| Question 1: A survey was conducted amongst therapy medical physicists in the US in 2018. According to survey results, surface imaging is most commonly used for initial positioning and intrafraction monitoring of which one of the following treatment sites: |
| Reference: | Padilla L, Havnen-Smith A, Cerviño L, Al-Hallaq HA. A survey of surface imaging use in radiation oncology in the United States. J Appl Clin Med Phys. 2019;20(12):70-77. doi:10.1002/acm2.12762 |
| Choice A: | Lung (SBRT) |
| Choice B: | Brain (SRS) |
| Choice C: | Head and neck |
| Choice D: | Breast |
| Choice E: | Prostate |
| Question 2: In a proof-of-concept study, stereotactic body radiotherapy treatments for liver and lung tumors were performed under surface-guided deep Inspiration breathhold. This study found that: |
| Reference: | Naumann P, Batista V, Farnia B, et al. Feasibility of Optical Surface-Guidance for Position Verification and Monitoring of Stereotactic Body Radiotherapy in Deep-Inspiration Breath-Hold. Front Oncol. 2020;10:573279. doi:10.3389/fonc.2020.573279 |
| Choice A: | Lung targets have lower inter- and intrafraction variability than liver targets, indicating better surface-to-tumor correlation for lung targets |
| Choice B: | Liver targets have lower inter- and intrafraction variability than lung targets, indicating better surface-to-tumor correlation for liver targets |
| Choice C: | The use of CBCT is unnecessary beyond the first fraction due to minimal interfraction variability in the reference surface acquired under DIBH for these treatments |
| Choice D: | None of the above are correct |
| Question 3: The use of Styrofoam in phantoms for surface imaging QA might not always be adequate. However, the Styrofoam used in radiotherapy for the creation of block molds might be adequate because it is: |
| Reference: | “A monthly quality assurance procedure for 3D surface imaging”, Wooten et al., JACMP 2010 |
| Choice A: | black |
| Choice B: | smooth |
| Choice C: | flat |
| Choice D: | soft |
| Question 4: Which voluntary breathhold method has been shown to correlate best with the heart position and is also less prone to baseline shifts? |
| Reference: | Rong, Y., Walston, S., Welliver, M. X., Chakravarti, A., and Quick, A. M. (2014). “Improving intra-fractional target position accuracy using a 3D surface surrogate for left breast irradiation using the respiratory-gated deep-inspiration breath-hold technique.” PloS One 9(5):e97933.
Hughes, S., McClelland, J., Tarte, S., Lawrence, D., Ahmad, S., Hawkes, D., and Landau, D. (2009). “Assessment of two novel ventilatory surrogates for use in the delivery of gated/tracked radiotherapy for non-small cell lung cancer.” Radiother. Oncol. 91(3):336–341. |
| Choice A: | Surface imaging |
| Choice B: | Tracking surface markers (i.e., RPM) |
| Choice C: | Spirometer |
| Choice D: | None of the above |
| Question 5: Pan et al. reported on the use of SGRT-based SRS for treating intracranial metastases. What was their conclusion about SGRT-based SRS when compared to conventional frame-based and frameless stereotactic radiosurgery techniques? |
| Reference: | Pan et al Neurosurgery., Vol. 71, No. 4, pp. 844-852, 2012. |
| Choice A: | Clinical outcomes of SGRT-based SRS are inferior to those with conventional frame-based and frameless SRS |
| Choice B: | Clinical outcomes of SGRT-based SRS are comparable to those with conventional frame-based and frameless SRS |
| Choice C: | Clinical outcomes of SGRT-based SRS are superior to those with conventional frame-based and frameless SRS |
| Choice D: | More data is needed to determine whether or not clinical outcomes of SBRT-based SRS are comparable with conventional frame-based and frameless SRS |
| Choice E: | There was no conclusion from this work |
| Question 6: According to the FTA by Manger et al., the top SGRT-specific failure mode was, “the SGRT system fails to detect patient movement”. There were 7 basic causes leading to 3 different failure pathways for that failure mode. What was the basic cause that lead to the “SGRT system reports incorrect patient position” failure pathway? |
| Reference: | Manger et al Med Phys., Vol. 42, No. 4, pp. 2449-2461, 2015. |
| Choice A: | SGRT system is frozen |
| Choice B: | SGRT monitoring not initiated |
| Choice C: | SGRT QA not performed |
| Choice D: | Inaccurate CBCT-CT Sim registration |
| Choice E: | Inaccurate SGRT camera calibration |
