| Question 1: Which of the following is NOT a characteristic of grid therapy treatment delivery? |
| Reference: | Yan et al. Spatially Fractionated radiation therapy: History, present, and the future. Clin Transl Radiat Oncol. 2020. 20: 30-38. |
| Choice A: | Spatially fractionated radiation |
| Choice B: | Heterogeneous dose distribution with alternating regions of high dose peaks and low dose valleys |
| Choice C: | Partial tumor radiation |
| Choice D: | Ultra-high FLASH dose rates |
| Question 2: What is the minimum single fraction dose that is typically used for grid therapy? |
| Reference: | Billena and Khan. A Current Review of Spatial Fractionation: Back to the Future? Int J Radiat Oncol Biol Phys. 2020. 104 (1): 177-187. |
| Choice A: | 8 Gy |
| Choice B: | 10 Gy |
| Choice C: | 12 Gy |
| Choice D: | 15 Gy |
| Question 3: What is a possible radiobiologic mechanism responsible for the effectiveness of grid therapy? |
| Reference: | Billena and Khan. A Current Review of Spatial Fractionation: Back to the Future? Int J Radiat Oncol Biol Phys. 2020. 104 (1): 177-187. |
| Choice A: | Radiation Induced Bystander Effects |
| Choice B: | Anti-tumor immune responses |
| Choice C: | Tumor microvasculature changes |
| Choice D: | All of the above |
| Question 4: What is a proposed dose heterogeneity metric used to evaluate the quality of VMAT-based Lattice Radiotherapy dose distributions? |
| Reference: | Zhang H, Wu X, Zhang X, et al. Photon GRID Radiation Therapy: A Physics and Dosimetry White Paper from the Radiosurgery Society (RSS) GRID/LATTICE, Microbeam and FLASH Radiotherapy Working Group. Radiat Res. 2020;194(6):665-677. |
| Choice A: | V95% for the high dose target |
| Choice B: | Mean dose |
| Choice C: | D10%/D90% for the target |
| Choice D: | The prescription dose divided by the target volume |
| Question 5: According to many clinical trials, what is the optimal method of delivering grid therapy treatments? |
| Reference: | Gholami, S., H. A. Nedaie, F. Longo, M. R. Ay, S. Wright and A. S. Meigooni (2016). "Is grid therapy useful for all tumors and every grid block design?" Journal of Applied Clinical Medical Physics 17(2): 206-219.
Billena, C. and A. J. Khan (2019). "A Current Review of Spatial Fractionation: Back to the Future?" Int J Radiat Oncol Biol Phys 104(1): 177-187.
Yan, W., M. K. Khan, X. Wu, C. B. Simone, 2nd, J. Fan, E. Gressen, X. Zhang, C. L. Limoli, H. Bahig, S. Tubin and W. F. Mourad (2020). "Spatially fractionated radiation therapy: History, present and the future." Clin Transl Radiat Oncol 20: 30-38. |
| Choice A: | A brass block and 6 MV photons |
| Choice B: | A VMAT Lattice technique with 6 MV FFF photons |
| Choice C: | Proton techniques which duplicate the aperture arrangement of the brass block |
| Choice D: | There have been no clinical trials which have established one method as superior to another. |
| Question 6: The volume ratio of high dose “spheres” to the gross tumor volume (VV/VGTV) is typically: |
| Reference: | Wu, X., Perez, NC., Zheng, Y., Jiang, L., Amendola, BE., Xu, B., Mayr, N., Lu, JJ., Hatoum, GF., Zhang, H., Chang, SX., Griffen, RJ., Guha, C. (2020). “The technical and clinical implementation of LATTICE Radiation Therapy (LRT).” Radiation Research 194 (6): 737 - 746.
Kavanaugh, JA., Spraker, MB., Duriseti, S., Basarabescu, F., Price, A., Goddu, M., Knutson, N., Prusator, M., Robinson, CG., Mazur, T. (2022). “LITE SABR M1: Planning design and dosimetric endpoints for a phase I trial of lattice SBRT.” Radiotherapy and Oncology. 167: 172-178 |
| Choice A: | 0.01 – 0.03 |
| Choice B: | 0.05 – 0.10 |
| Choice C: | 0.10 – 0.30 |
| Choice D: | 0.30 – 0.50 |
