Point/counterpoint. Radiotherapy is an appropriate treatment to consider for patients infected with the Ebola virus.

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Published in Med Phys on March 01, 2015

Authors

Wilfred F Ngwa1, Roland Teboh2, Colin G Orton

Author Affiliations

1: Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts 02115 (Tel: 617-525-7131; E-mail: wngwa@lroc.harvard.edu).
2: Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland 21231 (Tel: 410-502-1751; E-mail: troland1@jhmi.edu).

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Point/Counterpoint. Future radiotherapy practice will be based on evidence from retrospective interrogation of linked clinical data sources rather than prospective randomized controlled clinical trials. Med Phys (2014) 2.64

Point/counterpoint: it is not appropriate to "deform" dose along with deformable image registration in adaptive radiotherapy. Med Phys (2012) 2.17

Point/counterpoint. The adoption of new technology in radiation oncology should rely on evidence-based medicine. Med Phys (2011) 1.53

Point/Counterpoint. A major advantage of digital imaging for general radiography is the potential for reduced patient dose so film/screen systems should be phased out as unnecessarily hazardous. Med Phys (2006) 1.44

Point/counterpoint. IMRT should not be administered at photon energies greater than 10 MV. Med Phys (2007) 1.42

Point/Counterpoint: QA procedures in radiation therapy are outdated and negatively impact the reduction of errors. Med Phys (2011) 1.39

Point/counterpoint. The h index is the best measure of a scientist's research productivity. Med Phys (2009) 1.27

Point/Counterpoint: low-dose radiation is beneficial, not harmful. Med Phys (2014) 1.17

Point/counterpoint. Simultaneous PET/MR will replace PET/CT as the molecular multimodality imaging platform of choice. Med Phys (2007) 1.05

Medical use of all high activity sources should be eliminated for security concerns. Med Phys (2015) 0.96

Point/Counterpoint. The linear-quadratic model is inappropriate to model high dose per fraction effects in radiosurgery. Med Phys (2009) 0.95

Point/counterpoint. Respiratory gating for radiation therapy is not ready for prime time. Med Phys (2007) 0.95

Point/counterpoint.The use of bismuth breast shields for CT should be discouraged. Med Phys (2012) 0.92

Point/counterpoint. Resolution modeling enhances PET imaging. Med Phys (2013) 0.91

Point/Counterpoint: Within the next ten years treatment planning will become fully automated without the need for human intervention. Med Phys (2014) 0.90

Point/counterpoint. DASSIM-RT is likely to become the method of choice over conventional IMRT and VMAT for delivery of highly conformal radiotherapy. Med Phys (2013) 0.90

Point/counterpoint. The use of effective dose for medical procedures is inappropriate. Med Phys (2010) 0.90

Thermoradiotherapy is underutilized for the treatment of cancer. Med Phys (2007) 0.89

Point/counterpoint. Radiochromic film is superior to ion chamber arrays for IMRT quality assurance. Med Phys (2010) 0.89

Point/Counterpoint. Miniature x-ray tubes will ultimately displace Ir-192 as the radiation sources of choice for high dose rate brachytherapy. Med Phys (2008) 0.86

Point/counterpoint. Image-guided radiotherapy is being overvalued as a clinical tool in radiation oncology. Med Phys (2006) 0.85

Point/counterpoint. Molecular breast imaging will soon replace x-ray mammography as the imaging modality of choice for women at high risk with dense breasts. Med Phys (2009) 0.85

Point/Counterpoint. Kilovoltage imaging is more suitable than megavoltage imaging for guiding radiation therapy. Med Phys (2007) 0.85

Point/Counterpoint. Submillimeter accuracy in radiosurgery is not possible. Med Phys (2013) 0.84

Point/Counterpoint. Hypofractionation is a proven safe and effective modality for postoperative whole-breast radiotherapy for early breast cancer patients. Med Phys (2009) 0.84

Point/Counterpoint. Film mammography for breast cancer screening in younger women is no longer appropriate because of the demonstrated superiority of digital mammography for this age group. Med Phys (2006) 0.84

Point/Counterpoint. A 3D-conformal technique is better than IMRT or VMAT for lung SBRT. Med Phys (2014) 0.83

Point/counterpoint. Segmental MLC is superior to dynamic MLC for IMRT delivery. Med Phys (2007) 0.83

Point/Counterpoint. Cone beam x-ray CT will be superior to digital x-ray tomosynthesis in imaging the breast and delineating cancer. Med Phys (2008) 0.83

Point/counterpoint. Proton therapy is too expensive for the minimal potential improvements in outcome claimed. Med Phys (2007) 0.82

Point/counterpoint: backscatter x-ray machines at airports are safe. Med Phys (2012) 0.82

Point/Counterpoint. Patient-specific QA for IMRT should be performed using software rather than hardware methods. Med Phys (2013) 0.81

