Mosbys Exam Review for Computed Tomography 3rd Edition (2019)
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Mosby's Exam
Review for
Computed
Tomography
THIRD EDITION
Daniel N. DeMaio, MEd, RT(R)(CT)
Chair
Department of Health Sciences and Nursing
Director
Radiologic Technology Program
University of Hartford
West Hartford, Connecticut
2
Review for
Computed
Tomography
THIRD EDITION
Daniel N. DeMaio, MEd, RT(R)(CT)
Chair
Department of Health Sciences and Nursing
Director
Radiologic Technology Program
University of Hartford
West Hartford, Connecticut
2
3
Table of Contents
Cover image
Title Page
Copyright
Dedication
Preface
Content and Organization
Features
Acknowledgments
Part I
Chapter 1 Introduction
American Registry of Radiologic Technologists Postprimary
Certification in Computed Tomography
Nuclear Medicine Technology Certification Board Postprimary
Certification in Computed Tomography
4
Cover image
Title Page
Copyright
Dedication
Preface
Content and Organization
Features
Acknowledgments
Part I
Chapter 1 Introduction
American Registry of Radiologic Technologists Postprimary
Certification in Computed Tomography
Nuclear Medicine Technology Certification Board Postprimary
Certification in Computed Tomography
4
Using This Review Book
Text Format
Study Habits and Test-Taking Techniques
Chapter 2 Review of Patient Care in Computed Tomography
Patient Assessment and Preparation
Contrast Administration
Chapter 3 Review of Safety in Computed Tomography
Radiation Safety and Dose
Chapter 4 Review of Imaging Procedures in Computed
Tomography
Head
Neck
Chest
Abdomen and Pelvis
Hepatobiliary System
Spleen
Pancreas
Adrenal Glands
Genitourinary System
Gastrointestinal System
Pelvis and Reproductive System
Musculoskeletal System
5
Text Format
Study Habits and Test-Taking Techniques
Chapter 2 Review of Patient Care in Computed Tomography
Patient Assessment and Preparation
Contrast Administration
Chapter 3 Review of Safety in Computed Tomography
Radiation Safety and Dose
Chapter 4 Review of Imaging Procedures in Computed
Tomography
Head
Neck
Chest
Abdomen and Pelvis
Hepatobiliary System
Spleen
Pancreas
Adrenal Glands
Genitourinary System
Gastrointestinal System
Pelvis and Reproductive System
Musculoskeletal System
5
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Chapter 5 Review of Image Production in Computed Tomography
CT System Principles, Operation, and Components
Image Processing and Display
Image Quality
Artifact Recognition and Reduction
Informatics
Part II
Chapter 6 Simulated Examination One
Questions
Chapter 7 Simulated Examination Two
Questions
Chapter 8 Simulated Examination Three
Questions
Chapter 9 Answer Key—Examination One
Answers
Chapter 10 Answer Key—Examination Two
Answers
Chapter 11 Answer Key—Examination Three
Answers
6
CT System Principles, Operation, and Components
Image Processing and Display
Image Quality
Artifact Recognition and Reduction
Informatics
Part II
Chapter 6 Simulated Examination One
Questions
Chapter 7 Simulated Examination Two
Questions
Chapter 8 Simulated Examination Three
Questions
Chapter 9 Answer Key—Examination One
Answers
Chapter 10 Answer Key—Examination Two
Answers
Chapter 11 Answer Key—Examination Three
Answers
6
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Glossary
Bibliography
Index
7
Bibliography
Index
7
Loading page 8...
Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
MOSBY'S EXAM REVIEW FOR COMPUTED TOMOGRAPHY,
THIRD EDITION
ISBN: 978-0-323-41633-7
Copyright © 2018, Elsevier Inc. All rights reserved.
Previous editions Copyright 2011, 1996 by Mosby, Inc., an affiliate
of Elsevier Inc
No part of this publication may be reproduced or transmitted in
any form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Details
on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with
organizations such as the Copyright Clearance Center and the
Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions.
This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).
8
3251 Riverport Lane
St. Louis, Missouri 63043
MOSBY'S EXAM REVIEW FOR COMPUTED TOMOGRAPHY,
THIRD EDITION
ISBN: 978-0-323-41633-7
Copyright © 2018, Elsevier Inc. All rights reserved.
Previous editions Copyright 2011, 1996 by Mosby, Inc., an affiliate
of Elsevier Inc
No part of this publication may be reproduced or transmitted in
any form or by any means, electronic or mechanical, including
photocopying, recording, or any information storage and retrieval
system, without permission in writing from the publisher. Details
on how to seek permission, further information about the
Publisher's permissions policies and our arrangements with
organizations such as the Copyright Clearance Center and the
Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions.
This book and the individual contributions contained in it are
protected under copyright by the Publisher (other than as may be
noted herein).
8
Loading page 9...
Notices
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described
herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified,
readers are advised to check the most current information provided
(i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on
their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
material herein.
