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XR220 Image Production and Evaluation II > Digital Fluoroscopy > Flashcards

Digital Fluoroscopy Flashcards

1
Q

Difference between conventional fluoro and digital is

A

the way the image is processed

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2
Q

In digital fluoroscopy, A computer is placed

A

between the tv camera and tv monitor

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3
Q

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

A

computer, transmitted to tv monitor

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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

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5
Q

In DF the spatial resolution is determined by

A

the image matrix and the size of image intensifier

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6
Q

Formula for Digital fluoro pixel size:

A

Pixel size = image intensifier size

matrix

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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.

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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

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9
Q

In DF, Tube current measured in:

A

hundreds of mA compared to less than 5mA

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10
Q

Tube is not continuously energized, Images obtained by

A

pulsing x-ray beam

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11
Q

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

A

1 per second to 10 per second

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12
Q

It requires how much time to produce one video frame?

A

1/30th of a second.

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13
Q

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

A

switching on & off very rapidly

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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

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15
Q

What is the definition of Extinction time?

A

time required for x-ray tube to be switched off

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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

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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.

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18
Q

The CCD converts visible light to

A

electrons

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19
Q

Sensitive component of a CCD is:

A

layer of crystalline silicon

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20
Q

When silicon is illuminated, __________ is generated

A

an electrical charge

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21
Q

CCD is placed

A

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

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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
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23
Q

The spatial resolution of a CCD is determined by

A

its physical size & pixel count

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24
Q

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

A

no distortion with CCD

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25
Q

Advantages of CCD

A
  • 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)
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26
Q

What is lag?

A

the continuation of luminescence after the x-ray source has stopped

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27
Q

What is blooming?

A

overflow of electrons into a detector element

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28
Q

True or false: CCD has an unlimited lifetime and requires no maintenance.

A

True

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29
Q

Most important feature of CCD is

A

its linear response
Whereas other image receptors have S-shaped response, this one is linear
Particularly helpful for subtraction imaging

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30
Q

The linear response of CCD gives:

A

improved dynamic range & better contrast resolution

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31
Q

CCD’s will eventually be replaced by

A

flat panel image receptors (FPIRs)

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32
Q

Flat panel image receptors (FPRIs) are composed of:

A

cesium iodide/amorphous silicon pixel detectors

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33
Q

Advantages of FPIR over CCD

A

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

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34
Q

A 525-line system is adequate for video,however, for DF higher spatial resolution is obtained with:

A

1000-line systems

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35
Q

In DF, the camera tube reads in ______ mode.

A

progressive

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36
Q

The electron beam of tv camera sweeps target assembly continuously from top to bottom in (how much time?)

A

33ms (1/30s)

37
Q

As the video image is formed on the television monitor:

A

There is no interlacing of one field with another

This produces a sharper image with less flicker

38
Q

All analog electronic devices are inherently noisy. Why?

A

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
Q

Noise limits what?

A

contrast resolution and conveys no useful information/obscures electronic signal

40
Q

A high signal to noise ratio gives us

A

a much better image with more clarity and more detail

41
Q

As mAs is increased the SNR is

A

increased. This happens at the expense of increased pt dose

42
Q

Conventional tv camera tubes have a SNR about

A

200:1

This is not sufficient for DF

43
Q

Minimum SNR for digital is

A

1000:1

44
Q

Important characteristics of a DF system that are computer controlled and affect your image:

A

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
Q

The output signal from tv camera tube is transmitted by cable to

A

an analog-to-digital converter (ADC)

46
Q

The ADC accepts the continuously varying tv camera output signal, the analog signal, and

A

digitizes it

47
Q

The output of the ADC is transferred to

A

main memory and manipulated so that a digital image in matrix form is stored

48
Q

The dynamic range of each pixel, the number of pixels and the method of storage determines

A

the speed with which the image can be acquired, processed, and transferred to an output device

49
Q

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?

