| Question 1: Molecular Imaging Guided Interventions are understood as being facilitated by |
| Reference: | Munley, T.M. , Kagadis, G.C., McGee K.P., Kirov, A.S. , Jang, S., Mutic, S. Jeraj, R., Xing, L, “An introduction to molecular imaging in radiation oncology: A report by the AAPM Working Group on Molecular Imaging in Radiation Oncology (WGMIR)”, Med. Phys., 40, 101501 (2013); doi: 10.1118/1.4819818 |
| Choice A: | Contrast enhanced X-Ray Computed Tomography (CT) Images |
| Choice B: | Ultrasound (US) or Magnetic Resonance (MR) Images without contrast |
| Choice C: | Positron Emission Tomography (PET), Single Photon Emission Computed tomography (SPECT), Fluorescence, US and/or MR Images using a targeted tracer |
| Choice D: | Fluorescence, US and/or MR Images of a physiological tracer |
| Question 2: Which parameter of an image guided procedure is most critical for the realization of radical resections? |
| Reference: | Meershoek P, Buckle T, van Oosterom MN, KleinJan GH, van der Poel HG, van Leeuwen F (2019) Can fluorescence-guided surgery help identify all lesions in unknown locations or is the integrated use of a roadmap created by preoperative imaging mandatory? A blinded study in prostate cancer patients. J Nucl Med; doi: 10.2967/jnumed.119.235234 |
| Choice A: | Ability to plan the procedure based on preoperative 3D imaging roadmaps that display targets within their anatomical context (imaging modalities used suffer from limited signal attenuation by tissue, e.g. SPECT, PET, CT or MR ) |
| Choice B: | Ability to provide real-time visual target delineation in the surgical wound (imaging signals used e.g. fluorescence or ultrasound suffer from signal attenuation by tissue) |
| Choice C: | Ability to use “GPS-like” navigation (in combination with virtual and/or augmented reality displays) to guide the surgical instruments in the human body |
| Choice D: | Back table confirmation (in the OR) of tracer presence in resected tissue |
| Question 3: Within the field of surgical guidance there always is a debate on the role of sensitivity (as much signal as possible) vs. specificity (only signal in the relevant tissues). Acknowledging there should always be an interplay between sensitivity and specificity, which of the below properties is most important to pursue when trying to develop a technique for minimally invasive surgery? |
| Reference: | Frangioni JV (2009) The problem is background, not signal. Mol Imaging, 8[6], 303-304; PMID 20003888 |
| Choice A: | A high sensitivity - enables resection of more lesions reduces the chance of false negatives, but increases the chance of false positives. |
| Choice B: | A low sensitivity - enables resection of less lesions, reduces the chance of false positives, but increases the chance of false negatives. |
| Choice C: | A high specificity - improves signal to background ratio’s and reduces the chance of false negatives and positives. |
| Choice D: | A low specificity - reduces the signal to background ratios and increases the chance of false negatives and positives. |
| Question 4: Real-time PET/CT guidance of interventional procedures |
| Reference: | Shyn PB (2013) Interventional Positron Emission Tomography/Computed Tomography: State-of-the-Art. Techniques in Vascular and Interventional Radiology, 16[3], 182-190; doi: 10.1053/j.tvir.2013.02.014
Solomon SB, Cornelis F (2016) Interventional Molecular Imaging. J Nucl Med, 57[4], 493-496; doi: 10.2967/jnumed.115.161190 |
| Choice A: | Does not require facilities enabled for anesthesia |
| Choice B: | May use scanners with any diameter bore |
| Choice C: | Allows to see and intervene on tumors not seen in anatomical images |
| Choice D: | Can’t use fusion of the initial PET with a later CT with the needle in place |
| Question 5: Potential problems of intra-procedural PET/CT guidance of interventions are |
