2016 AAPM Annual Meeting
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Session Title: Implanted Markers for Radiation Therapy and TG 199 Update
Question 1: What fiducial marker is not recommended for proton therapy?
Reference:Newhauser W, et al. Phys. Med. Biol. 2007;52:2937–2952 Cheung J, et al. Phys. Med. Biol. 2010;55:7135–7147 Lim Y, et al. Int. J. Radiat. Oncol. Biol. Phys. 2009;74:1609–1616 Ahn S, et al. Med. Phys. 2015;42:2626-2637
Choice A:Carbon coated ZrO2 fiducial marker.
Choice B:Microscopic gold particles.
Choice C:Conventional gold fiducial marker with a diameter of 1.2 mm and a length of 3.0 mm.
Choice D:Plastic coated stainless steel marker.
Choice E:BaSo4 mixed with polymer phosphate buffer saline.
Question 2: Which of the following statements is false regarding the use of fiducial markers in proton therapy treatment of prostate cancer?
Reference:Lim Y, et al. Int. J. Radiat. Oncol. Biol. Phys. 2009;74:1609–1616 Newhauser W, et al. Phys. Med. Biol. 2007;52:2937–2952
Choice A:Good radiographic visibility for diagnostic X-rays is required.
Choice B:Fiducial markers should have minimal impact on dose delivery.
Choice C:Fiducial markers should produce minimal artifacts in the CT images used for treatment planning.
Choice D:There should be little or no migration of the marker over the course of treatment.
Choice E:Fiducial markers should be oriented parallel to the direction of the beam.
Question 3: Which of following item would be best to account for the system latency for real-time fiducial tracking technique based on pairs of x-ray images?
Reference:Rottmann J, Berbeco R, ‘Using an external surrogate for predictor model training in real-time motion management of lung tumors’, Med Phys. 2014 Dec; 41(12):121706. doi: 10.1118/1.4901252.
Choice A:Linear correlation model between the internal/external fiducials created before treatment.
Choice B:Linear correlation model between the internal/external fiducials created before and during treatment.
Choice C:An adaptive prediction model between the internal/external fiducials before and during treatment.
Choice D:An adaptive prediction model between the internal/external fiducials before treatment.
Question 4: Which direction has the largest prediction uncertainties in the CyberKnife real-time tracking technique in the lung?
Reference:Pepin EW, Wu H, Zhang Y, Lord B., ‘Correlation and prediction uncertainties in the cyberknife synchrony respiratory tracking system’, Med Phys. 2011 Jul;38(7): 4036-44.
Choice A:The lateral direction.
Choice B:The superior-inferior direction.
Choice C:The anterior-posterior direction.
Choice D:None of the above.
Question 5: Implanted markers have been used as target surrogates in which of the following sites?
Reference:Litzenberg D, Dawson LA, Sandler H, Sanda MG, McShan DL, Ten Haken RK, Lam KL, Brock KK, Balter JM. Daily prostate targeting using implanted radiopaque markers. Int J Radiat Oncol Biol Phys. 2002 Mar 1;52(3):699-703. 2. Shirato H, Seppenwoolde Y, Kitamura K, Onimura R, Shimizu S. Intrafractional tumor motion: lung and liver. Semin Radiat Oncol. 2004 Jan;14(1):10-8.
Choice A:Liver
Choice B:Prostate
Choice C:Lung
Choice D:All of the above
Question 6: Which issue listed below will affect target localization with implanted markers?
Reference:Imura M, Yamazaki K, Shirato H, Onimaru R, Fujino M, Shimizu S, Harada T, Ogura S, Dosaka-Akita H, Miyasaka K, Nishimura M. Insertion and fixation of fiducial markers for setup and tracking of lung tumors in radiotherapy. Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1442-7. Epub 2005 Aug 18
Choice A:Marker stability
Choice B:Tissue deformation
Choice C:Imaging artifacts/distortion
Choice D:All of the above
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