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RP > Final > Flashcards

Final Flashcards

1
Q

Current Scanners

A

No longer single slice
Data collected as a continuous data stream
Single breath hold for the patient
Entire body can be done in less than a minute
1st generation took 5 minutes for a single slice
Spiral scanners are acquiring 900 slices in under a minute

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2
Q

Resolution

A

Is the ability to image two separate objects and visually distinguish one from the other.

Spatial resolution is the ability to image small objects that have high subject contrast. Ex: bone-soft tissue interface, breast calcifications, calcified lung nodule
Conventional radiography has excellent spatial resolution

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3
Q

How does a CT scanner work?

A

X-rays are generated in an x-ray tube in the same way x-rays are generated for a radiograph
High voltage(120-150kV for CT) is used to drive electrons across the tube striking the target
Higher voltage results in higher energy photons which mean fewer photons are absorbed in tissue
This is important because photons that are absorbed create deficits at the detectors which result in artifacts
Photons are detected by a detector(s) and quantified
The detectors are essentially DR plates
The data is then processed into an image

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4
Q

CT Imaging System

A 
Operating console—two or more monitors
Patient data annotation
Management of imaging technique, gantry movement, contrast injection, image reconstruction
Computer
Microprocessor
Primary memory
Gantry
X-ray tube
Detector array
HV generator
Table
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5
Q

Pixel and Voxel

A

Field of view (FOV) = diameter of image reconstruction

Pixel size = FOV/matrix size

Voxel = pixel area × slice thickness

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6
Q

CT Image Quality:

Digital Image Quality

A

Spatial resolution
The ability of an imaging system to RESOLVE and render on the image a HIGH CONTRAST object (shades of gray differences in close objects to one another)

Contrast resolution
The ability of the imaging modality to distinguish between differences in image intensity. Remember, the more densities you can visualize the more anatomy you can see.

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7
Q

Advantages of spiral v. conventional CT

A 
Faster image acquisition
Contrast can be followed better
Reduced patient dose at pitches > 1
Physiologic imaging
Improved 3d and reconstructions
Less partial volume
Fewer motion artifacts
No misregistration
Increased throughput
Real time biopsy
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8
Q

Hybrid PET/CT

A

CT/MRI provides anatomic detail
Diagnosing, staging and restaging cancer
Obvious structural disruptions, necrotic, scar tissue, inflammatory changes. Lymph nodes that are enlarged, malignant or benign?

Nuclear Medicine
Developed molecular imaging, physiology of cells

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9
Q

Positron Emission Tomography

A

PET provides functional information
CT provides structural information

Key factor: Radiotracer fluorine-18 fluorodeoxyglucose (FDG)

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10
Q

Hybrid PET/CT

A

PET and CT can be done separately, the most complete diagnosis comes with a combination of modalities

Aligning images acquired on two different scanners is a complex problem

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11
Q

PET

A

Essential tool in the management of cancer patients

Diagnosis and accurate staging

Staging determines the extent and distribution of disease influencing choice of treatments

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12
Q

How Does PET Work?

A

FDG-PET – radiation is given off when positrons (antimatter electrons) encounter electrons in the body
Radiopharmaceutical emits positrons that encounter electrons in the body
They annihilate each other, producing high-energy photons that can be detected by the imaging device
The pharmaceutical portion of FDG is glucose that allows localization that favor glycolysis
Increased glucose uptake is associated with malignancies, more glucose uptake more aggressive malignancy
PET can create images of blood flow and metabolism
PET can detect functional changes before structural changes (CT and MR)
Glucose metabolism is a normal physiologic function of brain, muscles, salivary glands, etc

Timing of the patient’s last meal, insulin injection, and level of hydration can affect PET results

Patients are NPO 4 to 6 hours before a PET exam.

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13
Q

Determining Protocol

A

PET Exam
CT Exam degree of quality
CT images for attenuation correction and localization only or more detailed anatomic images. IV and/or PO contrast, etc.

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14
Q

Using CT for Radiation Treatment Planning

A

Radiation treatment planning team, oncologists, radiation therapist, medical physicists and medical dosimetrists plan the appropriate external beam radiotherapy or internal brachytherapy treatment for cancer.