A

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
Q

The time to transfer data is made slow due to

A

the time required to conduct the enormous quantities of data from one segment of memory to another

51
Q

Principal advantage of DF exams are

A

the image subtraction techniques and ability to visualize vasculature with a venous injection of contrast material

52
Q

Digital fluoroscopy provides better contrast resolution by

A

postprocessing image subtraction. It provides instant viewing of subtracted images during injection of contrast

53
Q

The subtraction techniques used to enhance contrast are:

A

Temporal
Energy
Hybrid – combination of two
Only some digital capable of producing this

54
Q

Temporal Subtraction – consists of

A

number of computer-assisted techniques whereby an image obtained at one time is subtracted from an image obtained at a later time

55
Q

Two methods of temporal subtraction:

A

Mask mode

Time-interval difference mode (TID)

56
Q

Mask Mode

A

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
Q

Mask mode Requires an increase in

A

in x-ray tube current with activation of pulse image

58
Q

During mask mode, Injector is fired and

A

an initial x-ray pulsed exposure is made before contrast reaches anatomic site

59
Q

the mask image is:

A

(pre-contrast) is stored in primary memory and displayed on video monitor A

60
Q

Additional images (to the mask image) are taken with contrast and

A

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
Q

By subtracting the static object, we can

A

see arteries much more clearly than just viewing it dynamically while contrast is flowing in vessels

62
Q

Advantages of digital subtraction

A

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
Q

image integration

A

Because the video system is slow to respond and noise is high, several video frames may be necessary to make an image.

64
Q

Image integration improves ________ but also increases _______ because more frames are required.

A

contrast resolution, pt dose.

65
Q

Sometimes the initial mask image is inadequate due to:

A

pt motion
improper technique
noise

66
Q

remasking:

A
  • 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
Q

time interval difference mode

A

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
Q

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

A

the flow of the contrast medium dynamically.

Observing dynamically as opposed to a slower rate in mask mode

69
Q

TID image shows it to be relatively free of motion artifacts but

A

with less contrast than mask-mode imaging

70
Q

TID imaging is principally applied in

A

cardiac monitoring

71
Q

Misregistration occurs when:

A

there is patient motion between the mask image and a subsequent image
The subtraction image will contain misregistration artifacts

72
Q

Cause of Misregistration

A

The same anatomy is not registered in the same pixel of the image matrix

73
Q

Misregistration artifact can be eliminated by

A

reregistration of the mask.

74
Q

superimposition of images

A

shifting the mask by one or more pixels

75
Q

Energy subtraction

A

uses two different x-ray beams alternately to provide a subtraction image resulting from differences in photoelectric interaction

76
Q

What is energy subtraction based on?

A

the change in photoelectric absorption of contrast media for soft tissue compared to bone

77
Q

“K-absorption edge”

A

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
Q

Describe the X-rays used for energy subtraction:

A

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
Q

Disadvantage of using energy subtraction:

A

Requires a method of providing an alternating x-ray beam of two different emission spectra (70 & 90)

80
Q

What are the two methods of energy subtraction?

A

Alternately pulsing the x-ray beam at 70 then 90 kVp

Alternately utilizing different metal filters in beam

81
Q

Hybrid subtraction

A

the technique of combining temporal and energy subtraction

82
Q

How is hybrid subtraction achieved?

A

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
Q

Roadmapping

A 
Special application of DSA
Initial images acquired in same manner 
Mask acquired
Contrast injected
Subtraction image acquired
84
Q

What is the main difference in roadmapping?

A

Catheter is fluoroscopically advanced & image is formed by subtracting from second mask

85
Q

Static images with DF are also lower dose per frame than

A

with a 100-mm spot film camera

86
Q

Digital fluoro

A

produces series of dynamic images obtained with x-ray beam and image intensifier

87
Q

Digital subtraction angiography

A

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
Q

registration

A

lining up of the mask with the correct pixels within the matrix.

XR220 Image Production and Evaluation II (8 decks)

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