Medical Imaging Techniques Quiz

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Questions and Answers

What is the primary benefit of multi slice CT scanners?

  • They are smaller in size than traditional scanners.
  • They produce color images.
  • They allow for rapid collection of projection data. (correct)
  • They require less radiation than single slice scanners.

Cone beam CT (CBCT) increases the size of the scanner while decreasing radiation dosage.

False (B)

Who was the leader in the development of the first CT scanner introduced in 1971?

Sir Godfrey Hounsfield

CT scanners produce ___ dimensional images.

<p>three</p> Signup and view all the answers

Match the following components of a CT scanner with their functions:

<p>X-ray tube = Emits the x-ray beam X-ray detectors = Receives and measures x-ray exposure Gantry rotation = Supports and positions the x-ray components Projection data = Information collected from scanned areas</p> Signup and view all the answers

Which of the following imaging modalities is NOT commonly used in oncology?

<p>Microchip Imaging (A)</p> Signup and view all the answers

X-rays provide functional information about the body.

<p>False (B)</p> Signup and view all the answers

What is a common use of contrast agents in imaging?

<p>To make structures visible</p> Signup and view all the answers

The intensity of the emerging primary beam in X-ray imaging provides information about the interactions that have occurred within the _____ .

<p>body</p> Signup and view all the answers

Match the imaging modalities with their description:

<p>X-ray = Produces 2D images of body structures MRI = Uses magnetic fields to produce images Ultrasound = Uses sound waves for imaging CT = Provides cross-sectional images of the body</p> Signup and view all the answers

What is an important limitation of X-rays?

<p>Ability to show features in low contrast tissue (C)</p> Signup and view all the answers

Digital imaging has largely replaced film-based systems in medical imaging.

<p>True (A)</p> Signup and view all the answers

How does the atomic number of tissues affect X-ray imaging?

<p>It affects the amount of absorption of the X-rays.</p> Signup and view all the answers

What is the purpose of Image Guided Radiotherapy (IGRT)?

<p>To improve or verify the accuracy of radiotherapy (D)</p> Signup and view all the answers

Online treatment verification involves comparisons made after the treatment has been delivered.

<p>False (B)</p> Signup and view all the answers

What imaging technique allows direct visualization of the radiotherapy target volume?

<p>Cone Beam CT (CBCT)</p> Signup and view all the answers

The __________ compares images taken with reference images at a point after treatment has been delivered.

<p>offline treatment verification</p> Signup and view all the answers

Which of the following statements about DRR's is true?

<p>DRR's help ensure accurate targeting of the tumor. (D)</p> Signup and view all the answers

Match the imaging technique with its description:

<p>KV imaging = Uses kilovoltage x-rays for imaging MV imaging = Utilizes megavoltage x-rays for imaging during therapy IGRT = Image guidance aimed to improve treatment accuracy DRR = Reconstructed images from 3D datasets</p> Signup and view all the answers

Further treatment is never required after the initial radiotherapy session.

<p>False (B)</p> Signup and view all the answers

What is one purpose of follow-up in radiotherapy?

<p>To monitor tumor response</p> Signup and view all the answers

What type of x-ray beam is used in second and third generation CT scanners?

<p>Fan-shaped x-ray beam (A)</p> Signup and view all the answers

Fourth generation CT scanners have detectors that are movable.

<p>False (B)</p> Signup and view all the answers

What is the duration of a scan on a first generation CT scanner?

<p>25-30 mins</p> Signup and view all the answers

MRI uses a strong magnetic field and _____ pulses to produce images.

<p>radiofrequency (RF)</p> Signup and view all the answers

Match the following CT generations with their key characteristics:

<p>First Generation = Pencil-like x-ray beam, 25-30 mins scan Second Generation = Fan-shaped x-ray beam, less than 90 sec scan Third Generation = Fan-shaped x-ray beam, approximately 5 sec scan Fourth Generation = Fan-shaped x-ray beam, fixed detectors</p> Signup and view all the answers

Which of the following advantages does MRI have over CT?

