X-Ray Fundamentals Part 3 V1.7 Theory Training

WW X-ray
Fundamentals
Training
Part 3, Version 1.7

Jim Coyne, Claudio Rossi
Unrestricted Internal Use
Carestream Health, © 2014
p.2
Welcome
Welcome to X-ray Fundamentals Part 3 – Theory training.
• Introductions
• Organization and role
• Safety / Convenience
– Location of building exits (e.g., fire drill)
– Location of restrooms / cafeteria / vending
machines
• Timing: Class times / schedule
• Courtesy: Cell phones, Blackberries, etc.,
turned to “off” or “silent.”
• Parking lot for unanswered questions

p.3
Introduction
The courses in the X-ray
Fundamentals Training Curriculum
are designed to introduce new
service professionals to the subject
of diagnostic X-ray equipment for the
purpose of building a foundation
upon which all subsequent X-ray
equipment training will be based.
Some subjects are simply touched

upon, while others are covered in
more depth because they are often
not covered at all in typical
system/equipment level training.

p.4
X-ray Fundamentals Curriculum

The curriculum consists of these
courses:
• X-ray Fundamentals Part 1: Basic
introduction (eCampus)
• X-ray Fundamentals Part 2: Basic
introduction (eCampus)
• X-ray Fundamentals Part 3 – Theory:
Basic theoretical introduction to the X-
ray environment (instructor-led)
• X-ray Fundamentals Part 3 – Theory
Final Exam (eCampus)
• X-ray Fundamentals Part 4 –
Troubleshooting Lab: In-depth and
practical application of the understanding
of the basic X-ray technology

p.5
Agenda: Part 3 – Theory

DAY 1: DAY 2: DAY 3:
• START 1:00 p.m. • Electrical Basics •Collimation
• Training Introduction • Mains •The Bucky
• X-ray History • Exposure Control Factors •The Anti-scatter Grid
• X-ray Terminology • The X-ray Tube Assembly •AEC
• Physics Basics • The X-ray Generator •Receptors
• Medical Imaging Basics •Exposure Sequence
Equipment • High Voltage Cables
DAY 4: DAY 5:
•X-ray Room Requirements •Regulatory & Acceptance
•Filtration and Compliance
•Measurement •Safety
•Image Quality •Final Exam
•Training Evaluation
•END Friday 12:00 p.m.
WW X-ray
Fundamentals
Module 3: X-ray Terminology
Training
WW X-ray
Fundamentals
Training
Module 2: X-ray History

p.7
Objectives
Welcome to the X-Ray History
module.
When you complete this module,
you will be able to:
• Describe the origin of the term “X-ray.”
• Explain who discovered X-rays.
• Explain how X-rays are used today.
• Describe the highlights in the
development of X-rays.

p.8
The First X-ray

1895: The Mistake That Changed the World
• X-rays were discovered in 1885 by Wilhelm
Conrad Roentgen, a German physicist, but
many scientists before him paved the way for
his discovery.
• When Roentgen referred to the rays in On a
New Kind of Ray, he called them "X" rays
because their source was unknown at the time.
• However, the name persisted, and even today,
we refer to his mystery rays as “X-rays.”
Wilhelm Conrad Roentgen

(1845-1923)

p.9
History of Radiography
• X-ray were discovered in 1895 by
Wilhelm Conrad Roentgen, but many
scientists before him paved the way
for his discovery. Many major
discoveries relating to electricity had
been made during the three centuries
that preceded the discover of X-rays,
but it was the study of electrical
discharges under high voltage in
vacuum tubes that led to the actual
discovery of X-rays.
• Scores of scientists had
experimented with electrical
discharges through different types of
vacuum tubes, and many of them
had produced X-rays but did not
recognize them as a new type of ray.

p.10
History of Radiography (con’t.)

