Practical Imaging Informatics
Most servers have additional hardware capacity to support the increased demands of multiple simultaneous users such as:
- Faster multi-core CPUs - Large memory stores - Large hard drives
What is the diagnostic workstation comprised of?
- High performance personal computer with high-resolution - High brightness monitors
What are the components located in a CT gantry?
- High power X-ray tube - Collimators - Linear array of detectors
What are some other IT infrastructures in a hospital that are integrated with PACS?
- Hospital information system (HIS) - Radiology information system (RIS)
What is the most commonly found network protocol over Ethernet?
- Internet protocol suite (IPS) - transmission control protocol/Internet protocol (TCP/IP)
How is PACS fundamentally different from traditional radiology purchases, like CT or MRI?
- It does not result in additional income for radiology. - PACS must pay for itself in cost savings from the reduced need to produce, store, and handle film/reducing the likelihood of preventing medical errors.
How can a CPU perform multiplication or division?
- It has to be taught how to do it. A CPU cannot perform simple multiplication or division on its own - By stringing a series of machine codes together, more complex processing (e.g., multiplication) is possible
What are some examples of web applications or webapps?
- JavaScript - Active Server Pages (ASP) - Java - HTML
Provides radiation dose details for an examination in the DICOM image metadata:
- Kerma Area Product (KAP) - ''Point air kerma''
What are the functions of Imaging Service Representatives?
- Locate exams - Track studies - Provide images to patients and physicians requesting access - Ensure all data necessary for the accurate interpretation of an exam are provided for the radiologist
What does the client-server architecture concentrate on?
- Maximizing virtually all of the computational power on the server - Minimizing the computational requirements of the client stations
How are modern PACS systems different than early point-to-point networking systems?
- Most modern PACS do not attempt to automatically route entire studies (and needed comparison studies) to individual workstations before the radiologist needs them. - Usually, all the images of the exam and the comparison studies reside in the PACS core and are only temporarily retrieved to the PACS workstation for review.
What do routers instantaneously analyze and balance?
- Network traffic - Route packets over segments that are currently under a lighter load
What are the two components that act together to provide the underlying "intelligence" of the computer system?
- OS (operating system) software - CPU (central processing unit)
Various technologies for direct or digital radiography (DR) include:
- Optically coupled CCD camera systems - Slot-scan detectors - Thin-film transistor (TFT) flat-panel detectors
In a relational model, how are one or more tables linked?
- Order number - Serial number - Accession number
In digital fluoroscopy and interventional radiology, typical image sizes range from _______ x _______ x _______bit up to ________ x ________ x ________ bit.
512 x 512 x 8 bit 1024 x 1024 x12 bit
What are typical images sizes in MB for individual projection images?
8-32 MB
What are the image sizes of a mammogram in MB with FOV of 18 x 24 and 24 x 30?
8-50 MB
What is the WW/WL for a brain?
80/35
How many revolutions per second does the x-ray tube, collimators and detectors rotate in the CT gantry?
>2 revolutions per second (<0.5 s rotation)
New adaptations of DR devices take advantage of the high-speed acquisition capabilities to produce alternate image processing schemes, such as:
- Dual-energy radiography - Digital tomosynthesis
In the relational model how is data abstracted into tables with rows and columns?
- Each row is an individual record - Each column is a separate attribute or field for each record
An application that relies primarily on the server for processing and focuses principally on conveying input and output between the user and the server:
Thin client (lean or slim client)
What were early networks primarily used for?
To backup data to a central location during off-hours
Why does legacy equipment interfacing require a third-party interface box?
To capture and encapsulate images for archiving
What is the goal of a peer review?
To let a fellow physician know about suggestions for improvement in a tactful, productive, and respectful manner
True or False Although low-level programming instructions produce efficient programs, programming in machine code or assembler is difficult, tedious, and very time consuming.
True
True or False Databases are integral to the infrastructure of most business systems including information systems in Radiology.
True
True or False Digital spot and digital subtraction angiography (DSA) images are typically archived.
True
True or False For mammography, dedicated X-ray systems are used in conjunction with digital detectors.
True
True or False In a radiograph of the chest, bony structures highly attenuate (or absorb x-rays, passing less signal through the body to the detector; whereas soft tissues are less attenuating, passing more signal through to the detector.
True
True or False Most PACS client viewing software that runs within a web browser is classified as hybrid-client
True
True or False PACS communications functions within radiology are commonly carried out using dedicated, high-speed networks
True
True or False Raw data is necessary for computer-aided detection (CAD) algorithms often used with digital mammography images:
True
True or False Study splitting software is not typically available on older CT equipment and requires a third-party solution.
True
True or False The OS (operating system) provides a foundation or software platform for all other software (application programs). Therefore, the choice of OS, to a large extent, determines which application software can be used on a particular system.
True
True or False The diagnostic workstation holds and operates the study retrieval and study viewing software.
True
True or False The networking equipment ideally segregates the PACS data traffic for performance and reliability, but route traffic between networks as needed.
True
True or False The nighthawk radiologist uses networking to get images read within a few minutes and faxes out preliminary reports to radiology departments and emergency departments. This function is widely used by most hospitals in the United States, particularly those that are too small to have radiologists provide 24/7 onsite service.
True
True or False With the coming of PACS, the role of the traditional film librarian is greatly enhanced, not eliminated
True
True or false Application software does not supplant the base OS (operating system) software. Instead, application software runs on top of the OS such that an application is written (or coded) to work with a specific OS (operating system).
True
True or False A host that is hidden within a private network does not need a globally unique address (it only needs to be unique on the local network)
True ***This scheme allows for conservation of unique IP addresses***
True of False The motherboard, the CPU, and memory retain no previous information about how the computer is configured.
True Every time the computer turns on, it pulls itself up by its bootstraps (''booting up'')
Generates tomographic images of the acoustic properties of body tissues by sending short, high-frequency sound pulses into a specific volume, listening for echoes, and creating anatomic grayscale images:
Ultrasound (US)
Regarding contrast resolution, what is the formula for the number of X-ray photons per voxel?
Volume element = pixel dimensions x slice thickness dimension
Any application that is accessed via a web browser over a network that is coded in a browser-supported language:
Web applications or webapps
The most basic client application that interacts directly with the server to render data, images, or advanced visualizations:
Web browser
Software applications that are designed to operate principally over a network in a client-server configuration are grouped collectively into something known as:
Web services
How do web services differ from web applications?
Web services do not need to run inside a browser or be constructed with web elements
A brief preliminary interpretation rendered by the radiologist before taking the time to formally and completely review the images.
Wet read
When does PACS work the best?
When the strongest aspects of the organizational powers of the RIS are combined with the database and archive access tools of PACS
The average brightness setting of the grayscale values:
Window level
Determines the range of grayscale values portrayed, where a larger number provides a wide latitude, low-contrast appearance appropriate for bone:
Window width (WW)
Provides instantaneous translation of image grayscale on the display:
Window width (WW) Window level (WL)
What is the most popular operating system?
Windows OS (Microsoft, Redmond Washington) ***runs on majority of computers worldwide***
What does the variations in the grayscale of an image represent?
X-ray attenuation or density of tissues
What is the imaging source in Computed Tomography?
X-ray beam; X-ray tube rotates around the patient
In fluorography, what is the role of the detector?
X-ray image intensifier amplifies the output image
What is the source in projection radiography?
X-rays; ionizing radiation; part of the electromagnetic spectrum emitted as a result of bombardment of a tungsten anode by free electrons from a cathode.
You are concerned that HL7 order messages are not being communicated successfully between your electronic medical record system and your RIS. To which system should you turn first to investigate this issue?
You should look first into your HL7 message passing engine if you have one.
How is memory different than a CPU (central processing unit)?
a memory module has no capability to process instructions; instead memory is designed to reliably store large chunks of data and then release these data on command (often at the behest of the CPU).
During the startup or boot process, what is the first piece of software to load?
a portion of the operating system that will coordinate the other software programs
Projection (planar) imaging, such as projection radiography in which X-rays from a source pass through the patient and are detected on the opposite side of the body, produces:
a simple two-dimensional (2-D) shadow representation of the tissues lying between the source and the detector. Each point in the image has contributions from all objects in the body along a straight line trajectory through the patient. Overlapping layers of tissues can make planar imaging difficult to interpret.
In what type of setting does the local area connection (LAN) serve for computers?
a small geographic area such as a home or an office
A single print statement in high-level source code programming language might produce how many individual machine code commands once it is compiled?
a thousand
The CT number most likely to be encountered in the lung area of a CT image is which of the following? a. -800 b. -20 c. 0 d. 500 e. 2000
a. -800
Which of the following filters may be applied in real time (before all images are acquired)? 1. averaging 2. Nonlocal means 3. Gaussian 4. Anisotropic diffusion a. 1 & 3 b. 4 only c. 1 and 2 d. 2 & 4
a. 1 & 3 1. averaging 3. Gaussian
What is the correct order for the following steps? 1. The responses to the RFP should be summarized and tabulated for evaluation. 2. The RFP should be sent out to the vendors giving them a firm response date. 3. Each vendor should be scored for each criterion and these scores weighted based on the importance of the category being analyzed. 4. The PACS selection team should short list 4-6 vendors selecting those who appear to be most suitable for their requirements. a. 4, 2, 1, 3 b. 1, 2, 3, 4 c. 2, 1, 3, 4 d. 2, 4, 1, 3 e. 2, 3, 1, 4
a. 4, 2, 1, 3 4. The PACS selection team should short list 4-6 vendors selecting those who appear to be most suitable for their requirements. 2. The RFP should be sent out to the vendors giving them a firm response date. 1. The responses to the RFP should be summarized and tabulated for evaluation. 3. Each vendor should be scored for each criterion and these scores weighted based on the importance of the category being analyzed.
The usual period of time for calculating total cost of ownership is a. Two to three years b. Two to five years c. Ten years d. Five or seven years e. Fifteen years
d. Five or seven years
The Mammography Quality Standards Act (MQSA) establishes national standards for mammography and is regulated by the a. American College of Radiology. b. Centers for Medicare and Medicaid Services. c. Department of Health and Human Services. d. Food and Drug Administration.
d. Food and Drug Administration.
Which of these is not one of the benefits of spatial separation in the reading room environment? a. Visual privacy b. Acoustic privacy c. Ability to work independently with minimal distractions d. Less space for collaborating with others e. None of the above
d. Less space for collaborating with others
Which one of the following modalities uses nonionizing radiation from interactions with the body to generate the resultant image? a. Pulsed fluoroscopy b. Computed tomography c. Positron emission tomography d. Magnetic resonance e. Single-photon emission computed tomography
d. Magnetic resonance
How is light generated for indirect DR devices?
light is generated using an X-ray sensitive phosphor and converted to a proportional charge-coupled device (CCD) or flat panel Am-Si (amorphous silicon) TFT (thin-film transistor) array.
What is the limitation of a CPU (central processing unit)?
limited capability to store data before or after execution
Every CPU model has its own native machine code or instruction set. What does the instruction set consist of?
limited number of relatively primitive tasks: - adding or subtracting data in specialized memory placeholders called registers - moving data from one register to the next
What is the most common network?
local area connection (LAN)
Why is memory allocation crucial for maintaining stability of the system?
if two programs try to use the same area of memory, both programs will usually fail
Modalities can be characterized by their energy source as invasive (using ionizing radiation) or noninvasive. They are acquired in 2-D planar projection mode or tomographic cross-section; and produce:
images representative of anatomical structure and/or physiological or molecular function.
The OSI (International Organization for Standardization) model describes five to seven _______________ ______________ that link computer software application to the hardware that must perform the actual transmission and receipt of data.
information layers
The OSI model describes five to seven ________________ ________________ that link computer software application to the hardware that must perform the actual transmission and receipt of data.
information layers
Most of the hardware components in the modern digital computer are contained within small modular semiconductor packages called:
integrated circuits [ICs] or chip ***contain millions of discrete components***
one or more networks that are under control of a single administrative authority:
intranet ***access to any external or unregulated networks is either not provided or is limited to authorized users***
What can cause "white for air" and "black for bones" in fluorography?
inverted grayscale
Bone absorbs large amounts of radiation allowing ________ signal to reach the detector, resulting in white or bright areas of the image. more signal or less signal?
less signal
How many instructions per second can a personal computer CPU (central processing unit) perform?
over 3 billion instructions per second or 3 gigahertz (3 GHz)
Cat5 cabling frequently terminates in special rectangle plastic connectors that resemble:
oversized telephone handset connectors
What is the most common data bus design used today?
peripheral component interconnect (PCI) and PCI-Express
What is an MRI detector composed of?
phased array receiver coils capable of acquiring multiple channels of data in parallel
The digital detector in computed radiography (CR) uses what kind of imaging plate?
photostimulable or storage phosphor imaging plate
What does the CPU rely on in order to store information and provide it to the CPU on demand?
physical memory
Elements in the digital array are called _____________ for picture elements and each is represented by a numerical value in the computer.
pixels
What would happen if images are insufficiently sampled?
poorer resolution images may have a characteristic blockiness or checkerboard artifact.
