Chapter 1 Book Notes

Nature of our surrouding

  • matter is anything that occupies space and has mass

  • all matter is composed of fundamental building blocks called atoms

  • mass and weight are NOT the same

  • mass is described by its energy equivalence

  • weight is force exerted on a body under the influence of gravity

Matter and Energy

  • matter is anything that occupies space

  • fundamental complex building blocks of matter are atoms and molecules

  • the prefix kilo stands for 1000

  • a kilogram(kg) is equal to 1000 grams(g)

  • mass remains uncharged regardless of its state it can be transformed from one shape, size, and form to another

  • energy can exist in several forms

  • in the SI energy is measured in joules(j)

  • In X-ray energy is measured in electron volt (eV)

  • potential energy is the ability to do work by virtue of position (the “potential” to move)

  • kinetic energy is energy in motion

  • chemical energy is energy released by a chemical reaction

  • electrical energy is work that can be done when an electron moves through an electron potential difference (voltage)

  • thermal energy is energy of motion at the molecular level .. the kinetic energy of molecules

  • nuclear energy that is contained w/in the nucleus of the atom

  • electromagnetic energy least familiar form of energy .. most important .. type of energy used in x-ray imaging

  • electromagnetic energy includes radiowaves, microwaves, ultraviolet, infrared, and visible light .. does not include sound or diagnostic ultrasound

  • frequently matter and energy exist side-by-side

  • matter and energy are interchangeable

  • energy emitted and transferred through space is called radiation

  • matter that intercepts radiation and absorbs part or all of it is said to be exposed or irradiation

  • ionizing radiation is a special type of radiation that includes x-rays

  • ionizing radiation is any type of radiation that is capable of removing an orbital electron from the atom with which it interacts

  • this type of interaction between radiation and matter is called ionization

  • ionization occurs when an x-ray passes close to an orbital electron of an atom and transfers sufficient energy to the electron to remove it from the atom

  • the orbital electron and the atom from which it was separated are called an ion pair

Sources of ionizing radiation

  • many types of radiation are harmless, but ionizing radiation can injure humans

  • can be divided into 2 main categories .. natural environmental radiation .. man-made radiation

  • natural radiation results in an annual does of approx. 3 millisieverts (mSv)

  • made by human radiation results in 3.1 mSv annually

  • the mSv is the SI unit of effective dose

  • natural environmental consists of four .. cosmic rays .. terrestrial radiation .. internally deposited radionuclides .. radon

  • cosmic rays are particulate and electromagnetic radiation emitted by the sun and stars

  • terrestrial radiation results from deposits of uranium, throium, and other radionuclides in the earth

  • largest source of natural radiation is radon

  • radon is a radioactive gas that is produced by the natural radioactive decay of uranium

  • radon emits alpha particles which are not penetrating and therefore only contribute to the radiation dose of the lung

  • these sources result in approx. 300-1000 microsieverts at waist level

  • diagnostic x-rays constitute the largest man-made source of ionizing radiation

  • other sources include ( man-made) nuclear power generation, research applications, industrial sources, and consumer items

Discovery of X-rays

  • during the 1870s and 1880s many university physics labs were investigating the construction of cathode rays through a glass tube known as the Crooks tube

  • Sir William crooks is who the tube is named after

  • the tube was the forerunner of modern fluorescent lamps and x-rays tubes

  • November 8th 1895, wilhelm roentgen was experimenting w/ a type of crooks tube when he discovered x-rays

  • a plate coasted w/ barium platinocyanide glowed while he was experimenting w/ the fully covered crooks tube

  • “x” is x-ray stands for the unknown

  • roentgen reported his findings before the end of 1895

  • the first medical image was of his wife hand in 1896

Development of medical imaging

  • there are 3 general types of x-ray exams .. radiography .. fluoroscopy .. computed tomography (CT)

  • x-ray voltages are measured in kilovolt peak (kVp) .. one kV = 1000v of electric potential

  • x-ray currents are measured in milliamperage (mA) where the ampere (A) is a measure of electric current

  • prefix milli = 1/1000 or 0.001

  • early radiographic procedures often required exposure times of 30mins

  • one development that helped reduce the exposure the exposure time was the use of a fluorescent intensifying screen in conjunction with the glass photographic plates

  • Michael pupin is said to have demonstrated the use of a radiographic intensifying screen in 1896

  • the demonstration of double-emulsion radiography was conducted in 1904 but did not become commercially available until 1918

