Technical University of Denmark

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1 Technical University of Denmark Page 1 of 11 pages Written test, 9 December 2010 Course name: Introduction to medical imaging Course no Aids allowed: none. "Weighting": All problems weight equally. Instruction: See answer sheet. The right answer is the one which is most correct Problem 1 One of the reasons, that bone cannot be imaged very well with ultrasound in vivo is that A. the sound speed through bone is too fast to allow for echo registration. B. the reflection coefficient between soft tissue and bone is quite large, so for the bone to be imaged, the ultrasound pulse would need a very high amplitude, since both the forward propagating pulse and the echoes from the inside of the bone would need to pass the interface. C. the sound speed through bone is so large compared to soft tissue that the sound beam of the forward propagating pulse will be completely diffracted at an angle of nearly 90 degrees and thus travel along the bone. D. the specific acoustic impedance of bone is much lower than the specific acoustic impedance of soft tissue, creating a negative reflection coefficient that makes the forward propagating wave imaginary. Problem 2 A thin 1-mm-in-diameter silicone tube contains a radioactive tracer (radiopharmaceutical). The tracer was injected into the tube via a syringe (Danish: sprøjte). This was not done carefully, so the tracer in the tube contained air bubbles of approximately 1 mm of length. Which modality is most sensitive in distinguishing between tracer and air bubbles in the tube, when the tube is placed in a liquid containing air bubbles of size and concentration similar to that of the tube? The wall of the tube is infinitely small. A. MRI B. CT C. Ultrasound D. PET

2 Problem 3 Page 2 of 11 pages The sketch below shows an ultrasound measurement situation and four versions of the corresponding received signal. The received signals are plotted as a function of time directly underneath the measurement situation. Which is most correct? Transducer Water Muscle d Received signal Voltage gr(t) Emitted pulse Echo signal Ultrasound beam A t Voltage gr(t) Emitted pulse Echo signal B t Voltage gr(t) Emitted pulse Echo signal C t Voltage gr(t) Emitted pulse Echo signal D t A. The sketch shown in A is the most correct. B. The sketch shown in B is the most correct. C. The sketch shown in C is the most correct. D. The sketch shown in D is the most correct. Problem 4 Which of the following is not part of typical scanners for magnetic resonance imaging? A. A magnet generating a static field 1 Τ. B. A rotating coil generating linear field variations 1 mt across the imaged region. C. A coil used for generating magnetic fields oscillating at frequencies 1 MHz. D. A coil used for detecting magnetic fields oscillating at frequencies 1 MHz.

3 Problem 5 Page 3 of 11 pages The figure shows a cross-sectional view of the measurement situation involving a square rod (Danish: kvadratisk (firkantet) stang) of homogeneous material. The upper row shows the situation when using a CT scanner and the lower row shows the situation when using an ultrasound scanner. It is the same material and it is placed in a homogeneous liquid. The four figures A - D show different sketches for how the images look and how to measure the side length of the rod (indicated by the coloured arrows). μ m and μ w is the x-ray attenuation coefficient of rod and water, respectively. z m and z w are the specific acoustic impedance of the rod and water, respectively. μ m μ w and z m z w. The sketches are exaggerated to improve interpretation. Detector & X-ray tube ring A B C D CT (X-ray) μm μw Ultrasound transducer US zm zw A. The sketch in A is the most correct. B. The sketch in B is the most correct. C. The sketch in C is the most correct. D. The sketch in D is the most correct. Problem 6 Which of the following sentences about T 1 relaxation is correct? A. The T 1 parameter describes how fast the longitudinal magnetization is lost after excitation. B. The T 1 parameter describes how fast the transversal magnetization is lost after excitation. C. The T 1 parameter describes how fast the transversal magnetization approaches its full amplitude after excitation. D. The T 1 parameter describes how fast the longitudinal magnetization approaches its full magnitude after excitation.

