PRINCIPLES

of
RT IMAGING
 Discovery of “X-
rays”
X-rays were not developed; they were discovered, and quite by accident. During
the 1870s and 1880s, many university physics laboratories were investigating the
conduction of cathode rays, or electrons, through a large, partially evacuated glass
tube known as a Crookes tube.

Sir William Crookes was an Englishman from a humble background who was a
self-taught genius. The tube that bears his name was the forerunner of the modern
fluorescent lamps and x-ray tubes.

There were many different types of Crookes tubes; most of the them were capable
of producing x-rays. Wilhelm Conrad Roentgen was experimenting with a type of
tube when he discovered x-rays.

Source: Radiologic Science for Technologist by Stewart Carlyle

Bushong
On November 8, 1895, Roentgen was working in his physics laboratory at
Wurzburg University in Germany. He darkened his laboratory and completely
enclosed his Crookes tube with black photographic paper so he could better visualize
the effects of cathode rays in the tube.

A plate coated with Barium Platinocyanide, a fluorescent material, happened to be

lying on a bench several meters from the Crookes tube.

No visible light escaped from the Crookes tube because of the black paper that
enclosed it, but Roentgen noted that the barium platinocyanide glowed. The
intensity of the glow increased as the plate was brought closer to the tube ;
consequently, there was little doubt about the origin of the stimulus of the glow. This
glow is called fluorescence.

Roentgen’s immediate approach to investigating this “ x-light” as he called it, was to

interpose various materials -wood, aluminum, and his hand! -between the Crookes
tube and the fluorescing plate. The “x” for unknown! He feverishly continued these
investigations for several weeks.

Source: Radiologic Science for Technologist by Stewart Carly

 Early in his experiment, he was astonished to see the
image of the bones in his own hands on the screen,
while the flesh was penetrated through by the x-rays.
The field of radiography was born when he placed
his wife’s hand in front of the screen and allowed
the screen’s fluorescent light to expose a photographic
film for about four minutes. Along with three other
radiographs, this image was published two months later
in his paper, “On a New Kind of Rays”,
introducing the process of radiography to the world.

Source: Radiography in the Digital Age

by Quinn Carol
Anna Bertha First x-ray Wilhelm Conrad
Ludwig-Roentgen image Roentgen
Discovered “X-ray”
Nov. 8, 1895
“On a New Kind of
Rays”
 Nature of our Surroundings
In a physical analysis, all things can be classified as
matter or energy.
Matter is anything that occupies space and has
mass. It is the material substance of which
physical subjects are composed.
All matter is composed of fundamental building
blocks called atoms.
The primary distinguishable characteristic of
matter is mass, the quantity of matter.

Source: Radiologic Science for Technologist by Stewart Carlyle

 We generally use the term weight when
describing the mass of an object, and for our
purposes, we may consider mass and weight to be
the same. Remember, however, that in the
strictest sense, they are not the same.
 Mass is actually described by its energy
equivalence whereas, weight is the force exerted
on a body under the influence of gravity.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
Energy is the ability to do work.
Similar to matter, energy can exist in several forms.
 Electromagnetic energy is perhaps the least familiar form
of energy.
It is the most important for our purposes, however, because it
is the type of energy that is used in x-ray imaging.
 RADIATION
Radiation has been defined as the energy emitted
and transferred through matter.
General classifications of radiation:
1.Non-ionizing radiation - radiation for which the
mechanism of action in tissue does not directly ionize atomic
or molecular systems through a single interaction.
 A radiation that is not capable of causing ionization.

2.Ionizing radiation – radiation that is capable of

ionization.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
IONIZATIO occurs when an
electromagnetic
N radiation passes close
to an orbital electron
of an atom and transfer
sufficient energy to the
electron to remove it
from the atom.

 The orbital electron and the atom which it was

separated are called ion pair. The electron is the
negative ion and the remaining atom is a positive
ion.
Source: Radiologic Science for Technologist by Stewart
Irradiation &
Contamination
 Irradiation/Exposure – matter that
intercepts radiation and absorbs part or
all of it.
 During a radiographic examination, the patient is exposed
to x-rays.
 Contamination – matter that has been
irradiated and becomes a source of
radiation.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 SOURCES OF
IONIZING
RADIATION
“ Many types of radiation are harmless, but ionizing
radiation can injure humans. We are exposed to
many sources of ionizing radiation.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 NATURAL
ENVIRONMENTAL/BACKGROU
ND RADIATION
1. Cosmic rays
 radiation emitted by the sun and stars.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
2. Terrestrial radiation
 results from deposits of
uranium, thorium, and
other radionuclides in the
Earth.
 The intensity is highly
dependent on the geology
of the local area.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
3. Internally-deposited Radionuclides
 mainly potassium-40 (40K), are natural
metabolites.
 Carbon 14 (14C) deposited in trees and fossils.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
Source: Radiologic Science for Technologist by Stewart
Carlyle Bushong
 MAN-MADE
RADIATION
Diagnostic x-rays
 constitute the largest source of man-made ionizing radiation.
Nuclear Power Stations and Industrial
Sources
Consumer Products
Radioactive Fallout
 The deposition on the surface of the earth of radioactive
particles, released into the atmosphere as a result of
nuclear explosions and by discharge from nuclear-
power and atomic installations.
IONIZING
RADIATION
 Particulate Radiation
 Electromagnetic Radiation

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
PARTICULATE
RADIATION
 Any subatomic particle is capable of causing
ionization. Consequently, electrons, protons, and
even rare nuclear fragments can all be classified as
particulate ionizing radiation if they are in motion and
posses sufficient kinetic energy. At rest, they cannot
cause ionization.

There are two main types of particulate radiation:

A. Alpha particles
B. Beta particles

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
Alpha Particles ( )
 The
a
alpha particle is equivalent to helium
nucleus. It contains two protons and two
neutrons. Its mass is approx. 4 amu, and it
carries two units of positive electric charge.
 Alpha particles are emitted only from the
nuclei of heavy elements. Radioisotopes with
mass greater than 150.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 After being emitted from a radioactive atom,
the alpha particle travels with high velocity
through matter. Because of its great mass and
charge, however, it easily transfers this kinetic
energy to orbital electrons of the atom.
 Because of this amount of ionization, the energy
of an alpha is particle quickly lost. It has a very
short range in matter.
 In air alpha particle can travel approx. 5 cm. In
soft tissue, the range may be less than 100 um.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 Irradiation of alpha particle from an
external source is nearly harmless
because the radiation energy is deposited
in the superficial layers of the skin.
 But, if an alpha-emitting radioisotope is
deposited in the body, it can intensely
irradiate the local tissue.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
Beta Particles (βˉ/β+)
 Beta particles are light with an atomic mass number of
zero (0) and carry one unit of negative (beta minus)or
positive (beta plus) charge.
 The only difference between electrons and negative beta
particles is their origin.
 A beta particle originates in the nuclei of radioactive
atoms and electrons exist in shells outside the nuclei of all
atoms.
 Positive beta particles are positrons. They have the same
mass as electrons and are considered to be anti-matter.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 After being emitted from a radioisotope,
beta particles traverse air, ionizing several
hundred atoms per cm. Beta particle range
is longer than that for the alpha particle.
 Depending on its energy, a beta may
traverse 10 to 100 cm of air and approx. 1
to 2 cm of soft tissue.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
PARTICULAT Energy Air Soft
E Tissue
Alpha (a) 4-7 MeV 1-10 cm < 0.1 mm

Beta (βˉ/β+) 0-7 MeV 0-10 m 0-2 cm

Origin
(a) Heavy radioactive
nuclei
(βˉ/β+) Radioactive nuclei

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
ELECTROMAGNETIC RADIATION
 X-rays and gamma rays are forms of
electromagnetic ionizing radiation.
 X-rays and Gamma rays are often called
photons.
 Photons have no mass and no charge.
 They travel at the speed of light (c=3.0 x 108
m/s) and are considered energy disturbances in
space.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 After being emitted, they have an ionization rate in
air of approx. 100 ion pairs/cm. In contrast to beta
particles, however, x-rays and gamma rays have an
unlimited range in matter.
 Photon radiation loses intensity with distance but
theoretically never reaches zero. Particulate
radiation, has a finite range in matter, and that range
depends on the particle’s energy.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 The only difference between x-rays
and gamma rays is their origin.

