100+ Free TER Radioterapia Practice Questions

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CBR Prova de Título de Especialista em Radiologia e Diagnóstico por Imagem (Brazil)

Practice Questions100 questions

2026 Statistics

Key Facts: TER Radioterapia Exam

100 Items

Multiple-choice questions on the official TER Prova Teórica Objetiva

Edital TER SBRT / AMB 2026

2 Phases

Comprehensive evaluation phases (Theoretical Objective + Practical & Radioprotection)

Regulamento Oficial TER SBRT

R$ 1.800,00

Registration Fee for SBRT/AMB Affiliated Members (R$ 3.600,00 for Non-Members)

Edital SBRT / AMB

70% (7.0)

Minimum Passing Grade Benchmark across Theoretical & Practical Stages

Regulamento Oficial TER SBRT

RQE Radioterapia

Specialist Registration Credential Conferred with CFM

Conselho Federal de Medicina (CFM) / AMB

Annual

Official Examination Frequency Conducted by SBRT and AMB

Sociedade Brasileira de Radioterapia (SBRT)

The TER (Título de Especialista em Radioterapia) is the premier Brazilian radiation oncology board certification examination administered annually by SBRT and AMB. It consists of a 100-question theoretical phase covering radiation physics, radiobiology, and clinical trials, followed by a radioprotection qualification exam and a theoretical-practical case analysis testing contouring, plan evaluation, and clinical decision-making.

Sample TER Radioterapia Practice Questions

Try these sample questions to test your TER Radioterapia exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1In megavoltage external beam radiotherapy (e.g., 6 MV to 18 MV photon beams from a clinical linear accelerator), which physical interaction process between incident photons and matter is overwhelmingly dominant in biological soft tissues?

A.Compton scattering (incoherent scattering)

B.Photoelectric absorption

C.Pair production

D.Rayleigh coherent scattering

Explanation: In the megavoltage energy range utilized in clinical linear accelerators (approximately 1 MeV to 20 MeV in soft tissue), Compton scattering is the predominantly dominant interaction mechanism. Compton scattering probability depends primarily on electron density (number of electrons per gram) and is essentially independent of the atomic number (Z) of the absorbing tissue, enabling uniform dose deposition across varying soft tissue compositions.

2Modern linear accelerators frequently offer Flattening Filter-Free (FFF) photon beam modes for stereotactic radiosurgery (SRS) and stereotactic body radiation therapy (SBRT). Compared to standard flattened beams of the same nominal energy, which physical characteristic is a key feature of an FFF beam?

A.Substantially higher dose delivery rate (up to 2 to 4 times higher) and lower out-of-field scatter/leakage dose

B.A harder effective photon energy spectrum with significantly greater beam penetration at depth

C.A completely flat, uniform lateral profile across large field sizes exceeding 30 x 30 cm

D.Higher head scatter and increased neutron contamination at 10 MV

Explanation: Removing the conical flattening filter eliminates beam attenuation in the central axis, resulting in a dramatic increase in dose rate (e.g., up to 1400–2400 MU/min for 6–10 MV FFF beams) which markedly shortens treatment delivery times in SRS/SBRT. Additionally, removing the filter reduces linac head scatter and out-of-field scatter/leakage, providing a sharper lateral penumbra and lower peripheral organ dose.

3Multileaf collimators (MLCs) are fundamental for 3D-CRT, IMRT, and VMAT. When designing treatment plans, which dosimetric artifact occurs due to the stepped interlocking leaf edges designed to minimize radiation leakage between adjacent leaves?

A.Tongue-and-groove effect (underdose in regions between adjacent abutting segments)

B.Compton edge backscatter surge

C.Charged-particle equilibrium shift

D.Electron contamination build-up peak

Explanation: The tongue-and-groove design features interlocking protrusions and indentations along adjacent leaf sides to prevent interleaf radiation leakage; however, when adjacent leaves are open during different subfields/segments, the stepped edge receives partial shielding in both segments, creating a localized underdose (the tongue-and-groove effect). Modern treatment planning systems incorporate leaf sequencing algorithms that model and compensate for this dosimetric phenomenon.

