MINISTRY OF HEALTH OF UKRAINE UKRAINIAN MEDICAL DENTAL

ACADEMY

Approved at the meeting of the department

oncology and radiology
with radiation medicine
Minutes № _______ of _____________. Head
department _________ prof. Bashtan VP

Methodical instructions
for independent work students
in preparation for the practical lesson
and in the qualification of educational "Master of Medicine", "Master of Pediatrics"
qualification of professional "Doctor", "Pediatrician"

Academic discipline Radiology

Module № AND
Lesson topic: Basic properties of ionizing radiation. Biological effect of ionizing
radiation on a healthy and pathologically altered cell.

Course III
Faculty medical

Poltava - 2018
1. Relevance of the topic: Study of the biological action of ionizing radiation (IR) as a science and
teaching the general laws of the biological response to the action of IP, on the basis of which it is possible to regulate their
action, controlling the radiation reactions of the organism. Thus, to solve it, it is necessary to understand and overcome the
basic radiological paradox, which includes the mismatch between the small amount of energy absorbed in tissues when
irradiated with a completely lethal dose of 10 Gy and a very large response of the body - until death.

2. Specific objectives:
1. To study the properties of ionizing radiation.
2. The principles of protection against ionizing radiation (IR) are general.
3. Principles of radiation safety.
4. Categories of the population in relation to IP.
5. Borderline doses for staff and patients.

3. Basic knowledge, skills, abilities necessary for studying the topic (interdisciplinary integration).

Discipline Know Be able to

Normal and topographic Anatomical structure of organs and Orient in topographic anatomy for adequate
physical anatomy surrounding tissues, topography treatment.
for radiation therapy.

Normal physiology The nature of physiological processes Distinguish physiological processes from
organism. pathological ones and learn to correct the latter.

Pathological physiological The nature of pathological processes Assess the severity of the pathological process in
gia in the body. the body.
Internal diseases To set the final Orient in the course and in the clinical manifestations of
diagnosis and treatment tactics, taking into the disease.
account concomitant diagnoses.
Oncology Features of oncosis- Orient in the course and clinical manifestations
theft, verification of diagnosis and of cancer.
treatment of cancer patients.
Radiology Ability to navigate in sufficient volume in Correctly appoint this or that X-ray examination
radiographs, and evaluate it.
navigate in localizations.

4. Tasks for independent work in preparation for classes and in class.

4.1. The list of the basic terms which the student should master at preparation for employment: Term
Definition
X-ray This amount of X-ray or gamma radiation in the air, in which the associated corpuscular
emission of 0.001293 g of air conducts ions that carry a charge in one electrostatic unit of the
amount of electricity of each sign.

Surface dose The dose in X-rays or its derivatives or the dose rate measured on the surface of the irradiated
object or body is called the dose rate on the surface or the surface dose.

Isodose A line connecting a number of dots that have received the same dose. The isodose may
correspond to the same values of the percentage dose of X-ray or gamma radiation or the
percentage of absorbed radiation dose. Spatial distribution of absorbed radiation energy in the
Dose field irradiated medium or body.
4.2. Theoretical questions for classes:
1. What is the dose, types of doses and units of dose?
2. What are the types of energy dissipation?
3. What are the types of energy absorption?
4. Radiation factors that determine the degree of ionization.
5. What is the linear ionization density?

4.3. Practical tasks performed in class:

1. Professional algorithms (instructions, indicative maps), regarding the acquired skills and abilities
2. Educational tasks
3. Tests
4. Tasks that complement independent work in practice, as well as reference materials: materials of post-classroom
work and independent work, topics of research work of students.

Topic content:
The biological action of ionizing radiation (IR) is studied by a science called radiobiology. It studies the general
patterns of the biological response to the action of IP, on the basis of which it is possible to regulate their action,
controlling the radiation reactions of the body. This problem is very difficult, because to solve it you need to understand
and overcome the basic radiological paradox, which includes the mismatch between the small amount of energy
absorbed in tissues when irradiated with a lethal dose of 10 Gy and a very large bioresponsiveness - until death.

