THE X-RAY TUBE

A device for generating x-rays by accelerating electrons to a high energy by an electrostatic field and
making them strike a metal target either in a tube containing a low-pressure gas or, as in modern tubes,
in a high vacuum x-ray tube. The target is made from a heavy metal, usually tungsten, and is backed
by a massive metal anode to conduct the heat away (see illustration showing a liquid-cooled copper
anode). The electron beam is produced by heating the cathode by means of a white-hot tungsten
filament. A transformer supplies the high voltage, often 100 kV, the tube acting as its own rectifier. On
the half-cycles when the target is negative nothing happens. When the target becomes positive, the
electrons bombarding it generate x-rays.

TWO MAIN PARTS OF X-RAY TUBE

• Cathode
• Anode

The Cathode Assembly

Cathode Assembly
• Consists of the filament, focusing cup, and associated wiring.

Filament
• A small coil of thin thoriated tungsten wire. The filament is where the electrons for the production
of x-Rays are emitted.

Focusing Cup
The filament is set centrally in a slot machined into a metal focusing cup:
the cathode cup.
The shape of the cup, along with electrostatic forces, prevents the electron
beam fanning out, concentrating it on the focal spot of the anode.
This design is called an electronic lens system with a resulting focal
spot width that depends upon:
• The diameter of the filament helix
• The length of the filament helix
• The width of the cathode cup slot
• The depth of the filament in the cathode cup slot
Cathode cups are typically manufactured from molybdenum, nickel or an iron alloy to ensure
dimensional stability during use when the assembly becomes hot.
A separate filament transformer in the high tension tank separates the primary low voltage side
from secondary high tension (HT) side of the transformer. The HT is connected to a common lead for
both filaments and the focusing cup. Both filaments and focusing cup make-up the cathode and have
negative polarity.
When the x-ray set is turned on the filament is supplied with a lower than operating current to
heat the filament and prepare it for the higher current needed during exposure. This produces a cloud
of electrons around the filament.
The electrostatic field limits the number of electrons produced at the filament, thereby limiting
the maximum tube current possible; this is called the "space charge effect". As the tube voltage
increases, the tube current increases up to a point when all the electrons in the space charge have
been used up and the tube is then said to have reached saturation current.

Space Charge Effect: As more and more electrons build up in the area of the filament, their negative
charges begin to oppose the emission of additional electrons. Saturation Current: As kVp increases, a
greater percentage of the thermionically emitted electrons are driven toward the anode.

The diagram on the left below shows a very basic wiring for a dual focus filament. The blue lines are
the wires for the small filament and are notoperating in this diagram, because the switch open for the
blue filament. The red lines are the wires for the large filament and the switch is closed for the red
filament.
The diagram on the right above shows the wiring for a dual filament tube. The autotransformer is where
you select the milliamps for the filament. The filament selector is where the different filaments are
selected.

The Anode Assembly

Anode Assembly: Consists of the anode, stator, and rotor. The anode is positively charged so that the
electrons from the filament (cathode) are attracted to it to produce x-rays. The rest of the anode
assembly is there so that the anode can rotate and have a bigger target for the electrons.

X- RAY TUBE

Stator: The stator is the stationary part of an electric motor or alternator. Depending on the
configuration of the motor the stator may act as the field magnet, interacting with the armature to create
motion. The stator consists of series of electromagnets equally spaced around the neck of the tube.

Rotor: The rotor is the non-stationary part of a rotary electric motor or alternator, which rotates because
the wires and magnetic field of the motor are arranged so that a torque is developed about the rotor's
axis.
Purpose of Anode:
1. serves as a target surface for the high-voltage electrons
2. conducts the high-voltage from the cathode back into the x-ray generator circuit
3. serves as the primary thermal conductor.

Stationary Anode: An anode assembly that is immobile. Rotating Anode: An anode assembly that
turns during exposure.

In the diagram below the left anode is a stationary anode because it does not move when an exposure
occurs. The anode on the right is a rotating anode because the anode rotates during an exposure.

The target (place where the electrons interact with the anode to produce x-rays) part of the anode is
made of tungsten or molybdenum.

Properties of Tungsten
• Proton (atomic) number 74 - the higher the proton number of the target the greater the amount
of the target the greater the amount of radiation that will be produced for a given tube voltage
and current.
• High melting point- tungsten's melting point of around 3400°C means it can withstand the high
temperatures involved without melting and with little distortion.
•
• Electrical conductivity - the anode is required to conduct the tube current.
• Thermal conductivity - the target needs to dissipate the large amounts of heat produced.

Molybdenum (42) is used for soft tissue imaging.

In the diagram below the construction of a rotating anode is shown. The base is made of graphite for a
solid base. The target (dual target for this example) is made of a tungsten-rhenium alloy. The parts
holding the target are made of molybdenum.
When the anode gets old or from miss use the target can get pock marked as shown below.

Anode Warm-up Procedure: Need to follow manufacture's recommendations.

Target Area
Target, focus, focal point, focal spot means the same thing. This is where the high- voltage electrons
hit the anode.

Actual focal spot: The physical area of the focal track that is impacted.

Focal Track: The portion of the anode where the high-voltage electron stream will impact. When
discussing a rotating anode this describes the circular path that will be impacted by the electron beam.

Effective focal spot: The area of the focal spot that is projected out of the tube toward the object being
radiographed.

In the diagram below there are two anodes with different size focal spots. The one on the left has a
larger actual focal spot than the one on the right. Because of the angle of the anode the effective focal
spot is also different for each anode.

The angle of the focal spot is one way to control the size of the effective focal spot. The larger the angle
the larger the effective focal spot, as illustrated in the next two diagrams.
Line-Focus Principle (Goetze principle): Used to reduce the effective area of the focal spot.

The effective focal-spot size is controlled by the size of the actual focal spot and the anode target angle.

The effective focal spot's vertical dimension is the one that is stated as the focal-spot size.

Anode Heel Effect

Anode Heel Effect: Due to the geometry of the angled anode target, the radiation intensity is greater
on the cathode side.

As the figure below indicates the intensity of the x-ray beam is greater towards the cathode (filament)
end of the tube,

The reason that the Heel Effect occurs is illustrated below. The letters represent interactions with
electrons from the cathode and the lines coming from the interactions are x-rays. More x-rays will be
able to get out of the anode on the right side (the angle side) than on the left side because of all the
material the x-rays must pass through to get out of the anode.
The picture next page shows what can happen to an anode when the anode stops turning. The anode
actually melts.

The Envelope
The envelope is the glass housing that protects the tube. It is also used to help protect from excessive
exposure to x-rays. The envelope is the first part of the filtration system.

Vacuum
The removal of the air permits electrons to flow from cathode to anode without encountering the gas
atoms of air.

Protective Housing
The housing controls leakage and scattered radiation, isolates the high voltages, and provides a means
to cool the tube.

Leakage Radiation: Any photons that escape from the housing except at the port.
Leakage radiation must not exceed 100 mR/hr at 1 meter.

Off-Focus Radiation: Photons that were not produced at the focal spot or extrafocal radiation. These
can be produced when an electron from the filament interacts with the tungsten. Then the electron that
was given off from the ionization does the same thing to another tungsten atom and creates another x-
ray.

The image below shows an extreme effect of off-focus radiation. You can see the image of the nose
from the off-focus radiation.

Rating Charts and Cooling Curves

Radiographic Tube Rating Chart: A guide regarding the most common technical factor combinations
that can be used without overloading the tube.

X-Ray Tube Heating

There are three main types of heat generation in an x-ray tube.

Convection: The transfer of thermal energy by actual physical movement from one location to another
of a substance in which thermal energy is stored. Also known as thermal convection. The air is what is
moving the heat energy around in the tube. If the tube has oil in it, then the oil is the convection material.

Conduction: The flow of thermal energy through a substance from a higher-to a lower-temperature
region. This is from the stator axel to the anode.

Radiation: The energy radiated by solids, liquids, and gases in the form of electromagnetic waves as
a result of their temperature. Also known as thermal radiation. This occurs when the electrons hit the
anode target and heat up the anode. The x-ray radiation is given off which heats up the tube.

Anode Cooling Charts: Permits the calculation of the time necessary for the anode to cool enough for
additional exposure to be taken
Heat Unit: a quantity related to the heat storage capacity of an X-ray tube.

INTRODUCTION
Diagnostic x-rays are produced in the target of the anode when high-energy projectile electrons are
rapidly decelerated. Diagnostic x-ray imaging equipment provides the means for practitioners to control
the quality and quantity of the x-ray beam. Consequently, it is important to understand the process of
x-ray production and the factors that influence the characteristics of the beam. Practitioners familiar
with the concepts and factors that influence quality and quantity are better able to control exposure
factors to produce optimal radiographic images while minimizing patient dose.

