| Question 1: The correlation among voxels between FDG-PET uptake and hypoxia imaging uptake, for example using F-MISO imaging, is usually...
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| Reference: | Zegers CM, Van Elmpt W, Reymen B, Even AJ, Troost EG, Öllers MC, Hoebers FJ, Houben RM, Eriksson J, Windhorst AD, Mottaghy FM. In vivo quantification of hypoxic and metabolic status of NSCLC tumors using [18F] HX4 and [18F] FDG-PET/CT imaging. Clinical Cancer Research. 2014 Dec 15;20(24):6389-97.
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| Choice A: | Weak or statistically uncorrelated. |
| Choice B: | Positively statistically correlated. |
| Choice C: | Negatively statistically correlated. |
| Choice D: | Dependent on the tumor. |
| Choice E: | Unknown. |
| Question 2: Tumor regression during radiotherapy is thought to be due to:
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| Reference: | Jeong J, Shoghi KI, Deasy JO. Modelling the interplay between hypoxia and proliferation in radiotherapy tumour response. Physics in medicine and biology. 2013 Jun 21;58(14):4897. |
| Choice A: | Reoxygenation of tumor cells. |
| Choice B: | Reduced FDG uptake due to radiation damage. |
| Choice C: | Death of cells attempting mitosis. |
| Choice D: | Death of cells by due to lack of glucose. |
| Choice E: | Death of cells due to hypoxia. |
| Question 3: Which of the following is correct regarding PET-guided adaptive treatment in Hodgkins’ lymphoma? |
| Reference: | Aridgides P, Bogart J, Shapiro A, Gajra A. PET Response-Guided Treatment of Hodgkin's Lymphoma: A Review of the Evidence and Active Clinical Trials. Adv Hematol. 2011;2011:309237. doi: 10.1155/2011/309237. Epub 2010 Dec 27. PubMed PMID: 21234382; PubMed Central PMCID: PMC3017897.
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| Choice A: | Current standard RT in lymphoma is tailored treatment based upon PET assessment. |
| Choice B: | There is consensus regarding the appropriate treatment of PET-avid disease (interim or after completion of therapy): i.e. more intensive treatment for poor responders. |
| Choice C: | PET response is strongly prognostic for treatment outcome. |
| Choice D: | PET guided adaptive trial has demonstrated superiority of such treatment in lymphoma. |
| Question 4: Regarding PET scan obtained during the course of radiotherapy, which of the following is correct? |
| Reference: | Feng M, Kong FM, Gross M, Fernando S, Hayman JA, Ten Haken RK. Using fluorodeoxyglucose positron emission tomography to assess tumor volume during radiotherapy for non-small-cell lung cancer and its potential impact on adaptive dose escalation and normal tissue sparing. Int J Radiat Oncol Biol Phys. 2009 Mar 15;73(4):1228-34. doi: 10.1016/j.ijrobp.2008.10.054. PubMed PMID: 19251094; PubMed Central PMCID: PMC3381895.
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| Choice A: | Midtreatment FDG-PET guided therapy can escalate the dose to tumor while not increasing doses to normal tissues. |
| Choice B: | FDG-PET-CT performed during the course of RT has limited value as the imaging is often confounded by the effect of radiation induced inflammation |
| Choice C: | Metabolic tumor volume decreased during the course of radiation therapy, but not more than CT gross tumor volume. |
| Choice D: | Midtreatment FDG-PET guided radiation therapy is not feasible. |
| Question 5: RTOG1106 use which of following methods to define FDG-PET scan to guide adaptive treatment in non-small cell lung cancer: |
| Reference: | Biehl KJ, Kong FM, Dehdashti F, Jin JY, Mutic S, El Naqa I, Siegel BA, Bradley JD. 18F-FDG PET definition of gross tumor volume for radiotherapy of non-small cell lung cancer: is a single standardized uptake value threshold approach appropriate? J Nucl Med. 2006 Nov;47(11):1808-12. PubMed PMID: 17079814.
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| Choice A: | Threshold SUVmax at 2.5. |
| Choice B: | Threshold at 40% of SUVmax. |
| Choice C: | Manual drawing per treating physician. |
| Choice D: | Tumor background ratio. |
| Question 6: The GTV in prostate cancer is defined as... |
| Reference: | Boosting imaging defined dominant prostatic tumors: a systematic review. Bauman G1, Haider M, Van der Heide UA, Ménard C.G. Radiotherapy and Oncology 107 (2013) 274–281
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| Choice A: | The index lesion. |
| Choice B: | The prostate gland. |
| Choice C: | The prostate gland plus seminal vesicles. |
| Choice D: | The visible cancer inside the prostate and seminal vesicles. |
| Question 7: Multi-parametric MRI as defined in PI-RADS v2 is necessary for the delineation of..
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| Reference: | Magnetic resonance imaging for prostate cancer radiotherapy. Dinh et al. Physica Medica 32 (2016) 446-451 |
| Choice A: | The GTV. |
| Choice B: | The prostate gland. |
| Choice C: | The seminal vesicles. |
| Choice D: | The peripheral zone of the prostate. |
| Question 8: Tumor probability reflects.. |
| Reference: | Magnetic resonance imaging for prostate cancer radiotherapy. Dinh et al. Physica Medica 32 (2016) 446-451
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| Choice A: | The size of the tumor. |
| Choice B: | The number of tumor cells in a voxel. |
| Choice C: | The likelihood that tumor is found in a voxel. |
| Choice D: | The aggressiveness of the tumor cells in a voxel. |
| Question 9: Regarding apparent diffusion-coefficient (ADC), which of the following statement is not true?
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| Reference: | Dalah E, Moraru I, Paulson E, Erickson B, Li XA. Variability of target and normal structure delineation using multimodality imaging for radiation therapy of pancreatic cancer. Int J Radiat Oncol Biol Phys. 2014 Jul 1;89(3):633-40. doi:10.1016/j.ijrobp.2014.02.035. Epub 2014 Apr 20. PubMed PMID: 24755533.
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| Choice A: | ADC maps are generated from diffusion-weighted MRI. |
| Choice B: | ADC values correlate with cellularity in tumor. |
| Choice C: | ADC can be used to measure tumor hypoxia. |
| Choice D: | ADC values may be used to assess treatment response. |
| Question 10: During a course of radiation therapy for head and neck cancer, parotid gland volumes are expected to... |
| Reference: | Feng M, Yang C, Chen X, Xu S, Moraru I, Lang J, Schultz C, Li XA. Computed tomography number changes observed during computed tomography-guided radiation therapy for head and neck cancer. Int J Radiat Oncol Biol Phys. 2015 Apr 1;91(5):1041-7. doi: 10.1016/j.ijrobp.2014.12.057. PubMed PMID: 25832695. |
| Choice A: | Remain constant in all patients. |
| Choice B: | Decrease in most of cases as a result of irradiation. |
| Choice C: | Increase in all cases, since parotid glands swell during radiotherapy. |
| Choice D: | Decrease in all cases as a result of irradiation. |
