2022 AAPM 64th Annual Meeting
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Session Title: Brain Mets Management: Registries and Automation for Longitudinal Assessment
Question 1: What is most common pattern of failure of brain metastasis patients treated with SRS alone?
Reference:Stereotactic radiosurgery plus whole-brain radiation therapy vs stereotactic radiosurgery alone for treatment of brain metastases: a randomized controlled trial. Aoyama H, Shirato H, Tago M, Nakagawa K, Toyoda T, Hatano K, Kenjyo M, Oya N, Hirota S, Shioura H, Kunieda E, Inomata T, Hayakawa K, Katoh N, Kobashi G.JAMA. 2006 Jun 7;295(21):2483-91. doi: 10.1001/jama.295.21.2483.
Choice A:Local failure of treated lesions
Choice B:Marginal failure of treated lesions
Choice C:In brain failure with new metastasis
Choice D:Both local and in brain failure
Question 2: SRS may be considered in which of the following clinical conditions.
Reference:Recent Advances and Applications of Radiation Therapy for Brain Metastases. Mathis NJ, Wijetunga NA, Imber BS, Pike LRG, Yang JT.Curr Oncol Rep. 2022 Mar;24(3):335-342.
Choice A:A breast cancer patient with 3 brain metastases
Choice B:A melanoma cancer patient with 9 brain metastases
Choice C:A colon cancer patients with a resected brain metastasis
Choice D:All of the above
Question 3: One of the most important rules for the governance of the quality and outcome data in the SRS registry included:
Reference:J. Sheehan et al., Inception of a national multidisciplinary registry for stereotactic radiosurgery, J. Neurosurgery 2016 124(1): 155-162. doi: 10.3171/2015.1.JNS142466
Choice A:Restrictions on the technology platforms that could be connected to the registry.
Choice B:The ability to create per-user additions to the registry data dictionary.
Choice C:A backup and recovery plan for the registry data.
Choice D:A firewall between the registry’s corporate partners and the registry data.
Choice E:Specific quotas for the number of patients required to be entered per year for each participating site.
Question 4: In a 2017 Cochrane review of randomized controlled trials (RCTs) assessing the efficacy of whole brain radiation therapy (WBRT) plus stereotactic radiosurgery (SRS) vs WBRT alone in the treatment of adults with brain metastases, how many RCTs were located and included in the meta-analysis?
Reference:C.G. Patil et al., Whole brain radiation therapy (WBRT) alone versus WBRT and radiosurgery for the treatment of brain metastases., Cochrane Database of Systematic Reviews 2017 9/25/2017. Doi: 10.1002/14651858.CD006121.pub4
Choice A:0
Choice B:1
Choice C:2
Choice D:5
Choice E:10
Question 5: What computer language is often used to create, update, and delete data from the clinical database:
Reference:Sager, N., Lyman, M., Bucknall, C., Nhan, N., & Tick, L. J. (1994). Natural language processing and the representation of clinical data. Journal of the American Medical Informatics Association, 1(2), 142-160.
Choice A:SQL
Choice B:Python
Choice C:C/C++
Choice D:Golang
Question 6: Which one of the following statements about Electronic medical records (EMR) and Electronic health records (EHR) is true?
Reference:Garets, D., & Davis, M. (2006). Electronic medical records vs. electronic health records: yes, there is a difference. Policy white paper. Chicago, HIMSS Analytics, 1-14.
Choice A:EHR and EMR are the same by definition
Choice B:EMR is only used for research studies
Choice C:EMRs are used in the physician's office and EHRs are used across facilities
Choice D:EHRs store the same amount of information but are less accessible than EMR
Question 7: The strategy of using multiple courses of SRS for distant new brain metastases after an initial course of SRS, with continued deferral of WBRT, yields high rates of local control, low rates of toxicity, and favorable durations of overall and neurologic survival. Which factor in the following did not correlate with overall survival?
Reference:D. B. Shultz, et al., "Repeat Courses of Stereotactic Radiosurgery (SRS), Deferring Whole-Brain Irradiation, for New Brain Metastases After Initial SRS," Int. J. Radiat. Oncol. Biol. Phys. 92 (5), 993-999 (2015). C. G. Benjamin, J. Gurewitz, A. Kavi, K. Bernstein, J. Silverman, M. Mureb, B. Donahue, and D. Kondziolka, "Survival and outcomes in patients with ≥ 25 cumulative brain metastases treated with stereotactic radiosurgery," J. Neurosurg., 1-11 (2021).
Choice A:Aggregated tumor volume
Choice B:Initial SRS tumor numbers
Choice C:Cumulative tumor numbers
Choice D:Graded prognostic assessment (GPA)
Choice E:Karnofsky performance status (KPS)
Choice F:Histology
Question 8: Deep learning neural networks can be optimally utilized to improve segmentation accuracy and efficiency for the clinical workflow in brain metastases SRS
Reference:K. Bousabarah, et al., "Deep convolutional neural networks for automated segmentation of brain metastases trained on clinical data," Radiation Oncology 15 (1), 87 (2020) Z. Yang, et al., "A web-based brain metastases segmentation and labeling platform for stereotactic radiosurgery," Med. Phys. 47 (8), 3263-3276 (2020).
Choice A:True
Choice B:False
Question 9: Which of the following dosimetry parameter(s) could be used as predictor(s) for brain radio-necrosis during SRS treatment?
Reference:Single- and Multifraction Stereotactic Radiosurgery Dose/Volume Tolerances of the Brain, Milano, Michael T. et al. International Journal of Radiation Oncology, Biology, Physics, Volume 110, Issue 1, 68 – 86
Choice A:Conformity Index
Choice B:V12Gy
Choice C:V14Gy
Choice D:B and C
Choice E:A, B, and C
Question 10: Why is automated treatment planning system a preferred solution compared to manual planning for multi-course SRS management of brain metastasis?
Reference:Multi-institutional dosimetric evaluation of modern day stereotactic radiosurgery (SRS) treatment options for multiple brain metastases, I Vergalasova et al, Frontiers in Oncology, 2019
Choice A:Automated treatment planning is faster
Choice B:Automated treatment planning produces more consistent plan quality amongst planners with different experience levels
Choice C:Automated treatment planning reduces normal tissue dose by optimizing more delivery parameters than what human planners can do
Choice D:B and C
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