Displaying publications 1 - 20 of 28 in total

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  1. Kron T, Healy B, Ng KH
    Phys Med, 2016 Jul;32(7):883-8.
    PMID: 27320695 DOI: 10.1016/j.ejmp.2016.06.001
    OBJECTIVE: Our study aims to assess and track work load, working conditions and professional recognition of radiation oncology medical physicists (ROMPs) in the Asia Pacific Region over time.

    METHODS: A structured questionnaire was mailed in 2008, 2011 and 2014 to senior medical physicists representing 23 countries. The questionnaire covers 7 themes: education and training including certification; staffing; typical tasks; professional organisations; resources; research and teaching; job satisfaction.

    RESULTS: Across all surveys the response rate was >85% with the replies representing practice affecting more than half of the world's population. The expectation of ROMP qualifications (MSc and between 1 and 3years of clinical experience) has not changed much over the years. However, compared to 2008, the number of medical physicists in many countries has doubled. Formal professional certification is only available in a small number of countries. The number of experienced ROMPs is small in particular in low and middle income countries. The increase in staff numbers from 2008 to 2014 is matched by a similar increase in the number of treatment units which is accompanied by an increase in treatment complexity. Many ROMPs are required to work overtime and not many find time for research. Resource availability has only improved marginally and ROMPs still feel generally overworked, but professional recognition, while varying widely, appears to be improving slowly.

    CONCLUSION: While number of physicists and complexity of treatment techniques and technologies have increased significantly, ROMP practice remains essentially unchanged over the last 6years in the Asia Pacific Region.

