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• Discuss the human response to ionizing radiation, radiation doses and radiation protection • Describe the various radiologic imaging techniques and their applications MATTER is anything that occupies space and has mass (quantity of matter within a physical object) ATOMS AND MOLECULES are the fundamental, complex binding blocks of matter ENERGY is the ability to do work and can exist in many forms: Potential energy, Kinetic energy, Chemical energy, Electrical energy, Thermal energy, Nuclear energy, Electromagnetic energy Electromagnetic Energy • Most important form of energy in radiography because it is the type of energy in the x-ray ELECTROMAGNETIC RADIATION • Electromagnetic energy emitted by a source and transferred through space ROENTGEN RAYS • form of electromagnetic energy of very short wavelengths (0.5 to 0.6A or less) • have the ability to penetrate matter hence used in the study of body tissues
terminals of the tube so that a negative charge is applied to the heated filament and a positive charge to the anode; the electrons will be repelled from the cathode and forced towards the anode. The electrons travel at a very high speed and the stream continues as long as the current is applied. A focusing cup within the tube directs the electrons toward the target in the anode terminal. The terminals are usually made of tungsten metal because of its high melting point. When highspeed electrons are stopped by the tungsten target, the major portion of their energy is transformed into heat and only a small part, less than 1% into Roentgen rays.
X-RAY PRODUCTION X-rays are generated by two different processes: (1)Bremsstrahlung radiation • (braking) x-rays are produced when incident electrons interact with nuclear electric fields , which slow them down (brake) and change their direction (2) Characteristic radiation • is the result of ionization and is produced when inner-shell electrons of the anode target are ejected by the incident electrons IONIZATION occurs when an electron is ejected from a neutral atom, leaving behind a positive ion. Electromagnetic radiation with sufficient energy to remove electrons is called IONIZING RADIATION Ionizing radiation includes x-rays and gamma rays SOURCES OF IONIZING RADIATION Natural sources of ionizing radiation 1.Cosmic rays - emitted by the sun and stars 2.Terrestial radiation -emitted from deposits of uranium, thorium & other radioactive substances in the earth Radon-largest component of terrestial radiation 3. Radionuclides mainly potassium-40 - part of human metabolism 1 of 4 | P a g e
Physical manifestations are classified in the ĒM spectrum based on energy (E) and wavelength (l) and comprise the following general categories: – Radiant heat, radio waves, microwaves – “Light” – infrared, visible and ultraviolet – X-rays and gamma-rays (high energy ĒM emitted from the nucleus) Wilhelm Conrad Roentgen • November 8, 1895 • Würzburg University, Germany Roentgen’s experimental apparatus (Crookes’ tube) led to the discovery of the new radiation. He demonstrated that the radiation was not due to charged particles, but due to an as yet unknown source, hence “x” radiation or “x-rays” • “the radiograph of Bertha Roentgen’s hand” taken Dec. 22, 1895 X-RAY PRODUCTION The x-ray tube is a glass-encased vacuum bulb. An electrode is at either end. Then a high-voltage current is applied to the
absorbed by the anatomic structure being x-rayed Pair Production • photon interacts with the nuclear force field creating two oppositely charged electrons Photodisintegration • high energy x-ray photons escape interaction with the electron cloud and the nuclear force field and be absorbed directly by the nucleus. Gastrointestinal Syndrome c. Hematologic Syndrome b. Cytogenetic damage Syndromes are dose related Three stages of acute radiation lethality 1.rem (radiation equivalent man) . Skin b. do not reach the film. Latent period 3.quantity of radiation received by radiation workers (radiographers and nuclear power plant personnel) Curie (Ci) or Becquerel (Bq) .radiation response occurs within minutes or days after the radiation exposure LATE EFFECTS . smoke detectors. TVs and airport surveillance system Natural radiation sources contribute approximately 360 mrad to the average absorbed dose to each human Medical x-rays on average contribute 40 mrad Basic interactions between X-rays and Matter • Coherent Scattering • Photoelectric Effect • Compton Scattering • Pair Production • Photodisintegration Coherent Scattering • interaction between low-energy x-rays and atoms • x-ray loses no energy but changes direction slightly • no energy transfer and therefore no ionization • little importance to diagnostic radiology Compton Scattering • interaction between moderate energy x-rays and outer-shell electrons • results in ionization of the target atom.most radiosensitive cell: spermatogonia in males and oocyte in the mature follicle in females 10 rad : minimal aspermia/delay menstruation 200 rad: temporary sterility/ 2 of 4| P a g e Man-made sources of ionizing radiation 1. raising it to an excited state and instantaneously emit a nucleon or nuclear fragment Three types of x-rays