| Question 1: "In regard to the beam-specific PTV (bsPTV) used in PBS treatment planning, which of the following is TRUE?" |
| Reference: | Park PC, Zhu XR, Lee AK, et al., A beam-specific planning target volume (PTV) design for proton therapy to account for setup and range uncertainties, Int J Radiat Oncol Biol Phys. 2012 Feb 1; 82(2): e329-36. |
| Choice A: | Is dependent on patient setup and internal motion uncertainties and proton range uncertainty |
| Choice B: | Varies with beam angle and the local density of anatomical objects in the patient |
| Choice C: | Varies with beam angle and the local density of anatomical objects in the patient |
| Choice D: | All of the above |
| Question 2: Regarding the current clinical practice of relative biological effectiveness (RBE) of proton beams, which of the following statement is correct: |
| Reference: | H Paganetti, et al., Report of the AAPM TG-256 on the relative biological effectiveness of proton beams in radiation therapy, Med. Phys. 46(3), March 2019, e53-78 |
| Choice A: | Dose-averaged linear energy transfer (LETd) distribution could be minimized in critical structures to improve the therapeutic ratio using IMPT |
| Choice B: | The RBE varies with the proton beam depth and the end point, therefore the use of a constant RBE =1.1 shouldn’t be maintained in current clinical practice |
| Choice C: | The RBE variability is the same for pencil beam scanning technique and the passive scattered beam delivery |
| Question 3: Which of the following mitigation methods to reduce motion interplay has NOT been implemented with pencil beam scanning proton therapy? |
| Reference: | The Report of AAPM Task Group 202, Physical Uncertainties in the Planning and Delivery of Light Ion Beam Treatments, March 2020 |
| Choice A: | Breath hold and beam gating |
| Choice B: | 4D CT scan and compression belt |
| Choice C: | Motion tracking |
| Choice D: | Beam rescanning |
| Question 4: Based on TG-224 recommendations, for which conditions should the daily output constancy be checked? |
| Reference: | AAPM task group 224: Comprehensive proton therapy machine quality assurance” Arjomandy, et al. Med. Phys. 46 (8), 2019 |
| Choice A: | Different ranges on different days |
| Choice B: | One energy |
| Choice C: | Every available energies |
| Choice D: | Should be checked monthly |
| Question 5: Which protocol should be used for the standard output calibration of proton beam scanning systems? |
| Reference: | AAPM task group 224: Comprehensive proton therapy machine quality assurance” Arjomandy, et al. Med. Phys. 46 (8), 2019
IAEA TRS-398: Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water” International Atomic Energy Agency, 12, 2006 |
| Choice A: | AAPM TG-51 |
| Choice B: | AAPM TG-224 |
| Choice C: | IAEA TRS-398 |
| Choice D: | All of above |
| Question 6: Which ion chamber should be used for reference dosimetry of proton beams with qualities at the reference depth Rres < 0.5 g.cm-2? |
| Reference: | IAEA TRS-398: Absorbed Dose Determination in External Beam Radiotherapy: An International Code of Practice for Dosimetry based on Standards of Absorbed Dose to Water” International Atomic Energy Agency, 12, 2006 |
| Choice A: | Plane-parallel ion chambers |
| Choice B: | Farmer type ion chambers |
| Choice C: | Pinpoint ion chambers |
| Choice D: | Large-area ion chambers (such as a Bragg peak chamber) |