ELECTRON PRODUCTION

Four conditions are necessary for the production of diagnostic x-rays

• A source of free electrons
• A means to provide the electrons with high kinetic energy (motion) energy
• A method to concentrate the electrons into a beam
• A suitable material to rapidly decelerate the electrons

In the x-ray tube, the purpose of the filament is to provide the free electrons necessary for x-ray
production. As the rotor is activated the current passing through the filament heats to the point where
electrons boil off. This process is referred to as thermionic emission. At this point, a space charge
(cloud of electrons) forms around the filament. The focusing cup temporarily concentrates the free
electrons and helps form them into a beam.

When the exposure begins, the primary circuit closes and a high voltage is applied across the anode
(positively charged) and cathode (negatively charged). This causes electrons to stream towards the
anode at a high-rate speed. The potential energy for each electron is one kiloelectron volt (keV) of
energy for each kilovolt (kV) of. voltage set for the exposure. Electrons (sometimes called projectile
electrons) that travel from the cathode to anode make up the tube current.
TARGET INTERACTIONS

When the high-speed projectile electrons collide with the x-ray tube target they interact with the orbital
electrons or the nuclear field of the target atoms. Kinetic energy transferred from the projectile electrons
to the target atoms converts into heat or x-rays. When projectile electrons strike outer target shell
electrons it puts them in excited state and as a result, infrared (heat) radiation is emitted. Approximately
99% of the energy of projectile electrons converts into heat. Only about 1% of the energy converts into
x-ray photons. Two types of interaction produce x-ray photons bremsstrahlung interactions and
characteristic interactions.

Bremsstrahlung radiation
• To brake radiation or braking radiation. Continuous radiation.
• Occurs when projectile electrons pass by the outer shell of target
atoms and interact with the force field of the nucleus of the atom.
• Because of the nuclei are positively charged, there is a mutual
attraction between them.
• The nuclear force field causes the entering electron to slow down (or
brake) and change direction.
• The loss of kinetic energy that occurs when a projectile electron slows
down is emitted as an
• x-ray photon.
• These x-ray photons are known as bremsstrahlung photons or brems radiation
• In the diagnostic range, approximately 85% of x-ray emissions are the result of bremsstrahlung
interactions.

Characteristic interactions
• It occurs when projectile electrons interact with inner shell electrons of the target atoms.
• Recall that orbital electrons within an atom have a specific binding energy.
• The binding energy, based on the size of the atom and the shell in which the electron is located,
is the energy that would be required to remove the electron from the atom.
• Characteristic radiation is produced when projectile electrons with sufficient kinetic energy eject
an inner orbital electron.
• When this happens, the atom becomes unstable and temporarily
ionized because of the missing electron.
• An electron from an outer shell instantly fills and void created by the
missing electron and an x-ray photon is emitted.
• This process continues until the atom is stable. The energy of emitted
x-ray photon is equal to difference between the binding energy of the
two involved orbital electrons.
• The energy emitted is characteristic of the target element and the
involved shells.
 • Higher energy x-ray photons result with target materials of a higher proton number and
interactions that involve the ejection of inner shell electrons.
• The production of "characteristic" x-rays by electron bombardment of pure elements was first
observed in 1909 by Charles G. Barkla and C.A. Sadler.

Characteristics of the Cathode and the Anode

Cathode
• It is essential to have at least one filament for x-ray production; modern multipurpose x-ray tubes
are dual-focus (they contain two filaments)
• Each filament is situated in a hollow area in the cathode called a focusing cup (slight negative
charge).
• The shape of the focusing cup and its negative electric charge cause the electrons to be repelled
in the direction of a very precise area on the target called the focal spot.

Anode
• The vast majority of the energy of the electron stream is converted into heat.
• This energy conversion takes place at the target.
• Constructed to dissipate heat.
• Excellent material for x-ray tube targets because it has a very high melting point and it is efficient
at conducting heat away from the anode.
• Early x-ray tubes had and current dental tubes have a solid, stationary copper anode with a
slanted tungsten face.
• Modern tubes for radiography have a rotating anode.
• The rotating anode is in the form of a disk, with a beveled-edge target.

EMISSION SPECTRUM
The emission spectrum is a graphic representation of the number of x-rays plotted against the energy
of the radiation, which is measured in kiloelectron volts (keV). The emission spectrum for
bremsstrahlung radiation is continuous because bremsstrahlung x- rays include a range of energies.
The emission spectrum for characteristic x-ray consists of predictable energies that are specific to the
target element.

CONTINUOUS X-RAY SPECTRUM

Bremsstrahlung radiation as a continuous spectrum. The energy of a bremsstrahlung photon is the
difference between the entering and exiting kinetic energy of the projectile electron. As a result, there
is a continuous range of x-ray energies from zero to the maximum established by the potential
difference across the x-ray tube. Maximum energy is realized if all the kinetic energy of an electron is
converted into a single x-ray photon. The maximum photon energy, determined by the maximum
voltage, is the kilovolt peak (kVp). For example, if the potential difference across the tube were 90 kVp,
an electron accelerated across the tube would attain a kinetic energy of 90 keV as it interacted with the
target. If the electron transferred all of its energy, the energy of the x-ray photon would be 90 keV. The
maximum photon energy is dependent on the potential difference across the tube (kVp), regardless of
the target material.
The size and shape of the emission spectrum reflects the quality and quantity of the x-ray beam.
While the relative shape of the emission spectrum remains the same, its location along the horizontal
axis can vary. Ranges located more towards the right represent x-ray beams of higher energy or quality.
Graphically, the area under the curve represents the total number of x-rays emitted. A larger area
represents x-ray beams with higher intensity or quantity. The greatest number of x-rays have
approximately one-third to one-half of the maximum energy.
DISCRETE X-RAY SPECTRUM
Characteristic radiation energy depends on the differences between the electron binding energies of a
particular target material. As a result, the spectrum produced by characteristic x-rays is referred to as
discrete or distinct. For example, there are only 15 specific energy levels of characteristic x-ray from
tungsten: five from interaction at the K shell, four from interactions at the L shell, and the remainder
from interactions at the lower energy outer shells. In tungsten, only characteristic x-rays produced from
five K shell interactions are of sufficient energy to be of diagnostic value. The number of photons
produced at each characteristic energy level is different because the likelihood for filling a K shell void
varies from shell to shell. Often, the five energy levels are represented on the emission spectrum as a
single line.

X- RAY QUALITY AND QUANTITY

The quality of radiation in an x-ray beam is the penetrating ability of the beam. The quantity of radiation
in an x-ray beam is the number of photons in the beam. The terms exposure and intensity may also be
used to describe quantity: Basic factors influencing the quality and quantity of the x-ray beam:
• Target material
• Beam filtration
• Distance
• Prime exposure factors

While practitioners have little control over the selection of the target material and limited options for the
use of added beam filtration, it is valuable to understand how the target material and beam filtration
affect the quality and quantity of the x-ray beam. Practitioners are able to control distance and prime
factors. Consequently, it is essential to understand how these factors influence the quality and quantity
of the x- ray beam.

TARGET MATERIAL
The photon number of the target material affects both quantity and quality of the x- ray beam.

BEAM FILTRATION
Filtration of the x-ray beam affects both the quality and quantity. Beam filtration changes the
characteristics of the beam by removing ineffective low energy x-rays. Inherent and added filtration
reduces the quantity and increases the average energy of the x-ray beam. The result is reduced patient
skin dose.

DISTANCE
The distance of the anode from the image receptor (source-image distance, SID) affects the quantity
of x-ray photons. The inverse square law governs the relationship between the quantity of x-ray photons
and the distance from the target to the image receptor. The quantity of x-ray photons at the image
receptor is inversely proportional to the square of the distance from the source. For example, if the SID
is reduced by one-half, the number of x-ray photons quadruples.
PRIME EXPOSURE FACTORS
The prime exposure factors include kVp, mA exposure time. The kVp affects both quality and quantity,
while mA and exposure time affect the quantity of the x-ray beam.

Kilovoltage (kVp)
The kilovoltage peak (kVp) set by the practitioner determines the voltage or potential difference applied
across the cathode and anode during the exposure. This setting affects both quality and quantity of the
x-ray beam. Kilovoltage setting controls the speed of electrons travelling from the cathode to anode.
An increase in kVp causes greater attraction of electrons towards the anode. This increased speed
means projectile electrons possess greater potential energy.

