BC Cancer

We evaluate the performance of a 4-channel plastic scintillator for real-time dose monitoring during VMAT total body irradiations (TBI).

We aim to compare cervical cancer brachytherapy treatment plans created using custom 3D-printed patient-specific cylindrical templates (PSCTs) to commercially available hybrid interstitial applicators (Geneva/Venezia, Elekta).

To determine the dosimetric impact of 3D-printed patient-specific cylindrical templates (PSCTs) printed with Formlabs Biomed Clear (BC) resin in gynecologic (GYN) high-dose-rate brachytherapy (HDRBT), and to validate clinical intuition of typical cases that w...

To compare and evaluate the benefit of having dual activity on LDR prostate implants as opposed to one single activity to either decrease dose in organs at risks (OARs) urethra and rectum or increase dose to inaccessible areas as in pubic arc obstruction.

RayStation’s Fallback Planning (FBP) uses dose mimicking to automatically generate a new radiotherapy plan from an existing plan using a different treatment modality, technique, or unit. This facilitates contingency planning in the event of a non-paired treat...

Metals in computed tomography (CT) scans often saturate image pixel values, making low- and high-density metals indistinguishable. The purpose of this work was to test the effectiveness of the extended HU mode on a GE Discovery RT16 CT scanner to distinguish...

The dielectric wall accelerator (DWA) offers a low-cost solution for proton therapy with non-resonant waveguides. Radial waveguides (RWGs) transport electronically-switched nanosecond pulses and produce an accelerating electric field in the beam pipe. Previou...

To compare two patient-specific quality assurance measurements for trigeminal neuralgia (TN) treatments to ensure that the QA delivery matches the mechanical treatment limitations.

At BC Cancer-Victoria, existing pathways for patients requiring rapid, same-day RT are limited to simple field-based planning. Patients who would benefit from more conformal techniques or who require consideration of prior treatment history currently experien...

To compare the reproducibility of radiomics features between deep learning (DL) and adaptive statistical iterative reconstruction (ASIR) CT images under systematic acquisition parameter variations using the GE Revolution Apex scanner.

Requiring a radiation oncologist (RO) to be physically present during online adaptive radiation therapy (ART) constrains scheduling and limits patient access. We have developed and implemented a prescribed workflow to delegate contour review and plan approval...

To validate the Acuros XB dose calculation algorithm for lung Stereotactic Body Radiation Therapy (SBRT) by comparing it with the Anisotropic Analytical Algorithm (AAA) and Monte Carlo calculation, and to assess the influence of tumor features and location on...

A partial breast irradiation (PBI) VMAT technique has been implemented at our center based on clinical trial evidence that showed reduced long-term toxicity when compared with whole breast irradiation. Our use case for PBI includes difficult anatomy like very...

To characterize patient‑specific quality assurance (PSQA) measurement frequency patterns across Canadian radiotherapy centers and to identify factors associated with reduced PSQA measurement frequency for routine VMAT and SBRT deliveries. The survey scope was...

Uncertainty about radiotherapy treatments can cause patients distress, which has been linked to poorer outcomes. During interactions with their nursing team, patients often seek information about the safety of their treatments to reduce anxiety. However, the...

Therapy Physics

Radiopharmaceuticals, Theranostics, and Nuclear Medicine

Evidence from randomized trials demonstrates improved memory, cognition, and quality of life in patients whose hippocampi are spared during radiotherapy (RT) to the brain. We present a RapidPlan (RP) model for high-grade glioma RT planning that includes hippo...

A Novel system to distribute evenly and efficiently patient-specific daily, quarterly and yearly clinical workload was developed and optimized to reduce risk of burnout and create space for non-clinical activities.

Magnetic resonance imaging (MRI) is an important tool for visualizing tumor sites and organs at risk during spine radiation treatment planning. Some people with spinal metastasis require pedicle screw fixation to stabilize the spinal column which causes metal...

Treatment planning system (TPS) beam modelling is identified as the largest cause of independent dosimetry audit failure. This study aims to develop and validate a universal beam model (UBM) specific to single-iso multi-target (SIMT) stereotactic radiosurgery...

To evaluate the accuracy of Metal Artifact Reduction (MAR) reconstructions in Head and Neck scans using Virtual Monoenergetic Images (VMI) acquired with the Dual-Energy CT (DECT) technology Gemstone Spectral Imaging (GSI)

To develop an open-source application capable of retrospectively monitoring the position of radiopaque markers from bi-planar fluoroscopy images. To enable investigation of the cardiorespiratory motion of implanted cardiac leads from bi-planar fluoroscopy fro...

