Experience the Elekta Differ - Institute of Physics and Engineering in ...

P06 IMPACT OF TECHNOLOGY 

An institutional experience of 

new technology in radiotherapy 

P07 DETECTOR DENSITY 

Impacts on small-field 

dosimetric measurements 

P07 RANGE UNCERTAINTY 

Proton range uncertainty in 

patient stopping power ratios 

SCOPE 

INSTITUTE OF PHYSICS AND ENGINEERING IN MEDICINE | www.ipem.ac.uk | Volume 21 Issue 3 | SEPTEMBER 2012 

A work of 

fiction? 

Alice through the 

archive cupboard 

Radiating 

enthusiasm 

IPEM at the 2012 Big 

Bang Science Fair 

Call for engagement 

Science and Parliament

DOSIMETRY 

SOLUTIONS 

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A WIDER PERSPECTIVE 

Recently, it was my 

privilege to attend the 

World Congress on 

Medical Physics and 

Biomedical Engineering 

in Beijing, China, which 

was held under the banner of 

‘Promoting Health through 

Technology’. Spread over 5 days and 

with at least 17 parallel sessions, this 

was clearly the challenge that came 

through those elements that I was able 

to experience directly! 

This congress occurs every 3 years 

and is held under the auspices of the 

International Union of Physical and 

Engineering Sciences in Medicine 

(IUPESM). It brings together the 

International Federation for Medical 

and Biological Engineering (IFMBE) 

and the International Organisation for 

Medical Physics (IOMP), and these 

societies were further supported by 

the World Health Organization 

(WHO) and the International Atomic 

Energy Agency (IAEA) as global 

organisations with specific objectives 

in health. 

The world congress can seem a 

little remote from the issues in 

healthcare science in the UK, or even 

in Europe, especially as this was the 

third time in 9 years that it has been 

held in Asia. Although this perhaps 

reflects the changes in the global 

economic landscape, it soon became 

clear to me that it is important not to 

lose sight of the global health 

challenges and the role that we could 

and should fulfil both individually 

and as IPEM. 

INTERNATIONAL 

RELATIONSHIPS 

IFMBE is directly linked to the WHO 

and the United Nations as a nongovernmental 

organisation 

(NGO). It is a position to 

which IOMP aspires and 

hopes to achieve within 

the next 3 years. This 

relationship provides a 

route to influence the delivery 

of healthcare worldwide through 

physics and engineering and is 

already recognised in a programme 

within the WHO which is seeking to 

promote the development of 

appropriate medical devices for 

Peter Jarritt 

President 

▼ 

Being part of 

the global 

medical physics 

community. 

developing countries. This challenge 

was powerfully delivered in a 

plenary lecture given by Adriana 

Velazquez Berumen who is coordinator 

of the Medical Devices Unit 

at the WHO in Geneva. The 

availability and access to appropriate 

medical products and technologies is 

one of the WHO strategic objectives 

for its member states. It is not difficult 

to understand such an objective in 

relation to the developing world, yet 

to me, the challenge was identical to 

that facing the developed world. The 

healthcare agenda in the UK is to 

develop innovative, affordable and 

appropriate healthcare technology to 

address the health needs of the 

population. The developing world 

needs simple, low-powered, low-cost, 

robust and accurate diagnostic tools 

to solve their issues. Does this sound 

familiar? 

The congress had many themes, 

some less familiar than others, 

including education and training, 

radiation safety, safety of medical 

devices, developments in photon and 

ion therapy and x-ray CT, biochipenabled 

translational medicine, signal 

processing and bio-magnetism and 

physiology modelling. It is good to 

know that research and development 

is alive and well. 

IPEM INVOLVEMENT 

IPEM will re-engage with 

the worldwide 

physics and 

engineering 

community 

through the 

International 

Conference 

on Medical 

Physics to be 

held in 

Brighton, 

1st–4th 

September 

2013. The 

programme will 

address the 

international agenda as well 

as showcase the latest scientific 

research. Our response to and 

involvement in these wider 

agendas is important. 

IPEM is formally linked as a 

PRESIDENT’S LETTER | SCOPE 

National Member Organisation to 

the European Federation of 

Medical Physics (EFOMP) and the 

IOMP. IPEM is able to nominate 

and support individuals who are 

willing to stand as officers in these 

organisations. Individuals do not 

represent IPEM but stand to 

develop and support the aims and 

objectives of their respective 

organisation. IPEM supports and 

benefits from these activities 

including the formal recognition 

of the medical physicist as a 

healthcare professional, the 

specification of European 

standards for the medical physics 

expert, and the harmonisation and 

recognition of training 

programmes. 

If you have a passion for 

physics and engineering in 

healthcare, I would encourage you 

to consider if there is a role you 

would be prepared to undertake to 

support these wider agendas. This 

might be through direct 

involvement in programmes in 

developing countries or through 

an international organisation. The 

websites of EFOMP 

(www.efomp.org) and IOMP 

(www.iomp.org) provide an 

indication of their respective 

activities. The IPEM VP 

International, Dr Manivannan 

(a.mani@adn.ac.uk), can provide 

further information and advice. 

In conclusion we should not 

lose sight of the immediate needs 

of the profession in the UK and 

the contribution it can and does 

make to the delivery of healthcare. 

I would refer you to the article 

from Andrew Miller MP in this 

edition of Scope. Parliament 

represents the voice of the people 

and we should equally heed his 

encouragement to lobby and 

inform our MPs, whether in 

devolved governments or 

Westminster, to ensure that our 

contribution is recognised and 

supported appropriately. This is a 

role we can all undertake. If you 

feel you would like support then I 

would encourage you to talk to 

Steve Keevil (President Elect) or 

Carl Rowbottom (VP External). 

SCOPE | SEPTEMBER 2012 | 03

SCOPE | CONTENTS 

THIS ISSUE 

09 

13 

17 

26 

36 

COVER FEATURE 

ENGAGEMENT CALL 

The links between 

science and 

Parliament, and a 

challenge for all 

members 

04 | SEPTEMBER 2012 | SCOPE 

13 ALICE THROUGH THE ARCHIVE CUPBOARD 

A short story about what medical physicists get up to in their spare time. 

Can you find yourself? 

17 RADIATING ENTHUSIASM: IPEM AT THE 2012 BIG BANG SCIENCE FAIR 

How do you explain radioactivity to a 6-year-old? Celebrating science, 

technology, engineering and maths with the next generation 

18 THE LAUNCH OF IPEM OUTREACH STRATEGY 

Helping members to communicate science and engineering to students to 

encourage them to study the subjects further 

TRAVEL AWARD 

19 AAPM–IPEM MEDICAL PHYSICS TRAVEL GRANT REPORT 

Jun Deng 

MEETING REPORTS 

23 BESPOKE SOFTWARE IN MEDICAL PHYSICS AND CLINICAL ENGINEERING 

Andrew Robinson 

26 2012 ESTRO 31/WORLD CONGRESS OF BRACHYTHERAPY 

Ahamed Badusha Mohamed Yoosuf 

30 REPORT ON NPL CLINICAL TEMPERATURE MEASUREMENT MEETING 

Rosie Richards and Jason Britton 

HISTORICAL FEATURE 

46 A HISTORY OF MEDICAL PHYSICS 

Francis Duck 

REGULARS 

03 PRESIDENT’S LETTER A wider perspective 

05 EDITORIAL Farewell Marc 

06 NEWS Recent discoveries in radiotherapy research 

33 INTERNATIONAL NEWS International conferences in 2012 and 2013 

35 MEMBERS’ NEWS Accolades for current and retiring members 

40 BOOK REVIEWS Medical physics and popular science textbooks 

© r.nagy / Shutterstock

Scope is the quarterly 

magazine of the Institute 

of Physics and Engineering 

in Medicine 

IPEM Fairmount House, 

230 Tadcaster Road, 

York, YO24 1ES 

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E office@ipem.ac.uk 

W www.ipem.ac.uk 

W www.scopeonline.co.uk 

EDITOR-IN-CHIEF 

Gemma Whitelaw 

Radiotherapy Physics, 

Basement, New KGV 

Building, 

St Bartholomew's Hospital, 

West Smithfield, 

London, EC1A 7BE 

E glwhitelaw@gmail.com 

ASSISTANT EDITOR 

Usman I. Lula 

Department of 

Radiotherapy, 

Poole Hospital, 

Longfleet Road, Poole, 

BH15 2JB 

E usman.lula@poole.nhs.uk 

MEETING REPORTS 

EDITOR 

Angela Cotton 

Head of Non-Ionising 

Radiation Support, 

Medical Physics & 

Bioengineering, 

Southampton General 

Hospital, Southampton, 

SO16 3DR 

E angela.cotton@suht. 

swest.nhs.uk 

NEWS EDITORS 

Usman I. Lula 


Radiotherapy, Poole 

Hospital, Longfleet Road, 

Poole, BH15 2JB 


and 

Richard A. Amos 

Department of Radiation 

Physics, The University of 

Texas M.D. Anderson 

Cancer Center, 

1840 Old Spanish 

Trail,Houston, 

Texas 77054, U.S.A. 

T + 1 713 563 6894 

F + 1 713 563 1521 

E richamos@mdanderson. 

org 

BOOK REVIEW EDITOR 

Usman I. Lula 


Radiotherapy, 

Poole Hospital, 

Longfleet Road, Poole, 

BH15 2JB 


MEMBERS’ NEWS EDITOR 

Matt Gwilliam 

Cancer Research UK 

Clinical MR Research 

Group, Institute of Cancer 

Research and Royal 

Marsden NHS Foundation 

Trust, Sutton 

SM2 5PT 

E mattgwills@gmail.com 

INTERNATIONAL EDITOR 

(Developing countries) 

Andrew Gammie 

Clinical Engineer, 

Bristol Urological Institute, 

BS10 5NB 

T +44(0)117 950 5050 

extension 2448 or 5184 

E agammie@iee.org 


(North America) 

Richard A. Amos 

Department of Radiation 

Physics, The University of 

Texas M.D. Anderson 

Cancer Center, 1840 Old 

Spanish Trail,Houston, 

Texas 77054, U.S.A. 

T + 1 713 563 6894 

F + 1 713 563 1521 

E richamos@mdanderson. 

org 


Ryan D. Lewis 

Department of Medical 

Physics and Clinical 

Engineering, Abertawe Bro 

Morgannwg University, 

NHS Trust, Singleton 

Hospital, Swansea, 

Wales, SA2 8QA 

T +44(0)179 220 5666 

extension 6438 

E ryan.lewis@swansea- 

tr.wales.nhs.uk 

ONLINE EDITOR 

Position vacant 

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© IPEM 2012 

ISSN 0964-9565 

“ 

Please 

contact me if 

you wish to 

contribute to or 

comment on 

our magazine 

GEMMA WHITELAW 

” 

GEMMA WHITELAW EDITOR-IN-CHIEF 

COMMENT | SCOPE 

AFAREWELL MARC 

fter 5 years our Editor Marc 

Miquel is stepping down. I 

want to thank Marc for all his 

hard work; he has achieved 

many things whilst Editor, 

including the launch of Scope 

Online (www.scopeonline.co. 

uk), several changes to the editorial board and 

launching the Keith Boddy prize for best 

educational article. It’ll be a tough act for me to 

follow, a daunting but exciting challenge, and I 

shall keenly miss the guidance and direction 

Marc has given me whilst I was his deputy. 

Thankfully his office is just across the road 

from mine, so his unseen hand may be visible 

until I find my feet. 

This edition of Scope includes a fascinating 

article kindly written for us by Andrew Miller 

MP. Here he discusses the links between 

science and politics and presents all IPEM 

members with a challenge, which will 

hopefully improve the profile of our field in 

Parliament. Of course what goes for 

Westminster MPs also applies to MSPs and 

representatives in the other devolved 

assemblies. 

If you ever wondered what was lurking in 

the back of your department’s archive 

cupboard or what your colleagues do outside 

the office, then look no further than Henry 

Lawrence and Lynn Martinez’s article ‘Alice 

through the archive cupboard’. Who would 

have thought extreme ironing and free diving 

were in our collective skill-set? 

This issue also heralds other changes: Robert 

Nielson, IPEM’s General Secretary, and Peter 

Sharp OBE, the second President of IPEM, are 

both retiring. I am sure they will both be 

missed by all who have worked with them. 

This issue also includes all the regulars such 

as news from Richard and Usman, a very full 

book review section and another absorbing 

chapter in Francis Duck’s tales on the history 

of medical physics. This one focuses on 

statistical thinker and physician Jules Gavarret. 

Scope is a magazine written by and for the 

membership of IPEM. If you are a member 

then it is your magazine! If you know 

something that no-one else does or want to 

share your point of view more widely amongst 

your colleagues then this is the forum to join 

in. So, please contact me if you wish to 

contribute to or comment on our magazine. 


SCOPE | NEWS BY USMAN I. LULA AND RICHARD AMOS 

IN BRIEF 

HIFU REDUCES 

SIDE EFFECTS 

According to a study from 

UCL UK, 42 patients 

received focal HIFU 

delivered to clinically 

significant cancer lesions. 

Twelve months after 

treatment, urinary and 

erectile function returned to 

pre-treatment levels 

(Lancet Oncol; doi: 

10.1016/S1470- 

2045(12)70121-3). Early 

evidence on cancer control 

was also encouraging. 

BRAIN MINI 

MAGNETOMETER 

In experiments performed at 

the Physikalisch-Technische 

Bundesanstalt in Germany, 

the sensor was used for 

magnetoencephalography 

(MEG) to measure alpha 

waves associated with a 

subject opening and closing 

their eyes, and signals 

resulting from hand 

stimulation (Biomed Opt; 

doi: 10.1364/BOE.3.000981). 

COILS MODULATE 

ACTIVITY 

Investigators from 

Massachusetts have shown 

that magnetic stimulation 

can generate similar neural 

activity to that elicited by the 

electrical impulses used for 

DBS. They demonstrated 

that a magnetic coil could 

elicit neuronal signals in 

retinal cells when implanted 

into the brain directly above 

retinal tissue (Nat Commun; 

doi: 10.1038/ncomms1914). 

ENGINEERED 

MICROVESSELS 

Bioengineers at the 

University of Washington, 

Seattle, have developed a 

means to grow small 

human blood vessels, 

creating a 3D test bed with 

which to study vascular 

phenomena such as 

angiogenesis and 

thrombosis. The engineered 

vessels could transport 

human blood smoothly, even 

around corners. 


Institutional experience of new 

technologies in radiotherapy 

TABLE 1 

Category Selections 

Demographics 

Process step 

of origination 

Event type 

Simulation 

Treatment 

planning 

According to the Radiotherapy Risk 

Profile report, published by the 

World Health Organization, it is 

estimated that treatments for 

approximately 3,000 patients were 

affected by radiotherapy errors 

between 1976 and 2007. Analysis, 

even of clinically insignificant 

events, can uncover QA 

deficiencies whilst also providing a 

method to study the impact of 

patient safety enhancements. 

Date of event 

Time of event (May 2007 onwards) 

Number of treatment sessions for course 

Treatment site 

Treatment machine 

Simulation 

Treatment planning 

Data entry/transfer 

Treatment delivery 

Patient measurement 

Simulation documentation 

Incorrect manual application of transmission factor 

Calculation error – inverse square 

Calculation error – other parameters 

MD prescription/planner prescription misinterpretation 

Transcription error 

Other planning error 

Incorrect manual entry of treatment parameters 

Data entry Incorrect scheduling of treatment fields or treatment 

sessions 

Incorrect/omitted block, bolus, compensator 

Incorrect/omitted wedge 

Incorrect/omitted static MLC shape 

Incorrect/omitted dynamic MLC shape (IMRT) 

Treatment 

Incorrect treatment record (charting) 

Incorrect use of field parameters or R&V override 

Incorrect treatment distance 

Incorrect field position (other than distance) 

2.5 mm 3%/3 mm 

Event impact 

Dosimetric magnitude per treatment session 

Dosimetric magnitude over treatment course 

Number of treatment sessions for which event occurred 

Table 1: Patient event demographic and event type classification. 

Thanks to Margie A. Hunt for supplying the image. Figure © Elsevier, 

'The impact of new technologies on radiation oncology events and 

trends in the past decade: an institutional experience’, Margie A. Hunt, 

Gerri Pastrana, Howard I. Amols, Aileen Killen, Kaled Alektiar, Int J 

Radiat Oncol 2012; article in press. 

Some previous studies have 

shown that new technologies such 

as record-and-verify (R&V) systems 

can both decrease certain event 

types and increase the potential for 

others, e.g. field parameter/R&V 

override and charting events. 

The purpose of this study, from 

the Memorial Sloan-Kettering 

Cancer Center in New York, was to 

review the type and frequency of 

patient events from external beam 

radiotherapy over a 10-year period. 

This was a period which 

encompassed significant 

technology change. The study would 

allow the group to identify trends, 

achievements and areas for 

improvement. 

Four radiation oncology process 

steps were classified and further 

sub-classified according to event 

type (table 1): simulation, treatment 

planning, data entry/transfer and 

treatment delivery. Events were 

segregated according to the most 

frequently observed types. 

There was generally a downward 

trend over time in the event rate 

mainly due to technological 

changes, e.g. replacement of R&V 

system and widespread 

implementation of IMRT. A total of 

284 events were recorded between 

2001 and 2010. During this time, 

approximately 30,600 new 

treatment courses and 597,000 

treatments were delivered, yielding 

an event rate of 0.93 per cent per 

course and 0.05 per cent per 

treatment session. Frequency of 

event types particularly in planning 

and treatment delivery changed 

significantly over the course of the 

study. Treatments involving manual 

intervention carried an event risk 

four times greater than those 

relying heavily on computer-aided 

design and delivery. 

Areas for improvement include 

manual calculation and data entry, 

late-day treatments and staff 

overreliance on computer systems. 

The changing roles of R&V systems 

inherent in an electronic medical 

record environment, the 

introduction of even more complex 

technology and the emergence of 

hypofractionated treatment 

paradigms may all lead to new types 

of errors. 

Further improvements in patient 

safety are imperative, given the 

severe consequences that can arise 

from radiotherapy errors. 

MORE INFORMATION 

This work was recently published in Int 

J Radiat Oncol 2012; article in press, 

http://dx.doi.org/10.1016/j.ijrobp. 

2012.01.042

Detector density impacts 

small-field dosimetry 

A group of researchers at the 

Clatterbridge Cancer Centre are 

investigating how physical 

characteristics of detectors 

affect small-field dosimetric 

measurements. The group 

recently published their report 

on the impact of density and 

atomic composition on the 

response of various detectors in 

small fields. 

Monte Carlo modelling was 

used to examine variations of a 

correction factor, F detector , 

with field size. F detector is 

defined as the ratio of dose to a 

water voxel and dose to the 

same voxel with the density of 

the detector. 

In total, three detector types 

were studied: PTW diamond 

detector (density 3.5 g/cm 3 ); 

PTW 31016 Pinpoint chamber 

(0.0012 g/cm 3 ) and Scanditronix 

unshielded electron diode (2.3 

g/cm 3 ). Monte Carlo simulations 

modelled a 15 MV beam incident 

upon a water phantom with 

source-to-surface distance 

(SSD) of 100 cm. Detector voxels 

were located at 5 cm depth with 

volumes roughly equal to each 

detector’s active volume. 

The specific impact of 

detector density on response 

was isolated through two sets of 

calculated values for F detector . 

The group first calculated 

F detector using the density and 

mass radiological properties of 

the modelled detectors, and 

then repeated the calculations 

using the densities of diamond, 

silicon and air, but with mass 

radiological properties fixed at 

those of unit density. 

Simulations using field sizes 

ranging from 0.25 to 10 cm 

showed that F detector varied 

significantly as a function of field 

size for all three detector types. 

The high-density diamond and 

silicon detectors over-read at 

small field sizes, relative to 

wide-field readings, whereas 

the low-density air-filled 

detector under-read at small 

field sizes. Similar patterns 

were observed for the densitymodified 

water voxels, although 

values for F detector converged 

to unity for large fields. This 

behaviour suggests that the 

variation of F detector at small 

field sizes arises from 

differences in detector density, 

rather than atomic composition. 

The researchers then 

studied integral doses of slit 

fields using the silicon diode 

and Pinpoint detectors. It was 

observed that doses measured 

along a profile varied far less 

than central axis doses, 

suggesting that, while doses at 

the centres of individual small 

fields would contain errors if left 

uncorrected, integral doses 

calculated for VMAT or IMRT 

plans (which contain many 

overlapping small fields) would 

be approximately correct. This 

implies that correcting 

measured small-field dose 

distributions simply by scaling 

them using central axis 

F detector values may lead to 

erroneous estimates of the 

integral doses delivered by 

techniques using multiple small 

fields. As such, the authors 

describe the ideal small-field 

dosimeter as having a small 

active volume and water-like 

density. 

Work is ongoing to develop a 

cavity theory that describes this 

density dependence. 

