| Question 1: What elements of MRI-guided radiation therapy enable assessment of tumor response during RT? |
| Reference: | Hunt A, Hansen VN, Oelfke U, Nill S, Hafeez S. Adaptive radiotherapy enabled by MRI guidance. Clinical Oncology. 2018 Nov 1;30(11):711-9.
Mittauer K, Paliwal B, Hill P, et al. A New Era of Image Guidance with Magnetic Resonance-guided Radiation Therapy for Abdominal and Thoracic Malignancies. Cureus. 2018;10(4):e2422. |
| Choice A: | Electron return effect |
| Choice B: | Minimal spatial distortion |
| Choice C: | Lack of patient immobilization requirement |
| Choice D: | Longitudinal imaging of soft tissue tumors with a high contrast-to-noise modality |
| Choice E: | Integrated treatment planning |
| Question 2: Tumor of which anatomic sites have shown significant shrinkage during RT: |
| Reference: | Musunuru H, Rosenberg S, Bayouth J, Mitteur K, Ritter M, Paliwal B, Witek M, Baschnagel A, Uboha N, Lubner S, Loconte N. PV-0322: Rapid Early Response of Gastroesophageal Junction Tumors During Real-time MRI-Guided Radiotherapy. Radiotherapy and Oncology. 2017 May 1;123:S168-9.
Musunuru HB, Rosenberg SA, Mittauer KE, Yadav P, Kuczmarska-Hass A, Uboha N, Deming DA, Bayouth J, Harari PM, Bassetti MF. Differential Response Rates of Gastrointestinal Tumors During Real-time MRI-Guided Radiation Therapy: Opportunities for Treatment Individualization. International Journal of Radiation Oncology• Biology• Physics. 2017 Oct 1;99(2):S194-5. |
| Choice A: | Gastrointestinal esophageal junction |
| Choice B: | Anal |
| Choice C: | Pancreas |
| Choice D: | Sarcomas |
| Question 3: What is one of the limitations for monitoring patient response to RT for lung cancer patients? |
| Reference: | Lim G, Bezjak A, Higgins J, Moseley D, Hope AJ, Sun A, Cho JBC, Brade AM, Ma C, Bissonnette J-P. Tumour Regression and Positional Changes in Non-Small Cell Lung Cancer During Radical Radiotherapy. J Thorac Oncol. 2011 Mar;6(3):531-6. |
| Choice A: | Pronounced motion blur |
| Choice B: | Hounsfield units are not accurate enough for quantitative analysis |
| Choice C: | Cannot be used quantitatively to assess nodal response |
| Choice D: | Is unreliable since tumor growth can be seen in some patients |
| Choice E: | Images are too noisy to analyze all patients |
| Question 4: Which of the following statements is false? |
| Reference: | MacManus M, Nestle U, Rosenzweig KE, Carrio I, Messa C, Belohlavek O, et al. Use of PET and PET/CT for radiation therapy planning: IAEA expert report 2006-2007. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2009;91:85-94. |
| Choice A: | FDG-18 is a specific marker of hypoxia |
| Choice B: | FDG-18 PET/CT imaging can identify responders from non-responders |
| Choice C: | Tumor subvolumes with high uptake are correlated with sites of recurrence |
| Choice D: | FDG-18 PET/CT imaging can help differentiate tumor from atalectasis |
| Choice E: | FDG-18 PET/CT imaging can guide adaptive radiotherapy |
| Question 5: A local ‘energy budget’ within a tumor implies that: |
| Reference: | Jeong J, Shoghi KI, Deasy JO. Modelling the interplay between hypoxia and proliferation in radiotherapy tumour response. Physics in Medicine & Biology. 2013 Jun 21;58(14):4897. |
| Choice A: | Mitosis and synthesis cannot occur at the same time. |
| Choice B: | Hypoxia and proliferation levels within a tumor voxel are related. |
| Choice C: | Only a given amount of proliferation can be supported in a given small tumor volume. |
| Choice D: | Hypoxia is limited. |
| Question 6: What elements of cone-beam guided radiation therapy images enable assessment of tumor response during RT? |
| Reference: | Zhao S, Mahon RN, Mukhopadhyay ND, Hugo GD, Weiss E. Changes in Radiomic Features During Radiation Therapy as Predictors for Outcome in Locally Advanced Non-Small Cell Lung Cancer. International Journal of Radiation Oncology• Biology• Physics. 2018 Nov 1;102(3):S71.
Leger S, Zwanenburg A, Pilz K, Zschaeck S, Zöphel K, Kotzerke J, Schreiber A, Zips D, Krause M, Baumann M, Troost EG. CT imaging during treatment improves radiomic models for patients with locally advanced head and neck cancer. Radiotherapy and Oncology. 2019 Jan 1;130:10-7. |
| Choice A: | Volumetric changes |
| Choice B: | Radiomic changes |
| Choice C: | FDG-PET changes |
| Choice D: | All of the above. |