4 Problem 7 Page 4 of 11 pages This problem is about diagnostic ultrasound and it is illustrated in the figure. It concerns the intensity of the emitted acoustic pulse as it propagates from the transducer in the z-direction. The measurement is done with a so-called hydrophone (a very small transducer that does not influence the field it aims at measuring). The hydrophone is placed in the biological tissue as illustrated. The biological tissue consists of muscle, tendon, facia, fat, etc. The attenuation is the loss of intensity as compared to a measurement in pure water. List all possible factors which can influence this intensity measure? Sound intensity is measured here Transducer Water Biological tissue Cable z Ultrasound beam Hydrophone A. Absorption, scattering, reflection and refraction taking place in the tissue. B. Absorption, scattering and reflection taking place in the tissue. C. Absorption and scattering taking place in the tissue. D. Absorption taking place in the tissue. Problem 8 The sound speed, c material, in a slab (Danish: en skive) of material of thickness D is to be measured. An ultrasound transducer is emitting ultrasound towards the material, so that the acoustic axis is perpendicular to the surface of the material. The centre frequency of the ultrasound pulse is f 0. Which technique is the most effective to use: A. Measure the wavelength, λ, and then calculate an estimate of the speed of sound from: c = λf 0. B. Measure the wavelength, λ, and then calculate an estimate of the speed of sound from: c = λ/f 0. C. Record the echoes from the two interfaces between the material and the surroundings. Estimate the time difference between the echoes, Δt, and then calculate an estimate of the speed of sound from c = 2DΔt. D. Record the echoes from the two interfaces between the material and the surroundings. Estimate the time difference between the echoes, Δt, and then calculate an estimate of the speed of sound from c = 2D/Δt.

5 Problem 9 Page 5 of 11 pages Which of the following sentences best describes parameters for typical clinical imaging systems used at the hospital? A. Ultrasound imaging: Transducer centre frequency of 10 MHz. Magnetic resonance imaging: Static B 0 field of 1.5 Tesla. Probing electromagnetic pulse at about 63 MHz. Computed tomography with X-ray: Photon beam where the centre of the energy spectrum is about 70 kev. B. Ultrasound imaging: Transducer centre frequency of 63 MHz. Magnetic resonance imaging: Static B 0 field of 1.5 Tesla. Probing electromagnetic pulse at about 63 MHz. Computed tomography with X-ray: Photon beam where the centre of the energy spectrum is about 70 kev. C. Ultrasound imaging: Transducer centre frequency of 10 MHz. Magnetic resonance imaging: Static B 0 field of 0.1 Tesla. Probing electromagnetic pulse at about 10 MHz. Computed tomography with X-ray: Photon beam where the centre of the energy spectrum is about 512 kev. D. Ultrasound imaging: Transducer centre frequency of 63 MHz. Magnetic resonance imaging: Static B 0 field of 1.5 Tesla. Probing electromagnetic pulse at about 10 MHz. Computed tomography with X-ray: Photon beam where the centre of the energy spectrum is about 512 MeV. Problem 10 The figure shows a sketch of the interaction between an planar sound wave and two interfaces between three homogenous media of different specific acoustic impedance, z 1 z 2 z 3. The dotted lines indicate the normal to the interfaces. Which sketch is most correct? A B C D z1 z z3 A. Sketch A is most correct. B. Sketch B is most correct. C. Sketch C is most correct. D. Sketch D is most correct.