A closer look at proton range uncertainties 

The major challenge for 

accurate range calculations for 

therapeutic proton beams is the 

uncertainty in patient stopping 

power ratios (SPRs). Margins 

along the beam axis, both distal 

and proximal to the clinical 

target volume, are used during 

the treatment planning stage to 

account for this uncertainty and 

ensure target coverage. A value 

of 3.5 per cent has been 

commonly used in the design of 

these margins for many years, 

but recently a group of 

researchers at the University of 

Texas MD Anderson Cancer 

Center took a closer look at this 

uncertainty. 

Using a combination of 

previously published data and 

new, measured data, the 

researchers assessed five 

contributions to SPR 

uncertainty in three 

representative tissue types: 

low-density lung, intermediatedensity 

soft tissue and highdensity 

bone. Four of the 

contributing factors correspond 

to steps in the stoichiometric 

calibration method, the most 

commonly used method for 

deriving SPRs for different 

tissue types. The fifth originates 

from the dose calculation 

algorithm used in a treatment 

planning system. Stopping 

NEWS BY USMAN I. LULA AND RICHARD AMOS | SCOPE 

F detector as a function of field size. 

power ratios vary with proton 

energy and consequently vary 

along the proton beam path, 

whereas common algorithms 

ignore this effect. 

The researchers used the 

uncertainties for each tissue 

type to estimate the composite 

range uncertainty for each 

beam in the treatment plans of 

15 patients who were 

undergoing proton therapy for 

lung, prostate and head and 

neck cancers. 

Uncertainty in individual 

tissue types, expressed to one 

standard deviation, ranged from 

1.6 per cent for soft tissue to 5.0 

per cent for lung. Expressed 


This story was first reported on Medical 

Physics Web on 11th July: 

http://medicalphysicsweb.org/cws/art 

icle/research/50234 

using the 95th percentile, 

beams used to treat lung 

tumours exhibited the greatest 

composite uncertainty of 3.4 

per cent. Beams treating 

prostate and head and neck 

cancer both resulted in an 

uncertainty of 3.0 per cent. 

This study highlighted that 

the currently used value of 3.5 

per cent is appropriate as a 

general recommendation to 

account for SPR uncertainties, 

and the group have no 

immediate plans to change 

their clinical practice. 


This paper was published in Phys Med 

Biol 2012; 57: 4095–115. 


FEATURE | SCOPE 

SCIENCE AND 

PARLIAMENT: 

A CALL FOR ENGAGEMENT 

© r.nagy / Shutterstock 

Andrew Miller MP discusses the links between 

science and politics, outlining a challenge that 

all members can be involved with in order to 

benefit not only the profession but also 

healthcare and the whole science community 

Irecently spent a weekend at 

Ditchley Park in Oxfordshire, 

a house that has not only been 

graced with great names like 

Winston Churchill among its 

visitors, but has been the 

home of high-level brain storming 

sessions amongst experts on many 

subjects over the last 60 years. 

Initially Sir David Wills, who 

conceived the idea and at that time 

owned the house, saw it as a venue 

for improving relations across the 

Atlantic, especially between our 

respective governments here and in 

the US. 

Today the transatlantic dimension 

is just as strong but many other 

nations participate in trying to find 

solutions to problems that face us 

all. That is why I leapt at the 

opportunity when I was invited to 

attend a seminar entitled ‘Putting 

Science, Government, Business and 

Innovation Together’. All of my 

adult life I have been fascinated with 

the challenge of how to use science 

in a way that benefits people, and 

also the vexed question of engaging 

our society in the scientific 

challenges of today and helping 

people without a science 

background to understand the 

relevance of research that is 

undertaken. Those challenges exist 

throughout our society but are 

especially acute in Parliament. MPs 

are expected to take important 

decisions not just about the science 

budget but about the application of 

science throughout the country we 

seek to represent, dabbling in areas 

ranging from education through to 

why we should invest in CERN or 

the next generation of astronomy. 

You do not need to know much 

about the political process to realise 

that this presents a challenge; 

politics is all about priorities. But as 

only about 10 per cent of the House 

of Commons (a figure that has 

stayed relatively stable for some 

time) have ever worked in an STEM 

discipline, engaging with MPs is 

essential. 

At the end of the Ditchley Park 

weekend we were each asked to sum 

up in one sentence what we got out 

of the event. In my case I learnt a 

tremendous amount but it 

convinced me more than ever of the 

importance of continuing the 

longstanding work I am involved in 

within Parliament to help build a 

bridge between science and politics. 

SCIENCE IN PARLIAMENT 

There are some stunningly good 

arrangements in place, such as the 

Royal Society’s pairing scheme, 

which offers Fellows an opportunity 

to pair with an MP or civil servant 

▼ 


▼ 

SCOPE | FEATURE 

and both spend time together in their 

respective environments. My limited 

knowledge of nanotechnology came 

from such an experience. There are 

also schemes like Newton’s Apple, 

devised and run passionately by 

Michael Elves, a man with a 

distinguished industrial and 

academic record who brings young 

scientists into the House. 

Similarly there are events like the 

Parliamentary Links Day, now 

organised by the Society of Biology 

on behalf of the science and 

engineering community, and 

supported by the Institute of Physics, 

the Royal Society, the Royal Society 

of Edinburgh, the Royal Academy of 

Engineering, the Biochemical Society, 

the Society for Experimental Biology, 

the Society for Applied Microbiology, 

the British Pharmacological Society, 

the Astronomical Society, the 

Geological Society, the Council for 

the Mathematical Sciences, the New 

Engineering Foundation, the Royal 

Society of Chemistry, the Campaign 

for Science and Engineering and the 

Parliamentary and Scientific 

Committee. This year more than 120 

people came to the House to focus on 

a series of discussions around science 

and sport; the subject was obviously 

not chosen by accident! 

The Speaker of the House of 

Commons, Rt Hon John Bercow MP, 

opened the meeting. He is quoted on 

the Society of Biology’s website as 

saying: ‘I know, from my unique 

vantage point in the House, that 

Members on all sides continue to 

raise issues that have a scientific 

aspect to them. 

‘It is all the more important that 

every Member of Parliament should 

be able to benefit from non-partisan 

assistance of the kind offered by 

professional scientific bodies like the 

Society of Biology, the Institute of 

Physics, the Royal Society of 

Chemistry and many others with 

their proven commitment to public 

interest.’ 

The first All Party Parliamentary 

Group was the Parliamentary and 

Scientific Committee (P&SC). All 

Party Groups are made up of MPs 

and peers working together across 

parties on areas of common interest. 

The P&SC engages regularly with the 

science community and publishes its 

quarterly magazine entitled Science 

in Parliament. 

One of the more recent 

innovations is ‘SET for Britain’, 


originated by the late Dr Eric 

Wharton and continued by the 

former MP for Bristol Dr Doug 

Naysmith. The event is organised 

and run by staff of the P&SC with a 

tremendous amount of help from 

learned societies and private 

companies. This successfully brings 

a great poster competition to the 

House, gathering early career 

researchers together from a number 

of disciplines and most importantly 

getting them engaged with MPs. 

Both Houses have a Science and 

Technology Select Committee 

working on a range of topics. The 

Commons Committee that I chair is 

currently working on a number of 

projects including, for example, a 

report on medical implants. We are 

supported by a team of extremely 

well qualified science specialists and 

clerks. (The name clerk in Parliament 

applies to a highly qualified advisor 

not simply a scribe.) 

Parliament is also served by 

brilliant librarians and the 

Parliamentary Office of Science and 

Technology (POST). The latter is 

Parliament’s in-house source of 

independent, balanced and 

accessible analysis of public policy 

issues related to science and 

technology. The organisation has 

some permanent staff as well as a 

network of seconded extremely 

bright young scientists. 

WHAT ELSE IS NEEDED? 

That all sounds like a long list but it 

does not alter the fact that MPs are 

under permanent pressure to be 

doing other things and the degree of 

engagement with science and science 

policy is somewhat limited. So this is 

where you come in! 

IPEM members are working in a 

discipline that every politician, 

irrespective of their original training, 

will see as relevant to the society 

within which we live. Whilst the 

scientists and technicians within the 

Institute rarely get a mention in the 

popular press compared with, say, 

doctors and nurses, anyone who 

has ever visited a hospital 

either professionally or as a 

patient will readily see the 

importance of the 

underlying science that 

supports our health system. 

So each and every one of you 

are in a strong position to 

help address the challenge I 

have described. Whether you 

ABOVE LEFT 

Ditchley Park 

in Oxfordshire. 

▼ 

ABOVE RIGHT 

Parliamentary 

Links Day: 

Julian Huppert 

MP, Rt Hon John 

Bercow MP, 

Andrew Miller 

MP and Dame 

Nancy Rothwell. 

▼ 

work in a hospital or are involved in 

designing or manufacturing tools for 

the health service I simply invite you 

to engage with your own local MP 

and make sure that he or she 

understands the importance of the 

underlying science that supports the 

great innovations that are going on in 

healthcare on a daily basis. Don’t just 

talk to MPs about healthcare but 

about how modern science today 

crosses disciplines. Without people 

like Alan Turing would we have 

mapped the genome so quickly? In 

the great advances we have seen in 

scanning and x-ray tools the 

crossover between the needs of highend 

engineering companies working 

in a whole range of industrial 

disciplines and the application of the 

technologies for the benefit of human 

health are issues that each of you can 

wax considerably more lyrically than 

I, for example on how 3D printing is 

going to have a significant role in 

orthopaedics. But the key 

message to get over is that 

medicine does not exist in 

isolation from the rest of the 

science base and indeed 

could not. 

This is not just a challenge I 

am laying down to IPEM 

members. I think that it should be

© Ralph Loch 2010 

the responsibility of every scientist to 

engage with the political community 

so that MPs get directly from the 

people they are representing the 

importance of work that has been 

undertaken under their very noses in 

their own constituencies. The more 

we can make this happen the more 

optimistic I would be that this 

government and future governments 

will take the science budget seriously. 

The other end of the telescope is of 

course what the Institute can do to 

match the work that has been 

undertaken by other learned societies 

directly within Parliament. 

Stephen Keevil and others are 

frequently knocking on my door and 

those of my colleagues to press the 

case for the Institute. Many of the 

larger or perhaps more well-off 

societies have professionalised that 

process; some hire in external 

government affairs specialists, some 

employ their own. Some societies 

collaborate together and share the 

costs of a person to front their 

activities in Parliament. And there is 

a high degree of co-operation 

between various organisations, for 

example the Links Day that I 

mentioned earlier involves people 

from earth sciences, biology, physics, 

engineering and chemistry, etc. 

“ 

They 

have spinoff 

benefits to 

the whole 

of the 

health 

machine 

” 

So my second challenge to the 

Institute is to invite you to ask the 

question: how do you get a better 

voice in Parliament? 

Both of the challenges I am setting 

out for you are clearly not just good 

for your own profession but they 

have spin-off benefits to the whole of 

the health machine, as well as much 

more broadly across the science 

community. 

Finally, some of you will come 

across difficult cases (I mean the MPs 

not the patients) but each of you will 

have anecdotes that will help get the 

message across. For example, when I 

was being treated by a consultant 

who has now retired I went to one 

appointment and found him in a 

very excited mood. 

He said, ‘Andrew, you’re 

interested in technology; come and 

have a look at my new system’. 

Picture archiving had just been 

switched on in his hospital and for 

the first time he was able to send me 

for an x-ray, having just read my 

notes, and to have it in front of him 

as I came up through the queue of 

patients. He played with his 

computer and showed me how he 

could enlarge these shots of various 

bits of me and alter the contrasts to 

hone in in more detail. The net result 


was a more satisfactory outcome 

because he could better interpret the 

data and equally importantly, as a 

result of the fact that he no longer has 

to re-read the patient’s file due to the 

long gap between being sent off for 

an x-ray and the information getting 

back to him, he saw real productivity 

improvements and was able, he 

guessed, to see at least one more 

patient in each clinic session. There 

was a consultant who understood the 

relevance of technology and here is a 

patient who was grateful for its 

application. 

There are hundreds more such 

anecdotes that are directly related to 

health improvement in every single 

constituency. MPs need to know 

about them and the best people to 

talk to MPs about technologies like 

this are people like you. n 

FURTHER READING 

Science in Parliament 

www.vmine.net/scienceinparliament 

SET for Britain 

www.setforbritain.org.uk 

House of Commons Select 

Committee of Science and Technology 

www.parliament.uk/science 

Parliamentary office of 

Science and Technology (POST) 

www.parliament.uk/post 


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All images © Henry Lawrence and Lynn Martinez, 2012 

other’, said Alice, ‘I’ll 

never get this training 

portfolio finished until 

I can find that ion 

recombination paper 

by Havercroft’. 1 B‘ 

She had looked everywhere, 

Medline, Scopus, and worst of all she 

remembered seeing a dog-eared copy 

lying somewhere around the 

department. 

Her eyes drifted to the archive 

cupboard. Nobody ever used it; 

maybe once a year things no-one had 

the courage to throw away got 

dumped there. It was worth a try. 

She opened the door. Slowly, then 

with an unstoppable momentum, 

generations of reports, graphs and 

FIGURE 1. 

Was that the 

sound of music in 

the distance? 

▼ 

charts stirred, and in one long, slow 

movement avalanched over her. 

She was completely covered, and 

all went dark. Frantically she waved 

her arms around, pushing papers 

hither and thither. At last she saw 

light, and looked up. 

She turned around. There was no 

sign of the cupboard! Or her office. 

The whole medical physics 

department of Lymeswold Hospital 

had been transformed into a vast, 

brooding forest. 

She strained her ears. Was that 

music in the distance? It sounded like 

some sort of barn dance band, 

banjos, 42 mandolins, 19,27 a flute, 37 

highland pipes, 71 a ukulele 72 and a 

fiddle. 2,58 


Alice through the 

archive cupboard 

Henry Lawrence (Ipswich Hospital) reveals what your colleagues really get up to in 

their spare time! Illustrated by Lynn Martinez (Royal Free Hospital, London) 

‘Golly’, thought Alice, ‘that 

sounds fun!’. I like to do a little 

Appalachian clog dancing65 myself. 

I’ll go and ask them where I am. As 

she came to the brow of a hill she 

looked down at a full-blown barn 

dance27 in operation. Her experienced 

ear told her straightaway… ‘That’s 

North West Morris, 6 I can’t dance 

that! Maybe if they did some Welsh 

folk dance7 I might stand a chance’. 

No sooner did that thought cross 

her mind when the band stopped, 

and a woman in full seventeenthcentury 

costume brought her lute15 out from within the flowing folds of 

her woven17 gown and the lilting 

notes of Greensleeves filled the air, 

joined by tenor and bass recorders. 66 

▼ 


▼ 

And when the choirs 5,11,16,20,23,33,64 joined 

in, Alice was in seventh heaven. ‘But 

she shouldn’t have been doing 

Regency dance ‘, 6 thought Alice. 

‘That’s all wrong.’ 

‘What is this place?’, she 

wondered. ‘And who are all these 

people? Such a change from all those 

boring people at work.’ 

The whirr of a Super-8 movie 

camera brought her round. 30 ‘It’s an 

arty film’, the operator said, ‘and 

we’re recording the soundtrack’. She 

beckoned, and together they peeped 

through a window. 

Inside was a complete recording 

studio, 71 and a jazz band 12 was hitting 

a groove with a long solo. A bunch of 


hangers-on sat behind the recording 

desk. Some were doing crosswords, 11 

others origami, 53 balloon modelling 52 

or playing board games; 3 that solo 

must have been going on a long time! 

The film-maker panned her 

camera round; a well honed 

muscleman 31 was bouncing up and 

down on a trampoline. 5 Some actors 54 

were practicing ice skating 35 on the 

pond, throwing Frisbees. 55 A girl was 

staring intently at a train set. 19,35 

‘Why is she playing with that?’, 

asked Alice. ‘She’s secretly 

committed to saving the 

environment‘, 10 replied the filmmaker. 

‘She believes in “Small is 

Beautiful”.’ 

“ 

‘Such 

a change 

from all 

those 

boring 

people at 

work’ 

” 

There is something about the 

smell of homemade bread. 18,55 It was 

wafting from behind the bushes. 

Alice was there in a flash, in front of 

a table laid out with cakes, 

wonderfully decorated, 41 showing the 

sugar craft artist’s 42 skills to 

perfection. And in the middle, an 

enormous jar of award-winning 

marmalade! 52 

It was a market. Next to the cake 

stall were all sorts of people selling 

their wares. Someone was selling 

felt, 17 lovely crochet toys 37 and leather 

craft. 42 A gallery stall was showing a 

mixed exhibition of photographs, 18,28 

paintings 40 and sketches. 17 Another 

was piled high with pottery 39,42 that

would not have been out of place in 

any Cornish seaside shop. And there 

was even a detector calibration jig, all 

built out of Lego. 21 

But best of all was the beaded 

jewellery. 2 ‘Who makes that?’, she 

asked. ‘No-one knows’, replied the 

cuckoo clockmaker. 56 ‘But I hear she 

is getting married on top of the 

mountain.‘ 2 ‘Oh goody’, giggled 

Alice. ‘I’d love to come.’ 

So off they went, some 

hiking, 19,47,61,66 some on mountain 

bikes, 28,51,62,69 some on horseback. 45,68 A 

sheep farmer seemed to be dancing 

the Salsa. 67 When they came to a 

clearing some of the guys started 

kicking a ball about. 8,60,63 

FIGURE 2. 

[ LEFT] 

And there stood 

the vicar, 

vestments 

blowing in the 

wind. 

▼ 

FIGURE 3. 

[ RIGHT] 

A sweating 

woman was 

balancing on her 

head. 

▼ 

‘I want to play’, shouted Alice, but 

ladies don’t play football. So 

everyone played Korfball 32 and 

rounders 8,13 instead. 

Suddenly, some characters who 

looked like they came out of a roleplaying 

game 3 stood on the path in 

full armour, but one of the horsemen 

tucked his lance under his arm and 

charged. 45 The Aikido warriors 16,43 

drew their swords, but it was the 

kung fu fighters 2 who caused the role 

players to retreat, and recommence 

their Ars Magica game in the dark 

recesses of the palace. 

They came to a wide, slow flowing 

river. Some kayaks and boats 9,14,19 

were heading upstream; they 


shouted and a sailing boat57 offered 

to take them across. But just as she 

stepped onboard, Alice slipped and 

fell into the dark, murky water. A 

scuba diver28 came straight to her 

aid, but it was the bog snorkelling 

champion34 who found her. Together 

they brought her spluttering to the 

surface. 

‘Lucky I can do breath-hold free 

diving‘, 34 thought Alice as she broke 

the surface. 

On the other side of the river, 

stretching high into the sky, stood 

the mountains. 

‘Good that I’ve done a bit of 

climbing’, thought Alice. And so had 

the others, 2 and there were some 

scoutmasters too, 14,24,41 so everyone 

was under safe leadership. 24,40,59,70 The 

paths looked like a maze, 11 but 

someone had a map; a secret map of 

all the footpaths2 that had been 

made clandestinely and handed 

down through generations. 

Thick clouds were forming on the 

top of the mountain. ‘They’re not 

clouds’, said Alice. She had done 

research on extreme weather, 49 and 

knew it was a volcano. But the 

sound of church bells2,11,29 spurred 

them on, and the orchestra, 2,22,26,36,37 

played the wedding march as they 

neared the top. She had never seen 

so many church officials. 2,22,26,36 But 

which one was the vicar? 

Almost on cue the church doors 

opened to the insistent riff of 

Hawkwind’s ‘Silver Machine’, the 

band27,53 led by a large moustachioed 

bass player. 8 And there stood the 

vicar, vestments blowing in the 

wind, his Stratocaster pounding out 

the chords. 50 

‘The groom should be along any 

moment’, someone hoped. There he 

is at the edge of the volcano crater. 

‘It looks as if he’s ironing his 

shirt‘, 25 said Alice. ‘He must be very 

proud of his appearance.’ 

‘It’s getting hot’, she thought as 

she went up to a building next to the 

church. ‘It’s like a sauna!’ Steam was 

coming out, and she peeped inside. 

A sweating woman was balancing 

on her head. 4,61 ‘Golly’, thought 

Alice. ‘That’s the yoga Sirsha Asana 

position. 4 I could never master that.‘ 

‘Never mind’, said the inverted 

practitioner. ‘You can always go 

home and practice Thulaikatchi* 

Asana.’ 

A buzz turned her attention 

skywards. Were they model aircraft 

close to, 38,46 or real ones48,63 far away? 

▼ 


▼ 

Some of the models were almost life 

size, 38 so it was hard to tell. But one 

was trailing a long banner; the 

writing too small to read. 

Just then the volcano started 

rumbling, and great plumes of 

smoke billowed skywards. Panic set 

in; everyone started running down 

the mountain. Great folds of lava, 

red hot, and sulphurous fumes 

chasing them. 

