| Question 1: All of the following were addressed within the GYN GEC ESTRO working group reports EXCEPT: |
| Reference: | C. Haie-Meder et al., “Recommendations from Gynaecological (GYN) GEC-ESTRO Working Group (I): concepts and terms in 3D image based 3D treatment planning in cervix cancer brachytherapy with emphasis on MRI assessment of GTV and CTV,” Radiotherapy and Oncology, 74, 235-45 (2005).
R. Potter et al., “Recommendations form gynaecological (GYN) GEC ESTRO working group (II): Concepts and terms in 3D image-based treatment planning in cervix cancer brachytherapy – 3D dose volume parameters and aspects of 3D image-based anatomy, radiation physics, radiobiology,” Radiotherapy and Oncology,78, 67-77 (2006).
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| Choice A: | Reconstruction of both plastic and titanium applicators. |
| Choice B: | Recommendation of image sequences for 1.5 – 3 T MR scanners. |
| Choice C: | Definition and guidance in the contouring of clinical target volumes. |
| Choice D: | Recommended target and organ at risk dose volume parameters. |
| Question 2: The advantage of integrating MR imaging in the HDR prostate workflow compared with CT and/or US is: |
| Reference: | S.J. Frank and F. Mourtada, “Bending the slope of the brachytherapy curve: Magnetic resonance imaging-assisted radiosurgery for treatment of prostate cancer,” Brachytherapy, 16, 657 – 658 (2017).
T.J. Pugh and S.S. Pokharel, “Magnetic resonance imaging in prostate brachytherapy: Evidence, clinical end points to data, and direction forward,” Brachytherapy, 16, 659 – 664 (2017).
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| Choice A: | The superior visualization of the dominant intraprostatic lesion(s). |
| Choice B: | The superior visualization of the neurovascualar bundles. |
| Choice C: | The evaluation of the extracapsular extension. |
| Choice D: | The evaluation of seminal vesicle invasion. |
| Choice E: | All of the above. |
| Question 3: All of the following terms are currently used by vendors based on the recommendations of the MR Task Group of the American Society for Testing Materials (ASTM) International when labeling a brachytherapy applicator, except: |
| Reference: | F.G. Shellock and A. Spinazzi, “Review. MRI safety update 2008: Part 2, Screening patients for MRI,” American Journal of Roentgenology, 191, 1140 -1149 (2008).
T.O. Woods, “Standards for medical devices in MRI: present and future,” Journal of Magnetic Resonance Imaging, 26, 1186 – 1189 (2007).
American Society for Testing and Materials (ASTM) International. Standard practice for marking medical devices and other items for safety in the magnetic resonance environment. West Conshohocken, PA: ASTM International, 2005; designation: F2503-05
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| Choice A: | MR safe. |
| Choice B: | MR compatible. |
| Choice C: | MR conditional. |
| Choice D: | MR unsafe. |
| Question 4: Which directional brachytherapy approach for cervical cancer therapy uses the most afterloader channels? |
| Reference: | Han et al, Direction-modulated brachytherapy for high-dose-rate treatment of cervical cancer. I: Theoretical design, Int J Radiat Oncol Biol Phys 89(3), 666-673 (2014). |
| Choice A: | Dynamic Modulated Brachytherapy (DMBT). |
| Choice B: | Compensator-based Intensity Modulated Brachytherapy (CIMBT) . |
| Choice C: | Rotating Shield Brachytherapy (RSBT). |
| Choice D: | Low-dose-rate brachytherapy shielded seeds. |
| Question 5: In a center participating in EMBRACE II, what percentage of patients must receive combined intracavitary and interstitial brachytherapy? |
| Reference: | Pötter et al, The EMBRACE II study: The outcome and prospect of two decades of evolution within the GEC-ESTRO GYN working group and the EMBRACE studies, Clinica and Translational Radiation Oncology 9, 48-60 (2018). |
| Choice A: | 5% |
| Choice B: | 10% |
| Choice C: | 20% |
| Choice D: | 50% |
| Question 6: Generally, a brachytherapy robotic system has multiple degrees-of-freedom (DOF) for placing a catheter or needle at a desired location. What is the minimum number of DOF required to insert a needle in a gland (prostate, breast, liver, lung)? |
| Reference: | K. S. Fu, R. C. Gonzalez, and C. S. G. Lee, “Robotics: Control, Sensing, Vision, and Intelligence” (2nd print) McGraw-Hill, New York, NY (1988).
