Question 1: Describe an x ray tube and explain its mode of function

CATHODE

The cathode is part of an x-ray tube and serves to expel the electrons from the circuit and focus
them in a beam on the focal spot of the anode. It is a controlled source of electrons for the
generation of x-ray beams. The electrons are produced by heating the filament (Joule heating
effect) i.e., a coil of wire made from tungsten, placed within a cup-shaped structure, a highly
polished nickel focusing cup, providing electrostatic focusing of the beam on the anode. In order
to expel the electrons from the system, they need to be given the energy. Heat is used to expel
the electrons from the cathode. The filament is crystallized during construction and its
crystallized structure gives the filament stability. The process is called thermionic emission (or
Edison effect). The filament is the source of electrons used in the production of X-rays

Filament

Made of thin (0.2 mm) tungsten wire because tungsten, has a high atomic number (A 184, Z 74).
It is a good thermionic emitter (good at emitting electrons) can be manufactured into a thin wire
and has a very high melting temperature (3422°c). There are usually two filaments: a small one
with low output for better geometric resolution and a larger filament for higher output capacity,
with wire diameters of 0.22 mm and 0.3 mm diameter, respectively. The filament is constructed
as a spiral, with dimensions calculated to maximize the even density of the electrons produced.
An alternative electron source is the flat emitter filament instead of a helix. This is used for some
modern mammography tubes and allows a better X-ray intensity distribution than with the helix,
thus improving image quality.

Focusing cup

Made of Nickel with high melting point and poor thermionic emitter so electrons aren’t released
to interfere with electron beam from filament. Negatively charged to focus the electrons towards
the anode and stop spatial spreading. The Nickel is a shallow depression shaped into a cup
opened to the anode direction of the x ray tube (Jeremy Jones, Sept 2021). Its structure supports
the filaments.

ANODE

The anode (or anticathode) is the component of the x-ray tube where x-rays are produced. It is a
piece of metal, shaped in the form of a beveled disk with a diameter between 55 and 100 mm,
and thickness of 7 mm, connected to the positive side of the electrical circuit. The anode converts
the energy of incident electrons into x-rays dissipating heat as a byproduct. Most x-ray tube
anodes are made of tungsten (the target material). Tungsten has a high atomic number (Z=74)
and a high melting point of 3370°C with a correspondingly low rate of evaporation. The high
atomic number of tungsten gives more efficient bremsstrahlung production compared to lower
atomic number target materials. An alloy containing tungsten and rhenium is also used because
the addition of 5-10% rhenium prevents grazing and cracking of the anode surface at high
temperatures and through usage (Arlene Campos, 2024).

The body of the anode is made of materials that are light and have a good heat storage capacity,
like molybdenum and graphite. Molybdenum stem, which is a poor conductor of heat to prevent
heat transmission to the metal bearings. Silver lubricated bearings between the stem and rotor
that have no effect on heat transfer but allow very fast rotation at low resistances. The disc with a
thin bevelled rim of tungsten around the circumference that rotates at 50 Hz. Because it rotates it
overcomes heating by having different areas exposed to the electron stream over time.
Blackened rotor to ease heat transfer. The rotor is actually part of a motor that is made to rotate
at very high speed. In most x-ray tubes, the revolutions per minute is usually at 3,200 for
standard technique settings, however if the technologist selects exposure factors that are
considerably larger and therefore very hot, then the rotor can rotate at a much greater speed
exceeding 5,000 rpm. Anodes are designed as beveled disks attached to a large copper rotor of
the electric motor, rotating them at the speeds up to 10,000 rpm, with a temperature of 2000°C.
The purpose of the rotation is to dissipate heat. Most rotating anodes actually represent rather
complex electromechanical systems consisting of approximately 350 pieces, taking around 150
assembly operations (Hai Nguyen, 2021). The rotor has a rotatable shaft with a longitudinal
extending axis, while a pair of bearings disposed radially to support the stator.

Focal spot

The anode disc rotates and is subjected to a focused beam of electrons emanating from the
cathode, which is accelerated by a high potential difference between the cathode and the anode.
When the electron beam hits the anode (at the actual focal spot), interactions of the electrons
with the target material produces the x-ray beam. The anode angle is the angle between the
vertical and the target surface with most x-ray tubes having an anode angle of 12-15°. A smaller
angle results in a smaller effective focal spot. The whole anode is not included in x-ray
production. X-rays are produced on the rather small rectangular surface, the actual focal spot.
The small focal spot is superimposed over the large one.