  2. Zaman ZK, Ung NM, Malik RA, Ho GF, Phua VC, Jamalludin Z, et al.
    Phys Med, 2014 Dec;30(8):980-4.
    PMID: 25086486 DOI: 10.1016/j.ejmp.2014.07.002
    Cobalt-60 (Co-60) is a relatively new source for the application of high-dose rate (HDR) brachytherapy. Radiation dose to the rectum is often a limiting factor in achieving the full prescribed dose to the target during brachytherapy of cervical cancer. The aim of this study was to measure radiation doses to the rectum in-vivo during HDR Co-60 brachytherapy. A total of eleven HDR brachytherapy treatments of cervical cancer were recruited in this study. A series of diodes incorporated in a rectal probe was inserted into the patient's rectum during each brachytherapy procedure. Real-time measured rectal doses were compared to calculated doses by the treatment planning system (TPS). The differences between calculated and measured dose ranged from 8.5% to 41.2%. This corresponds to absolute dose differences ranging from 0.3 Gy to 1.5 Gy. A linear relationship was observed between calculated and measured doses with linear regression R(2) value of 0.88, indicating close association between the measured and calculated doses. In general, absorbed doses for the rectum as calculated by TPS were observed to be higher than the doses measured using the diode probe. In-vivo dosimetry is an important quality assurance method for HDR brachytherapy of cervical cancer. It provides information that can contribute to the reduction of errors and discrepancies in dose delivery. Our study has shown that in-vivo dosimetry is feasible and can be performed to estimate the dose to the rectum during HDR brachytherapy using Co-60.
  3. Govindaraju K, Badruddin IA, Viswanathan GN, Ramesh SV, Badarudin A
    Phys Med, 2013 May;29(3):225-32.
    PMID: 22704601 DOI: 10.1016/j.ejmp.2012.03.008
    Coronary Artery Disease (CAD) is responsible for most of the deaths in patients with cardiovascular diseases. Diagnostic coronary angiography analysis offers an anatomical knowledge of the severity of the stenosis. The functional or physiological significance is more valuable than the anatomical significance of CAD. Clinicians assess the functional severity of the stenosis by resorting to an invasive measurement of the pressure drop and flow. Hemodynamic parameters, such as pressure wire assessment fractional flow reserve (FFR) or Doppler wire assessment coronary flow reserve (CFR) are well-proven techniques to evaluate the physiological significance of the coronary artery stenosis in the cardiac catheterization laboratory. Between the two techniques mentioned above, the FFR is seen as a very useful index. The presence of guide wire reduces the coronary flow which causes the underestimation of pressure drop across the stenosis which leads to dilemma for the clinicians in the assessment of moderate stenosis. In such condition, the fundamental fluid mechanics is useful in the development of new functional severity parameters such as pressure drop coefficient and lesion flow coefficient. Since the flow takes place in a narrowed artery, the blood behaves as a non-Newtonian fluid. Computational fluid dynamics (CFD) allows a complete coronary flow simulation to study the relationship between the pressure and flow. This paper aims at explaining (i) diagnostic modalities for the evaluation of the CAD and valuable insights regarding FFR in the evaluation of the functional severity of the CAD (ii) the role of fluid dynamics in measuring the severity of CAD.
  4. Al-jarrah AM, Abdul Rahman A, Shahrim I, Razak NN, Ababneh B, Tousi ET
    Phys Med, 2016 Jan;32(1):36-41.
    PMID: 26494156 DOI: 10.1016/j.ejmp.2015.09.003
    Genipin gel dosimeters are hydrogels infused with a radiation-sensitive material which yield dosimetric information in three dimensions (3D). The effect of inorganic salts and glucose on the visible absorption dose-response, melting points and mass density of genipin gel dosimeters has been experimentally evaluated using 6-MV LINAC photons. As a result, the addition of glucose with optimum concentration of 10% (w/w) was found to improve the thermal stability of the genipin gel and increase its melting point (Tm) by 6 °C accompanied by a slight decrease of dose-response. Furthermore, glucose helps to adjust the gel mass density to obtain the desired tissue-equivalent properties. A drop of Tm was observed when salts were used as additives. As the salt concentration increased, gel Tm decreased. The mass density and melting point of the genipin gel could be adjusted using different amounts of glucose that improved the genipin gel suitability for 3D dose measurements without introducing additional toxicity to the final gel.
