Calculation of radiation complication probabilities in

organs and tissues on the basis of a modified Weibull's function for use in optimization algorithms

L. Y. Klepper , V. N. Chekhonadsky , V. A. Klimanov

Department of Radiation Physics, Biophysics and Ecology, Moscow State Engineering Physics Institute, Russia

Abstract

At present under the development of optimization algorithms for radiation therapy such values as TCP and NTCP are frequently used. The calculation of these values is carried out basically on the basis of Lyman's models and logistic formula. At the same time in 1982 in Russia Dr. L. Y. Klepper has suggested to use for calculation of complication probability in normal tissues (NTCP) a mathematical model based on a modified Weibull's function.

In this work the application of this approach is considered for optimization problem solving under inhomogeneous irradiation, for calculation of an effective dose under inhomogeneous irradiation of a tissue, being equivalent (by complication probability) to inhomogeneous distribution. The values of free parameters that are included into a mathematical model for different kinds of tumors are presented. The advantages of this model and ways of local set-up of model on the basis of the clinical data are considered also.

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Dynamic shaping, modulation and filtering by gravity oriented absorbers

C. Danciu and B. S. Proimos

Medical Physics Dept., School of Medicine, University of Patras, 26500 Patras, Greece

Abstract

Purpose: To deliver a high and uniform dose to a PTV (convex or concave in shape) with simultaneous protection of the organs at risk (OAR) or any other area.

Materials and Methods: (a) Beam shaping: The two opposite sides of the beam, which are initially parallel to the axis of rotation, are continuously shaped by two absorbers, made of “cerrobend”, attached to two gravity oriented shafts. The outer rays of the so-shaped beam remain always tangential to any convex PTV. The exact form of the absorbers is geometrically determined and depends on the PTV size, shape and location; (b) Beam modulation: If a region near or in the PTV requires protection (i.e. concave PTV), then another absorber, similar to this region, is attached to a third gravity oriented shaft, which is parallel to the axis of rotation and meets the central ray perpendicularly. The absorber’s material depends on the degree of required protection and the size of its transverse cross-section; (c) Beam filtering: The above protection is spilled around the OAR and makes the dose in the PTV non-uniform. To achieve dose uniformity in the PTV, two gravity oriented wooden filters are suspended in the beam. For tumors near the spinal cord, the protector is a lead rod 1.6 cm in diameter and the two filters are wooden disks (0.7 g/cm3 density and 9.0 cm in diameter).

Results and Conclusions: The above techniques have been applied to phantoms for: head and neck tumors, cervix cancer with involvement of the parametria, etc. resulting in an excellent conformation. I.e. the 90 % isodose surface wraps the PTV surface, while the dose to the OARs is kept below the prescribed level.

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Inhomogeneity correction method for irregular fields in conformal radiotherapy

C. Kappas¹, S. Stathakis¹, K. Theodorou¹, N. Papanikolaou² J.C.Rosenwald³

Medical Physics Department, University of Patras, Hellas
Emory University, USA
Institute Curie, France

Abstract

The effect of inhomogeneities in the human body should be considered in order to calculate the dose accurately within the + 5% allowed margin. Up to now, the conventional ("bulk") methods of inhomogeneity correction for high energy X-ray beams assume infinite lateral extend of the heterogeneous volumes. Sophisticated inhomogeneity corrections methods exist but they are time consuming. One of the shortcomings of the "bulk" methods for inhomogeneity correction is that they do not consider directly the shape of the irradiating field (irregular field). As many radiotherapy treatment planning systems are still using such conventional methods for internal inhomogeneity correction, we propose a new approach which combines the 3D Beam Subtraction Method, "3D-BSM" (Kappas and Rosenwald) and Clarkson integration principles. This new approach takes into account the position and the volume extend of the inhomogeneity, as well as, the shape (rectangular or irregular) of the irradiating field and the position of the calculation point. In addition, the method is able to take into account multiple inhomogeneities located anywhere in the irradiated volume.

The method has been extensively tested for open rectangular fields and the results, against the original 3D-BSM method, have been slightly improved. Experimental results with irregular fields showed errors ranging between 1%, for points towards the center of the field, and 2.5%, for points located at the edge of the fields or close to the blocked area.

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Ten theses OF THE invention

"Endoscope with single-use cartridge

for the invagination of endoscopic tube"

(Concept of the development of the Colonoscope for the early diagnostics of colon cancer)

S. Matasov

"Contra Cancrum Coli", Riga, Latvia

Abstract

1.Colon cancer might be controlled if colonoscopy becomes "democratic" - available to family doctors and their patients.

