INI CET Radiology Syllabus

Radiology syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Radiology in INI CET, not a summary of it.

1. 1

   Introduction to Radiology

   2 topics

   • History of radiology
     • Evolution of imaging techniques and modalities
   • Basics of radiological physics
     • X-ray production
     • Interactions of X-rays with matter
     • Radiation safety
2. 2

   Radiological Anatomy

   3 topics

   • Radiological anatomy of the chest
     • Normal radiographic anatomy of the lungs
     • Normal radiographic anatomy of the mediastinum
     • Normal radiographic anatomy of the pleura
   • Radiological anatomy of the abdomen
     • Normal radiographic anatomy of the gastrointestinal tract
     • Normal radiographic anatomy of the liver
     • Normal radiographic anatomy of the spleen
     • Normal radiographic anatomy of the pancreas
     • Normal radiographic anatomy of the kidneys
     • Normal radiographic anatomy of the urinary tract
   • Radiological anatomy of the musculoskeletal system
     • Normal radiographic anatomy of the bones
     • Normal radiographic anatomy of the joints
     • Normal radiographic anatomy of the soft tissues
3. 3

   Diagnostic Radiography

   3 topics

   • Chest Radiography
     • Technique
     • Positioning (Posteroanterior, Lateral, and Oblique Views)
     • Interpretation of Common Findings (Pneumonia, Pneumothorax, Pleural Effusion)
   • Abdominal Radiography
     • Technique
     • Positioning (Supine, Upright, and Decubitus Views)
     • Interpretation of Common Findings (Intestinal Obstruction, Bowel Perforation, Renal Calculi)
   • Skeletal Radiography
     • Technique
     • Positioning (Anteroposterior, Lateral, and Oblique Views)
     • Interpretation of Common Findings (Fractures, Dislocations, Osteoarthritis)
4. 4

   Fluoroscopy

   2 topics

   • Upper gastrointestinal (GI) series
     • Technique
     • Indications
     • Interpretation of barium swallow studies for evaluation of esophageal and gastric pathology
   • Barium enema
     • Technique
     • Indications
     • Interpretation of barium enema studies for evaluation of colorectal pathology
5. 5

   Computed Tomography (CT)

   3 topics

   • Principles of CT imaging
     • Generation of CT images
     • Contrast enhancement
     • Multiplanar reconstruction
   • CT of the head
     • Indications
     • Protocols (non-contrast, contrast-enhanced)
     • Interpretation of findings (intracranial hemorrhage, brain tumors, stroke)
   • CT of the chest and abdomen
     • Indications
     • Protocols (contrast-enhanced, multiphase)
     • Interpretation of findings (pulmonary embolism, solid organ injuries, abdominal masses)
6. 6

   Magnetic Resonance Imaging (MRI)

   3 topics

   • Principles of MRI imaging
     • Generation of MRI images
     • Tissue contrast
     • Pulse sequences (T1-weighted, T2-weighted, diffusion-weighted)
   • MRI of the brain and spine
     • Indications
     • Protocols (with and without contrast)
     • Interpretation of findings (brain tumors, spinal cord compression, multiple sclerosis)
   • MRI of the musculoskeletal system
     • Indications
     • Protocols (with and without contrast)
     • Interpretation of findings (ligamentous injuries, soft tissue tumors, osteomyelitis)
7. 7

   Ultrasound Imaging

   3 topics

   • Principles of ultrasound imaging
     • Generation of ultrasound images
     • Transducer types
     • Doppler imaging
   • Abdominal ultrasound
     • Indications
     • Techniques (transabdominal, transvaginal)
     • Interpretation of findings (liver cysts, gallstones, renal calculi)
   • Obstetric ultrasound
     • Indications
     • Techniques (transabdominal, transvaginal)
     • Interpretation of findings (fetal anatomy, placental abnormalities)
8. 8

   Principles of nuclear medicine imaging

   3 topics

   • Radiopharmaceuticals
   • Gamma cameras
   • Single-photon emission computed tomography (SPECT)
9. 9

   Interventional Radiology

   2 topics

   • Image-guided procedures
     • Percutaneous biopsies
     • Drainages
     • Catheter-based interventions
   • Minimally invasive therapies
     • Radiofrequency ablation (RFA) for tumor treatment
     • Microwave ablation for tumor treatment
     • Cryoablation for tumor treatment
10. 10

    Radiation Oncology

    2 topics

    • Principles of radiation therapy
      • External beam radiation therapy (EBRT)
      • Brachytherapy
      • Intensity-modulated radiation therapy (IMRT)
    • Planning and delivery of radiation therapy
      • Treatment planning techniques (CT simulation, treatment planning software)
      • Radiation delivery methods (linear accelerators, gamma knife)

Radiology flashcards for INI CET

21 of 50 cards from the Radiology deck — real questions with worked answers.

1. Who discovered X-rays and in what year, and how were they initially named?

   Wilhelm Conrad Roentgen discovered X-rays in 1895; he called them 'X-rays' because their nature was unknown ('X' for the unknown). He won the first Nobel Prize in Physics (1901).

2. Which radioactivity discoveries laid the foundation for nuclear medicine, and who made them?

   Henri Becquerel discovered natural radioactivity (uranium, 1896), and Marie and Pierre Curie discovered radium and polonium (1898); their work enabled radiopharmaceutical use of radioisotopes.