  5. Jothy SL, Saito T, Kanwar JR, Chen Y, Aziz A, Yin-Hui L, et al.
    Phys Med, 2016 Jan;32(1):150-61.
    PMID: 26526749 DOI: 10.1016/j.ejmp.2015.10.090
    The radioprotective effect of Polyalthia longifolia was studied in mice. P. longifolia treatment showed improvement in mice survival compared to 100% mortality in the irradiated mice. Significant increases in hemoglobin concentration, and red blood cell, white blood cell and platelet counts were observed in the animals pretreated with leaf extract. Pre-irradiation administration of P. longifolia leaf extract also increased the CFU counts of the spleen colony and increased the relative spleen size. A dose-dependent decrease in lipid peroxidation levels was observed in the animals pretreated with P. longifolia. However, although the animals pretreated with P. longifolia exhibited a significant increase in superoxide dismutase and catalase activity, the values remained below normal in both liver and the intestine. Pre-irradiation administration of P. longifolia also resulted in the regeneration of the mucosal crypts and villi of the intestine. Moreover, pretreatment with P. longifolia leaf extract also showed restoration of the normal liver cell structure and a significant reduction in the elevated levels of ALT, AST and bilirubin. These results suggested the radioprotective ability of P. longifolia leaf extract, which is significant for future investigation for human applications in developing efficient, economically viable, non-toxic natural and clinically acceptable novel radioprotectors.
  6. Lubis LE, Bayuadi I, Pawiro SA, Ng KH, Bosmans H, Soejoko DS
    Phys Med, 2015 Nov;31(7):659-68.
    PMID: 26050060 DOI: 10.1016/j.ejmp.2015.05.011
    The purpose of this study is to quantify the quality of the available imaging modes for various iodine-based contrast agent concentration in paediatric cardiology. The figure of merit (FOM) was defined as the squared signal to noise ratio divided by a patient dose related parameter. An in house constructed phantom simulated a series of vessel segments with iodine concentrations from 10% or 30 mg/cc to 16% or 48 mg/cc of iodine in a blood plasma solution, all within the dimensional constraints of a paediatric patient. The phantom also used test inserts of tin (Sn). Measurements of Entrance Surface Air Kerma (ESAK) and exit dose rate were performed along with calculations of the signal-to-noise ratio (SNR) of all the objects. A first result showed that it was favourable to employ low dose fluoroscopy mode and lower frame rate modes in cine acquisition if dynamic information is not critical. Normal fluoroscopy dose mode provided a considerably higher dose level (in comparison to low dose mode) with only a slight improvement in SNR. Higher frame rate cine modes should be used however when the clinical situation dictates so. This work also found that tin should not be intended as iodine replacement material for research purposes due to the mismatching SNR, particularly on small vessel sizes.
  7. Ng KH, Bezak E
    Phys Med, 2020 Jul;75:83-84.
    PMID: 32559649 DOI: 10.1016/j.ejmp.2020.06.011
    In the current pandemic times, medical physicists may not be aware that there is an interesting story on two significant discoveries related to the coronavirus. One is the invention of the polymerase chain reaction (PCR) and the other is the first electron microscopic observation and identification of the coronavirus. Both of them were disregarded by the reviewers and major journals declined to publish these discoveries. These days, PCR, for example, is a widespread method for analyzing DNA, having a profound effect on healthcare, especially now during the Covid-19 pandemic. Prejudice or perhaps ignorance prevail in every aspect of our society, and there is no exception in scientific research. We need to, however, learn from these two stories and be open-minded about novel discoveries and findings - as they may be just disruptive in the "right" way to lead to an unexpected breakthrough.
  8. Azlan CA, Wong JHD, Tan LK, A D Huri MSN, Ung NM, Pallath V, et al.
    Phys Med, 2020 Dec;80:10-16.
    PMID: 33070007 DOI: 10.1016/j.ejmp.2020.10.002
    PURPOSE: We present the implementation of e-learning in the Master of Medical Physics programme at the University of Malaya during a partial lockdown from March to June 2020 due to the COVID-19 pandemic.

