| Question 1: Which imaging modality can localize metal needles to an accuracy of at least 1mm?
|
| Reference: | Wang et al, de Leeuw et al). Localization of the first dwell position on MRI is within 1-2mm (de Leeuw et al). |
| Choice A: | CT. |
| Choice B: | MRI. |
| Choice C: | Both CT and MRI. |
| Choice D: | None of the above. |
| Question 2: Workflow efficiency on day of initial treatment can be improved by completing select tasks prior to day of implantation. |
| Reference: | Damato AL, Lee LJ, Bhagwat MS, et al. Redesign of process map to increase efficiency: Reducing procedure time in cervical cancer brachytherapy. Brachytherapy. 2015;14:471–480.
|
| Choice A: | True. |
| Choice B: | False. |
| Question 3: Methods for verifying applicator placement for interstitial GYN brachytherapy typically include at least one of the following, EXCEPT:
|
| Reference: | ABS Consensus Guidelines for Interstitial Brachytherapy for Vaginal Cancer, Beriwal S et al, Brachytherapy 11 (2012) 68-75
|
| Choice A: | Clinical examination. |
| Choice B: | CT imaging. |
| Choice C: | MR imaging. |
| Choice D: | PET imaging. |
| Choice E: | Laparoscopy. |
| Question 4: Which statement best describes the implementation of graphic optimization?
|
| Reference: | Dose Optimization in Gynecological 3D Image Based Interstitial Brachytherapy using Martinez Universal Perineal Interstitial Template (MUPIT) -An Institutional Experience. J Med Phys (2014) 39 (3): 197-202.
|
| Choice A: | Optimizes to user-defined dose points. |
| Choice B: | Optimizes to the source dwell positions themselves as dose points. |
| Choice C: | Optimizes based on prescribed dose-volume constraints. |
| Choice D: | Optimizes by the user manually adjusting isodose lines on screen. |
| Question 5: All of the following are advantages of using an MR system with a higher magnetic field strength (e.g., 3 T versus 1.5 T) EXCEPT:
|
| Reference: | Kim et al., “Evaluation of artifacts and distortions of titanium applicators on 3.0-Tesla MRI: Feasibility of titanium applicators in MRI-guided brachytherapy for gynecological cancer,” Int J Radiation Oncology, 80 (3), 947-55 (2011).
Dimopoulous et al., “Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (IV): Basic principles and parameters for MR imaging within the frame of image
based adaptive cervix cancer brachytherapy,” Radiotherapy and Oncology, 103, 113-22 (2012).
|
| Choice A: | Higher signal-to-noise ratio (SNR). |
| Choice B: | Smaller applicator induced susceptibility artifacts. |
| Choice C: | Shorter acquisition times. |
| Choice D: | Improved contrast in the uterine cervix and vagina. |
| Question 6: If an applicator has been shown to be MR conditional for a 1.5T MRI, then it can be safely used in a 3T system without the need for further testing: |
| Reference: | Woods, “Standards for medical devices in MRI: Present and future,” JMRI, 26 (5), 1186-1189 (2007).
U.S. Department of Health and Human Services, Food and Drug Administration, “Establishing safety and compatibility of passive implants in the magnetic resonance environment,” https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm107708.pdf (2014).
|
| Choice A: | True. |
| Choice B: | False. |
