Basic principles of Radiology

Bachtiar Murtala
Department of Radiology Medical Faculty
Hasanuddin University
Makassar
 Tujuan pembelajaran
• Mengetahui posisi modalitas radiologi dalam diagnose dan
terapi penyakit
• Mengetahui jenis-jenis pemeriksaan radiologi ( x-ray
conventional, CT-Scan, MRI, Kedokteran nuklir, USG )
• Memahami cara kerja alat-alat radiologi
• Memahami potensi setiap alat-alat radiologi untuk diagnostik,
dan terapi
• Mengetahui efek samping radiasi dan prinsip proteksi radiasi
 Introduction
• Procedure of diagnosis of disease consist of
– Clinical history
– Physical examination
– Laboratory
– Visualization ( Radiology, endoscopy )
 Radiology
Diagnostic radiology—Radiations (ionizing and
nonionizing ), used as a tool to make diagnosis of
diseases.
Radiotherapy or radiation oncology --radiation used as
an agent to eradicate/to kill tumor/cancer

Diagnostic radiology can be categorized :

-Conventional
-Imaging/cross sectional ( CT,MRI,US,Nuclear Medicine )

Interventional radiology -therapeutic

 History in brief

• Radiology started when Prof.Wilhelm Conrad Roentgen

discovered of a new kind of rays (x-rays) in November 8,1895
in Germany
• He made a first photograph of his wife’s (Bertha) hand in Dec
22, 1895 using the rays, signed the true birthday of radiology
as a medical specialty.
• He was awarded Nobel Prize in Physics in 1901
• Later, CT (Computed Tomography) was discovered by Sir
Godfrey Hounsfield, and together with Allen Cormack ,
awarded Nobel Prize in 1979.
• Ultrasound ( US ) and Magnetic Resonance Imaging ( MRI )
discovered in eightieth
 Types of radiation source
• Radiations can be categorized into two main
forms :
• (1) Electromagnetic
X-rays,gamma-rays, uv, infra red, visible light,
radio waves.
• (2) Particles
• Electron, positron,etc
 X-ray
• To develop of x-ray beam, we need :
– A vacuum tube
– Electrons
– Focusing cup
– Metal filament
– Target
 Characteristic of X-ray
• Penetrating power
• Divergen
• Attenuation
• Scattering
• Ionizing
• Biologic effect
• Photographic
• Generated by electric power
• In (conventional) radiography, after passing the
body, x-ray will create an image directly on
photographic film.

• The film is covered by a thin emulsion of Silver

Bromide (AgBr), which is very sensitive to x-rays and
visible light,  blackening the film after having
developed in liquid developer ( washing processing )
 Positioning in radiography
• In conventional radiography, we should
familiar with the routine positions
• PA : Postero-anterior
• AP : Anterio-posterior
• RLD : Right lateral decubitus
• LLD : Left lateral decubitus
• etc
BASIC PRINCIPLES OF
RADIOLOGY
Bachtiar Murtala
 Terms in conventional radiography
Darkness to brightness

• Hyperradioluscent : free-air
• Radioluscent : lung, fat tissue
• Intermediate : soft tissues,water/fluid
• Radiopaque : Calsium, bone
• Hyperrariopaque : metal
 CT-Scan
(Computerized Tomography Scan )
• The greatest step forward since the discovery of X-
rays. First CT-Scan was introduced in 1972.
• X-rays pass the patient and reach detectors ( not on
the film )
• Only thin tissue slices are exposed by X-rays high
contrast resolution, no superimposition/ blurring of
structures
• Tissue and water/fluid can be distinguished ( in
conventional radiography can not be )
CT-axial
 Terms in CT
• Hyperdense : blood, calcification, bone
• Isodense/normodense : normal soft tissues
such as; brain, liver, spleen,etc
• Hypodense : fluid, edema, fat, abscess, tumor,
etc
HU=Hounsfield Unit
 MRI
( Magnetic Resonance Imaging )
• The latest newcomer of radiological modalities
• Exploits hydrogen nuclei (proton) of the human body
to develop signal
• Images in any plane of any part of the body
• No ionizing radiation No biologic effects
• Contraindication for patients with using
ferromagnetic material such as pacemaker
• More expensive, theoretically more difficult, and
technically more advanced
 Main Components
• A very strong magnet ( 0.1-1.5 Tesla or > )
• A radio transmitter
• A radio frequency receiver coil
• A computer
 Terms in MRI
• T1WI, T2WI, DWI, etc
(T1 Weighted Image)
• Hyperintense : brightness
• Isointense : same with normal adjacent
tissue
• Hypointense : darkness
Coronal view
Sagittal view

Arteriografi
CT Scan
MRI sagittal/samping
 T1WI
T2WI
 Radionuclide Imaging
( Nuclear medicine )
• Radioactive introduced into the body of the
patients orally or intravenously
• Detection of radiation emitted from
radioactive tracer inside the patient
• Radioactive tracers, termed
radiopharmaceuticals emit gamma rays.
• Gamma camera is used to detect the rays and
produce image.
 Two major tomographic methods :
• (1) SPECT ( single photon emission computed
tomography)
• (2) PET ( positron emission tomography )
PETPET
 Ultrasonography
• Ultrasound (US) sound wave freq >20 KHz
(above the human hearing range)
• Commonly used : 2-10 MHz
• No biologic effects
 Components
• Transducer/probe which contain piezo-
electrical crystals ( the main component )
These crystals act as both transmitter/produce
ultrasound and receiver (of echo)
• Computer and dysplay
• Printer
• The most important part is transducer
• Transducer contains piezoelectric crystals
with two functions : transmitter of US and
receiver of echo
• Echo returning to transducer generates
electrical signalscomputer image
 Terms in US
• Hyperechoic = echorich  brightness :
calcification, stone, gas
• Isoechoic= normoechoic : normal soft tissue;
liver, spleen, etc
• Hypoechoic = echopoor : tumor, abscess
• Free-echoic = unechoic : fluid ;water,etc
 Biologic effects
• Come from X-rays and gamma-rays since they
can ionize atoms/molecules of human tissue
• Can be grouped into : immediately effects,
latent somatic effects, and manifest genetic
damage
 Principles of radiation protection
• Should be apply to : patient, personnel, and
environment / around people
• Work with : - shorten time,
- appropriate distance,
- use protective tools
• Avoid and reduce somatic and genetic doses
to as low as possible ( ALARA, As Low As
Reasonably Achievable )
Thank you