rad 101 quick review

Radiographer: administers ionizing radiation

ASRT- practice standards: includes clinical performance standards, quality performance standards, and professional performance standards

ARRT: ethics- code of ethics 10 statements(behavioral guide) and 22 rules of ethics

Hand hygiene!

Wear surgical mask if performing lumbar punctures

Rad tech must obtain patient clinical history

-verify correct procedure ordered

-observe any abnormality to report to radiologist

Involuntary motion- use shorter exposure time

Voluntary motion- explain procedure, make patient comfortable, use support devices, and if needed shorted exposure time

4 types of IRs

PSP plate used in CR

Cassette with film rarely used

Solid state digital detector- now used in DR

fluoroscopic image receptor

Technique charts should be in every room and on mobile machines, it should specify projections performed in room and exposure factors for each projection

Primary factors must be taken into account to establish correct foundation technique for each unit:

mAs

kVp

AEC

SID

Relative patient or partial thickness

Grid

CR/DR exposure indicators

IR or collimated field dimensions

Electrical supply characteristics

Gonad shielding : when gonads lie within 5cm from the primary x ray field despite proper beam limitation

And only do so if anatomy of image is not obstructed

IR positions : lengthwise, crosswise, and diagonal

Most used is lengthwise

(Name is based on the relation to the long axis of the body)

CR IS ALWAYS CENTERED TO IR (unless displacement is being used)

CR should be perpendicular to the part and IR to minimize distortion

Main reasons to angle the CR:

  • Prevent structures from overlapping

  • Make curved anatomy look straighter

  • Line up with tilted/angled joints

  • Reduce image distortion

SID affects magnification,spatial resolution, and patient dose

Longer SID reduces magnification

Exposure field must be restricted to only include anatomy of interest

Collimation minimizes patient exposure and reduces scatter radiation

Shuttering is aesthetics only, not trying to cover up over radiating a patient

R and L markers are mandatory

Shouldn’t obscure anatomy

Should be placed in exposure field placed outside of lead shielding

Each radiographer must evaluate each radiograph and determine: acceptability of image features, proper radiation safety practices, objectives have been met, presence of marker, proper collimation, patient identification,evidence of required shielding, absence of artifacts

Radiographs are viewed in anatomical position except for hands, wrists, feet, toes

Required on images: marker, date, patients name, and institution identity

BMI 30-39.9 is obese

Above 40 is morbidly obese

Pubic symphysis can be located on patient using jugular notch by height

<5ft: 21 inches

5ft-6ft: 22 inches

>6ft: 24 inches

High kVp= more scatter

More energetic X-rays create greater scatter within the patient's body, which can cause a "foggy" effect on the image

but higher kVp also reduces patient exposure and increases image quality

What higher kVp DOES improve

Penetration

Higher kVp gives x-rays more energy, so they pass through anatomy easier.

Benefits:

  • anatomy is penetrated better

  • fewer repeat exams

  • can see through thicker body parts

  • more grayscale visibility

So the image can look:

  • more “smooth”

  • more penetrated

  • less underexposed

What higher kVp DOES worsen

Scatter radiation

More energetic photons also:

  • bounce around more inside the patient

  • create more scatter

Scatter reaching the IR causes:

  • foggy appearance

  • lower contrast

  • loss of detail

So why use high kVp at all?

Because radiography is balancing:

  • penetration

  • contrast

  • patient dose

  • scatter

That’s why we use:
collimation
grids
proper exposure factors

to control the scatter created by higher kVp.

I need engraved into my head that the 3 major things affected by kVp is magnification, spatial resolution, and patient dose

Long SID= less size distortion

Collimation affect patient dose and scatter radiation