Radiography

Below are the ARRT category specifications for exam coverage.

ARRT Radiography exam categories

200 Total Questions
1. Patient Interactions and Management
A. Ethical and Legal Aspects
1. patient’s rights
a. informed consent (*e.g., written, oral, implied)
b. confidentiality (HIPAA)
c. American Hospital Association (AHA) Patient Care Partnership (Patient’s Bill of Rights)
1. privacy
2. extent of care (e.g., DNR)
3. access to information
4. living will, health care proxy, advanced directives
5. research participation
2. legal issues
a. verification (e.g., patient identification, compare order to clinical indication)
b. common terminology (e.g., battery, negligence, malpractice, beneficence)
c. legal doctrines (e.g., respondeat superior, res ipsa loquitur)
d. restraints versus immobilization
e. manipulation of electronic data (e.g., exposure indicator, processing algorithm, brightness and,contrast, cropping or masking off anatomy)
3. ARRT Standards of Ethics
B. Interpersonal Communication
1. modes of communication
a. verbal/written
b. nonverbal (e.g., eye contact, touching)
2. challenges in communication
a. interactions with others
1. language barriers
2. cultural and social factors
3. physical or sensory impairments
4. age
5. emotional status, acceptance of condition
b. explanation of medical terms
c. strategies to improvemunderstanding
3. patient education
a. explanation of current procedure (e.g., purpose, exam length)
b. verify informed consent when necessary
c. pre- and post-examination instructions (e.g., preparation, diet, medications and discharge instructions)
d. respond to inquiries about other imaging modalities (e.g., CT, MRI, mammography, sonography, nuclear ,medicine, bone densitometry regarding dose differences, types of radiation, patient preps)
C. Physical Assistance and Monitoring
1. patient transfer and movement
a. body mechanics (e.g., balance, alignment, movement)
b. patient transfer techniques
2. assisting patients with medical equipment
a. infusion catheters and pumps b. oxygen delivery systems
b. other (e.g., nasogastric tubes, urinary catheters, tracheostomy tubes)
3. routine monitoring
a. vital signs
b. physical signs and symptoms (e.g., motor control, severity of injury)
c. fall prevention
d. documentation
D. Medical Emergencies
1. allergic reactions (e.g., contrast media, latex)
2. cardiac or respiratory arrest (e.g., CPR)
3. physical injury or trauma
4. other medical disorders (e.g., seizures, diabetic reactions)
E. Infection Control
1. cycle of infection
a. pathogen
b. reservoir
c. portal of exit
d. mode of transmission
1. direct
2. indirect
e. portal of entry
f. susceptible host
2. asepsis
a. equipment disinfection
b. equipment sterilization
c. medical aseptic technique
d. sterile technique
3. CDC Standard Precautions
a. hand hygiene
b. use of personal protective equipment (e.g., gloves, gowns, masks)
c. safe injection practices
d. safe handling of contaminated equipment/surfaces
e. disposal of contaminated materials
1. linens
2. needles
3. patient supplies
4. blood and body fluids
4. transmission-based precautions
a. contact
b. droplet
c. airborne
5. additional precautions
a. neutropenic precautions (reverse isolation)
b. healthcare associated (nosocomial) infections
F. Handling and Disposal of Toxic or Hazardous Material
1. types of materials
2. chemicals
3. chemotherapy
4. safety data sheet (e.g., material safety data sheets)
G. Pharmacology
1. patient history
