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					                  REPORT TO THE AAPM RADIATION THERAPY COMMITTEE
Report No. 114                                                                         October 1, 2002, - February 28, 2003

PERSONNEL                                                      points of contact for the study groups. ITC and RCET
Mary Lou Lesseraux, the Department Administrator for the       function as developers of tools that facilitate interaction
Section of Outreach Physics, retired from M.D. Anderson at     with the study groups by the other three subcontractors. An
the end of January 2003. Mary Lou has been with Outreach       Executive Committee has been formed and is expected to
Physics and with the RPC with many years and has made          meet in April.
enormous contributions. She will be missed, but her
presence at the RPC will be felt for a long time.              Recent activities of the RPC with regard to the ATC include
                                                               implementation of ITC-RCET software tools for electronic
Dorene Biagas, MBA, began as the Department                    transmission of images and treatment plan information for
Administrator for Outreach Physics as of March 3, 2003.        external beam and brachytherapy. In particular, we are
Ms. Biagas brings a wealth of experience with the              investigating the use of these tools for HDR treatment plans
Department of Radiation Physics, where she has been Office     and for LDR GYN plans. Both RPC and QARC credential
Manager for three years. She also has training and             institutions to participate in prostate brachytherapy trials.
experience in financial management.                            We have agreed on reference cases to be performed by the
                                                               institutions, as well as a procedure for evaluating the
A medical physicist, Paola Alvarez, MS began working with      information provided by the institution. We are holding
the RPC in September 2002. She has undergoing several          ongoing discussions on specific issues regarding the
months of training with other RPC physicists, and has made     maintenance of these credentials. In addition, discussions
one supervised visit to a participating institution. The RPC   have been held regarding the use of the QARC IMRT
presently is fully staffed.                                    benchmark plan. The RPC has recently performed the bench
                                                               mark plan and also has reviewed the procedures for
Jackeline Esteban, Malcom Heard, Gary Fisher and Joao          evaluating an institutions submission.
Borges are graduate students who began working with the
RPC during the last year. Seungsoo Lee, Ph.D. is a post-       The ATC will support a phase III protocol under
doctoral fellow who joined us last summer.                     development at NSABP for partial breast irradiation. This
                                                               protocol will compare conventional tangential beam
GRANT ACTIVITIES                                               treatment with conformal/IMRT external beam therapy and
The RPC major grant began its fourth year of the current       HDR brachytherapy.
five year cycle on January 1, 2003. We anticipate preparing
the application for competing renewal later this year, and     Last summer the NCI published guidelines addressing the
anticipate an NCI site visit early next year.                  use of IMRT in clinical trials. The guidelines stated that
                                                               IMRT may not be used to treat patients on clinical trials
The Advanced Technology for Radiation Therapy grant to         unless the protocol specifically permits or requires the use
Washington University in St. Louis has been renewed. The       of IMRT. IMRT may not be used to treat lung cancer
grant period will be five years and began July 1, 2002.        patients on clinical trials. Protocols that required IMRT,
Funding to the RPC is reduced somewhat from previous           such as the RTOG H-0022 protocol, may require that
years. In addition, the grant is structured differently than   institutions irradiate a phantom provided by the RPC. The
before, with five entities as subcontractors: the RPC, ITC,    guidelines can be found on the RPC website.
RCET, QARC, and the RTOG QA office. These
subcontractors form the Advanced Technology Consortium         As part of the ATC discussions, the proposal was made that
(ATC). The ATC last met face-to-face in Providence, Rhode      RPC include on its website each participating institution‟s
Island on November 19-20, 2002. Recent meetings have           credentialing status. A list of monitored institutions is
been by monthly conference calls.                              available on our website. Clicking an institution‟s name
                                                               brings up a list of equipment. An additional page lists
The ATC continues to function according to the following       details of the institutions protocol credentials. We anticipate
structure: the RPC, QARC and RTOG are the principal            that a password would be required to view these details. Our
RPC Report to the AAPM Radiation Therapy Committee                                                        Page 2 of 12
Report No. 114


clinical advisory committee is presently reviewing this           mailing, but will monitor three electron beams, rather than
proposal.                                                         two. This will ensure that in most cases, each electron beam
                                                                  is checked no less than biannually. During 2002 we visited
The COMS subcontract has been continued. The RPC has              44 institutions and audited 248 megavoltage beams.
had discussions with COMS regarding our participation
with one or two new projects concerning the relationship          At the end of December, approximately 450 institutions had
between dosimetry and clinical outcomes.                          converted to the TG-51 protocol; this is roughly 35% of the
                                                                  institutions we monitor. The rate of conversion has been
The RPC continues contracts with AMGEN Corporation to             steady for the last 2 years.
support a study of total body irradiation. Contracts have also
been received from Imagyn Medical Technologies and ATI
Medical Corporation for evaluation of prostate                    STUDY GROUP ACTIVITIES
brachytherapy seeds.                                              The RPC continues to send one or more representatives to
                                                                  meetings of every cancer trials study groups. We are most
BUDGET STATUS                                                     heavily involved with NSABP, NCCTG, COMS, GOG, and
In October, we reported that the M. D. Anderson Grants and        RTOG. Through coordinated activities with QARC, we are
Contracts Department indicated to us that they would begin        actively involved in protocols or credentialing activities at
charging indirect costs on the funds generated by the yearly      several other study groups. In addition, we participate in the
quality assurance program fee. However, that decision has         QA committee of ACRIN, the ACR imaging network.
been reversed and the institution will not charge overhead.       Through the Cancer Trials Support Unit (CTSU) we
                                                                  participate by assuring that institutions that participate in
Additional increased costs have made it necessary for us to       clinical trials through CTSU are properly monitored and
approach NCI to request an increase on the quality                credentialed where necessary.
assurance program fee. The NCI approved our raising the
fees to $500 per institution per year as has been previously      Radiation Therapy Oncology Group
proposed and approved by RTC. The increased fee went
into effect when invoices were mailed to institutions last        Prostate brachytherapy credentialing
October.
                                                                  Through the efforts of the RPC and QARC we have issued
COMMUNICATIONS                                                    prostate brachytherapy credentials to 64 institutions. We are
The RPC webpage continues to be enhanced. We are                  conducting a survey of credentialed institutions to confirm
continuing to post monthly newsletters announcing items of        that the conditions leading to their credentialing are still in
importance, or answering common questions posed to the            place. In anticipation of the P-0232 protocol, we are
RPC. The AAPM distributes an e-mail burst for us each             advising institutions that they need to be credentialed for
month to announce the availability of the latest newsletter.      any seed models they propose to use on the protocol. Seeds
                                                                  must meet the AAPM prerequisites to be used in RTOG
GENERAL QA ACTIVITIES                                             protocols. There are presently 15 seeds that meet the AAPM
The RPC is presently monitoring 1,315 megavoltage                 prerequisites and are listed on the RPC website.
therapy sites. Effective January 1, 2003, we have reduced
                                                                  RPC anthropomorphic phantoms
 500
                                                                  1.   Stereotactic brain phantom
 450

