| Question 1: According to AAPM Report 038, what is the first responsibility of the radiation oncology physicist? |
| Reference: | Asp L, Bank M, Fields T, et al. The Role of a Physicist in Radiation Oncology. AAPM; 1993. doi:10.37206/37 |
| Choice A: | To ensure a good working environment for their coworkers |
| Choice B: | To assure the best possible treatment for the patient |
| Choice C: | To implement new technology |
| Choice D: | To perform cutting edge research |
| Question 2: According to the latest ROILS Aggregate Data Report (Q3 2021), at what step in the radiation therapy workflow were most reported events discovered based on the aggregate historical sum? |
| Reference: | Clarity PSO. ROILS Aggregate Data Report, Quarter 3, 2021 (July 1 – Sept 30, 2021). https://www.astro.org/ASTRO/media/ASTRO/Patient%20Care%20and%20Research/PDFs/ROILS_2021_Q3.pdf. Accessed April 28, 2022. |
| Choice A: | Pre-planning imaging and simulation |
| Choice B: | Treatment Planning |
| Choice C: | Pre-Treatment QA Review |
| Choice D: | Treatment Delivery Including Imaging |
| Question 3: Of the clinical recommendations provided in AAPM TG-132 regarding image registration and fusion, which has the most relevance to plan quality review? |
| Reference: | Brock KK, Mutic S, McNutt TR, Li H, Kessler ML. Use of image registration and fusion algorithms and techniques in radiotherapy: Report of the AAPM Radiation Therapy Committee Task Group No. 132. Med Phys. 2017;44(7):e43-e76. doi:10.1002/mp.12256 |
| Choice A: | Clinics should establish a patient-specific QA practice for efficient evaluation of image registration results. |
| Choice B: | Vendors should provide the ability to export the registration matrix or deformation vector field for validation. |
| Choice C: | Clinics should perform comprehensive commissioning of image registration using digital phantom data provided in the report. |
| Choice D: | Clinical users should understand the basic components of the registration algorithm used clinically to ensure its proper use. |
| Question 4: According to AAPM TG275, what high-risk failure mode in the treatment planning process had the highest Risk Priority Number? |
| Reference: | Ford E, Conroy L, Dong L, et al. Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275. Med Phys. 2020;47(6). doi:10.1002/mp.14030 |
| Choice A: | Suboptimal gantry and/or collimator angles. |
| Choice B: | Wrong or inaccurate MD contours. |
| Choice C: | Failure to assess potential overlap of prior and current treatment fields. |
| Choice D: | Wrong scan used for planning. |
| Question 5: According to MPPG 9.a, what special training must occur when the principal professionals responsible for an SRS-SBRT program do not have direct prior experience with the services being offered? |
| Reference: | Halvorsen PH, Cirino E, Das IJ, et al. AAPM‐RSS Medical Physics Practice Guideline 9.a. for SRS‐SBRT. J Appl Clin Med Phys. 2017;18(5):10-21. doi:10.1002/acm2.12146 |
| Choice A: | Self-guided review of literature relevant to the procedure by the principal team |
| Choice B: | On-site review and proctoring of the first clinical procedure by professionals with experience relevant to the new service |
| Choice C: | Dry-run of the clinical procedure by the principal team the day before the service goes live |
| Choice D: | FMEA risk-assessment for the service completed by the principal team |
| Question 6: Which of the following descriptions is not true about knowledge-based or deep-learning-based plan quality prediction models? |
| Reference: | Yuan L, Ge Y, Lee WR, Yin FF, Kirkpatrick JP, Wu QJ. Quantitative analysis of the factors which affect the interpatient organ-at-risk dose sparing variation in IMRT plans. Med Phys. 2012;39(11):6868-6878. doi:10.1118/1.4757927 |
| Choice A: | The models can be used as a plan quality check tool |
| Choice B: | Models trained in one institution can be deployed in multiple institutions |
| Choice C: | The models are not patient-specific; rather, they perform DVH prediction using the average value over all patients in the database |
| Choice D: | The models require validation before clinical implementation |
| Question 7: Which quality management school of thought put quality in the hands of the inspector and prioritized efficiency over error reduction? |
| Reference: | Evans, J. and Lindasy, W. Managing for Quality and Performance Excellence, 8th ed., South-Western Cengage Learning. |
| Choice A: | Total Quality Management |
| Choice B: | Scientific Management |
| Choice C: | Zero Quality Control |
| Choice D: | Crew Resource Management |
| Question 8: According to TG-275, what is the primary concern when automation is not properly implemented or tested? |
| Reference: | Ford et al., (2020). Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275, Medical Physics, 47(6):e236-272 |
| Choice A: | Takes a long time to run |
| Choice B: | Errors remain systematically unidentified |
| Choice C: | Inconvenient to use |
| Choice D: | Results are hard to interpret |
| Question 9: Which cost of quality related to the process steps of designing scripting, automation, and hard stops of the plan review? |
| Reference: | Harrington, H J. Poor-quality Cost. New York: M. Dekker, 1987. |
| Choice A: | Internal Failure costs |
| Choice B: | External Failure costs |
| Choice C: | Prevention costs |
| Choice D: | Appraisal costs |
| Question 10: At what point in the treatment chain does TG 275 recommend that radiation oncology practices should incorporate physics review for each patient? |
| Reference: | Ford et al., (2020). Strategies for effective physics plan and chart review in radiation therapy: Report of AAPM Task Group 275, Medical Physics, 47(6):e236-272 |
| Choice A: | After the MD has reviewed the treatment plan with the dosimetrist and approved it for treatment |
| Choice B: | As early in the radiation oncology workflow as possible, and not rely solely on review at the end of treatment planning |
| Choice C: | Before the patient has been referred to the radiation oncology department |
| Choice D: | No sooner than before 600 cGy has been delivered to the patient |
