Question 1: Describe an x ray tube and explain it's mode of function

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Cathode

The cathode is part of an x-ray tube and serves to expel the electrons from the circuit and focus them in
a beam on the focal spot of the anode. It is a controlled source of electrons for the generation of x-ray
beams. The electrons are produced by heating the filament (Joule heating effect) i.e. a coil of wire made
from tungsten, placed within a cup-shaped structure, a highly polished nickel focusing cup, providing
electrostatic focusing of the beam on the anode. In order to expel the electrons from the system, they
need to be given the energy. Heat is used to expel the electrons from the cathode. The filament is
crystallized during construction and its crystallized structure gives the filament stability. The process is
called thermionic emission (or Edison effect). The filament is heated with the electric current passing
through it (to the glowing temperature) and the electrons are then expelled from the cathode.

Anode

Last revised by Arlene Campos on 11 Jan 2024

The anode (or anticathode) is the component of the x-ray tube where x-rays are produced. It is a piece
of metal, shaped in the form of a beveled disk with a diameter between 55 and 100 mm, and thickness
of 7 mm, connected to the positive side of the electrical circuit. The anode converts the energy of
incident electrons into x-rays dissipating heat as a byproduct.

Structure

Most x-ray tube anodes are made of tungsten (the target material). Tungsten has a high atomic number
(Z=74) and a high melting point of 3370°C with a correspondingly low rate of evaporation. The high
atomic number of tungsten gives more efficient bremsstrahlung production compared to lower atomic
number target materials. An alloy containing tungsten and rhenium is also used because the addition of
5-10% rhenium prevents grazing of the anode surface. The body of the anode is made of materials that
are light and have a good heat storage capacity, like molybdenum and graphite. Molybdenum is also
often used as the target material for anodes used in mammography because it has an intermediate
atomic number (Z=42) and the produced characteristic x-rays are of energies suited for this purpose.
Some anodes used in mammography are also made of rhodium (Z=45), which has characteristic x-rays of
slightly higher energies, which are more penetrating and preferably used in dense breast imaging.

Rotating or stationary anode

Anodes are designed as beveled disks attached to a large copper rotor of the electric motor, rotating
them at the speeds up to 10,000 rpm, with a temperature of 2000°C. The purpose of the rotation is to
dissipate heat. Most rotating anodes actually represent rather complex electromechanical systems
consisting of approximately 350 pieces, taking around 150 assembly operations.
For X-ray examinations that require infrequent exposures or low anode current such as in dental units,
portable X ray units and portable fluoroscopy systems, only stationary anode is required 5.

Focal spot

The anode disc rotates and is subjected to a focused beam of electrons emanating from the cathode,
which is accelerated by a high potential difference between the cathode and the anode. When the
electron beam hits the anode (at the actual focal spot), interactions of the electrons with the target
material produces the x-ray beam. The anode angle is the angle between the vertical and the target
surface with most x-ray tubes having an anode angle of 12-15°. A smaller angle results in a smaller
effective focal spot.

The whole anode is not included in x-ray production. X-rays are produced on the rather small
rectangular surface, the actual focal spot.

Tube shielding refers to the use of a material within the X-ray tube housing to limit leakage of scattered
radiation, to protect both patients and staff from unnecessary exposure.

Lead (Pb) is an ideal material for this purpose due to its high atomic density (Z = 82). Due to these
properties, it is also preferred for its use in personal protective equipment.

Typically, a thin sheet of lead (2-3 mm thickness) is lined within the tube housing.

Tube shielding is regulated so that the legal limit of radiation leakage from an X-ray tube running at its
maximum voltage does not exceed 1 mGy in 1 hour at 1 meter from the anode.

Question 2: Explain how a high-tension generator works

this paper, the proposed series-load resonant plasma generating configuration is shown in Figure 1. At
the first stage, a rectifier is employed to convert 220V, 60Hz AC grid voltage into DC. Next, the half-
bridge DC/AC converter with power switches in the resonant circuit being turned ON and OFF in 22 kHz
switching frequency and generating a high-frequency square wave is implemented. The appropriately
assigned resonant inductor Lr and resonant capacitor Cr constitute the resonant circuit to supply the
primary side of transformer with high-frequency sinusoidal voltage. With the step-up transformation, a
high-voltage output with peak value as high as 8kV~10kV, and 22 kHz frequency AC sinusoidal voltage is
created. If the driving circuit of resonant converter is designed to possess inductive feature. The
switching pattern of power switches can be aimed at zero-voltage-switching to reduce the switching
losses effectively [16].

Question 3 discuss the ward radiography

mobile radiography allows for the diagnostic imaging of patients who are unable to be seen in
the X-ray examination room. Therefore, mobile X-ray equipment is useful for patients who have
difficulty with movement. However, staff are exposed to scattered radiation from the patient, and
can receive potentially harmful radiation doses during radiography. The protection of staff is of
utmost importance, hence use of personal dosimeters when operating portable X-ray units. As
eye doses can be significant, protective measures are essential for RTs. It is important to evaluate
the radiation doses delivered to RTs during mobile radiography, as well as the scattered radiation
distribution, to ensure adequate protection. To ensure both patients and operators are safe when
using portable X-ray units, experts recommend proper training and protocols for use must be in
place, and must be strictly adhered to. Regular compliance audits, along with manufacturer-
recommended equipment servicing.