4Proton beam therapy provides unique physical dose distribution advantages compared to photon radiotherapy. What physical property characterizes proton beam energy deposition in tissue, and what generic relative biological effectiveness (RBE) is clinically standard?

A.The Bragg peak with zero exit dose beyond the range; standard clinical RBE of 1.1

B.Exponential attenuation with depth and continuous exit dose; standard clinical RBE of 1.0

C.A linear dose increase without a peak followed by rapid Bremstrahlung tail; standard clinical RBE of 2.0

D.Surface dose peaking with rapid inverse square falloff; standard clinical RBE of 0.85

Explanation: Heavy charged particles like protons deposit relatively low dose as they enter tissue and accelerate energy loss near the end of their finite range, creating a sharp maximum called the Bragg peak, after which the dose drops abruptly to zero (no exit dose). In clinical proton therapy planning, an internationally accepted generic RBE value of 1.1 is applied across spread-out Bragg peaks (SOBP) relative to high-energy megavoltage photons.

5In 4-dimensional computed tomography (4D-CT) simulation for thoracic and upper abdominal lesions, how is the Internal Target Volume (ITV) defined according to ICRU Report 62?

A.ITV = Clinical Target Volume (CTV) + Internal Margin (IM) accounting for physiological tumor motion and shape variations

B.ITV = Gross Tumor Volume (GTV) + Planning Target Volume (PTV) setup margin

C.ITV = Gross Tumor Volume (GTV) + micro-invasion margin only

D.ITV = Total treated volume receiving at least 95% of the prescription dose

Explanation: According to ICRU Report 62, the Internal Target Volume (ITV) is formed by expanding the Clinical Target Volume (CTV) by an Internal Margin (IM) to account for internal physiological movement, respiration, and organ deformation. The Planning Target Volume (PTV) is subsequently generated by adding a Setup Margin (SM) to the ITV to account for patient positioning uncertainties and beam geometry.

6Under the AAPM TG-51 and IAEA TRS-398 reference dosimetry protocols for external beam linear accelerator calibration, what is the standard calibration medium and primary reference dosimeter type?

A.Absorbed dose to water using a calibrated cylindrical ionization chamber with an absorbed-dose-to-water calibration factor (N_D,w)

B.Air-kerma collision equivalent using a parallel-plate chamber in solid water phantom

C.Exposure in air using a free-air ionization chamber under non-equilibrium conditions

D.Thermoluminescent dosimeter (TLD) chips evaluated in polystyrene phantoms

Explanation: Both AAPM TG-51 and IAEA TRS-398 protocols are based on direct determination of absorbed dose to liquid water (the international standard reference phantom material) using cylindrical (thimble) ionization chambers calibrated at an accredited dosimetry calibration laboratory (ADCL) in terms of absorbed dose to water calibration coefficient (N_D,w) with a beam quality conversion factor (k_Q).

7Surface-Guided Radiotherapy (SGRT) using stereoscopic optical camera systems has become widely integrated into clinical practice. Which clinical scenario represents a primary, evidence-based application of real-time SGRT?

A.Left-sided breast cancer treatment under Deep Inspiration Breath-Hold (DIBH) without ionizing imaging radiation

B.Tracking internal prostate soft-tissue motion during high-dose fractionated treatment

C.Determining microscopic mucosal tumor margins during head and neck setup

D.Direct monitoring of rectal filling during pelvic brachytherapy applicator insertion

Explanation: SGRT continuously maps the patient's 3D external body surface in real time using non-ionizing optical stereoscopy. In left-sided breast cancer, SGRT enables precise, non-radiographic verification of chest wall elevation during Deep Inspiration Breath-Hold (DIBH), automatically gating the linear accelerator beam if the breath-hold drifts outside the predefined tolerance window.

8According to AAPM Task Group 142 (TG-142) quality assurance guidelines for medical accelerators, what is the daily and monthly tolerance for radiation vs. mechanical isocenter coincidence (e.g., Winston-Lutz test) on a machine dedicated to Stereotactic Radiosurgery (SRS) / Stereotactic Body Radiotherapy (SBRT)?