• Roentgen himself was experimenting with cathode rays when he
observed the presence of this new radiation. He was working with the
Hittorf-Crookes vacuum tube through which a current under high
voltage was being passed. The tube was entirely enclosed in black
paper so as to exclude all the light emanating from it.
• During the experiment, Roentgen observed
a fluorescence of some barium
platinocyanide crystals coating a piece of
cardboard lying nearby. It had been known
for some time that these crystals would
fluoresce in the presence of a vacuum tube
activated by high voltage, but it occurred to
Roentgen that the fluorescence of the
crystals was due to some type of ray that
could pass through the black paper around
the tube.

p.11
History of Radiography (con’t.)

• When he picked up the chemically-coated
cardboard, his fingers came between it and the
tube, and he saw the bones in his hand. He
realized that he had discovered the presence
of a ray that would penetrate solid matter.
• By replacing the chemically-coated cardboard
with a photographic plate, he was able to
record an image of the internal structure of his
wife’s hand.
• He also noted that the rays could not be
reflected or refracted by the usual means and
that they were not affected by electrical and
magnetic fields as were the cathode rays that
he was studying. Because he did not know the Bertha Roentgen’s Hand
nature of these rays, he called the “X” rays. November 8, 1895
Others have sometimes called them “Roentgen
rays.”
p.12
Benefits of X-rays to Medical Science

Modern medical science has
profited greatly as a result of
this important discovery. X-rays
are used by the medical
profession to:
• Diagnose illnesses
• Study bone fractures
• Locate foreign substances in the
body
• Treat cancer and skin diseases

p.13
Timeline
1895 X-rays, discovered by German physicist Wilhelm Conrad Roentgen. He also
produced the first X-ray picture of the body (his wife's hand) in December.
1896 January: First images of fractured bone, followed by gallstones,
arteriosclerosis, arteries using contrast injection, chest, kidney stones,
fluoroscopy images using fluorescing screen, stomach and intestines using
barium sulfate as the contrast medium.
1900 Chest X-ray: widespread use of the chest X-ray allowed for early detection of
tuberculosis (most common cause of death at the time).
1929 Cardiac Catheterization first performed by Werner Forssmann on himself.
1945 Coronary artery imaging: visualization of blood vessels that feed the heart.
1955 X-ray Image Intensifier - Television units

Allowed dynamic X-ray imaging of moving scenes. These fluoroscopic movies
provided new information of the beating heart and its blood vessels.
Panoramic X-ray images of the entire jaw and teeth.
1970 X-ray Mammography finds widespread application in imaging the breasts.
1972 Computed Tomography (CT) scanning invented by British engineer Godfrey
Hounsfield of EMI Laboratories, England, and South African born physicist
Allan Cormack of Tufts University, Massachusetts.

p.14
Timeline (con’t.)
1978 Digital Radiography: TV signal from the X-ray system is converted to a digital picture
which can then be enhanced for clearer diagnosis and stored digitally for future review.
1983 Fuji commercialized the first computed radiography CR system utilizing storage phosphor
technology (from Kodak phosphor screen).
1985 Clinical Networks were first implemented to allow digital diagnostic images to be shared
between physicians a via computer network, allowing a doctor in Boston to review a CT
examination from a patient in Beijing, China.
1989 Spiral CT allows fast-volume scanning of an entire organ during a single, short patient
breath hold of 20 to 30 seconds.
1994 Kodak introduced the KDS CR System 400 (Model 5110).
1997 DRC introduced the first amorphous selenium Detector array (dual panel) for clinical use.
2000 Kodak starts the DR business (first four Kodak DR products used the DRC detector).
2007 Kodak sells its Health Imaging division in May 2007, and Carestream Health is born.
2009 June: Carestream launches the DRX-1 Detector – the first wireless flat panel digital
receptor in a 35 x 43 cassette format with GOS scintillator.
October: Carestream launches the DRX-Evolution digital radiography system – the
system goes on to win several design awards and is considered an industry leader.
2012 June: Carestream launches the DRX-Revolution mobile X-ray system.

p.15
Skill Check
Q: Who is given credit for the discovery of
X-rays?
A: Wilhelm Conrad Roentgen
Q: Fill in the blanks: “It was the study of

___________ under high voltage in
___________ that led to the actual
discovery of X-rays.”
A: electrical discharges; vacuum tubes
Q: In 2009, Carestream launched the first

wireless flat panel digital receptor in a 35
x 43 cassette format with GOS
scintillator. What was its name?
A: The DRX-1 Detector

p.16
Summary
You have completed the X-ray
History module.
You are now able to:
• Describe the origin of the term “X-ray.”
• Explain who discovered X-rays.
• Explain how X-rays are used today.
• Describe the highlights in the
development of X-rays.

