Lecture 2

Radiography
Outline
Prof. Defeng Wang

Department of Imaging and Interventional Radiology
The Chinese University of Hong Kong
I. Introduction
II. Basic Physics of X-ray
III. Radiography Equipment
Email: dfwang@cuhk.edu.hk
IV. Image Quality

V. Mode of Radiography & Application
VI. Biologic Effects & Safety
1
louwutao@gmail.com
2
louwutao@gmail.com
I. Introduction
X-rays discovery by Wilhelm Roentgen in 1895
Roentgen: Nobel laureate in physics (1901)
70% of the medical imaging are based on X-ray
One of the major diagnostic tools in medicine
From
Cathode
rays to X-ray
Wilhelm Conrad Rntgen
louwutao@gmail.com
4
louwutao@gmail.com
Characteristics of X-ray
Physical effects
Penetrating high energy
Fluoroscopy emit visible light
Ionizing
Chemical effects
Perceiving light AgBr.
Change the color of certain material, like lead glass,
crystals
Biological effects
Direct & indirect
First Publication
First Image
X: Mysterious
5
louwutao@gmail.com
6
louwutao@gmail.com
Outline
I. Introduction
Basic Physics of X-ray
1. Physics of X-ray
2. Generation of X-ray
3. X-ray interaction with matter
IV. Image Quality
4. Quantifying interactions

7
louwutao@gmail.com
8
louwutao@gmail.com
1. What are X-rays?

Electromagnetic radiation emitted by charged particles
Photons which can penetrate through matter
Have no mass or charge
Travel at the speed of light
Energy = h = hc/
9
louwutao@gmail.com
10
louwutao@gmail.com
Bremsstrahlung
X-ray production efficiency of bremsstrahlung is influenced by the
target atomic number (Z) and acceleration potential (kVp)
2. Generation of X-ray
X-rays are generated when high energetic electrons interact
with matter
Example:
Diagnostic:100-keV electrons impinging tungsten (Z = 74)
X-ray production ~ 0.7%
Therapeutic: 6-MeV electrons, tungsten target
X-ray production ~ 44%
Happened in X-Ray tube

Cathode current releases electrons by thermal excitation
Bremsstrahlung ( braking radiation)
yields a continuous X-ray spectrum
Characteristic radiation
yields characteristic peaks
11
louwutao@gmail.com
12
louwutao@gmail.com
Characteristic radiation
Bremsstrahlung & Characteristic radiation
when an electron from the high energy shell (e.g., Lshell with energy EL) drops into the low energy shell
(e.g., K-shell with energy EK), a photon of energy
E = EL EK will be emitted
13
louwutao@gmail.com
Intensity distribution in the Rntgen spectrum of molybdenum for different voltages. The
excitation potential of the K-series is 20.1 kV. This series appears as characteristic peaks in the
25 kV curve. The peaks K and K are due to L-shell and M-shell drops respectively.
14
louwutao@gmail.com
X-Ray Tube
Energy of X-ray
How does a X-ray tube work?

frequency
speed of light
(in vacuum)
wavelength
Plancks constant
15
louwutao@gmail.com
16
louwutao@gmail.com

Photoelectric Effect
3. X-ray interaction with matter
Interaction of incident photon with inner shell electron

Results in a photoelectron and characteristic x-ray
Photoelectric Effect (PE)

Compton Scattering
Pair Production
Rayleigh scattering
These four major interactions are of importance to
diagnostic radiology and nuclear medicine
17
louwutao@gmail.com
18
louwutao@gmail.com

Compton Scattering
About Photoelectric Effect
Interaction of incident photon and outer shell electron
Proportional to
Z3/E3
Results in ionization of the atom, a scattered photon,

and the ejected electron
E: photon energy
Z: atom number of the matter
E0= incident photon energy

Esc= scattered photon energy
Ee= ejected electron energy
e.g.,
mammogram
density
Z
fat
0.91
5.92
muscle
0.91
7.46
Proportional to 1/E
Major source of radiation scattering:
- Lower the quality of image;
- Needs better protection.
Muscle absorbs 2
times of X-ray than fat
(7.463/5.923)!
19
louwutao@gmail.com
20
louwutao@gmail.com
Pair Production
Rayleigh (Coherent) Scattering
Only occurs if incident photons energy exceeds 1.02 MeV
Incident photon interacts with and excites the total atom
Directly interaction with the nucleus
Occurs at very low energies (15 to 30 keV), increases in

probability with decreasing energy
Creating an electron-positron pair
(Detection of scattered photon has negative effect on image quality)
Proportional to E
21
louwutao@gmail.com
22
louwutao@gmail.com
Atom number of the matter Z
100
80
4. Quantifying interactions
Photoelectric
Effect
(PE)
Compton
Scattering
(CS)
40
Attenuation Coefficients-Linear and Mass
Pair
Production
(PP)
60
20
0.01 0.05 0.1
10
50 100
Photon energy MeV

