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CSB013 > Week 8 MI > Flashcards

Week 8 MI Flashcards

1
Q

Describe the patient journey through the Radiology department

A
  1. Referring physician generates a radiology referral
  2. patient arrival to radiology
  3. radiographer acquires imaging
  4. Images sent to PACS
  5. Radiologist reviews and creates radiology report
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2
Q

Radiology department data management systems

A
  • Review Workstation
  • PACS
  • Modality
  • RIS
  • HIS
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3
Q

Patient preparation for imaging

A
  • Hello, my name is……
  • Check patient identity (4W’s) and details using 3C’s protocol
  • Verification and Justification of Procedure
  • Check for Pregnancy
  • Remove radio-opaque objects
  • Change if necessary
  • Continue to reassure and communicate throughout procedure
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4
Q

4ws

A
  • What is your full name?
  • What is your date of birth?
  • What is your address?
  • What examination/procedure are you here for today?
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5
Q

3cs

A
  • Correct Patient
  • Correct Procedure
  • Correct Site
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6
Q

Duty of radiographer to check clinical history to verify

A

o Standard procedures
o Normal/abnormal variations
o Pathological conditions
o Selection of exposure factors

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7
Q

What is palpation

A

o Physical examination in medical diagnosis by pressure of the hand or finders to the surface of the body

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8
Q

Colours of different objects in imaging

A
  • Black = air/gas
  • Dark Grey = Fat
  • Light Grey = Soft Tissues/water
  • Off White = Bone
  • White (Bright) = Contrast Material/Metal
  • Different grey scales represent different absorption by tissue types
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9
Q

Methods of introduction of contrast media

A 
-	Oral 
o	Barium Compounds / Gastrografin 
-	Injected 
o	Iodinated Compounds 
-	Administered Directly 
o	Rectally / Bladder / Fistulas 
o	Barium Compounds
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10
Q

Side effects and contraindication of barium sulphate compounds

A

stomach cramps
constipation
Contraindications: perforation/obstruction

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11
Q

Side effects and contraindications of Iodinated contrast IV or IA

A

Expected : feeling of warmth, metallic taste, sensation of passing urine
• Mild reactions: nausea, itching, hives
• Moderate reactions: wheezing; severe skin rash; shortness of breath
• Severe reactions: swelling of throat; convulsions; difficulty breathing;
cardiac arrest
Contraindications:
• known allergies to iodine
• history of asthma and hay fever
• history of kidney, heart diseas

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12
Q

Precautions that need to be taken during use of contrast media

A
  • Screening of patients through questionnaire
  • Informed Consent
  • Leave the cannula in place throughout the examination
  • Observed the start of the injection
  • Maintain a visual of your patient throughout the CT scan
  • React promptly if there is a reaction
  • Ensure emergency trolley is readily accessible
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13
Q

MRI Contrast agent - Gadolinium based compounds

A

Gd-DTPA (Gadopentetate dimeglumine) is a clear
injectable contrast agent
◦ Lower toxicity and fewer side effects than iodinated
contrast
◦ Gd-DTPA results in greater MR signal and higher contrast
in areas damaged by pathologic processes
◦ Improves visualisation of small tumours particularly in
evaluation of the central nervous system

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14
Q

Side effects and contraindications of gadolinium

A
  • Side Effects
    o FDA warnings about the risk of nephrogenic systemic fibrosis for all gadolinium-based contrast agents
  • Contraindicated
    o In patient with acute or chronic severe renal insufficiency
    o Should not use GCBA in these patients unless the diagnostic information is essential and not available with non-contrast enhances magnetic resonance imaging
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15
Q

Medical Imaging modalities

A
  • MRI
  • CT
  • Nuclear Medicine
  • Mammography
  • Ultrasound
  • Fluoroscopy
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16
Q

Explain Computed Tomography (CT)

A
  • Patient lies on the positioning couch which moves through the acquisition plane in the gantry
  • The x-ray beam rotates round the patient
  • Detector arrays measure the radiation passing through the patient and record it digitally
  • The information is fed into a computer which produces images from different x-ray absorption readings as the beam travels through the patient
17
Q

CT Application

A 
-	Diagnostic Imaging 
o	Demonstration of tumours, masses, enlarged organ or lymph nodes 
o	Used for imaging all body parts 
o	More information than plain x-rays 
	Trauma (internal injuries) 
	Diagnose disease 
	Plan medical, surgical and radiation treatment 
o	For Oncology Patients 
	Initial Diagnosis of disease 
	Extent of disease for staging 
	Assess response to treatment 
	Check for recurrence of disease 
-	Radiation Therapists 
o	CT SIM 
	For simulation and treatment planning
18
Q