    METHODS: Teaching and Learning (T&L) activities were conducted virtually on e-learning platforms. The students' experience and feedback were evaluated after 15 weeks.

    RESULTS: We found that while students preferred face-to-face, physical teaching, they were able to adapt to the new norm of e-learning. More than 60% of the students agreed that pre-recorded lectures and viewing videos of practical sessions, plus answering short questions, were beneficial. Certain aspects, such as hands-on practical and clinical experience, could never be replaced. The e-learning and study-from-home environment accorded a lot of flexibility. However, students also found it challenging to focus because of distractions, lack of engagement and mental stress. Technical problems, such as poor Internet connectivity and limited data plans, also compounded the problem.

    CONCLUSION: We expect e-learning to prevail in future. Hybrid learning strategies, which includes face-to-face classes and e-learning, will become common, at least in the medical physics programme of the University of Malaya even after the pandemic.

  9. Wong JHD, Ng KH, Sarasanandarajah S
    Phys Med, 2019 Oct;66:21-28.
    PMID: 31546154 DOI: 10.1016/j.ejmp.2019.09.079
    The increased use of medical imaging and radiation therapies has resulted in a high demand for medical physicists. Although medical physics programmes are well established in advanced countries, the same cannot be said for many low- and medium-income countries. In some countries, there may be huge variations in the graduates' skill and quality, which pose a problem in ensuring patient safety, providing quality assurance in treatments, optimisation of protocols and standardisation of quality. It also makes any yet-to-be-established regional peer recognition efforts problematic. In order to understand the depth of this problem, a survey was carried out as part of the home-based assignment under the RAS 6088 IAEA programme. A large diversity in terms of course content, duration, clinical training and student profile could be observed across the Asia-Oceania universities surveyed. Out of 25 programmes, only six received recognition from professional bodies, and they were mostly in Australia and New Zealand. Hence, to ensure quality education, a regional curriculum model needs to be developed to harmonise standards. And there is still a long way to go towards standardizing medical physics education and clinical training in the region.
  10. Fum WKS, Wong JHD, Tan LK
    Phys Med, 2021 Apr;84:228-240.
    PMID: 33849785 DOI: 10.1016/j.ejmp.2021.03.004
    PURPOSE: This systematic review aims to understand the dose estimation approaches and their major challenges. Specifically, we focused on state-of-the-art Monte Carlo (MC) methods in fluoroscopy-guided interventional procedures.

