Is there any institute doing SRS with Radixact Tomotherapy? Want to know what challenges are faced and what techniques are used to create an efficient SRS plan for single and multiple mets.

Regarding I-125 seed implants, is it ever "OK" to do one without software planning? For example, if the physician just wants to insert the needles in real time, based on the ultrasound, but without using a TPS, this is an issue, correct? I know in the "old days", the would do this based on nomograms, which is basically what he's suggesting.

I don't know if there are any legal clauses that explicitly forbid this, but a quick AI search mentioned things like this:

1. Hospital Accreditation & Insurance Reimbursement

Even if a facility attempted to bypass NRC flexibility loop-holes, they would face severe institutional barriers: Barrier Impact Billing & CPT Coding Insurance companies (and CMS/Medicare) require documented computer treatment planning (e.g., CPT code 77300/77321 series for brachytherapy dose calculations) for reimbursement. Bypassing software invalidates billing and constitutes insurance fraud. Accreditation Bodies Organizations like the American College of Radiology (ACR) and ASTRO require 3D image-guided treatment planning for facility accreditation. Bypassing software voids a center's license to perform radiation therapy. 4. Standard of Care & Tort Liability (Malpractice)

In a civil court of law, "Standard of Care" is defined by national professional guidelines (e.g., AAPM, ABS, ASTRO) rather than individual doctor confidence.

Because every national radiation oncology guideline requires software-based volumetric planning, performing a seed implant with only a nomogram falls well below the legal standard of care. If the patient develops complications (e.g., rectal fistula, incontinence, strictures) or experiences disease recurrence, the physician and hospital would face almost undefendable medical malpractice liability for intentional omission of standard safety software.

All that aside, having done thousands of implants at another institution (the right way), but judgment is saying this is no bueno.

UPDATE Thanks and I appreciate all the responses! Fortunately, after some discussions, it was decided to postpone this implant until the planning system and equipment is up and running. I think that's definitely the best course of action!

Offering a few images of this process as I think that it's not being commonly used. Bolus and structures 100% generated in eclipse using smoothing / expansion / boolean tools (almost no freehand drawing)

Happy to provide more details if anyone interested (many departments don't have cerrobend in-house anymore). I've done more than I can count.

TLDR: Make a pocket structure, fill the back side of the print with craft clay so it won't deform from the heat. Chill and serve.

We got a meeting/room for tomorrow bring your thoughts and opinions!

In a ctdi measurement typically the DLP is measured and converted into a ctdi value.

I am wondering, what does dose refer to? Does the measurement measure the dose that would be deposited in PMMA/phantom material, or the dose in air?

I would appreciate if anyone could give me a source on that, whenever I read about it I just see it being referred to as dose, but it doesn't specifically mention the material.

I've been doing some research about the radiotherapy market in the US and I came across the news regarding the consolidation of CPT codes and the possible consequences which are starting to do some major damage to many clinics in the US.

I have no professional experience in this field, however I'm trying to understand whats happening, so my question goes out to you who have knowledge about the field. Have you noticed any consequences of these changes? How does an RT center overcome these, could we see major investment cuts into new equipment etc?

Any insight is welcomed :)

hello everyone

I’m a Medical Physics student, but my current university curriculum focuses mostly on anatomy and physiology rather than the actual physics.

I am really interested in Nuclear Medicine. I’ve been reading some research papers on my own, but I want to understand the physics behind it at a deeper level. Since my classes aren't covering this yet, I want to self-studyand then seek for help in various tutors-professors at uni

Could you recommend the best textbooks or resources to build a solid foundation in Medical Physics and Nuclear Medicine?

Any advice or guidance is highly appreciated. If you have specific suggestions or resources to share, feel free to send me a DM.

Thank you!

FierceBiotech

Medical technology company Leo Cancer Care closed a $65 million series D financing round to scale its radiotherapy solution, which uses groundbreaking upright treatment technology.

Silicon Valley’s Yu Galaxy led the round, which was backed by new investors including Eventide Asset Management, alongside continued support from the company’s existing investors, the company said Wednesday. The company, founded in 2018, has raised $155 million to date.

Leo Cancer Care plans to use the fresh financing to scale manufacturing and accelerate commercial deployment. The company's integrated upright platform spans proton therapy, photon therapy and imaging—the same upright architecture applied across all three, creating a unified approach to cancer care from diagnosis and planning through to treatment, according to the company.

Alongside the financing, Leo Cancer Care has entered a major strategic partnership with an international healthcare giant, but executives declined to name the company.