When the body is irradiated with a dose of 10G, it is transferred the amount of energy from which it is heated by
0.0024e, less than a cup of hot tea. Therefore, a significant catastrophe in the body, which arises from a meager amount of
energy absorbed and is a mystery of the radiobiological effect. By biodiversity understand the ability of IP to cause functional
and anatomical changes at the molecular, cellular, organ levels. The biology of IP is due to the energy of radiation, which it
gives to various tissues and organs.

Pathogenetic action.
A. Direct destructive hope of IP on cells and tissues.
B. Effect on the central and peripheral nervous system. B. Occurrence
of secondary reactions.
D. Effects on blood and other body fluids, which form toxins, both at the time of ionization and the latter.

D. Appropriate reaction of the whole organism, under the influence of nervous and humoral impulses.

Features of the biology of IP: secret period. The effect on the body of a high level of development is not immediately after irradiation,
but with a significant delay.

Graph of the logical structure on the topic: Stages of biological action of ionizing radiation

Time Process during irradiation and subsequent Stage

overflow
process
10- 12 sec I - absorption of energy radiation by atoms and molecules. Primary interaction of llamas with ionization and
excitation of molecules.
10- 9 sec II - the formation of radical molecules, from which constructed cells. Radiochemical reactions Interaction with each other
and with molecules of other substances.
Seconds, III - DNA damage in chromosomes, damage in lesions cells and other organelles
hours and membranes cells,
which provide the function of heredity.
 IV - changes in cell function. Biochemical
V - changes morphology cells. Morphological
Minutes, VI - organ dysfunction. Organ damage
months VII - morphological changes in organs and systems. Direct somatic
non-stochastic effects (acute
neva disease, radiation reactions and injuries, burns). Remote
Years non-stochastic somatic effects Defeat organism
(chronic radiation sickness, cataracts, hypothyroidism, nephrosclerosis and others),
there is a threshold dose.
Stochastic effects (cancer) - without threshold effects. Remote
Not recognized genetic effects (stochastic),
but chromosomal aberrations, genimutation, teratogenic effects
long (stochastic). Accelerate aging. Death of the organism.
time

Theories of biological action of IP:

1. Target theory - a direct effect on the cell, especially on the nucleus and membrane.
2. The theory of side effects - the theory of hydroxyl radicals.
3. Stochastic theory.
4. Structural and metabolic theory.
Direct action of IP. As a result of direct action of IP on the cell nucleus in its structures is the formation of radicals,
which have unpaired electrons and, as a consequence, they are very reactive.
is destroyed DNA, on indicating accumulation in
cytoplasminucleic acids. Complex polysaccharides are divided on
simple increase in their viscosity, the last in your own queue are divided on acids and
histamine-like compounds that are very toxic. Also decreases the number of amino acids and H-groups, changes the activity of
enzymes. Membrane lipids are destroyed, with the formation of peroxides. Kills only the cell where the above changes
occurred.
Side effects of IP: t If the body consists of 70% water, then 50% of the energy absorbed in it is water. And as a consequence,
there are decays with the formation of radicals.
This, in turn, leads to:
a) violation of the synthesis of proteins, fats, carbohydrates; b)
changes in enzyme systems;
c) disorders of tissue respiration and more.
The result can be: cell death, delayed cell division, cell dysfunction, cancer, genetic changes, teratogenic changes.

Formed radicals enter the intercellular fluid and then with the flow of lymph and blood spread
on organism. Such changes occur in
any cell of the irradiated organism.
Stochastic theory rejects the theory of a particular target, recognizing that the targets can be all components of a living
system. Reaction,
which is registered due to the interaction of various primary trigger events.
Structural and metabolic theory is crucial not
not only radiation damage to nuclear macromolecules, but also the violation of cytoplasmic structures.

The main types of cell damage:

1. Single-stranded damage to DNA molecules - delayed division, cell dysfunction, cancer, and when irradiating
gametes - genetic changes. When the fetus is irradiated - teratogenic changes.

