Medical Applications

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The CIRMS Medical Applications subcommittee deals with diagnostic and therapeutic uses of ionizing radiation, whether isotope or accelerator sourced radiation. New topics of interest involve the growing use of proton beam therapy for more targeted cancer treatment and a need for enhanced dosimetry systems to quantify exposure levels in computerized tomography scans (CT scans). An introduction to the overall areas of interest in the medical area in the use of ionizing radiation can be found in (Appendix D). This was taken from the fourth “Needs Report” of December 2004. More complete details on all of the MPD’s generated by the CIRMS Medical Applications subcommittee can be found in PDF form in prior “Needs Reports” which are accessible on the CIRMS web site: [1].

CIRMS has been very effective in the Medical Applications area by drawing together professionals from the academic and medical communities, from the US FDA’s Center for Devices and Radiological Health (CDRH), and by involvement of the National Institutes of Health, in particular the National Cancer Institute, and of inter-agency groups such as the Biomedical Advanced Research and Development Authority (BARDA). One of CIRMS early success stories (MPD A.1.0 - National Air-Kerma Standards for Mammography) was the organization’s ability to pull together of various agencies to cofund a needed radiation target facility at NIST so that air-kerma measurements for mammography equipment could be calibrated.

NIST, through the guidance of the CIRMS Medical Applications subcommittee, has also established radioactivity standards for nuclear medicine (MPD A.2.3) and for determining the absorbed dose-to-water for photon external beam radiation therapy (MPD A.4.1 - Absorbed-Dose-to-Water Standards for Photon External Beam Radiation Therapy). National standards for the air-kerma measurements of diagnostic X-ray beams (MPD A.5.0 - Air Kerma National Standards for Diagnostic X-ray Beams) and for the air kerma strength of photons emitted by brachytherapy sources (MPD A.6.0 - National Air Kerma Strength Standards for Photon Brachytherapy Sources) have also been established. NIST has obtained equipment, such as a medical linear accelerator, to facilitate these activities. Below is a list of the completed Measurement Program Descriptions prepared by the CIRMS Medical Applications subcommittee. One or two page descriptions of the active MPDs follow. These present the objectives, some background information and needs in each active area.

Medical Applications - Active Measurement Program Descriptions (MPD's)

----High Priority----

A.19.0 Standardization in Radiobiology

A.9.0 Dosimetry for Proton Beam Therapy

A.15.0 Standards for Small Fields in External Beam Therapy

---Medium Priority---

A.8.1 Liquid Based and Micro-Brachytherapy Sources

A.13.0 Enhanced Dosimetry Systems for CT Scans

A.14.0 Cone-Beam CT Dosimetry in Radiation Therapy - maybe this can be combined into A.13.0

A.16.0 Absorbed Dose to Water Standards for Megavoltage Therapy Beams - (Modify for dissemination)

A.17.0 3D Dosimeters for Non-Standard External Beam Therapy Dosimetry - Larry suggested adding Presage and more description

A.18.0 Air Kerma Standards for Ir-192 and Electronic Brachytherapy Sources - (Updating)

A.20.0 Absorbed Dose to Water Standards for Low-Energy X-ray Beams - (Updating)

---Proposed - Works in Progress---

A.21.0 Standardizing Metrics and Methods for Weight Bearing 3D Imaging Devices in Orthopedic Applications

A.22.0 Dosimetry Measurement Protocol for Cone Beam CT Used in Weight Bearing 3D Imaging Devices- (Updating)

A.23.0 Quantitative Imaging - (Updating)

A.24.0 Calorimetry- (Updating)

A.25.0 TRT Dosimetry

A.26.0 Flash Radiotherapy Dosimetry

Medical Applications -- Completed MPDs:

A.1.0 National Air-Kerma Standards for Mammography

A.2.3 Radioactivity Standards and Techniques for Nuclear Medicine

A.3.4 Dose Mapping Systems for 3D Conformal Radiation Therapy and Intensity Modulated Radiation Therapy

A.4.1 Absorbed-Dose-to-Water Standards for Photon External Beam Radiation Therapy

A.5.0 Air Kerma National Standards for Diagnostic X-ray Beams

A.6.0 National Air Kerma Strength Standards for Photon Brachytherapy Sources

A 7.3 Absorbed Dose Standards for Brachytherapy Sources

A.10.0 External Beam Therapy

A.11.0 Radionuclides for Imaging