a. medication reconciliation (current medications)
b. premedications
c. contraindications
d. scheduling and sequencing examinations
2. administration
a. routes (e.g., IV, oral)
b. supplies (e.g., enema kits, needles)
3. venipuncture
a. venous anatomy
b. supplies
c. procedural technique
4. contrast media types and properties (e.g., iodinated, water soluble, barium, ionic versus non-ionic)
5. appropriateness of contrast media to exam
a. patient condition (e.g., perforated bowel)
b. patient age and weight
c. laboratory values (e.g., BUN, creatinine, GFR)
6. complications/reactions
a. local effects (e.g., extravasation/infiltration, phlebitis)
b. systemic effects
1. mild
2. moderate
3. severe
c. emergency medications
d. radiographer’s response and documentation
1. Radiation Protection
A. Minimizing Patient Exposure
1. exposure factors
a. kVp
b. mAs
c. automatic exposure control (AEC)
2. shielding
a. rationale for use
b. types
c. placement
3. beam restriction
a. purpose of primary beam restriction
b. types (e.g., collimators)
4. filtration
a. effect on skin and organ exposure
b. effect on average beam energy
c. NCRP recommendations (NCRP #102, minimum filtration in useful beam)
5. patient considerations
a. positioning
b. communication
c. pediatric
d. morbid obesity
6. radiographic dose documentation
7. image receptors
8. grids
9. fluoroscopy
a. pulsed
b. exposure factors
c. grids
d. positioning
e. fluoroscopy time
f. automatic brightness control (ABC) or automatic exposure rate control (AERC)
g. receptor positioning
h. magnification mode
i. air kerma display
j. last image hold
k. dose or time documentation
l. minimum source-to-skin distance (21 CFR)
10. dose area product (DAP) meter
B. Personnel Protection (ALARA)
1. sources of radiation exposure
a. primary x-ray beam
b. secondary radiation
1. scatter
2. leakage
c. patient as source
2. basic methods of protection
a. time
b. distance
c. shielding
3. protective devices
a. types
b. attenuation properties
c. minimum lead equivalent (NCRP #102)
4. special considerations
a. mobile units
b. fluoroscopy
1. protective drapes
2. protective Bucky slot cover
3. cumulative timer
4. remote-controlled fluoroscopy
c. guidelines for fluoroscopy and mobile units (NCRP #102, 21 CFR)
1. fluoroscopy exposure rates (normal and high-level control)
2. exposure switch guidelines
5. radiation exposure and monitoring
a. dosimeters
1. types
2. proper use
b. NCRP recommendations for personnel monitoring (NCRP #116)
1. occupational exposure
2. public exposure
3. embryo/fetus exposure
4. dose equivalent limits
5. evaluation and maintenance of
6. personnel dosimetry records handling and disposal of radioactive material
2. Radiation Physics and Radiobiology
A. Principles of Radiation Physics
1. x-ray production
a. source of free electrons (e.g., thermionic emission)
b. acceleration of electrons
c. focusing of electrons
d. deceleration of electrons
2. target interactions
a. bremsstrahlung
b. characteristic
3. x-ray beam
a. frequency and wavelength
b. beam characteristics
1. quality
2. quantity
3. primary versus remnant (exit)
c. inverse square law
d. fundamental properties (e.g., travel in straight lines, ionize matter)
4. photon interactions with matter
a. Compton effect
b. photoelectric absorption
c. coherent (classical) scatter
d. attenuation by various tissues
1. thickness of body part
2. type of tissue (atomic number)
B. Biological Aspects of Radiation
1. SI units of measurement
a. absorbed dose
b. dose equivalent
c. exposure