Alice could feel the lava lapping 

at her feet, her lungs were bursting, 

the smoke enveloping her. Just in 

time, without a second to spare, the 

plane with the banner swooped 

down low on Alice. A drowning man 

REFERENCES 

1 Havercroft, Klevenhagen. 

Phys Med Biol 1993; 38: 

25–38. 

2 Anon 

3 Adrian Lonsdale 

4 Agelos Saplaouros 

5 Alexis Moore 

6 Alison Scott 

7 Andrew Tyler 

8 Andy Beavis 

9 Andy Buckle 

10 Angela Cotton 

11 Angela Newing 

12 Arek Mazurek 

13 Bruce Walmsley 


will grasp at a straw, and a trainee 

clinical scientist will do the same to 

a banner trailing from a model 

aircraft when being chased down a 

mountain by a stream of boiling 

lava. 

‘Lucky I learned how to climb 

silks 34,36 when I was at juggling 27,52,72 

school’, thought Alice, as she 

performed her favourite double 

hocks climb. It was when she was 

safely near the top that she paused 

and looked down at the writing on 

the banner. It was Havercroft’s 

paper on ion recombination, the 

very one she had been looking for! 

Engrossed by the elegance of 

14 Caroline Rudland (May) 

15 Carolyn Richardson 

16 Catherine Eveleigh 

17 Clare Hadley 

18 Conor Heeney 

19 David Carpenter 

20 David Taylor 

21 Ed Hockaday 

22 Elizabeth Crawford 

23 Eve Shin 

24 Giles David Morrison 

25 Graham Freestone 

26 Heather Williams 

27 Henry Lawrence 

28 Ian Negus 

29 Jack Aylward 

30 Jacqueline Roberts 

31 James Goracy 

32 James Weston 

33 Janet Droege (née 

Havercroft) 

34 Jason Cashmore 

35 Joseph O'Brien 

36 Karen Chalmers 

37 Karen Fuller 

38 Keith Mitchell 

39 Lucy Winch 

40 Lynn Martinez 

41 Lynsey Hamlett 

42 Maria Holstensson 

FIGURE 4. 

‘Lucky I learned 

how to climb silks 

when I was at 

juggling school.’ 

▼ 

*‘Thulaikatchi’ is 

Tamil for 

‘television’. 

Talekatchi Asana is 

sitting in front of 

the telly. 

43 Marina Romanchikova 

44 Mark Powell 

45 Mark Rawson 

46 Mathew James 

47 Matilda Nyekiova 

48 Mike Avison 

49 Neil S. Robinson 

50 Paul Ganney 

51 Peter Clinch 

52 Peter Julyan 

53 Philip Orr 

54 Rachel Cooke 

55 Robert Flintham 

56 Robert Speller 

57 Robin Laney 

Havercroft’s analysis, she read on. 

Soon she had quite forgotten her 

plight, being towed behind a giant 

model aircraft escaping from an 

exploding volcano. And when she 

had finished the conclusion she 

looked up. Like a magic trick 44 she 

had recombined with reality! She 

was back in her office at Lymeswold 

Hospital, surrounded by a pile of 

debris from the archive cupboard. 

‘Golly, what an adventure!’, 

thought Alice. ‘If I wrote it up, noone 

would believe me. 2,27,47 I can’t 

wait until I finish my portfolio and 

meet up with some normal people 

again.’ n 

58 Rosalind Perrin 

59 Rosemary Morton 

60 Ryan Lewis 

61 Samantha Eustace 

62 Sarah Naylor 

63 Sean Owen 

64 Sharan Packer 

65 Stephanie Wentworth 

66 Stephen Mason 

67 Steve Weston 

68 Teresa Clark 

69 Tom Jordan 

70 Usman Lula 

71 Wayne Gardner 

72 Yatigammana Dylan

Radiating enthusiasm: IPEM at 

the 2012 Big Bang Science Fair 

Lisa Parker-Gomm (External Relations Manager, IPEM) 

How do you explain 

radioactivity to a 6-yearold? 

This was just one of 

the challenges IPEM’s 

team of outreach 

volunteers set 

themselves at this year’s Big Bang Fair 

– a national event for young people 

which celebrates science, technology, 

engineering and maths. 

In March over 56,000 visitors 

flocked to the NEC in Birmingham and 

hundreds of them visited IPEM’s stand 

where they had hands-on experience of 

how physics is used in healthcare. Matt 

Dunn, Head of Radiology Physics at 

Nottingham University Hospitals NHS 

Trust, led the IPEM team: ‘Our stand 

seemed relatively low-budget – no 

expensive plasma screens and suchlike. 

But our real strength was in allowing 

the visitors to get their hands on real 

equipment that is actually used in 

hospitals. Hundreds of people came to 

our stand, and we were busy most of 

the time’. 

DISCOVERING RADIOACTIVITY 

IPEM’s most attention-grabbing 

offering was a simulated hospital 

radioactivity incident. Every 30 

minutes the alarms went off and it was 

time to don the big yellow CBRN 

protection suit, apron, gloves, 

overshoes, hat and other pretend 

‘protection’ gear and start searching for 

radiation! No-one was in danger, of 

course, but it gave visitors the 

opportunity to scan unfortunate 

victims with a Geiger counter to find 

‘radiation’ (it was just alcohol vapour), 

and also to discover how everyday 

items such as bananas and potassium 

salt (Lo-Salt) are radioactive too. As 

well as being fun, the demonstrators 

had the opportunity to explain the 

many ways radiation is used in 

medicine for the benefit of patients. 

One parent asked a volunteer to 

explain radioactivity to his 6-year-old 

daughter. Amazingly, the child claimed 

to know what atoms were, and they 

were both happy with the impromptu, 

if perhaps non-PC, explanation that 

some atoms didn’t like the way they 

looked, so they threw off bits of 

themselves until they felt better! 

Another activity on offer was using 

an ultrasound scanner to identify 

sweets and fruit concealed in miniphantoms. 

‘The children enjoyed the 

game, and on a few occasions we 

scanned ourselves to show the very 

enthusiastic ones our kidneys, hearts 

and blood vessel in our wrists’, 

commented Matt Dunn. This proved 

to be a very engaging demonstration 

when families would be guessing the 

fruit together, and parents telling their 

children about their experience with 

ultrasound during pregnancy. 

IPEM’s third offering was blood 

pressure and pulse monitoring. ‘My 

readings were sky high at the start 

due to the stress of organising the 

event!’, said Matt Dunn. ‘We were a 

bit worried too in case some of the 

visitors’ readings fell outside the 

normal range, but fortunately that 

didn’t happen.’ Children approached 

the experience with anxiety, much 

giggling and a spirit of competition to 

see who had the best reading. 

Volunteers agreed that although it 

could be tiring to stand all day talking 

to people, when they found someone 

who was genuinely interested in what 

they were saying it was a real joy. Matt 

said: ‘Many of the kids were really 

enthusiastic about science and it was 

really good to see that. We weren’t 

really trying to recruit them to be 

medical physicists, but just trying to 

inspire them to carry on their science 

education so that hopefully in years to 

come there will be a better supply of 

scientists contributing to the UK 

economy and society in general.’ Part 

II trainee Kirsty Hodgson commented: 

‘It was great to talk to so many 

interesting people, not only the 

children and teachers, but members of 

the Science Council, the STEM 

ambassador scheme and many others. 

It will be a good experience to put into 

my portfolio and it was nice to 

promote physics in healthcare as 

many people had not come across it 

before.’ 

BENEFITS OF VOLUNTEERING 

The Big Bang Fair is delivered by over 

170 organisations from the public, 

private and voluntary sectors. Led by 

▼ Scanning 

victims to 

detect 

‘radiation’. 


EngineeringUK in partnership with 

the British Science Association, the 

Institute of Physics, the Science 

Council, the Royal Academy of 

Engineering and Young Engineers, the 

event is supported by the Department 

for Business, Innovation and Skills as 

well as numerous sponsors from 

industry. IPEM has taken part in each 

of the 4 years the event has been 

staged. For more information see: 

www.thebigbangfair.co.uk. 

Next year’s national event will be 

in London on 24th–26th March and 

IPEM will once again be taking part. If 

you’re passionate about your 

profession and want to share this with 

young people, why not give it a go? 

IPEM has a range of pre-prepared 

activities, supporting materials for 

teachers, and will deal with all the 

logistics – all we need is a little of 

your time and enthusiasm. To find out 

more, contact outreach@ipem.ac.uk. 

As Evelyn Shin, another volunteer 

from Nottingham University 

Hospitals, enthused: ‘If offered again, 

I’d volunteer in a heartbeat. It was a 

really great experience.’ n 

ACKNOWLEDGEMENTS 

Thanks to the following for their contribution 

to this report: Matthew Dunn, Head of 

Radiology Physics, Nottingham University 

Hospitals NHS Trust; Evelyn Shin, Nottingham 

University Hospitals NHS Trust; Kirsty 

Hodgson, University Hospitals Birmingham 

NHS Foundation Trust; Eva McClean, 

Development and Communications Manager, 

IPEM, and to all the other volunteers who 

helped on the stand or loaned equipment for 

the demonstrations. 


SCOPE | FEATURE 

The launch of IPEM outreach 

strategy to connect with students 

Matthew Dunn (Nottingham University Hospitals NHS Trust) 

The new IPEM outreach 

strategy was recently 

launched at the 

communicating 

science session at 

MPEC 2012 in Oxford. 

The outreach strategy aims to help 

members communicate science and 

engineering to students to encourage 

them to study these subjects further. 

It is vital that students understand 

the excitement and importance of 

science, technology and engineering 

in medicine. The NHS alone is by far 

the largest employer of scientists in 

the UK yet students are often 

unaware of the career opportunities 

in healthcare science and 

engineering. The types of events that 

members currently support is wideranging. 

Examples include: 

n school careers fairs, 

n classroom experiments and 

demonstrations, 

n hospital open days, 

n departmental visits or tours, 

n teacher-focussed events. 

IPEM and the membership have 

supported 35 such events throughout 

2011 and 2012. 

Every event has a different 

audience so it is important that the 

right type of activity is matched to 

the event in order to maximise 

impact. The purpose is to encourage 

the study of general science GCSE 

and A-level subjects and to introduce 

the concept of scientists and 

engineers working in medicine. 

Students are generally surprised to 

learn that physics and engineering 

degrees can lead to jobs in the 

medical industry and healthcare. 

IPEM’S OUTREACH ACTIVITIES 

IPEM’s outreach activities have 

traditionally been delivered and 

supported by individual members on 

a local level, often in their own time. 

As a result efforts were often 

duplicated and experiences not 

shared. The impact was sometimes 

limited as the activities were not 

always targeted at the appropriate 


Working with 

school children to 

stimulate their 

interest can be 

hugely rewarding. 

▼ 

“ 

The 

types of 

events that 

members 

currently 

support is 

wideranging 

” 

group and were costly in terms of 

time to develop and administer. In 

the last few years more office support 

has been requested by members and 

the resulting increase in outreach 

activities requires a more strategic 

approach to IPEM’s outreach efforts. 

IPEM Council has allocated funding 

to deliver this strategy over 2 years. 

IPEM will also continue to directly 

support a limited number of events 

such as the national Big Bang Fair 

(www.thebigbangfair.co.uk, see 

page 17). 

The vast majority of outreach 

activity is best delivered by volunteer 

IPEM members; however, the effort 

involved in delivering outreach 

activities can be substantially 

reduced by having a range of ‘readymade’ 

activities and resources which 

can be downloaded from the website 

or sent out to members from the 

office. When developed these 

materials will allow members to 

concentrate on the delivery of 

outreach. 

IPEM members at all stages of 

their careers are encouraged to 

support the initiative and get 

involved in outreach activities from 

talking to students to developing 

activities or experiments. Although 

working with school children may 

initially be daunting, most members 

find the experience hugely rewarding 

and also a great way of improving 

communication skills. n 

GET INVOLVED 

To find out more or volunteer please 

contact the outreach team: 

outreach@ipem.ac.uk

2011 AAPM–IPEM MEDICAL PHYSICS 

TRAVEL GRANT REPORT 

JUN DENG Yale New Haven Hospital, New Haven, CT, USA 

I 

n April 2012 I visited the UK 

after receiving an 

AAPM–IPEM Medical 

Physics Travel Grant. Here I 

outline my experiences at 

each of the centres that I went 

to and the people that I met. 

16TH APRIL: CASTLE 

HILL HOSPITAL 

After a long train ride from London to 

Hull, I finally arrived at the Castle 

Hill Hospital where Dr Andy Beavis, 

Head of the Radiation Physics 

Department, was the host for my first 

stop during this trip to the UK. My 

visit started with a tour of the 

department led by Dr Beavis. The 

whole oncology centre is very new 

with eco- and patient-friendly designs 

everywhere, which to me makes it 

seem rather more like a hotel than a 

cancer centre for radiotherapy. Then I 

gave a lecture talking about the 

kVCBCT imaging doses and the 

associated cancer risks, after which 

we had a round-table meeting for 

physics staff so that everyone could 

get involved in a more interactive 

discussion. The primary concerns 

were about the imaging doses and 

why CT manufacturers did a better 

job than the linac manufacturers for 

CBCT in terms of imaging dose 

reduction, protocol optimisation and 

patient safety. I also learnt that a 

virtual CT reconstructor has been 

developed by this group so that 

virtual CT scans can be simulated to 

study the correlation between the 

imaging doses and the image quality 

without actually performing a scan 

on a patient. I was very interested in 

this project and indicated that our 

group was developing a similar tool 

dedicated to CBCT virtual simulation 

and reconstruction. Finally, I was 

lucky enough to experience a state-ofthe-art 

technology named VERT 

developed and co-founded by Dr 

Beavis. VERT (virtual environment 

for radiotherapy and training) is a 

linac simulator set in a 3D virtual 

environment, which can help users 

train with full access to the linac 

functionality without interfering with 

the clinical workflow. We actually 

took a picture as shown in figure 1 

with VERT displayed in the 

background. 

FIGURE 1. 

Dr Andy Beavis 

and Jun at 

Castle Hill 

Hospital. 

▼ 

TRAVEL AWARD | SCOPE 

17TH APRIL: CLATTERBRIDGE 

CENTRE FOR ONCOLOGY 

The following day I visited the 

Clatterbridge Centre for Oncology 

where Dr Alan Nahum was my 

host. We actually started our 

conversion with our fond memories 

of the past. I was fascinated by all 

sorts of legendary stories told by 

Alan about our common friends. 

Alan’s postdoc Dr Julien Uzan gave 

me a brief introduction to their latest 

research tool called Biosuite, aiming 

to facilitate biologically based 

treatment planning and 

optimisation. The software analysed 

the DVH data exported from 

conventional treatment planning 

systems and computed TCP and 

NTCP based on published Marsden 

and LKB models. In addition, the 

software was able to optimise the 

plan with a fixed NTCP value, the 

so-called isotoxic planning scheme, 

and generate a series of plans with 

different TCP values corresponding 

to different fractionations. Later on, 

I gave a lecture on kVCBCT and was 

engaged in a very interactive 

discussion with dozens of physicists 

and research staff. I enjoyed some 

tough questions raised by Alan and 

Dr Geoff Lawrence. Finally, I was 

kindly given a tour of the only 

proton radiotherapy facility in the 

UK, Douglas Cyclotron (figure 2), by 

Dr Andrzej Kacperek. It produced a 

single energy of 62 MeV proton 

beams dedicated to radiotherapy of 

eye tumours due to its limited 

treatment depth in tissue of 3 cm. 

The highly acclaimed 

professionalism and rigorous efforts 

to quality control the clinical 

practices at every step made it a 

highly successful facility, which 

treated one-third of eye patients in 

the UK and dozens of patients 

across the world. It was a busy day 

for me. In fact, I was so involved 

with the intensive discussions that I 

forgot my room number when I got 

back to my hotel. Luckily I did not 

forget which hotel I was staying in! 

▼ 


▼ 

SCOPE | TRAVEL AWARD 


FIGURE 2. 

Dr Andrzej 

Kacperek, Dr 

Alan Nahum and 

Jun at 

Clatterbridge 

Centre for 

Oncology. 

▼ 

FIGURE 3. 

Dr Jonathan 

Sykes, Dr Vivian 

Consgrove and 

Jun at St James's 

Institute for 

Oncology. 

▼ 

FIGURE 4. 

Jun, Dr Jim 

Warrington, Dr 

Margaret 

Bidmead, Dr 

Ellen Donovan 

and Dr Phil Evans 

at Royal Marsden 

Hospital. 

▼ 

FIGURE 5. 

Dr Elizabeth 

Macaulay and 

Jun at Churchill 

Hospital. 

▼ 

18TH APRIL: ST JAMES’S 

INSTITUTE FOR ONCOLOGY 

My third visit took place at St James’s 

Institute for Oncology in Leeds where 

Dr Vivian Consgrove, Head of 

Radiotherapy Physics, was my host 

(figure 3). The centre has ten Elekta 

linacs for clinical treatments and two 

for research. With about 6,500 patients 

treated annually, it is quite a challenge 

to manage the whole clinical workflow 

seamlessly without errors. I noticed 

three major factors contributing to their 

high efficiency: (1) a well thought-out 

design of the clinic such that patients 

received professional care from a 

dedicated group of clinicians while 

maintaining a high degree of privacy; 

(2) a clear structure of management and 

easy-to-follow guidelines and policies, 

and (3) all the photon beams are 

matched throughout the department. 

Later on, I gave a lecture on imaging 

doses from kVCBCT and their 

associated cancer risks. Although my 

study indicated large imaging doses 

from CBCT procedures, I emphasised 

more than once that people should not 

be scared by the potential cancer risks 

associated with the medical imaging 

procedures as long as those procedures 

are administrated in a prudent way and 

are clinically justified. The risk of not 

having those procedures done would 

be much greater for most of the cancer 

patients. Dr Jonathan Sykes, one of the 

physicists doing research work on IGRT 

and kVCBCT, exchanged his ideas with 

me on how to correlate CBCT with CT 

as planning CT has always been 

considered as reference to the CBCT 

images in determining the shifts. I 

pointed out that another possible 

approach would be to use online CBCT 

image datasets as the reference instead 

of planning CT as long as the 

Hounsfield number in CBCT images is 

accurately determined. 

19TH APRIL: ROYAL 

MARSDEN HOSPITAL 

I visited Royal Marsden Hospital 

(RMH) in Sutton the next day. My host 

was Dr Phil Evans, Head of the 

Radiation Physics Department, who 

gave me a detailed introduction to the 

organisation of RMH (figure 4). He 

showed me a copy of the RMH’s 2010 

annual report and discussed some of 

the fascinating projects that were 

conducted during 2010. I delivered my 

oral presentation to a large audience 

including the staff members from the 

Chelsea site. My lecture generated quite 

a few questions regarding the CBCT

applications in the clinic. I also 

emphasised in my talk that prudent 

medical imaging procedures always 

outweighed the potential cancer risks, 

because missing the tumour target 

would lead to greater cancer risks in 

the future if necessary medical imaging 

procedures were not performed. Later 

on I had the opportunity to have a oneon-one 

discussion with some of the 

research fellows, postdocs and PhD 

students at RMH. The topics were very 

interesting and significant, covering 

imaging dose, toxicity and margin 

reduction correlations in breast cancer 

radiotherapy with CBCT, patient 

fatigue study in IMRT treatments of 

head and neck cancer, a CT x-ray 

energy spectrum simulator, breast 

tissue segmentation for better and 

more accurate contouring and dose 

painting, dynamic leaf tracking for 

Elekta MLC, as well as a new CMOS 

technology developed to replace 

current EPID for better and quicker 

responses to high-dose radiation. I had 

a pleasant and in-depth discussion 

with each one of them and caught a 

glimpse of what was going on in each 

project. In fact, it was an unforgettable 

experience for me as I was exposed to 

so many different projects within such 

a short period of time. 

20TH APRIL: CHURCHILL 

HOSPITAL 

My last stop was the Churchill 

Hospital in Oxford, a beautiful college 

town and host to the University of 

Oxford. Dr Elizabeth Macaulay, Head 

of Radiation Physics, was my host in 

this visit and gave me a quick tour of 

the facility (figure 5). My talk on 

kVCBCT was well received and 

generated a lot of discussions on 

CBCT applications and imaging 

doses. Three research scientists from 

diagnostic imaging remained after my 

talk and we had further discussions 

on the status and future directions of 

CBCT as compared to the CT 

technology. I acknowledged that our 

current CBCT technology was still not 

mature yet, and more research work 

would be needed from both academia 

and industry to further improve it to 

be more efficient and safer for the 

patients. As our colleagues in CT are 

I had a 

pleasant 

and indepth 

discussion 

with each 

one of 

them 

“ 

” 

TRAVEL AWARD | SCOPE 

doing everything they can to optimise 

the scan protocol and reduce the dose 

to patients, we should also be engaged 

in efforts to optimise our clinical 

routines so that low-dose CBCT can be 

administered to patients in an optimal 

and individual way. 

This concluded my 10-day visit to 

five great institutions in the UK. 