WW X-ray
Fundamentals
Training
Module 3: X-ray Terminology

p.18
Objectives
Welcome to the X-Ray
Terminology module.
When you complete this
module, you will be able to:
• Explain the common terms used in
X-ray technology.
• Describe projections.

p.19
Common Equipment Terms

X-ray tube:
• The component that produces X-radiation. More
precisely, the actual tube or “insert” is installed
inside the tube housing.
Tube housing:
• The visible portion of an X-ray tube assembly.
X-ray tube assembly:
• The complete X-ray tube and housing
assembly.
Collimator:
• X-ray beam limiting device (BLD). Used to
shape and limit the size of the X-ray field.
Generator:
• The X-ray power supply used to energize the
X-ray tube, and “generate” X-rays.
p.20
Common Equipment Terms (con’t.)

OTC (OTS) – Over-table Tube Crane/Support:
• Purpose is to allow the tube to be positioned
for performing exams.
Bucky:
• Early definition - the assembly that
comprises the grid, grid frame, and grid drive
assembly.
• Today’s definition – the assembly that
comprises the grid, grid frame, grid drive, and
means to hold the receptor.
• Anti-scatter grid likely invented by Gustav
Bucky, but later improved by Hollis Potter.
• We generically call the assembly that holds
our digital detectors on our DR systems “the
Bucky”.
p.21

Receptor:
• Device that receives the X-ray, for
example, film, CR plate, digital detector,
Image Intensifier (II), CCD camera, TV
camera, etc.
Fluoroscopy:
• “Live” or continuous X-ray used for real-
time land marking and investigation.
• Images presented on TV monitor.
• Low dose, resulting in poor image
quality.
Source (Focal Spot):
• The focal spot of the X-ray tube, or the
point where the electrons collide with the
target, and X-ray photons are produced.
p.22

SID (Source to Image Distance):
• Distance from source (focal spot) to the imaging plane of receptor.
SOD (Source to Object Distance):
• Distance from the source to the object being imaged.
OID (Object to Image Distance):
• Distance from the object being imaged to the receptor (image) plane.
HVL (Half Value Layer):
• A measure of X-ray beam quality.
• The amount of filtration (mm AL) required to reduce the dose by ½ of
the original X-ray beam.

p.23

PREP:
• The common term for describing the phase of operation where the
generator is ‘preparing’ for the production of
X-rays.
Expose:
• The common term for describing the phase of operation where the
generator is producing high-voltage, and X-rays are being produced.

p.24
Common Exam Terms

AEC:
• Automatic Exposure Control.
• A mode of generator operation in which a sensor is used to sense when
the amount of X-rays being produced reaches a set threshold, when the
threshold is reached, a signal is sent to the generator controller to
terminate the exposure.
DAP (Dose Area Product):
• A measurement device used to measure the exposure generated by the
X-ray tube assembly and multiplied by the area of the X-ray field size (or
the product of the dose times the X-ray field area).
Technique:
• Exposure Technique – the exposure parameter and equipment setup for
an examination (i.e., kV, mA, time, SID, upright, etc.).

p.25
Common Exam Terms (con’t.)

kV (kilo-volts):
• Electrical potential applied to the X-ray tube.
• kV is synonymous with ‘beam energy,” or the penetrating ability of the X-
ray beam.
mA (milli-amperes):
• Tube current, or the setting to describe the flow of electrons across the
tube.
• Correlates with the “amount” of X-ray photons that are being produced.
Dual Energy (not so common):
• An exam where two images are acquired at differing beam energies.
The Image data is then processed together to allow the ability to create
images that enhance certain anatomical features (i.e., bone versus soft
tissue).