1.
2.
3.
4.
louwutao@gmail.com
Probability of PE and CS are equal at 35keV

E = 0.8~4MeV, CS dominates
E > 5MeV, PP starts
For diagnosis, E = 10~150keV
E > 50MeV, PP dominates
23
24
louwutao@gmail.com

Attenuation Coefficients
Attenuation includes
is a function of both the

photon energy and the material,
that is, = (E, material)
I = Io e (- x)
Io
Absorption Photoelectric
(10 keV,H2O) = 5 cm1
Scattering Rayleith, Compton
(100 keV,H2O) = 0.17 cm1
(10 keV, Ca) = 144 cm1
I is the radiation intensity after traversing a thickness x

Io is the original radiation intensity
is the linear attenuation coefficient (cm-1)
x is the thickness of attenuating material (cm)
(100 keV, Ca) = 0.40 cm1.
25
louwutao@gmail.com
26
louwutao@gmail.com
Outline
Mass attenuation coefficient m (=/)

normalization of linear attenuation coefficient () for the
mass density of the attenuating medium ()
I. Introduction
m(10 keV,H2O) = 5 cm2/g

m(100 keV,H2O) = 0.17 cm2/g
IV. Image Quality
m(10 keV, Ca) = 93 cm2/g
m(100 keV, Ca) = 0.258 cm2/g.
27
louwutao@gmail.com
28
louwutao@gmail.com
Equipment
Equipment
1. Components
1. Components
1.1 X-ray tube
2. Digital Radiography System
1.2 X-ray tube controls

1.3 Radiographic tables
1.4 Collimator
1.5 Control console
1.6 Image receptors
29
louwutao@gmail.com
30
louwutao@gmail.com
Equipment
Equipment
1.1 The X-ray Tube
1.1 The X-ray Tube

X-rays are produced in a cathode ray tube
They are produced from a series of energy conversions
Has a positive (anode) and

negative (cathode) electrode.
The cathode (filament) serves as
the source of electrons
High voltage is applied (kV) to
accelerate the electrons across
the tube
The anode (target) stops the
electrons suddenly which results
in the production of x-rays
31
louwutao@gmail.com
32
louwutao@gmail.com
Equipment
Equipment
1.1 The X-ray Tube
Tube housing protects the patient

and operator from radiation
emanating in all directions.
The collimator decreases or
increases the size of the x-ray
field (inc or dec exposure.)
Longitudinal lock - locks tube into

position along the length of the table
Transverse lock-locks tube into
position across the width of the table
Vertical lock-locks tube vertically to
set the SID*
Collimator controls
*SID is the distance

between the source (anode)
and the image receptor (IR)
33
louwutao@gmail.com
34
louwutao@gmail.com
Equipment
Equipment

Detent lock: locks the tube into the center of the bucky tray
(where IR is) transversely.
The table is designed to support the

patient in a position that enhances the
radiographic examination
Tube angulation lock: allows angulation of the tube cephalad

(towards the head) and caudad (towards the feet)
The table must be uniformly radiolucent

(allows x-rays to easily pass through)
Tube angle indicator: indicates the degrees of tube angulation
It must be easily cleaned.

It must be hard to scratch.
Some tables are stationary (ie. They
dont move)
35
louwutao@gmail.com
It is not
designed for
comfort!
36
louwutao@gmail.com
Equipment
Equipment
1.5 Collimator
Bucky tray in the table is to hold image receptors (IR) and a

radiographic grid
Attaches directly below the x-ray tube

Serves as a x-ray beam limiting device
Control the size and shape of x-ray field
As field size increases,

intensity of scatter radiation
also increases rapidly.
Especially during
fluoroscopy
37
louwutao@gmail.com
38
louwutao@gmail.com
Equipment
Equipment
1.6 Control console
1.7 Image receptors
The control console is device that allows the technologist to set

technical factors (mAs & kVp) and to make an exposure.
film cassettes
CR (computerized radiography) imaging plates (IP).
photostimulable phosphor
kVp
The Higher kVp more penetrating
Ranges is 50 -110 in Diagnostic x-ray
mA is the current in combination with the
time
Determines HOW LONG the beam will
stay on
Controls the density on the film/image
Digital flat detector
39
louwutao@gmail.com
40
louwutao@gmail.com
Equipment
Digital Radiography Equipment
2. Digital Radiography System

DR is cassetteless
In DR detectors, the materials used for detecting the x-ray
signal and the sensors are permanently enclosed inside a rigid
protective housing
Thin-film transistor (TFT) detector arrays may be used in both
direct- and indirect-conversion detectors
41
louwutao@gmail.com
42
louwutao@gmail.com
Equipment
Outline
Direct conversion
x-ray photons are absorbed by
the coating material and
immediately converted into an
electrical signal.
I. Introduction
Indirect conversion
IV. Image Quality
Indirect conversion is a two-step

process: x-ray photons are
converted to light, and then the
light photons are converted to an
electrical signal.