During this trip, I not only met many 

wonderful colleagues in the UK and 

learnt a lot about their research 

projects and clinical practices, but also 

shared my experiences with them on 

some mutually interesting topics, 

which was indeed an invaluable 

experience to me and my future career 

development. I would like to take this 

opportunity to express my sincere 

gratitude to Drs Andy Beavis, Alan 

Nahum, Vivian Consgrove, Phil Evans 

and Elizabeth Macaulay for their 

valuable time and genuine hospitality. 

Finally, I’d like to thank both AAPM 

and IPEM for this wonderful travel 

grant that allowed me to visit the UK 

and exchange ideas and share my 

research work with my fellow 

physicists in the UK. 


Austrian Medical Center Upgrades Cancer Treatment System to Accelerate 

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4513 371 1012 08:12

FIGURE 1. 

A slide from 

David Willis’ talk. 

▼ 

MEETING REPORTS | SCOPE 

BESPOKE SOFTWARE IN MEDICAL PHYSICS 

AND CLINICAL ENGINEERING CONFERENCE 

ANDREW ROBINSON The Harley Street Clinic, London 

UCLH INSTITUTE FOR CHILD HEALTH 28th May 2012 

IT WAS A WONDERFULLY SUNNY DAY IN MAY 

when nearly 90 delegates descended on London for this 

conference organised by IPEM’s Informatics and 

Computing Special Interest Group (ICSIG). The Special 

Interest Group was keen to highlight the key work that 

is performed by medical physicists and clinical 

engineers in designing, developing and maintaining 

bespoke software that is used in their departments. 

Presentations on a variety of applications across all 

medical physics and clinical engineering specialities 

were delivered, as well as a large collection of scientific 

posters that delegates could peruse at their leisure 

during the breaks. 

PRESENTATIONS 

David Willis (Norfolk and Norwich University 

Hospital, Norwich) opened the conference with an 

informative presentation entitled ‘Bespoke software: 

concept to clinical’, where he went through his 

experience of software development from a 

commercial, research and clinical perspective (figure 1). 

His presentation summed up the role of the bespoke 

software/in-house developer well. He also hit the nail 

on the head with the often found problem in 

departments that rely on one or two people to make 

bespoke software: ‘Couldn’t write 

us a program to do that?’, a statement that may 

resonate with some readers! It was also interesting to 

hear about some of the radiotherapy-related software 

that he has developed, including software to perform 

transit EPID dosimetry, an area where there are few 

commercial alternatives. 

A highly enjoyable talk was given by the 

conference’s invited speaker Ian Wells (University of 

Surrey, Guildford). In his talk ‘In-house software 

development: a retrospective view’, he gave an 

overview of how computing had changed during his 

career, as well as highlighting the importance of 

ensuring that software meets appropriate standards 

from both a patient safety and professional point of 

view. He had four questions for in-house software 

developers to take away with them: is your software 

durable? Are your systems safe? Is your methodology 

appropriate? Are your qualifications suitable, and does 

SCOPE | SEPTEMBER 2012 | 23 

▼

▼ 

SCOPE | MEETING REPORTS 


FIGURE 2. 

A slide from Ian 

Well’s talks. 

▼ 

FIGURE 3. 

Overview slide for 

Ed McDonagh and 

Laurence King’s 

presentation. 

▼

FIGURE 4. 

Delegates 

enjoying a coffee 

break. 

▼ 

this really matter? Professor Wells also talked about the 

use of software as a medical device and the importance 

of knowing what any software that you develop will be 

used for once you have released it, citing an example 

where he was asked to be an expert witness in a 

criminal trial following the analysis of data using 

software that he had developed (figure 2). 

By far the most animated presentation of the day 

was by Ed McDonagh and Laurence King (Royal 

Marsden Hospital, London), whose presentation 

dazzled the audience with their work on automating 

dose audits in diagnostic radiology through a variety 

of techniques, including optical character recognition 

software (figure 3). As dose audits can be particularly 

time consuming and span multiple equipment 

manufacturers, their work to automate this process 

across multiple manufacturers has a significant impact 

on reducing their workload, and is something that 

other centres may wish to look into. 

There were a couple of talks from scientists Marc 

White (National Hospital for Neurology and 

Neurosurgery, London) and Peter Wright (University 

Hospital of North Staffordshire, Stoke on Trent) about 

applications of bespoke software in MRI. One thing 

that I learned was how vast the DICOM standard 

actually is, and that it even has a ‘tag’ for how many 

legs a patient has. An interesting point that was 

discussed during the MRI talks was that QA of 


diffusion techniques in MRI will be of vast importance 

soon as neurosurgeons heavily rely on the information 

yielded by this type of scan. 

At lunchtime delegates took the opportunity to look 

at the large collection of posters that were on show, as 

well as speak with the authors about the work on 

display. One author even bought an interactive 

demonstration to accompany their poster on 

applications of MatSOAP (Rasam Teymouri). The 

poster session was a good opportunity to network, 

and also for delegates to discuss ideas with each other 

about implementing different software solutions back 

in their respective hospitals. 

DISCUSSION 

At the end of the meeting there was time for a 

discussion about various topics that had come up in 

the day. One area that was highlighted was the need to 

have an appropriate amount of computing covered in 

the new Modernising Scientific Careers curriculum for 

medical physics and clinical engineers. Another was 

the desire for more of a ‘community’ for professionals 

working in medical physics and clinical engineering, 

where computing advice could be sought and 

resources shared. All in all the conference seemed to be 

well received, with the potential for similar meetings 

in the future a distinct possibility given the interest 

shown in this meeting (figure 4). n 



IPEM TRAVEL BURSARY: 2012 ESTRO 31/ 

WORLD CONGRESS OF BRACHYTHERAPY 

AHAMED BADUSHA MOHAMED YOOSUF Northern Ireland Cancer Centre, Belfast 

BARCELONA 9th–13th May 2012 

THE EUROPEAN SOCIETY OF RADIOTHERAPY AND 

Oncology (ESTRO) is an interdisciplinary society with 

an aim to advance all aspects of radiation oncology. 

Events are organised to facilitate the meeting of 

professionals to share their ideas and work. This year 

ESTRO 31 and the World Congress of Brachytherapy 

(WCB) were organised as a joint conference. Being an 

Indian medical physicist working in the UK, there is so 

much that I wanted to learn and experience for myself 

about radiotherapy practice in Europe. As a recipient of 

an IPEM bursary award, I had the opportunity to attend 

the ESTRO 31/WCB conference from 9th–13th May 

2012, held in the International Convention Centre in 

Barcelona. The city offers a feast of sculptures, paintings, 

mosaics, impressive architecture and fashion. Especially 

remarkable is the work of architect Antoni Gaudí 

(figures 1 and 2), which can be seen throughout the city. 

GLOBAL CONFERENCE 

This year’s conference was a huge success with almost 

4,000 delegates from 50 different countries in 

attendance. Eighty exhibitors in the 10,000 m² exhibition 

area provided the opportunity to discover the latest 

products and services within radiation oncology. There 

were 300 invited speakers, 188 oral presentations, 241 

oral posters and 662 e-posters. At any one time there 

were eight parallel streams spread across different 

auditoriums of the International Convention Centre 

(figure 3), allowing delegates the ability to attend 

relevant sessions throughout the conference. 

I predominantly attended World Congress of 

Brachytherapy sessions. This is a 4-yearly conference 

and is attended by physicians, physicists, biologists, 

technicians and company reps from all over the world 

with a keen interest in brachytherapy. This is the fifth 

edition of this joint meeting and the programme took 

place over 4 days, including a pre-meeting course 

covering many aspects of brachytherapy. 

The scientific programme was organised by Groupe 

Européen de Curiethérapie and The European Society for 

Therapeutic Radiology and Oncology (GEC-ESTRO), in 

co-operation with the American Brachytherapy Society 

(ABS), Asociacion Latino-americana de Terapia Radiante 

Oncologica (ALATRO), Indian Brachytherapy Society 

(IBS) and Australian Brachytherapy Group (ABG). My 

goal on attending this conference was to expand my 

current knowledge of brachytherapy physics and gather 

useful information which could be adopted in our 

centre’s practice to improve our service. 

The first day of WCB (9th May) started with a premeeting 

workshop on ‘Recent advances in 

brachytherapy physics’ that brought together eminent 

speakers from a variety of backgrounds, both medical 

and scientific, from Europe and the USA. The workshop 

demonstrated the most recent advances in high dose 


rate (HDR) and low dose rate (LDR) brachytherapy. 

Topics included source calibration, quality assurance, 

3D conformal imaging, advanced treatment planning 

using model-based algorithms, in vivo dosimetry, 

uncertainties in brachytherapy and professional society 

recommendations. 

The use of model-based algorithms in brachytherapy 

treatment planning was reported by Luc Beaulieu 

(Laval University Cancer Research Centre, Québec, 

Canada) and a review of current developments in 

planning systems was discussed. In current practice, all 

dose calculations in brachytherapy treatment planning 

are based on AAPM Task Group (TG) Report 43 which 

utilises a factor-based algorithm. In a recent study 

published by Mark Rivard et al. (United States), the 

limitations of TG 43 were described and it was found 

that in lower photon energies, as used in brachytherapy, 

the absorbed dose in water to tissue differs due to 

higher photoelectric effect cross-sections of tissue 

compared to water. Similarly, the mass attenuation 

coefficient of tissues differs at low photon energies. 

Dose calculation algorithms are being developed based 

on Monte Carlo methods, collapsed cone and solving 

the linear Boltzmann transport equation. Also reported 

was the recommendation that routine in vivo dosimetry 

should be introduced in brachytherapy procedures, as at 

present these are performed without any record and 

verify systems. 

INTRODUCTORY SESSIONS 

The official opening ceremony took place at 6pm in the 

main auditorium with a special lecture by the keynote 

speaker Manel Esteller (IDIBELL – Bellvitge Biomedical 

Research Institute, Barcelona, Spain), about medical 

applications of epigenetics, a study of heritable changes 

in gene expression caused by mechanisms other than 

changes in the underlying DNA sequence, in health and 

disease. After the lecture we were entertained by the 

innovative music show of Pagagnini (figure 4), who 

brought to life some of the most treasured musical 

pieces in the key of comedy. The day was rounded off 

by a special opening reception in the exhibition area 

where the technical exhibition was formally opened. 

With such a massive exhibition and hundreds of 

scientific posters, the conference had an extremely 

vivacious atmosphere. 

Thursday began with the symposium on ‘Modern 

brachytherapy: role of new image modalities’ with six 

presentations discussing the latest imaging innovations, 

from orthogonal radiograph to functional imaging, and 

their impact in brachytherapy. Although every 

presentation was informative, the topic I found most 

appealing was the role of ultrasound in modern 

brachytherapy. In brachytherapy, ultrasound has a role 

in prostate, gynaecological and interstitial applications.

FIGURE 1 

[TOP LEFT] 

Casa Batlló, 

Barcelona. 

▼ 

FIGURE 2 

[TOP RIGHT] 

La Sagrada 

Familia, 

Barcelona. 

▼ 

FIGURE 3 

Barcelona’s 

International 

Convention 

Centre (CCIB). 

▼ 



▼

▼ 



FIGURE 4. 

Pagagnini music 

show. 

▼ 

FIGURE 5. 

[LEFT] 

Discussion in the 

poster area 

during a coffee 

break. 

▼ 

FIGURE 6. 

[RIGHT] 

Poster 

presentation. 

▼

Developments in ultrasound were fundamental to the 

rise in activity in prostate brachytherapy in recent years 

based on the transrectal ultrasound-guided transperineal 

implant technique. 

Ultrasound techniques have matured with further 

scientific developments and are integrated with modern 

dosimetry algorithms; image fusion techniques enable 

ultrasound to be combined with computed tomography 

(CT) and magnetic resonance imaging (MRI) in prostate 

brachytherapy which can result in accurate real-time 

imaging and may translate into better patient dosimetry. 

The use of ultrasound images in gynaecological 

brachytherapy was presented by Sylvia Van Dyk (Peter 

MacCallum Cancer Centre, East Melbourne, Victoria, 

Australia). With the advent of high-quality threedimensional 

imaging, ultrasound can provide an 

excellent representation of the cervix and uterus 

enabling the definition of clinical target volume (CTV) as 

per the GEC-ESTRO requirements. It was demonstrated 

that the size and shape of the cervix measured in 

ultrasound and MRI images correlate well. For those 

centres with limited or no MRI facility, ultrasound 

provides a more readily available tool to define CTV for 

conformal planning. 

POSTER PRESENTATION 

Throughout the duration of conference, the poster area 

and manufacturer’s stalls kept us occupied during coffee 

breaks (figure 5). 


I felt honoured that my abstract was accepted for 

poster presentation and to be displayed amongst the sea 

of posters (figure 6). On Thursday evening there was a 

poster reception at 6.30pm so I tethered myself to my 

poster during this time. The poster is entitled ‘Sector 

analysis of I-125 prostate implants provides an effective 

method comparing pre- and post-implant dosimetry’. In 

this study, a sector analysis treatment planning tool was 

used as a scientific method of examining the distribution 

of dose within 12 separate sub-volumes or ‘sectors’ of 

the prostate and compared pre- and post-implant 

dosimetry. 

The next two days also consisted of an intense 

programme of educational courses, lunchtime 

symposiums, debates and scientific sessions. The 

conference covered many areas of ‘state-of-the-art’ 

brachytherapy and was very informative. The meeting 

was an exceptional educational opportunity and a great 

forum for discussion. I gained an essential insight into 

the current status and future development of 

brachytherapy physics and found this ESTRO 31/WCB a 

valuable experience. 

I am grateful to IPEM for giving me the chance to 

attend this very useful conference. I would also like to 

thank colleagues in Radiotherapy Physics, Northern 

Ireland Cancer Centre, for their support and 

encouragement, especially Geraldine Workman and Dr 

Darren M. Mitchell who supported me in the research 

work reported in the poster presentation. n 



REPORT ON NPL CLINICAL TEMPERATURE 

MEASUREMENT MEETING 

ROSIE RICHARDS North London Consortium 

JASON BRITTON Leeds Teaching Hospitals NHS Trust 

NATIONAL PHYSICAL LABORATORY 30th January 2012 

THE NATIONAL PHYSICS LABORATORY (NPL), AT 

their premises in Teddington, hosted a one-day 

scientific meeting on clinical temperature measurement 

with some excellent speakers and interesting 

discussions on the research and development 

presented. The meeting was jointly organised by the 

National Physical Laboratory and the IPEM 

Physiological Measurement Special Interest Group. 

The morning keynote speaker was Helen McEvoy 

(NPL, Teddington), who talked about clinical 

thermometry using tympanic thermometers. Helen has 

been investigating different approaches to the training 

of clinical staff in the appropriate use of the devices, 

such that the uncertainty associated with the technique 

may be reduced. She covered the factors to consider 

when measuring temperature and the risks to consider 

when using such a device. The risks include: (1) 

misdiagnosis due to an inaccurate reading which could 

be due to poor calibration, handling or storage, or (2) 

injury due to the probe being pushed too far into the 

ear or cross-contamination. A focussed 1-hour training 

programme has now been developed working with 

Oxford Radcliffe Hospitals NHS Trust which can now 

be purchased and is delivered by NPL. 

TIME FOR A CHANGE 

The second speaker was Martha Sund-Levander 

(Hoegland Hospital, Eksjo, Sweden), whose 

presentation entitled ‘Time for a change when 

assessing and evaluating body temperature in clinical 

practice’ looked at the variability of clinical 

temperature measurement and the factors that may 

affect the readings in different healthcare settings. She 

discussed a literature review carried out by her and 

colleagues reviewing the variability of temperature 

measurements made at different body sites and how 

this could impact on the clinical management of 

patients. Her work also looked at the effects of ageing 

on normal body temperature ranges. It has been 

identified that elderly patients with dementia may be 

at risk of hypothermia as slightly lower than normal 

temperature readings in this patient cohort may not be 

seen as clinically significant. The discussions following 

prompted Francis Ring (University of Glamorgan, 

Pontypridd) to comment that paracetamol (which 

Martha had discussed in relation to its effect on 

temperature) was not an anti-inflammatory drug, 

having only analgesic effects, and was not now 

routinely used in clinical practice. 

Following this, the programme moved onto an 

interesting presentation by Sheera Sutherland 

(Churchill Hospital, Oxford) who has researched the 

potential of monitoring the core temperature of 

patients (with established renal failure) during 


haemodialysis with a thermal imaging camera and 

establishing if this can have a positive impact on their 

overall clinical management. The research 

investigated the affects of lowering the dialysate 

temperature to less than 37°C (which is traditionally 

used in haemodialysis treatments). There is some 

evidence that this may be actively warming the 

patient with a statistically significant difference in preand 

post-dialysis temperatures shown at a level of p = 

0.001. However, it has been found that some patients 

do not tolerate cooler dialysate. Thermal imaging was 

also used to investigate the possibility that changes in 

measured core body temperature could be correlated 

with a ‘crash’ or hypovolemic event that commonly 

occurs. Kevin Howell (Royal Free Hospital, London) 

commented that hypovolemia may be the main issue 

to consider. 

DENTAL THERMOGRAPHIC IMAGING 

The next speaker, Paula Lancaster (Leeds Dental 

Institute), showed her work on vital dental 

thermographic imaging. The aim of the work was to 

investigate the temperature of the tooth in the hope of 

using this as an objective method to measure the 

vitality of the tooth. 

Currently sensitivity tests are performed to 

subjectively assess the neural supply to the tooth but 

this does not tell the dentist anything about the blood 

supply. Alternatively an x-ray may be taken of the 

patient’s mouth; however, this carries concerns of the 

use of ionising radiation (albeit in very low doses). A 

dental x-ray will only provide anatomical rather than 

physiological information. The researchers tested the 

theory that the central core of the tooth is warmer 

than the rest of the crown by using a skeletal model. 

They found that a thermal gradient could be detected, 

when the tooth is subjected to external cooling. This 

may be promising for using a similar model in vivo 

once ethical approval is obtained. Paula suggested 

that possible applications of thermography may 

include: 

n assessment of vitality of the tooth in people with 

toothache and the provision of information on 

which to base treatment decisions, 

n assessment of the extent of trauma to the teeth, 

n assessment of the development of the root in tooth 

transplant (this is currently done using 

radiographs). 

Any methods developed need to be simple and 

need to give consistent results. The discussions that 

followed this talk brought up issues such as how to 

find the emissivity of enamel. Since the tests are 

looking for relative differences in temperature, it was 

suggested that this may not be too important.

The day’s presentations then moved on to research 

into thermal symmetry on the upper and lower 

extremities on normal healthy volunteers carried out at 

Glamorgan University by Ricardo Vardasca 

(University of Minho, Braga, Portugal). For this work 

high-resolution thermal imaging cameras were used to 

capture a large number of images of the upper and 

lower extremities. Unlike previous work in the area, 

the images were captured in a controlled environment 

and the analysis was not based on single points. The 

images were then collated and standardised using 

geometric models. The models were used to scale the 

images to the same shape and size for each subject. The 

final outcome showed a small difference of 0.5°C ± 

0.3°C between left and right regions. A difference of 

0.1°C was also found between ventral and dorsal 

regions. Francis Ring commented after the presentation 

that there is a measurement uncertainty associated 

with the cameras which must be accounted for when 

reviewing the results. It was also unclear how the 

results could be used in the management of patients 

and where this may be used in the care pathway. 

The next speaker, Ismael Fernandez Cuevas 

(Universidad Politecnica de Madrid), presented results 

of a pilot study looking at the effects of the circadian 

cycle on skin surface temperature. The measurements 

were conducted in a controlled thermal environment 

and were taken periodically over a 13-hour day with 

The Handhound voice-operated 

‘hands-free’ hand monitor 

Designed for use in radioisotope handling 

situations where hands could be contaminated. 

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the subject standing in the same position. Although 

there was no obvious pattern resulting from the 

measurements at different times, the temperature 

fluctuations were fairly constant for all areas of the 

body that were analysed. After correcting the 

temperature using the calibration area, the data 

showed similarities with existing results in this field 

by Professor Ring et al. Since observations showed that 

when the body was expecting food intake the 

temperature increased, a member of the audience 

suggested that the glucose level could be monitored if 

the experiment was repeated. Discussion also took 

place about the ‘constant core-variable shell’ theory 

that is often applied to thermal regulation of the 

human body. 

THYROID-ASSOCIATED EYE DISEASE 

John Allen (Freeman Hospital, Newcastle upon Tyne) 

was the next speaker, presenting work on ‘Detecting 

inflammatory disease in patients with active (Graves) 

thyroid eye disease’. The treatment regimen used for 

thyroid-associated orbitopathy depends on the 

outcomes of subjective clinical assessment. John’s pilot 

investigation was aiming to develop a working 

protocol for thermal imaging of the eye and use it to 

explore a range of characteristics in patients with this 

pathology. Complications involved blinking, sweating 

and tearing which may be asymmetric. Before the 

Web: www.southernscientific.co.uk 


▼

▼ 


images were obtained the environment was cooled to 

allow inflammatory areas (deeper vessels) to become 

dominant. The initial results were quite encouraging 

and the thermal imaging results demonstrated elevated 

temperature in the eyes in patients where the disease 

was active compared to inactive. John presented some 

statistical analysis to show that a probability graph or 

contour plot may be the way forward to classify these 

patients in the future. However, this was only based on 

a cohort of 15 patients and therefore its statistical 

validity is equivocal. 