Library of Congress Cataloging-in-Publication Data
Names: DeMaio, Daniel N., author.
Title: Mosby's exam review for computed tomography / Daniel N.
DeMaio.
Other titles: Exam review for computed tomography
Description: Third edition. | St. Louis, Missouri : Elsevier, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017035969 | ISBN 9780323416337 (paperback)
Subjects: | MESH: Tomography, X-Ray Computed | Examination
9
Knowledge and best practice in this field are constantly changing.
As new research and experience broaden our understanding,
changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own
experience and knowledge in evaluating and using any
information, methods, compounds, or experiments described
herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified,
readers are advised to check the most current information provided
(i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or
formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on
their own experience and knowledge of their patients, to make
diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the
authors, contributors, or editors, assume any liability for any injury
and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of
any methods, products, instructions, or ideas contained in the
material herein.
Library of Congress Cataloging-in-Publication Data
Names: DeMaio, Daniel N., author.
Title: Mosby's exam review for computed tomography / Daniel N.
DeMaio.
Other titles: Exam review for computed tomography
Description: Third edition. | St. Louis, Missouri : Elsevier, [2018] |
Includes bibliographical references and index.
Identifiers: LCCN 2017035969 | ISBN 9780323416337 (paperback)
Subjects: | MESH: Tomography, X-Ray Computed | Examination
9
Loading page 10...
Questions
Classification: LCC RC78.7.T6 | NLM WN 18.2 | DDC
616.07/57076–dc23 LC record available at
https://lccn.loc.gov/2017035969
Senior Content Strategist: Sonya Seigafuse
Senior Content Development Manager: Ellen Wurm-Cutter
Content Development Specialist: Sarah Vora/ Charlene Ketchum
Publishing Services Manager: Deepthi Unni
Project Manager: Janish Ashwin Paul
Designer: Ryan Cook
Printed in United States
Last digit is the print number: 9 8 7 6 5 4 3 2 1
10
Classification: LCC RC78.7.T6 | NLM WN 18.2 | DDC
616.07/57076–dc23 LC record available at
https://lccn.loc.gov/2017035969
Senior Content Strategist: Sonya Seigafuse
Senior Content Development Manager: Ellen Wurm-Cutter
Content Development Specialist: Sarah Vora/ Charlene Ketchum
Publishing Services Manager: Deepthi Unni
Project Manager: Janish Ashwin Paul
Designer: Ryan Cook
Printed in United States
Last digit is the print number: 9 8 7 6 5 4 3 2 1
10
Loading page 11...
Dedication
For my family – Christine, Ryan, and Emily.
11
For my family – Christine, Ryan, and Emily.
11
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Preface
Content and Organization
Mosby's Exam Review for Computed Tomography is designed to
prepare the radiologic technologist for successful completion of the
American Registry of Radiologic Technologists (ARRT) Advanced
Certification Examination for Computed Tomography. This review
text will also help prepare the nuclear medicine technologist for the
Computed Tomography certification examination offered by the
Nuclear Medicine Technology Certification Board (NMTCB).
Because many general radiographers and nuclear medicine
technologists are now cross-training in computed tomography and
are performing computed tomography as part of their daily
practice, this text will be a valuable resource for preparing for the
applicable CT certification examination.
This text first offers a thorough review in an outline format of the
content areas on the ARRT Computed Tomography Examination:
Patient Care, Safety, Image Production, and Procedures. The review
is followed by three 165-question mock examinations and answer
keys.
Features
Simulated Examinations
The format of the questions is similar to the ARRT examination.
Answers and rationales are provided for each question.
12
Content and Organization
Mosby's Exam Review for Computed Tomography is designed to
prepare the radiologic technologist for successful completion of the
American Registry of Radiologic Technologists (ARRT) Advanced
Certification Examination for Computed Tomography. This review
text will also help prepare the nuclear medicine technologist for the
Computed Tomography certification examination offered by the
Nuclear Medicine Technology Certification Board (NMTCB).
Because many general radiographers and nuclear medicine
technologists are now cross-training in computed tomography and
are performing computed tomography as part of their daily
practice, this text will be a valuable resource for preparing for the
applicable CT certification examination.
This text first offers a thorough review in an outline format of the
content areas on the ARRT Computed Tomography Examination:
Patient Care, Safety, Image Production, and Procedures. The review
is followed by three 165-question mock examinations and answer
keys.
Features
Simulated Examinations
The format of the questions is similar to the ARRT examination.
Answers and rationales are provided for each question.
12
Loading page 13...
Evolve Resources
One of the most valuable features of this review resource is the
accompanying Evolve site, http://evolve.elsevier.com/DeMaio/CT.
The Evolve site contains questions that can be randomly accessed to
compile an unlimited number of variations of mock examinations.
Examinations on the Evolve site may be taken in quiz mode with
immediate feedback or in a timed mode to simulate the actual
examination experience.