2. Double-stranded breaks of DNA molecules - death and cause of aberrations.

3. Violation of communication with protein - blocking processes of proliferation and regeneration.
4. Variableepigenomic (not related to nuclearmaterials), hereditycarrier, which is
 various cytoplasmic organelles - metabolic disorders, nucleic metabolism, oxidative phosphorylation,
chromosome adhesion.
5. Changes in viscosity and hydrophilicity of cytoplasm.
6. Violation of membranes.
Changes in the kernel:
1. Chromosome breaks;
2. Chromosomal aberrations;
3. Point mutations;
4. Violation of the DNA structure of the membrane.
As a result of these changes, the cell either slows down the division, or possibly complete suppression of the division. As a
result, the cell is alive, but can not divide - a giant dinuclear cell.
Cell death:
1. Interphase - cell death before division (at high sensitivity cells, or high dose).
2. Mitotic - cell death after division - reproductive;
Sublethal destruction cells at the next irradiation and division cells turn into lethal (cumulative effect).

Potentially lethal cell disorders or corrected, or manifest himself at

actions of other factors (temperature, hyperglycemia that apply
and others), at
amplification of the radiation effects of both corrected. Radiosensitizers - means, by
using which enhance the effects of radiation (eg, oxygen, chemotherapeutic agents).
Radioprotectors - means by which weaken the effect of radiation (for example: vitamins).

Damage to the body:

Damage to the body after radiation - cereaction on him. she is
deviation activities of various bodies and systems real their action. Degree
damage depends on several factors, and
reaction of the organism is directly proportional to the degree of deviation of the system from the normal level.
Bioreaction of the organism to irradiation depends on:
1. Dose, with sublethal damage, with increasing dose, increases the proportion of reacting cells,
and size reactions ( duration of the separation delay)
each irradiated cell.
2. Also by the nature of the dose distribution over time (dose power, rate of energy absorption). With increasing
power dose irradiation bioeffect increases, but only until such time as the received dose cell dies.

3. Type of irradiation (relative biological efficiency of IP depends on its energy, charge, mass).

4. The volume of irradiated tissue (the more irradiated the volume, the greater the reaction). Kind of
5. irradiated tissue. Radiosensitivity of the fabric direct
proportional to proliferative activity, and
inversely proportional to the degree of differentiation cells of which it consists.
Earl logical structure: Type of radiosensitivity to IP.
Species radiosensitivity Man (highest)
Bacteria (lowest)
Individual Sexual (more sensitive women)
radiosensitivity Age (more sensitive babies and old people).
Less sensitive newborns and adults.
Cellular radiosensitivity:
High:
Bone marrow cells.
Cell lymphoid tissue.
Sex cells.
Average: Embryonic.
Low: Cryptitic intestine, endothelium, epithelium, skin cells. Cellsliver, lung, gland,
nerve, bone, cartilage, fat.
Graph of logical structure:
Factors that determine the sensitivity of the cell to ionizing radiation.
Histological structure.
Factors Proliferation and duration of individual stages of the cell cycle Mitotic
activity of cells.
Differentiation.
Container.
Some exchange factors.

The most sensitive to ionizing radiation cells, which often are divided
(stem cells). This is due to the fact that they are more likely to be in M-phasimitosis. If the cell is irradiated
in this period, then in it does not exist time on restoration.
Initially presyntheticperiod (G 1) survival rate increases by 5 times. During the transition of the mitotic cycle to the S-phase
of synthesis, the percentage of cell survival decreases sharply, and
grows 10 times by the end of the S-period. In the postsyntheticperiod (G 2) interest
cell survival decreases.
Restoration - multi-stage enzymatic process, which distinguish:
1. Removal of the area of damage.
2. З using complementary section of the opposite threads DNA,
built formed gaps. Extraction occurs with the help of an enzyme endonuc-
leases, and building with the help of DNA polymerase or polynucleotide legase. Repair - enzymatic process,
in communication with
than its intensity depends on the overall level of cellular metabolism and energy reserves. The use of ionizing
radiation in clinical practice necessitates a correct quantitative and qualitative assessment of the nature of the
distribution of radiation energy in the irradiated volume. It is known that the biological effect of ionizing radiation on the
body is directly dependent on the quantity and quality of energy absorbed by tissues. All methods of registration and
determination of ionizing radiation belong to a special section of physics, which is called dosimetry.

At the present stage of development of radiology, knowledge of the peculiarities of the distribution of radiation energy contributes to
the successful application of various methods of radiation therapy and allows to give a more objective assessment of the results.