A.<= 1.0 mm (or <= 0.75 mm for dedicated stereotactic delivery)

B.<= 2.0 mm

C.<= 3.0 mm

D.<= 5.0 mm

Explanation: TG-142 specifies strict QA criteria for machines performing SRS/SBRT, requiring radiation and mechanical isocenter coincidence (assessed via the Winston-Lutz test with a ball-bearing phantom) to be within <=1.0 mm (and ideally <=0.75 mm), compared to the more lenient <=2.0 mm tolerance permitted for conventional non-stereotactic external beam machines.

9In classical radiobiology, the biological response of cells and tissues to fractionated radiation is governed by the '5 Rs'. Which 'R' specifically explains why dividing a total radiation dose into multiple small daily fractions spares late-responding normal tissues more than rapidly proliferating tumors?

A.Repair of sublethal cellular DNA damage between fractions

B.Repopulation of surviving clonogens during the overall treatment course

C.Reassortment of surviving cells into radiosensitive cell cycle phases

D.Reoxygenation of hypoxic radioresistant tumor subvolumes

Explanation: Repair of sublethal DNA damage (predominantly double-strand breaks via non-homologous end joining and homologous recombination) occurs in the 4–6 hours between fractions. Late-responding normal tissues (characterized by a low alpha/beta ratio) exhibit a broader shoulder on the cell survival curve and possess greater sublethal repair capacity than early-responding tissues and most tumors, making fractionation protective against late normal tissue injury.

10In the Linear-Quadratic (LQ) model of cell survival, the alpha/beta ratio (expressed in Gray, Gy) represents the dose at which the linear and quadratic components of cell kill are equal. Which tissue types are typically characterized by a LOW alpha/beta ratio (~1.5 to 3.5 Gy)?

A.Late-responding normal tissues (e.g., spinal cord, kidney, brain, deep connective tissue) and prostate adenocarcinoma

B.Acute-responding normal tissues (e.g., mucosal epithelium, bone marrow) and squamous cell carcinomas

C.Early-responding tissues (e.g., small intestinal crypt cells) and high-grade lymphomas

D.Epidermal keratinocytes and small cell lung cancer

Explanation: Late-responding normal tissues (such as the spinal cord, brainstem, kidneys, lung parenchyma, and fibrosis-prone subcutaneous tissues) have low alpha/beta ratios typically between 1.5 and 3.5 Gy, indicating marked sensitivity to changes in fraction size. Interestingly, prostate adenocarcinoma and breast carcinoma also exhibit low alpha/beta ratios (~1.5–4.0 Gy), providing the radiobiological rationale for hypofractionated radiotherapy regimens.

About the TER Radioterapia Exam

The Título de Especialista em Radioterapia (TER) is the official medical specialist board certification for radiation oncologists in Brazil, awarded by the Sociedade Brasileira de Radioterapia (SBRT) in partnership with the Associação Médica Brasileira (AMB) and registered with the Conselho Federal de Medicina (CFM). The examination assesses comprehensive competence in clinical radiation oncology across all anatomical sites, radiation physics, radiobiology (LQ model, BED, EQD2 calculations), modern treatment planning (3D-CRT, IMRT, VMAT, SRS, SBRT, Proton therapy), image guidance (IGRT, CBCT, SGRT), brachytherapy (LDR, HDR, IGABT), normal tissue dose constraints (QUANTEC, HyTEC), and radiation protection (CNEN regulations). Achieving the TER is the definitive requirement for Brazilian radiation oncologists to obtain their Registro de Qualificação de Especialista (RQE) in Radioterapia.

Assessment

Two-phase examination administered by the Sociedade Brasileira de Radioterapia (SBRT) with the AMB. Phase 1 (Prova Teórica Objetiva): 100 multiple-choice questions covering radiation physics, radiobiology, technological innovations (IMRT, VMAT, SRS, SBRT, protons), and clinical disease-site radiation oncology. Phase 2: Prova de Qualificação em Proteção Radiológica (radiation safety, shielding, dosimetry, and CNEN-NN 3.01 / CNEN-NE 3.02 regulations) and Prova Teórico-Prática (clinical cases, target volume delineation/contouring, DVH plan evaluation, and image-guided adaptive brachytherapy).

