Final Prep Flashcards
1
Q
Provides the source of the microwave power used to accelerate electrons (housed in drive stand)
A
Klystron
2
Q
Carries microwave power from Klystron to accelerator guide (housed in drive stand)
A
Waveguide
3
Q
Placed between the klystron and waveguide to direct the RF energy into the waveguide and prevents any reflective microwaves from returning to the klystron. This allows the klystron to last longer (house in drive stand)
A
Circulator
4
Q
Allows components in the gantry and drive stand to operate at a constant temperature. (housed in drive stand)
A
Cooling System
5
Q
Responsible for producing electrons and injecting them into the accelerator structure. (Gantry)
A
Electron Gun
6
Q
Sometimes called the accelerator waveguide. Microwave power is transported to the accelerating waveguide, in which corrugations are used to slow the waves. (Gantry)
A
Accelerator Structure
7
Q
One of the electrodes in the x-ray tube (negative side) Consists of the filament and focusing cup. Primary function is to produce electrons and focus the electron stream toward the metal anode. (Gantry)
A
Cathode (Remember Negative)
8
Q
Positive side of the X-ray tube. Receives electrons from the cathode as a target, dissipates the heat as a result of the x-ray production and serves as the path for the flow of high voltage. (Gantry)
A
Anode (Remember Positive)
9
Q
Directs the electrons vertically toward patient on the table. Otherwise the electrons would continue straight out, horizontally thru the treatment head of the gantry. (Treatment head)
A
Bending Magnet
10
Q
Monitors beam dosimetry to within 2% for long-term consistency and stability. (Treatment Head)
A
Ion Chamber
11
Q
It is located on the carousel with the scattering foil. Placed in beams path when treating with x-rays to shape the x-ray beam in it cross-sectional dimension (Treatment head)
A
Beam Flattening Filter
12
Q
The purpose of this foil to broaden the pencil-like electron beam and produce a flat field across the treatment field. (Treatment head)
A
Scattering foil-used in electron mode (used matches the electron energy called)
13
Q
This is the point at which x-ray photons are produced and begin to fan out in a divergent path (Treatment head)
A
Target (portion of the anode)
14
Q
An arrangement of shielding material designed to define the X and Y dimensions of the beam of radiation. (Treatment head)
A
Collimators
15
Q
How did the Linear Accelerator get it’s name
A
Electrons or charged particles travel in a straight line (within tube) Gantry
16
Q
What is produced in X-ray mode and what filter is used in the carousel?
A
Photons and a Flattening Filter (X-ray mode has to hit a target)
17
Q
What does the Scattering foil produce
A
Electrons
18
Q
The carousel will continue to rotate until the opening allows the scattering foil to open?
A
True
19
Q
What are the advantages of KV images
A
- Better detailed (better contrast)
- Provides more info about soft tissue and bony anatomy
- Less dose to patient than MV imaging
20
Q
What Orthovolotage image is used to verify portal
A
MV image
21
Q
System producing real-time portal images on computer screen for evaluation
A
Electronic portal imaging device
22
Q
Created during the simulation
A
DRR (Digitally reconstructed radiograph)
23
Q
Acquires many projections over the entire volume of interest as the gantry rotates around the patient. (The gantry rotates around the patient taking images the entire time it is rotating using the KV images system)
A
CBCT imaging (Cone Beam CT)
24
Q
Area or region at the beams edge where the radiation intensity falls to 0
A
Penumbra
25
What are the two verify systems used within our program during clinical's
Aria and Mosaiq
26
Provides valid parameters from the treatment plan to the treatment machine for setup and delivery. Compares the actual machine settings with those prescribed for a particular filed and prevents beaming on if the settings are not within the specified tolerance ranges
Record and Verify system
27
Individual treatment dose
Fractionation
28
Time period during which the treatment will be given
Protraction
29
Changes occurring between treatment sessions
Interfraction (examples: Prostate treatment, patient did not drain bladder completely and or have a empty rectum.
30
Safety switches blocking or terminating radiation production. Prevent beam initiation and include alerts prompting completion of treatment setup and safety procedures, including closing the door, beam-modifiers placement such as wedges and electron cones.
Interlocks-Safety switches
31
________ will prevent initiation of beam if water temp, water pressure, and vacuum system measurements not in range.
Interlocks-Safety switches
32
Suffix for (Intra)
Within
33
Suffix for (Inter)
Between
34
The arrangement of shielding material designed to define the x and y dimensions of the field
Collimation
35
The measure of the angle between central rays of two intersecting treatment beams.
