Fluoroscopy Syllabus Flashcards
Irradiation of the bone marrow results in hematological depression. Which cell type is most severely depressed?
lymphocytes
What are examples of high bone marrow dose examinations?
barium enema
upper GI series
abdominal angiography
What are examples of somatic indicators?
- bone marrow
2. thyroid and skin
What are somatic effects?
damage to the individual being irradiated (vs. genetic effects which affect future offspring)
Examinations on the order of ___ rads to the gonads may produce temporary sterility.
30 rads
What does the nonthreshold, linear dose-effect curve hypothesis suggest?
any dose of radiation, no matter how small, is considered to have some degree of effect
Regulatory radiation guides are based on what?
nonthreshold dose-effect relationship
What does the Law of Bergonie and Tribondeau state?
the radiosensitivity oftissues depends on the # of undifferentiated cells, the degree of mitotic activity, and the length of time the cells of the tissue stay in active proliferation
What tissue types are the most radiosensitive?
blood forming organs (spleen, red bone marrow)
GI tissue
developing embryo/fetus (in the 1st trimester)
What cell types are the most radiosensitive?
(MOST SENSITIVE to LEAST sensitive)
lymphyocytes or WBC > erythrocytes or RBC> epithelial cells > endothelial cells > connective tissue cells> bone cells > nerve cells > brain cells > muscle cells
What are the most frequently occuring radiation-induced cancers/
(in descending order of susceptibility)
female breast > thyroid gland > hematopoietic tissue > lungs > GI tract > bones
Absorbed doses of about ___ rads to the fetus could result in a spontaneous abortion.
50 rads
Deleterious effects may be produced with doses of as little as ___ rads delivered to the embryo.
10 rads
Lead goggles of at least 0.25mm Pb equivalence reduce radiation exposure to the eyes by what %?
85-90%
What are stochastic effects?
the probability of an event occurring, rather than its severity
Ex. somatic effects or carcinogenesis
What are non-stochastic effects?
those effects for which the severity of an effect varies with radiation dose
Ex. cataracts, bone marrow cell depletion
If the operator is wearing protective clothing, substantial exposure reduction from ____ type of radiation can be achieved.
scatter radiation
What does “whole body dose” refer to?
exposure to any of the following:
- head
- trunk
- arms above the elbow
- legs above the knee
What is the annual maximum whole body dose for occupationally exposed persons?
5 rem (or 0.05 Sv)
What is the annual maximum occupational dose equivalent for skin and extremities for occupationally exposed persons?
50 rem or 0.5 Sv
What is the annual maximum occupational dose equivalent for lens of the eye for occupationally exposed persons?
15 rem or 0.15 Sv
What is the radiation dose limit for individual members of the public ?
0.1 rems (1mSv) in a year
OR 0.002 rem *or 2 millirems) in any one hour
How often should film badges or TLD badges be changed?
once every month (*not specified by regulations though)
What type of light receptor is responsible for daylight (photopic vision)?
cones
What type of light receptor is responsible for nightime (scotopic vision)?
rods
What is nightime vision called?
scotopic vision
rods perceive this
What is daytime vision called?
photopic
cones perceive this
What light receptors perceive color?
cones
*rods perceive grays
What is the ability to perceive fine detail called?
visual acuity
Which light receptors have greater visual acuity?
Photopic visual acuity (cones) is about 10x greater than scotopic acuity
How do you improve visual acuity?
bring the illumination of the image into the cone vision region (which is in the center of the retina) to obtain high brightness
What is the normal viewing distance of an image?
12 to 15 inches
What is the time required by the eye for recognition of an image (integration time)?
0.2 second
What is the unit for ABSORBED dose?
rad (or gray- SI unit)
*stands for radiation absorbed dose
What is the unit for dose equivalent?
rem (sievert- SI unit)
What is the conversion between Sv and rem?
1 Sv= 100 rem
What are the 3 basic principles to reduce dose to radiation?
time, distance and shielding
What is the target-to-tabletop distance on fluoroscopes?
at least 18 inches
how does intensity vary with distance?
intensity varies inversely with the square of the distance
(I1)(D1)^2= (I2)(D2)^2
If the distance from an x-ray source is tripled, the intensity is reduced by how much?