VACUUM ENVELOPE

The tube housing protects the delicate insert from damage during use. It is made of steel or
aluminum with an external protective coat of paint to allow easy cleaning and an internal lining
of lead to reduce radiation leakage to below the required maximum. The cover has special
mounting rings, trunnions for attachment to the tube suspension equipment, and sealed terminals
and sockets for the high-tension cables and other associated control equipment connections. The
envelope needs to be strong enough to support the anode and cathode assemblies, provide
electrical insulation between the two and maintain the vacuum. The required vacuum is less than
10–5 mm Hg. The tube vacuum envelope is generally made of glass although some high-power
tube envelopes are made of metal or ceramic. Glass tube envelopes are made of borosilicate
glass, which provides the required strength, low coefficient of thermal expansion and electrical
insulation. Metal and combined metal with ceramic insulation are alternative methods of
construction with the advantages of greater strength and mechanical stability compared to
previous tubes made of glass; heat dissipation is also improved. The tube housing is earthed to
provide shock proofing and contains mineral oil surrounding the insert to electrically insulate it
and aid cooling. Additionally, the oil helps insulate electrically for safety and one additional
thing it does is if you notice where the primary beam exits the housing, the x-rays must pass
through a small thickness of oil before they emerge from the tube and this contributes to minimal
filtration or absorption of the x-ray beam when you make an exposure. Expansion bellows within
the tube housing allows expansion of the oil when the X-ray tube heats up during use. The X-ray
window is a portion of the tube envelope which is thinner than the rest of the structure to allow
X-ray output from the tube, minimizing radiation absorption. The wire penetrating the glass seals
at the end of the tube is known as Dumet wire, a copper-coated alloy of nickel and iron that has
the same coefficient of expansion as the glass. The cover is lined with lead to reduce radiation
leakage, except for the X-ray port, which is made of plastic or beryllium. Beryllium is used as it
has low X-ray absorption due to its proton number of 4. Lead (Pb) is an ideal material for this
purpose due to its high atomic density (Z = 82). Due to these properties, it is also preferred for its
use in personal protective equipment. Typically, a thin sheet of lead (2-3 mm thickness) is lined
within the tube housing.

MODE OF OPERATION
The tube cathode (filament) is heated with a low-voltage current of a few amps. The filament
heats up and the electrons in the wire become loosely held. A large electrical potential is created
between the cathode and the anode by the high-voltage generator. The high-voltage between the
cathode and the anode affects the speed at which the electrons travel and strike the anode.
Electrons that break free of the cathode are strongly attracted to the anode target. The stream of
electrons between the cathode and the anode is the tube current. The tube current is measured in
milliamps and is controlled by regulating the low-voltage, heating current applied to the cathode.
The higher the temperature of the filament, the larger the number of electrons that leave the
cathode and travel to the anode. The milliamp or current setting on the control console regulates
the filament temperature, which relates to the intensity of the X-ray output.

The high-voltage potential is measured in kilovolts, and this is controlled with the voltage or
kilovoltage control on the control console. An increase in the kilovoltage will also result in an
increase in the intensity of the radiation. tube cathode (filament) is heated with a low-voltage
current of a few amps. The filament heats up and the electrons in the wire start breaking free. To
kick off the flow of electrons, a strong electrical potential is created between the cathode and the
anode by the generator. Electrons that break free of the cathode are strongly attracted to the
anode disc. The electron flow between the cathode and the anode is called the tube current. The
tube current is measured in milliamps (mA) and is controlled by regulating the low-voltage,
heating current applied to the cathode. Higher the temperature of the filament, the larger the
number of electrons that leave the cathode and travel to the anode. A high vacuum maintained
between the anode and cathode is necessary avoid the collision between electrons and gas
molecules, which gives raise to ionization that reduces the kinetic energy of the electrons prevent
oxidation of electrodes and act as an electrical insulator Saturation: Above 40 kVp, the space
charge effect is overcome, and the tube current is controlled by the filament current. This is
called the saturation. Because all of the electrons accelerated from cathode to anode are
electrically negative, the electron beam tends to spread out owing to electrostatic repulsion.
Some electrons can even miss the anode completely. Space charge effect: When the applied kV
is zero or small, the electrons surrounding the filament forms a cloud, resulting in space charge
effect. As the kVp is increased, (0–40 kV) the effect of space charge reduces gradually and the
tube current also increases.

The focusing cup controls the width of the electron distribution, and directs the electron toward
the anode target. this results in a profiled beam of electrons as the focusing cup terminals are
negatively charged through coulomb’s law of repulsion. The emitted electrons are focused into a
concentrated group accelerated toward the anode, striking a small area at the lower part of the
disc called the focal spot. Rotation “spreads” the build-up of heat along the entire disc rather than
just one given spot.

