INTRODUCTION TO

RADIOLOGY
Sajid Ali
Lecturer
Department of Veterinary Surgery
Course code: SURG-302
Credit Hours 2(1-1)
 COURSE GOALS

 Understand basics of image generation.

 Relate imaging to gross anatomy.

 See clinical relationship to basic science.

 Develop imaging vocabulary.

 WHAT IS RADIOLOGY?

Medical specialty that supervises

and interprets imaging studies.

Reports findings to referring

physicians.

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 Radiology
• Branch of medical science which deals with
diagnostic & therapeutic application of radiant energy
• Veterinary radiology: use of radiant energy for
diagnostic & therapeutic purpose in animals.
• Radiologist: any person qualified to use radiant
energy in diagnostic & therapeutic purpose
• Radiographer: a technically trained person who can
obtain quality radiograph for use by radiologist
 Scope of Radiology
• The most common diagnostic tool used to investigate
orthopedic disease is radiography.
• Radiography is also used to rule out other concurrent
common diseases. It is extremely useful in detecting and
evaluating fractures, joint dislocations, osteoarthritis,
neoplasia, and congenital joint conditions (e.g.hip
dysplasia).
• It is also useful in evaluating fracture fixation and
healing as well as in following progress of joint
treatments.
• In general, two orthogonal (90 degrees to each other)
views of an area are taken.
RADIOLOGIST ROLE
 Separate: Normal from Abnormal

 Characterize / Describe: Abnormality

 Determine: Extent (stage) of disease

 Suggest: Diagnosis / Differential

 Recommend: Further exams / follow-up

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 X-RAY
 Discovered and named by
Dr. W. C. Röentgen at
University of Würzburg,
1895

 Awarded first Nobel prize

for physics, 1901

 Did not patent invention

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• Radiograph of Mrs. Wilhelm Conrad Roentgen
• Sketch of 1st x-ray machine
 Important Units to Remember

• a millimeter (mm) is 10-3 meters

• a micrometer (m) or micron is 10-6 meters
• a nanometer (nm) is 10-9 meters
• an angstrom (Å) is 10-10 meters
 Construct of modern X-Ray machine
Primary function of X-ray tube is to convert
electrical energy into X-rays
• Transformer
• Control panel
• Steel cover (Lead Coating inside) and Console
Panel
• X-Ray tube is made of
Glass Envelope
Tube Window
Cathode assembly
Anode
Electric circuits
Steel cover(Lead Coating inside) and Console Panel
X-Ray tube
Glass Envelop and Tube Housing
• Anode and cathode are enclosed in a vacuum
glass tube or envelop.
• Vacuum allows unobstructed path for
electron stream and prevents oxidation and
burning out of the filament.
Cathode Assembly
-ve side of X-Ray tube is called cathode.
It consist of:-
• Focusing Cup (Nickel or Molybdenum)
• Filament(Tungsten /Tungsten-Rhenium alloy)
• Cathode severe as source of electron for x-ray
tube and direct their flow towards anode.
• The X-ray tube current measured in mA (no. of
electron flowing per seconds from filament to the
target).
 Filament
Usually made of Tungsten /Tungsten-Rhenium
alloy because of its
• High melting point
• Little tendency to vaporise therefore prolong
the life of X-Ray tube.
• Higher electron emission than other metals
In modern machine filaments is made up of
Tungsten-Rhenium alloy to enhance thermionic
emission efficiency and prolong tube life.
 Focusing Cup
• Made up of Nickel or Molybdenum
• Electron accelerated from cathode to anode are
negatively charged and tend to spread out , a
negative electrical potential is maintained in
the focusing cup.
 Anode
+ve side the X-Ray tube.
Anode (Made of Tungsten)
• Two types
Stationary anode for portable units , dental unit
and special purpose unit where high power and
current is not used. (soft x-rays)
Rotating anode for larger capacity capable of
producing high intensity x-rays in short time
(hard x-rays)
 X-ray production
• The evacuated X-Ray tube or hot filament X-Ray tube is
a device for producing free electron from cathode this
process called thermionic emission by heating the
filament (2300-2500 ⁰C)
• The electron remains in constant rotation and their
number increases as the temperature of filament is
increases.
• Under the influence of high potential difference (kVp)
applied across the X-ray tube , the cathode is given very
high negative charge while the target or anode is given
equal high positive charge. This cause rush of electron
towards the anode
 Continue..
• This stream of electron is called tube current
or cathode rays.
• The electron stream in the tube is confined and
concentrated on a small spot on the anode face
called focus or focal spot
• When they hit the anode it produces X-rays.
• At 100 mA approximately 6*1015 electrons
travels per second from cathode to anode.
 Electric circuits
 Source of electricity
 Main X-Ray circuit
Most X-Ray unit work from a power source of
220 volts, 60 hertz some unit can operate on
110 volts or 440 volts.
 Radiological units

