Training program IAEA TCS-37 (Training course series No.37) “Clinical Training of Medical Physicists Specializing in Radiation Oncology (2009)” was fixed to practical training syllabus at faculty and graduate course of medical physics of a university. TCS-47 for diagnostic radiology (2010) and TCS-50 for nuclear medicine (2011) were also involved in the syllabus. These training courses had been developed by IAEA RCA RAS6038 project since 2002. In this paper, first, comparison with other training programs in the world was made in terms of (1) Degree of extent of subject or field, (2) Concreteness or specificity, (3) Degree of completion, (4) Method of certification and (5) Practicability. IAEA TCS series got the most points among ten programs such as EMERALD/EMIT, AAPM rpt.No.90 and CAMPEP accredited programs. Second, TCS-37, TCS47 and TCS50 were broken down to 6, 5 and 6 subjects of training course respectively. Third, each subject was further broken down to 15 times of training schedule where every time was composed by 3 hours of training. Totally 45 hours of a subject were assigned to one semester for getting one unit of credit. Seventeen units should be credited up to three years in graduate course to finish the whole program.

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In Hitachi Medical Area, a large-scale lung cancer screening program using low-dose CT has been underway in two medical facilities since its introduction in 1998 and 2001. A total of 61,914 tests were performed among 25,385 participants until 2006. Two hundred and ten lung cancer patients had been identified on CT screening. The estimated 5-year survival rate for all patients was 90%. Among residents in Hitachi City, nearly 40% of inhabitants aged 50∼69 years were estimated to have participated in the screening from 1998 through 2009. Cancer mortality data were obtained from a regional cancer registry and the standardized mortality ratio (SMR) of lung cancer was calculated for each 5-year period during 1995∼2009. For residents aged 50∼79 years, SMR was nearly unity between 1995 and 2004; however, there was a significant decrease during 2005∼2009, with SMR (95% confidence interval) being 0.76 (0.67∼0.86). These results suggest that the wide implementation of CT screening may reduce lung cancer mortality in the community, 4∼8 years after introduction. It is desirable to continue to focus on future developments, including original research in Japan.

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Current status of the developments of computer-aided detection/diagnosis (CAD) system for lung cancer screening with CT imaging is reviewed along with the commercialization status. Issues to be solved for the lung CAD popularization and QA for CAD are also described followed by the future perspectives of the CAD.

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PHITS is a general purpose Monte Carlo particle transport simulation code developed through the collaboration of several institutes mainly in Japan. It can analyze the motion of nearly all radiations over wide energy ranges in 3-dimensional matters. It has been used for various applications including medical physics. This paper reviews the recent improvements of the code, together with the biological dose estimation method developed on the basis of the microdosimetric function implemented in PHITS.

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