Digital Fluoroscopy Flashcards

1
Q

Difference between conventional fluoro and digital is

A

the way the image is processed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In digital fluoroscopy, A computer is placed

A

between the tv camera and tv monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

In digital fluoroscopy, a video signal from camera is routed through ______, manipulated and ___________ to view

A

computer, transmitted to tv monitor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The advantage of digital fluoro over conventional fluoro is

A

the speed of retrieving the image and the ability to use postprocessing to enhance the image

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

In DF the spatial resolution is determined by

A

the image matrix and the size of image intensifier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Formula for Digital fluoro pixel size:

A

Pixel size = image intensifier size

matrix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

The differences in the equipment between conventional and digital fluoro include the following additions for DF:

A

a more complex operating console that includes two monitors, more keys, computer-interactive video controls and a pad for cursor and ROI manipulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When two monitors are utilized, one is used to _____________ while the other is used to ____________.

A

edit pt. data, exam data and annotate final images, display subtracted images

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

In DF, Tube current measured in:

A

hundreds of mA compared to less than 5mA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Tube is not continuously energized, Images obtained by

A

pulsing x-ray beam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

With Pulse-progressive fluoroscopy,The rate to acquire an image ranges from

A

1 per second to 10 per second

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

It requires how much time to produce one video frame?

A

1/30th of a second.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Because of pulse-progressive fluoroscopy, the x-ray generator must be capable of:

A

switching on & off very rapidly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the definition of Interrogation time?

A

time required for x-ray tube to be switched on and reach selected levels of kVp & mA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the definition of Extinction time?

A

time required for x-ray tube to be switched off

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

DF systems must incorporate 3-phase or high frequency generators with interrogation and extinction times of less than ____
This will accommodate switching on and off as rapidly as needed

A

1ms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Benefits of Pulse Progressive Fluoro

A

• Utilizes high mA by operating the undertable tube in radiographic mode.
– Reduces quantum mottle and improves signal-to-noise ratio.
• Delivers radiation in rapid, high intensity pulses, about 30 per second.
– Protects tube from thermal overload.
– Aids in controlling patient dose.
• Utilizes a 1023-line display monitor, and scans in progressive mode.
– Improves resolution.
– Reduces flicker on the monitor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

The CCD converts visible light to

A

electrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Sensitive component of a CCD is:

A

layer of crystalline silicon

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When silicon is illuminated, __________ is generated

A

an electrical charge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CCD is placed

A

on output phosphor of image intensifier tube, Coupled by fiber optics or a lens system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Principal advantages of CCDs:

A
High spatial resolution
High signal-to-noise ratio
High detective quantum efficiency (DQE)
No warm-up require, No lag
No spatial distortion, No maintenance
Unlimited life
Unaffected by magnetic fields
Linear response & lower dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The spatial resolution of a CCD is determined by

A

its physical size & pixel count

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Because of its flat surface ___________ as with tv cameras (pincushion distortion*)

