Patient Care
16-17%of exam
Safety
25%of exam
Image Production
25-26%of exam
Procedures
33%of exam
Quick Facts
- Exam
- ARRT Radiography
- Scored
- 200 (+30 pilot)
- Time
- 230 min
- Pass
- Scaled 75
- Fee
- $225
- Format
- MCQ (Pearson VUE)
- Domains
- 4 categories
- Blueprint
- Jan 2022
Barium vs Water-Soluble
Barium
- Intact GI tract
- Better coating
- Not if perforation
Water-soluble
- Suspected perforation
- Iodinated, absorbable
- Safe in peritoneum
Intact vs perforation
Contrast Picker
- Suspected GI perforation→Water-soluble iodinated
- Impaired renal function→Check eGFR, hydrate
- Prior contrast reaction→Premedicate steroids
- Joint evaluation→Arthrography, iodinated
- Uterus and tubes→Hysterosalpingography
Vitals & Assessment
- Pulse
- 60-100 bpm adult
- Respirations
- 12-20 per minute
- SpO2
- 95-100% normal
- Hypoxemia
- Below 90% SpO2
- Blood pressure
- About 120/80 mmHg
- Nasal cannula
- 1-6 L/min low-flow
Contrast Media
- LOCM
- Nonionic, fewer reactions
- HOCM
- Ionic, more reactions
- Barium
- Intact GI tract only
- Water-soluble
- If perforation suspected
- eGFR/creatinine
- Screen before iodinated
- Shellfish myth
- Not a contraindication
Infection & Emergencies
- Hand hygiene
- Most effective control
- Airborne
- N95 + negative-pressure room
- Droplet
- Surgical mask, close range
- Contact
- Gown and gloves
- PPE order
- Gown, mask, goggles, gloves
- Epinephrine
- First for anaphylaxis
- Vasovagal
- Supine, legs elevated
Cardinal Rules
Time - Distance - Shielding
Time: less beam-onDistance: inverse squareShielding: lead barrierDistance is most effective
Gray vs Sievert
Gray (Gy)
- Absorbed dose
- Energy per kg
- Tissue dose
Sievert (Sv)
- Equivalent dose
- Weighted by risk
- Stochastic reporting
Absorbed vs biological
Radiation Units
- Gray
- Absorbed doseGy
- Sievert
- Equivalent/effective doseSv
- Roentgen
- Exposure (air kerma)
- Becquerel
- One disintegration per second
- Coulomb/kg
- SI exposure unit
- LET / RBE
- Biological damage factors
Dose Limits
Whole 50, Lens 150, Skin 500
50 mSv: whole body150 mSv: eye lens500 mSv: skin/extremities1 mSv: public
NCRP Dose Limits
- Occupational
- 50 mSv per year
- Cumulative
- 10 mSv times age
- Public
- 1 mSv per year
- Fetus
- 5 mSv over gestation
- Monthly fetus
- 0.5 mSv after declaration
- Lens of eye
- 150 mSv per year
- Skin/extremities
- 500 mSv per year
Protection & ALARA
- ALARA
- As Low As Reasonably Achievable
- Cardinal rules
- Time, distance, shielding
- Inverse square
- Double distance, quarter dose
- Filtration
- 2.5 mm Al above 70kVp
- Collimation
- Less scatter, lower dose
- Protective apron
- 0.25-0.5 mm Pb equivalent
- Distance
- Most effective protection
Radiobiology & Fluoro
- Stochastic
- No threshold, probability
- Deterministic
- Threshold, tissue reactions
- Bremsstrahlung
- Braking radiation
- Characteristic
- Shell-transition x-rays
- Photoelectric
- Absorption, more contrast
- Compton
- Scatter, patient dose
- Last-image hold
- Freezes frame, cuts dose
15% kVp Rule
+15% kVp = double exposure
+15% kVp: 2x exposureHalve mAs to holdLower dose, lower contrast
mAs vs kVp
mAs
- Receptor exposure
- Density/brightness
- Directly proportional
kVp
- Beam penetration
- Contrast scale
- More scatter
Exposure vs contrast
Exposure Fix Picker
- Quantum mottle noise→Increase mAs(More photons)
- Low contrast, scatter fog→Add grid, collimate
- Need lower patient dose→+15% kVp, halve mAs
- Motion blur→Shorter exposure time
- Too much magnification→Raise SID, reduce OID
- Overexposed, high DI→Reduce mAs
Exposure Factors
- mAs
- Controls receptor exposure
- kVp
- Controls penetration/contrast
- 15% rule
- +15% kVp doubles exposure
- SID
- Affects exposure and magnification
- OID
- Increases magnification, air gap
- AEC
- Auto-terminates exposure
- Focal spot
- Small = better detail
EI vs DI
EI
- Receptor exposure
- Detector-specific
- Technique feedback
DI
- Deviation from target
- Zero is ideal
- +3 doubles dose
Amount vs deviation
Image Quality
- Contrast
- Density difference (kVp)
- Spatial resolution
- Recorded detail/sharpness
- Distortion
- Size or shape misrepresentation
- Magnification
- Enlarged by OID
- Quantum mottle
- Noise from low mAs
- SNR
- Signal-to-noise ratio
Window Width vs Level
Window width
- Displayed contrast
- Gray range shown
- Post-processing only
Window level
- Displayed brightness
- Midpoint value
- Post-processing only
Contrast vs brightness
Digital Imaging
- EI
- Receptor exposure indicator
- DI
- Deviation from target (0 ideal)
- Dose creep
- DI +3 doubles dose
- DQE
- Efficiency of signal capture
- Direct DR