Point/Counterpoint. The best radiotherapy for the treatment of prostate cancer involves hypofractionation. Med Phys (2006) 0.81

Advocating for use of the ALARA principle in the context of medical imaging fails to recognize that the risk is hypothetical and so serves to reinforce patients' fears of radiation. Med Phys (2016) 0.80

Point/Counterpoint. IGRT has limited clinical value due to lack of accurate tumor delineation. Med Phys (2013) 0.80

Tumor hypoxia is an important mechanism of radioresistance in hypofractionated radiotherapy and must be considered in the treatment planning process. Med Phys (2011) 0.80

Point/counterpoint. The terminal M.S. degree is no longer appropriate for students interested in a career in clinical medical physics in the United States. Med Phys (2011) 0.80

Point/Counterpoint. MRI/CT is the future of radiotherapy treatment planning. Med Phys (2014) 0.80

Point/counterpoint. GPU technology is the hope for near real-time Monte Carlo dose calculations. Med Phys (2015) 0.79

"SABER": A new software tool for radiotherapy treatment plan evaluation. Med Phys (2010) 0.79

Point/Counterpoint. Exposure tracking for x-ray imaging is a bad idea. Med Phys (2014) 0.78

Point/Counterpoint. Intensity modulated electronic brachytherapy will soon become the brachytherapy treatment of choice for irregularly shaped tumor cavities or those closely bounded by critical structures. Med Phys (2009) 0.78

Point/counterpoint. The shortage of radiation oncology physicists is addressable through remote treatment planning combined with periodic visits by consultant physicists. Med Phys (2008) 0.78

Point/counterpoint. There is currently enough evidence and technology available to warrant taking immediate steps to reduce exposure of consumers to cell-phone-related electromagnetic radiation. Med Phys (2008) 0.78

Point/counterpoint. High intensity focused ultrasound may be superior to radiation therapy for the treatment of early stage prostate cancer. Med Phys (2011) 0.78

Point/Counterpoint. Exposure limits for emergency responders should be the same as the prevailing limits for occupational radiation workers. Med Phys (2008) 0.78

Point/Counterpoint. Noncoplanar beams improve dosimetry quality for extracranial intensity modulated radiotherapy and should be used more extensively. Med Phys (2015) 0.78

Point/Counterpoint. Peer reviews of medical physics practices often yield little information because the AAPM has not been proactive in developing appropriate peer-review guidelines. Med Phys (2007) 0.78

Point/counterpoint. PDT is better than alternative therapies such as brachytherapy, electron beams, or low-energy x rays for the treatment of skin cancers. Med Phys (2011) 0.78

Point/Counterpoint. EPID dosimetry must soon become an essential component of IMRT quality assurance. Med Phys (2009) 0.77

Point/Counterpoint. Radiation departments should be certified to provide certain new technologies such as IGRT. Med Phys (2009) 0.77

Point/Counterpoint. Evaluation of treatment plans using target and normal tissue DVHs is no longer appropriate. Med Phys (2015) 0.77

Treatment planning evaluation and optimization should be biologically and not dose/volume based. Med Phys (2015) 0.77

Point/counterpoint. Helical tomotherapy will ultimately replace linear accelerator based IMRT as the best way to deliver conformal radiotherapy. Med Phys (2008) 0.77

Point/counterpoint: pulsed reduced dose rate radiation therapy is likely to become the treatment modality of choice for recurrent cancers. Med Phys (2011) 0.77

Point/counterpoint: computer-aided detection should be used routinely to assist screening mammogram interpretation. Med Phys (2012) 0.77

Intensity modulated neutron radiotherapy for the treatment of adenocarcinoma of the prostate. Int J Radiat Oncol Biol Phys (2007) 0.76

Point/counterpoint. Office-based cone-beam and digital tomosynthesis systems using flat-panel technology should not be referred to as CT units. Med Phys (2011) 0.76

Point/counterpoint. Radiotherapy physicists have become glorified technicians rather than clinical scientists. Med Phys (2010) 0.76

Point/counterpoint: we do not need randomized clinical trials to demonstrate the superiority of proton therapy. Med Phys (2012) 0.75

Point/counterpoint. "Hybrid gold" is the most appropriate open-access modality for journals like Medical Physics. Med Phys (2015) 0.75

In regard to Nahum et al. (Int J Radiat Oncol Biol Phys 2003;57:391-401): Incorporating clinical measurements of hypoxia into tumor control modeling of prostate cancer: implications for the alpha/beta ratio. Int J Radiat Oncol Biol Phys (2004) 0.75

Only a therapist should operate an HDR unit for patient treatments. Med Phys (2015) 0.75

Point/counterpoint. Therapeutic rather than diagnostic medical physicists should lead the development and clinical implementation of image-guided nonionizing therapeutic modalities such as MR-guided high-intensity ultrasound. Med Phys (2013) 0.75

