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Intro to Clinical's (Gwen)- Nicole Calvin > Final Prep > Flashcards

Final Prep Flashcards

1
Q

Provides the source of the microwave power used to accelerate electrons (housed in drive stand)

A

Klystron

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2
Q

Carries microwave power from Klystron to accelerator guide (housed in drive stand)

A

Waveguide

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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

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4
Q

Allows components in the gantry and drive stand to operate at a constant temperature. (housed in drive stand)

A

Cooling System

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5
Q

Responsible for producing electrons and injecting them into the accelerator structure. (Gantry)

A

Electron Gun

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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

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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)

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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)

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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

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10
Q

Monitors beam dosimetry to within 2% for long-term consistency and stability. (Treatment Head)

A

Ion Chamber

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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

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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)

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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)

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14
Q

An arrangement of shielding material designed to define the X and Y dimensions of the beam of radiation. (Treatment head)

A

Collimators

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15
Q

How did the Linear Accelerator get it’s name

A

Electrons or charged particles travel in a straight line (within tube) Gantry

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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)

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17
Q

What does the Scattering foil produce

A

Electrons

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18
Q

The carousel will continue to rotate until the opening allows the scattering foil to open?

A

True

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19
Q

What are the advantages of KV images

A
  1. Better detailed (better contrast)
  2. Provides more info about soft tissue and bony anatomy
  3. Less dose to patient than MV imaging
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20
Q

What Orthovolotage image is used to verify portal

A

MV image

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21
Q

System producing real-time portal images on computer screen for evaluation

A

Electronic portal imaging device

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22
Q

Created during the simulation

A

DRR (Digitally reconstructed radiograph)

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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)

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24
Q

Area or region at the beams edge where the radiation intensity falls to 0

A

Penumbra

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25
Q

What are the two verify systems used within our program during clinical’s

A

Aria and Mosaiq

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26
Q

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

A

Record and Verify system

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27
Q

Individual treatment dose

A

Fractionation

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28
Q

Time period during which the treatment will be given

A

Protraction

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29
Q

Changes occurring between treatment sessions

A

Interfraction (examples: Prostate treatment, patient did not drain bladder completely and or have a empty rectum.

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30
Q

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.

A

Interlocks-Safety switches

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31
Q

________ will prevent initiation of beam if water temp, water pressure, and vacuum system measurements not in range.

A

Interlocks-Safety switches

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32
Q

Suffix for (Intra)

A

Within

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33
Q

Suffix for (Inter)

A

Between

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34
Q

The arrangement of shielding material designed to define the x and y dimensions of the field

A

Collimation

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35
Q

The measure of the angle between central rays of two intersecting treatment beams.

A

Hinge Angle (ex: POP fields have a hinge angle of 180 degrees)

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36
Q

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”)

A

Time Out

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37
Q

Used to modify the dose distribution across the beam accommodating for the patients contour

A

Compensators ( example: Bolus, Wedge)

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38
Q

Is the cpmpensator that goes into the head of the gantry is skin sparring unlike bolus

A

True

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39
Q

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.

A

Virtual Wedge

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40
Q

When you make shifts on the patient/or to treatment couch, when reviewing the council screen are you reviewing the plan or the actual?

A

Actual

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41
Q

What is the minimum x-ray beam energy required for a radiation therapy machine to be classified as a megavoltage machine?

A

1MV

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42
Q

Is the control console located inside or outside of the room

A

outside

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43
Q

Gross palpable or visible tumor

A

GTV- Gross Tumor Volume

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44
Q

GTV plus any margin of subclinical disease that needs to be eliminated thru the treatment planning process

A

CTV- Clinical Target Volume

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45
Q

CTV plus margins for geometric uncertainties such as patient motion beam penumbra and treatment setup differences.

A

PTV- Planning Target Volume

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46
Q

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.

A

MU-Monitor Units

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47
Q

Unit of energy absorbed per unit mass of any material

A

cGY (centigray)

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48
Q

Measurement of the thickness of a patient along the central axis or at any other specified point within the irradiated volume

A

Sep (Separation Measurement)

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49
Q

Suffix for Treatment

A

Tx

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50
Q

Suffix for Fraction

A

Fx

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51
Q

Suffix for Field Size

A

FS (Field size dimensions of the treatment field a the isocenter)

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52
Q

What is EPID

A

Electronic Portal Imaging Device- system producing near real-time portal images on a computer screen for evaluation

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53
Q

What is a DRR and when is it created?

A

Digitally Reconstructed Radiograph/ During simulation

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54
Q

What is IGRT and what is the rationale for using it?

A

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)

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55
Q

What are MLC’s, where are they found and what are they used for

A

Multileaf Collimator- gantry head- shaping or blocking the field shaping

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56
Q

What is the range finder used for on the gantry head

A

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.

