Lesson 1-4 (FINALS) Flashcards
Provides a numeric value indicating the level of radiation exposure to the image receptor
Exposure Indicator Range
Background information received by IR.
Image Noise
Contributes no useful diagnostic information.
Image Noise
Serves only to reduce quality of image within acceptable range
Image Noise
Image noise often results in a _____, _____, _____ appearance
Mottled, Black and-White, Salt-and-Pepper
Enumerate 4 components of image noise
- Film graininess
- Structure mottle
- Quantum mottle
- Scatter radiation
- Refers to the distribution in size and space of silver halide grains in the emulsion
- Inherent in the image receptor
- Not under control of the RT
Film Graininess
- Phosphor crystals in the radiographic intensifying screen
- Inherent in the image receptor
- Not under control of the RT
Structure Mottle
- Principal contributor to radiographic noise
- Random nature by which x-rays interact with the image receptor
- Under the control of RT
Quantum Mottle
- Result of Compton interaction
- A type of secondary radiation that occurs when the beam intercepts an object, causing the X-rays to be scattered
Scatter Radiation
Term used in both digital and film screen imaging to describe the variations in brightness and density
Contrast
Radiograph must exhibit differences in brightness levels in order to differentiate anatomic tissues.
Contrast
Enumerate 4 types of contrast
- Long scale contrast
- Physical contrast
- Short scale contrast
- Visible contrast
Demonstrates light difference between structures, has a maximum total number of densities
Long Scale Contrast
Refers to an image that demonstrate considerable differences between structures has a minimum total number of densities
Short Scale Contrast
Total range of density/exposure
values recorded by image receptor
Physical Contrast
Total range of density/exposure values that can perceived by the human eye when looking at image
Visible Contrast
Degree of geometric sharpness or accuracy of the structural lines actually recorded in the image
Recorded Detail
Enumerate 2 types of image distortion
- Size distortion
- Shape distortion
Image Distortion. Magnification
Size Distortion
Enumerate 2 types of shape distortion
- Elongation
- Foreshortening
Unwanted image on radiograph
Artifacts
Decrease the overall image quality
Artifacts
Enumerate 5 types of artifacts
- Patient artifacts
- Equipment artifacts
- Exposure artifacts
- Processing artifacts
- Moiré effect
Enumerate patient artifacts
- Clothing artifacts
- Foreign body
- Motion artifacts
Artifacts. One of the common preventable artifacts in radiographs
Clothing Artifacts
Artifacts. e.g. shirt, bra, belt, hair bun, jewelry
Clothing Artifacts
Artifacts. Cause: Clothing or jewelry not removed
Clothing Artifacts
Artifacts. Action: Retake the image after the patient has removed the offending garment
Clothing Artifacts
Artifacts. May be ingested, inserted into a body cavity, or deposited into the body by a traumatic or iatrogenic injury
Foreign Body
Artifacts. e.g. coin, bullet, scalpel, gloves
Foreign Body
Artifacts. Cause: Objects lying partially or wholly within the body that originated in the external environment
Foreign Body
Artifacts. Cause: Voluntary or involuntary movement of patient during exposure
Motion Artifacts
Artifacts. Appearance: Blurred image or abnormal shadows
Motion Artifacts
Artifacts. Action: Reduce time exposure, good patient communication, immobilization
Motion Artifacts
Enumerate equipment artifacts
- Detector drop artifact
- Liquid contamination artifacts
- Crack on the imaging plate artifacts
- Disparity artifacts
- Malfunctioning rollers
- Dust particles on imaging plate artifacts
Artifacts. Wireless flat panel detectors get dropped
Detector Drop Artifact
Artifacts. Cause: Disruption of the readout circuitry, or loss of adhesion between scintillation and TFT layers
Detector Drop Artifact
Artifacts. Appearance: White smoothly edged defect or straight lines
Detector Drop Artifact
Artifacts. Action: Protective Cases, Use Handgrip
Detector Drop Artifact
Artifacts. Electronic equipment was contaminated with liquid
Liquid Contamination Artifacts
Artifacts. Cause: Liquid infiltration into detector that damage the circuitry
Liquid Contamination Artifacts
Artifacts. Appearance: Repeated vertical banding and water contamination
Liquid Contamination Artifacts
Artifacts. Action: Use watertight protection
Liquid Contamination Artifacts
Artifacts. Cause: Damaged imaging plates (external forces)
Crack on the Imaging Plate Artifacts
Artifacts. Appearance: Visible cracks or kinks in the image
Crack on the Imaging Plate Artifacts
Artifacts. Action: Change imaging plate
Crack on the Imaging Plate Artifacts
Artifacts. Defective scanning of the CR reader resulting in alteration of contrast
Disparity Artifacts
Artifacts. Cause: Malfunctioning of reader
Disparity Artifacts
Artifacts. Appearance: Alteration in image contrast
Disparity Artifacts
Artifacts. Action: Periodic cleaning of CR Reader
Disparity Artifacts
Artifacts. Cause: Slipping of feed rollers
Malfunctioning Rollers
Artifacts. Appearance: Half-read image
Malfunctioning Rollers
Artifacts. Action: Periodic cleaning and recalibration of feed rollers
Malfunctioning Rollers
Artifacts. Cause: Dust particle wedged over imaging plate
Dust Particles on Imaging Plate Artifacts
Artifacts. Appearance: Focal radiopacities
Dust Particles on Imaging Plate Artifacts
Artifacts. Action: Regular cleaning of imaging plates with proper cleaner (ethyl alcohol). Use lint-free cloth.
