Breast Imaging - Digital Mammography, Ultrasound, and MRI

Question 1

Identify the three uses of the film in analog mammography imaging.

Answer 1

A film is used to acquire the diagnostic information, to display the information and to store the information.

Question 2

What piece of equipment replaces the film in digital imaging?

Answer 2

Both digital and computed mammography have replaced the film with an electronic detector that generates discrete picture elements or pixels

Question 3

The range of values over which a digital system can respond, also known as the gray-scale range is called the ____

Answer 3

Dynamic range is the range of values over which a system can respond and is also known as the gray-scale range

Question 4

In digital imaging, which matrix of cells will have less information, a 5x5 or a 10x10?

Answer 4

A 5x5 image matrix of cells will have less information stored per cell than a 10x10 matrix of cells.

Question 5

What is the name of the photoconductor used in direct digital systems?

Answer 5

Selenium (Se) is the common photoconductor used in direct flat panel detector system.

Question 6

What is the name given to the device that replaces the film in computed radiography?

Answer 6

Computed mammography uses a flexible imaging receptor (IR)- also called a photo stimulator storage phosphor (PSP)- because it is coated with storage phosphors.

Question 7

In digital imaging, name the process whereby a phosphor crystal will emit light when exposed t radiation.

Answer 7

Scintillation is the process by which certain materials scintillate or emit a flash of light in response to the absorption of ionization radiation.

Question 8

What is described as the biggest advantage of digital mammography?

Answer 8

The wide latitude of the digital signals.

Question 9

What do the initials PACS stand for?

Answer 9

Picture archiving and communication system.

Question 10

How can CAD technology help in the detection of breast cancer?

Answer 10

CAD acts as a second reader, a map of normal healthy breast is stored in the CAD system as a reference. Future images are compared to the normal reference map allowing the computer to analyze the image, detecting abnormalities by a process of enhancing the important point on the image and de-emphasizing area of little importance.

Question 11

On what effect is the basic principle of ultrasound based?

Answer 11

Piezoelectric effect.

Question 12

Higher frequency ultrasound transducers have less penetration power. what feature makes them ideal for breast imaging?

Answer 12

They have greater resolution

Question 13

What is the effect of applying too much gain when imaging a simple cyst using ultrasound?

Answer 13

Artifactual echoes will be created,mimicking a malignant lesion.

Question 14

Why is it recommended that a lesion be imaged with and without a caliper in ultrasound?

Answer 14

To avoid obscuring the margins of the lesions.

Question 15

What information can ultrasound give about a cyst?

Answer 15

Rule out a malignancy or prove a benign lesion by showing that the cyst is fluid-filled versus solid

Question 16

Describe the borders of a benign lesion.

Answer 16

Smooth

Question 17

On ultrasound, if a lesion is irregular shaped with speculated margins, what is it likely to be?

Answer 17

Malignant

Question 18

What type of lesion tends to show “posterior enhancement” on the ultrasound image?

Answer 18

Benign

Question 19

What type o f ultrasound lesion generally has spiculated margins?

Answer 19

Malignant

Question 20

How many protons and electrons does the hydrogen atom have?

Answer 20

One of each

Question 21

In MR imaging, how would you describe the wobble motion similar to the motion of a spinning top just before it falls?

Answer 21

Precession

Question 22

In MR imaging, why is the primary magnet kept supercooled?

Answer 22

To ensure superconductivity

Question 23

Identify the coil closest to the patient during a MRI scan.

Answer 23

Radio frequency (RF) coil or RF probe

Question 24

What action(s) creates the noise heard during the MRI examination?

Answer 24

The switching on and off of the gradient coils

Question 25

In MR imaging, describe the relation of T1 to T2 in larger molecules such as those found in fat.

Answer 25

Longer T1 and shorter T2

Question 26

What describes the time interval between a 90-degree pulse and the measurement of the MRI signal?

Answer 26

Time to echo TE

Question 27

Slice selection is determined by the selection of which coils in MR imaging?

Answer 27

Gradient coils

Question 28

Give the term describing an imaging sequence using one RF excitation pulse at less than or equal to 90 degrees.

Answer 28

Gradient echo pulse

Question 29

How soon after injection of contrast are the MR images taken?

Answer 29

Within 5 minutes

Question 30

What type of artifact is created if the part is outside the RF coil during MR scanning?

Answer 30

Aliasing artifact

Question 31

Name two common benign disorders that can mimic malignancy on the MR image.

