e-AIT

(Applied Imaging Technology)

Paper 1 Exam
2 September 2014

Level 9, 51 Druitt Street, Sydney NSW 2000, Australia Ph: +61 2 9268 9777 Fax: +61 2 9268 9799
Web: www.ranzcr.edu.au Email: ranzcr@ranzcr.edu.au ABN 37 000 029 863
CASE 1 - Radiation Biology and Safety

Question 1

A 60 year old female patient with inflammatory bowel disease is scheduled to have a CT scan of the abdomen - pelvis with
and without contrast. She has concerns about her radiation exposure as she has had similar scans twice in the last year
and she has heard that CT scans are dangerous .

(a) Indicate the magnitude of absorbed doses for organs irradiated in the scanned volume and the effective dose from the
exams (4 marks)

(b) Discuss the various radiation related risks that may apply (3 marks)

(c) What might you say to her to alleviate her concerns? (3 marks)

Question 2

Section 1 (Radiation Biology and Safety)

(a) Define the terms absorbed dose, equivalent dose and effective dose and indicate the SI units used to quantify them.
(4 marks)

(b) Dose limits do not apply to patient expsures but increasingly Siagnostic Refernce Levels (DRLs) do. What are DRLs, how
are they derived, and how can they be used to optimize imagine procedures in diagnostic radiology? (6 marks)

Question 3

Section 1 (Radiation Biology and Safety)

A C-arm X-ray system is used for X-ray guided interventional fluoroscopy on adult patients. The X-ray unit has automatic
brightness control (ABC) with a range of dose rate options, including pulsed fluoroscopy and an image intensifier with
variable field size. Discuss practical procedural measures that you might implement to ensure that the patient dose is
minimised without compromising the diagnostic information obtained. Supplement your answer with reasons for your
actions. (10 marks)

e-AIT Paper 1 Exam

© The Royal Australian and New Zealand College of Radiologists® 2014
September 2014

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CASE 2 - Basic Physics & Technology Including Mammography, Fluoroscopy & DSA

Question 1

(a) Indicate the expected changes to the shape of the X-ray spectrum when (a) the mAs and (b) the kVp applied to the
X- ray tube is increased. (3 marks)

(b) Explain the intent behind the operation of an Automatic Exposure Control (AEC) system used with a Digital
Radiography system. A description of the technology is not required. (3 marks)

(c) Discuss, with reasons, the impact of increasing the kVp on image quality and patient dose when a Digital Radiography
unit is used in conjunction with an AEC system. (4 marks)

Question 2

(a) K-edge filtration is frequently used in mammography. Explain what is meant by this concept and why it is particularly
useful in mammography. (3 marks)

(b) When undertaking assessment of women with suspected breast disease magnification mammography views are
undertaken as an adjunct to the usual contact mammography views. Describe how the magnification technique differs from
the contact technique. (3 marks)

(c) Discuss the advantages & disadvantages of the magnification mammogrpahy when compared with contact
mammography. (4 marks)

Question 3

(a) Flat panel detectors in Digital Radiography (DR) are generally based on two distinct types, the s-called direct and in-
direct detectors. Describe the basic features of the detection process with each type and indicate any possible
advantages one type might have over the other. (5 marks)

(b) Multi field size image intensification has been the traditional method of undertaking fluoroscopy. Explain the benefits of
using a small field size (magnification mode) and indicate, with reasons, what the patient dose implications might be when
choosing a small versus a large field size when the image intensifier is operated under automatic brightness control.
Specifically, if you were to change from a field size of 30 cm diameter to one of 20 cm what would be the approximate
change in dose to the patient if the kV was kept unchanged? (3 marks)

(c) Briefly explain nthe difference between continuous fluoroscopy and digital image acquisition (pulsed fluorography)
such as might be used in digital subtraction angiography. (2 marks)

e-AIT Paper 1 Exam

© The Royal Australian and New Zealand College of Radiologists® 2014
September 2014

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Case 3 - CT, MRI, US & Nuclear Medicine

Question 1

Describe four (4) operator adjustable factors that have a significant effect on the effective dose to the patient
in multi-detector CT imaging. For each factor describe what changes are required to cause a reducation in
patient dose when scanning and describe the specific effects that these changes will have on image quality
(i.e. noise, spatial resolution, contrast etc). (10 marks)

Question 2

Briefly explain what is meant by the following terms and how they are relevant in Magnetic Resonance Imaging

(i) Fixed magnetic field

(ii) rf coils
(iii) Spin echo pulse sequence
(iv) Magnetic field gradients
(v) Chemical shift

(10 marks)

Question 3

(a) Lateral resolution in real time ultrasound imaging using a phased array transducer can be improved by
focusing the ultrasound beam in the scan plane
(i) Briefly describe the construction of a phased array transducer and how focusing is achieved (3 marks)
(ii) Describe how the depth of the focal zone can be adjusted (2 marks)

(b) Lateral resolution can be improved over a range of depths by using multiple focal zones. If 2 focal zones
are set and the line density and maximum depth of imaging are unchanged, explain what will happen to the
fram rate and why. (2 marks)

(c) The image (Ultrasound Artifact. jpg) shows tissue brightening posterior to a fluid filled cyst which is
artifactual.

(i) name the artifact. (1 mark)

(ii) explain the physical processes that cause this artifact. (2 marks)

Question 4

(a) SPECT imaging is most often performed with a dual head gamma camera fitted with parallel hole
collimators.

(i) Briefly describe the principles of SPECT imaging acquisition and reconstruction (5 marks)
(ii) During SPECT acquisition it is desireable to keep the detectors as close to the patient as possible. Explain
why this is done. (1 mark)

(b) A parallel hole collimator is essentially a lead sheet with thousands of holes. If the hole diameter is
increased, while maintaining the hole length (thickness of collimator), state the effect on the;

(i) Spatial resolution (2 marks)

(ii) Sensitivity (2 marks)

of the camera, and briefly explain why this occurs.

e-AIT Paper 1 Exam

© The Royal Australian and New Zealand College of Radiologists® 2014
September 2014

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