Dust Particles on Imaging Plate Artifacts
Enumerate exposure artifacts
- Light bulb effect
- Twin artifacts / Double exposure
- Delayed scanning
- Exposure through back of cassette
Artifacts. Cause: High kV, scatter radiation, or improper collimation
Light Bulb Effect
Artifacts. Appearance: Darkening of lower and outer portions of an image
Light Bulb Effect
Artifacts. Action: Reduce back scatter by lowering kV or collimating properly
Light Bulb Effect
Artifacts. Cause: Two subsequent exposure on same imaging plate
Twin Artifacts / Double Exposure
Artifacts. Appearance: Duplication of images
Twin Artifacts / Double Exposure
Artifacts. Action: Proper knowledge of using X-ray Equipment.
Twin Artifacts / Double Exposure
Artifacts. Causes Delay between acquisition and processing of image (12 hours beyond)
Delayed Scanning
Artifacts. Appearance: Fading of Image
Delayed Scanning
Artifacts. Action: Proper knowledge of Radiographers to check that no delay occurs between acquisition and processing
Delayed Scanning
Artifacts. Cause: Placing the back portion of cassette facing front
Exposure Through Back of Cassette
Artifacts. Appearance: Various patterns according to cassette design
Exposure Through Back of Cassette
Artifacts. Action: Pay attention when placing cassette
Exposure Through Back of Cassette
Enumerate processing artifacts
- Communication error artifact
- Midgray clipping artifact
- Improper erasure setting artifact
- Finger mark artifact
- Hyporetention artifact
Artifacts. Cause: Power failure during image transmission
Communication Error Artifact
Artifacts. Appearance: Missing lines or pixels in resulting image
Communication Error Artifact
Artifacts. Action: Repeat procedure
Communication Error Artifact
Artifacts. Cause: Poor contrast enhancement
Midgray Clipping Artifact
Artifacts. Appearance: Loss of contrast in certain areas
Midgray Clipping Artifact
Artifacts. Action: Adjust image processing settings
Midgray Clipping Artifact
Artifacts. Cause: Malfunctioning of the erasure light
Improper Erasure Setting Artifact
Artifacts. Appearance: Residual image is left in IP
Improper Erasure Setting Artifact
Artifacts. Action: Replace the erasure light
Improper Erasure Setting Artifact
Artifacts. Cause: Improper handling of film
Finger Mark Artifact
Artifacts. Appearance: Presence of finger mark in the film
Finger Mark Artifact
Artifacts. Action: Keep fingers dry and clean. Touch only film edges
Finger Mark Artifact
Artifacts. Cause: Inadequate washing
Hyporetention Artifact
Artifacts. Appearance: Yellowish stain that appears on finished radiograph
Hyporetention Artifact
Artifacts. Action: Adequate washing of film
Hyporetention Artifact
Artifacts. Cause: Incorrectly oriented grid whereas the grid lines are running parallel to the plate readers scan of the lines
Moiré Effect
Artifacts. Appearance: A wavelike, cloudy or frosted appearance of textile fabrics or metallic surfaces
Moiré Effect
Artifacts. Action: Apply a slight blur or smoothing filter to the affected areas of the image
Moiré Effect
A program used by management to maintain
optimal diagnostic image quality with minimum hazard and distress to patients.
Quality Assurance
Enumerate daily QC duties for technologies
- Inspect and clean cassettes
- Inspect hinge and latch
- Erase imaging plates
- Verify digital interfaces and network transmission
- Inspect laser printer
A quality indicator and critical tool for dose and image quality optimization in radiology departments.
Reject Analysis
Responsibility of Radiation Physicist
- Conducting test to ensure the safety and proper performance of imaging equipment used
- May handle multiple medical facilities, visiting each one on a weekly or monthly basis
- Employed by only one facility and be much
more active in determining review procedures
_____ are monitors used by radiologist for
diagnostic interpretation.
Primary Monitors
The monitor of the technologist should also be of _____ _____.
High Quality
A display monitor having diagonal dimensions of _____ is adequate to view images sized _____.
54cm & 35 x 43 cm
Enumerate types of monitor
- Cathode Ray Tube (CRT)
- Liquid Crystal Display (LCD)
Major components are the electron gun encasing a cathode focusing coils and deflecting coils, and the anode.
Cathode Ray Tube (CRT)
This type of display monitor typically has a curved face plate, and its dimensions are deeper
Cathode Ray Tube (CRT)
Replaced the CRT’s and newer technologies
Liquid Crystal Display (LCD)
This monitor passes light through liquid
crystals to display the image on the
glass faceplate.
