2016 AAPM Annual Meeting
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Session Title: Research Opportunities with Digital Linear Accelerators
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?
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?
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.
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?
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
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.
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.
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.
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