| Question 1: Potential imaging biomarkers for detecting influences of cardiac radiation exposure and damage include all of the following EXCEPT? |
| Reference: | Speers, C., Murthy, V.L., Walker, E.M., Glide-Hurst, C.K., Marsh, R., Tang, M., Morris, E.L., Schipper, M.J., Weinberg, R.L., Gits, H.C. and Hayman, J., 2022. Cardiac Magnetic Resonance Imaging and Blood Biomarkers for Evaluation of Radiation-Induced Cardiotoxicity in Patients With Breast Cancer: Results of a Phase 2 Clinical Trial. International Journal of Radiation Oncology* Biology* Physics, 112(2), pp.417-425. |
| Choice A: | Left ventricular ejection fraction (LVEF) |
| Choice B: | Quantitative T2 mapping |
| Choice C: | Qualitative T1-weighted images |
| Choice D: | Quantitative T1 mapping |
| Question 2: Following ICRU 62 guidelines, to derive an ideal planning organ at risk (PRV) margin for cardiac substructure sparing, which of the following uncertainties should be considered? |
| Reference: | International Commission on Radiation Units and Measurements, 1999. ICRU Report 62. Prescribing, Recording and Reporting Photon Beam Therapy (Supplement to ICRU 50). |
| Choice A: | Inter-fraction setup error |
| Choice B: | Intra-fraction respiratory motion |
| Choice C: | Intra-fraction cardiac motion |
| Choice D: | All of the above |
| Question 3: In dosimetric analysis of patients included in RTOG 0617, which cardiac dose metrics were associated with increased risk of death? |
| Reference: | Bradley, J. D., Paulus, R., Komaki, R., Masters, G., Blumenschein, G., Schild, S., ... & Choy, H. (2015). Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. The Lancet Oncology, 16(2), 187-199. |
| Choice A: | Mean heart dose |
| Choice B: | V5 Gy (the percentage of the heart receiving >5 Gy) |
| Choice C: | V30 Gy (the percentage of the heart receiving > 30 Gy) |
| Choice D: | B & C |
| Choice E: | All of the above |
| Question 4: 2. The shown knowledge-based planning example follows a linear model for dose volume histogram (DVH) estimation. Structures are decomposed into subunits, then principal component analysis is applied to estimate the DVH for which subunit? |
| Reference: | Harms, J., Zhang, J., Kayode, O., Wolf, J., Tian, S., McCall, N., ... & Yang, X. (2021). Implementation of a Knowledge-Based Treatment Planning Model for Cardiac-Sparing Lung Radiation Therapy. Advances in Radiation Oncology, 6(6), 100745 |
| Choice A: | Out-of-field |
| Choice B: | MLC Transmission |
| Choice C: | In-field |
| Choice D: | Overlap |
| Choice E: | All of the above |
| Question 5: At thirty years from diagnosis, the cumulative incidence of any cardiac disease in childhood cancer survivors is nearly |
| Reference: | Bates JE, Howell RM, Liu Q, Yasui Y, Mulrooney DA, Dhakal S, Smith SA, Leisenring WM, Indelicato DJ, Gibson TM, Armstrong GT, Oeffinger KC, Constine LS. Therapy-related cardiac risk in childhood cancer survivors: An analysis of the childhood cancer survivor study. J Clin Oncol 37(13):1090-1101, 5/2019. e-Pub 3/2019. PMCID: PMC6494356 |
| Choice A: | 1% |
| Choice B: | 5% |
| Choice C: | 10% |
| Choice D: | 20% |
| Choice E: | 30% |
| Question 6: Which of the following heart dose and dose-volume metrics are associated with radiation-related late cardiac disease in childhood cancer survivors? |
| Reference: | Bates JE, Howell RM, Liu Q, Yasui Y, Mulrooney DA, Dhakal S, Smith SA, Leisenring WM, Indelicato DJ, Gibson TM, Armstrong GT, Oeffinger KC, Constine LS. Therapy-related cardiac risk in childhood cancer survivors: An analysis of the childhood cancer survivor study. J Clin Oncol 37(13):1090-1101, 5/2019. e-Pub 3/2019. PMCID: PMC6494356. |
| Choice A: | Mean heart dose ≥ 10 Gy |
| Choice B: | Heart V20 ≥ 0.1% |
| Choice C: | Heart V5(20=0) ≥ 50% |
| Choice D: | Mean substructure dose ≥ 5 Gy or ≥ 10 Gy, depending on substructure |
| Choice E: | All of the above |