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57
Q

MLC’s do not move while the beam is on

A

Static

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58
Q

MLC’s are moving while the beam is on

A

Dynamic

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59
Q

When treating a patient with skin cancer and using electrons, does the electron beam strike the x-ray target in the treatment head

A

NO

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60
Q

When treating a patient with skin cancer and using electrons, which foil is used?

A

Scattering Foil

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61
Q

What is used in the treatment head to allow the therapist to set the field size for each patient?

A

Collimator Jaws

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62
Q

Lining the patient up to the three points marked on the patient using the three machine- aligned lasers

A

Triangulation

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63
Q

The arrangement of shielding material designed to define the x and y dimensions of the field

A

Collimation

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64
Q

While treating a patient should the the lights be on or off

A

On

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65
Q

List two methods for identifying a patient

A
  1. picture in the chart
  2. wrist bracelet
  3. name
  4. date of birth
  5. last 4 of social
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66
Q

Will the three point localization marks placed on the patient for triangulation will always coincide with the treatment isocenter

A

False

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67
Q

What is a portal image

A

Port Film

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68
Q

An image that verifies that BEV path, including the beam shape, position and projection of the beams central axis

A

Portal Image

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69
Q

What else can be used as a bolus?

A

Paraffin Wax, Vaseline gauze, wet gauze or towels, superflab and water bags

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70
Q

What are compensators used for?

A

To modify the dose distribution across the beam accommodating for the patients contour

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71
Q

The thin end of the wedge is called _______ and the thick end of the wedge is called __________

A

toe/heel

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72
Q

What are the (4) standard wedge sizes

A

15, 30, 45, 60

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73
Q

What is the name of the wedges placed in the gantry head?

A

physical wedges

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74
Q

What is commonly used to treat prostate?

A

Four Field Box

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75
Q

An AP/PA and two lateral fields are often referred to as a _________?

A

Four Field Box

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76
Q

IMRT technique where the leaves reposition then come to rest while the beam is delivered in multiple segments at each gantry angle.

A

Step and Shoot

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77
Q

IMRT technique where the MLC’s move from one side of the field to the other wile the beam is on.

A

Sliding Window

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78
Q

IMRT allows a _______ dose to be delivered to the target while delivering _______ dose to the normal structures around it.

A

High/Low

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79
Q

Side Effects of Prostate Cancer

A

Decrease urinary stream (Slow growing/Risk
Frequency increases with age)
Difficulty starting to urinate
Painful Urination (dysuria)
Blood in Uria (Hematuria)

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80
Q

When treating the whole brain what are the boarder you watch out for?

A

Supra orbital ridge, EAM (external auditory meatus) Mastoid Process and C1/2

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81
Q

When treating the whole brain what is the collimator set to treat the patients right side if the patient is supine?

A

45 degrees (Left would be 315 degrees)

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82
Q

What do you check before treating whole or helmet brain cancer?

A

1cm of flash

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83
Q

Helmet Brain Prescription

A

3000cGy/300cGy fx/10 fx/ 6mv/ midplane

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84
Q

What field are you using when treating a Helmet or Whole Brain?

A

POP Field- parallel opposing Field (180 degrees)

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85
Q

What is the most common sign of Metastasis to the brain?

A

Headaches

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86
Q

What are the signs of Metastasis to the brain?

A
  1. headaches
  2. seizures
  3. dizziness
  4. difficulties with balance
  5. mental and personality changes
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87
Q

What are the common PRIMARY cancers that spread to the brain?

A
  1. lung
  2. breast
  3. gastrointestinal
  4. head/neck
  5. prostate
  6. melanoma
    Brain mets occurs in about 25% of patients with cancer
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88
Q

Small Cell Lung Cancer has such a propensity to spread to Brian that patients are usually with ___________

A

Prophylactic Cranial Irradiation (PCI)

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89
Q

What does the Z shift do to the table

A

Moves the table UP and Down

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90
Q

What does the Y shift do to the table

A

Moves the table IN and Out

91
Q

What does the X shift do to the table

A

Moves the table Right and Left

92
Q

Treatment to Spine

A

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
Q

What is Tegaderm

A

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
Q

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.

95
Q

The spreading out of the beam of radiation. The farther from the source the more the beam has spread

A

Beam Divergence

96
Q

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

A

Shift Method

97
Q

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.