Changes in kVp affect the production of bremsstrahlung radiation, which influences both the
quality and quantity of photons in the x-ray beam. An increase in AVP results in higher quality x-ray
photons with higher average energy and more penetrating ability. Keep in mind that the maximum
energy of an x-ray beam remains equal to the KVp setting. With an increase in KVp there is relatively
greater for the high energy x-rays than for low energy x-rays.
Changes in KVp also affect the production of characteristic radiation, which influences the
quantity but not the quality of photons in the x-ray beam. Recall that no characteristic radiation is
produced if the KVp is less than the binding of the K sheil electrons. For example, no characteristic
radiation is produced when the applied voltage is less than 69.5 kVp for a tungsten target because the
binding energy of the K shell is 69.5 keV. However, the quantity of characteristic radiation increases
when the kVp exceeds the K shell binding energy. The increase is typically proportional to the difference
between the kVp and the binding energy.

Milliamperage (mA) and exposure time

The milliamperage (mA) set by the practitioner determines the quantity of electrons in the tube current.
The relationship between mA and quantity of x-ray photons produced is directly proportional. As mA is
increased, the quantity of electrons in the tube current and the number of x-ray photons increases
proportionally. As mA is decreased, the quantity of electrons in the tube current and the number of x-
ray photons decreases proportionally.
The exposure time set by the practitioner controls the length of time electrons are permitted to
travel from the cathode to the anode. The relationship between exposure time and the quantity of x-ray
photons produced is directly proportional. As exposure time is increased, the quantity of electrons and
the number of x-ray photons increases proportionally. As exposure time is decreased, the quantity of
electrons and the number of x-ray photons decreases proportionally.
In sum, the quantity of electrons that travel from the cathode to the anode and the quantity of x-
ray photons produced are directly proportional to the mA and exposure time. The milliampere-second
(mAs) is the product of mA and exposure time. The mAs affects only the quantity of photons in the x-
ray beam; it does not affect the quality or energy of the x-ray photons.

X- RAY IMAGING SYSTEM

• The Console is the part of the machine that the operator controls the operation of the x-ray
machine
• All machine consoles are a little different but there are always similarities. The console is where
we control x-ray tube current and voltage.

The console will have controls for:

• mA and time or mAs
• Focal Spot
• Line Voltage Compensation
• Automatic Exposure Control
Line Compensation
• Most machine are designed to operate at 220 volts while some will work with 110 volts or 440
volts
• The power company often cannot provide exactly 220 volts at all times.
• Elevators and Air Conditioners may reduce the voltage available for the x-ray unit.
• Older machine has a meter to monitor the line voltage attached to the autotransformer.
• The operator can adjust the taps on the transformer to account for low or high incoming voltage.
• More modern units automatically adjust for the incoming power so a meter is not provided.
• Often over looked by the operator.
• Results in improper exposure.

Autotransformer
• The autotransformer is designed to supply voltage of varying magnitude to several different
circuits of the x-ray machine including both the filament circuit and high voltage circuits.
• The autotransformer has only one winding and one core.
• The single winding has a number of connection or electric taps.

kVp Adjustment
• Most consoles will have one or two knobs that change the taps on the autotransformer for major
and minor kVp.
• Modern units have LED readout of kVp.
• Setting the desired kVp will determine the voltage applied to the step-up transformer in the high
voltage section of the machine.
• If a meter is provided, it is placed across the output terminals of the autotransformer and
therefore it reads voltage and not kVp. The scale will read in kVp.
mA Control
• The tube current, the number of electrons crossing from the cathode to anode per second is
measured in milliamperes (mA).
• The quantity of electrons is determined by filament temperature.
• The filament normally operates at currents between 3 and 6 A. The Tube Current is controlled
through a separate circuit called the filament circuit,
• Voltage is provided by taps of the autotransformer. This voltage is reduced with precise resisters
to a value corresponding to the mA stations available.
• Tube current is usually not continuously variable, usually only currents of 50, 100, 150, 200 and
300 mA and higher are provided.
• Newer units are continuously variable
• The voltage is then delivered to the filament transformer. The filament transformer lowers the
voltage so it is called a step-down transformer.
• The selection of the small or large filament is connected to the mA selection or as a separate
control.

Exposure Timers
• For any given radiographic examination, the number of x-rays reaching the image receptor is
directly related to the tube current and the time that the tube in energized.
• The timer circuit is separate from the other main circuits.
• It consists of a mechanical or electronic device whose action is to make and break the high
voltage across the tube on the primary side of the high voltage section.

Types of Timers
• Mechanical Timers
• Synchronous Timers
• Electronic Timers
• mAs Timers
• Phototimers

Mechanical Timer
• Very simple device that has a clock mechanism.
• Operator turns the dial to the desired time. As it unwinds, the exposure is made.
• Can be used for exposure time longer than 250 milliseconds.
• Very old machine and dental units.

Electronic Timer
• Most sophisticated, complicated and most accurate timer.
• Consists of complex circuit based upon the time required to charge a capacitor through a variable
resister.
• Depending upon the incoming power accurate to I mAs. Most units have this type timer.

mAs Timer
• Most modern machine is designed to accurately control the tube current and exposure time.
• The product of mA and time (mAs) determines the number of x-ray photons emitted and the
density on the film.
• A special type of timer monitors the product of mA and terminates the exposure when the desired
mAs has been attained.
• Designed to provide the shortest exposure and the highest safe tube current for the given
filament.
 • Some have the ability to change mA manually.
• Since it monitors the actual tube current, it is on the secondary side of the H.V. Circuit
• Units here have mAs timers.
• APT or Anatomically Programs Timers have computers that store the technical factors in the
machine.

Phototimer
• A phototimer that measures the quantity of radiation reaching the receptor and terminates the
exposure when sufficient radiation needed to produce the correct density on the film.
• Offered in addition to a manual timer.
• Commonly referred to as Automatic Exposure Control or AEC.
• Widely used in Medical Radiography.

There are two types of phototimers:

1. Photomultiplier tube that reads a fluorescent screen behind the film.
2. Ion chamber between the grid and film.

• lon Chambers is used on most modern x-ray units.

• It is flat and radiolucent so it will not interfere with the image. Multiple chambers can be used to
optimize the image.

Automatic Exposure Control (AEC) Console

With AEC, the operator can select:

• Where to read the radiation
• The desired film density
• kVp and backup mAs
• Many operators do not measure the patient and set an arbitrary back up mas or time.
• Ideally, the patient is measured and the back-up mAs is set at 2x the normal mAs.
• This allows the AEC to adjust exposure for the patient's habitus and area density.
• Radiation is measured at the center of the film or off to the sides of the film.
• The center is read for most radiography and especially for the spine.
• The sides are read for PA chest, abdomen and rib radiography.

Other Functions of Control Console

• The console will also have the exposure button
• The prep button is depressed to prepare the tube for exposure.
• The rotor will spin up to 3400 RPM.

Exposure Button
• A green light will let you know that the machine is ready to make the exposure.
• The exposure button is then depressed and the exposure is initiated.
• The button must be held down until the exposure is complete.
• If your finger slips off the button, the exposure is terminated.
• The exposure control buttons are referred to as a "Dead man Switch"
• After the buttons are released, the rotor motor reverses and the rotor reduces speed.
• During the exposure you will hear an audible tone so you will know that the exposure is in
progress.
High Voltage Section
• The high voltage section converts low voltage from incoming power to kilo- voltage of the correct
wave form.
• It is usually enclosed in a large metal container in the x-ray room.

It consists of three primary sections:

▪ High voltage step up transformer
▪ Filament Transformer
▪ Rectifiers (Diodes)
o All components immersed in oil.

High-Voltage Transformer
• The high voltage transformer is a step-up transformer.
• There will be more winding on the secondary side compared to the primary side.
• The ratio of windings is referred to as the turns ratio.
• The only difference between the primary and secondary waveforms is the amplitude.
• The turn ratio for most x-ray high voltage transformers is between 500 and 1000.
• Incoming Volts converted to output: Kilovolts.

Voltage Rectification
• Transformers operate with alternating current.
• Remember that x-ray tubes operate on direct voltage (electron moving in one direction).
• To convert AC to DC we use rectifiers.

Half-Wave Rectification
• Sometimes the x-ray tube alone will work as the diode this is called self-rectification.
• When one or two diodes are placed in the circuit that stops the negative flow of electrons it is
called Half Wave Rectification.
• 60 pulses per second.

Full-Wave Rectification
• Full wave rectified x-ray machines contain at least four diodes.
• It changes the polarity of the negative half of the wave.
• This allows 120 pulses of x-ray per second.
• The exposure time can be cut in half compared to half-wave systems.

Three-Phase Power
• If three phases of power are combines with the phase off by one step, the normal reduction of
voltage back to zero is removed. Commonly called the Ripple.
• Technical factor cut in half due to more efficient power.
• Too expensive got office use.

High Frequency Generator

• By changing the frequency from 60 Hz to a higher frequency of 500 to 1000, the ripple is reduced
to less than 1%.
• Single phase machine operating on 220 volts and even 110 volts are more efficient that machine
operating on three-phase power.