    METHODS: All relevant studies were identified through keyword searches in electronic databases from inception until September 2020. The searched publications were reviewed, categorised and analysed based on their respective methodology.

    RESULTS: Hundred and one publications were identified which utilised existing MC-based applications/programs or customised MC simulations. Two outstanding challenges were identified that contribute to uncertainties in the virtual simulation reconstruction. The first challenge involves the use of anatomical models to represent individuals. Currently, phantom libraries best balance the needs of clinical practicality with those of specificity. However, mismatches of anatomical variations including body size and organ shape can create significant discrepancies in dose estimations. The second challenge is that the exact positioning of the patient relative to the beam is generally unknown. Most dose prediction models assume the patient is located centrally on the examination couch, which can lead to significant errors.

    CONCLUSION: The continuing rise of computing power suggests a near future where MC methods become practical for routine clinical dosimetry. Dynamic, deformable phantoms help to improve patient specificity, but at present are only limited to adjustment of gross body volume. Dynamic internal organ displacement or reshaping is likely the next logical frontier. Image-based alignment is probably the most promising solution to enable this, but it must be automated to be clinically practical.

  11. Chuah SH, Md Sari NA, Chew BT, Tan LK, Chiam YK, Chan BT, et al.
    Phys Med, 2020 Oct;78:137-149.
    PMID: 33007738 DOI: 10.1016/j.ejmp.2020.08.022
    Differential diagnosis of hypertensive heart disease (HHD) and hypertrophic cardiomyopathy (HCM) is clinically challenging but important for treatment management. This study aims to phenotype HHD and HCM in 3D + time domain by using a multiparametric motion-corrected personalized modeling algorithm and cardiac magnetic resonance (CMR). 44 CMR data, including 12 healthy, 16 HHD and 16 HCM cases, were examined. Multiple CMR phenotype data consisting of geometric and dynamic variables were extracted globally and regionally from the models over a full cardiac cycle for comparison against healthy models and clinical reports. Statistical classifications were used to identify the distinctive characteristics and disease subtypes with overlapping functional data, providing insights into the challenges for differential diagnosis of both types of disease. While HCM is characterized by localized extreme hypertrophy of the LV, wall thickening/contraction/strain was found to be normal and in sync, though it was occasionally exaggerated at normotrophic/less severely hypertrophic regions during systole to preserve the overall ejection fraction (EF) and systolic functionality. Additionally, we observed that hypertrophy in HHD could also be localized, although at less extreme conditions (i.e. more concentric). While fibrosis occurs mostly in those HCM cases with aortic obstruction, only minority of HHD patients were found affected by fibrosis. We demonstrate that subgroups of HHD (i.e. preserved and reduced EF: HHDpEF & HHDrEF) have different 3D + time CMR characteristics. While HHDpEF has cardiac functions in normal range, dilation and heart failure are indicated in HHDrEF as reflected by low LV wall thickening/contraction/strain and synchrony, as well as much reduced EF.
  12. Jamal AbuAlRoos N, Azman MN, Baharul Amin NA, Zainon R
    Phys Med, 2020 Oct;78:48-57.
    PMID: 32942196 DOI: 10.1016/j.ejmp.2020.08.017
    PURPOSE: The main objective of this study was to evaluate the efficacy of tungsten carbide as new lead-free radiation shielding material in nuclear medicine by evaluating the attenuation properties.

    MATERIALS AND METHODS: The elemental composition of tungsten carbide was analysed using Field-Emission Scanning Electron Microscopy (FESEM) with energy dispersive X-ray (EDX). The purity of tungsten carbide was 99.9%, APS: 40-50 µm. Three discs of tungsten carbide was fabricated with thickness of 0.1 cm, 0.5 cm and 1.0 cm. Three lead discs with similar thickness were used to compare the attenuation properties with tungsten carbide discs. Energy calibration of gamma spectroscopy was performed by using 123I, 133Ba, 152Eu, and 137Cs. Gamma radiation from these sources were irradiated on both materials at energies ranging from 0.160 MeV to 0.779 MeV. The experimental attenuation coefficients of lead and tungsten carbide were compared with theoretical attenuation coefficients of both materials from NIST database. The half value layer and mean free path of both materials were also evaluated in this study.