<p>Offers better visualization of soft tissue (C)</p> Signup and view all the answers

Dual energy CT scanning is a feature of first generation CT technology.

<p>False (B)</p> Signup and view all the answers

What does T2 weighted MRI images reveal about cerebrospinal fluid (CSF)?

<p>CSF appears very bright</p> Signup and view all the answers

What is a significant characteristic that differentiates cancerous cells from healthy tissue?

<p>Higher glucose consumption (B)</p> Signup and view all the answers

PET imaging provides detailed anatomical information about the tissues.

<p>False (B)</p> Signup and view all the answers

What imaging technique has become the standard for localization in radiotherapy?

<p>CT</p> Signup and view all the answers

PET is often fused with ______ to enhance anatomical detail.

<p>CT or MRI</p> Signup and view all the answers

Match the imaging techniques with their primary uses:

<p>X-rays = Basic imaging for fractures MRI = Detailed soft tissue imaging Ultrasound = Real-time imaging of soft tissues Fluoroscopy = Dynamic imaging of moving structures</p> Signup and view all the answers

Which of the following modalities is known for its ability to reveal distant metastases?

<p>PET (C)</p> Signup and view all the answers

Volumetric data from CT scans are solely 2D images.

<p>False (B)</p> Signup and view all the answers

What kind of data is generated for physics planning in radiotherapy?

<p>Digitally Reconstructed Radiographs (DRRs)</p> Signup and view all the answers

What is one major advantage of using MRI for imaging?

<p>It provides excellent soft tissue delineation (D)</p> Signup and view all the answers

Patients with non-ferromagnetic metal implants can be scanned using MRI.

<p>True (A)</p> Signup and view all the answers

Name one disadvantage of ultrasound imaging.

<p>It can be subjective or difficult to interpret.</p> Signup and view all the answers

PET imaging utilizes _____ that are administered to patients to gather information about physiological function.

<p>radioactive isotopes</p> Signup and view all the answers

Match the imaging technique with its main characteristic:

<p>MRI = Excellent imaging for soft tissues Ultrasound = Uses high-frequency sound waves Radionuclide Imaging = Focuses on physiological functions PET = Uses radioactive glucose markers</p> Signup and view all the answers

What is a typical frequency range used in ultrasound imaging?

<p>1 to 20 MHz (B)</p> Signup and view all the answers

Contrast-enhanced MRI is ineffective for diagnosis and staging.

<p>False (B)</p> Signup and view all the answers

What is the most common radiopharmaceutical used in PET scans?

<p>18FDG (fluorodeoxyglucose)</p> Signup and view all the answers

MRI images can be fused with _____ data for better treatment planning.

<p>CT</p> Signup and view all the answers

What is one of the advantages of radionuclide imaging?

<p>It visualizes the physiological function of organs (D)</p> Signup and view all the answers

Flashcards

Computerized Tomography (CT)

A medical imaging technique that uses X-rays to create detailed cross-sectional images of the body.

How CT scanner works?

The CT scanner uses a rotating X-ray tube to create multiple images of the target area.

Evolution of CT scanners

CT scanners have evolved over time, with increases in the number of detectors and decreases in scan time.

Multi-slice CT

Multi-slice CT uses multiple detectors to collect data simultaneously, enabling faster scans and more efficient use of X-rays.

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Cone Beam CT (CBCT)

A compact and faster version of CT that uses a cone-shaped X-ray beam.

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What is medical imaging?

Medical imaging uses different techniques to visualize internal body structures, obtain images, provide structural or anatomical information, and sometimes functional information. It's mostly non-invasive and painless.

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What is an image?

An image is a representation of how a property is distributed within an object. It's created by transferring information from the object into an image using energy.

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What are X-rays?

X-rays are a type of electromagnetic radiation used in medical imaging. It travels in straight lines and is absorbed or scattered by matter, providing information about the body's internal structures.

