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RMG0 32 > Lesson 2 (PRELIMS) > Flashcards

Lesson 2 (PRELIMS) Flashcards

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1
Q

X-ray Mammography became clinically acceptable with the introduction of _____ as the target and filter (_____) and the dedicated, _____, _____ image receptor (_____).

A

molybdenum 1966
single- emulsion, screen-film 1972

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2
Q

Focal Spot Size: Tilting the x-ray tube to achieve an even smaller effective focal spot ensures imaging of the tissue next to the _____.

A

Chest wall

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2
Q

By _____, ______, emphasis on _____, _____ and _____ raised mammography to the level of excellence in breast imaging.

A

1990
grid technique
compression
high-frequency generators
automatic exposure control (AEC)

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2
Q

Components of Equipment

A
  1. Generator
  2. Support system
  3. X-ray tube
  4. Collimator or cone
  5. Breast compressor
  6. Anti-scatter holder
  7. Cassette holder
  8. Automatic Exposure Control (AEC)
  9. Phototimer
  10. Detector system
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2
Q

Generator:
- _____ of x-ray energy is required for good contrast.
- _____ tube rating.

A
  • 20-40 kVp
  • 3-10 kW
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2
Q
  • All mammography imaging system incorporate _____ generators.
  • Such a generator accepts a _____ input, which is rectified and _____ to produce a direct current (DC) voltage waveform.
  • A maximum limit of _____ is standard for preventing excessive patient radiation dose.
A

High-Voltage generator
- high frequency
- single-phase; capacitor-smoothed
- 600 mAs

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2
Q

Target Composition: Mammographic x-ray tubes are manufactured with a _____, _____ or ______ target.

A

Tungsten (W) 74, Molybdenum (Mo) 42 or Rhodium (Rh) 45

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2
Q

Target Composition: The x-rays most useful for enhancing differential absorption in breast tissue and for maximizing radiographic contrast are those in the range of _____.

A

17 to 24 keV

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2
Q

Target Composition: Characteristic radiation produced by ____ and ____ are effective for breast imaging.

A

Mo and Rh

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2
Q

Target Composition: Mammographic x-ray tube have _____ anode
● Anode angle – _____ degrees
● Tube tilt – _____ degrees
●Source-to-image receptor distance – _____ cm

A

Rotating
- 0 to 16
- 6 to 24
- 60 to 65

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2
Q

Types of AEC devices (Phototimers): Refers to a key component within a _____, which is used to convert X-rays directly into electrical signals.

A

Solid State Diode
solid-state detector

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2
Q

The size of the _____ is an important characteristic of mammography x-ray tubes because of the higher demands for _____ resolution.

A

Focal spot
Spatial

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2
Q

Focal Spot Size: Imaging of microcalcifications requires _____ focal spots.

A

Small

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3
Q

Focal Spot Size: Mammography x-ray tubes usually have stated focal- spot sizes – large and small of _____ and _____, respectively

A

0.3 mm and 0.1 mm

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3
Q

Filtration: At low kVp used for mammography, it is important that the x-ray tube window not attenuate the x-ray beam significantly. Therefore dedicated mammography x-ray tubes have either a _____ window or a very thin _____ window.

A

beryllium (Z=4)
borosilicate glass

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3
Q

Filtration: Most mammography x-ray tubes have inherent filtration in the window of approximately _____.

A

0.1mm Al equivalent

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3
Q

Mammographic Technique Chart
Compressed Breast Thickness
0-2
3-4
5-6
7-8
7-8
Target Filter
Kilovolt Peak

A

Compressed Breast Thickness
0-2
3-4
5-6
7-8
7-8
Target Filter
0-2 > Mo-Mo
3-4 > Mo-Mo
5-6 > Mo-Rh
7-8 > Mo/Rh
7-8 > Rh/Rh
Kilovolt Peak
0-2 = 24
3-4 = 25, 26
5-6 = 28
7-8 = 32
7-8 = 30 (a)

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3
Q

Heel Effect: The conic shape of the breast requires that the radiation intensity near the chest wall must be _____ than that to the nipple side to ensure near uniform exposure of the image receptor.
- Positioning the _____ over the chest wall of the patient and the _____ over the anterior portion (nipple) achieves better uniformity of the transmitted x-rays through the breast.