Wave Form of Different Generator Type

• As the ripple effect decreases, the efficiency increases.
 • There is one more type of generator. It uses is called stored energy.

Stored Energy Generators

• If 220-volt power is not available, the operator may choose a stored energy machine.
• A battery charger is powered by typical house hold current.
• If produces direct current.

Stored energy or Capacitor Discharge Generators

• There is a short charging time before the exposure can be made.
• The disadvantage to the design is a drop in power at the end of the exposure of about 1 kV/mAs.
This is called a falling load generator.

Generator Types Pros and Cons

• Single-phase half or self-rectified: Cheap but not efficient. Fuil rectified better.
• Three phase: Expensive to install but cheaper to maintain. Too costly for most offices. 6 pulse
less costly than 12 pulse
• High Frequency: very efficient and works with single or three phase power.
• Stored energy: works on conventional 110-volt power but batteries must be replaced.

The Basic X-ray Circuits

• Circuits that make up the basic x-ray machine.

Other Parts of the X-ray Room

• The tube is suspended on the tube stand.
• The tube stand may be wall and floor mounted or ceiling suspended. Locks are provided for
horizontal and vertical movement.
• When the tube is angled toward the wall grid holder, the horizontal lock allows us to set the
distance between the tube and the film (SID).
• When the tube is aimed at the table, the vertical lock allows us to set the SID.
• Hanging on the wall grid cabinet is the non-Bucky film holder.
• It allows erect non-grid films.
• X-ray tables may be bolted to the floor or mobile. The table will also have a grid cabinet for grid
radiography.
• We will discuss grids in greater detail next week.

Collimator and Angle Indicator

• The tube stand also has an angle indicator attached parallel to the tube.
• There are views that will require tube angles.
• The Collimator is attached to the x-ray tube below the glass window where the useful beam is
emitted.
• Lead shutters are used to restrict the beam.
• A mirror and light source allows us to restrict the beam to the area of interest.
• Collimation is our greatest tool in keeping patient exposure as low as possible.

Other items that may be in x-ray room

• Fluoroscopy Equipment: Allows dynamic imaging of the body.

Consists of:
• Image intensifier with television camera and monitor.
• Spot-film device for making radiographs or
 • Motion picture camera or digital imaging.

Image Intensifier & Fluoroscopy

• Thomas Edison invented the fluoroscope in 1896. Early units consisted of a fluorescent hand-
held viewer that the doctor held in from of the patient during continuous exposure.
• This resulted in the first x-ray death.
• Dose is still relatively high compared to plain film radiography.
• Plain film radiography uses up to several hundred mA and fractions of seconds.
• Fluoroscopy tubes operate at less than 5 mA. 2 to 4 mA is normal.
• Shortly after WW2, Bell Laboratories invented the photomultiplier tube. This was developed into
the modern image intensifier.
• The multiplication of the light emitted by an input fluorescent screen is picked up by a cesium
photocathode and converted into electrons.
• A potential of about 25,000 volts is maintained between the photocathode and the anode.
• There are electronic optics and electrostatic focusing lenses between the photocathode and
output phosphor.
• The output phosphor can be viewed via mirror optics or a video monitoring system.
• A Videotape recorded can be placed into the video chain.
• Fluoroscopy allows the evaluation of the internal structures in motion.

Uses of Fluoroscopy
• Dynamic spinal imaging of range of motion and with contrast called myelograms.
• Dynamic studies of joints with or without contrast media.
• Studies of the digestive system.
• Studies of arteries and blood flow called angiography.

INTRODUCTION

Imaging the human body is the major thrust of radiography. In-depth knowledge of the equipment is
essential for making proper exposures. Such studies are covered in detail in radiation physics,
equipment and maintenance courses. This chapter will summarize the types of equipment used in
imaging to help you understand what you will be seeing early in your educational program.

X- RAY TUBE
• An evacuated glass bulb with positive (anode) and negative (cathode) electrodes.
• The anode is an electrode toward which negatively charged electrons migrate.
• The cathode is a filament that gives off electrons when heated (the source of electrons).
• The primary by-product of energy conversion is 99% heat and less than 1% is X-ray
• The x-rays exit the tube housing through a device consisting of open lead shutters called a
collimator.

DIGITAL IMAGING
• Enhances images of the body, but it does not provide cross-sectional views.
• The primary advantages of digital equipment include the ability to post- process images in a
variety of ways to provide multiple views if the anatomy.
• In DR, the density and contrast of the image can be altered any time after the completion of the
study without re-exposing the patient.
• In digital fluoroscopy, most of the follow-up "overhead" films are eliminated.
• The images are stored in a computer and can be transferred to multiple locations on a network.
 • In digital imaging studies of arteries, for example, it is possible to remove the tissue and bones
from the image.

FILM-SCREEN SYSTEM

Intensifying screen
• A sheet of plastic that is embedded with crystals called phosphors.
• When struck by radiation, phosphors glow with visible light.
• This light from the phosphors exposes the x-ray film, which is sandwiched between intensifying
screens in the lid and the base of the cassette.
• The phosphors produce thousands of light rays for each x-ray striking them, thereby significantly
reducing the amount of radiation necessary to make a good exposure.
• In the interest of patient safety, it is imperative that dosages be kept as low as possible.
• Approximately 95% of the image on the film is made by light from the intensifying screens; only
5% of the image is made directly by the x-rays.

X- ray film
• A sheet of polyester plastic coated with a thin layer of gelatin and silver compounds.
• The image contained in the film is made visible by developing the film; the finished radiograph
then becomes a permanent record of the examination and is considered a legal document.
• Some cassettes contain only one intensifying screen and a sheet of x-ray film that is coated on
only one side.
• This film-screen system provides excellent recorded detail (resolution) and is used primarily in
radiography of the extremities.

Fluoroscopy
• It provides a "live-action" view of the internal part of the body.
• There is no need to wait for film to be developed, because the image is immediately displayed
on a television monitor.
• The x-ray tube is located inside the x-ray table.
• The radiation passes through the tabletop and the patient, and it strikes the fluoroscopic screen
to produce an image of the patient's body part.
 • It uses image intensifier that improves and enhances the image and transmits it to the television
monitor. In digital fluoroscopy it allows an image to be captured, saved in a computer and post-
processed in a variety of ways.
• Older equipment it uses spot-film device, which is attached to the fluoroscope film, which is later
processed and kept for analysis.

SPECIALIZED IMAGING EQUIPMENT

Computed Tomography
• Provide cross-sectional views of the body.
• It greatly improves diagnoses and, in many cases, eliminates the need
for exploratory surgery.
• With the patient lying on a movable couch, an x-ray tube and a radiation
detector rotate around the table; this rotation provides the computer with
a "slab" of information about the patient's body. Figure 13.3 CT Scan
machine
• The computer reconstructs the information into an image that is viewed on a television screen
and stored for later retrieval and interpretation.
• CT scanners are able to obtain several dozen "slices" of information with one exposure.

Magnetic Resonance Imaging

• It allows cross-sectional views of the body to be made without the use of ionizing radiation.
• With the patient lying on the couch in the cylindrical imager, the body part in question is exposed
to a magnetic field and radio wave transmission.
• The images are produced in the computer by reconstructing the information with the body part.
• The information and images provide the physician with data about both the anatomy and the
physiology of the body part being examined.

Positron Emission Tomography

• It is similar to nuclear medicine in that it uses a radiopharmaceutical injected into the circulatory
system to image the area of interest.
• It is used to evaluate the physiology or function of an organ or system in the body.
• The radiation emanates from the body and is received by radiation detectors.
• The resulting images cross-sectional and indicate how the are radiopharmaceutical was taken
up and used by the body.
• Radiopharmaceutical is treated by the body much like its own naturally occurring components;
the information acquired is a highly accurate representation of the function of the area in
question.
Portable Radiography and Fluoroscopy
• Can be performed if the patient cannot be moved from conventional electrical circuits.
• Mobile radiography units operate from conventional electrical circuit or battery power. The quality
of images of some body parts is equivalent to that obtained in the radiology department.
However, many radiography procedures cannot be performed with a portable unit.
• Portable radiography is used in such areas as the OR, PAR, ICU, ICU, CCU, burn unit,
orthopaedic unit and morgue.
• Mobile fluoroscopy (C-arm) is used primarily in the operating room, where the surgeon must see
the images immediately.
• Portable fluoroscopy must be used with great care to prevent those involved both workers and
patients- from being unnecessarily irradiated.

Tomography
• A technique used to obtain radiographs of a section or slice of a body part, as in the use of
computed tomography.
• In conventional tomography, however, a computer is not used; the x-ray tube and film are
connected by a rod and set in motion in opposite direction during the exposure.
• All structures above and below a particular level of the body are blurred while the particular level
being studied remains in focus.