Daniel N. DeMaio
13
One of the most valuable features of this review resource is the
accompanying Evolve site, http://evolve.elsevier.com/DeMaio/CT.
The Evolve site contains questions that can be randomly accessed to
compile an unlimited number of variations of mock examinations.
Examinations on the Evolve site may be taken in quiz mode with
immediate feedback or in a timed mode to simulate the actual
examination experience.
Daniel N. DeMaio
13
Loading page 14...
Acknowledgments
Sincere thanks to the superb staff of Elsevier, including Sonya
Seigafuse, Sarah Vora, and Janish Paul. Working with editor
Charlene Ketchum was an absolute pleasure, and I am very
appreciative of her guidance and support throughout this project.
I am truly grateful to Mr. Steven Ahrenstein. Not only did he
provide me with some excellent images for this revised edition, but
he was also my first CT teacher and helped instill within me a love
for this imaging modality that I still carry to this day.
To my friends and colleagues at the University of Hartford,
thanks for all that you do in support of me, our programs, and our
students. I could not ask for a better group of professionals to work
with.
To my students, past and present, it remains a distinct honor for
me to be a part of your education in the radiologic sciences. I have
the best job in the world, and so much of that is because of you.
To my wife and best friend Christine, our son Ryan, and our
daughter Emily, you make me the proudest husband and father on
the planet. I love you all more than I'll ever be able to describe with
words on a page.
Daniel N. DeMaio
14
Sincere thanks to the superb staff of Elsevier, including Sonya
Seigafuse, Sarah Vora, and Janish Paul. Working with editor
Charlene Ketchum was an absolute pleasure, and I am very
appreciative of her guidance and support throughout this project.
I am truly grateful to Mr. Steven Ahrenstein. Not only did he
provide me with some excellent images for this revised edition, but
he was also my first CT teacher and helped instill within me a love
for this imaging modality that I still carry to this day.
To my friends and colleagues at the University of Hartford,
thanks for all that you do in support of me, our programs, and our
students. I could not ask for a better group of professionals to work
with.
To my students, past and present, it remains a distinct honor for
me to be a part of your education in the radiologic sciences. I have
the best job in the world, and so much of that is because of you.
To my wife and best friend Christine, our son Ryan, and our
daughter Emily, you make me the proudest husband and father on
the planet. I love you all more than I'll ever be able to describe with
words on a page.
Daniel N. DeMaio
14
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Part I
OUTLINE
Chapter 1 Introduction
Chapter 2 Review of Patient Care in Computed Tomography
Chapter 3 Review of Safety in Computed Tomography
Chapter 4 Review of Imaging Procedures in Computed
Tomography
Chapter 5 Review of Image Production in Computed Tomography
15
OUTLINE
Chapter 1 Introduction
Chapter 2 Review of Patient Care in Computed Tomography
Chapter 3 Review of Safety in Computed Tomography
Chapter 4 Review of Imaging Procedures in Computed
Tomography
Chapter 5 Review of Image Production in Computed Tomography
15
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C H A P T E R 1
Introduction
CHAPTER OUTLINE
AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS
POSTPRIMARY CERTIFICATION IN COMPUTED
TOMOGRAPHY
NUCLEAR MEDICINE TECHNOLOGY CERTIFICATION
BOARD POSTPRIMARY CERTIFICATION IN COMPUTED
TOMOGRAPHY
USING THIS REVIEW BOOK
TEXT FORMAT
STUDY HABITS AND TEST-TAKING TECHNIQUES
1. Do Not Wait Until the Last Minute to Prepare!
2. Practice Your Time Management Skills
3. Zero in on the Correct Answer
4. Have Confidence!
American Registry of Radiologic
Technologists Postprimary
Certification in Computed
Tomography
16
Introduction
CHAPTER OUTLINE
AMERICAN REGISTRY OF RADIOLOGIC TECHNOLOGISTS
POSTPRIMARY CERTIFICATION IN COMPUTED
TOMOGRAPHY
NUCLEAR MEDICINE TECHNOLOGY CERTIFICATION
BOARD POSTPRIMARY CERTIFICATION IN COMPUTED
TOMOGRAPHY
USING THIS REVIEW BOOK
TEXT FORMAT
STUDY HABITS AND TEST-TAKING TECHNIQUES
1. Do Not Wait Until the Last Minute to Prepare!
2. Practice Your Time Management Skills
3. Zero in on the Correct Answer
4. Have Confidence!
American Registry of Radiologic
Technologists Postprimary
Certification in Computed
Tomography
16
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Technologists who wish to enter the postprimary pathway to
certification in computed tomography (CT) must hold a registration
in one of the following supporting categories:
• Radiography
• Nuclear Medicine Technology
• Radiation Therapy
To attain eligibility for American Registry of Radiologic
Technologists (ARRT) certification in CT, technologists must
complete a minimum of 16 hours of structured education credits in
topics that reflect the certification examination content. In addition,
candidates for CT certification are required to document
performance of core clinical procedures to establish eligibility.