43
louwutao@gmail.com
44
louwutao@gmail.com
Image quality
Image quality
1. Image quality characteristics
1.1 Contrast resolution
1. Characteristics
1.2 Spatial resolution
2. Quantitative Measurements
1.3 Image noise

1.4 Uniformity/Artifacts
45
louwutao@gmail.com
46
louwutao@gmail.com
Image quality
Image quality
Contrast of Image
1.1 Contrast
Determined by tissue contrast + imaging condition
the ability of distinguishing

between similar tissues, e.g.
liver vs. spleen
Tissues contrast: atomic number (Z), mass density, etc

Lead (atomic number 82, 11340 kg per cubic meter)
Oxygen (atomic number 8, 1.492kg per cubic meter)
high contrast presented as white

and black on a radiograph
Imaging condition: scatter radiation, kV, mA, dynamic range,

etc
Plain film radiography have

lower contrast resolution than
CT
Scatter increased noise increased, contrast decreased

kV increased contrast decreased
Larger dynamic range less contrast
mA increased contrast increased
47
louwutao@gmail.com
48
louwutao@gmail.com
Image quality
Image quality
Example:
Example:
Scatter increased
mA decreased
noise increased, contrast decreased
noise increased, contrast decreased
49
louwutao@gmail.com
50
louwutao@gmail.com
Image quality
Image quality
1.2 Spatial Resolution

The ability to faithfully reproduce small objects under
sufficient subject contrast (contrast resolution)
Described subjectively by the degree of blurring
System of higher spatial resolution can distinguish
objects with higher spatial frequency
Line pair phantoms
Higher resolution in
system blue
51
louwutao@gmail.com
52
louwutao@gmail.com
Image quality
Image quality
Spatial Resolution of Image

1.3 Image Noise
Determined by
Noise is the random (stochastic)

component in the image
Reconstruction
Smaller pixel size, smaller FOV, larger matrix size
higher resolution
Radiographic noise = random

fluctuation on the optical density of
the image
Devices
Smaller detector size higher resolution
Smaller tube focal spot size higher resolution
Narrower predetector collimation higher resolution
53
louwutao@gmail.com
54
louwutao@gmail.com
Image quality
Image quality
Example:
1.3 Image Noise
noise affect contrast resolution
Determinators:
Scatter radiation noise
mA noise
pixel size noise
Considering patient safety:

Children high kV, low mAs
Mammography low kV, high mAs
55
louwutao@gmail.com
56
louwutao@gmail.com
Image quality
Image quality
1.4 Artifacts
Causes of artifact in X-ray
Any irregularity on an image which is not caused by

proper shadowing of tissue by the primary x-ray beam
Scratches in the detector

dead pixels
unread scan lines
inhomogeneous X-ray beam intensity
afterglow
57
louwutao@gmail.com
58
louwutao@gmail.com
Image quality
Image quality
But sometimes mimic a foreign object
Exposure artifacts caused by patients motion during

exposure
59
louwutao@gmail.com
60
louwutao@gmail.com
Image quality
Image quality
2.1 Modulation Transfer Function (MTF)
2. Quantitative Measurements
Point spread function (PSF): describing the

spot distribution of a point (light source) on a
image by a imaging system

2.2 Signal-to-Noise Ratio (SNR)
2.3 Detective Quantum Efficiency (DQE)
Point
(light source)
Points spot
on image
Ideal imaging system real imaging system
61
louwutao@gmail.com
62
louwutao@gmail.com
Image quality
Image quality
The Fourier transform (FT): converting intensity

distance relationship into intensity - 1/distance
(spatial frequency) relationship
Smaller object, higher spatial frequency, lower MTF;

