| Question 1: Can a photon knowledge-based planning model, created from photon therapy, be used directly for proton therapy planning? – Select the best answer from the following: |
| Reference: | (1) Kalet, Alan M., Samuel MH Luk, and Mark H. Phillips. "Quality assurance tasks and tools: The many roles of machine learning." Medical physics (2019); (2) Delaney, Alexander R., Lei Dong, Anthony Mascia, Wei Zou, Yongbin Zhang, Lingshu Yin, Sara Rosas et al. "Automated knowledge-based intensity-modulated proton planning: an international multicenter benchmarking study." Cancers 10, no. 11 (2018): 420. |
| Choice A: | Yes, photon beams have a similar lateral penumbra as proton beams |
| Choice B: | Yes, the target dose coverage is the same for both photon and proton plans |
| Choice C: | No, proton beam has the Bragg Peak, you will get a completely wrong plan. |
| Choice D: | No, it would be better to use proton plans to train and create knowledge-based plans specifically for proton planning. |
| Question 2: What is the biggest challenge for applying AI in proton therapy? |
| Reference: | : (1) Ford, Eric, Leigh Conroy, Lei Dong, Luis Fong de Los Santos, Anne Greener, Grace Gwe‐Ya Kim, Jennifer Johnson et al. "Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275." Medical Physics (2020). (2) Paganetti, Harald. "Range uncertainties in proton therapy and the role of Monte Carlo simulations." Physics in Medicine & Biology 57, no. 11 (2012): R99. |
| Choice A: | Lack of standard practice and beam delivery techniques |
| Choice B: | Lack of knowledge of failure modes in QA |
| Choice C: | Lack of motivation to improve the workflow |
| Choice D: | Too many uncertainties to predict accurate results |
| Question 3: In terms of dose delivery, what are the challenges for the development of small animal irradiators at clinical proton therapy centers? |
| Reference: | Parodi et al, Acta Oncol. 2019 Oct;58(10):1470-1475. doi: 10.1080/0284186X.2019.1630752
Kim et al, Phys Med Biol. 2019 Jul 4;64(13):135013. doi: 10.1088/1361-6560/ab20d9 |
| Choice A: | There are no challenges specific to proton beams, and commercial small animal proton irradiators are already widely integrated at clinical facilities |
| Choice B: | The major challenge is the reduction of the beam energy and size, maintaining good dosimetric quality and beam intensity |
| Choice C: | It is not possible to perform small animal irradiation starting from a clinical proton beam |
| Choice D: | Small animal proton irradiation can only be performed at clinical facilities supporting pencil beam scanning delivery |
| Question 4: What are the unique demands for integrating image guidance on a proton irradiator? |
| Reference: | Parodi et al, Acta Oncol. 2019 Oct;58(10):1470-1475. doi: 10.1080/0284186X.2019.1630752 |
| Choice A: | There are no special demands, since the imaging requirements for proton irradiators are exactly the same as for X-ray irradiators |
| Choice B: | Accurate placement of the Bragg peak in the small animal requires pre-treatment imaging providing not only morphology but also stopping power ratio information (eg. dual-energy CT, proton CT) |
| Choice C: | Accurate placement of the Bragg peak in the small animal requires possibilities of range verification during/shortly after irradiation, e.g., based on the detection of secondary emissions (e.g., positron emission tomography imaging of the activated tissue) |
| Choice D: | Given the ballistic precision of proton beams and the accuracy of the available beam delivery systems and robotic positioners, no imaging is needed for accurate small animal proton irradiation |
| Choice E: | b and c |
| Question 5: According to Karger et al, how does the RBE of the rat spinal cord change as a function of the number of fractions for the Plateau portion (low LET) of the carbon Bragg curve? |
| Reference: | Christian P. Karger, Peter Peschke, Rita Sanchez-Brandelik, Michael Scholz, Jürgen Debus,
Radiation tolerance of the rat spinal cord after 6 and 18 fractions of photons and carbon ions: Experimental results and clinical implications, International Journal of Radiation Oncology*Biology*Physics, Volume 66, Issue 5, 2006, Pages 1488-1497, ISSN 0360-3016,
https://doi.org/10.1016/j.ijrobp.2006.08.045. |
| Choice A: | The RBE decreases as the number of fractions increase |
| Choice B: | The RBE does not change with fractionation |
| Choice C: | The RBE increases as the number of fractions increase |
| Choice D: | None of the above |
| Question 6: According to Karger et al, how does the RBE of the rat spinal cord change as a function of the number of fractions for the Peak portion (high LET) of the carbon Bragg curve? |
| Reference: | Christian P. Karger, Peter Peschke, Rita Sanchez-Brandelik, Michael Scholz, Jürgen Debus,
Radiation tolerance of the rat spinal cord after 6 and 18 fractions of photons and carbon ions: Experimental results and clinical implications, International Journal of Radiation Oncology*Biology*Physics, Volume 66, Issue 5, 2006, Pages 1488-1497, ISSN 0360-3016,
https://doi.org/10.1016/j.ijrobp.2006.08.045. |
| Choice A: | The RBE decreases as the number of fractions increase |
| Choice B: | The RBE does not change with fractionation |
| Choice C: | The RBE increases as the number of fractions increase |
| Choice D: | None of the above |
