Advances in Oncology and Radiotherapy

The Essential Physics of Medical Imaging

Africa’s readiness for artificial intelligence in clinical radiotherapy delivery: Medical physicists to lead the way

BACKGROUND: There have been several proposals by researchers for the introduction of Artificial Intelligence (AI) technology due to its promising role in radiotherapy practice. However, prior to the introduction of the technology, there are certain general recommendations that must be achieved. Also, the current challenges of AI must be addressed. In this review, we assess how Africa is prepared for the integration of AI technology into radiotherapy service delivery. METHODS: To assess the readiness of Africa for integration of AI in radiotherapy services delivery, a narrative review of the available literature from PubMed, Science Direct, Google Scholar, and Scopus was conducted in the English language using search terms such as Artificial Intelligence, Radiotherapy in Africa, Machine Learning, Deep Learning, and Quality Assurance. RESULTS: We identified a number of issues that could limit the successful integration of AI technology into radiotherapy practice. The major issues include insufficient data for training and validation of AI models, lack of educational curriculum for AI radiotherapy-related courses, no/limited AI teaching professionals, funding, and lack of AI technology and resources. Solutions identified to facilitate smooth implementation of the technology into radiotherapy practices within the region include: creating an accessible national data bank, integrating AI radiotherapy training programs into Africa's educational curriculum, investing in AI technology and resources such as electronic health records and cloud storage, and creation of legal laws and policies to support the use of the technology. These identified solutions need to be implemented on the background of creating awareness among health workers within the radiotherapy space. CONCLUSION: The challenges identified in this review are common among all the geographical regions in the African continent. Therefore, all institutions offering radiotherapy education and training programs, management of the medical centers for radiotherapy and oncology, national and regional professional bodies for medical physics, ministries of health, governments, and relevant stakeholders must take keen interest and work together to achieve this goal.

Medical physics services in radiology and nuclear medicine in Africa: challenges and opportunities identified through workforce and infrastructure surveys

Abstract The International Atomic Energy Agency (IAEA) developed a staffing model to estimate the number of clinically qualified medical physicists (CQMP) that are required in an imaging facility, including diagnostic radiology and nuclear medicine. For the first time this staffing model was applied on a large scale across Africa. Within the framework of the IAEA African Regional Agreement (AFRA) Technical Cooperation (TC) project RAF6/053 entitled “Enhancing Capacity Building of Medical Physics to Improve Safety and Effectiveness of Medical Imaging (AFRA)”, a survey based on the IAEA staffing model was used to investigate the current CQMP workforce needs in imaging and radionuclide therapy in Africa in order to establish a baseline, identify gaps and suggest steps for improvement. The survey was open for five months, after which data verification was performed. 82 responses were received from 21 countries, including data from 97 diagnostic radiology and 40 nuclear medicine departments, as well as 75 interventional radiology departments and/or catheterization laboratories. Only 26·8% of centres employed an adequate number of CQMPs. The staffing model indicated that 134·3 CQMPs were required for these centres, but only 63 are currently employed in medical imaging and/or nuclear medicine at these centres. At least 11 countries do not have a single institution with an adequate number of CQMPs. Data analysis indicated that the number of radiology and nuclear medicine CQMPs is largely inadequate, at least by a factor of 20 in almost all countries in the region.

Medical physics practice and training in Ghana

Radiation Therapy Physics Quality Assurance and Management Practices in Low- and Middle-Income Countries: An Initial Pilot Survey in Six Countries and Validation Through a Site Visit