As MTF value is reduced, image blur increases;
MTF = 1.0: absolutely perfect image;
The FT of a PSF results in the MTF
Usually, the spatial frequency at the .1 (10%) MTF is

identified as the limiting resolution of the system
63
louwutao@gmail.com
64
louwutao@gmail.com
Image quality
Image quality
2.3 Detective Quantum Efficiency (DQE)
2.2 Signal-to-Noise Ratio (SNR)
MTF mainly reflect signal, DQE mainly reflect

signal-to-noise performance
SNR is the inverse of the relative noise;

signal (N) increases, the SNR increases
SNR = N
=N
( SNRout )
DQE =
2
( SNRin )
= N
photon-detecting process is essentially a Poisson

process (the variance is equal to the mean)
65
louwutao@gmail.com
66
louwutao@gmail.com
Outline
Mode of Radiography and Application

1. Routine examination
I. Introduction
Fluoroscopy
Plain film radiography
2. Special examination
IV. Image Quality
Mammography
3. Contrast media examination

67
louwutao@gmail.com
68
louwutao@gmail.com

1.1 Fluoroscopy
1.1 Fluoroscopy
Old fluoroscopy imaging chain
dynamic motion of internal

structures in real time
Specialized x-ray tube
Image receptor
Fluoroscopic screen
Mirrors
Image intensification
Video camera and monitor
69
louwutao@gmail.com
70
louwutao@gmail.com

1.1 Fluoroscopy
Image intensifier
New fluoroscopy imaging chain
71
louwutao@gmail.com
72
louwutao@gmail.com

1.2 Plain film radiography
Plain film radiographs display
the shadow of the body part
on the film.
Fluoroscopy application
Used to visualize motion of
internal fluid and structures
an important tool for the

diagnosis of many disorders
GI tract studies
Angiograms
Orthopedics surgery
73
louwutao@gmail.com
The X-rays are absorbed by

the material they pass
through in differing amounts
depending on
the density and composition
of the material.
74
louwutao@gmail.com
Plain film radiography application
2. Mammography
A mammography machine is an X-ray machine dedicated to
breast imaging.
Chest
Abdomen
Mammograms are obtained with much lower energy X-rays
Spine
Soft X-ray
Extremities & Joints
30~45 kV; E=17~19keV
Skull
Plain film radiographys

application in different
organ/system
louwutao@gmail.com
75
76
louwutao@gmail.com
Mammography
Contrast is chemical substance which is introduced in human
body via enteral/parenteral route to visualize certain structures
not seen in plain radiography.
Types of contrast
Positive- produce opaque image, e.g. barium sulphate, iodine
containing contrasts such as urografin, omnipaque, iopamiro.
Negative- produce radiolucent image, e.g. air.
77
louwutao@gmail.com
78
louwutao@gmail.com
3. Contrast media examination application
Routes of contrast
System related contrast studies
Enteral contrast is given by oral route.
GIT
Anal orifice contrast study is called barium

enema/gastrografin enema
Barium swallow
Barium meal
Intravenous.
Barium enema
Intraarterial.
hepatobiliary system
External opening on body surface study is called sinogram /

fistulogram/loopogram
Urinogenital system
Breast
mammary ductography
79
louwutao@gmail.com
80
louwutao@gmail.com

Contrast media examination
Ulcer
Barium meal examination: radiographs of the oesophagus are taken

after barium sulfate is swallowed by a patient
Barium meal
81
louwutao@gmail.com
82
louwutao@gmail.com

ovarian
duct
mammary
duct
Intravenous urography (IVU): the contrast is injected into a vein ('intravenous'

injection), travels in the bloodstream, concentrates in the kidneys, and is passed
out into the ureters with urine made by the kidneys. The structure of the kidneys,
83
ureters and bladder shows up clearly as white on X-ray pictures
louwutao@gmail.com
hysterosalpingography
mammary ductography
84
louwutao@gmail.com
Outline
Biologic Effects & Safety

I. Introduction
1. Direct and indirect
2. Different dose and tissues
3. Types of effect
IV. Image Quality
4. Quantification
5. Principles of Radiation Safety
85
louwutao@gmail.com
86
louwutao@gmail.com
1. Direct and indirect biologic effects

Direct effect
Radiolysis of DNA
dissociation of molecules by
nuclear radiation
Indirect Effect
Free radicals by radiolysis of water.
2H20
H2O+ + H20-
H2O+
OH. + H+
Hydroxyl radicals react with other molecules (such as DNA)

damaging them.
87
louwutao@gmail.com
88
louwutao@gmail.com
2.1 Effects by different dose
2.2 Effect on different tissue
At lower doses cells are able to repair damage

without cell death (shoulder region)
Tissue Type (Law of Bergonne and Tribondeau)