 400
                                                                  The SRS brain phantom has been sent to approximately 60
                                                                  institutions. ACOSOG has recently informed participating
 350
                      TG51 CONVERSIONS                            institutions that they are expected to obtain the RPC brain
 300                                                              phantom as part of their participation in stereotactic brain
 250                                                              protocols.
 200
                                                                  2.   Pelvis Phantom
 150

 100                                                              The RPC pelvis phantom is currently undergoing
  50
                                                                  experiments to evaluate heterogeneity correction
                                                                  capabilities. The phantom has been fitted with a hip
   0
                                                                  prosthesis for this test. The phantom will be available for
         9




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        9




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                                                                  credentialing institutions to participate in IMRT trials.
    b-




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the mailing frequency to annually for most institutions. We
will continue to monitor all photon beams with each
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          RPC Report to the AAPM Radiation Therapy Committee                                                                                                                     Page 3 of 12
          Report No. 114


          3.      RPC lung phantom                                                            Results from the initial 10 institutions to receive the
                                                                                              phantom were presented previously. Since that time, the
          On the advice of a physician the RPC lung phantom is                                RPC has used the web tools provided by the ITC to
          presently being modified with a new dosimetry/imaging                               reevaluate the institution‟s calculations of doses to the
          insert to reposition the target. Both designs will be available                     TLDs. Our evaluation has resulted in a few small changes,
          so either can be used. We are initiating a series of tests to                       and the revised data appear in Table 2. The data for
          evaluate heterogeneity corrections provided by four                                 institution #5 (institutions are not listed in the same order in
          treatment planning system.                                                          these two tables) have been deleted as institution #5
                                                                                              irradiated the phantom at a time when our experience was
                                                                                              limited and our instructions were not clear. Therefore the
                         iv        H          o
     I nst itu tio n s R e c ien g &N Ph a n tm                                               data were not submitted to the ITC webpage.
                                                                                              The new analysis indicates that the average dose delivered
       Inst Na m      e         c M            v e
                            M ah. an . De l i ry De v i   c ee
                                                            T    h i          r
                                                                 c n que Ene gy TP S          to the TLDs and the PTVs is unchanged and still very close
          USCF                       s
                             Sie m e n      M C L         st e       sh
                                                                 p a nodo t 6     Corv us
   Cro s Ca ner Ctr.  c       V aia n
                                r           M C L         st e       sh
                                                                 p a nodo t 1 5   Hela x      to unity with a standard deviation of 5% or less. The dose
   M e Coll iW ni n Sie m e n co m p sa n r o
        d          sco s             s            e t     st e   p a nodo t 6
                                                                     sh           Corv us     delivered to the critical structure is on average close to
                f
        Je f rs eo n               a
                              Ele k t       M C L         st e       sh
                                                                 p a nodo t 6     Corv us     unity, but the standard deviation is large.
          UTM B                      s
                             Sie m e n      M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e
        MDACC                   r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6     Corv us
         Was h      U           r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6     Corv us
       S akat o o n
          s                   V aia n
                                r           M C L         st e   p a nodo t 6
                                                                     sh                 a
                                                                                 Pin n cl e      Figure 2
          MGH
         U o FL    f
                              V aia n
                                r
                              V aia n
                                r
                                            M C
                                            M C
                                                L
                                                L
                                                          st e
                                                          st e
                                                                 p a nodo t 6
                                                                     sh
                                                                 p a nodo t 6
                                                                     sh
                                                                                  Heli s
                                                                                       o
                                                                                  Corv us
                                                                                                                                      IMRT: Film Analysis
           f
     U o Wisc osi n     n       r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e                                                  Posterior-Anterior Profile
       Wau k sh a   e           r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e                                                             10
              t
          S ut e r              r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e                     Posterior                                                                Anterior

   CA Canc r Ce n r e Sie m e n
                 e        t          s      M C L         st e   p a nodo t 6
                                                                     sh                 a
                                                                                 Pin n cl e                                     Critical                     Primary PTV
                                                                                                                               Structure
         o
      Fl wer Hosp .             r
                              V aia n       Mim c i        t o    th r
                                                                 m oeap y   6     Corv us                                                               8
                B r
      Wilke s are               r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e
                s k
     Jo h nHop in s             r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6           a
                                                                                 Pin n cl e
       Fo x  Chas e                  s
                             Sie m e n      M C L         st e       sh
                                                                 p a nodo t 6     Corv us                                                               6
                                                                                                                                                                                                          Inst.   Diff (mm)
                                                                                                    Dose (Gy)