A

Higher
Cathode
Anode

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3
Q

Two types of AEC devices are used

A
  1. Ionization Chamber
  2. Solid - State Diode.
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3
Q

Filtration: _____ is equivalent to 0.1 mm Al material (inherent filter).

A

1mm of Be

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3
Q

Target and Filter Composition: The filters used in mammography are based on the “_____” principle and attenuate the radiation above the _____ energy of the specific filter material, either _____ or _____

A

k edge
molybdenum or rhodium

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3
Q

Advantages of Vigorous Compression:
Effect: Immobilization of breast

A

Reduced motion blur

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3
Q

Advantages of Vigorous Compression:
Effect: Reduced scatter radiation

A

Improved contrast resolution

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3
Q

Compression:
- A compressed breast is of _____ thickness; therefore, the response of the image receptor is _____.
- Vigorous compression must be used in x-ray mammography.
- Compression improves _____ and _____ and _____ the patient radiation dose.
- It is achieved with a low attenuating _____ attached to a compression device.
- _____ (_____) of force is typically used.
- A flat, _____ paddle (not curved) provides a uniform density image.
- _____ to the breast support table

A
  • more uniform
  • spatial resolution and contrast resolution and reduces
  • lexan paddle
  • 10 to 20 Newtons (22 to 44 pounds)
  • 90 degree
  • Parallel
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3
Advantages of Vigorous Compression: Effect: Uniform thickness
Uniform x-ray exposure of the image receptor
4
Advantages of Vigorous Compression: Effect: Shorter OID
Improved spatial resolution
4
Advantages of Vigorous Compression: Effect: Thinner tissue
Reduced patient radiation dose
4
_____ are required for proper direction of x-ray beam, proper collimation, for rejecting scatter radiation and protection of chest wall and lungs from unnecessary radiation.
Cones
4
- The anti-scattered grid must be a _____ grid. - _____ is the preferred interspace material - Focused grid with a grid ratio of _____ or _____ - Grid frequencies of _____ - Use of such grid _____ compromise the spatial resolution but it does _____ the patient dose. - Use of _____ ratio grid approximately double the patient dose as compare to _____ contact mammography
- moving - Carbon fiber - 3:1 or 5:1 - 30-40 lines/cm - doesn’t; increase - 4:1 - non-grid
4
Three design of collimators or cones
1. Fixed aperture 2. A set of interchangeable cones for various sizes of breast 3. An internal set if collimating blades - diaphragm beam restrictor - cone beam restrictor - collimator beam restrictors
5
Image receptor: Mammographic Cassette Sizes
18 x 24 cm (8 x 10 inch) and 24 x 30 cm (10x12inch) sizes.
5
- A unique grid that has been developed specifically for mammography is the _____ grid - This grid has the clean-up characteristics of a _____ grid in that it reduces scatter radiation in _____ directions rather than the single direction of the parallel grid - The _____ grid has _____ as grid strip material and _____ for interspace, and its physical dimension results in a _____ grid ratio
- high- transmission cellular (HTC) - crossed; two - copper; air; 3.8:1
6
- _____ techniques are used frequently in mammography, producing up to twice the normal size. - Requires special equipment such as _____, _____ and _____. - _____ mammography should not be used _____.
Magnification - microfocus x ray tubes, adequate compression, and patient positioning devices - Magnification; routinely
6
_____ for mammography are designed to measure not only x-ray intensity at the image receptor but also x-ray quality. These phototimers are called _____ devices.
Phototimers AEC devices
6
Types of AEC devices (Phototimers): - Is a specialized device used to measure the radiation dose delivered to the patient by the X-ray machine, allowing for quality control and accurate dose calculations.
Ionization Chamber
7
- Used with existing film mammography unit - Film cassettes are replaced with _____ with photo-stimulable phosphor
CR Mammography - CR imaging plates
7
Screen film Mammography: Four types of image receptors have been used for x-ray mammography
1. Direct exposure film 2. Xeroradiography 3. Screen-film 4. Digital image receptor
8
