Mammography

Question 1

What is a mammogram?

Answer 1

A x-ray picture of the breast

Question 2

When is a mammogram used?

Answer 2

It is used to check for breast cancer in women with no signs or symptoms and for those who are showing symptoms

Question 3

What are the 3 main types of tissue within the breast?

Answer 3

Connective Tissue
Glandular Tissue
Fatty Tissue

Question 4

What is the function of connective tissue and suspensory ligaments?

Answer 4

Provide support to the breast and give it shape

Question 5

What is the glandular tissue comprised of?

Answer 5

Lobes
Lobules
Milk Ducts

Question 6

What is within the fatty tissue?

Answer 6

Network of Ligaments
Fibrous Connective Tissue
Nerves
Lymph Vessels
Lymph Nodes
Blood Vessels

Question 7

Describe how the Pectoralis Major Muscle is seen on X-ray

Answer 7

Can be seen as white triangles

Question 8

Describe how Fat looks on X-ray

Answer 8

Dark areas of the image

Question 9

How does Glandular tissue look on x-ray?

Answer 9

Thicker white areas

Question 10

What does connective tissue look like on x-ray?

Answer 10

Can be seen as white thin lines

Question 11

How many compression plates are there? What size are these plates?

Answer 11

There are 2 compression plates. 18x24 and 24x30

Question 12

What range of low keV does the x-ray tube provide?

Answer 12

From 25 to 32 keV

Question 13

Describe why the x-ray tube has a small focal spot

Answer 13

To allow for good resolution

Question 14

What is the target materials can be used on a rotating anode?

Answer 14

Molybdenum, Rhodium or Tungsten

Question 15

Why is Rhodium or tungsten used for the rotating anode?

Answer 15

Gives it a higher energy spectrum for larger of denser breasts

Question 16

What is the compression limited to within the x-ray tube

Answer 16

<200 N

Question 17

Why is anti-scatter used in the x-ray tube?

Answer 17

It is used for contact films which is usually a moving linear grid. The moving grid improves the image quality but also increases the dose

Question 18

What is the AEC System used for within the x-ray tube?

Answer 18

Uses high technology in that it used a series of photocells instead of a single pick up.

Question 19

Describe the Heel Effect

Answer 19

It lowers the x-ray intensity on the anode side of the field

Question 20

Why is a low kV used in mammography?

Answer 20

Low kV is necessary for good subject contrast between similar density tissues

Question 21

What does the radiation spectrum that is created depend on?

Answer 21

KVp Selected and Target Material

Question 22

Where is the AEC positioned over?

Answer 22

The Glandular part of the Breast

Question 23

What is the benefits of compression?

Answer 23

• Dose and exposure time reduction
• Reduced unsharpness
• Improved Contrast
• Reduces Overlap
• Flexi Designs

Question 24

Describe QA within mammography

Answer 24

Monitor tests are carried out using phatoms provided by the manufacturers of the machines
a good breast phantom should:
- Have an established correlation with clinical image quality
- Allow objective rather than subjective analysis
- Be sensitive to small changes in mammography technique

Question 25

What QA test should be checked Daily

Answer 25

- Consistency of mAs, DDI and SNR using perspex test object - Monitors and printers

Question 26

What QA test should be carried out weekly?

Answer 26

- Uniformity test - Consistency of CNR using perspex test object - Image quality test using TOR(MAM)

Question 27

What QA Test should be carried out monthly?

Answer 27

- AEX test using 2cm, 4/4.5cm & 6/7cm Perspex test object - More detailed monitor checks using test pattern - Mechanical, Safety and functionalW

Question 28

What QA tests should be carried out every 6 months?

Answer 28

- CR image plate matching and artefact check

Question 29

What are standard radiographic views in mammography?

Answer 29

- Mediolateral Oblique (MLO) - Cranio-Caudal (CC)

Question 30

What is the criteria for assessing MLO mammograms

Answer 30

- Whole breast imaged according to local protocols - Nipple in Profile - Correct Annotation - Appropriate Exposure - Absence of moving - Appropriate compression - Correct Processing - Skin Fold Free - Absence of artefacts covering the image - Symmetrical Images

Question 31

What is the criteria for assessing CC mammograms?

Answer 31

- Medial border imaged according to local protocols - Some of axillary tail of the breast - Pectoral muscle shadow may be shown - Nipple in profile - Correct annotation - Appropriate Exposure - Appropriate Compression - Absence of Movement - Correct Processing - Skin Fold Free - Absence of Artefacts covering the image - Symmetrical Images

Question 32

What is a Mediolateral technique used?

Answer 32

Depth localisation of lesions

Question 33

Why is Extended CC technique used?

Answer 33

Lesions high in axillary tail

Question 34

Why is magnification used?

Answer 34

Used for specific areas of interest e.g. calcifications

Question 35

What is the Rolled CC technique used for?

Answer 35

Allows superimposed tissue to separate

Question 36

Describe the stages of cancer

Answer 36

- Stage 1 is a tumour up to 2cm in diameter with negative lymph nodes - Stage 2 is a 2 - 5cm tumour and positive lymph nodes - Stage 3 is a less than 5cm tumour, which may have spread to axillary lymph nodes or the chest wall - Stage 4 is when the tumour has spread to distant sites

Question 37

What are common benign pathologies?

Answer 37

- Breast Cysts - Fibroadenoma - Breast Calcifications

Question 38

What is the use of the SmartCurve Breast Stabilisation system?

Answer 38

- Provides a curved compression surface and is more comfortable for the patient

Question 39

What is the Computer-aided detection used for?

Answer 39

- To search digitised mammographic imaged for abnormal areas of density, mass or calcification - Alerts radiologist to assess the area

Question 40

What is Contrast Enhanced Spectral Mammography used for?

Answer 40

Gives more detailed information to radiologists

Question 41

What is a Digital Breast Tomosynthesis (DBT)?

Answer 41

Is an advanced form of breast imaging where multiple images of the breast from different angles are captured and reconstructed into a three-dimensional image set