Practice Problems 1. Convert the following: a. .50mCi Ir-192 to mgRaeq b. .50mCi Au-198 to mgRaeq c. .50mCi Radium eq.

to mCi of I-125 2. In order to perform a 4000 mg-hr implant using 100 iridium seeds, what should the mgRaeq per seed be if the total implant time is to be 5 days? 3. Calculate the total millicurie hours for a 40 seed I-125 permanent prostate implant, at initial 0.5mCi per seed? 4. An I-125 seed implant delivers an initial dose rate of 10 cGy/hr. What is the total dose delivered to the implant site (in cGy)? 5. The initial activity of an isotope is 10 mCi with a half-life of 60 days. Calculate the isotopes activity after 30 days. 6. The measured dose rate @ 2 meters from an isotope is 250 mrem/hr. If an individual stands 6 meters from the isotope for 2 hours, what exposure will the person receive? 7. Prior to the release from the hospital, a patient who has just completed radiation with a temporary radioactive implant, the NRC requires which of the following: a. All patient care personnel dosimeters must be read and any unusual exposures explained b. The institutions RSO must certify that correct procedures were followed involving care of the patient c. A radiation survey must be performed of the patient and a physical count of the radioactive sources must be completed to confirm all source were removed 8. An I-125 seed has an activity of .48mCi apparent on the date of calibration. Seven days later the activity will be: a. .92mCi b. .52mCi c. .47mCi d. .44mCi e. .04mCi 9. The exposure rate @ 1m from 100 mgRaeq of Cs-137 is: a. 8.25 R/hr b. 8.25 mR/hr c. 82.5 mR/hr d. 82.5 mR/min e. .825 R/hr 10. A permanent implant is performed using an isotope of half-life 60 days. If the initial dose rate at a peripheral point is 7.7 cGy/hr, the total dose delivered to that point will be: a. 18,000 cGy b. 16,000 cGy c. 11,100 cGy d. 7,770 cGy e. 665 cGy

11. A vaginal cylinder is loaded with 20-15-20 mgRaeq sources of Cs-137. What is the total number of mCi of Cs-137? [Exposure rate constant Cs-137 = 3.26 R.cm2/mCi.hr @ 1cm] a. 16.6 b. 21.7 c. 55.0 d. 139.2 e. 352.2 12. The half-life of I-125 is 60 days. In 6 months the activity will be _____ its original value. a. 50% of b. 1/8 of c. 5% of d. 1/64 of 13. The approximate dose delivered by a single Ir-192 seed of activity 0.5 mgRaeq in 24 hrs to tissue 2 cm from the seed is: a. 384 cGy b. 96 cGy c. 48 cGy d. 24 cGy e. 2.4 cGy 14. A patient has an interstitial Ir-192 implant. The dose rate is found to be 50 mrem/hr @1m. A nurse taking care of the patient has her head @25 cm from the implant for 6 minutes. The dose to her eyes would be: a. 200 mrem b. 80 mrem c. 50 mrem d. 20 mrem e. 5 mrem 15. I-125 seeds are ordered for a prostate implant. The procedure is then delayed for one week, but the same seeds are implanted. The change in the actual dose delivered to the prescription isodose is: a. 16% b. 8% c. 4% d. 2.4% e. 0.8% 16. A Cs-137 source had an activity of 30 mgRaeq in September 1989. What is the activity in mCi in March 1994? [Exposure rate constant Cs-137 = 3.32 R.cm2/mCi.hr] a. 27 b. 59 c. 67 d. 74 e. 86

17. The exposure rate 4 meters from a patient containing 60 mgRaeq filtered with 0.5mmPt is about ______ mR/hr. Consider the applicator to be a point source and that the patient absorbs about 30% of the radiation. a. 1 b. 2 c. 3 d. 4.5 e. 16 18. The anisotropy correction is used in I-125 brachytherapy calculations to account for the: a. Self absorption in adjacent seeds placed end-to-end b. Decay of I-125 seeds between the dates of calibration and implantation c. Changes in dose rate at a given distance around the seed due to self absorption along the seed axis d. Conversion from units of Bq to Air Kerma Rate 19. Up to a distance of 5cm in tissue the dose rate around an Ir-192 seed falls off approximately as inverse square, whereas that around an I-125 seed falls off more quickly. This is because: a. The average photon energy of I-125 is much less than of Ir-192 b. Tissue attenuation is an important factor for I-125 c. Dose build-up due to scatter balances tissue attenuation for Ir-192 d. All of the above e. None of the above 20. The number of Bq in one Ci is: a. 1 b. 107 c. 3.7 x 107 d. 3.7 x 1010 e. 2.7 x 10-11 21. Compared to 1mg Radium, 1 mgRaeq of Ir-192 has: a. The same mass b. The same half-life c. The same activity d. The same exposure rate @ 1cm e. The same number of atoms 22. The exposure rate constant for Co-60 is approximately 4 x greater than the exposure rate constant for Cs-137, although the gamma energy is only twice as high. This is because: a. Co-60 has more energetic beta rays b. Lower energy Cs-137 photons are more likely to be absorbed by photoelectric process c. Co-60 has a lower atomic number (z) d. Co-60 emits two photons per disintegration, whereas Cs-137 emits one e. Cs-137 emits only one photon with a fractional abundance (n) of about 0.5