Purpose: Our purpose was to assess physics quality assurance (QA) practices in less resourced radiation therapy (RT) centers to improve quality of care. Methods and Materials: A preliminary study was conducted in 2020 of 13 select RT centers in 6 countries, and in 2021, our team conducted onsite visits to all the RT centers in Ghana, one of the countries from the initial survey. The RT centers included 1 private and 2 public institutions (denoted as Public-1 and Public-2). Follow-up surveys were sent to 17 medical physicists from the site visit. Questions centered on the topics of equipment, institutional practice, physics quality assurance, management, and safety practices. Qualitative and descriptive methods were used for data analysis. Questions regarding operational challenges (machine downtime, patient-related issues, power outages, and staffing) were asked on a 5-point Likert scale. Results: The preliminary survey from 2020 had a 92% response rate. One key result showed that for RT centers in lower gross national income per capita countries there was a direct correlation between QA needs and the gross national income per capita of the country. The needs identified included film/array detectors, independent dose calculation software, calibration of ion chambers, diodes, thermoluminiscence diodes (TLDs), phantoms for verification, Treatment Planning System (TPS) test phantoms, imaging test phantoms and film dosimeters, education, and training. For the post survey after the site visit in 2021, we received a 100% response rate. The private and the Public-1 institutions each have computed tomography simulators located in their RT center. The average daily patient external beam workload for each clinic on a linear accelerator was: private = 25, Public-1 = 55, Public-2 = 40. The Co-60 workload was: Public-1 = 45, Public-2 = 25 (there was no Co-60 at the private hospital). Public-1 and -2 lacked the equipment necessary to conform to best practices in Task Group reports (TG) 142 and 198. Public-2 reported significant operational challenges. Notably, Public-1 and -2 have peer review chart rounds, which are attended by clinical oncologists, medical physicists, physicians, and physics trainees. All 17 physicists who responded to the post site visit survey indicated they had a system of documenting, tracking, and trending patient-related safety incidents, but only 1 physicist reported using International Atomic Energy Agency Safety in Radiation Oncology. Conclusions: The preliminary study showed a direct correlation between QA needs and the development index of a country, and the follow-up survey examines operational and physics QA practices in the RT clinics in Ghana, one of the initial countries surveyed. This will form the basis of a planned continent-wide survey in Africa intended to spotlight QA practices in low- and middle-income countries, the challenges faced, and lessons learned to help understand the gaps and needs to support local physics QA and management programs. Audits during the site visit show education and training remain the most important needs in operating successful QA programs.

Science diplomacy in medical physics – an international perspective

The State of Clinical Medical Physics and Education in Ghana

Establishing a global medical physics graduate clinical training and development program in Ghana: A model for global health international education and collaboration

PURPOSE: The Global Medical Physics Training and Development Program (GMPTDP) is a novel initiative that provides United States (US)-based graduate students in medical physics with structured, immersive clinical training in Ghana. METHODS: The five-week program begins with a cultural and clinical orientation in the US, followed by 4 weeks of clinical rotations across leading Ghanaian medical institutions. During rotations, students gain experience with teletherapy (LINACs and cobalt-60), brachytherapy, treatment planning, imaging, and more. Trainees participate in clinical activities, conduct collaborative projects, and engage in community outreach and cultural immersion. The program culminates in a symposium highlighting student experiences and future directions with speakers including physicists, oncologists, engineers, and policymakers. RESULTS: The pilot year of the program was successfully completed by three students from May 28 2024-July 2 2024. This article outlines the development, structure, and implementation of GMPTDP as a replicable model for global health training in medical physics, emphasizing sustainable partnerships between high-income and low- and middle-income countries. Educational objectives include demonstrating effective cross-border training models, fostering collaborative research, and expanding global clinical experience in the field of medical physics. CONCLUSIONS: A model for a global medical physics training program was developed and successfully implemented.

Empowering young minds through STEM education: Engaging high schoolers in Ghana through medical physics

PURPOSE: To promote diversity in Science, Technology, Engineering, and Mathematics (STEM), an educational presentation and hands-on session was organised to raise awareness of STEM career opportunities among high school girls to introduce the students to the field of medical physics. MATERIALS AND METHODS: The study involved 65 first-year Senior High School girls, aged 13-16, pursuing general science in Accra, Ghana. This initiative, organised by the Girls Excellence Movement (GEM) in collaboration with a United States (US) institution, implemented the "heroes in radiation oncology" program, which included a relatable presentation and hands-on experience in simulation to treatment planning activities. The program's effectiveness was assessed through pre-and post-assessment surveys, and a thematic analysis of student feedback. RESULTS: Participants' awareness of career fields showed an interest in traditional healthcare professions (92%) and engineering (73.8%), with minimal medical physics awareness (12.3%). Post-presentation survey showed a significant change in participants' perception of medical physics 87.3%. Thematic analysis revealed increased awareness, understanding, and interest, dispelled misconceptions about radiation safety, and highlighted the interdisciplinary nature and career opportunities. The presentation was successful in inspiring participants and expanding their perspectives on medical physics. CONCLUSION: The program raised awareness of medical physics among participants, many of whom were previously unfamiliar with the field. Participants reported a newfound understanding of the interdisciplinary nature of medical physics, its connections to biology, mathematics, and engineering.This program can easily be reproduced in community and school outreaches.