6 Problem 11 Page 6 of 11 pages In this problem, Data is a SIS structure and contains a 3D image. Its corresponding axes have an increment of 1 mm in all three dimensions. The following is calculated for the Data: Data2 = sis_zoom( Data, [15 1 1], [ ] ); N = prod( size ( Data2.Images )); delta_1 = Data2.Axes(1).Axis(2) - Data2.Axes(1).Axis(1); delta_2 = Data2.Axes(2).Axis(2) - Data2.Axes(2).Axis(1); delta_3 = Data2.Axes(3).Axis(2) - Data2.Axes(3).Axis(1); V = N * delta_1 * delta_2 * delta_3; (prod(x) is calculating the product of the numbers in x). What is calculated and what is the value of V approximately? A. Three images are created: One with image values in the range 15 to 57, one with image values in the range 1 to 80 and one with image values 1 to 30. These images are multiplied. V is the third moment and is mm 3. B. Three images are created: One with image values in the range 15 to 57, one with image values in the range 1 to 80 and one with image values 1 to 30. These images are multiplied. V is the third moment and is 12.5 mm 3. C. A 3D image with index from 15 to 57 along the first dimension, index from 1 to 80 along the second dimension and index from 1 to 30 along the third dimension is extracted from the Data. The volume of this image is calculated and the value of V is approximately mm 3. D. A 3D image with index from 15 to 57 along the first dimension, index from 1 to 80 along the second dimension and index from 1 to 30 along the third dimension is extracted from the Data. The volume of this image is calculated and the value of V is approximately 12.5 mm 3. Problem 12 Consider a material with N radioactive atoms. What does half-life mean? A. After one half-life, there are N/2 radioactive atoms left. After two half-lives, there are N/3 radioactive atoms left. After three half-lives, there are N/4 radioactive atoms left. B. After one half-life, there are N/2 radioactive atoms left. After two half-lives, there are N/4 radioactive atoms left. After three half-lives, there are N/6 radioactive atoms left. C. After one half-life, there are N/2 radioactive atoms left. After two half-lives, there are N/4 radioactive atoms left. After three half-lives, there are N/8 radioactive atoms left. D. After one half-life, there are N/2 radioactive atoms left. After two half-lives, there are N/8 radioactive atoms left. After three half-lives, there are N/16 radioactive atoms left.

7 Problem 13 Page 7 of 11 pages The figure shows an X-ray tube for generation of X-rays. I signifies the current of a current generator. What is I, if I a = 100 ma and I b = 75 ma? Protective lead Cathode (heated filament) Glass envelope I Electrons Anode Ib Ia + U X-rays A. 25 ma. B. 75 ma. C. 100 ma. D. 175 ma. Problem MBq 18 F-FDG is administered to a patient. Subsequently, the patient is scanned with PET three times: 1 hour, 5 hours and 9 hours after tracer administration. A full-body scan is performed and the PET signal from the entire body is considered. What happens with the recorded PET-signal and why? A. The magnitude decreases. This is due to the decay of the radioactive tracer and the amount of tracer expelled from the body. B. The magnitude decreases. This is due to tracer expelled from the body. C. The magnitude increases until about 90 minutes after administration, then it decreases. This is why cancer patients are scanned 1 hour after 18 F-FDG-administration. D. The magnitude is almost constant, because the half-life of 18 F is much, much longer than 9 hours.

8 Problem 15 Page 8 of 11 pages The figure below illustrates different phenomena within Positron emission tomography (PET). Which description is most correct? Detector ring A. All situations contribute to the correct image. B. Situations 1, 3 and 4 contribute to the correct image. C. Only situation 1 contributes to the correct image. D. Only situation 2 contributes to the correct image. Problem 16 Below are four statements of how blood appears on grey scale ultrasound and CT on images. It is also explained why. Which is most correct? A. In ultrasound, the scattering from blood is much smaller than from muscle and fat, so the blood regions usually appear dark (black). In CT, blood is attenuating with a value that is approximately 30 HU and thus typically appears dark grey (black). B. In both US and CT, blood appears black on the typical image. This is because attenuation of blood (especially the absorption) is practically zero for both ultrasound and X-ray. C. In ultrasound, the attenuation of blood is frequency dependent just as for any other type of tissue. This shifts the spectrum of the received signal towards lower frequencies, where the transducer is less sensitive, thus yielding a lower signal amplitude resulting in blood appearing black in the ultrasound image. In CT, blood is attenuating with a value that is approximately 30 HU and thus typically appears dark grey (black). D. In ultrasound, the attenuation of blood is frequency dependent just as for any other type of tissue. This shifts the spectrum of the received signal towards lower frequencies, where the transducer is less sensitive, thus yielding a lower signal amplitude resulting in blood appearing black in the ultrasound image. In CT, blood is scattering the X-rays, yielding false information at the detectors, resulting in somewhat unpredictable results in the CT image.

