Final

Enterprise Imaging

Allows healthcare members to log on to one account and have access to any image, not just radiology; merged into the EMR

Health Level Seven Standard (HL₇)

Manages non-imaging data and provides protocols for exchange, management and integration of clinical and administrative electronic health data

What are advantages of data health monitoring?

• Shift from reactive to proactive monitoring reducing the number of issues

• Improve the performance of your database and application

• Analyze logs and use this knowledge to improve performance

What are cybersecurity issues?

• Computer virus

• Ransomware

• Theft and publication of patient data

What law/right does theft and publication of patient data violate?

HIPAA

Wide Area Network (WAN)

Extends to other businesses or locations that may be at great distances; allows different LANs to communicate

What assigns the accession number to the patient?

Radiology Information System (RIS)

What assigns the MRN to the patient?

Hospital/Health Information System (HIS)

What are benefits of EMR/EHR?

• Streamlines clinicians workflow

• Support other care-related activities

• Strengthen the relationship between patients and clinicians

What are the 3 types of network protocols?

• Communication

• Management

• Security

Every computer within a network has a unique _______________ (ex. 172.811.3.1)

IP address

Network Interface Card (NIC)

Hardware component used to connect a computer with another computer onto a network

PACS (MIMPS)

Makes radiographs, CT scans, MRI scans, US and Nuc Med images for a particular patient available within the network

What are the components of PACS (MIMPS)?

• Image acquisition

• Display workstations

• Archive servers

What is the first point of entry into PACS (MIMPS)?

Image Acquisition

Navigation Functions

Customizable worklists dependent on technologists’ selections during a procedure (ex. verbal reports, image check)

Study Navigation

Allows images to be viewed individually or in a cine run

Magnify

Image manipulation & enhancement used to make things bigger

Archive Servers

Fastest growing component of PACS (MIMPS)

What does archive servers consist of?

• Image manager

• Image storage

Image Manager

Contains master database of everything in the archive; controls the receipt, retrieval and distribution of the images it stores

What does VNA stand for?

Vendor Neutral Archives

What is the main function of PACS (MIMPS)?

Act as a database

What dept. works with DICOM?

Dept. of Defense

DICOM

Different modalities can now share data with one another or a central server

What is included in the DICOM header?

• Date/time of procedure

• # of images taken

• Body part & position

• Technique used

• Image format & receptor size

• Parameters used to digitally process the image

All information in the DICOM header is stored as ____________.

Metadata

What is the benefit of the DICOM access work order (worklist)?

• Reduces human error

• Reduces time

Volume Rendering Technique (VRT)

Shaded Surface Display (SSD)

Creates a 3D, moveable image based on the pixel intensity of choice

What modality uses CAD?

Mammography

What is the circled part?

Image markup

Network Attached Storage (NAS)

Users on a local area network (LAN) access the shared storage via an ethernet cord

Storage Area Network (SAN)

A dedicated, independent high-speed network that interconnects and delivers shared pools of storage devices to multiple servers

Direct Attached Storage (DAS)

Dedicated server or storage device that is not connected to a network (ex. laptop, phone)

Which RAID level is the most common used for a PACS (MIMPS) archive?

5

Striping

RAID distributes data across multiple disks to increase storage capacity and improve speeds

What makes up Service Object Pair (SOP)?

• Service Class User (SCU)

• Service Class Provicer (SCP)

What digital image compression is a smaller file and can result in a loss of detail?

Lossy

What function of hard copy images has the most storage?

Blu-ray

What is the weakest link of image display?

Monitors

Aspect Ratio

Used to describe the shape of the monitor

Pixel (dot) Pitch

The distance between the centers of any two adjacent hardware pixels

Which has better spatial resolution?

B

Photometer

Used to measure the brightness output of an LCD

Contrast Resolution

Ability of the display to distinguish between multiple densities in a radiographic image

Which has better contrast resolution?

B

Monochrome Monitors

Has only one phosphor of color

What phosphors make up a color monitor?

