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INTERVENTIONAL HEALTH ALLIED SCIENCE

DEPARTMENT
RADIOLOGY BACHELOR OF SCIENCE IN
RADIOLOGIC TECHNOLOGY

Introduction to
Interventional Radiology
Fluoroscope
 Thomas A. Edison invented the fluoroscope
in 1896
 The fluoroscope is used primarily for dynamic
studies
 Fluoroscopy is actually a rather routine type
of x-ray examination except for its
application in the visualization of vessels,
called angiography.
 Two main areas
 Vascular Radiology
 Neuroradiology
 The x-ray tube is usually hidden the patient
couch, and the image intensifier or other
image receptors are set over the patient
couch.
 Some fluoroscopes are operated remotely
from outside the x-ray room.
 During fluoroscopy, the x-ray tube is
operated at less than 5 mA
 radiographic examination, in which the x-ray
tube current is measured in hundreds of mA
 Despite the lower mA, however, the patient
dose is considerably higher during
fluoroscopy than during radiographic
examinations because the x-ray beam
exposes the patient continuously for a
considerably longer time.
AUTOMATIC BRIGHTNESS CONTROL (ABC)
 Fluoroscopic equipment allows the
radiologist to select an image brightness level
that is subsequently maintained
automatically by varying the kVp, the mA, or
sometimes both.
Visual Physiology
 Cones are used primarily for daylight vision,
called photopic vision,
 Cones perceive small objects much better
than rods.
 Cones are also much better at detecting
differences in brightness levels.
 Rods are used for night vision, called scotopic
vision
 Cones perceive color, but rods are essentially
color blind.
 Visual acuity - ability to perceive fine detail
 Contrast perception - detecting differences in
brightness levels.
Fluoroscopic technique
 The brightness of the fluoroscopic image
depends primarily on the:
 anatomy that is being examined,
 kVp,
 mA.
 The influence of kVp and mA on fluoroscopic
image quality is similar to their influence on
radiographic image quality.
 Generally, high kVp and low mA are
preferred.

Illumination
 levels are measured in units of lumen per
square meter or lux
 Radiographs are visualized under
illumination levels of 100 to 1000 lux

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 COLLEGE OF OUR LADY OF MERCY
INTERVENTIONAL
RADIOLOGY
Image-Intensifier Tube
 The image-intensifier tube is a complex
electronic device that receives the image-
forming x-ray beam and converts it into a
visible-light image of high intensity
 The Cesium Iodiode (CsI) crystals are grown
as tiny needles and are tightly packed in a
layer of approximately 300 µm.
 Each crystal is approximately 5 µm in
diameter
 The photocathode is a thin metal layer
usually composed of cesium and antimony
compounds that respond to stimulation of
input phosphor light by the emission of
electrons.
 The photocathode emits electrons when
illuminated by the input phosphor
 Photoemission is electron emission that
follows light stimulation.
 What is the relationship between the
number of electrons emitted by the
photocathode and intensity of light
reaches it? Directly Proportional
 Intensity of the incident image-
forming x-ray beam
 Intensity of light
 Number of electrons emitted
RT NER CARLO
HEALTH ALLIED SCIENCE 
DEPARTMENT The
BACHELOR OF SCIENCE IN
RADIOLOGIC TECHNOLOGY
image-intensifier tube is approximately 50
cm long.
 A potential difference of about 25,000 V is
maintained across the tube between
photocathode and anode
 The anode is a circular plate with a hole in
the middle through which electrons pass to
the output phosphor
 The output phosphor is the site where
accelerated electrons interact and produce
light.
 For the image pattern to be accurate, the
electron path from the photocathode to the
output phosphor must be precise.
Flux gain
 ratio of the number of light photons at the
output phosphor to the number of x-rays at
the input phosphor
  Flux Gain ="Number of output light
photons" /"Number of input x-ray photons"
Minification gain
 the image minification from input phosphor
to output phosphor is the ratio of the square
of the diameter of the input phosphor to the
square of the diameter of the output
phosphor
  Minification gain = (di/do)²
 where di is the diameter of input phosphor
and do is the diameter of output phosphor.
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 COLLEGE OF OUR LADY OF MERCY
INTERVENTIONAL HEALTH ALLIED SCIENCE
DEPARTMENT
RADIOLOGY BACHELOR OF SCIENCE IN
RADIOLOGIC TECHNOLOGY

 Output phosphor size is fairly standard at

2.5 or 5 cm
 Input phosphor size varies from 10 to 40
cm

Brightness gain
 The ability of the image intensifier to
increase the illumination level of the image
 The brightness gain of most image
intensifiers is 5000 to 30,000
 simply the product of the minification gain
and the flux gain
 Brightness Gain = Minification gain x Flux
gain

Conversion factor
 the ratio of the illumination intensity at the
output phosphor, measured in candela per
meter squared (cd/m^2) to the radiation
intensity incident on the input phosphor,
measured in milligray per second (mGy/s)
 approximately 0.01 times the brightness gain.
 the proper quantity for expressing image
intensification.
 Conversion factor = ("Output phosphor
illumination" (cd/m^2 ))/"Input exposure
rate (mGy /s) "

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 COLLEGE OF OUR LADY OF MERCY
INTERVENTIONAL HEALTH ALLIED SCIENCE
DEPARTMENT
RADIOLOGY BACHELOR OF SCIENCE IN
RADIOLOGIC TECHNOLOGY

size as the output phosphor of the image-

Monitor intensifier tube
 The television camera tube or CCD converts
Multifield Image Intensification the light image from the output phosphor of
 These numeric dimensions refer to the the image intensifier into an electrical signal
diameter of the input phosphor of the image- that is sent to the television monitor.
intensifier tube.  Significant advantage of television
 Multifield image intensifiers produce monitoring is that brightness level and
different magnification of the image. contrast can be controlled

Television camera tube

 15 mm in diameter by 25 cm in length

 contains the heart of the television camera

 This increase in patient radiation dose results
in better image quality.
 The patient radiation dose is higher because
more x-rays per unit area are required to
form the image.
 This results in lower noise and improved
contrast resolution.
tube.
 It also contains electromagnetic coils that are
used to properly steer the electron beam
inside the tube.
Television camera tube Parts
 The electron gun is a heated filament that
supplies a constant electron current by
thermionic emission

MAGNIFICATION MODE RESULTS IN

 Better spatial resolution
 Better contrast resolution
 Higher patient radiation dose
 Vignetting
 a reduction in brightness at the
periphery of the image

FLUOROSCOPIC IMAGE MONITORING

 Vidicon is the television camera tube that is
most often used in television fluoroscopy. It  Target
has a sensitive input surface that is the same

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 COLLEGE OF OUR LADY OF MERCY
INTERVENTIONAL HEALTH ALLIED SCIENCE
DEPARTMENT
RADIOLOGY BACHELOR OF SCIENCE IN
RADIOLOGIC TECHNOLOGY

 photoconductive layer of antimony

trisulfide is applied to the inside of the
signal plate
 When light from the output phosphor of
the image-intensifier tube strikes the
window, it is transmitted through the
signal plate to the target.
 Signal plate
 Coated on the inside of the window is a
thin layer of metal or graphite,
 thin enough to transmit light yet thick
enough to efficiently conduct electricity.
 it conducts the video signal out of the
tube into the external video circuit.

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