p.26
Common Patient Positioning Terms

Common terms that indicate patient position relative to the X-ray beam.
PA: Posterior/Anterior (X-ray

enters back to front).
AP: Anterior/Posterior (X-ray
enters front to back): used
more often than PA for
mobile imaging.
Lateral: X-ray beam enters one
side of the patient and
exits on the other side.
Supine: Patient is lying on the
back or is facing upward.

p.27
Projections
For two-letter acronyms, the first letter indicates where the X-ray enters
and the second letter indicates where the beam exits.
For three-letter acronyms, the first two letters indicate where the X-ray
enters and the third letter indicates where the beam exits.
PA
Posterior Anterior
RPO LPO
Right Posterior Oblique Left Posterior Oblique
RL LL X-ray Direction
Right Lateral Left Lateral
RAO LAO
Right Anterior Oblique Left Anterior Oblique
AP
Anterior Posterior
p.28
Skill Check
Q: For mobile imaging, which is used
most often, AP or PA?
A: AP
Q: What is the name of the device used to

shape and limit the size of the X-ray field?
A: Collimator
Q: What does “AEC” refer to?

A: Automatic Exposure Control

p.29
Summary
Terminology module.
• Explain the common terms used in
X-ray technology.
• Describe projections.

WW X-ray
Fundamentals
Training
Module 4: Basics of Physics

p.31
Objectives
Welcome to the Basics of Physics
module.
• Define what an X-ray is.
• Describe the electromagnetic
spectrum.
• Describe the difference between
photographs and radiography.
• Identify the characteristics of X-rays.
• Describe how X-rays are produced.
• Describe the interaction of X-rays with
matter.
• Explain scatter.
p.32
What Are X-rays?

X-rays are a form of electromagnetic energy just like light rays
and micro-waves.
X-rays have more energy than light rays, so they can penetrate
and travel through materials that light rays cannot.

The Electromagnetic Spectrum
The electromagnetic spectrum can be divided up into various regions,
with x-rays having higher frequencies than those of visible light.
p.34
Photographs and Radiographs

In photography, reflected light rays from the
object expose the film to produce an image.
In radiography, X-rays that pass through the

object expose the film to produce an image.
Differences in the types and amounts of the

materials that the X-rays must travel through
are responsible for the details of the
radiographic image.

p.35
X-ray Characteristics
• X-ray photons travel at approximately the speed of light.
• X-ray photons move rectilinearly, meaning they travel in a straight path
away from the source until they interact/collide with another object.
• X-ray photons are part of the spectrum that has ionizing characteristics.
Ionization is the physical process of converting an atom or molecule into
an ion by adding or removing charged particles such as electrons.
• X-ray photons have a photoelectric effect: This means the energy
produced can be viewed by exposing film or capturing on TV system.
• X-ray photons do not yield to electric, magnetic, or high-frequency fields.
• Depending on the density and thickness of matter, X-rays can penetrate
matter, where they undergo an attenuation, producing secondary or
scatter radiation with a lower penetration intensity.
• X-ray photons cause a biological effect. For example, they affect tissue.

p.36
How Are X-rays Produced?

• Short answer:
– By turning on the X-ray tube.
• Longer answer:
– Electron energy is converted into X-ray photons by colliding them into a target
material.
• Even longer answer:
– When an electron is accelerated into a target material (typically tungsten or
copper) and then rapidly decelerated as it collides with the material. Some of
the electrons colliding with the material will have their paths deflected by the
nucleus of the metal atoms. X-rays are produced due to the loss of the
electron energy as a result of this deflection.
– The X-rays produced in this manner are called “Bremsstrahlung.”

p.37
Interaction of X-rays with Matter

Scatter
Collimator
Reduced
X-ray Beam
X-ray Beam
Absorption
The absorption is characterized by Photoelectric Effect (and Pair

production).
The scatter is characterized by Compton Effect (and classical scatter).