Time Limit

4 to 5 hours for the theoretical objective examination, followed by structured practical and clinical case evaluations

Passing Score

Final composite score of at least 70% (7.0 on a 10.0 scale) across theoretical and practical stages, including the radioprotection qualification exam

Exam Fee

R$ 1.600,00 (sócios adimplentes da SBRT ou da AMB) / R$ 2.100,00 (não sócios) (Sociedade Brasileira de Radioterapia (SBRT) — Associação Médica Brasileira (AMB))

TER Radioterapia Exam Content Outline

15%

Física das Radiações, Tecnologia e Garantia de Qualidade (QA)

Photon and electron interactions, linac design (magnetron, klystron, bending magnet, target, flattening filter vs FFF), multileaf collimators (MLC penumbra, transmission, leaf width), 3D-CRT, IMRT (step-and-shoot, dynamic dMLC), VMAT, proton therapy (Bragg peak, RBE 1.1), IGRT (CBCT, orthogonal kV, SGRT optical surface imaging), 4D-CT motion management (gating, DIBH, tracking), and AAPM QA protocols (TG-51, TG-142).

15%

Radiobiologia Clínica e Modelagem de Doses (BED/EQD2)

The 5 Rs of radiobiology (Repair, Reassortment, Repopulation, Reoxygenation, Radiosensitivity), linear-quadratic (LQ) model, alpha/beta ratio for early-responding (~10 Gy) and late-responding tissues (~1.5–4 Gy), BED formula calculations: BED = nd[1 + d/(alpha/beta)], EQD2 equivalents, Oxygen Enhancement Ratio (OER), radiosensitizers, radioprotectors (amifostine), and QUANTEC/HyTEC normal tissue dose constraints.

12%

Tumores do Sistema Nervoso Central e Oncologia Pediátrica

Glioblastoma IDH-wildtype (Stupp protocol 60 Gy/30 fx + temozolomide, MGMT methylation), elderly hypofractionation (Roa/Perry 40 Gy/15 fx or 25 Gy/5 fx), low-grade gliomas (RTOG 9802, 1p/19q codeletion), brain metastases SRS vs WBRT (hippocampal-avoidance HA-WBRT CC001), meningiomas (Simpson grade, doses 54–60 Gy), vestibular schwannoma SRS (12–13 Gy), and pediatric medulloblastoma CSI (23.4–36 Gy + boost to 54–55.8 Gy).

13%

Tumores de Cabeça e Pescoço

Nasopharyngeal carcinoma (definitive 70 Gy + cisplatin, EBV DNA), oropharyngeal carcinoma (HPV/p16 status, AJCC 8th ed), laryngeal preservation (RTOG 91-11), early glottic T1 hypofractionation (63 Gy/28 fx or 65.25 Gy/29 fx), postoperative high-risk features (ENE and positive margins - RTOG 9501, EORTC 22931), parotid-sparing IMRT (PARSPORT trial, mean <26 Gy), and altered fractionation (MARCH meta-analysis, RTOG 9003).

17%

Tumores Torácicos e Câncer de Mama

Early-stage NSCLC SBRT (54 Gy/3 fx, 48–50 Gy/4 fx, 50–60 Gy/5 fx; RTOG 0236/0813 central vs peripheral constraints), locally advanced NSCLC concurrent chemorad (60–66 Gy) + durvalumab (PACIFIC), SCLC hyperfractionation (45 Gy BID in 30 fx) + PCI, whole breast moderate hypofractionation (40 Gy/15 fx) vs ultra-hypofractionation (FAST-Forward 26 Gy/5 fx), boost indications (Bartelink/EORTC), PMRT indications, regional nodal irradiation (MA.20, EORTC 22922), and DIBH cardiac sparing.