Specific educational and clinical requirements and documentation
procedures may be obtained from the ARRT.
The ARRT postprimary examination in CT was first offered in
March 1995. It was designed to give the technologist an opportunity
to become certified in the specific modality of CT. The CT registry is
a 165-question, multiple-choice examination covering four major
subject areas in the following manner:
• Patient Care: 22 questions
• Safety: 20 questions
• Image Production: 55 questions
• Procedures: 68 questions
The latest content specifications for the ARRT examination in CT
are provided in the box at the end of this chapter. The approximate
number of test questions for each major topic is provided in
parentheses. The computer-based CT certification examination is
currently given at specific test centers located throughout the
United States. Please contact the ARRT (www.ARRT.org) for
additional information regarding application procedures,
deadlines, testing center locations, and so on.
Nuclear Medicine Technology
Certification Board Postprimary
17
certification in computed tomography (CT) must hold a registration
in one of the following supporting categories:
• Radiography
• Nuclear Medicine Technology
• Radiation Therapy
To attain eligibility for American Registry of Radiologic
Technologists (ARRT) certification in CT, technologists must
complete a minimum of 16 hours of structured education credits in
topics that reflect the certification examination content. In addition,
candidates for CT certification are required to document
performance of core clinical procedures to establish eligibility.
Specific educational and clinical requirements and documentation
procedures may be obtained from the ARRT.
The ARRT postprimary examination in CT was first offered in
March 1995. It was designed to give the technologist an opportunity
to become certified in the specific modality of CT. The CT registry is
a 165-question, multiple-choice examination covering four major
subject areas in the following manner:
• Patient Care: 22 questions
• Safety: 20 questions
• Image Production: 55 questions
• Procedures: 68 questions
The latest content specifications for the ARRT examination in CT
are provided in the box at the end of this chapter. The approximate
number of test questions for each major topic is provided in
parentheses. The computer-based CT certification examination is
currently given at specific test centers located throughout the
United States. Please contact the ARRT (www.ARRT.org) for
additional information regarding application procedures,
deadlines, testing center locations, and so on.
Nuclear Medicine Technology
Certification Board Postprimary
17
Loading page 18...
Certification in Computed
Tomography
Nuclear medicine technologists certified by the Nuclear Medicine
Technology Certification Board (NMTCB), the Canadian
Association of Medical Radiation Technologists (CAMRT), or the
ARRT may be eligible to sit for the new CT certification
examination offered by the NMTCB. First offered in 2014, this 200-
question multiple-choice examination covers much of the
information included on the ARRT certification examination in CT.
However, the NMTCB/CT certification examination also includes
information pertaining to the hybrid imaging studies that combine
CT with molecular imaging techniques such as positron emission
tomography (PET) and single-photon emission computed
tomography (SPECT).
To attain eligibility for NMTCB certification in CT, technologists
must complete a minimum of 35 contact hours of instruction in the
following topics:
• Contrast administration
• Cross-sectional anatomy
• X-ray physics
• CT radiation safety
In addition, appropriately credentialed nuclear medicine
technologists must complete a minimum of 500 clinical hours in CT,
PET/CT, and/or SPECT/CT. Specific educational and clinical
requirements and documentation procedures/forms may be
obtained from the NMTCB.
Using This Review Book
The first edition of this book, titled Registry Review in Computed
Tomography, was developed shortly after I had successfully
completed the CT registry examination in March 1995. A second
edition published in 2011 was vastly updated and expanded. This
third edition incorporates much of the information included in the
second edition, but has been completely revised and updated to
18
Tomography
Nuclear medicine technologists certified by the Nuclear Medicine
Technology Certification Board (NMTCB), the Canadian
Association of Medical Radiation Technologists (CAMRT), or the
ARRT may be eligible to sit for the new CT certification
examination offered by the NMTCB. First offered in 2014, this 200-
question multiple-choice examination covers much of the
information included on the ARRT certification examination in CT.
However, the NMTCB/CT certification examination also includes
information pertaining to the hybrid imaging studies that combine
CT with molecular imaging techniques such as positron emission
tomography (PET) and single-photon emission computed
tomography (SPECT).
To attain eligibility for NMTCB certification in CT, technologists
must complete a minimum of 35 contact hours of instruction in the
following topics:
• Contrast administration
• Cross-sectional anatomy
• X-ray physics
• CT radiation safety
In addition, appropriately credentialed nuclear medicine
technologists must complete a minimum of 500 clinical hours in CT,
PET/CT, and/or SPECT/CT. Specific educational and clinical
requirements and documentation procedures/forms may be
obtained from the NMTCB.
Using This Review Book
The first edition of this book, titled Registry Review in Computed
Tomography, was developed shortly after I had successfully
completed the CT registry examination in March 1995. A second
edition published in 2011 was vastly updated and expanded. This
third edition incorporates much of the information included in the
second edition, but has been completely revised and updated to
18
Loading page 19...
include the latest information on this dynamic imaging modality.