 Gamma rays are emitted from the nucleus

of a radioisotope and are usually associated
with alpha or beta emission.
 X-rays are produced outside the nucleus in
the electron shells.

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
 EM Energy Air Soft
RADIATION Tissue
X-rays (X) 0-25 MeV 0-100 m 0-30 cm

Gamma rays (Y) 0-5 MeV 0-100 m 0-30 cm

Origin
(X) Electron cloud

(Y) Radioactive nuclei

Source: Radiologic Science for Technologist by Stewart

Carlyle Bushong
Principal parts of an x-ray
imaging system
 Operating Console
 High-voltage generator
 X-ray tube
Early Pioneers in
Radiography
 Michael Pupin -demonstrated the use of a radiographic
intensifying screen in 1896, but only many years later
did it receive adequate recognition and use.
Note: Radiographs during Roentgen’s time were made by
exposing a glass plate with a layer of photographic
emulsion coated on one side.

 Charles L. Leonard - found that by exposing two glass

x-ray plates with the emulsion surfaces together,
exposure time was halved, and the image was
considerably enhanced.
Note: The demonstration of double-emulsion
radiography was conducted in 1904, but double-
 Thomas A. Edison –developed the fluoroscope in 1898.

 Clarence Dally -experienced a severe x-ray burn that

eventually required amputation of both arms.
Note: Dally died in 1904 and is counted as the first x-ray fatality
in the United States.

 Before 20th century Boston dentist William Rollins -used x-rays

to image a teeth and found that restricting the x-ray beam with a
sheet of lead and with a hole in a center, a diaphragm, and
inserting a leather or aluminum filter improved the diagnostic
quality of radiographs.
Note: This was the first application of collimation and filtration. It was later
recognized that these devices reduce the hazard associated with x-rays.
 In 1907, H.C. Snook -introduced a substitute high-voltage power
supply, an interrupless transformer. It was not until the introduction
of Coolidge tube that the Snook transformer was widely adopted.
Note: During Roentgen’s time, only static generators were available.
These units could provide currents of only few milliamperes and a
voltage to 50 kVp.
 
 In 1913, William D. Coolidge unveiled his hot-cathode x-ray
tube to the medical community. It was immediately recognized as far
superior to the Crookes tube. It was a vacuum tube that allowed x-
ray intensity and energy to be selected separately and with great
accuracy. X-ray tubes in use today are refinements of the Coolidge
tube.
Note: Radiology emerged as a medical specialty because of the Snook
transformer and the Coolidge x-ray tube.
 In 1913, Gustav Bucky (German) invented the stationary
grid (“Glitterblende”); 2 months later, he applied his second
patent for a moving grid.
 
 In 1915, Hollis Potter (American), probably unaware of
Bucky’s patent because of WWI, also invented a moving
grid. To his credit, Potter recognized Bucky’s work, and the
Potter-Bucky grid was introduced in 1921.
 
 In 1946, the light amplifier tube was demonstrated at Bell
Telephone Laboratories. This device was adapted for
fluoroscopy by 1950 as an image intensifier tube. Today,
image-intensified fluoroscopy is being replaced by solid-state
image receptors.
Each recent decade has seen remarkable
improvements in medical imaging.
 Diagnostic ultrasonography and Gamma Camera
appeared in the 1960s.
 Positron Emission Tomography (PET) and
Computed Tomography (CT) were developed in
1970s.
 Magnetic Resonance Imaging (MRI) became
accepted modality in the 1980s, and
 Now, Digital Radiography and Digital Fluoroscopy
are rapidly replacing Screen-Film Radiography and
Image-Intensified Fluoroscopy.
Source: Radiologic Science for Technologist by Stewart
Carlyle Bushong
X-Ray Production
Electron Target Interaction
The projectile electron interacts with the
orbital electrons or nuclear field of target
atoms.
These interactions result in the conversion
of electron kinetic energy into thermal
energy (heat) and electromagnetic energy in
the form of infrared radiation (also heat) and
x-rays.
Anode Heat
Most of the kinetic energy of projectile electrons is
converted into heat. The projectile electrons interact
with the outer-shell electrons of the target atoms but
do not transfer sufficient energy to these outer-shell
electrons to ionize them. Rather, the outer-shell
electrons are simply raised to an excited, or higher,
energy level.
Approximately 99% of the kinetic energy of
projectile electrons is converted to heat. Only
approximately 1% of projectile electron kinetic energy
is used for the production of x-radiation.
 Processes involved in x-ray production
1. Production of electrons
(Thermionic emission)
2. Acceleration of electrons
3. Deceleration of electrons
4. Emission of electron as Heat & X-rays
When the rotor, or prep button is
pushed:
On the cathode side of the x-ray tube:
a. Filament current heats up the filament
b. This boils electrons off the filament
(Thermionic emission)
c. The electrons gather in a cloud around the filament
(Electron cloud)
d. The negatively charged focusing cup keeps the electron
cloud focused together
e. The number of electrons in the space charge is limited
(Space charge effect)
When the rotor, or prep button is
pushed:
On the anode side of the x-ray tube:
a. The rotating target begins to turn rapidly, quickly
reaching top speed.
When the exposure, or x-ray button is
pushed:
On the cathode side of the x-ray tube:
a. High negative charged strongly repels electrons.
b. The electrons stream away from the cathode and
toward the anode (tube current)

On the anode side of the x-ray tube:

a. High positive charge strongly attracts electrons in
the tube current.
b. These electrons strike the anode.
c. X-rays and heat are produced.
CHARACTERISTIC RADIATION
If the projectile
electron interacts
with an inner-
shell electron of
the target atom
characteristic x-
rays can be
produced.

Characteristic x-rays are emitted when an

outer-shell electron fills an inner-shell void.
 CHARACTERISTIC RADIATION
Tungsten: 18474W

Shell # of e- Binding energy (keV)

K 2 69
L 8 12
M 18 3
N 32 1
O 12 0.1
P 2

Note: Only the K-characteristic x-rays of

tungsten are useful for imaging.
BREMSSTRAHLUNG RADIATION
 Bremsstrahlung is a German word that
means “slowed-down radiation”.
Bremsstrahlung x-rays can be considered
radiation that results from the braking of
projectile electrons by the nucleus.

 Bremsstrahlung x-rays are produced when a

projectile electron is slowed by the nuclear
field of a target atom nucleus.
BREMSSTRAHLUNG RADIATION
Note: Bremsstrahlung x-rays can be produced
at any projectile electron energy.
K-characteristic x-rays requires an x-ray tube
potential of at least 69 kVp.
 
At 65 kVp, for example, no useful characteristic
x-rays are produced, therefore, the x-ray
beam is all bremsstrahlung.
BREMSSTRAHLUNG RADIATION
X-Ray Emission
 X-rays are emitted through a window in
the glass or metal enclosure of the x-ray
tube in the form of a spectrum of
energies.
 The x-ray beam is characterized by:
Quantity -the number of x-rays in the
beam and;
Quality -the penetrability of the beam.
X-ray Quantity
X-ray Intensity
The x-ray intensity of the x-ray beam of an x-ray imaging
system is measured in milligray in air (mGya) and is called
the x-ray quantity. Another term, radiation exposure,
is often used instead of x-ray intensity or x-ray quantity.

X-ray quantity/X-ray intensity/Radiation exposure

is the number of x-rays in the
useful beam.
Factors That Affect X-ray QUANTITY
1. milliAmpere-seconds (mAs)
X-ray quantity is directly proportional
to the mAs. When mAs is doubled
the number of electrons striking the
tube target is doubled, and therefore
the number of x-rays emitted is
doubled.
milliAmpere-seconds (mAs)

X-ray Quantity and mAs

Mathematically,
I1/I2 = mAs1/mAs2

where I1 and I2 are the x-ray intensities at mAs1

and mAs2, respectively.
milliAmpere-seconds (mAs)
Equation:
I1/I2 = mAs1/mAs2

Practice question:
A lateral chest technique calls for 110 kVp, 10
mAs, which results in an x-ray intensity of 320
µGya at the position of the patient. If the mAs
is increased by 20 mAs, what will the x-ray
intensity be?
2. Kilovolt peak (kVp)
X-ray quantity varies rapidly with
changes in kVp. The change in x-ray
quantity is proportional to the square of
the ratio of the kVp.

