Download X-ray fluoroscopy imaging in the invasive cardiac laboratory

X-ray fluoroscopy imaging in the invasive cardiac laboratory: Medical physics
support of a contemporary practice
1. Introduction to the invasive cardiac invasive laboratory
a. Procedure types
b. Imaging equipment
c. X-ray imaging tasks
2. Interventional x-ray systems
a. Hardware components
b. System control
c. Radiation dose monitoring
3. System performance testing
a. Resolution
b. Beam quality
c. Contrast to noise ratio
d. Patient air-kerma rate
4. Patient radiation dose reduction
a. Patient dose monitoring
b. Spectral filtration
c. Detector target dose
d. Frame rate
e. Low, normal, and high dose rate fluoroscopy
f. Patient size and projection angle
g. Custom programs for pediatric patients
5. New and emerging technologies
a. Cone-beam CT
b. 4D Ultrasound
c. RF mapping and navigation
d. Integration of imaging modalities
6. References
Questions: (As submitted to AAPM Spring Clinical Meeting)
Which statement is true regarding the relationship between decreasing field of view and
increased patient dose rate for flat panel fluoroscopy systems?
a) The size of the output phosphor is constant.
b) Decreasing minifaction gain requires increase tube output.
c) Detector target dose remains constant for all FOV.
d) As the FOV gets smaller, local photon density increases.
e) Use of secondary collimators results in increased patient dose.
What is the legal maximum cine or acquisition mode air-kerma rate?
a) There is not a legal maximum
b) 88 mGy/min
c) 176 mGy/min
d) 880 mGy/min
e) 2,000 mGy/min
What is the effect of adding 0.1 mm Cu filter on half-value layer (mm AL)?
a) Decreases HVL by 35% to 45%
b) Decreases HVL by 15% to 25%
c) No change
d) Increases HVL by 15% to 25%
e) Increases HVL by 35% to 45%
What is the approximate radiation dose rate reduction associated with removing the antiscatter grid during pediatric imaging?
a) No change
b) 15%
c) 35%
d) 55%
e) 75%
Which statement regarding the relationship between FDA air-kerma rate (KFDA-min ) and
patient skin entrance air-kerma rate at the reference point (Ka,r-min ) during fluoroscopy is
correct?
a) Ka,r-min is always less than KFDA-min.
b) Ka,r-min is always the same as KFDA-min.
c) Ka,r-min is always greater than KFDA-min.
d) Ka,r-min may be 2x greater than KFDA-min.