2022 AAPM 64th Annual Meeting
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Session Title: Enhancing a Physicist's Role in Radiation Therapy Treatment Plan Assessment
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
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