To record the amount of radiation in medical practice, various methods of dosimetry are used, which, depending
on the effect caused by radiation, are divided into:
1. ionization
2. photographic
3. chemical
4. scintillation, or luminescent
5. biological methods of dosimetry.

Quantities and units of dose

To determine the amount of energy absorbed, the concept of radiation dose is introduced. Dose means the
amount of energy absorbed per unit mass of irradiated substance. In the practice of radiation therapy it is accepted to
distinguish exposure dose. Under the exposure dose understand the amount of X-rays or gamma radiation absorbed in
a given mass of air. The unit of exposure dose is x-ray. X-ray - such quantity of X-ray or gamma radiation in air at which
the connected corpuscular emission on 0,001293 g of air conducts the ions carrying a charge in one electrostatic unit of
quantity of electricity of each sign. The number 0.001293g represents the value of mass in grams of 1 cm3 of
atmospheric air at a temperature of O0c and a pressure of 760 mm. mercury column.
 Energy absorbed in a certain volume of irradiated matter by unit of time is called
dose rate. X-rays per hour is taken as a unit of radiation dose rate
(r / hour), x-ray per minute ( r / min), x-ray per second ( r / sec). The dose rate is equal to:
P = - erg / cm9 juice
where Р - dose rate; D - radiation dose; t - irradiation time.
The dose of radiation in X-rays or X-ray derivatives or the dose rate of the primary beam of radiation, measured
in the open air in the absence of scattering bodies, is called
the dose rate of radiation in the open air.
The dose in X-rays or its derivatives or the dose rate measured on the surface of the irradiated object or body, is
called the surface dose rate, or surface dose.
The dose in X-rays or its derivatives or the dose rate measured at a certain depth or at some distance from the
surface of the irradiated object is called the radiation dose, or the radiation dose rate at depth - depth dose.

The ratio of the dose at depth to the dose in the open air, expressed as a percentage, is called the relative, or
percentage, deep radiation dose.
The energy of ionizing radiation absorbed per unit mass of the irradiated substance is called absorbed
radiation dose.
The energy of ionizing radiation transferred to matter and converted into other forms of energy is called absorbed
radiation energy.
The unit of absorbed radiation energy is glad - absorbed energy of radiation
not equal to 100 ergam per 1 g of irradiated substance. Erg - unit of work and energy, equal to the work performed by the force in 1 dinu when
moving the point of its application by 1 see Dean - a unit of force equal to the force which, acting on the mass in, 1g, informs it of the
acceleration in 1 cm / sec2.
The dose absorbed per unit time, is called the absorbed dose rate. The units of absorbed dose rate are:
radium per hour ( pad / hour), per minute ( radium / min), billions per hour
(mrad / hour), microrad per second ( mkrad / sec).
When conducting radiation therapy, it is necessary to know not only the exposure and depth, but also the
integrated absorbed dose, which means the energy of ionizing radiation absorbed in a certain mass of matter. When
assessing the biological effect on the body, it is necessary to take into account the integrated absorbed dose in the
irradiated organ or focus and the integrated absorbed dose throughout the body. The unit of measurement of the integrated
absorbed dose is gram-rad (g / rad) - energy ionizing radiation absorbed in a given mass of matter. Sometimes it is
necessary to determine the average absorbed dose, which means the average energy of ionizing radiation absorbed per
unit mass of the irradiated body. It is usually equal to the ratio of the integrated absorbed dose in the total irradiated volume
to body weight, ie the average value of the absorbed dose per gram of body weight. Unit the average absorbed dose is
radium.

In order to better navigate in clinical dosimetry, you need to know what it is dose field. Under the dose field understan
the spatial distribution of the absorbed radiation energy in the irradiated medium or body. Isodose curves give a clear
idea of the nature of the dose field.

Isodose - a line connecting a number of points that have received the same dose. Isodosis may correspond to
give the same value of the percentage dose of X-ray or gamma radiation or the percentage of absorbed radiation dose.

A large number or series of isodose curves constructed for a certain cross-section of the dose field on the same
scale and corresponding to certain values of the dose of X-ray or gamma radiation, is called an isodose map.

