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.
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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.
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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.
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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.
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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. |