In other words, if kVp were doubled, the x-ray

intensity would increase by a factor of 4.
Kilovolt peak (kVp)

X-ray Quantity and kVp

Mathematically,
I1/I2 = (kVp1/kVp2)2

where I1 and I2 are the x-ray intensities at kVp1

and kVp2, respectively.
Kilovolt peak (kVp)
Equation:
I1/I2 = (kVp1/kVp2)2

Practice question:
A lateral chest technique calls for 110 kVp, 10
mAs and results in an x-ray intensity of 0.32
mGya. What will be the intensity if the kVp is
increased to 125 kVp and the mAs remains
fixed?
3. Distance
X-ray intensity varies inversely with the square
of the distance from the x-ray tube target.
This relationship is known as the inverse square
law.
X-ray Quantity and Distance
Mathematically,
I1/I2 = (d2/d1)2

where I1 and I2 are the x-ray intensities at

distance d1 and d2, respectively.
 
Inverse Square Law
Equation:
I1/I2 = (d2/d1)2

Practice question:
A posteroanterior (PA) chest examination (120
kVp/3mAs) with a dedicated x-ray imaging system is
taken at an SID of 300 cm the exposure at the image
receptor is 0.12 mGya. If the same technique is used
at a SID of 100 cm, what will be the x-ray exposure?
 Compensating for a change in SID by changing
mAs by the factor SID2 is known as the square law, a
corollary to the inverse square law.
 
The Square Law
Mathematically,
mAs1/mAs2 = (SID1/SID2)2

where mAs1 is the technique at SID1 and mAs2 is

the technique at SID2.
 
The Square Law
Equation:
mAs1/mAs2 = (SID1/SID2)2

Practice question:
What will be the new mAs in the previous
question to reduce the x-ray quantity to 0.12
mGya at 100 cm?
4. Filtration
 X-ray imaging systems have metal filters,
usually 1 to 5 mm of aluminum (Al),
positioned in the useful beam. The
purpose of these filters is to reduce
the number of low energy x-rays.
 Low energy x-rays contribute nothing useful
to the image. They only increase the
patient dose unnecessarily, because they
are absorbed in superficial tissues and do
not penetrate to reach the image receptor.
 
 Affecting Effects on
Factor QUANTITY

Increased quantity
mAs
Increased quantity
kVp

Distance Decreased quantity

Decreased
Filtration quantity
X-ray Quality
Penetrability
As the energy of an x-ray beam is increased, the
penetrability is also increased.
The penetrability of an x-ray beam is called the x-ray
quality. X-rays with high penetrability are termed
high-quality x-rays. Those with low penetrability are
low-quality x-rays.
Penetrability
refers to the ability of
x-rays to penetrate deeper in tissue.
Factors That Affect X-ray QUALITY
1. Kilovolt peak (kVp)
 As the kVp is increased, so is x-ray beam
quality.
 An increase in kVp results in a shift of the x-
ray emission spectrum toward the high energy
side, indicating an increase in the effective
energy of the beam. The result is a more
penetrating x-ray beam.
 Increasing the kVp, increases the quality of an
x-ray beam.
Factors That Affect X-ray QUALITY
2. Filtration
The primary purpose of adding filtration to an x-ray beam is
to remove selectively low-energy x-rays that have little
chance of getting to the image receptor.
 Increasing filtration increases the quality of an x-ray beam.
 Al (Z = 13) is chosen because it is efficient in removing low-
energy x-rays through the photoelectric effect and because it
is readily available, inexpensive, and easily shaped.
 As filtration is increased, so is beam quality, but
quantity is decreased.
Types of Filtration
Inherent Filtration 
Refers to the filtration that is permanently in the
path of the x-ray 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

Added Filtration 
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.
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.
Compensating filter –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.

Wedge Filters –most common

type of compensating filters. The thicker
part of the wedge filter 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.
 Bilateral wedge
filter/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.

Special “Bow-tie”
-shaped filters are used with
computed tomography imaging
systems to compensate for the
shape of the head or body.
Affecting Effects on
Factor QUALITY

Increased quality
kVp

Increased
Filtration quality
 Factor Effects on Effects on
Increased QUANTITY QUALITY

mAs Increases No effect

kVp Increases Increases

Distance Decreases No effect

Filtration Decreases Increases

X-ray Interactions w/ Matter
 Coherent/Classical
Scattering
 Compton Scattering
 Photoelectric Effect
 Pair Production
 Photodisintegration
Coherent/Classical
Scattering

1st described by J.J Thompson

 Coherent/Classical
Scattering
 X-rays with energies below approx. 10 keV interact with
matter by coherent scattering.
 The incident x-ray interacts with a target atom, causing
it to become excited.
 The target atom immediately releases this excess
energy as a scattered x-ray with wavelength equal to
that of the incident x-ray and therefore of equal energy.
However, the direction of the scattered x-ray is different
from that of the incident x-ray.

1st described by J.J Thompson

Compton Scattering

Named after: Arthur Holly Compton

 Compton Scattering
 In Compton scattering, the incident x-ray
interacts with an outer-shell electron
and ejects it from the atom, thereby
ionizing the atom. The ejected electron is
called a Compton electron or recoil
electron.
 During Compton scattering, most of the
energy is divided between the scattered x-
ray and the Compton electron.

Named after: Arthur Holly Compton

 Selected scattering cases
can be considered:
1. The minimum energy transfer occurs for a 0-degree photon
scatter (gazing hit), there is no interaction, and the
scattered photon has the same energy as the incident photon.
The electron is scattered at 90-degree with zero energy. 
2. The maximum energy transfer occurs for a direct hit with a
backscattered photon (180-degrees) and yields a
(minimum) scattered photon energy. The electron has
maximum energy and travels in forward direction.
3. The 90-degree Compton scattered photon energy will
always be less than the incident photon energy. The electron
travels in a direction that depends on the incident photon
energy.

Note: Compton scattering reduces image

contrast.
Photoelectric Effect

Works of Albert Einstein

 Photoelectric Effect
 X-rays in the diagnostic range also undergo ionizing
interactions with inner-shell electrons. The x-ray is not
scattered, but it is totally absorbed.
 This process called the Photoelectric effect.
 The electron removed from the atom is called a
photoelectric electron.
 A photoelectric interaction cannot occur unless the
incident x-rays has energy equal to or
greater than the electron binding energy.

Works of Albert Einstein

 PROBLEM EXERCISES:
1. Within the patient’s body, a 40 kV x-ray undergoes a
Compton interaction within an L-shell electron in a
calcium atom. The absolute value for the binding
energy of the L-shell is 0.5 kV (rounded). The recoil
electron speeds away from the atom with 5 kV of
kinetic energy. What is the energy of Compton
scattered photon?

2. Within the patient’s body, a 30 kV x-ray undergoes a

photoelectric interaction with a K-shell electron in a
calcium atom (4 kV). What will be the kinetic energy
of the photoelectron speeding away from the atom?
Pair Production
 Pair Production
 If the incident x-ray has sufficient energy, it may
escape interaction with the electrons and come close
enough to the nucleus of the atom.
 The interaction between the x-ray and the nuclear
field causes the x-ray to disappear, and in its place,
two electrons appear, one positively charged
(positron) and one negatively charged. This process
is called pair production.
 The incident x-ray photon must have at least
1.02 MeV of energy. An x-ray with less than
1.02 MeV cannot undergo pair production.
 Pair Production
 The positron unites with the free electron, and
the mass of both particles is converted to energy
in a process called annihilation
radiation. 
 Because pair production involves only x-rays with
high energies greater than 1.02 MeV, it is
unimportant in x-ray imaging, but is very
important for Positron Emission Tomography
imaging (PET) in nuclear medicine.
Photodisintegration
 Photodisintegration
 X-rays with energy above approx. 10 MeV
can escape interaction with electrons and
the nuclear field and be absorbed directly
by the nucleus.
 When this happens, the nucleus is raised to
an excited state and instantly emits nucleon
or other nuclear fragment. This process is
called photodisintegration.
Of the five ways an x-ray can interact
with tissues, only two are important
to radiology,
 Compton Scattering
 Photoelectric Effect
 DIFFERENTIAL ABSORPTION
Differential absorption occurs because of
Compton scattering, photoelectric effect, and x-
rays transmitted through the patient.
Compton-scattered x-ray contributes no useful information
to the image.
X-rays that undergo photoelectric interaction provide
diagnostic information to the image receptor.
Because they do not reach the image receptor, these x-
rays are representative of anatomical structures with high
x-ray absorption characteristics; such structures are
radiopaque. Photoelectric absorption produces light areas
in a radiograph, such as those corresponding to bones.
Other x-rays penetrate the body and are transmitted
to the image receptor with no interaction. They produce
the dark areas of a radiograph. The anatomical structures
through which these x-rays pass are radiolucent.
 