Hinge Angle (ex: POP fields have a hinge angle of 180 degrees)
36
A standardize approach to verify that you are treating the right patient, area, etc. (Example: Patient is on the treatment couch and the therapist says: "we are treating Jon Smith")
Time Out
37
Used to modify the dose distribution across the beam accommodating for the patients contour
Compensators ( example: Bolus, Wedge)
38
Is the cpmpensator that goes into the head of the gantry is skin sparring unlike bolus
True
39
A moving jaw starts at one side of a treatment field and opens to the full field over the beam exposure. The dose is effectively sloped over the field, in the manner of a physical wedge.
Virtual Wedge
40
When you make shifts on the patient/or to treatment couch, when reviewing the council screen are you reviewing the plan or the actual?
Actual
41
What is the minimum x-ray beam energy required for a radiation therapy machine to be classified as a megavoltage machine?
1MV
42
Is the control console located inside or outside of the room
outside
43
Gross palpable or visible tumor
GTV- Gross Tumor Volume
44
GTV plus any margin of subclinical disease that needs to be eliminated thru the treatment planning process
CTV- Clinical Target Volume
45
CTV plus margins for geometric uncertainties such as patient motion beam penumbra and treatment setup differences.
PTV- Planning Target Volume
46
Calibrated so that 1 MU delivers 1cGy for a standard reference field size (usually 10x10) at a standard reference dept at a standard source to calibration point.
MU-Monitor Units
47
Unit of energy absorbed per unit mass of any material
cGY (centigray)
48
Measurement of the thickness of a patient along the central axis or at any other specified point within the irradiated volume
Sep (Separation Measurement)
49
Suffix for Treatment
Tx
50
Suffix for Fraction
Fx
51
Suffix for Field Size
FS (Field size dimensions of the treatment field a the isocenter)
52
What is EPID
Electronic Portal Imaging Device- system producing near real-time portal images on a computer screen for evaluation
53
What is a DRR and when is it created?
Digitally Reconstructed Radiograph/ During simulation
54
What is IGRT and what is the rationale for using it?
Image Guided Radiation Therapy- To image the patient before treatment and compare the position of external setup and marks and internal anatomy with the treatment plan. (Image can detect: weight loss, respiratory motion, movement of body or internal structures and tumor shrinkage)
55
What are MLC's, where are they found and what are they used for
Multileaf Collimator- gantry head- shaping or blocking the field shaping
56
What is the range finder used for on the gantry head
Used to read the SSD- the projects onto the patients skin and match the intersecting crosshairs that coincide with the central ray of the beam.
57
MLC's do not move while the beam is on
Static
58
MLC's are moving while the beam is on
Dynamic
59
When treating a patient with skin cancer and using electrons, does the electron beam strike the x-ray target in the treatment head
NO
60
When treating a patient with skin cancer and using electrons, which foil is used?
Scattering Foil
61
What is used in the treatment head to allow the therapist to set the field size for each patient?
Collimator Jaws
62
Lining the patient up to the three points marked on the patient using the three machine- aligned lasers
Triangulation
63
The arrangement of shielding material designed to define the x and y dimensions of the field
Collimation
64
While treating a patient should the the lights be on or off
On
65
List two methods for identifying a patient
1. picture in the chart
2. wrist bracelet
3. name
4. date of birth
5. last 4 of social
66
Will the three point localization marks placed on the patient for triangulation will always coincide with the treatment isocenter
False
67
What is a portal image
Port Film
68
An image that verifies that BEV path, including the beam shape, position and projection of the beams central axis
Portal Image
69
What else can be used as a bolus?
Paraffin Wax, Vaseline gauze, wet gauze or towels, superflab and water bags
70
What are compensators used for?
To modify the dose distribution across the beam accommodating for the patients contour
71
The thin end of the wedge is called _______ and the thick end of the wedge is called __________
toe/heel
72
What are the (4) standard wedge sizes
15, 30, 45, 60
73
What is the name of the wedges placed in the gantry head?
physical wedges
74
What is commonly used to treat prostate?
Four Field Box
75
An AP/PA and two lateral fields are often referred to as a _________?
Four Field Box
76
IMRT technique where the leaves reposition then come to rest while the beam is delivered in multiple segments at each gantry angle.
Step and Shoot
77
IMRT technique where the MLC's move from one side of the field to the other wile the beam is on.
Sliding Window
78
IMRT allows a _______ dose to be delivered to the target while delivering _______ dose to the normal structures around it.
High/Low
79
Side Effects of Prostate Cancer
Decrease urinary stream (Slow growing/Risk
Frequency increases with age)
Difficulty starting to urinate
Painful Urination (dysuria)
Blood in Uria (Hematuria)
80
When treating the whole brain what are the boarder you watch out for?
