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physics Flashcards

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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
what are the most common areas for skin calcs on mammography?
parasternal and inframammary fold
26
what is the birads for complex cyst vs complicated cyst?
complex: birads 4, complicated: birads 2/3
27
what is the direction of lymphatic flow in lymph nodes?
cortex to hilum
28
what percent of male breast ca occurs in a patient who is BRCA2?
20-30 percent of men that get breast cancer are BRCA 2
29
by what factor does ADH increase the risk of developing breast cancer?
4-5 times
30
how does the FGT move in the breast after breast reduction surgery?
the FGT moves from the upper outer to inner inferior quadrant.
31
at what are do BRCA carries being screening mammo?
age 30.
32
by what precent does CAD increase the breast cancer detection rate? does it increase or decrease the recall rate? by how much?
by about 7-20 percent (increases the breast ca detection rate). It increases recall rate by about 10 %
33
why does subareolar breast ca present with earlier metatstatic disease than other breast cancer locations?
bc it mets via lymphatics thru the sappey plexus
34
what implication does her2neu positivity have on breast cancer prognosis?
these cancers are more aggressive and less responsive to hormonal Rx
35
what tracer is used in BSGI? what part of the body does BSGI have the greatest radiation dose to?
Tc 99 m sestamibi. most dose is to the bowel wall.
36
what is the peak age of incidence of breast ca in patients with a history of NHL treated with radiation?
15 years after treatment
37
what is an interval breast cancer? what types of cancers are often interval breast cancers?
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
what is the stroke margin?
the distance from the needle tip after firing to the image receptor in stereotactic biopsy
39
when does radiation pneumonitis usually occur after XRT for breast cancer?
usually 4-12 weeks after treatment
40
when is chemo contraindicated in pregnancy?
first trimester
41
What is the difference in mgmt btw ADH and ALH?
ADH is a surgical lesion, ALH is a high risk lesion and there is controversy whether to take it out
42
what gauge and type of biopsy device should be used for stereo?
11 gauge vaccum assisted
43
what is the dose of contrast used for ductography?
0.3-1.0 mL
44
what is the most common location for an intramammary LN?
upper outer quadrant
45
what is the definiiton of a giant fibroadenoma?
8 cm or more
46
what does elastography measure?
the stiffness of a lesion compared to the surrounding tissue
47
what is the ddx for unilateral adenopathy on a mammogram?
silicone granulomas from prior rupture, infection, (reactive), mets
48
what does silicone look like on a water saturdated image?
bright
49
in what males is lobular ca a consideration?
transgender taking high dose estrogen, or those on DES for prostate ca
50
how are rolled CC views performed?
by rolling the superior half of the breast medial and lateral
51
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 LM view
52
is diabetic fibrous mastopathy seen in type 1 or 2 diabetes?
type 1
53
what is the most common cancer to produce mets to the breast besides breast cancer?
melanoma
54
what are the features of a fibroadenoma on MRI
oval or lobulated smooth lesions with heterogeneous enh and non enhancing septations
55
what percent of all invasive breast ca is lobular invasive?
10%
56
what is the most common male breast cancer?
IDC
57
what does PASH look like on ultrasound?
hypoechoic, no posterior shadowing, make have small vascular spaces
58
what percent of breast ca is inflammatory? what is its stage?
1-4%. T4.
59
what are the two most common cancers in pregnancy?
cervical then breast
60
what is the MRI finding that confirms invasion into muscle?
enhancement of the muscle
61
what is the precent of local recurence after breast conservation treatment? at what time frame after MCT is local recurrence most common?
1-2%/. usually occurs 4-6 years after treatment.
62
what is the ddx for calcifications within axillary LN?
granulomatous disease (TB), silicone, mets from breast or ovarian ca
63
what type of exogenous threapy causes focal fibrosis?
HRT
64
what are the causes of BL breast edema?
CHF, renal failure, anascara, SVC syndrome
65
what is the birads classification of PASH? when do u exicse it? what is growth associated with?
Bi2. excise if its growing. associated with angiosarcoma if its growing
66
what is the ddx for a rim enhancing lesion on MRI?
complicated cyst, fat necorsis, cancer
67
where does phyllodes mets to?
lung and bone, axiallry nodes NOT COMMON
68
what lesions require surgical excision?
DCIS, ADH, pappillary with atypia, phyllodes, cancer, insufficient sample of a lesion, rad/path discordance
69
what is the percentage of Pagets disease out of all breast cancers?
1-3 percent
70
what is the mgmt for extrabdominal desmoid in the breast?
wide local excision
71
how far apart can two masses be to be labelled as multifocal?
they must be within 4-5 cm of eachother
72
in what situation should u biopsy a fibroadenoma?
more than 20 % increase in size in 6 months
73
if u do an FNA or core biopsy of a suspicious axillary LN what do u place the specimen and send it for?
place it in saline or culture plate not formalin, and send for flow cytometry (needed for lymphoma)
74
what type of biopsy is done for inflammatory breast ca? for pagets disease of the nipple?
do punhc biopsy: shows tumor in dermal lymphatics. for pagets do wedge biopsy of nipple-areolar complex
75
what ultrasound characteristic is more likley with a high grade vs low grade carcinoma?
posterior acoustic enhancement
76
is rupture of a silicone implant more common with subglandular or subpectoral implants?
subpectoral
77
what is the size limit to call a lesion a focus (vs a mass) on breast MRI?
foci are less than 5 mm
78
what is the msot common MRI appearance of DCIS?
clustered ring enhancement
79
what is the difference btw gynecomastia and pseudogynecomastia?
gynecomastia is proliferation of stromal and ductal elements, pesudo is only fatty porliferation so its lucent on mammo
80
how do u tell btw an MR contrast enhanced subtraction image that has been corrected for motion vs the image that is non corrected?
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
what is the birads for clustered, amorphous calcifications?
birads 4
82
what percent of DCIS per year will become invasive ca if left untreated?
1% per year

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