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Introduction to Medical Imaging
Rena Widita
Types of ionizing radiation
How do x-rays create an image of internal body
structures?
What are the 5 basic radiographic densities?
Objectives
List of diagnostic imaging studies
Plain x-rays
CT scan
MRI
Nuclear imaging/SPECT/PET
Ultrasound
Mammography
Angiography
Fluoroscopy
Primary Types of Ionizing Radiation
Alpha particles
Beta particles
Gamma rays (or photons)
X-Rays (or photons)
Neutrons
Alpha Particles
2 neutrons and 2 protons
They travel short distances
Have large mass
Only a hazard when inhaled
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Beta Particles
Electrons or positrons having small mass and variable energy
Electrons form when a neutron transforms into a proton and
an electron
Gamma Rays (photons)
Result when the nucleus releases
Energy, usually after an alpha, beta or
positron transition
X-rays (photons)
Occur whenever an inner shell orbital electron
is removed and rearrangement of the atomic
electrons results with the release of the
elements characteristic X-Ray energy
Neutrons
Have the same mass as protons but are
uncharged
They behave like bowling balls
Ionization
Ionizing radiation is produced by unstable
atoms. Unstable atoms differ from stable
atoms because they have an excess of energy
or mass or both.
Unstable atoms are said to be radioactive. In
order to reach stability, these atoms give off,
or emit, the excess energy or mass. These
emissions are called radiation.
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Direct Ionization Caused By:
Protons
Alpha Particles
Beta Particles
Positron Particles
Indirect Ionization Caused By:
Neutrons
Gamma Rays
X-Rays
Radiation Units
Exposure
a quantity relating to radiation intensity in air is used to
describe a property of a beam of x-rays or gamma rays
emitted from an external therapy machine
also known as the roentgen (R)
Roentgen is defined as the amount of x-ray or gamma
radiation that will generate 2.58 x 10
-4
coulombs (a
measure of electrical charge) per kilogram of air at
standard temperature and pressure
m
Q
X

=
Q is the sum of all the electrical charges of all ions of one sign
produced in air, when all the electrons liberated by photons in a
volume element of air whose mass is m are completely stopped
in air
1 R = 2.58 x 10
-4
C/kg
Exposure cannot be used to specify the radiation energy absorbed by
a target volume within a patient the absorbed dose (D) unit was
then defined
Absorbed dose
The amount of energy deposited per unit mass
m
E
D
d

=
E
d
: the energy imparted by ionizing radiation to the matter
in a volume element
m: the mass of matter in that volume element.
Absorbed dose is measured using the conventional rad which is the amount of
radiation that will deposit 0.01 Joules of energy in a kilogram (or 100 ergs/gm) of
material.
The SI unit of absorbed dose is the gray (Gy) which has the units of
Joules/kilogram. A gray is equal to 100 rad.
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Units of Radioactivity
Curie (Ci) = 2.22 E12 dpmor 3.7E10 dps
Becquerel (Bq) = 1 dps
Maximum Dose/year = 5 REM or 50 mSv
Maximum Dose/year for Declared Pregnant
Woman & Minors= 0.5 REM or 5 mSv
X-rays
What are x-rays?
No mass
No charge
Energy
The Discovery of X rays
Wilhelm Conrad Roentgen
November 8 1895
While working in his lab - saw the glow
coming from a phosphorescent screen
Imaged his wifes hand
1901 Nobel Prize for Physics
www.upei.ca/~vetrad
Forms of Diagnostic Imaging
Diagnostic Radiology/Radiography
X-rays used to produce image, transmitted
through patient
Static images
Dynamic images fluoroscopy
Contrast agents used
Barium, Iodine examples of studies
www.upei.ca/~vetrad
Forms of Diagnostic Imaging
Ultrasonography
Uses sound waves to produce image, transmitted
Sending out and listening for echoes
Internal architecture
Dynamic, US can not penetrate air or bone
Operator dependent
www.upei.ca/~vetrad
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Forms of Diagnostic Imaging
Computed Tomography
Uses X-rays to produce an image, transmitted
Cross sectional imaging
No superimposition of structures
Requires computer manipulation of images
www.upei.ca/~vetrad
Forms of Diagnostic Imaging
Nuclear Scintigraphy
Uses gamma rays to produce an image, emitted
from the patient
Radioactive nuclide given IV, per os, per rectum
etc.
Abnormal function, metabolic activity, abnormal
amount of uptake
Poor for anatomical information
www.upei.ca/~vetrad
Forms of Diagnostic Imaging
Magnetic Resonance Imaging
Uses a strong magnetic field and radiofrequency
waves to image structures
No ionizing radiation
Hydrogen protons water
Cross sectional imaging
Great for soft tissue
www.upei.ca/~vetrad
Forms of Diagnostic Imaging
Radiation Therapy
Uses radiation to treat and palliate neoplastic and
some benign diseases
Cobalt
Linear Accelerators
Must have special training
www.upei.ca/~vetrad
What is an X ray?
Production of X rays
Form of EM radiation
All forms move at the speed of light
Vary in energy and wavelength
They penetrate matter
Can cause fluorescence of some atoms
Can expose film
Can cause biological damage
www.upei.ca/~vetrad
Three things can happen
X-rays can:
Pass all the way through the body
Be deflected or scattered
Be absorbed
Where on this image
have x-rays passed
through the body
to the greatest degree?
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X-rays Passing Through Tissue
Depends on the energy of the x-ray and the
atomic number of the tissue
Higher energy x-ray - more likely to pass
through
Higher atomic number - more likely to absorb
the x-ray
How do x-rays passing through the body
create an image?
X-rays that pass through the body to the film render the film
dark (black)
X-rays that are totally blocked do not reach the film and
render the film light (white)
Air = low atomic # = x-rays get through = image is dark
Metal = high atomic # = x-rays blocked = image is light (white)
Five Basic Radiographic Densities
Air
Fat
Soft tissue/fluid
Mineral
Metal
X-ray viewing station
Diagnosis?
Medical Imaging
Primary purpose is to identify pathologic
conditions.
Requires recognition of normal anatomy.
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Radiographic Analysis
Any structure, normal or pathologic, should be
analyzed for:
1. Size
2. Shape and contour
3. Position
4. Density (You must know the 5 basic densities)
The anatomical position
right
left
Absorbed
Passed through
Medullary bone
Soft tissue
Metal
Note:
Right-left marker
Technologists initials