Basic Radiology Principles

Friday, October 18th 2019

Sandy Pamadya, drg. Sp. RKG.
Plays as XXX Found X-Ray
In November 8th 1895, Wilhelm
Conrad Rontgen accidentally
produced a new kind of
electromagnetic radiation and
called it an X-Ray (X is stand for
the mathematical equation for
something unknown)
The very first radiograph taken
was the radiograph of Rontgen’s
wife, Anna Bertha Ludwig.

This inspired one of radiograph

technique used in medical
science, hand-wrist/carpal
radiograph.
RADIATION PHYSICS
• X-ray are high-energy electromagnetic radiation.
• X-ray contains waves of packet energies called
PHOTONS.
• The X-ray beams used in diagnostic radiology is
made up of millions of individual PHOTONS.
• To understand how an X-ray were produced, a
basic knowledge of atomic physics is essential.
 ELECTROMAGNETIC SPECTRUM

Longer
wavelength

Shorter
wavelength

Source: Whaites E., Drage N. Essential of Dental Radiology and Radiography 5th Edition. Elsevier. 2013. p. 15.
 ATOM

Neutral atom  Number of protons = Number of electrons

Source:
1. http://www.whoinventedfirst.com/who-discovered-the-atom/
2. Whaites E., Drage N. Essential of Dental Radiology and Radiography 5th Edition. Elsevier. 2013. p. 15.
 X-RAY PRODUCTION

X-ray Machine
Components

Source: Whaites E., Drage N. Essential of Dental Radiology and Radiography 5th Edition. Elsevier. 2013. p. 17.
 X-RAY PRODUCTION
Filament is heated 
cloud of electrons is
produced around the
filament
The high-voltage across the
X-ray emitted in all tube accelerates the
directions electrons at very high
speed towards the anode

The energy lost by the The focusing device

electrons is transferred into aims the electron
either heat (about 99%) or stream at the focal spot
X-rays (about 1%). on the target

The electrons bombard

the target and are
brought suddenly to rest
 X-RAY PRODUCTION

Source: https://www.youtube.com/watch?v=IsaTx5-KLT8
 X-RAY PRODUCTION
Factors that affect the intensity and/or quality of X-ray beams
• Size of the tube voltage (kV)
• Size of the tube current (mA)
• Distance from the target
• Time = length of exposure
• Filtration
• Target material
 X-RAY CHARACTERISTIC
• X-rays are capable for producing ionization, which is when neutral atom
loses an electron, it becomes a positive ion, and the free electron
becomes a negative ion. Thus, X-rays referred as ionizing radiation.

Source: https://radiologykey.com/basic-physics-for-radiography/
 X-RAY INTERACTION IN ATOMIC LEVEL
• Incident photon interacts with an electron in an inner
Photoelectric orbital of an atom. The photon ejects the electron
from its inner orbital, and it becomes a recoil electron
Absorption (photoelectron). The incident photon gives up all of
its energy and ceases to exist.

• Incident photon interacts with an electron in an outer

orbital of an atom. The photon ejects the electron
Compton from its outer orbital, and it becomes a recoil electron
Scattering (photoelectron). The path of the incident photon is
deflected by this interaction and is scattered in a new
direction from the site of the collision.
 X-RAY INTERACTION IN ATOMIC LEVEL

Source: White SC, Pharoah MJ. Oral Radiology Principles and Interpretation 7th Edition. Mosby Elsevier. 2014. p.12.
 X-RAY INTERACTION IN ATOMIC LEVEL
Photoelectric Absorption

Source: Whaites E., Drage N. Essential of Dental Radiology and Radiography 5th Edition. Elsevier. 2013. p. 23.
 X-RAY INTERACTION IN ATOMIC LEVEL
Compton Scattering

Source: Whaites E., Drage N. Essential of Dental Radiology and Radiography 5th Edition. Elsevier. 2013. p. 23.
 DOSIMETRY
• Definition of dosimetry:

• The determination and measurement of the

amount or dosage of radiation absorbed by a
substance or living organism by means of a
dosimeter

Source: https://www.merriam-webster.com/dictionary/dosimetry
 DOSIMETRY
High risk
Radiation Absorbed
Equivalent Dose Effective Dose
Dose
• Measure of the total • Measurement used to • A calculation that
energy absorbed by any compare the biologic considers the relative
type of ionizing effects of different biologic effectiveness
radiation per unit of types of radiation on a of different types of
mass of any type of tissue or organ. radiation and the
matter. • SI unit: sievert (Sv); 1 radiosensitivity of
• SI unit: gray (Gy); 1 Gy = Sv = 1 Gy. different tissues
1 J/kg. exposed (tissue
• Traditional unit: rem
• Traditional unit: rad; 1 (roentgen equivalent weighting factor).
rad = 0,01 Gy. • SI unit: sievert (Sv); 1
man); 1 rem = 0,01 Sv.
Sv = 1 Gy.
Low risk
 DOSIMETRY
Dose Limits
• Justification,
optimization, limitation.
• According ICRP 2007,
annual dose limit for
public are 1 mSv in a
year; while for
occupational purpose
the limits are 20 mSv in
a year.
● Justification
No practice shall be adopted unless its
introduction produces a positive net benefit
● Optimization
All exposures shall be kept as low as
reasonably achievable (ALARA), taking
economic and social factors into account.
● Limitation
The dose equivalent to individuals shall not
exceed the limits recommended by the ICRP.
BIOLOGICAL EFFECTS
 RADIATION SOURCE