2. For family doctors the "non-democratic" character of colonoscopy is connected with manual colon intubation complexity, for patients - with painfulness, possibility of hepatitis and AIDS infections, high price.

3. The essence of manual colon intubation difficulties lies in colon's tortuousness and the "push" principle implementation.

4. The simplification of manual colon intubation lies in the "pull&push" principle implementation.

5. In the new colonoscope endoscopic tube introduction is realized by pneumatic vanguard and manual rearguard forces interacting in the elastic channel of the invaginator's everted part.

6. Since the invaginator repeats all natural colon curves and excludes intestinal wall stretching, patient does not feel the intubation process.

7. The invaginator and condoms preventing the contact between endoscopic tube and the patient's intestines are combined in a cheap disposable cartridge, which will reduce colonoscopy cost for patients.

8. Manual extraction-intraction of "cable-Boudden" units' cables for guiding the distal end of the new colonoscope is inapplicable.

9. Inutility of long "cable-Boudden" units is due to colon's turtuousness.
10. In the new colonoscope extraction-intraction of cables is realized by hydraulics whose operating cylinders are set maximally to the distal end of the endoscopic tube.

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X-RAY LUMINESCENCE EFFICIENCY AND SPECTRAL COMPATIBILITY OF THE CdPO3Cl:Mn PHOSPHOR FOR APPLICATION IN DIGITAL SOLID STATE RADIATION DETECTORS

I. Kandarakis¹, D. Cavouras¹, S. Tsoukos², A. Kateris², C. D. Nomicos³, and G.S. Panayiotakis²

1. Dept. of Medical Instrumentation Technology, Technological Educational Institution of Athens, Ag. Spyridonos Street, Aigaleo, 122 10 Athens, Greece.

mailto: cavouras@hol.gr
2. Dept. of Medical Physics, Medical School, University of Patras, Greece.
3. Dept.of Electronics, Technological Educational Institution of Athens, Ag. Spyridonos Street, Aigaleo, 122 10 Athens, Greece.

Abstract

Phosphors coupled to crystaline silicon (c-Si) or amorphous silicon (a-Si) photodiode arrays are employed in modern digital imaging systems. In this study the performance of CdPO3Cl:Mn phosphor for use in digital detectors was investigated. To this aim the following parameters were determined: 1. The absolute luminescence efficiency defined as the ratio of emitted light fluence over incident exposure. 2. The compatibility between the light spectrum and the spectral sensitivity of photodiode arrays. Phosphor layers with coating weights from 20 to 250 mg/cm2 were prepared in laboratory by sedimentation of phosphor powder. These layers were irradiated by 50-150 kVp x-rays. The emitted light energy flux was measured by a photomultiplier coupled to an electrometer. The light spectrum was measured by a grating monochromator. Spectral sensitivities of a-Si and c-Si were obtained from manufacturers. Results showed that CdPO3Cl:Mn phosphor exhibited peak absolute luminescence efficiency in the range of tube voltages between 70 and 110 kVp. Spectral compatibility with a-Si photodiode was 0.89, while with c-Si was 0.61. Both values are higher than those of currently employed phosphors. This is interesting for recent flat panel digital imaging detectors.

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OBJECTIVE ASSESMENT OF THE DIAGNOSTIC INFORMATION CONTENT OF IMAGES PRODUCED BY X-RAY SCINTILLATION DETECTORS

D. Cavouras¹, I. Kandarakis¹, A. Kateris², S. Tsoukos², C. D. Nomicos³, and G.S. Panayiotakis².

1. Dept. of Medical Instrumentation Technology, Technological Educational Institution of Athens, Ag. Spyridonos Street, Aigaleo, 122 10 Athens, Greece

2. Dept. of Medical Physics, Medical School, University of Patras, Greece.

3. Dept.of Electronics, Technological Educational Institution of Athens, Ag. Spyridonos Street, Aigaleo, 122 10 Athens, Greece.

Abstract

The performance of x-ray image receptors may be evaluated by the amount of information contained in the images they produce. In this study a method is presented for information estimation in images produced by scintillator detectors. The method follows three steps: 1. Output signal determination in spatial frequency space. The signal is expressed in terms of the x-ray quantum fluence ( ), the detector optical gain (DOG) (number of emitted quanta per x-ray) and the modulation transfer function (MTF). 2.Signal to noise ratio (SNR) determination. SNR is usually expressed via the detective quantum efficiency (DQE) (output over input SNR squared). DQE quantifies useful information in the presence of noise in terms of DOG and NPS (noise power spectrum). 3. Information entropy (IE) and information capacity (IC) determination. These parameters are based on the number of visually distinguishable image gray levels and pixels. Both IE and IC are expressed in terms of DOG, MTF, NPS, DOG, MTF,NPS were experimentally determined at various scintillators and x-ray energies. The latter were prepared in laboratory with various thicknesses. Results showed that x-ray energy, intrinsic physical properties and thickness of the scintillator are important factors in determining image information content.

