| Question 1: 1. Which of these techniques can be used to account for target deformation? |
| Reference: | Ge et. al. Real-time tumor deformation tracking using dynamic multileaf collimator (DMLC). International Journal of Radiation Oncology•Biology•Physics 84.3 (2012): S83. |
| Choice A: | Beam gating |
| Choice B: | Patient re-positioning |
| Choice C: | Couch tracking |
| Choice D: | MLC tracking |
| Question 2: What is the largest source of latency for MLC tracking on MRI-Linacs? |
| Reference: | Liu et. al. First experimental investigation of simultaneously tracking two independently moving targets on an MRI-linac using real-time MRI and MLC tracking. Medical Physics 47.12 (2020): 6440-6449. |
| Choice A: | Target localization |
| Choice B: | MRI acquisition and reconstruction |
| Choice C: | MLC leaf travel time |
| Choice D: | Calculation of MLC leaf positions |
| Question 3: How does MR fingerprinting differ from conventional quantitative imaging methods? |
| Reference: | Ma et. al. Magnetic resonance fingerprinting. Nature 495 (2013): 187-192. |
| Choice A: | Imaging data are acquired in the steady state with MRF. |
| Choice B: | k-space data are collected on a uniform Cartesian grid. |
| Choice C: | Quantitative maps are generated by matching measured signals with a dictionary of known signals. |
| Choice D: | MRF has longer scan times than conventional quantitative imaging. |
| Question 4: What are the benefits to the patient when using MRF over conventional quantitative imaging? |
| Reference: | Ma et. al. Music-based magnetic resonance fingerprinting to improve patient comfort during MRI examinations. 75.6 (2016): 2303-2314.
Ma et. al. Fast 3D magnetic resonance fingerprinting for a whole-brain coverage. 79.4 (2018): 2190-2197. |
| Choice A: | Shorter scan times |
| Choice B: | Less intrusive scan acoustics |
| Choice C: | Robust and repeatable measures give clinicians confidence in the quantitative imaging metrics for more accurate diagnoses. |
| Choice D: | All of the above |
| Question 5: What is the dominant variable impacting quantitative MRI accuracy at low-field? |
| Reference: | Marques et. al. Low-Field MRI: An MR Physics Perspective. Journal of Magnetic Resonance in Medicine 49 (2019): 1528-1542. |
| Choice A: | Magnetic field homogeneity |
| Choice B: | Signal-to-noise ratio (SNR) |
| Choice C: | Spatial distortions |
| Choice D: | Differences in T1 and T2 times compared with high-field MRI |
| Question 6: How can quantitative imaging accuracy be improved at low field? |
| Reference: | Tamir et. al. T2 Shuffling: Sharp, multicontrast, volumetric fast spin echo imaging. Magnetic Resonance in Medicine 77 (2017): 180-195. |
| Choice A: | Using constrained image reconstruction methods |
| Choice B: | Using a volumetric RF coil instead of surface RF coils |
| Choice C: | Maximizing readout bandwidth to minimize scan time |
| Choice D: | Using high parallel imaging acceleration factors |
| Question 7: One of the primary contributors to therapeutic resistance in patients with glioblastoma is: |
| Reference: | Qazi MA et al. Intratumoral heterogeneity: pathways to treatment resistance and relapse in human glioblastoma. Ann Oncol 2017; 28(7):1448-56. |
| Choice A: | Radio- and chemo-sensitivity |
| Choice B: | A predominant pattern of distant failure after chemoradiation |
| Choice C: | Tumor heterogeneity |
| Choice D: | A prolonged natural history and average survival |
| Question 8: Standard radiotherapy treatment planning for glioblastoma includes all of the following except: |
| Reference: | Wernicke AG et al. Glioblastoma: Radiation treatment margins, how small is large enough? Pract Radiat Oncol 2016; 6(5):298-305.Stupp R et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352:987-996. |
| Choice A: | Target delineation using T1-weighted contrast enhanced and T2-FLAIR MRI |
| Choice B: | Patient-specific treatment adaptation using advanced imaging techniques |
| Choice C: | Uniform, anatomically constrained 2-3 cm expansions for volume delineation |
| Choice D: | A standard prescribed dose of 60 Gy in 30 fractions |
| Question 9: Which of the following are sources of variability in quantitative MRI? |
| Reference: | Shukla-Dave et. al. Quantitative imaging biomarkers alliance (QIBA) recommendations for improved precision of DWI and DCE-MRI derived biomarkers in multicenter oncology trials. Journal of Magnetic Resonance Imaging 49.7 (2019): e101-e121. |
| Choice A: | Pulse sequence implementation. |
| Choice B: | Data post processing implementation. |
| Choice C: | Scanner instability over time. |
| Choice D: | All of the above. |
| Question 10: What is the purpose of standards in quantitative MRI? |
| Reference: | https://www.rsna.org/research/quantitative-imaging-biomarkers-alliance |
| Choice A: | Standardized methods can create biomarkers that meet a claimed performance. |
| Choice B: | They encourage each vendor and research group to use their own preferred methods. |
| Choice C: | Standards provide guidance to patients to ensure that they conform to protocols. |
| Choice D: | They improve the comfort of the patient in the scanner. |
