IMAGING SYSTEM CHARACTERISTICS

Focal-Spot Size

Most x-ray tubes are equipped with two focal-spot sizes. On the operating console,
these usually are identified as small and large. Conventional tubes have two focal
spots of size, that is, 0.5 mm/1.0 mm, 0.6 mm/1.2 mm, or 1.0 mm/2.0 mm. X-ray
tubes used in angiointerventional procedures or magnification radiography may
consist of 0.3 mm/1.0mm focal spots.

Most mammography tubes have 0.1 mm/0.3 mm focal spot. These are called micro
focus tubes and are designed specifically for imaging very small
microfocalcalfications at relatively short SID.

For normal imaging, the large focal spot is used. This ensures that sufficient mAs
can be used to image thick or dense body parts. The large focal spot also provides for
a shorter exposure time, which minimizes motion blur.

One difference between large and small focal spots is the capacity to produce x-rays.
Many more x-rays can be produced with the large focal spot because anode heat
capacity is higher. With the small focal spot, electron interaction occurs over a much
smaller area of the anode, and the resulting heat limits the capacity of x-ray
production.

Changing the focal spot for a given kVp/mAs setting does not change x-ray
quantity or quality.

A small focal spot is reserved for fine-detail radiography, in which the quantity of
x-rays is relatively low. Small focal spot are always used for magnification
radiography. These are normally used during extremity radiography and in
examination of other thin body parts in which higher x-ray quantity is not necessary.

FILTRATION

Three types of filtration are used: inherent, added, and compensating. All x-ray
beams are affected by the inherent filtration properties of the glass or metal
envelope of the x-ray tube. For general purpose tubes, the value of inherent
filtration is approximately 0.5 mm Al equivalent.

The variable aperture light-localizing collimator usually provides an additional 1.0

mm Al equivalent. Most of this is due to the reflective surface of the mirror of the
collimator. To meet the required total filtration of 2.5 mm Al, an additional 1-mm Al
filter is inserted between the x-ray tube housing and the collimator. The radiologic
technologist has no control over these sources of filtration but may control stages of
added filtration.

Some x-ray imaging systems have selectable added filtration. Usually, the imaging
system is placed into service with the lowest allowable added filtration. Radiographic
technique charts usually are formulated at the lowest filtration position. If a high
filter position is used, .a radiographic technique chart must be developed at that
position.

Multiple layers of different filtration materials designed for specialty examinations

and patient dose reduction.

Under normal conditions, it is unnecessary to change the filtration. Some facilities

may be set for higher filtration during examinations of tissue with high subject
contrast, such as extremities, joints, and chest. When properly used. Higher filtration
for these examinations results in lower patient dose. When added filtration is
changed, be sure to return it to its normal position before beginning the next
examination
HIGH-VOLTAGE GENERATION

The radiologic technologist cannot select the type of high-voltage generator to be

used for a given examination. That choice is fixed by the type of x-ray imaging system
that is used. Still, it is important to understand how the various high-voltage
generators affect radiographic technique and patient dose.

Three basic types of high-voltage generators are available: single phase, three
phase, and high frequency. The radiation quantity and quality produced in the x-ray
tube are influence by the type of high-voltage generator that is used.

Take a review for the shape of the voltage wave form associated with each type of
high voltage generator. Table below lists the percentage ripple of various types of
high-voltage generators, the variation in their output, and the change in radiographic
technique used for two common examinations associated with each generator.

Characteristics Of The Various Types Of High-Voltage Generators

Equivalent technique
(kVp/mAs)

Generator type Percentage Relative Chest Abdomen

Ripple Quantity

Half-wave 100 100 120/20* 74/40

Full-wave 100 200 120/20 74/40

3-Phase, 6-pulse 14 260 115/6 72/34

3-Phase, 12-pulse 4 280 115/4 72/30

High-frequency ¿1 300 115/3 70/24

*The milliampere-second value equals that for a full-wave generator; exposure

time is double.

A half-wave-rectified generator has 100% voltage ripple. During exposure with a half-
wave-rectified generator, x-rays are produced and emitted only half the time. During
each negative half-cycle, no x-rays are emitted.

A half-wave rectification result in the same radiation quality as is produced

by full-wave rectification but the radiation quantity is halved.

Half-wave rectification is used rarely today. Some mobile and dental x-ray imaging
systems are half-wave rectified.
The voltage waveform for full-wave rectification is identical to that for half-wave
rectification, except there is no dead time. During exposure, x-rays are emitted
continually as pulses. Consequently, the required exposure time for full-wave
re4ctification is only half that for half-wave rectification.

Radiation quality does not change when going from half-wave to full-wave
rectification; however, radiation quantity doubles.

Three-phase power comes in two principal forms: 6 pulse or 12 pulse. The difference
is determined by the manner in which the high-voltage step-up transformer is
engineered.

Three-phase power results in higher x-ray quantity and quality.

The difference between the two forms is minor but does cause a detectable change in
x-ray quantity and quality. Three-phase power is more efficient than single-phase
power. More x-rays are produced for a given mAs setting, and the average energy of
those x-rays is higher. The x-radiation emitted is nearly constant rather than pulsed.

High-frequency generators were developed in the early 1980s and are increasingly
used. The voltage waveform is nearly constant, with less than 1% ripple.

High-frequency generation results in even greater x-ray quantity and

quality.