Physics audit of selected diagnostic X-Ray machines in Ghana: towards implementation of a national dosimetry audit programme

Twenty years of medical physics education and training in Ghana: past, current, and future perspectives

Expanding the horizons of medical physics beyond medical radiation science

Dear Editor, The vast expanse of medical physics, as a discipline, traverses far beyond the mere application of radiation in healthcare. Yet, there seems to be an inadvertent narrowing of its scope in both academic curricula and public perception. By sequestering the role of medical physics to predominantly radiation-based applications, we risk overlooking its comprehensive potential in revolutionizing patient care and clinical solutions. Medical physics involves the application of the concepts and methods of physics to medicine. Its footprint can be observed wherever physics aids in the prevention, diagnosis, and treatment of diseases. This understanding, reinforced by numerous scientists and authors, is also delineated in general literature, from encyclopedias to dictionaries. Consequently, the realm of medical physics extends across every nook and cranny of healthcare facilities. From assessments, such as temperature and pressure-related vitals, to diagnostic procedures involving medical imaging, and treatments encompassing cardiac defibrillators and artificial heart valves, medical physics plays an instrumental role. However, the current academic trend is concerning. A majority of graduate programs in medical physics seem to be anchored predominantly on diagnostic imaging, radiation therapy, and nuclear medicine physics. These subjects, while crucial, focus primarily on radiation's clinical, research, and industrial applications. This skewed emphasis has led to a scenario where the term “medical physics” evokes immediate associations with “diagnostic imaging physics, radiotherapy physics, and nuclear medicine physics.” This tunnel vision not only shapes public perception but also manifests itself in the job market. Hospitals tend to list radiologically-related roles when appointing medical physicists, perpetuating this limited scope. Through your esteemed journal, we wish to shed light on the need for a broader understanding and application of medical physics, extending beyond the radiation-centric narrative that currently prevails. We believe that diversifying the roles and responsibilities of medical physicists will significantly contribute to the advancement of healthcare and scientific communities. Thank you for considering our perspective. We look forward to your action in addressing this urgent matter for the betterment of healthcare and the scientific community at large. Yours sincerely, Corresponding author. Mr. Alhassan Mohammed Baidoo: Conception of research idea, writing of initial draft, review and approval of finished work. Stephanie Brako Boateng: Conception of research idea and writing of initial draft. Ruth Beulah Awotwe: Conception of research idea and rewriting of initial draft. Samuel Nii Adu Tagoe: Review and correction of written work. Philip Odonkor: Rewriting of initial draft. Anna Mamoud: Rewriting of initial draft. The authors have nothing to report. The authors declare no conflicts of interest.

Medical physics audit of radiotherapy centres in Ghana

Medical Physics Innovations in Cancer Screening and Therapy within Ghana's Healthcare Framework

This study addresses a current research gap in Physics concerning Application of Medical Physics Techniques in Cancer Diagnosis and Treatment in Resource-Limited Settings in Ghana. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A structured analytical approach was used, integrating formal modelling with domain evidence. The results establish bounded error under perturbation, a convergent estimation process under stated assumptions, and a stable link between the proposed metric and observed outcomes. The findings provide a reproducible analytical basis for subsequent theoretical and applied extensions. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Application of Medical Physics Techniques in Cancer Diagnosis and Treatment in Resource-Limited Settings, Ghana, Africa, Physics, conference paper This work contributes a formal specification, transparent assumptions, and mathematically interpretable claims. The empirical specification follows $Y=\beta_0+\beta^\top X+\varepsilon$, and inference is reported with uncertainty-aware statistical criteria.

Medical Physics Innovations in Cancer Screening and Therapy within Ghana's Healthcare Framework

This study addresses a current research gap in Physics concerning Application of Medical Physics Techniques in Cancer Diagnosis and Treatment in Resource-Limited Settings in Ghana. The objective is to formulate a rigorous model, state verifiable assumptions, and derive results with direct analytical or practical implications. A structured analytical approach was used, integrating formal modelling with domain evidence. The results establish bounded error under perturbation, a convergent estimation process under stated assumptions, and a stable link between the proposed metric and observed outcomes. The findings provide a reproducible analytical basis for subsequent theoretical and applied extensions. Stakeholders should prioritise inclusive, locally grounded strategies and improve data transparency. Application of Medical Physics Techniques in Cancer Diagnosis and Treatment in Resource-Limited Settings, Ghana, Africa, Physics, conference paper This work contributes a formal specification, transparent assumptions, and mathematically interpretable claims. The empirical specification follows $Y=\beta_0+\beta^\top X+\varepsilon$, and inference is reported with uncertainty-aware statistical criteria.