Electrons accelerate toward the positively charged anode. The higher the kilovoltage, the more
speed and, therefore, energy the electrons have when they strike the anode. Electrons striking
with more energy results in X-rays with more penetrating power. The anode is where electrons
decelerate, and the energy from deceleration is released in the form of heat and X-rays (photons).
The tube current is proportional to the x-ray flux at any tube voltage applied. Most of the
electrons that strike the anode deposit their kinetic energy, generated by the applied tube voltage
and current, as heat. Bombarding electron approaches the nucleus. Electron is diverted by the
electric field of the nucleus. The energy loss from this diversion is released as a photon
(Bremsstrahlung radiation). Bremsstrahlung causes a spectrum of photon energies to be released.
80% of x-rays are emitted via Bremsstrahlung. Rarely, the electron is stopped completely and
gives up all its energy as a photon. More commonly, a series of interactions happen in which the
electron loses energy through several steps. The resulting spectrum of x-ray photon energies
released is shown in the graph. At a specific photoenergy there are peaks where more x-rays are
released. These are at the characteristic radiation energies and are different for different
materials. The rest of the graph is mainly Bremsstrahlung, in which photons with a range of
energies are produced. Bremsstrahlung accounts for the majority of x-ray photon production.

At x-ray energies, filters consist of material placed in the useful beam to absorb, preferentially,
radiation based on energy level or to modify the spatial distribution of the beam. Filtration is
required to absorb the lower-energy x-ray photons emitted by the tube before they reach the
patient. The use of filters produces a cleaner image by absorbing the lower energy x-ray photons
that tend to scatter more. The aluminium window where the x ray exits the tube is used to filter
out the soft x-rays. Softer (lower energy) x-ray photons contribute to patient dose but not to the
image production as they do not have enough energy to pass through the patient to the detector.
To reduce this redundant radiation dose to the patient these x-ray photons are removed.

Lead collimator is a metal disc with a small opening in the center to control the size and shape of
the x-ray beam as it leaves the tubehead. Position-indicating device (PID) is the open-ended,
lead-lined cylinder that extends from the opening of the metal housing of the tube head.

Question 2: Explain how a high-tension generator works

The high-frequency generator is now the contemporary state-of-the-art choice for diagnostic x-
ray systems. Its name describes its function, whereby a high-frequency alternating waveform (up
to 50,000 Hz) is used for efficient conversion of low to high voltage by a step-up transformer.
Subsequent rectification and voltage smoothing produce a nearly constant output voltage. These
conversion steps are illustrated in the diagram above. The operational frequency of the generator
is variable, depending on the exposure settings (kV, mA, and time), the charge/discharge
characteristics of the high-voltage capacitors on the x-ray tube, and the frequency-to-voltage
characteristics of the transformer (T Murphy, 2008)

Low-frequency, low-voltage input power (50 to 60 cycles/s AC) is converted to a low voltage,
direct current. The full wave rectification rectifies the negative component of the input sinusoidal
current to a positive pulse current utilizing a diode bridge configuration (four individual
rectifying diodes connected in a closed loop). At the first stage, a rectifier is employed to convert
220V, 60Hz AC grid voltage into direct current which flows in one direction. The resultant is a
double frequency since the wavelength is reduced by half the frequency is increased by a times 2
factor to 120Hz.

The pulsating direct current that is produced is then filtered by the use of a capacitor, the reason
behind this is that pulsating DC will have discrete time intervals of little to no voltage supply of
which the x ray circuits need continuous linear regulated power supply. To smooth the output of
the rectifier a reservoir capacitor is placed across the output of the rectifier in parallel with the
load. The capacitor charges up when the voltage from the rectifier rises above that of the
capacitor, stores charge and when the rectifier voltage falls it then provides the required current
from its stored charge. This reduces the DC ripple into an almost constant flow.

The feed of the DC capacitor into a DC chopper converts the DC to pulsating DC. The inversion
is done by an invertor which chops the smooth wave back into very smaller wave length
sinusoidal alternating current. The chopper utilizes high-speed switching at frequencies than
significantly higher than the standard 50/60 Hz grid. This function increases the frequency up to
500-40000 Hz and in this case to 6500 Hz.

An inverter circuit creates a high-frequency AC waveform, which supplies the high-voltage

transformer to create a high-voltage, high-frequency waveform. The high-tension transformer
uses ferrite instead of iron core to increase in efficiency. The primary side of the transformer has
less windings to the secondary side. With the step-up transformation, a high-voltage output with
peak value as high as 8kV~10kV which is needed for x ray production, and high frequency AC
sinusoidal voltage is created.