Total body irradiation (TBI) requires the entirety of the patient's body to be irradiated, and treatment methods vary greatly across treatment centres. For the majority of techniques, excluding intensity modulated TBI, little is known about the heterogeneity...

To evaluate the stability of interstitial applicators, secured using a belt-and-ties system, during gynecological high-dose rate brachytherapy (HDRBT) delivered over 3 days using a single implant.

To demonstrate and evaluate open-source software for Varian Eclipse TPS to accelerate contouring and planning of breast tangent plans. Eclipse Breast Radiotherapy Auto-planner (Eclipse BRAP) enables production of a quality breast plan within minutes.

High Dose Rate (HDR) brachytherapy requires a rapid turnaround from treatment planning to delivery. Medical physicists perform dose planning and quality assurance (QA) checks prior to treatment, but these tasks are time-consuming and involve repetitive manual...

The accessibility of proton therapy is limited by the size and cost associated with traditional acceleration techniques. The dielectric wall accelerator (DWA) was proposed as a low-cost, compact proton accelerator capable of generating suitable beams for prot...

To quantify the efficacy of CBCT-guided external beam online adaptive radiotherapy (oART) compared to conventional cervical cancer treatment methods, and to determine the impact of intrafraction anatomical motion on dosimetry.

Dual Energy Computed Tomography (DECT) is readily available in some clinical settings, enabling image visualization at multiple energy levels to extract material-dependent attenuation differences. This ability enables improved tissue differentiation and contr...

Accurate 177Lu SPECT quantification is essential for patient-specific dosimetry in radiopharmaceutical therapies. Monte Carlo (MC) based reconstruction uses comprehensive system modeling to stochastically simulate photon transport and detector interactions, p...

Physiologically based pharmacokinetic (PBPK) models used in radiopharmaceutical therapy (RPT) and theranostic digital twins are rapidly increasing in size and mechanistic detail, often containing tens to hundreds of parameters. While such models fit imaging a...

Radiomics enables quantitative characterization of tumors from PET and CT imaging. When anatomic-region-specific cancer data are limited, transfer and semi-supervised learning can improve prediction by leveraging data from different regions; however, the basi...

Head-and-neck radiotherapy inadvertently irradiates salivary glands, leading to radiation-induced xerostomia. Diffusion MRI provides sensitivity to radiation-induced microstructural tissue changes. We hypothesize that changes in intravoxel incoherent motion (...

To describe the development and validation of in-house automatic planning for VMAT partial breast irradiation (PBI) in either 1 or 5 fractions.

To develop and validate a cost-effective 3D printed phantom for off-axis dosimetry using ion chambers

Deviceless 4DCT (D4D) reconstruction relies on changes to patient anatomy, such as lung volume or external contour to generate a pseudo respiratory trace which is used to bin 4DCTs for use in radiotherapy planning. This poses a challenge due to the lack of an...

To investigate internal treatment margins for targets undergoing cardiorespiratory motion with the use of dynamic tracking technology.

Proton therapy (PT) has demonstrated superior healthy tissue sparing compared to photon radiotherapy for various sites; however, PT systems are expensive, which limits global availability. The dielectric wall accelerator (DWA) is proposed as a low-cost, compa...

Gold nanoparticles (GNPs) are promising radiosensitizing agents for high dose rate brachytherapy (HDR); however, complex treatment delivery for HDR has prohibited systematic evaluation of GNP-induced radiosensitization both in vitro and in vivo. Here, we use...

Stereotactic Ablative Radiotherapy (SABR) requires highly complex treatment planning, often consuming many hours of manual effort. The Treatment Planning Automation System (TPAS) was developed to improve efficiency and reduce planner workload while maintainin...

To establish the equivalence of dual-energy 120kVp-like virtual monochromatic images (VMIs) to 120kVp standard single-energy CT images in terms of electron density, image quality, and as applied to clinically representative external beam therapy plans.

Foundation models are general-purpose, adaptable deep learning models trained on vast amounts of data. Despite unprecedented performance in language and vision tasks, their utility for predicting patient outcomes remains to be explored. This retrospective stu...

AI–based radiomics models for thyroid ultrasound often lack interpretability, limiting clinical trust. This study aims to develop and validate a fully interpretable radiomics framework for thyroid nodule classification by linking quantitative ultrasound featu...

To address the limited robustness of existing CT-based radiogenomic models, this study develops a multicenter framework for non-invasive dual prediction of EGFR and KRAS gene mutations in personalized management of non-small cell lung cancer (NSCLC), comparin...