Sonography
• Uses high-frequency sound waves, which is a form of non-ionizing radiation, to obtain sectional
images of the body.
• Originally used by the military to detect enemy submarines (SONAR, sound navigation and
ranging), sonography is a useful diagnostic tool in certain areas of radiology.
• The sound waves bounce off interior structure of the body and return as echoes to a probe from
which images can be electronically displayed on a television screen; permanent images can
then be made from the screen.
• Evaluation of moving organs can also be made using with sonography.
• Doppler technique is used to evaluate blood flow through the arteries.
Picture Archiving and Communication System (PACS)
• It brings digital imaging together with hospital and radiology information systems; it allows for
the total management of a patient's case.
• Digital images and patient information form a computer network that can be accessed from any
workstation that is connected to the system.
• Data are stored on optical disks.
• Information can be transmitted from the computer storage device via cable throughout the
hospital and vicinity or via satellite across the world.
• A total PACS eliminates the need for x-ray film, because the images are ultimately viewed on
monitors, resolution is of the utmost importance.
• PACS continues to grow in use as the cost of technology decreases.
• The ability to manage all imaging procedures as well examination interpretation, scheduling,
patient history, cost analyses, demographics, and billing- makes PACS an invaluable tool patient
care.
• Digital imaging and communications in medicine (DICOM) is a standard protocol used for
blending PACS.

Single Photon Emission Computed Tomography

• A Single Photon Emission Computed Tomography (SPECT) scan is a type of nuclear imaging
test that shows how blood flows to tissues and organs.
• Imaging technique using gamma rays.
• It is able to provide true 3D information. This information is typically presented as cross-sectional
slices through the patient, but can be freely reformatted or manipulated as required.
• The basic technique requires delivery of a gamma-emitting radioisotope (called radionuclide)
into the patient, normally through injection into the bloodstream.
•
• The radioisotope is a simple soluble dissolved ion, such as a radioisotope of gallium (III), which
happens to also have chemical properties that allow it to be concentrated in ways of medical
interest for disease detection.
• Most of the time in SPECT, a marker radioisotope, which is of interest only for its radioactive
properties, has been attached to a specific ligand to create a radioligand, which is of interest for
its chemical binding properties to certain types of tissues.
• This marriage allows the combination of ligand and
radioisotope (the radiopharmaceutical) to be carried and
bound to a place of interest in the body, which then (due to
the gamma-emission of the isotope) allows the ligand
concentration to be seen by a gamma-camera.

Application
• Myocardial perfusion imaging
• Functional brain imaging
 Image Production and Evaluation
Radiation and It’s Discovery:
Discovery:
X-rays were discovered in Europe in the late 19th century by German scientist Wilhelm Conrad
Roentgen. Although Roentgen discovered x-rays by accident he proceeded and study them so
thoroughly that within short time, he had identified all of the properties of x-rays that are recognized
today. Roentgen was less interested in the practical use of x-rays than in their characteristics as a form
of energy. X-rays are classified as specific type of energy termed electromagnetic radiation, but like all
other types of electromagnetic energy, x-rays act both like waves and like particles.
November 08, 1895 - x-rays were discovered by Wilhelm Conrad Roentgen.
Crookes Tube - a specific type of tube that Roentgen was working with low vacuum tube that is
simply a glass tube that has some air evacuated from it.
Roentgen covered his tube with black cardboard and again electrified the tube. By chance, he
noticed a faint glow coming from some material located several feet from his electrified tube. The
source was a piece of paper coated with barium platinocyanide. Not believing the cathode rays could
reach that far from the tube, Roentgen repeated the experiment.
Each time Roentgen energized his tube, he observed this glow coming from the barium
platinocyanide paper. He understood that energy emanating from his tube was causing this paper to
produce light or fluoresce.
In December 1895, Roentgen decided that his investigations of this energy were complete
enough to inform his physicist colleagues of what he now believed to indeed be a discovery of a new
form of energy. He called this energy x-ray with the x representing the mathematical symbol of this
unknown.
Roentgen Discovery was lauded as one of great significance to science and medicine, and
Roentgen recieved the first Nobel Prize in Physics in 1901.

In 1898 tempered by realization that x-rays could cause biologic damage. This was first noticed
as a reddening and burning of the skin of those who were exposed to the large doses of x-rays required
at that time. More serious effects, such as the growth of malignant tumors and the alteration of one's
chromosomes, were attributed in latest decades to x-ray exposure.
Despite these disturbing findings, however, it was also realized that x-rays could be used safely.
When radiation protection procedures are followed, which safeguard both radiographer and patient, x-
rays assist medical diagnosis by imaging virtually part of the human body.
X-radiations, or x-rays, are type of electromagnetic radiation. Electromagnetic radiation refers to
radiation that has both electrical and magnetic properties.
The Dual Nature of X-ray Energy
X rays act both the waves and like particles
Wavelength and Frequency
Wavelength and frequency are inversely related. If one increases, the other decreases.
Properties of X-rays
X-rays are invisible.
X-rays are electrically neutral. They have neither a positive nor a negative charge, therefore
they cannot be accelerated or made to change direction by magnet or electrical field.
X-rays have no mass. They create no resistance to being put into motion and cannot produce
force.
X-rays travel at the speed of light in a vacuum. They move at a constant velocity of 3 x 10 m/s
miles/s in a vacuum.
X-rays cannot be optically focused. Optical lenses have no ability in focusing or refracting x-
ray photons.
 X-rays form a polyenergetic or heterogenous beam. The x-ray beam that is used in
diagnostic radiography is composed of photons that have many different energies. The maximum
energy that a photon in any beam may have been expressed by the kilovoltage peak (kVp) that is set
on the control panel of the radiographic unit by the radiographer.
X-rays can be produced in a range of energies. There is useful for different purposes in
diagnostic radiography. The medically useful diagnostic range of x-ray energies extends up to 20 to 150
kVp.
X-rays travel in straight lines. X-rays used in diagnostic radiography form a divergent beam
which each individual photon travels in a straight line.
X-rays cause some substances to fluoresce. When x-rays strike substances, those
substances produce light. These substances are used in diagnostic radiography, in intensifying
screens, and in image intensifiers used in fluoroscopy.
X-rays cause chemical changes to occur in radiographic and photographic film. X-rays are
capable of causing images to appear in radiographic film and are capable of causing images to appear
on radiographic film and are capable of fogging photographic film.
X-rays can penetrate the human body. X-rays have the ability to pass through the body, based
on the energy of the x-rays and on the composition and thickness of the tissues being exposed.
X-rays can be absorbed or scattered by tissues in the human body. Depending on the
energy of an individual x-ray photon, that photon may be absorbed in the body or be made to scatter,
moving in another direction.
X-rays can produce secondary radiation. When x-rays are absorbed as a result of a specific
type of interaction with matter, the photoelectric effect, a secondary or characteristic photon, will be
produced.
X-rays can cause chemical and biologic damage to living tissue. Through excitation and
ionization of atoms comprising cells, damage to those cells can occur.
The X-ray Beam
The x-ray tube is the most important part of the x-ray machine because the tube is where the x-
rays are actually produced.
X-ray Production
The production of x-rays requires a rapidly moving stream of electrons that are suddenly
decelerated or stopped. The source of electron is the cathode, or the negative electrode. Electrons are
stopped or decelerated by the anode, or the positive electrode. Electrons move between the cathode
and the anode because there is a difference in charge between the electrodes.

Cathode
is a negatively charge electrode. It comprises a filament and a focusing cup.
Filament
is a coiled tungsten wire that is the source of electrons during x-ray production.
Focusing cup
is made of nickel and nearly surrounds the filament. It is open at one end to allow electrons to
flow freely across the tube from cathode to anode. It has a negative charge, which keeps the cloud of
electrons emitted from the filament from spreading apart. Its purpose is to focus the stream of electron.
Anode
is a positively charged electrode. It consists of a target and, in rotating anode tubes, a stator and
rotor.
The Target
is a metal that abruptly decelerates and stops electrons in the tube current, thereby allowing the
production of x-rays. It can be either stationery or rotating. Rotating anodes are manufactured to rotate
at a set speed ranging from 3000 to 10, 000 revolution per minute.
Is the part of the anode that is struck by the focused stream of electrons coming from the
cathode. The target stops the electrons and thus creates the opportunity for the production of x-rays
 It is made of tungsten and rhenium alloy. This layer, or track, is then embedded in a base of
molybdenum and graphite. Tungsten generally makes up 90% of the composition of the rotating target,
with rhenium making up the other 10%.