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15
Q

Imaging

A

Typically CT is the primary set of images
MRI can be used for soft tissue contouring
PET is less commonly used.

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16
Q

Radiobiology

A

The study of the effects of ionizing radiation on biologic tissue

Most radiobiology research is designed to develop dose-response relationships to determine the effect of planned doses or accidents

X-rays are harmful, low energy photons can cause skin burns, cancer, leukemia

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17
Q

Early measurement of Radiation

A 
Skin dryness and erythemia
Ulcers formed
Late Effects:
Cataracts
Cancers
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18
Q

ALARA

A

As Low As Reasonably Achievable

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19
Q

Natural Radiation

A

Natural radiation accounts for approximately 3 mSv (300 millirem, mrem)

3 sources of environmental radiation: cosmic rays, terrestrial radiation and internally deposited radionuclides. The largest source of natural radiation is radon.

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20
Q

Deterministic (non stochastic) vs. Stochastic

A

Even though radiation can be of great benefit, too much exposure can be dangerous. There are two types of radiation effects:

  1. Effects that will occur given enough exposure (or threshold effects)
  2. Effects that have a higher chance of occurring as you receive higher amounts of exposure (or chance effects)
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21
Q

Acute Radiation Syndromes

A 
Radiation Exposure Accidents
Chernobyl (30 deaths due to ARS)
Three Mile Island (0 deaths)
Fukushima (0 deaths)
3 separate syndromes
Hematologic death
Gastrointestinal (GI) death
Central nervous system (CNS) death
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22
Q

Response Stages Following

Lethal Level of Radiation Exposure

A

Prodromal Period
Begins minutes to hours after exposure
Lasts hours to days
Nausea, vomiting, diarrhea, leucopenia

Latent Period
Symptoms recede
Lasts hours to weeks
Manifest Illness

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23
Q

LD50/60 for Various Species

A

50% of the irradiated subjects to die w/in 60 days

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24
Q

Local Tissue Damage

A

deterministic radiation response
minimum necessary to cause a change
threshold-type dose-response
severity of the response increases with increasing dose in a nonlinear fashion

Skin erythema
5000 mGy
annual occupational dose limit 50 mGy

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25
Q

Hemopoietic System

A

Bone marrow, circulating blood, and lymphoid tissue
deterministic radiation response
minimum necessary to cause a change
threshold-type dose-response
severity of the response increases with increasing dose in a nonlinear fashion

Hemopoietic Depression
Cells renew over time

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26
Q

Effects on the Gonads

A

Doses as low as 100 mGy

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27
Q

Stochastic Effects

A

Chance effects
Results when low doses are delivered over a long period

More associated with the type of exposure associated with medical imaging .
Malignancy and genetic effects
Life span shortening and effects on local tissue

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28
Q

Risk Estimates

A 
Relative risk
Observed cases/Expected cases
Excess risk
Observed cases/Expected cases 
Absolute risk
Number of cases/106 persons/rad/yr
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29
Q

Radiation-Induced Leukemia

A

Latent period = 4–7 years

At-risk period = 20 years

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30
Q

Radiation-Induced Cancers

Observed in Irradiated Populations

A 
Thyroid cancer
Thymus irradiation
Rongelap Atoll nuclear test
Bone cancer
Radium watch dial painters
Radium salt treatment 
Skin cancer
Orthovoltage radiation therapy 
Breast cancer
Tb treatment
A-bomb survivors
Lung cancer
Uranium miners
Liver and spleen cancer
Thorotrast
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31
Q

Fertility and Pregnancy Risks

A

Low doses of radiation have no effect on fertility. Effects in fertility is a deterministic effect.

Exposure during pregnancy can present some increased risk to the fetus.

Two at risk populations
Patients and Technologists

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32
Q

Pregnancy and Radiation

A

Since their cells are reproducing more often, developing embryos, fetuses, and children are typically more sensitive to radiation than adults.

When the abdomen of a pregnant woman is exposed to radiation, a fraction of that exposure is also received by the embryo or fetus.

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33
Q

Effects of radiation in utero are time and dose related

A

Effects include:
Prenatal death, neonatal death, congenital abnormalities, malignancy inductions, general impairments of growth, genetic effects, and mental retardation.