This review text is essentially designed for two different groups of
examination applicants. For the established CT technologist, the
review outline and examination questions help bridge the gap
between clinical experience and cognitive knowledge. Those of you
who are experienced in CT will already be familiar with much of
the subject matter covered. This review book allows you to answer
questions concerning the principles and procedures that you put
into practice each day. Used in conjunction with some additional
reference materials, this book should adequately prepare you for
the CT certification examination.
Keep in mind that the ARRT and NMTCB CT certification
examinations are “advanced-level” examinations. Some of the
subject matter may go beyond the standard responsibilities of the
staff CT technologist. Practical experience in CT does not eliminate
the need for study and preparation in order to achieve success on
this examination.
Many examinees may be looking to use an advanced-level
certification examination as a vehicle toward developing a career in
CT. This second group of test applicants may have little experience
in CT beyond the ARRT or NMTCB clinical requirements. If you are
among this group, you have a significantly larger amount of work
ahead of you. It would certainly be advisable to use several of the
textbooks listed as references in the bibliography during the initial
stages of preparation. It is extremely important to review the
physical principles of CT imaging along with the many clinical
applications, such as patient care, scanning protocols, cross-
sectional anatomy, and the identification of pathology on the CT
image. Mosby's Exam Review for Computed Tomography will then
serve as an invaluable tool to test your newly acquired knowledge
and practice “registry-type” questions.
Please remember that the best way to reap benefits from review
books such as this one is to concentrate on the material you are
unfamiliar with: the questions that you incorrectly answer. It is not
sufficient to simply grade each examination and calculate your
score to determine whether or not you passed the examination.
Take the time to carefully review each chapter. If you find that you
are in need of further explanation, turn to the bibliography for
19
This review text is essentially designed for two different groups of
examination applicants. For the established CT technologist, the
review outline and examination questions help bridge the gap
between clinical experience and cognitive knowledge. Those of you
who are experienced in CT will already be familiar with much of
the subject matter covered. This review book allows you to answer
questions concerning the principles and procedures that you put
into practice each day. Used in conjunction with some additional
reference materials, this book should adequately prepare you for
the CT certification examination.
Keep in mind that the ARRT and NMTCB CT certification
examinations are “advanced-level” examinations. Some of the
subject matter may go beyond the standard responsibilities of the
staff CT technologist. Practical experience in CT does not eliminate
the need for study and preparation in order to achieve success on
this examination.
Many examinees may be looking to use an advanced-level
certification examination as a vehicle toward developing a career in
CT. This second group of test applicants may have little experience
in CT beyond the ARRT or NMTCB clinical requirements. If you are
among this group, you have a significantly larger amount of work
ahead of you. It would certainly be advisable to use several of the
textbooks listed as references in the bibliography during the initial
stages of preparation. It is extremely important to review the
physical principles of CT imaging along with the many clinical
applications, such as patient care, scanning protocols, cross-
sectional anatomy, and the identification of pathology on the CT
image. Mosby's Exam Review for Computed Tomography will then
serve as an invaluable tool to test your newly acquired knowledge
and practice “registry-type” questions.
Please remember that the best way to reap benefits from review
books such as this one is to concentrate on the material you are
unfamiliar with: the questions that you incorrectly answer. It is not
sufficient to simply grade each examination and calculate your
score to determine whether or not you passed the examination.
Take the time to carefully review each chapter. If you find that you
are in need of further explanation, turn to the bibliography for
19
Loading page 20...
additional study materials. Attempt the practice examinations with
the mind-set that they are “dry runs” for the real thing. After
grading a practice examination, concentrate on the questions that
you answered incorrectly. Look up each correct answer, read the
brief explanation given, and then further review the topic in the
review chapter and/or bibliography provided. You have much
more to learn from the mistakes that you make, and when properly
used, this book will give you the information you need.
Text Format
Part I of Mosby's Exam Review for Computed Tomography contains a
review in outline form of the four content areas covered on the
ARRT certification examination in CT. In addition, information
specific to the NMTCB certification examination in CT is included
in the outline.
Part II contains three examinations and the answers for each
examination. A brief explanation accompanies each correct answer,
and more detailed information about the question's subject may be
found in the review chapters.
Many of the questions in each examination pertain to an included
CT image. Be sure to use all of the information provided by the
image when attempting to correctly answer these questions. Each
examination contains 165 multiple-choice questions. The topics for
questions follow the latest content specifications of the ARRT and
NMTCB advanced-level examination in CT. Each practice
examination is weighted by subject area in a similar manner to the
ARRT certification examination.”
Study Habits and Test-Taking
Techniques
Each of you preparing to take an advanced-level certification
examination in CT is a registered and/or licensed medical imaging
technologist. Most of you have already successfully completed a
similar certification examination in an imaging discipline. You
undoubtedly know how to take standardized examinations, and
20
the mind-set that they are “dry runs” for the real thing. After
grading a practice examination, concentrate on the questions that
you answered incorrectly. Look up each correct answer, read the
brief explanation given, and then further review the topic in the
review chapter and/or bibliography provided. You have much
more to learn from the mistakes that you make, and when properly
used, this book will give you the information you need.