13%

Tumores Gastrointestinais

Esophageal cancer (CROSS trial neoadjuvant 41.4 Gy + carboplatin/paclitaxel; definitive 50–50.4 Gy), gastric cancer adjuvant chemorad (INT-0116) vs FLOT, pancreatic cancer neoadjuvant/definitive RT, hepatocellular carcinoma SBRT (mean liver dose <28–30 Gy), rectal cancer total neoadjuvant therapy (TNT: PRODIGE 23, RAPIDO) vs short-course RT (5x5 Gy) vs long-course chemorad (45–50.4 Gy) and Watch-and-Wait, and anal canal SCC Nigro chemorad (5-FU + MMC + 50.4–54 Gy).

15%

Tumores Geniturinários e Ginecológicos

Prostate cancer risk stratification, moderate hypofractionation (60 Gy/20 fx - CHHiP, PROFIT) vs ultrahypofractionated SBRT (36.25–40 Gy/5 fx - PACE-B) vs conventional 78–80 Gy, ADT duration (4–6 mo intermediate, 18–36 mo high risk - RTOG 9202, EORTC 22961), pelvic nodal RT (POP-RT), postoperative early salvage vs adjuvant RT (ARTISTIC), bladder trimodality therapy (TMT: TURBT + 64–66 Gy chemorad), cervical cancer chemorad + IGABT (EMBRACE guidelines, HR-CTV D90 >= 85–90 Gy EQD2), and endometrial cancer VCBT vs pelvic EBRT (PORTEC-1/2/3, molecular subtyping POLE, dMMR, p53abn).

10%

Braquiterapia, Cuidados Paliativos e Proteção Radiológica

Radioactive isotopes (Ir-192 half-life 73.8d, Cs-137 30.1y, I-125 59.4d, Pd-103 17d, Co-60 5.27y), HDR vs LDR dose rates, applicator geometry (tandem/ring/ovoids, interstitial templates), prostate seed brachytherapy, palliative bone metastases (8 Gy single fx vs 20 Gy/5 fx vs 30 Gy/10 fx), spine SBRT, spinal cord compression (Patchell trial), SVC syndrome, and CNEN radioprotection regulations (occupational 20 mSv/yr, public 1 mSv/yr).

How to Pass the TER Radioterapia Exam

What You Need to Know

Passing score: Final composite score of at least 70% (7.0 on a 10.0 scale) across theoretical and practical stages, including the radioprotection qualification exam
Assessment: Two-phase examination administered by the Sociedade Brasileira de Radioterapia (SBRT) with the AMB. Phase 1 (Prova Teórica Objetiva): 100 multiple-choice questions covering radiation physics, radiobiology, technological innovations (IMRT, VMAT, SRS, SBRT, protons), and clinical disease-site radiation oncology. Phase 2: Prova de Qualificação em Proteção Radiológica (radiation safety, shielding, dosimetry, and CNEN-NN 3.01 / CNEN-NE 3.02 regulations) and Prova Teórico-Prática (clinical cases, target volume delineation/contouring, DVH plan evaluation, and image-guided adaptive brachytherapy).
Time limit: 4 to 5 hours for the theoretical objective examination, followed by structured practical and clinical case evaluations
Exam fee: R$ 1.600,00 (sócios adimplentes da SBRT ou da AMB) / R$ 2.100,00 (não sócios)

Keys to Passing

Work through all 100 available questions
Review every answer and explanation
Track weak areas and revisit them
Use our AI tutor for tough concepts

TER Radioterapia Study Tips from Top Performers

1Master Radiobiological & Physics Calculations: Be completely fluent with BED formulas (BED = nd[1 + d/(α/β)]), EQD2 conversions, isotope half-lives (Ir-192: 73.8d, I-125: 59.4d, Cs-137: 30.1y, Pd-103: 17d), and photon/electron interaction physics (Compton effect predominance in megavoltage therapy).

2Memorize QUANTEC & HyTEC Dose-Volume Constraints: Internalize critical organ-at-risk (OAR) thresholds: spinal cord (Dmax <45–50 Gy), brainstem (Dmax <54 Gy), optic chiasm/nerve (Dmax <54–55 Gy), mean parotid (<20–26 Gy), mean lung dose (<20 Gy, V20 <30–35%), mean heart dose (<2–4 Gy), rectum (V50 <50%, V70 <20%), and bladder (V65 <50%).

