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Medical Imaging > Breast Imaging > Flashcards

Breast Imaging Flashcards

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USMLE® Step 1 flashcards
1
Q

What are 7 malignant breast cancers?

A

Invasive ductal
DCIS
Lobular Carcinoma
Tubular
Inflammatory
Triple Negative
Paget’s disease

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2
Q

What are 6 symptomatic clinical indications?

A

New lump
bloody nipple discharge
changes to nipple
skin dimpling
rash around nipple
skin thickening

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3
Q

What are 3 asymptomatic clinical indications?

A

Family history
surgery follow-up
breast screening

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4
Q

What is triple assessment clinic?

A

Clinical exam
imaging (mammogram and/or ultrasound)
Biopsy

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5
Q

What is mammography?

A

Imaging modality that uses low energy x-rays specifically for imaging of breast tissue

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6
Q

What does mammography practice utilise?

A

Standardized views of breasts for assessment of breast lesions

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7
Q

What are 4 technical requirements of mammography?

A

High spatial resolution
contrast between cancerous tissue & normal glandular tissue
minimize radiation dose
high signal-to-noise ratio

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8
Q

What are 7 parts of a mammographer?

A

Generator
x-ray tube
target
beryllium window
molybdenum filter
compression device
AEC - automatic exposure control

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9
Q

What does the beryllium window do?

A

minimises absorption of radiation in tube

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10
Q

What does the molybdenum filter do?

A

absorbs unwanted radiation

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11
Q

What are two targets in the equipment?

A

Molybdenum
Rhodium

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12
Q

What is the linear attenuation coefficient?

A

Constant that describes fraction of attenuated incident photons in monoenergetic beam per unit thickness of a material

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13
Q

What is the x-ray spectrum determined by?

A

x-ray tube anode material
filter material kV

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14
Q

What voltage are mammography devices?

A

24-32kV

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15
Q

What are filters used for?

A

Reduce low energy components of x-ray spectrum

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16
Q

Which filter is used for thicker breast tissue?

A

Rhodium

17
Q

What is a focal spot?

A

Area in anode where electrons are targeted
smaller focal spot = sharper image production
(lower energie)

18
Q

What is spatial resolution limited by?

A

Focal spot

19
Q

What acts as the AEC?

A

Detector

20
Q

What 3 things does the AEC ensure?

A

signal to noise & contrast to noise
ratios are adequate
doses are within limits

21
Q

How is full field digital mammography different?

A

X-ray film replaced by digital detector & latent image is converted into a digital data set

22
Q

What are routine projections?

A

Cranio-caudal
45-degree medio-lateral oblique

23
Q

What should the CC projection should demonstrate?

A

Whole breast
appropriate depth
nipple in profile
majority of medial & lateral
pectoral muscle on centre of film
no movement

24
Q

What should the MLO projection demonstrate?

A

Pectoral muscle to level of nipple
no skin folds
inflamammary angle clearly visible
nipple in profile

25
Q

What are benefits of breast compression?

A

More uniform breast thickness
more homogenoous film density
separation of structures in breast
reduced thickness = reduced dose

26
Q

How much is the compression in CC and MLO?

A

70-140N CC
100-140N in MLO

27
Q

When are breast ultrasound used?

A

Symptomatic
recall from mammo/MRI
Image guidance of procedures
assess response to treatment

28
Q

What are 4 roles of ultrasound?

A

Diagnosis
staging (TNM)
Guide treatment planning
Assess response to treatment

29
Q

Does ultrasound need a AOC?

A

Yes - its not specific/sensitive enough to screen the breast without a palpable AOC

30
Q

When are MRIs used?

A

Screening/surveillance
Increased breast density
imaging characteristics of some cancers may look benign on mammograms
specific cancer types

31
Q

What 2 types of breast cancer is MRI used?

A

TP53
BRCA

32
Q

What are 2 other imaging modalities used?

A

Digital breast tomosynthesis
Contrast enhanced spectral mammography

33
Q

What are DBTs?

A

Low-dose projection images acquired by rotating x-ray tubes around stationary compressed breast in a limited angular range

34
Q

What is CESM?

A

Complementary breast imaging modality low energy (26-31kVp) & high energy image (45-49kVp)

35
Q

What is the MoA pf CESM?

A

IV injection of a contrast dye
series of x-ray images
high energy & low energy exposure (4 positions)
Image examined

36
Q
A

Medical Imaging (10 decks)

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