Each computer network cable has an individual connection (_______________) to the hub.
port
The CPU's (central processing unit's) strength is in its ability to:
process instructions and manipulate data at amazing speeds.
What is application software?
programs that help users to perform specific tasks
What do layers in the OSI (International Organization for Standardization) model rely upon to regulate how information is passed up through and down the OSI stack?
protocols
What is the largest wide area network (WAN) that is a global system of interconnected computer networks?
public Internet
What does networking allow for multiple independent users?
to share the same resources (i.e., applications and data) and work with these data simultaneously
True or False There is a one-to-one relationship between computers and network devices. That is, there is only one computer attached to each network cable.
true
How many CPUs do modern CPUs contain in one IC (integrated circuit) or chip (multi-core CPU)?
two to eight CPUs This provides unparalleled computational speed as each core shares the processing tasks formerly assigned to one CPU.
Memory that can only retain data with power applied is referred to as
volatile memory ***most of the motherboard memory modules are of this type***
3-D images consist of ___________ or volume elements
voxels
What is used as a reference material for determining CT numbers and is, by definition, equal to 0?
water
What kind of information can the BIOS (basic input/output system) provide for the motherboard?
where to find the first piece of software to load during the startup process
A network that is comprised of two or more local area networks (LANs) is termed:
wide area network (WAN)
What is the imaging source for Nuclear Medicine and Positron Emission Tomography (PET)?
x-ray or y-ray emitting radioisotopes are injected, inhaled, or ingested
Uses a very low constant X-ray tube current while the fluoro pedal is depressed:
Continuous fluoroscopy
Chiefly dependent on the number of X-ray photons per voxel and the X-ray technique (radiation dose):
Contrast resolution
The diagnostic workstation may be a generic ______________ viewer, or a proprietary system offered by the PACS vendor, or may have features of both architectures.
DICOM
What does a PACS broker generally provide?
DICOM capabilities (for example, DICOM modality worklist) to components within the PACS network that use DICOM
You are given a DICOM conformance statement by a vendor. To which part of the DICOM standard should you refer to decipher its meaning?
DICOM part 2, "Conformance."
In an ultrasound, sound waves travel through the body and are affected by:
Different types of tissues encountered and reflected back. A moving image is obtained as the transducer is passed across the body.
The standard format for PACS files and messages:
Digital Imaging and Communication in Medicine (DICOM)
Use much higher X-ray intensity (mAs), on the order of 10-100 times larger per frame than conventional fluoroscopy to produce images of low-quantum noise and higher resolution:
Digital fluoroscopy "photospot images"
An X-ray projection imaging procedure specifically used for imaging the breast:
Digital mammography
Uses temporal subtraction to eliminate stationary anatomy and enhance iodinated contrast displacing blood; sensitivity of dramatically increased to allow lower injected contrast volume:
Digital subtraction angiography (DSA)
Assumed to have an integrated detector and X-ray tube/generator system and does not require direct user interaction or handling to acquire and/or display images:
Direct or digital radiography (DR)
How do reconstruction filters define/emphasis image contrast?
Distinguish between "soft tissue" vs. spatial resolution ("bone or detail") filter
A technique used to examine moving objects in the body:
Doppler Ultrasound
A patient dose greater than necessary:
Dose-creep
A host application that performs the bulk of data processing operations for the user with minimal to no reliance on network resources:
Fat client (thick or rich client)
Provides greater transmission capacity (bandwidth) than Cat5 and wireless cables:
Fiber optic cables (optical fiber) ***affords greater access where physical connections are not readily available***
Discuss the fundamental functional requirements of enterprise image distribution.
Flexibility, Performance, Scalability, Cost-effectiveness, Integration to EHR, Security
A ''real-time'' X-ray projection image acquisition sequence used for dynamic evaluation of many patient procedures in diagnostic and interventional radiology:
Fluoroscopy
Describe the characteristics of an ''image-intensive user''
Frequently make patient management decisions based on their interpretation of the image; frequently demand and require full-fidelity/diagnostic-quality images; also demand rapid ("near real time") delivery of images, including relevant priors; usually still constrained by existing network and personal computer infrastructure.
For a contrast enhanced MRI study, what type of solution is used to change tissue contrast based on T1 and T2?
Gadolinium
For a Radiology Information System (RIS), what type of format is used to send messages outbound to PACS broker?
HL7
What is the difference between hardware and software?
Hardware can be seen and handled. Software, on the other hand, is a virtual concept. While we can handle the media that software is written on, we cannot actually ''see'' the software.
The client makes requests from a dedicated, powerful networked ______________ computer (a server) that stands ready to provide application services or data to the client over the network.
Host
In Computed Tomography, thin transverse sections of the body are acquired representing an absorption pattern or X-ray attenuation of each tissue. Absorption values are expressed as:
Hounsfield units
A specialized form of high-performance memory is found on most CPUs to help efficiently buffer data that move in and out of the microprocessor core:
L2 cache memory
A typical Radiology department network would consist of at least one _____________ that may be interconnected to a larger _____________ (e.g., hospital network)
LAN (local area network) WAN (wide area network)
Acquires images during rotation of the source- detector around the patient. Projection images can be played back in real time, or data can be reconstructed to produce tomographic slices of the patient volume:
Rotational angiography
Devices that examine each packet and forward it through the relevant port that corresponds to the recipient:
Routers
What does compression allow clinicians to view?
Large image sets from remote locations with relatively low-speed network connections
Old equipment purchased before new standards were widespread. Often requires upgraded interfaces to communicate with modern PACS:
Legacy device
What does MRN stand for? How does it differ from a social security number?
Like a social security number, a medical record number (MRN) is intended to uniquely identify a patient, and to resolve the problem of two patients with the same name. MRN is intended for use only within a hospital system. A single patient may have multiple MRNs if they move from one hospital system to another.
May result in a significant compression ratio (10:1 or more), but may result in some image quality loss:
Lossy compression
Analyzes intrinsic tissue characteristics of metabolites in single or multiple voxels (volume elements):
MR spectroscopy (MRS) This is a method to noninvasive ''biopsy'' indeterminate tissue areas in the MR image.
Which imaging modality has image sizes that vary widely, more than any other modality?
MRI 64 x 64 64 x 128 128 x 128 128 x 192 256 x 512 512 x 512 512 x 1024
A specific machine that acquires images (e.g., CT scanner #3), or a class of machines that use the same basic technology
Modality
Which places normally configure their internal network to have extranet?
Most hospitals and business organizations
The rate at which information can be transmitted per second (bits/s):
Network bandwidth
You notice that one of your systems timestamps is not correct. You need to ask your vendor to turn on software that implements which standard?
Network time protocol (NTP) (www.ntp.org).
Generic term indicating preliminary or final interpretations provided on overnight and weekend cases:
Nighthawk
What is the most important software component running on any computer?
OS (operating system) ***a modern computer cannot operate without an OS***
At the receiving end, the _____________ model also details how to reassemble the individual packets back into the original file
OSI (Open Systems Interconnection)
How are learning objectives used in the design of a training program?
Objectives are used as a means to determine the material covered in the training program as well as a guideline for evaluation of the effectiveness of the training.
What should help limit the need to transport and import outside CDs?
Once PACS is in place at many sites in a region, image data can be transmitted between disparate PACS. This can be made automated or semi-automated.
When is lossy compression recommended for performance?
Only when the images will NOT be used for primary interpretation
What types of things can you expect to find on sourceforge.net?
Open-source software
A software application that does not depend upon any additional software components and does not perform any processing on the local host:
Thin Client
The implementation of a PACS for electronic image acquisition, display, and archiving is associated with the conversion of digital to analog or analog to digital radiography technology?
Analog to digital
For spot imaging applications, _________ x _________ x __________ bit matrices are often used:
2048 x 2048 x 12
For CT, thin-slice datasets comprise _________+ images, up to __________+ per study
500+ 2500+
What is the most common reconstructed image size for axial images in bits?
512 x 512 x 12 bits
A significant number of sequences and images result in an average of approximately ___________ MB of data storage per study.
300 MB
What is the knowledge base needed for a PACS systems analyst?
- Database schemata - Networking - Report building - Script development - Application development
What does a digital radiography image size depend on?
- Detector element dimension (0.2-0.1 mm) - Field of view (FOV) of 18 x 24 cm to 35 x 43 cm - Bit depth of 10-14 bits/pixel
What is the WW/WL for an abdomen?
400/40
How are X-ray systems in mammography integrated with digital detectors?
(1) CR as a direct replacement for screen-film, which can be used with existing acquisition systems (2) Flat-panel DR, which is integrated with the X-ray and generator system
The Hounsfield Unit is a CT number representing absorption values of tissues; expressed on a scale of _______ units for the maximum X-ray beam absorption of bone to ________ units for the least absorbent air.
+1000 -1000
Functions of PACS workstation for the radiologist:
- Allows assembly of sets of cases to be sorted and identified (i.e., worklists) so that individual radiologists can pull their respective workload from the overall archive. - Facilitates retrieval of new studies to be read from the PACS core to local memory or the local hard drive. - Communicates with the PACS core to identify, retrieve, or prefetch the pertinent comparison studies that the radiologist is most likely to need. - Allows viewing new and old exams. - Facilitates retrieval and semi-automated display of available prior studies. - Image manipulation software tools operated via an intuitive GUI. - Commonly linked to dictation/reporting tools. - Changes the status of studies to prevent multiple radiologists from trying to dictate the same case. - Allows all radiologists to be aware of what is waiting to be reported.
Scripted language is often reserved for smaller programs that are not computationally intensive. Scripting languages include:
- Apple Script - Visual Basic (or VB) script - Shell script - JavaScript
What are the essential elements included with PACS?
- Archive - Database - Broker - Network infrastructure - Distribution software
What are some examples of the many high-level languages in common use today?
- C, C#, C++ - BASIC - Pascal - Java - FORTRAN - COBOL
What are some of the largest studies in CT that include thin-slice datasets?
- CT angiography - Cardiac CT - Perfusion/diffusion
Clinicians may receive images and reports in one or more of several means:
- Clinical review stations - PC-based review on general-purpose, multi-usage PCs. - Creating CD-ROMs of patient exams (''burning a CD'') - Printing traditional film copies and paper reports (this is very expensive)
What are some important skills for maintaining PACS?
- Communication - Vendor relationship - Planning - Project management - Customer service - Financial management
What are the cross-sectional imaging acquisitions of choice over projection radiography?
- Computed tomography (CT), - Magnetic resonance imaging (MRI) - Ultrasound (US) - Single-photon emission computed tomography (SPECT) - Positron emission computed tomography (PET)
What types of files are included on CD's?
- DICOM format - JPEG - Vendor-specific proprietary file type
Additional metadata is automatically married to each data packet based upon protocols specified in by IPS (internet protocol suite) and contains information such as:
- Data type - Packet number - Total number of packets - IP address of the sender and receiver **Analogous to placing a letter (packet) in an envelope with delivery information (sender and return address).**
What are some asynchronous communication tools?
- Over-reading - Remote feedback and teaching of radiology residents - Communications with referring physicians, such as the emergency department - Can be auto-linked to existing email programs (assuming HIPAA-secure email protections).
List several methods of communication for scheduled and unscheduled downtimes.
- Paging systems - EMR and departmental websites - digital dashboard
What are the pertinent data elements included in the PACS database?
- Patient demographics - Associated reports - Study description - Where the images were obtained - Where the images are stored
4. Name five data fields critical to billing and coding of radiologic procedures.
- Patient name - Patient date of birth - Facility name - Date of service - Department code - Type of study - Body part(s) - Number of views - Administration of contrast - Patient history - Diagnosis
"Enhanced CT Information Object Definition (IOD)" provides updated and required elements and tags for new scanner characteristics such as:
- Pitch - Modulated mA - Dose data
Who is considered the core customer base of PACS?
- Radiologists - Technologists - Clinicians
What are the most common programmatic operations on a relational database?
- Reading or selecting records for analysis - Adding records - Updating records - Deleting records
What is the responsibility of a PACS administrator?
- Responsible for the day-to-day operation of the PACS - Understands the intricate nuances of the radiology workflow - Knows how to use the PACS to ensure that workflow is optimal for all users - Takes care of the basic functions of a PACS (transmission, display, and archive) - Fixes errors that occur throughout the normal workflow, whether they are caused by human or system error
Common names for projection images acquired with the detector gantry stationary and the table incremented:
- Scout - Topogram - Scanogram
Tissue characteristics exploited by MRI to manipulate tissue contrast:
- T1 - T2 - Proton density - Blood flow - Perfusion - Diffusion
Examples of user parameters in MRI:
- TR (repetition time) - TE (echo time) - TI (inversion time) - Flip angle - Slice thickness
What are the components of a Radiology Information System (RIS)?
- The tool that most technologists and radiology administrators use for their daily activities - Multiple vendor choices - May be bundled with other Hospital Information Systems (HIS) - Must be able to seamlessly receive ordering information from HIS - Must allow radiology personnel to enter and alter orders - Uses Health Level 7 (HL7) as its core communication protocol
What are other operating system choices that are used?
