Physics Flashcards
Appropriate target range for medical audit:
Recall rate?
4-7%
My note: Prometheus says 4-7 in one place, 5-7 in another, and “less than 10%” in another.
Appropriate target range for medical audit:
Cancers/1000 screened?
3-8
How often:
Processor QC
Daily
How often:
Darkroom Cleanliness
Daily
How often:
Viewbox Conditions?
Weekly
How often:
Phantom Evaluation?
Weekly
How often:
Repeat Analysis?
Quarterly
How often:
Compression Test?
Semi-Annually
How often:
Darkroom Fog?
Semi-Annually
How often:
Screen-Film Contrast?
Semi-Annually
Places that do mammo have to be “accredited and certified”…..and pay money…. every _________.
3 years
_______ is the evil overlord begins the MQSA.
The FDA
Gaining the privilege to read mammograms: 3 criteria you must meet
1) read 240 mammography exams over 6 months during last 2 years of training, under direct supervision,
2) 3 months of mammography in residency,
3) 60 documented hours of mammo education
Spatial Resolution (mammo):
LP/mm in Anode-Cathode Direction ?
13 LP/mm
Spatial Resolution (mammo):
LP/mm in left-right Direction ?
11 LP/mm
Spatial Resolution (mammo):
MQSA resolution for screen-film: _____
12 LP/mm
Spatial Resolution (mammo):
MQSA resolution for digital: _____
Manufacturer specs (~ 7 LP/mm)
What is the MQSA breast dose phantom?
MQSA has breast phantom which is supposed to be an “average breast.”
- 4.2 cm of compressed breast
- 50% adipose, 50% glandular.
Dose for MQSA phantom
Phantom limit (per image)=
3 mGy (300 millirads) WITH GRID
1 mGy WITHOUT GRID.
Note: Dose limit ONLY for phantom!!! There is no regulation for dose to real human breast.
How Often:
Localization/Accuracy (for Stereotactic Biopsy)?
Daily before patient exams
Mammography facilities are required to provide patients with a “lay report”
- what is it?
- when does it need to be provided?
- written results of the mammogram in language that is easy to understand.
- within 30 DAYS of the study (MUST).
Consumer complaint mechanism is required to be established in mammography facilities to provide patients with a process for addressing their concerns.
.
Patients can have their ORIGINAL mammograms (not just copies) when they are needed.
.
If a facilities mammograms are determined to be substandard and a risk to public health, what happens?
Those FACILITIES will notify patients and their doctors and suggest an appropriate plan of action.
Who is ultimately responsible for the Quality Control program?
The “INTERPRETING PHYSICIAN”
Not the techs.
To make it (the phantom?) pass image quality, must show: _____(4 distinct things)
- 4 fibers
- 3 microcalcification clusters,
- 3 masses
- only “acceptable artifacts”
Patient dose limit in mammography
THERE IS NONE!
Only a dose limit for phantom (3 mGy/view). But a denser real breast could require more than 3 mGy/view.
Typical patient and phantom doses (not limits).
~2 mGy/view
~4 mGy for a two-view screening exam
Typical (average) compressed breast is
_______ cm,
_______ % glandularity.
6cm,
15-20%
Digital systems generally use higher beam quality, which results in ______ doses.
Lower
Digital mammography does NOT use fixed dose (screen-film). Can use as much or as little radiation as deem appropriate.
.
Nukes QC: how often to check…
Constancy
(And “Dose should be within ___% of computed activity.”)
Daily
5% of computed activity
Checked with reference sources
Nukes QC: how often to check…
Linearity
Quarterly
Nukes QC: how often to check…
Accuracy
At installation of device AND
Annually
Nukes QC: how often to check…
Geometry
At installation of device AND
Any time you move device
Does it affect Spatial resolution or Contrast resolution?:
Focal spot
Spatial
Smaller spot= better
Does it affect Spatial resolution or Contrast resolution?:
Detector Width
Spatial
Smaller detector = better
Does it affect Spatial resolution or Contrast resolution?:
Nyquist Limitations “Sampling”
Spatial
Oversampling = better
Does it affect Spatial resolution or Contrast resolution?:
Reconstruction Filter
Spatial
Ex: bone “sharp” algorithm gives a higher spatial resolution.