ISO STANDARDS 

The second keynote speaker of the day was Francis 

Ring, whose presentation was entitled ‘ISO standards 

for fever screening and their implications’. This 

presentation raised questions about the feasibility of 

fever screening on a large scale. 

The reason for continued investigations into fever 

screening is that there is always a risk of a new 

influenza virus emerging and spreading. This would 

cause disruption to society and fatalities, especially in 

vulnerable groups such as the elderly and children. 

Francis described the various stages of an influenza 

pandemic before moving on to speak about fever 

screening requirements. Finally, he presented some 

results of the research investigating the mean inner 

canthus temperature in febrile and afebrile children 

presenting at an A&E department in Warsaw. It was 

unclear from the presentation as to why the research 

could not have been undertaken in the UK and if all the 

possible variables had been sufficiently well controlled 

or properly investigated. 

The penultimate speaker, Kevin Howell, reviewed 

his work on the use of a low-cost (£2,500), low thermal 

and spatial resolution (160 × 120 pixels) thermal imager 

in the clinical assessment of patients with Raynaud’s 

phenomenon. The aim of the work was to determine 

whether the low-cost portable thermal camera would 

give comparable results to a more expensive device 

(£10,000–£11,000) with higher resolution and better 

thermal resolution which has been used to assess this 

cohort of patients at the Royal Free Hospital. Despite 

small differences in the measured finger temperatures, 

the results demonstrated that the cheaper thermal 

imager can be used in assessing patients with 

Raynaud’s phenomenon and when compared to the 

more expensive device clinically it would have no 


impact on clinical management. It was therefore 

concluded that low spatial resolution is not a limitation 

for Raynaud’s phenomenon work (see figure 1). 

THERMAL IMAGING APPLICATIONS IN 

CRYOTHERAPY 

The final speaker of the day, Armand Cholewka 

(University of Silesia, Katowice, Poland), presented on 

thermal imaging applications in whole-body 

cryotherapy. This was an interesting application of 

thermography using the cold environment to constrict 

surface vessels and detect and treat deeper areas of 

inflammation. A typical cryosauna has a temperature of 

−120°C and the patient is required to spend 2–3 

minutes at a time in it. The aims of Armand’s work 

were to evaluate the effects of cryotherapy and to 

determine the skin response due to the low 

temperature used in whole-body cryotherapy. After the 

patients had been in the chamber thermal images were 

captured of different skin segments. These showed a 

mean whole-body decrease in temperature of 5.8°C 

with a maximum of 8.7°C. After use patients reported a 

significant recovery after one to ten cryogenic sessions. 

There was also a slight improvement in the fitness of 

the patients. In conclusion, Armand claimed that there 

was increased diagnostic value of thermal imaging 

after body cooling and that thermal imaging can be 

helpful in the monitoring of therapeutic effects of 

whole-body cryotherapy. However, very little evidence 

was presented to support this view and it was unclear 

from the presentation how thermal imaging 

contributed to patient care or overall management, and 

where this would be used in the care and diagnostic 

pathway. 

It was clear from the presentations that outside the 

use of thermal imaging for patients with Raynaud’s 

phenomenon a lot of possible clinical uses are in the 

very early stages of development and have not really 

become established in mainstream clinical practice. 

SUMMARY 

The meeting was attended by about 25 delegates and 

will hopefully become a regular event in the NPL 

calendar since it proved to be a great success. n 


All of the slides and talks can be accessed via YouTube at: 

http://www.youtube.com/playlist?list=PL08A8E92B0363DA68&fe 

ature=plcp 

FIGURE 1 

Images from the 

more expensive 

thermal imaging 

camera (left) 

when compared 

to the less 

expensive device 

(right). As can be 

seen, very little 

clinical 

difference can be 

observed. 

▼

MEETINGS 2012/2013 

EUROPEAN MEETINGS 

Meeting Venue and dates More information 

World Molecular Imaging Congress 

6th European Conference on Medical 

Physics 

IPEM Medical Physics and Engineering 

Conference 

Mathematics of Medical Devices and 

Surgical Procedures 

7th IET International Conference on 

Appropriate Healthcare Technologies for 

Developing Countries (AHT2012 ) 

Annual Meeting of the German Society of 

Medical Physics (DGMP) 

International Conference on Medical Image 

Computing and Computer Assisted 

Intervention 

3rd Newport 1-Day Update Course on 

Phototherapy Dosimetry 

International Cancer Imaging Society 12th 

Annual Teaching Course 

International Symposium on Biomedical 

Engineering and Medical Physics 

European Medical Physics and Engineering 

Conference (EMPEC 2012) 

MR Safety Training Course 

4th International Symposium on 

Radionuclide Targeted Radiotherapy and 

Dosimetry (ISTARD) 

12th IEEE International Conference on 

BioInformatics and BioEngineering 

(BIBE 2012) 

2012 International Conference on 

NeuroRehabilitation 

IAEA International Conference on Radiation 

Protection in Medicine – Setting the Scene 

for the Next Decade 

38th World Hospital Congress – Future 

Healthcare 

Dublin, Ireland 

5th–8th September 

Sibiu, Romania 


Oxford, UK 


London, UK 


London, UK 


Jena, Germany 


Nice, France 

1st–5th October 

Newport, Wales, UK 

2nd October 

Oxford, UK 

4th–6th October 

Riga, Latvia 


Sofia, Bulgaria 


Vienna, Austria 


Milan, Italy 

27th–31st October 

Larnaca, Cyprus 

11th–13th November 

Toledo, Spain 


Bonn, Germany 

3rd–7th December 

Oslo, Norway 

18th–20th June 2013 

INTERNATIONAL NEWS | SCOPE 

This is a non-exhaustive list of meetings of interest. For IPEM workshops and meetings and a full list of meetings, please check the IPEM website: 

http://www.ipem.ac.uk/Conferencesandevents 

http://www.wmicmeeting.org/ 

http://www.ecmp2012.ro/ 

http://www.ipem.ac.uk/Conferencesandevents/ 

mpec/Pages/default.aspx 

http://www.ima.org.uk/conferences/conferences_cal 

endar/maths_of_medical_devices_&_surgical_proce 

dures.cfm 

http://www.theiet.org/aht2012 

http://www.conventus.de/dgmp2012/ 

http://medical.rob.uni-luebeck.de/miccai2012rt/ 

http://www.bini.rtu.lv/isbemp 

http://www.bsbpe.org 

Contact ESMRMB Society 

http://bibe2012.cs.ucy.ac.cy/ 

http://www.icnr2012.org 

http://www-pub.iaea.org/ 

mtcd/meetings/Meetings2012.asp 

http://www.oslo2013.no 


▼

SCOPE | INTERNATIONAL NEWS 

MEETINGS 2012/2013 

NORTH AMERICAN MEETINGS 

Meeting Venue and dates More information 

Applied Health Physics (5-week course) Oak 

Ridge Associated Universities Hands-on 

Training in the Radiological Sciences 

Computed Tomography Hands-on Workshop 

for Physicists 

Principles and Practices of Radiation Safety: 

Occupational and Environmental Radiation 

Protection 

ASTRO Annual Meeting 

IEEE Nuclear Science Symposium, Medical 

Imaging Conference and Workshop on 

Room-temperature Semiconductor X-ray 

and Gamma-ray Detectors 

Respiratory Motion Management for 

Radiation Therapy 

Radiological Society of North America 

(RSNA) Annual Meeting 2012 

Practical Aspects of Stereotactic Body 

Radiation Therapy (SBRT) 

HPS Mid-year Topical Meeting on Medical 

Health Physics and Accelerator Dosimetry 

7th International Conference on Ethical 

Issues in Biomedical Engineering 

REST OF THE WORLD MEETINGS 

Thai International Workshop on New 

Technologies in Radiotherapy 

12th International Conference on Radiation 

Shielding (ICRS-12) and 17th Topical Meeting 

of the Radiation Protection and Shielding 

Division of the American Nuclear Society 

IC3DDose: 7th International Conference on 

3D Radiation Dosimetry (formerly known as 

DOSGEL) 

Engineering & Physical Sciences in Medicine 

Conference (EPSM2012) 

IEEE-EMBS – International Conference on 

Biomedical Engineering and Sciences 

(IECBES 2012) 

17th International Conference on the Use of 

Computers in Radiation Therapy (ICCR) 


Oak Ridge, TN 

10th September–12th October 

Houston, TX 


Boston, MA 

23rd–27th September 

Boston, MA 

28th–31st October 

Anaheim, CA 

29th October–3rd November 

St Louis, MO 


Chicago, IL 


Stanford, CA 

30th November–1st December 

Scottsdale, AZ 

27th–30th January 2013 

New York, NY 

20th–21st April 2013 

Bangkok, Thailand 

22nd–25th August 

Nara, Japan 

2nd–7th September 

Sydney, Australia 


Gold Coast, Queensland, Australia 

2nd–6th December 

Langkawi, Malaysia 

17th–19th December 

Melbourne, Australia 

6th–9th May 2013 

http://www.orau.org/environmental-assessmentshealth-physics/capabilities/health-physicstraining/course-descriptions-and-schedules.aspx 

http://www.mdanderson.org/education-andresearch/departments-programs-andlabs/departments-and-divisions/imagingphysics/education/index.html 

https://ecpe.sph.harvard.edu/programs.cfm?CSID= 

OERP0913&pg=cluster&CLID=1 

https://www.astro.org/Meetings-and-Events/2012- 

Annual-Meeting/Index.aspx 

http://www.nss-mic.org/2012/NSSMain.asp 

http://radonc.wustl.edu/pdf/MMRTCourse.pdf 

http://www.rsna.org/Annual_Meeting.aspx 

http://hps.org/meetings/meeting33.html 

http://www.downstate.edu/orthopaedics/ 

bioethicsconf2013/ 

http://www.cccthai.org/en_/ 

http://www.icrs12.org/ 

http://www.ic3ddose.org 

http://www.epsmconference.org/ 

http://iecbes2012.myembs.org/ 

http://www.iccr2013.org 

Email: iccr2013@arinex.com.au

MEMBERS’ NEWS | SCOPE 

Röntgen Prize of the British Journal of Radiology 

One of our own, Peter Mountford, 

was recently awarded the 

prestigious Röntgen Prize of the 

British Journal of Radiology. 

Peter was formerly Director of 

Medical Physics and Clinical 

Technology, University 

Hospital of North 

Staffordshire, Stoke-on- 

Trent, and also a Reader in 

the School of Postgraduate 

Medicine of Keele 

University. 

At a reception 

held at UKRC in 

Manchester on 

Monday 25th 

June 2012, 

Peter was 

awarded the 

2010 Röntgen 

Prize of the 

British Journal 

of Radiology. Founded in 1924, in 

memory of Professor W.C. 

Röntgen, this prize is awarded 

annually to a member, or a team 

of workers including a member, 

whose contribution to the British 

Journal of Radiology has 

been of special merit. 

The subject of the 

contribution must be 

related to radiotherapy, 

radiobiology or physics. 

The BIR stated in 

their citation that: 

‘Throughout his NHS career Dr 

Mountford served the British 

Institute of Radiology with 

distinction. In 1994 he joined the 

Editorial Board of 

the British 

Journal of 

Radiology 

and later 

became 

Deputy 

Laser Positioning 

Innovative equipment for radiotherapy 

First laser positioning system designed 

with a double diode. 

Switch between red and green for each 

laser line at the touch of a button. 

No manual adjustment needed. 

Smart Phantom® calibrates to 0.1mm 

accuracy. 

Editor for physics and 

technology. He additionally 

made scientific contributions to 

the BJR in numerous articles 

published between 1976 and 

2009 and, for 6 years, was a 

member of the BIR Radiation 

Protection Committee. 

The BIR recognises with 

gratitude Peter Mountford's long 

and distinguished association 

with its activities and is 

delighted to award him the 2010 

Röntgen Prize.’ 

I think that our whole 

readership would wish to join 

me in congratulating Peter on 

his achievement. 

Peter Mountford (right) and 

Dr Stephen Davies, the President 

of the British Institute of 

Radiology. Thank you to the BIR 

for providing the image. 

▼ 

www.osl.uk.com 

enquiry@osl.uk.com 

+44 (0)1743 462694 


▼

SCOPE | MEMBERS’ NEWS 

Robert Neilson 

Peter Sharp acknowledges the exceptional hard work of IPEM’s retiring General Secretary 

One can argue as to 

who is the more 

important person in 

the Institute, the 

President or the 

General Secretary. A President 

is rather like a pigeon, he (or 

she) flies in, makes a mess and 

then flies off again after 2 years. 

The General Secretary has the 

brush and pan and is 

responsible for cleaning up 

afterwards. 

MAJOR ACHIEVEMENTS 

As one of the first pigeons that 

Robert had to clean up after, I 

have no doubts about the 

importance of the role of the 

General Secretary. Of course he 

is now well supported by an 

administrative team in 

Fairmount House, but he 

carries the ultimate 

responsibility. I asked Robert 

what his greatest challenge had 

been and certainly well up the 

top ten list was the introduction 

of the new computer system. 

Those of you who are keen 


subscribers to Private Eye will 

frequently read about the 

disasters that befall many 

government departments when 

they try to introduce new 

computer systems and IPEM, 

while not (yet) featuring in that 

august organ, was not immune 

from that. I have often said that a 

new President has two options; 

either introduce a new computer 

system for the office or 

undertake a reorganisation of 

how IPEM works. Either way 

he/she will have an excuse for 

putting off any difficult decisions 

until after their term of office. But 

Robert is the man with the brush 

and pan. 

“ 

The General 

Secretary has the 

brush and pan and 

is responsible for 

cleaning up 

” 

Like many leading lights in 

IPEM Robert has Scottish roots. 

Being a keen amateur 

genealogist Robert has traced 

one part of his family back to St 

Ninians, near Stirling. However, 

in the middle of the nineteenth 

century they moved down to 

Yorkshire, first to the York area 

and then, his sub-branch, to 

Knottingley, where Robert 

himself was born. Robert is now 

a fully fledged Yorkshireman, 

having lived in the county all 

his life. Not only does he 

love its moors and 

dales but as a 

committed Christian 

Robert has many 

connections through 

his work with the 

Congregational 

Church in Pontefract. 

Those of us who 

have had the privilege of working 

with Robert over the years 

appreciate his openness, honesty 

and full commitment to the aims 

of the Institute. When I suggested 

to Robert that perhaps not being 

a scientist would have been a 

disadvantage in his early days, he 

pointed out that he had always 

been keen on science and it was 

only a quirk of the educational 

system that meant he had ended 

up on the arts side. Also, in his 

previous jobs in the power 

industry, he had worked with 

scientists and engineers and 

needed a strong technical 

background to carry out audits 

and manage the functions for 

which he was responsible at a 

power station and in the fuel 

supply chain. 

That devotion to the 

profession showed itself again 

when I asked Robert of what 

achievement he was most proud. 

He said that it was the work he 

did with the Science Council, on 

behalf of the Institute. During 

that time the Chartered Scientist 

designation was developed and 

he played an important role on 

the Registration Authority, acting 

as its chair during the crucial 

formative period when CSci 

standards were set and initial 

licences were awarded. In the 

last year he has been involved in 

introducing the RSci and 

RSciTech qualification for 

science technologists at different 

career stages, with IPEM being 

one of the first organisations to 

be able to award the new 

designations. There is something 

in the genes of medical physicists 

that makes them cynical about 

the value of qualifications but, in 

a competitive world, marks of 

professional standing are 

increasingly important and 

Robert must be congratulated on 

his work. 

So how has the role of the 

General Secretary developed over 

the time Robert has been in 

office? He reminded me of a 

question that I had asked him at 

his interview, ‘Do you feel that 

this job is really a full-time one?’ 

His answer had been that no, it 

wasn’t, at least not as we had 

described it in the job 

specification, but it should be full 

time as there was much more 

that needed to be done and he 

promptly listed all the extra 

tasks. Despite that he was 

appointed. 

CHALLENGES FACED 

The main change has been the 

move from the post being 

primarily administrative to one of 

being the Chief Executive, the 

person who makes a significant 

contribution to the strategic 

vision of the Institute. Now that 

the Institute has a well-organised 

office to take on the many tasks 

that an organisation of our size 

needs doing, the role has been 

much more hands-off with 

Robert increasingly being asked 

to represent the Institute on 

external bodies, such as the 

Science Council. I know that 

during my time as President I 

found it very helpful to have 

Robert sitting next to me at 

committee meetings to provide 

wise advice and remind me when 

I was straying from the party line. 

Of course in the past few years 

the landscape in which the 

Institute operates has changed 

significantly. The Institute is faced 

with an administration in 

Westminster which does not 

always appreciate the value of 

professional societies and seems 

to prefer to take on much of their 

roles themselves. Robert’s view 

of the challenges facing his 

successor is that they need to 

create an organisation that gives

a strong professional 

leadership. The old model of the 

majority of work being carried 

out by volunteers is now not so 

appropriate with everyone 

under much more scrutiny as to 

how they use their time. More 

reliance will need to be on paid 

staff with appropriate 

professional backgrounds. He 

also has a typically trenchant 

view on who is the audience of 

IPEM. Of course the NHS is a 

major customer (I can hear 

Robert mutter four devolved 

NHS organisations) but we need 

to service a far broader 

congregation; academia, biology 

and related industries, perhaps 

even agriculture. 

Robert has served the 

Institute well for the past 16 

years and even in his final 

months his enthusiasm for the 

‘ 

RETIREMENT 

Eight IPEM Presidents and the President-Elect had lunch with Robert Neilson in York to mark his retirement as General Secretary. 

Back row (left to right): Peter Sharp OBE (1997–99); Steve Smye (2001–03); Peter Wells CBE (1995–97); Peter Jackson (2005–07); Keith Ison 

(2007–09); Peter Williams (2003–05). Front row: Chris Gibson (2009–11); Peter Jarritt (2011–13); Robert Neilson (General Secretary, 

1996–2012); Steve Keevil (President-Elect, 2011–13). Rod Smallwood (1999–2001) was unable to attend at the last minute. 

work of the Institute is strong. 

We will miss his wise guidance, 

his hard work and his strategic 

vision. We will also miss his 

many anecdotes from his 

previous jobs! We wish him a 

long and productive retirement 

which he says he will spend 

bringing to fruition five books 

and finally tracing his Scottish 

ancestry beyond a blank period 

in records, which he believes 

was caused by a ‘disruption’ in 

the established, Scottish 

Presbyterian Church in St 

Ninians. He is amused, as a 

member of a church that had its 

origins in similar principled 

dissent from the 1662 Act of 

Uniformity in England, that his 

Scottish ancestors may 

themselves have been involved 

in the Scottish version of dissent 

in the 1700s. 


SCOPE | MEMBERS’ NEWS 

Professor Peter Sharp OBE, FRSE, FIPEM, CSci, FInstP 

Robert Neilson pays tribute to the incredible work achieved in a long career 

Professor Peter 

Sharp retired from 

his twin 

appointments as 

Professor of 

Medical Physics at the 

University of Aberdeen and 

Clinical Director of Medical 

Physics for NHS Grampian at 

the end of August 2012. He is 

one of a decreasing number of 

people with truly dual 

appointments, whose salary is 

paid by both the university and 

the hospital. He observes that 

this means both employers 

expect him to do a full-time job 

for them! He actually has found 

the arrangement very useful, as 

working with medical staff in 

his NHS role has given him 

opportunities for spotting 

research projects that he could 

carry out in his university role. 

EARLY CAREER 

Born in Lincolnshire, and after 

a grammar school education in 

Spalding, Peter read Physics at 

Durham University and was 

awarded the degree of BSc 

(Hons) in 1968. During his final 

year he applied to Aberdeen for 

a place on the MSc in Medical 

Physics course developed by 

John Mallard OBE, who was the 

first Professor of Medical 

Physics at Aberdeen, and whom 

Peter would later succeed as 

the second Professor. Peter 

decided his interests really 

were in going on to do a PhD, 

and gave this as the reason for 

withdrawing his application. 

John Mallard countered by 

offering Peter a place as a PhD 

student to undertake research 

into the quality of nuclear 

medicine images, and the rest, 

as they say, is history. 

When Peter had completed 

his PhD, he obtained a 

permanent appointment and 


stayed for the whole of his 

working life, eventually 

succeeding John Mallard as 

Professor of Medical Physics 

when he retired. 

When asked why he had spent 

his entire career in Aberdeen, he 

said simply that there was a lot of 

interesting scientific work going 

on there and he wanted to be part 

of it. In the early 1970s two SPECT 

“ 

This means 

both employers 

expect him to do a 

full-time job for 

them! 