    RESULTS: This study found that the peaks obtained from gamma spectroscopy have linear relationship with all energies used in this study. The relative differences between the measured and theoretical mass attenuation coefficients are within 0.19-5.11% for both materials. Tungsten carbide has low half value layer and mean free path compared to lead for all thickness at different energies.

    CONCLUSION: This study shows that tungsten carbide has high potential to replace lead as new lead-free radiation shielding material in nuclear medicine.

  13. Raziff HHA, Tan D, Tan SH, Wong YH, Lim KS, Yeong CH, et al.
    Phys Med, 2021 Feb;82:40-45.
    PMID: 33581616 DOI: 10.1016/j.ejmp.2021.01.067
    PURPOSE: To investigate the efficacy of a newly-developed laser-heated core biopsy needle in the thermal ablation of biopsy tract to reduce hemorrhage after biopsy using in vivo rabbit's liver model.

    MATERIALS AND METHODS: Five male New Zealand White rabbits weighed between 1.5 and 4.0 kg were anesthetized and their livers were exposed. 18 liver biopsies were performed under control group (without tract ablation, n = 9) and study group (with tract ablation, n = 9) settings. The needle insertion depth (~3 cm) and rate of retraction (~3 mm/s) were fixed in all the experiments. For tract ablation, three different needle temperatures (100, 120 and 150 °C) were compared. The blood loss at each biopsy site was measured by weighing the gauze pads before and after blood absorption. The rabbits were euthanized immediately and the liver specimens were stained with hematoxylin-eosin (H&E) for further histopathological examination (HPE).

    RESULTS: The average blood loss in the study group was reduced significantly (p 

  14. Santos JC, Goulart LF, Giansante L, Lin YH, Sirico ACA, Ng AH, et al.
    Phys Med, 2020 Aug;76:337-344.
    PMID: 32759035 DOI: 10.1016/j.ejmp.2020.07.023
    Mentoring aims to improve careers and create benefits for the participants' personal and professional lives. Mentoring can be an individual or a shared experience for a group, while the mentor's role remains the same in both models. Mentors should increase confidence, teach, inspire, and set examples, helping the mentees to mould their path, contributing to the pursuit of their personal and professional goals. This study aims to report on the experience of early-career medical physics professionals and postgraduate students participating in a global mentoring program and to assess the impact of this activity on their professional development. The objectives of this mentoring program are to develop leadership roles among young medical physicists and to provide guidance and support. An online questionnaire was administered to the mentee participants. The analysis of their responses is reported in this work and the current status of the programme was examined using a SWOT analysis. In general, the mentoring experience had a positive impact on the mentees. The mentors were found especially helpful in the decision-making situations and in other conflicts that may arise with career development. Additionally, the mentees felt that mentoring contributed to the development of leadership skills required for the job market and assist in personal development. This paper concludes that participation of young medical physicists in a mentoring group program is beneficial to their career and therefore should be encouraged.
  15. Faust O, Acharya UR, Sudarshan VK, Tan RS, Yeong CH, Molinari F, et al.
    Phys Med, 2017 Jan;33:1-15.
    PMID: 28010920 DOI: 10.1016/j.ejmp.2016.12.005
    The diagnosis of Coronary Artery Disease (CAD), Myocardial Infarction (MI) and carotid atherosclerosis is of paramount importance, as these cardiovascular diseases may cause medical complications and large number of death. Ultrasound (US) is a widely used imaging modality, as it captures moving images and image features correlate well with results obtained from other imaging methods. Furthermore, US does not use ionizing radiation and it is economical when compared to other imaging modalities. However, reading US images takes time and the relationship between image and tissue composition is complex. Therefore, the diagnostic accuracy depends on both time taken to read the images and experience of the screening practitioner. Computer support tools can reduce the inter-operator variability with lower subject specific expertise, when appropriate processing methods are used. In the current review, we analysed automatic detection methods for the diagnosis of CAD, MI and carotid atherosclerosis based on thoracic and Intravascular Ultrasound (IVUS). We found that IVUS is more often used than thoracic US for CAD. But for MI and carotid atherosclerosis IVUS is still in the experimental stage. Furthermore, thoracic US is more often used than IVUS for computer aided diagnosis systems.
  16. Jong WL, Ung NM, Vannyat A, Jamalludin Z, Rosenfeld A, Wong JH
    Phys Med, 2017 Jan;33:127-135.
    PMID: 28089106 DOI: 10.1016/j.ejmp.2016.12.020
    Dosimetry in small radiation field is challenging and complicated because of dose volume averaging and beam perturbations in a detector. We evaluated the suitability of the "Edge-on" MOSkin (MOSFET) detector in small radiation field measurement. We also tested the feasibility for dosimetric verification in stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). "Edge-on" MOSkin detector was calibrated and the reproducibility and linearity were determined. Lateral dose profiles and output factors were measured using the "Edge-on" MOSkin detector, ionization chamber, SRS diode and EBT2 film. Dosimetric verification was carried out on two SRS and five SRT plans. In dose profile measurements, the "Edge-on" MOSkin measurements concurred with EBT2 film measurements. It showed full width at half maximum of the dose profile with average difference of 0.11mm and penumbral width with difference of ±0.2mm for all SRS cones as compared to EBT2 film measurement. For output factor measurements, a 1.1% difference was observed between the "Edge-on" MOSkin detector and EBT2 film for 4mm SRS cone. The "Edge-on" MOSkin detector provided reproducible measurements for dose verification in real-time. The measured doses concurred with the calculated dose for SRS (within 1%) and SRT (within 3%). A set of output correction factors for the "Edge-on" MOSkin detector for small radiation fields were derived from EBT2 film measurement and presented. This study showed that the "Edge-on" MOSkin detector is a suitable tool for dose verification in small radiation field.
  17. Safari MJ, Wong JHD, Jong WL, Thorpe N, Cutajar D, Rosenfeld A, et al.
    Phys Med, 2017 Mar;35:66-72.
    PMID: 28256398 DOI: 10.1016/j.ejmp.2017.02.002
    PURPOSE: The purpose of this study was to investigate the effects of routine exposure parameters on patient's dose during neuro-interventional radiology procedures.

