2022 AAPM 64th Annual Meeting
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Session Title: Cardiac Imaging
Question 1: Which imaging modality allows the best visualization of flow in the heart and great vessels?
Reference:Peter D. Gatehouse, Jennifer Keegan, Lindsey A. Crowe, Sharmeen Masood, Raad H. Mohiaddin, Karl-Friedrich Kreitner & David N. Firmin. Applications of phase-contrast flow and velocity imaging in cardiovascular MRI. European Radiology. Volume 15, (2005)
Choice A:Cardiac CT
Choice B:Cardiac MRI
Choice C:Nuclear medicine SPECT
Choice D:All have equal ability to visualize flow
Question 2: What is a relative strength of cardiac CT as compared to cardiac MRI for the evaluation of pericardial disease?
Reference:Zhen J. Wang, Gautham P. Reddy, Michael B. Gotway, Benjamin M. Yeh, Steven W. Hetts, Charles B. Higgins. CT and MR Imaging of Pericardial Disease. Radiographics. Vol. 23, No. suppl 1 (2003).
Choice A:Ability of CT to quantify flow
Choice B:Ability of CT to visualize calcium
Choice C:Lack of cardiac motion evaluation using MRI
Choice D:Lack of visualization of fibrous tissue using MRI
Question 3: Which imaging modality allows the best direct visualization of the coronary arteries?
Reference:Mangla A, Oliveros E, Williams KA Sr, et al. Cardiac imaging in the diagnosis of coronary artery disease. Curr Probl Cardiol. 2017 Oct. 42 (10):316-66.
Choice A:Cardiac CT
Choice B:Cardiac MRI
Choice C:Nuclear medicine SPECT
Choice D:All have equal ability to visualize the coronary arteries
Question 4: What is an advantage of Rb-82 labelled radiotracer in cardiac PET imaging, compared to N-13 labelled radiotracer?
Reference:Ran Klein, PhD, Emel Celiker-Guler, MD, Benjamin H. Rotstein, PhD, and Robert A. deKemp, PhD. PET and SPECT Tracers for Myocardial Perfusion Imaging. Semin Nucl Med. 2020; 50(3):208-218.
Choice A:It has superior spatial resolution
Choice B:It does not require the access to on-site cyclotron
Choice C:It supports myocardial blood flow quantification with higher accuracy and reliability
Choice D:It makes exercise stress imaging protocols easier to perform
Question 5: For rest-stress myocardial perfusion imaging, Tc-99m SPECT may be preferred to Rb-82 or N-13 PET when:
Reference:Singh, V., Di Carli, M.F. SPECT Versus PET Myocardial Perfusion Imaging in Patients with Equivocal CT. Curr Cardiol Rep 22, 43 (2020).
Choice A:High spatial resolution is desired
Choice B:Myocardial blood quantification is needed
Choice C:Pharmacologic stress is contraindicated
Choice D:Radiation dose to patient needs to be kept low
Question 6: A main clinical value of myocardial blood flow quantification to myocardial perfusion imaging is:
Reference:Dilsizian V, Bacharach SL, Beanlands RS, Bergmann SR, Delbeke D, Dorbala S, Gropler RJ, Knuuti J, Schelbert HR, Travin MI. ASNC imaging guidelines/SNMMI procedure standard for positron emission tomography (PET) nuclear cardiology procedures. J Nucl Cardiol. 2016 Oct;23(5):1187-1226.
Choice A:Improved identification of multi-vessel coronary artery disease (CAD)
Choice B:Improved identification of single-vessel coronary artery disease (CAD)
Choice C:Improved assessment of myocardial viability
Choice D:Improved evaluation of cardiac function
Question 7: Which of the following techniques can be used in cardiac CT to improve temporal resolution?
Reference:Eugene Lin, and Adam Alessio. What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT? Journal of Cardiovascular Computed Tomography (2009) 3, 403–408. https://doi.org/10.1016/j.jcct.2009.07.003
Choice A:Short (partial) scan reconstruction
Choice B:Fast rotation time
Choice C:Dual source CT technology
Choice D:Multisegment reconstruction
Choice E:All of above
Question 8: Which of the following statement regarding prospective and retrospective ECG gating is correct?
Reference:JR. Mayo and JA Leipsic. Radiation Dose in Cardiac CT. American Journal of Roentgenology. 2009;192: 646-653. 10.2214/AJR.08.2066
Choice A:Prospective gating has more flexibility than retrospective gating
Choice B:Retrospective gating can only be performed with a wide area detector
Choice C:In general, prospective gating has lower radiation dose than retrospective gating
Choice D:ECG pulsing is a dose reduction technique that can only be used in prospective gating
Question 9: The MRI pulse sequence commonly used in cardiac MRI to evaluate global left ventricular function is:
Reference:Cardiac MR physics for clinicians: parts I and II, JCMR 2010, Nov 30:12(1):71.
Choice A:Inversion-recovery prepared fast gradient echo
Choice B:Saturation-recovery prepared fast gradient echo
Choice C:Turbo spin echo
Choice D:Balanced steady-state free precession
Choice E:Phase contrast magnetic resonance imaging
Question 10: Myocardial spin-spin relaxation time (T2) can be used to evaluate:
Reference:Ismail et al. Cardiac MR: From Theory to Practice. Front Cardiovasc Med. 2022 Mar 3;9:826283
Choice A:Myocardial fibrosis
Choice B:Myocardial fiber orientation
Choice C:Myocardial fat content
Choice D:Myocardial inflammation
Choice E:Myocardial blood flow
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