Basically, an x-ray image results from the difference
between those x-rays absorbed
photoelectrically in the patient and
those transmitted to the image receptor.
This difference in x-ray interaction is called
differential absorption.

Differential absorption increases as the kVp is

reduced.
 P. Interaction = Radiopaque
Transmitted = Radiolucent

Approx. 1% of the photons that

interact with the patient (primary
beam) reach the IR. Of that 1%
approx. 0.5% interact to form
the image.
 What causes blacks, whites, and grays of
an x-ray image?
 X-ray beams contains x-ray photons of
differing energies

As these photons pass through our body

Some are absorbed completely White
Some are not absorbed at all (transmitted)
Black
Some are absorbed partially
Gray
 Differential Absorption
 Dependence on
Atomic Number (Z)
 Example: Extremity
examination
 More photons are absorbed
photoelectrically in bone than
in soft tissue
 Probability of PE interaction is
7 times for bone than soft tissue
 Photoelectric absorption is
proportional to Z3
Example:
1.How much more
likely is an x-ray
photon to interact
with bone than in
fat?
 Differential Absorption
 Dependence on Mass
Density
 Intuitively, we could image bone
even if differential absorption
were not related to Z
 Bone has a higher mass density
than soft tissue
 Mass density: mass per unit
volume (kg/m3)
 All interaction is proportional to
mass density
Example:
1.Assume that all
interactions during
mammography are
photoelectric. What is the
differential absorption of
x-rays in
microcalcifications
relative to fatty tissue?
 Differential Absorption
 Contrast Examination
 Barium and Iodine
 Both have high Z and density than soft tissue

Example:
1.What is the
probability that an x-
ray will interact with
iodine rather than in
soft tissue?
Extremity X-rays
Barium Exam
Iodine Exam
 Exponential Attenuation
 An interaction such as the photoelectric effect is
called an absorption process because the x-ray
disappears.
 Interactions in which the x-ray is only partially absorbed,
such as Compton scattering, are only partial
absorption process.
 The total reduction in the number of x-rays remaining in
an x-ray beam after penetration through a given thickness
of tissue is called attenuation.
 Exponential Attenuation
 When a broad beam of x-rays is incident on
any tissue, some of the x-rays are absorbed,
and some are scattered. The result is a
reduced number of x-rays, a condition
referred to as x-ray attenuation.
 
IMAGE RECEPTORS

 Double Emulsion radiographic film, as used in a cassette

with intensifying screens, is the most common film-screen
image receptor used in radiography today.
 The Intensifying Screens absorb the transmitted x-rays and
produce light, which exposes the film.
 The film records the image based on the pattern transmitted x-
rays and light produced by the intensifying screens.
 The cassette is the rigid, light-tight container that holds the
screens and film in close contact.
Radiographic Film
 
 Several types of radiographic film are used in
medical imaging departments, depending on the
specific application. Film manufacturers produce
film in a variety of sizes, ranging from 20x25 cm
(8x10 inches) to 35x43 cm (14x17 inches)
Film Construction
 The composition of film can be describes in layers:

 
1. Super Coat / Top Coat – is a durable protective layer that is
intended o prevent damage to the sensitive emulsion layer
underneath it.
2. Emulsion – is the radiation sensitive and light sensitive layer
of the film. It consists of:
a. Silver Halide Crystals – is the material that is sensitive to
radiation and light. It is made up of silver bromide (AgBr)
and silver iodide (AgI). It is believed that silver bromide
constitutes 90% to 99% of the silver halide in film emulsions
and that silver iodide makes up the remaining 1% to 10%.
a. Gelatin – made up from the calf skin. It is an ideal
suspension medium for the silver halide crystals.
3. Base – is polyester (plastic) that gives the film physical
stability. The emulsion layer is fairly fragile and must
have this plastic base so that film can be handled and
processed, tet remain physically strong after processing.
Most film used in radiographic procedures has a blue
dye or tint added to the base layer to decrease eye strain
while one view the finished radiograph.
4. Adhesive Layer – between the emulsion layer and the
base. It simply adheres one layer of the film to another.
Latent Image Formation
Latent Image
 Refers to the image that exists on film after that film has been exposed but
before it has been processed.
Manifest Image
 Refers to the image that exist on film after exposure and processing. The
manifest image typically is called radiographic image.
Gurney-Mott Theory of Latent Image Formation:
 Before exposure, silver halide (AgBr and AgI) is suspended in gelatin in
the emulsion layer. Sensitivity specks exist as physical imperfections in
film lattice.
 Exposure to x-rays and light ionizes the silver halide.
 Negatively charged electrons and positively charged silver ions float
freely in the emulsion gelatin.
 Sensitivity specks trap electrons
 Each trapped electrons attracts a silver ion
 Silver clumps around the sensitivity specks
Sensitivity Specks and Latent Image Centers
 Sensitivity specks serves as the focal point for the
development of latent image centers. After
exposure, these specks trap the free electrons and
then attract and neutralize the positive silver ions.
After enough silver is neutralized, the specks become
a latent image center and are converted to black
metallic silver after chemical processing.
 Types of Film
 Two general types of film are used in diagnostic imaging:
1. Direct Exposure Film – is often called nonscreen film.
 It is intended to be used in a cardboard holder and without intensifying
screens.
 It has a single emulsion that significantly thicker than screen film and
requires more development time.
 Compared with screen film, it requires considerably more exposure and
may necessitate manual processing.
 Commonly used for intra oral dental radiography.
 Considered out dated technologies.
2. Screen Film – is the most widely used radiographic
film.
        It is intended to be used with one or two intensifying
screens.
        It is more sensitive to light and less sensitive to x-
rays.
        The emulsion layer is thinner than those of the direct
exposure film and requires less developing time.
        Requires less x-ray exposure, can be either manually
or automatically processes and can have either a single or
double emulsion coating (sometimes referred to as
duplitized)
Double- emulsion film
 Has an emulsion coating on both sides of the base and a layer of supercoat
over each coating. Radiographic imaging typically uses double-emulsion
film with two intensifying screen.
Single-emulsion film
 With only one emulsion layer, is used with single intensifying screen. It
has many uses:
a. duplication
b. subtraction
c. computed tomography (CT)
d. magnetic resonance imaging (MRI)
e. sonography
f. nuclear medicine
g. mammography
h. laser printing
 Contains an anticurl/antihalation layer, which differentiates it from
double-emulsion film.
Anticurl / Antihalation layer
 Is a colored backing on single emulsion film that
prevents film from curling and prevent halation.

Halation – refers to an image being recorded on the

film by reflected light that exposes the emulsion a
second time.
Film Characteristics
1. Film Speed – is the degree to which the emulsion is
sensitive to x-rays or light. The greater the speed of a film
the more sensitive it is. This increase in sensitivity results in
less exposure necessary to produce a specific density. Two
primary factors that affect the speed of radiographic film:
a. the number of silver halide crystals present in the film
b. the size of silver halide crystals present in the film
 Silver Halide and Film Sensitivity
 As the number of silver halide crystals increases, film
sensitivity or speed increases; as the size of the silver halide
crystals increases, film sensitivity or speed increases.
 
Film Speed and Radiation Exposure
 
 The faster the speed of a film, the less radiation exposure
needed to produce a specific density.
 
2. Film Contrast – refers to the ability of radiographic
film to provide a certain level of image contrast.
 
3. Exposure Latitude - refers to the range of exposures
that produce optical densities with the straight line region
of the sensitometric curve.
Spectral Matching
 
 Refers to the color of light to which particular film is
most sensitive. In radiography, there are generally
two categories of spectral sensitivity films:
a. blue sensitive
b. green sensitive (orthochromatic)
 When radiographic film is used with intensifying
screens, it is important to match the spectral
sensitivity of the film with spectral emission of the
screens.
 
Spectral emission – refers to the color of light produced
by a particular intensifying screen.
 