To develop a Gaussian process regression (GPR) framework that treats along-core HDR prostate brachytherapy dose as a spatially correlated signal, in order to denoise voxel-level dose and dose-uncertainty summaries used for Monte Carlo biopsy dose quality assu...

To demonstrate an automated workflow for fiducial marker tracking using online daily CBCT data and to characterize the geometric limitations of utilizing offline CT-sim fiducial centroids for the Varian TrueBeam triggered-imaging system.

To investigate the effect of tumour location and incidental radiation dose delivered to the internal mammary lymph nodes (IMLNs) in breast radiotherapy (RT) on breast cancer-specific mortality (BCSM).

Radiation pneumonitis (RP) is a dose-limiting toxicity following thoracic radiotherapy. Existing RP prediction models have largely focused on clinical factors and conventional dose-volume histogram (DVH) metrics, with limited consideration of higher-order dos...

To develop and evaluate a personalized physician-in-the-loop (PPitL) AI framework for accurate and efficient CT tumor segmentation through iterative clinician feedback.

To determine if Artificial Intelligence (AI) deep learning models can infer patient ethnicity from screening mammograms, and to identify the image features enabling this inference.

Radiopharmaceutical therapies (RPTs) effectively treat metastatic castration-resistant prostate cancer, yet injected radioactivities remain empirically prescribed. Although physiologically-based pharmacokinetic (PBPK) and pharmacodynamic (PD) models can separ...

Ultra-high dose-rate (>40 Gy/s) or “FLASH” radiation therapy has the potential to improve cancer treatment through reduced radiation side effects. The purpose of this work is to create and validate a particle phase space for an electron FLASH (e-FLASH) treatm...

Estimate impact of setup and motion uncertainties on dosimetry of SRS with Virtual Cone (VC) and evaluate a simple method to account for such uncertainties in clinical dose calculations.

Existing "one-size-fits-all" approaches in PSMA radiopharmaceutical therapies (RPTs) fail to account for critical inter-patient variabilities, risking under- or over-treatment. To address this, we are developing theranostic digital twins (TDTs) for reliable p...

To evaluate the reproducibility and electron density sensitivity of CT radiomics features across spectral image types and deep learning reconstruction levels using a tissue-equivalent phantom.

To perform cohort-level probabilistic quality assurance of biopsy dose thresholds in HDR prostate brachytherapy under a fixed localization-uncertainty model and relate robustness to nominal distance from threshold.

Computational nuclear oncology (CNO) methods are advancing rapidly but often developed in isolated tools and workflows that are difficult to reproduce, compare, and share. This fragmentation limits virtual studies and slows translation of physiologically base...

To develop "ROBot" (Radiation Oncology Bot), a unified plugin-based gateway for the Eclipse Treatment Planning System. The system consolidates disparate automation tools into a single interface, providing managed, role-based access control for all radiation o...

Magnetic resonance (MR) imaging is routinely used to contour targets for stereotactic radiotherapy planning. However, MR images can suffer from susceptibility-induced geometric distortions, especially near air-tissue interfaces. The objective of this work is...

Lesion tracking establishes correspondence across imaging time points to assess disease evolution and treatment response. Despite registration-, graph-, and AI-based methods across CT, MR, PET, and PET/MR, robust correspondence in whole-body CT remains challe...

Occasionally radiation therapy staff accidentally place their personal radiation dosimeter badges in the laundry. This study assessed the effects of standard household laundry wash/dry cycles on the dose readings of Landauer Luxel®+ Optically Stimulated Lumin...

Theranostic digital twins (TDTs) are virtual representations of individual patients, that integrate clinical patient history, imaging, and physiologically based pharmacokinetic (PBPK) modeling to simulate radiopharmaceutical therapies (RPTs). Their validation...

Interrupted patient treatments that are split into multiple partially delivered trajectory log files for a given field may be most susceptible to Linac delivery errors. The AAPM TG-100 recommends independent QA checks to prevent the most hazardous failure mod...

Knowledge-based planning tools like RapidPlan (RP) estimate dose-volume histograms (DVH) for organs-at-risk based on anatomical features and historical data. DVH estimates can then be used to guide treatment planning. However, planners may modify the optimiza...

Accurate Hounsfield Unit (HU) to density calibration curves are essential for reliable dose calculations in adaptive radiotherapy. This study quantifies variations in HU-mass density and HU-electron density relationships across imaging protocols, and Ethos Hy...

Accurate quantitative assessment in positron emission tomography (PET) is essential for reliable lesion characterization and therapy response evaluation. Quantitative accuracy is conventionally investigated using physical phantoms or numerical simulations; ho...