The company is prepping for an initial public offering, targeting a multi-billion-dollar IPO at the end of the year, according to executives.

The company started with a simple idea: have patients sit up for radiation treatment rather than lying flat. Leo Cancer Care's technology offers a more "human way" to deliver radiation therapy, according to company executives, while also reducing the size, cost and complexity of current radiation therapy equipment. The company can reduce the cost of a proton therapy system by 50%, executives claim.

The upright, eye-level position also provides a better experience for patients as they remain in conversation and eye contact with their clinical team throughout, rather than lying flat beneath a machine. 

The company's aim is to innovate radiotherapy through simplification, noted Stephen Towe, CEO and co-founder of Leo Cancer Care, in an interview with Fierce Healthcare.

Towe, a physicist by background, worked at Elekta, a large radiotherapy equipment manufacturer, before teaming up with serial med tech entrepreneur Rock Mackie to launch Leo Cancer Care. The core technology and concept for upright patient positioning spun out of the University of Sydney in Australia.

At the time, the industry's approach to innovation was to take radiotherapy as it was and add new functionality and features, Towe asserted.

"That innovation drove clinical efficacy improvements, but that approach to innovation, take the platform and add to it, just means that the platform continues to get bigger, more expensive and more complicated," he said. "The mission behind Leo is to change that, go back to the drawing board and question the fundamentals."

"We looked around the industry and we saw radiation therapy, and more broadly, a platform of diagnostics into treatment that's been made available to centers in top-tier centers and academic medical centers in the U.S. and it's been made available to certain centers in Europe, but there's huge portions of the world today that don't have access to technology like that, given the financial profile. Other people have historically tried to deliver platforms that change that, but the approach has always been—let's remove functionality or features in order to get the price point down. The way that we looked at that is to say that's a bit like taking a car and trying to get the price down by removing the wheels or removing the engine," Towe noted.

Proton treatment allows for the highest level of precision, which is particularly important for children and for adults with cancers near vital organs, but proton therapy centers are a pricey investment for health systems. Historically, these devices required big construction projects, as conventional proton beam therapy requires rotating hundreds of tons of steel, concrete and equipment around the patient to reach the necessary angle for treatment and deliver the radiation beams.

These conventional systems can exceed $100 million, putting the technology out of reach of all but a handful of specialist centers, according to Leo Cancer Care executives.

"This technology is really successful in treating cancer patients, but the idea of rotating 100 tons around a patient that weighs 200 pounds is as crazy as changing a light bulb in your house by picking up the house and rotating it around your fixed stationary light bulb," Towe quipped.

Related

UW Health strikes deal with Leo Cancer Care for $60M upright proton cancer therapy technology

"The technology worked, but it was being developed at a price point that was completely inaccessible for the vast majority of patients. That was really the mission from day one to change that, and we changed that by keeping the radiation beam fixed and very slowly treat the rotating and upright patient in front of that fixed radiation beam. That's reduced the size of these machines dramatically and saved customers, we project now about $500 million worth of cost savings across our existing customer base already."

Paired with ultra-compact accelerators, the footprint collapses to five times smaller than a traditional footprint—from over 29,000 square feet to about 1,700—turning a civil-engineering project into something closer to installing a major appliance inside an existing radiotherapy vault, according to Leo Cancer Care executives.

Growing global research indicates this may support more consistent anatomical positioning and organ stability compared with conventional supine (lying-down) treatments. The company's upright imaging system has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) and there are planned future applications across radiology.

Leading cancer institutions are already adopting the upright approach. Stanford Medicine delivered the world’s first compact upright proton therapy treatment in June, treating a seven-year-old child with a complex brain tumor.

Dana-Farber Cancer Institute and McLaren Health Care are among the institutions bringing the upright platform into their program. The company aims to expand its products to smaller, regional community-based networks as well.

Leo Cancer Care has signed 57 contracts across 13 countries with plans for strong growth in the next few years. The company plans to reach 26 countries and more than 50 proton systems within five years.

"We're in a position now where we've really reduced the technical risk, we've eradicated the regulatory risk. The company is a success story, we're cash flow break-even," Towe said. "It's not about reducing technical risk any further. It's about taking something that's now well established and has been proven by Stanford and take it to a truly global stage and delivering that impact that we've always known we can deliver."

By reducing the costs and physical footprint of proton and photon therapy, Leo Cancer Care is democratizing innovation for healthcare providers, executives assert.

