2019 AAPM Annual Meeting
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Session Title: Efficiency/throughput RT for Low Resource Settings
Question 1: According to the WHO report from May 2018, cancer was in the top 5 leading causes of death in 2016:
Reference:https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
Choice A:Globally
Choice B:In low-income countries
Choice C:In high-income countries
Question 2: What are some of the reasons for the lack of radiotherapy services in low and middle income countries?
Reference:Sirohi, B., et al., August 2018. Developing institutions for cancer care in low-income and middle-income countries: from cancer units to comprehensive cancer centres. The Lancet Oncology, 19, pp.e395-e406.
Choice A:Competing health priorities
Choice B:A lack of radiotherapy professionals
Choice C:Inadequate infrastructure and services, e.g. unstable power
Choice D:A lack of adequate diagnosis (imaging and laboratory)
Choice E:Inequity between public and private cancer services
Choice F:All of the above
Question 3: How many radiotherapy clinics per million people are there in the US as compared to India?
Reference:Education and Training Needs in Radiation Oncology in India: Opportunities for Indo-US Collaborations, Grover, S. et al., Int J Radiat Oncol Biol Phys, 93, 957-960, 2015
Choice A:5 times less
Choice B:2 times more
Choice C:18 times more
Choice D:150 times more
Question 4: What is the relative daily patient throughput for VMAT treatments if there are 3 hours of power outage per day on average?
Reference:Model for Estimating Power and Downtime Effects on Teletherapy Units in Low-Resource Settings, McCarroll, R. et al., J Global Onc, 3(5), 563-571, 2017
Choice A:5%
Choice B:20%
Choice C:70%
Choice D:90%
Question 5: Why is kilovoltage x-ray beam therapy to deep-seated targets challenging?
Reference:Breitkreutz, D.Y., Renaud, M.A., Seuntjens, J., Weil, M.D., Zavgorodni, S. and Bazalova-Carter, M., 2018. Inverse optimization of low-cost kilovoltage x-ray arc therapy plans. Medical physics, 45(11), pp.5161-5171.
Choice A:the fast beam attenuation in tissue
Choice B:higher dose to bone
Choice C:low x-ray beam output
Choice D:all of the above
Question 6: When increasing KVAT collimator thickness which statement is correct?
Reference:Bazalova-Carter, M., Weil, M.D., Breitkreutz, D.Y., Wilfley, B.P. and Graves, E.E., 2017. Feasibility of external beam radiation therapy to deep-seated targets with kilovoltage x-rays. Medical physics, 44(2), pp.597-607.
Choice A:the target-to-skin ratio decreases and beam output increases
Choice B:the target-to-skin ratio increases and beam output decreases
Choice C:both the target-to-skin ratio increases and beam output decrease
Choice D:both the target-to-skin ratio increases and beam output increase
Question 7: Fixed beam radiotherapy could be more cost effective than conventional radiotherapy due to:
Reference:Eslick, E. M., & Keall, P. J. (2015). The Nano-X Linear Accelerator: A compact and economical cancer radiotherapy system incorporating patient rotation. Technology in cancer research & treatment, 14(5), 565-572.
Choice A:More compact treatment system
Choice B:Less bunker shielding required
Choice C:Linac components can be kept stationary
Choice D:All of the above
Question 8: Why is upright patient rotation more challenging to deliver than horizontal patient rotation?
Reference:Kairn, T. (2018). Patient rotation during linac‐based photon electron radiotherapy. Journal of medical imaging and radiation oncology, 62(4), 548-552.
Choice A:Cost of patient rotation system
Choice B:Tumor motion during treatment
Choice C:Horizontal orientation of treatment planning images
Choice D:Patient discomfort during rotation
Question 9: What is the maximum annual radiation dose for the general public (i.e., belonging to the uncontrolled treatment area) required by the National Council on Radiation Protection and Measurement (NCRP)?
Reference:NCRP (1993). National Council on Radiation Protection and Measurements. Limitation of Exposure to Ionizing Radiation, NCRP Report No. 116 (National Council on Radiation Protection and Measurements, Bethesda, Maryland).
Choice A:0.5 millisievert (mSv)/year
Choice B:0.1 millisievert (mSv)/year
Choice C:10 millisievert (mSv)/year
Choice D:100 millisievert (mSv)/year
Question 10: Overall radiation leakage in the patient plane is limited by the International Electrotechnical Commission (IEC) to what mean percentage of total dose?
Reference:Reference: International Electrotechnical Commission: IEC 60601-2-1, v. 2014.
Choice A:0.05%
Choice B:0.1%
Choice C:0.01%
Choice D:0.015%
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