d. effective dose
e. air kerma
2. radiosensitivity
a. dose-response relationships
b. relative tissue radiosensitivities (e.g., LET , RBE)
c. cell survival and recovery (LD50)
d. oxygen effect
3. somatic effects
a. short-term versus long-term effects
b. acute versus chronic effects
c. carcinogenesis
d. organ and tissue response (e.g., eye, thyroid, breast, bone marrow, skin, gonadal)
4. acute radiation syndromes
a. hemopoietic
b. gastrointestinal (GI)
c. central nervous system (CNS)
5. embryonic and fetal risks
6. genetic impact
a. genetically significant dose
b. goals of gonadal shielding
1. Image Acquisition and Technical Evaluation
A. Selection of Technical Factors Affecting Radiographic Quality
1. mAs
a. receptor exposure
2. kVp
a. receptor exposure
b. contrast
3. OID
a. contrast (air gap)
b. spatial resolution
c. distortion
4. SID
a. receptor exposure
b. spatial resolution
c. distortion
5. focal spot size
a. spatial resolution
6. grids
a. receptor exposure
b. contrast
7. tube filtration
a. receptor exposure
b. contrast
8. beam restriction
a. receptor exposure
b. contrast
9. motion
a. spatial resolution
b. distortion
10. anode heel effect
a. receptor exposure
11. patient factors (size, pathology)
a. receptor exposure
b. contrast
c. spatial resolution
d. distortion
12. angle (tube, part, or receptor)
a. spatial resolution
b. distortion
B. Technique Charts
1. anatomically programmed technique
2. caliper measurement
3. fixed versus variable kVp
4. special considerations
a. casts
b. pathologic factors
c. age (e.g., pediatric, geriatric)
d. body mass index (BMI)
e. contrast media
C. Automatic Exposure Control (AEC)
1. effects of changing exposure factors on radiographic quality
2. detector selection
3. anatomic alignment
4. exposure adjustment (e.g., density, +1 or –1)
D. Digital Imaging Characteristics
1. spatial resolution (equipment related)
a. pixel characteristics (e.g., size, pitch)
b. detector element (DEL) (e.g., size, pitch, fill factor)
c. matrix size
d. sampling frequency
2. contrast resolution (equipment related)
a. bit depth
b. modulation transfer function (MTF)
c. detective quantum efficiency (DQE)
3. image signal (exposure related)
a. dynamic range
b. quantum noise (quantum mottle)
c. signal to noise ratio (SNR)
d. contrast to noise ratio (CNR)
E. Image Identification
1. methods (e.g., radiographic, electronic)
2. legal considerations (e.g., patient data, examination data)
2. Equipment Operation and Quality Assurance
A. Imaging Equipment
1. components of radiographic unit (fixed or mobile)
a. operating console
b. x-ray tube construction
1. electron source
2. target materials
3. induction motor
c. automatic exposure control (AEC)
1. radiation detectors
2. back-up timer
3. exposure adjustment (e.g., density, +1 or –1)
4. minimum response time
d. manual exposure controls
e. beam restriction
2. x-ray generator, transformers and rectification system
a. basic principles
b. phase, pulse and frequency
c. tube loading
3. components of fluoroscopic unit (fixed or mobile)
a. image receptors
1. image intensifier
2. flat panel
b. viewing systems
c. recording systems
d. automatic brightness control (ABC) or automatic exposure rate control (AERC)
e. magnification mode
f. table
4. components of digital imaging
a. CR components
1. plate (e.g., photo-stimulable phosphor (PSP))
2. plate reader
b. DR image receptors
1. flat panel
2. charge coupled device (CCD)
3. complementary metal oxide semiconductor (CMOS)
5. accessories
a. stationary grids
