| Question 1: In which situation below is Multiple CT robust optimization is effective? |
| Reference: | Multiple-CT optimization of intensity-modulated proton therapy – Is it possible to eliminate adaptive planning? X Wang, et al. Radiotherapy and Oncology (2017), https://doi.org/10.1016/j.radonc.2017.09.032 |
| Choice A: | Accounting for patient setup up uncertainty. |
| Choice B: | Decreasing proton range uncertainty. |
| Choice C: | Minimize dose degradation due to patient anatomical changes. |
| Choice D: | Sparing organs at risk |
| Question 2: Potential limits or challenges of multiple CT optimization for IMPT include: |
| Reference: | Anatomical robust optimization to account for nasal cavity filling variation during intensity modulated proton therapy: a comparison with conventional and adaptive planning strategies, Steven van de Water, et al. 2018 Phys. Med. Biol. 63 025020 |
| Choice A: | Substantially longer plan optimization and calculation time. |
| Choice B: | Accurate modelling of anatomic change in the synthetic CTs; |
| Choice C: | Higher dose to OARs. |
| Choice D: | All of the above. |
| Question 3: Which of the follow is NOT explicitly verified in a phantom measurement for proton patient specific QA program? |
| Reference: | Zhu XR, Li Y, Mackin D, et al. Towards Effective and Efficient Patient-Specific Quality Assurance for Spot Scanning Proton Therapy. Weiss R, ed. Cancers. 2015;7(2):631-647. doi:10.3390/cancers7020631. |
| Choice A: | Correct modeling of radiation fluence emitted from treatment machine. |
| Choice B: | Data transfer between the treatment planning system and the delivery system. |
| Choice C: | Dose calculation accuracy. |
| Choice D: | Patient anatomical changes. |
| Choice E: | Machine performance. |
| Question 4: Which of the following statements is true for properly commissioned proton dose calculation algorithms in heterogeneous mediums? |
| Reference: | Quantification of Proton Dose Calculation Accuracy in the Lung
Grassberger, Clemens et al.
International Journal of Radiation Oncology • Biology • Physics , Volume 89 , Issue 2 , 424 - 430
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| Choice A: | Analytic algorithms are generally more accurate than Monte Carlo algorithms |
| Choice B: | The accuracy of both algorithms is indistinguishable |
| Choice C: | Monte Carlo algorithms are generally more accurate than analytic algorithms. |
| Question 5: Repainting can reduce the following motion effects for intensity-modulated proton therapy (IMPT): |
| Reference: | Breathing interplay effects during proton beam scanning: simulation and statistical analysis. Seco J et al. Phys Med Biol 54, N283-N294 (2009). |
| Choice A: | Dose blurring. |
| Choice B: | Dose inhomogeneities caused by target motion during beam delivery. |
| Choice C: | Dose inhomogeneities caused by target motion between beam deliveries. |
| Choice D: | Shift of the high-dose volume relative to the target. |
| Question 6: The most efficient repainting strategy for reduction of interplay effects is: |
| Reference: | Breathing interplay effects during proton beam scanning: simulation and statistical analysis. Seco J et al. Phys Med Biol 54, N283-N294 (2009). |
| Choice A: | Fast layer repainting , where each energy layer is repainted N times as fast as possible. |
| Choice B: | Fast volume repainting , where the whole volume is repainted N times as fast as possible. |
| Choice C: | Breath sampling repainting, where each energy layer is repainted N evenly spaced times within one breathing cycle. |
| Choice D: | Random repainting, where each energy layer is repainted N times with random delays between the repaintings. |