” 

scanners were built, the first in 

the UK and predating the x-ray CT 

scanner. Later, a gamma camera 

was mounted on the stand from 

an old cobalt machine to produce 

an early SPECT camera. In the 

early 1980s Aberdeen developed 

the first clinical whole-body MR 

imager and established a PET 

centre in Aberdeen, the first in the 

UK apart from the MRC PET 

Centre at Hammersmith 

Hospital. This involved 

dismantling a cyclotron that had 

been used in a radiotherapy 

project in Edinburgh, shipping it 

up to Aberdeen (courtesy of the 

Army) and then reassembling it. 

The Aberdeen PET centre also 

used a second-hand PET scanner 

that had previously been at the 

Hammersmith PET centre. 

Initially there was nowhere to put 

the equipment, so money had to 

be raised to buy an old farm 

building which was then 

converted into a PET centre with a 

radiochemistry facility. Peter 

remembers it as fun to see so 

much being achieved on a 

shoestring budget, although it 

didn’t seem like it at the time. 

PROFESSIONAL WORK 

Peter has spent most of his 

career working in nuclear 

medicine, but when he succeeded 

John Mallard as Chair and as 

Head of Department in 1992, he 

relinquished his role as Head of 

Nuclear Medicine, whilst 

retaining a professional interest 

in the area. His continuing 

interest resulted in him 

persuading the hospital to pay for 

a new building for the PET centre 

to bring it on to the hospital site, 

raising money for a new cyclotron 

and radiochemistry facility and 

purchasing a new PET imager. A 

few years later the Scottish 

Government wanted to know if 

PET was likely to be of value in the 

management of cancer, and 

Peter was asked to chair an 

advisory group to formulate 

advice. A model was constructed 

showing how PET would be used 

in the clinical setting, and 

populated with measures of the 

sensitivity and specificity of PET 

for various cancers, to work out 

the likely costs of a PET service 

and then demonstrate that it 

would be cost effective. The 

Scottish Government was 

persuaded that they should invest 

in PET scanners, which by this 

time were PET/CT scanners, and 

equip the four cancer centres in 

Scotland. Peter was awarded the 

Norman Veal Medal of the British 

Nuclear Medicine Society in 1999 

in recognition of his contribution 

to nuclear medicine. 

Away from nuclear medicine, 

Peter’s research interests had 

developed into the science 

underpinning ophthalmology. 

There was a strong research 

group at Aberdeen University 

interested in the biology of 

diabetic eye disease, which is the 

most common cause of blindness 

in the working age population. 

This group approached Peter’s 

physics team to see if they could 

develop a scanning laser 

ophthalmoscope. This was a 

device that scanned a laser beam 

over the retina of the eye and built 

up a picture from the reflected 

light. The team went further and 

built a machine that used three 

lasers at different wavelengths, to 

give a full colour, rather than 

monochromatic, image. It also 

went on to modify the scanner so 

that it would image individual 

blood cells as they flowed 

through the retinal vasculature in 

rats and genetically modified 

mice. This allowed measurement 

of their speed and number of 

cells, thus providing tools to 

investigate vascular diseases 

where it was believed that the 

blood cells would stick to the 

walls of the vessels. 

Peter’s team was then 

approached by a group of 

ophthalmologists who were 

running a diabetic retinal 

screening service in Scotland. 

Every person in Scotland with 

diabetes has annual images of 

their eyes taken to look for early 

signs of eye disease. They were 

training retinal screeners to 

examine the tens of thousands of 

images and clearly it was 

extremely time consuming, 

expensive and not very reliable. 

The physics team’s task was to 

develop software that would 

analyse the retinal images for the 

pathology that was indicative of 

early eye disease. If none was 

found then the person would 

simply be told to return the next 

year for another picture. If there 

were some abnormal features 

then the images would be passed 

on to a human screener for 

further analysis. The required 

software was developed and 

trialled with thousands of 

patients. The trials showed that it 

was reliable, and cheaper than

employing human screeners for 

basic screening. A licence on 

the software was taken up by a 

company and the system is now 

in routine use in the Scottish 

Screening Service. 

HONOURS RECEIVED 

Research supporting 

ophthalmology continues. 

Another clinical trial 

concerning automating 

macular oedema detection has 

just been completed; another 

project is looking at whether 

diabetic eye disease is a 

predictor of cardiovascular 

disease, and another is looking 

at the information that can be 

derived from serial retinal 

photographs. 

In 2000 Peter’s department 

was awarded the Queen's 

Anniversary Prize for Higher 

and Further Education in 

recognition of its ‘pre-eminence 

in medical imaging technology 

for over 30 years’. As Peter had 

been there for the entire 30 

years (and now 12 years more), 

this was not only a recognition 

of the work that the department 

had been doing, it also reflected 

his contribution to it. 

But Peter’s work and 

achievements must also be set 

in the context of his wider 

professional contribution in 

Scotland, in the UK and, more 

recently, in Europe. 

Even as a PhD student, 

Peter’s research involved 

contact with the NHS 

department in Aberdeen and 

John Mallard quickly persuaded 

him to join HPA/IPSM, 

predecessor organisations of 

IPEM. He recalled that an early 

involvement in professional 

body ‘corridors of power’ was 

when he attended a meeting of 

the IPSM Professional 

Committee at the Institute of 

Physics’ former offices in 

Belgrave Square, where the 

HPA/IPSM office was then hosted. 

Keith Boddy, who was to attend 

the meeting, was delayed 

because he had been asked to 

meet with IOP officers, to be given 

the news that HPA /IPSM were 

being asked to find alternative 

office accommodation. It was 

decided to move to York, where 

IPEM (as it now is) now occupies 

its third office premises. 

Peter was the second IPEM 

President (1997–99), having 

previously served as the first 

IPEM Vice President (1995–97) 

and the last Honorary Secretary 

of IPSM (1992–95), prior to which 

he was IPSM’s Assistant 

Honorary Secretary (1990–92). 

His reward for such dedicated 

service, post Presidency, was to 

be nominated by IPEM to be Chair 

of the Association of Clinical 

Scientists, to chair RPA 2000 

(which certificates Radiation 

Protection Advisers on behalf of 

the Health and Safety Executive), 

to chair IPEM’s Professional 

Conduct Committee, to represent 

IPEM on the Executive of the 

IOP–IPEM Medical Physics 

Group, to be Company Secretary 

of Radiation and Oncology 

Congresses, to represent IPEM 

on the Scottish Forum for 

Healthcare Science (which he 

also chaired), to be Honorary 

Treasurer of the (UK) Federation 

for Healthcare Science, to be 

Honorary Treasurer of the 

European Federation of 

Organisations for Physics in 

Medicine (EFOMP) and to be a 

member of the Science Council’s 

Registration Authority. Peter was 

elected as a Fellow of the 

Royal Society of Edinburgh 

(FRSE) and has served on 

its Council and its 

Fellowship Appointments 

Committee. 

‘ 

OTHER INTERESTS 

As retirement (from employment, 

at least!) has drawn closer, Peter 

has managed to hand over most 

of his roles that had not already 

come to the end of a defined term 

of office. He remains a member of 

the Science Council’s 

Registration Authority and in 

January 2011 stood down after 5 

years as Honorary Treasurer to 

become Vice President of EFOMP, 

in the knowledge that he would 

succeed to the Presidency of 

EFOMP from January 2012 for a 

term of 3 years. 

He confesses that he has ‘lived 

to work rather than worked to 

live’, but does find time for some 

interests that are not workrelated. 

He chairs the 

Administration Board for the 

Diocese of Brechin in the Scottish 

Episcopal Church. Several years 

ago he was appointed as an 

Honorary Sherriff, which in the 

Scottish legal system is the 

equivalent of a judge. However, 

while he has the power to give 

custodial sentences, he is not 

allowed to preside at trials by jury. 

Peter enjoys classical 

music, 

especially 

opera, 


believes 

that the 

Kindle is 

one of the 

most 

useful 

devices to 

have been 

developed 

RETIREMENT 

in the past 10 years. So, although 

it looks as if reading is on his 

retirement agenda, erecting more 

bookshelves is not! 

Over a long and successful 

career, Peter’s contribution to 

medical physics has been 

incalculable, even for a physicist 

or mathematician, and IPEM and 

the profession in general in the 

UK will be the poorer to lose his 

active presence. His outstanding 

contribution has, however, 

recently been recognised by the 

award to him of an OBE in the 

Queen’s Birthday Honours List, 

for services to healthcare 

science. However, with his 

retirement from employment, the 

UK’s loss is Europe’s gain, for a 

few more years at least, as he 

brings his accumulated wisdom 

to bear on medical physics 

matters European. Peter has also 

agreed to be the President of 

ICMP 2013 (the International 

Congress of Medical Physics), to 

be hosted by IPEM in Brighton in 

September 2013, and which will 

incorporate, with IOMP’s 50th 

anniversary congress, IPEM’s 

annual Medical Physics and 

Engineering Conference 

(MPEC) and EFOMP’s 

biennial European 

Medical Physics 

Congress (EMPC). 

So, as Peter retires 

from his career in 

medical physics in 

Aberdeen, for IPEM it 

will not be a complete 

‘goodbye’, but ‘au revoir’, 

and we wish him well in 

his far-from-inactive 

retirement. 


SCOPE | BOOK REVIEWS 

Welcome to another 

issue of Scope 

‘Book Reviews’! 

This time around 

we have had the 

highest number of 

reviews submitted 

by our team of Ubidesk book reviewers. A 

special thanks to our reviewers who have, 

for the first time this year, supplied more 

than the target number of book reviews! 

Textbook reviews cover both the medical 

physics and popular science genres. A list 

of the reviewed titles with reviewers can be 

found below in table 1. 

As with each Scope issue, there are a 

number of new medical physics textbooks 

in the ‘Just Published’ section. You will 

find some interesting reports listed in the 

‘New Reports’ section, such as ‘Health 

Effects from Radiofrequency 

Electromagnetic Fields’. I have included a 

reference to a relatively recent report 

published by the Department of Health in 

2011, ‘Radiotherapy Dataset Annual 

Report’, for completeness. You may also 

want to have a look at the ‘Safer 

Radiotherapy’ newsletter of the HPA, the 

last of which was published in 2011 (issue 

6). Reader(s) who are interested in 

reviewing listed/unlisted books please do 

get in touch with me so I can arrange to 

send you the required material directly 

from the publisher. Note that some of the 

new reports are freely available to 

download from the respective websites. 

A warm welcome to another book 

reviewer – Ms Rebecca Quest, Principal 

Clinical Scientist specialising in MRI and 

working at the Imperial College Healthcare 

NHS Trust in London. Dr Mark McJury, 

Consultant Clinical Scientist, rejoined us 

after moving hospitals – he now works at 

the Beatson Cancer Centre as the Head of 

Research and Development in 

Radiotherapy Physics. 

We do require more book reviewers to 

allow us to consistently hit our 2012 target 

TABLE 1 


of eight book reviews per quarter, so please 

drop me an email if you are interested in 

becoming a reviewer. The reviewing 

process is relatively relaxed, and there are 

no tight deadlines. If you are new to 

reviewing, then there is a process 

document on finding your way around 

Ubidesk as well as a guidance document 

on reviewing textbooks. 

Usman I. Lula, Clinical Scientist, Radiotherapy 

Physics, Poole Hospital NHS Trust 

usman.lula@poole.nhs.uk 

Cardiac Fibrillation– 

Defibrillation 

This is an impressive book offering a review 

of current biomedical concepts in atrial and 

ventricular fibrillation – initiation, 

maintenance, pharmacological therapies and 

engineering solutions for treatment are all 

given their due. Chapters cover fibrillation 

mechanisms, including the multiple ectopic 

foci, re-entry and rotor theories of 

fibrillation, as well as general concepts of 

defibrillation (minimum defibrillatory mass, 

pharmacological and electrical defibrillation, 

monophasic and biphasic DC shocks, etc.). 

The design and generic build of external 

defibrillators is discussed, as are algorithms 

that adjust delivered energy based on 

measures of transthoracic impedance. 

Implantable cardiac defibrillators (ICD) are 

passed over in brief, mainly in reference to 

software methods to discriminate ventricular 

Book title Reviewer 

Cardiac Fibrillation–Defibrillation James Stirrup 

The Emperor of All Maladies Jennifer Lowe 

Physics of Societal Issues Malcolm Sperrin 

The Fundamentals of Imaging Lisa Davenport 

The Essential Physics of Medical Imaging Elizabeth Berry 

Susceptibility Weighted Imaging in MRI Glyn Coutts 

Biohybrid Systems Julie Wooldridge 

Quantitative MRI in Cancer John McLean 

Proton Therapy Physics Angela Newing 

tachycardia/fibrillation from normal or 

benign cardiac rhythms. From a personal 

perspective, this section was fascinating 

given the clinical issues that can arise which 

necessitate device reprogramming to 

prevent inappropriate discharge. The real 

focus in this section though is on the 

application of such software to automated 

external defibrillators, which I suppose 

makes the book useful to any reader who 

regularly frequents large public spaces. 

Approaches to fibrillation detection are 

discussed in escalating order of complexity, 

from probability density functions and 

threshold crossing intervals through to 

time-frequency Fourier techniques and 

phase space analysis. 

The biggest selling point of the book is, 

to my mind, the balance between the clinical 

and engineering content. As a clinician, I 

found the electrophysiology sections to be 

the most useful, but there is plenty of 

material to keep the engineer happy. There 

were sections that were harder going for me 

– I confess that the section on theoretical 

models went over my head (non-linear 

microscopic models of cardiac dynamics), as 

did the chapter on electrodes and pastes – 

but this is only really a reflection of the 

multidisciplinary appeal of the book. 

Although now more than 16 months old 

(more considering the standard delay 

between submission and publication), this is 

a very readable account of current 

understanding based on a broad analysis of 

the field. I read the book from cover to cover 

over three Winchester–London train rides, 

which should give some idea of its length 

and easy accessibility. Like many textbooks 

purporting to cover the current state-of-theart, 

there is the significant danger of being 

out of date almost upon publication. 

Indeed, it is likely that those most interested 

in this field will refrain from an outright 

purchase in favour of one or more journal 

subscriptions. This would be a shame as the 

majority of the material discusses 

established concepts. I give this book a

confident recommendation to biomedical 

engineers, and for that matter, anyone for 

whom cardiac electrophysiology forms a 

significant part of their working life. 

Dr James Stirrup is a Clinical Research 

Fellow at the Cardiac Imaging National Heart 

and Lung Institute, Imperial College, London. 

He is also a Cardiology Specialist Registrar at 

the Wessex Deanery, UK 

CARDIAC FIBRILLATION–DEFIBRILLATION: 

CLINICAL AND ENGINEERING ASPECTS – 

SERIES ON BIOENGINEERING AND BIOMEDICAL 

ENGINEERING 

Author: Max E. Valentinuzzi 

Publisher: World Scientific 

Volume: 6 

ISBN: 978-9814293631 

Pages: 304 

The Emperor of All 

Maladies 

I loved this book which was a slight relief 

as it would have been interesting to write a 

review in opposition to the many people 

who decided that this book was worthy of 

a Pulitzer Prize (General Nonfiction, 2011), 

the Guardian First Book Award 2011 and 

shortlisted for both the Duff Cooper Prize 

2011 and the Wellcome Trust Book Prize. 

The author, Siddhartha Mukherjee, is a 

well-published cancer physician and 

researcher who lives in New York. He 

started researching the history of cancer 

when he began his advanced training in 

medical oncology in Boston, which after 

about 7 years resulted in this book. The text 

follows a roughly chronological path 

through the history of cancer from its first 

description around 2500 BC in Egypt, to 

recent discoveries in the understanding of 

the activation or inactivation of genes or 

pathways that result in cancer. The 

‘biography’ is also interspersed with the 

very human stories of a few of Mukherjee’s 

own patients and the successes and failures 

of their cancer treatments. 

The book is very well written, and in 

spite of being packed with lots of 

interesting facts and historical references, I 

found it to be a gripping read. I 

particularly liked how each theme was 

developed by pulling together different 

strands from different researchers, 

hospitals and countries across the world. 

The ‘chapters’ are introduced with a wide 

variety of quotations – historical, literary, 

and from contemporary media, activists, 

researchers and cancer patients which gave 

added interest and context to the material. 

The book is predominantly plain text 

but in the middle section there are eight 

pages of black-and-white photos, cartoons 

and drawings offering, in my opinion, a 

limited and random selection of pictures of 

varying significance to cancer treatment. I 

did feel somewhat disappointed when the 

book abruptly ended a significant distance 

from the back cover. However, for the 

reader who wants to delve deeper, the 70 

or so pages of notes, references and 

bibliography at the end of the book will be 

invaluable. A comprehensive index is also 

included to facilitate returning to passages 

of interest. 

“ 

The text follows a 

roughly chronological path 

through the history of 

cancer from its first 

description around 2500 

BC in Egypt 

” 

I doubt that I will directly make use of 

any knowledge gained from this book in 

my future radiotherapy work, but I feel 

that I am more informed about the field in 

general and will have a better appreciation 

of how far medicine has come (and still has 

to go) in the treatment of cancer. 

Specifically I found it very interesting to 

see how clinical trials and randomisation 

developed and learning of some of the 

naming conventions for cancer drugs. 

I highly recommend this book to anyone 

with an interest in medical history and/or 

who is working in, or close to, the field of 

oncology. I found it to be highly 

informative, a real page-turner and a 

welcome Christmas present. As the 

paperback edition is currently available on 

Amazon.co.uk for a bargain price of £6.79, 

I think it would be rude not to. 

Mrs Jennifer Lowe is a Clinical Scientist 

(Radiotherapy) currently on a career break, 

Falls Church, VA, USA 

THE EMPEROR OF ALL MALADIES: 

A BIOGRAPHY OF CANCER 

Author: Siddhartha Mukherjee 

Publisher: HarperCollins 

ISBN-13: 978-1439107959 (US) 

Format: Hardback 

Pages: 592 

USMAN I. LULA | SCOPE 

Physics of Societal 

Issues 

This title is not necessarily one that jumps 

off the shelf at you as a prime text for 

medical physics applications, but I would 

strongly urge you to at least have a browse 

through it. One implication from the title is 

that the content is accessible to a lay public; 

however, I would suggest that the content 

does require a good deal of advanced 

scientific competence. The reviewed edition 

was published in 2007 and although only 5 

years old the implications of the Fukushima 

nuclear disaster clearly play no part in the 

scientific analysis. That being said, it is an 

easy extrapolation of the book’s analysis to 

those events in Japan. This book looks to 

provide a well considered scientific 

approach to many of the influences on 

everyday life and there is considerable 

cross-over with our profession. 

The book is broadly divided into: 

national security, environment and energy, 

but these broad categories do not fully 

convey their content. For instance, Chapter 7 

discusses nuclear pollution, albeit not from a 

medical standpoint; nevertheless, the 

analysis is applicable for those of us who 

have a professional interest in radiation 

protection. Similarly, Chapter 9 discusses 

electromagnetic fields and epidemiology 

which continue to be very much in the 

news. Other chapters such as Chapter 16 on 

energy economics are reasonably considered 

to be peripheral to our profession, 

nonetheless the analytical approach and 

important subject matters are of general 

interest. In addition, there are useful 

appendices and reference/bibliography lists 

at the end of each chapter which, whilst 

limited, certainly do provide routes for more 

insight into some of the complex social 

arguments discussed within the text. 

As might be expected, the text is 

American and allowances need to be made 

for the units and also some of the content 

which is American-centric, but that aside, 

the text is very readable. One useful aspect 

of each chapter is the inclusion of ‘problems’ 

and I have used many of these to discuss 

aspects of general physics with my trainees 


▼

▼ 


and to encourage a breadth of awareness of 

physics in addition to the specialist 

applications more familiar to us. 

To my knowledge there are very few 

other books either of this type or with the 

same general usefulness, although the 

Internet does give access to some of the 

material albeit in a less consolidated form. 

Unfortunately, many of the diagrams and 

images could be clearer but that is more of a 

convenience than a limiting factor. I would 

highly recommend this text, probably as an 

inclusion to a departmental library rather 

than to an individual but I can see it being 

well used. 

Professor Malcolm Sperrin is the Director of 

Medical Physics and Clinical Engineering at the 

Royal Berkshire Hospital NHS Trust, Reading, UK 

PHYSICS OF SOCIETAL ISSUES: CALCULATIONS 

ON NATIONAL SECURITY, ENVIRONMENT, AND 

ENERGY 

Author: David Hafemeister 

Publisher: Springer 

ISBN: 978-0-387-95560-5 

Pages: 488 

The Fundamentals of 

Imaging 

I was a bit worried that this book was going 

to be massive and maybe a bit dull. It 

encompasses, as the title suggests, almost 

all imaging techniques, which is quite a big 

subject (especially everything the author 

considers to be imaging – more on that 

later) and potentially a hard slog for 

someone who doesn’t read physics books 

for fun (I’d just like to point that out now). 