        ra         i o
   Ce n t lW sc nsin            r
                              V aia n       M C L         st e       sh
                                                                 p a nodo t 6       r     l
                                                                                Th ea p n a                                                                                                                 1         3.0
      LDS Hos it a l  p                                                                                                                                                                                     2        -0.5
                 f
    Univ o ichiM a n    g                                                                                                                               4                                                   3         3.0
                                                                                                                                                                                                            4         3.5
                                                                                                                                                                                                            5         1.0
                                                                                                                                                                                                            6         2.5
                                                                                                                                                        2                                                   7         0.5
          4.      Head and Neck IMRT phantom                                                                          RPC film
                                                                                                                                                                                                            8        -3.2
                                                                                                                      Institution's                                                                         9         1.0
                                                                                                                      Plan                                                                                 10         3.3
                                                                                                                                                        0
          The RPC has considerable experience with the head and                                           -3.5              -2.5      -1.5       -0.5         0.5          1.5     2.5              3.5
                                                                                                                                                 Distance (cm)
          neck IMRT phantom. This phantom has now been sent to
          the institutions listed in table 1. The table also indicates the                    Included in Table 2 are data for five institutions who have
          treatment machine manufacturer, the delivery device, the                            received the phantom in the last few months and for whom
          technique used, the beam energy used and the institution‟s                          the data analysis is complete.
          treatment planning system.
Table 2                                                                                       The RPC has expended considerable effort on appropriate
                    IMRT: TLD Results                                                         procedures for analyzing the dose to the organ at risk in this
                              RPC/Institution                                                 phantom. We now conclude that rather than relying on the
    Institution    Primary PTV sup Primary PTV inf Secondary PTV Critical Structure           ratio of TLD reading to institution calculation, we should
         1              0.97            1.04           1.10             0.99
         2              0.93            0.96           0.93             0.82                  also consider the data provided by the radiochromic film
         3              1.04              --           1.01             1.16                  (See Figure 2). Therefore, the RPC has proposed the
         4              0.96            1.00           0.98               --
         5              1.09            1.07           1.11             1.35
                                                                                              following criteria to the RTOG Physics Committee:
         6              1.01            1.03           0.99             1.10
         7
         8
                        1.02
                        0.98
                                        1.03
                                        0.98
                                                       1.00
                                                       0.97
                                                                        0.95
                                                                        0.88
                                                                                              Agreement between the TLD readings and the institution‟s
         9              1.04            1.04           1.06             1.09                  stated dose to the TLDs should be within 7%.
         10             1.04            1.05           1.04             1.18
     a verage           1.01            1.02           1.02             1.07
      std dev           4.8%            3.5%           5.7%            15.6%                  Agreement between the institution‟s stated dose and the
     a verage           1.00            1.02           1.01             1.02                  RPC‟s determination of dose from radiochromic film should
    % std dev           4.1%            3.2%           5.1%            13.0%
                                                                                              be within 4 mm, in the region of high dose gradient between
    Institution    Primary PTV sup Primary PTV inf Secondary PTV Critical Structure
         11             0.89            1.01           1.01             1.09                  the primary PTV and the critical structure.
         12             1.02            1.05           1.02             1.18
         13             0.98            1.03           0.98             0.90
         14             1.04            1.11           1.05             1.15                  The RPC is proposing a number of small changes to the
         17             1.04            0.92           1.04             1.10                  IMRT head and neck phantom to improve its functionality.
                                                                                              Projects are presently underway to reduce the size of the
                                                                                              TLD capsules in the phantom, as well as to move the TLDs
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RPC Report to the AAPM Radiation Therapy Committee                                                         Page 4 of 12
Report No. 114


closer to the radiochromic film. It is believed that doing so     Health Insurance Portability and Accountability Act
will both improve spacial resolution of the TLDs and              (HIPAA)
improve our ability to normalize the film doses to the TLD
readings.                                                         Provisions in HIPAA are going to impact on the conduct of
                                                                  clinical trials. Several of the study groups have already
In addition, significant progress has been made in                distributed instructions to their member institutions
implementing a gel dosimeter with the RPC phantom.                informing them that they must pay attention to requirements
Preliminary data are available indicating that gel dosimeter      of HIPAA when registering patients to clinical trials. The
can be used effectively to record and display IMRT dose           RPC has received training in the consent/authorization
distributions. (See Figure 3).                                    requirements of HIPAA and has determined that no new
                                                                  procedures are required of us at present. In the future
                                                                  however, it appears that the security requirements of HIPAA
                                                                  may impact us. These will not go into effect for some time
                                                                  and we expect to receive training from M.D. Anderson in
                                                                  advance.

                                                                  PARTICIPANT FEE:
                                                                     Institutions invoiced FY02                      1303
                                                                     No XRT/Canceled/Inactive                          90
                                                                     Invoiced by RDS                                   11
                                                                     Institutions paid                                745

                                                                  PUBLICATIONS AND ABSTRACTS
                                                                  Publications Accepted/Published (2001-2003):

