| Question 1: According to the ACR 2017 Computed Tomography Quality Control Manual, how often should CT protocols be reviewed for accredited scanners by a team that includes a supervising radiologist, qualified medical physicist, and the lead CT technologist? |
| Reference: | Chad Dillon, William Breeden III, Jessica Clements, Dianna Cody, Dustin Gress, Kalpana Kanal, James Kofler, Michael F. McNitt-Gray, James Norweck, Doug Pfeiffer, Thomas G. Ruckdeschel, Keith J. Strauss, James Tomlinson, Cynthia Davidson, Dina Hernandez. ACR 2017 Computed Tomography Quality Control Manual, page 58. |
| Choice A: | Sites must follow their established written procedures, but there is no maximum time between reviews |
| Choice B: | All protocols must be reviewed at least annually |
| Choice C: | All protocols much be reviewed within 36 months of the last review. |
| Choice D: | The frequency should meet local/state/federal regulations, with a frequency no less than 24 months if there is no specific regulatory requirement |
| Question 2: While manufacturers are not required to implement Integrating the Healthcare Enterprise (IHE) profiles, they often respond to repeated requests from their customers. Which IHE profile would allow centralized, cross-vendor review and approval of scanner protocols if implemented by manufacturers? |
| Reference: | Integrating the Healthcare Enterprise. Management of Acquisition Protocols. IHE Wiki, accessed 21 Apr 2021. https://wiki.ihe.net/index.php/Management_of_Acquisition_Protocols. |
| Choice A: | Management of Acquisition Protocols (MAP) |
| Choice B: | Scheduled Workflow (SWF) |
| Choice C: | Portable Data for Imaging (PDI) |
| Choice D: | Radiation Exposure Monitoring (REM) |
| Question 3: Which of the following parameters will have the largest impact on peak arterial enhancement of the descending aorta? |
| Reference: | Timothy Szczykutowicz. Chapter 8, The CT Handbook: Optimizing Protocols for Today's Feature-rich Scanners, Timothy Szczykutowicz. Medical Physics Publishing, Madison, WI. 2020. |
| Choice A: | Scan duration |
| Choice B: | Use of a saline flush |
| Choice C: | Contrast viscosity |
| Choice D: | Contrast concentration |
| Question 4: Which of the following will likely cause the largest difference in mean enhancement for a routine liver study over patient size? |
| Reference: | Bae, K. T. (2010). Intravenous contrast medium administration and scan timing at CT: considerations and approaches. Radiology, 256(1), 32-61.
https://pubs.rsna.org/doi/pdf/10.1148/radiol.10090908. |
| Choice A: | Different CT scanners used for small and large patients |
| Choice B: | Using bolus tracking for small patients and fixed delay for large patients |
| Choice C: | Using a weight-based contrast dosing scheme for small patients and a fixed volume for large patients |
| Choice D: | Size-adjusted kV |
| Question 5: What is a potential mode of malfunction for a cardiovascular implanted electronic device (CIED) that is directly exposed to x-rays during a CT scan? |
| Reference: | U.S. Food and Drug Administration. “Effects of X-ray irradiation from CT imaging on Pacemakers and Implantable Cardioverter Defibrillators (ICD) – Literature review”. Updated June 13, 2019. Accessed April 28, 2021. https://www.fda.gov/radiation-emitting-products/electromagnetic-compatibility-emc/effects-x-ray-irradiation-ct-imaging-pacemakers-and-implantable-cardioverter-defibrillators-icd. |
| Choice A: | Permanent device failure |
| Choice B: | Temporary oversensing and pacing inhibition during direct exposure |
| Choice C: | Inappropriately delivered defibrillation shocks |
| Choice D: | Oversensing and pacing inhibition for a short period following the CT scan |
| Question 6: True or False: motion of gas bubbles during the CT acquisition can cause hypointense curvilinear artifacts extending from the gastrointestinal tract. |
| Reference: | Reference: F Liu, C Cuevas, AA Moss, O Kolokythas, TJ Dubinsky, PE Kinahan. American Journal of Roentgenology. 2008; 190:294-299. https://www.ajronline.org/doi/full/10.2214/AJR.07.2702. |
| Choice A: | True |
| Choice B: | False |
