2018 AAPM Annual Meeting
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Session Title: In Memoriam of James G. Kereiakes: Designing Pediatric Imaging to Achieve the Best Benefit/Risk for Our Patients
Question 1: One reason that evidence of long-term radiation-induced stochastic effects in medically exposed human children is difficult to demonstrate in epidemiologic studies is:
Reference:Wagner, L.K. If it is published in the peer-reviewed literature, it must be true? Pediatr Radiol. 44(3):468-74, 2014.
Choice A:Stochastic radiation effects probably have a threshold.
Choice B:Doses are too low to cause effects on macromolecules like DNA.
Choice C:Children are more resilient to radiation than are adults.
Choice D:Medically exposed children are inevitably less healthy than unexposed children.
Choice E:Radiations from diagnostic medicine have low linear energy transfer (low LET).
Question 2: AHARA differs from ALARA in that AHARA:
Reference:Wagner, L. K. Toward a holistic approach in the presentation of benefits and risks of medical radiation. Health Physics, 101 566-571, 2011.
Choice A:Exaggerates the benefits of medical radiation.
Choice B:Requires an examination of both benefit and risk.
Choice C:Is benefit/risk whereas ALARA is risk/benefit.
Choice D:Requires the best image quality at all times.
Choice E:Ignores the risk of radiation.
Question 3: When optimizing image quality, which metric best quantifies the effect of iterative reconstruction on image noise?
Reference:Andersen HK et al. European Journal of Radiology Open (2018) 5: 35-40
Choice A:Noise power spectrum (NPS).
Choice B:Modulation Transfer Function (MTF).
Choice C:Contrast to Noise Ratio (CNR).
Choice D:Signal to Noise Ratio (SNR).
Question 4: What is the most important factor to consider when optimizing scan start time for IV contrast injections?
Reference:Bae KT; Radiology (2010) 256(1):32–61
Choice A:Injection rate.
Choice B:Arrival time (Tarr).
Choice C:Injection delay (ID).
Choice D:Scan duration (Tscan).
Question 5: Organ dose modulation (ODM) has been shown to decrease anterior organ dose by:
Reference:Lungren, et al, AJR (2012) 199:W65–W73
Choice A:10-15%
Choice B:15-20%
Choice C:20-25%
Choice D:25-30%
Question 6: In the context of pediatric SPECT imaging, which of the following can potentially lead to both improved image quality and lower radiation dose?
Reference:Fahey F. et al. Physical Aspect of Pediatric Nuclear Medicine in Pediatric Nuclear Medicine and Molecular Imaging, S.T. Treves ed., Springer, 2014.
Choice A:High sensitivity collimation.
Choice B:Iterative tomographic reconstruction.
Choice C:Long imaging times.
Choice D:High administered activity.
Question 7: Which of the following leads to dose optimization of the CT component of pediatric PET/CT?
Reference:Fahey FH et al. Operational and Dosimetric Aspects of Pediatric PET/CT. J Nucl Med. 2017;58:1360-1366.
Choice A:Acquiring a diagnostic quality CT scan over the length of the PET component.
Choice B:Acquiring the CT component with the lowest dose possible.
Choice C:Standardizing the acquisition parameters for all pediatric acquisitions.
Choice D:Using automatic exposure control/tube current modulation.
Question 8: Which of the following create imaging challenges during pediatric fluoroscopy that are less likely during imaging of adults?
Reference:Strauss KJ. Pediatric interventional radiography equipment: safety considerations. Pediatr Radiol (2006) 36 (Suppl2): 126-35
Choice A:Larger range of size of patients.
Choice B:Smaller anatomy of some patients.
Choice C:Increased involuntary motion of some patients.
Choice D:All of the above.
Question 9: With respect to the size (abdominal thickness) of pediatric patients:
Reference:Kleinman PL, et. al. Patient size measured on CT Images as a function of age at a tertiary care children’s hospital. AJR 2010 194: 1611-19.
Choice A:Age of the patient is a good descriptor of the size of pediatric patients.
Choice B:New born pediatric patients typically have abdomens 9 - 10 cm thick.
Choice C:The largest 9 year-old is typically the same size as the smallest 18 year old.
Choice D:Patients > 200 pounds cannot be considered a pediatric patient.
Question 10: The Aufrichtig Principle calculates the __________ in the dose per pulse at the __________ as the pulse rate is decreased during fluoroscopy:
Reference:Aufrictig R, et. al. Perceptual comparison of pulsed and continuous fluoroscopy. Med Phys 1994 21(2): pp 246 – 56.
Choice A:Increase, entrance plane of patient.
Choice B:Decrease, entrance plane of patient.
Choice C:Increase, entrance plane of image receptor.
Choice D:Decrease, entrance plane image receptor.
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