Tx Planning Final Flashcards by Brianne Bradford

T/F: Penumbra decreases w/increasing SSD

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T/F: Penumbra increases with larger source size

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Electrons can be used to treat tumors to a depth of _________cm deep.

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T/F: Safety is no accident is published by ASTRO and is a recommendations for radiation therapy departments

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Treatment planning includes the following steps: (select all that are true)
patient positioning
tumor delineation
beam arrangement
computing dose delivered and eval of treatment plan
transfer of the treatment planning information to delivery sysetm

All

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T/F: If you tattoo a patient in SIM at the CT setup point but dosi moves isocenter to another location you will have to shift daily on the machine?

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How do you verify your shifts from CT isocenter to treatment isocenter?

Subtract the coodinates in the X,Y, and Z direction from CT iso to plan iso

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When determining parameters to optimize a patients treatment some of the parameters include: (select all that are true)
Target volume
Dose-limiting structures
Treatment volume
dose prescription
dose fractionation
dose distribution

All

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T/F: OARs are contoured on a CT scan by the physician

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T/F: IMRT is known as inverse planning

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What modality gives the best spatial resolution?

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motion artifact can happen on scan from the following: (Select all that is correct)
breathing motion
cardiac motion
bone motion
table motion

breathing motion

cardiac motion

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Match the tissue-type to the associated HU:
bone
water
air

bone = +1000
water = 0
air = -1000

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At diagnostic energies the most common interaction in tissue is what? (select all that is correct)
photo electric
compton effect
pair production

photo electric

compton effect

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Gross tumor + microscopic disease is called

CTV

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T/F: Target volume is defined as the primary tumor + local spread and lymphatic spread

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Commonly used imaging studies to help delineate the tumor is the following: (Select all that apply)
CT
PET
SPECT
MRI
PMRI

CT
PET
SPECT
MRI

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Irradiated volume is defined as the ____________ Isodose line

50%

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What’s the energy range?

Co-60, 4MV, 6MV

Low-energy Megavoltage X-ray

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What’s the energy range?

10-25MV

Medium or High energy Megavoltage X-ray

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T/F: To treat with IMRT you must have MLC or compensator option on your treatment unit

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T/F: Using low energy megavoltage x-ray beams while treating parallel-opposed beams, the body thickness should not exceed approximately 15cm?

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Delivering diff dose to diff volumes in 1 course of tx over 33 fxs.

Dose painting

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Select below the MLC size that would give you smaller beamlet options
1cm
0.5cm

0.5cm

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Constraint or objective? | Conditions that are to be satisfied in any case

constraint

Constraint or objective? | Functions that measure the quality of a treatment plan

objective

Serial or parallel organ? | spinal cord

serial

Serial or parallel organ? | lung

parallel

T/F: Dynamic or sliding window IMRT delivery technique is best described as when the beam turns on and delivers dose, then turns off while the MLCs move to the next position then the beam turns back on. This pattern continues until all MU are delivered.

Yaw, pitch, and roll are what type of shifts?

Rotational

The interaction that happens with PET scans is what - Annihilation Radiation or Compton?

Annihilation Radiation

An ITV is created when there is movement of the tumor that needs to be accounted for.

The size of MLCs are defined how? The projected size at 100cm SSD The physical size of each MLC

The projected size at 100cm SSD

Select all that are true: According to TG 57, what are some facts about organ movement related to breathing? select all that apply Breathing cycle lasts around 4 sec Patients spend more time in exhale than inhale Tumors at the apex move less than those near the diaphragm Patient specific motion needs to be assessed

All

What are the two primary histologies of Esophagus cancer?

