Course Content

RANZCR Exam Information
Welcome to the RANZCR Learning Objectives ANSWERED course
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Theoretical principles
Basic Concepts of Electromagnetic Radiation (BCER)
6 Topics
Describe Electromagnetic waves
Describe the relationship between frequency and wavelength
Describe the electromagnetic spectrum
Describe sources of electromagnetic radiation
Describe energy of photons.
Outline the principle of wave-particle duality of photons
Production of X-rays
6 Topics
Describe the production of X-rays and the distinction between Bremsstrahlung and Characteristic radiation.
Describe and illustrate the spectrum of X-ray energies produced by an X-ray tube.
Discuss the impact of changes in peak kilovoltage (kVp), anode material, milliampere (mA) and filtration on the X-ray spectrum, patient dose and image quality.
Describe and illustrate the basic components of X-ray tube construction.
Describe and illustrate the line focus principle.
Broadly describe and illustrate the heel effect and its implication for image quality.
Interactions between X-rays and matter of relevance to medical imaging
7 Topics
Distinguish between atomic ionisation and excitation in respect of Photostimulable phosphors, Luminescence, and Thermoluminescent Dosimeters (TLDs).
Describe the interaction processes of photoelectric effect and Compton scattering.
Discuss the impact of field size, and patient thickness on scatter production.
Describe the coherent scattering interaction process.
Describe the process of attenuation.
Describe the attenuation of monoenergetic and polychromatic radiation in terms of linear and mass attenuation coefficients and half-value layers (HVLs).
Outline the factors that impact on attenuation.
Filters, collimators and grids
4 Topics
Explain what is meant by inherent and added filtration.
Describe the impact of filtration on the spectrum from an X-ray tube, including filter material (e.g. AI, Cu, K-edge and combination filters).
Describe how and why scatter reduction techniques work: Collimation, Compression, Grids, and Air Gaps
Discuss the implication of these techniques on image quality and dose.
Digital imaging concepts
5 Topics
Define the following terms in image presentation and display and describe their application in image interpretation: Image presentation and Image display
Distinguish between lossless and lossy images.
Describe the main elements of picture archiving and communications systems (PACS) and teleradiology.
Broadly discuss the general structure of a digital imaging and communication in medicine (DICOM) file.
Be aware of advanced imaging processing (e.g. perfusion, computer aided detection (CAD).
Imaging Technology
Radiographic image acquisition
7 Topics
Describe the key elements of the digital radiography (DR) system that lead to image formation.
Differentiate between indirect (a-Si) and direct (a-Se) flat panel detector (DR) systems.
Describe detector elements of DR systems.
Describe how an automatic exposure control (AEC) system operates in generic terms.
Generally describe the key factors that contribute to image quality for softcopy reporting.
Broadly describe the concept of dual energy X-ray absorptiometry (DEXA).
Broadly describe the elements involved in the acquisition of dental radiographic images, including intra oral, cephalometric and OPG imaging.
Fluoroscopic image acquisition
10 Topics
Describe the modes of fluoroscopic operation and compare them with high-resolution imaging acquisition, with regard to image quality and dose.
Compare and contrast flat panel detectors and image intensifiers.
Explain the implications of field size and pulsed fluoroscopy on image quality and patient dose.
Describe the purpose of automatic brightness control (ABC) and automatic dose rate control (ADRC) and broadly describe how they operate.
Describe the physical principles of digital subtraction angiography (DSA).
Describe the process of mask subtraction and understand the impact that the subtraction process has on image noise.
Describe what is meant by image processing operations such as pixel shifting and re-masking and explain why they are important in minimising impact of motion artefact.
Discuss the relationship of cumulative air kerma (CAK) and kerma-area product (KAP) to patient skin dose and effective dose.
Discuss strategies to minimise patient and operator dose while maintaining imaging quality.
Compare the application, image quality and dose of Cone Beam CT with fluoroscopy equipment, with conventional CT.
Measures of radiographic a fluoroscopic image quality
7 Topics
Discuss in detail the key image descriptors, contrast, spatial resolution, temporal resolution and noise.
Explain the impact of magnification and focal spot size on image quality.
Explain the impact of noise on image quality.
Explain what is meant by quantum mottle (random noise), signal-to-noise ratio (SNR) and contrast-to noise ratio (CNR).
Define the line-spread function (LSF) and modulation transfer function (MTF)
Distinguish between quantum noise and other types of noise.