J. J. Craig, “Introduction to Robotics: Mechanics and Control,” (2nd edition) Addison-Wesley Pub. Co., New York, NY (1989).
L. Sciavicco and B. Siciliano, “Modelling and Control of Robot Manipulators,” (2nd edition) Springer, New York, NY (2000).
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| Choice A: | 1 DOF |
| Choice B: | 2 DOF |
| Choice C: | 3 DOF |
| Choice D: | 5 DOF |
| Choice E: | 6 or more DOF |
| Question 7: What is the most commonly used imaging modality for robot-assisted brachytherapy (especially for PSI)? |
| Reference: | T. Podder et al., “AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: Report of Task Group 192,” Medical Physics, 41 (10), 101501-1-27 (2014). |
| Choice A: | MR. |
| Choice B: | CT. |
| Choice C: | US/ TRUS. |
| Choice D: | PET. |
| Question 8: In prostate seed implantation (PSI), depositing seeds is more challenging as compared to placing a needle in the prostate while both tasks are performed by a robotic system |
| Reference: | D. Stoianovici et al., “MRI Stealth robot for prostate interventions,” Minim. Invasiv. Ther. Allied. Technol. 16, 241–248 (2007).
T. Podder et al., “AAPM and GEC-ESTRO guidelines for image-guided robotic brachytherapy: Report of Task Group 192,” Medical Physics, 41 (10), 101501-1-27 (2014).
T. K. Podder, I. Buzurovic, K. Huang, T. Showalter, A. P. Dicker, and Y. Yu, “Reliability of EUCLIDIAN: An autonomous robotic system for image-guided prostate brachytherapy,” Medical Physics, 38, 96–106 (2010).
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| Choice A: | True. |
| Choice B: | False. |
| Question 9: Current passive EM tracking technology allows the user to obtain WHICH of the following information at a rate of 40Hz? |
| Reference: | Franz, Alfred M, Tamas Haidegger, Wolfgang Birkfellner, Kevin Cleary, Terry M Peters, and Lena Maier-Hein. 2014. “Electromagnetic Tracking in Medicine--a Review of Technology, Validation, and Applications.” IEEE Trans Med Imaging 33 (8): 1702–25.
Seiler, P G, H. Blattmann, S Kirsch, R K Muench, and C Schilling. 2000. “A Novel Tracking Technique for the Continuous Precise Measurement of Tumour Positions in Conformal Radiotherapy.” Physics in Medicine and Biology 45 (9): N103–10.
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| Choice A: | X,Y and Z + pitch (4 DOF). |
| Choice B: | X,Y and Z + pitch and yaw (5 DOF). |
| Choice C: | 3 positions and 3 angles (6 DOF). |
| Choice D: | B and C. |
| Choice E: | None of the above. |
| Question 10: The accuracy of the EM system is below 1 mm and 1 degree. What is the work area for the Aurora-based EM tracking system? |
| Reference: | Boutaleb, Samir, Emmanuel Racine, Olivier Filion, Antonio Bonillas, Gilion Hauvast, Dirk Binnekamp, and Luc Beaulieu. 2015. “Performance and Suitability Assessment of a Real-Time 3D Electromagnetic Needle Tracking System for Interstitial Brachytherapy.” J Contemp Brachytherapy 7 (4): 280–89.
Bharat, Shyam, Cynthia Kung, Ehsan Dehghan, Ananth Ravi, Niranjan Venugopal, Antonio Bonillas, Doug Stanton, and Jochen Kruecker. 2014. “Electromagnetic Tracking for Catheter Reconstruction in Ultrasound-Guided High-Dose-Rate Brachytherapy of the Prostate.” Brachytherapy 13 (6): 640–50.
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| Choice A: | 5x5x5 cm3 in front of the field generator. |
| Choice B: | 30x30x30 cm3 with a dead zone in the first 5 cm in front of the field generator. |
| Choice C: | 50x50x50 cm3 with a dead zone in the first 5 cm in front of the field generator. |