b. Bucky assembly
c. compensating filters
B. Image Processing and Display
1. raw data (pre-processing)
a. analog-to-digital converter (ADC)
b. quantization
c. corrections (e.g., rescaling, flat fielding, dead pixel correction)
d. histogram
2. corrected data for processing
a. grayscale
b. edge enhancement
c. equalization
d. smoothing
3. data for display
a. values of interest (VOI)
b. look-up table (LUT)
4. post-processing
a. brightness
b. contrast
c. region of interest (ROI)
d. electronic cropping or masking
e. stitching
5. display monitors
a. viewing conditions (e.g., viewing angle, ambient lighting)
b. spatial resolution (e.g., pixel size, pixel pitch)
c. brightness and contrast
6. imaging informatics
a. DICOM
b. PACS
c. RIS (modality work list)
d. HIS
e. EMR or EHR
C. Criteria for Image Evaluation of Technical Factors
1. exposure indicator
2. quantum noise (quantum mottle)
3. gross exposure error (e.g., loss of contrast, saturation)
4. contrast
5. spatial resolution
6. distortion (e.g., size, shape)
7. identification markers (e.g., anatomical side, patient, date)
8. image artifacts
9. radiation fog
D. Quality Control of Imaging Equipment and Accessories
1. beam restriction
a. light field to radiation field alignment
b. central ray alignment
2. recognition and reporting of malfunctions
3. digital imaging receptor systems
a. maintenance (e.g., detector calibration, plate reader calibration)
b. QC tests (e.g., erasure thoroughness, plate uniformity, spatial resolution)
c. displaymonitorqualityassurance (e.g., grayscale standard display function, luminance)
4. shielding accessories (e.g., lead apron, glove testing)
1. Head, Spine and Pelvis
A. Head
1. Skull
a. AP axial (Towne)
b. lateral
c. PA axial (Caldwell)
d. PA
e. submentovertex (full basal)
f. PA axial (Haas)
g. trauma cross table (horizontal beam) lateral
h. trauma AP axial (reverse Caldwell)
i. trauma AP
j. trauma AP axial (Towne)
2. Facial Bones
a. lateral
b. parietoacanthial (Waters)
c. PA axial (Caldwell)
d. modifiedparietoacanthial (modified Waters)
e. traumaacanthioparietal (reverse Waters)
3. Mandible
a. axiolateraloblique
b. PA
c. AP axial (Towne)
d. PA axial
e. PA (modifiedWaters)
f. submentovertex (full basal)
4. Zygomatic Arch
a. submentovertex (fullbasal)
b. parietoacanthial (Waters)
c. AP axial (modifiedTowne)
d. obliqueinferosuperior (tangential)
5. Temporomandibular Joints
a. axiolateraloblique (modified Law)
b. axiolateral (modified Schuller)
c. AP axial (modifiedTowne)
6. Nasal Bones
a. parietoacanthial (Waters)
b. lateral
c. PA axial (Caldwell)
7. Orbits
a. parietoacanthial (Waters)
b. lateral
c. PA axial (Caldwell)
d. modifiedparietoacanthial (modified Waters)
8. Paranasal Sinuses
a. lateral,horizontalbeam
b. PA axial (Caldwell), horizontal beam
c. parietoacanthial (Waters), horizontal beam
d. submentovertex (full basal), horizontal beam
e. openmouth parietoacanthial (Waters), horizontal beam
B. Spine and Pelvis
1. Cervical Spine
a. AP axial
b. AP open mouth
c. lateral
d. cross table (horizontal beam) lateral
e. PA axial obliques
f. AP axial obliques
g. lateral swimmers
h. lateral flexion and extension
i. AP dens (Fuchs)
2. Thoracic Spine
a. AP
b. lateral,breathing
c. lateral,expiration
3. Scoliosis Series
a. AP or PA
b. lateral
4. Lumbar Spine
a. AP
b. PA
c. lateral
d. L5-S1 lateral spot
e. posterior oblique
f. anterior oblique
g. AP axial L5-S1
h. AP right and left bending
i. lateral flexion and extension
5. Sacrum and Coccyx
a. AP axial sacrum
