| Question 1: Dose accumulation on 4D cone beam CT images shows the most common cause of substantial dose deviations in liver SBRT is: |
| Reference: | Velec M, Moseley JL, Craig T, Dawson LA, Brock KK. Accumulated Dose in Liver Stereotactic Body Radiotherapy: Positioning, Breathing, and Deformation Effects. Int J Radiat Oncol Biol Phys 2012; 83: 1132-1140.
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| Choice A: | Residual positioning uncertainty. |
| Choice B: | Abdominal deformation. |
| Choice C: | Respiratory variation. |
| Choice D: | Machine ouput. |
| Question 2: The QUANTEC recommendations for liver mean dose limits for SBRT include: |
| Reference: | Pan CC, Kavanagh BD, Dawson LA, Li XA, Das SK, Miften M, Ten Haken RK. Radiation-Associated Liver Injury. Int J Radiat Oncol Biol Phys 2010; 73(S3): S94-S100.
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| Choice A: | 28 Gy for primary liver cancer and 32 Gy for liver metastases in six fractions. |
| Choice B: | 32 Gy for primary liver cancer and 28 Gy for liver metastases in six fractions. |
| Choice C: | 18 Gy for primary liver cancer and 20 Gy for liver metastases in six fractions. |
| Choice D: | 20 Gy for primary liver cancer and 18 Gy for liver metastases in six fractions. |
| Question 3: The best surrogate for the gross tumor volume location during IGRT is: |
| Reference: | Seppenwoolde Y, Wunderink W, Wunderink-van Veen SR, Storchi P, Mendez Romero A, Heijmen BJM. Treatment precision of image-guided liver SBRT using implanted fiducial markers depends on marker-tumour distance. Phys Med Biol 2011; 56: 5445-5468
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| Choice A: | Implanted gold fiducial markers |
| Choice B: | Diaphragm |
| Choice C: | Vertebrae |
| Choice D: | External frame |
| Question 4: Pre-planning peer review of SBRT treatments has been shown to identify required changes due to: |
| Reference: | Matuszak, M. M., S. W. Hadley, et al. (2016). "Enhancing safety and quality through preplanning peer review for patients undergoing stereotactic body radiation therapy." PRRO 6(2): e39-46.
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| Choice A: | Previous radiation treatment. |
| Choice B: | Plan quality. |
| Choice C: | Machine output. |
| Choice D: | IGRT registration. |
| Question 5: HCC tumors get their blood supply primarily from the: |
| Reference: | McEvoy SH, McCarthy CJ, Lavelle LP, Moran DE, Cantwell CP, Skehan SJ, Gibney RG, Malone DE. Hepatocellular Carcinoma: Illustrated Guide to Systematic Radiologic Diagnosis and Staging According to Guidelines of the American Association for the Study of Liver Diseases. Radiographics 2013: 33; 1653-1668
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| Choice A: | Hepatic artery. |
| Choice B: | Portal vein. |
| Choice C: | Neither |
| Question 6: Imaging of metastatic tumors is best done with: |
| Reference: | Tirumani SH, Kim KW, Nishino M, Howard SA, Krajewski KM, Jagannathan JP, Cleary JM, Ramaiya NH, Shinagare AB. Update on the Role of Imaging in Management of Metastatic Colorectal Cancer. Radiographics 2014; 34: 1908-1928. |
| Choice A: | Early phase contrast CT. |
| Choice B: | Late phase contrast CT. |
| Choice C: | T2 MRI. |
| Choice D: | Both B. and C. |
