ACR CMP Members Answer the Call at AAPM Annual Meeting

2019MAHESH mahadevappa[1]This post was contributed by Mahadevappa Mahesh, MS, PhD, FACR, chair of the American College of Radiology (ACR) Commission on Medical Physics.

The American College of Radiology’s (ACR) Commission on Medical Physics (CMP) met on July 14, 2019 in San Antonio, Texas during the Annual Meeting of the American Association of Physicists in Medicine (AAPM). As most ACR physics members are also AAPM members, it’s tradition for commission members to meet at the AAPM annual meeting.

In addition, there was a flurry of activities by ACR physics members:

  • The ACR CMP hosted a student and trainee reception on Saturday evening with more than 80 students and residents in attendance. Members of the physics commission spoke about the ACR, how it supports the interests of medical physics and other membership benefits
  • For the first time, the ACR CMP organized a two hour SAM course titled “ACR Updates: Digital Mammography/CT/Fluoroscopy.” Courses were well attended and presented by ACR physics members:
    • Introduction to ACR activities by Dustin Gress
    • Digital Mammography QC manual by Eric Berns
    • ACR CT Accreditation program by Chad Dillon
    • ACR-DIR Fluoroscopy Pilot Program by Kyle Jones
  • A number of ACR physics committees and subcommittees met face-to-face for productive meetings

ACR CMP members have kept busy in the past few months with several initiatives and activities, including:

  • The Richard L. Morin Fellowship in Medical Physics was developed late fall 2018. Upon approval by the ACR Board of Chancellors in Jan. 2019, CMP was successful in rolling out the program, developing a rubric for reviewing applications and selecting the first Morin Fellow, Ashley Rubinstein, who attended the ACR Annual Meeting in May 2019.
  • CMP chair Dr. Mahadevappa Mahesh was invited to speak at the International Symposium on Standards, Applications and Quality Assurance in Medical Radiation Dosimetry at United Nations — International Atomic Energy Agency (UN-IAEA) in Vienna, Austria
  • The ACR Radiation Safety Officer Resources update is currently underway
  • Media coverage related to CMP was published in the Radiology Business Journal, the ACR Bulletin and other sources

A common thread observed by attendees among the scientific program and vendor exhibits is the increased use of imaging in radiation therapy. I’m proud to see ACR CMP members advancing radiological care through various events and initiatives like AAPM.

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TMIST Defining Breast Imaging Studies for Years to Come

Amy Curtis MD PhotoThis post is contributed by Amarinthia Curtis, MD, radiation oncologist, site investigator for the Tomosynthesis Mammographic Imaging Screening Trial (TMIST) at the Spartanburg Medical Center in South Carolina.

As I recently told The Cancer Letter, TMIST will not only help tailor future breast cancer screening, but the demographic and socioeconomic information on those who enroll—and choose not enroll — will help us know characteristics of those who take part in clinical trials and what barriers may prevent others from doing so.

This information can help expand representation in future trials and make study results more generalizable across populations.

TMIST is the first large randomized controlled trial (RCT) that seeks to identify women in which digital breast tomosynthesis (DBT) may outpace two-dimensional (2D) digital mammography at reducing advanced breast cancer development. TMIST will also create the world’s largest breast cancer biorepository.

TMIST is not just a technology trial, and many women are excited by that. In 2019, the number of women taking part in TMIST has doubled, and the number of TMIST sites is up 50 percent. We have even opened our first site outside of North America as international providers take notice.

However, even as the number of women and sites participating in TMIST moves higher, we have room for many more of both. If your facility has both DBT and 2D digital mammography, you can do this. Check out this new video for more details on TMIST participation.

My site accrues about 40 women per month (2 to 3 per day, 4 days a week) to TMIST. Our lead coordinator recently outlined to the TMIST E-newsletter how our recruitment program has boosted enrollment. TMIST investigators and staff share ideas that may be of help to one another and to you, should you decide to take part.

On July 24, TMIST Principal Investigator Etta Pisano, MD, FACR, will show AHRA 2019 attendees how TMIST participation enables you to help shape breast cancer screening, strengthen your practice and provide covered screening exams to uninsured women.

TMIST participation also opens the door for you to co-author papers resulting from the data produced by this landmark study.

I strongly encourage you to look into TMIST participation. Together, we can move medicine forward.

Visit acr.org/TMIST for information on how to take part in TMIST.

Email any questions you may have to TMIST@acr.org.

Please share your thoughts in the comments section below.

Reducing Lung Cancer Deaths with Low-Dose CT

2016-ACR-223Debra S. Dyer, MD, FACR, chair of the American College of Radiology Lung Cancer Screening 2.0 Steering Committee, contributed this post.

On June 28, 2019, the Journal of Thoracic Oncology published an update to the National Lung Screening Trial (NLST). The new study reports a sustained reduction in cancer deaths from low-dose computed tomography (LDCT) lung screening roughly 12 years after the initial screening exam.

This is good news, and adds to the ever-growing body of evidence that lung cancer screening with LDCT is effective.

The study found the incidence of lung cancer to be nearly the same in both the LDCT group and the chest radiograph (CXR) groups. Lung cancer mortality was 3.3 points lower in the LDCT group (42.9 per 1000) compared to the CXR group (46.2 per 1000), which is similar to the 3.1 points noted in the original NLST study results.

A significantly higher proportion of patients in the LDCT group (39.6%) were found to have Stage 1 cancers compared to the CXR group (27.5%). Fewer in the LDCT group (17.5%) were found to have Stage IV cancer compared to CXR group (22.3 %). This shows persistence of a stage shift with CT screening.

The Number Needed to Screen (NNS) to prevent one death was 303, slightly less than the 320 which was reported in the original study. The stability of the difference in NNS over time indicates that LDCT screening did not just delay lung cancer death by a few years, but prevented it.

In addition, the overdiagnosis rate fell to 3.1%, considerably less than 18% in the original study.

By demonstrating a similar and sustained mortality benefit as the original study, the extended follow-up of NLST confirms what the ACR Lung Cancer Screening 2.0 Steering Committee (ACR LCS 2.0) knows: that LDCT is effective, and that more lives can – and will –  be saved by its effective utilization.

To learn more about how ACR LCS 2.0 is addressing the barriers, identifying solutions and empowering radiologists to lead efforts to increase LDCT adoption, register for our free Lung Cancer Screening Boot Camp Web Series and visit the Lung Cancer Screening Resources page on acr.org.

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