| Question 1: Scan time in CT can be computed by which of the following equations?" |
| Reference: | “Computed Tomography Principles, Design, Artifacts, and Recent Advances ” by Jiang Hsieh |
| Choice A: | Dividing DLP by CTDIvol and dividing by the scanner pitch. |
| Choice B: | Dividing CTDIvol by DLP and dividing by the scanner pitch*collimation/rotation time. |
| Choice C: | Dividing DLP by CTDIvol and dividing by the scanner pitch*collimation/rotation time. |
| Choice D: | Dividing DLP by CTDIvol and dividing by pitch*collimation*rotation time. |
| Question 2: The Joint Commission requires which of the following aspects of a CT protocol to be addressed in CT protocol documentation: |
| Reference: | Joint Commission Diagnostic imaging standard Element of Performance PC.01.03.01 |
| Choice A: | The protocol specifies what indication, contrast administration details, age (i.e. pediatric or adult), patient size, and expected dose index range. |
| Choice B: | The Joint Commission does not specify what facets of a CT protocol are required to be addressed. |
| Choice C: | The protocol specifies the imaging site (i.e. body region), the patient positioning, and the correct imaging parameters (i.e. pitch, rotation time, beam collimation, etc.). |
| Choice D: | The protocol must adhere to ACR generated appropriateness criteria. |
| Question 3: Adjusting scan parameters including scanner speed and inter phase/series time delays is most important to ensure: |
| Reference: | chapter 2 of “MDCT From Protocols to Practice” Springer 2008 |
| Choice A: | Proper x-ray tube cooling. |
| Choice B: | The patient is not startled by a fast moving CT couch. |
| Choice C: | The contrast dynamics are at the optimal state for each phase/series. |
| Choice D: | All patients receive the same inter-scan delay independent of scan length on all scanners. |
| Question 4: Which of the following two types of x-ray interaction are the basis for dual-energy CT? |
| Reference: | R. E. Alvarez and A. Macovski (1976). "Energy-selective Reconstructions in X-ray Computed Tomography." Phys. Med. Biol. 21(5): 733-744. |
| Choice A: | Photoelectric and pair production. |
| Choice B: | Compton effect and Rayleigh scattering. |
| Choice C: | Compton effect and Photoelectric. |
| Choice D: | Photoelectric and Rayleigh scattering. |
| Question 5: What is the clinical benefit of the virtual non-contrast application of dual-energy CT? |
| Reference: | C. H. McCollough, S. Leng, L. Yu, J. G. Fletcher (2015). "Dual- and Multi-Energy CT: Principles, Technical Approaches, and Clinical Applications." Radiology 276(3): 637-653. |
| Choice A: | Improve image quality of the unenhanced scan. |
| Choice B: | Improve image quality of the contrast-enhanced scan. |
| Choice C: | Reduce radiation dose by half. |
| Choice D: | May provide valuable information when the un-enhanced scan was not performed. |
| Question 6: Which of the following parameter has the most impact on the iodine contrast enhancement in the virtual monochromatic images generated from dual-energy CT? |
| Reference: | L. Yu, S. Leng, C. H. McCollough (2012). "Dual-Energy CT-Based Monochromatic Imaging." American Journal of Roentgenology 199(5): S9-S15. |
| Choice A: | Monochromatic energy. |
| Choice B: | Spectra separation between low and high energy beams. |
| Choice C: | Radiation Dose distribution between low and high energy beams. |
| Choice D: | Total radiation dose. |
| Question 7: The estimated lifetime risk of death from cancer attributable to a single abdominal CT scan of a newborn is: |
| Reference: | • Brenner and Hall (2007). Computed tomography – an increasing source of radiation exposure. N Engl J Med. Fig 3. |
| Choice A: | 14% |
| Choice B: | 1.4% |
| Choice C: | 0.14% |
| Choice D: | 0.014% |
| Question 8: Based on radiation sensitivity and the high usage of the exam, it is best to first develop and optimize pediatric protocols that image the: |
| Reference: | • UNSCEAR, 2013. Sources, Effects and Risks of Ionizing Radiation. UNSCEAR Report 2013 to the General Assembly with Scientific Annexes. Volume II, Scientific Annex B: Effects of Radiation Exposure of Children. E.14.IX.2. United Nations, New York. |
| Choice A: | Brain. |
| Choice B: | Chest. |
| Choice C: | Abdomen. |
| Choice D: | Pelvis. |
| Question 9: When reviewing CT dose for a recently developed protocol, it is best to evaluate: |
| Reference: | • Strauss K.J., Goske M.J., Towbin A.J., Sengupta D., Callahan M.J., Darge K., Podberesky D.J., Frush D.P., Maxfield C., Westra S.J., Prince J.S., Wu H., Bhargavan-Chatfield M. Pediatric Chest CT Diagnostic Reference Ranges: Development and Application. Radiology. 2017 (epub ahead of print).
• Goske M.J., Strauss K.J., Coombs L.P., Mandel K.E., Towbin A.J., Larson D.B., Callahan M.J., Darge K., Podberesky D.J., Frush DP, Westra S.J., Prince J.S. Diagnostic Reference Ranges for Pediatric Abdominal CT. Radiology. 2013;268(1):1010-1017.
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| Choice A: | AD. |
| Choice B: | DRR. |
| Choice C: | DRL. |
| Question 10: The Joint Commission requires facilities to match protocols across scanners based on what metric? |
| Reference: | The Joint Commission. Diagnostic Imaging Requirements. August 10, 2015 |
| Choice A: | Image or quantum noise. |
| Choice B: | Computed tomography dose index. |
| Choice C: | Low contrast detectability. |
| Choice D: | No requirement to match protocols. |