| Reference: | Ryan ER, Thornton R, Sofocleous CT, Erinjeri JP, Hsu M, Quinn B, Dauer LT, Solomon SB (2013) PET/CT-guided interventions: personnel radiation dose. Cardiovasc Intervent Radiol, 36[4], 1063-1067; doi: 10.1007/s00270-012-0515-9
Solomon SB, Cornelis F (2016) Interventional Molecular Imaging. J Nucl Med, 57[4], 493-496; doi: 10.2967/jnumed.115.161190 |
| Choice A: | Higher injected activities |
| Choice B: | Typical personnel doses are high and may limit the number of procedures |
| Choice C: | Patient or organ motion between the PET and the CT after needle insertion |
| Choice D: | Uptake times significantly different from 60 min |
| Question 6: Performing autoradiography of the radioactive biopsy specimens has potential to provide |
| Reference: | Fanchon LM, Dogan S, Moreira AL, Carlin SA, Schmidtlein CR, Yorke E, Apte AP, Burger IA, Durack JC, Erinjeri JP, Maybody M, Schöder H, Siegelbaum RH, Sofocleous CT, Deasy JO, Solomon SB, Humm JL, Kirov AS (2015) Feasibility of in situ, high-resolution correlation of tracer uptake with histopathology by quantitative autoradiography of biopsy specimens obtained under 18F-FDG PET/CT guidance. J Nucl Med, 56[4], 538-544; doi: 10.2967/jnumed.114.148668 |
| Choice A: | The distribution of activity along the specimen. |
| Choice B: | Information if the needle was correctly placed in the lesion |
| Choice C: | High-resolution validation of new PET radiopharmaceuticals |
| Choice D: | All of the above |
| Question 7: [18F]FDG-PET is NOT commonly used in radiation therapy for: |
| Reference: | Das SK, McGurk R, Miften M, Mutic S, Bowsher J, Bayouth J, Erdi Y, Mawlawi O, Boellaard R, Bowen SR, Xing L, Bradley J, Schoder H, Yin F-F, Sullivan DC, Kinahan P (2019) Task Group 174 Report: Utilization of 18 FFluorodeoxyglucose Positron Emission Tomography (18 FFDG-PET) in Radiation Therapy. Med Phys, 46[10], e706-e725; doi: 10.1002/mp.13676 |
| Choice A: | Organ Segmentation |
| Choice B: | Staging |
| Choice C: | Tumor Segmentation |
| Choice D: | Treatment planning |
| Question 8: The parameter that does NOT influence FDG-PET patient uptake distribution is: |
| Reference: | Das SK, McGurk R, Miften M, Mutic S, Bowsher J, Bayouth J, Erdi Y, Mawlawi O, Boellaard R, Bowen SR, Xing L, Bradley J, Schoder H, Yin F-F, Sullivan DC, Kinahan P (2019) Task Group 174 Report: Utilization of 18 FFluorodeoxyglucose Positron Emission Tomography (18 FFDG-PET) in Radiation Therapy. Med Phys, 46[10], e706-e725; doi: 10.1002/mp.13676 |
| Choice A: | Physical activity during the uptake phase |
| Choice B: | Fasting pattern consumption of food/drinks containing carbon hydrates |
| Choice C: | Ethnicity of patient |
| Choice D: | Duration between administration of tracer and PET imaging |
| Question 9: [18F]FDG-PET will map the following biological function during and after thermal treatment: |
| Reference: | Mihcin S, Melzer A (2018) Principles of focused ultrasound. Minim Invasive Ther Allied Technol, 27[1], 41-50; doi: 10.1080/13645706.2017.1414063 |
| Choice A: | Proliferation |
| Choice B: | Glucose Metabolism |
| Choice C: | Blood flow |
| Choice D: | Oxygenation (Hypoxia) |
| Question 10: The effect of energy transfer to the cells and drug carriers by focused ultrasound entails: |
| Reference: | Gourevich D, Dogadkin O, Volovick A, Wang L, Gnaim J, Cochran S, Melzer A (2013) Ultrasound-mediated targeted drug delivery with a novel cyclodextrin-based drug carrier by mechanical and thermal mechanisms. J Control Release, 170[3], 316-324; doi: 10.1016/j.jconrel.2013.05.038 |
| Choice A: | Opening of the cell and liposome membrane in the focus by heating and mechanical effects |
| Choice B: | No changes of the drug carrier |
| Choice C: | DNA alterations (Mutations) in/of the cells in focus |
| Choice D: | No alteration of the cell membrane |