A

no distortion with CCD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Advantages of CCD
- Because CCD has a high DQE, the CCD has higher sensitivity to light (detective quantum efficiency) - Lower level of electronic noise than tv camera - Higher signal-to-noise (SNR) and better contrast resolution - All of this results in lower patient dose - Warm up is not required (because of CCD’s response to light)
26
What is lag?
the continuation of luminescence after the x-ray source has stopped
27
What is blooming?
overflow of electrons into a detector element
28
True or false: CCD has an unlimited lifetime and requires no maintenance.
True
29
Most important feature of CCD is
its linear response Whereas other image receptors have S-shaped response, this one is linear Particularly helpful for subtraction imaging
30
The linear response of CCD gives:
improved dynamic range & better contrast resolution
31
CCD’s will eventually be replaced by
flat panel image receptors (FPIRs)
32
Flat panel image receptors (FPRIs) are composed of:
cesium iodide/amorphous silicon pixel detectors
33
Advantages of FPIR over CCD
Distortion-free images Constant image quality over the entire image Improved contrast resolution over the entire image High DQE at all dose levels Rectangular image area coupled to similar image monitor Unaffected by external magnetic fields
34
A 525-line system is adequate for video,however, for DF higher spatial resolution is obtained with:
1000-line systems
35
In DF, the camera tube reads in ______ mode.
progressive
36
The electron beam of tv camera sweeps target assembly continuously from top to bottom in (how much time?)
33ms (1/30s)
37
As the video image is formed on the television monitor:
There is no interlacing of one field with another | This produces a sharper image with less flicker
38
All analog electronic devices are inherently noisy. Why?
Due to heated filament and voltage differences always produce very small electric current flowing in any circuit This is known as background electronic noise
39
Noise limits what?
contrast resolution and conveys no useful information/obscures electronic signal
40
A high signal to noise ratio gives us
a much better image with more clarity and more detail
41
As mAs is increased the SNR is
increased. This happens at the expense of increased pt dose
42
Conventional tv camera tubes have a SNR about
200:1 | This is not sufficient for DF
43
Minimum SNR for digital is
1000:1
44
Important characteristics of a DF system that are computer controlled and affect your image:
Image matrix size – affects image quality System dynamic range – shades of gray Image acquisition rate – speed with which image is acquired Image processing & manipulation
45
The output signal from tv camera tube is transmitted by cable to
an analog-to-digital converter (ADC)
46
The ADC accepts the continuously varying tv camera output signal, the analog signal, and
digitizes it
47
The output of the ADC is transferred to
main memory and manipulated so that a digital image in matrix form is stored
48
The dynamic range of each pixel, the number of pixels and the method of storage determines
the speed with which the image can be acquired, processed, and transferred to an output device
49
The dynamic range of each pixel, the number of pixels and the method of storage determines the speed with which the image can be acquired, processed, and transferred to an output device Why?
because the larger the image matrix the longer it will take and The larger the matrix the fewer (slower) the images per second produced
50
The time to transfer data is made slow due to
the time required to conduct the enormous quantities of data from one segment of memory to another
51
Principal advantage of DF exams are
the image subtraction techniques and ability to visualize vasculature with a venous injection of contrast material
52
Digital fluoroscopy provides better contrast resolution by
postprocessing image subtraction. It provides instant viewing of subtracted images during injection of contrast
53
The subtraction techniques used to enhance contrast are:
Temporal Energy Hybrid – combination of two Only some digital capable of producing this
54
Temporal Subtraction – consists of
number of computer-assisted techniques whereby an image obtained at one time is subtracted from an image obtained at a later time
55
Two methods of temporal subtraction:
Mask mode | Time-interval difference mode (TID)
56
Mask Mode
patient is positioned under fluoro to ensure that region of anatomy under investigation is within the FOV of the image intensifier Power injector is armed and readied to deliver contrast material through venous or arterial entry
57
Mask mode Requires an increase in
in x-ray tube current with activation of pulse image
58
During mask mode, Injector is fired and
an initial x-ray pulsed exposure is made before contrast reaches anatomic site
59
the mask image is:
(pre-contrast) is stored in primary memory and displayed on video monitor A
60
Additional images (to the mask image) are taken with contrast and
stored in another memory location. The mask image is subtracted from these and stored in primary memory. These subtracted images are displayed on video monitor B.
61
By subtracting the static object, we can
see arteries much more clearly than just viewing it dynamically while contrast is flowing in vessels
62
Advantages of digital subtraction
The digital subtraction allows a better analysis of the opacified arteries These images are stored in memory and can later be recalled for closer examination
63
image integration
Because the video system is slow to respond and noise is high, several video frames may be necessary to make an image.
64
Image integration improves ________ but also increases _______ because more frames are required.
contrast resolution, pt dose.
65
Sometimes the initial mask image is inadequate due to:
pt motion improper technique noise
66
remasking:
- Later images (#5 image instead of #1) may be used as the mask image. - The examiner can even integrate several images using the composite image as the mask. - A typical exam may require a total of 30 images in addition to the mask image
67
time interval difference mode
produces subtracted images from progressive masks and following frames First image = frame 1 subtracted from frame 5 Second image = frame 2 subtracted from frame 6, etc.
68
The images observed during time interval difference mode convey the flow of the contrast medium dynamically. Observing dynamically as opposed to a slower rate in mask mode
the flow of the contrast medium dynamically. | Observing dynamically as opposed to a slower rate in mask mode
69
TID image shows it to be relatively free of motion artifacts but
with less contrast than mask-mode imaging
70
TID imaging is principally applied in
cardiac monitoring
71
Misregistration occurs when:
there is patient motion between the mask image and a subsequent image The subtraction image will contain misregistration artifacts
72
Cause of Misregistration
The same anatomy is not registered in the same pixel of the image matrix
73
Misregistration artifact can be eliminated by
reregistration of the mask.
74
superimposition of images
shifting the mask by one or more pixels
75
Energy subtraction
uses two different x-ray beams alternately to provide a subtraction image resulting from differences in photoelectric interaction
76
What is energy subtraction based on?
the change in photoelectric absorption of contrast media for soft tissue compared to bone
77
“K-absorption edge”
When the incident x-ray energy is sufficient to overcome the K-shell electron binding energy of iodine, an abrupt and large increase in absorption occurs
78
Describe the X-rays used for energy subtraction:
A low (70) kVp mask is created for soft tissue As well as a high (90) kVp mask for bone The two are subtracted with a resulting image
79
Disadvantage of using energy subtraction:
Requires a method of providing an alternating x-ray beam of two different emission spectra (70 & 90)
80
What are the two methods of energy subtraction?
Alternately pulsing the x-ray beam at 70 then 90 kVp | Alternately utilizing different metal filters in beam
81
Hybrid subtraction
the technique of combining temporal and energy subtraction
82
How is hybrid subtraction achieved?
The mask and each subsequent image are formed by an energy subtraction technique If patient motion is controlled, hybrid imaging can produce the highest quality DF images
83
Roadmapping
``` Special application of DSA Initial images acquired in same manner Mask acquired Contrast injected Subtraction image acquired ```
84
What is the main difference in roadmapping?
Catheter is fluoroscopically advanced & image is formed by subtracting from second mask
85
Static images with DF are also lower dose per frame than
with a 100-mm spot film camera
86
Digital fluoro
produces series of dynamic images obtained with x-ray beam and image intensifier
87
Digital subtraction angiography
a type of fluoroscopy technique used in interventional radiology to clearly visualize blood vessels in a bony or dense soft tissue environment. Images are produced using contrast medium by subtracting a 'pre-contrast image' or the mask from later images, once the contrast medium has been introduced into a structure.
88
registration
lining up of the mask with the correct pixels within the matrix.