Dosimetry methods
Significant successes of radiation therapy are largely due to the development of clinical dosimetry. Currently, the
radiology clinic uses a large number of dosimetric methods and a wide range of measuring instruments, which are based
mainly on the assessment of physical phenomena arising from the interaction of radiation with matter.
Physical methods The dose measure can be ionization, which occurs as a
dosimetry result of the absorption of radiation energy by the
substance. Ionization dosimetry is the most common
method of radiation therapy. It is carried out by
dosimeters or X-ray meters, which work on the principle
of determining the total effect of ionization in the
irradiated volume and recording doses for power.

The main part of the dose- dose only in X-rays.

meters there is an ionization chamber,
or detector.
To determine the dose rate on X-ray and gamma therapy
devices are used dosimeters (Fig. 5 and 6), which work
on the principle of discharge capacity of the ionization
chamber. To determine the degree of contamination with
radioactive substances, working premises, special radio
probes or portable gamma ray indicators are used. To
detect beta particles and gamma quanta, and sometimes
alpha particles, Geiger-Mueller counters are used, which
have a very high sensitivity.

MRM-2 dosimeter.

For dosimetry of ionizing radiation its light-exciting action

Fig. 8. Dosimeter CD-m
(fluorescence and scintillation) is also used. The
propagation of any charged particles through matter is
accompanied by the excitation of atoms and molecules of
the medium, ie, the appearance of quanta of visible and
ultraviolet light. The charged particle, passing through the
transparent crystal, always causes a light flash.
Fluorescent meters have a higher sensitivity than
ionization chambers. Dosimetry, based on the
light-exciting action of ionizing radiation, has been widely
used only in recent years due to the introduction of

Fig. 9. Photographic film doses - the practice of photoelectronic multipliers. meters IFC-02.
 Their effectiveness is especially high in cases where high
accuracy in determining the dose of gamma radiation is
required. The dosimeter, operating on the above
principles, consists of a scintillator, a photoelectron
multiplier, a source of constant high voltage and

Fig. 10. Scheme of scintillation - a device that registers the pulse counter.

Scintillation counters are also used in the diagnosis of

malignant tumors by contact radiometry. It is carried out
by means of a complex of the radiodiagnostic equipment
which includes a set of special sensors of beta probes;
each of them is connected to the power supply and the
enumerator.

This complex is called a radiometer.

Fig. 11. Radiometer.

Chemical and photochemical reactions Of all the radiochemical reactions, the most studied and
most commonly used in dosimetry is the radiochemical
symmetry reaction of oxidation of ferrous iron to trivalent. For many
such reactions, this ratio is not a constant value, but
depends on the dose rate or differential ionization by the
corresponding radiation.

photographic way The photographic method is widely used in individual

dosimetric control. Working with sources of ionizing
radiation receive special cassettes with sensitive
photographic film. After some time, the photographic film
is detected, and the blackening density of the
photographic emulsion is measured using

microphotometer. Comparing
the blackening density of the film with the standard,
determine the radiation dose in X-rays. Biological
Biological dose- methods of dosimetry are directly dependent on the
metry reactions that occur in the irradiated organism. Erythema
was considered the minimum dose, which after a single
local irradiation of the skin after 14 days caused a
noticeable redness. Usually erythema appeared after a
dose of 500 to 800 p depending on the quality of the
radiation. Unequal species, organ, and cellular sensitivity
to radiation, which was poorly studied at the time, are
now explained by
 disadvantages of this method.

RADIATION PROTECTION.
The set of protective devices and organizational measures as a result of which the effect of X-rays should not
exceed the maximum allowable dose (MPA), which is set depending on the category of radiation.

Category A Professional irradiation of persons working directly with X-rays

Category B irradiation of persons working in the premises adjacent to the X-ray room

Category B irradiation of the population of all age categories

According to the Sanitary Rules for Working with Radioactive Substances (1960), the SDA for X-ray room staff is
100 mrad per week, or 5 rad per year; for those working in adjacent premises 10 mrad per week, or 0.5 rad per year; for
the rest of the population 1 mrad per week, or 0.05 rad per year. At professional irradiation the SDA for bunches of
hands is established 5 times more, ie 500 mrad a week.