However, not only is it compact, but it is 

also very easy to read and I even found it 

quite endearing in parts. 

The author sets the scene by explaining 

why sight is by far the best human sense 

before telling us about the human visual 

system and the evolution of all different 

eyes (I now know all about flatworm and 

nautilus eyes if you have any questions). 

Then we embark on the proper physics 

sections. There is the obligatory bit on 

medical imaging but that is only a tiny bit 

of a book that covers waves and image 

formation, microscopes, photography, film, 


television, infrared imaging, radar, imaging 

the universe, imaging with sound and 

imaging atoms and particles. As I 

mentioned at the beginning, there are a few 

bits I wasn’t sure about as to their imaging 

credentials, but they were some of my 

favourite bits: classical map making, trig 

points and aerial archaeology. Not that the 

book isn’t up to date – 3D television and 

imaging the Eyjafjallajökull ash cloud are in 

here too. 

The author’s writing style is friendly and 

charming, and the book includes lots of 

historical bits. The physics throughout are 

explained simply with equations where 

need be and plenty of pictures and 

diagrams. 

I would not recommend this book if you 

are looking specifically for an introduction 

to medical imaging as the section is really 

brief. Likewise, I found the seismic imaging 

section a bit short. On the other hand, the 

universe sections seemed to take up quite a 

lot of the book, but I have to confess 

skipping those, having managed to avoid 

anything space-related in my life to date. 

However, the book is clearly intended as a 

basic introduction to everything and for 

that it serves its purpose really well. 

As for the target audience, well, the 

introduction states that it should be 

accessible to those with an interest in 

science and who have studied it at school – 

I can only agree with that. It’s good for 

explaining all those things you (or at least I) 

never thought about before such as how an 

intruder alarm works. 

The book is clearly 

intended as a basic 

introduction to everything 

and for that it serves its 

purpose really well 

“ 

” 

In conclusion, I think that any physics 

book that mentions beluga whales and 

Bradford Media Museum can only be a 

good thing. And did you know that in 1880 

they could detect the heat radiated by a cow 

at a distance of 400 m? 

Mrs Lisa Davenport is a Clinical Scientist in 

Radiation Protection at the Radiation Physics 

Department, Bradford Teaching Hospitals NHS 

Foundation Trust, Bradford, UK 

THE FUNDAMENTALS OF IMAGING – FROM 

PARTICLES TO GALAXIES 

Author: Michael M. Woolfson 

Publisher: Imperial College Press 

ISBN: 9781848166851 

Format: Paperback 

Pages: 360 

Price: £32.00 

The Essential Physics 

of Medical Imaging 

This is the third edition of a well-respected 

text on the physics of medical imaging. It 

covers all the expected imaging modalities 

together with radiation biology and 

radiation protection. Although the earlier 

editions were intended for radiologists-intraining, 

the comprehensive coverage made 

the book a popular graduate-level text for 

medical physicists too. In this third edition, 

the physicist readership has been recognised 

with the inclusion of an appendix on Fourier 

transforms and increased mathematical 

rigour throughout. 

The content of the book has been 

thoroughly overhauled. In line with the 

spread of digital technologies, the section on 

informatics has been moved into the basic 

concepts section and has been expanded 

upon. There have been corresponding 

reductions in the material on analogue 

techniques. Modalities that have entered 

clinical use since the last edition, such as 

digital breast tomosynthesis and dual 

modality imaging systems, have now been 

included. 

The book is surprisingly colourful inside, 

not only giving it a contemporary feel, but 

also helping to communicate information. 

There are coloured text headings, tables, 

photographs and figures. Many of the 

figures have been redrawn for this edition, 

and with colour they get their messages 

across very well indeed. Figures and 

photographs have been brought up to date, 

showing the thoroughness of the revisions. 

For example, a photo of a film badge 

belonging to one of the authors now shows a 

badge dated 2011; the badge in the second 

edition was dated 2000. 

Another innovation is the inclusion of 

access to online content. You scratch a sticker 

inside the book to reveal a code, visit the 

publisher’s website and use the code to 

register. Once registered, you can access 

online content – this comprises the entire 

content of the book, displayed in your 

browser using Adobe Flash Player 

technology format. The content is searchable 

and, for a book of this length, this provides a 

welcome alternative to using the index.

Books in this subject area can become 

somewhat unbalanced in their later 

editions, with rather short chapters on 

modalities such as ultrasound and MRI 

dominated by the ionising radiation 

content. Whilst this is true to a degree here, 

the balance in this book is good. 

Furthermore, in spite of the range of topics 

and multiple authors, the style is clear and 

consistent throughout the book. This is very 

much a reference text, and does not include 

questions or exercises to help radiologists 

with their exam preparation. One concern 

about using this book outside the US is the 

lack of information on European and more 

specifically UK legislation and regulation 

concerning ionising radiation. 

The book is comprehensive, 

authoritative, well illustrated and bang up 

to date. It makes a suitable masters level 

textbook, and is an ideal reference text for 

the training or practicing medical physicist. 

It provides good value for money, and 

owners of the second edition will not regret 

buying a replacement. 

Dr Elizabeth Berry of Elizabeth Berry Ltd in 

Leeds, UK 

THE ESSENTIAL PHYSICS OF MEDICAL IMAGING, 

3RD EDITION – INTERNATIONAL EDITION 

Authors: Jerrold T. Bushberg, J. Anthony Seibert, 

Edwin M. Leidholdt Jr and John M. Boone 

Publisher: Lippincott Williams & Wilkins 

ISBN: 9781451118100 


Pages: 1,048 

Susceptibility 

Weighted Imaging in 

MRI 

‘Susceptibility weighted imaging (SWI) 

consists of using both magnitude and phase 

images from a high-resolution threedimensional 

fully velocity compensated 

gradient echo sequence.’ The reader will 

encounter this sentence or similar many 

times in this text, followed by a brief 

description of the use of phase masks and 

minimum intensity projections (mIP). 

However, this is merely a symptom of the 

ambition of this volume in which 66 

contributors seek to cover every aspect of 

fully exploiting the phase information 

content in the acquired MR signal in a 

manner that is accessible to an audience of 

radiologists, physicists, cardiologists, 

oncologists, biochemists and students. 

The first eight (arguably nine) chapters 

(of Part I: ‘Basic Concepts’) serve as an 

introduction to the technique, ranging from 

what many will find familiar such as signal 

formation in gradient echo imaging through 

to advanced but necessary concepts – for 

instance, high-pass filtering and the 

influence of voxel aspect ratio – to the more 

daunting, such as the formation of phase 

images from multiple receiver coils. This 

then leads into the application of these 

concepts to MR venography, with the by 

now familiar high-resolution, high-contrast 

images, and brain imaging. 

Part II covers current clinical applications 

and may well be the starting point for those 

just beginning to use this technique. 

Included are vascular applications along 

with imaging cerebral microbleeds and 

haemorrhage, imaging of brain tumours, 

exploiting iron content in 

neurodegenerative disease and imaging of 

breast calcification. The book includes 

reprints of three seminal papers published 

in 1997, 2004 and 2006, but it is a mark of 

how much this technique is in its infancy in 

that much of the work presented here is 

based on relatively small studies from 

single research centres. 

The final chapter in Part II introduces 

SWI at ultrahigh field strengths (7T or even 

9.4T) with a balanced summary of both the 

opportunities and challenges. The last and 

largest section, Part III, is headed 

‘Advanced Concepts’ and ranges across 

applications which may well bear fruit for 

SWI, such as quantification of iron content, 

the effects of contrast agents, quantification 

of oxygen saturation and the interplay with 

the BOLD effect, as well as advanced 

acquisition methods. Also discussed in 

these chapters is susceptibility mapping 

which effectively inverts the problem in 

order to produce maps of the susceptibility 

sources that are producing the measured 

phase patterns, with the aim of producing 

quantitative information about, say, the iron 

or calcium content of tissues. 

There is inevitably some variation in 

style across the many contributors but for a 

work of this size and scope the errors of 

grammar, presentation and suchlike are 

relatively few. Throughout, the text is 

supported well by the images, including 

colour images where needed. 

It will be of interest in a few years’ time 

to see how much progress has been made in 

fully exploiting susceptibility differences as 

a basis for (quantitative) MR imaging. For 


now this volume will be a useful reference 

for any MRI department. 

Dr Glyn Coutts is a Clinical Scientist at the 

Christie Medical Physics and Engineering, The 

Christie NHS Foundation Trust, Manchester 

Department, UK 

SUSCEPTIBILITY WEIGHTED IMAGING IN MRI 

Editors: E. Mark Haacke and Jürgen R. 

Reichenbach 

Publisher: Wiley-Blackwell 

ISBN: 978-0-470-04343-1 


Pages: 776 

Biohybrid Systems 

This text offers a detailed overview of recent 

advances in biohybrid systems interfacing 

nerves, muscles and machines. It contains 

numerous mathematical models of 

neurophysiology, ranging from models of the 

cell biology such as membrane equivalent 

circuits to the mathematical descriptions of 

neural spike trains. The text also considers 

the hardware required to interface with a 

neuron, in particular the dynamic clamp 

which is used to influence membrane 

potentials and the latest nanotransducers, 

being developed using carbon nanotubes. 

This book is primarily aimed at researchers 

in the field with recommendations on the 

best software for implementing a dynamic 

clamp and suppliers of real-time control 

boards for neuronal models. 

Each chapter commences with a short 

introduction, placing the subject matter into 

context with the other chapters. Each also 

closes with a conclusion which generally 

does a good job of summing up the salient 

points of the text, particularly useful for the 

first-time reader. Much of the modelling 

assumes a high level of background 

knowledge in mathematics, electronics and 

neuroscience. This should probably not be 

considered an introductory text; however, 

even the casual reader will come away with 

an enhanced understanding of the field. 

The chapters are well written and despite 

being a multi-authored work there is little 

repetition and appropriate links to other 

sections are provided. There are a good 

number of illustrations, most of which are ▼ 


▼ 


very useful, in particular in Chapter 6 with 

its scanning electron micrographs of 

microelectrode arrays and Chapter 7 with 

numerous Simulink diagrams providing 

excellent support to an introduction of 

biohybrid systems analysis. 

The medical physicist 

will find little description 

of the practical 

applications of this 

technology until the last 

three chapters 

“ 

” 

Aside from a very interesting short 

section in the first chapter on an actuated 

articulated false-foot orthosis (designed to 

aid crutch-free walking for injured combat 

troops), the medical physicist will find 

little description of the practical 

applications of this technology until the 

last three chapters. This makes some of the 

intervening chapters rather ‘dry’ and it’s a 

shame that more short examples of the 

applications weren’t included. The last 

part of the book is dedicated to a few 

examples of medical applications, 

including neuromorphic hardware for 

audition and vision, neurocardiology and 

sensing of insulin demand. This is where 

the readers’ hard work in the earlier 

chapters will pay off! Chapter 9, 

‘Neuromorphic Hardware for Control’, is 

particularly interesting, demonstrating a 

biohybrid system to restore lost locomotor 

control and a silicon retina in which spatial 

and temporal filtering are computed at 

pixel level allowing low-power real-time 

control of a system. 

As a research text, this book will find 

little immediate application in the majority 

of clinical engineering departments. Many 

of the systems demonstrated will be 

confined to studies in research laboratories 

for some time to come. However, for 

anyone intrigued by the latest 

neuroprostheses showcased in the news or 

nature, this publication offers a fascinating 

insight into the field. 

Ms Julie Wooldridge is a Trainee Clinical 

Scientist in Electrodiagnostics and Clinical 

Engineering at the University Hospitals of 

Leicester NHS Trust, UK 

BIOHYBRID SYSTEMS: NERVES, INTERFACES 

AND MACHINES 

Editor: Ranu Jung 

Publisher: Wiley-VCH 

ISBN: 9783527409495 


Pages: 224 


Quantitative MRI in 

Cancer 

I was keen to review this book as I have an 

interest in QMRI methods. Probably the 

most comprehensive book to date on this 

topic is the QMRI in the brain book by Paul 

Tofts. However, it has been several years 

since it was published and I was interested 

to see how others presented these themes. 

The unique selling point of this new book 

is its focus on the application of QMRI 

methods in the treatment of cancer. This 

book provides a focussed, disease-led 

approach to presenting QMRI methods. This 

reflects the target audience, who in this case 

is likely to be researchers and clinicians with 

an interest in the application of novel 

imaging methods to cancer. 

A further feature of this textbook is that it 

does not focus solely on the brain by 

covering QMRI techniques applied to a 

range of other areas of the body such as the 

breast and prostate. 

The book itself is structured into five 

sections, namely: ‘The Physical Basis of 

MRI’; ‘Characterising Tissue Properties with 

Endogenous Contrast Mechanisms’; 

‘Characterising Tissue Properties with 

Exogenous Contrast Mechanisms’, and 

ending with ‘Image Processing in Cancer 

and Emerging Trends’. 

The introductory chapters on the biology 

and imaging of cancer set the scene for the 

rest of the book. The chapters on the physics 

of MRI and in particular the chapter on 

hardware and data acquisition are some of 

the best I’ve seen where the text is well 

supported by clear figures and equations. 

Beyond the introductory chapters of the 

book the QMRI methods begin to be 

introduced. Many of the chapters follow the 

structure of having both quantitative and 

then qualitative descriptions. This makes the 

book accessible to readers who may just 

want an overview of the topic as well as 

providing more detailed quantitative and 

mathematical descriptions for those who 

may wish to try and implement or develop 

the methods for themselves. 

The structure and choice of sections of the 

book are sensible and there is an entire 

section (five chapters) devoted to image 

processing methods in cancer. This reflects 

the importance of modern image processing 

methods in facilitating quantitative 

methods. The individual chapters contain 

the essential descriptions and underlying 

mathematics for each of the topics. 

Throughout this book each chapter is well 

referenced and importantly the authors 

direct the reader to associated software tools 

that have been used to perform image 

processing tasks. 

The final section of the book introduces 

emerging trends of QMRI in cancer. These 

are the use of MRI in radiation therapy; 

molecular and cellular imaging and the use 

of hyperpolarised MR in cancer. These topics 

are exciting and it is right that they have 

been included in a text such as this to enable 

the reader to get the best perspective on the 

current status of active research in this 

particular field. 

Overall, this is an excellent book for 

anyone interested in the application of 

QMRI methods ‘to cancer’. This textbook 

would also be useful for anyone interested 

in QMRI methods, irrespective of their 

disease of interest. 

Dr John McLean is a Clinical Scientist in 

Neuroradiology at the Institute of Neurological 

Sciences, Glasgow, Scotland, UK 

QUANTITATIVE MRI IN CANCER 

Editors: T. Yankeelov, D. Pickens and R. Price 

Publisher: CRC Press (Taylor & Francis) 

ISBN: 9781439820575 


Pages: 338 

Proton Therapy 

Physics 

Did you know that the possibility of using 

protons in radiotherapy was first postulated 

as long ago as 1946 by R. R.Wilson at 

Harvard University? He suggested that the 

finite range and Bragg peak of proton beams 

could be used to treat deep targets in the 

body with minimal damage to normal 

tissue. The idea was taken up a few years 

later by Tobias and his colleagues at 

Berkeley Laboratories in California and the

first small group of patients was treated 

there in 1954. 

This was a revelation to me and, I 

imagine, to most readers of Scope today. In 

the UK at Clatterbridge, protons have been 

used to treat ocular tumours, with good 

results, since 1989. Worldwide, many 

different sites have been treated since the 

1970s, with Russia and Japan leading in 

contention with the United States. There 

has been an exponential rise in interest 

over the last 30 years as demonstrated by 

the rise in papers in peer-reviewed 

journals. From one or two in 1980, there 

were almost 150 in 2010. You will find all 

this in Chapter 1 of this amazing book. 

There are 22 contributors, mostly 

American physicists, but with input from 

Germany, Switzerland, NPL (UK) and the 

Netherlands. The editor, who provides 

several chapters himself, is of German 

origin but has been the Director of Physics 

Research in Boston, Massachusetts, for 

some years. 

The basic physics is thoroughly 

explored in the 60 pages of Chapter 2. 

Cyclotrons, synchrotrons and accelerator 

technologies are dealt with in Chapter 3, 

followed by several chapters on clinical 

uses, dosimetry and treatment planning. 

There is comprehensive coverage of all 

aspects of proton radiotherapy here, set out 

in a concise manner for readers who have a 

good knowledge of physics to start with. 

“ 

Did you know that the 

possibility of using protons 

in radiotherapy was first 

postulated as long ago as 

1946? 

” 

I think that this book will be an 

indispensable aid for physicists beginning 

to work in the area of proton therapy and I 

have no hesitation in recommending it. 

The future of radiotherapy depends 

upon precise beam shaping and being able 

to use the distal fall off in dose due to finite 

beam range. 

Professor Angela Newing is a Retired 

Director of Medical Physics for 

Gloucestershire, UK 

PROTON THERAPY PHYSICS (SERIES IN 

MEDICAL PHYSICS AND BIOMEDICAL 

ENGINEERING) 

Editor: Harald Paganetti 

Publisher: CRC Press (Taylor & Francis) 

ISBN: 9781439836446 


Pages: 704 

Just Published! 

Electrical Safety Handbook by John Cadick, 

Mary Capelli-Schellpfeffer, Al Winfield and 

Dennis K. Neitzel (McGraw-Hill) is an 

essential, fully updated on-the-job safety 

resource covering every major electrical 

standard. It is written by experts in 

electrical construction safety and medicine 

as a practical guide for electrical workers 

and others exposed to electrical hazards. 

Biomedical Signals and Sensors I by 

Eugenijus Kaniusas (Springer) focuses on the 

interface between physiologic mechanisms 

and diagnostic human engineering. This is 

the first part of a two-volume set and this 

volume describes the basic cellular level up 

to their advanced mutual co-ordination 

level during sleep. 

Walter & Miller’s Textbook of 

Radiotherapy by Paul Symonds, Charles 

Deehan, Catherine Meredith and John Mills 

(Elsevier Health Sciences) covers underlying 

principles of physics and offers a systematic 

review of tumour sites, concentrating on the 

role of radiotherapy in the treatment of 

malignant disease and setting its use in 

context with chemotherapy and surgery. 

Technologies of Medical Sciences by 

Renato Jorge, Joao Tavares, Marcos Barbosa and 

Alan Slade (Springer) explores some of the 

latest innovations being employed in 

medicine. It covers areas such as 

computation modelling and simulation, 

image processing and analysis, medical 

imaging, human motion and posture, tissue 

engineering, design and development of 

medical devices and mechanic biology. 

How to Land a Top-paying Medical 

Physics Professors Job by Randy Spencer 

(Emereo Ltd) is a complete guide to 

opportunities, resumés, cover letters, 

interviews, salaries and promotions. 

Towards Practical Brain–Computer 

Interfaces by Brendan Allison, Stephen 

Dunne, Robert Leeb, Jose Millan and Anton 

Nijholt (Springer) features contributions by 

many of the top brain–computer interface 

researchers and developers. This book 

reviews the latest progress in the 

components of BCIs with a discussion that 

includes a range of practical issues in an 

emerging BCI-enabled community. 

Point-of-Care Diagnostics on a Chip by 

David Issadore and Robert Westervelt 

(Springer) reviews the latest biochip 

technology, examining progress in moving 

medical tests out of the laboratory and into 

the home, with automated and inexpensive 


technology that provides clinicians with 

real-time biochemical data. 

External Beam Radiotherapy, 2nd Edition 

by Peter Hoskins (Oxford University Press) 

provides practical guidance of the use of 

external beam therapy. It takes the reader 

through the basic principles covering 

indication, treatment and then developing 

this by individual sites. 

New Reports 

n Functionality and Operation of 

Fluoroscopic Automatic Brightness 

Control/Automatic Dose Rate Control 

Logic in Modern Cardiovascular and 

Interventional Angiography Systems: A 

Report of Task Group 125, Imaging 

Physics Committee. Medical Physics 2012; 

Volume 39, No. 5. 

n Dose Calculations for Photon-emitting 

Brachytherapy Sources with Average 

Energy Higher than 50 keV: Report of the 

AAPM and ESTRO. Medical Physics 2012; 

Volume 39, No. 5. 

n Avoidance of Unnecessary Dose to 

Patient while Transitioning from 

Analogue to Digital Radiology. Medical 

Physics 2012; IAEA TECDOC 1667. 

n Guidance on the Import and Export of 

Radioactive Sources. IAEA; 2012. 

n Communications with the Public in a 

Nuclear or Radiological Emergency, 

Emergency Preparedness and Response, 

EPR-Public Communications. IAEA; 2012. 

n Risk of Solid Cancers following Radiation 

Exposure: Estimates for the UK 

Population, RCE 19. HPA; 2012. 

n Health Effects from Radiofrequency 

Electromagnetic Fields, RCE 20. HPA; 

2012. 

n Doses to Patients from Radiographic and 

Fluoroscopic X-ray Imaging Procedures 

in the UK – 2010 Review, HPA-CRCE-034. 