Rectification and smoothing of the high voltage and high frequency output from the high-
tension transformer produces high-voltage DC power that charges the high-voltage capacitors
placed across the anode and cathode in the x-ray tube circuit. Rectification and capacitance
smoothing provide the resultant high-voltage output waveform, with properties similar to those
of a three-phase system. and tube current and continuously supply charge to the capacitors as
needed to maintain a nearly constant voltage. The high voltage rectifier will again double the
frequency from 6500 Hz to 13000 Hz.

Linkage to the x ray tube

Accumulated charge in the capacitors will produce a voltage to the x-ray tube according to the
relationship V= Q/C, where V is the voltage (volts), Q is the charge (coulombs), and C is the
capacitance (farads). During the x-ray exposure, feedback circuits monitor the tube voltage in a
high-frequency inverter generator, a single- or threephase AC input voltage is rectified and
smoothed to create a DC waveform. For kV adjustment, a voltage comparator measures the
difference between the reference voltage (a calibrated value proportional to the requested kV )
and the actual kV measured across the tube by a voltage divider (the kV sense circuit). Trigger
pulses generated by the comparator circuit produce a frequency that is proportional to the voltage
difference between the reference signal and the measured signal. A large discrepancy in the
compared signals results in a high trigger-pulse frequency, whereas no difference produces few
or no trigger pulses. For cach trigger pulse, the DC/AC inverter circuit produces a corresponding
output pulse, which is subsequently converted to a high-voltage output pulse by the transformer.
When the requested x-ray tube voltage is reached, the output pulse rate of the comparator circuit
settles down to a constant value, and recharging of the high-voltage capacitors is constant. When
the actual tube voltage drops below a predetermined limit, the pulse rate increases. The feedback
pulse rate (generator frequency) strongly depends on the tube current (mA), since the high-
voltage capacitors discharge more rapidly with higher mA, thus actuating the kV comparator
circuit.

Question 3 discuss the ward radiography

Mobile radiography allows for the diagnostic imaging of patients who are unable to be seen in
the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have
difficulty with movement. However, staff are exposed to scattered radiation from the patient, and
can receive potentially harmful radiation doses during radiography. The protection of staff is of
utmost importance, hence use of personal dosimeters when operating portable X-ray units. As
eye doses can be significant, protective measures are essential for RTs. It is important to evaluate
the radiation doses delivered to RTs during mobile radiography, as well as the scattered radiation
distribution, to ensure adequate protection. To ensure both patients and operators are safe when
using portable X-ray units, experts recommend proper training and protocols for use must be in
place, and must be strictly adhered to. Regular compliance audits, along with manufacturer-
recommended equipment servicing.

Justification

The principle of justification is that, in general, ‘any decision that alters the radiation exposure
situation should do more good than harm. This means that by introducing a new radiation source,
by reducing existing exposure, or by reducing the risk of potential exposure, one should achieve
sufficient individual or societal benefit to offset the detriment it causes’ (ICRP, 2007b,c). The
principal aim of medical exposures is to do more good than harm to the patient, subsidiary
account being taken of the radiation detriment from the exposure of the radiological staff and
other individuals (ICRP, 2007b).

Because of its risks, the portable x-ray equipment should only be used for examinations where it
is impractical or not medically acceptable to transfer patients to a fixed unit. The medical
practitioners should justify the use. The limited kV used in portable X-rays also limits the
examination types because some examinations require quite large kV parameters so there are
some projections that are unjustifaible as they will do harm to patient in unnecessary radiation
due to poor image quality.

Dose limit

There is need to observe the exposure doses, the public dose limit should be monitored. There is
no need to keep on increasing the dose. The radiation should be as low as reasonably possible
rather than not considering use of selective mAs and kVp. Exposure factors can be reduced
manually.

Besides, another thing that must be considered is work area restriction, namely the control area
and supervision area. Access to work areas where radiation is being used should be controlled to
ensure doses to visitors are below the dose limits for the public. In a diagnostic radiology facility,
the control area is the locations where the X-ray equipment is operated. Therefore, where
portable X-ray equipment is placed can also be categorized as controlled areas during
radiological procedures are being carried out. The site should be shielded and should be
restricted, and there should be radiation warning signs indicate that X-ray equipment is being
operated. Following BAPETEN Chairman Regulation No. 4 of 2013, personnel in the control
area should use individual dose monitor and radiation protective equipment. The supervised area
may involve areas surrounding the control area. The supervised site is not primarily based on the
radiation exposure level, which in radiology diagnostic can be kept very low, but instead as a
'buffer zone' due to other individuals' potential to enter the X-ray area inadvertently and be
exposed. Thus, this supervision area should also be marked.