9 Problem 17 Page 9 of 11 pages An agar phantom with porcine thoracic tissue is scanned with CT and MRI. Both scanners provide images that are cross-sectional and oriented in parallel planes. The centre-to-centre distance between neighbouring images (inter-image distance) is 2 mm and 5 mm, respectively. It is assumed that the slice thickness of tissue represented by an image is equal to the inter-image distance. The images also reveal the location of fiducial markers on the top of the agar block so that the two 3D data sets can be aligned (as was done in the course). It is assumed that this alignment can be done perfectly. Which way is the most precise, when comparing a CT and an MR image? A. Since the images are recorded with two different inter-image distances, the distance between an MR image and the closest CT image varies. The CT and MR images that are closest should be compared. B. The CT and MR images closest to the central fiducial marker should be compared. C. Since the images are recorded with two different inter-image distances, the distance between an MR image and the closest CT image varies. Since the CT and MR images represent different volumes of tissue, approximately two CT images should be averaged. This can be done in two ways: averaging image 1 with 2, 3 with 4, etc. or 2 with 3, 4 with 5, etc. The distances between centres of averaged CT images and the MR images are found. The MR image(s) closest to an averaged CT image should be compared. D. Since the images are recorded with two different inter-image distances, the distance between an MR image and the closest CT image varies. Since the CT and MR images represent different volumes of tissue, approximately two CT images should be averaged by averaging image 1 with 2, 3 with 4, etc. The distances between centres of averaged CT images and MR images are found. The (or those) MR image(s) closest to an averaged CT image should be compared. Problem 18 What is the wavelength of ionizing radiation with energy E = J? Planck s constant, h = Js. The speed of light, c km/s. A. 331 nm. B. 662 nm. C. 331 pm. D. 662 pm.

10 Problem 19 Page 10 of 11 pages In the figure below, μ 0, μ 1 and μ 2 are linear attenuation coefficients for three different materials. These are exposed to monoenergetic electromagnetic radiation. The intensity of the incoming radiation is I(0). When μ 0 = 1 cm -1, μ 1 = 2 cm-1, μ 2 = 3 cm -1, z 1 = 1 cm, z 2 = 3 cm and z 3 = 4 cm, what is the intensity I(z 3 )? I(0) 0 μ1 z1 μ0 z2 μ2 z3 I(z3) z A. I(z 3 ) = I(0)exp(-5). B. I(z 3 ) = I(0)exp(-6). C. I(z 3 ) = I(0)exp(-7). D. I(z 3 ) = I(0)exp(-8). Problem 20 The problem concerns the frequency of the energy carrier that is used to make medical images. Any energy provided by static (DC) fields are ignored. The drawings below show the order in which the modalities can be listed with respect to frequency. Both mechanical and electromagnetic energy is considered. Which is most correct? A: US MRI X-ray & CT PET Frequency (Hz) B: PET X-ray & CT US MRI Frequency (Hz) C: MRI US X-ray & CT PET Frequency (Hz) D: US MRI PET X-ray & CT Frequency (Hz) A. Drawing A is most correct. B. Drawing B is most correct. C. Drawing C is most correct. D. Drawing D is most correct.

11 Problem 21 Page 11 of 11 pages The units of the following different medical images used in the course are the following: A. CT: Relative. Planar X-ray: Relative. B. CT: Hounsfield. Planar X-ray: Relative. C. CT: Relative. Planar X-ray: Hounsfield. D. CT: Hounsfield. Planar X-ray: Hounsfield. Problem 22 Which properties do normal T 1 - and T 2 -weighted MR images reflect: A. The protein content since proteins contain large amounts of hydrogen. B. The water content and electromagnetic waves from neural activity. C. The water content and the mobility of water molecules. D. The concentration of injected protons and their relaxation. Problem 23 Which of the following combinations of static and RF magnetic fields is used for MRI? A. A static field and a weaker radio-frequency field oriented perpendicular to the static field. B. A static field and a weaker radio-frequency field oriented parallel to the static field. C. A static field and a stronger radio-frequency field oriented parallel to the static field. D. A static field and a stronger radio-frequency field oriented perpendicular to the static field. Problem 24 What is a collimator? A. A device used to collect gamma radiation. B. A device used to avoid collision of gamma radiation. C. A device used to ensure collision of gamma radiation. D. A device through which only gamma radiation travelling in a specific direction can pass.

Technical University of Denmark

Technical University of Denmark Technical University of Denmark Page 1 of 10 pages Written test, 12 December 2012 Course name: Introduction to medical imaging Course no. 31540 Aids allowed: None. Pocket calculator not allowed "Weighting":

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