Chapter 2

X rays and Radiography

Jean Tabet
Ph.D in Physics
MS in Biomedical engineering
jeantabet@gmail.com
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Chap 2: X rays and Radiography
X-rays

• Discovered by Conrad Röntgen on

1895  Nobel Price of physics
• Electromagnetic radiations of high
frequency
• X-rays vs Gamma rays
• Artificial ionizing radiations
• Applications in medical imaging (keV)
and radiotherapy (MeV)

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Chap 2: X rays and Radiography
X-rays production: X-ray tube

• Filament of tungsten heated electrically by a current (mA)

• Voltage for electron acceleration (15 to 150 kV)
• Rotating anode of molybdenum or tungsten
• Cooling system Voltage for Vacuum
filament
• Vacuum system

• Only 1% of the
electrons energy is Cathode Rotating
transformed to X-rays Filament Anode system
energy surface

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High voltage
Chap 2: X rays and Radiography
X-rays production: Linear accelerator

• Based on the acceleration of electrons by step.

• A Filament of tungsten is heated electrically by a current (mA).
• An alternative voltage of high frequency is applied (3 MHZ) to generate a
series of electron acceleration.
• Kinetic energy of electrons: 4 up to 40 MeV.
• Accelerated electrons are converted to X-rays after the insertion of
Molybdenum target.
• The yield is very high, and it is not necessary to cool the target.
• Linear accelerators are used exclusively in radiotherapy.

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Chap 2: X rays and Radiography
X-rays production: Betatron

• Betatrons, or circular accelerator, use a

magnetic field instead of electric voltage
to accelerate electrons.
• A coil creates a variable magnetic field of
magnitude B that is perpendicular to the
circular chamber.
• The magnetic field B has a sinusoidal
variation at a frequency of 200 Hz.
• This magnetic field accelerates electrons in a circular trajectory.
• Another magnetic coil is used to export electrons from the
chamber.
• Betatrons are used only in radiotherapy. 5
Chap 2: X rays and Radiography
X-ray spectrum

General emission due to Bremsstrahlung radiation

(friction)

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Chap 2: X rays and Radiography
X-ray spectrum

Characteristic emission due to electronic transition in

the target atoms

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Chap 2: X rays and Radiography
X-ray spectrum

X-ray spectrum is
composed from 2 main
emissions of X-rays:

• General emission due to

Bremsstrahlung radiation
(friction)
• Characteristic emission
due to electronic
transition in the target
atoms (molybdenum or
Tungsten)
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Chap 2: X rays and Radiography
X-rays attenuation

• For a radiation beam passing through a medium

with linear attenuation coefficient μ:

• μ depends on the material type and the beam

energy. 9
Chap 2: X rays and Radiography
X-rays absorption coefficients of organs

• X-rays are strongly

absorbed by bones
whatever the energy X.
• Contrast between soft
tissues and bony structures
is clearly seen in gray levels
on the film.
• A bone fracture is clearly
seen as a black line in a
white medium (that of the
bone), since it allows X-
rays to pass without
attenuation.
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Chap 2: X rays and Radiography
X-ray projection imaging

The contrast can be

improved by the injection
of absorbent solids of X rays
called contrast products.

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Chap 2: X rays and Radiography
Effect of the focal spot

• X-rays are produced in a region that is nearly a point

source and then are directed on the organ to be
imaged.

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Chap 2: X rays and Radiography
Image detection: Screen film combination

• Screens are usually made with light sensitive CaWO2 or

phosphors using rare earth elements such as doped Gd2O2S
or LaOBr.
• The sensitive film is enclosed in a light-tight cassette in
contact with an X-ray screen.
• When X-rays strike the cassette, they are absorbed by the
screen with high efficiency, and their energy is converted to
visible contrast.
• Residual X-rays cause blackening of the photographic film.
Dense structure (bones)  white color
Ventilated areas (lungs)  black color
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Chap 2: X rays and Radiography
Radiography applications

• 2 D images of dense and articular

structures:
• Used in orthopedic, rheumatology
and orthodontics. It permits to
study:
 Bone trauma (fractures, etc.)
 Skeletal deformities & dental
implants
 Pneumology (radiography of lungs)
 Mammography  cancer prevention
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Chap 2: X rays and Radiography
Image detection: Intensifiers

• Intensifiers are used in case of fluoroscopy needed, where lower X-ray

levels are produced continuously and many images must be presented
almost immediately.

