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stochastic effects
probability or frequency of the biologic response to radiation dose
non-threshold- any dose is damaging
usually a low dose of radiation exposure in a long period of time and a late response
long term: takes months or years
non-stochastic effects
aka deterministic effects
radiation response increases in severity with increasing radiation dose
has a threshold dose
usually a high dose of radiation exposure in a short period of time and an early response
short term: takes hours or days
non-threshold dose
there is no safe amount/dose of radiation
threshold dose
first evidence of biologic effects does not occur until a certain minimum dose is achieved- like sunburn
unobservable effects may occur
genetic effects
effect that is passed down genetically from person who was radiated
somatic effects
occurs only in the person who was radiated
factors that may influence the amount of effect from radiation
size of dose
rate of dose
part of body exposed
age of person
type of radiation involved
law of bergonie and tribondeau
the most radiosensitive cells are immature cells that are highly proliferative, have a high growth rate, and are poorly differentiated
younger the tissue the more sensitive
tissues with high metabolic rate have higher sensitivity
what are the cardinal principles of radiation saftey
time, distance, shielding
patient shielding
was used to shield reproductive regions but no longer used because they had caused too many retakes that resulted in more exposure
what does ALARA stand for
as low as reasonably achievable
primary barrier
wall that central ray is directed at
behind where bucky is
secondary barrier
barriers designed to protect from scatter and leakage
less thick than primary barrier, rarely require lead
what are two types of radiation monitoring devices
film badges and thermoluminescent dosimeters
maximum permissable dose (MPD)
doses below the MPD should not result in somatic or genetic effects
what is the MPD based on
a linear non-threshold dose response relationship
the more radiation, the more chance of ill effect
what is the whole body occupational MPD per year
5 REM/year
what is whole body occupational MPD for pregnant women
0.5 REM/year
what is whole body non-occupational MPD
0.1 REM/year
MPD for lens of eye
15 REM/year
MPD for skin
50 REM/year
new formula for calculating MPD
1 x patients age
linearity
different mA and time that result in same mAs
all images should look the exact same
reproducability
using the same settings on the console
images should be the exact same
what is the unit for intensity of x-rays in the air in classical
Roentgen (R)
what is the unit for absorbed dose in classical
RAD
what is the unit for occupational exposure in classical
REM
when should x-rays of a female be taken
0-10 days from the onset of menstruation
start of period to day 10 of cycle
conventional radiography
plain film x-ray
requires chemical processing narrow film latitude
what are two types of digital radiography
computed radiography
direct to digital radiography
computed radiography
uses a cassette and PSP plate
PSP plate is read and sent to computer
easier to update because it can fit older equipment better
direct to digital radiography
no cassette requited
images sent directly from machine to computer
able to do post processing
wider film latitude
what is the best way to reduce scatter
grid
when should you use a grid
with kVp over 60 and when body parts are over 10 cm
grid ratio
height of the lead strip divided by the interspace width
grid ratio relationships
higher grid ratio, less scatter
higher grid ratio, increased contrast
higher grid ratio, decreased density
higher grid ratio, more patient exposure
intensifying screens
used inside a conventional cassette and intensifies the light so you need less x-ray photons
contains rare earth elements/crystals
lowers patient dose
what are the geometric properties
magnification and penumbra
what affects magnification and penumbra
SID: decreased SID, more magnification vice versa
OID: increase OID, more magnification vice versa
what are photographic factors
density and contrast
what affects density
SID: shorter SID, more density
OID: shorter OID, more density
amount of scatter
mAs
what affects contrast
OID: longer OID, more contrast
amount of scatter
kVp
what is fog
gray on an image (scatter)
what is quantum mottle
graininess
what are the three interactions with matter
absorption, transmission, scatter
absorption
white or lightness on an image
photon disappears
transmission
black or darkness on an image
photon goes straight through and hits image receptor
scatter
shades of gray on image
photon changes energy and direction
what determines the type of interaction that occurs
the energy of the photon
what occurs at 0-10 kVp
classical scatter
does not contribute to image, photon just gets excited
what occurs at 10-60 kVp
photoelectric effect (absorption)
what occurs at 60-125 kVp
Compton scatter
what is the process of producing x-rays
electrons are boiled off at the cathode and are sent to the anode and create x-rays at the focal spot and then are delivered to the patient
what is the main controlling factor of density
mAs
what is the main controlling factor of contrast
kVp
what is the purpose of the developer when processing film x-rays
to convert exposed silver halide crystals to black metallic silver
what are the four basic steps of developing film
developing: produces visible image from latent image
fixing: removes remaining silver halide and hardens gelatin
washing: removes excess chemicals
drying: removes water and prepares image for viewing
where should digital x-rays be stored
PACs system
steps for CR
cassette with PSP plate loaded and exposure taken
cassette placed in CR reader for image to be read
scanner sends image to computer within 25-90 seconds and then erases PSP plate
how many images can be converted at a time using CR
one
steps for DDR
exposure taken
look at computer screen
how often should film badges be sent in
every month
how often should TLD badges be sent in
every three months
what parts of the x-ray machine are designed for protection
protective tube housing, control panel, SID, Collimation, beam alignment, filtration
what is the controlled area
where you take the x-rays
what is the maximum exposure rate for controlled area
less than 100 mR/year
what is the uncontrolled area
other areas in the office such as waiting rooms
what is the maximum exposure rate of uncontrolled area
less than 10 mR/year
when is it necessary to wear a dosometer
when you might receive 10% MPD
what should you do with the control badge
keep away from radiation area- place in a drawer or cabinet
measures background radiation and is sent back with other badges
direct effect
single or double DNA strand break
indirect effect
free radical is formed from a water molecule
effects of stochastic effect
leukemia
cancers: bone, lung, thyroid, breast
local tissue damage: skin, gonads, eyes
shortened life span
genetic damage
effects of deterministic effect
acute radiation syndrome: hemolytic, GI, CNS
local tissue damage: skin, gonads, extremities
hematologic depression
genetic damage
what can increase patient dose
high frequency grid ratio, increasing mAs, longer exposure time, larger field size, ect.