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34
Q

Pregnancy Risks

A

Within 2 weeks of fertilization with a very high dose the outcome is spontaneous abortion.

First 2 weeks all-or-nothing risk.

Estimates conclude that a high dose during the first 2 week of pregnancy will increase the rate of spontaneous abortion by 0.1%
Normal incidence of spontaneous abortions are 25 – 50%

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35
Q

Deterministic Effects (non stochastic) = threshold, nonlinear

A

Hematologic depression, erythema, epilation

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36
Q

Stochastic (chance) = nonthreshold, linear

A

Malignancy, genetic effects, life span shortening

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37
Q

Radiation Protection Features of a Radiographic Imaging System

A 
Source-to-Image Receptor Distance Indicator
Collimation
Positive-Beam Limitation
Beam Alignment
Filtration
Reproducibility
Linearity
Operator Shield
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38
Q

Fluoroscopic Protection Features

A 
Source-to-Skin Distance
Primary Protective Barrier
Filtration
Collimation
Exposure Control
Bucky Slot Cover
Protective Curtain
Cumulative Timer
Dose Area Product
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39
Q

Occupational Monitoring

A

Required when someone may receive more than 10% of the recommended dose limit.
5 Rem/yr
Monitoring is not protection, it is awareness

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40
Q

Location of the Monitor

A

Ideally, at the collar outside on the lead apron.
Extremities
At the waist
Typically during pregnancy

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41
Q

Monitoring Report

A

Must include
Current exposure
Annual exposure
When leaving employment or school exposure should move with you

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42
Q

Protective Apparel

A

Aprons
Gloves
Thyroid shields
Glasses
All of these are required to have a minimum lead thickness of 0.25 mm
They are designed to stop scatter radiation NOT PRIMARY

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43
Q

Technologist Position

A 
In the room you should always be as far as possible from the patient and beam
You should never hold patients
Image receptor
May be controllable, most likely not
Patient positioning
Correct positioning minimizes repeats
AP versus PA may reduce dose
Shielding
Blocks the beam
Reduces dose
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44
Q

Reduction of Patient Dose

A 
Unnecessary exams
Typically, you cannot control this
Repeat exams
This you can control and are expected to control
Radiographic technique
Totally within your control
Using proper SOD, source object distance
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45
Q

Atoms and molecules are the fundamental building blocks of

A

Matter

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46
Q

The formula e=mc2 represents

A

Nuclear power

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47
Q

Ionizing radiation is capable of removing

A

electrons

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48
Q

Biggest source of man made radiation

A

Diagnostic x-rays

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49
Q

Exposure is measured in

A

Grays

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50
Q

Today Radiology is considered

A

A very safe operation

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51
Q

ALARA means

A

As low as reasonably achievable

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52
Q

Filtration is used to absorb

A

low energy x-rays

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53
Q

Photons with the highest frequencies have the

A

Shortest wavelength

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54
Q

Which scientist discovered x-rays

A

William roentgen

Crookes

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55
Q

Smallest particle all the properties of an element

A

Atom

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56
Q

Positively charged nucleus surrounded by negatively charged electrons is

A

Bohr Model

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57
Q

Atom in normal state is..

A

Electrical charge is 0

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58
Q

Binding energies is represented by

A

Shells

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59
Q

Atom same number proton but different number neutrons is called

A

Isotope

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60
Q

Atoms combines form is called

A

Molecules

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61
Q

Atom looses or gains electrons

A

Ion

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62
Q

Innermost electron shell is

A

K

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63
Q

A chemical compound is any quantity of

A

one type of molecule

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64
Q

during beta atom releases

A

electrons

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65
Q

the only difference between gamma and x-ray is their

A

origin

66
Q

smallest electromagnetic radiation

A

photon

67
Q

rise and fall of sin wave is

A

frequency

68
Q

wavelength beam of electromagnetic radiation is increases by factor of 2 then frequency is

A

decreased by half

69
Q

the reduction of radiation intensity due to scattering and absorption is called

A

attenuation

70
Q

the lowest energy range of electromagnetic spectrum is

A

radio waves

71
Q

photons tend to interact with matter

A

equal in size with their wavelengths

72
Q

smallest unit of charge is

A

the electron

73
Q

like charges repel unlike charges

A

attract

74
Q

on the surface of an electrified object the charges concentrate on

A

the sharpest curvature

75
Q

a battery is a source of

A

direct current

76
Q

Ohms law

A

I=V/R

77
Q

Rubber and glass are

A

insulators

78
Q

the magnetic intensity of an electromagnet is greatly increased by the addition of an