                                                                  1.   Melia, Sc.M., Michele; Abramson, M.D., David;
Lateral profiles from the absolute comparison between the              Albert, M.D., Daniel; Boldt, M.D. Culver; Earle, M.D.,
gel 1 measured dose distribution and the computed dose                 John; Hanson, Ph.D., William; Montague, Paul; Moy,
distribution on the third day of evaluation (10 days after gel         Ph.D., Claudia; Schachat, M.D., Andrew; Simpson,
manufacture)                                                           M.D., Rand; Straatsma, M.D., Bradley; Vine, M.D.,
                                                                       Andrew; and Weingeist, M.D., Ph.D., Thomas:
Southwest Oncology Group                                               Collaborative Ocular Melanoma Study (COMS)
                                                                       Randomized Trial of I-125 Brachytherapy for Medium
SWOG has to made a decision to contract with QARC for                  Choroidal Melanoma I. Visual Acuity after 3 Years,
                                                                       COMS Report No. 16”, Opthalmology, 108(2):348-366,
all their QA services. We are in the process of returning
                                                                       2001.
charts that were sent to us for review to SWOG so they can
be forwarded to QARC.
                                                                  2.   Kirsner, S.M., Prado, K.L., Tailor, R.D., and BenComo,
Gynecological Oncology Group
                                                                       J.A.: Verification of the accuracy of 3D calculations of
                                                                       breast dose during tangential irradiation: measurements
The RPC review many charts from the GOG and
                                                                       in a breast phantom. J. Applied Clinical Medical
participates extensively in the semi-annual meetings at
                                                                       Physics 2(3):149-156, 2001.
which clinical reviews are conducted. The GOG is
proposing to open one or more of their protocols
                                                                  3.   Villarruel, S., Ibbott, G.S., and Lai-Fook, S.J.: Effect of
internationally. In particular, they are considering opening
                                                                       concentration and hydration on restriction of albumin
GOG 191 in Scandinavia. The RPC has been discussing
                                                                       by lung interstitium. Microvascular Research 63, 27-
procedures for assuring quality in international institutions
                                                                       40, 2002.
that participate in US clinical trials. We are in contact with
QA offices in Europe and also with the NCI.
                                                                  4.   Diener-West, M., Albert, D.M., Byrne, S.F., Davidorf,
                                                                       F.H., Followill, D.S., Green, R.L., Hawkins, B.S.,
North Central Cancer Treatment Group
                                                                       Kaiser, P.K., Kline, R.W., Robertson, D.M., Straatsma,
                                                                       B.R: Comparison of clinical, echographic and
The RPC is participating in the rapid review of cases
                                                                       histopathologic measurements of medium-sized
submitted to N0028, a phase I/II study of escalating doses of
                                                                       choroidal melanoma: 644 eyes in the Collaborative
radiotherapy for non-small cell lung cancer.
                                                                       Ocular Melanoma Study, COMS Report No. 21. Arch
                                                                       Ophthalmol, 119:961-965, 2001.

                                                                  5.   Urie, M., FitzGerald, T.J., Followill, D.S., Laurie, F.,
                                                                       Marcus, R., Michalski, J:         Current calibration,
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RPC Report to the AAPM Radiation Therapy Committee                                                       Page 5 of 12
Report No. 114


     treatment, and treatment planning techniques among               networks for radiotherapy dosimetry. Accepted by
     institutions participating in the Childrens Oncology             International Atomic Energy Agency, November, 2002.
     Group. Int. J. Radiat. Onc. Biol. Phys., 55:245–260,
     2002.
                                                                  15. Tailor, R.C., Hanson, W.F., Ibbott, G.S. TG-51:
                                                                      Experience from 150 institutions, common errors, and
6.   Cadman, P., Bassalow, R., Sidhu, N.P.S., Ibbott, G. and          helpful hints.  Appl. Clin. Med. Phys. Accepted
     Nelson, A., Dosimetric considerations for validation of
                                                                      November 2002.
     a sequential IMRT process with a commercial treatment
     planning system, Physics in Medicine and Biology, 47:
                                                                  16. Hanson, W. F., Tailor, R. C., Ibbott, G.S. (Letter to
     3001-3010, 2002.                                                 Editor) „„Comment on „Calculated absorbed-dose
                                                                      ratios, TG51/TG21, for most widely used cylindrical
                                                                      and parallel-plate ion chambers over a range of photon
7.   Gifford, K.A., Followill, D.S., Liu, H.H., Starkschall,
                                                                      and electron energies‟ ‟‟ Accepted by Med. Phys. 30,
     G., Verification of the accuracy of a photon dose-               XXX December 2002
     calculation algorithm, J. Appl. Clin. Med. Phys., 3:26-
     45, 2002.
                                                                  17. Nag, S., Quivey, J.M., Earle, J.D., Followill, D.S.,
                                                                      Fontanesi, J., and Finger, P. The American
8.   Tailor, R.C., Hanson, W.F. Calculated absorbed-dose              Brachytherapy     Society     Recommendations    for
     ratios, TG-51/TG-21, for most widely used cylindrical
                                                                      Brachytherapy of Uveal Melanomas, accepted Int. J.
     and parallel-plate ion chambers over a range of photon
                                                                      Radiat. Oncol. Biol. Phys., 2003.
     and electron energies. Med. Phys. 29: 1464-1472
     (2002)                                                       18. Krintz, A.L., Hanson, W.F., Ibbott, G.I. and Followill,
                                                                      D.S., Recalculation of Eye Plaque Dosimetry for the
9.   Ibbott, G.S., Meigooni, A. S., Gearheart, D. M. (Letter
                                                                      Collaborative Ocular Melanoma Study Medium Tumor
     to Editor) Monte Carlo determination of dose rate
                                                                      Trial. Accepted Int. J. Radiat. Oncol. Biol. Phys., 2003.
     constant. Med Phys., 29 (7) 1637-8, 2002
                                                                  19. Followill, D.S., Hanson, W.F., Eglezopoulos, L.R.E.,
10. Rivard, M.J., Coursey, B.M., DeWerd, L.A., Hanson,
                                                                      Chui, C.S. and Ibbott, G.I., Differences in electron
    W.F., Huq, M.S., Ibbott, G.S., Nath, R., Williamson,
                                                                      beam dosimetry using two commercial ionization
    J.F.: (Letter to Editor) Comment on “Let‟s abandon                chambers and the TG-21 protocol: Another reason to
    geometry factors other than that of a point source in
                                                                      switch to TG-51. Accepted by the Journal of Applied
    brachytherapy dosimetry,” Medical Physics 29, 1917-
                                                                      Clinical Medical Physics, 2003.
    1918, 2002.
                                                                  20. Tailor, R.C., Followill, D.S., Hernandez, N., Ibbott,
11. Aguirre, J.F., Tailor, R., Ibbott, G., Stovall, M. Hanson,
                                                                      G.I., and Hanson, W.F., Predictability of electron cone
    W. TLD as a tool for remote verification of output for
                                                                      ratios with respect to linac make and model. Accepted
    radiotherapy beams: 25 years of experience. Accepted
                                                                      by the Journal of Applied Clinical Medical Physics,
    by International Atomic Energy Agency, November,                  2003.
    2002.
                                                                  21. Followill, D.S., Stovall, M.S., Kry, S.F., and Ibbott,
12. Ibbott, G., Beach, M., Maryanski, M.              An
                                                                      G.S., Neutron source strength measurements for Varian,
    anthropomorphic head phantom with a BANG®                         Siemens, Elekta, and General Electric linear
    polymer gel insert for dosimetric evaluation of IMRT
                                                                      accelerators. Accepted by the Journal of Applied
    treatment delivery. Accepted by International Atomic
                                                                      Clinical Medical Physics., 2003.
    Energy Agency, November, 2002.
                                                                  Manuscripts in Preparation
13. Ibbott, G., Nelson, A., Followill, D., Balter, P., Hanson,    1. Diener-West, M., Albert, D.M., Frazier Byrne, S.,
    W. An anthropomorphic head and neck phantom for                  Davidorf, F.H., Followill, D.S., Green, R.L., Hawkins,
    evaluation of intensity modulated radiation therapy.             B.S., Kaiser, P.K., Robertson, D.M., and Straatsma,
    Accepted by International Atomic Energy Agency,                  B.R., Comparison of Clinical, Echographic and
    November, 2002.                                                  Histopathologic Measurements from Eyes with
                                                                     Medium-Sized       Choroidal    Melanoma:     in the
14. Izewska, J., Svensson, H., Ibbott, G. Worldwide QA               Collaborative Ocular Melanoma Study. COMS Report
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RPC Report to the AAPM Radiation Therapy Committee                                                     Page 6 of 12
Report No. 114


