Anna Bertha First x-ray Wilhelm Conrad

PRINCIPLES Ludwig-Roentgen image Roentgen

Discovered “X-ray”

RT 103: of IMAGING Nov. 8, 1895

“On a New Kind of
Rays”

RADIATION
Radiation has been defined as the energy emitted
and transferred through matter.
General classifications of radiation:
1. Non-ionizing radiation - radiation for which the
mechanism of action in tissue does not directly ionize
atomic or molecular systems through a single
interaction.
 A radiation that is not capable of causing ionization.

2. Ionizing radiation – radiation that is capable of

ionization.
Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

1
IONIZATION
Ionization occurs when
an electromagnetic
SOURCES OF IONIZING
radiation passes
close to an orbital
electron of an atom
RADIATION
and transfer sufficient
energy to the electron “Many types of radiation are harmless, but ionizing radiation can
injure humans. We are exposed to many sources of ionizing
to remove it from radiation.
the atom.

Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

The orbital electron and the atom which it

was separated are called ion pair. The
electron is the negative ion and the
remaining atom is a positive ion.
Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

2
NATURAL ENVIRONMENTAL/BACKGROUND 3. Internally-deposited Radionuclides
RADIATION  mainly potassium-40 (40K), are natural
metabolites.
1. Cosmic rays  Carbon 14 (14C) deposited in trees and
fossils.
 radiation emitted by the sun and stars.

Source: Radiologic Science for Technologist by Stewart Carlyle Bushong Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

2. Terrestrial radiation 4.
 resultsfrom deposits of
uranium, thorium, and
other radionuclides in
the Earth.
 The intensity is highly
dependent on the
geology of the local
area.

Source: Radiologic Science for Technologist by Stewart Carlyle Bushong Source: Radiologic Science for Technologist by Stewart Carlyle Bushong

3
 MAN-MADE RADIATION 3. Consumer Products

1. Diagnostic x-rays
 constitute the largest source of man-made ionizing
radiation.

2. Nuclear Power Stations and 4. Radioactive Fallout

Industrial Sources  The deposition on the surface of the earth of
radioactive particles, released into the
atmosphere as a result of nuclear explosions
and by discharge from nuclear-power and
atomic installations.

4
Early Pioneers in Radiography
1. Michael Pupin -demonstrated the use of a
radiographic intensifying screen in 1896.
Note: Radiographs during Roentgen’s time were made
by exposing a glass plate
2. Charles L. Leonard - found that by exposing two
glass x-ray plates with the emulsion surfaces
together, exposure time was halved, and the image
was considerably enhanced.
Note: The demonstration of double-emulsion
radiography was conducted in 1904, but
double-emulsion film did not become
commercially available until 1918.
3. Thomas A. Edison –developed the fluoroscope
in 1898.
4. Clarence Dally -experienced a severe x-ray burn
that eventually required amputation of both arms.
Note: Dally died in 1904 and is counted as the first x-
ray fatality in the United States.
5. William Rollins -used x-rays to image a teeth
and found that restricting the x-ray beam with a
sheet of lead and with a hole in a center, a
diaphragm, and inserting a leather or aluminum
filter improved the diagnostic quality of radiographs.
Note: This was the first application of collimation and
filtration. It was later recognized that these
devices reduce the hazard associated with x-rays.
5
6. William D. Coolidge unveiled his hot-cathode
x-ray tube to the medical community. It was
immediately recognized as far superior to the
Crookes tube. It was a vacuum tube that allowed
x-ray intensity and energy to be selected separately
and with great accuracy. X-ray tubes in use today
are refinements of the Coolidge tube.
Note: Radiology emerged as a medical specialty
because of the Snook transformer and the
Coolidge x-ray tube.
7. H.C. Snook -introduced a substitute high-
voltage power supply, an interruptless transformer.
It was not until the introduction of Coolidge tube
that the Snook transformer was widely adopted.
Note: During Roentgen’s time, only static generators
were available. These units could provide currents
of only few milliamperes and a voltage to 50 kVp.
8. Gustav Bucky (German) invented the stationary
grid (“Glitterblende”); 2 months later, he applied his
second patent for a moving grid.
9. Hollis Potter (American), probably unaware of
Bucky’s patent because of WW I, also invented a
moving grid.
Note: Potter recognized Bucky’s work, and the Potter-
Bucky grid was introduced in 1921.
Remarkable improvements in
Medical Imaging
 1960s - Diagnostic ultrasonography and Gamma
Camera
 1970s - Positron Emission Tomography (PET) and
Computed Tomography (CT)
 1980s - Magnetic Resonance Imaging (MRI)
 Current - Digital Radiography and Digital Fluoroscopy
Source: Radiologic Science for Technologist by Stewart Carlyle Bushong
6
 Principal parts of an x-ray
imaging system
 Operating Console
 High-voltage generator
 X-ray tube

