| Question 1: The recently increased exploration of motion in which component of the digital linear accelerator has demonstrated high potential in dosimetric improvement but calls for new quality assurance procedures?
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| Reference: | Yu et al. Medical Physics 41:081712, 2014 |
| Choice A: | Gantry |
| Choice B: | Couch |
| Choice C: | Multi-leaf Collimators |
| Choice D: | Jaws |
| Choice E: | On-Board Imager |
| Question 2: What is the currently achievable treatment delivery time of a 20 beam IMRT plan with fully automated delivery through custom scripting?
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| Reference: | Yu et al, Medical Physics 42:6457, 2015 |
| Choice A: | 5 minutes |
| Choice B: | 15 minutes |
| Choice C: | 30 minutes |
| Choice D: | 45 minutes |
| Choice E: | 1 hour |
| Question 3: With the Elekta Agility MLC the dynamic leaf guides and the MLC leaves can be used simultaneously to perform tumour tracking... |
| Reference: | Med Phys. 2014 Nov;41(11):111719. doi: 10.1118/1.4899175.
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| Choice A: | True. |
| Choice B: | False. |
| Question 4: To what extend is it possible to reduce the CTV to PTV margin without significantly compromising the CTV dose distribution if dynamic MLC delivery tracking techniques (planning study) are applied?
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| Reference: | Phys Med Biol. 2016 Feb 21;61(4):1546-62. doi: 10.1088/0031-9155/61/4/1546. Epub 2016 Jan 27.
|
| Choice A: | 5mm |
| Choice B: | 3mm |
| Choice C: | 1mm |
| Question 5: Which of the following about 4p radiotherapy is true? |
| Reference: | The Development and Verification of a Highly Accurate Collision Prediction Model for Automated Non-coplanar Plan Delivery , Victoria Y. Yu, Angelia Tran, Dan Nguyen, Minsong Cao, Dan Ruan, Daniel A. Low and Ke Sheng, Medical Physics 42, 6457 (2015) |
| Choice A: | 4π radiotherapy is a planning method to incorporate non-coplanar beams in inverse optimization. |
| Choice B: | 4π radiotherapy a method to model the collision space for safe and efficient non-coplanar beam delivery. |
| Choice C: | 4π radiotherapy is only deliverable on a robotic gantry system. |
| Choice D: | 4π radiotherapy requires beams from the entire 4π steradian angles. |
| Choice E: | A and B. |
| Question 6: Extensive use of optimized non-coplanar beams mainly improves... |
| Reference: | 4pi non-coplanar SBRT for centrally located or larger lung tumors, Peng Dong, Percy Lee, Yingli Yang, Daniel Low, Edwin Romeijn, Troy Long, Patrick Kupelian, Ke Sheng*, Int J Radiat Oncol Biol Phys 2013 Jul 1;86(3):407-13 |
| Choice A: | Overlap of 100% isodose with the PTV. |
| Choice B: | Dose homogeneity. |
| Choice C: | The volume of 50% isodose. |
| Choice D: | Tumor response. |
| Choice E: | Integral dose. |
| Question 7: Which of the following about beam orientation optimization is NOT true?
|
| Reference: | 4pi non-coplanar IMRT beam angle selection by convex optimization with group sparsity penalty Daniel O'Connor , Yevgen Voronenko, Dan Nguyen, Wotao Yin, Ke Sheng, AAPM 2016 TH-EF-BRB-5
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| Choice A: | The purpose of beam orientation optimization is to confirm human operator selected non-coplanar beams. |
| Choice B: | Beam orientation optimization can be performed using a greedy column generation algorithm. |
| Choice C: | Beam orientation optimization problem is a combinatorial problem without global solution. |
| Choice D: | Automated beam orientation selection is necessary because the human intuition and experience in the non-coplanar space is inadequate. |
| Choice E: | The dosimetry quality improves with increasing number of non-coplanar beams and the improvement tends to plateau later than the coplanar plans. |
| Question 8: Compared with conventional electron beam therapy, Dynamic Electron Arc Radiotherapy (DEAR) has the following advantages except: |
| Reference: | Rodrigues, A, Yin, F, and Wu, Q, "Dynamic Electron Arc Radiotherapy (DEAR): a feasibility study", Phys Med Biol, 2014. 59(2): p. 327-345. |
| Choice A: | It can treat target area that is larger than the electron cones. |
| Choice B: | Gantry/collimator angle, couch position/angle, and dose rate can all change simultaneously during beam on. |
| Choice C: | It can produce uniform dose distributions to target area over curved skin. |
| Choice D: | It has reduced Bremsstrahlung X-ray contaminant at distance inside phantom. |
| Choice E: | It can produce more conformal dose distribution through inverse planning. |
| Question 9: The challenges in implementing Dynamic Electron Arc Radiotherapy (DEAR) include the following except: |
| Reference: | Rodrigues, A, Yin, F, and Wu, Q, "Dynamic Electron Arc Radiotherapy (DEAR): a feasibility study", Phys Med Biol, 2014. 59(2): p. 327-345.
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| Choice A: | Small field electron field dosimetry |
| Choice B: | It cannot be delivered in clinical mode yet |
| Choice C: | It cannot hold the beam to accommodate couch motion. |
| Choice D: | Lack of dedicated dynamic collimation devices for electron beams and fine energy resolution on current linac. |
| Choice E: | Lack of inverse planning tools. |
| Question 10: What is the single most significant challenge to the clinical translation of dynamic radiotherapy delivery incorporating couch motion:
|
| Reference: | Fahimian B, Yu V, Horst K, Xing L, Hristov D. Trajectory modulated prone breast irradiation: a LINAC-based technique combining intensity modulated delivery and motion of the couch. Radiother Oncol. 2013;109(3):475-81.
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| Choice A: | Lack of demonstrated dosimetric advantages over coplanar-isocentric VMAT/IMRT delivery with fixed isocenter. |
| Choice B: | Lack of algorithms/planning tools for optimization. |
| Choice C: | Lack of accurate dose calculation algorithms. |
| Choice D: | Lack of viable intra-fractional imaging solutions to track the intended target. |