While mentorship programs by AAPM and other institutions are increasing, there remains a strong need to raise awareness and provide resources for students and early-career physicists to explore diverse and rewarding career opportunities. This session aims to...

The future of medical physics depends on how effectively we train and support the next generation. As the field, certification requirements, and trainees themselves continue to evolve — driven by advances in artificial intelligence, imaging technologies, and...

Clinical innovation is essential for advancing radiation therapy and is often led by clinically medical physicists. As the clinical and academic landscape evolves, establishing a research portfolio presents challenges and new opportunities for medical physici...

As adaptive radiotherapy (ART) evolves from early innovation to standard clinical practice, structured training and credentialing frameworks are essential to ensure safety, consistency, and confidence across institutions. While technical readiness of ART plat...

The recent clinical trials to evaluate novel dose and fractionations, including for non-malignant conditions, may change the clinical role and scope of RT practice. Clinical trials are ongoing to evaluate the use of RT to treat non-malignant conditions such a...

The coming decade will reshape the practice of medical physics. Economic pressures, workforce shortages, and emerging technologies—particularly artificial intelligence (AI)—will challenge the traditional boundaries of our profession. To sustain excellence in...

Automated quantification of tumor burden in PSMA PET/CT imaging is hampered by the low specificity of image-only AI models, which frequently misclassify physiological uptake as disease. This necessitates time-intensive manual corrections, limiting clinical ut...

Radiopharmaceuticals, Theranostics, and Nuclear Medicine

The AMPERE (Access for Medical Physicists to Education and Research Excellence) program, developed in partnership with the American Association of Physicists in Medicine (AAPM), is a new NIH-supported Research Education initiative designed to strengthen the g...

To apply a multiparametric model selection strategy within a tensor radiomics paradigm, whereby different flavours of radiomics features are generated from multiple PET-CT image fusion strategies, to identify reliable and generalizable machine learning (ML) m...

To determine whether radiomic features extracted from normal endocrine organs, when combined with clinical variables, can capture systemic imaging signatures predictive of clinical progression in patients with PSMA-negative prostate cancer.

At the AAPM 2025 conference, these speakers conducted a 90-minute session titled “Building a Radiopharmaceutical Therapy Program and Expanding to Clinical Trials.” Following the talks and the ten-minute Q&A session, the audience continued to ask questions for...

Professional

To quantify the dosimetric impact of transitioning from water-based TG-43 dose evaluations to advanced model-based TG-186 calculations in permanent prostate brachytherapy, and to assess the effects on target coverage, organ-at-risk doses, and the appropriaten...

In the current Oncology HHR crisis, existing training programs cannot keep up with demand for trained and certified medical physicists. The conventional residency pathway is not keeping up with market demand, resulting in unfilled positions and unsustainable...

Previous work suggests that automatically optimized plans were dosimetrically non-inferior to manual, interactively optimized plans based on institutional clinical goals in a retrospective paired analysis. This study aimed to extend this work to clinical acce...

Professional

Quantitative Lu-177 SPECT imaging requires balancing statistical precision with clinically feasible acquisition times. Conventional reconstruction relies on triple-energy-window (TEW) scatter correction and is therefore effectively limited to the 208 keV phot...

Builds on the AI theme from AAPM's 2025 Annual Meeting while moving from image interpretation to quantitative, treatment-enabling applications. This is an area of growing convergence between SNMMI and AAPM. Focus: How AI and machine learning are transforming...

Radiopharmaceuticals, Theranostics, and Nuclear Medicine

Radiopharmaceuticals, Theranostics, and Nuclear Medicine

Over the past two decades Radiation Therapy has become increasingly reliant on complex software systems, locally developed scripts and spreadsheets. Recent advances in AI technology suggest that this reliance will only increase in the future. While software e...

Professional

Burnout is a widespread phenomenon for health care employees due to heavy workload and emotional distress. With increasing workload and complexity in radiation therapy technology, Medical Physicists are at risk of burnout. The aim of this study is to examine...

For single-isocenter multi-target (SIMT) stereotactic radiosurgery (SRS), benchmarking, auditing and inter-institutional standardization of dose delivery remains challenging as it requires specialized equipment and expertise. Electronic portal imaging devices...

To investigate characteristics of the heart’s respiratory-induced motion and its geometric impact for motion monitoring in cardiac radioablation.

To quantify treatment-associated immune density changes in prostate cancer following HDR brachytherapy, and to determine whether Raman spectroscopic signatures of tissue biochemistry may serve as potential biomarkers of immune response.

To demonstrate that TPAS can generate high-quality plans across the full spectrum of external-beam radiotherapy, from rapid palliative treatments to complex curative SABR.