A

No-Shift Method

98
Q

Nearer to the point of origin

99
Q

Father away from the point of origin

100
Q

On or near the body surface

A

Superficial

101
Q

Away from the body surface

102
Q

On the same side of the body

A

Ipsilateral

103
Q

On the opposite side of the body

A

Contralateral

104
Q

Planes of Body- Midsagittal

A

Mean (Right and left half)

105
Q

Planes of the Body- Coronal

A

Frontal (Anterior and Posterior)

106
Q

Planes of the Body- Transverse

A

Horizontal (Superior and inferior)

107
Q

Step and Shoot

A
  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
Q

Sliding Window Technique

A
  1. Dynamic

2. Moves leaves through beam on/off sequence

109
Q

Symptoms of Lung Cancer

A
  1. weight loss
  2. coughing
  3. coughing up blood (hemoptysis)
  4. shortness in breath (dyspnea)
  5. chest pain
110
Q

What is VMAT

A

Volume modulated arc therapy (Rapid Arc)

111
Q

What does the Rapid Arc treatment do?

A
  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
Q

Most Common Cause of Lunch Cancer

A

Tobacco Exposure

113
Q

Sterotactic Body Radiation Therapy

A
  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
Q

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?

115
Q

In a parallel opposed field arrangement, two treatment fields share common central axes ________ degrees apart?

A

180 Degrees

116
Q

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?

A
  1. ( 225)
  2. 90
  3. 135
  4. 45
  5. 315
  6. 270
117
Q

A patient is being treated to the whole brain. What is the gantry angle for the RT. lateral

A
  1. (270)
  2. 90
  3. 180
  4. 0
118
Q

A prone patient is being treated to the rectum. What is the gantry angle for the Lt. Lateral rectum field

A
  1. (270)
  2. 0
  3. 180
  4. 90
119
Q

What is the opposing field for an LAO

120
Q

When taking an image, which beam orientation will show the depth of treatment

A

Right or left lateral

121
Q

Which of the following movements will make a shift on the X axis

A

Left/Right

122
Q

Which of the following movements will make the a shift on Z axis?

123
Q

Which direction will the gantry rotate to get to gantry angle 180E

A

Counter clockwise

124
Q

Which of the headrest tilt the chin up the most

A

headrest C (C for chin)

125
Q

Which mask will most likely be used to treat the whole brain

A

short S-frame mask

126
Q

The wingboard will most likely be used to treat the __________

127
Q

Your treating a spine with an 8x10 treatment field. The length of the treatment field is

128
Q

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?

A
  1. (Right)
  2. left
  3. superior
  4. inferior
  5. anterior
  6. posterior
129
Q

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?

A
  1. (Raise the table)
  2. move the table laterally
  3. move the table out
  4. move the table in
  5. lower the table
130
Q

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

A
  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
Q

Toward the back (shift is called)

132
Q

Toward the head (shift is called)

133
Q

Toward the feet (shift is called)

134
Q

Toward the side (shift is called)

135
Q

Towards the midline (shift is called)

136
Q

Towards the surface (shift is called)

A

Superficial

137
Q

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?

A
  1. (88cm)
  2. 76cm
  3. 92cm
  4. 24cm
138
Q

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_____

139
Q

X1=5cm, X2=5cm, Y1=8cm, Y2=8cm (This treatment field is symmetric or asymmetric?)

140
Q

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?

141
Q

What reads the SSD

142
Q

Used to bring the dose closer to the skin

143
Q

Process of lining the patient up to three points

A

Trangulation

144
Q

shapes the beam

145
Q

Patient support assembly

A

Treatment couch

146
Q

The spreading out of the beam of radiation

A

beam divergence

147
Q

Point in space where radiation beams intersect from any of the 360 degree gantry angles

148
Q

a line perpendicular to the cross section of the treatment field

149
Q

Refers to the measurement of the thickness of a patient along the CAX from the entrance point to the exit point.

A
  1. (separation)
  2. depth
  3. beam divergence
  4. SAD
  5. SSD
150
Q

An isocentric technique is also referred to as an/a_________ technique

151
Q

Which technique is used most often when treating single fields?

152
Q

Which of the following degrees of translation does our machine in the Vert clinic not have?

A
  1. (Pitch)
  2. lateral
  3. vertical
  4. longitudinal
  5. rotation
153
Q

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?

A
  1. (45)
  2. 315
  3. 225
  4. 90
  5. 135
154
Q

Which of the following is not a oblique angle

A
  1. (90)
  2. 135
  3. 315
  4. 45
155
Q

A spine patient is being treated prone to a single filed with an SSD of 100. Which technique is being used?

156
Q

Which of the following fields are considered parallel opposed?

A
  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
Q

A patient is being treated with two parallel opposed fields. One field is an AP field. What is the other field?