Radiation protection during mobile radiography

Radiographer’s understanding and adherence to radiation protection control measures during
mobile radiography is of paramount importance in protecting patients, themselves and members
of the public visiting the ward/unit. However, some research studies have found limited
awareness and non-adherence to radiation protection control measures among radiographers
during mobile radiography (Anim-Sampong et al, 2015; Luntsi et al, 2016; Azimi et al, 2018).
This can be attributed to a lack of radiation protection awareness programmes for nurses and
radiographers working in clinical settings where ionizing radiation is used, such as ICU and
hospital wards. There are three practical methods of controlling the external radiation exposure
during mobile radiography: time, distance and shielding.

Shielding

Placing a barrier of lead or concrete between the radiation source and an individual provides
protection from X-radiation (Jones and Taylor, 2006; Ehrlich and Coakes, 2017). During mobile
radiography, anyone assisting in an examination and staying in the radiation field should wear a
lead-rubber apron or stand behind a mobile lead screen. Generally, walls in special care units
where ionising radiation is used are designed to contain the radiation produced by the mobile X-
ray tube within a set of criteria and limits determined by relevant legislation (Hart et al, 2002).
Lead glasses may also be necessary for protecting the eyes of RTs to reduce scatter radiation that
can lead to biological stochastic effect with time to the radiosensitive eyes. Although portable X-
ray manufacturers typically include a lead shield within a portable X-ray unit, and/or a lead-
embedded acrylic protective shield at the end of the X-ray tube head, improper use can put
operators at risk of radiation exposure. The radiographer has to remain shielded behind a
protective lead wall, when operating X-ray units to avoid exposure from backscatter and
radiation leakage.

Time

Minimising the exposure time of an individual reduces the dose from the radiation source
(Whitley et al, 2016; Martin et al, 2019). In the context of this article, the radiation source is the
X-ray tube of the mobile equipment. The control measure of time does not generally apply to
mobile radiography. If there is a need for a nurse to stay with the patient during the exposure, a
lead apron should be provided and rotation of nurses for patients requiring periodical mobile X-
ray examinations should be in place. Rotation reduces the amount of exposure to each nurse
(Jones and Taylor, 2006). However, nurses are rarely required to stay with the patient during the
X-ray exposure in mobile radiography.

Distance

The dose of radiation decreases dramatically as the distance is increased from the source
(Whitley et al, 2016; Martin et al, 2019). This is commonly called the inverse square law.
Therefore, nurses and supporting staff should stand as far as possible from the X-ray mobile
equipment and outside the radiation field when the radiographer is making an exposure (Whitley
et al, 2016). Mobile patients not on a life support system and members of the public should stand
at a safe distance during the X-ray exposure. The recommended minimal safe distance is 2
metres, at which scattered radiation is attenuated equivalent to background levels (Chiang et al,
2015).

Patients within 2 metres of the radiation field should be provided with shielding such as lead
aprons, especially paediatric patients, who are most vulnerable to ionising radiation due to a
higher sensitivity of the developing organs and tissue (International Commission on Radiation
Protection, 2013). It should be noted that radiographers and nurses have a responsibility to
ensure that no one is within the radiation field during the X-ray exposure of the patient. This is
achieved by informing all persons in the immediate area that an X-ray exposure is about to be
made and asking them to stand a safe distance from the radiation field area.

X-ray operators are universally recommended to maintain a safe distance outside the “controlled
zone”. Radiographers can be located close to a patient (i.e., the source of scattered radiation)
during mobile radiography. To reduce occupational radiation exposure, the radiographer should
remain distant from the patient if possible. However, because this distance may hinder
verification of the patient’s condition, the radiographer sometimes works in close proximity to
patients so there is need for one to be professional in applying radiation protection precautions as
there is need to balance both radiation safety and patient attention.

It is the radiographer’s responsibility to give verbal warnings to the immediate people in the
radiation field before the exam. Although all these precautions can be undertaken during ward
radiography the departmental radiography is safer as compared to the ward radiography.
Considerations to even try and move the bed written patient to the x ray department. The
transportation of the mobile unit to the wards need monitor since there is high risk of it being
exposed to people who are unaware of the hazard the tool can impose.

In conclusion it is by far of much help to examine patients in the radiography department

carefully designed on radiation protection considerations

REFERENCES