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. |