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160 Cards in this Set
- Front
- Back
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Compare annual deaths due to lung cancer to those that result from breast cancer.
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175,000 new cases each year. 2nd to lung cancer as leading cause of death by cancer and 1 out of 4 case will lead to death
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How many women will develop breast cancer?
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One out of eight
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What is the cure rate for early detection of breast cancer?
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90% cure rate for early detection
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Since what year has mortality rate dropped for breast cancer
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1995
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What type of breasts have very low sensitivity to radiation-induced cancer?
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mature breast tissue
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Compare the subject contrast in soft tissue radiography to subject contrast in routine radiography and fluoroscopy.
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much less contrast in soft tissue
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What is the history of mammography?
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1st attempted in 1920's & unsuccessful, late 1950 low kVp with high mAs and direct exposure but no intensifying screen; 1960 xeromammography (superior to direct exposure, lower pt. dose, edge enhancement); 1990 screen film mammo superior quality lower patient dose
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Compare what is meant by diagnostic and screening mammography
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diagnostic patients with elevated risk factors or symptoms; screening asymptomatic patients
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9. When does the American cancer society suggest when a woman should do a monthly self exam?
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at age 20
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10. When does the American cancer society suggest when a woman should have a yearly physician examination?
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at age 40
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What is the approximate risk benefit factor for mammo
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older you are the greater the risk, mother or sister w/ breast cancer, presence of BRCA2 genes, if mens start b/4 age 12, if menap starts after 55, prolonged use of estrogen, late birth of 1st child, no children, risk increases with higher education
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When should a woman start receiving a baseline mammogram
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at age 35
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What are the risks vs. benefits of mammography?
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radiation can induce cancer, est 700-1000 lives saved to every 1 death caused
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What are the three types of tissue that compose the breast
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fibrous, glandular and adipose
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What type of tissue is premenopausal tissue
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dense glandular and connective tissue
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What type of tissue is postmenopausal tissue
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fibro glandular tissue degenerates and adipose tissue increases
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What is adipose tissue like
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less dense and requires less exposure
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What are younger breasts like
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less fatty and more difficult to image
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What is the most radiosensitive breast tissue
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glandular
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What is the radiographic appearance of breast tissue
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appears as distortion of normal ductal and connective tissue patterns MAY have micro calcifications
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What is 80% of breast cancer?
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ductal
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What three factors is degree of x-ray absorption determined by?
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mass density, effective atomic number and photon energy
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What is the mass density and atomic number like in breast tissue?
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does not have much variation
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At what range of kvp does Compton scatter predominate over photoelectric in soft tissue?
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70 to 100 kVp
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Is there much differential absorption in soft tissue?
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no
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Know how mass density affects the degree of x-ray absorption
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at low energy
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Know how atomic number affects the degree of x-ray absorption
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Compton: absorption proportional to mass density & photoelectric: absoption proportional to mass density
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What is the appropriate range of kilovoltage for mammography
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23-28 kVp
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Know how atomic number affects the degree of x-ray absorption
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Compton: directly proportional photoelectric: proportional to the cube of the atomic number
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What type of generator is used in mammography?
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high frequency
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List the stages involved in created a high –frequency electric signal
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single phase input, rectified to DC, power converted to high frequency
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State the frequency range of electricity produced by a high frequency generator>
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5-10 KHz
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State the ripple of electricity produced by a high voltage generator
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1%
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What is the Kev range of breast tissue
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17-24 kev
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State the two main anode target materials that are used in mammography.
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molybdenum and rhodium
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State three filtration materials that can be used in mammography
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tungsten target, molybdenum anode target, & rhodium anode target
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What is the filtered tungsten target at 30 kvp
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0.5 mm
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Give the atomic number for tungsten, rhenium, and molybdenum
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tungsten 74, rhenium 45 & molybdenum 42
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What is the K shell characteristic radiation in the tungsten target
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none
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What is the L shell characteristic radiation in the tungsten target
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12 Kev
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How much molybdenum is there filtered in the molybdenum target
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30 micrometers
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What is the K shell characteristic radiation in the molybdenum target?
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19 Kev
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What is the K shell characteristic radiation in the rhodium target
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23 Kev
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What type of x-rays are there more of in the rhodium target
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Brems x-rays
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What is the focal spot size for mammography
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small - not greater than 0.1mm
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Explain how the anode heel effect is used in mammography
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cathode should never be near the chest wall, compression ensures uniform thickness of tiussue, spatial resolution is reduced at cathode side,more focal spot blur, larger effective focal spot
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focal spot blur
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blurred region on the radiograph over which the technologist has little control
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focal spot
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region of the anode target in which electrons interact to produce x-rays
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anode heel effect
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absorption of x-rays in the heel of the target resulting in reduced x-ray intensity to the anode side of the central axis
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What is the SID for mammography
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24-32" or 60-80cm
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What is the kvp and mAs for mammography
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low kVp and high mAs
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State how much inherent filter is normally found in mammographic tube.
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0.1mm Al eq.