• Red

• Green

• Blue

If all 3 phosphors in a color monitor were set at 255, what color would be seen on the monitor?

255

In an LCD monitor, a single pixel consists of how many individual bar-like segments?

18

Hardware Pixel

Intersections of flat, transparent wires crossing over each other to form an overall square shape

On a display monitor, a pixel that appears dark against a light background is ________.

Stuck

What monitors do we use in the radiology department?

LCD

What are benefits of a LCD monitor?

• Lightweight

• No glare/reflection of the screen; ambient light is minimal

A ray of light is electromagnetic radiation that consists of a double wave; these waveforms are ___________ to one another.

Perpendicular

LCD monitors consist of 2 thin sheets of glass each with a light polarizing layer that are __________ to one another.

Perpendicular

Nematic Liquid Crystals

A crystalline arrangment of molecules that are inserted between polarizing glass sheets/lenses in an LCD monitor

If there is an electrical charge being applied to the electrodes of an LCD monitor, it is considered to be in an ______ state.

Off

What is the most common type of backlighting.

LED

LCD or LED are in what matrix?

Active

Each hardware pixel possess its own _______.

TFT

What types of cleaners should not be used on monitors?

Acetone (ethyl alcohol)

Grayscale Standard Display Function (GSDF)

Allow medical images to be transferred according to the DICOM standard to be displayed on any DICOM-compatible display device with a consistent gray scale appearance

Luminance Ratio

Compares maximum luminance to the minimum luminance

Luminance Uniformity

Digital imaging spatial resolution is determined primarily by:

• Matrix size

• Pixel size

What does this test for?

Resolution

What is the best viewing angle of a monitor?

• At the screen directly

• Decrease ambient light

Specular Reflection

What post-processing can help to eliminate veil glare?

Apply a black surround mask

Who discovered the fluoroscope?

Thomas Edison

What is the typical fluoro mA range?

0.5-5

What is the material of the input phosphor in the II?

Cesium iodide (Csl)

What does the photocathode in the II do?

Convert light photons to electrons

What is the charge of the electrostatic focusing lenses in the II?

Negative

What does the electrostatic focusing lenses in the II do?

• Accelerate the electrons

• Ensure electrons travel an equal distance from the photocathode → anode

What is the charge of the anode in the II?

Positive

What does the ouptut phosphor in the II do?

Convert electrons back into light photons

Magnification

Voltage of the electrostatic lenses is increased causing a smaller diameter of input phosphors to be used and the focal point to shift closer to the input phosphor

Magnification causes a reduction in _______________.

Minification gain

Flux Gain

The increase in brightness from input to output as a result of the acceleration of the electrons traveling across the II

Total brightness gain decreases ______ each year due to aging of the tube.

10%

Conversion factor is equal to approximately _______ of the total brightness gain.

1%

Coupling

Takes light from II to next component in imaging chain

Continuous fluoro produces _____ frames a second.

30

Pulse Width

Exposure length of each pulse

T/F: Input phosphor does not absorb all x-ray photons.

True

Pincushioning Distortion

The borders of fluoro image are inherently magnified

Vignetting Distortion

Reduction of brightness at the edges of a fluoro image

Spot Image

Static image recorded at diagnostic mA levels; from radiation before it reaches the II

Any fluoroscopy system can be made digital with the addition of ________.

An ADC

Dynamic FPDs have what kind of DELs?

Larger DELs (smaller AMA)

What is a benefit of digital fluoroscopy?

The flat surface eliminates vignetting and pincushioning distortion

Road Mapping

A cine run is performed during an injection of contrast

In fluoro, the audible timer goes off every _____ minutes.

5

What is the SSD of fixed fluoro units?

15 in (38 cm)

Last Image Hold

Displays the last image on the monitor allowing fluoro to be stopped

What is the best method of technologist protection during fluoro?

• Stand to the side of the table

• Use the remote operation

What is the lead curtain & bucky slot cover lead equivalent?

0.25 mm