Digital Radiography An Introduction 1st

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Chapter 6 - Digital Fluoroscopy

TRUE/FALSE

1. Through the years, fluoroscopy has developed into a sophisticated imaging system as new
technologies have emerged to improve its imaging system characteristics.

ANS: T PTS: 1 REF: Introduction

2. The X-ray tube used in fluoroscopy must be capable of producing X-rays either continuously or in
long series.

ANS: F PTS: 1 REF: Conventional Fluoroscopy Principles: A

Review

3. The output screen is coated with a ZnCdS phosphor that converts the photoelectrons into light.

ANS: T PTS: 1 REF: Conventional Fluoroscopy Principles: A

Review

4. Conventional fluoroscopy with an image intensifier operates in the low mA mode, and therefore
the noise level is usually high.

ANS: T PTS: 1 REF: Conventional Fluoroscopy Principles: A

Review

5. Recently, 43 cm x 43 cm dynamic FPD has become available for digital fluoroscopy; however, it is
still not available for digital radiography.

ANS: F PTS: 1 REF: Digital Fluoroscopy with Flat-Panel Detectors

6. Dynamic FPD detectors were first used in GI tract fluoroscopy and then later in angiography.

ANS: F PTS: 1
REF: Digital Subtraction Angiography: A Brief Overview

7. DSA has advanced from film-based imaging using image intensifier/video camera technology to
imaging with dynamic FPDs.

ANS: T PTS: 1
REF: Digital Subtraction Angiography: A Brief Overview

8. The range of the numbers in FPDs is defined as the window level and the center of the range is
defined as the window width.

ANS: F PTS: 1 REF: Digital Image Postprocessing

9. In digital fluoroscopy, the display image receives the video signal from the video camera and with
suitable electronics, uses the signal to create the television image.

ANS: F PTS: 1 REF: Conventional Fluoroscopy Principles: A

Review
 10. In digital fluoroscopy, the ADC receives the output video signal (analog signal) from the video
camera.

ANS: T PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

MULTIPLE CHOICE

1. Which of the following was developed to solve the image quality problems imposed by the
fluoroscopic screen of the early fluoroscopes?
a. flat-panel digital radiography c. image intensifier tube
b. computed radiography system d. flat panel dynamic detector
ANS: C PTS: 1 REF: Introduction

2. ____ uses an image intensifier coupled to a video camera that converts the image from the output
screen of the image intensifier into a video signal.
a. Conventional fluoroscopy c. Radiography
b. Fluoroscopic exposure d. Pulsed fluoroscopy
ANS: A PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

3. A(n) ____ couples the video camera to the television monitor by means of a coaxial cable and
control electronics.
a. X-ray tube and generator c. grid-controlled X-ray tube
b. closed-circuit X-ray television d. X-ray beam
ANS: B PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

4. ____ refers to the brightening of the fluoroscopic image using the image intensifier.
a. Pulsed fluoroscopy c. Magnification
b. Conventional fluoroscopy d. Image intensification
ANS: D PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

5. ____ is the continued emission of light from the screen when the radiation beam has been turned
off.
a. Image lag c. Contrast ratio
b. Image quality d. Image intensifier
ANS: A PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

6. In fluoroscopy, a ____ converts the light from the output screen of the image intensifier into an
electrical signal (output video signal), which is sent to the television monitor where it is converted
into a visible image that can be viewed in real time.
a. CCD camera c. closed-circuit camera
b. television camera d. video camera
ANS: D PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review
 7. The spatial resolution for a digital fluoroscopic image depends on ____.
a. matrix format c. pixel size
b. mass density d. bit depth
ANS: C PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

8. Which of the following changes the contrast and brightness of an image display?
a. digital fluoroscopy imaging c. digital subtraction angiography
b. temporal frame averaging d. grayscale-image manipulation
ANS: D PTS: 1 REF: Digital Image Postprocessing

9. The ____ changes the image contrast and the ____ changes the brightness of the image.
a. WW; WL c. DSA; WL
b. WL; WW d. DSA; WW
ANS: A PTS: 1 REF: Digital Image Postprocessing

10. In ____, a pre-contrast image referred to as a mask image is first obtained and post-contrast images
are then digitally subtracted from the mask image.
a. digital subtraction angiography c. temporal frame averaging
b. temporal subtraction d. last-image hold
ANS: B PTS: 1
REF: Digital Subtraction Angiography: A Brief Overview

11. Which of the following is an image-processing technique used to reduce the radiation dose to the
patient?
a. temporal frame average c. last-image hold
b. edge enhancement d. grayscale-image manipulation
ANS: C PTS: 1 REF: Digital Image Postprocessing

12. Which process produces a new image that is subsequently added to the original image to produce
the final image, referred to as the edge-enhanced image?
a. temporal frame averaging c. image-processing
b. dynamic FPDs d. subtraction
ANS: D PTS: 1 REF: Edge Enhancement

13. Digital fluoroscopy systems with an image intensifier and video camera (both television camera
tubes and CCD cameras) in the imaging chain have been replaced with ____.
a. WLs c. DSAs
b. FPDs d. LEDs
ANS: B PTS: 1 REF: Digital Fluoroscopy Flat-Panel Detectors