158
Q

On which axis is a Vertical shift made

159
Q

True or False- The field size is the size of the field that is displayed on the patients skin when using an SAD technique

160
Q

Metastatic cancer is also referred to as___________

A

Secondary Cancer

161
Q

A patient who is being treated only to relieve pain is receiving ___________ treatment

A

Palliative

162
Q

Radiation Therapy

A

Administers the external beam radiation

163
Q

Dosimetrist

A

Creates the treatment plan

164
Q

Medical Physicist

A

Oversees the treatment planning and radiation safety programs

165
Q

Radiation Oncologist

A

Determines radiation treatment options and writes the prescription

166
Q

Remember X1 and Y1 are_______________

A

Negative fields

167
Q

Remember X2 and Y2 are ___________

A

Positive fields

168
Q

The ________defines the dimensions of the FS

A

Collimator

169
Q

When all (3) lasers cross on the patients skin, the SSD is

170
Q

When our linear accelerator VRT is set at 0, the SSD to the couch is ________cm.

171
Q

When treating using an AP/PA POP fields arrangement, the shape of the PA field_________(remember BEV)

A

a mirror image of the AP field

172
Q

When using an SSD technique, the isocenter is located_______

A

a the patients skin

173
Q

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___________

174
Q

The field light projected onto the patients skin at an SSD of 87cm measures 8cm x 12cm. The FS is___________

A

equal to 8cm x 12cm

175
Q

An electron cone is used to treat_________

A

superficial lesions

176
Q

Which of the following is the smallest?

A
  1. (GTV)
  2. PTV
  3. CTV
177
Q

Thoracic

A

T-12 (Lunch)

178
Q

Lumbar

A

L-5 (Breakfast)

179
Q

Cervical

A

C-7 (Dinner)

180
Q

Which critical structure must be avoided when treating the whole brain?

A

Lens of the eye

181
Q

The part of the field that extends past the body part being treated is called

182
Q

When treating the spine, we are usually treating

A

metastatic disease

183
Q

Blastic lesions will usually appear_________on an image?

184
Q

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?

185
Q

Which type of cancer is a helmet brain most often used to treat?

A

Metastatic Cancer

186
Q

The first floating rib is located at what vertebral body?

187
Q

What is the TD/D for spinal Cord

188
Q

Treatments to which Vertebral bodies would most likely require the widest treatment field

189
Q

Which type of imaging delivers less dose to the patient per exposure

A

KV Imaging

190
Q

Where is the prostate located in relation to the symphysis pubis?

191
Q

Segmental MLC

A

Step and Shoot

192
Q

IMRT technique where the MLC’s move from one side of the field to the other while the beam is on

A

Sliding Window

193
Q

Dynamic MLC

A

Sliding Window

194
Q

Static MLC

A

Step and Shoot

195
Q

IMRT technique where the leaves reposition then come to rest while the beam is delivered in multiple segments

A

Step and shoot

196
Q

Where is the bladder located in relation to the prostate

197
Q

Where is the trachea located in relation to the esophagus

198
Q

Where are the Seminal Vesicles located in relation to the prostate

A

Superior and Posterior

199
Q

What imaging modality is used in the placement of fiducials into the prostate

A

Ultrasound

200
Q

Which of the following type of cancer is SBRT most often used?

201
Q

Which of the following delivers a uniform dose across the BEV

202
Q

Which of these two uses more MU’s to deliver the prescribed dose?

203
Q

Which one will deliver less dose to critical structures

204
Q

Difficult or labored breathing is called

205
Q

Painful urination is called

206
Q

The study of disease is called

207
Q

What are the four components of the drive stand

A
  1. Klystron
  2. Waveguide
  3. Circulator
  4. Cooling System
208
Q

The spreading out of the beam of radiation. The farther from the source, the more the beam has spread

A

Beam Divergence

209
Q

Two treatment fields share common central axes, 180 degrees apart

A

Parallel Opposed Fields (POP)

210
Q

Point in space where radiation beams intersect from any of the 360 degree gantry angles. It is similar to the spokes of a bicycle

211
Q

Source-skin distance is the distance from the source of the radiation to the skin surface of the patient.

212
Q

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

213
Q

Refers to the measurement of the thickness of a patient along the central axis from the entrance point to the exit point.

A

Separation

214
Q

This procedure has a higher dose and treats with small fields

215
Q

Fields are defined thru BEV and shaped to include target/ w minimal normal tissue margins and a uniform dose

216
Q

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

217
Q

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)

A

Respiratory Gating

218
Q

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

A

SBRT (Stereotactic Body Radiation Therapy)

219
Q

Field arrangements for head and neck cancers are treated with IMRT rather than conformal (True or False)

220
Q

When approaching the Spinal Dose Tolerance What do you do?

A

You would use an oblique filed angle and go OFF cord

221
Q

Where is the prostate located in relation to the bladder

222
Q

Where is the rectum located in relation to the prostate

223
Q

Where is the trachea located to the esophagus

Intro to Clinical's (Gwen)- Nicole Calvin (1 decks)

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