Radiation protection is achieved by a number of measures that can be conditionally grouped as follows.

Screening
Protective materials (lead, leaded rubber, barite, etc.) are placed between the radiation source and the person.

Personnel shielding is carried out by stationary (non-movable) protective devices - protective coating of walls,
floors, doors, doorways, viewing windows and non-stationary (movable) protective devices - screen, X-ray tube cover,
additional filter, handpiece, tube, diabetic. Aprons, skirts, gloves made of leaded rubber are personal protective
equipment.

Small and large protective screens, multi-bladed apron suspended from the screen, must have a lead equivalent
of at least 1 mm; protective aprons, skirts - not less than 0.3 mm. Aprons should completely cover the anterior-lateral
parts of the torso and lower extremities at least 8 - 10 cm below the knee joints.

Especially careful screening of personnel with the use of all personal protective equipment is necessary for
trochoscopic examinations (irigoscopy, angiography, bronchography, etc.). It is recommended to use additionally small
mobile protective screens (width 150 cm, height 130 cm).

Shielding of the subjects is carried out using lead and leaded rubber, additional filters, reducing the size of the
irradiation field. Here it is necessary to allocate protection of gonads and other bodies and fabrics of inspected.

To protect the gonads that fall into the sphere of the working bundle, men use lead capsules, and women use
lead protectors that cover the ovaries and tubes when they are placed on the anterior abdominal wall. In all cases where
the gonads do not fall into the sphere of the working beam, they must be shielded with lead rubber.

The use of additional filters can significantly reduce the dose rate and radiation exposure to the subject. "Rules
of the device and operation of X-ray rooms" the following general filtering of radiation by a protective casing, the block
transformer and the filter is recommended: at generation voltage to 75 kV - the filter of 1,5 mm of aluminum, to 100 kV -
2 mm, to 125 kV - 3 mm, to 150 sq. - 5 mm of aluminum. At X-ray inspection of pregnant women presence of additional
filters is provided: at generation voltage of 100-110 kV - 3 mm of aluminum, 125 kV - 4 mm, 150 kV - 5 mm of aluminum.

An additional filter, usually aluminum, is placed at the exit of the X-ray beam. If necessary, the filter can be
replaced with another, more massive. Replacement of fil-
three should be performed only by an X-ray technician. The rules provide for the attachment of an additional filter so that
it can not be changed without special tools.
To reduce the volume of irradiated tissues, sash diaphragms with smooth adjustment and protective tubes with
optical centering and sash diaphragm are used.
Protection of distance (distance) and proper cabinet planning. Distance protection is based on the law of spatial
attenuation of X-rays: the intensity of radiation is inversely proportional to the square of the distance from the radiation
source.
In order to reduce the exposure of personnel to the "Rules of the device and operation of X-ray rooms" (1962) in
the newly built rooms, there are separate rooms in which the control panel of the X-ray diagnostic unit. In such a room
(hardware) you can install control panels for several installations located in adjacent rooms. In addition to the control
panel, the hardware should be equipped with booths for subjects and equipped with workplaces for doctors and
radiologists.

In cases where the control panel is not carried out in a separate room, it must be at the greatest distance from
the source of scattered radiation and away from the direction of the primary beam. The working beam at illumination
goes towards capital walls of the room; the tube must stand at least 2 m from the wall to which the beam of radiation is
directed.

When operating X-ray diagnostic equipment, the distance from the focus of the tube to the skin of the subject
should be at least 25 cm; in installations for dental diagnostics - not less than 12.5 see The optimal distance for
transmission is 35-60 cm
Subjects during irradiation should be installed close to the fluoroscopic screen to maximize the distance between
the source and the skin and to reduce the absorbed integrated dose.

Reducing the duration of the study. Illumination should be carried out in a carefully darkened room after a good
adaptation (at least 10-15 minutes). All interrogations of the patient should be carried out not behind the screen at the
included installation, and before. Explanations to physicians, cadets, and students should be kept to a minimum during
screening. Irradiation should be carried out sparingly, turning off high voltage when the examination is interrupted even
for a few seconds. To account for the duration of the X-ray examination using an optical or acoustic signal mounted in
the control panel of the installation.