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Chap 2: X rays and Radiography
Image detection: Intensifiers

• Produce a light image with sufficient brightness to allow

the use of video and film cameras.

• Produce an output image of small enough size to allow

convenient coupling to video and film cameras.

• The image intensifier provides real-time imaging

capability (fluoroscopy).

• Fluoroscopy allows patient positioning and catheter

manipulation, and recording of the angiographic injection
(digital angiography, analog video recording.
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Chap 2: X rays and Radiography
X-ray projection angiography

• This technique is based on

projection radiography.
• A coronary angiogram is a
special X-ray test. It’s done to
find out if coronary arteries
are blocked or narrowed,
where and by how much.
• An angiogram evaluates the
need for treatment such as
angioplasty or stent, coronary
artery bypass surgery or
medical therapy.
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Chap 2: X rays and Radiography
X-ray projection angiography: Principle

• Contrast material is needed to increase the opacity

vascular structures because the radiographic contrast of
blood is the same as that of soft tissue.

• Contrast material consists of an iodine-containing (Z= 53)

compound, with maximum iodine concentrations of
about 350 mg/cm3.

• Radiographic images of the contrast-filled vessels are

recorded using either film or video.

• Digital imaging technology has become instrumental in

the acquisition and storage of angiographic images. 18
Chap 2: X rays and Radiography
X-ray projection angiography: Images

Aortogram shows the total

occlusion of left subclavian
artery.

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Chap 2: X rays and Radiography
Mammography

• Mammography is an X-ray imaging procedure

for breast examination.
• It is used for the detection and diagnosis of
breast cancer, but also for pre-surgical
localization of suspicious areas.
• X-rays (25 – 35 KV) from a quasi-point source
irradiate the breast. The transmitted X-rays
are recorded by an image receptor.
• Because of the X-rays spread from the source,
structures are magnified as they are
projected onto the image receptor.
• The signal is a result of differential
attenuation of X-rays along paths passing
through the structures of the breast.
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Chap 2: X rays and Radiography
Mammography: X-ray beam geometry

Geometric arrangement
of system components in
mammography:
(a) Correct alignment
provides good tissue
coverage.
(b) incorrect alignment
causes tissue near the
chest wall not to be
imaged.
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Chap 2: X rays and Radiography
Mammography: Anti-scatter grid

• In mammography of dense breasts, image contrast can

be reduced significantly by scattered radiation from the
breast being recorded by the imaging system.
• The scatter-to-primary ratio for a breast of average size
and density can be 0.6 or greater.
• The use of an aluminum grid significantly improves
image contrast for dense breasts.
• To avoid excessive increase in patient dose, the grid
should have a high transmittance of primary radiation.
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Chap 2: X rays and Radiography
Digital mammography

• Many of the limitations of conventional mammography can

be effectively overcome with a digital mammography
imaging system, in which image acquisition, display, and
storage are performed independently, allowing optimization
of each.
• Acquisition can be performed with low noise due to the
highly linear X-ray detectors, while since the image is stored
digitally, it can be displayed with contrast independent of
the detector properties and defined by the needs of the
radiologist.
• Whatever image processing techniques, simple contrast
enhancement, histogram modification and spatial
frequency filtering could conveniently be applied.
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Chap 2: X rays and Radiography
Digital mammography

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Chap 2: X rays and Radiography
Detection of microcalcifications

(a) Microcalcification
seen in the white
circle.

(b) Calcifications are

better observed
after compression

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