Text Format
Part I of Mosby's Exam Review for Computed Tomography contains a
review in outline form of the four content areas covered on the
ARRT certification examination in CT. In addition, information
specific to the NMTCB certification examination in CT is included
in the outline.
Part II contains three examinations and the answers for each
examination. A brief explanation accompanies each correct answer,
and more detailed information about the question's subject may be
found in the review chapters.
Many of the questions in each examination pertain to an included
CT image. Be sure to use all of the information provided by the
image when attempting to correctly answer these questions. Each
examination contains 165 multiple-choice questions. The topics for
questions follow the latest content specifications of the ARRT and
NMTCB advanced-level examination in CT. Each practice
examination is weighted by subject area in a similar manner to the
ARRT certification examination.”
Study Habits and Test-Taking
Techniques
Each of you preparing to take an advanced-level certification
examination in CT is a registered and/or licensed medical imaging
technologist. Most of you have already successfully completed a
similar certification examination in an imaging discipline. You
undoubtedly know how to take standardized examinations, and
20
Loading page 21...
your previous results support this assumption. However, it may
have been some time since you participated in a standardized
examination, so here are some points to assist you in your
preparation.
1 Do Not Wait Until the Last Minute to
Prepare!
Although easier said than done, beginning to study early definitely
improves your potential for success. The review chapters are just
that—a review! They provide succinct outlines of the pertinent
material and will serve as an excellent resource. But you may also
find yourself in need of additional, more in-depth information.
There is a multitude of excellent resources in both print and online
form. Start with a general text in the physical principles of CT and
progress through the many clinical applications. Also, a large
proportion of the examination pertains to cross-sectional anatomy.
Do not rely only on your practical experience in this area. Take care
to review the CT images in this text. You may want to refer to the
cross-sectional anatomy books listed in the bibliography for
additional review. For some people, this book may be sufficient as
the sole preparatory tool for the CT examination. However, it is not
a “quick fix” and will not make up for lack of adequate experience,
research, and study.
2 Practice Your Time Management Skills
Time management is equally important during preparation and
while you are taking the actual examination. The ARRT allows you
3.5 hours to complete 165 questions. This should be more than
sufficient if you take care to keep track of your progress during the
examination. You will be provided with a countdown timer during
the computerized examination and should follow the standard rule
of not spending too much time on any one question.
3 Zero In on the Correct Answer
Success on standardized examinations relies on your ability not
21
have been some time since you participated in a standardized
examination, so here are some points to assist you in your
preparation.
1 Do Not Wait Until the Last Minute to
Prepare!
Although easier said than done, beginning to study early definitely
improves your potential for success. The review chapters are just
that—a review! They provide succinct outlines of the pertinent
material and will serve as an excellent resource. But you may also
find yourself in need of additional, more in-depth information.
There is a multitude of excellent resources in both print and online
form. Start with a general text in the physical principles of CT and
progress through the many clinical applications. Also, a large
proportion of the examination pertains to cross-sectional anatomy.
Do not rely only on your practical experience in this area. Take care
to review the CT images in this text. You may want to refer to the
cross-sectional anatomy books listed in the bibliography for
additional review. For some people, this book may be sufficient as
the sole preparatory tool for the CT examination. However, it is not
a “quick fix” and will not make up for lack of adequate experience,
research, and study.
2 Practice Your Time Management Skills
Time management is equally important during preparation and
while you are taking the actual examination. The ARRT allows you
3.5 hours to complete 165 questions. This should be more than
sufficient if you take care to keep track of your progress during the
examination. You will be provided with a countdown timer during
the computerized examination and should follow the standard rule
of not spending too much time on any one question.
3 Zero In on the Correct Answer
Success on standardized examinations relies on your ability not
21
Loading page 22...
only to choose the correct answer, but also to identify the incorrect
ones. The process of elimination is your most valued asset when
you encounter a multiple-choice question. Carefully examine each
answer, and eliminate those that are obviously incorrect. This step
often narrows the possible choices and improves your chances
when guessing becomes a necessity.
4 Have Confidence!
You are in the midst of a successful career in medical imaging. Your
interest in the field and your dedication to continued learning have
brought you here to this advanced-level examination. Have
confidence in your ability, and put some faith in your preparation
and experience: you know the material, so relax, and simply tap
into this knowledge.
American Registry of Radiologic
Technologists Computed Tomography
Certification Examination: Content
Specifications
Patient Care (22)
1. Patient interactions and management (22)
A. Patient assessment and preparation
1. Clinical history
2. Scheduling and screening
3. Education
4. Consent
5. Immobilization
6. Monitoring
22
ones. The process of elimination is your most valued asset when
you encounter a multiple-choice question. Carefully examine each
answer, and eliminate those that are obviously incorrect. This step
often narrows the possible choices and improves your chances
when guessing becomes a necessity.