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State the limit for total filtration in a mammographic tube
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greater than 0.5mm AL eq.
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What is added filtration selected based on
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tissue size
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What are the two rotating anodes
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bi-angle and double track anodes (Mo & Rh targets for double track
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List the benefits of compression for mammography
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creates more uniform thickness, consistent optical density over entire image, reduces OID of tissue, increasing spatial resolution, reduces scatter, increases contrast resolution, and reduces pt. dose
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State the purpose of a grid in mammography
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increases contrast
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What do grids do to grid ratio
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increases it
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What happens to patient dose with a grid
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it increases b/c you must increase technique when grid ratio increases
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State the types of grids commonly used in mammography
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moving (4:1), focused (30-50 lines/cm), high transmission cellular grids (works like a crossed grid
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What does a 4:1 grid do to patient dose compared to no grid
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doubles pt. dose
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Compare AEC in diagnostic radiography to AEC used in mammography.
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AEC detectors are positioned under the IR in mammo
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What is the magnification in mammography?
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2x
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What are the types of mammography image receptors
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direct exp, xeroradiography, screen film and digital detectors
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Compare screen film systems used in mammography to screen film systems used in diagnostic.
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Mammo is single emulsion/single screen and eliminates crossover with a special grain film design and increases contrast which makes spectral matching essential---cassette designed for low attenuation, receptor speed 200RS
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What is digital mammography like compared to screen
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Charged Couple Device (CCD), decreased spatial resolution and increased contrast resolution
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What can poor mammography result in
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miss cancerous lesion, false neg diagnosis can delay early treatment, resulting in unavoidable death, OR poor quality mammo can lead to false positives
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What are false positive diagnoses
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normal tissue judge abnormal, needless anxiety for pt., costly additional testing, and unnecessary biopsy
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What is NEXT
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Nationwide Evaluation of X-ray Trends - study found that the image quality in as many as one third of facilities were of substandard quality
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State the meaning and significance of MQSA
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Mammography Quality Standards Act: set standards for image quality, radiation dose, personnel qualifications, examination procedures, it ensures that all women have quality mammography for detection of breast cancer in earliest most treatable stages
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What is the quality control team for mammography
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radiologist, medical physicist, mammographer
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Who has the ultimate responsibility
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the radiologist
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How many pounds of pressure are used for compression
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25-40 lbs.
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Soft tissue radiography requires special techniques because of the low
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subject contrast
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When doing soft tissue radiography, differential soft tissue between ___ and ___ should be enhanced
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muscle and fat
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The breast tissue tends to be increasingly ___ in older women
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fatty
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About 80 % of breast cancer occurs in ___ tissue.
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ductal
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5. The American Cancer Society recommends that all women ___ years of age and above have an annual screening mammogram
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50
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6. The American Cancer Society recommends biannual screening mammograms for all women over the
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age 40-49
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A dedicated mammography unit should have an automatic adjustable _____ device
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compression
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Every dedicated mammography unit is equipped with a:
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low ratio grid
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A target of Molybdenum or Rhodium is preferable on mammography because it reduces the:
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scatter
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Breast compression has the advantage of lowering
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Patient dose, Motion blur, Superimpositions
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Breast compression is used to ___ patient dose and ___ focal spot blur.
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lower and reduce
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The spatial resolution is improved in mammography by always placing the emulsion side of the film _____ the screen and _____ the tube
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against the screen and away from the tube
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Screening mammography requires _____ view(s) of each breast, whereas diagnostic mammography requires _____ views
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2, 2 or more
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The quality assurance program includes measures of
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Patient Satisfaction, Processor quality control, Equipment function
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The _____ is responsible for supervising quality assurance
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chief radiologist
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The average glandular dose to mammography patients must be tested annually by the
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medical physicist
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The medical physicist is responsible for _____ performance evaluation of the imaging equipment
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annual
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The medical physicist is responsible for the
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annual artifact evaluation
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The role of medical physicist includes
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doing annual performance evaluations of equipment, consulting with the mammographers concerning QC, reviewing the QC records to check for compliance
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How often should the mammographer perform the quality control test for screen-film contact
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semiannually
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The first step in quality control is the daily
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darkroom cleaning
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Every daily sensitometry Strip should be fed in the processor
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emulsion side down,on the same edge of the feed tray, with the least exposed end first
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Once control values are set, the daily speed index (mid density) and contrast index (density difference) should not vary more than _____ from the control
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0.15
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The processor quality control begins with the daily tests for
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Developer temp and sensitometric values
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The sensitometry strip step with the optical density closest to, but not less than, _____ is the speed index (mid density) step
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1-2
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What are other words for medical sonography
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diagnostic ultrasound, diagnostic medical sonography, ultrasonography, vascular sonography, echocardiogram
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How long has sonography been around for
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4 decades
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How is sonography visualized
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by non-ionizing, high frequency sound waves
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State what type of tissue structures are best imaged with sonography.