- UNIX - Linux - DOS - Mac OS (Macintosh)
What are some examples of non-volatile memory that will retain data written to it until it is erased or over-written?
- USB memory sticks - disk drives
What is the process of compiling a program?
- Using high-level programming languages, programmers (or ''coders'') type out individual lines of the source code for an application, using a development software program. - The lines of the source code need to be translated into machine code before the program can be understood and tested on the microprocessor.
Software for distribution of images to clinicians may be:
- Web-based or web-deployable - Integrated with an enterprise EMR - Part of core PACS or a free-standing system
What are the most cost-effective means of distributing images and reports?
- Web-based product - Off-the-shelf PCs - Wide area networks that are already in place
What is an example of an image file size?
- a CT slice is typically 512 rows by 512 columns and the grayscale is represented by 16 bits. - It requires 2 bytes to account for 16 bits of grayscale, and therefore, a CT slice file size is then 512 x 512 x 2 = 524,288 bytes or approximately half a megabyte (MB). **** 1 byte = 8 bits****
Which parts of the computer does the OS (operating system) monitor?
- all internal functions of the computer - maintains stability of the hardware components - regulates the processing of data in the microprocessor
What kinds of files can store image sequence with up to several hundred images that are produced and stored individually or as video sequences?
- avi -mpeg
In Positron Emission Tomography, positron isotopes are short-lived positively charged electrons. Main clinical applications are in the:
- brain - heart - tumors
What defines the data bus?
- data-width (typically 32 or 64 bits), which specifies how much data are delivered across the bus per cycle - clock speed (given in megahertz).
What is image gray level quantization?
- digitization of the amplitude or brightness - determined by computer bit depth - is reflected in the image contrast resolution.
What are additional features included with the typical broadband network router used in home networking?
- dynamic host control protocol (DHCP) - network address translation (NAT) - network firewall
What are two of the most critical jobs of the OS (operating system)?
- ensuring that programs do not unintentionally interfere with each other - maintaining security
What are advantages of projection radiography?
- fast and easy to perform - equipment is relatively inexpensive/widely available - low amounts of radiation - high spatial resolution capability - assesses parts of the body that have inherently high contrast resolution but require fine detail (imaging chest or skeletal system)
What are other physical forms of the computer network connection that are used less often?
- fiber optic cables (optical fiber) - wireless (802.11x)
What is the WW/WL for the liver?
200/50
What is the WW/WL for bone?
2000/300
What are advantages of Computed Tomography?
- good contrast resolution allowing differentiation of tissues with similar physical densities - tomographic acquisition eliminates superposition of images of overlapping structures - advanced scanners can produce images that can be viewed in multiple planes or as volumes - any region of the body can be scanned; has become diagnostic modality of choice for a large number of disease entities - useful for tumor staging
What are disadvantages of PET and Nuclear Medicine?
- high cost - PET isotopes require a cyclotron for production
What are disadvantages of Computed Tomography?
- high cost of equipment and procedure - high dose of ionizing radiation per examination - artifacts from high contrast objects in the body such as bone or devices
What are disadvantages of MRI?
- high purchase and operating costs - lengthy scan time - more difficult for some patients to tolerate - poor images of lung fields - inability to show calcification - contraindicated in patients with pacemakers or metallic foreign bodies
What is the imaging source in Magnetic Resonance Imaging (MRI)?
- high-intensity magnetic field; typically, helium-cooled superconducting magnets are used today - non-ionizing; gradient coils turn radiofrequency (RF) pulses on/off
What are some types of network switches?
- hub - bridge - router
What are some complexities in medical imaging?
- human variability - performance requirements - safety considerations - motion artifacts - technical limitations - cost
What are advantages of fluorography?
- image anatomic motion and provide real-time image feedback during procedures - monitoring and carrying out barium studies of the gastrointestinal tract - arteriography - interventional procedures (positioning catheters)
What are the CT acquisition techniques that depend on patient size and type of study?
- kV - mA - Time - Slice thickness
What are some examples of input devices?
- keyboard - touch screen - mouse - microphone - camera
How does spatial resolution affect an image?
- limits sharpness (edges separating objects in the image) or visibility of fine detail - function of sampling that affects matrix and pixel size
What are advantages of an ultrasound?
- low cost - non-ionizing energy source and safe - can scan in any plane - equipment is portable and can be used for bedside imaging - useful for monitoring pregnancy - imaging the neonatal brain - visualizing the uterus, ovaries, liver, gallbladder, pancreas, and kidneys - confirming pleural effusions and masses - assessing the thyroid, testes, and soft-tissue lesions
The OS (operating system) is designed to automatically manage nearly every task (or process) including:
- maintenance of the files on the disk - tracking input from peripheral devices (keyboards or network cards) - displaying output on printers and video displays - control of memory allocation
What are advantages of PET and Nuclear Medicine?
- measures targeted specific chemical-physiologic tissue function - imaging infarcts in the cardiovascular system - perfusion - ventilation scanning of the respiratory tract for pulmonary embolus - imaging uptake at sites of increased bone turnover as in arthritis and tumors - assessing focal nodules - oncologic assessment
What are the interactions of the radioisotope that are measured in Nuclear Medicine and Positron Emission Tomography (PET)?
- metabolic - chemical - physiologic
What are some basic physical components of a computer network?
- network card - cabling - point of connection (hub, repeater, bridge, router, or network switch)
What are advantages of MRI?
- non-ionizing radiation, originally called nuclear magnetic resonance (NMR) but because the word "nuclear" was associated with ionizing radiation, the name was changed to emphasize the modality's safety - can image in any plane - has excellent soft tissue contrast detail - visualizes blood vessels without contrast - no bony artifact since no signal from bone - particularly useful in neurological, cardiovascular, musculoskeletal, and oncological imaging
What are disadvantages in ultrasound?
- operator-dependent - poor visualization of structures underlying bone or air - scattering of sound through fat yields poor images in obese patients
Positron Emission Tomography uses cyclotron-produced positron-emitting isotopes including:
- oxygen - carbon - nitrogen - fluorine enabling accurate studies of blood flow and metabolism
What is visible light imaging used for in light microscopy?
- pathological diagnosis - hematology - dermatology - photograph the skin - gastroenterology (colonoscopy/endoscopy), - ophthalmology - image the retina - surgical procedures
What are disadvantages of projection radiography?
- poor differentiation of low contrast objects - superposition of structures makes image interpretation difficult - uses ionizing radiation
What does the motherboard rely on when the power is first applied to the computer?
- relies on the BIOS (basic input/output system) to tell what additional components are available to the motherboard for input and output (e.g., disk drives, memory, keyboard, etc.). - the motherboard ''becomes aware'' of what is available and how to access it, each and every time the computer is restarted
What does the negotiation process between two computers include prior to making a connection?
- request and acceptance of an initial connection - type of connection - rate of transmission - data packet size - data acknowledgement - when and how to transmit missing data
The development process with ____________ languages is typically more rapid than with ____________ code; however, because __________ languages are interpreted at the time of execution, they are typically slower to execute.
- scripted - compiled code - scripting
Computer networks can be classified on the basis of:
- size - complexity - scope - topology - architecture - connection method
There are additional forms of computer memory that are classified simply as storage, principally because they are characterized by slower speed compared to solid-state memory and non-volatile characteristics (data persist indefinitely until erased/overwritten). These are made up of:
- spinning media (disk drives, CDs, and DVDs) - linear media (tape)
How are motherboard memory modules rated?
- storage capacity (given in megabytes or gigabytes) - access speed (in nanoseconds) - data rate (DDR2) - configuration (single or dual inline memory SIMM or DIMM)
What categories of software are there?
- system software - application software - programming software
What are the most common isotopes in Nuclear Medicine and Positron Emission Tomography (PET)?
- technetium-99 - thallium-201 - iodine-131
What is image sampling?
- the digitization of the spatial coordinates - related to pixel size - reflective of matrix size - affects spatial resolution
A software abstraction of protocols and services necessary for the establishment of communication between two computers on a network:
- transmission control protocol (TCP) - internet protocol (IP)
What are some typical output devices?
- video display - printer - plotter - speaker
What are some examples of application software?
- word processor - spreadsheet
What are the Hounsfield Units for fatty tissues?
-10 to -100
The CT numbers, or "Hounsfield Units" (HU) indicate the X-ray attenuation characteristics of the tissues and range from: __________ (air) to _________ (water) to __________ (dense bone).
-1000 0 +3000
What are the Hounsfield Units for muscle?
0 to +100
Digital mammography image size ranges from _________ to ________ mm detector element size.
0.1 to 0.05 mm
In digital fluoroscopy and interventional radiology, how many video sequences in frames/s are acquired for viewing and evaluating patient anatomy?
1 - 60 frames/s
Networking equipment usually has _____ or _____ Gb at the core and between large nodes of the enterprise.
1 or 10 Gb
What does optimum network design mandate?
1. Minimizing collisions 2. Maximizing collision detection to maintain fidelity of data transmission
What are four processes that should be included in a training program?
1. Needs assessment 2. Program design using sound educational principles 3. Program implementation according to design 4. Evaluation of effectiveness
Five core hardware components of the modern digital computer system:
1. central processing unit or CPU 2. memory 3. input devices 4. output devices 5. bus
What is the function of the detector in Nuclear Medicine and Positron Emission Tomography (PET)?
1. gamma camera with NaI scintillation crystal measures the radioactive decay of the active agent 2. emitted light is read by photomultiplier tubes 3. pulse arithmetic circuitry measures number and height of pulses 4. pulses converted into electrical signal that is processed into a grayscale image
What is the process of digital image production?
1. scanning of the analog image line-by-line to obtain a continuous analog signal representing the variations in image brightness 2. dividing the analog signal into individual pixels in a process known as spatial sampling, which is typically performed in equal intervals 3. converting the amplitude into a digitized numerical pixel value in the process of contrast quantization 4. analog-to-digital (ADC) converter turns the quantized level into binary code
How many MB is a single-view chest radiograph?
10 MB
The theoretical bandwidth of Ethernet ranges from:
10 to 1000 Mb/s
The number of individual instructions specified in any one program varies depending upon the type and complexity of the software -from ________ to ________ million lines of code.
10 too 100 million
Since the bridge needs to examine all data sent through it, it creates some processing overhead that slows the data transmission rate. Bridges typically support data transmission rates of how many megabits per second (Mb/s)?
10, 100, and 1000 megabits per second (Mb/s)
What is the minimum Mb that the networking equipment provides for individual PACS workstations?
100Mb
How many bits of data per pixel are used in mammography?
12-16 bits
What is the WW/WL for the lung?
1500/-700
Asynchronous transfer mode (ATM) can support bandwidths ranging from:
155 Mb/s (OC3) 622 Mb/s (OC12) 2488 Mb/s (OC48)
What are the simultaneous slice acquisitions that multidetector row CT scanners acquire?
16, 64, 128, 256, 320
Lossless compression (typically used within the PACS core) results in no image degradation, but only allows compression rates of about:
2.5:1
An idealized functional representation of a real-world object. It often contains more attributes than the real-world object it represents:
A DICOM Information Object Definition (IOD)
Why are simple hubs rarely used today?
A network hub is the most basic and inefficient means of connectivity
In CT, the X-ray source is tightly collimated to interrogate a thin transverse section through the body. The source and detectors rotate together around the patient producing:
A series of one-dimensional projections at a number of different angles. The projection data are mathematically reconstructed to create a 2-D image of a slice through the body. Digital geometric processing can be used to generate a three-dimensional (3-D) image of the inside of objects from a series of 2-D image slices taken around a single axis of rotation.
Describe some examples that might constitute a single point of failure.
A single copy of image data on a single server in only one location
What is a database?
A structured collection of data
Describe how the IHE Integration Profile for Portable Data for Imaging (PDI) and the IHE Integration Profile for Import Reconciliation Workflow (IRWF) will help with your enterprise image distribution service.
A. the PDJ Profile guarantees that the CD/DVD will have a DICOMDIR and DICOM part 10 image; this will enable the import and export of images using CD/DVD portable media. B. The Profile for Import Reconciliation Workflow (IRWF) provides the ability to efficiently reconcile imported image datasets by matching external identifiers with local identifiers (medical record number, accession number).
You would like to configure a new workstation to perform DICOM query retrieve studies from your PACS. A: What three pieces of information about the PACS will you need to have to configure the workstation? B: What three pieces of information will you need to have to authorize the workstation on the PACS?
A: called application entity title (AE Title), IP address, DICOM port number. B: calling application entity title (AE Title), IP address, DICOM port number.
You would like to know if there is a US standards development organization that specifies how plumbing lines should run through a computed tomography imaging suite. To which organization should you turn to identify US SDOs?
ANSI (www.ansi.org).
Describe the advantages of a PACS archive with ''native'' support for enterprise image distribution.
