2020 Joint AAPM | COMP Virtual Meeting
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Session Title: GYN Brachytherapy Applicators
Question 1: Which of the following modalities is considered the gold standard for the imaging of gynecologic cancers?
Reference:International Commission on Radiation Units and Measurements. (2016). ICRU Report 89: Prescribing, recording, and reporting brachytherapy for cancer of the cervix. Journal of the ICRU, 13.
Choice A:CT
Choice B:US
Choice C:Planar Image
Choice D:PET
Choice E:MRI
Question 2: A variety of HDR applicators are needed for the treatment of gynecologic cancers. Which of the following applicators is not considered a standard tool for this treatment?
Reference:Viswanathan, A., & Thomadsen, B. (2012). American Brachytherapy Society consensus guidelines for locally advanced carcinoma of the cervix. Part I: General principles. Brachytherapy, 11(1), 33-46.
Choice A:Tandem and ovoid
Choice B:Tandem and Ring
Choice C:Leipzig Applicator
Choice D:Interstitial Applicator
Question 3: The most common applicator used in vaginal cuff brachytherapy is:
Reference:Damato, A., et al. (2017). Brachytherapy for gynecological malignancies. In M. Rivard, L. Beaulieu, & B. Thomadsen (Eds), Clinical Brachytherapy Physics (pp. 225-256). Medical Physics Publishing.
Choice A:Tandem & Ovoid
Choice B:Vaginal Cylinder
Choice C:Tandem & Ring
Choice D:Interstitial Applicator
Question 4: The total treatment time (external beam + brachytherapy) in cervical cancer patients should be limited to avoid decreased local control and survival. What is the maximum recommended total treatment duration?
Reference:Girinsky, T., et al. (1993). Overall treatment time in advanced cervical carcinomas: A critical parameter in treatment outcome. International Journal of Radiation Oncology, Biology, Physics, 27(5), 1051-1056.
Choice A:45 days
Choice B:80 days
Choice C:70 days
Choice D:52 days
Question 5: Dose escalation for cervical cancer via SBRT/IMRT shows no difference in overall survival when compared to brachytherapy.
Reference:Gill, B., et al. (2014). National cancer data base analysis of radiation therapy consolidation modality for cervical cancer: The impact of new technological advancements. International Journal of Radiation Oncology, Biology, Physics, 90(5), 1083-1090
Choice A:True
Choice B:False
Question 6: What was the trend in brachytherpy utilization in the United States between 1988 and 2009?
Reference:Han, K., et al. (2013). Trends in the utilization of brachytherapy in cervical cancer in the United States. International Journal of Radiation Oncology, Biology, Physics, 87(1), 111-119
Choice A:Brachytherapy utilization decreased
Choice B:Brachytherapy utilization increased
Choice C:Brachytherapy utilization stayed the same
Question 7: The susceptibility distortions in MRI field strengths up to 3.0T are generally acceptable for brachytherapy applications
Reference:Dimopoulos, J., et al. (2012). Recommendations from Gynaecological (GYN) GEC-ESTRO working group (IV): Basic principles and parameters for MR imaging within the frame of image based adaptive cervix cancer brachytherapy. Radiotherapy and Oncology, 103(1), 113-122.
Choice A:True
Choice B:False
Question 8: Which of the following statements is true with regards to applicator reconstruction:
Reference:Hellebust, T., et al. (2010). Recommendations from Gynaecological (GYN) GEC-ESTRO working group: Considerations and pitflalls in commissioning and applicator reconstruction in 3D image-based treatment planning of cervix cancer brachytherapy. Radiotherapy and Oncology, 96(2), 153-60.
Choice A:Applicator reconstruction is more difficult on MRI images
Choice B:Applicator reconstruction is more difficult on CT images
Choice C:Applicator reconstruction is equally difficult on both CT and MRI images
Choice D:There is no known data on this
Question 9: Which of the following statements is/are true regarding point A:
Reference:International Commission on Radiation Units and Measurements. (2016). ICRU Report 89: Prescribing, recording, and reporting brachytherapy for cancer of the cervix. Journal of the ICRU, 13.
Choice A:Point A overestimates absorbed target dose for large tumors
Choice B:Point A underestimates absorbed target dose for small tumors
Choice C:Both a and b
Choice D:None of the above
Question 10: Based on the results of retroEMBRACE, the combination of intracavitary/interstitial treatment techniques over conventional intracavitary techniques has
Reference:Fokdal, L., et al. (2016). Image guided adaptive brachytherapy with combined intracavitary and interstitial technique improves the therapeutic ratio in locally advanced cervical cancer: Analysis from the retroEMBRACE study. Radiotherapy and Oncology, 120(3), 434-440.
Choice A:No effect at all on local control
Choice B:An increased probability of Local Control for tumors > 30 ccm
Choice C:Better tumor coverage with improved sparing of organs at risk
Choice D:Both b and C
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