| Question 1: Respiratory gating increases treatment time as compared to non-gated treatments, and the duty cycles (ratio of beam on to total beam delivery time) range from: |
| Reference: | C. (Benedict, et al. Stereotactic body radiation therapy: the report of AAPM Task Group 101, Med Phys. 2010 Aug; 37(8):4078-101) |
| Choice A: | 5-10% |
| Choice B: | 10-20% |
| Choice C: | 30-50% |
| Choice D: | 50-80% |
| Question 2: The estimated ranges (in mm) of motion (SI direction) in lung are on the order of the following for tumors located in lower lobe, middle lobe, and upper lobe: |
| Reference: | (Keall et al. The management of respiratory motion in radiation oncology report of AAPM Task Group 76. Med Phys. 2006 Oct; 33(10):3874-900.) |
| Choice A: | 9-32, 4-10, 2-11 |
| Choice B: | 4-10, 2-11, 9-32 |
| Choice C: | 4-10, 9-31, 2-11 |
| Question 3: Which of the following is true regarding motion management: |
| Reference: | 1. Benedict, Stanley H., et al. "Stereotactic body radiation therapy: the report of AAPM Task Group 101." Medical physics37(8) (2010): 4078-4101.
2. Bouilhol, Gauthier, et al. "Is abdominal compression useful in lung stereotactic body radiation therapy? A 4DCT and dosimetric lobe-dependent study." Physica Medica: European Journal of Medical Physics 29(4) (2013): 333-340.
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| Choice A: | The tumor respiratory motion range is reduced in a respiratory gated treatment compared to free breathing treatment. |
| Choice B: | The tumor respiratory motion range in a breath-hold treatment is the same as that in a free breathing treatment. |
| Choice C: | The tumor respiratory motion range in a respiratory gated treatment is similar as that in a free breathing treatment, except that the treatment is delivered only within certain phase window. |
| Choice D: | Abdominal compression is mostly useful for reducing the respiratory motion of lung tumors located in the upper lobe. |
| Question 4: Which of the following is true regarding the imaging and planning process of various motion management techniques? |
| Reference: | 1. Benedict, Stanley H., et al. "Stereotactic body radiation therapy: the report of AAPM Task Group 101." Medical physics 37(8) (2010): 4078-4101.
2. Brandner, E. D., Chetty, I. J., Giaddui, T. G., Xiao, Y., & Huq, M. S. (2017). Motion management strategies and technical issues associated with stereotactic body radiotherapy of thoracic and upper abdominal tumors: a review from NRG oncology. Medical physics, 44(6), 2595-2612.
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| Choice A: | The average CT of all phases is typically used for treatment planning in a respiratory gated case. |
| Choice B: | End-inspiration breath-hold can increase the lung volume and therefore help reduce the lung V20 during the planning process. |
| Choice C: | kV fluoro and MV cine images are typically used for verifying liver tumors without implanted markers. |
| Choice D: | The PTV margin used in lung SBRT is typically larger than that used in liver SBRT due to the larger respiratory motion in the lung. |
| Question 5: Targeting internal anatomy in real-time during radiotherapy has been clinically used on: |
| Reference: | Uchinami Y, Katoh N, Abo D, et al. An Organ Motion and Acute Toxicity Study of Image-Guided Spot-Scanning Proton Beam Therapy With An Internal Fiducial Marker for Pancreatic Cancers. International Journal of Radiation Oncology• Biology• Physics 2017;99:E194.
Keall P, Nguyen D, O’Brien R, et al. A Review of Real-Time 3D IGRT on Standard-Equipped Cancer Radiotherapy Systems: Are We at the Tipping Point for the Era of Real-Time Radiotherapy? International Journal of Radiation Oncology• Biology• Physics 2018.
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| Choice A: | CyberKnife and Vero systems. |
| Choice B: | Standard-equipped linear accelerators. |
| Choice C: | Particle therapy systems. |
| Choice D: | All of the above. |
| Question 6: From rotating 2D projection images of three of more implanted markers acquired during treatment, which answer best describes the information about the target pose that can be learned from these images? |
| Reference: | Tehrani JN, et al. Real-time estimation of prostate tumor rotation and translation with a kV imaging system based on an iterative closest point algorithm. Phys Med Biol 2013;58:8517-8533. |
| Choice A: | 3D target position and target rotation information. |
| Choice B: | 3D target position information. |
| Choice C: | 2D target position information. |
| Choice D: | No target position information. |