4 Have Confidence!
You are in the midst of a successful career in medical imaging. Your
interest in the field and your dedication to continued learning have
brought you here to this advanced-level examination. Have
confidence in your ability, and put some faith in your preparation
and experience: you know the material, so relax, and simply tap
into this knowledge.
American Registry of Radiologic
Technologists Computed Tomography
Certification Examination: Content
Specifications
Patient Care (22)
1. Patient interactions and management (22)
A. Patient assessment and preparation
1. Clinical history
2. Scheduling and screening
3. Education
4. Consent
5. Immobilization
6. Monitoring
22
Loading page 23...
a. Level of consciousness
b. Vital signs
c. Heart rhythm and cardiac cycle
d. Oximetry
7. Management of accessory medical devices
a. Oxygen delivery systems
b. Chest tubes
c. In-dwelling catheters
8. Lab values
a. Renal function (e.g., BUN, eGFR, creatinine)
b. Other (e.g., D-dimer, LFT, INR)
9. Medications and dosage
a. Current
b. Preprocedure medications (e.g., steroid, antianxiety)
c. Postprocedure instructions (e.g., diabetic patient)
B. Contrast administration
1. Contrast media
a. Ionic, nonionic
b. Osmolarity
c. Barium sulfate
d. Water soluble (iodinated)
23
b. Vital signs
c. Heart rhythm and cardiac cycle
d. Oximetry
7. Management of accessory medical devices
a. Oxygen delivery systems
b. Chest tubes
c. In-dwelling catheters
8. Lab values
a. Renal function (e.g., BUN, eGFR, creatinine)
b. Other (e.g., D-dimer, LFT, INR)
9. Medications and dosage
a. Current
b. Preprocedure medications (e.g., steroid, antianxiety)
c. Postprocedure instructions (e.g., diabetic patient)
B. Contrast administration
1. Contrast media
a. Ionic, nonionic
b. Osmolarity
c. Barium sulfate
d. Water soluble (iodinated)
23
Loading page 24...
e. Air
f. Water
g. Other
2. Special contrast considerations
a. Contraindications
b. Indications
c. Pregnancy
d. Lactation
e. Dialysis patients
3. Administration route and dose calculations
a. IV
b. Oral
c. Rectal
d. Intrathecal
e. Catheters (e.g., peripheral line, central line, PICC line)
f. Other (e.g., stoma, intraarticular)
4. Venipuncture
a. Site selection
b. Aseptic and sterile technique
c. Documentation (e.g., site, amount, gauge, concentration,
rate, and number of attempts)
5. Injection techniques
24
f. Water
g. Other
2. Special contrast considerations
a. Contraindications
b. Indications
c. Pregnancy
d. Lactation
e. Dialysis patients
3. Administration route and dose calculations
a. IV
b. Oral
c. Rectal
d. Intrathecal
e. Catheters (e.g., peripheral line, central line, PICC line)
f. Other (e.g., stoma, intraarticular)
4. Venipuncture
a. Site selection
b. Aseptic and sterile technique
c. Documentation (e.g., site, amount, gauge, concentration,
rate, and number of attempts)
5. Injection techniques
24
Loading page 25...
a. Safety
b. Manual
c. Power injector options
1. Single or dual head
2. Single phase
3. Multiphase
4. Flow rate
5. Timing bolus
6. Bolus tracking
6. Postprocedure care
a. Treatment of contrast extravasation
b. Documentation
7. Adverse reactions
a. Recognition and assessment
b. Treatment
c. Documentation
Safety (20)
1. Radiation safety and dose
A. Radiation physics
1. Radiation interaction with matter
2. Acquisition (geometry)
25
b. Manual
c. Power injector options
1. Single or dual head
2. Single phase
3. Multiphase
4. Flow rate
5. Timing bolus
6. Bolus tracking
6. Postprocedure care
a. Treatment of contrast extravasation
b. Documentation
7. Adverse reactions
a. Recognition and assessment
b. Treatment
c. Documentation
Safety (20)
1. Radiation safety and dose
A. Radiation physics
1. Radiation interaction with matter
2. Acquisition (geometry)
25
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3. Physical principles (attenuation)
B. Radiation protection
1. Minimizing patient exposure
a. kVp
b. mAs
c. Pitch
d. Collimation/beam width
e. Multidetector configuration
f. Gating
2. Personnel protection
a. Controlled access
b. Education
3. Shielding
a. Traditional (e.g., lead apron)
b. Nontraditional (e.g., bismuth)
4. Dose measurement
a. CT dose index (CTDI)
b. Dose length product (DLP)
c. Documentation
5. Patient dose reduction and optimization
a. Pediatric
26
B. Radiation protection
1. Minimizing patient exposure
a. kVp
b. mAs
c. Pitch
d. Collimation/beam width
e. Multidetector configuration
f. Gating
2. Personnel protection
a. Controlled access
b. Education
3. Shielding
a. Traditional (e.g., lead apron)
b. Nontraditional (e.g., bismuth)
4. Dose measurement
a. CT dose index (CTDI)
b. Dose length product (DLP)
c. Documentation
5. Patient dose reduction and optimization
a. Pediatric
26
Loading page 27...
