2016 AAPM Annual Meeting
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Session Title: Pediatric Image Quality Optimization
Question 1: Compared with adult patients, what are the challenges when performing cardiovascular MRI in pediatric patients?
Reference:Ntsinjana HN, Hughes ML, Taylor AM.The role of cardiovascular magnetic resonance in pediatric congenital heart disease. J Cardiovasc Magn Reson. 2011 Sep 21;13:51. doi: 10.1186/1532-429X-13-51.
Choice A:Higher spatial resolution due to small anatomic size.
Choice B:Higher temporal resolution due to fast heart rate.
Choice C:Parameter adjustments for optimal imaging contrast due to fast or irregular heart rate.
Choice D:Shorter breath-hold time.
Choice E:All of the above
Question 2: What can be done to mitigate the banding artifact in balanced steady-state free precession (bSSFP) images for younger patients when field-of-view (FOV) is small?
Reference:Kacere RD, Pereyra M, Nemeth MA et-al. Quantitative assessment of left ventricular function: steady-state free precession MR imaging with or without sensitivity encoding. Radiology. 2005;235 (3): 1031-5.
Choice A:Decrease imaging matrix.
Choice B:Increase bandwidth.
Choice C:Use shimming box to improve local field homogeneity.
Choice D:Minimize the interval between two RF pulses.
Choice E:All of the above.
Question 3: What techniques can be applied to mitigate cardiac motion in cardiac MRI?
Reference:Lanzer P, Barta C, Botvinick EH, et al. ECG-synchronized cardiac MR imaging: method and evaluation. Radiology 1985;155:681–686
Choice A:ECG synchronization.
Choice B:Shorten breath-hold time using parallel imaging.
Choice C:Real-time/single shot imaging with highly accelerated acquisition.
Choice D:A and C.
Choice E:A, B and C.
Question 4: Age is not a good surrogate for pediatric patient size. For example, pediatric head development is greatest up to 2 years of age where it begins to plateau, but there can still be an overlap between the largest 2-year-old head and the smallest 20-year-old head.
Reference:P. L. Kleinman, K. J. Strauss, D. Zurakowski, K. S. Buckley, and G. A. Taylor. Patient Size Measured on CT Images as a Function of Age at a Tertiary Care Children’s Hospital. American Journal of Roentgenology. 194(6): 1611-1619, 2010. DOI:10.2214/AJR.09.3771.
Choice A:True
Choice B:False
Question 5: What are Diagnostic Reference Ranges (DRRs) and how are they used clinically?
Reference:Diagnostic Reference Ranges for Pediatric Abdominal CT. Goske MJ1, Strauss KJ, Coombs LP, Mandel KE, Towbin AJ, Larson DB, Callahan MJ, Darge K, Podberesky DJ, Frush DP, Westra SJ, Prince JS. Radiology. 2013 Jul;268(1):208-18.
Choice A:DRRs take into account the scan range along the z-axis and they are used to monitor the scan length of the protocol for the different pediatric size categories.
Choice B:DRRs are a compilation of diagnostic reference levels (DRLs) used in the pediatric population that cover the range of patient sizes. They are used to compare pediatric and adult protocols.
Choice C:DRRs are optimized minimum and maximum CTDIvol values, below which diagnostic image quality is lost and above which excessive dose is delivered. They are used to balance dose and image quality in pediatric protocols.
Question 6: The ACR has revised the CT Accreditation Program Requirements to change the definition of a pediatric patient as:
Reference:ACR CT Accreditation Program Requirements. http://www.acraccreditation.org/~/media/Documents/CT/Requirements.pdf?la=en
Choice A:≤15 years old
Choice B:≥16 years old
Choice C:≤18 years old
Choice D:≤21 years old
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