Source: https://www.researchgate.net/publication/221929417_Gamma_Dose_Rates_of_Natural_Radioactivity_in_Adana_Region_in_Turkey
 RADIATION INDUCED-TISSUE DAMAGE
Direct Damage
• The X-ray photons, or
high-energy ejected
electrons, interact directly
with, and ionize, vital
biologic macromolecules
such as DNA, RNA,
proteins and enzymes.
Indirect Damage
• Involves the ionization of
the water molecule
producing both ions and
free radicals which can
combine to damage the
vital biologic
macromolecules such as
DNA.
CLASSIFICATION OF BIOLOGICAL EFFECTS
DETERMINISTIC EFFECT

Radiation Radiation injury

results from
injury results sublethal damage to
from killing the genome of

STOCHASTIC EFFECT
individual cells that
large number results in cancer
of cells formation or
heritable mutation
 CLASSIFICATION OF BIOLOGICAL EFFECTS

Sufficient cell killing

required to cause a Even one photon could
clinical response, hence a cause a change in DNA
large number of X-ray that leads to a cancer or
photons required heritable effect
 RADIOSENSITIVITY

Source: White SC, Pharoah MJ. Oral Radiology Principles and Interpretation 7th Edition. Mosby Elsevier. 2014. p.19.
 RADIOSENSITIVITY

Source: White SC, Pharoah MJ. Oral Radiology Principles and Interpretation 7th Edition. Mosby Elsevier. 2014. p.20.
 MODIFYING FACTORS OF BIOLOGICAL EFFECTS
The severity of deterministic
damage seen in irradiated
Dose tissues or organs depends on
the amount of radiation
received. Higher dose or more
often exposure means higher
Dose risks.
Rate

Linear
Oxygen
Energy
Transfer Level
 MODIFYING FACTORS OF BIOLOGICAL EFFECTS
Higher LET radiations (e.g., α particles) are more
efficient in damaging biologic systems because Dose
their high ionization density is more likely than
x-rays to induce double-strand breakage in DNA.
Low LET radiations such as x rays deposit their
energy more sparsely, or uniformly, in the Dose
absorber and thus are more likely to cause Rate
single-strand breakage and less biologic damage.

Linear
Oxygen
Energy
Transfer Level
BASIC RADIOGRAPHY
 NATURE OF RADIOGRAPHIC IMAGE
• Traditionally the image was produced by the X-rays
passing through an object (the patient) and interacting
with the photographic emulsion on a film, which
resulted in blackening of the film.
• To better understand the nature of radiographic image,
it requires knowledges of the radiographic shadows,
the three-dimensional anatomical tissues and the
limitations imposed by a two-dimensional picture and
superimposition.
NATURE OF RADIOGRAPHIC IMAGE
NATURE OF RADIOGRAPHIC IMAGE
 IMAGE RECEPTORS

CONVENTIONAL DIGITAL

Film package CCD, CMOS and PSP sensors

 X-RAY FILMS

Size 2
30,5 x 40,5 mm

Size 4 Size 1
7,7 x 5,8 cm 24 x 40 mm

Size 0
22 x 35 mm
X-RAY FILMS
 X-RAY FILMS
Emulsion:
- Silver halide grains (consists mostly silver
bromide crystals)
- Sensitive to X-ray and visible light

Film Composition
Base:
- To support the emulsion
- Made of polyester polyethylene
terephthalate, which provides the proper
degree of flexibility to allow easy handling of
the film
FORMATION OF LATENT IMAGE
 FILM PROCESSING
The sensitized silver halide crystals in the emulsion
Development are converted to black metallic silver to
produce the black/grey parts of the image

Drying Washing

The unsensitized silver halide crystals in the

emulsion are removed to reveal the transparent or
Washing Fixation white parts of the image and the emulsion is
hardened.
FILM PROCESSING
THE RADIOGRAPH
REFERENSI
1. Oral Radiology Principles and Interpretation 7th Edition
(White & Pharoah).
2. Essentials of Dental Radiography and Radiology 5th
Edition (Whaites)
To be continued...