Able to deliver via the web client all images that reside within the PACS archive; no prefetch or persistence logic is required; the enterprise user can be given a complete, comprehensive view of the patient's medical image history; with some vendors, the enterprise user also shares a common view with respect to annotations, presentation states, etc.
What are the image engines in a picture archiving and communications system (PACS)?
Acquisition modalities
What must be done before all the computer software is executed by the microprocessor?
All computer software must be moved into storage (i.e., disk drive) or physical memory (RAM) ***The instructions are passed through a series of software layers where they ultimately reach the microprocessor. Each instruction causes the computer to perform one or more operations.***
What does a PACS ideally replace?
All stand-alone, single-modality workstations.
Almost the entire structure of the Internet is based upon what model?
Client-server model ***This infrastructure supports delivery of web pages over the World Wide Web and e-mail***
How much actual bandwidth consists of theoretical values?
Approximately one-half
Any component of the image that is extraneous to the representation of tissue structures; can be caused by a technique, technology, hardware, or software error.
Artifact
How fast do data packets move?
At the speed of light
What is a major function of tissue radiodensity?
Attenuation of an x-ray beam
What solutions can you put in place to help users who forget their passwords?
Automatic ways for email reminders for forgotten passwords or a 24/7 help desk.
Regarding the reconstructed FOV, what are the approximate x-y plane dimensions?
Approximately 0.2 to 1.0 mm
Regarding slice thickness, what is the approximate z-axis dimension in mm?
Approximately 0.5 to 10 mm
What is the data acquisition rate in frames/s for X-ray detectors (image intensifier/TV or digital flat-plate detectors)?
Approximately 30 frames/s
Instances where two or more computers attempt to send data along the same segment simultaneously. This phenomenon is termed a:
Collision
What anatomical structure has a higher attenuation coefficient than soft tissue?
Bone
While some PACS may claim to be ''_____________,'' they are simply embedding the functionality generally performed by the ______________ into other parts of the PACS.
Brokerless Broker While not explicitly called a ''broker,'' these systems contain hardware and software that do what is traditionally referred to as a ''broker.''
Arrange the modalities in order that produce the most amount of radiation to the least amount: A. ultrasound, x-ray, CT, MRI, nuclear medicine B. CT, nuclear medicine, ultrasound, x-ray, MRI C. nuclear medicine, MRI, CT, ultrasound, x-ray D. MRI, x-ray, nuclear medicine, CT, ultrasound
C. nuclear medicine, MRI, CT, ultrasound, x-ray
What is the difference between CPT (current procedural terminology) and ICD9 (International Classification of Diseases, ninth revision) codes? Why are two different sets of codes needed?
CPT (current procedural terminology) codes describe procedures and methods; ICD9 (International Classification of Diseases, ninth revision) codes describe symptoms and diseases. Both are needed for appropriate coding.
Tomographic (cross-sectional) imaging modalities include:
CT, MRI, and ultrasound.
Assist radiation dose assessment and problem solving in the DICOM metadata:
Capture of kV, mA, exposure time
Computed radiography (CR) is largely __________ based, and as a direct replacement for screen-film, can use existing radiographic equipment.
Cassette
A computer or software application that receives application services and data:
Client
Close interrelationship of multiple clients and a server:
Client-server architecture
This model is one of interdependency between two or more computers where one computer provides data or services to the other:
Client-server computing model
All data written to physical media, whether it is magnetic disk, USB stick, CD, DVD, or RAM memory is stored as:
an orderly series of bits
What is the difference between DICOM ready and DICOM conformant?
DICOM ready: The equipment does not include a DICOM interface, but one is available as an option. Caution: Though equipment may have been purchased as ''DICOM ready,'' if it is more than a few years old, the option may no longer be available from the manufacturer. DICOM conformant: The equipment includes a DICOM interface and a conformance statement is available that describes the particulars of the DICOM implementation.
Your computed radiography systems have just been upgraded and you notice that your PACS workstations are not displaying the images correctly. You are comparing the DICOM headers from the new and old images and notice some difference in the DICOM data elements. To which part of the standard do you need to refer?
DICOM, part 3, "information object definitions."
Since large data sets from PACS would bog down in many WAN (wide area network) environments, what would be commonly utilized for clinical review purposes?
Data compression
Data packets with additional data wrapper are referred to as:
Data frames
The current workflow is accessed by the radiologist at a high-performance computer, commonly called the:
Diagnostic workstation
A manufacturer generated number that indicates the ''speed class'' of the digital detector for a given examination, which should be used as an indication of the proper exposure to the patient (and to the detector):
Exposure index
True or False Air is most attenuating, and thus low signal hits the detector and is represented as white in most images; no signal hitting the detector is usually represented as white.
False Air is LEAST attenuating, and thus HIGH signal hits the detector and is represented as BLACK in most images No signal hitting the detector is usually represented as white.
True or False CR and DR does not capture a large range of transmitted exposures
False CR and DR can capture a large range of transmitted exposures (wide exposure latitude) allowing for under and overexposures.
True or False Clinician viewers of studies and reports are commonly located inside the core hospital local area network (LAN) and are reliant on faster connections.
False Clinician viewers of studies and reports are commonly located OUTSIDE the core hospital local area network (LAN) and are reliant on SLOWER connections.
True or false Low-level languages implies diminished quality or efficiency. Programs written directly in machine code or assembly are inefficient.
False Low-level does NOT imply diminished quality or efficiency; programs written directly in machine code or assembly language are VERY EFFICIENT.
True or False Imaging Service Representatives (ISRs) generally understand the PACS application at a level much deeper than that of PACS systems analysts:
False PACS Systems Analysts generally understand the PACS application at a level much deeper than that of the typical users or Imaging Service Representatives (ISRs)
True or False PACS is a relatively inexpensive undertaking both for the required system hardware and support and for the required support staff.
False PACS is a relatively EXPENSIVE undertaking both for the required system hardware and support and for the required support staff.
True or false Real-time fluoro sequences are typically archived.
False Real-time fluoro sequences are NOT typically archived.
True or False Visible light is non-invasive but has maximal ability to penetrate tissues deeply like the energies used in radiological imaging.
False Visible light is non-invasive but has LIMITED ability to penetrate tissues deeply like the energies used in radiological imaging.
True or False Since each packet is self-contained and auto-routable, different packets from a single message can ONLY travel over the SAME routes to arrive at the SAME destination.
False different packets from a single message can travel over COMPLETELY DIFFERENT routes to arrive at the SAME destination.
True or False A host that is accessible globally does not need a unique internet protocol (IP) address
False a host that is accessible globally MUST have a unique internet protocol (IP) address
True or false application software can interact directly with hardware; it cannot work through the OS (operating system).
False application software CANNOT interact directly with the hardware; it MUST work through the OS (operating system)
True or False The central processing unit (CPU) is intelligent and has the ability to make decisions
False it has no innate ''intelligence'' or inherent ability to make decisions
Encloses the MR room to create an environment that is free of extraneous RF signals:
Faraday cage (copper mesh/plate)
Describe the format of a typical ICD9 (International Classification of Diseases, ninth revision) code.
ICD9 (International Classification of Diseases, ninth revision) codes are used to describe diseases and symptoms that justify the need for radiology procedures. - The format of ICD9 codes is an optional one-letter prefix, followed by three-digit number, followed by a decimal point, followed by up to two additional optional numbers (e.g., ''372.25,'' ''E919.0,'' ''V84.01''). - Each additional number provides a more specific diagnosis, and usually results in greater reimbursement. - The prefix ''E'' denotes codes that describe an external source of injury (e.g., motor vehicle accident). - The prefix ''V'' denotes factors that are not true diseases, but influence a person's health status or their effect on the health of others. V-codes have only two primary digits instead of three. ** More than one ICD9 code if often applied to a single examination. ** Unlike CPT codes, ICD9 codes are in the public domain, so a complete list can be downloaded from several sites. Make sure that you obtain the most recent ICD9-CM updates. ** ICD10 is in use outside the United States, and ICD11 is in development.
When shopping for a new healthcare information system, what is the most important document for which to ask?
IHE integration statement
Information that is used at the destination computer to re-create the original file:
Identifier and sequential number Specifies what part of the original file each packet contains
Why is the term "hybrid-client" used instead of "thin client" when the application is used inside of a web browser?
If additional software or browser plug-ins are required or local data processing occurs, the term "hybrid-client" is more appropriate.
Commonly the personnel formerly thought of as ''film librarians'' who play a less obvious role when a PACS is implemented:
Image Service Representatives (ISR)
Where is the "nighthawk radiologist" usually located?
In a different time zone
List some of the major ergonomic factors one should consider when setting up a digital reading room.
Include but not limited to ambient lighting, chair selection, mouse/trackball selection, monitor height, room noise, airflow.
List some of the important software capabilities one should consider and evaluate when purchasing display software for a workstation.
Include but not limited to window/level, zoom/pan, measurement tool.
Databases support an _____________ mechanism that confers greater speed to the system when accessing or updating data.
Indexing
hardware extensions that allow humans (or other devices) to interact with a computer:
Input/output devices
Your vice president of operations asks you to prepare to share images between your institution and a new partner. To which technical framework are you going to refer?
Integrating the Healthcare Enterprise (IHE), IT infrastructure technical framework.
Your digital mammography images from Vendor A do not display correctly on the workstation from Vendor B. Where do you look for insight?
Integrating the Healthcare Enterprise (IHE), IT radiology technical framework, mammography image integration profile.
What is the network abstraction (TCP) - transmission control protocol/(IP) - internet protocol) also referred to as?
International Organization for Standardization (OSI) network model
You want to learn more about how the Internet and web services work. To which standards development organization should you turn?
Internet Engineering Task Force (www.ietf.org); World Wide Web Consortium (www.w3c.org).
A configurable 32-bit numeric value (192.123.456.789) that is used to uniquely identify devices and the networks to which they belong:
Internet protocol address (IP address)
Regarding spatial resolution, each pixel can have only one numerical value and is not possible to observe any:
anatomical detail within a pixel
Instead of relying on the value of the hardware network interface card (NIC) media access control (MAC) address (which is fixed and not configurable), the router is capable of discerning data based upon a software configurable identifier known as?
Internet protocol address (IP address)
Defines a number of rules for establishment of communication between computers:
Internet protocol suite
Connection of two or more networks that changes the scope of network resources to any computer on the network:
Internetworking
Why does indexing come at a cost for databases?
It adds some processing overhead to the system
How does the operating system (OS) differ from essential hardware components?
It consists entirely of software - millions of lines of machine commands that are understood and obeyed by the microprocessor
PACS allows the attending to review or ''__________-__________'' the on-call exam and the attached reading and to provide ''grading'' and feedback, using mechanism similar to peer review for radiology trainees (residents). This commonly occurs on the weekend or at night when the attending radiologist is not physically available.
Over-read
Often the first individual identified to support a PACS:
PACS administrator
Software that converts and translates between HL7 messages (for the HIS or RIS) and DICOM transactions (for the PACS):
PACS broker
If the PACS administration manages the ''front end'' of the PACS application, who manages the ''back end?''
PACS system analyst
Responds to system issues that fall outside the scope of normal day-to-day operation issues and works very closely with the vendor of the PACS to solve significant system problems:
PACS system analyst
Performs user training for radiologists and non-radiologists and gives advice on networking and firewall access:
PACS systems analyst
How is connectivity improved with PACS workstations?
PACS workstations maintain separate, direct links to the PACS database and to the PACS archive. This reduces the routing path for data and improves performance.
Part of the ''negotiations'' when establishing a network connection with another computer:
Packet size
Data transmitted over a network is broken up into multiple small discrete chunks or ______________ before being sent over the network by the NIC (network interface card).
Packets
Medical Imaging Hierarchy:
Patient - Examination (Study) - Series (Sequence) - Image. For example, a patient may undergo an imaging examination, also called a study, such as computed tomography (CT) of the abdomen. This study may include several sequences or series, such as the set of images with and the set without contrast. A sequence or series may consist of a single image or multiple images.
A formal process for reviewing the work of a fellow physician in a confidential, nonthreatening, and non-legally discoverable manner to provide feedback in a protected manner:
Peer review
Since computed radiography (CR) is largely cassette based, it is also known as:
Photostimulable storage phosphor (PSP) radiography
Represent the technological core of a modern, digital, radiology department. Their core function is storage, distribution, and display of medical images:
Picture archiving and communications systems (PACS)
What features does Nagios software perform to help the IIP?
Proactive Monitoring of entire system
What does structured query language (SQL) provide to databases?
Programmatic interface from virtually any development platform
Specific timing methods used for applying RF excitation and magnetic field gradients to achieve desired image contrast and anatomical presentation:
Pulse sequences
Uses high-tube current with short pulses synchronized with the video-frame rate. Typical rates are 15, 7.5, 3.75 frames/seconds:
Pulsed fluoroscopy
What factors contribute to network overhead that can impede actual performance?