The high sensitivity of screens and film and the optimal technique of chemical photoprocessing of the film are of
considerable importance for reducing the duration of X-ray examination during radiography. For example, produced by
the plant named Semashko calcium tungsten amplifying screens (type UFDM) can reduce exposure time by 1.5-2 times
without compromising image quality, and amplifying screens "Simultan-1" and "Simultan-2" allow obtain simultaneous 5
tomograms at the same exposure as for the production of one tomogram with a normal screen.

Reduction of radiation exposure can also be achieved by using minimal exposures with the simultaneous use of
high generating voltages of about 100 kV and above.
Scheme of the device of the electron-optical converter with the X-ray screen which is in optical contact with a
photocathode.
1-x-ray tube; 2-object of study; 3-EOP; 4-input X-ray screen; 5 photocathode; 6-focusing electrode; 7-flask; 8-output
screen; 9-protective glass, 10-optical system; 11-eye exploring; 12-TV camera; 13-camera; 14 widescreen film camera.

Use of electron-optical converter. To reduce the radiation exposure to personnel and subjects of great
importance is the use of new equipment, in particular electron-optical X-ray image amplifier. The latter is a device
designed to multiply the brightness of the image on the X-ray screen by converting a light image into an electronic one
and then converting it into a light image. This image amplification is achieved by means of an electrovacuum device
called an electron-optical converter (EOC).

The X-ray image amplifier is designed mainly for screening, X-ray cinematography and the use of television in
X-ray diagnostics.
The principle of the device of the electron-optical amplifier is that the X-ray radiation, passing through the object
under study and causing the glow of the fluorescent screen, then acts by fluorescence rays (see) on the photocathode of
the transducer, causing electron emission. The latter are accelerated by positive high voltage and focused by
electrostatic or magnetic lenses, bombarding the output screen of the converter and causing it to glow, as a result of
which the electronic image is converted into light, visible to the eye.

Image amplification in thousands and more times is achieved by accelerating electrons (see) and concentrating them on an
area tens of times smaller than the area of the photocathode.
The image obtained on the output screen can be viewed with the help of an appropriate optical system,
photographed with a film camera or film transmitted to the receiving tube of a television set.

The main advantage of the electron-optical amplifier is a sharp decrease in the dose of X-rays in diagnostic
tests, especially in X-ray imaging, as well as the ability due to a sharp increase in image brightness to shine in a slightly
darkened room, using low-power X-ray machines. Further reduction of radiation exposure, especially to personnel,
should be expected from the use of X-ray television.

Fig. 58. Translucency using an electron-optical amplifier

Organizational and medical measures to reduce radiation exposure.

 When referring a patient for an X-ray examination in the outpatient card or medical history, the attending
physician must indicate the purpose and scope of the examination, as well as the date and results of the last X-ray
examination. The appointment of complex radiological examinations (urography, angiography, bronchography, etc.) is
possible only on strict clinical evidence, agreed with the radiologist and the attending physician. Repeated complex
radiological examinations associated with high radiation exposure, it is desirable to conduct no earlier than 15 days.

It is desirable to limit X-ray examinations of organs close to the gonads (pyelography, urethrograph, radiography
of the lumbar spine, pelvis and hip joints, irigoscopy).

Such examinations in women of childbearing age should be performed only during the first week after
menstruation. X-ray examination of pregnant women should be performed only on strict clinical evidence, preferably in
the second half of pregnancy, using mainly radiography.

The use of radiography (instead of radioscopy) in the study of the thoracic cavity significantly reduces the
radiation exposure to staff and subjects.

DURATION OF WORKING DAY AND ADDITIONAL VACATIONS for personnel

working in the field of ionizing radiation.
For the staff of X-ray diagnostics offices (departments) the relevant order of the Ministry of Health of the USSR
established a reduced 5-hour working day, additional leave of 18 working days and limitation of the number of
procedures associated with high radiation exposure.
For the staff of X-ray therapy offices the 6-hour working day and additional leave of 12 working days is
established. For the staff of remote gamma therapy rooms, respectively, a 5-hour working day and 18 working days of
additional leave. A 4-hour working day and 24 working days of additional leave have been set for the staff of radio
manipulation rooms using closed gamma radiation sources. For medical staff serving patients with radioactive drugs in
the wards, a 5-hour working day and 18 working days of additional leave.

