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Ch42 Mammo

when did mammography first develop early 1900s
when first dedicated mammography machine introduced 1967, France
type of mammography used in US from 1960-1990s xeromammography
first dedicated film screen system 1972 - DuPont USA
designed Min-R screen film & cassette system 1975 - Kodak USA
rare earth phosphor sensitive to what color? green
orthochromatic film is sensitive to what? blue-green sensitive
first reciprocating grid mammography unit 1978 Phillips Netherland
first advanced level exam for mammography for ARRT 1991
digital mammography introduced 2006
baseline- never had any symptoms screening
when you have symptoms or have already been diagnosed diagnostic
annual screening is recommended at what age? 40+
clinical breast exam recommendations 20-30 every 3 years 40+ annually
only modality regulated by FDA Mammography
three types of tissue that make up the breast fibrous, glandular, adipose (fat)
composition of premenopausal breast primarily have fibrous and glandular
composition of postmenopausal breast primarily have adipose- adipose is tissue is less dense
tissue most sensitive to cancer by radiation glandular
first time x-ray machine and personnel were regulated by federal government Mammography quality standards act of 1999
what kind of subject contrast does breast have? low subject contrast
what technique produces high radiographic contrast in breast images low kVp
disadvantage of low energy x-rays high absorption contributes to patient dose
what kVp is used in mammo? 22-40kVp usually 25-28kVp
what kind of SID is used in mammo? short SID - 24 to 30"
rapid growing very lethal cancer- on outside of breast inflammatory breast disease
average energy preferred in mammo 17-24keV
what happens when x-rays over preferred peak are used energy overpenetrates, produces scatter and decrease radiographic contrast
what sized focal spot used for mammo? small .1mm / large .3mm
material of choice for mammo target & why? molybdenum. high melting point & conducts heat well.
why is tungsten not used in dedicated mammography unit? too high atomic number, too high energies and degrades image
allows vertical central ray to be placed at the chest wall-movement of glass envelope forward off-center placement
filtration used in mammography beryllium window
function of beryllium window filter, reduce high energy x-ray
inherent filtration of beryllium window .1mm AL equivalent
new/additional target material in mammography rhodium (Z#45)
type of target that provides better penetration of larger or very dense breasts & reduces exposure time rhodium
disadvantage of rhodium target energy level too high to use on small and average sized breast
filters beyond the window is what kind of material? same material as target (molybdenum or rhodium)
purpose of filter beyond filtration window filters out low energy x-rays and higher bremstrahlung x-rays
utilization of anode heel effect in mammo? cathode closest to chest wall, anode end closest to nipple
typical grid used in mammo linear, very low ratio 4:1 or 5:1, moving grid. grid frequency 40 lines/cm
Direct Current is fed through an ______, changes power to high-frequency inverted circuit
minimizes OID and improves spatial resolution, positioned after the image receptor. AEC
2 types of AEC ionization chambers & solid state diode
what is cathode made of? tungsten
how many filaments are in mammo tube? 1 filament
what is the charge of the cathode in the mammo tube? negative - strong negative charge
rotating or stationary anode in mammo? rotating
benefits of magnification increased resolution, reduction of scatter, improved visibility of detail
disadvantage of magnification exposure to breast is 2-3x higher
4 types of image receptors direct exposure xeroradiography screen/film digital
what are mammo cassettes made out of? plastic or low-attenuation carbon fiber
single or double emulsion film in mammo? single
what is screen mounted on in mammo? foam pad
what are screens made of in mammo? green emitting gadolinium oxysulfide
what is benefit of slow screen speed used in mammo? reduces noise and increases resolution
what is caveat of single emulsion film use in mammo emulsion side must always be against screen
how much is tube tilted in mammo machine? 6 degrees
what is anode degree angle in mammo? 23 degrees
how are images captured in computed radiography for mammo? photostimulable storage phosphor
how are images captured in direct digital radiography in amorphous selenium
how are images captures in indirect conversion system? flat panel detectors involve the detection of light by a series of smaller photodiodes
advantages of digital mammo? elimination of processor artifacts, contrast enhancement, ability to perform invasive procedures faster, better resolution, reduce time, increased production, images immediately available, ability to digitally magnify
2 reasons we don't want low energy x-rays increased scatter (image contrast), increased patient dose
advantages of compression red. mag, red. thickness, red. exposure, red. motion unsharpness, improved visualization, more uniform image receptor exposure
disadvantages of digital mammo? cost, integration of equip, comparison of FSM images with digital images, large MB images
what does DMT stand for? digital mammography tomosynthesis
what is DMT? takes 11 different angles and computes into 3D image, uses less compression, 7 second exam
principle advantages of digital mammography capacity to manipulate image contrast & density; capacity to transmit images for consultation; teaching, etc; archiving PACS simplified storage and access
types of detectors in digital mammography phosphor flat panel, phosphor CCD, selenium flat panel, computed radiography
3 categories where digital mammo has shown significant results under age of 50, of any age with very dense or extremely dense breast tissue, pre- or periomenopausal women with lmp within 12 of last mammo
what does MQSA stand for? Mammography Quality Standards Act
when was MQSA enacted by FDA & ACR 1992
what must be accredited according to MQSA mammography machine, radiologists, tech, med physicists
what must be checked daily according to MQSA? darkroom cleanliness, processor QC
what must be checked weekly according to MQSA? screen cleanliness, view boxes and viewing conditions
what must be checked monthly according to MQSA? visual checklist
what much be checked quarterly according to MQSA? repeat analysis
soft tissue radiography requires special technique because of the low subject contrast
breast tissue tends to be increasingly ___ in older women fatty
dedicated mammo units should have automatic adjustable ___ device compression
Created by: jen.studer