Quality of cabling and efficiency of network switches
_____________________ emissions can cause artifacts in the MR images:
Radiofrequency (RF)
Of the modality mix, ______________ comprises approximately 60-70% of all studies performed in a diagnostic radiology department
Radiology
Software that manages the day-to-day operations of a radiology department, or group of cooperating radiology departments:
Radiology Information System (RIS)
The tool that most technologists and radiology administrators use for their daily activities:
Radiology Information System (RIS)
There are a number of database models; however, the _______________ model is used most often.
Relational
A computer that provides application services or data:
Server
Data are collected and stored in a ''_____________'' storage matrix, from which the CT system reconstructs tomographic slices by a ''filtered back-projection'' algorithm.
Sinogram
What is spatial resolution typically dependent upon?
Slice thickness Reconstructed FOV
A network segment can only be used by a single computer at any one instant and the physical parts of the network (i.e., cabling and switches) are shared by many computers. What is it that dramatically improves network efficiency?
Splitting data streams up into smaller parcels in a shared network model
Use the highest dose and achieve the highest contrast and spatial resolution by employing cassette-based CR detectors in the cassette carriage:
Spot radiographs
What is the local PACS workstation linked by?
Standard networking to the PACS core and archive
A database-specific computer language designed to retrieve and manage data in relational database management systems (RDMS):
Structured query language (SQL)
Important for assigning specific accession numbers associated with the exams and delivering only the pertinent information for overlapping studies such as chest, abdomen and pelvis:
Study splitting
What is the function of a PACS database?
Supports powerful patient-search and study-matching tools
What happens if packets are lost during the transmission process?
TCP/IP (transmission control protocol/Internet protocol) has methods for requesting re-transmission of missing or corrupt packets
What advantages can you expect from proactive system monitoring?
The IIP can recognize problems before users even notice there is a problem
What would happen if a radiology department fails to provide good web access, with a relatively deep archive, in a reliable and accessible system?
The department should expect clinicians to demand more costly service, such as their own workstations, printed films, or a never-ending stream of CDROMs
Describe the format of a typical CPT (current procedural terminology) code.
The format of CPT codes is five alphanumeric characters. - Category I codes consist of five numbers and describe a reimbursable procedure that is part of accepted medical practice. - Category II codes consist of four numbers and one letter and are used for tracking performance. They are not reimbursable. - Category III codes consist of four numbers and one letter and are used for experimental procedures. They are not reimbursable. **In many cases, specific modifiers are used to ensure proper reimbursement is achieved.** **More than one CPT code may be assigned to a single examination. This may or may not necessitate a separate radiology report.** **Medicare reimbursement rates depend on CPT code and geographic area.**
What does the network hub provide for all computers?
The hub provides a simple and passive method for all computers connected to it to transmit and receive data to each other
What is clock speed?
The number of instructions that a CPU can perform per second
Explain why decision criteria are necessary when considering whether to switch to a backup system during a downtime.
The time needed to change personnel tasks and possibly applications and/or systems at the start of a downtime may take longer than the actual downtime.
employed on video graphics cards to store graphical information to improve video display performance:
Video memory (VRAM)
What types of clinician outreach techniques might help improve communications with clinicians?
Visit community medical association meetings as a guest speaker, attend staff meetings for other practices or departments, and publish newsletters and blogs with tips for better viewing and access to images.
The primary functions of PACS include image transmission, display, and ______________? a. Archiving b. Manipulation c. Registration d. Compression
a. Archiving
Investments in information technology will not yield improvements unless a. Business processes are redesigned to take advantage of the technology. b. Additional money is invested each year. c. The organization hires more than one PACS administrator. d. The CFO sees a tangible financial return. e. None of the above.
a. Business processes are redesigned to take advantage of the technology.
Which imaging modality provides higher spatial resolution? a. Chest radiograph b. Chest CT
a. Chest radiograph
Medical images have unique performance requirements, safety restrictions, characteristic attributes, and technical limitations that often make them more difficult to create, acquire, manipulate, manage, and interpret. Some of these contributing factors include:
a. Complexity of imaging situations due to equipment size and available space, inaccessibility of the internal structures of the body to measurement, patient positioning, patient illness, and procedure practicality. b. Variability of the data between patients; for example, between normal and abnormal anatomy and physiology, within normal range, and within the same patient at different times or body positions. c. Effect of imaging transducer on the image, including artifacts created by the imaging method or by something in the patient's body. A major source of artifact in images of living systems is motion. d. Safety considerations, patient discomfort, procedure time, and cost-benefit tradeoffs.
Which of these best describes a request for proposal? a. Contains detailed information about the customer's institution b. Sent to a large number of potential vendors c. Determines which vendors receive a request for information d. Determines the vendor of choice
a. Contains detailed information about the customer's institution
Which of the following are hard-dollar savings from PACS? a. Cost of film and chemicals b. Faster report turnaround c. Improved physician satisfaction d. Increased patient safety e. None of the above
a. Cost of film and chemicals
Monochrome displays for diagnostic viewing and interpretation of images should be calibrated to what standard? a. DICOM gray scale standard display function b. HDTV display standards c. SMPTE display standard
a. DICOM gray scale standard display function HDTV is a broadcasting standard for television. The SPMTE was also developed for television and was used in radiology before the development of DICOM but is no longer recommended.
Which of the following is an example of optical media? a. DVD b. Hard drive c. Tape drive d. Flash drive
a. DVD
The primary officer responsible for ensuring that an organization meets HIPAA requirements a. HIPAA compliance officer b. HIPAA privacy officer c. HIPAA regulatory officer d. HIPAA security officer
a. HIPAA compliance officer
Data exchanged between the RIS and the PACS would most likely use which standard for data formatting? a. HL7 b. DICOM c. TCP/IP d. IMAP
a. HL7
The earliest step in developing the plan among those listed below should be a. Defining the acceptance test b. Defining the detailed functionality requirements c. Selecting the hardware and software to be used d. Deciding who will agree that the final payment should be made
a. Defining the acceptance test
What is the first step in selection of a vendor? a. Developing a strategic business plan b. Writing an RFP c. Negotiating the contract d. Site visits e. Deciding payment options
a. Developing a strategic business plan
The procedure used to outline steps to utilize a second copy of image data being stored in a separate location after a catastrophic event is an example of a. Disaster recovery procedure b. Incident report c. Scheduled downtime procedure d. Modality downtime procedure e. Infrastructure downtime procedure
a. Disaster recovery procedure
Contrast sensitivity peaks in the mid-spatial frequency range around 3-5 cycles/degree and is important for what aspect of image viewing? a. Distinguishing between objects and background in an image. b. Measuring the size of an abnormality. c. Distinguishing blue stained cells in a pathology slide from red stained cells. d. Detecting fine features in an image.
a. Distinguishing between objects and background in an image. Contrast perception is important for discriminating subtle shades of gray between lesions and background.
What type of light is not recommended for reading rooms? a. Fluorescent b. Incandescent c. Halogen d. LED e. None of the above
a. Fluorescent
In the project management process, selection of the stakeholders who will participate in the oversight group occurs in phase a. Initiation b. Assessment c. Planning d. Execution e. Monitoring
a. Initiation
What is not true about site visits? a. Location is always decided by the vendor b. The review team can include radiologists and clinicians c. One or more site visits should be made d. Different visits should be close to each other e. A specific site visit agenda should be established
a. Location is always decided by the vendor
What does the compiler turn the source code into?
an executable program that is customized for the specific OS/microprocessor combination that the program was developed for
Which component of the PACS typically communicates with both the HL7 and DICOM protocols? a. PACS broker b. PACS database c. PACS diagnostic workstation d. Master patient index
a. PACS broker
Who is the most likely person to deal with managing the day-to-day operations of the PACS? a. PACS system analyst b. Imaging service representative c. PACS administrator d. PACS clinical outreach coordinator
a. PACS system analyst
The least costly way to finance PACS over its useful life is a. Pay cash (capital) b. Operating lease c. Capital lease d. Application service provider e. Vendor financing
a. Pay cash (capital)
Who is the person who has the last opportunity to detect and correct an error before it can affect patient care? a. Radiologist b. Medical physicist c. Imaging informatics professional d. Radiologic technologist e. Radiology administrator
a. Radiologist
Who sets the standard for quality in an imaging operation? a. Radiologist b. Medical physicist c. Imaging informatics professional d. Radiologic technologist e. Radiology administrator
a. Radiologist
The RACI matrix in project management is an acronym for a. Responsible, accountable, consulted, informed b. Representative and actionable contact information c. Reasonable action for consultant information d. Responsible activity for continual integrity e. None of the above
a. Responsible, accountable, consulted, informed
What is one of the causes of veiling glare? a. The room's color and tonal value b. Ergonomic chairs c. Air conditioning d. All of the above e. None of the above
a. The room's color and tonal value
Which is true of thin-client applications? a. They require a web browser to run b. They do not need additional software c. They require a networked server d. They require an internal database e. All of the above
a. They require a web browser to run
Regarding datacenters, which of the following is true? a. Tier 4 is the highest Tier rating for datacenters. b. The IT Department is responsible for specifying the characteristics of the resources and the availability requirements. c. Power and cooling represent a small cost fraction of datacenter costs d. 24/7 information availability is desirable, but not necessary.
a. Tier 4 is the highest Tier rating for datacenters.
Which of the following is frequently overlooked or underestimated in calculating the total cost of ownership? a. Training b. Hardware maintenance c. Ongoing software maintenance d. Renovation expenses e. Interest on bank loans
a. Training
An important document which should be developed prior to designing the user training program is a. User workflow b. Cheat sheets c. ROI d. Translation tables
a. User workflow
Medical imaging technologies enable views of the internal structure and function of the human body. Information obtained from the various modalities can be used to diagnose:
a. abnormalities b. guide therapeutic procedures c. monitor disease treatment.
A radiographic image has areas of saturation and no anatomical information, but is acquired using an appropriate technique (kV and mAs). This outcome is likely due to which one of the following? a. histogram scaling error b. overexposure c. underexposure d. antiscatter grid e. exposure index miscalibration
a. histogram scaling error
Which of the following is the LEAST reliable method of workflow analysis? a. informal discussions b. formal surveys c. time-motion studies b. direct observation
a. informal discussions
Which of these is NOT a usual element of radiologist workflow? a. obtain images b. convey unexpected findings c. protocol ongoing cases d. collect clinical data
a. obtain images
Which of these is NOT a hierarchical IHE component? a. postprocessing b. order c. requested procedure d. worklist
a. postprocessing
Besides providing high-resolution anatomy fused with low-resolution metabolic activity, the other chief reason for CT and PET system combination is to ________. a. provide attenuation correction for the PET reconstruction b. reduce the injected dose of the radionuclide c. eliminate the need for a CT scan elsewhere d. use the CT scan data for treatment planning e. allow 3D rendering for improved diagnosis
a. provide attenuation correction for the PET reconstruction
Medical modalities produce representations of anatomical (structural) or molecular/physiological (functional) information of the imaged body parts. Examples include:
a. x-ray images are representations of the distribution of the linear attenuation coefficients of tissues and are largely images of anatomy or the structural nature of the tissues in the body. b. Radioisotope imaging of nuclear medicine produces images of the distribution of chemical, molecular, or physiological function of the tissue. c. Some modalities, such as ultrasound, can provide other types of functional measures, such as flow through vessels.
The modern OS (operating system) is intentionally designed to sustain itself automatically with minimal user interaction. The software that is designed to perform real work for users is the _______________ software.
application
a program designed to do real work for a user:
application software
How many lines of code does the Windows XP operating system contain?
approximately 40 million lines of code
Historically, CT images have been generated in the ___________ (transverse) plane that is orthogonal to the long axis of the body. Today's modern scanners can reformat the data in any orientation (orthogonal or oblique to the body axis) or as a volumetric representation.
axial
The ratio of maximum to minimum luminance of a display should be at least a. 25 b. 50 c. 75 d. 100
b. 50 Psychophysical studies have shown that a ratio of 50 is best.
The Security Rule identifies three categories of safeguards for HIPAA compliance: a. Administrative, legal, and technical. b. Administrative, physical, and technical. c. Legal, physical, and technical. d. Authentication, encryption, and automatic logoffs.
b. Administrative, physical, and technical.
Evaluating the value of information over time to find the most cost-effective means of storage and disposition is called a. HSM b. CILM c. MAID d. PIT
b. CILM (Clinical information lifecycle management application)
Which of the following imaging modalities use ionizing radiation as its source? a. Magnetic Resonance Imaging b. Computed Tomography c. Ultrasound imaging d. All of the above e. None of the above
b. Computed Tomography
Morphological filtering is commonly used for? a. registration b. de-noising c. ''cleaning up'' segmentation d. image display
c. ''cleaning up'' segmentation
Ambient room lights should be indirect or backlight and set to what level? a. Turned off completely b. 40-60 lux c. 20-40 lux d. 0-20 lux
c. 20-40 lux A moderate amount of light is recommended for viewing rather than too dark or too bright.