Spectral matching – refers to correctly matching the
color sensitivity of the film to the color emission of the
intensifying screen.
 
Corssover – refers to the light that has been produced
by an intensifying screen that exposes one emulsion
and then crosses over the base layer of the film to
expose other emulsion. It is a radiographic problem
because it decreases recorded detail as seen on the
image.
Intensifying Screen
 
 Is a device found in radiographic cassettes that contains
phosphors that convert x-ray energy to light, which then
exposes the radiographic film.
 Intensify or amplify the energy to which they are exposes.
 With screens, the total amount of energy to which the film is
exposed is divided between x-rays and light. Approximately
90% to 99% of the total energy to which the film is exposed
is light. X-rays account for the remaining 1% to 10% of the
energy.
 
Luminescence – is the emission of light from the screen
when stimulated by radiation. IS operates in this
process.
 
Fluorescence – refers to the ability of phosphors to emit
visible light only while exposed to x-rays.
 
Phosphorescence – occurs when screen phosphors
continue to emit light after the x-ray exposure has
stopped. It is also called screen lag or afterglow.
 Screen Construction
Layers of Intensifying Screen:
1. Protective Layer – the outermost layer, found closest to the film. It
is made of plastic and protects the fragile phosphor material beneath
it.
2. Phosphor Layer – or active layer, is the most important screen
component because it contains the phosphor material that absorbs the
transmitted ex-rays and converts them to visible light.
3. Reflecting Layer – to reflect light toward the film. It is made up of
either magnesium oxide or titanium dioxide.
4. Base – the bottom layer, found farthest from the film. Made of
polyester or cardboard. It must be flexible and chemically stable. It
provides support and stability for the phosphor layer.
Intensifying Screen Phosphor Materials and Their
Spectral Emissions
Phosphor Spectral
Emission
Calcium Tungstate (CaWO4) Blue

Rare Earth elements  

Lanthanum oxybromide (LaOBr) Blue
Yttrium Tantalate (YtaO4) Ultraviolet/blue
Gadolinium oxysulfide (Gd2O2S) Green
Others  
Barium lead sulfate (BaPbSO4) Blue
Barium strontium sulfate Blue
(BaSrSO4)
Screen Speed – the capability of a screen to produce visible light.
 
Screen Speed and Light Emission
 
 The faster an intensifying screen, the more light emitted for the same
intensity of x-ray exposure.
 
Intensification Factor
 
 The intensifying action of the screen. This factor accurately represents
the degree to which exposure factors (and patient dose) are reduced when
intensifying screens are used. The intensification factor (IF) can be
sated as follows:
 
IF = Exposure required without screens
Exposure required with screens

 
Screen Speed and Patient Dose
 
As screen speed increases, less radiation is
necessary and radiation dose to the patient
decreases; as screen speed decreases, more
radiation dose to the patient increases.
Relative speed – the ability of the screen to produce light, and therefore
density.
Screen Speed and Density
 For the same exposure, as screen speed increases, density increases; as
screen speed decreases, density decreases.
 Screen speed density are directly proportional. The mAs conversion
formula for screens is a formula for the radiographer to use in
determining how to compensate or adjust mAs when changing
intensifying screen system speeds. This formula is stated as follows:
mAs1 = Relative screen speed 2
mAs2 Relative screen speed 1

 Phosphor Thickness, Crystal Size, and Screen Speed

 As thickness of the phosphor layer increases, the speed of the
intensifying screen increases; as the size of the phosphor crystals
increases, the speed of the screen.
 Summary of Effect of Screen factors on Screen Factors on Screen
Speed, Recorded Detail, and Patient Dose

Screen Factor Screen Speed Recorded Detail Patient Dose

Thicker phosphor layer Increase Decrease Decrease

Larger phosphor crystal size Increase Decrease Decrease

Reflective layer Increase Decrease Decrease

Absorbing layer Decrease Increase Increase

Dye in phosphor layer Decrease Increase Increase

Screen Speed and Recorded Detail
 
 With any given phosphor type, as screen speed increases, recorded detail
decreases, and as screen speed decreases, recorded detail increases.
 
Quantum Mottle
 
 Commonly called image noise, can be defined as the statistical fluctuation
in the quantity of x-ray photons that contribute to image formation per
square millimeter.
 When a very low number of photons are needed by the intensifying
screens to produce appropriate image density, the image appears mottled
or splotchy. This appearance can be described as a “salt and pepper”
look.
 It decreases recorded detail, which results in a radiographic image that is
grainy, or noisy, in appearance.
 
Screen Maintenance
 
 The maintenance of intensifying screens is
significant because radiographic quality depends I
large part on how well the screens are continuously
maintained. Two important maintenance procedures
should be performed on intensifying screens:
1. regular cleaning
2. check cassette for film screen contact
RADIOGRAPHIC FILM
PROCESSING
RADIOGRAPHIC FILM PROCESSING
 Converts the invisible image on exposed film into a permanent visible
radiographic image.
 
Automatic Processing
 
Automatic processor – is a device that encompasses chemical tanks, a
roller transport system, and a dryer system for processing of radiographic
film.
 
Processing cycle – refers to the amount of time it takes to process a single
piece of film. This amount of time varies between 45 seconds and 3.5
minutes, depending on the processor that is used.

Processor capacity – refers to the number of films that can be processed

per hour. 
 
 The processing of radiograph occurs in four stages:
 
1. Developing – converts the latent image into a manifest
or visible image. There are also two secondary
purposes of developing:
a. To amplify the amount of metallic silver on the film by
increasing the number of silver atoms in each latent
image center.
b. To reduce the exposed silver halide crystals into
metallic silver.
 Agent Chemical Function

Developing or Solution
Developer Phenidone
Agents, Chemicals, andFast-reducing, produces gray
Their Functions
reducing agents   densities
   
Hydroquinone Slow-reducing, produces black
densities

Accelerator or Sodium carbonate Elevates and maintains

activator solution pH
Restrainer Potassium bromide Decreases reduction of
unexposed silver halide
Preservative Sodium Sulfite Decreases oxidation of solution

Hardener Gluteraldedyde Hardens the emulsion

Solvent Water Dilutes the chemical

2. Fixing – to remove unexposed silver
halide from the film and to make the
remaining image permanent. There
are also two secondary functions of
fixing:
a. To stop the development process.
b. To further harden the emulsion
 Agent Chemical Function
Fixeragent
Fixing Solution Agents, Chemicals,
Ammonium ThiosulfateAnd TheirClears
Functions
away
unexposed silver
halide crystal
Acidifier Acetic Acid Stops Development

Preservative Sodium Sulfite Prevents mixing of

fixing agent and
acidifier
Hardener Chrome Alum Hardens Emulsion
Potassium Aluminium
Sulfate
Aluminium Chloride
Solvent Water Dilutes the
Chemicals
Washing - to remove fixing solution
from the surface of the film. This is a
step in making further step in making the
manifest image permanent. If not
properly washed, the resulting radiograph
will show a brown staining of the image,
resulting in image loss and a decrease in
its diagnostic value.
Archival Quality of Radiographs
 Maintaining the archival (long-term) quality of radiographs
requires the most of the fixing agent be removed (washed)
from the film. Staining or fading of the permanent image
results when too much thiosulfate remains on the film.
2. Drying – the final processes. It removes 85% to90% of the
moisture from the film so that it can be handled easily and
stored while maintaining the quality of the diagnostic image.
Archival Quality of Radiographs
 Permanent radiographs must retain moisture of 10% to 15%
to maintain archival quality. Excessive drying can cause the
emulsion(s) to crack.
Automatic Processing System
 Tanks
 Developer tank
 Fixer tank
 Water tank
Principal Components of Automatic Processor
 Vertical Transport System
 Motor Drive System
 Recirculation
 Time-Temperature
 Replenishment System
 Drying System
 Electrical
Vertical Transport System
 Automatic processors use a vertical transport system of rollers
that advance the film through the various stages of film
processing. All rollers in a processor move at the same speed.
 A film is introduced into the processor on the feed tray. Feed
tray is a flat metal surface with an edge on either side that
permits the film to enter the processor easily and correctly
aligned.
 The entrance roller assembly consist of rollers that are
covered with corrugated rubber, that straightens the path of
the film so that it moves through the processor efficiently.
 The next type of roller that the film encounters is a transport
rollers that moves the film through the chemical tanks and
dryer assembly.
A turnaround roller at the bottom of the roller
assembly turns the film from moving down the
transport assembly to moving up the assembly.
 The final type of roller used in the vertical transport
system is the crossover roller that moves the film
one tank to another and into dryer assembly.
 Guide plates are slightly curved metal plates that
properly guide the leading edge of the moving film
through the roller assembly.
Motor Drive
 
 An electric motor provides power for the roller
assemblies to transport the film through the
processor.
 The on/off switch provides electrical power to the
processor activates this motor.
 The standby control is an electric circuit that
shuts off power to the roller assemblies when the
processor is not being used.
Replenishment System
 
 Refers to the replacement of fresh chemicals after the loss of
chemicals during processing, specifically developer solution and
fixer solution.
 Provides fresh chemicals to the developing and fixing solutions to
maintain their chemical activity and volume when they become
depleted during processing.
 
