| Question 1: Synthetic CTs for MR-only planning can be generated directly from MR images using which of the following: |
| Reference: | Owrangi AM, Greer PB and Glide-Hurst CK, “MR-only treatment planning: benefits and challenges”, Phys. Med. Biol. 2018 Feb 26; 63(5): 05TR01 |
| Choice A: | Machine learning. |
| Choice B: | Compressed sensing. |
| Choice C: | Multi-atlas registration. |
| Choice D: | A & B. |
| Choice E: | A & C. |
| Question 2: Which of the following statements concerning MR-only planning is true? |
| Reference: | Tyagi N, Fontenla S, Zelefsky M, Chong-Ton M, Ostergren K, Shah N, Warner L, Kadbi M, Mechalakos J and Hunt M, Clinical workflow for MR-only simulation and planning in prostate. Radiat Oncol 2017 Jul 17;12(1):119 |
| Choice A: | Patient motion is not a concern for MR-only because patients are in an immobilization mask. |
| Choice B: | Patients with bilateral hip implants are not good candidates for MR-only planning. |
| Choice C: | An MR simulator with 70 cm bore size can give geometrically accurate images within the entire bore size. |
| Choice D: | MR simulators allow absolute isocenter marking. |
| Question 3: Emerging PET radiotracers using 89Zr and 64Cu have half-lives on the order of: |
| Reference: | McQuade P, Rowland DJ, Lewis JS, Welch MJ. Positron-Emitting Isotopes Produced on Biomedical Cyclotrons. Curr Med Chem 2005; 12(7): 807-818. |
| Choice A: | Minutes. |
| Choice B: | Hours. |
| Choice C: | Days. |
| Choice D: | Weeks. |
| Choice E: | Months. |
| Question 4: Delineation of targets for radiation treatment using PET is complicated by which of the following: |
| Reference: | Jeraj R, Bradshaw T, Simončič. Molecular Imaging to Plan Radiotherapy and Evaluate Its Efficacy. J Nuc Med 2015; 56(11): 1752-1765. |
| Choice A: | Spatial distortions in the image |
| Choice B: | The low spatial resolution of PET |
| Choice C: | The lack of a well-defined tumor margin based on functional PET signals |
| Choice D: | The short half-lives of common PET radiotracers |
| Choice E: | B and C. |
| Question 5: What biological aspect of tumors that has been most closely linked to radiation sensitivity and imaged with PET? |
| Reference: | Rajendran JG, Hendrickson KR, Spence AM, Muzi M, Krohn KA, Mankoff DA. Hypoxia Imaging-Directed Radiation Treatment Planning. Eur J Nucl Med Mol Imaging 2006; 33(S1): 44-53. |
| Choice A: | Angiogenesis |
| Choice B: | Hypoxia |
| Choice C: | Metabolism |
| Choice D: | Immune cell infiltration |
| Choice E: | Cell proliferation |
| Question 6: PET-MR can be challenging when quantifying hepatic tumor uptake as compared to PET-CT because : |
| Reference: | MRI-Based Nonrigid Motion Correction in Simultaneous PET/MRI. Chun S., Reese T., Ouyang J., Guerin B., Catana C., Zhu X, Alpert N., El Fakhri G. J. Nucl. Med. 2012; 53: 1-9. |
| Choice A: | MR yields worse contrast that CT in soft tissues. |
| Choice B: | PET in PET-MR is less sensitive than PET in PET-CT. |
| Choice C: | MR-based attenuation correction is more challenging than CTA. |
| Choice D: | MR is less sensitive to motion than CT. |
| Choice E: | MR allows to reduce radiation dose to the patient but at a cost of increased noise. |
| Question 7: Motion compensation in PET-MR yields promising results in improved lesion detection as compared to gated PET-CT because: |
| Reference: | MRI-Based Nonrigid Motion Correction in Simultaneous PET/MRI. Chun S., Reese T., Ouyang J., Guerin B., Catana C., Zhu X, Alpert N., El Fakhri G. J. Nucl. Med. 2012; 53: 1-9. |
| Choice A: | MR yields better spatial resolution than CT. |
| Choice B: | MR acquisitions are faster than CT. |
| Choice C: | MR is a non ionizing imaging modality. |
| Choice D: | MR is more sensitive to motion than CT. |
| Choice E: | MR allows to correct for motion while incorporating all counts detected hence greater SNR. |
| Question 8: Which of the following statements concerning DECT acquisition modes is TRUE? |
| Reference: | McCollough, C.H., et al., Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications. Radiology, 2015. 276(3): p. 637-53. |
| Choice A: | All scanners create images using fixed kVp for high and low energy tubes. |
| Choice B: | All scanners reconstruct images in projection space. |
| Choice C: | High and low energy images may be blended in to create a final image that simulates a standard single energy 120 kVp CT image. |
| Choice D: | DECT images cannot be acquired with isotropic voxels. |
| Question 9: Concerning monoenergetic imaging, which of the following statements is FALSE? |
| Reference: | Grant, K.L., et al., Assessment of an advanced image-based technique to calculate virtual monoenergetic computed tomographic images from a dual-energy examination to improve contrast-to-noise ratio in examinations using iodinated contrast media. Invest Radiol, 2014. 49(9): p. 586-92 |
| Choice A: | <50 keV images can help reduce the amount of administered IV contrast due to increased conspicuity of iodine |
| Choice B: | >100 keV images are useful for metal artifact reduction |
| Choice C: | Monoenergetic acquisitions have been shown to minimize pseudoenhancement of lesions. |
| Choice D: | Hounsfield units are unchanged when comparing images at any monoenergetic setting. |
| Question 10: Concerning virtual non-contrast images derived from DECT data, which of the following statements is TRUE? |
| Reference: | Toepker, M., et al., Accuracy of dual-source computed tomography in quantitative assessment of low density coronary stenosis--a motion phantom study. Eur Radiol, 2010. 20(3): p. 542-8. |
| Choice A: | VNC Hounsfield unit (HU) values are reliably within 5 HU of true non-contrast (TNC) images |
| Choice B: | VNC HU are relatively independent of the amount of the iodine concentration in a given contrast enhanced ROI |
| Choice C: | VNC HU can be directly calculated from rapid kV switching DE scanners |
| Choice D: | VNC HU are less noisy than TNC images |