  • much of the glass used in radiography came from Belgium and other European countries. this was interrupted during WW1 therefore rads began to make use of film rather than glass plates

  • the fluoroscope was developed in 1898 by thomas a, eddison

  • eddison abandoned his x-ray research when his assistant and long-time friend Clarence Dally experienced a severe x-ray burn that eventually required amputation of both arms .. dally died in 1904 and is counted as the first x-ray fatality

  • a boston dentist William rollins introduced two devices designed to reduce the exposure time of pts. to the x-rays and thereby reduce the possibility of x-ray burn before the turn of the 20th century

  • rollins found that restricting the x-ray beam with a sheet of lead w/ a hole in the center (a diaphragm) and inserting a leather or aluminum filter improved the diagnostic quality of radiographs

  • in 1907 H.C. Snook introduced a substitute high-voltage power supply, an interrupts transformer

  • it was not until the intro of the coolidge tube that the snook transformer was widely adopted

  • William d. coolidge unveiled his hot-cathode x-ray tube to the medical community in 1913

  • the hot-cathode tube was a vacuum tube that allowed x-ray intensity and energy to be selected separately & w/ great accuracy

  • x-ray tubes In use today are refinements of the coolidge tube

  • in 1913 gustav bucky invented the stationary grid … 2 months later he applied for a patent for a moving grid

  • in 1915 H. Potter also invented a moving grid

  • potter recognized bucky’s work and the potter-bucky grid was introduced in 1921

  • in 1946 the light amplifier tube was demonstrated at the bell telephone lab .. it was adapted by 1950 as image intensifer tube

  • diagnostic ultrasonography appeared in the 1960s

  • position emission tomography and x-ray CT were developed in the 1970s

  • MRI became an accepted modality in the 1980s and currently digital radiography and digital fluoroscopy are rapidly replacing screen-film radiography and image intensified fluoroscopy

Reports of Radiation Injury

  • the first x-ray fatality in the US occurred in 1904

  • these injuries usually took form of skin damage (sometimes severe), loss of hair, and anemia

  • physicians and more commonly pts. were injured primarily because the low energy of radiation then available resulted in the necessity for long exposure time to obtain acceptable images

  • by 1910 these acute injuries began to be controlled as the biological effects of xrays were scientifically investigated and reported

  • with the introduction of the coolidge tube and the snook transformer the frequency of reports of injuries to superficial tissues decreased

  • years later It was discovered that blood disorders such as aplastic anemia and leukemia were occurring in radiologists at a much higher rate than in others

Basic radiation protection

  • lead impregnated material is used to make aprons and gloves worn by radiologists and radiologic technologists during fluoroscopy and some radiographic procedures

  • gonadal shielding should be used with all persons of childbearing age or younger when the gonads are in or near the useful x-ray beam and when use of shielding will not interfere with the diagnostic value of exam

  • the radiographic or CT control console is always located behind a protective barrier

  • the barrier is lead lined and is equipped with a leaded-glass window

  • pts who require assistance during examinations should never be held by x-ray personnel .. medical immobilization devices should be used

  • metal filters usually copper or aluminum are inserted into the x-ray tube housing so that low energy xrays are absorbed before they reach the pt.

  • collimation restricts the useful x-ray beam to that part of the body to be imaged and thereby spares adjacent tissue from unnecessary radiation exposure

Terminology for radiologic science

  • two units .. mA and kVp .. by writing 70 kVp instead of 70,000 volt peak

  • in 1981 the international commission on radiation units and measurements issued standard units based on SI that have been since adopted by all countries except the US

  • the NCRP and all US scientific medical societies adopted the SI units by the early 1990s

  • it was not until 2017 that the ARRT adopted SI in their examination process

  • Air kerma is the kinetic energy transferred from photons to electrons during ionization and excitstion

  • air kerma is measured in joules per kilogram (J/kg) where 1 J/kg is 1 gray (Gya)

  • absorbed dose is the radiation energy absorbed per unit mall and has units of J/kg or Gyt

  • the units Gya and Gyt refer to radiation dose in air and tissue

  • occupational radiation monitoring devices are analyzed in terms of sievert which is used to express the quantity of radiation received by radiation workers and populations

  • some types of radiation produce more damage than xrays

  • the becquerel is the unit of quantity of radioactive material, not the radiation emitted by the material

  • one becquerel is the quantity of radioactivity in which a nucleus disintegrated every second

  • radioactivity and the becquerel have nothing to do with xrays