Explain the origin of image distortion arising from geometric effects.
Mammography
8 Topics
Describe the basic principles of mammography
Describe the construction and operational principles of digital X-ray mammography equipment.
Discuss the impact of kVp, filtration, glandular content and breast thickness on the Mean Glandular Dose
Describe tomosynthesis and stereotactic imaging processes.
Generally describe the performance characteristics of X-ray mammography equipment.
Generally describe the impact of system geometry on spatial resolution
Generally describe the effect of image processing on image quality
Generally describe the use of CAD and quality assurance in mammography.
Ultrasound
16 Topics
Discuss the basic parameters which characterise a sound wave
Conduct simple calculations relating to frequency, wavelength and relative intensity in decibels.
Discuss the fundamental physics of ultrasound waves and the interactions that occur as it traverses through tissues and other media.
Outline the basic principles of ultrasound imaging and processing and how various technical factors affect image quality.
Describe how real-time systems work, and be aware of the interplay between temporal resolution, spatial resolution and depth of penetration.
Describe the various types of ultrasound transducers available and select a transducer on the basis of its physical characteristics and suitability for a given application.
Describe the operation of a simple duplex transducer.
Describe details of the main physical parameters which characterise transducers and their effect on the image.
Describe the basic physical principles underlying the use of the Doppler effect in ultrasound imaging.
Perform simple calculations using the Doppler shift equation and understand the concepts underlying spectral analysis colour Doppler and power Doppler.
Explain how choice of frequency affects attenuation, spatial resolution, and the maximum flow rate that can be detected.
Recognise common ultrasound artefacts and explain how they are formed.
Demonstrate working knowledge of the relative magnitudes of sound velocity, acoustic impedance and attenuation in various biological media, and their implications for imaging.
Describe the basic principles of B-mode pulse-echo imaging, including parameters such as pulse length, frequency, pulse repetition frequency and time-gain compensation affect the image.
Demonstrate a general working knowledge of more complex technology involving harmonic imaging, 3D imaging and ultrasound contrast agents.
Broadly describe the basic principles of: Panoramic imaging, Harmonic, Compounding, 3D imaging, Elastography, and US contrast agents.
Computed Tomography (CT) EDITED
19 Topics
Discuss the principles of CT scanning.
Describe various methods of image reconstruction.
Explain how iterative reconstruction leads to dose reduction with similar image quality.
Describe and contrast the various scanner configurations used for CT scanning
Define Hounsfield units (HU).
Discuss the quality of CT images in terms of spatial and contrast resolution, noise, and slice thickness, highlighting factors that affect each.
Distinguish between collimated slice width, acquired slice thickness and reconstructed slice thickness.
Discuss the impact of pixel size, imaged slice thickness, milliampere-seconds (mAs), kVp, algorithm and field view on image quality and patient dose.
Discuss the advantages of lower kVp techniques on intravenous contrast-enhanced images.
Describe the origin and appearance of common artefacts in CT images
Discuss radiation dose features unique to CT scanning techniques.
Explain in generic terms how tube current modulation works and its impact on patient dose.
Discuss the advantages and disadvantages of prospective and retrospective ECG gating.
Discuss the following different CT intervention modes and their advantages and disadvantages including their impact on occupational and patient dose: Step and shoot and Continuous fluoroscopy.
Discuss the importance and application of dose descriptors and common diagnostic reference levels (DRLs)
Describe the method of CT perfusion.
Optimise paediatric protocols (e.g. weight-based).
Broadly compare cone beam CT (e.g. dental, with fluoroscopy equipment) and conventional CT in terms of differences in acquisition, image quality and dose.
Generally describe the unique features of the X-ray tube used in CT.
Magnetic Resonance Imaging (MRI) EDITED
19 Topics
Describe basic Magnetic Resonance Imaging (MRI)
Discuss the significance and the uniqueness of the Larmor frequency for a nuclear species.
Describe the origin of the Free Induction Decay and discuss the key factors which determine its strength.
Describe the origin of the T1 and T2 relaxation mechanisms.
Describe the behaviour of T1 and T2 as the strength of the static field is changed. Describe the effect of field inhomogeneities and T2.
Discuss the advantages and characteristic features for common pulse sequences.
Outline the principles and advantages of different fat suppression techniques, including STIR, SPIR/SPAIR and DIXON.
Outline the advantages and disadvantages of imaging at different commercially available field strengths (e.g. 1.5 Tesla, 3 Tesla).