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ZERO-MAGNETIC FIELD MODIFIES E.COLI RESISTANCE TO ANTIBIOTICS

Antonia Poiata¹, V.V. Morariu², M.Gheorghiu³, D.E. Creanga³

1."Gr.T.Popa" University, Faculty of Pharmacy, Iasi, Romania
2."Babes-Bolyai" University, Faculty of Physics, Cluj-Napoca, Romania

3."Al.I.Cuza" University, Faculty of Physics, Iasi, Romania

Abstract

A lot of 25 E.coli strains, from different patients, was tested for antibiotic drugs resistance using the agar - diffusion method. The bacterial strains were then submitted to zero-magnetic field treatment in a well-controlled laboratory area, where a couple of Helmholtz coils (170 cm in diameter) are able to compensate local geo-magnetic field. The magnetic treatment duration was of six days. The same antibiotics were used in order to evaluate bacteria resistance: ampicillin, ceftazidim, tetracicllin, ofloxacin and kanamicin. The aqueous solutions of drug had dilutions of: 0.25, 0.50, 4, 8, 16, 32, 64 ml/ml. Two types of behavior were detected: strains sensitive to magnetic treatment and strains non-affected by geo-magnetic field compensation. The work parameter was MIC - minimum inhibitory concentration of antibiotic solution. The box-plot representation technique was used to accomplish a statistical comparison of the three data points series. We found that the magnetic- sensitive strains represent the most of the analyzed samples, some of them presenting a significant increase of their resistance to antibiotic drugs while the others present a diminishing of the antibiotic resistance. A possible explanation of these experimental evidences could be related to the putative magnetic contamination of some bacterial strains we analyzed.

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INSTRUMENTAL NEUTRON ACTIVATION ANALYSIS OF BIOLOGICAL MATERIALS VIA SHORT-LIVED RADIONUCLIDES

F. Tzika^1,2, I.E. Stamatelatos¹, G. Lefkopoulos¹ and J. Kalef-Ezra²

Institute of Nuclear Technology and Radiation Protection, NCSR “Demokritos”, Aghia Paraskevi, 15310, Greece.
Medical Physics Laboratory, Medical School, University of Ioannina, Ioannina 45110, Greece.

Abstract

Recent developments in Instrumental Neutron Activation Analysis (INAA) of biological materials via short-lived radionuclides at “Demokritos” research reactor are presented. A new semi-automated apparatus based on a pneumatic sample transfer system for short-time irradiation and rapid gamma-ray counting was developed. The system is optimized for analysis of activation products ranging in half-life from about 60 s to 600 s. Irradiation is performed in a well thermalized neutron fluence rate of 1x1013 cm^-2s^-1 or in a higher flux with a larger fast and epithermal neutron components. The gamma-ray spectroscopy system is tuned for accurate measurements at high and varying count-rates using a Loss Free Counting (LFC) technique. Minimum Detection Limit (MDL) and Minimum Quantification Limit (MQL) for the elements Br, Cl, Na, K, Al, Mg, Mn and V for two common biological reference materials: freeze-dried animal blood (IAEA, A-13) and fish flesh (IAEA, MA-A-2), were determined as a function of irradiation, transfer and counting times.

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LARGE SAMPLE NEUTRON ACTIVATION ANALYSIS OF BIOLOGICAL MATERIALS: A PILOT STUDY

F. Stromatia^1,2, I.E. Stamatelatos¹, G. Lefkopoulos¹ and J. Kalef-Ezra²

Institute of Nuclear Technology and Radiation Protection, NCSR “Demokritos”, Aghia Paraskevi, 15310, Greece.
Medical Physics Laboratory, Medical School, University of Ioannina, Ioannina 45110, Greece.