b. AP axial coccyx
c. lateral sacrum and coccyx, combined
d. lateral sacrum or coccyx, separate
6. Myelography
7. Sacroiliac Joints
a. AP
b. posterior oblique
c. anterioroblique
8. Pelvis and Hip
a. APhiponly
b. cross-table (horizontal beam) lateral hip
c. unilateral frog-leg, non-trauma
d. axiolateral inferosuperior, trauma (Clements-Nakayama)
e. AP pelvis
f. AP pelvis, bilateral frog-leg
g. AP pelvis, axial anterior pelvic bones (inlet, outlet)
h. anteriorobliquepelvis, acetabulum (Judet)
9. Hysterosalpingography
2. Thorax and Abdomen
A. Thorax
1. Chest
a. PA or AP upright
b. lateral upright
c. AP lordotic
d. AP supine
e. lateral decubitus
f. anterior and posterior obliques
2. Ribs
a. AP and PA, above and below diaphragm
b. anterior and posterior obliques
3. Sternum
a. lateral
b. RAO
4. Soft Tissue Neck
a. AP upper airway
b. lateral upper airway
B. Abdomen and GI Studies
1. Abdomen
a. AP supine
b. AP upright
c. lateral decubitus
d. dorsal decubitus
2. Esophagus
a. RAO
b. left lateral
c. AP
d. PA
e. LAO
3. Swallowing Dysfunction Study
4. Upper GI series
a. AP scout
b. RAO
c. PA
d. right lateral
e. LPO
f. AP
5. Small Bowel Series
a. PA scout
b. PA (follow through)
c. ileocecal spots
6. Contrast Enema
a. left lateral rectum
b. left lateral decubitus
c. right lateral decubitus
d. LPO and RPO
e. PA
f. RAO and LAO
g. AP axial (sigmoid)
h. PA axial (sigmoid)
i. PA post-evacuation
7. Surgical Cholangiography
8. ERCP
C. Urological Studies
1. Cystography
a. AP
b. LPO and RPO
c. lateral
d. AP axial
2. Cystourethrography
a. AP voiding cystourethrogram female
b. RPO voiding cystourethrogram male
3. Intravenous Urography
a. AP, scout, and series
b. RPO and LPO
c. post-void
4. Retrograde Urography
a. AP scout
b. AP pyelogram
c. APureterogram
3. Extremities
A. Upper Extremities
1. Fingers
a. PA entire hand
b. PA finger only
c. lateral
d. medial and/or lateral oblique
e. AP thumb
f. medial oblique thumb
g. lateral thumb
2. Hand
a. PA
b. lateral
c. lateral oblique
3. Wrist
a. PA
b. lateral oblique
c. lateral
d. PA–ulnar deviation
e. PA axial (Stecher)
f. tangential carpal canal (Gaynor-Hart)
4. Forearm
a. AP
b. lateral
5. Elbow
a. AP
b. lateral
c. lateral oblique
d. medial oblique
e. AP partial flexion
f. trauma axial laterals (Coyle)
6. Humerus
a. AP
b. lateral
c. neutral
d. transthoracic lateral
7. Shoulder
a. AP internal and external rotation
b. inferosuperior axial (Lawrence)
c. posterioroblique(Grashey)
d. APneutral
e. scapularY
8. Scapula
a. AP
b. lateral
9. Clavicle
a. AP
b. AP axial
c. PA axial
10. Acromioclavicular Joints – AP Bilateral With and Without Weights
B. Lower Extremities
1. Toes
a. AP, entire forefoot
b. AP or AP axial toe
c. oblique toe
d. lateral toe
e. sesamoids, tangential
2. Foot
a. AP axial
b. medial oblique
c. lateral oblique
d. lateral
e. AP axial weight bearing
f. lateral weight bearing
3. Calcaneus
a. lateral
b. plantodorsal, axial
c. dorsoplantar, axial
4. Ankle
a. AP
b. mortise
c. lateral
d. medial oblique
e. AP stress views
f. AP weight bearing
g. lateral weight bearing
5. Tibia/Fibula
a. AP
b. lateral
6. Knee/patella
a. AP
b. Lateral
c. AP weight bearing
d. lateral oblique
e. medial oblique
f. PA axial–intercondylar fossa (Holmblad)
g. PA axia–intercondylar fossa (Camp Coventry)
h. AP axial–intercondylar fossa (Béclère)
i. PA patella
j. tangential (Merchant)
k. tangential (Settegast)
l. tangential (Hughston)
7. Femur
a. AP
b. lateral
8. Long Bone Measurement
C. Other
1. Bone Age
2. Bone Survey
3. Arthrography