Aerial oxidation – refers to a reduction in chemical strength as a
result of exposure to air.
 
Use oxidation – refers to a reduction in chemical strength as a result
of exposure to increased temperature over an extended period.
Recirculation System
 
 Acts to circulate the solutions in each of these tanks by
pumping solution out of one portion of the tank and
returning it to a different location with the same tank
from which it was removed.
 It keeps the chemicals mixed, which helps maintain
solution activity and provides agitation of the
chemicals about the film to facilitate fast processing.
 Helps maintain the proper temperature of the developer
solution. The developer recirculation system includes
an in-line filter that removes impurities as the
developer solution is being recirculated.
Temperature Control
 Temperature control of the developer solution is important
because the activity of this solution depends directly on its
temperature . An increase or decrease in developer
temperature can adversely affect the quality of the
radiographic image.
 In most 90-second automatic processors, developer
temperature must be maintained at 93º to 95ºF (33.8º to
35ºC).
Drying System
 The dryer assembly controls the amount of moisture removal
to maintain the archival quality of radiographic film
Indicators OfAppearance
Radiographic Inadequate Processing
Processing Problems

Decrease in Density Developer exhausted

Developer under replenished
Processor running too fast
Low developer temperature
Developer improperly mixed
Increased in density Developer over replenishment
High developer temperature
Light leaks in the processor
Developer improperly mixed
Pinkish Stain (dichroic fog) Contamination of developer by fixer
Developer or fixer under replenishment
Brown Stain Inadequate washing
(thiosulfate stain)
Emulsion removed by Insufficient hardener in developer
developer
Milky appearance Fixer is exhausted
Inadequate washing
Streaks Dirty processor rollers
Inadequate washing
Inadequate drying
Water spots Inadequate drying

Minus-plus density Scratches from guide plates caused by roller or plate misalignment
Film-Handling Areas
Storing Unexposed Film
 Unexposed film should be stored in its original packaging so
that important information about the film can be maintained.
 Film boxes should be stored vertically, not horizontally, to
prevent pressure artifacts on the film.
 Film should be stored at temperatures ranging from 50º to
70ºF (10º to 21ºC) and a relative humidity of 40% to 60%.
 Films should be stored away from heat sources and ionizing
radiation.
 The shelf life of the film, as expressed by its expiration date,
must be observed.
Possible Consequences of Storing Unexposed Film in Environments with
Improper Temperature and Relative Humidity

Storage Environment Problem Possible Consequence

Temperature too high Increased fog level

Temperature too low Increased static discharge

Humidity too high Increased fog level

Humidity too low Increased static discharge

The Darkroom
 Must be free from all outside white-light exposure. A white
light source maybe located inside the darkroom, but it should
be connected to an interlock system whereby the film bin may
not be opened as long as the darkroom white-light source is
on.
 Safelights used in the darkroom must be equipped with a
safelight filter that is appropriate for the type of film(s) being
handled in the darkroom.
 Commonly used filters include Kodak Wratten 6B filter for
blue sensitive film and Kodak GBX for orthochromatic film,
which is sensitive to both blue-violet and green visible light.
 Ionizing radiation exposure to film in the darkroom is potential
hazard because many darkrooms share common walls with
radiographic rooms. The walls that are common with the darkroom
and exposure room must be lined with lead as required by law for
standard protection from radiographic exposures.
 Other potential hazards to the film in the darkroom include heat and
chemical exposure.
 Should be centrally located to radiographic rooms so that they can
be accessed quickly.
 Darkroom should be equipped with a single door, a revolving door,
or a maze access. The color of interior walls should be light to
reflect the small amount of light available from safelights. Floors
should be of some material that makes them non slippery when wet
if chemicals or water spills or leak inside the darkroom.
 Quality Control For The Darkroom And Automatic Processor

Quality Control Test Schedule Standards

Darkroom environment Daily Maintained clean, well ventilated, organized and safe

Safelight test Semiannually Less than = 0.05 optical density added as fog

Automatic Processor Temperature Weekly Should not vary more than +- 0.5ºF (0.3ºC)

Replenishment Rates Weekly Should fall within +- 5% of manufacturer’s

specification for replenishment type

Developer Solution pH Quarterly Maintained between 10-11.5

Fixer Solution pH Quarterly Maintained between 4-4.5

Developer Specific Gravity Quarterly Should not vary more than =-0.004 from the
manufacturer’s specifications

Processor Control Chart Monitoring Daily Speed and contrast indicators should not vary more =-
0.15 optical density from baseline measurements
Radiographic Artifacts
 Is any unwanted image on the radiograph.
 Are detrimental to radiographs because they can make
visibility of anatomy, a pathologic condition, or patient
identification information difficult or impossible.
 They decrease the overall radiographic quality of the image.
 Can be classified as:

a. plus density artifacts– are greater in density than the area of

the radiograph immediately surrounding them.
b. minus density artifacts – are of less density than the area of
the radiograph immediately surrounding them.
 SomeCommon Plus-Density Artifacts Not caused
By Processing
Artifact Cause

Half-moon marks Bending or kinking of film

Scratches, abrasions Fingernail or other scratches

Static discharges Sliding films over flat surface

Fogging Exposure to white light, ionizing

radiation, heat, safelight fogging;
expired film
Density outside Off-focus or “off-stem” radiation
collimated area
 Some Common Minus-Density Artifacts

Artifact Cause

Fingerprints Moisture on finger transferred

to the film before exposure

Scratches, abrasions Scraping or removing

emulsion
Foreign object Some unintended object in the
imaging chain
Non specific decrease Dirty screens or cassette
SENSITOMETRY
SENSITOMETRY

 In radiography sensitometry is the study of the relationship

between the intensity of radiation exposure to the film and
amount of blackness produced after processing (density). The
intensity of radiation exposure is the measurement of the
quantity of radiation reaching an area of the film.
 It provides a method of evaluating the characteristics of film
and film-screen combinations used in radiography.
 A method of evaluating the performance of automatic
processors. Because the automatic processors affect a
radiograph’s density and contrast, the variability of their
performance can be monitored by sensitometric methods.
Equipment

1. Penetrometer – is a device constructed of uniform

absorbers of increasing thicknesses, such as
aluminum or tissue equivalent plastic. When
radiographed, the penetrometer produces a series of
uniform densities that resemble a step-wedge . When
step-wedge densities are produced with a
penetrometer and radiographic x-ray unit, the
variability of the output of the equipment could
affect the range of densities produced.
2. Sensitometer – is designed to produce
consistent step-wedge densities by
eliminating the variability of the x-ray unit.
It uses a controlled light source to expose an
optical step-wedge template. The step-
wedge template transmits light in varying
intensities to expose the radiographic film.
After the film has been processed, a density
step-wedge image, or sensitometric strip, is
produced.
 