kVp Maximum energy of X-ray photons kVp

mA (mAs) Electron production in the X-ray tube mA

keV Kinetic energy of electrons in X-ray keV

tube
Heat unit Heat produced at anode (kVp ×mAs) HU

Gray Dose absorbed by a medium Gy

Sievert Dose equivalent Sv
Coulomb/kg Measure of atmospheric exposure C/kg

Becquerel Radioactive disintegrations per second Bq

kVp
• The potential difference between the cathode
and anode in an X-ray tube is measured in
kilovolts.
• This value determines the maximum energy of
the X-ray photons emitted that will give the
quality and intensity of the beam.
• In many machines, this value may fluctuate
and so the peak value is given (kVp).
mA/mAs
• In the production of X-rays, fast-moving electrons must
strike the anode within the X-ray tube.
• To produce these electrons, an electrical current must be
applied to the cathode. This is measured in milliamperes
(mA).
• These electrons could be produced continuously, but
this would cause damage to the tube and so the
production of electrons is limited to a period of time
(exposure time).
• The exposure time is expressed in mAs or milliamperes
per second.
keV
• As an electron is accelerated across the tube from
the cathode to the anode, it gains kinetic energy.
This is measured in keV. The keV will be the same
as the kVp.
Heat units
• The production of X-rays produces heat at the
anode. The amount of heat is specific to each
exposure and can be calculated by multiplying kVp
and mAs together. This is correct only if the voltage
and current remain constant throughout the
exposure.
Absorbed dose
• The dose absorbed by the patient is
measured in gray (Gy). This is specific to
the patient dose received and will vary
according to the exposure used and the
region being examined. The absorbed
dose is the measurement of the energy
absorbed by a medium.
1 Gray=1 Joule per kilogram
Dose equivalent
• The dose received by designated people working
with radiation (dose equivalent) is measured in
sieverts (Sv).
• This measurement is calculated by multiplying the
grays received by a quality factor.
• The quality factor will take into account the
different levels of damage caused by radiation and
will alter depending on the type of ionizing
radiations and the energy of the ionizing radiation.
• The dose equivalent is calculated from monitoring
devices worn by personnel working with radiation.
Exposure in air
• The amount of radiation in the atmosphere can be measured
in coulomb/kilogram(C/kg).
• This measure of radiation can only be used for air and for X-
ray so gamma rays within this air.
• The measure gives the total electric charge formed by
ionization in air. This can be used for X-rays emerging from
the tube or the intensity of gamma rays during a scintigraphic
examination.
Activity
• The final radiographic unit is the becquerel (Bq). Radioactive
substances have unstable nuclei and try to change the
structure of the nucleus to a more stable form. Each change in
structure is called disintegration. The becquerel measures the
number of changes per second.
 Types of x-ray machine
• Portable x-ray machines
• Mobile x-ray machines
• Fixed x-ray machines
 Portable x-ray machines
• Commonly used in Veterinary practice
• Small sized low weight transformer
• Small control panel is attached to the tube stand
• Stationary anode suitable for X-raying of limbs
below stifle and elbow of large animals and can
be used for taking X-rays of abdomen and
skeletal systems of small animals
• The maximum output varies from 70-110 kV
and 15-35 mA
 Advantages
1. Relatively cheap and require little maintenance
2. Being light in weight, are easy to transport
Disadvantage
3. Because of low output, these machines are of
limited value in radiographic examination of
limbs above carpus and tarsus in large animals
4. Low mA range of such machines necessitates
longer exposure times
 Mobile x-ray machines
• Transformer is larger to permit higher output
• Can not be transported easily
• Rotating anode
• The output varies from 90-125 kV and 40-300
mA
 Fixed x-ray machines
• These units are usually installed in a room
• Large transformers/greater output
• The output vary from 120-300 kV and 300-
1000 mA
 Advantages
• Suitable for all types of radiographic
examinations in case of small and large animals
• Exposure time is less, because of high KV and
mA output
Disadvantages
• Because of higher KV output, more scatter
radiation occurs
• Expensive to purchase and 3 phase electricity is
required for installation of the machine
 X-RAY ACCESSORIES
• LEAD APRONS AND GLOVES
• COLLIMATORS
• ALUMINUM FILTER
• GRID
• CASSETTES (FILM HOLDERS)
• X-RAY FILMS
• X-RAY FILM HANGERS
• CASSETTE HOLDERS AND
BLOCKS
• LEAD/FILM MARKERS
• ILLUMINATOR OR VIEWERS
• X-RAY FILM DRIERS
 Collimators
• Collimators restrict the x-ray beam to a confined
region
• Collimators are located outside the tube housing