     No. 21, The Collaborative Ocular Melanoma Study
     Group, submitted to Archives of Ophthalmology 2002.          7.   Tailor, R.C. and Hanson, W.F.: Estimated Absorbed -
                                                                       Dose Ratios "TG51/TG21" for Most Commonly Used
2.   Krintz, A.L., Hanson, W.F., Ibbott, G.I. and Followill,           Cylindrical and Parallel-Plate Ion Chambers over a
     D.S., Verification of Plaque Simulator Dose                       Range of Photon and Electron Energies. Medical
     Distribution      Using      Radiochromic        Film.,           Physics, Vol. 28: 1192, 2001.
     submitted/rejected to Medical Physics, 2002. Will
                                                                  8.   BenComo, J.A., Hernandez, N., and Hanson, W.F.:
     address reviewers concerns and resubmit.
                                                                       Problems and Shortcomings of the RPC Remote
                                                                       Monitoring Program of Institutions Dosimetry Data.
3.   Nelson, A., Followill, D.S., Balter, P.A., Hanson, W.F.,          Medical Physics, Vol. 28: 1212, 2001.
     and Ibbott, G.S., Design and Implementation of an
     Anthropomorphic Quality Assurance Phantom for                9.   Balter, P.A., Lowenstein, J.R., and Hanson, W.F.:
     Intensity Modulated Radiation Therapy, Sixth draft                Electron Calibrations: Parallel Plate Chambers vs.
     under review, 2003.                                               Cylindrical Chambers Using TG-51. Medical Physics,
                                                                       Vol. 28: 1214, 2001.
4.   Neblesky, A., Tatcher, M., Davis, D.S., Followill, D.S.
     and Ibbott, G.S., Specification of Electron Beam             10. Hanson, W.F., Martin, B., Kuske, R., Arthur, D.,
     Energies for Radiotherapy, second draft under review,            Rabinovitch, R., White, J., Wilenzick, R. Harris, I.,
     2003.                                                            Tailor, R., and Davis, D.: Dose Specification and
                                                                      Quality Assurance of RTOG Protocol 95-17, A
5.   Olch, A., Ibbott, G., Followill, D., et. al, Quality             Cooperative Group Study of 192Ir Breast Implants as
     Assurance for Clinical Trials: A Primer for Physicists.          Sole Therapy. Medical Physics, Vol. 28: 1297, 2001.
     Prepared by AAPM Subcommittee on QA for Clinical
                                                                  11. Duzenli, C., Baldock, C., Ibbott, G., Schreiner, L.J.,
     Trials. Second draft under review, 2003.
                                                                      Jordan, K., Oldham, M., Short, K., CCPM/COMP
Published Abstracts:                                                  Symposium on Gel Dosimetry, Medical Physics, Vol.
                                                                      29: 1313, 2002.
1. Krintz, A., Followill, D., Melia, M., and Hanson W.F.:
    A Reanalysis of the Collaborative Ocular Melanoma
    Study Medium Tumor Trial Eye Plaque Dosimetry.                12. Nath, R., Rivard, M., Coursey, B., DeWerd, Hanson,
    Medical Physics, Vol. 28: 1192, 2001.                             W., Huq, M., Ibbott, G., Williamson, J., Status of the
                                                                      American Association of Physicists in Medicine
2.   Radford, D.A., Followill, D.S., Hanson, and W.F.: A              Radiation Therapy Committee‟s Subcommittee on
     Standard Method of Quality Assurance for Intensity               Low-Energy      Interstitial  Brachytherapy    Source
     Modulated Radiation Therapy of the Prostate. Medical             Dosimetry: Procedure for the Development of
     Physics, Vol. 28: 1211, 2001.                                    Consensus Single-Source Dose-Distribution. Medical
                                                                      Physics, Vol. 29: 1349, 2002.
3.   Gluckman, G., Foraci, J, Meek, A., Reinstein, L.,
     Radford, D., Followill, D.: Adaptation of the RPC            13. Nelson, A., Balter, P., Hanson, W., Ibbott, G.,
     IMRT Prostate Phantom for Full 3D Dose Verification              Experience with an IMRT head and neck QA phantom.
     Using Polymer Gel and Multiple-plane Radiochromic                Medical Physics, Vol. 29: 1366, 2002.
     Film Inserts. Medical Physics, Vol. 28: 1269, 2001.
                                                                  14. Ibbott, Geoffrey S. and BenComo, José A., Quality
4.   Rogers, D.W.O., Followill, D.: TG-51: A Review of                Assurance Measurements of Beam Parameters of a
     the Background and Implementation Issues. Medical                Linear Accelerator using MOSFET Dosimeters: A
     Physics, Vol. 28: 1223, 2001.                                    Feasibility Study, Medical Physics, Vol. 29: 1201,
                                                                      2002.
5.   Followill, D.S., Hernandez, N., and Hanson, W.F.:
     Standard Wedge and Tray Transmission Values for              15. Krintz, Amanda, Hanson, William F., Ibbott, Geoffrey
     Varian, Siemens, Elekta/Philips Accelerators; A                  S., and Followill, David, Verification of PLAQUE
     Quality Assurance Tool. Medical Physics, Vol.                    SIMULATOR Dose Distributions Using Radiochromic
     28:1211, 2001.                                                   Film Medical Physics, Vol. 29: 1220, 2002.