3. Densitometer – is a device used to numerically
determine the amount of blackness on the film after
processing. This device is constructed to emit a
constant intensity of light (incident) onto an area of
film and then measure the amount of light
transmitted through the film. The densitometer
determines the amount of light transmitted and
calculates a measurement known as optical density
(OD).
Optical Density
        Is a numeric calculation that
compares the amount of light
transmitted through an area of
radiographic film to the amount of light
originally striking the film.
Percentage of Light Transmittance And Calculated Optical Densities
Percentage of Fraction of Light Optical
Light Transmitted Transmitted Density

100 1 0
50 ½ 0.3
32 8/25 0.5
25 ¼ 0.6
12.5 1/8 0.9
10 1/10 1
5 1/20 1.3
3.2 4/125 1.5
2.5 1/30 1.6
1.25 1/80 1.9
1 1/100 2
0.5 1/200 2.3
0.32 2/625 2.5
0.125 1/800 2.9
0.1 1/1000 3
0.05 1/2000 3.3
0.032 1/3125 3.5
0.01 1/10,000 4
 Notice the relationship between light transmittance
and optical density. When 100% of the light is
transmitted, the optical density equals 0.0.
When the 50% of the light is transmitted, the optical
density equals to 0.3, and when 25% of the light is
transmitted, the optical density equals 0.6.
When the logarithmic scale base 10 is used, every
0.3 change in optical density corresponds to a
change in the percentage of light transmitted by a
factor of 2 (log10 of 2 = 0.3).
 
Light Transmittance and Optical
Density
        As percentage of light transmitted
decreases, the optical density increases;
as the percentage of light transmitted
increases, the optical density decreases.
Optical Density and Light Transmittance
        For very 0.3 change in optical density, the percentage of
light transmitted has changed by a factor of 2. A 0.3 increase
in optical density result from a decrease in the percentage of
light transmitted by half, whereas a 0.3 decrease in optical
density results from an increase in the percentage of light
transmitted by a factor of 2.
        Optical densities can range from 0.0 to 4.0 OD. Because
most radiographic film has a tint added to its base and
processing adds a slight amount of fog, the lowest amount of
optical density is usually between 0.10 and 0.20 OD. This
minimum amount of density on the radiographic film is
termed the base plus fog (B+F).
Diagnostic Range
The useful range of optical densities is
between 0.25 and 2.5 OD. However, the
diagnostic range of optical densities for
general radiography usually falls between 0.5
and 2.0 OD. This desires range of optical
densities is found between the extreme low
and high densities produced on the film.
 
Log Relative Exposure
A 0.3 change in log of exposure represents a
change in intensity of radiation exposure by a
factor of 2. An increase of 0.3 log of
exposure results in doubling the amount of
radiation exposure, whereas a decrease in 0.3
log of exposure results in halving the amount
of radiation exposure.
 
Three Distinct Regions:
1. Toe Region – represents the area of low density. The point
on the sensitometric curve where the minimum amount of
radiation exposure produced a minimum amount of optical
density is known as Dmin.
 
2. Straight-Line Region – is where the diagnostic or most
useful range of densities is produced.
 
3. Shoulder Region – the point on the curve where maximum
density has been produced also known as Dmax.
Film Characteristics
Speed – sensitivity to radiation exposure,
indicates the amount of optical density
produced for a given amount of radiation
exposure. It is a characteristic of the film’s
sensitivity to the intensity of radiation
exposure.
 
 
Film Speed and Optical Density
 
 For a given exposure, as the speed of a film increases, the
optical density produced also increases; as the speed of a film
decreases, the optical density decreases.
 
Contrast – is a result of both the subject contrast and film
contrast. Film contrast is controlled by the design and
manufacturing of the film components and the effect of
processing. The ability of radiographic film to provide a level
of contrast can be evaluated by the steepness, or slope, of the
sensitometric curve.
Slope and Film Contrast
 
The steeper the slope of the straight-line
region (more vertical), the higher the film
contrast; the lesser the slope (less vertical), the
lower the film contrast.
 Exposure Factor Selection
Exposure Factor Selection
Exposure Technique Charts
Are preestablished guidelines used by the
radiographer to select standardized manual or
AEC exposure factors for each type of
radiographic examination.
Technique charts standardized the selection of
exposure factors for the typical patient so that
the quality of radiographic images is consistent.
 
.
Exposure Technique Charts and
Radiographic Quality
 
A properly designed and used technique chart
standardizes the selection of exposure factors
to help the radiographer produce consistent
quality radiographs while minimizing patient
exposure.
 
Technique Chart Limitations
 
 Exposure technique charts are designed for the typical or
average patient. Patient variability in terms of body build or
physical condition, or the presence of a pathologic condition,
requires the radiographer to problem solve when selecting
exposure factors.
Equipment Performance
 
 Radiographic equipment must be operating within normal
limits for technique charts to be effective
Measurement of Part Thickness
 Accurate measurement of part thickness is critical to the effective use of
exposure technique charts.
Contents Standardize in a Technique Chart
 Anatomic part
 Automatic exposure control detector selections, if applicable
 Central ray location
 Type of image receptor
 Focal spot size
 Grid ratio
 Kilovoltage peak
 Milliamperage
 Part thickness and measuring point
 Position or projection
 Source-to-image receptor distance
  Exposure Technique Chart

 Characteristics

Design Part Contrast Radiogra- Patient Tube

Type Measurment Scale phic Dose Head
Contrast Load

Variable Critical Shorter Variable Hogher Increased

kVp/
Fixed mAs

Fixed kVp/ Less Critical Longer Standard- Lower Decreased

Variable ized
mAs
Types of Technique Charts:
1. Variable kVp/Fixed mAs technique Chart – is
based on the concept that kVp can be increased as
the anatomic part size increases. Specifically, the
baseline kVp is increased by 2 for every 1 cm
increase in part thickness, whereas the mAs is
maintained.
 The variable kVp charts adjusts the kVp for changes
in part thickness while maintaining a fixed mAs.
Variable kV/ Fixed mAs Technique Chart
Anatomic Part Knee Image 400 Speed
Receptor
Projection AP Table Top/ Bucky
Bucky
Measuring point Midpatella
cm kVpGrid RatiomAs 12:1
10 63 20
11 65 20
SID 40 inches
12 67
FSS 20
Small
13 69 20
14 71 20
15 73 20
16 75 20
17 77 20
18 78 20
Variable kVp technique charts may be more effective when
small extremities are being imaged.
2. Fixed kVp/Variable mAs Technique Chart – uses the
concept of selecting an optimal kVp value that is required for
the radiographic examination and adjusting the mAs for
variations in part thickness. Optimal kVp can be described as
the kVp value that is high enough to ensure preparation of the
part but not too high to diminish radiographic contrast.
Fixed kVp/variable mAs technique charts identify optimal
kVp values and alter the mAs variations in part thickness
Anatomic Part Knee Image Receptor 400 Speed
Fixed kVp/ Variable mAs Technique Chart
Projection AP Table Top/ Bucky Bucky

Measuring point Midpatella Grid Ratio 12:1

SID 40 inches FSS Small

cm kVp mAs

10-13 73 10

14-17 73 20

18-21 73 40
Accuracy of measurement is less critical with
fixed kVp/variable mAs technique charts than that
with variable kVp/fixed mAs technique charts.
The fixed kvP/variable mAs technique chart has
the advantages of easier use, more consistency in
the production of quality radiographs, greater
assurance of adequate penetration of all anatomic
parts, standardization of radiographic contrast, and
increased accuracy with extreme variation in size
of the anatomic part.
Exposure Technique Chart Development
1. Select a kVp value appropriate to the anatomic area to be radiographed.
Determine the mAs value that produces the desired radiographic density.
2. Using a patient-equivalent phantom, produce several radiographs, varying
the kVp and mAs values. Use the general rules for exposure technique
adjustment (i.e., the 15% rule). Radiographic densities should be similar.
3. Evaluate the quality of the radiographs, and eliminate those deemed
unacceptable.
4. Of the remaining acceptable radiographs, select those having the kVp value
appropriate for the technique chart desired and according to departmental
standards.
5. Extrapolate the exposure techniques (variable kVp or variable mAs) for
changes in part thickness.
6. Use the concept of comparative anatomy to develop technique charts for
similar anatomic areas.
7. Test the technique chart for accuracy, and revise if needed.
Example of How to Develop a Fixed kVp/Variable mAs
Exposure Technique Chart
 
Step 1. Pelvis phantom is positioned on the radiographic
table for an anteroposterior (AP) projection of the right
hip. The central ray (CR) is at the midpoint of the hip,
the source-to-image receptor distance (SID) is 40 inches,
and collimation is to film size. The part was measured
(2^ cm) at the CR entrance point. Select initial exposure
technique factors based on departmental standards.
 