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How does the amount of absorption of X-rays work?

The amount of X-rays absorbed by tissues depends on how dense they are. Dense tissues like bone absorb more X-rays.

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What are contrast agents?

Contrast agents like iodine or barium are used in X-ray imaging to make specific structures visible. These agents have different densities than surrounding tissues, improving contrast.

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What are the limitations of X-rays?

X-rays have limitations such as difficulty showing low-contrast tissues and providing only a 2D view, meaning depth perception is lacking.

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What is CT scan?

CT (Computed Tomography) scans use X-rays to create detailed 3D images of the body. It's like taking many X-ray slices and stacking them together to create a comprehensive view.

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What is an MRI scan?

MRI (Magnetic Resonance Imaging) uses magnetic fields to create detailed images of organs and soft tissues. It is used for diagnosis of many different conditions.

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First Generation CT Scanners

The first generation of CT scanners used a single detector and a pencil-like x-ray beam. It required a slow translat-rotate motion, resulting in scan times of approximately 25-30 minutes.

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Second Generation CT Scanners

Second-generation CT scanners improved upon their predecessors by utilizing multiple detectors (up to 30) and a fan-shaped x-ray beam. The translat-rotate motion remained, but scan times significantly decreased to less than 90 seconds.

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Third Generation CT Scanners

Third-generation CT scanners featured an array of detectors arranged in an arc, capturing data from a fan-shaped x-ray beam. The tube-detector system now rotated continuously, drastically reducing scan time to approximately 5 seconds.

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Fourth Generation CT Scanners

Fourth-generation CT scanners employ a fixed ring of over 2000 detectors, enabling the x-ray tube to rotate continuously while the detectors remain stationary. The scan time is further reduced to a few seconds, enhancing efficiency and accuracy.

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Helical CT

Helical CT, also known as spiral CT, is a technique that captures data continuously as the x-ray tube and detector system move along a helical path. This allows for faster and more efficient image acquisition.

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Dual-Energy CT (DECT)

Dual-energy CT (DECT) utilizes two different x-ray beams with distinct energy levels to capture information about tissue composition. This enables improved material differentiation and enhanced image quality.

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MRI

MRI utilizes a strong magnetic field and radiofrequency pulses to create images of hydrogen distribution within the body, providing detailed visualization of soft tissues.

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Advantages of MRI

MRI offers several advantages over other imaging modalities. It does not employ ionizing radiation, excels in visualizing soft tissues, and allows the use of contrast agents to highlight specific areas.

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What is MRI?

A medical imaging technique that uses strong magnetic fields and radio waves to create detailed images of organs and tissues.

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What are the applications of MRI?

MRI is used for diagnosis, localization, and follow-up of various medical conditions. It can also be used in planning radiotherapy treatments when combined with CT data.

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What are the limitations of MRI?

A disadvantage of MRI is that patients with metal implants in their bodies cannot be scanned, unless the implants are non-ferromagnetic, like titanium.

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What are the advantages of modern MRI?

In modern MRI, technologies allow us to plan directly from MRI scans. Algorithms can extract information and create images, reducing the need for separate CT scans.

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What is Ultrasound?

A medical imaging technique that uses high-frequency sound waves to create images of internal structures.

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What are the applications of Ultrasound?

Ultrasound is used to visualize internal structures, differentiate solid masses from fluid-filled cysts, and can also be used to guide biopsies.

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What are the advantages of Ultrasound?

Ultrasound is relatively cheap, safe as it doesn't use ionizing radiation, and provides real-time images.

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What are the disadvantages of Ultrasound?

Ultrasound examinations can be subjective, meaning interpretations can vary between operators, and sometimes the images can be difficult to interpret.

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What is Radionuclide Imaging?

A type of medical imaging that uses radioactive substances to visualize the function of organs and tissues.

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How does Radionuclide Imaging work?