which are important to the making of a radiograph are: (1) Those scattered by Compton interaction (2) Those absorbed photoelectrically . change in photon direction and reduction of photon energy • produce a uniform optical density on radiograph (fog) which results in reduced image contrast Photoelectric Effect • x-ray interact with inner-shell electrons and is totally absorbed • provide diagnostic information to the film. Central Nervous System Syndrome 2. Extremities 3. Prodromal stage 2.if the human injury is not observable for many months or years EARLY EFFECTS 1.unit of radiation intensity in air . Gonads c. Consumer items like watch dials.quantity of radioactive material and has nothing to do with radiation emitted . Hematologic depression 4. Medical x-rays – constitute the largest source of manmade ionizing radiation 2. atrophy .output of x-ray units is specified in milliroentgens (mR) Rad or Gray (Gy) . epilation.used in nuclear medicine Human Responses to Ionizing Radiation RADIOBIOLOGY – study of the effects of ionizing radiation on biologic tissue EARLY EFFECTS .rad (radiation absorbed dose) .erythema.damage basal cells Gonads . Acute Radiation Syndrome a. Local Tissue Damage a. Manifest illness stage Acute radiation Lethality 200-1000 rad Hematologic 1000-5000 rad Gastrointestinal (10-50 Gy) >5000 rad CNS (50 Gy) Local Tissue damage Skin .-2(3) Those transmitted through the patient without interaction Units of Ionizing Radiation Roentgen (R) or Coulomb/kilogram (C/kg) . Nuclear power plants and industrial source 3.quantity of radiation received by a patient Rem or Sievert (Sv) .
Breast – atomic bomb survivors. Very radiopaque – metal Thick structures attenuate more radiation than thin structures of the same composition CONVENTIONAL TOMOGRAPHY .Radiation-induced genetic mutations at the levels used in diagnostic imaging today are essentially zero EFFECTS OF FETAL IRRADIATION 1. Genetic damage . Neonatal death 3. Malignancy a. Lung – exposure to radon in mines c.000 persons/rad/year 3. most radiosensitive cell. Leukemia – atomic bomb survivors 2. Moderately radiolucent – fatty tissues c. gonadal shields IMAGING TECHNIQUES/MODALITIES • Conventional Radiography • Conventional Tomography • Fluoroscopy • Angiography • Ultrasound • Computed Tomography • Magnetic Resonance Imaging • Radioisotope Scanning CONVENTIONAL RADIOGRAPHY Five basic radiographic densities a. Very radiolucent – air or gas b. Bone – radium watch dial painters b.The structures above and below the focal plane are blurred by motion of the tube and film while objects within the focal plane are visualized with improved detail . Childhood malignancy 5.Seldom done today FLUOROSCOPY . Intermediate radiolucent – soft tissue d. ALARA (As Low As Reasonably Achievable) 1966 International Council of Radiation Protection (ICRP) concept has no specific numerical guidelines Basic Tenets of ALARA: 1. Radiation exposure must have a specific benefit 2. the exposure will be doubled. very slow to recover Granulocytopenia Thrombocytopenia Erythrocytes – less sensitive LATE EFFECTS 1. Prenatal death 2.000. Dose of individuals shall not exceed limits for appropriate circumstances Cardinal Principles for Radiation Protection Minimize TIME MAXIMIZE DISTANCE MAXIMIZE SHIELDING The dose to an individual is directly related to the duration of exposure. Congenital malformation 4. gloves.first cells to become affected after exposure. Thyroid – irradiation in childhood d.More radiation given to the patient Indications: 3 of 4| P a g e . the radiation exposure decreases rapidly. acute postpartum mastitis The over-all absolute risk of developing malignant disease is 10 cases/1. . All exposure should be kept as low as reasonably achievable 3.Allows real time radiographic visualization of moving anatomic structures with continuous x-ray beam passing through the patient and falls onto a continuous fluorescing screen where it is amplified electronically by an image intensifier and the image is displayed on the TV screen . Inverse Square Law: As the distance between the source of radiation and a person increases.-3500 rad: sterility Hematologic Depression Lymphocytes . Diminished growth and development These abnormalities are based on doses greater than 100 rad. reduced in number. Positioning shielding between the radiation source and persons exposed greatly reduces the level of exposure Primary devices for minimizing radiation • Filtration • Collimation • Intensifying screens • Protective barriers – lead-lined walls or lead-glass windows • Protective apparel – aprons. Lifespan shortening – reduced life span of 10 days for every rad of radiation exposure 5. thyroid. There is no evidence at either the human or animal level to indicate that the levels of radiation exposure currently experienced occupationally or medically are responsible for any such effects on fetal growth and development.Provides radiographic slices of a living patient done by simultaneously moving the x-ray tube or film about a pivot point centered in the patient in a plane of anatomic structures to be studied. gonads. Moderately radiopaque – bone e. eyes 4. Local Tissue Damage – skin. If the time of exposure to radiation is doubled.
