2020 Joint AAPM | COMP Virtual Meeting
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Session Title: End to End (E2E) Testing in Radiation Therapy
Question 1: A major objective of E2E QA is to:
Reference:Schreiner LJ. End to End QA in Image Guided and Adaptive Radiation Therapy. J.Phys.: Conf. Ser. 1305 012062 (5pp), 2019. doi:10.1088/1742‐6596/1305/1/012062
Choice A:Make treatment unit commissioning more efficient
Choice B:Provide modelling data for treatment planning system commissioning
Choice C:Establish a methodology that tests whether all components in the treatment process function as intended
Choice D:Improve primary beam calibration
Question 2: Which two statements below correctly report observations from IROC phantom based E2E testing?
Reference:Followill DS, Clark CH, and Kron T Audits using end‐to‐end tests. 2018 In Clinical 3D Dosimetry in Modern RadiationTherapy Mijnheer B (ed) Boca Raton: CRC Press. Kry SF, Molineu A, Kerns JR, et al. Institutional patient‐specific IMRT QA does not predict unacceptable plan delivery. Int J Radiat Oncol Biol Phys. 2014;90(5):1195‐1201. doi:10.1016/j.ijrobp.2014.08.334
Choice A:Over the years the pass rate for IROC phantom tests has remained constant with ~75% of deliveries passing within acceptance criteria
Choice B:Not all treatment planning algorithms have given the correct heterogeneity corrections when used for lung RT planning
Choice C:More than 125 of the ~540 institutions that delivered radiation to an IROC E2E test phantom failed the delivery criteria on their first attempt
Choice D:IROC E2E test outcomes are well predicted by In‐house patient specific QA results
Choice E:all of the above are true
Choice F:b and c are true
Question 3: An in-house E2E program designed to test all components of a specific image guided adaptive radiation therapy protocol should involve:
Reference:Schreiner LJ. End to End QA in Image Guided and Adaptive Radiation Therapy. J. Phys.: Conf. Ser. 1305 012062 (5pp), 2019. doi:10.1088/1742‐6596/1305/1/012062
Choice A:The complete treatment team including planning therapists, dosimetrists, treatment therapists, medical physicists and radiation oncologists
Choice B:Only medical physicists as they have the expertise to prepare the phantoms and dosimeters therein
Choice C:Only therapists as they implement the many steps in the treatment process
Choice D:Individuals from an external practice to ensure tests are unbiased
Question 4: Which of the statements below is false:
Reference:Schreiner LJ. End to End QA in Image Guided and Adaptive Radiation Therapy. J. Phys.: Conf. Ser. 1305 012062 (5pp), 2019. doi:10.1088/1742-6596/1305/1/012062 Followill DS, Clark CH, and Kron T Audits using end-to-end tests. 2018 In Clinical 3D Dosimetry in Modern RadiationTherapy Mijnheer B (ed) Boca Raton: CRC Press
Choice A:E2E testing cannot fully replace conventional physics QA since hardware and technical systems must be maintained to high standards a priori
Choice B:A full understanding of the technical functioning of equipment, supported by well-established QA records, is needed to specify point of breakdown if E2E testing fails
Choice C:Regular (quarterly, bi-annually, etc.) performance of E2E QA would ensure sustained adherence to the process protocols at the high levels adopted in the initial commissioning and implementation of advanced IGART techniques
Choice D:It is not possible to obtain phantoms suitable for valid E2E testing of realistic dose deliveries
Question 5: What is the main advantage to verifying isocenter accuracy using a 3D dosimeter which can be read out by on-board KV-CBCT ?
Reference:Pant K, Umeh C, Oldham M, Floyd S, Giles W, Adamson J. Comprehensive radiation and imaging isocenter verification using NIPAM kV‐CBCT dosimetry. Medical Physics, 2020, 47(3), 927-936. doi: 10.1002/mp.14008. Epub 2020 Jan 28.
Choice A:Higher spatial resolution
Choice B:Can quantify the coincidence of both imaging and treatment isocenters
Choice C:Shorter measurement time
Question 6: When would 3D verification of isocenter accuracy be most appropriate ?
Reference:Pant K, Umeh C, Oldham M, Floyd S, Giles W, Adamson J. Comprehensive radiation and imaging isocenter verification using NIPAM kV‐CBCT dosimetry. Medical Physics, 2020, 47(3), 927-936. doi: 10.1002/mp.14008. Epub 2020 Jan 28
Choice A:Commissioning of a linac
Choice B:Commissioning of a new radiosurgery technique
Choice C:Routine pre-treatment patient QA
Choice D:Both a and b
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