In Radionuclide Imaging, a radioactive isotope is combined with a pharmaceutical, which then targets a specific biological function. The emitted gamma rays are detected by a gamma camera to create images.

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What is PET imaging?

A type of medical imaging that uses a radioactive tracer to detect and measure metabolic activity in the body. This allows doctors to see how organs are functioning and can help identify cancerous cells.

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Why is PET often combined with CT or MRI?

PET imaging is often combined with other imaging modalities, such as CT or MRI, to provide a more complete view of the body. This allows for more precise diagnosis and treatment planning.

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What are the advantages of combining PET and CT?

CT scans provide detailed anatomical information about the body, while PET scans show metabolic activity. Combining these two imaging modalities allows for more accurate localization of tumors and evaluation of their spread.

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What are the roles of CT and MRI in oncology?

CT and MRI are both used for diagnosis and treatment planning in oncology. CT focuses on accurate anatomical details, while MRI offers higher resolution detail and soft tissue contrast, making it well-suited for treatment planning.

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Why is CT used for radiotherapy localization?

CT is the standard imaging modality for radiotherapy planning. It provides detailed anatomical information for targeting tumors and helps identify sensitive structures. The data can be directly transferred to planning software, streamlining the process.

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What are Digitally Reconstructed Radiographs (DRRs)?

The process of generating virtual images of the patient from CT data, showing the target area from the perspective of the radiotherapy beam. This helps ensure the treatment is accurately directed.

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How are CT images used in radiation therapy setup?

CT simulation images are attached to the treatment sheet, and setup information is completed before radiation therapy begins. This helps ensure the patient is accurately positioned for treatment delivery.

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Can other imaging modalities be used with CT for radiotherapy planning?

CT is the standard for radiotherapy planning, but other modalities can be registered or fused with CT to enhance the planning process. This allows for a more comprehensive understanding of the patient's anatomy and helps improve treatment accuracy.

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Image-Guided Radiotherapy (IGRT)

A process of ensuring the accurate positioning of a patient for radiotherapy treatment, using various imaging techniques to verify and adjust the treatment plan.

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Treatment Verification

A process of comparing images taken before or during treatment with the reference images to ensure the accuracy of the treatment plan.

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Online Treatment Verification

A type of treatment verification that uses images taken immediately before treatment delivery, allowing for adjustments to be made in real-time.

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Offline Treatment Verification

A type of treatment verification that compares images taken after treatment delivery to the reference images, allowing for adjustments to be made before the next treatment session.

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KV Imaging

A type of imaging that uses X-rays to produce images of the patient's anatomy. commonly used for IGRT in radiotherapy.

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Follow-up

Periodic assessments after treatment to monitor the response of the tumour, evaluate the effectiveness of treatment, and determine if further treatment is required.

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Magnetic resonance imaging (MRI)

A powerful and versatile medical imaging technique using strong magnetic fields and radio waves to create detailed images of the body's internal structures, including organs and soft tissues. Often used for diagnosis and planning of various medical interventions, including radiotherapy.

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Study Notes

Imaging Principles/Imaging in Oncology

  • The lecture aims to explain the principles of different imaging techniques and their role in the oncology patient pathway.
  • The session will cover the understanding of the principles of different imaging techniques and the role of imaging in the oncology patient pathway.

Types of Imaging

  • Different imaging modalities are used in oncology, such as X-rays, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Ultrasound, and Radionuclide Imaging.
  • The images have specific applications, including X-rays used to demonstrate spatial relationships within the body, while CT scans produce 3-dimensional cross-sectional images in standard anatomical planes.
  • Images from various imaging modalities can be combined (fused) for comprehensive analysis.

X-rays

  • X-rays are created in an X-ray tube.
  • The X-ray beam travels in straight lines and interacts with body tissue, where they are either absorbed or scattered.
  • The intensity of the emerging beam contains information on tissue interactions.
  • This beam is detected by an image intensifier to produce an X-ray image.
  • The amount of absorption depends on the atomic number of the tissues and the energy of the X-rays.
  • Contrast agents like iodine or barium enhance visual clarity by having different absorption characteristics than surrounding tissue.
  • X-rays have limitations, including difficulty visualizing low contrast tissues and only providing a 2D image.