Abstract

Neutron activation analysis is the only analytical technique that allows non-destructive, multi-element analysis of large samples (i.e. of volume larger than 500 ml). The purpose of this work was to study the physical parameters affecting neutron irradiation and gamma-ray measurement of large samples, with emphasis given on biological materials. Irradiations were performed at “Demokritos” reactor graphite column in a thermal neutron flux of 4.5x10⁶ cm^-2s^-1. Gamma radioactivity measurements were performed using a HPGe detector. The thermal neutron flux perturbation, the self-attenuation of the induced gamma rays and the detector efficiency for voluminous sources were examined in detail. Moreover, as a demonstration of the capabilities of the technique the amount of lean tissue mass and extra-cellular tissue mass was determined in a 500 ml sample of beef muscle by measurement of potassium (K) and chlorine (Cl), respectively. Thus, large sample neutron activation analysis provides a unique tool for body composition studies.

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NEUTRONS FOR MEDICINE AT “DEMOKRITOS” RESEARCH REACTOR

I.E. Stamatelatos¹, I. Anoussis¹, S. Messoloras¹, J. Pirmattis² and M. Fani²

Institute of Nuclear Technology and Radiation Protection,
Institute of Radioisotopes and Radiodiagnostic Products, National Center for Scientific Research “Demokritos”, Aghia Paraskevi, 15310, Greece.

Abstract

“Demokritos” research reactor provides a wide range of research and training opportunities in the challenging field of neutron applications in biomedicine. Current research activities aim to improve medical diagnostic tools, cure cancer with radiopharmaceuticals, study human and animal body composition, analyze biological materials and investigate their properties in health and disease. To achieve these tasks several experimental facilities have been developed. In-pool and in-core neutron irradiation positions are used for radioisotope production and neutron activation analysis. A pneumatic sample transfer system has been advanced for neutron activation analysis via short-lived radionuclides. The technique of large sample neutron activation analysis is explored both at the reactors’ graphite column and using isotopic neutron sources. A new powder diffractometer facility has been installed. In addition, “state-of-the-art” shielding design and technology capabilities are used. Thus, research and development in the life sciences constitute a high priority at “Demokritos” research reactor.

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EVALUATION OF A MODEL FOR DIGITAL SIMULATION OF CIRCUMSCRIBED LESIONS IN MAMMOGRAPHY

S. Skiadopoulos¹ , L. Costaridou¹ , C.P. Kalogeropoulou CP², E. Likaki ², L.Livos ¹, G G. Panayiotakis¹

Dept. of Medical Physics School of Medicine, University of Patras, Hellas
Dept. of Radiology, School of Medicine, University of Patras, Hellas.

Abstract

Introduction. The introduction of models for digital simulation of pathological findings in mammography, used in performance evaluation of digital image processing and computer-aided diagnosis techniques, has increased the need for evaluation of such models. The aim of this study is the evaluation of a model for radiopaque circumscribed lesions, developed in our department.

Materials and Methods. The evaluation of the model was based on the comparison between real and simulated radiopaque lesions and performed on a high resolution monitor. The sample consists of 120 lesions (60 real and 60 simulated lesions). The lesions were evaluated by three experienced radiologists independently, using five-level grading scale. The observer responses were statistically analyzed by means of Receiver Operating Characteristic (ROC) analysis. Specifically, the area under the ROC curve (Az) and the corresponding 95 % confidence interval were calculated for each observer.

Results: The Az values and the corresponding confidence intervals are 0.56 0.05, 0.56 0.05, 0.57 0.05 and (0.46, 0.66), (0.46, 0.66), (0.47, 0.67) for each observer independently, indicating there is no statistical difference between real and simulated lesions.

Conclusion. The model simulates adequately radiopaque circumscribed lesions, met in the clinical environment.

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A QUANTITATIVE EVALUATION OF THE UNDER-EXPOSURE AND OVER-EXPOSURE REGIONS IN MAMMOGRAPHY

K. K. Gallias¹, S. Skiadopoulos¹, L. Costaridou¹, C. P. Kalogeropoulou², G. Panayiotakis¹

1. Department of Medical Physics School of Medicine, University of Patras, Hellas

2. Department of Radiology, School of Medicine, University of Patras, Hellas.

Abstract

Introduction. In mammographic imaging, areas of the film corresponding to dense regions and breast periphery are under- and over-exposed, respectively, which results in deterioration of image quality. The aim of this study is a phantom-based evaluation of under- and over-exposure regions.

Materials and Methods. Plexiglass plates and the Leeds TOR [MAX] test plate were used to simulate mammary gland, dense regions and breast periphery. Comparative evaluation, between mammary gland and dense regions and/or breast periphery was based on the visualization of 6 mm low contrast details, 0.5 mm and 0.25 mm high contrast details. Image quality was quantitatively studied with respect to tube voltage, optical density (OD) and object to holder distance (OHD). Images were interpreted by two observers and comparison was performed by means of the Wilcoxon test.

