| Question 1: The Radiography and Fluoroscopy Subcommittee reports to the Committee on Imaging Physics, which falls under the purview of which AAPM Standing Committee? |
| Reference: | AAPM Rules 3.10.2 (https://peat.aapm.org/govdocs/rules.php, retrieved 5.6.2022) |
| Choice A: | Executive Committee |
| Choice B: | Administrative Council |
| Choice C: | Membership Committee |
| Choice D: | Science Council |
| Choice E: | Professional Council |
| Question 2: Often, interventional imaging equipment (IXE) is calibrated with 18 to 20 cm of water equivalent material in setting up the system response to incoming radiation. In the AAPM TG 125, 190 and 272 reports, the use of PMMA is strongly suggested. What is the primary reason for this suggestion? Select one correct answer. |
| Reference: | Lin et al., “Functionality and Operation of Fluoroscopic Automatic Brightness Control/Automatic Dose Rate Control Logic in Modern Cardiovascular and Interventional Angiography Systems”, AAPM Report No. 125 (2012). |
| Choice A: | Aluminum is too cumbersome to handle in simulating a large patient |
| Choice B: | Copper is too heavy to carry around for testing |
| Choice C: | Aluminum and copper cause the fluoroscopy operation logic to jump back-and-force resulting in unstable reading of air kerma rate |
| Choice D: | PMMA simulates water closely although it is heavy and cumbersome to handle |
| Choice E: | All of the above |
| Question 3: Which of the following is true regarding the Interventional Reference Point (IRP) or Patient Exposure Reference Point (PERP). |
| Reference: | International Electrotechnical Commission. IEC 60601-2-43:2010+AMD1:2017+AMD2:2019 CSV, Consolidated Version. Medical electrical equipment – Part 2–43: particular requirements for the basic safety and essential performance of X-ray equipment for interventional. |
| Choice A: | It was defined by DICOM |
| Choice B: | It was defined by IEC |
| Choice C: | It was defined by AAPM in 2018 |
| Choice D: | None of the above |
| Question 4: For a typical bi-plane angiography system, the geometrical coordinate system is defined in conformance with DICOM and/or IEC. Which statement(s) is/are correct? |
| Reference: | Digital Imaging and Communications in Medicine. PS 3.3-2003: Part 3: Information Object Definitions. C.8.7.4.1: X-ray table attribute description. National Electrical Manufacturers Association; 2003. |
| Choice A: | Frontal plane and lateral plane are employing the same coordinate system. Therefore, there is just one Cartesian coordinate employed. |
| Choice B: | As seen from the lateral plane, the frontal plane is rotated in 90-degrees with the Z-axis being the rotation axis, in the counter clockwise direction. This is due to the fact, these two imaging planes are orthogonal in design. |
| Choice C: | The Y-axis is along the vertical line with -Y direction of Y-axis pointing to the X-ray tube. |
| Choice D: | The expressions such as RAO and LAO are based on the frontal plane only, because the lateral plane is often not mechanical possible to provide such an angulation. |
| Choice E: | The isocenter (X,Y,Z) = (0,0,0) is defined in Cartesian coordinate corresponding to the frontal plane only and is mechanically fixed to the frontal plane. |
| Question 5: The increase in AKR during fluoroscopy ________________ for small pediatric patients when the thickness of the PMMA phantom is increased by 5 cm. |
| Reference: | Mahmood et al., “Survey of Pediatric Fluoroscopic Air Kerma Rate Values and Recommended Application of Results”, AAPM Report No. 251 (2022). |
| Choice A: | Increases by 30% |
| Choice B: | Increases by 70% |
| Choice C: | Doubles |
| Choice D: | Triples |
| Choice E: | Quadruples |
| Question 6: The increase in AKR during fluoroscopy ________________ for medium adult sized patients when the thickness of the PMMA phantom is increased by 5 cm. |
| Reference: | Mahmood et al., “Survey of Pediatric Fluoroscopic Air Kerma Rate Values and Recommended Application of Results”, AAPM Report No. 251 (2022). |
| Choice A: | Increases by 30% |
| Choice B: | Increases by 70% |
| Choice C: | Doubles |
| Choice D: | Triples |
| Choice E: | Quadruples |
| Question 7: With respect to reconfiguration of fluoroscopic imaging equipment for improved pediatric imaging: |
| Reference: | Strauss KJ. Advancing safety: role of equipment design and configuration change in pediatric fluoroscopy. Health Phys. 2019 116(2):256-262. |
| Choice A: | The vendor must first obtain 510(k) approval of the FDA for changes requested by end users. |
| Choice B: | The need only applies to dedicated pediatric hospitals. |
| Choice C: | This is not needed due to configurations that have already been developed by the manufacturers. |
| Choice D: | IGA and MITA have collaborated to identify possible improvements for future imaging equipment brought to market by the manufacturers. |
| Choice E: | e. Most vendors welcome the opportunity to work with customers to reconfigure their equipment. |
| Question 8: The reference point for which the reference air kerma value is given in a C-arm fluoroscopic unit is defined by which of the following: |
| Reference: | Andersson, J., D.R. Bednarek, W. Bolch, T. Boltz, H. Bosmans, A.J. Gislason-Lee, C. Granberg, M. Hellstrom, K. Kanal, E. McDonagh, R. Paden, W. Pavlicek, Y. Khodadadegan, A. Torresin, A. Trianni, and D. Zamora, Estimation of patient skin dose in fluoroscopy: summary of a joint report by AAPM TG357 and EFOMP. Med Phys, 2021. 48(7): p. e671-e696. |
| Choice A: | 15 cm from isocenter toward the x-ray source along the beam axis |
| Choice B: | 15 cm from the x-ray source toward the isocenter along the beam axis |
| Choice C: | 20 cm from isocenter toward the x-ray source along the beam axis |
| Choice D: | 20 cm from the x-ray source toward the isocenter along the beam axis |
| Question 9: Which of the following parameters is not presently available in the Radiation Dose Structured Report (RDSR) for skin dose mapping in fluoroscopy? |
| Reference: | Andersson, J., D.R. Bednarek, W. Bolch, T. Boltz, H. Bosmans, A.J. Gislason-Lee, C. Granberg, M. Hellstrom, K. Kanal, E. McDonagh, R. Paden, W. Pavlicek, Y. Khodadadegan, A. Torresin, A. Trianni, and D. Zamora, Estimation of patient skin dose in fluoroscopy: summary of a joint report by AAPM TG357 and EFOMP. Med Phys, 2021. 48(7): p. e671-e696. |
| Choice A: | Distance from x-ray source to image receptor (SID) |
| Choice B: | Air kerma at the reference point |
| Choice C: | Positioner primary and secondary angles |
| Choice D: | Patient position relative to the table top |
| Question 10: What is the approximate uncertainty in the x-ray backscatter factor to soft tissue which is immediately above regions of cortical bone (such as the skin overlaying the cranium)? |
| Reference: | Andersson, J., D.R. Bednarek, W. Bolch, T. Boltz, H. Bosmans, A.J. Gislason-Lee, C. Granberg, M. Hellstrom, K. Kanal, E. McDonagh, R. Paden, W. Pavlicek, Y. Khodadadegan, A. Torresin, A. Trianni, and D. Zamora, Estimation of patient skin dose in fluoroscopy: summary of a joint report by AAPM TG357 and EFOMP. Med Phys, 2021. 48(7): p. e671-e696. |
| Choice A: | No uncertainty |
| Choice B: | Below 2% |
| Choice C: | Up to 15% |
| Choice D: | Up to 150% |
