First Year Exam: Imaging Flashcards
How are DRRs produced?
- Use a virtual source position
- Ray trace lines projected through CT onto a virtual imager plan (at same distance as a real imager)
- Sum attenuation coefficients in ray path through CT
Which is smaller and more concentrated, fan beam or cone beam?
Fan beams are smaller
What is used for imaging in CT and Tomo, fan beam of cone beam?
Fan beams
What is the major difference between a Cone beam vs a fan beam?
Cone beam does a larger scan area at once, and typically only requires one rotation since you’re scanning everything in one go
What are the main uses of PET scans in radiation therapy? (three uses)
- To provide functional images that can differentiate between malignant tumors and surrounding normal tissues AND benign tumors for contouring.
- Can also be used for clinical staging in certain sitauations.
- Follow changes in tumor over time
Note: Normal tissues and benign tumors appear relatively similar. Malignant tumors only appear different because of increased metabolic acitivity
Between PET and CT, which has the better spatial resolution?
CT
What are the three limitations of PET spatial resolution? Which of the three is the main limiting constraint?
- Main constraint is the energy of the emitted positron (higher energy means it travels more, so it’s harder to narrow down where the initial positron forming even occured)
- Deviation from 180 degree annihilation photon orientation (usually annihilation photons orient 180 +- 0.25 degrees)
- Detector thicknesses
What is the typically spatial resolution of a PET scan?
6 - 10 mm
What does it mean to say that PET and CT are complementary of each other?
They cover each others inherent weaknesses
In what 3 ways are PET and CT complementary?
- PET gives functional physiological information that CT lacks
- When fused onto a CT, a PET scan is given the correlative anatomy that it originally lacked
- Having a CT with a PET image allows you to apply attenuation correction factors on the PET image
True or False
The majority of PET scanners are PET/CT scanners?
True
Typically PET by itself is pretty useless. You need correlative anatomy to make sense of a PET scan, which is why you use a PET/CT scanner to make fusion of the PET to the CT much simpler
How do you fuse a PET image to a CT sim image?
This is a trick question
PET images are usually PET/CT. The PET is already fused onto its CT.
You then fuse the CT from the PET/CT to the CT sim, and that also brings along the PET with it
What is the most common radiopharmaceutical for PET scans?
FDG
What is FDG?
A F-18 isotope with a glucose molecule analog
Why is FDG good for spotting malignant tumors?
FDG, since it’s a glucose analog, will behave like glucose
Some tumors are highly metabolic to the point where they are able to distinguish themselves vs the surrounding tissue metabolically. Also tumors have a hard time breaking down glucose molecule analogs, so the FDG will be trapped in cancerous cells for longer
In what situations does using FDG fail? (2)
- When a tumor is masked by proximity to structures that normally have very high glucose uptake
- When a cancer does not readily uptake FDG
In terms of physics, biology and practicality, why is FDG the most commonly used tracer? (4 reasons)
- It has a short half-life
- It is easily biologically binded to glucose
- Cheap to produce F-18
- Has a low positron emission energy (allows for better spatial resolution)
What is the half-life of F-18?
109.8 mins
What is the approximate typical range in water of F-18 positron? What is the max range?
1-2 mm typically
Max range of 2.2 mm
Why do annihilation photons not get emitted exactly 180 degrees from each other? Why is it 180 +- 0.25 degrees?
Because when the positron annihilates with a medium electron, there is some inherent remaining kinetic energy right before the annihilation
Conservation laws dictate the photons can’t be perfectly 180 degrees, unless the kinetic energy before interaction is exactly 0, which is often isn’t.
What is the HVL in tissue of an annihilation photon?
7 cm
Why is it important to apply attenuation corrections to a PET scan?
Because the annihilation photons have a relatively small HVL in tissue
The annihilation photons from the periphery of a patient are much more likely to be counted than those from the center
Thus, if you don’t correct for attenuation, then the peripheral counts are gonna be skewed up relatively to the central counts
What is the time window for two photons to interact with the detector in order for a count to be considered?
20 ns
What is the normally used computation algorithm for PET scans?
Filtered back-projection


