Midterm

Question 1

Reporting system used to describe the result of a mammogram, breast Uts or breast MRI in a standard way, breast imaging studies are assigned one of seven assessment categories, provide standardized terminology to describe imaging findings

Answer 1

Breast imaging-reporting and data system (BI-RADS)

Question 2

Needs additional imaging evaluation (additional mammographic views or UTS) and or for mammography, obtaining previous images not available at the time of reading

Answer 2

Bi-rads 0: incomplete

Question 3

Symmetrical and no masses, architectural distortion or suspicious calcifications

Answer 3

Bi-rads 1: negative

Question 4

0% probability of malignancy

Answer 4

Bi-rads 2: benign

Question 5

<2% probability of malignancy, short interval follow-up suggested

Answer 5

Bi-rads 3: probably benign

Question 6

2-94% probability of malignancy, for mammography and UTS

Answer 6

Bi-rads 4: suspicious for malignancy

Question 7

Low suspicion for malignancy (2-9%)

Answer 7

Bi-rads 4-A

Question 8

Moderate suspicion for malignancy (10-49%)

Answer 8

Bi-rads 4-B

Question 9

High suspicion for malignancy (50-94%), biopsy should be considered

Answer 9

Bi-rads 4-C

Question 10

> 95% probability of malignancy, appropriate action should be taken

Answer 10

Bi-rads 5: Highly suggestive of malignancy

Question 11

known biopsy-proven malignancy, cancer

Answer 11

Bi-rads 6

Question 12

2 correlation to mammographic findings

Answer 12

Concordance
Non-concordance

Question 13

When multiple imaging modalities or radiologists agree on the interpretation of mammographic findings

Answer 13

Concordance

Question 14

Occurs when there is a disagreement between different imaging modalities or different radiologist regarding the interpretation of mammograms, when there’s ___, further evaluation or additional imaging may be necessary to clarify the findings

Answer 14

Non-concordance

Question 15

As associated with malignancies, irregular in shape and size ranging from 1-3 mm in diameter, 50% of breast cancers are associated with __

Answer 15

Calcifications

Question 16

If calcification is located very superficially, conforms to a pattern (such as within skin folds) has stippled appearance

Answer 16

Artifacts and pseudocalcifications

Question 17

Substances that can appear as microcalcification

Answer 17

Deodorants
Bath powder
Creams
Lotions
Ointments
Adhesive tape

Question 18

Mammographic equipment artifacts, cassette artifacts, and processing, film handling artifacts

Answer 18

Technical/non-patient factors

Question 19

Evaluating calcifications

If determined real?

Answer 19

Check location and position/depth within the breast relative to nipple, conduct assessment of morphology
Main calcifications: ductal and lobular

Question 20

Mammographic equipment parts

Answer 20

Xray tube
Tube port
Filter
Collimator
Compression paddle
Grid
Xray detector
Phototimer detector

Question 21

Uruguanian radiologist first uses breast compression

Answer 21

1949 R. Leborgne

Question 22

compression devices common on dedicated mammography units

Answer 22

1970

Question 23

Evolution of breast compression

Answer 23

1960- no compression
1970- cones
1980- flat plate

Question 24

positioned parallel to the support table, and attached to mechanical assembly. It is controlled by the operator by a foot pedal.

Answer 24

Flat radiolucent plate

Question 25

Difference between area compression and spot compression

Answer 25

Full compression paddle,Uniform density, clear polycarbonate paddle 0.3 cm thick Spot compression paddle, better compression over small area, spot paddle decreases tissue thickness, decrease superimposition of tissue

Question 26

Used to magnify small area of breast for better visualization

Answer 26

Spot compression

Question 27

Depends on the breast size and the px tolerance

Answer 27

Manual compression

Question 28

Consideration for painful breasts

Answer 28

Px take ibuprofen prior to mammogram Schedule mammogram just after the menstrual cycle Proper communication b4 the examination, importance of the compression

Question 29

Px support

Answer 29

Lead apron thyroid shield Px gown Holding Support

Question 30

Ammount of compression is between __ & __ pounds of pressure

Answer 30

25 and 40

Question 31

Disadvantage of spot compression

Answer 31

Px discomfort

Question 32

Difference of scatter to primary ratio between uncompressed and compressed breast?

Answer 32

0.8-1.0 uncompressed, 0.4-0.5 compressed

Question 33

Breast compression

Answer 33

Reduces breast thickness • lowers radiation dose • spreads breast tissues apart • produces a more uniform thickness • Allow uniform penetration of structures within the breast • Reduces motion and geometric unsharpness • Reduces x-ray scatter, thus improving contrast

Question 34

The cathode assembly of mammography x-ray tube is configured with?

Answer 34

Filament (dual-filament), focusing cup

Question 35

Two types of anode

Answer 35

Rotating anode/ stationary anode

Question 36

Anode materials

Answer 36

Molybdenum, rhodium, tungsten

Question 37

Most common anode target material used in soft tissue imaging

Answer 37

Molybdenum

Question 38

Dual targets also used?

Answer 38

Molybdenum and rhodium

Question 39

conventional Xray tube

Answer 39

Glass envelope, tungsten anode, anode angle 5*-20*, horizontal, al filter for dose reduction

Question 40

Mammography x-ray tube

Answer 40

Metal tube housing, grounded Mo, Rh anode, angle 0*, tube tilt 26*, axis rotation vertical, Mo/Rh filters fir spectral shaping.

Question 41

__ to __ for contact mammography (breast compressed against the grid and image receptor)

Answer 41

Focal spot size 0.3-0.4 mm

Question 42

__ for magnification mammography, it reduces geometric blurring so that microcalcifications can be resolved.

Answer 42

0.1 mm

Question 43

Most common to have effective focal spot in mammo

Answer 43

23* anode angle, 6* tube tilt

Question 44

The area of the X-ray tube anode from which the X-ray photon are emitted called?

Answer 44

Actual focal spot

Question 45

The beam projected onto the patient

Answer 45

Effective focal spot

Question 46

As the anode angle decreases, the effective focal spot decreases.

Answer 46

Line focus principle

Question 47

Wider useful beam

Answer 47

Greater anode

Question 48

Narrower useful beam

Answer 48

Smaller anode angle

Question 49

One unfortunate consequence of line focus principle, Radiation intensity on the cathode side of the x-ray tube is higher than the anode side

Answer 49

Anode heel effect

Question 50

Chest wall- Nipple-

Answer 50

Cathode side Anode side

Question 51

Target and Filter Combination • Mo target with __ • Rh target with __ • W Target with __

Answer 51

0.03 mm Mo filter (atomic no. 42) 0.02mm Rh filter (atomic no. 45) 0.05mm rh filter

Question 52

Fatty breast (up to 4 cm) Target filter kvp used

Answer 52

Mo mo 24-26 kVp

Question 53

Glandular breast (5-7 cm thick) Target filter kvp used

Answer 53

Mo rh 27-29 kVp

Question 54

Breast thickness (7cm and denser breast) Target filter kvp used

Answer 54

Rh rh 29 kVp (or above for more than 7 cm)

Question 55

0-2cm Target filter kvp used

Answer 55

Mo mo 24

Question 56

3-4 cm Target filter kvp used

Answer 56

Mo mo 25,26

Question 57

5-6 cm Target filter kvp used

Answer 57

Mo rh 28

Question 58

7-8 cm Target filter kvp used

Answer 58

Mo rh 32

Question 59

7-8 cm (2) Target filter kvp used

Answer 59

Rh rh 30 used only with rh target

Question 60

The __ the anode angle, the __ the anode heel effect

Answer 60

smaller, greater