Supra orbital ridge, EAM (external auditory meatus) Mastoid Process and C1/2
81
When treating the whole brain what is the collimator set to treat the patients right side if the patient is supine?
45 degrees (Left would be 315 degrees)
82
What do you check before treating whole or helmet brain cancer?
1cm of flash
83
Helmet Brain Prescription
3000cGy/300cGy fx/10 fx/ 6mv/ midplane
84
What field are you using when treating a Helmet or Whole Brain?
POP Field- parallel opposing Field (180 degrees)
85
What is the most common sign of Metastasis to the brain?
Headaches
86
What are the signs of Metastasis to the brain?
1. headaches
2. seizures
3. dizziness
4. difficulties with balance
5. mental and personality changes
87
What are the common PRIMARY cancers that spread to the brain?
1. lung
2. breast
3. gastrointestinal
4. head/neck
5. prostate
6. melanoma
Brain mets occurs in about 25% of patients with cancer
88
Small Cell Lung Cancer has such a propensity to spread to Brian that patients are usually with ___________
Prophylactic Cranial Irradiation (PCI)
89
What does the Z shift do to the table
Moves the table UP and Down
90
What does the Y shift do to the table
Moves the table IN and Out
91
What does the X shift do to the table
Moves the table Right and Left
92
Treatment to Spine
Include one vertebral body above and one below the metastatic site. Place the superior and inferior boarders in the intervertebral spaces (Include the transverse process)
93
What is Tegaderm
Clear film- usually see placed over marks on patients to preserve the marks during treatment. Placed on during simulation if tattoos will not be placed.
94
A tissue equivalent material used to increase the skin dose and or even out irregular contours in the patient. Often used to treat superficial lesions.
Bolus
95
The spreading out of the beam of radiation. The farther from the source the more the beam has spread
Beam Divergence
96
The reference marks (BB's) are placed on the patient before the CT scan. As soon as the patient is scanned they are allowed to leave
Shift Method
97
The patient is scanned and while the patient is still lying on the CT, images are reviewed and the isocenter is determined. A shift sheet is printed and the therapist inputs the coordinates into the external laser system. Tattoos could be applied.
No-Shift Method
98
Nearer to the point of origin
Proximal
99
Father away from the point of origin
Distal
100
On or near the body surface
Superficial
101
Away from the body surface
Deep
102
On the same side of the body
Ipsilateral
103
On the opposite side of the body
Contralateral
104
Planes of Body- Midsagittal
Mean (Right and left half)
105
Planes of the Body- Coronal
Frontal (Anterior and Posterior)
106
Planes of the Body- Transverse
Horizontal (Superior and inferior)
107
Step and Shoot
1. static
2. segments
3. Beam is off as the leaves are getting into postion, then the beam turns on once and in place
108
Sliding Window Technique
1. Dynamic
| 2. Moves leaves through beam on/off sequence
109
Symptoms of Lung Cancer
1. weight loss
2. coughing
3. coughing up blood (hemoptysis)
4. shortness in breath (dyspnea)
5. chest pain
110
What is VMAT
Volume modulated arc therapy (Rapid Arc)
111
What does the Rapid Arc treatment do?
1. single or multiple arcs around patient
2. gantry speed, dose rate, and shape of mic change during the arc rotation
3. less time to treat
112
Most Common Cause of Lunch Cancer
Tobacco Exposure
113
Sterotactic Body Radiation Therapy
1. higher dose
2. targets mostly tumor
3. motion of the tumor should be controlled
4. less fractions (1-5)
5. May use vacuum based patient immobilization system
114
The field size is 10x10cm. Which of the following is true of an AP view when the patient is set at the proper SSD using an SAD technique?
smaller
115
In a parallel opposed field arrangement, two treatment fields share common central axes ________ degrees apart?
180 Degrees
116
A patient is being treated to the prostate. One of the fields is named RPO prostate. Which of the following is the correct gantry angle for the named field?
1. ( 225)
2. 90
3. 135
4. 45
5. 315
6. 270
117
A patient is being treated to the whole brain. What is the gantry angle for the RT. lateral
1. (270)
2. 90
3. 180
4. 0
118
A prone patient is being treated to the rectum. What is the gantry angle for the Lt. Lateral rectum field
1. (270)
2. 0
3. 180
4. 90
119
What is the opposing field for an LAO
RPO
120
When taking an image, which beam orientation will show the depth of treatment
Right or left lateral
121
Which of the following movements will make a shift on the X axis
Left/Right
122
Which of the following movements will make the a shift on Z axis?
up/down
123
Which direction will the gantry rotate to get to gantry angle 180E
Counter clockwise
124
Which of the headrest tilt the chin up the most
headrest C (C for chin)
125
Which mask will most likely be used to treat the whole brain
short S-frame mask
126
The wingboard will most likely be used to treat the __________
Thorax
127
Your treating a spine with an 8x10 treatment field. The length of the treatment field is
10 cm
128
The therapist is treating a patient to the prostate. After imaging the patient, the therapist goes into the room and stands on the right side of the patient and pushes the table away to make a .2cm shift. What direction did the field shift?