A

iron core

79
Q

an alternating ac current is represented by

A

a sinusoidal line

80
Q

us alternating current goes through a complete cycle every

A

1/60 seconds

81
Q

is defined as the ability to image two separate objects and visually detect one from the other

A

resolution

82
Q

Higher speed image receptors generally produce images with

A

increased noise

83
Q

In general radiography, the useful optical densities lie between _____ and _____.

A

0.25, 2.5

84
Q

The best way to minimize magnification is to use a

A

long SID, small OID

85
Q

Distortion can be reduced by

A

placing the object plane perpendicular to the image plane

86
Q

The bit represents

A

zero or one.

87
Q

In computer language, 2 bytes is a

A

“word.”

88
Q

Projectile electrons travel from

A

cathode to anode

89
Q

During an exposure, most of the kinetic energy of the projectile electrons is
converted to ________.

A

heat

90
Q

The efficiency of x-ray production is not affected by

A

the tube current.

91
Q

Electron interactions at the inner-shell of the target atoms produce

A

characteristic radiation

92
Q

Characteristic x-rays are produced by __________________.

A

released binding energy

93
Q

The quantity of bremsstrahlung radiation increases proportionately with
increased _____.

A

mAs

94
Q

The quality of an x-ray beam is higher when the peak of the emission
spectrum is further to the___________.

A

right

95
Q

The number of x-rays in the useful beam defines x-ray ________.

A

quantity

96
Q

X-ray quantity increases in direct proportion to increases in __________.

A

mAs

97
Q

the distance from the source to the image (SID) is reduced by half, how is the
x-ray intensity at the image affected?

A

It is increased 4 times.

98
Q

Beam quality is affected by ______________.

A

kVp and filtration

99
Q

X-ray beam quality is improved by ____________.

A

increasing filtration

100
Q

The two primary forms of x-ray interaction in the diagnostic range are
________________.

A

Compton scattering and photoelectric absorption

101
Q

An incident x-ray interacts with an atom without ionization during
______________.

A

coherent scattering

102
Q

Which x-ray interaction involves the ejection of the K-shell electron?

A

Photoelectric absorption

103
Q

Compton scatter is directed at _____ angle from the incident beam.

A

any

104
Q

In ________________, there is complete absorption of the incident x-ray photon.

A

photoelectric interaction

105
Q

___________ occurs only at the very high energies used in radiation therapy and
in nuclear medicine P.E.T. imaging.

A

Pair production

106
Q

K-shell binding energy increases with increasing ____________.

A

atomic number

107
Q

Which has the greatest mass density?

A

Bone

108
Q

Barium is a good contrast agent because of its __________________.

A

high atomic number

109
Q

Computed radiography screens respond to radiation with

______________________.

A

photostimulable luminescence

110
Q

The computed radiography cassette is called a(n) ______________ plate.

A

imaging

111
Q

The principal source of noise in computed radiography is

____________________.

A

scatter radiation

112
Q

The digital imaging plate can sit for some time after the erase cycle.

A

False

113
Q

Digital imaging techniques are always applied to ___________________.

A

computed tomography, ultrasound, magnetic resonance imaging.

114
Q

In digital radiography, the brightness of the image is determined by
_______________.

A

pixel values

115
Q

In digital radiography, spatial resolution is improved with increased
_____________.

A

matrix size

116
Q

The dynamic range determines the degree of __________________ in the
image.

A

contrast resolution

117
Q

Spatial resolution is determined by the ratio of ________________ to
____________.

A

field of view, matrix size

118
Q

Conventional x-ray tubes and cassettes are used with ________ radiography
systems.

A

computed

119
Q

Radiographic image quality is improved when the __________ is increased.

A

source image distance

120
Q

If 5% of an incident beam is transmitted through a body part, then 95% of that
beam was ______________.

A

attenuated

121
Q

A charge-coupled device used in digital fluoroscopy provides high _________________.