-4Evaluation of GIT. Ability to provide images on any anatomic plane 3. magnetically or mechanically activated implants RADIOISOTOPE SCANNING (NUCLEAR IMAGING) .The emitted rays are recorded by a gamma camera or less commonly by a rectilinear scanner during the period of gamma emission 4 of 4| P a g e .g. Long imaging time 3. breast.Images of arterial structures are called ARTERIOGRAMS and venous structures are called VENOGRAMS ULTRASONOGRAPHY .Intra-operative guidance ANGIOGRAPHY .Evaluation of diaphragmatic movement . Absence of radiation Disadvantages of MRI versus CT 1.5 Mhz) .best for superficial structures like thyroid. Superior bone detail 3. Simple cyst .Anechoic – complete absence of echoes e. High frequency transducers (5-10Mhz) .Hyperechoic – lesion with greater echogenicity compared to surrounding parenchyma . pelvic organs Advantages of Ultrasound o Examination is done fast o No radiation to the patient o Allows real-time images of moving patient tissues o Cost-effective o Can differentiate solid from cystic structures Disadvantages of Ultrasound o Limited by bone and gas o Poor tissue delineation in obese patients o Operator-dependent COMPUTED TOMOGRAPHY (CT scan) – Also called CAT (computerized axial tomography) scan – Gives focused radiographic information about one cross-sectional slice of the patient.Hypoechoic – lesion with lower echogenicity compared to surrounding parenchyma . liver.Complex lesions – with solid and cystic components Frequency of transducers 1. spleen . Generally limited to axial plane 2.Performed by using pulse echo technique. GUT (e.Monitor catheter placement .g.An image is obtained because the radioactive isotope emits gamma rays for a brief period of time . More radiation to the patient MAGNETIC RESONANCE IMAGING (MRI) – Based upon the ability of a small number of protons within the body to absorb and emit radiowave energy when the body is placed within a strong magnetic field – Like ultrasound. Contraindicated in patients with electrically.Solid tissues – demonstrate speckled pattern of tissue texture e.The selected chemical substance by which the isotope has been attached is normally involved in the physiologic metabolism of that organ or will remain there long enough to be imaged . it doesn’t use ionizing radiation Advantages of MRI versus CT 1.Images are viewed in “real-time” Principles of interpretation . Demonstration of calcification Disadvantages of CT versus MRI 1. whereby the transducer converts electrical energy to a brief pulse of high frequency sound energy that is transmitted into the patient tissues and at the same time becomes the receiver detecting echoes of sound energy reflected from the tissues . without confusing superimposed images – Gives a range of density values for a particular chosen slice of the patient – Contrast media may be used to enhance the difference in density of various structures - Advantages of CT versus MRI 1.Vascular system is imaged by x-ray during intravascular injection of iodinated contrast agents .good for abdomen. for infants 2. Limited spatial resolution 4. Outstanding soft tissue contrast resolution 2. Inability to demonstrate dense bone detail or calcification 2.Living organs and tissues are visualized after injection of a radioactive isotope (radionuclide) that stays within the organ for quite sometime .Contrast studies) Evaluation of the dynamics of the cardiovascular system and respiration . Rapid scan acquisition 2. Low frequency transducers (1-3.g. Unavailability and expense 5. testes.
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