1. (Right)
2. left
3. superior
4. inferior
5. anterior
6. posterior
129
The therapist is treating a patient to the right lung. After imaging the patient, the therapist determines the field needs to shift .3cm posteriorly. What table movement needs to be made?
1. (Raise the table)
2. move the table laterally
3. move the table out
4. move the table in
5. lower the table
130
Mary, a therapist is treating a patients whole brain. Mary is standing to the side of the table to read the Rt. lateral SSD at the CAX. It is suppose to be 93cm but reads 92cm. To set the correct SSD, Mary
1. (Moves the table away from her)
2. raises the table
3. lowers the table
4. moves the table in
5. moves the table out
6. moves the table toward here
131
Toward the back (shift is called)
Posterior
132
Toward the head (shift is called)
Superior
133
Toward the feet (shift is called)
Inferior
134
Toward the side (shift is called)
Lateral
135
Towards the midline (shift is called)
Medial
136
Towards the surface (shift is called)
Superficial
137
A patient is being treated to a midplane depth. The separation at the CAX is 24cm. The patient is being treated using AP/PA POP field arrangement. What is the SSD for the AP field?
1. (88cm)
2. 76cm
3. 92cm
4. 24cm
138
A patient is being treated to the prostate. The separation thru the CAX on the lateral is 43cm the right lateral SSD is 79cm. The SSD for the left lateral is_____
1. 78cm
139
X1=5cm, X2=5cm, Y1=8cm, Y2=8cm (This treatment field is symmetric or asymmetric?)
Symmetric
140
A patient is being treated to a midplane depth using two POP lateral fields. The SSD on the Rt. lateral is 91 what is the SSD for the Lt. lateral?
91cm
141
What reads the SSD
ODI
142
Used to bring the dose closer to the skin
Bolus
143
Process of lining the patient up to three points
Trangulation
144
shapes the beam
MLC's
145
Patient support assembly
Treatment couch
146
The spreading out of the beam of radiation
beam divergence
147
Point in space where radiation beams intersect from any of the 360 degree gantry angles
isocenter
148
a line perpendicular to the cross section of the treatment field
CAX
149
Refers to the measurement of the thickness of a patient along the CAX from the entrance point to the exit point.
1. (separation)
2. depth
3. beam divergence
4. SAD
5. SSD
150
An isocentric technique is also referred to as an/a_________ technique
SAD
151
Which technique is used most often when treating single fields?
SSD
152
Which of the following degrees of translation does our machine in the Vert clinic not have?
1. (Pitch)
2. lateral
3. vertical
4. longitudinal
5. rotation
153
A patient is being treated to the rectum. The patient is prone. One of the fields is named RPO rectum. Which of the following is the correct gantry angle for the name field?
1. (45)
2. 315
3. 225
4. 90
5. 135
154
Which of the following is not a oblique angle
1. (90)
2. 135
3. 315
4. 45
155
A spine patient is being treated prone to a single filed with an SSD of 100. Which technique is being used?
SSD
156
Which of the following fields are considered parallel opposed?
1. (field 1 gantry =90, field 2 gantry = 270)
2. field 1 gantry = 0, field 2 gantry = 90
3. field 1 gantry = 90, field 2 gantry = 280
157
A patient is being treated with two parallel opposed fields. One field is an AP field. What is the other field?
PA
158
On which axis is a Vertical shift made
Z
159
True or False- The field size is the size of the field that is displayed on the patients skin when using an SAD technique
False
160
Metastatic cancer is also referred to as___________
Secondary Cancer
161
A patient who is being treated only to relieve pain is receiving ___________ treatment
Palliative
162
Radiation Therapy
Administers the external beam radiation
163
Dosimetrist
Creates the treatment plan
164
Medical Physicist
Oversees the treatment planning and radiation safety programs
165
Radiation Oncologist
Determines radiation treatment options and writes the prescription
166
Remember X1 and Y1 are_______________
Negative fields
167
Remember X2 and Y2 are ___________
Positive fields
168
The ________defines the dimensions of the FS
Collimator
169
When all (3) lasers cross on the patients skin, the SSD is
100cm
170
When our linear accelerator VRT is set at 0, the SSD to the couch is ________cm.