b. Adult
c. Dose modulation techniques (e.g., SMART mA, auto
mA, CARE dose, and SURE exposure)
d. Iterative reconstruction
e. Dose notification
f. Dose alert
Image Production (55)
1. Image formation (30)
A. CT system principles, operation, and components
1. Tube
a. X-ray production
b. Warm-up procedures
2. Collimation/beam width
3. Generator
4. Detectors
a. Detector configuration
b. Detector collimation
5. Data acquisition system (DAS)
6. Computer and array processor
B. Imaging parameters and data acquisition
1. Parameters
27
c. Dose modulation techniques (e.g., SMART mA, auto
mA, CARE dose, and SURE exposure)
d. Iterative reconstruction
e. Dose notification
f. Dose alert
Image Production (55)
1. Image formation (30)
A. CT system principles, operation, and components
1. Tube
a. X-ray production
b. Warm-up procedures
2. Collimation/beam width
3. Generator
4. Detectors
a. Detector configuration
b. Detector collimation
5. Data acquisition system (DAS)
6. Computer and array processor
B. Imaging parameters and data acquisition
1. Parameters
27
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a. kVp
b. mAs
c. Pitch
d. Acquisition thickness
e. x, y, z planes
f. Scan field of view
2. Acquisition
a. Axial/sequential
b. Helical/spiral
c. Volumetric
C. Image processing
1. Reconstruction
a. Filtered back projection reconstruction
b. Iterative reconstruction
c. Interpolation
d. Reconstruction algorithm
e. Raw data vs. image data
f. Prospective/retrospective reconstruction
g. Reconstruction thickness
h. Reconstruction interval
2. Postprocessing
28
b. mAs
c. Pitch
d. Acquisition thickness
e. x, y, z planes
f. Scan field of view
2. Acquisition
a. Axial/sequential
b. Helical/spiral
c. Volumetric
C. Image processing
1. Reconstruction
a. Filtered back projection reconstruction
b. Iterative reconstruction
c. Interpolation
d. Reconstruction algorithm
e. Raw data vs. image data
f. Prospective/retrospective reconstruction
g. Reconstruction thickness
h. Reconstruction interval
2. Postprocessing
28
Loading page 29...
a. Multi-planar reformation (MPR)
b. 3-D rendering (MIP, SSD, VR)
c. Quantitative analysis (e.g., distance, diameter, calcium
scoring, ejection fraction)
2. Image evaluation and archiving (25)
A. Image display
1. Pixel, voxel
2. Matrix
3. Image magnification
4. Display field of view (DFOV)
5. Window level, window width
6. Cine
7. Geometric distance or region of interest (ROI) (e.g.,
mean, standard deviation [SD])
B. Image quality
1. Spatial resolution
2. Contrast resolution
3. Temporal resolution
4. Noise and uniformity
5. Quality assurance and accreditation
6. CT number (Hounsfield units)
7. Linearity
29
b. 3-D rendering (MIP, SSD, VR)
c. Quantitative analysis (e.g., distance, diameter, calcium
scoring, ejection fraction)
2. Image evaluation and archiving (25)
A. Image display
1. Pixel, voxel
2. Matrix
3. Image magnification
4. Display field of view (DFOV)
5. Window level, window width
6. Cine
7. Geometric distance or region of interest (ROI) (e.g.,
mean, standard deviation [SD])
B. Image quality
1. Spatial resolution
2. Contrast resolution
3. Temporal resolution
4. Noise and uniformity
5. Quality assurance and accreditation
6. CT number (Hounsfield units)
7. Linearity
29
Loading page 30...
C. Artifact recognition and reduction
1. Beam hardening or cupping
2. Partial volume averaging
3. Motion
4. Metallic
5. Edge gradient
6. Patient positioning (out-of-field)
7. Equipment induced
a. Rings
b. Streaks
c. Tube arcing
d. Cone beam
e. Capping
D. Informatics
1. Hard/electronic copy (e.g., DICOM file format)
2. Archive
3. PACS and electronic medical record (EMR)
4. Security and confidentiality
5. Networking
Procedures (68)
30
1. Beam hardening or cupping
2. Partial volume averaging
3. Motion
4. Metallic
5. Edge gradient
6. Patient positioning (out-of-field)
7. Equipment induced
a. Rings
b. Streaks
c. Tube arcing
d. Cone beam
e. Capping
D. Informatics
1. Hard/electronic copy (e.g., DICOM file format)
2. Archive
3. PACS and electronic medical record (EMR)
4. Security and confidentiality
5. Networking
Procedures (68)
30
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Subject
Medicine