Results. A highly significant score decrease (p<0.0001) was obtained for dense regions and/or breast periphery as compared with mammary gland. Image quality deterioration ranges from 20.4%-47.4% and 29.0%-88.6% for dense regions and breast periphery, respectively. Visualization of details was independent of tube voltage, OHD and dependent on OD, except for details situated at mammary gland.

Conclusion. Quantitative evaluation of under- and over-exposure regions in mammography, by means of a physical phantom, demonstrated deterioration of image quality in these regions as compared with mammary gland.

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X-ray Software Simulator Tool for Diagnostic Radiology

K. Guerguieva-Bliznakova, J. Bliznakov, Z. Kolitsi, N. Pallikarakis

Department of Medical Physics, School of Health Sciences, University of Patras, Greece.

Abstract

Purpose: This paper presents an investigative software tool, used to simulate the entire radiological imaging process. It includes the imaging modality, operating parameters, objects to be imaged, beam transport. As such, it can be used for a broad range of experimental investigations in radiology: the estimation of the absorbed dose in the phantom and the application in the detector response.

Materials and Methods: The simulator consists of three independent modules: (i) The graphical electronic phantom generator module; (ii) The x-ray spectra generation, simulated using a semiempirical model and selectable parameters for the beam generation; (iii) Beam transport using Monte Carlo simulations.

The output of the system is expressed in terms of: simulated 2D images; angular distribution of the scattered photons; absorbed dose simulation; detector response.

Results: System performance and verification has been assessed against published or measured data. The verification was accomplished in three categories: (i) Verification of the Monte Carlo algorithm. Primary and scattered components of the simulated image were compared to published data. (ii) Verification of the detector response. (iii) Verification of the absorbed dose. Two-dimensional spatial distribution of the absorbed energy in the phantom, respectively in the detector was compared to the published and measured data. Simulated results show good agreement, deviations being of the order of 1 - 2 %. Furthermore, application of the system to carry out a broad scope and effort demanding study, proved an effective and efficient approach.

Discussion and Conclusions: The integrated radiographic simulator provides sufficient accuracy and flexibility to allow for its use in a wide range of approaches. While it may be argued that simulator based investigations cannot always lead to conclusive results, such tools are valuable aids for designing experiments and carrying out first level trials, while their use as training tools is expected to be of particular value.

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A digital density equalization technique improving visualization of dense mammary gland and breast periphery in mammography

A.P. Stefanoyiannis¹, L. Costaridou¹, S. Skiadopoulos¹, C.P. Kalogeropoulou², G. Panayiotakis¹

1. Department of Medical Physics School of Medicine, University of Patras, Hellas

2. Department of Radiology, School of Medicine, University of Patras, Hellas.

Abstract

Purpose: In mammographic imaging, use of high contrast screen-film combinations results in under-exposed and over-exposed film areas corresponding to dense mammary gland and breast periphery, respectively, further characterized by degraded contrast. A digital density equalization technique was designed and developed in order to deal with the problem of poor visualization of these regions.

Materials and methods: In the framework of this study, the non-linear behaviour of the film is considered as the main cause of degraded image quality in both dense breast regions and breast periphery. As the first step of the proposed technique is digitization of the mammogram under consideration, the characteristic curve of the digitizer also has to be taken into account. The problem that is dealt with afterwards is the segmentation of the breast region from the background of the mammogram. Finally, the grey level values corresponding to the segmented breast region are remapped through a filtering process, which takes into account an exposure model of the breast. The technique can be applied either globally to the entire mammogram or locally to a user selected Region Of Interest (ROI).

Results: The performance of the technique was initially evaluated on a sample of 60 mammograms. The resulting mammographic images are density equalized and the visualization improvement of both dense mammary gland and breast periphery was found to be statistically significant (p<0.05).

Conclusions: Application of the proposed technique results in improved visualization of both dense mammary gland and breast periphery regions. The proposed technique is applicable either globally or locally, independent of breast size, breast symmetry and mammographic view.

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Evaluating Image Quality of a New Healthcare Telematics Service (OTE-TS)

O. Kocsis¹, L. Costaridou¹, E. Karavatselou², D. Lymberopoulos², G. Panayiotakis¹

1. Department of Medical Physics, School of Medicine, University of Patras, Greece

2. Wire Communications Laboratory, Department of Electrical and Computer Engineering, University of Patras, Greece

Abstract

The Hellenic Telecommunication Organization (OTE) is in the process of implementing a telematics service for telemedicine, denoted as OTE-TS, providing a stack of functions, protocols and interfaces suitable for co-ordination and management of high level consult, report and review activities. As medical images are a very important component of medical data used for diagnosis, the image quality evaluation of the service is required.

