23-10 Block diagram and operation of a fluoroscopic machine Fluoroscopie machines are X-ray machines that ‘generate soft X-rays (reduced frequency and inten- sity) to produce dynamic visualizations on a fluo~ roscope. Internal body organs are viewed through the use of a contrast medium that is opaque to X- rays, Patient dosage should not exceed 10 R per minute, Transmitted X-rays fall upon a fluorescent plate or screen as a function of varying tissue den- sity. Fluorescence is the emission of visible light Figure 23-7 ‘Simplified block diagram of a fuoroscope machine, (Choxed-Cireut Video System produced when X-rays fall upon crystals in the coating of the screen. As shown in Figure 23-7, the major sections are the X-ray machine (subsections previously dis- cussed), fluoroscope image pickup, and CRT or closed-circuit video system. The X-ray image falling on a fluorescent grid causes a visible “light” picture to appear. This is optically focused by a lens on the film of a motion picture (auto- ‘matic) camera. The film can be played back at a later date. The visual image is also focused on a phototube lens and made brighter by an image en- Filhhancer. A video camera converts the light image into an electrical video signal, which is delivered to a CRT and displayed through a closed-circuit video system, This gives a real-time or instanta- ‘neous visualization. A fluorascope machine is shown in Figure 23-8. 23-11 Block diagram and loperation of a nuclear medicine system Nuclear medicine systems are used to count ra dioactive decay from isotopes that have been in- jected into the body in small amounts and taken up by a target organ to measure its activity. The basic Components are a gamma ray camera, rectilinear scanner, fixed detector for in vitro samples, scintil- lation counter, and survey instrument. As shown in Figure 23-94, a Geiger-Mueller tube radiation detector counts beta particles. Beta particles passing through the gas mixture in the tube cause ionization, and the electrons are col- lected by the anode and the positive ions by the cathode via a high potential of approximately 1 KV. Therefore, each beta particle causes a brief pulse of current, The total number of current pulses, electronically counted over a given period of time, indicates the radiation intensity falling on the mica window. ‘As shown in Figure 23-95, a scintillation crys- tal detector with photomultiplier tube measures gamma radiation intensity. The incident gamma rays are detected by the crystal, and flashes of light are produced and reflected onto the cathode of the photoamplifier tube. The dynodes multiply the electrical signal in a secondary emission process bby as much as 10 million to produce an apprecia- ble current pulse, Current pulses are produced for rays striking the fixed surface area of the scintilla- tion detector and are then counted to indicate radi- ation intensity (rays per second). ‘A nuclear medicine system (rectilinear scan- ner), as shown in Figure 23-10, consists of a detector-collimator, amplifier, analyzer, and recorder. The detector-collimator, driven by the scanner motor assembly, scans back and forth in a linear fashion. A graph or contour map of radioac- tivity can then be drawn indicating the amount of radioactive isotope taken up by the target organ. Improper amounts indicate organ malfunction, ‘The detector-collimator typically uses an Na-t ‘crystal to detect the radiation collimated toward its surface. The photomultiplier tube intensifies the signal after which i is linearly amplified. Its pulse is analyzed for comparisons between successive ‘events. Numbers of pulses per unit of time are im- portant. The dot scan recorder produces a map of[rir Lead Cathode Tube Mica Bead | Suppon \ Lead Base = }— ~ Base Pins, Be [b— for Elements Wire 7 Glas Tube \ specat ‘Anode ‘eternally Ger bane 0.01 in Plated With Fats he Tube Diameter Silver or Copper Scintillation e ‘Tube ‘Crystal or Phosphor Photocatbode Base Ancient (Gamma Radiation Reflector Dyieies Electrons are Multiplied Down the Tube Figure 23-9 ‘Nuclear medicine system. (a) Geiger-Mueller tube. (b) Scintillation crystal detector with photo ‘muttiplier tube. tm |_, Photomuttipher a. Analyzer aa Nf ane Cc 1 Nadie t ee} ‘Dot Scan Photo Recorder Cpa aes | |e a Recorder Meter Nee = X it — mae Patcn Prewously Injected with a Nuclear Medicine: Radioactive ote Targeted ata Specific Organ Figure 23-10 ‘Simplified block diagram of a nuclear medicine eystem (rectilinear scanner).dots or dash marks on paper representing the distribution of radioactivity. The photographic recorder produces a photograph of light flashes, Recordings move simultaneously with the scan- ‘ning device to produce one line scan in unison. Figure 23-11 illustrates a nuclear medicine system. ‘il ‘The gamma ray camera, shown in Figure 23-12, produces an image in a different manner than that ‘of a scanner. Gamma rays interact with a large sodium iodide scintillation erystal in the camera, ‘and the scintillations (flashes) are observed by an array of photomultiplier tubes. Typically, 19 tubes fare used, and a position analyzer evaluates the flashes from four crystal quadrants. Flashes are produced on an oscilloscope display when the gamma ray meets the pulse-height analyzer re- ‘quirements. A Polaroid or 35 mm camera pho- tographs the flashes on the oscilloscope to produce a scintiphoto. Up to $00,000 counts, for example, ‘may accumulate for brain scans on the CRT screen.