Materials for self-control.

A. Questions for self-control:
1. What are the parts of the core?
2. What types of radiation exist?
3. What are the theories of the structure of the atomic nucleus?
4. What are the properties of nuclear forces?
5. What are the types of nuclear transformations?
6. What is radioactivity?
7. What is the activity, decay constant, half-life, biological half-life?

8. In what units is activity measured?

9. What are the dose, types of doses and units of dose? What are the
10. types of energy dissipation?
11. What are the types of energy absorption?
12. Radiation factors that determine the degree of ionization. What is the
13. linear ionization density?
14. What is the minimum average amount of energy required to form one pair of ions in the air? Types of radiology
15. departments?

B. Tasks for self-control:

1. What is the need to equip our senses with devices that detect radioactive radiation?

2. You need to register the accumulation of beta-emitting RFP in the cavity. You have a scintilla-
 a detector that allows you to record radiation outside and above the surface of the body and a gas-discharge sensor
inserted into the test cavity. Which sensor will you choose, why?
3. You need to study the functional state of the kidneys. You have a gamma chronography and a gamma topograph. What
device do you use, why?
4. In a patient with heart disease, the task is to study the condition of his cavity. At your disposal is a scanner and a gamma
camera with a computer. What do you use and why?
5. You study the nature of accumulation 131 in the thyroid gland. Your laboratory has a scanner, a radiometer. What device
are you using?
6. Your laboratory organizes the study of biological samples using radionuclides. What radio diagnostic device will you
buy?
7. Is it possible to examine the thyroid gland at the same time 131 and Ts99?
8. Or is it necessary to study the dynamics of the accumulation of RFP in the body to assess the entire study organ, or to narrow the field
of view of the detector and send it to a separate area of this organ?
9. Is it necessary to make tanks for sewage containing radioactive substances in the radionuclide laboratory of the 3rd class?

10. You have the task to study the division in the body of RFP, emitting gamma rays. You have a scintillation and gas
discharge sensor. Which do you prefer, why?

ANSWERS
1. Lack of sense organs that perceive radiation. Gas discharge sensor to be
2. installed in contact. Gammachronograph, with its help they study the
3. function Gamma camera is a high-speed radiation recorder. In vivo
4. radiometer
5.
6. In vitro radiometer
7. So.
8. Need to evaluate the whole body None.
9.
10. Scintillation. He is more sensitive.

Tasks 3 levels
1. How many pairs of ions can form gamma quanta when the nucleus of a Co60 atom decays?
2. What is the amount of Bq is 1 Cl?
3. What is the difference between the action of gamma rays, X-rays from each other?
4. What kind of rays arise as a result of changes in the energy state of the atom? What kind of decay was in this case?

5. What kind of rays are formed as a result of electron inhibition in the electromagnetic field of the atomic nucleus?

4.3. Recommended reading on the topic: Basic

(educational):
1. M.I. Milko, AF Lazar, N.F. Nazimok "Medical Radiology". - К .: 1991р.
2. "Guide to Nuclear Physics" / Under. ed. G.P. Sivachenko. - К .: 1991р.
3. L.D. Lindenbraten, F.M. Forest "Medical Radiology |". - М .: 1986г.
Additional (scientific, professional, monographic and periodicals):
1. I.A. Pereslegin, Yu.Kh. Sargsyan "Clinical Radiology" 1973 "Medicine" Moscow.
2. "Handbook of Radiology and X-ray Diagnostics"

Internet resources
1. http://www.sworld.com.ua
2. medvuz.info
3. www.hotline.ua
4. vrachivmeste.ru
5. www.youtube.com
6. mdtube.ru
7. med-video.livejournal.com
8. vasily-sergeev.livejournal.com
9. ru-ru.facebook.com/mdtube
10. www.hospsurg.ru/content/view
11. https://sites.google.com/site/medicinskievideolekcii/videolekcii-po-predmetno
Methodicaldevelopmentprepared by:
Assoc. kaf. TO Zhukov