1 Flashcards
(109 cards)
1
Q
What’s the limit in on manual compression
A
None
2
Q
Benefits of compression
A
Decreases radiation by decreasing thickness
Separates overlap/super
Brings lesions closer to detector
3
Q
What projection helps detect if a lesion is medial or lateral to the nipple?
A
CC
4
Q
Best lateral position for pain at sternum
A
LM
5
Q
What projection best images the posterior and upper outer quadrant
A
MLO
6
Q
Most moveable parts of the breast
A
Lateral and inferior
7
Q
What projection sees teacup calls the best?
A
Lateral
8
Q
What is lymphosciniography?
A
Sentinel node mapping
Sub-Areolar lymph plexus injected to ID sentinel node
9
Q
If the detector is too high which tissue may be lost
A
Posterior inferior
10
Q
What type of biopsy is least invasive but needs cytologist there
A
FNB
11
Q
If detector is too low what tissue might be missed
A
Superior and posterior
12
Q
What type of biopsy uses a 14G needle, takes large sample
A
Core
13
Q
RT QC daily
A
Phantom (checks detector)
14
Q
RT monthly tests
A
Compression thickness
Visual
AWS/RWS
15
Q
Quarterly Tech QC
A
Compression force
16
Q
Optional Tech QC
A
Repeat analysis
17
Q
Types of filters used on fatty breast
A
RH or MO
18
Q
Types of filters used on dense breasts
A
AG (silver)
RH
19
Q
Material used on exit window
A
BE
20
Q
What does the physicist check yearly (14)
A
Equipment
Collimation
Spatial and MTF resolution
Contrast (SNR/CNR)
AEC
Phantom
KVP
HVL
AV gland dose
Room illumination
Eval tech QC
Compression
Paddle
AWS/RWS
21
Q
What is primapara
Nullipara
A
One child
No children
22
Q
Subjective
A
Perceived by pt
23
Q
Objective
A
Seen, heard, felt
24
Q
Side effects of tamoxifen
A
Uterine/endometric CA
Pulmonary embolism
Deep vein thrombosis
25
Difference between DIEP and TRAM flap
DIEP uses skin, fat, abdomen muscles, need to connect BV
Tram uses tissue muscle
26
What type of material does HTC grid use
Copper for strips
Air for interspace
27
What does WW control
Contrast
28
What does WL mean
Brightness
29
Av dose with a GRID
.3 RAD (300 MRAD 3 mGy)
30
AV dose without a grid
.1 RAD (100 MRAD 1Mgy)
31
Risk factors
(15)
Female
Age
Personal history
Family history
Genetics
Abnormal BX
Race
Early period
Late menopause
0 kids
Late age primipara
Previous chest RAD
Obesity
HRT
Density
32
Skin changes
Skin changes (thick, lesion, irritation, swelling, eczema, itchiness, redness, distortion)
33
Removal of entire breast with possibly a few nodes
Simple/total
34
Removal of Entire breast including lymph nodes
Nipple, skin, chest lining
Modified Rad
35
ER + drug types
SERMS, aromatase inhibitors
36
Treatment drug that has risks of deep vein thrombosis, cataracts and uterine CA
Tamoxifen
37
Treatment drugs for HER2 Neu CA
Trastuzumb
Lapitinib (Tykerb)
38
SERM drugs
Tamoxifen
Ralox (evista)
Fulv (faslo)
39
KVP range
20-40
40
Anode tilt
0-16
41
Grid ratio
3:1 - 5:1
42
Advantage of flat panel receptors
Wide latitude
^ DQE
^ sensitivity
Linear response
Improved workflow
Decrease repeat
Storage/retrieval
PACS
Telerad
43
Initial training MQSA
Tech 40 hrs
Physicist 20+40 60?
DR 60 hrs
44
CEU
15
45
Required on image
Name
ID
View
Laterality
Facility name/location
Tech ID
Mammo unit ID
46
How long images kept?
5 years or ten if only one
47
Equip q’s
Is there procedure for correction for poor quality images
Comply with image quality standards
Procedure for oversight QA/QC
48
Image eval
KVP
MAS
AEC
Exposure
Compression thickness
Target/filter
Focal spot
Grid
Magnification
Labeling
49
Image quality
Positioning
Compression
Exposure
Contrast
Sharpness
Noise
Artifacts
Collimation
Motion
50
CC require
Nipple centered/in profile
Pec muscle on 30-40?