14. What do conventional fluoroscopy imaging units use to ensure efficient production of X-rays?
a. image intensifier tube c. charge-couple device
b. X-ray tube d. high frequency generator
ANS: D PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

15. Early fluoroscopy had to be performed in the dark using ____ for dark adaptation.
a. imaging gloves c. glass envelopes
 b. red goggles d. black goggles
ANS: B PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

16. Which system couples the video camera to the television monitor by means of a coaxial cable and
control electronics?
a. fluoroscope imaging c. image distributor
b. image intensifier d. magnification
ANS: A PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

17. Since the input screen is convex with respect to the X-ray tube, the spatial resolution is much better
at the center of the input screen compared to ____.
a. the screen’s magnitude c. the screen’s contrast
b. the screen’s intensification d. the screen’s periphery
ANS: D PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

18. Which of the following ensures that the X-ray beam is pulsed rather than being produced
continuously?
a. video camera c. generator
b. CCD camera d. X-ray tube
ANS: C PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

19. The exposure rate for a ____ cm mode is about 30 R/sec, while it is 60 R/sec, and 120 R/sec
for the 17 cm and 12 cm modes respectively.
a. 20 c. 30
b. 25 d. 35
ANS: B PTS: 1 REF: Conventional Fluoroscopy Principles: A
Review

20. The computer operates on the data it receives from the ADC in ____ format.
a. pixel c. matrix
b. grayscale d. digital
ANS: C PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

COMPLETION

1. In 1983, the ____________________ replaced the TV camera tube in digital fluoroscopy.

ANS: CCD camera

PTS: 1 REF: Introduction

2. While the X-ray tube and generator provide the appropriate X-ray beam for both fluoroscopy and
____________________, the image intensifier converts X-rays into light that is captured by the
video camera.

ANS: radiography
 PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

3. Modern conventional fluoroscopy imaging units use a high frequency generator to ensure efficient
production of ____________________.

ANS:
X-rays
X rays

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

4. _________________ of the image in conventional fluoroscopy is an important feature of the image

intensifier.

ANS: Magnification

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

5. The ____________________ ratio of an image intensifier tube is the ratio of the image brightness
at the periphery to that at the center of the output screen.

ANS: contrast

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

6. In some systems, it is possible to adjust the pixel size by ____________________ four pixels into
one larger pixel.

ANS: binning

PTS: 1 REF: Digital Fluoroscopy with Flat-Panel Detectors

7. The operational elements of a dynamic FPD involve three sequences, resulting in a single
____________________ that must be completed in at least 33 ms for fluoroscopy.

ANS: image

PTS: 1 REF: Digital Fluoroscopy with Flat-Panel Detectors

8. All digital imaging modalities, including digital fluoroscopy, make use of various types of image
post-processing algorithms (software), essentially to manipulate the image presented to the
observer in order to enhance diagnostic ____________________.

ANS: interpretation

PTS: 1 REF: Digital Image Postprocessing

9. The purpose of ____________________ frame averaging is to reduce the noise present in an

image by continuously displaying an image that is created by averaging the current frame with one
or more previous frames of digital fluoroscopic image data.

ANS: temporal
 PTS: 1 REF: Digital Image Postprocessing

10. The ____________________ operation is based on subtraction of images taken at different kVs.

ANS: energy subtraction

PTS: 1 REF: Digital Subtraction Angiography: A Brief Overview

11. Digital fluoroscopy can be applied to both gastrointestinal (GI) tract imaging and DSA, and the
image ____________________ operations are specific to each application.

ANS:
post-processing
postprocessing

PTS: 1 REF: Digital Image Postprocessing

12. A digital image is made up of a matrix of pixels in which each pixel is assigned a number and each
number corresponds to a(n) ____________________.

ANS: gray shade

PTS: 1 REF: Digital Image Postprocessing

13. ____________________ subtraction involves the digital subtraction of images in time.

ANS: Temporal

PTS: 1 REF: Digital Subtraction Angiography: A Brief Overview

14. The image intensifier tube has been developed to replace the conventional fluorescent screen of the
early ____________________.

ANS: fluoroscopes

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

15. The image at the output screen of the image intensifier tube is far too small and too bright to be
observed directly by a(n) ____________________.

ANS: radiologist

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

16. The ____________________ is a high-frequency generator and can provide the high mA values
used in digital fluoroscopy, as opposed to the low mA values typical of conventional fluoroscopy.

ANS: generator

PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

17. In the case of ____________________ scanning, 262.5 odd lines (one TV field) are first scanned,
followed by 262.5 even lines (one TV field).
 ANS: interlaced

PTS: 1 REF: Conventional Fluoroscopy Principles: A Review

18. At the heart of a digital fluoroscopy imaging system is a(n) ____________________ computer, a
minicomputer system capable of receiving dynamic digital data from the ADC and processing it
quickly for image display and subsequent storage.

ANS: host

PTS: 1 REF: Digital Fluoroscopy with Image Intensifiers

19. The energy subtraction operation is based on subtraction of images taken at different
___________________.

ANS: kVs

PTS: 1 REF: Digital Subtraction Angiography: A Brief Overview

20. A pre-contrast image, referred to as a(n) ____________________ image, is first obtained and
post-contrast images are then digitally subtracted from the mask image.

ANS: mask

PTS: 1 REF: Digital Subtraction Angiography: A Brief Overview