| Question 1: Which of the following is TRUE about online adaptive MR guided radiation therapy? |
| Reference: | Henke et al, Phase I trial of stereotactic MR-guided online adaptive radiation therapy (SMART) for the treatment of oligometastatic or unresectable primary malignancies of the abdomen. Radiother Oncol. 2018 Mar;126(3):519-526. doi: 10.1016/j.radonc.2017.11.032. Epub 2017 Dec 23 |
| Choice A: | The images of soft tissue are worse than cone-beam CT |
| Choice B: | It is only a research topic and not clinically implemented |
| Choice C: | Quality assurance cannot be done with online plan adaptation |
| Choice D: | There are clinical outcomes showing minimal toxicity with ablative radiation doses |
| Question 2: How can thoracic image registration accuracy be improved? |
| Reference: | K. Cao, K. Ding, J.M. Reinhardt, and G.E. Christensen, “Improving Intensity-Based Lung CT Registration Accuracy Utilizing Vascular Information” Int. J. Biomed. Imaging 2012, 285136 (2012).
Y. Yin, E.A. Hoffman, and C.L. Lin, “Lung Lobar Slippage Assessed with the Aid of Image Registration” Lect. Notes Comput. Sci. 6362 LNCS, 578–585 (2010).
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| Choice A: | Segmenting and including individual lobes. |
| Choice B: | Segmenting and including pulmonary vasculature. |
| Choice C: | Modeling intensity changes with mass-preserving similarity. |
| Choice D: | All of the above. |
| Question 3: It is well established that cumulative dose is useful to guide adaptive radiation therapy> |
| Reference: | H. Zhong and I.J. Chetty, Caution Must Be Exercised When Performing Deformable Dose Accumulation for Tumors Undergoing Mass Changes During Fractionated Radiation Therapy, Int. J. Radiat. Oncol. Biol. Phys. 97(1), 182–183 (2017) PMID: 27979447. |
| Choice A: | True. |
| Choice B: | False. |
| Question 4: Which of the following statements is true regarding the use of deformable image registration (DIR) to generate a virtual CT from CBCT in proton therapy? |
| Reference: | Veiga, C., G. Janssens, C-L Teng, et al. (2016). “First Clinical Investigation of Cone Beam Computed Tomography and deformable Registration for Adaptive Proton Therapy for Lung Cancer.” Int. J. Radiat. Oncol. Biol. Phys. 95:549–59. |
| Choice A: | DIR is a robust tool for generating a virtual CT with large anatomical change in the lungs |
| Choice B: | Photon scatter is less for lung tissue which increases the accuracy of Hounsfield numbers of lung tissue and DIR |
| Choice C: | DIR errors can be localized and visual inspection and manual correction of the virtual CT may be necessary |
| Choice D: | DIR errors may be eliminated by using a CBCT with higher dose |
| Question 5: FDG PET tumor imaging during the course of radiotherapy contains multifactorial induced bio-activity having which of the following properties? |
| Reference: | D Hanahan & RA Weinberg. Hallmarks of Cancer: The Next Generation. Cell 2011, 144:646-74 |
| Choice A: | Clinically practical and sensitive to tumor radiation dose. |
| Choice B: | Good to monitor a bio-marker activity.. |
| Choice C: | Good image-marker for a targeting drug. |
| Choice D: | Good for imaging anatomy. |
| Question 6: How is the optimal Dose Prescription Function defined? |
| Reference: | Bentzen SM. Theragnostic imaging for radiation oncology: dose-painting by numbers. Lancet Oncol 2005, 6:112-7 |
| Choice A: | The clinical prescription dose used in the conventional radiotherapy. |
| Choice B: | A uniform dose prescribed to GTV. |
| Choice C: | The quantity link between a specific value of imaging variable(s) and the optimum clinical dose to be prescribed to the corresponding tumor voxel. |
| Choice D: | The maximum dose to tumor which can be tolerated by human. |