Justification
9) The principle of justification is that, in general, ‘any decision that alters the radiation exposure
situation should do more good than harm. This means that by introducing a new radiation source,
by reducing existing exposure, or by reducing the risk of potential exposure, one should achieve
sufficient individual or societal benefit to offset the detriment it causes’ (ICRP, 2007b,c). The
principal aim of medical exposures is to do more good than harm to the patient, subsidiary
account being taken of the radiation detriment from the exposure of the radiological staff and
other individuals (ICRP, 2007b).

Because of its risks, the portable x-ray equipment should only be used for examinations where it
is impractical or not medically acceptable to transfer patients to a fixed unit. The medical
practitioners should justify the use. The limited kV used in portable X-rays also limits the
examination types because some examinations require quite large kV parameters so there are
some projections that are unjustifaible as they will do harm to patient in unnecessary radiation
due to poor image quality.

Dose limit

Besides, another thing that must be considered is work area restriction, namely the control
area and supervision area. Access to work areas where radiation is being used should be
controlled to ensure doses to visitors are below the dose limits for the public. In a diagnostic
radiology facility, the control area is the locations where the X-ray equipment is operated.
Therefore, where portable X-ray equipment is placed can also be categorized as controlled
areas during radiological procedures are being carried out. The site should be shielded and
should be restricted, and there should be radiation warning signs indicate that X-ray equipment
is being operated [9]. Following BAPETEN Chairman Regulation No. 4 of 2013, personnel in the
control area should use individual dose monitor and radiation protective equipment [8]. The
supervised area may involve areas surrounding the control area. The supervised site is not
primarily based on the radiation exposure level, which in radiology diagnostic can be kept very
low, but instead as a 'buffer zone' due to other individuals' potential to enter the X-ray area
inadvertently and be exposed. Thus, this supervision area should also be marked [3].

Warning
Shielding

Placing a barrier of lead or concrete between the radiation source and an individual provides
protection from X-radiation (Jones and Taylor, 2006; Ehrlich and Coakes, 2017). During mobile
radiography, anyone assisting in an examination and staying in the radiation field should wear a
lead-rubber apron or stand behind a mobile lead screen. Generally, walls in special care units
where ionising radiation is used are designed to contain the radiation produced by the mobile X-
ray tube within a set of criteria and limits determined by relevant legislation (Hart et al, 2002).
Lead glasses may also be necessary for protecting the eyes of RTs to reduce scatter radiation that
can lead to biological stochastic effect with time to the radiosensitive eyes. Although portable X-
ray manufacturers typically include a lead shield within a portable X-ray unit, and/or a lead-
embedded acrylic protective shield at the end of the X-ray tube head, improper use can put
operators at risk of radiation exposure. The radiographer has to remain shielded behind a
protective lead wall, when operating X-ray units to avoid exposure from backscatter and
radiation leakage.

Radiation protection during mobile radiography

Radiographer’s understanding and adherence to radiation protection control measures during

mobile radiography is of paramount importance in protecting patients, themselves and members
of the public visiting the ward/unit. However, some research studies have found limited
awareness and non-adherence to radiation protection control measures among radiographers
during mobile radiography (Anim-Sampong et al, 2015; Luntsi et al, 2016; Azimi et al, 2018).
This can be attributed to a lack of radiation protection awareness programmes for nurses and
radiographers working in clinical settings where ionizing radiation is used, such as ICU and
hospital wards. There are three practical methods of controlling the external radiation exposure
during mobile radiography: time, distance and shielding.

Time
Minimising the exposure time of an individual reduces the dose from the radiation source
(Whitley et al, 2016; Martin et al, 2019). In the context of this article, the radiation source is the
X-ray tube of the mobile equipment. The control measure of time does not generally apply to
mobile radiography. If there is a need for a nurse to stay with the patient during the exposure, a
lead apron should be provided and rotation of nurses for patients requiring periodical mobile X-
ray examinations should be in place. Rotation reduces the amount of exposure to each nurse
(Jones and Taylor, 2006). However, nurses are rarely required to stay with the patient during the
X-ray exposure in mobile radiography.

Distance

The dose of radiation decreases dramatically as the distance is increased from the source
(Whitley et al, 2016; Martin et al, 2019). This is commonly called the inverse square law.
Therefore, nurses and supporting staff should stand as far as possible from the X-ray mobile
equipment and outside the radiation field when the radiographer is making an exposure (Whitley
et al, 2016). Mobile patients not on a life support system and members of the public should stand
at a safe distance during the X-ray exposure. The recommended minimal safe distance is 2
metres, at which scattered radiation is attenuated equivalent to background levels (Chiang et al,
2015).

Patients within 2 metres of the radiation field should be provided with shielding such as lead
aprons, especially paediatric patients, who are most vulnerable to ionising radiation due to a
higher sensitivity of the developing organs and tissue (International Commission on Radiation
Protection, 2013). It should be noted that radiographers and nurses have a responsibility to
ensure that no one is within the radiation field during the X-ray exposure of the patient. This is
achieved by informing all persons in the immediate area that an X-ray exposure is about to be
made and asking them to stand a safe distance from the radiation field area.

X-ray operators are universally recommended to maintain a safe distance outside the “controlled
zone”. Radiographers can be located close to a patient (i.e., the source of scattered radiation)
during mobile radiography. To reduce occupational radiation exposure, the radiographer should
remain distant from the patient if possible. However, because this distance may hinder
verification of the patient’s condition, the radiographer sometimes works in close proximity to
patients so there is need for one to be professional in applying radiation protection precautions as
there is need to balance both radiation safety and patient attention.