X-Ray

In a nutshell

What is X-ray?

Made of photons

Travels at speed of light Travels in a straight line

Has neither mass nor charge X-ray beam has a mix of energies

Maximum energy in a beam = kVp Diagnostic X-ray range 20-150 kVp

What are X-rays?

The X-ray tube

The X-ray tube parts:

Cathode (-)

Filament made of tungsten Tungsten disc that turns on a rotor motor that turns the rotor Exit for the x-rays

Anode (+) target

Stator

Port

X-ray production

Push the rotor or prep button

Charges the filament causes thermionic emission (e- cloud) Begins rotating the anode.

Push the exposure or x-ray button

e-s move toward anode target to produce x-rays

Hitting the target

e-s hitting the target creates x-rays in two different ways:

Characteristic x-rays are due to the material the e-s hit (tungsten). Only occurs above 70 kVp Bremsstrahlung (braking) x-rays due to slowing down of e- beam.

Characteristic

Bremsstralung

Anode Heel Effect

Exposure Factors:

kVp kilovoltage peak mA miliamps (current) s seconds (duration of exposure) mAs product of mA and s

Exposure factors are set by radiographer

X-ray Quality vs. Quantity

Quality = penetrating power / energy Quantity = # of X-rays in beam kVp = speed of e- = quality kVp = efficiency of x-ray production = quantity mA = more e- hit target = quantity s = longer exposure time = quantity

Interactions in the Body:

Three things can happen to x-rays as they hit the body:

Absorption (photoelectric effect) x-ray is absorbed by tissues does not contribute to image. Scatter (Compton effect) contributes to fog Transmission penetrates through body to hit radiographic film.

Problem:

Only x-rays of sufficient energy (quality) can transmit through body to create an image. Low energy x-rays dont contribute to the image, but add to patient radiation dose. Also, different thicknesses, and composition of body parts will determine amount of x-ray penetration. Therefore we need to reduce low energy (low quality) x-rays, but at the same time have the right quantity of x-rays hitting the body part.

Filtration

We fix the problem with filtration Three kinds of filtration:

Inherent due to tube housing, insulation, etc. Added aluminum shielding that blocks low energy x-rays. Special used to image body parts that have varying thickness or density.

Filtration is measured in terms of half-value layer

Image Quality

Density

Controlling Factors:

mA and s mAs = quantity of photons reaching film = density

Density

Influencing factors:

kVp = quality (penetration) = density SID (source-image distance) = density

Due to inverse square law intensity of x-ray is inversely proportional to the square of the distance from source.

OID (object-image distance) = density Grids (discussed later) = grids density Film/screen speed = density body part thickness = density filtration = density

Image Quality

Contrast

contrast = short scale = more black and white (less detail) contrast = long scale = mores shades of grey (more detail)

Contrast

Controlling factor kVp

kVp = contrast (more shades of grey)

Contrast

Influencing factors:

Grid fog (scatter) = contrast Collimation narrow collimation = scatter = contrast Anatomic part variation in tissue density visible on film What are the 5 tissue densities?

Air, Fat, Water/Tissue, Bone, Metal

Recorded Detail

The sharpness of structural lines in the image

Geometric unsharpess Image receptor unsharpness Motion unsharpnesss

Geometric Unsharpness

SID = divergence of rays = unsharpness OID = divergence of rays = unsharpness

Penumbra = geometric unsharpness along the edges of the film.

Image receptor unsharpness

film/screen speed = detail = unsharpness

Motion Unsharpness

motion of patient, image receptor, or tube = unsharpness Prevention of motion unsharpness:

exposure time Patient instruction (i.e. hold breath) immobilization

Image Quality

Distortion

Size Distortion

OID = size distortion (magnification) SID = size distortion Occurs when anatomical part is not parallel to the image receptor (elongation or foreshortening) Reduced by proper patient positioning and/or tube tilt.

Shape distortion

Collimation

Is located under the port of the X-ray tube. Has a light in it for radiographer to see where x-rays would hit the patient Purpose- restricts beam

patient dose scatter (contrast)

Collimation should be visible on a minimum of three sides of the film

Grids

Part of the bucky that hold the film cassette Reduces scatter radiation that hits film Grid is made of lead strips

Grid ratio height/width of interspace

Hitting prep button causes grid to vibrate to blur out grid lines (doesnt show up on film)

Film

Photographic film has several layers:

Supercoat protective covering Emulsion is radiation and light sensitive

Made of silver halide and gelatin

Base plastic; for stability

Film is available in different speeds just like 35 mm camera film: the faster the speed, the less radiation is needed to produce an image.

Image formation

Latent image invisible image caused by light or radiation exposure Manifest image shows up after film is developed

Intensifying screen

Is located in the cassette that film is placed inside of. Screen contains phosphors that fluoresces when exposed to x-rays. Purpose screens amplify x-rays that hit the film so you need a lot less mAs to produce an image . Drawback lose some recorded detail Screens also come in different speeds i.e. the degree to which it fluoresces upon exposure.

Film Processing

May become obsolete as the industry moves to digital Steps of processing (automatic)

Developer converts latent image to manifest image (22 sec) Fixer acetic acid Wash- water removes residual chemicals Dry blow dryer in the processor

Radiation Dosimetry - definitions

Roentgen unit of radiation that will liberate a charge of 2.58 x10(-4) coulombs per kilogram of air. Coulomb unit of electrical charge RAD = radiation absorbed dose 1 rad is equal to the radiation necessary to deposit 100 ergs (unit of energy) in 1 gram of irradiated material

SI unit: 1 gray = 100 RAD

Radiation Dosimetry - definitions

REM rad equivalent man is the unit of absorbed dose equivalent; is a measure of the biological effect of radiation.

SI unit: 1 sievert = 100 REM

Radiosensitivity

Radiation damages DNA Tissues that are sensitive to radiation are:

High lymphocytes, spermatogonia, erythroblasts, intestinal crypt cells Intermediate- endothelial cells, osteoblasts, spermatids, fibroblasts Low muscle cells, nerve cells, chondrocytes.

Rule of thumb the cells that proliferate more are more sensitive