Ch42 Mammo
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| when did mammography first develop | early 1900s
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| when first dedicated mammography machine introduced | 1967, France
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| type of mammography used in US from 1960-1990s | xeromammography
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| first dedicated film screen system | 1972 - DuPont USA
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| designed Min-R screen film & cassette system | 1975 - Kodak USA
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| rare earth phosphor sensitive to what color? | green
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| orthochromatic film is sensitive to what? | blue-green sensitive
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| first reciprocating grid mammography unit | 1978 Phillips Netherland
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| first advanced level exam for mammography for ARRT | 1991
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| digital mammography introduced | 2006
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| baseline- never had any symptoms | screening
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| when you have symptoms or have already been diagnosed | diagnostic
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| annual screening is recommended at what age? | 40+
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| clinical breast exam recommendations | 20-30 every 3 years
40+ annually
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| only modality regulated by FDA | Mammography
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| three types of tissue that make up the breast | fibrous, glandular, adipose (fat)
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| composition of premenopausal breast | primarily have fibrous and glandular
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| composition of postmenopausal breast | primarily have adipose- adipose is tissue is less dense
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| tissue most sensitive to cancer by radiation | glandular
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| first time x-ray machine and personnel were regulated by federal government | Mammography quality standards act of 1999
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| what kind of subject contrast does breast have? | low subject contrast
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| what technique produces high radiographic contrast in breast images | low kVp
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| disadvantage of low energy x-rays | high absorption contributes to patient dose
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| what kVp is used in mammo? | 22-40kVp
usually 25-28kVp
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| what kind of SID is used in mammo? | short SID - 24 to 30"
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| rapid growing very lethal cancer- on outside of breast | inflammatory breast disease
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| average energy preferred in mammo | 17-24keV
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| what happens when x-rays over preferred peak are used | energy overpenetrates, produces scatter and decrease radiographic contrast
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| what sized focal spot used for mammo? | small .1mm / large .3mm
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| material of choice for mammo target & why? | molybdenum. high melting point & conducts heat well.
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| why is tungsten not used in dedicated mammography unit? | too high atomic number, too high energies and degrades image
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| allows vertical central ray to be placed at the chest wall-movement of glass envelope forward | off-center placement
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| filtration used in mammography | beryllium window
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| function of beryllium window | filter, reduce high energy x-ray
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| inherent filtration of beryllium window | .1mm AL equivalent
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| new/additional target material in mammography | rhodium (Z#45)
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| type of target that provides better penetration of larger or very dense breasts & reduces exposure time | rhodium
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| disadvantage of rhodium target | energy level too high to use on small and average sized breast
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| filters beyond the window is what kind of material? | same material as target (molybdenum or rhodium)
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| purpose of filter beyond filtration window | filters out low energy x-rays and higher bremstrahlung x-rays
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| utilization of anode heel effect in mammo? | cathode closest to chest wall, anode end closest to nipple
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| typical grid used in mammo | linear, very low ratio 4:1 or 5:1, moving grid. grid frequency 40 lines/cm
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| Direct Current is fed through an ______, changes power to high-frequency | inverted circuit
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| minimizes OID and improves spatial resolution, positioned after the image receptor. | AEC
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| 2 types of AEC | ionization chambers & solid state diode
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| what is cathode made of? | tungsten
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| how many filaments are in mammo tube? | 1 filament
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| what is the charge of the cathode in the mammo tube? | negative - strong negative charge
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| rotating or stationary anode in mammo? | rotating
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| benefits of magnification | increased resolution, reduction of scatter, improved visibility of detail
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| disadvantage of magnification | exposure to breast is 2-3x higher
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| 4 types of image receptors | direct exposure
xeroradiography
screen/film
digital
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| what are mammo cassettes made out of? | plastic or low-attenuation carbon fiber
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| single or double emulsion film in mammo? | single
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| what is screen mounted on in mammo? | foam pad
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| what are screens made of in mammo? | green emitting gadolinium oxysulfide
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| what is benefit of slow screen speed used in mammo? | reduces noise and increases resolution
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| what is caveat of single emulsion film use in mammo | emulsion side must always be against screen
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| how much is tube tilted in mammo machine? | 6 degrees
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| what is anode degree angle in mammo? | 23 degrees
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| how are images captured in computed radiography for mammo? | photostimulable storage phosphor
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| how are images captured in direct digital radiography | in amorphous selenium
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| how are images captures in indirect conversion system? | flat panel detectors involve the detection of light by a series of smaller photodiodes
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| 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
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| 2 reasons we don't want low energy x-rays | increased scatter (image contrast), increased patient dose
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| advantages of compression | red. mag, red. thickness, red. exposure, red. motion unsharpness, improved visualization, more uniform image receptor exposure
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| disadvantages of digital mammo? | cost, integration of equip, comparison of FSM images with digital images, large MB images
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| what does DMT stand for? | digital mammography tomosynthesis
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| what is DMT? | takes 11 different angles and computes into 3D image, uses less compression, 7 second exam
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| 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
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| types of detectors in digital mammography | phosphor flat panel, phosphor CCD, selenium flat panel, computed radiography
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| 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
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| what does MQSA stand for? | Mammography Quality Standards Act
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| when was MQSA enacted by FDA & ACR | 1992
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| what must be accredited according to MQSA | mammography machine, radiologists, tech, med physicists
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| what must be checked daily according to MQSA? | darkroom cleanliness, processor QC
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| what must be checked weekly according to MQSA? | screen cleanliness, view boxes and viewing conditions
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| what must be checked monthly according to MQSA? | visual checklist
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| what much be checked quarterly according to MQSA? | repeat analysis
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| soft tissue radiography requires special technique because of the low | subject contrast
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| breast tissue tends to be increasingly ___ in older women | fatty
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| dedicated mammo units should have automatic adjustable ___ device | compression
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