- a-Se converts to charge
- Indirect DR
- Scintillator makes light first
QC & Artifacts
- Window width
- Displayed contrast
- Window level
- Displayed brightness
- kVp accuracy
- Within about 5%
- Reproducibility
- Output varies under 5%
- Flat-field
- Corrects dead pixels
- Grid cutoff
- Primary-beam absorption loss
- Moire
- CR grid-line aliasing
Oblique Spine
Cervical up, Lumbar down
Cervical foramina: farthest (up)Lumbar zygapophyseal: nearest (down)Scotty dog = lumbar
Fluid vs Air Decubitus
Fluid (effusion)
- Affected side down
- Fluid layers dependent
- Horizontal beam
Air (pneumothorax)
- Affected side up
- Air rises nondependent
- Horizontal beam
Fluid down, air up
Projection Picker
- Suspect pleural effusion→Lateral decub, side down(Fluid layers dependent)
- Suspect pneumothorax→Lateral decub, side up(Air rises nondependent)
- Free air, cannot stand→Left lateral decubitus(Air over liver)
- Lung apices clear→AP lordotic (Lindblom)
- Scaphoid detail→Stecher, ulnar deviation
- Carpal tunnel→Gaynor-Hart
- Open glenohumeral joint→Grashey method
- Suspected hip fracture→Danelius-Miller lateral
Chest & Thorax
- PA chest SID
- 72 inches (180 cm)
- CR centering
- T7, inferior scapular angle
- Full inspiration
- 10 posterior ribs
- Fluid decub
- Affected side down
- Air decub
- Affected side up
- AP lordotic
- Apices free of clavicles
- SC joints
- PA or shallow oblique
Decubitus Rule
Fluid down, Air up
Effusion: affected side downPneumothorax: affected side up
Frog-leg vs Danelius-Miller
Frog-leg (Cleaves)
- Routine lateral hip
- Requires abduction
- Not for fracture
Danelius-Miller
- Trauma lateral hip
- Horizontal beam
- No limb movement
Routine vs trauma
Abdomen & Contrast
- KUB centering
- Iliac crests
- Upright abdomen
- 2 inches above crests
- Free air
- Left lateral decubitus
- Erect wait
- 5 minutes before exposure
- Esophagram/UGI
- RAO position
- Small bowel
- Images 15-30 minutes
- IVU centering
- Iliac crests
Spine & Skull
- Open-mouth
- Dens, C1-C2
- Cervical oblique
- Foramina farthest (upside)
- Lumbar oblique
- Zygapophyseal joints (Scotty dog)
- Lateral lumbar
- Centered at L4
- Towne
- 30 caudad, occipital bone
- Waters
- Maxillary sinuses, orbital floors
- Caldwell
- 15 caudad, frontal sinuses
Extremities & Pelvis
- PA oblique hand
- 45 external rotation
- Stecher
- Scaphoid, ulnar deviation
- Gaynor-Hart
- Carpal canal/tunnel
- Lateral elbow
- 90 degrees flexion
- Grashey
- Open glenohumeral joint
- AP mortise ankle
- 15-20 internal rotation
- Calcaneus axial
- 40 cephalad angle
- AP pelvis
- 15-20 internal rotation
Trauma / Mobile / OR
- Trauma C-spine
- Cross-table lateral first
- Must include
- C7-T1 visualized
- Trauma rule
- CR perpendicular, 2 projections 90
- Mobile chest
- Upright as tolerated
- C-arm
- Tube under table
- Markers
- In field, at exposure
Common Traps
Gray vs Sievert
Gray = absorbed dose ≠ Sievert = equivalent dose
mAs vs kVp
mAs = exposure ≠ kVp = contrast
Shellfish myth
Shellfish allergy irrelevant ≠ Prior reaction matters
Barium danger
Barium if intact ≠ Water-soluble if perforation
Decub direction
Fluid: side down ≠ Air: side up
EI is not dose
EI = receptor exposure ≠ Not patient dose
Distance beats shielding
Distance most effective ≠ Shielding not first
Last Minute
- 1.Procedures 33%, biggest domain
- 2.Pass = scaled score 75
- 3.200 scored, 30 pilot
- 4.230 minutes total test time
- 5.PA chest = 72-inch SID
- 6.Distance beats time and shielding
- 7.Occupational limit 50 mSv yearly
- 8.mAs = exposure; kVp = contrast
- 9.Perforation = water-soluble contrast
- 10.Fluid decub down, air up
- 11.Epinephrine first for anaphylaxis
- 12.Gray = absorbed; Sievert = equivalent
Buy on Amazon
Practice exams on ExamEdge
Study guide on MometrixSame family resources
Explore More ARRT Certifications
Continue into nearby exams from the same family. Each card keeps practice questions, study guides, flashcards, videos, and articles in one place.
More From This Family
Videos and articles for deeper review.
VideoARRT Radiation Therapy Exam Guide 2026: Pass the 230-Item Board (FREE)This examVideoARRT Radiography Pass Rate + Study Tips (2026)This examVideoARRT Limited Scope Radiography Exam Guide 2026VideoARRT Radiation Therapy Exam Guide 2026: Pass the 230-Item Board (FREE)ArticleFREE ARRT Radiography Study Guide 2026: 85% Pass Rate12 min readArticleFREE ARRT MRI Study Guide 2026: Blueprint-Weighted Plan to Pass on Your First Attempt14 min readArticleARRT Radiation Therapy Exam Guide 2026: Pass the 230-Item Board (FREE)30 min readArticleARRT Radiography Pass Rate + Study Tips (2026)14 min read