X-Ray Production
Electron Target Interaction
 The projectile electron interacts with the
orbital electrons or nuclear field of target
atoms.
 These interactions result in the conversion
of electron kinetic energy into thermal
energy (heat) and electromagnetic energy
in the form of infrared radiation (also
heat) and x-rays.

7
 Atomic Nomenclature

Atom
Smallest particle of an element that cannot
be divided or broken by chemical means.

Element
Atoms that have the same atomic number
and the same chemical properties.
Substance that cannot reduce further without
changing its chemical properties.

8
 Anode Heat

Most of the kinetic energy of

projectile electrons is
converted into heat by
interactions with outer-shell
electrons of target atoms.

Approximately 99% of the kinetic energy of projectile

electrons is converted to heat. Only approximately
1% of projectile electron kinetic energy is used for the
production of x-radiation.

9
CHARACTERISTIC RADIATION CHARACTERISTIC RADIATION
Tungsten: 18474W

Shell # of e- Binding energy (keV)

K 2 69
L 8 12
M 18 3
N 32 1
O 12 0.1
P 2
If the projectile electron interacts with an inner-
shell electron of the target atom characteristic Note: Only the K-characteristic x-rays of
x-rays can be produced. tungsten are useful for imaging.

CHARACTERISTIC RADIATION BREMSSTRAHLUNG RADIATION

 Bremsstrahlung is a German word that
means “slowed-down radiation”.
Bremsstrahlung x-rays can be considered
radiation that results from the braking of
projectile electrons by the nucleus.

 Bremsstrahlung x-rays are produced when

a projectile electron is slowed by the nuclear
field of a target atom nucleus.
Characteristic x-rays are emitted when
an outer-shell electron fills an inner-shell
void.

10

BREMSSTRAHLUNG RADIATION
CHARACTERISTIC RADIATION
Note: K-characteristic x-rays requires
an x-ray tube potential of at least
69 kVp/keV.
BREMSSTRAHLUNG RADIATION
Note: Bremsstrahlung x-rays can be
produced at any projectile
electron energy.
X-Ray Emission
X-rays are emitted through
a window in the glass or
metal enclosure of the x-ray
tube in the form of a
spectrum of energies.
The x-ray beam is characterized by:
• Quantity -the number of x-rays in the beam
• Quality -the penetrability of the beam
X-ray Quantity
X-ray Intensity
 The x-ray intensity of the x-ray beam of an x-ray
imaging system is measured in milligray in air
(mGya) and is called the x-ray quantity. Another
term, radiation exposure, is often used instead
of x-ray intensity or x-ray quantity.
 X-ray quantity/X-ray intensity/Radiation
exposure is the number of x-rays
in the useful beam.
11
Factors That Affect X-ray QUANTITY
1. milliAmpere-seconds (mAs)
X-ray quantity is directly proportional
to the mAs.
• When mAs is doubled the number of
electrons striking the tube target is
doubled, and therefore the number of
x-rays emitted is doubled.
milliAmpere-seconds (mAs)
Equation:
Practice question:
A lateral chest technique calls for 110 kVp, 10
mAs, which results in an x-ray intensity of 320
µGya at the position of the patient. If the mAs
is increased by 20 mAs, what will the x-ray
intensity be?
2. Kilovolt peak (kVp)
X-ray quantity varies rapidly with
changes in kVp. The change in x-ray
quantity is proportional to the square
of the ratio of the kVp.
• In other words, if kVp were doubled,
the x-ray intensity would increase by
a factor of 4.
12