HPA; 2012. 

n The Measurement of X-Ray Beam Size 

from Dental Panoramic Radiography 

Equipment, HPA-CRCE-032. HPA; 2012. 

n Radiotherapy Dataset Annual Report 

2009/2010. Department of Health, 

Gateway Reference 16350; 2011. 

n Safety Is No Accident – A Framework for 

Quality Radiation Oncology and Care. 

ASTRO Blue Book; 2012. 


A HISTORY OF MEDICAL PHYSICS 

THE STORY OF JULES GAVARRET (1809–1890) 

FRANCIS DUCK returns to Paris for the seventh part of his history series 

ules Gavarret 

(1809–1890) was 

Professor of Medical 

Physics in the Faculty of 

Medicine in Paris for 33 

years. By the time of his 

death he had earned an enviable 

national and international 

reputation, and many tributes were 

paid for his contributions to physics, 1 

to medicine2 and to education. 3 He 

was then largely forgotten. Recently, 

his name has reappeared in the 

histories of medicine and science. 4,5 

J 

This is his story. 


FIGURE 1. 

Jules Gavarret 

(1809–1890) (BIU 

Santé, Paris). 

▼ 

Louis-Dominique-Jules Gavarret 

(figure 1) was the second son of a 

provincial doctor. He was born on 

28th January 1809, in the small town 

of Astaffort in southern France. His 

intelligence and ability was 

recognised early and, on leaving his 

local town college in Agen, he 

gained a place at the prestigious 

École polytechnique in Paris, a 

gateway to high office in the 

professions, education and 

government. Here he met some of 

the greatest men in French science 

including Siméon Poisson 

(1781–1840) and Claude-Louis 

Navier (1785–1836). He initially 

turned away from the family’s 

profession, medicine. For a young 

man who would be later described 

by a friend as a pense-libre, a 

freethinker, 3 his first career choice 

was surprising: he joined the army. 

But his own character and army 

discipline were incompatible, and 

after 2 years at the artillery officers’ 

training school at Metz, he had a 

row and resigned. Some of his 

military colleagues never forgave 

this insult.

GAVARRET’S CAREER IN 

MEDICINE 

Back in Paris in early 1833, now 24years-old 

and with a strong interest in 

mathematics and physics, but also the 

need to gain a professional 

qualification, Gavarret turned to 

medicine. He spent the next 10 years 

in the Faculty of Medicine, at first in 

medical training, and subsequently in 

physiological research. 

It is usually possible to see early 

evidence in publications of a creative 

talent that will later flower into a full 

scientific career. Not so with 

Gavarret. His first publication, in 

1840, was a full-length monograph on 

medical statistics. 4,6 At that time, the 

term statistics meant, for the medical 

profession, simply the careful 

gathering and tabulation of 

comparative data. 

Our present understanding of 

probabilities, correlations and 

associations was entirely absent, and 

Gavarret’s book was the first time 

that such analysis had been applied 

to medical data. Built around 

Poisson’s methods of statistical 

analysis, Gavarret used many 

examples to demonstrate the 

importance of using large numbers of 

observations, of ascertaining limits of 

error from laws of probability, and 

the erroneous nature of results drawn 

without such analysis. It is perhaps 

unsurprising that this seminal work, 

by a then unknown author, failed to 

make the impact it deserved. Medical 

reputations were potentially 

threatened, being often based on 

particular treatment regimes. It 

would not be until the twentieth 

century that such statistical methods 

started to make any inroads into 

medical thinking. 

Gavarret then engaged in an 

intensive and highly productive 4year 

period of original physiological 

research, under the renowned 

physiologist Gabriel Andral 

(1797–1876). He published work on 

haematological pathology, 7 

emphysema and cardiopulmonary 

disease (his MD thesis), analysis of 

exhaled CO 2 (figure 2) and body 

temperature during intermittent 

fever. His emerging talent started to 

be appreciated outside France. The 

Lancet gave his work positive 

reviews, the studies on 

haematological pathology were 

published in America, 7 and his book 

on medical statistics was translated 

into German. 

THE CONCOURS FOR THE 

CHAIR OF MEDICAL PHYSICS 

The chair of medical physics in the 

Faculty of Medicine in Paris fell 

vacant on 20th July 1843, when Pierre 

Pelletan resigned. Pelletan had 

become heavily involved in business 

and industrial enterprises and had 

overstretched himself financially. 

Pressed by creditors, he resigned 

from his post and left France. 8 

The method by which senior 

academic posts were filled in France 

at this time was known as the 

concours (contest), a gruelling process 

of competitive interviews and 

examinations. The 1843 concours for 

the chair of medical physics consisted 

of four examinations, one written, 

two oral and a practical, and the 

defence of a thesis. The candidates 

appeared before a formidable 

academic panel consisting of nine 

professors from the Faculty of 

Medicine and four from the Faculty 

of Science. The panel was chaired by 

Claude Pouillet (1790–1868), a 

physicist whose name appears 

repeatedly in the story of medical 

physics. 8,9 

The field was very strong. Of the 

six candidates, three had taken part 

in the previous concours, 13 years 

earlier. 8 Jacques-Henri Maissiat 

(1805–1878) had been Pelletan’s 

assistant (agrégé) and had been giving 

the medical physics course since 

1839. The prize was highly attractive. 

The post was tenured. The salary was 

6,000 francs, about 10 times the 

average wage of a working man at 

that time, and well towards the upper 

end of government-supported 

salaries. Furthermore, there was no 

comparable post elsewhere at this 

time: in the other two full medical 

schools in France, at Montpellier and 

Strasbourg, the teaching of medical 

physics was still combined with that 

of hygiene. 

The written examination was 

about the human voice. For the first 

oral examination the candidates were 

each given their own topic, with 24 

hours’ notice to prepare a lecture. The 

six topics were: atmospheric 

humidity and its physiological 

effects; electrical phenomena in fish 

(Gavarret’s subject); sight; animal 

heat; capillarity and endosmosis, and 

radiant heat. There were only three 

topics for the second oral, which the 

candidates had to prepare with only 

3 hours’ notice: the microscope in 

medical science; physiology of gas 

“ Gavarret’s 

book was 

the first 

time that 

such 

analysis 

had been 

applied to 

medical 

data 

” 

HISTORICAL FEATURE | SCOPE 

and liquid pressure, and atmospheric 

electricity. The 25-minute physics 

practical examination followed: the 

explanation and use of Rumford’s 

calorimeter and Cagniard de Latour’s 

siren (figure 3). Finally, Gavarret 

defended his thesis on the laws of 

dynamic electricity. 

A report in the press (the concours 

was public) said that all candidates 

performed to a very high standard. 

Gavarret himself was deemed to have 

the best mind. The votes of the panel 

were equally divided between 

Gavarret and Maissiat, six each, 

leaving Pouillet to make the casting 

vote. Maissiat represented the safe 

option, known by the medical faculty, 

and capable of competent delivery of 

the first-year physics lectures to a high 

standard. Gavarret had presented as 

an outstanding and clear-minded 

intellect, with a high-quality, though 

brief, track record in research, but 

with no teaching experience. 

But Pouillet knew that he was 

living in a time of extraordinary 

change, both in physics and in 

medicine, and this was a critical 

appointment if Paris had any chance 

of maintaining its international 

position as a centre of medical 

excellence. He chose Jules Gavarret. 

The endorsement of his appointment 

was announced as a ministerial order 

on 16th January 1844. 

GAVARRET AS A TEACHER 

The record of Gavarret’s life for the 

next 10 years is muted. He settled 

himself into his new role, his ideas on 

how to apply physics to medicine 

undergoing a slow gestation. He 

engaged quickly with the life of the 

faculty, and in the year of his 

appointment as professor he also 

became assessor to the Dean. But 

those who might have expected 

further research output were 

disappointed, and no new textbook on 

medical physics appeared to replace 

Pelletan’s Physique general et médicale. 

His defence might have been that, in 

common with all academics, the 

combination of lecture preparation, 

examinations, tutorials and 

administration left no time for 

anything else; and furthermore, 

medical training at that time required 

no laboratory experience, so he had no 

space for experimental work. Perhaps 

Pouillet’s confidence had been 

misplaced, and he had selected 

another time-serving middle-rate 

academic. 

▼ 


▼ 

SCOPE | HISTORICAL FEATURE 

48 | SEPTEMBER 2012 | SCOPE

But Gavarret had not ceased 

thinking. In 1849 we see the next 

example in which he demonstrated 

that he was following developments at 

the interface between physics and 

medicine, in this case electricity. 

Conventional wisdom in France still 

broadly held to Volta’s electrochemical 

model to explain all galvanic sources, 

rejecting Galvani’s view of animal 

electricity as an innate property of 

living tissues. Gavarret published a 

careful review based on the best 

evidence he could find, concluding 

that much criticism of Galvani had 

been inappropriate, and that there was 

much new evidence to suggest that 

electric phenomena were inherent to 

all living matter. 

HEAT AND ELECTRICITY 

Gavarret planned to write a book 

about animal electricity. He said so in 

the introduction to his next book, on 

animal heat. 10 This book was a 

thorough review of a topic for which 

considerable advances in measurement 

techniques (figure 4) and 

understanding had recently occurred. 

This was to be the first in his Medical 

Physics series, in which he intended to 

review carefully each aspect of physics 

in its relationship to medicine. (In fact, 

none of his later books bore this series 

title.) Animal electricity would have 

been Volume 2 in this series. But 

controversy still surrounded this 

subject: Du Bois Reymond’s visit to 

Paris in 1850 did little to clear the air. 9 

So, instead, Gavarret’s next book was a 

thorough review on the current state of 

electricity as a whole, publishing his 

Traité d’Électricitié in two volumes in 

1858 and 1859. However, he omitted 

biomedical electricity, which he says 

needed to mature further before a 

proper review could be written. This 

book established his reputation as an 

academic author who could explain 

difficult concepts in easily-understood 

prose, without compromising scientific 

accuracy. The book was also soon 

published in German. 

He was immediately invited to 

serve as a member of a commission of 

the Ministry of Finance to give advice 

on the electric telegraph. This was at 

the start of the nineteenth-century 

communications revolution, both in 

extent and speed, with an impact 

comparable with that which arose from 

the introduction of the World Wide 

Web. Up to 1844, when the first electric 

telegraph line was installed from Paris 

to Tours, there were only five 

semaphore lines in France, and a 

message took 20 minutes to reach 

Toulon. Within 7 years, London and 

Paris were in instantaneous 

communication by a telegraph cable 

under the English Channel, and by 

1860 there were 22,000 km of lines 

criss-crossing the whole of France. In 

1861 Gavarret published a detailed 

book on the telegraph (figure 5). 11 This 

book was again followed by a German 

translation. 

LIGHT AND SOUND 

Gavarret’s next books, on optics and 

acoustics, endorsed his reputation as 

an outstanding educational 

communicator. They also serve to 

emphasise his understanding of his 

unique role – to understand 

contemporary developments in 

physics in depth, and to interpret 

them for his colleagues in medicine. 

Much had already been written on the 

optics of the eye, and he saw it as 

unnecessary to go over this well-tilled 

soil. So, instead, he wrote an 

interpretation of Gauss’s 1840 

Dioptrishe Untersuchungen. In his book, 

entitled Images par reflexion et par 

refraction (1866), he gave a clear 

exposition of Gauss’s paraxial 

approximation for focal systems, 

giving a tool using principal and 

nodal points that could be easily 

applied in physiological optics. The 

preface of the 1891 translated Russian 

edition of Gavarret’s book emphasises 

its considerable value in the teaching 

of optics. 

In his last book 12 he reviewed the 

mechanisms of speech and hearing, 

drawing on the work of Helmholtz 

and Fourier, including several 

appendices of a more mathematical 

nature. The text itself draws strongly 

on experimental physics, including 

many examples of physical 

measurements applied to 

physiological acoustics (figure 6). 

BIOLOGICAL PHYSICS 

Gavarret was always concerned to 

avoid a too narrow interpretation of 

the physics syllabus for first-year 

medical students. He knew that there 

was insufficient time during his three 

physics lectures per week to do justice 

to the broader applications of physics 

to medicine. In response to this 

conflict, around 1866 he started to 

offer an advanced course called 

Biological Physics, where he assumed 

his audience had some knowledge not 

only of physics, but also of 

FIGURE 2. 

[TOP LEFT] 

Gavarret’s 

apparatus for the 

measurement of 

expired CO2 . 10 

▼ 

FIGURE 3. 

[TOP RIGHT] 

Cagniard de 

Latour’s siren. 

▼ 

FIGURE 4. 

[MIDDLE LEFT] 

Intra-muscular 

temperature 

using 

thermocouples by 

A.-C. Becquerel 

(1788–1878): 

1835. 10 

▼ 

FIGURE 5. 

[BOTTOM RIGHT] 

Electrical 

telegraph 

transmitter c. 

1850. 11 

▼ 

FIGURE 6. 

[BOTTOM LEFT] 

Voice analysis 

using the dancing 

flame. 12 

▼ 

HISTORICAL FEATURE | SCOPE 

physiology, pathology and anatomy. 

Such was the interest in these lectures 

that typically more than half his 

audience consisted of qualified 

doctors, anxious to update themselves 

on the possible impact on their 

medical practice of new developments 

in physics. 

In 1869, he published a book 

derived from this course, Phénomènes 

physique de la vie. Once more we see 

him applying modern physics 

concepts to medical problems, 

allowing him to peer into the future 

whilst remaining cautious about 

inappropriate extrapolation from 

present knowledge. In the 

introduction he applauds the value of 

physical measurement, using the 

example of Marey’s multichannel 

measurements on intra-cardiac 

pressure: he was Marey’s examiner for 

his thesis in 1859. 

Étienne-Jules Marey (1830–1904) 

later became famous for his use of 

photographic methods for analysis of 

animal locomotion. He even included 

the comment that, since the brain is 

doing work during thinking, 

comparing, wanting and so on, its 

energy use may be sufficient cause 

and not just a necessary condition for 

all mental activity, and by implication 

subject to the same energy 

considerations as any other organ. In 

this he draws on the new concepts in 

physics that clearly excited him most, 

the reciprocity of forces and the 

conservation of energy. Using the 

terminology of the time, he says that 

travaille is as universal as mass, and 

that its conservation is as 

fundamentally true in living as in 

inorganic materials. It is here, he says, 

that physiological phenomena, heat, 

bio-electricity, muscular power and 

nutrition, will find their true 

explanation. In comparison with his 

British contemporaries, he felt no need 

to mention any apparent conflict with 

religious thought, although he had to 

fight against a residual belief in a vital 

life force, still maintained by the 

dominant French physiologist Claude 

Bernard (1813–1878). 

It was left to his younger colleagues 

Desplats and Gariel to write the next 

full medical physics text 13 in 1870, to 

which Gavarret added an 

introduction. 

POLITICS 

Jules Gavarret lived through a highly 

turbulent time in French history. He 

was just 4 years old when Napoleon 

▼ 


▼ 

SCOPE | HISTORICAL FEATURE 

lost the battle of Waterloo. During his 

formative teenage years, the country 

was under the strict right-wing 

regime of Charles X. The year after 

his arrival as a student in Paris, he 

watched the violent riots that 

deposed Charles and established the 

July Monarchy of Louis Phillipe. 

Gavarret lived through the 1848 

revolution and the coup d’état of 1852, 

which created the second Empire 

under Napoleon III. He survived the 

siege of Paris, the subsequent 

commune, and observed its bloody 

suppression and the formation of the 

Republic. At each swing of the 

political pendulum, academic 

positions, being public appointments, 

were potentially under threat. 

Pouillet, for example, lost his 

professorship at the Conservatoire des 

arts et métiers in 1852 when he refused 

to swear allegiance to the Emperor. 

Gavarret’s name is nowhere linked to 

political activity and he was able to 

gain the approval of each new 

administration. 

Decorated with the Legion 

d’honneur in 1847, towards the end of 

the July Monarchy, he was made an 

Officer of this order in 1862 during 

the second Empire, and finally raised 

to Commander in 1882 by the 

Republic. Liberal by inclination, the 

only reference linking his name to a 

political event occurred at the start of 

the 1867 academic year. Some 

students, objecting nominally to 

changes in the opening ceremony, 

started singing the Marseillaise as he 

entered the lecture hall. The row 

continued and, after an hour, 

Gavarret reportedly looked at his 

REFERENCES 


watch and left. It seems that this 

demonstration was directed towards 

the establishment rather than 

against him. 

GAVARRET’S LATER LIFE 

During his early life Gavarret 

remained single. Eventually, on 14th 

September 1860, he married Eudoxie 

Binesse de Saint-Victor, a lady in her 

late 30s from an aristocratic family. 

They set up home in rue de Grenelle on 

the Left Bank, and became part of 

Parisian society. Affable and replete 

with anecdotes, told with manners of 

speech from his southern childhood, 

Gavarret presided over many 

Saturday night soirees with ‘the ladies 

of medical assistants who were 

seeking professorships’. 5 

In 1873 he was appointed to review 

the preparatory medical schools, with 

a view to recommending those 

appropriate for upgrading, and 6 

years later became the inspectorgeneral 

for higher medical education. 

He continued writing, contributing 

articles on popular science to the 

Moniteur universel and compiling all 

17 physics definitions in the 

Dictionnaire encyclopédique des sciences 

médicales. Still active in his 70s, he 

became President of the Academy of 

Medicine in 1882, and presided over 

the revision of the French 

pharmacopoeia in 1884. He retired in 

1885 and was subsequently awarded 

an honorary professorship. He was 

replaced by Charles-Marie Gariel 

(1841–1924). 1,13 His death came on 30th 

August 1890, whilst on holiday with a 

friend, and only 5 months after that of 

his wife. 

1 Gariel C-M. Médecine. In École polytechnique. Livre du 

centenaire 1794–1894, 1897; Vol. 3: 394–408. 

2 Corlieu A. Centenaire de la Faculté de médecine de Paris 

(1794–1894). Ch IV: Chaire de Physique. 1896. 

3 Laborde M. Le professeur Gavarret. Bull Soc 

d’Anthropologie de Paris, 4th ser, 1890; 1: 645–51. 

4 Huth E. Jules Gavarret’s Principes Généraux de Statistique 

Médicale. J R Soc Med 2008; 101: 205–12. 

5 Beyneix A. Le professeur Jules Gavarret (1809–1890) et 

l’application des méthodes mathématiques et physiques à 

la médecine. Bull Acad Natle Med 2001; 185: 1327–35. 

6 Gavarret J. Principes généraux de statistique médicale. 

Paris, 1840. 

7 Andral G. An Essay on the Blood in Disease. Translated by 

Meigs & Stillé. Philadelphia, 1844. 

His 

high 

academic 

status 

ensured a 

legacy for 

medical 

physics 

“ 

” 

GAVARRET’S CONTRIBUTION 

TO MEDICAL PHYSICS 

The nineteenth century saw 

extraordinary advances in science, 

technology and medicine. By his 

appointment as the only full professor 

of medical physics in France at that 

time, Gavarret was placed in a unique 

position to develop and clarify this 

new discipline. It is difficult to fault 

him. He gained considerable respect 

from his medical colleagues as an 

outstanding communicator and for 

his ability to explain difficult concepts 

of physics without compromising 

scientific integrity. He understood 

that a medical physicist must 

constantly keep abreast of 

developments in physics and 

mathematics, which for him included 

Poisson’s statistics, the optics of 

Gauss, and insights into acoustics and 

energy conservation from Helmholtz, 

and be prepared to understand these 

in depth in order to apply them and 

explain them to his medical 

colleagues. His high academic status 

ensured a legacy for medical physics 

both in his own highly-respected 

department and elsewhere in 

France. 14,15,16 Within a decade of his 

death, the discovery of x-rays and 

radioactivity permanently cemented 

the relationship between medicine 

and physics in a way that would 

probably not have surprised him. 

ABOUT THE AUTHOR 

Francis Duck is Honorary Consultant 

Medical Physicist in the Department of 

Medical Physics and Bioengineering at 

the Royal United Hospital Bath NHS 

Trust and visiting professor at the 

University of Bath. 

Email: f.duck@bath.ac.uk 

8 www.scopeonline.co.uk/pages/articles/history/history.shtml 

9 Duck F. A history of medical physics – Adolf Fick and 

physiological physics. Scope June 2012: 50–54. 

10 Gavarret J. Physique Médicale – de la Chaleur Produite par 

les Êtres Vivants. Paris, 1855. 

11 Gavarret J. Télégraphie Électrique. Paris, 1861. 

12 Gavarret J. Acoustique Biologique – Phénomènes 

Physiques de la Phonation et de l’Audition. Paris, 1877. 

13 Desplats V, Gariel C-M. Nouveaux Éléments de Physique 

Médicale. Paris, 1870. 

14 Gréhant N. Manuel de Physique Médicale. Paris, 1869. 

15 Wundt W, Monoyer F. Traité Élémentaire de Physique 

Médicale. Paris, 1871. 

16 Lefèvre J. Manuel de Physique Médicale. Paris, 1889.

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