| Question 1: Uncertainties in dose calculation due to the frameless immobilization device will be largest for which technique? |
| Reference: | Snyder KC, Xhaferllari I, Huang Y, Siddiqui MS, Chetty IJ, Wen N. Evaluation and verification of the QFix EncompassTM couch insert for intracranial stereotactic radiosurgery. J Appl. Clin. Med. Phys. 2018; 19(4):222�229. |
| Choice A: | 3D using 5 beams |
| Choice B: | IMRT using 11 beams |
| Choice C: | Dynamic conformal arc using 5 arcs |
| Choice D: | VMAT using 3 arcs |
| Choice E: | All techniques have equal uncertainty |
| Question 2: When comparing VMAT plan quality for 2.5 mm and 5 mm MLC leaf widths, the 2.5 mm leaf width has: |
| Reference: | Serna A, Puchades V, Mata F, Ramos D, Alcaraz M. Influence of multi-leaf collimator leaf width in radiosurgery via volumetric modulated arc therapy and 3D dynamic conformal arc therapy. Phys. Med. 2015 May; 31(3):293-6. |
| Choice A: | no difference from the 5 mm leaf width |
| Choice B: | better conformity index, same gradient index |
| Choice C: | same conformity index, better gradient index |
| Choice D: | better conformity index, better gradient index |
| Choice E: | better conformity index, worse gradient index |
| Question 3: Complete the following sentence: Multiple SRS targets can be treated with a single isocenter to the same accuracy if… |
| Reference: | JF Calvo-Ortega, M Pozo, S Moragues, and J Casal, “Targeting accuracy of single-isocenter intensity modulated radiosurgery for multiple lesionsâ€, Med. Dosim. 42, 104-110 (2017). |
| Choice A: | a 6 degrees of freedom couch is used |
| Choice B: | the targets are within a defined distance from each other |
| Choice C: | end to end testing has been used to validate the accuracy |
| Choice D: | all of the above |
| Question 4: Complete the following sentence in regards to end to end testing: When commissioning frameless SRS techniques, end to end testing… |
| Reference: | PH Halvorsen, E Cirino, IJ Das, JA Garrett, J Yang, FF Yin and LA Fairobent, “AAPM-RSS Medical Physics Practice Guideline 9.a. for SRS-SBRT†J. Appl. Clin. Med. Phys. 18, 10-21 (2017). |
| Choice A: | is not required as all system components have already been fully commissioned |
| Choice B: | is only required if tertiary collimation is used |
| Choice C: | is not needed if patient specific QA is performed |
| Choice D: | is required as part of the validation for the entire standard operating procedure for SRS |
| Question 5: Which of the following is NOT true for Cyberknife in delivering radiosurgery: |
| Reference: | Physics Essential Guide, Accuray, Inc., 2013 |
| Choice A: | Capable of non-planar radiation delivery |
| Choice B: | Can only treat one target in one path |
| Choice C: | Capable of isocentric and non-isocentric beam |
| Choice D: | Capable of both tracking and correction of target’s motion |
| Question 6: Which of the following conditions would be safely treated using frameless immobilization with the ICON? |
| Reference: | A. Carminucci, K. Nie, J. Weiner, E. Hargreaves, and S. Danish, “Assessment of motion error for frame-based and noninvasive mask-based fixation using the Leksell Gamma Knife Icon radiosurgery systemâ€, J Neurosurg (Suppl). 129: 133-139 (2018). |
| Choice A: | Trigeminal neuralgia |
| Choice B: | Essential tremor |
| Choice C: | Large post-op cavity |
| Choice D: | Small acoustic neuroma |