Tungsten is used in both rotating and stationary targets because it has a high atomic number of
74 for efficient x-ray production and a high-melting point of 3370°C.
Stator
is an electric motors that turns the rotor at very high speed during x-ray production.
Rotor
is rigidly connected to the target through the anode stem.
Dissipating Heat
As heat is produced when the x-ray exposure is made, the rotating anode conducts the heat to
insulating oil that surrounds the x-ray tube.
Rotating Anode
Rotating anodes can withstand higher heats loads than stationary anodes because the rotation
causes a higher greater physical state area, or focal track, to be exposed to electrons.
X-Ray Exposure
Preparing the tube for exposure:
When the rotor, or prep, button is pushed:
On the cathode side of the x-ray tube:
• Filament current heats up the filament
• This boils electrons off the filament (Thermionic Emission)
• These electrons gather in a cloud around the filament (Space Charge)
• The negatively charged focusing cup keeps the electron cloud focused together.
• The number of electrons in the space charge is limited (Space Charge Effect)

On the anode side of the x-ray tube:

The rotating target begins to turn rapidly, quickly reaching top speed.
Making an x-ray exposure:
• When the exposure, or x-ray, button is pushed:
• On the cathode side of the x-ray tube:
• High negative charged strongly repels electron.
• These electrons stream away from the cathode and toward the anode (tube current)

On the anode side of the x-ray tube:

• High positive charge strongly attracts electrons in the tube current.
• These electrons strike the anode.
• X-rays and heat are produced.
Thermionic Emission
When the tungsten filament gains enough heat (therm), the outer shell electrons (ions) of the
filament atoms are boiled off, or emitted, from the filament.
Tube current
Electrons flow in only one direction in the x-ray tube from cathode to anode. This flow of
electrons is called the tube current and is measured in milliamperes (mA)

Energy Conversion in the X-Ray Tube

As electrons strike the anode target, approximately 99% of their kinetic energy is converted to
heat, whereas only 1% (approximately) of their energy is converted to x-rays.
Kilovoltage and the Speed of Electrons
The speed of the electrons traveling from the cathode to the anode increases as the kilovoltage
applied across the x-ray tube increases.
The Speed of Electrons and the Quality of the X-Rays
The speed of the electrons in the tube current determines the quality or energy of the x-rays
produced. The quality or energy of the x-rays that are produced determines the penetrability of the
primary beam.
kVp and Beam Penetrability
As kVp increases beam penetrability increase; as kVp decreases, beam penetrability decreases.
kVp and X-Ray Quality:
• Higher kVp results in electrons that move faster in the tube current from cathode to anode.
• The faster the electrons in the tube current move, the greater the quality of x-rays produced. The
greater the quality of x-rays produced, the greater the penetrability of the primary beam.

Milliamperage, Tube Current, and X-Ray Quality Milliampere (ma)

• is the unit used to measure the tube current. Tube current measures the number of electrons
flowing per unit time between the cathode and anode.
• The quantity of electrons in the tube current and quantity of X-rays produced are directly
proportional to the milliamperage

MA and X-Ray Quantity:

• Higher mA results in more electrons that move in the tube current from cathode to anode.
• The more electrons in the tube current, the more x-rays that will be produced.
• The number of X-rays that are produced is directly proportional to the mA.

Exposure Time(s)
Determines the length of time that the X-ray tube produces X-rays.
Exposure Time, Tube Current, and X-Ray Quantity
The quantity of electrons that flows from the cathode to anode and the quantity of x-rays
produced are directly proportional to the exposure time.
Exposure Time and X-Ray Quantity:
• Longer exposure time results in more electrons that move in the tube current from cathode to
anode.
• The more electrons in the tube current, the more X-rays produced.
• The number of x-rays that are produced is directly proportional to the exposure time.

Milliamperage and Time

When milliamperage is multiplied by exposure time, the result is known as mAs which the
radiographer may be able to set at the control panel.

Mathematically mAs is simply expressed as follows:

 • m A x s = mAs,
• Where s represents exposure time in fractions of a second (as actual fractions or in decimal
form) or in seconds.

mAs and X-Ray Quantity:

• Higher mAs results in more electrons that move in the tube current from cathode to anode.
• The more electrons in the tube current, the more x-rays that will be produced.
• The number of x-rays that are produced is directly proportionate to the mAs.

The Quantity of Electrons, X-Rays and mAs.

The quantity of electrons flowing from the cathode to the anode and the quantity x-rays produced
are directly proportional to mAs.

Line Focus Principle

• allow large area for heating and maintaining a small focal spot.
• The line focus principles describe the relationship between the actual focal spot, where the
electrons in the tube current bombard the target, and the effective focal spot, that same area as
seen from directly below the tube.
• Provides the sharpness of image of a small focal spot and heat capacity of a large focal spot.

Actual Focal Spot Size

Refers to the size of the area on the anode target that is exposed to electrons from the tube
current. It depends on the size of the filament producing the electron stream.

Effective Focal Spot Size

• 0.1.1.5 mm
• Refers to the focal size as measured directly under the anode target.

Anode Angle Heel Effect

Based on the line focus principle, the smaller the anode angle, the smaller the effective focal
spot size.

The Anode Heel Effect

X-rays are more intense on the cathode side of the tube. The intensity of the x-rays decreases
toward the anode side.
Line Focus Principle

• The area of the X-ray tube anode from which the x- ray photon
are emitted called Actual Focal Spot.
• The projection perpendicular to the central ray, which is its
apparent area from the position of the film, is the effective
focal spot.

Anode Heel Effect

• Construction phenomenon that causes the x-ray photons

exiting the tube on the cathode side to have a greater
energy value than those exiting the tube on the anode side.

Using the Anode Heel Effect

• The anode heel effect can be used in imaging the thoracic spine, which has small vertebrae at
the top and large vertebrae at the bottom. By placing the patient's head under the anode end of
the tube, the more intense radiation will directed toward the lower, larger portion of the spine and
less intense radiation will expose the upper, smaller vertebrae.

Beam Filtration
• Low Energy Photons, Patient Dose and Image Formation
• Low-energy photons serve only to increase patient dose and do not contribute to image
information.

Added filtration
• 2 - 3 mm
• All equivalent, first, 1 or 2 mm sheets of Al installed in a part of x-ray tube
• It describes the filtration that is added to the port of the x-ray tube Aluminum is the material
primarily used for this purpose to absorb the low energy photons while allowing the useful higher-
energy photons to exit.

Inherent Filtration
Refers to the filtration that is permanently in the path of the x-day beam. Three components contribute
to inherent filtration.
1. The glass envelope of the tube
2. The oil that surrounds the tube.
3. The mirror inside the collimator

Total Filtration
In the x-ray beam is the sum of the added filtration and the inherent filtration. For x-ray tubes operating
above 70 kVp must have a minimum filtration of 2.5 mm of aluminum or its equivalent.

Special filters
Compensating Filters
Are special filters to be added to the primary beam to alter its intensity. These types of filters are used
to image anatomic areas that non-uniform in make-up and assist in creating a radiographic image with
more uniform density.

1. Wedge Filters
Most common type of compensating filters. The thicker part of the wedge is lined up with the
thinner portion of the anatomic part that is being image, allowing fewer x-ray photons to reach that end
part. Most commonly used in AP femur.

2. Trough Filters
Performs a similar function to the wedge filter; however, it is designed differently. It has a double
wedge commonly used for AP thorax to compensate for the easily penetrated air-filled lungs.

Heat Units
The amount of heat produced from any given exposure
HU = mA x time x KVp x generator factor

The Generator Factor:

Generator Type Factor

Single Phase 1.00
Three Phase 6 Pulse 1.35
Three Phase 12 Pulse 1.41
High Frequency 1.45

Calculating Heat Units:

An exposure is made with a three phase, 12 pulse x-ray unit using 600 mA, and 0.05 seconds, 75 kVp.
How many heat units are produced from this exposure?
HU = mA x time x kVp x generator factor
HU = 600 x .05 x 75 x 1.41
= 3172.5 HU
The number of Hus produced depends on the type of x-ray generator used and the
exposure factors selector

RADIOGRAPHIC IMAGE FORMATION

Differential Absorption and Image Formation

Differential Absorption
Is a process whereby some of the x-ray beam is absorbed in the
tissue and some passes through (transmits) the anatomic part. The term differential is used because
varying anatomic parts do not absorb the primary beam to the same degree.
A radiographic image is created by passing an x-ray beam through the patient and interacting with
and image receptor, such as a film-screen system. The variations in absorption and transmission of the
transmission of the exiting x-ray beam will structurally represent the anatomic area of interest.

Beam Attenuation
The reduction in the energy of the primary x-ray beam. As the primary x-ray beam passes through
anatomic tissue, it will lose some of its energy. It occurs as a result of photon interactions with the
anatomic structures that compose the tissue. Three (3) distinct processes occur during beam
attenuation:

1. X-ray photon absorption. During attenuation of the x-ray beam, photoelectric effect is
responsible for total absorption of the incoming x-ray photon.