                                                                  PRESENTATIONS
6.   Followill, D. and Gifford, K: A Measured Data Set for
                                                                  INTERNATIONAL ACTIVITIES
     Photon Dose Calculation Verification. Medical Physics,
     Vol. 28: 1290, 2001.
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RPC Report to the AAPM Radiation Therapy Committee                                                      Page 7 of 12
Report No. 114


Geoffrey Ibbott attended the International Atomic Energy              Medical College of       Virginia,   Richmond,    VA,
Agency International Symposium on Standards and Codes                 December 15-19, 2002.
of Practice in Medical Radiation Dosimetry, Vienna,
Austria, November 23- 29, 2002.                                   10. Andrea Nelson performed radiological physics
                                                                      measurements and reviewed patient dosimetry at
J. Francisco Aguirre attended the International Atomic                Medical College of Virginia, Richmond, VA,
Energy Agency International Symposium on Standards and                December 15-26, 2002.
Codes of Practice in Medical Radiation Dosimetry, Vienna,
Austria, November 23- December 2, 2002.                           11. David Followill performed radiological physics
                                                                      measurements and reviewed patient dosimetry at
Dr. Cho presented seminars on quality assurance and quality           Central Wisconsin Cancer Program, Fond du Luc, WI,
control in radiation therapy devices, as well as,                     January 13-16, 2003.
recommendations regarding the regulatory programs on the
Korea Institute of Nuclear Safety, Seoul and Daejeon, South       12. Paola Alvarez performed radiological physics
Korea, December 14-22, 2002.                                          measurements and reviewed patient dosimetry at
                                                                      Central Wisconsin Cancer Program, Fond du Luc, WI,
VISITS TO INSTITUTIONS                                                January 13-16, 2003.
1. Sang      Cho   performed   radiological    physics
    measurements and reviewed patient dosimetry at the            13. Francisco Aguirre performed radiological physics
    University of Chicago, Chicago, IL, October 20-                   measurements and reviewed patient dosimetry at
    25/2002.                                                          Central Wisconsin Cancer Program, Fond de Luc, WI,
                                                                      January 13-16, 2003.
2.   Jessica Lowenstein performed radiological physics
     measurements and reviewed patient dosimetry at Mercy         14. Jessica Lowenstein performed radiological physics
     Hospital, Scranton, PA and Hershey Medical Center,               measurements and reviewed patient dosimetry at Mayo
     Hershey, PA, October 21-29, 2002.                                Clinic - Jacksonville, Jacksonville, FL, January 15-20,
                                                                      2003.
3.   Geoffrey S. Ibbott performed radiological physics
     measurements and reviewed patient dosimetry at               15. Francisco Aguirre performed radiological physics
     Thomas Jefferson University Hospital, Philadelphia,              measurements and reviewed patient dosimetry at
     PA, November 4-8, 2002.                                          Veterans Administrative Hospital, Minneapolis, MN,
                                                                      January 22-26, 2003.
4.   Jessica Lowenstein performed radiological physics
     measurements and reviewed patient dosimetry at Fox           16. Geoffrey Ibbott performed radiological physics
     Chase Cancer Center, Philadelphia, PA, November 11-              measurements and reviewed patient dosimetry at
     14, 2002.                                                        Memorial Hospital in Colorado Springs, and Poudre
                                                                      Valley Radiation Oncology in Fort Collins, CO.
5.   David Followill performed radiological physics                   February 3-7, 2003.
     measurements and reviewed patient dosimetry at Fox
     Chase Cancer Center, Philadelphia, PA, November 11-          10. David Followill performed radiological physics
     14, 2002.                                                        measurements and reviewed patient dosimetry at
                                                                      Cancer Center of Northern Wyoming, Sheridan, WY
6.   Andrea Nelson performed radiological physics                     and Swedish Medical Center, Englewood, CA,
     measurements and reviewed patient dosimetry at UT                February 23-27, 2003.
     Medical Branch in Galveston, TX, November 18-21,
     2002.
                                                                  MEETINGS ATTENDED
7.   Jessica Lowenstein performed radiological physics            Geoffrey Ibbott attended the American Society for
     measurements and reviewed patient dosimetry at               Therapeutic Radiology and Oncology (ASTRO) Meeting,
     Virginia Mason Medical Center, Seattle, WA,                  New Orleans, October 4-9, 2002.
     December 9-15, 2002.
                                                                  Francisco Aguirre attended the American Society for
8.   Ramesh Tailor performed radiological physics                 Therapeutic Radiology and Oncology (ASTRO) Meeting,
     measurements and reviewed patient dosimetry at               New Orleans, LA, October 5-9, 2002.
     University of Alabama, Birmingham, AL, December
     13-23, 2002.                                                 David Followill attended the American Society for
                                                                  Therapeutic Radiology and Oncology (ASTRO) Meeting,
9.   Geoffrey S. Ibbott performed radiological physics            New Orleans, LA, October 5-9, 2002.
     measurements and reviewed patient dosimetry at the
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RPC Report to the AAPM Radiation Therapy Committee                                                    Page 8 of 12
Report No. 114


Ramesh Tailor attended the American Society for                   Francisco Aguirre attended the Cancer and Acute Leukemia
Therapeutic Radiology and Oncology (ASTRO) Meeting,               Group (CALGB) Meeting, Tampa, FL, November 8-9,
New Orleans, LA, October 5-9, 2002.                               2002.

