| Question 1: Why do we need to scan and treat patient in head first and feet first directions? |
| Reference: | philips ct scanner user manual
varian truebeam linac user manual |
| Choice A: | CT scanner table movement limitation |
| Choice B: | Treatment machine table movement limitation |
| Choice C: | All of the above. |
| Question 2: The main purpose of the target feathering zone is: |
| Reference: | Hong, C.S., et al., Feasibility of hybrid TomoHelical- and TomoDirect-based volumetric gradient matching technique for total body irradiation. Radiat Oncol, 2019. 14(1): p. 233. |
| Choice A: | Improve dose uniformity |
| Choice B: | Improve plan robustness to positioning uncertainty |
| Choice C: | Improve normal tissue sparing |
| Question 3: What benefits does VMAT TBI offer relative to conventional 2D AP/PA or Lateral TBI? |
| Reference: | Reference1: Blomain ES, Kovalchuk N, Neilsen BK, Skinner L, Hoppe RT, Hiniker SM. A Preliminary Report of Gonadal-Sparing TBI Using a VMAT Technique. Pract Radiat Oncol. 2021 Mar-Apr;11(2):e134-e138. doi: 10.1016/j.prro.2020.07.006. Epub 2020 Aug 12. PMID: 32795616.
Reference2: Simiele E, Skinner L, Yang Y, Blomain ES, Hoppe RT, Hiniker SM, Kovalchuk N. A Step Toward Making VMAT TBI More Prevalent: Automating the Treatment Planning Process. Pract Radiat Oncol. 2021 Mar 10:S1879-8500(21)00061-8. doi: 10.1016/j.prro.2021.02.010. Epub ahead of print. PMID: 33711488. |
| Choice A: | Possibility of superior organ sparing (lungs, kidneys, gonads, brain, thyroid, lenses) |
| Choice B: | Possibility of avoiding previously treated areas and boosting areas of interest |
| Choice C: | More accurate dose calculation and image-guided delivery |
| Choice D: | More comfortable patient positioning lying down |
| Choice E: | Ability to treat TBI patients under anesthesia |
| Choice F: | All of the above |
| Question 4: What are the benefits of automation for VMAT TBI treatment planning process? |
| Reference: | Simiele E, Skinner L, Yang Y, Blomain ES, Hoppe RT, Hiniker SM, Kovalchuk N. A Step Toward Making VMAT TBI More Prevalent: Automating the Treatment Planning Process. Pract Radiat Oncol. 2021 Mar 10:S1879-8500(21)00061-8. doi: 10.1016/j.prro.2021.02.010. Epub ahead of print. PMID: 33711488. |
| Choice A: | Consistent plan quality |
| Choice B: | Decrease in treatment planning time |
| Choice C: | Minimal planner intervention |
| Choice D: | All of the above. |
| Question 5: Relative low dose rate is important for optimal outcome and for reducing the risk of interstitial pneumonitis. What is the commonly used dose rate? |
| Reference: | Reference: ACR–ASTRO Practice Parameter for the Performance of Total Body Irradiation (CSC/BOC) 2017. |
| Choice A: | 0.1 - 0.2 Gy/min |
| Choice B: | 2 - 3 Gy/min |
| Choice C: | 6 – 10 Gy/min |
| Question 6: The Childrens' Oncology Group examined 143 patients (12-13.2 Gy conventional TBI) found that patients treated with mean lung dose < ?? Gy had better survival outcome and didn't appear to cause higher disease relapse. |
| Reference: | Esiashvili N, Lu X, Ulin K, et al. Higher Reported Lung Dose Received During Total Body Irradiation for Allogeneic Hematopoietic Stem Cell Transplantation in Children With Acute Lymphoblastic Leukemia Is Associated With Inferior Survival: A Report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys. 2019;104(3):513-521. |
| Choice A: | 7 Gy |
| Choice B: | 8 Gy |
| Choice C: | 9 Gy |