The primary data protocol for transmitting medical images between modalities is a. HL7 b. DICOM c. IHE d. HIPAA
b. DICOM
Small matrix (1 or 2 MP) are appropriate for all of the following types of images except what kind? a. CT b. Digital mammography c. MRI d. Ultrasound
b. Digital mammography The inherent resolution of digital mammography images is high and exceeds the display resolution of small matrix displays. To avoid extended use of zooming in to access the high resolution data and to view the entire image close to full resolution as possible, a large matrix display should be used for mammography.
If a patient has a question about how to access his or her images on the Internet, the imaging informatics professional must teach the patient how to access the images from home. a. True b. False
b. False
Which of the following systems that are used by the radiologists are typically supported by the IIP? a. PACS workstation, email, Internet b. HIS interface, PACS workstation, dictation system interface c. Dictation system, Internet, Microsoft office, email d. HIS/RIS, dictation system, turbo tax
b. HIS interface, PACS workstation, dictation system interface
What is the fundamental distinction between software and hardware? a. Price b. Hardware is a physical entity c. Packaging d. Complexity e. None of the above
b. Hardware is a physical entity
Display pixel size is a more accurate measure of display resolution and should be what size? a. 50 microns b. 100 microns c. 200 microns d. 300 microns
c. 200 microns Visual acuity and contrast sensitivity indicate that 2.5 cycles/mm or 200 micron pixel size is best.
How much time should be given to the vendors to respond to the RFP? a. Less than 16 weeks b. Less than 8 weeks c. Less than 2 weeks d. They can take as much time, as long as they address all the questions in the RFP e. Less than 4 weeks
b. Less than 8 weeks
Which of the following is NOT a direct volume rendering technique? a. MIP b. Marching Cubes c. Volume ray casting d. Splatting e. Shear-Warp
b. Marching Cubes
Which is not true about storage? a. On-line storage is readily available b. Near-line storage requires human intervention c. Off-line storage is not accessible by robotic devices d. Data are stored on media such as tape, compact disk or DVD e. None of the above
b. Near-line storage requires human intervention
The most complex network switch is the a. Network hub b. Network router c. Network bridge d. They are all similar in complexity e. Not listed
b. Network router
Which of the following is an advanced de-noising algorithm? a. Averaging filter b. Nonlocal means c. Gaussian filter d. Median filter
b. Nonlocal means
Which image acquisition technique uses annihilation radiation to create tomographic images? a. SPECT b. PET c. CT d. Emission imaging e. g-ray absorptiometry
b. PET
Which of the following workflow problems should receive the most attention? a. Low-frequency, high-time-commitment tasks b. Pain points c. Administrator workflow d. All of the above are equally important
b. Pain points
How many vendors should be selected by the PACS team to send out the RFPs (request for proposals)? a. 1-3 b. 2-4 c. 4-6 d. 8-10 e. 10-15
c. 4-6
To simultaneously render more than one object in a volume, which of the following volume rendering technique will lead to the best rendering quality? a. MIP b. SSD c. Volume ray casting d. Splatting e. Shear-Warp
b. SSD
Which of these best describes a request for information? a. Contains detailed information about the customer's institution b. Sent to a large number of potential vendors c. Follows the request for proposal d. Determines the vendor of choice
b. Sent to a large number of potential vendors
Which of the following is not a measurable indicator of quality? a. Availability of images and reports b. Single points of failure c. Ionizing radiation dose d. Repeated images e. Exceptions
b. Single points of failure
According to MQSA, it is permissible to electronically transfer mammography images specifically if a. The data are transferred in lossless compression format and are acceptable to the sending party. b. The data are transferred in lossless compression format and are acceptable to the receiving party. c. The data are transferred in lossy or lossless compression format and are acceptable to the sending party. d. The data are transferred in lossy or lossless compression format and are acceptable to the receiving party.
b. The data are transferred in lossless compression format and are acceptable to the receiving party.
The minimum native resolution for full-field digital mammography must be at least a. 1 line pair per millimeter. b. 2 line pairs per millimeter. c. 5 line pairs per millimeter. d. 10 line pairs per millimeter.
c. 5 line pairs per millimeter.
Value is defined as a. The financial return of an investment divided by the cost of the investment b. The results of an investment divided by the cost of the investment c. The percentage financial return over the life of the investment d. The cash flow of the investment over the life of the investment e. None of the above
b. The results of an investment divided by the cost of the investment
A training method that provides the advantage of having departmental user support persons long after go-live is a. Vendor training of all staff individually b. Train-the-trainers c. IT training of department users d. One-on-one training
b. Train-the-trainers
For an enterprise-level PACS, generally clinicians are a part of the site visit team a. Always true - clinicians must always attend visits. b. True to certain extent - experts in different divisions may attend or limited to Chief Medical in-charge Officer as the number of persons visiting sites is limited. c. False - consultants replace the clinicians in all visits as the number of people visiting sites is limited. d. False to certain extent - clinicians' demands are minimal when compared to radiologists. e. Vendor decides if clinicians must attend or not.
b. True to certain extent - experts in different divisions may attend or limited to Chief Medical in-charge Officer as the number of persons visiting sites is limited.
Which of the following modality is most affected by the skill of the operator? a. Projection radiography b. Ultrasound c. Computed Tomography d. Magnetic Resonance Imaging e. Positron Emission Tomography
b. Ultrasound
The window width and window level setting most appropriate for viewing a CT image when bones are being evaluated (e.g., wide contrast latitude) is closest to which setting? (WW is window width, WL is window level). a. WW = 400 WL = 40 b. WW = 2000 WL = 300 c. WW = 80 WL = 35 d. WW = 200 WL = 50 e. WW = 1500 WL = -700
b. WW = 2000 WL = 300
Which of these is NOT a usual element of clinician workflow? a. order study b. dictate radiology reports c. review radiologist report d. provide clinical data
b. dictate radiology reports
When troubleshooting a radiologist complaining of poor accuracy in speech recognition you should do everything except a. check the microphone connection with the soundcard b. encourage the radiologist to speak more slowly c. check soundcard quality using speech engine software d. encourage the radiologist to use a headset microphone
b. encourage the radiologist to speak more slowly
The retention period for PHI depends on all of the following EXCEPT: a. age of patient b. gender of patient c. federal statues d. state statutes
b. gender of patient
All of the following are true concerning an itemized report except: a. it is preferred by clinicians over a conventional report b. it saves time both in report creation and report interpretation c. it is not common in radiology reporting d. it is a form of structured reporting
b. it saves time both in report creation and report interpretation
An attribute that a typical diagnostic PACS workstation used for ultrasound image review does not commonly provide is the ability to ______. a. display acoustic grayscale images b. simultaneously play multiple avi video clips c. retrieve archived ultrasound images d. show color images for Doppler studies e. use measurement tools for evaluating distances
b. simultaneously play multiple avi video clips
The maximum amount of data that can be transmitted over a medium, usually measured in bits per second:
bandwidth
What is another key component to the typical computer motherboard?
basic input/output system (BIOS)
Software at its lowest level (the level at which it interacts with the CPU) consists of a long series of:
bits (ones and zeros)
In a chest radiograph, the air spaces in the lungs appear __________, soft tissues are lighter gray, and the bony ribs and spine are __________.
black white
What is the startup process also known as?
boot process
Assigns each computer in the home network its own internet protocol (IP) address that is only unique within the home network:
broadband network router
How does the network bridge improve upon the design of the basic network hub?
by providing a level of active management of the communication between attached hosts
Good project management should include all but a. Frequent team meetings b. Project management software c. Frequent adjustment of schedules to match achievements d. Communications with oversight groups/individuals e. Occasional external reviews
c. Frequent adjustment of schedules to match achievements
What is the most important furniture consideration? a. Visibility b. Sterility c. Adjustability d. Sustainability e. None of the above
c. Adjustability
Which is NOT a common component of enterprise image distribution? a. On-demand archive b. EHR integration c. Auto-routing d. Web server e. Citrix
c. Auto-routing
Which of the following scenarios is most appropriate for asynchronous communication? a. Alerting an emergency department physician to emergent radiologic findings b. Consulting a radiologist for an allergic contrast reaction c. Communicating the need for a 6-month follow-up examination d. Asynchronous communication is appropriate for all of the above
c. Communicating the need for a 6-month follow-up examination
MQSA certification must be renewed a. Every year. b. Every 2 years. c. Every 3 years. d. Every 5 years.
c. Every 3 years.
Which of the following is the most important environmental patient safety aspect concerning MRI? a. Tissue heating b. RF noise c. Ferromagnetic projectile d. Gradient switching e. Eddy currents
c. Ferromagnetic projectile
This project management coordination tool presents a graphical display of key project milestones tracked over time a. Run chart b. RACI matrix chart c. Gantt chart d. Cause and effect chart e. PERT matrix chart
c. Gantt chart
The Privacy Rule pertains to protected health information in any format, and specifies that ''covered entities'' are defined exclusively as a. Business associates of healthcare entities. b. Healthcare entities. c. Healthcare entities and business associates. d. Healthcare payors.
c. Healthcare entities and business associates.
Volatile memory is distinguished from non-volatile memory by a. Poorer performance of volatile memory b. Flammability of volatile memory c. Inability of volatile memory to retain data with power loss d. Greater expense of volatile memory e. None of the above
c. Inability of volatile memory to retain data with power loss
According to HIPAA, transmission security requires a. Integrity controls and the encryption of data that are exchanged between applications. b. Integrity controls and the encryption of data that are exchanged between local servers. c. Integrity controls and the encryption of data that are exchanged between remote locations. d. Integrity controls and the encryption of data are not required by HIPAA transmission security.
c. Integrity controls and the encryption of data that are exchanged between remote locations.
Which is the best statement regarding the motherboard data bus? a. It connects to the keyboard b. It connects to the power supply c. It interconnects the components on the motherboard d. It connects to the disk drive e. None of the above
c. It interconnects the components on the motherboard
4. Which of the following techniques might help keep the radiologists work areas run smoothly and correctly? a. Regulate exactly when each computer can be used and how it can be used so that no one can use it during a scheduled downtime and so you have complete control over its use. b. Change the passwords on the reading room computers every morning at 6 AM with an automatic reboot to enforce security. c. Monitor the computers in the work areas for correct operation. d. Purge all the images and databases from the PACS computers every morning at 7AM to be sure they start fresh each day.
c. Monitor the computers in the work areas for correct operation.
Which of the following enhancements, if added to a PACS, would enable an attending radiologist to check the work of a resident? a. Programmed peer review b. Integration of nighthawk ''wet'' readings c. Over-reading d. Electronic teaching files
c. Over-reading
In the project management process, vendor selection occurs in which phase a. Initiation b. Assessment c. Planning d. Execution e. Monitoring
c. Planning
Which of the following is NOT an element of workload assessment? a. Number of studies performed b. Estimate of growth rate c. RIS compatibility d. Peak times for report generation
c. RIS compatibility
Which registration transform is suitable for neuro-imaging registration? a. Thin-plate spline b. Affine transformation c. Rigid-body transformation
c. Rigid-body transformation
RadLex a. is a lexicon created by a single individual b. content was not dependent on existing lexicons c. decreases ambiguity in reports d. is simple and easy to manage
c. decreases ambiguity in reports
Which of the following is LEAST influential in product development? a. Customer requests b. Market direction c. Site visits d. Product release cycle
c. Site visits
Lossy data compression does all but which of the following? a. Allows for storage of more data compared to no compression. b. Loses data once the images have been compressed and uncompressed. c. Slows down transmission of image data over networks. d. Allows for reconstruction of exact original data as before compression without loss of information.
c. Slows down transmission of image data over networks. One of the main uses of compression of any kind (lossy or lossless) is to speed up transmission of data.
Computer drivers are: a. Names for a specific type of golf club b. Large programs that take control of the OS c. Small programs that provide a bridge or interface between hardware and software d. Similar to computer viruses e. None of the above
c. Small programs that provide a bridge or interface between hardware and software
Which of the following is true about the economics of storage management? a. Once storage is purchased, it is no longer an ongoing annual budget item b. Media itself accounts for approximately 50% of the total cost of storage c. Storage costs include personnel, utilities, datacenter space, and data backup d. Technological obsolescence will require upgrades approximately every 10 years.
c. Storage costs include personnel, utilities, data center space, and data backup
A good example of a learning objective for a training session on the QA module of a PACS system is: ''At the completion of this course the user will be able to. . . a. Define the image QA module.'' b. Do image QA.'' c. Successfully resolve typical image QA issues using the QA module.'' d. Avoid creating image QA issues.''
c. Successfully resolve typical image QA issues using the QA module.''
How can a Wiki be used to provide documentation of information systems? a. The IIP can download the information about each system from Wikipedia. b. The IIP can upload the documentation provided by vendors to Wikipedia and make it available to everyone. c. The Wiki installed on the institution's intranet can be modified by qualified personnel to inform all information systems' users about new features and proper use of the systems. d. The Wiki installed on the institution's intranet can be modified by qualified personnel to download Wikipedia information.
c. The Wiki installed on the institution's intranet can be modified by qualified personnel to inform all information systems' users about new features and proper use of the systems.