Does it affect Spatial resolution or Contrast resolution?:
Number of x-rays (mAs, kV, pitch)
Contrast
More dose—less mottle—will improve contrast resolution
Does it affect Spatial resolution or Contrast resolution?:
Slice thickness
Contrast
Thicker = more x-ray quanta = less noise
Does it affect Spatial resolution or Contrast resolution?:
Reconstruction Method
Contrast
Iterative > Filtered Back
Does it affect Spatial resolution or Contrast resolution?:
Reconstruction Filter
Contrast
Soft tissue > bone
Choose Increase or Decrease for all:
Holding matrix size constant and DECREASING FOV will
_______ pixel size. This will
_______ spatial resolution, and
_______ contrast resolution.
DECREASE pixel size
INCREASE spatial resolution
DECREASE contrast resolution
(Less photons per box)
Choose Increase or Decrease for all:
Holding matrix size constant and INCREASING FOV will
_______ pixel size. This will
_______ spatial resolution, and
_______ contrast resolution.
INCREASE pixel size
DECREASE spatial resolution
INCREASE contrast resolution
(More photons per box)
Will it improve Axial, Lateral, or Elevation Resolution?:
Shorter pulses
Axial
Smaller spatial pulse length
Will it improve Axial, Lateral, or Elevation Resolution?:
Greater Damping “Low Q”
Axial
Shorter pulses
Will it improve Axial, Lateral, or Elevation Resolution?:
Higher frequency
Axial
Shorter wavelength
Will it improve Axial, Lateral, or Elevation Resolution?:
Narrowing the beam in the proximal field (adding an acoustic lens). Minimal necessary gain (gain widens the beam).
I.e. “Put the thing you want to look at in the focal zone.”
Lateral
Will it improve Axial, Lateral, or Elevation Resolution?:
Phased array with multiple focal zones
Lateral
Will it improve Axial, Lateral, or Elevation Resolution?:
Increasing the “line density” or lines per cm
Lateral
Will it improve Axial, Lateral, or Elevation Resolution?:
Use fixed focal length across the entire surface of the array (downside is partial volume effects)
Elevation
Will it improve Axial, Lateral, or Elevation Resolution?:
Minimize slice thickness— done by phase excitation of the outer to inner arrays
Elevation
Axial Resolution is dependent on ________
Spatial Pulse Length
Lateral Resolution is dependent on ________
Transducer Element WIDTH
Elevation Resolution is dependent on ________
Transducer element HEIGHT
Artifacts:
Reverberation—what causes it?
Two parallel highly reflective surfaces
My note: looks like description might have been cut off. May want to double check not missing something
Artifacts:
Comet tail—what causes it?
Two parallel highly reflective surfaces —closer together (<1/2 SPL)
Artifacts:
Ring Down Artifact —what causes it?
Fluid trapped between tetrahedron of air bubbles
Artifacts:
Mirror Image—what causes it?
Trapped behind a strong reflector
My note: not sure this is complete…
Artifacts:
Reverberation—what does it look like?
Multiple equidistantly spaced linear reflections.
Artifacts:
Comet tail—what does it look like?
Triangle (comet) shaped…
Artifacts:
Ring Down Artifact—what does it look like?
Parallel band extending posterior to a collection of gas
Artifacts:
Mirror image—what does it look like?
This is almost always shown with the liver on lung.
MRI: Choose Increased, Decreased, or No Effect for each category when you have the following modification:
Thicker Slices
- Signal to Noise
- Spatial Resolution
- Duration of Exam
INCREASED signal to noise,
DECREASED spatial resolution,
NO EFFECT on duration of exam
MRI: Choose Increased, Decreased, or No Effect for each category when you have the following modification:
Larger Field of View
- Signal to Noise
- Spatial Resolution
- Duration of Exam
INCREASED signal to noise,
DECREASED spatial resolution,
NO EFFECT on duration of exam
MRI: Choose Increased, Decreased, or No Effect for each category when you have the following modification:
Larger Matrix
- Signal to Noise
- Spatial Resolution
- Duration of Exam
DECREASED signal to noise,
INCREASED spatial resolution,
INCREASED duration of exam
MRI: Choose Increased, Decreased, or No Effect for each category when you have the following modification:
Greater Field Strength
- Signal to Noise
- Spatial Resolution
- Duration of Exam
INCREASED signal to noise
NO EFFECT on spatial resolution
NO EFFECT on duration of exam
MRI: Choose Increased, Decreased, or No Effect for each category when you have the following modification:
Greater Receiver Bandwidth
- Signal to Noise
- Spatial Resolution
- Duration of Exam
DECREASED signal to noise
NO EFFECT on spatial Resolution
DECREASED duration of exam