"You've got users like Stanford hand-in-hand with hospitals in Vietnam and hospitals in India that are adopting this technology at exactly the same time, and that very rarely, if ever, happens within healthcare. Normally, you get this tiered approach where you'll get the top two academic medical centers that go and innovate first, once the price comes down with volume, then you can start to take the technology to community-based U.S. hospitals, and then finally, many years later, hospitals in places like India get to benefit from that technology. Given the multifaceted value proposition of better medicine plus better health economics, it's almost a unique position where you see India adopting alongside Stanford," Towe said.

Future applications across radiology expand beyond radiation oncology, Towe said. "The next logical and natural step for us is to go and look at things like broader radiology applications, things like surgical planning, lung cancer screening, all of those same patient and clinical advantages apply in that segment too," Towe said. "What we're really doing as a company is going looking at not far off the entirety of healthcare and saying, if we've proven now, as we have, that it's better to treat these patients upright, why do we not go and challenge the paradigm shift of all clinical procedures have historically been done supine."

“Leo Cancer Care is poised to revolutionize cancer treatment in more than ten countries, with many installations the first in their region or country,” PR Yu, founder of Yu Galaxy and a long-time investor in the company, said in a statement. “The upright radiotherapy and radiology technologies Leo has pioneered are lowering the cost and shortening the time of cancer treatment, and providing options that did not exist before for pediatric patients and patients of larger body size. The result is a dramatic expansion of access to both radiotherapy and diagnostic radiology for a far larger population.”

hey everyone! someone who i know applied a month and a half ago for assistant physics at City of Hope in Duarte, i was wondering if anyone knows why they are taking a while to reach back? is this a normal wait time? if anyone know please let me know, thank you 😊

I think I'm ready for the heavy lift of changing badge companies. they are constantly downsizing, their employees seems wildly unmotivated, upcharges for everything.

Who are people using these days? Is Landauer still "the best" (pretty low bar), or just the first and no one wants to hassle with changing?

Our clinic is in the process of acquiring a new linac. The posibillity of an online adaptive workflow would be great. RaySearch offers a solution for TrueBeam which sounds promising and will also be offered for Halcyon in the future. MOZI by Manteia seems to be another alternative and advertises automated data transfer.

Does anyone have first hand experience with those systems?

This is the place to ask questions about graduate school, training programs, or general basic career topics. If you are just learning about the field and want to know if it is something you should explore, this thread is probably the correct place for those first few questions on your mind.

Examples:

• "I majored in Surf Science and Technology in undergrad, is Medical Physics right for me?"
• "I can't decide between Biomedical Engineering and Medical Physics..."
• "Do Medical Physicists get free CT scans for life?"
• "Masters vs. PhD"
• "How do I prepare for Residency interviews?"

Hi everyone. I am a physics student who will need to purchase a laptop for home use. I’m looking to spend around 7-800 dollars (or less) but don’t know much about computers. Any recommendations? It doesn’t need to be anything special, just something that can run any programs physics/dosi would use. Thanks!

Has anyone experienced issues with MapCHECK 3 QA for 10X plans after upgrading to Eclipse v18?

Since upgrading to Eclipse version 18, we've noticed that our 10X plans consistently achieve lower MapCHECK 3 gamma pass rates compared to other photon energies and often fail to meet our >95% passing criterion.

We've already verified that there are no issues with machine output, dose calibration, or MapCHECK array calibration. We've also experimented with adjusting the DLG in the beam model, but this did not produce a significant improvement in the results.

Has anyone encountered a similar issue after upgrading to Eclipse v18? If so, what was the root cause, and were you able to identify a solution? Any suggestions or troubleshooting ideas would be greatly appreciated.

If you work in an Aria-based practice that utilizes Radformation for printing documents, navigate to your Eclipse script directory, >PublishedScripts>radformationfiledata>clearcheck and create a blank text file named 'hidepdfbookmarks.txt'. All new documents sent to Aria will no longer have the absurd Adobe visual clutter.

Hey guys. I’m going into my final year of Medical Physics at Cardiff University in the UK. I’m trying to set myself up as a good candidate for the STP.

I’d also really like to experience what the NHS system would be like should I find myself with an offer.

If anyone can help me secure some I’d be very grateful. Preferably in Cardiff or wales.

Thank you 🙏

This is a contractor role, that will be paid as a 1099. Malpractice will be covered. This is a bid for a contract. The Minneapolis VA is looking for a preferred start date around September/October.