Major components of a healthcare system architecture includes all but a. System b. Technical c. Topographic d. Information e. Physical
c. Topographic
The type of adult learner who benefits most from illustrations and cheat sheets during training is a. Kinesthetic learner b. Auditory learner c. Visual learner d. All of the above
c. Visual learner
The largest drawback of radiography compared to computed tomography is ______. a. higher radiation dose b. lower spatial resolution c. anatomical superimposition d. time required for the examination e. image storage requirements
c. anatomical superimposition
The best time to define the PACS acceptance test requirements is a. during user training b. after the PACS is installed. c. in the request for proposal that the vendor responds to d. All of the above e. None of the above
c. in the request for proposal that the vendor responds to
A point-and-click structured report with tracked data elements a. is used predominantly in general radiology b. can improve radiologist efficiency and decrease distraction during image interpretation c. is ideal for data mining d. is better accepted by radiologists than is speech recognition
c. is ideal for data mining
Which of the following methods is the most desirable DR method for the RIS database? a. multiple copies at multiple locations on the enterprise storage solutions SAN b. daily and weekly copies off-site on FCF Tier 3 storage c. multiple copies made at several intervals during the day on the enterprise SAN and a daily copy sent to an SSP d. daily and weekly tape copies sent off-site daily to a secure storage facility
c. multiple copies made at several intervals during the day on the enterprise SAN and a daily copy sent to an SSP
Performance is lowest for which of the following types of data storage? a. on-line b. near-line c. off-line
c. off-line Removable media that requires human intervention to load and retrieve data. As a result, performance is the lowest for off-line storage. While off-line storage is the least expensive storage strategy, it is otherwise quite inefficient and is therefore reserved for data that have a low probability for future use.
In Nuclear Medicine and Positron Emission Tomography (PET) the radioisotope is distributed according to which of the following? a. metabolic function b. chemical function c. physiological function
c. physiological function the image primarily represents functional information; however since function is distributed in the physical structures, recognizable anatomical images are produced.
All of the following pertain to the use of macros and templates in speech recognition except a. they are essential for efficient use b. users should be encouraged to create their own macros c. should be kept to few in number to avoid confusion d. are most effective for users with poor recognition
c. should be kept to few in number to avoid confusion
How can blood flow velocities be measured during a doppler ultrasound?
can be measured using the principle of a shift in reflected sound frequency produced by the moving objects
A doppler ultrasound is useful for imaging which areas of the heart?
cardiac chambers and valves of the heart, arterial flow, particularly to assess the carotids and peripheral vascular disease, and venous flow studies for the detection of deep-vein thrombosis
The physical connection of the computer to the network is usually accomplished through specialized cabling that contains four pairs of simple copper wires (twisted pair) in a configuration known as:
category 5 (Cat5) or its enhanced version Cat5e
Typically the largest integrated circuit on the motherboard. It is referred to as the "brain of the computer."
central processing unit (CPU) or microprocessor
What is the total resolution of a digital image?
combination of the spatial resolution and the contrast resolution.
What is the software that converts the source code to machine code?
compiler
The graphical user interface (GUI) is accomplished by creating a visual representation of what?
computer file system (the desktop), icons, and windows and linking them to the movements of a pointing device such as a mouse or trackball
a group of two or more interconnected computers that are capable of sharing data and resources:
computer network
limits differentiation of detail within and between objects and is a function of the bit depth used to represent the grayscale quantization:
contrast resolution
The motherboard is interfaced with other outside components (e.g., disk drives, power supply, keyboard, network, etc.) using specialized _____________ that provide necessary power and connectivity to peripheral devices such as disk drives (storage), video displays, and keyboards.
couplers
Imagine that you are planning a massive data migration in a busy department when changing PACS vendor. Which data would you move first? At what days and times would you perform the migration? 1. the most recent prior studies and build a new demographic database 2. the oldest prior studies and build a new demographic database 3. 24 hours x 7 days per week since there is much data to migrate 4. during periods when there would be minimum impact on clinical activities a. 1 & 3 b. 4 only c. 2 & 4 d. 1 & 4
d. 1 & 4 1. the most recent prior studies and build a new demographic database 4. during periods when there would be minimum impact on clinical activities
Integration of clinical information systems and PACS may result in a. An increase in accurate relevant clinical information available to radiologists b. Faster turnaround times of results to clinicians c. Richer information by the concurrent delivery of images and their associated report d. All of the above
d. All of the above a. An increase in accurate relevant clinical information available to radiologists b. Faster turnaround times of results to clinicians c. Richer information by the concurrent delivery of images and their associated report
A diagnostic workstation used by a radiologist generally offers what feature(s) over a ''standard'' PC used for clinical review of images: a. Higher quality and higher brightness monitors b. Faster network connection back to the PACS core c. Presence of more advanced image manipulation tools d. All of the above
d. All of the above a. Higher quality and higher brightness monitors b. Faster network connection back to the PACS core c. Presence of more advanced image manipulation tools
Which of the following are to be notified of a scheduled outage? a. Hospital administration b. House staff c. Referring physicians d. All of the above e. None of the above
d. All of the above a. Hospital administration b. House staff c. Referring physicians
Which of these changes should prompt a workflow analysis? a. Introduction of new technology b. Major personnel change c. Complaints from personnel about software inefficiencies d. All of the above
d. All of the above a. Introduction of new technology b. Major personnel change c. Complaints from personnel about software inefficiencies
What is programming software?
development software - programs that aid in the writing (i.e., coding) of other software
Which of the following must be documented when destroying PHI? a. Method of destruction b. Inclusive dates covered c. Statement that the records were destroyed in the normal course of business d. All of the above
d. All of the above a. Method of destruction b. Inclusive dates covered c. Statement that the records were destroyed in the normal course of business
Formative assessments of learning progress are done to a. Motivate learners b. Enhance training programs c. Improve the teaching process d. All of the above
d. All of the above a. Motivate learners b. Enhance training programs c. Improve the teaching process
Which of the following are examples of ''image-intensive users?'' a. Pulmonologist b. Neurologists c. Hospitalists d. All of the above e. None of the above
d. All of the above a. Pulmonologist b. Neurologists c. Hospitalists
What are some of the ramifications of poorly designed space and user interface? a. Reduced interpretation speed b. Reduced accuracy c. Job-related injuries d. All of the above e. None of the above
d. All of the above a. Reduced interpretation speed b. Reduced accuracy c. Job-related injuries
Which of the following are used for PACS image storage? a. Short-term storage b. Long-term archive c. Redundant or disaster recovery archive d. All of the above e. None of the above
d. All of the above a. Short-term storage b. Long-term archive c. Redundant or disaster recovery archive
Which of these are ways of providing acoustic control within a shared reading room? a. Sound absorbing materials for wall, floor, and ceiling finishes b. Sound masking systems c. Ceiling design d. All of the above e. None of the above
d. All of the above a. Sound absorbing materials for wall, floor, and ceiling finishes b. Sound masking systems c. Ceiling design
Which of the following is a component of an enterprise image distribution infrastructure? a. VPN b. On-demand archive c. Diagnostic display monitors d. All of the above e. None of the above
d. All of the above a. VPN b. On-demand archive c. Diagnostic display monitors
In the formation of a digital image, sampling affects which of the following? a. Visible fine detail b. Image matrix size c. Spatial resolution d. All of the above e. None of the above
d. All of the above a. Visible fine detail b. Image matrix size c. Spatial resolution
Which of the following can be used to deliver images to the enterprise? a. WADO b. Image compression c. Just in time data delivery d. All of the above e. None of the above
d. All of the above a. WADO b. Image compression c. Just in time data delivery
The HIS/RIS/PACS and other medical information systems connect with each other using a. a robust, secure network connection b. DICOM c. HL7 d. All of the above e. None of the above
d. All of the above a. a robust, secure network connection b. DICOM c. HL7
Protected Health Information (PHI) is defined as a. All information that is available at the patient or study demographics level. b. Any information that can be used to identify an individual at the patient demographics level. c. Any information that can be used to identify an individual at the study demographics level. d. Any information that can be used to identify an individual at the patient or study demographics level.
d. Any information that can be used to identify an individual at the patient or study demographics level.
Low-level programming languages are: a. Fairly simple to learn and use b. Are primarily used by human computer programmers to create applications c. Are not as costly as high-level programming languages d. Are used primarily by the CPU e. All of the above
d. Are used primarily by the CPU
Which of the following is true regarding mammography films that have been digitized? a. Can be used for primary diagnosis and comparison studies and can be used as a substitute for film for long-term archiving. b. Can be used for primary diagnosis and comparison studies and cannot be used as a substitute for film for long-term archiving. c. Can be used for comparison only and not for primary diagnosis and can be used as a substitute for long-term archiving. d. Can be used for comparison only and not for primary diagnosis and cannot be used as a substitute for long-term archiving.
d. Can be used for comparison only and not for primary diagnosis and cannot be used as a substitute for long-term archiving.
Which of the following is LEAST important to assess on a site visit? a. Compare clinical workflow between institutions b. Discuss installation issues c. Show interaction with other information systems d. Compare pricing between institutions
d. Compare pricing between institutions
Which procedure is used to transfer patient demographic information from the RIS to the image acquisition device? a. Performed procedure step (PPS) b. Presentation of grouped procedures (PGP) c. Key image note (KIN) d. Modality worklist (MWL) e. Portable data for imaging (PDI)
d. Modality worklist (MWL)
Which of the following is an advantage of departmental storage over enterprise storage? a. vendor independence and best-of-breed purchasing b. reduced cost of hardware and licensing fees c. ease of providing redundancy d. None of the above
d. None of the above
Who is not a stakeholder for PACS implementation? a. Radiologists b. Technologists c. Clinicians d. Nurses e. IT staff
d. Nurses
All of the following enhance workflow EXCEPT: a. Dashboards b. Base case workflow design c. Redundancy of key personnel d. Paper tokens
d. Paper tokens
Which RAID level will provide the best performance, redundancy, and availability for a busy Radiology Department's RIS database? a. RAID 1 b. RAID 5 c. RAID 6 d. RAID 10
d. RAID 10
Which of the following modalities has the highest spatial resolution? a. MRI b. Fluoroscopy c. CT d. Radiography e. Ultrasound
d. Radiography
Who has the first opportunity to detect and correct errors? a. Radiologist b. Medical physicist c. Imaging informatics professional d. Radiologic technologist e. Radiology administrator
d. Radiologic technologist
Creates a shared medium where only one computer can successfully transmit at a time and each computer (host) is responsible for the entire communication process:
hub
The typical radiology technologist is most likely to interact with which of the following systems throughout their workday? a. PACS broker b. PACS web viewer c. PACS diagnostic workstation d. Radiology information system
d. Radiology information system
An opportunity for training in a ''real patient'' environment is best provided during a. One-on-one training b. Group training in a classroom c. User presentations in the classroom d. Simulation prior to ''go-live''
d. Simulation prior to ''go-live''
Which of the following is NOT a downtime type? a. Hardware failure b. Network c. Printer failure d. Software failure e. Electrical
d. Software failure
Three of the key visual properties important for the interpretation of medical images are a. Contrast resolution, spatial resolution, and the color of the eyes. b. Night vision, contrast resolution, and spatial resolution. c. Color vision, spatial resolution, and blink rate. d. Spatial resolution, contrast resolution, and color vision.
d. Spatial resolution, contrast resolution, and color vision. - Spatial resolution is needed to discern fine details - contrast resolution is needed for visual acuity - color vision is required in medical imaging areas that use color images (pathology).