Kilovolt peak (kVp)
Equation:
Practice question:
A lateral chest technique calls for 110 kVp, 10
mAs and results in an x-ray intensity of 0.32
mGya. What will be the intensity if the kVp is
increased to 125 kVp and the mAs remains
fixed?
3. Distance
X-ray intensity varies inversely with the
square of the distance from the x-ray tube
target.
• This relationship is known as the Inverse
Square Law
Inverse Square Law
Equation:
Practice question:
A posteroanterior (PA) chest examination (120
kVp/3mAs) with a dedicated x-ray imaging system is
taken at an SID of 300 cm the exposure at the image
receptor is 0.12 mGya. If the same technique is used
at a SID of 100 cm, what will be the x-ray exposure?
13
 Compensating for a change in SID by changing
mAs by the factor SID2 is known as the Square
Law, a corollary to the Inverse Square Law.
• The Square Law
4. Filtration
• X-ray imaging systems have metal filters,
usually 1 to 5 mm of aluminum (Al),
positioned in the useful beam.
• The purpose of these filters is to reduce
the number of low energy x-rays.
• Low energy x-rays contribute nothing useful
to the image.
• They only increase the patient dose
unnecessarily, because they are absorbed in
superficial tissues and do not penetrate to
reach the image receptor.

Affecting Effects on
The Square Law Factor QUANTITY
Equation:

Increased
mAs quantity

Practice question: Increased

kVp quantity
What will be the new mAs in the previous
question to reduce the x-ray quantity to 0.12
mGya at 100 cm? Distance Decreased
quantity

Decreased
Filtration quantity

14
 Factors That Affect X-ray QUALITY
X-ray Quality
2. Filtration
Penetrability The primary purpose of adding filtration to an
 As the energy of an x-ray beam is x-ray beam is to remove selectively low-energy x-
increased, the penetrability is also rays that have little chance of getting to the
increased. image receptor.

 Penetrability refers to the  Increasing filtration increases the quality of

ability of x-rays to penetrate an x-ray beam.
deeper in tissue.

Factors That Affect X-ray QUALITY
1. Kilovolt peak (kVp)
 As the kVp is increased, so is x-ray
beam quality.
 Increasing the kVp, increases the quality
of an x-ray beam.
Factors That Affect X-ray QUALITY
Filter
 Aluminum (Z = 13) is chosen because:
• readily available
• inexpensive
• easily shaped
 As filtration is increased, so is beam
quality, but quantity is decreased.

15
 3.Total Filtration
Types of Filtration
In the x-ray beam is the sum of the added filtration
and the inherent filtration. For x-ray tubes operating
1.Inherent Filtration above 70 kVp must have a minimum filtration of 2.5 mm
Refers to the filtration that is permanently in the path of aluminum.
of the x-ray beam. Three components contribute to
inherent filtration:
1. The glass envelope of the tube
2. The oil that surrounds the tube
3. The mirror inside the collimator

4. Compensating filter –are special filters to be

added to the primary beam to alter its intensity. These
2.Added Filtration types of filters are used to image anatomic areas that
Describes the filtration that is added to the port of non-uniform in make-up, and assist in creating a
the x-ray tube. Aluminum is the material primarily radiographic image with more uniform density.
used for this purpose to absorb the low energy
photons while allowing the useful higher-energy
photons to exit.

Wedge Filters –most common

type of compensating filters. The thicker
part of the wedge filter is lined up with
the thinner portion of the anatomic part
that is being image, allowing fewer x-
ray photons to reach that end part.