A 
spatial resolution

signal-to-noise ratio

detective quantum efficiency
122
Q

Digital fluoroscopy with a charge-coupled device has lower patient dose and higher
light sensitivity than

A

conventional fluoroscopy.

123
Q

A principal advantage of digital fluoroscopy is the ______________.

A

image subtraction

124
Q

The combination of temporal and energy subtraction techniques is called _________.

A

hybrid subtraction

125
Q

Hybrid imaging can produce the highest-quality digital fluoroscopy images only if
_________________.

A

patient motion is controlled

126
Q

Digital fluoroscopic dose rate is lower than that for continuous analog fluoroscopy.

A

True

127
Q

When doing soft tissue radiography, the differential absorption between ________ and ______ must
be enhanced.

A

muscle, fat

128
Q

The breast tissue tends to be increasingly _________ in older women.

A

fatty

129
Q

About 50% of breast cancer occurs in the __________ quadrant .

A

upper outer

130
Q

It is recommended that women obtain their first baseline mammogram before the age of _____.

A

40

131
Q

A dedicated mammography unit should have an automatic adjustable _____________

A

compression device.

132
Q

A target of molybdenum or rhodium is preferable in mammography because it reduces the
_____________.

A

scatter

133
Q

Breast compression has the advantage of lowering _________________.

A 
patient dose

motion blur
 
superimpositions
134
Q

Breast compression is used to lower patient dose and ________

A

reduce focal spot blur.

135
Q

Distance and attenuation are

A

directly related

136
Q

Higher frequencies have/has more attenuation while lower frequencies have____________

A

less attenuation

137
Q

Of the following what contributes to attenuation.

A 
reflection

scattering

absorption
138
Q

As sound strikes the boundary layer between tissue interfaces, some of the sound is reflected back to
its source

A

true

139
Q

Scattering results in____ of sound

A

random redirection

140
Q

The half value layer thickness is the distance sound must travel in a medium that reduces the
intensity of sound to ½ its original value (intensity)!

A

true

141
Q

during ultrasound imaging higher frequencies result in ________

A

higher quality images.

142
Q

Most of the energy in ultrasonic imaging is converted to ______ during absorption

A

heat

143
Q

Spatial frequency is used to describe the quality of spatial resolution in terms of _____________.

A

line pairs

144
Q

In digital imaging, spatial resolution is ultimately limited by ___________________.

A

pixel size

145
Q

The human visual system can distinguish ________ shades of gray.

A

30

146
Q

The number of gray shades that an imaging system can reproduce is called its ________________.

A

dynamic range

147
Q

The bit capacity of each pixel identifies the ___________ of a digital imaging system.

A

dynamic range

148
Q

As mAs is increased the signal-to-noise ratio is ____________.

A

increased

149
Q

Image detail is also called _______________________.

A

spatial resolution

150
Q

With digital imaging, patient dose can be reduced by using higher ______ techniques.

A

kVp

151
Q

In MRI imaging the typical matrix size is _____

A

256 x 192

152
Q

of the following which has the lowest spatial resolution?

A

MRI

153
Q

Most MRI images are acquired after two minutes with some sequences taking _______

A

more time.

154
Q

MRI is a safe imaging procedure that can be utilized for any patient with limitations. These limitations
may include:

A

patients with a pacemaker

155
Q

MRI provides _________contrast resolution which allows for the visualization of structures_______
on conventional radiographs.

A

improved, unseen

156
Q

in between patient imagingthe magnet is

A

still on and personnel are restricted from entering the room

157
Q

what is sentinel node imaging used for?

A

imaging a suspected primary metastatic lymph node

158
Q

What is Nuclear Medicinefusion imaging

A

combines the functional imaging of nuclear medicine with the anatomic imaging of CT

159
Q

What is the most common cancer nuclear medicine is us used to treat

A

Thyroid

160
Q

now do the nuclear medicine technologist protect themselves radiationduring their daily routine

A

transport the material in shielded containers

wearing gloves while aspirating and injection radioactive material

placing the radioactive syringe in a special syringe shield

161
Q

what is the importance of the inverse square law in nuclear medicine?

A

protects the technologist from the radioactive patient

162
Q

during PET imaging photons are detected on/by the detector ringby a process called ______ imaging

A

coincident event

RP (1 decks)

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