| Question 1: A biokinetic model has been used to calculate the maximum theoretical size of a tumor to be effectively treated with DaRT to account for: |
| Reference: | Arazi et al, The treatment of solid tumors by alpha emitters released from 224Ra-loaded sources—internal dosimetry analysis Phys. Med. Biol. 55 (2010) 1203–1218 |
| Choice A: | Changes in the diffusion coefficient over large tumors |
| Choice B: | Hypoxic effects correlated to tumor size |
| Choice C: | Dose to distant organs from accumulation of radioactive elements that entered the bloodstream |
| Choice D: | Bystander effects of the tumor C-cells |
| Question 2: In Popovtzery et al., DaRT use in humans was first described. The technique used involved: |
| Reference: | Popovtzeri et al, Initial Safety and Tumor Control Results From a “First-in-Human” Multicenter Prospective Trial Evaluating a Novel Alpha-Emitting Radionuclide for the Treatment of Locally Advanced Recurrent Squamous Cell Carcinomas of the Skin and Head and Neck, Int. J. Radiat. Oncol. Biol. Phys. 106.3 (2020): 571-578 |
| Choice A: | DaRT of 2 mCi strength per wire implanted at 5-mm intervals |
| Choice B: | DaRT injected in an artery accessing the tumor |
| Choice C: | A single DaRT implanted at the tumor centroid |
| Choice D: | DaRT mounted on a linac gantry to take advantage of the linac imaging capabilities |
| Question 3: The effective diameter (region receiving > 10Gy) of a recoil-short lived alpha emitting device: |
| Reference: | Arazi et al, Diffusing alpha-emitters radiation therapy: approximate modeling of the macroscopic alpha particle dose of a point source, Phys. Med. Biol. 65 (2020) 015015 (24pp) |
| Choice A: | Increases linearly with the activity of the device. |
| Choice B: | Is smaller for tissues with higher diffusion coefficient. |
| Choice C: | Is expected to be between 5 and 8 mm for sources of 2 mCi. |
| Choice D: | Is always < 50 mm due to the short range of the alpha particles. |
| Question 4: What is the major side effect of coronary brachytherapy? |
| Reference: | Popma JJ, Suntharalingam M, Lansky AJ, et al.; Stents And Radiation Therapy (START) Investigators. Randomized trial of 90Sr/90Y beta-radiation versus placebo control for treatment of in-stent restenosis. Circulation. 2002;106(9):1090–1096 |
| Choice A: | Lymphopenia and risk for viral infections |
| Choice B: | Secondary Cancers |
| Choice C: | Thrombosis of the irradiated blood vessel |
| Choice D: | Perforation of the vessel wall |
| Question 5: Intravascular brachytherapy must meet the licensing requirements under which subpart of Code of Federal Regulations (CFR)? |
| Reference: | https://www.nrc.gov/materials/miau/med-use-toolkit/intravascular.html |
| Choice A: | 10 CFR 35.300 |
| Choice B: | 10 CFR 35.400 |
| Choice C: | 10 CFR 35.600 |
| Choice D: | 10 CFR 35.1000 |
| Question 6: Intravascular brachytherapy prescriptions are based on all of the following parameters EXCEPT: |
| Reference: | Beta-Cath 3.5F System User’s manual, http://www.bestvascular.com/assets/D03745D%20Beta%20Cath%20System%20Users%20Manual.pdf |
| Choice A: | Reference vessel diameter |
| Choice B: | Stented length |
| Choice C: | Source train length |
| Choice D: | Distal and/or proximal margin |
| Question 7: During an IVBT treatment, who is responsible for sending and returning 90Sr sources? |
| Reference: | https://www.nrc.gov/materials/miau/med-use-toolkit/intravascular.html |
| Choice A: | The Cardiologist |
| Choice B: | The Radiation Oncologist (authorized physician user) |
| Choice C: | The Physicist |
| Choice D: | Nurses |
| Question 8: To prepare for emergency source recovery during an IVBT procedure, all of the following items are required EXCEPT: |
| Reference: | Beta-Cath 3.5F System User’s manual, http://www.bestvascular.com/assets/D03745D%20Beta%20Cath%20System%20Users%20Manual.pdf |
| Choice A: | An acrylic temporary storage container |
| Choice B: | Reverse action tweezer (or magnetic source recovery probe) |
| Choice C: | A lead container |
| Choice D: | Water-soaked gauze sponges (4 or more) |
| Question 9: What advantages has Cs-131 exhibits in comparison to I-125 for brain brachytherapy? |
| Reference: | Mahase SS, Navrazhina K, Schwartz TH, Parashar B, Wernicke AG. Intraoperative brachytherapy for resected brain metastases. Brachytherapy. 2019 May-Jun;18(3):258-270. |
| Choice A: | Higher dose rate |
| Choice B: | Higher mean energy |
| Choice C: | Shorter half life |
| Choice D: | All the above |
| Question 10: Cavity shrinkage after surgical resection is correlated with an increased risk of radiation necrosis of the surrounding tissue for patients treated with SRS. |
| Reference: | Wernicke AG, Lazow SP, Taube S, Yondorf MZ, Kovanlikaya I, Nori D, Christos P, Boockvar JA, Pannullo S, Stieg PE, Schwartz TH. Surgical Technique and Clinically Relevant Resection Cavity Dynamics Following Implantation of Cesium-131 (Cs-131) Brachytherapy in Patients With Brain Metastases. Oper Neurosurg (Hagerstown). 2016 Mar;12(1):49-60 |
| Choice A: | True |
| Choice B: | False |