Answer 31

Fibroadenomas, inflammation, recent scaring, radial scars, fibrocystic changes, active glandular tissue

Question 32

What factor(s) is/are associated with the single major risk during an MRI examination.

Answer 32

The magnetic properties of the MRI machine.

Question 33

Can a patient with an aneurysm clip have a breast MRI?

Answer 33

Yes, Not all clips have magnetic properties. The clip should first be checked for magnetic properties.

Question 34

Give two uses of MR imaging of the breast.

Answer 34

Map tumor extent, screen dense breast, detect cancer reoccurrence, detect the spread of cancer, and assess the effects of chemotherapy or tamoxifen response, image implant to access leaks or rupture.

Question 35

Name two methods used to display the digital image.

Answer 35

Display methods include: Cathode ray tube (CRT), liquid Crystal Display (LCD), Organic Light-Emiting Diode Display )OLED), laser-printed film.

Question 36

As pixel size decreases the amount of data contained in the image will
A. increase
B. remain the same
C. decrease
D.pixel size has no effect on image data

Answer 36

A. The data contained in the images will increase however, the image noise will also increase.

Question 37

In digital imaging the dynamic range refers to A. the range of intensities that are displayed
B. the random background information that is detected but does not contribute to image quality
C. range of value over which a system can respond
D. layout of the cells in rows and columns

Answer 37

C. The range of values over which a system can respond. It is also known as the gray-scale or the number of shades of gray that can be represented in each pixel.

Question 38

The detector system in digital mammography is categorized as direct if
A.the x-rays are absorbed by the detector and an electrical signal is created in one step.
B. the x-rays are absorbed , converted to light which is then detected by TFD
C. the systems a wide dynamic range
D. the spatial frequency is high

Answer 38

A. The detector systems are direct or indirect. The direct system creates the electrical signal in one-step whereas the indirect system uses a two-step process similar to film-screen systems. The dynamic range refers to the range of values over which a system can respond and the spatial frequency is the measure of the line pairs per centimeter.

Question 39

PACS refers to
A. enhanced storage capacity of the digital image
B. transmission, storage, and access of images via the internet of cable
C. converting the analog image into acoustic pulses

Answer 39

B. PACS is a picture archiving and communication system that allows integration of various modalities. Images from multiple modalities can be transmitted over the internet or cable and viewsed at a central viewing area.

Question 40

Most of the risk of MR imaging of the breast are associated with
A. the magnetic properties of the patient
B. ferromagnetic metals
C. technologists errors
D. radiologist error

Answer 40

A. During an MR exam the patient is placed within a powerful magnet. Any metal objects on or around the patient can be a danger because they will be drawn to the magnet.

Question 41

Computer scanning of the mammogram to visually identify areas of concern or possible indicators of cancer describes"
A. PACS
B. CAD
C. PET
D. FDG

Answer 41

B. CAD is a device used to map an image of the breast from analog or digital imaging systems. The images analyzed and compared t a normal reference, allowing the computer to high-light areas of suspicion. FDG_PET is a method of molecular imaging and PACS is a Picture archiving and communication system.

Question 42

In MR imaging the breast, a large value for the T1 or T2 will indicate
A. a long, gradual relaxation time
B. a rapid relaxation time
C. hydrogen atoms are not aligned to the external magnetic field
D. the RF field was not applied

Answer 42

A. The MR image is a record in the difference in the radio frequency signals from different body tissues. A large value for T1 or T2 indicates a long, gradual relaxation time whereas a small value will indicate a rapid relaxation time.

Question 43

Sound waves cannot reveal through
A. a medium
B. vacuum
C. gasses
D. Liquids

Answer 43

B. Sound is a mechanical longitudinal wave that cannot travel very poorly through gases.

Question 44

Typically a lesion with no internal echoes, no spicy;nations and fewer than four gently lobulations would represent\_\_\_\_\_\_lesion on ultrasound
A. malignant
B. intermediate
C. carcinoma
D. benign

Answer 44

D. These are the characteristics of a benign lesion. Malignant lesions tend to be irregular and speculated margins. Intermediate lesions are harder t define however, they tend t have an echogenicity similar to fat.

Question 45

The ultrasound transducer is used to 
1. convert electric energy to acoustic pulses
2. convert acoustic pulses to electrical energy
3. change the speed of the sound waves
A. 1 and 2 only
B. 2 and 3 only
C. 1 and 3 only
D. 1,2 and 3

Answer 45

A. The transducer consists of crystal made up of piezoelectric material capable of converting electrical energy into acoustic energy on transmission and acoustic energy into electrical energy on reception.