16
 Factor Effects on Effects on
Bilateral wedge Increased QUANTITY QUALITY
filter/Trough Filters –
performs a similar function to the wedge
filter; however, it is designed differently.
It has a double wedge. Commonly used mAs Increases No effect
for AP thorax to compensate for the
easily penetrated air-filled lungs.
kVp Increases Increases

Special “Bow-tie” -
shaped filters are used with Distance Decreases No effect
computed tomography imaging
systems to compensate for the
shape of the head or body.
Filtration Decreases Increases

Affecting Effects on X-ray Interactions w/ Matter

Factor QUALITY  Coherent/Classical
Scattering
Increased
kVp quality  Compton Scattering
 Photoelectric Effect
Filtration
Increased
quality
 Pair Production
 Photodisintegration

17
 Coherent/Classical
Scattering
 X-rays with energies below approx.
10 keV interact with matter by
coherent scattering.

 The incident x-ray interacts with a

target atom, causing it to become
excited.

1st described by J.J Thomson

Coherent/Classical
Scattering
 The target atom immediately releases
this excess energy as a scattered x-ray
with wavelength equal to that of the
incident x-ray and therefore of equal
energy. However, the direction of the
scattered x-ray is different from that of the
incident x-ray.

1st described by J.J Thomson

18
 Coherent/Classical
Scattering Compton Scattering
 In Compton scattering, the incident x-ray
interacts with an outer-shell electron
and ejects it from the atom, thereby
ionizing the atom. The ejected electron is
called a Compton electron or recoil
electron.
 During Compton scattering, most of the
energy is divided between the scattered x-
ray and the Compton electron.

1st described by J.J Thomson Named after: Arthur Holly Compton

Compton Scattering Compton Scattering

 X-rays throughout the diagnostic
range can undergo an interaction
with outer-shell electrons that
not only scatters the x-ray but
reduces its energy and ionizes
the atom as well. This interaction is
called Compton scattering.

Named after: Arthur Holly Compton Named after: Arthur Holly Compton

19
 Selected scattering cases Selected scattering cases
can be considered: can be considered:

1. The minimum energy transfer occurs for a 0-
degree photon scatter (gazing hit),
there is no interaction, and the scattered
photon has the same energy as the incident
photon. The electron is scattered at 90-
degree with zero energy.
3. The 90-degree Compton scattered
photon energy will always be less than the
incident photon energy. The electron travels
in a direction that depends on the incident
photon energy.

Selected scattering cases

can be considered:
2. The maximum energy transfer occurs for a
direct hit with a backscattered photon
(180-degrees) and yields a (minimum)
scattered photon energy. The electron has
maximum energy and travels in forward
direction.

20
 Photoelectric Effect

Works of Albert Einstein

Photoelectric Effect
 X-rays in the diagnostic range also undergo
ionizing interactions with inner-shell electrons.
The x-ray is not scattered, but it is totally
absorbed.
 This process called the Photoelectric effect.
 The electron removed from the atom is called a
photoelectric electron.
 A photoelectric interaction cannot occur unless the
incident x-rays has energy equal to
or greater than the electron binding
energy.
Works of Albert Einstein

21
 Pair Production
 If the incident x-ray has sufficient energy, it may
escape interaction with the electrons and come close
enough to the nucleus of the atom.
 The interaction between the x-ray and the nuclear
field causes the x-ray to disappear, and in its
place, two electrons appear, one positively
charged (positron) and one negatively charged.
This process is called pair production.
 The incident x-ray photon must have at least
1.02 MeV of energy. An x-ray with less than
1.02 MeV cannot undergo pair production.

Pair Production
 The positron unites with the free electron, and
the mass of both particles is converted to energy
in a process called annihilation
radiation.
 Because pair production involves only x-rays with
high energies greater than 1.02 MeV, it is
unimportant in x-ray imaging, but is very
important for Positron Emission Tomography
imaging (PET) in nuclear medicine.