Computerised Tomography (CT)

  • CT uses X-rays to produce 3-dimensional images .
  • The images are cross-sectional in the 3 standard anatomical planes.
  • CT scanners can be categorized into different generations based on detectors and methodologies.
  • There are multi-slice CT scanners and cone beam CT.
  • CT scans have different image configurations to meet various imaging needs.

Magnetic Resonance Imaging (MRI)

  • MRI uses a strong magnetic field and radiofrequency pulses to create images of hydrogen distribution in the body.
  • It provides visualization of the body in slices, similar to CT.
  • MRI utilizes hydrogen atom properties and produces T1 or T2 weighted images for different tissue contrasts.
  • T1 weighted images show fat and white matter brighter than CSF. CSF shows brighter on T2 weighted images.
  • MRI has advantages like non-ionizing radiation and exceptional soft tissue visualization .
  • MRI has a disadvantage where patients with metallic implants cannot be scanned.

Ultrasound

  • Ultrasound uses high-frequency sound waves to create images of the internal body structures.
  • The frequency range of the waves is beyond human hearing.
  • Ultrasound can differentiate various tissues, like solid masses and fluid-filled cysts.
  • It's used in various applications, including breast cancer assessment, uterus, ovary, prostate, kidney scans.
  • Ultrasound is often used in combination with fine-needle biopsy.
  • Ultrasound image advantages are being relatively cheap, safe, and demonstrating real-time images.
  • Ultrasound image disadvantages are being subjective and difficult to interpret.

Radionuclide Imaging

  • Radionuclide imaging primarily focuses on the physiological function of organs and tissues.
  • It utilizes unsealed radiopharmaceuticals and isotopes to investigate and treat diseases.
  • Radiopharmaceuticals are coupled with a radionuclide, which spontaneously decays and emits energy.
  • This emission is detected to create an image.
  • Radiolabeled compounds are detected using a gamma camera that creates an image of the compound distribution and function.

Positron Emission Tomography (PET)

  • PET is focused on physiological function and uses positron emission from radioactive isotopes injected into the patient.
  • Radioactive markers are attached to glucose typically (e.g. 18FDG) to target cells that metabolize glucose rapidly.
  • PET itself lacks anatomical detail, usually paired with CT or MRI to provide full assessment.

CT and MRI Fusion

  • This method integrates data of both CT and MRI to offer a more comprehensive visualization of the body.

Role of Imaging in Oncology

  • Imaging plays a crucial role in the patient pathway, from diagnosis and staging to treatment planning and follow-up.
  • The patient's pathway includes diagnosis, CT planning, treatment planning, treatment verification, treatment delivery, and follow-up steps.

Radiotherapy Localisation

  • Localisation in radiotherapy aims to accurately target the tumour and avoid sensitive structures.

  • Imaging methods, such as CT planning scans and virtual simulations, are necessary to create treatment plans.

  • Other imaging data can be integrated with CT data for complete assessment.

  • Methods for verification include comparing images to reference images, digitally reconstructed radiographs (DRR), portal imaging (MV), and kV imaging.

  • Online and Offline imaging are used to verify imaging, including image-guided radiotherapy (IGRT), and cone-beam CT (CBCT).

Follow-up

  • Follow-up is essential to monitor tumour response and the outcome of treatment.
  • Monitoring for signs of disease recurrence, spread, or treatment effectiveness is vital.
  • Assessments are carried out to determine if the treatment was successful.
  • Follow up considers treatment curative status, disease extent, if further treatment is required, and possible metastatic disease symptoms.

Further Reading

  • NICE Pathways is an interactive toolkit for health professionals that provides access to NICE guidance and other resources.
  • There are available on target documents for Radiotherapy.

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