Liquid Crystal Display (LCD)
The electrical signals can vary the light waveforms that pass through the crystals for viewing on the faceplate.
Liquid Crystal Display (LCD)
It is high-contrast single-emulsion film with extremely fine grain, also known as IR film
Laser Film
A silver halide film sensitized red light (panchromatic) or laser light, e.g., HN Laser Film, IR Laser Film
Laser Film
It is the manner in which many computers can be connected with one another.
Network
In some countries, _____ _____ are used for medical data.
National Network
In the _____ department, in additional to secretarial workstation, the network may consist of various types of devices that allow storage, retrieval and viewing of images, PACS workstation, a departmental mainframe, hospital mainframe.
Radiology
A database application which primarily stores the demographic and contact details of patients as well as national identifiers and local identifiers.
Hospital Information System (HIS)
Hospital Information System (HIS) – also known as _____ or _____.
Master Patient Index or Patient Administration System
A generic name for an application or group of application used to handle the textual data related to imaging procedures.
Radiology Information System (RIS)
The first RIS were simply created as a replacement to the _____ that was widely used at that time.
Paper Diaries
RIS are _____ to Radiology, other department have similar systems.
Unique
Information of the Radiology Information System (RIS) can be shared with the _____
HIS
A centralized computer-based system designed to manage healthcare images acquired as part of the examination process via digital image acquisition modalities.
Picture Archiving and Communication System (PACS)
Enumerate functions of RIS
- Patient Registration
- Exam Scheduling
- Patient Tracking
- Film Archiving
- Report Generation
Uses a server to store and allow facile access to highquality radiologic images, including conventional films, CT, MRI, PET scans and other medical images over a network
Picture Archiving and Communication System (PACS)
It serves as the file room, reading room, duplicator, and courier
Picture Archiving and Communication System (PACS)
Early PACS were developed by the _____ in an effort to move images among veterinary administration (VA) hospitals
U.S military
Many PACS _____ _____ also have image
processing capabilities
Reading Stations
Enumerate functions of PACS
- Acquire
- Store
- View
Functions of PACS. PACS currently receives studies from modalities such as x-ray, MRI, CT scan, Ultrasound, and Nuclear Medicine
Acquire
Functions of PACS. Annually the PACS receives 860,000 studies from 14 hospital organization
Store
Functions of PACS. Radiologist interpret the studies using PACS, while Clinicians and either allied healthcare professionals access patients’ images and reports using PACS.
View
Enumerate PACS components
- Image and Data Acquisition Gateway
- Display Workstation
- PACS Server and Archive
PACS Components. It is any computer that a health care worker uses to view a digital image
Display Workstation
PACS Components. Acquire images reliably and in a timely manner from each radiological imaging modality via the acquisition
Image and Data Acquisition Gateway
A course of action designed to help an organization to respond effectively to a significant future event.
Contingency Plan
PACS Components. It is composed of a database server or image manager, short term and long-term storage, and a computer that controls the PACS workflow, known as a workflow manager
PACS Server and Archive
A standard protocol for the management and transmission of medical images and related data and is used in many healthcare facilities management, scheduling of acquisition and notification of completion, and security profiles
Digital Imaging and Communication in Medicine (DICOM)
The contingency plan should include emergency resource contacts, an overview of the goals of the plan, and instructions for four types of downtime: ___, ___, ___ and ___.
Power, RIS, PACS, and Network
A term used to describe the reading of images from outside of the hospital’s walls.
Teleradiology
This is where images are acquired in one location, stored on a single PACS, but reported from a different physical location without the images being copied
Teleradiology
Enumerate radiographer responsibilities
- Access work order (worklist)
- Post-processing
- Annotation issues
- Transmitting images to PACS
- Workflow
These are computer software operations available to the radiographer and radiologist that allow manual manipulation of the displayed image
Post-Processing
Image annotation allows selection of preset terms and or manual text input that can be particularly useful when such additional information is necessary. Input of annotation for identification of patient’s left or right side should never be used as a substitute for technologist’s anatomy markers.
Annotation Issues
Term that can be used in any industry or in any organization. It simply means how a process is done, step by step.
Workflow
In radiology, we have always used the term _____ to describe how we complete an examination from order entry to transcribed report.
Workflow
Film-Based Workflow
- Order-entry
- Exam performed
- Film processed
- Film interpreted
- Transcribed report
Generic PACS Workflow
- Order-entry
- Exam performed
- Image processed
- Image interpreted
- Transcribed report
Enumerate direct relationship with mAs
- Px dose
- Quantity
- Intensity
- Ampere
- No. of X-ray
(PQDIAN)
Enumerate inverse relationship with kVp
- Wavelength
- Contrast
- Px dose
(WE CAN PASS)
Enumerate inverse relationship with SID
- Px dose
- Intensity
- Density
(PX DID)
Meaning of HLLWM
- High kVp
- Low contrast
- Long scale
- Wide latitude
- Many shades of gray