Using computer-generated test objects and taking into account different possible scenarios for the use of this telematics service (e.g., digital to digital, analog to digital) evaluation studies are performed with respect to image quality. Also, the influence of each component of the system on the output image quality is estimated.

The results of the evaluation studies are dependent on the scenario used. In case of a scenario including a digitizer or a film printer the quality of the final medical image is influenced by the characteristics of these components. The degradation of image quality is also dependent on compression ratio for lossy compression. Finally, use of computer-generated test objects allow intercomparison between different systems and follow up in time for the same system.

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Education for registration as a hospital physicist in Sweden

B Nilsson

Department of Medical Radiation Physics, Stockholm University and Karolinska

Institutet, Box 260, S-171 76 STOCKHOLM, Sweden

Abstract

According to a new Swedish legislation there is since 1999 a need for a registration to work as a hospital physicist. In order to get this registration no clinical training at a hospital physics department is needed, but instead a new academic exam, the hospital physics exam was introduced. This exam takes 4.5 years of university studies, which is half a year longer than a Swedish M.Sc-exam. The exam was approved at four Swedish universities in the beginning of the year 2000. The exam comprises around one year of studies in mathematics and one year of classical physics, common for all physics students. The third year includes mainly courses in basic medical radiation physics. The fourth year is more directed towards the medical applications including both the physics of radiotherapy and physics in diagnostic radiology, nuclear medicine and MRI. Courses in applied mathematics and biostatistics are also covered within the education. While this exam is the only basis for registration as a hospital physicist the education besides the more theoretical part, includes several practical exercises and some clinical training. The last half year comprises a thesis project, which shall be directed towards medical radiation physics.

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CURRENT STATE OF TRAINING IN MEDICAL PHYSICS IN IASSY-ROMANIA

M. Gheorghiu, D.E. Creangă

Faculty of Physics, Univ. Al. I. Cuza, Iasi, Romania

Abstract

The education in medical physics significantly expanded in Romania after 1990, Al. I. Cuza University from Iassy being the only one - among the five Iassy universities - where a medical physics department developed. The International Agency for Atomic Energy from Vienna - Austria offered a considerable logistic and material support within the TEMPUS program. The collaboration of the University of Medicine and Pharmacy was also of great importance as specialists in physics and medicine had the chance to work together in a well-stated frame for research and education training. Young people that graduated the courses of Al. I. Cuza University could follow master courses in Patras Medical Center as well as doctorate programs in Greece and Belgium. This year the number of students from the medical physics department is twice larger and a master program was also approved in the frame of our university. Research activity in the field developed too, in the last several years the level of our international participation enlarging significantly.

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BME education: from application area to full program

Jan A. van Alsté

Department of Biomedical Engineering, University of Twente, The Netherlands

Abstract

Due to demographic changes and ongoing prosperity in the Western world it is expected that healthcare, its organisation and the enabling and supporting technology will grow and change rapidly in the next decade. At the same time the barriers between the traditional technological disciplines are fading. In this context the one or two year specialisation in the biomedical engineering application of traditionally educated engineers, is often not sufficient to fulfill the requirements of healthcare. The new challenges in healthcare need more and more, the multidisciplinary approach of engineers that are able to integrate both physical and mental aspects of human condition, into their solutions. For education this means that engineering should be integrated with biomedical knowledge and humanities from the first year on. This change in fact honours the evolution of biomedical engineering from an interesting application area to an independent engineering discipline. It brings forth engineers that are not only involved in the application of technology and engineering in medicine, but also in the direct needs and care of people. In the next years Biomedical engineers will enter the labour market with either a short BME specialisation or a full five-year education. How do we distinguish them?

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Education in Biomedical Engineering at the Technical University of Szczecin

Krzysztof Penkala

Dept. of Cybernetics and Electronics, Inst. of Electronics, Telecommunications and Informatics, Faculty of Electrical Engineering, TUS, Szczecin, Poland

Abstract

In the paper development and modernisation of education in BME at the Faculty of Electrical Engineering TUS are presented. Our University belongs to few centres in Poland offering education in this area, and we have been teaching BME since 1984, as one of specialities (semesters 7 - 10) within the field of studies Electronics and Telecommunications, the M.Sc. degree programme. Each year we have 10 - 15 graduates. The main department running courses in BME is the Department of Cybernetics and Electronics of the Institute of Electronics, Telecommunications and Informatics. Also research activities of the Department correspond to the BME area. Some other departments of the Faculty as well as collaborating scientists from the Pomeranian Academy of Medicine and local hospitals are also involved in teaching. Evolution of the speciality was mainly forced by the demands of regional labour market, which influenced on the students' expectations regarding the study programmes. In the last three years, within a TEMPUS project, aimed at restructuring the system of studies at our Faculty, an effort has been undertaken to modernise also the curricula and syllabi of the BME courses. Thanks to support of our Partners we improved teaching materials and educational skills of our academic staff.