Which of the following is the most significant source of artifact in medical images? a. Human variability b. Patient positioning c. X-ray dose d. Subject motion e. Safety considerations
d. Subject motion
Which one of the following parameters for an MR image acquisition is user defined, rather than a property of the patient's tissues? a. T1 b. T2 c. Proton density d. TR e. Blood flow
d. TR
What surface in the reading room has the greatest influence on sound transmission? a. The door b. The window c. The wall d. The ceiling e. None of the above
d. The ceiling
Which of the following is a NOT a downtime due to software failure? a. Virus b. Driver installation c. Windows updates d. Video card e. Corrupt file system
d. Video card
Which of the following software license costs would increase if the number of procedures performed per year increases? a. Per seat license b. Site license c. Per workstation license d. Volume-based license e. Size-based license
d. Volume-based license
Which of the following is NOT a form of network storage? a. RAID b. SAN c. NAS d. WAN
d. WAN
Which of these is not an ergonomic design consideration? a. Where eyes meet the monitor b. Where hands and fingers meet the input device c. Where body rests against chair d. Where ears meet the door e. None of the above
d. Where ears meet the door
Which of these is NOT a usual element of technologist workflow? a. send images to PACS b. check images for quality c. postprocess the study to create new images d. bring the patient to the radiology department
d. bring the patient to the radiology department
In a registration algorithm, the metric is used to a. filter the images b. find the global minimum c. segment the images d. determine if the images are in alignment
d. determine if the images are in alignment
Concerning interoperability of speech recognition and structured reporting with other software such as PACS and RIS: a. it is not necessary in smaller hospitals and imaging centers b. it improves mainly clerical but not clinical workflow c. integration is now standardized across all PACS and reporting vendors d. it may require an upgrade to workstation hardware
d. it may require an upgrade to workstation hardware
Which of these is NOT an IHE integration profile? a. reporting workflow b. evidence documents c. consistent presentation of images d. procedure step
d. procedure step
the physical data chain built into the motherboard that allows for efficient data transfer:
data bus ***supported by several ICs (integrated circuits) known as the chipset, which coordinates uninterrupted data transfers through the bus***
What is an example of online storage?
data on spinning hard disk arrays
What is the majority of time devoted to programming spent on?
debugging the code
What is the process that programmers must follow to compile, test, identify errors, correct errors, re-code, and re-compile?
debugging the program
an image d(x,y) that has been discretized (digitized) both in space (physical location) and in amplitude (gray level):
digital image it can be considered as a matrix whose row and column indices identify a point x1,y1 in the image, and the corresponding matrix element value d(x1,y1) identifies the gray level at that point
An OS (operating system) may consist of hundreds (or even thousands) of small programs called ____________ .
drivers
Small programs that enable the operating system and application programs to interact with each other and with peripheral hardware devices. They require periodic upgrades, especially when the operating system changes:
drivers
The image matrix size of a computed tomography image is? a. 128 x 128 x 12 bits b. 128 x 192 x 12 bits c. 256 x 256 x 12 bits d. 512 x 512 x 8 bits e. 512 x 512 x 12 bits
e. 512 x 512 x 12 bits
DICOM connections between the PACS and modalities include a. IP address b. System license c. AE (application entity) title d. Port number e. A, C, & D
e. A, C, & D a. IP address c. AE (application entity) title d. Port number
DICOM image sets used for evaluating workstation monitors are available from a. RSNA (Radiological Society of North America) b. IHE (Integrating Healthcare Enterprise) c. SIIM (Society for Imaging Informatics in Medicine) d. JCAHO (Joint Commission on Accreditation of Healthcare Organizations) e. ACR/AAPM (American College of Radiology/American Association of Physicist in Medicine)
e. ACR/AAPM (American College of Radiology/American Association of Physicist in Medicine)
Which of the following are important elements to assess in planning for a PACS transition? a. Estimated rate of growth for the department b. Current state of imaging equipment c. Current personnel d. Existing RIS capabilities e. All of the above
e. All of the above a. Estimated rate of growth for the department b. Current state of imaging equipment c. Current personnel d. Existing RIS capabilities
Which of the following is a possible technical solution to minimize downtime? a. Fault-tolerance PACS b. Multiple PACS workstations c. Backup system d. Full system backup prior to scheduled downtime e. All of the above
e. All of the above a. Fault-tolerance PACS b. Multiple PACS workstations c. Backup system d. Full system backup prior to scheduled downtime
PACS committee membership should include in the stakeholder group a. Hospital IT representative b. Cardiologists c. Imaging physicist d. Medical records representative e. All of the above
e. All of the above a. Hospital IT representative b. Cardiologists c. Imaging physicist d. Medical records representative
Which of the following are examples of results that support the strategic business objectives of the enterprise? a. Increased profitability b. Increased market share c. Ability to meet regulatory requirements d. Improvements in health status e. All of the above
e. All of the above a. Increased profitability b. Increased market share c. Ability to meet regulatory requirements d. Improvements in health status
Who among the following is a potential customer for an imaging informatics professional? a. Patients b. Radiologists c. Vendors d. Hospital IT e. All of the above
e. All of the above a. Patients b. Radiologists c. Vendors d. Hospital IT
The purpose of the operating system (OS) is a. To manage memory allocations b. To copy files to disk c. To manage the user interface d. To manage computer resources e. All of the above
e. All of the above a. To manage memory allocations b. To copy files to disk c. To manage the user interface d. To manage computer resources
What amount of light is ideal for a reading room? a. Complete darkness for image viewing b. As bright as the monitors c. Daylight only d. An adjustable variety of light sources e. B and D
e. B and D b. As bright as the monitors d. An adjustable variety of light sources
Scope creep includes all of the following except a. Trading some functionality for other functionality b. Adding functionality that can be accomplished within the contingency c. Adding a subsequent phase for addressing the needs of other facilities d. Adopting a new information model that better meets the plan e. Changing the standard video display card for PACS workstations
e. Changing the standard video display card for PACS workstations
Roles of the PACS committee include all except a. Ensure that any request for changes in the PACS plan align with initial project scope b. Review project plan to ensure it represents the clinical and technical requirements c. Serve as a project advocacy group in requesting of institutional funding d. Serve as an oversight group for project milestones and proper budget spending e. Ensure the current dominant modality vendor receives the PACS project contract
e. Ensure the current dominant modality vendor receives the PACS project contract
Of the following, which modality has the largest data size for a single image? a. MRI with an 8 channel phased array coil b. CT with a 128 channel multidetector array c. DR chest X-ray with 43 x 43 cm FOV, 200 μm detector element d. Digital photospot camera with a 40 cm diameter intensifier e. Mammography with 24 x 30 cm FOV, 50 μm detector element
e. Mammography with 24 x 30 cm FOV, 50 μm detector element
The core hardware components of a digital computer include everything except a. Microprocessor b. Memory c. Bus d. Keyboard e. Operating system
e. Operating system
What is the single best method for understanding radiology operations? a. Reliability analysis b. Reject analysis c. Task allocation matrix d. Policies and procedures e. Process mapping
e. Process mapping
How many programs does the operating system (OS) consist of?
hundreds or thousands of individual programs that are bundled together ***many of these individual programs are designed to work cooperatively with each other***
Advantages of pre-trained ''superusers'' include all of the following EXCEPT a. Potential career advancement for the superuser b. Knowledge of internal dynamics of the department c. Knowledge of key departmental personnel d. Reduced workload for dedicated support personnel e. Reduced cost of training
e. Reduced cost of training
Which of the following individuals does NOT require a workflow assessment in preparation for the transition to PACS? a. The radiologists b. The technologists c. The support personnel (transport, file room) d. The patients e. They ALL require workflow assessment
e. They ALL require workflow assessment a. The radiologists b. The technologists c. The support personnel (transport, file room) d. The patients
How many bit clusters of data form a byte of data?
eight-bit clusters
What does direct digital radiography (DR) devices convert X-ray energy to?
electron-hole pairs in an amorphous selenium photoconductor, which are read out by a thin-film transistor (TFT) array of amorphous silicon (Am-Si).
The wiring and signaling schema for the network interface card (NIC) and the cabling between devices on the network:
ethernet
What is the role of the central processing unit (CPU) or microprocessor?
execute specific commands or instructions/machine code dictated by a computer program and orchestrate the movement of data and instructions through the entire computer system
An internally managed network (intranet) that maintains limited connectivity to networks that are neither managed, owned, nor controlled by the same entity:
extranet
What type of network is typically isolated from the public Internet with security measures such as firewalls that regulate connectivity to outside or unmanaged networks?
extranet
Regarding contrast resolution, what happens if there is insufficient quantization?
false contouring or ridges in which smoothly varying regions of an object within the image become undifferentiable
In projection radiography, what does the analog detector consist of?
fluorescent screen and radiographic film
How does the source transducer in an ultrasound function?
functions as a receiver of reflected sound and converts the signal into an electric current, which is subsequently processed into a grayscale image
replaces typed computer commands with a graphical representation of the task (e.g., moving a file):
graphical user interface (GUI)
What do drivers enable software to interact with?
hardware devices attached to the motherboard and between components on the motherboard itself
What is the imaging source of an ultrasound?
high-frequency sound waves produced by a transducer made of a piezoelectric crystal.
Both machine code and its symbolic representation (assembly language) are considered as low-level or high-level languages?
low-level languages - they are the closest command analog to the actual functional details of the microprocessor
What is the imaging source of fluorography?
low-power X-ray beam; ionizing radiation
What are disadvantages of fluorography?
lower quality moving projection radiograph
Low-level programming language is the software language that is directly understood by a microprocessor, and is termed:
machine code or machine language
What does an MRI utilize to produce images of the body?
magnetic properties of certain nuclei, predominantly hydrogen (H+) in water and fat molecules the response of magnetized tissue when perturbed by an RF pulse varies between tissues and is differentiated for pathological tissue as compared to normal
What is an example of extranets that consist of a local area network (LAN) with access provided to the public Internet (WAN) via an Internet service provider (ISP) (Comcast, AT&T, Verizon, etc.)?
many home networks
Air has the least attenuation causing ________ signal to reach the detector, resulting in black or dark areas of the image. maximum signal or minimum signal
maximum signal
What is the efficiency of data retrieval with a near-line system dependent upon?
mechanical speed of the robotic system and the queuing mechanism of the media
Every network interface card (NIC) possesses a unique number that helps to route data to and from other computers:
media access control (MAC) address
What types of addresses is the bridge capable of learning from connected computers?
media access control (MAC) addresses
used to temporarily store data (and results) and applications or programs:
memory
The Wide area network (WAN) covers broad geographical areas, such as:
metropolitan, regional, or national
What would cause better visibility of fine detail and a better quality higher spatial resolution image?
more frequent sampling that results in smaller pixels (larger matrix sizes)
Numerous ICs (chip) are interconnected on a large circuit board, frequently referred to as the:
motherboard
supports two or more individuals to run programs concurrently on the same computer system:
multi-user OS (operating system)
Supports use of more than one CPU:
multiprocessing OS (operating system)
Allows more than one program to run simultaneously:
multitasking OS (operating system)
Allows different parts of a program to run concurrently:
multithreading OS (operating system)
What does high-level programming language use?
natural language elements instead of arcane numbers and abbreviations ***This makes the process of programming simpler, intuitive, and more understandable to the human programmer***
What consists of removable media (e.g., tapes, CDs, or DVDs) that are made available through mechanical means such as a robotic tape or optical disk jukebox?
near-line storage
What is the simplest and most inexpensive of network switches?
network hub
The piece of computer hardware that provides the capability for a computer to communicate over a network:
network interface card (NIC)
In order for them to communicate effectively, each device must adhere to a specific set of rules for communication called:
network protocols
Fast, reliable ________________ form the backbone of digital Radiology department and allow large quantities of imaging data to be efficiently transported between modalities, archives, and viewing stations.
networks
A characteristic of all medical images that lowers image quality and is also referred to as image mottle:
noise
What is the BIOS (basic input/output system) comprised of?
non-erasable read only memory (ROM) chip that contains the minimal amount of software necessary to instruct the computer how to access the keyboard, mouse, display, disk drives, and communications ports
Removable media that requires human intervention to load and retrieve data:
off-line storage
Refers to high-performance, non-removable media that requires no human or mechanical intervention to retrieve:
on-line storage
How many compilers do most development software platforms consist of?
one or more compilers
What is a system software also known as?
operating system
What is the underlying software that integrates the hardware with software applications?
operating system (OS)
Modalities can be characterized by whether their energy source uses ionizing radiation such as for:
radiography, fluoroscopy, mammography, CT, and nuclear medicine or non-ionizing radiation such as for ultrasound and magnetic resonance imaging (MRI).
A solid-state memory module that can be erased and rewritten for unlimited number of times is generically referred to as:
random access memory (RAM)
In fluorography, continuous acquisition of a sequence of X-ray images over time results in:
real-time X-ray movie
Why is the network hub a passive device?
replicates all messages to all hosts connected to it and does not have any capability to route messages to a specific destination
What type of network device is capable of examining the contents of the data passing through it and is able to discern the identity of the sender and the recipient?
router
What were the early sensors (detectors) in Computed Tomography?
scintillation detectors with photomultiplier tubes excited by sodium iodide (NaI) crystals
What is the purpose of a router using network address translation (NAT)?
serves as a proxy that allows multiple computers to share a single public Internet internet protocol (IP) address
How many commands per second can the typical microprocessor execute?
several billions of commands per second
Which is slower? The inherent speed of non-volatile memory or volatile memory?
since non-volatile memory is substantially slower than that of volatile memory, volatile RAM is typically employed on the motherboard to augment data processing
The term ''______________'' applies both to application programs and data.
software
What are the modern detectors in Computed Tomography?
solid-state scintillators coupled to photodiodes or are filled with low-pressure xenon gas *An image is obtained by computer processing of the digital readings of the detectors*
What are some examples of physical memory that can exist in solid-state form as an IC (integrated circuit) or as physical media?
spinning disk compact disk [CD] digital versatile disk [DVD]
The devices that connect other devices together on the network and are the cornerstones of the computer:
switches
What does noise look like an an image?
textured, snowy, or grainy appearance that can degrade visibility of small or low contrast objects
What does the bridge have to use to send data that is destined for a specific host?
the port associated with a unique media access control (MAC) address
What is an image file size equal to?
the product of the matrix size (number of rows times number of columns) times the number of 8-bit bytes required to represent the image bit depth.
How do scripting languages differ from compiled languages?
the source code is interpreted and converted into machine code at the time of execution - preventing the compiling process
