2016 AAPM Annual Meeting
Back to session list

Session Title: Online Adaptive Radiotherapy - Considerations for Practical Clinical Implementation
Question 1: According to studies reported thus far, what is a likely result of implementing online adaptive radiotherapy for prostate cancer?”
Reference:Ahunbay EE, Peng C, Holmes S, Godley A, Lawton C, Li XA. Online adaptive replanning method for prostate radiotherapy. Int J Radiat Oncol Biol Phys. 2010 Aug 1;77(5):1561-72.
Choice A:Will likely result in additional toxicity and should not be performed.
Choice B:Will likely result in a reduction in tumor control and should not be performed.
Choice C:Can improve dosimetry for organ-at-risk paring and/or tumor target coverage.
Choice D:Does not provide dosimetric benefit.
Question 2: The major challenge to perform online replanning for pancreatic cancer is:
Reference:Li XA, Liu F, Tai A, Ahunbay E, Chen G, Kelly T, Lawton C, Erickson B. Development of an online adaptive solution to account for inter- and intra-fractional variations. Radiother Oncol. 2011 Sep;100(3):370-4.
Choice A:The robustness of plan optimization.
Choice B:The quality of 3D images.
Choice C:The accuracy of segmentation.
Choice D:The reliability of plan delivery.
Question 3: Which of the following potential failure modes is least likely to affect on-line adaptive radiotherapy?
Reference:Noel, Camille E., et al. "Process-based quality management for clinical implementation of adaptive radiotherapy." Medical physics 41.8 (2014): 081717.
Choice A:Target/structure construction.
Choice B:Image artifact corrections.
Choice C:Data transfer.
Choice D:Plan optimization.
Question 4: A multi-disciplinary team present at the console for on-line adaptive treatments may need elements of the following expertise, depending on implementation:
Reference:Heijkoop, Sabrina T., et al. "Clinical implementation of an online adaptive plan-of-the-day protocol for nonrigid motion management in locally advanced cervical cancer IMRT." International Journal of Radiation Oncology* Biology* Physics 90.3 (2014): 673-679. Acharya, Sahaja, et al. "Online Magnetic Resonance Image Guided Adaptive Radiation Therapy: First Clinical Applications." International Journal of Radiation Oncology* Biology* Physics 94.2 (2016): 394-403.
Choice A:Image interpretation with on-line quality images.
Choice B:Knowledge of relevant anatomy.
Choice C:Treatment plan optimization.
Choice D:All of the above.
Question 5: The goal of online patient specific QA for adaptive radiotherapy:
Reference:Taoran Li, Quality assurance for online adapted treatment plans: Benchmarking and delivery monitoring simulation, Med. Phys. 42 (1), January 2015
Choice A:Is to validate the accuracy of the treatment planning system’s heterogeneity correction.
Choice B:Is to ensure patient did not move during treatment.
Choice C:Is to verify patient setup accuracy.
Choice D:Is to validate the accuracy of reoptimized plan and identify any large deviations.
Choice E:Online QA cannot be sufficient under any conditions and should never be used.
Question 6: The accuracy of mapping and accumulating the dose for adaptive therapy is limited by:
Reference:Murphy MJ, Salguero FJ, Siebers JV, Staub D, Vaman C. A method to estimate the effect of deformable image registration uncertainties on daily dose mapping. Med Phys. 2012; 39: 573-580.
Choice A:Errors in electron density map .
Choice B:Relative location of the errors in deformable registration and the dose gradient.
Choice C:Errors in deformable registration alone.
Choice D:Difference between original and new image resolution.
Choice E:There are no concerns regarding dose accumulation if the registration is verified.
Back to session list