Adenocarcioma and Squamous Cell

T/F: Treating a patient prone for an esophageal primary moves the esophagus on average 1.7cm away from the spinal cord

T/F: When evaluating a patient's DVH for an squamous cell carcinoma of the esophagus the total Lung: less than 20Gy should be 30% or less and preferable <25%

``` Select all that are true for patient position during SIM for a patient with gastric cancer: Supine Arms over head Empty stomach Oral contrast can be helpful ```

All

T/F: When treating proximal portion of the stomach for a gastric primary it might include a portion of the esophagus

According to the NCI the 5-year overall survival for pancreas cancer is __________?

10%

T/F: Celiac artery is located at

T12

Select all that are true that can be helpful when simulating a patient with anal cancer: Supine Frog-legged Vaginal dialator

All

Vaginal Cancer is usually treated with definitive RT

WEEK 9 QUIZ #1

....

T/F: 6 to 20 MeV is the most common energies for electron beams

1/4 the beam energy = ___ IDL

90%

1/3 the beam energy = ___ IDL

80%

1/2 the beam energy = ___ IDL

10% or useful range

T/F: Spinal cord max dose is 50Gy

T/F: Radiosurgery to a brain lesion is delivered in a single fraction.

T/F: Target volume and dose are inversely related.

Select the imaging modality that offers the best soft tissue resolution

MRI

Gamma knife uses what type of source?

Co-60

How do you make a beam "non-coplanar"?

Add a table kick

What type of cancer is the leading cause of cancer related deaths?

LUNG

True/False: The whole liver tolerance is 30-35Gy which is insufficient to achieve reasonable tumor control

Select all that are true with regards to electrons: Lower energy electrons scatter more The greater the SSD the greater the penumbra The smaller the electron cone the better treatment delivered

Lower energy electrons scatter more | The greater the SSD the greater the penumbra

Select all that are true with regards to electrons: Beam direction should be chosen to be perpendicular to skin surface that is nearest the target volume Energy is decided by max depth of target Usually prescribed to the 90% IDL

All

What type of esophageal cancer histology has been on the rise recently?

adeno

If the treatment field will include any of the stomach it is best to have what kind of prep from the patient?

NPO 3 hours

Ex 3 #21

...

``` Rectal tumors can be described as the following: (Select all that are true) moblie fixed teathered free floating ```

moblie fixed teathered

When treating rectal cancer with radiation is there better sphincter preservation with which type of fractionation? small dose per fraction over a longer course higher daily dose with fewer overall fractions

small dose per fraction over a longer course

What type of patient setup will reduce the amount of small bowel in the field? (rectal)

prone

If a rectal patient is being treated prone what type of setup is best?

Tape the buttocks open so it does not self-bolus

T/F: When adding PET to the imaging modalities used when defining the field for a rectal primary it has shown to increase the GTV by 25%

Apex of the prostate is located where?

Inferior portion

Ex 3 #29

...

What type of metastatic Hematogenous spread happens in prostate cancer?

Osteoblastic bone lesions to the axial skeleton

Ex 3 #31 & 32

...

According to NCCN the 5-year survival (2010-2016) for rectal cancer is 64.6%

What is considered a normal PSA value? | 4, 3, 2 or 1?

Prostate cancer tx options: | Patients who are asymptomatic and either has advanced age or other advanced disease

Watchful waiting

Prostate cancer tx options: | Involves serial DRE, PSA, & biopsies - expected to treat

Active surveilance

What type of patient prep is used for prostate patients

Full bladder, empty rectum

Which MRI technique is useful when contouring the prostate

Select all techniques for patient setup that are used for treating a patient with anal cancer (select all that apply) Frog-legged Full bladder to displace small bowel Bolus can be used

Frog-legged Full bladder to displace small bowel Bolus can be used

Ex 3 #39

...

T/F: When treating a whole pelvis with a 3D treatment using standard whole pelvis fields for a 4-field box it is best to use low energy over high energy to decrease hotspots

The superior border when treating PANs in an extended Radiotherapy pelvic fields is _____.

T12/L1

when treating a whole pelivs with a 4-feild box and PANs the best way to match the two areas are_________.

Using the gap formula to calculate the skin gap

When treating a bladder primary is it better to treat with what patient prep?

Empty bladder

Tx Planning Final Flashcards

(82 cards)