FC Rad Diag(SA) Part I

THE COLLEGES OF MEDICINE OF SOUTH AFRICA

Incorporated Association not for gain
Reg No 1955/000003/08

Part I Examination for the Fellowship of the

College of Diagnostic Radiologists of South Africa
29 January 2020
Paper 1 Physics
All questions are to be answered. Each question to be answered in a separate book (or books if more than one is
required for the one answer)

2 a) Briefly explain each of the following concepts

i) Linear energy transfer. (2)
ii) Binding energy. (2)
iii) Beam hardening. (2)
b) Briefly describe bremsstrahlung and draw a schematic bremsstrahlung spectrum that
shows both unfiltered and filtered spectrum, up to a maximum energy of 90 keV and label
the spectrum. (6)
c) Draw the Characteristic (H&D) Curve, label all the regions and briefly explain all the
regions in the curve. (6)
d) Discuss the influence of the following: Target material, Voltage (kVp) applied, and tube
current (mA) on beam quality and beam quantity of the x-ray beam produced from an
x-ray tube. (6)
e) With the aid of a diagram, describe how an anti-scatter grid works. (6)
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3 a) With the aid of a diagram, briefly explain the five main structural components of the
ultrasound transducer and give the function of each component. (8)
b) What is twinkling artefact and name one clinical scenario where it may be useful? (2)
c) Briefly explain Stochastic and Deterministic effects that are produced by exposure to
ionising radiation. (6)
d) A pregnant woman undergoes the following examinations at various stages of her
pregnancy as outlined below
i) CT of the abdomen with and without contrast at 7 weeks.
ii) CT of the brain without contrast at 8 weeks.
iii) Ultrasound of the liver at 10 weeks.
iv) Ventilation/perfusion lung scan at 14 weeks.
Indicate the magnitude of any fetal radiation doses involved and discuss any possible
risks to the foetus following each procedure. (8)
e) Along with a brief reasoning for your suggested technique(s), state an appropriate kVp
and target/filter combination for mammographic screen-film imaging of an average (4cm
compressed) and large (6cm compressed) breast. (6)
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4 a) For CT scanning the effective energy range is 40-60keV.

i) Which interaction mechanism dominates within this energy range in soft tissue?
(1)
ii) How is this interaction mechanism dependent on the density of tissues? (2)
iii) What is the effect of this interaction mechanism on image quality? (1)

PTO/Page 2 Question 4 b)…

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b) Compare high (>1) and low (<1) pitch helical CT scanning. (2)
c) Why does a thicker slice have less noise than a thin slice in CT scanning? (1)
d) A patient with hip implants undergoes a CT scan. Name and describe the artefact seen
on the images. (3)
e) How does the molecular structure of a magnetised sample influence T2 relaxation times
with reference to mobile molecules? (2)
f) Which spin echo pulse sequence would be used to visualise cerebral spinal fluid in the
brain in MRI scanning and why? Refer to TR and TE times. (4)
g) Where and why do magnetic susceptibility artefacts occur in MRI scanning? (2)
h) What is quenching in MRI? (2)
i) How does automatic exposure rate control work in fluoroscopy? (3)
j) What is the main contributor of radiation dose to personnel in a fluoroscopy suite and
how can personnel dose be minimised? (4)
k) Give 3 methods of scatter reduction in radiography. (3)
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