2. X-ray beam Scattering. During attenuation of the x-ray beam, the incoming x-ray photon may
lose energy and change direction as a result of the Compton effect.

3. Transmission. If the incoming x-ray photon passes through the anatomic part without interaction
with the anatomic structures.

Image Densities

➢ The range of image densities is created by the variation in the x-ray absorption and transmission
as the x-ray beam passes through the anatomic tissue.

Radiographic Image Techniques

Radiography
➢ The uses of ionizing radiation to produce a recorded image on photosensitive material.

Radiograph
➢ The image produced using the X-ray radiation.
➢ Represents the image recorded on photosensitive material called x-ray film.
Technical Competencies of a Radiologic Technologist:
1. Operation of the control panel.
2. Selection of appropriate accessories.
3. Selection of correct factors to make exposures.
4. Use of terminologies in the evaluation of radiographs
5. Measurement
6. Evaluation of results

Characteristics of a Radiograph:
1. Exposure factors are adequate.
2. There has been adequate penetration of the part of interest.
3. Sufficient radiographic density and contrast are present.
4. Field size selection is appropriate.
5. Motion is eliminated during exposure.
6. The anatomic part is properly positioned.
7. Proper accessories have been selected.

Radiographic Image Quality

Photographic Properties
• Evaluating radiographic quality requires the radiographer to assess the image both its visibility of
recorded detail (photographic properties) and its sharpness of recorded detail (geometric
properties). Radiographic quality is the combination of both visibility and sharpness of recorded
detail.

Photographic Properties
Are determined by the extent to which structural components of the anatomic area of interest can be
seen on the recorded image.

Photographic Properties

Density Contrast

Radiographic Quality

Photographic aspect Geometric aspect

(visibility) (sharpness)

1. Density 1. Definition
2. contrast 2. distortion
Radiographic Density

- Is the amount of overall blackness produced on the image after processing. A radiograph must have sufficient
density to visualize the anatomic structure of interest.
Controlling factors Influencing factors
1. Kilovoltage
2. Distance
3. Grids
4. Film-Screen Speed
Milliamperage Exposure Time 5. Collimation
6. Anatomic Part
7. Anode Heel Effect
8. Reciprocity law
9. Generator Output
10. Filtration
11. Film Processing

Controlling factors
Milliamperage and exposure time
- Milliamperage and exposure time control the quantity of radiation reaching the image receptor.
- The product of milliamperage (mA) and exposure time (mAs) has a direct proportional
relationship with the quantity of x-ray produced. When the quantity of x-rays is increased, the
radiographic density also increases. Conversely, when the quantity of x-ray decreased, the
radiographic density decreases. Therefore, radiographic density can be increased or decreased
by adjusting the amount of radiation (mAs)
mAS, Quantity of Radiation, and Radiographic Density
- As the mAs is increased, the amount Of radiation is increased and radiographic density is
increased. As the mAs is decreased, the amount of radiation is decreased and density is
decreased.
Milliamperage and Exposure Time
Contributing Factors
Facts to remember in density
1. the highest mAs= greatest density
2. The fastest screen film combination=greatest density
3. The lowest grid ratio= greatest density
4. Direct exposure techniques= least density
5. The shortest distance= greatest density
6. The longest time= greatest density
7. The highest kVp= greatest density
8. The smallest area of collimation= the least density (conventional techniques)
Facts to remember in Contrast
1. The lowest the kV= greatest contrast (short scale)
2. The highest grid ratio= greatest contrast (short scale)
3. The smallest area of= the greatest contrast (short scale)
Facts to remember in Detail (Geometric)
1. The smallest focal spot= greatest detail
2. The shortest object film distance= greatest detail
3. The greatest focal film distance = greatest detail
4. The shortest time= greatest detail if motion is a consideration
5. The slowest screen film system =the greatest detail (when comparing the same phosphor type)
6. Direct exposure technique= the greatest detail
1. Kilovoltage
- Kilovoltage peak (kVp) increases the quantity of radiation reaching the image receptor and
therefore increases radiographic density. Decreasing the kilovoltage peak decreases the
quantity of radiation reaching the image receptor and therefore decreases radiographic
density.
Kilovoltage and the 15% Rule
kilovoltage peak (kVp) will have the same effect on radiographic density by doubling the
-
mAs. A 15% decrease in kVp will have the same effect on radiographic density as
decreasing mAs by half
Mathematical Application Using the 15% Rule:
• To increase density: original kVp + 15%
• To decrease density: original kVp - 15%
To maintain density:
• When increasing kVp by 15%: original kVp + 15% divide the original mAs b 2
• When decreasing the kVp by 15%: original kVp - 15%, multiply the original mAs by half
2. Distance
- The distance between the source of the radiation and the image receptor, source-to-image
receptor distance (SID) affects the amount of density, produced on a radiograph. Because of the
divergence of the x-ray beam, the intensity of the radiation will vary at different distances. The
relationship between distance and xray beam intensity is best described by the inverse square
law

Inverse Square Law

- State that the intensity of the x-ray is beam is inversely proportional to the square of distance
from the source
SID and Radiographic Density
- As SID increases, radiographic density decreases as result of the square of the distance. As SID
decreases , the radiographic density inceases as a result of the square of the distance
SID and mAs
- Increasing the SID requires that mAs be increased to maintain density, and decreasing the SID
requires a decrease in mAs to maintain density
o Mathematical Application
▪ mAs1 = (SID1)2
Mas2 (SID2)2
 3. Object-to-Inage Receptor Distance (OID)
- When the distance is created between the object radiographed and the image receptor, object-
to-image receptor distance (OID), less density may result. As the exit radiation continues to
diverge, less overall density of the x-ray beam will reach the image receptor. Although the
amount of OID necessary to visibly affect the image density has not been standardized, the
radiographer should minimize the amount of OID whenever possible. OID has a greater effect on
image contrast and sharpness.

4. Grid
- Is a device that is placed between the patient and image receptor to absorb scatter radiation
exiting the patient. Limiting the scatter radiation that reaches the image receptor improves the
quality of the radiograph. It also absorbs some of the transmitted radiation exiting the patient and
therefore reduces the amount of density produced on a radiograph.

Grid and Radiographic Density

Grid Ration Grid Conversion Factor

No Grid 1
5:1 2
6:1 3
8:1 4
12:1 5
16:1 6

5. Film-Screen Speed
- The combination of the film and intensifying screen affects the image receptor’s sensitivity to
radiation exposure. The more sensitive the film-screen system is to radiation, the faster the
speed. The speed of the film-screen system affects the amount of radiation required to produce a
given amount of radiographic density. The greater the speed, the greater the density produced
for a given exposure technique.

Film-Screen System and radiographic Density

- The greater the speed of the film-screen system, the greater the amount of density produced on
the radiograph; the lower the speed of the film-screen system, the less density produced on the
radiograph.

Film-Screen System Speed and mAs

Increasing the film-screen speed requires a decrease in the mAs to maintain density. Decreasing
the film-screen speed requires and increase in the mAs to maintain density.
▪ mA = Time

▪ speed = mAs
6. Collimation
- Increasing collimation (field size) decreases radiographic density; decreasing collimation (wider
field size) increase radiographic density.

7. Anatomic Part
- The thickness of the anatomic part being imagined affects the amount of x-ray beam attenuation
that occurs. A thick part absorbs more radiation, whereas a thin part transmits more radiation.

Part Thickness and Radiographic Density

o A thick anatomic part decreases the radiographic density.
o A thin anatomic part increases radiographic density.
o For every change in part thickness of 4cm, the radiographer should adjust the mAs by a
factor of 2.
-
8. Anode Heel Effect
- As a result of the angle of the x-ray tube’s anode, the intensity along the longitudinal axis of the
primary beam varies; this variance is called the anode heel effect.

The anode heel effect is a decrease in the primary beam intensity on the anode side of the
tube, making the primary beam on the cathode side of the tube more intense in comparison.
Under circumstances, this decrease in intensity at the anode end of the primary beam could
affect the uniformity of densities produced and could be visible on the radiographic image.

9. Reciprocity Law
- States that the density produced on the radiograph will be equal for any combination of
milliamperage and exposure time, as long as the product of mAs is equal.

10. Generator Output

- Exposure techniques are developed in a radiographic room, and depend on the type of
generators used. Generators with more efficient output, such as three-phase units, require lower
technique settings to produce an image comparable to those of single-phase units.

11. Tube Filtration

- Small variations in the amount of tube filtration should not have visible effect on radiographic
density. Variability of the x-ray tube filtration should be checked as a part of routine quality
control checks on radiographic equipment. X-ra tubes that have excessive or insufficient filtration
may begin to affect the radiographic density.

