medical physicist should emerge and take a proactive lead in the everyday clinical routine in order to promote the value of optimization process.

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EFOMP policy statement 16: The role and competences of medical physicists and medical physics experts under 2013/59/EURATOM

Cited by 25 publications

References 9 publications

EANM position paper on article 56 of the Council Directive 2013/59/Euratom (basic safety standards) for nuclear medicine therapy

EANM position paper on article 56 of the Council Directive 2013/59/Euratom (basic safety standards) for nuclear medicine therapy

Evolution of clinical radiotherapy physics practice under COVID-19 constraints

Radiation dose optimization in diagnostic and interventional radiology: Current issues and future perspectives

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