2017 AAPM Annual Meeting
Back to session list

Session Title: HDR Brachytherapy: Interstitial Treatments for GYN Panel Discussion
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.
Back to session list