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CLINICAL ENGINEERING ACTIVITIES AT LOCAL HEALTH UNIT

NAPOLI 2: A PROFESSIONAL TRAINING.

M. Bracale¹, M. Cesarelli¹, P. Bifulco¹, R. Castaldo¹, A. Pepino¹, F. Faltoni², M. Festinese²

1.University of Naples "Federico II", Dept. of Electronic Engineering and Communications,Biomedical Engineering Unit. Via Claudio, 21 - 80125 Napoli, Italy.

2. "EBM Elettronica BioMedicale" Via Bettini, 13 - Foligno (PG), Italy.

Abstract

In the new European scenario, the Clinical Engineering is taking an important and increasing role, to provide a professional and practical answer to the question of safety, quality and cost-effectiveness now required by the Health Services.

The expansion and the complexity of the technologies nowadays employed in the Hospitals and the new laws and regulations of the administrations of the Health Services, need continuous and updated services of maintenance and certification of medical devices, providing also reporting data about their cost effectiveness for the management.

Different solutions are available to accomplish Clinical Engineering services, but probably the more often adopted in Italy are those which are based on a internal and/or public activities mixed with the expertise and organisation of specialised private enterprises.

The Local Health Unit Napoli 2 (ASL NA2) has recently established two Conventions with the Dept. of Electronic Engineering of the University of Naples "Federico II" about the electrical safety control of the electrical medical devices and the risks evaluation plans for improving the safety of operators and the users.

These activities have been carried out by the personnel of the University Bioengineering Group with the support of external professionals ("Elettronica Biomedicale" and others professional consultants) in co-operation with ASL NA2 all over the territory of the ASL, which includes 3 Hospitals, 1 Outpatient department and other 42 territorial Units. A group of undergraduate and postgraduate students have been involved in these activities to promote educational practical experiences in this applied field of Bioengineering.

This experience outline the positive, co-ordinational and integrative role that the University can play into the routinely Clinical Engineering activities, which have to be accomplished by the Health Units.

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ISLANDS PROJECT: EDUCATION IN TELEMEDICINE

M. Bracale¹, P. L. Cerato²

1. University of Naples "Federico II", Dept. of Electronic Engineering and Communications,Biomedical Engineering Unit. Via Claudio, 21 - 80125 Naples, Italy

2. General Manager of Local Health Unit ASL NA2 Naples, Italy.

Abstract

Telemedicine is passing from its experimental stage to more routinely and integrated activities. The Telemedicine potentially has a greater positive effect on the future of Healthcare and Medicine than any other modality, especially in isolated, underserved, remote or rural areas where it can bring high-quality care, often not available. Furthermore, by reducing the intervention time required for a specialist diagnosis and for an eventual therapy delivery, telemedicine can offer a prompt and efficient answer to the Healthcare Emergencies. Nowadays, the need of the integration of Telemedicine with the existing Health Services and interoperability between sites is arising. Beside, it is necessary to improve and promote specific educational activities to train the personnel involved. Since July 1997, a cardiological and radiological video-teleconsulting system, which connects the Islands of Procida and Ischia to mainland hospitals of Pozzuoli and Giugliano, has been established (Island Project). The telemedicine network has been enlarged enclosing the Vascular Surgery Dept. of the University of Naples "Federico II", the private Hospital "Clinica Villalba" and also the Dept. of Electronic Engineering and Telecommunication of the University "Federico II". In this context, Technology Assessment activities are being carried out in order to "quantitatively" evaluate the Telemedicine applications for the health services quality, the clinical results, the costs and also the perceptions of the patients and the clinicians with respect to this new tool. Particular attention has been dedicated to the educational aspects; specific courses, integrated with training telemedicine sessions, are given regularly to the operators. Recently, the National Health Services has established a network of equipped sites (SAUT) specialised for emergencies and for primary care; this service can be accessed through the telephone number 118. The Island Project will try to integrate and to co-operate with this service. In addition, recently, training courses dedicated to the emergency operators are being carried out by means of the communication facilities offered by the Telemedicine teleconsultation systems and networks.