Jessica Lowenstein attended the American Society for              Sang Cho attended the Eastern Cooperative Oncology
Therapeutic Radiology and Oncology (ASTRO) Meeting,               Group (ECOG) Meeting, Miami, FL, November 16-17,
New Orleans, LA, October 5-9, 2002.                               2002.

José BenComo attended the North Central Cancer                    David Followill attended the Advanced Technology
Treatment Group (NCCTG) Meeting, Rochester, MN,                   Consortium (ATC) Meeting, Providence, RI, November 19-
October 9-11, 2002.                                               20, 2002.

Geoffrey Ibbott attended the North Central Cancer                 David Followill attended the American College of Surgeons
Treatment Group (NCCTG) Meeting, Rochester MN,                    Oncology Group (ACOSOG) Meeting, Scottsdale, AZ,
October 9-10, 2002.                                               November 22, 2002.

Geoffrey Ibbott attended the Council on Ionizing Radiation        Geoffrey Ibbott attended the Food and Drug Administration
Measurements and Standards (CIRMS) and American                   Radiology Devices Panel Meeting, Gaithersburg, MD,
College of Radiology Imaging Network (ACRIN),                     December 9-10, 2002.
Washington, DC and Gaithersburg, MD, October 17-23,
2002.                                                             Geoffrey Ibbott attended the Gynecologic Oncology Group
                                                                  (GOG) Meeting, Savannah, GA, January 15-18, 2003.
José Bencomo attended the American College of Radiology
Imaging Network (ACRIN), Gaithersburg, MD, October 17-            Jessica Lowenstein attended the Gynecologic Oncology
23, 2002.                                                         Group (GOG) Meeting, Savannah, GA, January 15-18,
                                                                  2003.
David Followill attended the Children's Oncology Group
(COG) Meeting, St. Louis, MO, October 23-26, 2002.                Joye Roll attended the Gynecologic Oncology Group
                                                                  (GOG) Meeting, Savannah, GA, January 15-18, 2003.
Irene Harris attended the Southwest Oncology Group
(SWOG) Meeting, San Antonio, TX, October 26, 2002.                David Followill attended the RSS 2.0 Training &
                                                                  Radiotherapy Committee Meeting for the Cancer Trials
Geoffrey Ibbott attended the Southwest Oncology Group             Support Unit, Rockville, MD, January 29-30, 2003.
(SWOG) Meeting, San Antonio, TX, October 25-26, 2002.
                                                                  Geoffrey Ibbott    attended the RSS 2.0 Training &
Francicsco Aguirre attended the Southwest Oncology Group          Radiotherapy Committee Meeting for the Cancer Trials
(SWOG) Meeting, San Antonio, TX, October 25-26, 2002.             Support Unit, Rockville, MD, January 29-30, 2003.

José BenComo attended the Southwest Chapter of the                Joye Roll attended the RSS 2.0 Training & Radiotherapy
American Association of Physicists in Medicine                    Committee Meeting for the Cancer Trials Support Unit,
(SWAAPM) Meeting, Austin, TX, November 1-2, 2002.                 Rockville, MD, January 29-30, 2003.

Geoffrey Ibbott attended the Southwest Chapter of the
American Association of Physicists in Medicine
(SWAAPM) Meeting, Austin, TX, November 1-2, 2002.




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RPC Report to the AAPM Radiation Therapy Committee                                                        Page 9 of 12
Report No. 114


STATUS SUMMARY
         Dosimetry review visits were made to 21 institutions, at which 127 beams† were reviewed, 3,248 TLD reports were
evaluated, and 362 patients' charts were evaluated. There is one institution that is a special high priority for a dosimetry
review visit (based on TLD, chart check, etc).

           A summary of cooperative groups and institutions‟ participation in them are included in the attached table.

†The review of one photon energy is considered a "beam"; however, review of a cadre of electrons on one machine is
considered only one "beam". Measurement of TBI and other special procedures are also considered one "beam".

                                                                  Respectfully submitted,



                                                                  Geoffrey S. Ibbott, Ph.D.
                                                                  Chief, Section of Outreach Physics




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RPC Report to the AAPM Radiation Therapy Committee                                                Page 10 of 12
Report No. 114


                                EXPENDITURES OF THE RADIOLOGICAL PHYSICS CENTER
                             (RPC Grant, the COMS Subcontract, and the High Technology Subcontract)
                                               October 1, 2002 - February 28, 2003
____________________________________________________________________________
PERSONNEL (salaries, fringe benefits):                                                          $1,025,843.00
10 Physicists, 1 Supervisor of Quality Assurance Dosimetry Services, 4 Dosimetrists, 1 Information Manager, 1 Database
Administrator, 1 Programmer Analyst I, 1 Radiological Physics Supervisor, 6 Radiological Physics Technicians, 1
Department Administrator, 1 Sr. Administrative Assistant, 1 Departmental Buyer, 3 Secretaries, and 4 Graduate Research
Assistants.

