| Question 1: The translational force on a ferromagnetic object is usually greatest at: |
| Reference: | The physics of MRI safety. Panych LP, Madore B, J Magn Reson Imaging. 2018 Jan;47(1):28-43 |
| Choice A: | Magnet isocenter where the magnetic field is highest and most uniform |
| Choice B: | Scanner 5 Gauss line, which is why access to this area must be tightly controlled |
| Choice C: | Entrance to the bore of magnet where spatial gradient of magnetic field is greatest |
| Choice D: | Point during imaging when the encoding gradients are turned on |
| Question 2: Which of the following is not an acceptable safety label for a device in the MR environment per ASTM Standard F2503? |
| Reference: | Standards for medical devices in MRI: present and future. Woods TO, J Magn Reson Imaging. 2007 Nov;26(5):1186-9. |
| Choice A: | MR Safe |
| Choice B: | MR Compatible |
| Choice C: | MR Unsafe |
| Choice D: | MR Conditional |
| Question 3: The vendor-provided MR conditions for SAR state: Maximum whole-body averaged specific absorption rate (SAR) of 2-W/kg for 15 minutes of scanning.
To comply with these MR conditions: |
| Reference: | Standards for medical devices in MRI: present and future. Woods TO, J Magn Reson Imaging. 2007 Nov;26(5):1186-9. |
| Choice A: | the patient may be scanned for 7.5 minutes at 4-W/kg |
| Choice B: | the patient exam must be limited to 15 minutes |
| Choice C: | each series should be limited to 15 minutes |
| Choice D: | First Level Operating Mode is in effect |
| Question 4: The primary safety concern regarding the long metallic guidewires, such as those made of Nitinol, used in image-guided vascular procedures is: |
| Reference: | MR-Guided Intravascular Interventions: Technique and Applications. Bock M & Whacker FK, JMRI 2008. |
| Choice A: | increased torque during rapid imaging |
| Choice B: | artifacts obscuring crucial anatomy |
| Choice C: | excessive heating during imaging |
| Choice D: | there are no safety issues with Nitinol in the MR environment |
| Question 5: Safety concerns during MR-guided interventional and intraoperative procedures performed under anesthesia include: |
| Reference: | ACR Guidance Document on MR Safe Practices: 2013. Kanal et. al. Journal of
Magnetic Resonance Imaging 37:501-530 (2013) |
| Choice A: | inability for patients to report sensations or pain in the MR environment |
| Choice B: | ability to rapidly remove the patient from Zone IV in case of an emergency |
| Choice C: | proper set up of patient, RF coils and conductors needed to monitor the patient |
| Choice D: | all of the above |
| Question 6: The use of MR Unsafe devices in the interventional MRI suite is: |
| Reference: | Intraoperative and interventional MRI: Recommendations for a safe environment, Kettenbach J, et al, Minimally Invasive Therapy 2006 |
| Choice A: | always prohibited |
| Choice B: | acceptable if the nurse indicates it is needed |
| Choice C: | manageable through policy, procedure & testing |
| Choice D: | a reduced concern in multi-room suites |
| Choice E: | a & b only |
| Choice F: | c & d only |
| Question 7: Level 2 personnel have which of the following tasks in an MRI environment? |
| Reference: | ACR Guidance Document on MR Safe Practices: 2013. Kanal et. al. Journal of
Magnetic Resonance Imaging 37:501-530 (2013) |
| Choice A: | MR safety screening |
| Choice B: | Ensuring safety of non-MR personnel in Zones III and IV |
| Choice C: | Restricting access to Zone IV |
| Choice D: | All of the above |
| Question 8: A physician wants to deliver magnetic resonance guided radiation therapy on a 0.35T MR-linac to a pancreatic cancer patient. As the Level 2 MRI personnel, you found that the MR Safety Screening has discovered that the patient has a Class II implant of a deep brain stimulator. What is the best next step for you to take? |
| Reference: | ACR Guidance Document on MR Safe Practices: 2013. Kanal et. al. Journal of Magnetic Resonance Imaging 37:501-530 (2013) |
| Choice A: | Treat the patient because the implant is far from the cancer treatment site |
| Choice B: | Do not treat the patient |
| Choice C: | Determine the implant make and model |
| Choice D: | Convert the results from 1.5T testing conditions over to 0.35T and treat the patient |
| Question 9: On ultra-high field scanners, the upper limit for the 10g average specific absorption rate (SAR) for scanning the knee in First Level Controlled mode is: |
| Reference: | SAR Simulations & Safety. Fiedler TM, Ladd ME, Bitz AK. Neuroimage. 2018;168:33-58 |
| Choice A: | 2 W/kg |
| Choice B: | 4 W/kg |
| Choice C: | 10 W/kg |
| Choice D: | 40 W/kg |
| Question 10: Compared to lower fields (≤ 3T), vestibular activation at ultra-high fields is more severe due to: |
| Reference: | Vestibular stimulation by magnetic fields. Ward BK et al. Ann N Y Acad Sci. 2015; 1343(1): 69-79 |
| Choice A: | subject movement through the larger magnetic field gradients when entering the magnet |
| Choice B: | subject exposure to the large static B0 field when stationary at isocenter |
| Choice C: | increased voltages induced in the inner ear via the Faraday effect |
| Choice D: | A and C only |
| Choice E: | B and C only |
| Choice F: | A and B only |