22
 Pair Production Photodisintegration

Photodisintegration Of the five ways an x-ray can

 X-rays with energy above approx. 10 MeV
can escape interaction with electrons and
the nuclear field and be absorbed directly
by the nucleus.
 When this happens, the nucleus is raised to
an excited state and instantly emits nucleon
or other nuclear fragment. This process is
called photodisintegration.
interact with tissues, only two are
important to radiology,
 Compton Scattering
(Energy of radiation (x-ray) is partially absorbed)
 Photoelectric Effect
(Energy of radiation (x-ray) is totally absorbed)

23
 DIFFERENTIAL ABSORPTION
Differential absorption occurs because of
Compton scattering, photoelectric effect, and x- P. Interaction = Radiopaque
rays transmitted through the patient. Transmitted = Radiolucent
 Compton-scattered x-ray contributes no useful
information to the image.
 X-rays that undergo photoelectric interaction provide
diagnostic information to the image receptor.
Because they do not reach the image receptor, these x-
rays are representative of anatomical structures with
high x-ray absorption characteristics; such structures are Approx. 1% of the photons that
radiopaque. Photoelectric absorption produces light interact with the patient (primary
areas in a radiograph, such as those corresponding to
beam) reach the IR. Of that 1%
bones. approx. 0.5% interact to form
the image.

Other x-rays penetrate the body and are transmitted

to the image receptor with no interaction. They produce
the dark areas of a radiograph. The anatomical structures
What causes blacks, whites, and
through which these x-rays pass are radiolucent. grays of an x-ray image?
 X-ray beams contains x-ray photons
Basically, an x-ray image results from the difference of differing energies
between those x-rays absorbed
photoelectrically in the patient and
As these photons pass through our body
those transmitted to the image receptor.  Some are absorbed completely White
This difference in x-ray interaction is called
 Some are not absorbed at all
differential absorption. (transmitted)
Black

 Some are absorbed partially Gray

Differential absorption increases as the kVp
is reduced.

24
 Differential Absorption
 Dependence on
Atomic Number (Z)
 Example: Extremity
examination
 More photons are
absorbed photoelectrically
in bone than in soft tissue
 Probability of PE interaction
is 7 times for bone than soft
tissue
 Photoelectric absorption is
proportional to Z3
Example:
1. How much more
likely is an x-ray
photon to interact
with bone than in
fat?
Differential Absorption
 Dependence on
Mass Density
 Intuitively, we could image
bone even if differential
absorption were not related
to Z
 Bone has a higher mass
density than soft tissue
 Mass density: mass per unit
volume (kg/m3)
 All interaction is proportional
to mass density
Example:
1. Assume that all
interactions during
mammography are
photoelectric. What is
the differential
absorption of x-rays in
microcalcifications
relative to fatty tissue?
25
 Differential Absorption Barium Exam
 Contrast Examination
 Barium and Iodine
 Both have high Z and density than soft tissue

Example:
1. What is the
probability that an
x-ray will interact
with iodine rather
than in soft tissue?

Extremity X-rays Iodine Exam

26
 X-ray Attenuation
 When a broad beam of x-rays is incident on
any tissue, some of the x-rays are absorbed,
and some are scattered. The result is a
reduced number of x-rays, a condition
referred to as x-ray attenuation.

Attenuation
 An interaction such as the photoelectric
effect is called an absorption process because
the x-ray disappears.
 Interactions in which the x-ray is only partially
absorbed, such as Compton scattering, are
only partial absorption process.
 The total reduction in the number of x-rays
remaining in an x-ray beam after penetration
through a given thickness of tissue is called
attenuation.

27
 Types of x-radiation
Radiation workers should be concerned with
these radiation.

Useful beam – primary radiation used to form an

image.

Leakage radiation – secondary radiation emitted

through the tube housing.

Scatter radiation – x-rays scattered back in the

direction of the incident x-ray beam.

28