100cm
171
When treating using an AP/PA POP fields arrangement, the shape of the PA field_________(remember BEV)
a mirror image of the AP field
172
When using an SSD technique, the isocenter is located_______
a the patients skin
173
A patient is being treated using two AP/PA parallel opposed fields, The AP SSD is 87 and the PA SSD is 87. The dept of treatment is___________
midplane
174
The field light projected onto the patients skin at an SSD of 87cm measures 8cm x 12cm. The FS is___________
equal to 8cm x 12cm
175
An electron cone is used to treat_________
superficial lesions
176
Which of the following is the smallest?
1. (GTV)
2. PTV
3. CTV
177
Thoracic
T-12 (Lunch)
178
Lumbar
L-5 (Breakfast)
179
Cervical
C-7 (Dinner)
180
Which critical structure must be avoided when treating the whole brain?
Lens of the eye
181
The part of the field that extends past the body part being treated is called
flash
182
When treating the spine, we are usually treating
metastatic disease
183
Blastic lesions will usually appear_________on an image?
lighter
184
A patient is to be treated to the whole brain. The collimator rotation is on the left lateral at 313. What does the right lateral need to be set at?
47
185
Which type of cancer is a helmet brain most often used to treat?
Metastatic Cancer
186
The first floating rib is located at what vertebral body?
T-12
187
What is the TD/D for spinal Cord
4700 cGy
188
Treatments to which Vertebral bodies would most likely require the widest treatment field
Lumbar
189
Which type of imaging delivers less dose to the patient per exposure
KV Imaging
190
Where is the prostate located in relation to the symphysis pubis?
Posterior
191
Segmental MLC
Step and Shoot
192
IMRT technique where the MLC's move from one side of the field to the other while the beam is on
Sliding Window
193
Dynamic MLC
Sliding Window
194
Static MLC
Step and Shoot
195
IMRT technique where the leaves reposition then come to rest while the beam is delivered in multiple segments
Step and shoot
196
Where is the bladder located in relation to the prostate
Superior
197
Where is the trachea located in relation to the esophagus
Anterior
198
Where are the Seminal Vesicles located in relation to the prostate
Superior and Posterior
199
What imaging modality is used in the placement of fiducials into the prostate
Ultrasound
200
Which of the following type of cancer is SBRT most often used?
Lung
201
Which of the following delivers a uniform dose across the BEV
Conformal
202
Which of these two uses more MU's to deliver the prescribed dose?
IMRT
203
Which one will deliver less dose to critical structures
IMRT
204
Difficult or labored breathing is called
dyspnea
205
Painful urination is called
dysuria
206
The study of disease is called
etiology
207
What are the four components of the drive stand
1. Klystron
2. Waveguide
3. Circulator
4. Cooling System
208
The spreading out of the beam of radiation. The farther from the source, the more the beam has spread
Beam Divergence
209
Two treatment fields share common central axes, 180 degrees apart
Parallel Opposed Fields (POP)
210
Point in space where radiation beams intersect from any of the 360 degree gantry angles. It is similar to the spokes of a bicycle
Isocenter
211
Source-skin distance is the distance from the source of the radiation to the skin surface of the patient.
SSD
212
The central axis is a line perpendicular to the cross section of the treatment field. It is the only imaginary line emanating from the source of radiation that is not divergent
CAX
213
Refers to the measurement of the thickness of a patient along the central axis from the entrance point to the exit point.
Separation
214
This procedure has a higher dose and treats with small fields
IMRT
215
Fields are defined thru BEV and shaped to include target/ w minimal normal tissue margins and a uniform dose
Conformal
216
Delivers nonuniform exposure across BEV
Higher dose delivered to Target while minimizing dose to critical structures
More MU's than conformal
Sliding window technique & step and shoot
IMRT
217
Radiation turned on when the target is within the treatment volume and radiation is turned off when the target is outside target volume (deep inspiration, hold)
Respiratory Gating
218
Higher dose
targets mostly tumor
motion of the tumor must be well controlled and may use vacuum bases patient immobilization system
Less fractions- 1-5
SBRT (Stereotactic Body Radiation Therapy)
219
Field arrangements for head and neck cancers are treated with IMRT rather than conformal (True or False)
True
220
When approaching the Spinal Dose Tolerance What do you do?
You would use an oblique filed angle and go OFF cord
221
Where is the prostate located in relation to the bladder
Inferior
222
Where is the rectum located in relation to the prostate
Posterior
223
Where is the trachea located to the esophagus
Anterior