The Authors thanks Prof. M. Cesarelli, Dr. P. Bifulco and Mr. C. De Santis for their professional and technical support in preparing the demonstration of video-lecturing.

References:

- M.Bracale, M.Cesarelli, A.Pepino, P.Bifulco "Telemedicine - Islands Project: Cost-effectiveness and Cost-Comparison analysis". Proceedings of the World Congress on Medical Physics and Biomedical Engineering, Chicago, USA July 23-28, 2000.

- M. Bracale. "TELEPLANS and The Islands Project". Proceedings of the 3rd Nordic Congress on Telemedicine Copenhagen, Denmark, September 13-16, 2000.

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MP 1	Calculation of radiation complication probabilities in organs and tissues on the basis of a modified Weibull's function for use in optimization algorithms L. Y. Klepper, V. N. Chekhonadsky, V. A. Klimanov
MP 2	Dynamic shaping, modulation and filtering by gravity oriented absorbers C. Danciu and B.S. Proimos
MP 3	Inhomogeneity correction method for irregular fields in conformal radiotherapy C. Kappas, S. Stathakis, K. Theodorou, N. Papanikolaou, J.C.Rosenwald
MP 4	Ten theses of the invention "Endoscope with disposable cartridge for the invagination of endoscopic tube" (Concept of the development of the Colonoscope for the early diagnostics of colon cancer) S. Matasov
MP 5	X-ray luminescence efficiency and spectral compatibility of the CdPO3Cl: Mn Phosphor for application in digital solid state radiation detectors I. Kandarakis, D. Cavouras, S. Tsoukos, A. Kateris, C.D. Nomicos and G.S. Panayiotakis
MP 6	Objective assessment of the diagnostic information content on images produced by x-ray scintillation detectors D. Cavouras, I. Kandarakis, A. Kateris, S. Tsoukos, C.D. Nomicos and G.S. Panayiotakis
MP 7	Zero-Magnetic field modifies e.Coli resistance to antibiotics A. Poiata, V.V. Morariu, M. Gheorghiu and D.E. Creanga
MP 8	Instrumental neutron activation analysis of biological materials via short-lived radionuclides F. Tzika, I.E. Stamatelatos, G. Lefkopoulos and J. Kalef-Ezra
MP 9	Large sample neutron activation analysis of biological materials: A pilot study F. Stromatia, I.E. Stamatelatos, G. Lefkopoulos and J. Kalef-Ezra
MP 10	Neutrons for medicine at Demokritos research reactor I.E. Stamatelatos, I. Anoussis, S. Messoloras, J. Pirmattis and M. Fani
MP 11	Evaluation of a model for digital simulation of circumscribed lesions in mammography S. Skiadopoulos, L. Costaridou, C.P. Kalogeropoulou, E. Likaki, L. Livos, G. Panayiotakis
MP 12	A quantitative evaluation of the under-Exposure and over-exposure regions in mammography K.K. Gallias, S. Skiadopoulos, L. Costaridou, C.P. Kalogeropoulou, G. Panayiotakis
MP 13	X-ray Software simulator tool for diagnostic radiology K. Gueorguieva-Bliznakova, J. Bliznakov, Kolitsi N. Pallikarakis
MP 14	A digital density equalization technique improving visualization of dense mammary gland and breast periphery in mammography A.P. Stefanoyiannis, L. Costaridou, S. Skiadopoulos, C.P. Kalogeropoulou , G. Panayiotakis
MP 15	Evaluating Image Quality of a New Health Telematics Service (OTE-TS) O. Kocsis, L. Costaridou, D.Lymberopoulos, G. Panayiotakis

EDU 1	Education for registration as a hospital physicist in Sweden, B. Nilsson
EDU 2	Current state of training in medical physics in Iasi, Romania, M. Gheorghiu, and D.E. Creanga
EDU 3	BME EDUCATION: FROM APPLICATION AREA TO FULL PROGRAM, J.A. Van Alste
EDU 4	EDUCATION IN BIOMEDICAL ENGINEERING AT THE TECHNICAL UNIVERSITY OF SZCZECIN, K.Penkala
EDU 5	CLINICAL ENGINEERING ACTIVITIES AT LOCAL HEALTH UNIT NAPOLI 2: A PROFESSIONAL TRAINING, M. Bracale, M. Cesarelli, P. Bifulco, R. Castaldo, A. Pepino, F. Faltoni, M. Festinese.
EDU 6	ISLANDS PROJECT: EDUCATION IN TELEMEDICINE M. Bracale, P. L. Cerato