Point/Counterpoint: recent data show that mammographic screening of asymptomatic women is effective and essential. Med Phys (2012) 0.75

Point/counterpoint. Medical physics graduate programs should adjust enrollment to achieve equilibrium between graduates and residents. Med Phys (2011) 0.75

Point/counterpoint. To ensure that target volumes are not underirradiated when respiratory motion may affect the dose distribution, 4D dose calculations should be performed. Med Phys (2009) 0.75

The more important heavy charged particle radiotherapy of the future is more likely to be with heavy ions rather than protons. Med Phys (2013) 0.75

Point/Counterpoint. Medical physicists should be allowed by states to image and treat, just like radiologic technologists. Med Phys (2010) 0.75

Point/counterpoint. Only a single implanted marker is needed for tracking lung cancers for IGRT. Med Phys (2009) 0.75

Point/counterpoint: physicists who are responsible for high-tech radiotherapy procedures should have to be specially credentialed. Med Phys (2012) 0.75

Point/Counterpoint. Medical Physics residency programs in nonacademic facilities should affiliate themselves with a university-based program. Med Phys (2012) 0.75

Point/Counterpoint. The future h-index is an excellent way to predict scientists' future impact. Med Phys (2013) 0.75

Point/Counterpoint. Authorization to practice as a medical physicist is sometimes better achieved by registration rather than licensure. Med Phys (2010) 0.75

Point/counterpoint. The physics components of the ACR MRI Accreditation Program are overly tedious and beyond what is needed to ensure good patient care. Med Phys (2008) 0.75

Point/counterpoint. Medical physics should adopt double-blind peer review of all manuscripts. Med Phys (2010) 0.75

Point/Counterpoint: The disadvantages of a multileaf collimator for proton radiotherapy outweigh its advantages. Med Phys (2014) 0.75

Point/Counterpoint. Increasing dependence on industry-funded research creates higher risk of biased reporting in medical physics. Med Phys (2013) 0.75

Point/counterpoint. Bright young physicists should be advised to avoid careers in radiation therapy. Med Phys (2009) 0.75

Point/counterpoint. PET/CT will become standard practice for radiotherapy simulation and planning. Med Phys (2008) 0.75

Point/Counterpoint: The 2014 initiative can have potentially unintended negative consequences for medical physics in diagnostic imaging and nuclear medicine. Med Phys (2012) 0.75

Point/counterpoint. The title "radiation oncology physicist" should be changed to "oncologic physicist". Med Phys (2010) 0.75

Point/counterpoint. Most residency programs for radiation oncology physicists do not reflect the heightened importance of medical imaging. Med Phys (2010) 0.75

Point/counterpoint. The chief information technology officer in a radiation oncology department should be a medical physicist. Med Phys (2009) 0.75

Point/counterpoint. The traditional L-shaped gantry for radiotherapy linear accelerators will soon become obsolete. Med Phys (2010) 0.75

Point/counterpoint. Genomics, functional and molecular imaging will pave the road to individualized radiation therapy. Med Phys (2008) 0.75

Point/counterpoint. Preparation for a terrorism-related radiation event should be no different from that for a biological or chemical event. Med Phys (2009) 0.75

Point/counterpoint. Despite widespread use there is no convincing evidence that static magnets are effective for the relief of pain. Med Phys (2008) 0.75

Point/counterpoint: vendor provided machine data should never be used as a substitute for fully commissioning a linear accelerator. Med Phys (2012) 0.75

Point/counterpoint. Radiation therapists should not have to wear personnel dosimetry badges. Med Phys (2010) 0.75

Point/Counterpoint. Brachytherapy is better than external beam therapy for partial breast irradiation. Med Phys (2013) 0.75

Point/counterpoint. Medical physics residents should be placed using a matching program. Med Phys (2014) 0.75

Point/Counterpoint: PET-based GTV definition is the future of radiotherapy treatment planning. Med Phys (2012) 0.75

Point/Counterpoint. Within the next 10-15 years protons will likely replace photons as the most common type of radiation for curative radiotherapy. Med Phys (2008) 0.75

Point/Counterpoint: the 2014 initiative is not only unnecessary but it constitutes a threat to the future of medical physics. Med Phys (2011) 0.75

Point/counterpoint: TG-142 is unwarranted for IGRT QA. Med Phys (2013) 0.75

The linear-quadratic model is inappropriate to model high dose per fraction effects in radiosurgery. Med Phys (2009) 0.75

Point/counterpoint. Ultrasonography is soon likely to become a viable alternative to x-ray mammography for breast cancer screening. Med Phys (2010) 0.75

Point/counterpoint. The future of IMRT∕SBRT lies in the use of unflattened x-ray beams. Med Phys (2013) 0.75

Point/Counterpoint. The professions of Medical Physics and Clinical Engineering should be combined into a single profession "Clinical Science and Technology". Med Phys (2012) 0.75