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Mammo > physics > Flashcards

physics Flashcards

1
Q

what is the size of microcalcs seen on mammo

A

50-100microm

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2
Q

What is the grid ratio in mammo

A

4-5

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3
Q

how many projections in tomo

A

15

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4
Q

which filer/grid combo cannot be used

A

rh/mo

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5
Q

MQSA to be done weekly?

A

phantom (4.2 cm compressed), darkroom cleanliness

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6
Q

MQSA to be done quartery?

A

repeat analysis

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7
Q

What is the spatial resolution in mammo

A

10 lp/mm

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8
Q

Maximum room light in mammo?

A

50 lux

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9
Q

what is the lifetime chance of breast ca

A

1/8

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10
Q

ghosting artifact

A

latent image from prior exposure

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11
Q

artifact from flat field test in mammo?

A

gouging: paddle hits detector array

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12
Q

horizontal line artifact

A

image uniform plexiglass to calibrate machine or call service. caused by incorrect readout of data.

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13
Q

salt and pepper artifact

A

due to underexposure - photocell to close to breast or exposure too short

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14
Q

alternating white and black horizontal lines on digital

A

vibration artifact - due to cooling fans in the detector

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15
Q

loss of edge artifact

A

in women with big breasts, looks like a jagged surface on the skin

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16
Q

what is a disadvantage of harmonic imaging

A

reduced penetration, worse in large breasts

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17
Q

when should clustered microcysts on US be biopsied?

A

if new or enlarging in a post menopausal woman not on estrogen Rx

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18
Q

when should breast MRI be performed?

A

in the proliferative phase (TDLU is not proliferating), day 7-12 of menstrual cycle. MRI should not be performed in secretory (post ovulatory) phase

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19
Q

what are the descriptors for shape of a mass in breast US, what are the descriptors for margins?

A

oval, round, irregular are for shape. circumscribed and microlobulated are for margins.

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20
Q

how does an intramammary lymph node involved in cancer affect staging?

A

IMLN involvement leads to stage 2

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21
Q

where is the xray tube and where is the image receptor in an MLO view and in an ML view?

A

xray tube is medial, receptor is lateral parallel to long axis of pectoralis muscle; in ML its the same (xray tube medial and image receptor is lateral)

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22
Q

what view should u do to see a finding on high axillary tail (only seen on MLO)

A

XCCL

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23
Q

what is CAD sensitivity for malignant calcifications?

A

86-99 percent

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24
Q

what are the causes of secretory calcs?

A

only diagnose in pts older than 60, can be due to prior plasma cell mastitis, duct ectasia

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25
Q

what are the most common areas for skin calcs on mammography?

A

parasternal and inframammary fold

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26
Q

what is the birads for complex cyst vs complicated cyst?

A

complex: birads 4, complicated: birads 2/3

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27
Q

what is the direction of lymphatic flow in lymph nodes?

A

cortex to hilum

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28
Q

what percent of male breast ca occurs in a patient who is BRCA2?

A

20-30 percent of men that get breast cancer are BRCA 2

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29
Q

by what factor does ADH increase the risk of developing breast cancer?

A

4-5 times

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30
Q

how does the FGT move in the breast after breast reduction surgery?

A

the FGT moves from the upper outer to inner inferior quadrant.

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31
Q

at what are do BRCA carries being screening mammo?

A

age 30.

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32
Q

by what precent does CAD increase the breast cancer detection rate? does it increase or decrease the recall rate? by how much?

A

by about 7-20 percent (increases the breast ca detection rate). It increases recall rate by about 10 %

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33
Q

why does subareolar breast ca present with earlier metatstatic disease than other breast cancer locations?

A

bc it mets via lymphatics thru the sappey plexus

34
Q

what implication does her2neu positivity have on breast cancer prognosis?

A

these cancers are more aggressive and less responsive to hormonal Rx

35
Q

what tracer is used in BSGI? what part of the body does BSGI have the greatest radiation dose to?

A

Tc 99 m sestamibi. most dose is to the bowel wall.

36
Q

what is the peak age of incidence of breast ca in patients with a history of NHL treated with radiation?

A

15 years after treatment

37
Q

what is an interval breast cancer? what types of cancers are often interval breast cancers?

A

a breast cancer found in the interval btw screeings that is physically palpbale/symptomatic that may be mammographically occult or missed on prior mammo. lobular and mucinous are often found on histology.

38
Q

what is the stroke margin?

A

the distance from the needle tip after firing to the image receptor in stereotactic biopsy

39
Q

when does radiation pneumonitis usually occur after XRT for breast cancer?

A

usually 4-12 weeks after treatment

40
Q

when is chemo contraindicated in pregnancy?

A

first trimester

41
Q

What is the difference in mgmt btw ADH and ALH?