1/9
If the distance from an x-ray source is halved, how does this affect intensity?
exposure intensity is quadrupled
What is the half-value layer (HVL)?
defined as the thickness or layer of a specified materrial which attenuates the x-ray beam to an extent that the exposure is reduced to one-half
(HVL is used to describe the quality of an x-ray beam)
What does a higher HVL mean for an x-ray beam?
a higher HVL for an x-ray beam means that it has higherr penetrability (it can penetrate a given thickness of material to a greater extent than a lower HVL layer)
What is the maximum dose equivalent to an embryo/fetus during the ENTIRE pregnancy due to occupational exposure of a declared pregnant woman?
cannot exceed 0.5 rem (5 mSv)
What is the maximum dose equivalent to an embryo/fetus during ANY month of the pregnancy ?
may not exceed 0.05 rem (50 mrems)
The gonad shield protects the gonads from exposure to the _____ beam.
PRIMARY x-ray beam
which type of gonad shield is best suited for fluoroscopic exams?
shadow shield (not flat, contact shield of shaped/contoured contact shield)
What does the state of CA regulations require for minimum lead equivalent of gonadal shielding?
0.5mm
as opposed to 0.25mm
What is the target to panel (tabletop) distance?
at least 12 inches for under table x-ray tubes
Which fluoroscopic equipment quality control tests should be performed daily?
- brightness/contrast optimization of monitor
- verification of protective devices
- fluoroscopic tower locks
- compression device/spoon observation
- automatic collimation**
- low contrast performance
7, KvP and ma ** - mobile space for c-arm fluoroscopes**
Which fluoroscopic equipment quality control tests should be performed semi-annually?
- shutters ***
- automatic brightness control (ABC) tracking ***
- gain control system
- high contrast resolution (sensitivity)
- low contrast resolution (detectability)
- five minute timer
- actual fluoroscopic beam size
- filtration
- minimum source-to-tabletop distance
- KVP
- typical patient exposure rates
- maximum exposure rates
- apron/glove integrity
- distortion
what is the main source of scatter radiation during fluoroscopic exam?
the patient
What is the best configuration for minimizing radiation exposure to the patient and operator?
x-ray tube UNDER the table
For an x-ray tube located UNDER the table, the maximum intensities are received below the tabletop at what angles?
angles 120 and 135 degrees from the primary beam
For an x-ray tube located OVER the table, the maximum intensities are received below the tabletop at what angles?
30 deg
Minimum intensities are received at scatter angles in what order?
45, 60, and 90 deg to the primary beam
which xray exam has the most somatic detriment or carcinogenic potential in males and females?
barium enema exam
*upper GI is second most in males *lumbosacral films are next for females
What are the 4 different types of cameras that are in use?
- vidicon
- plumbicon
- image-orthicon cameras
- charge-coupled device
what are the two typical ways to record dynamic (motion) images ?
- video tape recording
2. cinefluorography
What are the 2 advantages of video tape recording compared to cinefluorography?
- image is available for iNSTANT REPLAY without any intermediate processing system
- patient’s exposure to radiation is NOT increased
What are the 2 disadvantages of video tape recording compared to cinefluorography?
- poor image quality
2. fixed frame speed (30 frames /sec)
What are the disadvantages of cinefluorography compared to video tape recording?
increased patient radiation dose
What is this: the operation of camera shutters at the same frequency as x-ray pulses (radiation production)?
synchronization
Why is synchronization important?
means that the patient is exposed to pulse xrays only when the camera shutters are open
How is framing frequency calculated?
# frames of film per second (f/s) *is a division of 60 (8.5, 15, 30, 90, 120)
How does patient radiation dose related to framing frequency?
(directly proportional)
Higher framing frequency means higher radiation dose
What is : the speed of any given camera system depends on the ability of its lens to concentrate light on a given area and is denoted by ?
f-number
How do you calculate f-number?
focal length / lens diameter
*usually in mm
What does a low f-number indicate?
faster lens
What is this: refers to the use of the available film to control the image as seen from the output phosphor?
framing