Step 2. Using the kVp/mAs 15% rule, the following five radiographs are
produced:
 
1. 51 kVp at 200 mAs
2. 60 kVp at 100 mAs
3. 70 kVp at 50 mAs
4. 81 kVp at 25 mAs
5. 93 kVp at 12.5 mAs
 
Step 3. Radiographs 1 and 5 are deemed unacceptable.
Step 4. Radiograph 3 is selected as optimum based on departmental standards.
 Step 5. The following technique chart is developed by extrapolating the exposure
techniques (variable mAs) for changes in part thickness.

Anatomic Part Knee Image Receptor 400 Speed

Projection AP Table Top/ Bucky Bucky

Measuring point Midpatella Grid Ratio 12:1

SID 40 inches FSS Small

cm kVp mAs

16-19 70 12.5

20-23 70 25

24-27 70 50

28-31 70 100

32-35 70 200
Automatic Exposure Control
 Isone method for setting exposure factors to
ensure that a quality radiographic image is
produced.
 Are the designed to produced radiograph with
optimum density by controlling the amount of
radiation exposure reaching the film
 When used correctly, AEC should produce
consistently optimal density radiographs because,
based on sensitometry, a specific amount of
radiation to the film produces a specific density.
X-Ray Exposure and Density
 Theamount of density on the film depends on the
amount of radiation exposure to the film. The
greater the exposure to the film, the greater the
resulting density.
Purpose:
 The relationship between AEC and density is
critical for film-screen imaging but does not hold
true for digital radiography where the digital
image density or brightness is manipulated by the
computer.
 However, AEC is still important for digital
radiography because the amount of radiation
reaching the digital image receptor is a key factor
in digital image quality.
Principles of AEC Operation
 Once a predetermined amount of radiation is
transmitted through the patient, the x-ray exposure
is terminated. This determines the exposure time
and therefore the resulting density.
AEC Systems:
 1. Photomultiplier Tube system – is an electronic
device that converts visible light energy into
electrical energy.
 Are considered exit type devices because the
detectors are positioned behind the cassette so that
radiation must exit the cassette before it is
measured by the detectors
 2. Ionization Chamber Systems – is a hollow cell
that contains air and is connected to the timer
circuit via an electrical wire.
 Are considered entrance-type devices because the
detectors are positioned infront of the cassette so
that radiation interacts with the detectors just
interacting with the cassette.
Technical Considerations with AEC
1. Centering of the Part
Proper centering of the part being examined is
crucial when using AEC system. The anatomic
area of interest must be centered properly over the
detectors that the radiographers has selected.
Improper centering of the part selected detector(s)
produces radiograph that is either underexposed or
overexposed.
 2.Detector Selection
 Selection of the detector(s) to be used for a
particular examination is critical when using an
AEC system. The selected detectors actively
measure radiation during exposure.
Accurate Part Centering and Detector
Selection
 Accurate centering and detector selection are
critical with AEC system because the radiograph
will demonstrate optimal density of the anatomy
located directly over the detector. If the area of
radiographic interest is not directly over the
selected detector, that area probably will be
overexposed or underexposed.
 3. kVp and mA Selections
 Because AEC controls only radiographic density
and has no effect on radiographic contrast, the kVp
for a particular examination should be selected as
it would be for that examination, regardless of
whether an AEC device is used.
 The radiographer must select kVp value that provides
appropriate scale of contrast and is at least the minimum
kVp to penetrate the part.
 The higher the kVp value used, the shorter the exposure time
needed by the AEC device.
 The kVp selected should be high enough to produce
radiographic contrast appropriate to the part being examined
while keeping the patient’s exposure as low as possible.
 ThemA value selected has a direct effect on the
exposure time needed by the AEC device.
Therefore, if the radiographer wants to decrease
exposure time for a particular examination, he or
she may easily do so by increasing the mA value.
 4.Density Selection
 AEC devices are equipped with density that is
produced by the unit. These generally are in the
form of buttons on the control panel
 5. Collimation
 Is a factor when AEC systems are used because the
additional scatter radiation produced by failure to
accurately restrict the beam may cause the detector to
terminate the exposure prematurely. The detector is
unable to distinguish transmitted radiation from scatter
radiation and, as always, ends the exposure when a
preset amount of exposure has been reached.
 6.Backup Time
 Refers to the minimum length of time the x-ray
exposure will continue when using AEC system.
The backup time may be set by the radiographer or
controlled automatically by the radiographic unit.
Function of Backup Time
 Backup time, the maximum exposure time allowed
during an AEC examination, serves as a safety
mechanism when the AEC is not used or is not
functioning.
Setting Backup Time
 Backup time should be set 150% to 200% of the
expected exposure time. This allows the properly
used AEC system to appropriately terminate the
exposure but protects the patient and tube from
excessive exposure if a problem occurs.
 7. The Patient
 Some patients require greater technical
consideration when AEC is used for their
radiographic procedures.
 The size, shape and location of anatomic part of
interest also affect the use of AEC system.
The Patient and AEC
 Ifthe anatomic area directly over the detector does
not represent the anatomic area of interest,
inappropriate density may result. This can happen
when the anatomic over the detector contains a
foreign object, a pocket of air, contrast media, or if
the anatomic area does not completely over the
detector.
 8. Bucky Selection
 Many radiographic units have AEC devices in both the
table bucky and an upright bucky. If more than one
bucky per radiographic units uses AEC, the
radiographer must be certain to select the correct bucky
before making an exposure.Failure to do so results in
the patient and image receptor being exposed to
excessive radiation.
 9. mAs Readout
 When a radiographic study is performed using an AEC
device, the total amount of radiation (mAs) required to
produce the appropriate density is determined by the
system. Many radiographic units include a mAs
readout display, where the actual amount of mAs used
for that image is displayed immediately after the
exposure, sometimes for only a few seconds.
Limitation of AEC Systems
 1. Interchangeability of Film-Screen System
 Different film screen system cannot be
interchanged easily once an AEC device is
calibrated to produce specific densities.
 2.Minimum Response Time
 Refers to the shortest exposure time that the
system can produce. Minimum response time
usually is longer with AEC systems than with
other types of radiographic timers.
 3.Lack of Calibration
 For an AEC device to work properly, the
radiographic unit and the AEC device must each
be calibrated to accepted standards. Failure to
maintain regular calibration of the unit and AEC
device results in radiographs that lack consistent,
reproductible, and appropriate density.
Anatomic Programming
 Refers to a radiographic system that allows the
radiographer to select a particular button on the
control panel that represents an anatomic area; a
preprogrammed set of exposure factor is displayed
and selected for use.
 Digital Imaging
 DigitalImaging, involves identical x-ray production,
differential absorption, and scatter control when
compared with film-screen imaging.
 The latent image is converted to digital information,
which can be manipulated y the computer.
Two Methods
 Computed Radiography
 Digital Radiography
Image Receptor
 Imaging plate- quite similar to the intensifying
screen. IP primarily consists of support layer,
phosphor layer and protective layer. The key
element is the phosphor layer, barium
fluorohalide crystals coated with euphorium.
Considerations
 If CR plates are not used within 48 hours, they
should be put through an erasure cycle before use
 CR imaging plates should be processed within 1
hour of exposure, otherwise fading of the latent
image will begin to impact image quality
 When using CR, it is appropriate to adjust mAs as
if using a 200 speed film-screen system.
Direct Readout Digital Radiography Image Receptor

 DR uses flat panel direct capture detector array

that absorbs radiation converts the energy into
electrical signals. It is found just below the
radiographic tabletop where the bucky tray is
located.
Direct Readout Digital Radiography Image Receptor

 The DR flat panel direct capture consists of large array

combination of detectors and thin film transistors (TFTs).
The exit radiation interacts with the detector and an
electrical charge is created. This charge is stored
temporarily in the transistor until readout. There two
types of detectors manufactured differ in how they
convert x-rays to electrical charge.
Indirect Conversion
 The indirect conversion system has the x-ray
absorbed by the cesium iodide, a scintillation
phosphor, which then produces a flash of light.
This light interacts with a layer of amorphous
silicon to create the electrical charge
Direct Conversion
 The direct conversion direct readout system has
the x-ray interact directly with a layer of
amorphous selenium, which then produces the
electric charge.
Direct Conversion
 In both cases, the charge is briefly stored in the
thin film transistor (TFT) until readout. According
to the manufacturers, both are very efficient at
absorbing the exit radiation and quickly producing
excellent quality latent image formation.