3. How are diagnostic X-rays produced in an X-ray tube?

   A heated cathode (filament) emits electrons by thermionic emission; these are accelerated by a high voltage (kVp) toward a tungsten anode (target). On striking the target, ~99% of energy becomes heat and ~1% becomes X-rays via bremsstrahlung and characteristic radiation.

4. What do kVp and mAs control in an X-ray exposure?

   kVp (kilovoltage peak) controls X-ray energy/penetration and influences image contrast (higher kVp = lower contrast). mAs (tube current x time) controls the quantity of X-rays produced and therefore image density/brightness and patient dose.

5. What are the five primary radiographic densities (from least to most attenuating)?

   Air (most radiolucent/black), fat, soft tissue/water, bone/calcium, and metal/contrast (most radiopaque/white).

6. What is the inverse square law in radiation, and state its formula?

   Radiation intensity is inversely proportional to the square of the distance from the source: I1/I2 = (d2)^2/(d1)^2. Doubling the distance reduces intensity to one-quarter.

7. What are the main mechanisms of X-ray interaction with matter at diagnostic energies?

   Photoelectric effect (dominant at low energy and high atomic number; gives contrast) and Compton scattering (dominant at higher diagnostic energies; main source of scatter and occupational dose). Coherent (Rayleigh) scatter contributes minimally.

8. On a standard PA chest radiograph, how is correct rotation assessed?

   The medial ends of both clavicles should be equidistant from the spinous process of the adjacent thoracic vertebra; asymmetry indicates patient rotation.

9. What are the borders of the cardiac silhouette on a frontal chest radiograph?

   Right border: superior vena cava (upper) and right atrium (lower). Left border (top to bottom): aortic knob, main pulmonary artery, left atrial appendage, and left ventricle.

10. Describe the 'silhouette sign' on chest radiography.

    Loss of a normal interface (border) between two structures of similar density indicates that a lesion abuts that structure. E.g., loss of the right heart border indicates right middle lobe pathology; loss of the right hemidiaphragm indicates right lower lobe pathology.

11. What is the normal cardiothoracic ratio on a PA chest film, and when is it abnormal?

    The cardiothoracic ratio (maximum cardiac width / maximum internal thoracic width) is normally less than 0.5 on a PA film. Greater than 0.5 suggests cardiomegaly. It is unreliable on AP/portable films, which magnify the heart.

12. What radiographic features distinguish a tension pneumothorax?

    Lucent hemithorax with absent lung markings, collapsed lung, mediastinal shift away from the affected side, depression/flattening of the ipsilateral hemidiaphragm, and widening of intercostal spaces.

13. How do you distinguish the small bowel from the large bowel on an abdominal radiograph?

    Small bowel is central, has valvulae conniventes (plicae circulares) crossing the full lumen width, and dilates beyond 3 cm. Large bowel is peripheral, has haustra that do not cross the full width, and dilates beyond 6 cm (caecum beyond 9 cm).

14. What are the radiographic signs of bowel obstruction versus perforation on a plain abdominal film?

    Obstruction: dilated bowel loops with multiple air-fluid levels on an erect film. Perforation: free intraperitoneal air, seen as gas under the diaphragm on an erect chest film or as Rigler's sign (air on both sides of the bowel wall) supine.

15. What is the normal radiological anatomy of a long bone?

    Epiphysis (end, near joint), physis (growth plate), metaphysis (flared region adjacent to physis), and diaphysis (shaft). The cortex is dense compact bone; the medulla contains trabecular (cancellous) bone.

16. What are Salter-Harris fractures and how is the classification structured?

    They classify physeal (growth-plate) injuries in children. Mnemonic SALTR: I = Slip (through physis), II = Above (metaphysis), III = Lower (epiphysis), IV = Through (epiphysis + physis + metaphysis), V = Rammed (crush). Higher types carry greater growth-arrest risk.

17. What radiographic features differentiate benign from aggressive bone lesions?

    Benign: narrow zone of transition, sclerotic well-defined margin, no/solid periosteal reaction, no soft-tissue mass. Aggressive/malignant: wide zone of transition, ill-defined margins, cortical destruction, lamellated/spiculated ('sunburst') periosteal reaction or Codman triangle, and soft-tissue mass.

18. What is a barium swallow / upper GI series, and what does it evaluate?

    A fluoroscopic study using ingested barium sulfate contrast to assess the pharynx, oesophagus, stomach, and duodenum for strictures, ulcers, masses, reflux, hiatus hernia, and motility disorders.

19. When should water-soluble contrast (e.g., Gastrografin) be used instead of barium in GI studies?

    When perforation or aspiration is suspected, or in the immediate postoperative period, because extravasated barium causes severe peritonitis/mediastinitis, whereas water-soluble contrast is reabsorbed. (Note: aspirated hyperosmolar water-soluble agents can cause pulmonary oedema.)

20. What is a barium enema and what are its main indications?

    A fluoroscopic examination of the colon and rectum after rectal instillation of barium (single- or double-contrast with air). Indications include colorectal masses/polyps, diverticular disease, strictures, and evaluation of obstruction; largely replaced by CT colonography and colonoscopy.

21. What classic barium enema sign is seen in colonic carcinoma?

    The 'apple-core' (or 'napkin-ring') lesion: a short, irregular, circumferential annular constriction with shouldered margins and mucosal destruction, indicating an annular constricting adenocarcinoma.

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