Describe how images are produced.
Discuss the physics behind the chemical shift phenomenon.
Describe interleaved multi-slice imaging and indicate why it is utilised.
Describe the factors that affect image quality
Describe the basic types of MR angiography (MRA).
Describe the basic principles of diffusion weighted imaging (DWI)
Generally discuss the role of the Fourier transform (FT) in MR image reconstruction
Generally describe 2D-FT reconstruction methods in terms of the three time intervals (slice selection, phase encoding and frequency encoding)
Generally compare the 3D-FT reconstruction technique with the 2D-FT method
Generally Identify the biomolecular species which may be analysed in clinical MR spectroscopy (MRS).
In relation to MRI, broadly describe: Instrumentation, Hybrid MR-PET, and Intra operative MR
Nuclear Medicine- EDITED
8 Topics
Describe: Atomic structure
Describe: Isotopes
Describe: Radioactivity
Perform simple calculations using the concepts of physical, biological and effective half-lives.
Describe the main features, mode of operation and performance characteristics of a positron emission tomography (PET) scanner.
Generally describe the main features of single photon emission computed tomography (SPECT)
Generally describe the purpose of CT in PET/CT and SPECT/CT scanners
Generally describe the statistics and mathematics of nuclear decay.
Radiation Protection and Patient Safety
Radiation Biology and Dosimetry -EDITED
16 Topics
Define the main radiation quantities and units used in diagnostic radiology and nuclear medicine, and the parameters they measure
Define basic dosimetry parameters
Discuss the function of specific dose measurement methods used for radiological procedures and interpret the values.
Explain the implications of measured dose parameters, both in terms of overall risk and the risk to specific tissues and organs.
Be aware of the relative radiation doses from different radiological procedures, and how they compare to natural background radiation doses
Examine the mechanism of how radiation interacts with tissue to cause biological damage (ionisation, excitation, free radicals), and the parameters used to quantify this damage.
Describe radiation carcinogenesis and other stochastic effects
Outline the reasons why risk associated with low dose stochastic effects underpin international dose limits and constraints
Describe the hereditary and genetic implications of radiation exposure.
Assess the approximate risk from radiation exposure and convey this risk in a simple manner to patients and other staff.
Discuss the variation of radiation risk for cancer induction
Describe the deterministic effects of radiation and the factors which influence them
Identify the procedures that may deliver large doses of radiation.
Discuss the effects of radiation on the developing embryo or fetus at various stages of gestation
Be aware of procedures which may deliver large doses to the embryo or fetus, and the actions to be taken in considering dose to a pregnant patient, prospectively or retrospectively.
Explain the importance and application of the dose descriptors
Radiation Protection – EDITED
9 Topics
Articulate the objective of radiation protection.
Discuss the medical and natural sources of radiation the population is subject to in Australia.
Describe the differences between medical exposure (including research participants and carers) and occupational and public exposure.
Describe the ICRP radiological protection principles, and how they relate to categories of exposure
State and compare the ICRP dose limits for various groups.
Describe, compare and contrast methods of occupational and public radiation dose reduction in both diagnostic radiology and nuclear medicine environments.
Describe and contrast common methods of assessing occupational radiation dose
Describe the role of the radiation safety officer and the regulatory framework for radiation safety.
Describe what constitutes a radiation incident and compare to a radiation emergency.
Patient Safety – EDITED
9 Topics
Describe the legal role and responsibilities of the radiologist in justification of imaging in diagnostic and interventional radiology.
Describe the concept of dose audit and Facility Reference Levels (FRLs) and the relationship to DRLs and explain how FRLs and DRLs are derived.
Describe the principle of dose optimisation, and how it is applied to diagnostic and interventional radiology.
Describe and contrast the most commonly used monitors for personal dose measurement.
Describe the various methods for calculation of patient and fetal radiation dose in radiology.
State approximate doses for common X-ray imaging and common nuclear medicine examinations
Describe the factors influencing patient dose in radiography, fluoroscopy, mammography and CT.
Generally describe the methods of calculating patient and fetal radiation dose for routine diagnostic nuclear medicine studies using ICRP publications
Generally describe electronic dosimeters commonly available for personal dose measurement that give immediate radiation exposure feedback and their typical applications in medical imaging
Safety in magnetic resonance imaging – EDITED
1 Topic
Discuss safety issues (patient and environmental) and contra-indications in the use of MRI