Rapidly dividing tissue is more radiosensitive
Rapidly growing cells are more radiosensitive
Younger and more immature cells are more radiosensitive
Mature cells are less radiosensitive
Dividing cells are more sensitive in G2 and G1 parts of the
cell cycle
89
louwutao@gmail.com
90
louwutao@gmail.com
3. Types of biologic effect on humans

Stochastic effects
Threshold after which there is an all or nothing effect
e.g. Cancer or genetic effects
Deterministic Effects
Vary with Dose
e.g. lens opacification, blood changes
Total body irradiation
Highly unlikely that an individual would survive a total exposure of
more than 3 Gray without intensive medical treatment
Partial body irradiation
Cataracts are formed if eyes are exposed to more than 2 Gray
Hair loss occurs at exposures over 3 Gray
91
louwutao@gmail.com
92
louwutao@gmail.com
4.1 Units of Radiation Exposure and Dose
4.1 Units of Radiation Exposure and Dose

Dose Equivalence (Sievert)-- Relative biological
effectiveness of different types of ionizing radiation
Absorbed dose (Gray)

Dose absorbed by the 1 kg irradiated material with 1 joule of
energy.
Dose is multiplied by a radiation weighting factor

(WR)
Therefore the absorbed dose is a useful measure and is

applicable to any type or energy of ionizing radiation
Dose Equivalence = D x WR
93
louwutao@gmail.com
94
louwutao@gmail.com
4.2 Dose limit (ICRP Prescribed Limits per annum)

Members of public
5. Principles of Radiation Safety:
1 mSv per annum above background
Minimise Exposure Time
5 mSv to eye
Maximise Distance from Source
20 mSv to hands
Use Correct Shielding
Radiation workers
20 mSv per annum above background
Follow Manufacturers Instructions
150 mSv to eye
Keep dosage As Low As Reasonably Achievable
500 mSv to hands
Pregnant women must receive no more than 2mSv

per annum
95
louwutao@gmail.com
96
louwutao@gmail.com

Lecture 2

Hochgeladen von

Dokumentinformationen

Originaltitel

Copyright

Verfügbare Formate

Dieses Dokument teilen

Dokument teilen oder einbetten

Freigabeoptionen

Stufen Sie dieses Dokument als nützlich ein?

Sind diese Inhalte unangemessen?

Copyright:

Verfügbare Formate

Lecture 2

Hochgeladen von

Copyright:

Verfügbare Formate

Radiography

Prof. Defeng Wang

IV. Image Quality

II. Basic Physics of X-ray

Basic Physics of X-ray

II. Basic Physics of X-ray

III. Radiography Equipment

IV. Image Quality

V. Mode of Radiography & Application

II. Basic Physics of X-ray

II. Basic Physics of X-ray

1. What are X-rays?

II. Basic Physics of X-ray

Happened in X-Ray tube

Bremsstrahlung & Characteristic radiation

How does a X-ray tube work?

II. Basic Physics of X-ray

II. Basic Physics of X-ray

3. X-ray interaction with matter

Interaction of incident photon with inner shell electron

Photoelectric Effect (PE)

II. Basic Physics of X-ray

About Photoelectric Effect

Interaction of incident photon and outer shell electron

Results in ionization of the atom, a scattered photon,

E0= incident photon energy

II. Basic Physics of X-ray

II. Basic Physics of X-ray

Rayleigh (Coherent) Scattering

Only occurs if incident photons energy exceeds 1.02 MeV

Incident photon interacts with and excites the total atom

Directly interaction with the nucleus

Occurs at very low energies (15 to 30 keV), increases in

Creating an electron-positron pair

(Detection of scattered photon has negative effect on image quality)

Atom number of the matter Z

II. Basic Physics of X-ray

Attenuation Coefficients-Linear and Mass

0.01 0.05 0.1

Photon energy MeV

Probability of PE and CS are equal at 35keV

II. Basic Physics of X-ray

is a function of both the

Scattering Rayleith, Compton

(100 keV,H2O) = 0.17 cm1

(10 keV, Ca) = 144 cm1

I is the radiation intensity after traversing a thickness x

(100 keV, Ca) = 0.40 cm1.

Mass attenuation coefficient m (=/)

m(10 keV,H2O) = 5 cm2/g

IV. Image Quality

m(10 keV, Ca) = 93 cm2/g

V. Mode of Radiography & Application

m(100 keV, Ca) = 0.258 cm2/g.

VI. Biologic Effects & Safety

1.1 X-ray tube

2. Digital Radiography System

1.2 X-ray tube controls

1.1 The X-ray Tube

Has a positive (anode) and

1.1 The X-ray Tube

1.2 X-ray tube controls

Tube housing protects the patient