23. Match the radioactive source with the approximate decay rate: a. < 1% per year b. 2.3% per year c. 1% per month d. 5% per day e. 1% per day I. Radium-226 II. Co-60 III. Cs-137 IV. Ir-192 24. The NRC requires which of the following QA measures for brachytherapy sources? 1. Quarterly inventory 2. a log showing the location of all sealed sources removed from the safe 3. annual training in radiation safety for all personnel who care for brachytherapy patients 4. a leak-test of all sealed sources every 2 years a. b. c. d. e. 1, 2, 3 1, 3 2, 4 4 only All of the above

25. Which of the following is a misadministration according to the NRC? a. A weekly teletherapy dose differing by 15% from the weekly prescribed dose b. A total teletherapy dose differing by 10% from the weekly prescribed dose, delivered in 25 fractions c. Brachytherapy using a source that is determined to be leaking d. All of the above e. None of the above 26. Safety precautions that should be taken for patients undergoing gynecological implant therapy are all of the following except: a. Implant patients may be placed with no more than one other patient in the same room b. A caution radiation sign should be posted on the patients door c. The dose rates in the room and in areas around the patients room should be measured d. A note should be placed in the chart and on the door stating how long a visitor can stay in the room

27. Implantation of the tongue by Ir-192 seeds results in less exposure to the radiotherapist than a Radium needle implant because: a. Ir-192 has lower energy gammas than Radium b. Of the difference in the exposure-rate constants c. Of the difference in the RBEs d. Ir-192 is an afterloading procedure e. Ir-192 has no radioactive daughters

28. After loading an Ir-192 implant, it is discovered that the sources were each 0.5 mgRaeq, instead of 0.5 mCi as intended. The consequence is: a. The dose rate in the patient will be higher b. The dose rate in the patient will be lower c. The dose rate will be the same, as mgRaeq = mCi for this isotope

29. The following are advantages of using Cs-137 sources over Radium sources except: a. Lower maximum photon energy b. Smaller HVL in Pb c. Shorter half-life d. Less exposure to personnel e. Less hazardous if broken 30. Which of the following would most reduce exposure to family members visiting a patient with a cesium needle implant? a. Reducing the visiting time by one half b. Doubling the distance between the patient and the visitors c. Placing a lead screen of thickness one HVL between the patient and the visitors d. None of the above, since all have an equal effect 31. I-125 has two advantages over Ir-192 as a source for afterloaded implants: 1. it costs less 2. it has a longer half-life 3. it poses less of a radiation safety hazard 4. the dose falls off more quickly outside the treatment volume a. 1,2 b. 1,3 c. 2,3 d. 2,4 e. 3,4 32. The NRC requires that LDR brachytherapy dose calculations are checked: a. Before any sources are inserted b. Before the sources are removed c. Before 10% of the dose has been delivered d. Before 50% of the dose has been delivered 33. The NRC defines a therapy misadministration (current term Medical Event) as: 1. treatment of the first fraction with a verbal prescription only 2. no check of calculations by an independent method or person 3. dose differing from the prescription by more than 50% in one fraction 4. dose differing from the prescription by more than 10% at completion of treatment a. 1,2,3 b. 1,3 c. 2,4 d. 3 only e. All of the above

34. Pd-103 is favored over I-125 for prostate implants in patients with a higher Gleason score due to palladiums: a. Shorter half-life b. Superior dose distribution c. Longer time to deliver 90% of the total dose d. All of the above

35. The average life of a radioisotope is: a. Used to calculate the total dose delivered by a permanent seed implant b. Equal to 1.44/half-life c. Used to calculate the dose rate mid-way through a temporary insertion d. Also called the decay constant e. All of the above 36. Cs-137 sources used for implants have a similar isodose distribution to radium sources because: a. They have similar half-lives b. They have similar gamma energies c. The inverse square law dominates the distribution d. The same activities can be used e. All of the above 37. Regarding palladium-103 model 200 seeds and Iodine-125 model 6711 seeds, which of the following is true? 1. Palladium has a half-life about 3.5 times longer than iodine 2. The higher average photon energy of palladium makes it difficult to shield 3. Palladium has a significantly higher exposure rate constant 4. Both seeds exhibit significant anisotropy, which is generally accounted for in treatment plans by using a dose rate averaged over all angles a. 1,2,3 b. 1,3 c. 2,4 d. 4 only e. All of the above 38. A radium source _____________ with its daughters. a. Is in transient equilibrium b. Is in secular equilibrium c. Never achieves equilibrium

39. TLD ring badges are worn in addition to a film badge for brachytherapy procedures because: a. The film badge cannot discriminate between different types and energies of radiation b. The MPD for the hands is higher than for the whole body and requires a separate measurement c. The ring badges is simply a back up for the badge in case the film is damaged during processing d. TLD is uniquely sensitive to the particles emitted from brachytherapy sources e. The skin of the hands has a lower MPD than the whole body

40. The NRC requires that sealed radioactive sources be leak tested: a. Initially (when received) b. Initially then monthly c. Initially then every 6 months d. Initially then annually e. Annually