Image reader or ADC
CR Mammography
8
Image processor or the computer system for post- processing
CR Mammography
9
- The x-ray film is replaced by _____ that converts x-ray into electrical signals - The electrical signals are used to produce images, can be seen on a computer or printed on special film
Digital mammography - solid-state detectors
9
Showed without question that contrast resolution is more important than spatial resolution for diagnostic efficacy.
Digital Mammography Imaging Study Trial (DMIST)
10
Designed to compare the efficiency of digital mammography with that of screen-film mammography with which we had 30 years of experience
Digital Mammography Imaging Study Trial (DMIST)
10
Digital mammography is also called
Full-field Digital Mammography (FFDM)
11
Advancement in Digital Mammography
1. Tomosynthesis 2. Photon counting 3. CAD - Computer Aided Detection
11
- Digital mammography has superior _____ resolution principally because of _____. - _____ resolution in digital mammography is limited by _____ size
- contrast resolution; postprocessing - spatial resolution; pixel
12
1960s = 1970s = 1980s = 2000s = Present =
1960s = industrial film mammography 1970s = xeromammography 1980s = film screen mammography 2000s = digital mammography Present = digital breast tomosynthesis
13
Types of mammography: Mammography providers have switched from traditional 2D mammography to using 3D mammography which can provide more clarity in screening but _____ radiation exposure. Some providers opt for another method that uses 3D mammography to create a _____
increases 2D composite image
14
Enumerate testing options
1. 3d mammogram with generated 2d composite image 2. Combination of 2d plus 3d mammogram 3. traditional 2d images
15
Testing Options: - Rotating machine takes multiple x-ray images (3D component) are used to create a 2D composite image rather than having to perform the 2D mammogram in addition to 3D. - Exposes patients to _____ radiation than 3D combined with 2D. - FDA approved in _____
3d mammogram with generated 2d composite image - less - 2013
16
Testing Options: Breast is compressed between two x-ray plates that each take a 2D picture
Traditional 2D images
16
Testing Options: - Rotating machine takes multiple x-ray images while breast is compressed between two x-ray plates that take 2D images. - Typically exposes patients to roughly _____ the amount of radiation compared with conventional 2D mammogram - FDA approved in _____
Combination of 2d plus 3d mammogram - double - 2011
17
_____ is a 3D imaging technology that acquires a series of low-dose projection images of the compressed or uncompressed breast at different angles
Digital Breast Tomosynthesis (DBT)
18
3D captures multiple slices of the breast, all at different angles. The images are brought together to create crystal clear 3D reconstruction of the breast
Digital Breast Tomosynthesis (DBT)
19
- The radiologist is then able to review reconstruction, one slide at a time, almost like turning pages in a book. - This makes it easier for doctors to see if there’s anything to be concerned about
Digital Breast Tomosynthesis (DBT)
20
The latest advance in digital mammography occurred in _____ with the first system approved by the Food and Drug Administration for _____.
2011 digital mammographic tomosynthesis.
20
The principal purpose of _____ and therefore _____ is to improve the _____ of the imaging system and increase _____.
tomography digital mammographic tomosynthesis contrast resolution image contrast
21
_____ is one of the newer forms of x-ray based mammography technologies.
Photon Counting Mammography
22
In _____, the _____ system was introduced by _____
2003 Micro Dose Mammography (MDM) Sectra Mamea
23
_____ employ a slot-scanning design in which the system performs a lateral scan of the breast with a slot collimator
Photon Counting Systems
23
_____ is a sophisticated FDA- approved technology that helps radiologists identify characteristics that may be associated with various forms of cancer.
Computer-Aided Detection (CAD)
24
The main principle is that _____ the detector used, the _____ the risk that a scattered photon will interact and _____ image quality.
Photon Counting smaller lower increase
24
No grid is needed
Photon Counting
25
_____ refers to a standard mammogram image that is analyzed by _____ software to highlight potential abnormalities
CAD mammogram computer-aided detection (CAD)

RMG0 32 (2 decks)

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