At present, high-frequency generators are used increasingly with dedicated

mammography systems, computed tomography systems, and mobile x-ray imaging
system. It is likely that the most high-voltage generators of the future will be of the
high-frequency type, regardless of the required power levels.

PATIENT FACTORS

Radiographic techniques may be described by identifying three groups of factors. The

first group includes patient factors, such as anatomical thickness and body
composition. The second group consists of image-quality factors, such as optical
density (OD), contrast, detail, and distortion. Also of importance is how these image-
quality factors are influenced by the patient.

The final group includes the exposure technique factors, such as kilovolt peak,
milliamperage, exposure time, and source-to-image receptor distance (SID), as well as
grids, screens, focal-spot size, and filtration. These factors determine the basic
characteristics of radiation exposure of the image receptor and patient dose, and
they provide the radiologic technologist with a specific and orderly means of
producing, evaluating, and comparing radiographs.

An understanding of each of these factors is essential for the production of high-

quality images.

Perhaps the most difficult task for the radiologic technologist involves evaluation of
patient. The patient’s size, shape, and physical condition greatly influence the
required radiographic technique.
The general size and shape of a patient is called body habitus. The sthenic patient –
meaning “strong active” – patients is the average patient. The hyposthenic patient is
thin but healthy appearing. Such patient requires less radiographic technique. The
hypersthenic patient is big in frame and usually overweight. The asthenic patient is
small, frail, sometimes emaciated, and often elderly.

Radiographic technique chart are based on the sthenic patient.

Recognition of body habitus is essential to radiographic technique selection. Once this

has been established, the thickness and composition of the anatomy being examined
must be determined.

THICKNESS

The thicker the patient, the more x-radiation is required to penetrate the patient to
expose the image receptor. For this reason, the radiologic technologist must use
calipers to measure the thickness of the anatomy that is being irradiated.

Patient thickness should not be guessed.

Depending on the type o radiographic technique practiced, the mAs setting or the kVp
will be altered as a function of the thickness of the part. Table below shows an
example of how the mAs setting changes when the abdomen is imaged if a fixed-kVp
technique is used and a reports the change in radiographic technique factors that
occurs as a function of thickness of part when a viable-kVp technique is used

FIXED-KVP TECHNIQUE FOR AN ANTERIOR-POSTERIOR ABDOMINAL EXAMINATION

kVp 80 80 80 80 80 80 80 80

Patient thickness in
(cm) 16 18 20 22 24 26 28 30

mAs 12 15 22 30 45 60 90 120

Variable-kVp Technique for an Anterior-Posterior Pelvis Examination

mAs 100 100 100 100 100 100 100 100

Patient thickness in 15 16 17 18 19 20 21 22
(cm)

kVp 56 58 60 62 64 66 68 70

COMPOSITION
Measurement of the anatomical part does not release the radiologic technologist from
exercising some additional judgment when selecting a proper radiographic technique.
The thorax and the abdomen may have the same thickness, but the radiographic
technique used for each will be considerably different. The radiologic technologist
must estimate the mass density of the anatomical part and the range of mass
densities involved.

In general, when only soft tissue is being imaged, low kVp and high mAs are used.
With an extremity, however, which consists of soft tissue and bone, low kVp is used
because the body part is thin.

When imaging the chest, the radiologic technologist takes advantage of the high
subject contrast. Lung tissue has very low mass density, the bony structures have high
mass density, and mediastinal structures have intermediate mass density.
Consequently, high kVp and low mAs can be used to good advantage. This results in an
image with satisfactory contrast and low patient radiation dose.

The chest has high subject contrast; the abdomen has low subject contrast.

These various tissues often are described by their degree of radiolucency or

radiopacity. Radiolucent tissue attenuates few x-rays and appears black on the
radiograph. Radiopaque tissue absorbs x-rays and appears white on the radiograph.
Table shows the relative degree of radiolucency for various types of body habitus and
tissue.

Radiolucent, referring to a tissue or materials that transmit x-rays and

appears dark on a radiograph.

Radiopaque, referring to a tissue or material that absorbs x-rays and

appears bright on a radiograph.

RELATIVE DEGREES OF RADIOLUCENCY

Radiographic Body habitus Tissue type

appearance

Radiolucent Black Asthenic Lung

⇓ Hyposthenic Fat
⇓ Sthenic Muscle
Radiopaque White hypersthenic Bone
PATHOLOGY

The type of pathology, its size and its composition influence radiographic technique.
In this case, the patient examination request form and previous images may be of
some help. The radiologic technologist should not hesitate to seek more information
from the referring physician, the radiologist, or the patient regarding the suspected
pathology.

Pathology can appear with increased radiolucency or radiopacity.

Some pathology is destructive, causing the tissue to be more radiolucent. Other

pathology can constructively increase mass density or composition, causing the tissue
to be more radiopaque. Practice and experience will guide the radiologic
technologist’s clinical judgment, but Box below presents a beginning classification
scheme.

CLASSIFYING PATHOLOGY

RADIOLUCENT (DESTRUCTIVE) RADIOPAQUE (CONSTRUCTIVE)

Active tuberculosis Aortic aneurysm

Atrophy Ascites

Bowel obstruction Atelectasis

Cancer Cirrhosis

Degenerative arthritis Hypertrophy

Emphysema Metastases

Osteoporosis Pleural effusion

Pneumothorax pneumonia

sclerosis