    METHODS: We scrutinized the routine radiological exposure parameters during 58 clinical neuro-interventional procedures such as, exposure direction, magnification, frame rate, and distance between image receptor to patient's body and evaluate their effects on patient's dose using an anthropomorphic phantom. Radiation dose received by the occipital region, ears and eyes of the phantom were measured using MOSkin detectors.

    RESULTS: DSA imaging technique is a major contributor to patient's dose (80.9%) even though they are used sparingly (5.3% of total frame number). The occipital region of the brain received high dose largely from the frontal tube constantly placed under couch (73.7% of the total KAP). When rotating the frontal tube away from under the couch, the radiation dose to the occipital reduced by 40%. The use of magnification modes could increase radiation dose by 94%. Changing the image receptor to the phantom surface distance from 10 to 40cm doubled the radiation dose received by the patient's skin at the occipital region.

    CONCLUSION: Our findings provided important insights into the contribution of selected fluoroscopic exposure parameters and their impact on patient's dose during neuro-interventional radiology procedures. This study showed that the DSA imaging technique contributed to the highest patient's dose and judicial use of exposure parameters might assist interventional radiologists in effective skin and eye lens dose reduction for patients undergoing neuro-interventional procedures.

  18. Jong WL, Ung NM, Wong JH, Ng KH, Wan Ishak WZ, Abdul Malik R, et al.
    Phys Med, 2016 Nov;32(11):1466-1474.
    PMID: 27842982 DOI: 10.1016/j.ejmp.2016.10.022
    The purpose of this study is to measure patient skin dose in tangential breast radiotherapy. Treatment planning dose calculation algorithm such as Pencil Beam Convolution (PBC) and in vivo dosimetry techniques such as radiochromic film can be used to accurately monitor radiation doses at tissue depths, but they are inaccurate for skin dose measurement. A MOSFET-based (MOSkin) detector was used to measure skin dose in this study. Tangential breast radiotherapies ("bolus" and "no bolus") were simulated on an anthropomorphic phantom and the skin doses were measured. Skin doses were also measured in 13 patients undergoing each of the techniques. In the patient study, the EBT2 measurements and PBC calculation tended to over-estimate the skin dose compared with the MOSkin detector (p<0.05) in the "no bolus radiotherapy". No significant differences were observed in the "bolus radiotherapy" (p>0.05). The results from patients were similar to that of the phantom study. This shows that the EBT2 measurement and PBC calculation, while able to predict accurate doses at tissue depths, are inaccurate in predicting doses at build-up regions. The clinical application of the MOSkin detectors showed that the average total skin doses received by patients were 1662±129cGy (medial) and 1893±199cGy (lateral) during "no bolus radiotherapy". The average total skin doses were 4030±72cGy (medial) and 4004±91cGy (lateral) for "bolus radiotherapy". In some cases, patient skin doses were shown to exceed the dose toxicity level for skin erythema. Hence, a suitable device for in vivo dosimetry is necessary to accurately determine skin dose.
  19. Wong JHD, Zin HM, Pawanchek M, Ng KH
    Phys Med, 2019 Nov;67:40-49.
    PMID: 31669669 DOI: 10.1016/j.ejmp.2019.10.019
    OBJECTIVE: Medical physics in Malaysia is still considered a young profession. This workforce survey aims to understand the status, aspirations, motivation and experiences of medical physicists (MPs) in the country. A subsection of this survey also aims to understand the role of women.

    METHOD: A survey was carried out between April 20 and May 30, 2018 by a working group under the Medical Physics Division of the Malaysian Institute of Physics (IFM). The survey form was designed using Google Form and sent to various public and private institutions nationwide that employed MPs registered with IFM.

    RESULTS: A total of 106 responses (28% men and 72% women) were analysed. This represented 30% of the medical physics workforce. Majority of them had postgraduate degrees, but their clinical training is mostly obtained on the job with no certification. The number of low-ranking female MPs was disproportionately high. MPs worked long hours and achieving work-life balance (WLB) was a challenge. Factors that improved their WLB included working close to home, having a supportive manager and flexible working hours. Most MPs aspired to become professional and mentor younger compatriots, besides contributing to patient care and research. Gender discrimination was reportedly low.

    CONCLUSION: Medical physics in Malaysia is growing and has a strong representation of women. In future, they would probably take over the top management from their male counterparts, whose number had stagnated. A united effort was essential to set up a proper clinical training system to train clinically qualified MPs.

  20. Hizam NDA, Ung NM, Jong WL, Zin HM, Rahman ATA, Loh JPY, et al.
    Phys Med, 2019 Nov;67:34-39.
    PMID: 31655398 DOI: 10.1016/j.ejmp.2019.10.023
    PURPOSE: Intensity Modulated Radiotherapy (IMRT) has changed the practice of radiotherapy since its implementation in the 1990s. The purpose of this study is to review current practice of IMRT in Malaysia.

    METHODS: A survey on medical physics aspects of IMRT is conducted on radiotherapy departments across Malaysia to assess the usage, experience and QA in IMRT, which is done for the first time in this country. A set of questionnaires was designed and sent to the physicist in charge for their responses. The questionnaire consisted of four sections; (i) Experience and qualification of medical physicists, (ii) CT simulation techniques (iii) Treatment planning and treatment unit, (iv) IMRT process, delivery and QA procedure.

    RESULTS: A total of 26 responses were collected, representing 26 departments out of 33 radiotherapy departments in operation across Malaysia (79% response rate). Results showed that the medical physics aspects of IMRT practice in Malaysia are homogenous, with some variations in certain areas of practices. Thirteen centres (52%) performed measurement-based QA using 2D array detector and analysed using gamma index criteria of 3%, 3 mm with variation confidence range. In relation to the IMRT delivery, 44% of Malaysia's physicist takes more than 8 h to plan a head and neck case compared to the UK study possibly due to the lack of professional training.

    CONCLUSIONS: This survey provides a picture of medical physics aspects of IMRT in Malaysia where the results/data can be used by radiotherapy departments to benchmark their local policies and practice.

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