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soft tissue, cysts
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What are some of the benefits of sonography
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more cost effective than MR, CT or angiography, distinguishes b/t cysts and soft tissue, measure size and depth of structures
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List three types of invasive procedures performed in DMS
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transvaginal, transesophageal, and transrectal
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What is used in coronary studies
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intraluminal transducers
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Explain the source of the term SONAR
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sound navigation and ranging used in WW2 to detect submarines
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When did Dussick discover head tumors could be detected
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1947
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When did sonography become practical
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early 1960s
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What is energy that vibrates at a steady rate
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acoustic wave
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State the difference between sound waves and electromagnetic radiation.
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sound wave travel in waves and a mechanical physical structure. electromagnetic radiation is pure energy and can travel in a vacuum
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Give the significance of amplitude of a sound wave
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refers to power, volume, intensity
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Give the unit of measurement for sound volume
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decibels
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What is velocity
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speed of a sound wave
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What does the velocity of sound varies dependent upon
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the medium
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State the speed of sound in air.
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331meters/second
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What is the speed of sound in stainless steel
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3100 meters/second
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State the speed of sound in soft tissue
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1540 meters/second
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What is wavelength of audible sound
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2 to 2000 cm
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What is the wavelength of ultrasound
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0.1 to 0.5mm
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What is frequency
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number of times a sound wave is repeated per second
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Give the frequency of ultrasound
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greater than 20 KHz
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Give the frequency of the sound used in diagnostic ultrasound
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1-20 MHz
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What is the frequency of infrasound (seismic waves)
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less than 20 Hz
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What is the frequency of audible sound (human hearing range)?
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20 to 20,000 Hz
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What is the frequency of ultrasound (beyond human hearing
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greater than 20,000 Hz
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What is the frequency of therapeutic ultrasound (high intensity for deep heating effects)?
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1 to 10 MHz
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List the three ways sounds waves are attenuated when they travel through tissue.
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absorption, reflection and scattering
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What is energy absorbed by
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the tissue
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What is most energy converted into
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heat (therapeutic ultrasound)
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At what energy levels in DMS is heat negligible
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low energy levels
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When does scattering occur?
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when sound waves encounter a surface smaller than the wave itself, can cause backscatter or non-specular reflection
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What is reflection?
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the sound back to the source, echo, and occurs when ultrasound beam passes through the tissues of a different acoustic impedence
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What is acoustic impedance?
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product of the density of a tissue and the speed of sound in tissue
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What is the speed of sound in soft tissue?
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1540 meters per second
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What is an echo?
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when sound crosses an interface only a small percentage is reflected and remainder travels on
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What three things are highly reflective?
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air, gas, and bone
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What two things are not penetrable by ultrasound
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air and bone
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What does gel do?
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it releases air transducer to skin
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*List the known biological effects of ultrasound.
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theoretically conversion to heaat could pose an issue but there are no known biological effects
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*Define transducer.
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any device that converts one form of energy to another
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What type of crystal does ultrasound use?
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a piezoelectric signal usually ceramic
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*Define the piezo electric effect.
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ability of a substance to produce a voltage when mechanical stress is applied to it. when a crystal is vibrated at a very high rate it can produce electricity and crystal expands and contracts a d creates ultrasonic pulse
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What type of images does ultrasound form
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transverse (to transducer not to the body)
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List three types of transducers.
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linear array, curved array, tightly curved array
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What is real-time ultrasound?
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uses multicrystal transducers known as linear array crystals, each crystal sends out sound waves in sequence, as each echo returns in sequence and is displayed it produces apparent motion
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*Explain the relationship between frequency and penetration of ultrasound.
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as frequency increases penetration decreases
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*Explain the relationship between frequency and resolution of ultrasound.
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as frequency increases resolution increases
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What frequency do abdomen studies use?
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2 to 5 MHz
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What is the relationship between size of structures and frequency?
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smaller structures use higher frequencies
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What type of frequency does premature baby fontanelle studies use?
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12 MHz
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What should sonagraphers be able to analyze?
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analyze mass to tell if borders are smooth, irregular poorly defined, thick or thin
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.What are two mass characteristics?
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heterogeneous and homogeneous
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*List and define the four types of echoic characteristics of masses.
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hypo echoic (low level echoes), hyper echoic (bright echo), iso echoic (same texture as surrounding tissue), anechoic (no internal echoes)
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*Explain the purpose of Doppler technique in DMS.
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a change in frequency when direction of flow is detected within a vascular structure, can determine direction, flowr esistance, turbulence, or regurgitation of blood within a vessel or cardiac chamber: color flow doppler assigns color scale to the change in frequency (Doppler shift)
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State the traditional significance of red and blue in color Doppler.
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red means flow to the transducer and blue is a shift away from the transducer
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What does the survey of abdominal cavity include?
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diaphram to the level of the umbilicus, liver, binary system, pancreas, spleen, vascular structures, retroperitoneum, and kidneys
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What position are the patients in?
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supine, upright prone on their side
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What may obstruct the beam?
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air and gas
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What is prep for the abdominal cavity
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NPO for 6 hours
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What does fasting do to the gallbladder and bile duct?
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it allows them to be distended
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