| Question 1: Benefits of a type B / C volumetric independent dose calculation over a type A point dose calculation include all of the following EXCEPT: |
| Reference: | Stern RL, Heaton R, Fraser MW, Goddu SM, Kirby TH, Lam KL, Molineu A, Zhu TC. Verification of monitor unit calculations for non‐IMRT clinical radiotherapy: report of AAPM Task Group 114. Medical physics. 2011 Jan 1;38(1):504-30. |
| Choice A: | Improved dosimetric accuracy especially in the presence of scatter disequilibrium and tissue heterogeneities |
| Choice B: | Ability to assess dosimetric uncertainties on the patient DVH |
| Choice C: | Effects of scatter, missing tissue, and tissue heterogeneity are separated and can be independently assessed |
| Question 2: The “independence” of the secondary dose calculation is defined as: |
| Reference: | (1). Stern RL, Heaton R, Fraser MW, Goddu SM, Kirby TH, Lam KL, Molineu A, Zhu TC. Verification of monitor unit calculations for non‐IMRT clinical radiotherapy: report of AAPM Task Group 114. Medical physics. 2011 Jan 1;38(1):504-30.
(2). Gibbons, J. P., et al. "Report of the AAPM Therapy Physics Committee Taks Group No. 71: monitor unit calculations for external photon and electron beams." Med Phys 41.3 (2014): 031501. See also the AAPM TG-219 2017 presentation. |
| Choice A: | one that uses a different method of calculation other than that used in the initial calculation |
| Choice B: | one that is commissioned using a separate set of beam data |
| Choice C: | either A or B |
| Question 3: Which of the following is not a benefit of using machine log-file based patient specific QA? |
| Reference: | Lee L, Mao W, Xing L. The use of EPID-measured leaf sequence files for IMRT dose reconstruction in adaptive radiation therapy. Med Phys. 2008;35(11):5019-5029. doi:10.1118/1.2990782 |
| Choice A: | Insusceptible to the quality of commissioning |
| Choice B: | Ability to perform in-vivo patient specific QA |
| Choice C: | High spatial and temporal resolution |
| Choice D: | The QA workflow can be fully automated |
| Question 4: Which of the following can be used to commission and QA log file for patient specific QA? |
| Reference: | Lim SB, Zwan BJ, Lee D, Greer PB, Lovelock DM. A novel quality assurance procedure for trajectory log validation using phantom-less real-time latency corrected EPID images. J Appl Clin Med Phys. 2021 Mar;22(3):176-185. doi: 10.1002/acm2.13202. Epub 2021 Feb 26. PMID: 33634952; PMCID: PMC7984475. |
| Choice A: | Single ion chamber |
| Choice B: | Film |
| Choice C: | Electron Portal Imager Device |
| Choice D: | both b and c |
| Question 5: What type of error would most likely not be detectable by in vivo dosimetry? |
| Reference: | Olaciregui-Ruiz I, Beddar S, Greer PB, Jornet N, McCurdy BMC, Paiva-Fonseca G, Mijnheer B, Verhaegen F, In vivo dosimetry in external beam photon radiotherapy: Requirements and future directions for research, development, and clinical practice. Phys Imaging Radiat Oncol. 2020 Aug 29;15:108-116. doi: 10.1016/j.phro.2020.08.003. eCollection 2020 Jul. PMID: 33458335 PMCID: PMC7807612 DOI: 10.1016/j.phro.2020.08.003 |
| Choice A: | Significant patient weight gain around treatment site. |
| Choice B: | Prescription error by the radiation oncologist |
| Choice C: | Patient shift of two centimeters |
| Choice D: | Atelectasis occurring between treatment fractions three and four. |
| Question 6: A challenge with using the EPID for exit dosimetry is: |
| Reference: | McCurdy BMC, Greer PB, Bedford J, Chapter 7: Electronic Portal Imaging Device Dosimetry, in Clinical 3D Dosimetry in Modern Radiation Therapy (ed. Mijnheer B),
CRC Press, Boca Raton, ISBN-10 : 148225221X, ISBN-13 : 978-1482252217, DOIhttps://doi.org/10.1201/9781315118826 |
| Choice A: | they are not widely available on linear accelerators |
| Choice B: | they do not exhibit a linear response with dose |
| Choice C: | they can’t provide a digital image to analyze |
| Choice D: | their energy response is not dose-to-water |
| Question 7: Which of the following best describes the challenges of PSQA for ART? |
| Reference: | Glide-Hurst et al. Adaptive Radiation Therapy (ART) Strategies and Technical Considerations: A State of the ART Review From NRG Oncology, International Journal of Radiation Oncology Biology Physics, Volume 109, Issue 4, 2021 |
| Choice A: | Checks need to be done in an accelerated time frame. |
| Choice B: | Predelivery checks may not be feasible since the patient is on the table. |
| Choice C: | Can become impractical as additional adapted plans are created frequently. |
| Choice D: | All the above |
| Question 8: Performing risk assessment of adaptive radiotherapy (ART) and standard IMRT shows that, |
| Reference: | Noel, C.E., Santanam, L., Parikh, P.J. and Mutic, S. (2014), Process‐based quality management for clinical implementation of adaptive radiotherapy. Med. Phys., 41: 081717. |
| Choice A: | ART introduces more risks |
| Choice B: | Standard IMRT is more risky |
| Choice C: | ART introduces different, but not necessarily more risks. |
| Choice D: | The workflows and risks are the same |
| Question 9: Plastic scintillators are also dielectric materials, which means light emitted during irradiation is a combination of Cherenkov and scintillation photons. Cherenkov light is emitted ______, and scintillation light is emitted ______. |
| Reference: | Therriault-Proulx F, Wen Z, Ibbott G, Beddar S. Effect of Magnetic Field Strength on Plastic Scintillation Detector Response. Radiat Meas. 2018 Sep;116:10-13. doi: 10.1016/j.radmeas.2018.06.011. Epub 2018 Jun 9. PMID: 30559600; PMCID: PMC6294456. |
| Choice A: | isotropically; isotropically |
| Choice B: | directionally; isotropically |
| Choice C: | directionally; directionally |
| Choice D: | isotropically; directionally |
| Question 10: All of the following are true of scintillator based dosimetry, except: |
| Reference: | Therriault-Proulx F, Wen Z, Ibbott G, Beddar S. Effect of Magnetic Field Strength on Plastic Scintillation Detector Response. Radiat Meas. 2018 Sep;116:10-13. doi: 10.1016/j.radmeas.2018.06.011. Epub 2018 Jun 9. PMID: 30559600; PMCID: PMC6294456. |
| Choice A: | Signal from plastic scintillation dosimeters (PSDs) has a shown dependence on magnetic field strength. |
| Choice B: | Most PSDs have densities similar to water, and can provide accurate measurements in real-time. |
| Choice C: | Optical fibers must be used to capture the scintillation signal. |
| Choice D: | The magnetic field has little effect on electron trajectories in solid plastic scintillators, when compared to electrons in air-filled ionization chambers. |