TRAVEL
Visits
Sang Cho - Chicago, IL                                                                            1253.04
Jessica Lowenstein - Scranton and Hershey, PA                                                     1409.42
Geoffrey Ibbott- Philadelphia, PA                                                                 1246.56
Jessica Lowenstein - Philadelphia, PA                                                               917.18
David Followill - Philadelphia, PA                                                                  971.57
Andrea Nelson - Galveston, TX                                                                       364.77
Jessica Lowenstein - Seattle, WA                                                                  1516.61
Ramesh Tailor - Birmingham, AL                                                                    1671.60
Geoffrey Ibbott - Richmond, VA                                                                      867.30
Andrea Nelson - Richmond, VA                                                                        893.04
David Followill - Fond du Luc, WI                                                                   857.87
Paola Alvarez - Fond du Luc, WI                                                                     589.52
Francisco Aguirre - Fond du Luc, WI                                                                 589.52
Jessica Lowenstein - Jacksonville, FL                                                             1459.10
Francisco Aguirre - Minneapolis, MN                                                                 942.86
Geoffrey Ibbott – Colorado Springs and Fort Collins, CO                                           1138.81
David Followill - Sheridan, WY and Englewood, CA                                                  1152.76
TOTAL:                                                                                          $17,841.53

Meetings:
Geoffrey Ibbott - New Orleans, LA                                                                     1,351.03
Francisco Aguirre - New Orleans, LA                                                                   1,339.90
David Followill - New Orleans, LA                                                                     1,633.57
Ramesh Tailor - New Orleans, LA                                                                       1,076.95
Jessica Lowenstein - New Orleans, LA                                                                  1,633.57
José Bencomo - Rochester, MN                                                                            810.33
Geoffrey Ibbott - Rochester, MN                                                                         736.24
Geoffrey Ibbott - Washington, DC and Gaithersburg, MD                                                 1,302.78
José Bencomo - Gaithersburg, MD                                                                           0.00
David Followill - St. Louis, MO                                                                         683.55
Irene Harris - San Antonio, TX                                                                          160.35
Geoffrey Ibbott - San Antonio, TX                                                                       568.93
Francisco Aguirre- San Antonio, TX                                                                      420.77
José BenComo - Austin, TX                                                                               261.17
Francisco Aguirre - Tampa, FL                                                                           729.34
Sang Cho - Miami, FL                                                                                    757.09
David Followill - Providence, RI                                                                        581.27
David Followill - Scottsdale, AZ                                                                        451.67
Geoffrey Ibbott - Vienna, Austria                                                                      1739.54
Francisco Aguirre - Vienna, Austria                                                                    1658.57
Geoffrey Ibbott - Gaithersburg, MD                                                                      363.50
Sang Cho - Seoul and Daejeon, South Korea                                                                 0.00
Geoffrey Ibbott - Savannah, GA                                                                         1459.10
Jessica Lowenstein - Savannah, GA                                                                      1140.92
Joye Roll - Rockville, MD                                                                                 0.00
David Followill - Rockville, MD                                                                           0.00
Geoffrey Ibbott - Rockville, MD                                                                           0.00
TOTAL:                                                                                         $ 20,860.14



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RPC Report to the AAPM Radiation Therapy Committee                    Page 11 of 12
Report No. 114




SUPPLIES:                                                         $ 10,642.17
Office supplies, laboratory and record keeping, TLD,
TLD supplies, software, etc.

OTHER EXPENSE:                                                      $ 6,472.86
Postage, telephone, reprints, copying, computer fees,
equipment repair, etc.

SPACE RENTAL:                                                     $ 34,017.78


Total Expenditures October 1, 2002 - February 28, 2003            $1,115,677.48
Indirect costs @ 25%                                                 270,414.93
TOTAL                                                             $1,386,092.41




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        RPC Report to the AAPM Radiation Therapy Committee                                                          Page 12 of 12
        Report No. 114


                                                             RPC Report to RTC September 2002


Clinical Study Groups                                                     Office Reviewing       Special Projects
                                                                          Patient Records

                                                                                                 Participate in the development of
American College of Radiology Imaging Network                                                    guidelines for quality assurance of
                                                                          N/A
ACRIN                                                                                            institution participating in ACRIN
                                                                                                 CT Dose Measurements

                                                                                                 TRUS Prostate Approval Collaboration
American College of Surgeons Oncology Group
                                                                          QARC                   RPC Institution List
ACOSOG
                                                                                                 Stereotactic Phantom

Cancer and Acute Leukemia Group B
                                                                          QARC                   TRUS Prostate Approval Collaboration
CALGB
Children’s Oncology Group COG                                                                    3D Benchmark Case
                                                                          QARC
(POG, CCG, WILMS, RHABDO)                                                                        IMRT Benchmark Case
Eastern Cooperative Oncology Group
                                                                          QARC
ECOG

                                                                                                 Radiotherapy manual
                                                                                                 HDR Pre-approval
Gynecologic Oncology Group                                                                       Electronic Transfer of
                                                                          RPC
GOG                                                                                               Patient Records
                                                                                                 Image Based Treatment Planning
                                                                                                 IMRT Guidelines


National Surgical Adjuvant Breast                                                                IMRT Guidelines
and Bowel Project                                                         RPC                    Breast phantom
NSABP                                                                                            Pre-approval discussion

                                                                                                 Rapid Review of Lung Study
North Central Cancer Treatment Group                                                             TRUS guided Prostate
                                                                          RPC
NCCTG                                                                                             Pre-approval

                                                                                                 IMRT Phantom /pre-approval
                                                                                                 Prostate Phantom
                                                                                                 Prostate Implant
                                                                          RTOG
Radiation Therapy Oncology Group                                                                  Pre-approval LDR/HDR
                                                                          3D CRT by ITC Center
RTOG                                                                                             Stereotactic Phantom
                                                                          Brachytherapy by RPC
                                                                                                 Lung Phantom
                                                                                                 Cervix HDR Pre-approval
                                                                                                 Patient Calculation Program
Southwest Oncology Group
                                                                          QARC
SWOG
                                                                                                 RPC Institution List
Clinical Trial Support Unit
                                                                          QARC, RPC, RTOG        RTF Numbers
CTSU
                                                                                                 TLD Monitoring
Collaborative Ocular Melanoma Study                                                              Cataracts follow-up
                                                                          RPC
COMS                                                                                             Visual acuity dose response




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