CT simulators in RT

A
  • Pivotal in the development of treatment planning
  • Flat tabletop to reproduce linear accelerator table
  • Larger bore than diagnostic scanners to accommodate treatment positions (80-90cm)
  • External lasers
  • High tube heat capacity
  • Modality used for dose calculation and distribution
  • Shorter scan times
  • Organ motion management
19
Q

Limitations of CT

A

o Suboptimal tissue contrast
o Lack of functional information (only anatomical information)
o Inability to visualise small groups of cancer cells that are separated from the gross tumour

20
Q

MRI

A
  • Uses magnetic field and pulses of radio waves energy to create detailed images of organs and tissues
  • Large cylindrical magnet device in which the patient lies with the RF coils surround the patient
  • Good contrast resolution makes it an excellent soft tissue imaging technique, particularly for the brain and spinal cord
  • Non-ionising radiation
  • No hazardous bioeffects at current field strengths
  • Tissue heating can occur at 3 Tesla and above and potential source of RF burns
    o Patient positioned no skin folds touching and pads
    o Tattoos, eye shadow containing iron oxides
21
Q

MRI Imaging safety zones

A
  • MRI Zone 1 – Outside the MRI
  • MRI Zone 2 – Taking patient to MRI
  • MRI Zone 3 – Control Room (restricted from general public)
  • MRI Zone 4 – Magnet Room (no individual is allowed in the scan room without being supervised)
22
Q

Contraindications for MRI

A

o Artificial joints
o Surgical clips
o Pacemakers, defibrillators
o Sheet metal workers

23
Q

What is Magnetic Resonance Spectroscopy

A
  • Glioma
  • MRS can help increase our ability to predict grade
  • As the grade increase NAA and creatine decreases and choline, lipids and lactate increase
24
Q

What is Nuclear Medicine

A
  • Use radioisotopes to diagnose and treat disease
  • Small amounts of radioactive tracers target a specific area in the body
  • Radioactive tracers used emit gamma rays which are detected by a Gamma camera
    o Functional study
    o Anatomical detail is poor compared to other imagine modalities
    o Provides complementary information
    o Sensitive for detection of some pathologies
  • Can identify diseases within its earliest stages
25
Q

Describe bone scans

A
  • Assess internal bone structure using Gamma camera
  • Study takes 5 – 6 houtrs for three phase bone scan,which includes a series of images taken at different times
    o As tracer is injected
    o Shortly after the injection, three to five hours post injection
  • Detection of:
    o Metastases
     Can detect bony Mets months before they are visible on an x-ray since x-rays may not detect a lesion until 50% demineralisation has occurred whereas NM detects osteoblastic activity which is generally vigorous at sites of bony mets
    o Stress Fracture
     Can be detected within 24-72 hours of onset (may never be visible on radiographs or take 3-4 weeks to appear
    o Infections
    o Cancers
    o Inflammation of Joints
26
Q

Nuclear Medicine Application

A

Medicine Application

o Bone Scan, Lung, Heart, Renal Studies, Brain Perfusion, Thyroid

27
Q

What are SPECT Scans

A

SPECT scans involve two steps: a radioactive
injection (called a tracer) and using a SPECT machine to scan a specific area of body to
provide 3D images.

The radioactive tracer highlights areas of
blood flow
most common uses of SPECT are to help
diagnose or monitor brain disorders, heart
problems and bone disorders.

SPECT scans can also diagnose and track the
progression of cancer that has spread to the
bones

28
Q

What is PET

A
  • Molecular Imaging Technique
  • Uses radiographic tracers that emit positron during the radioactive decay process
  • Demonstrate the metabolism and biochemical function of organs and tissues and identifying changes at a cellular level
  • Allows identification of areas of metabolic activity which enables escalation of the radiation dose for the most aggressively growing tumour
  • Radioactive compounds specificity for distinct tissues
29
Q

PET/CT Clinical Applications

A
  • Oncology
  • Cardiology
  • Neurology
  • Detect Cancer and Metastatic Disease
  • Monitor treatment Response
  • Assess Blood Flow
    o Brain
    o Heart
  • Identify Hot spots/pick up
    o At sites increased activity or blood flow
30
Q

Duty of mMR (pet.mri)

A
  • Simultaneous anatomical (MRI) and functional (PET) data to locate tumours and understand disease process
31
Q

MRI/LINAC

A

Combines a magnetic resonance imaging (MRI)
scanner and a radiotherapy linear accelerator
(Linac) into one integrated system – the MRI- Linac
Linac uses radiation to treat tumours
MRI provides visualization of tumours and soft tissues
during treatment
Constant monitoring of the patient during treatment
will enable the most precise targeting of the tumour
and help avoid healthy tissue.
MR/RT Magnetic Resonance Radiation Therapy *
Lungs, prostate, colorectal, stomach, liver, breast,
cervix

CSB013 (9 decks)

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