12. Film Processing

- Processing of the film after exposure to radiation has a major effect on both the density and the
contrast of the radiograph. Variability of the processor in temperature, chemistry, or film transport
can adversely affect the radiographic density or contrast.
Radiographic Contrast
Is a photographic factor that also affects the visibility of recorded detail. Contrast is the degree
of difference between adjacent densities. The ability to distinguish between densities enables
differences in anatomic tissues to be visualized.
Characteristics of Contrast Scale:
Short-scale contrast:
➢ Less number of useful densities on the radiograph
➢ Abrupt change from one density to another
➢ "high contrast"
➢ Produced by low KVp
Long-scale contrast
➢ Large number of useful densities on the radiograph
➢ Little change from one density to another
➢ "low contrast"
➢ Produced by high KVp
High Contrast
A radiograph with few densities but greater differences among them and also described as short-
scale contrast.
Low Contrast
A radiograph with a large number of densities but little differences among them and also
describes as long-scale contrast
TWO CATEGORIES OF CONTRAST
Film Contrast
Is a result of the inherent properties, manufactured into the type of film and how it is
radiographed (direct exposure or with intensifying screens), along with the processing conditions
Subject Contrast
is a result of the absorption characteristics of the anatomical tissue radiographed and the level of
kilovoltage used
SUBJECT CONTRAST FILM (IMAGE RECEPTOR)
kilovoltage Film type
Tissue Composition Direct Exposure or IS
contrast Medium Processing Condition
CONTRAST
CONTROLLING FACTOR INFLUENCING FACTOR
• Grids
• Collimation
• Object-to-Image Receptor Distance
• Contrast Media
Kilovoltage • Processing

Controlling Factor
Kilovoltage
➢ Is considered the controlling factor for radiographic contrast. The quality or penetrating power of
the X-ray beam has the most direct effect on controlling the desired level of contrast.
➢ The kilovoltage or penetrating power of the X-ray beam controls the desired level of radiographic
contrast.
Kilovoltage and Radiographic Contrast
High kilovoltage creates more densities but with few differences, resulting in a low-contrast (long-
scale) image. Low kilovoltage creates fewer densities but with greater differences, resulting in a high-
contrast (short-scale) image.
Kilovoltage, Scatter Radiation, and Radiographic Contrast
Increasing kilovoltage increases the amount of scatter radiation produced and decreases
radiographic contrast. Decreasing the kilovoltage decreases scatter production and reduces the amount
of fog, therefore increasing radiographic contrast.
INFLUENCING FACTORS:
1. Grids
- Radiographic grids affect contrast as a result of their absorption of the scatter radiation
that exits the patient.
2. Collimation
- Changes in the size of the x-ray field affect the amount of the tissue irradiated. A wider
field size (decrease collimation) irradiates more tissue and causes more scatter radiation
to be produced. The Increased amount of scatter radiation reaching the image receptor
results in less radiographic contrast. A smaller field size (more Collimation) irradiates less
tissue and reduces the amount of scatter radiation produced. The decreased amount of
scatter radiation reaching the image receptor results in greater radiographic contrast.
3. Object-to-Image Receptor Distance (OID)
- When sufficient distance between the object and image receptor exists, an air gap
created, preventing the scatter radiation from striking the image receptor. Whenever the
amount of scatter radiation reaching the image receptor is reduced, the radiographic
contrast is increased.
 4. Anatomic Part
- Increasing part thickness lowers radiographic contrast because of more scatter radiation
reaching the image receptor; decreasing part thickness increases radiographic contrast
because of less scatter radiation reaching the image receptor.
5. Contrast Media
- Is used when imaging anatomic structure has a low subject contrast. The use of a contrast
agent is an effective method of increasing radiographic contrast when radiographing areas
of low subject contrast.

Exposure Factor Modification

Pediatric patients are a technical challenge for radiographers for a number of reasons. Pediatric
patients, because of their smaller size, require lower values of kVp and mAs when compared with
adults.
Minimum kVp Values That Are Recommended To Penetrate The - Chest In Children
CHRONOLOGICAL MATURITY MINIMUM kVp to Penetrate the Part
Premature 50
Infant 55
Child 60

Exposure factors used for adult skull can be used for pediatric patients 6 years of age and older
because the bone density of these children has developed to an adult level. However, exposure factors
must be modified for patients younger than 6 years of age. It is recommended that the radiographer
decrease the kVp value by at least 15% to compensate for this lack of bone density.
Adapting Exposure Factors For Children Based on Exposure Factors For Adults, Excluding
Chest And Skull Examinations
AGE (IN YEARS) EXPOSURE FACTOR ADAPTATION
0-5 25% of mAs indicated for adults
6-12 50% of mAs indicated for adults

Casts and Splints

Cast and Splints can be produced with materials that attenuate x-rays differently. Selecting appropriate
exposure factors can be challenging because of the wide variation of materials used for these devices.
Cast
➢ Cast produced in fiberglass generally requires no change in exposure factors from the values
used for the same anatomical parts without cast.
➢ Cast produced in plaster present a problem in terms of exposure factors. Plaster cast requires an
increase in exposure factors compared with that needed to radiograph the same part without a
cast. However, the method and amount of increase in exposure has not been standardized.
➢ One of method of approaching the exposure factor conversion is to consider whether the cast is
still wet from the application or whether it is dry. This approach states that increase of 2 times the
mAs is needed for dry plaster casts and an increase of 3 times the mAs is needed for wet plaster
casts.
Splints
➢ Splint present less of a problem in determining appropriate exposure factor than casts. Inflatable
(air) and fiberglass splints do not require any increase in exposure. Wood, aluminum, and solid
plastic splints may require that exposure factors be increased, but only if they are in path of the
primary beam.
Body Habitus
➢ Refers to the general form or build of the body, including size. It is important for the radiographer,
to consider body habitus when establishing exposure techniques.
4 Types of Body Habitus:
1. Sthenic
➢ Accounts for approximately 50% of the adult population and is commonly called as normal
or average build.
2. Hyposthenic
➢ Accounts for approximately 35% of adults and refers to a similar type of body habitus as
sthenic, but with a tendency toward a more slender and taller build.
3. Hypersthenic
➢ A large, stocky build, accounts for only 5% of adult. These individuals have thicker part
sizes compared with sthenic and hyposthenic individuals, SO exposure factors for their
radiographic examination is higher.
4. Asthenic Refers
➢ to very slender body habits and accounts for only 10% of adults. Exposure factors for
asthenic individuals are at low end of technique chrats because their respective part sizes
are thinner than those of sthenic and hyposthenic individuals.
Pathology
Pathologic condition that can alter the absorption characteristics of the anatomic part being examined
are divided into two categories:
1. Additive Diseases
➢ are diseases or conditions that increase the absorption characteristics of the part, making
the part more difficult to penetrate.
2. Destructive Diseases
➢ are those diseases or conditions that decrease the absorption characteristics of the part,
making the part less difficult to penetrate. I
it is necessary to increase kVp when radiographing parts that have been affected by additive
disease and to decrease kVp when radiographing parts that are affected by destructive diseases.
Some Common Addictive and Destructive Diseases And Conditions by Anatomic Area
ADDICTIVE CONDITIONS DESTRUCTIVE CONDITIONS
Abdomen
Aortic Ane
Ascites Bowel obstruction
Cirrhosis Free Air
Hypertrophy of some organs
(e.g splenomegaly)
Chest Emphysema
Atelectasis Pneumothorax
Congestive Heart Failure
Malignancy
Pleural Effusion
 Pneumonia
Skeleton Gout
Hydrocephalus Metastases (Osteolytic)
Metastases (Osteroblastic) Multiple Myeloma
Osteochondrome (Exostoses) Paget’s Disease (Early Stage)
Paget’s Disease (Late Stage) Osteoporosis

Nonspecific Sites Atrophy

Abscess Emaciation
Edema Malnutrition
sclerosis

Variables and Their Effect on Photographic Properties Of The Radiographic Properties Of The
Radiographic Image Radiographic Variables Density Contrast
RADIOGRAPHIC DENSITY CONTRAST
VARIABLES
Increase mAs Increase 0
Decrease mAs Decrease 0
Increase kVp Increase Drecrease
Decrease kVp Decrease Increase
Increased SID Decrease 0
Decreased SID Increase 0
Increased OID Decrease Increase
Increase Grid Ratio Increase Decrease
Decrease Grid ratio Decrease Increase
Increase Film-Screen Decrease Decrease
Speed
Decrease Film-Screen Increase 0
Speed
Increase Collimator Increase 0
Decrease Collimator Decrease Increase
Increase Collimator Decrease Increase
Decrease Collimator Increase Decrease
Increase Focal Spot Size 0 0
Decrease Focal Spot Size 0 0
Increase Central Angle Decrease 0
Ray