3Internalize Landmark Trial Fractionation Schemes: Know exact doses, fractions, and systemic combinations from pivotal trials: Stupp (60 Gy/30 fx + TMZ), PACIFIC (60–66 Gy + durvalumab), FAST-Forward (26 Gy/5 fx), CROSS (41.4 Gy/23 fx + carbo/pacli), PRODIGE 23 / RAPIDO (rectal TNT), Nigro (50.4–54 Gy + 5-FU/MMC), CHHiP (60 Gy/20 fx), and EMBRACE (HR-CTV D90 >= 85–90 Gy EQD2).

4Understand ICRU Target Volume Hierarchy: Clearly differentiate GTV (gross tumor volume), CTV (subclinical microscopic disease), ITV (internal target volume incorporating internal motion), and PTV (planning target volume adding setup uncertainty margins), as well as OAR and PRV (planning organ-at-risk volume).

5Review Image-Guided Adaptive Brachytherapy (IGABT): Understand MRI-guided volume definitions in cervical cancer (GTVres, HR-CTV, IR-CTV), D90 and D98 dose reporting, and applicator types (tandem/ovoids, tandem/ring, interstitial Vienna template for large/asymmetric disease).

6Solve Multi-Step Quantitative & Clinical Vignettes: Regularly practice timed clinical scenarios to hone target delineation, dose prescription, fractionation calculation, and multidisciplinary treatment sequencing.

Frequently Asked Questions

What is the TER and why is it essential for radiation oncologists in Brazil?

The Título de Especialista em Radioterapia (TER) is the official medical specialist board certification awarded by the Sociedade Brasileira de Radioterapia (SBRT) in partnership with the Associação Médica Brasileira (AMB). Passing the TER examination enables physicians to register their specialized qualification (Registro de Qualificação de Especialista - RQE) in Radioterapia with the Regional Medical Councils (CRMs) and Federal Council of Medicine (CFM), which is legally required to formally practice and head a radiation therapy service in Brazil.

What are the eligibility prerequisites to sit for the TER examination?

Candidates must be fully licensed physicians registered with a Regional Medical Council (CRM) in Brazil and meet one of the qualifying pathways: (1) Completion of an accredited Medical Residency Program (CNRM/MEC) in Radiotherapy (Radioterapia); (2) Completion of an SBRT-recognized Specialization Program; or (3) Proven clinical practice in Radiation Oncology for at least double the duration of official residency (6 years), substantiated by documented institutional case logs and curricular scoring as defined in the annual SBRT edital.

How is the TER examination structured across its stages?

The examination consists of two main phases: (1) 1ª Fase (Prova Teórica Objetiva), consisting of 100 multiple-choice questions testing radiation physics, radiobiology, technology, and clinical oncology trials; and (2) 2ª Fase, comprising the Prova de Qualificação em Proteção Radiológica (CNEN radiation protection and dosimetry regulations) and the Prova Teórico-Prática (clinical cases, target volume contouring, DVH constraint evaluation, and brachytherapy planning).

What is the passing score and grading criteria for the TER?

Candidates must achieve a minimum final composite grade of 70% (7.0 on a 10.0 scale) across the theoretical and practical evaluations, and must attain passing marks in the specific radiation protection qualification component.

Which clinical trials and consensus guidelines are primarily tested on the TER?

The examination tests landmark phase III clinical trials and guidelines from SBRT, ASTRO, ESTRO, NCCN, and ICRU reports (50, 62, 83, 89). Key evidence includes Stupp (glioblastoma), PACIFIC (stage III NSCLC), FAST-Forward / START-B (breast hypofractionation), CROSS (esophageal cancer), PRODIGE 23 / RAPIDO (rectal TNT), Nigro (anal cancer), CHHiP / PACE-B (prostate hypofractionation/SBRT), EMBRACE (cervical IGABT), and PORTEC (endometrial cancer).

Why is this OpenExamPrep practice bank presented in English?

This practice bank is an English-language MCQ study adaptation designed to support Brazilian radiation oncologists revising international clinical trials, physics calculations, and consensus guidelines, as well as international fellows. All official Brazilian radiation oncology terminology, CNEN regulatory limits, and SBRT guideline references are preserved inline.