The Medical Dosimetrist is a highly trained medical professional who is also a valuable member of every Radiation Oncology department. According to the most recent American Association of Medical Dosimetrists survey, the majority hold the Medical Dosimetry Certification Board certificate and spend most of their time performing treatment planning1. With the advancement of artificial intelligence and machine learning, many health professionals, including Medical Dosimetrists and Medical Physicists are cautious about staffing needs and the future of their professions. A recent Point/CounterPoint in Applied Clinical Medical Physics continues this conversation.2 In a 2018 article in Radiotherapy and Oncology, Thompson et al state that increased efficiency in the treatment planning process is probably the largest benefit of artificial intelligence, not necessarily the elimination of treatment planners.3. Embracing technology and developing complementary skills can solidify the future of all health professionals, specifically the Medical Dosimetrist. One of these skills is leadership. Traditionally, leadership is defined as the action of leading a group of people or an organization. It can also be described as the behavior of an individual who influences other individuals to succeed toward a common purpose. This talk will discuss the traits and skills that leaders possess and how a clinical Medical Dosimetrist can develop leadership skills and take on leadership roles.

Learner Outcomes:
1. Identify three skills and three behaviors of a leader
2. Describe the importance of leadership as a Medical Dosimetrist
3. Apply leadership skills in their clinic

CE Credits = 1.0

Anne Greener, PhD, FACR, FAAPM, Chief Medical Physicist
VA-NJHCS - East Orange, NJ

Lee Culp, Annual Conference Committee Chair
AAMD

This panel discussion will showcase similarities and differences in the global practice of treatment planning. The panel will bring together treatment planning professionals from around the world to talk about how treatment planning is done outside of the US. Each panelist will give a brief overview of the unique aspects of treatment planning as it is practiced in their respective country.  The panel moderator will engage the panelists on discussions involving topics such as pathways to becoming a medical dosimetrist/treatment planner in their country, the need for certification, and the duties they are expected to perform in the clinic. Also discussed will be how they plan disease-specific sites, what equipment and tools they use, challenges they may face with training, and where the profession of medical dosimetry is going in their country.    

Learner Outcomes:

1. Compare pathways to the medical dosimetry profession in other countries
2. Outline how international treatment planners approach treatment planning for various disease sites
3. Identify potential challenges of delivering radiation treatment vis a vis expertise, equipment, staffing and other aspects of treatment delivery
4. Identify safety protocols for radiation therapy delivery in other countries
5. Outline the future of treatment planning in other countries  
6. Discover ways medical dosimetrists within the United States can assist international dosimetrists to achieve high outcomes for cancer patients

CE Credits = 1.0

Adriana da Silva Santos, Medical Dosimetrist
Vila Nova Star Hospital

Taeyoon Kim, MS, CMD, RT(T), Chief Medical Dosimetrist
Proton Therapy Center of Korea National Cancer Center

Bryan McLoughlin, Supervisor Radiation Therapist
W.P. Holman Clinic

Yasmin McQuinlan, BRT, Research Dosimetrist
Mirada Medical

Peter Rotich, Head of Radiotherapy
HCG Cancer Care Kenya

Adenike Olanrewaju, MBA, CMD, Medical Dosimetrist
The University of Texas MD Anderson Cancer Center

Jeffrey Antone, Chief Medical Dosimetrist
Northwell Health System

Cara Sullivan, Director of Dosimetry
Landauer Medical Physics

Originally patients diagnosed with diffuse brain mets had one option; WBRT. This was an open field, a tipped collimator and a hand block. Cerrobend blocking allowed us to shield the eye, nasal passages and oral structures.  The introduction of MLCs made Cerrobend blocks obsolete but allowed the same avoidance capabilities. This made treatments more efficient and less labor-intensive. Planning advancements allowed us to modify MLC further to reduce hot spots or minimize side effects. IMRT was available but not widely used for WBRT until clinical trials focused on hippocampal sparing in the brain. At the same time, patients with localized, single metastatic lesions to the brain had limited treatment options such as linac-based cone SRS or Gamma Knife.. As MLCs got smaller it opened the option of DCA SRS. As cancer treatments have improved, patients are often returning for retreatment to the same area. Patients have the option to receive radiation to multiple lesions delivered with separate isocenters. This planning is tedious and showed large levels of heterogeneity upon summing the total of the treatments together. These treatments were time-consuming in terms of treatment machine utilization, chart/plan verification and lengthy and uncomfortable treatment times for the patient receiving them. These problems and further continued advances in treatment planning systems has allowed for the advent of single isocenter plans that can treat multiple metastatic lesions simultaneously with VMAT. This provides more normal brain sparing and conformality. Other benefits include staff/machine time utilization and providing a better experience for patients.   

Learner Outcomes:

1. Recognize the historical advancement of whole-brain RT and SRS
2. Identify areas of improvement with current standard of care treatments 
3. Identify areas of improved efficiency in planning of these difficult cases 
4. Identify treatment planning techniques specific to Multi Met SRS

CE Credits = 1.0

Lexie Smith-Raymond, MAdm, CMD, RT(R)(T), Regional Radiation Oncology Director
Banner University Medical Center Tucson

Angela Locke, BS, CMD, RT(T), Medical Dosimetrist
Banner University Medical Center Tucson

Trinh Nguyen, Dosimetrist
Massachusetts General Hospital, Radiation Oncology

Sponsored by Elekta

Lung cancer is one of the most common cancers, and the leading cause of cancer deaths in men and women in North America and globally.  Stereotactic body radiation therapy (SBRT) is a technique that allows the delivery of very high doses of radiation large fractions (hypofractionation) and has become a standard of care for the treatment of early-stage Non-Small Cell Lung Cancers.

Learner Outcomes:

1. Explain how to plan and treat Lung SBRT with modern Dynamic conformal arcs, where the MLC's are dynamically and variably positioned around the target while the gantry delivers dose with a variable dose rate moving continuously around the patient
2. Apply the various Treatment Planning considerations using Monaco
3. Discuss how simulation, contouring, plan geometry, calculation settings and online treatment verification impact the clinical delivery

CE Credits = 1.0

Mary McCauley, CMD, RT(R)(T), Medical Dosimetrist
Allegheny Health Network

Jeffrey Antone, Chief Medical Dosimetrist
Northwell Health System

Brad Read, Director, Oncology Solutions
Elekta