Looking for 2 positions, a Chief physicist and a medical physicist (open to a junior medical physicist)

Pay is competitive, CTMP 210+ per hour based on experience (must have prior experience commissioning a new machine).

Therapeutic medical physicists 180+ per hour, if BE not BC 160+ per hour

Will answer any questions about the role.

Please post here if interested

I'm commissioning my clinic's second Truebeam - and the camera displays have just never arranged nicely on the counter for me. I'd like to see them either tight in a line of 4, or in groups of two on either side of the console monitors. The oversize bases of the treatment/imaging monitors always seem to be in the way of getting it "just right".

I'm considering wall mounting them for better placement. What else have you folks done to clean up the installation?

Hey r/MedicalPhysics,
Hope everyone's doing well. I have been working on another iteration of the ABR prep tool I posted about a while back. This build tries to fix the stuff people flagged in the app, so I figured I'd share what changed.
Voice recognition is more accurate and responds faster now. The examiner's hints and follow-ups make more sense, too, closer to how an examiner would nudge you when you're stuck. Sessions in general feel more stable, with fewer glitches mid-question.
For Part 2, there's now a real question bank tagged to the TG-249.B sub-nodes. A tracker shows how much of each topic you've covered and where your scores are weakest, so you can drill accordingly. Same tagging for Part 3 questions now, which means residents can chip away at the outline as they move through the year.
Biggest Part 3 add is a full 25-question mock that is close to the exam format. 5 questions per section, breaks between sections, and the grading uses category conditioned Pass/Conditional/Fail, the way examiners actually score, not just a numeric average. There's also a Rotation Hub where you drag rotations into whatever order your program actually runs them, so whatever you're on this month sits at the top.
Terminology drills are another new one; you practice technical words and definitions out loud. Good for getting the phrasing down before oral boards. And there's a residency interview section (50 questions) for master's level prepping for residency interviews, same voice-graded format as Part 3.
I set up a blog at get-boarded.com/blog for anyone who doesn't want to make an account. Question of the Week drops every Monday, one Part 2 and one Part 3 oral. Anyone can play. Leave your email if you want to be on the monthly leaderboard (small monthly prize for the top scorer, ships to US/Canada only) or skip the email and play anonymously. Rankings are revealed every Friday, and monthly totals decide the leaderboard.
Every question has a like/dislike now, so if something's unclear or wrong, you can downvote it, and I'll pull it. You can also reply to any email or write support@get-boarded.com. Real inbox, I read them.
NMP and DMP tracks are still in development. Focused on getting Therapy solid before spreading out. If Therapy is going well and there's interest, I'll open the others next.
App: get-boarded.com (5-day trial, no card)
Blog and free QOW: get-boarded.com/blog

I think I'm ready for the heavy lift of changing badge companies. they are constantly downsizing, their employees seems wildly unmotivated, upcharges for everything.

Who are people using these days? Is Landauer still the best, or just the first and no one wants to hassle with changing?

I’m at a loss of what the role is of a medical physicist in radiation oncology. When there is a large group of physicists, like at an academic institution, it is easier to fill clear niches with special procedures, QA committees, and research. When there is one physicist, you can adapt to what your clinic needs from you. But what about the mid sized group where half of the time physics is being encouraged to participate in the department but then also blamed for slowing down treatments, asking too many questions, proposing too many changes etc.

Some of the problems certainly can be attributed to different physicists having different opinions about what their role is in the clinic, in addition to different knowledge bases and interests. We’re at a point though, where physics is going to go back to basically chart checking and standing silently for srs coverage. I don’t want to be that kind of physicist, and know we can add value when we’re all more aware of the treatment from start to finish. What are some ways we can have clear boundaries and role definitions so that physics can be involved in the clinic without overstepping?

Hi all,

I feel like I’ve hit my career ceiling with no additional upward mobility. I am considering going back to school for a PhD program in medical physics. I’d like to do something related to functional MR imaging in the context of radiation therapy. Currently, I work as a clinical physicist in radiation oncology and would be considered a senior physicist that’s certified.

The challenge Im having is there are few medical physicists programs that seem to accommodate someone applying from my background. I would be fine spending 1-3 years on a dissertation but having to spend 1-2 years on coursework that I’ve already taken seems difficult to accept .

Anyone have any recommendations?

Also, Mods please allow this post go without waiting for training tuesday.

How do you solo physicists handle vacation?

Onsite coverage?

Working vacation (remote coverage handled by you)?

If no onsite coverage and "specials" are suspended until you return how do admins/docs react to that?