2019 AAPM Annual Meeting
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Session Title: Joint AAPM-SNMMI Symposium: Nuclear Medicine Theranostics and Functional Image-Guided Radiation Therapy for Precision Oncology
Question 1: The optimal FDG PET/CT imaging window for assessing response and adapting chemoradiotherapy of locally advanced lung cancer is:
Reference:Bissonnette JP, Yap ML, Clarke K et al. Serial 4DCT/4DPET imaging to predict and monitor response for locally-advanced non-small cell lung cancer chemo-radiotherapy. Radiother Oncol. 2018 Feb;126(2):347-354. doi: 10.1016/j.radonc.2017.11.023.
Choice A:Baseline
Choice B:< 2 weeks
Choice C:2-4 weeks
Choice D:> 4 weeks
Question 2: Dose painting by numbers (DPBN) differs from conventional dose painting in radiation oncology by:
Reference:Bentzen SM. Theragnostic imaging for radiation oncology: dose-painting by numbers. Lancet Oncol. 2005 Feb;6(2):112-7.
Choice A:Defining uniform dose to anatomic target volumes
Choice B:Defining uniform dose to functional / biological target volumes
Choice C:Defining non-uniform dose scaled by normal tissue voxel function
Choice D:Defining non-uniform dose scaled by target voxel biological disease burden / radiation resistance
Question 3: The physical property of 90Y that makes it well suited for radioembolization is that 90Y is a pure beta- emitter with a maximum energy of 2.28 MeV corresponding to:
Reference:Sarfaraz M, Kennedy AS, Lodge MA, Li XA, Wu X, Yu CX. Radiation absorbed dose distribution in a patient treated with yttrium-90 microspheres for hepatocellular carcinoma. Medical Physics 31(9):2449-2453, 2004.
Choice A:maximum tissue penetration depth of ~0.1 mm
Choice B:maximum tissue penetration depth of ~1 mm
Choice C:maximum tissue penetration depth of ~10 mm
Choice D:maximum tissue penetration depth of ~100 mm
Question 4: All else being the same, the estimate of radiation absorbed dose delivered to tumor and normal liver depends upon the dosimetry model used to compute it:
Reference:Mikell JK, Mahvash A, Siman W et al. Selective internal radiation therapy with 90Y glass microspheres: biases and uncertainties in absorbed dose calculations between clinical dosimetry models. Int J Radiat Oncol Biol Phys 96(4):888-896, 2016.
Choice A:True
Choice B:False
Question 5: In radioiodine therapy of thyroid cancer, the maximum tolerated radiation dose to the blood is:
Reference:Benua RS, Cicale NR, Sonenberg M, Rawson RW. The relation of radioiodine dosimetry to results and complications in the treatment of metastatic thyroid cancer. American Journal of Roentgenology, Radium Therapy, and Nuclear Medicine, 87 171-182. 1962
Choice A:0.5 Gy
Choice B:1 Gy
Choice C:2 Gy
Choice D:5 Gy
Question 6: What is the major advantage of peptides over antibodies for delivering radionuclide therapy:
Reference:Institute of Medicine and National Research Council. 2007. Advancing Nuclear Medicine Through Innovation. "Chapter 4 Targeted Radionuclide Therapy", Washington, DC: The National Academies Press. https://doi.org/10.17226/11985.
Choice A:Peptides exhibit higher tumor specificity
Choice B:Peptides have more favorable targeting kinetics
Choice C:Peptides are more flexible for labeling with more radionuclides
Choice D:Peptides give higher doses to tumors per administered activity
Question 7: At the steep part of the dose-response curve, the increase in local control after a 1% increase in radiation therapy dose to head-and-neck cancers is:
Reference:Bentzen SM. Radiation dose-response relationships, pp. In: Basic Clinical Radiobiology, 5th Edition. MC Joiner and AJ van der Kogel, CRC Press, 2018. ISBN 9781444179637
Choice A:About 1%
Choice B:About 10%
Choice C:About 0.2%
Choice D:About 2%
Question 8: Local failure in head-and-neck cancers after complete tumor response occurs mainly in:
Reference:Vogelius IR, Hakansson K, Due AK, Aznar MC, Berthelsen AK, Kristensen CA, Rasmussen J, Specht L, Bentzen SM. Failure-probability driven dose painting. Med Phys. 2013 Aug;40(8):081717. doi: 10.1118/1.4816308.
Choice A:Outside the high-dose volume
Choice B:Anywhere in the clinical target volume
Choice C:In the volume with high FDG PET avidity
Choice D:In FDG PET “cold” parts of the GTV
Question 9: FET-PET scans can:
Reference:Law, I., et al., Joint EANM/EANO/RANO practice guidelines/SNMMI procedure standards for imaging of gliomas using PET with radiolabelled amino acids and [18F]FDG: version 1.0. European Journal of Nuclear Medicine and Molecular Imaging, 2019. 46(3): p. 540-557.
Choice A:exhibit low tumor-to-background uptake in the brain
Choice B:be used to identify aggressive portions of a brain tumor
Choice C:distinguish between tumor recurrence and radionecrosis
Choice D:all of the above
Choice E:both b and c
Question 10: Studies show that using 18F-DOPA PET imaging, in addition to conventional MR imaging:
Reference:Kazda, T., Pafundi, D., et al., Dosimetric impact of amino acid positron emission tomography imaging for target delineation in radiation treatment planning for high-grade gliomas. Physics and Imaging in Radiation Oncology, 2018. 6: p. 94-100.
Choice A:significantly increases the tumor volume in contrast-enhancing high grade gliomas
Choice B:significantly decreases the 60 Gy volume in non-contrast-enhancing high grade gliomas
Choice C:does not lead to significant increases in radiation dose to critical structures
Choice D:all of the above
Choice E:both a and b
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