2016 AAPM Annual Meeting
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Session Title: PANEL DISCUSSION: SBRT/SRS Case Studies - Brain and Spine
Question 1: In robotic Cyberknife spine SBRT treatment setups, imaging guidance is provided via....
Reference:AAPM TG135 Med Phys. 2011 Jun;38(6):2914-36.
Choice A:MV cone-beam CT.
Choice B:kV stereoscopic imaging.
Choice C:MV cone-beam CT.
Choice D:MV stereoscopic imaging.
Question 2: Spinal cord tolerance for spine SBRT can be appropriately specified as:
Reference:“Response assessment after stereotactic body radiotherapy for spinal metastasis: a report from the SPIne response assessment in Neuro-Oncology (SPINO) group” Lancet Oncol. 2015 Dec;16(16):e595-603. doi: 10.1016/S1470-2045(15)00166-7.
Choice A:D(max)
Choice B:D(1.0 cc)
Choice C:D(3.0 cc)
Choice D:D(5.0 cc)
Question 3: What is the single fraction maximum dose limit to the thecal sac for spine SRS?
Reference:(10 Gy. Radiation Myelopathy has been observed above 10 Gy in some cases. Lowers dose limits for myelopathy were observed with cyberknife versus linac)
Choice A:8 Gy
Choice B:10 Gy
Choice C:12 Gy
Choice D:14 Gy
Choice E:16 Gy
Question 4: What is the primary advantage of spine SRS over conventional spine fractionated treatments?
Reference:(Increase local control. While the other answers have been demonstrated in some patient cohorts, they are not generally expected. )
Choice A:Better pain control.
Choice B:Reduced bone fracture risk.
Choice C:Reduced myelopathy risk.
Choice D:Increased local control.
Choice E:Reduced late toxicities.
Question 5: A physical model created for intracranial SRS treatments for multiple (1-60) brain metastases with the Gamma Knife Perfexion found that the increases in the 12 Gy peripheral dose volume were correlated with which?
Reference:A. Sahgal, et al., Prescription Dose guidelines based on physical criterion for multiple metastastic brain tumors treated with stereotactic radiosurgery, IJROBP 78 (2010), 605-608.
Choice A:The total volume of tumors treated.
Choice B:The total number of tumors treated.
Choice C:The number of tumors with volume > 1.0 cm3.
Choice D:A single tumor with volume > 4.0 cm3.
Choice E:All of the above.
Question 6: Studies published to date that specifically investigate the radiosurgical tolerance of the optic apparatus represent level III evidence.
Reference:J. Sheehan, et al., Chapter 11: Optic Apparatus Tolerance up to 8 Gy, in Controversies in Stereotactic Radiosurgery, J. Sheehan, P. Gerszten ed., Thieme, 2014. Source 2: J. Flickinger, et al., Chapter 12: Optic Apparatus Tolerance Greater than 8 Gy, in Controversies in Stereotactic Radiosurgery, J. Sheehan, P. Gerszten ed., Thieme, 2014.
Choice A:True.
Choice B:False.
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