A

ADH is a surgical lesion, ALH is a high risk lesion and there is controversy whether to take it out

42
Q

what gauge and type of biopsy device should be used for stereo?

A

11 gauge vaccum assisted

43
Q

what is the dose of contrast used for ductography?

A

0.3-1.0 mL

44
Q

what is the most common location for an intramammary LN?

A

upper outer quadrant

45
Q

what is the definiiton of a giant fibroadenoma?

A

8 cm or more

46
Q

what does elastography measure?

A

the stiffness of a lesion compared to the surrounding tissue

47
Q

what is the ddx for unilateral adenopathy on a mammogram?

A

silicone granulomas from prior rupture, infection, (reactive), mets

48
Q

what does silicone look like on a water saturdated image?

A

bright

49
Q

in what males is lobular ca a consideration?

A

transgender taking high dose estrogen, or those on DES for prostate ca

50
Q

how are rolled CC views performed?

A

by rolling the superior half of the breast medial and lateral

51
Q

if a lesion is seen in the medial breast only on the CC view and you want to localize it, what is the best next step?

A

a LM view

52
Q

is diabetic fibrous mastopathy seen in type 1 or 2 diabetes?

A

type 1

53
Q

what is the most common cancer to produce mets to the breast besides breast cancer?

A

melanoma

54
Q

what are the features of a fibroadenoma on MRI

A

oval or lobulated smooth lesions with heterogeneous enh and non enhancing septations

55
Q

what percent of all invasive breast ca is lobular invasive?

A

10%

56
Q

what is the most common male breast cancer?

A

IDC

57
Q

what does PASH look like on ultrasound?

A

hypoechoic, no posterior shadowing, make have small vascular spaces

58
Q

what percent of breast ca is inflammatory? what is its stage?

A

1-4%. T4.

59
Q

what are the two most common cancers in pregnancy?

A

cervical then breast

60
Q

what is the MRI finding that confirms invasion into muscle?

A

enhancement of the muscle

61
Q

what is the precent of local recurence after breast conservation treatment? at what time frame after MCT is local recurrence most common?

A

1-2%/. usually occurs 4-6 years after treatment.

62
Q

what is the ddx for calcifications within axillary LN?

A

granulomatous disease (TB), silicone, mets from breast or ovarian ca

63
Q

what type of exogenous threapy causes focal fibrosis?

A

HRT

64
Q

what are the causes of BL breast edema?

A

CHF, renal failure, anascara, SVC syndrome

65
Q

what is the birads classification of PASH? when do u exicse it? what is growth associated with?

A

Bi2. excise if its growing. associated with angiosarcoma if its growing

66
Q

what is the ddx for a rim enhancing lesion on MRI?

A

complicated cyst, fat necorsis, cancer

67
Q

where does phyllodes mets to?

A

lung and bone, axiallry nodes NOT COMMON

68
Q

what lesions require surgical excision?

A

DCIS, ADH, pappillary with atypia, phyllodes, cancer, insufficient sample of a lesion, rad/path discordance

69
Q

what is the percentage of Pagets disease out of all breast cancers?

A

1-3 percent

70
Q

what is the mgmt for extrabdominal desmoid in the breast?

A

wide local excision

71
Q

how far apart can two masses be to be labelled as multifocal?

A

they must be within 4-5 cm of eachother

72
Q

in what situation should u biopsy a fibroadenoma?

A

more than 20 % increase in size in 6 months

73
Q

if u do an FNA or core biopsy of a suspicious axillary LN what do u place the specimen and send it for?

A

place it in saline or culture plate not formalin, and send for flow cytometry (needed for lymphoma)

74
Q

what type of biopsy is done for inflammatory breast ca? for pagets disease of the nipple?

A

do punhc biopsy: shows tumor in dermal lymphatics. for pagets do wedge biopsy of nipple-areolar complex

75
Q

what ultrasound characteristic is more likley with a high grade vs low grade carcinoma?

A

posterior acoustic enhancement

76
Q

is rupture of a silicone implant more common with subglandular or subpectoral implants?

A

subpectoral

77
Q

what is the size limit to call a lesion a focus (vs a mass) on breast MRI?

A

foci are less than 5 mm

78
Q

what is the msot common MRI appearance of DCIS?

A

clustered ring enhancement

79
Q

what is the difference btw gynecomastia and pseudogynecomastia?

A

gynecomastia is proliferation of stromal and ductal elements, pesudo is only fatty porliferation so its lucent on mammo

80
Q

how do u tell btw an MR contrast enhanced subtraction image that has been corrected for motion vs the image that is non corrected?

A

non corrected image (with motion) has hyperintense signal around the periphery of the breast (the skin) and the FGT is linear and more hyperintense than the corrected image

81
Q

what is the birads for clustered, amorphous calcifications?

A

birads 4

82
Q

what percent of DCIS per year will become invasive ca if left untreated?

A

1% per year

Mammo (1 decks)

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