Collimator
 Collimator
• The beam restricting device may be fixed as a
cone, cylinder or diaphragm
• The better collimators have adjustable shutters
 Collimator
• Some collimators
have a light which
will show the area of
exposure and allow
for accurate
collimation to the area
of interest
 Collimators
• Collimation of the x-ray beam will reduce patient
exposure by limiting the area of radiation
• Collimators will improve image quality (better contrast)
by reducing scatter radiation
 Grids
• Grids are devices that are used to prevent
scatter radiation from reaching the film
• Scatter radiation decreases film quality by
reducing image contrast
 Grids
• Scatter radiation is the result of interactions of
x-rays with matter
• The thicker the body part the more scatter
radiation
• Any tissue greater than 10 cm should be
imaged using a grid
 Grids
• Grids are composed
of hundreds of
alternating lead
strips
Primary radiation will
travel in straight lines
and will pass through the
grid interspaces
Scatter radiation will be
deflected in other directions
and the lead strips will prevent
them from reaching the film
 Types of Grids
• Parallel grids – these grid has
a parallel alignment of the lead
strips
• Focused grids – these grids
have the lead strips aligned to
the divergent pattern of the x-
ray beam
 Types of Grids
• Cross Hatched Grids
are composed to two
parallel grids posited
90° to each other
 Grids
• Scatter radiation degrades image quality but
does contribute to the degree of exposure of the
film
• If scatter is removed by the grid then more
radiation is needed to adequately expose the
film
• Since more radiation is needed (quantity not
quality), radiographic technique is modified
when using a grid by increasing the mAs
 Grids
• The needed increase in mAs is dependent on
the grid ratio

Grid Ratio Increase in mAs

5:1 2x
8:1 3x
12:1 4x
 Grids
• Grids are usually mounted under the x-ray
table and are purchased as part of the x-ray
machine
– Low output machines (<300 mA) will typically
have 5:1 grids
– High output machines (>700 mA) will typically
have 12:1 grids
• Some cassettes have grids incorporated into
their design
• Grid caps are devices that attach to a regular
cassette
 Grids
• Stationary gird –
– does not move during exposure
– Grid lines are visible on radiograph
 Grids
• Moving Grid – Potter-Bucky diaphragm
– Also know as a Bucky grid
– The grids moves during exposure this
blurring the grid lines making them invisible
– Oscillating grids can scare veterinary
patients causing them to move at the time of
exposure