PNL w/in 1 cm of MLO
Dense tissue penetrated
Medial/lateral included
Appropriate labels/markers
51
Key points CC
Detector at raised IMF
Head away
Feet apart, equal wt dist
Raise contralateral arm
Relax arm
Suspend respiration
52
What is ancillary tail
Inferior/lat of pec muscle
53
What is fibrous tissue made of
Lobule, duct, glands, lobes
54
Functional unit
Lobule
55
Coolers ligament
Connective (fibrous) band that connects skin -breast
56
Where do lymph nodes drain
Lateral - axillary
Medial - internal thoracic
57
What is arch distortion
Distorted shape/pattern of tissue
58
Assymmetry
One breast looks different
Global one view
Focal both views
59
Types of primarily benign calcs
Skin
Vascular
Milk of calcium
Dystrophic
Rim (eggshell)
Coarse (popcorn)
Round punctate
60
Suspicious types of calcs
Amorphous
Heterogenic
Fine
Pleomorphic
Linear/rod like
Casting
Spiculated/stellate
61
Characteristics of benign masses
Round
Oval
Sharp margin
Radiopaque
62
Smoothe round in TDLU
Cyst
63
Signs of papilloma
Can have nipple discharge, dilated duct
circular
clusters of calcs
Berry like shape
64
Painless lump, large, round or oval, radiolucent, ducts
Galactocele
65
Can have solid painless lump round with distinct borders easily moveable
with micro calcs
Fibroadenoma
66
Soft painless
Moveable or
No lump
Smoothe
Radiolucent
Lipoma
67
Hematoma
Breast within breast
68
Abnormally wide ducts
Can have nipple discharge
Retraction
Pain
Tenderness
Palpable mass
Ducati ectasia
Malignant or benign
69
Well defined oval mass
Hematoma
70
Fat necrosis
Ill defined
Irregular
Spiculated
Mass like
Can have calcs
Lump
Smooth border
71
Radial scar
Spiculated
Low density
Star appearance
72
ILC
Arch distortion
Calcs
Spiculated mass
Asymmetric density
73
DCIS
Small clusters (casting) calcs
Soft tissue opacity
74
Enlarged breast
Red warm
Tender painful
Skin thickening
Nipple problems
Mass with malignant microcalc
Increased breast density
Inflammatory
75
Swelling
Irritation
Dimpling/retraction
Breast/nipple pain
Discharge
Idc
76
ILC on Mammo
Arch distortion
Irregular mass
Spiculated mass
Asymmetric density
77
Nipple changes
Skin thickening
Retraction
Microcalcs
Discrete subareolar mass
Pagets
78
Palpable fast growing mass
Oval
Hyper dense
Indistinct or circ margins
Sarcoma
79
Palpable mass
Thickening
Oval/round
Asymmetry
Rare
Sarcoma
80
What does MLO show best
Extreme posterior and UOQ
81
MLO positioning
Detector parallel to pec
Armpit corner
Up and out
Nipple in profile
0 sagging
82
MLO to ML
Medial lesion moves ____
Lateral moves _____
Up
Down
83
Which lateral is most common
ML projection
84
AT angle? Direction?
20 degree or less
Custom
Superomedial - inferolateral
85
What are rolled view for
Superimposition
86
Lateral position roll superior or inferior
Rolled
87
When not to do implant displaced view
Implant encapsulated
88
Why do anterior compression
Uneven breast tissue thickness
89
Why do mag view
To see fine details
Calcs
Margins of a lesion
Specimen
90
What is medical outcomes audit
Audit IP every year
Follow up on positive results
91
How does US work
Piezoelectric principles
High frequency sound waves
92
Breast MRI
Switching mag fields
RF waves
Uses GAD (paramagnetic)
93
What needs to be on informed consent
Risks
Benefit
Alternatives
Signature
94
What js breast localization
Locate non palpable mass or calcs prior to excisional biopsy
Wire placed
95
When should use manual technique
Implants
Small breast
96
How much overlap for sectional imaging
2.5 cm (1 inch)
97
What is contraindicated for MRI
Pacemakers
Aneurism clips
Neurostimulator
Shrapnel
Surgical clips or plates
Metal prosthesis
Metal implants
Cochlear implants
98
FNA
Removal of content of cyst for testing/analysis
99
Stereotactic
Determines location of lesion based on x y z coordinates
100
What determines type of bx?
Suspicion (severity)
Size
Shape
Location
Number of abnormalities
101
FNB
Obtain cell material for cytological analysis
Cystic and solid lesions
102
Core biopsy
Can do in US, MG or MRI
Most performed
Removes tissue
103
Vacuum core
Hollow probe inserted to area cylinder of tissue suctioned out
Rotating knife cuts sample
104
Advantages of minimally invasive BX
Less visible scarring
Outpatient
Fewer complications
No anesthesia
Less pain/bleeding
Lest costly
105
Difference between excisional and incisional
I = part of lesion
E= whole lesion
106
What are casting calcs
Malignant
Fragmented with irregular contours
107
Pleomorphic
Different shapes
Irregular in size form OD
108
Stellate
Can have linear rod like calcs
109
Dystrophix
Sutural (tubular)
Can be result of surgery