p.38
X-ray Interactions
There are three main interactions of diagnostic X-
Scattered X-ray rays with matter:
X-ray
1.Coherent Scattering: Interaction between a low
Coherent Scattering
energy photon and an atom: the photon does not lose
energy but it deviates by the incident radiation. It
X-ray contributes to create the gray fog (less than 5%) seen in
the resulting image.
Ejected Electron
Photoelectric Absorption 2.Photoelectric Absorption (secondary radiation): The
incident photon is absorbed creating an ionization of the
Scattered X-ray atom: a photoelectron is emitted. All of the X-ray photon’s
energy is absorbed by the patient.
X-ray
3.Compton Scattering: Interaction between the X-ray

Ejected Electron
photon and the outermost electrons: the electron is
Compton Scattering
evicted, and the photon is deviated from the original
direction. Highest contribution to scatter radiation.
p.39
Scatter
• Decreases the contrast in the image.
– Contrast is important for diagnostic capability.
• Provides no value to the medical image.
• Reduced or eliminated by use of grid (more about grids later).
• Any object/material in the X-ray beam can be a source of scatter
(e.g., the patient is typically the primary source of scatter).
• Compton Scatter is typically the highest contributor to scatter in
medical imaging.
More on the subject of scatter later when we discuss grids.

p.40
Skill Check
Q: X-rays are a form of __________
energy just like light rays and micro-
waves.
A: electromagnetic
Q: What is typically the highest contributor

to scatter in medical imaging?
A: Compton Scatter
Q: Scatter is reduced or eliminated by the

use of ______.
A: grid

p.41
Summary
You have completed the Basics of
Physics module.
• Define what an X-ray is.
• Describe the electromagnetic
spectrum.
• Describe the difference between
photographs and radiography.
• Identify the characteristics of X-rays.
• Describe how X-rays are produced.
• Describe the interaction of X-rays
with matter.
• Explain scatter.

WW X-ray
Fundamentals
Training
Module 5: Medical Imaging
Equipment

p.43
Objectives
Welcome to the Medical
Imaging Equipment module.
• Describe how X-rays are used in
medicine.
• Identify the requirements of a
basic X-ray system.
• Describe the types of X-ray
systems used in medicine today.

p.44
How Are X-rays Used in Medicine

• As a diagnostic tool, they allow
an inside view of the subject
without the use of invasive
measures.
• As a treatment for certain forms
of cancer.

p.45
X-ray System Requirements

Requirements of a basic X-ray system include:
• X-ray source
• Power supply and control
• Image receptor

p.46
The X-ray System

Optional or exam-specific features may include:
• X-ray tube portability (i.e., ceiling suspended tube support/crane, cart,
floor rail, table rail, mobile/portable, etc.)
• Receptor support (i.e., wall stand, table)
• Patient support (i.e., table)
• Fluoroscopy (live/sustained X-ray)
• Imaging software (i.e., subtraction for angiography)
• Tomography (moving the X-ray tube and receptor during the exposure)
• Mammography (dedicated breast imaging)
• Cardiology (dedicated heart imaging)
• Surgery (mobile X-ray, mobile fluoroscopy)
• Computed Tomography (CT)

p.47
The X-ray System (con’t.)

Can you think of any non-X-ray
producing imaging technologies?
• Magnetic Resonance Imaging (MRI)
• Ultrasound
• Nuclear Medicine

p.48

Typical Stationary X-ray
System
9 5 6
A.T. 8
6
4 2
3
5. BLD / Collimator
1. X-ray Tube 6. Bucky (Grid, AEC, Receptor)
2. X-ray Generator 7. Tube Support - Ceiling Suspension
3. X-ray Control Desk 8. Patient Support
4. HV Transformer 9. Radiation Protection
p.49

Example of a general radiographic diagnostic X-ray system:
• DRX-Evolution

p.50

Example of a mobile/portable radiographic diagnostic X-ray
system
Courtesy of GE Corp.

p.51

Example of a Computed Tomography (CT) system
Courtesy of Philips Medical

p.52

Example of a cardiology X-ray system

p.53

Example of a surgical C-arm R&F system

p.54

R&F tilting table system

p.55

Remote control table system

p.56

Universal remote control table

p.57

Cardiac catheter lab
Courtesy of Philips Medical

p.58
Dental
systems

p.59

Single HT cable to the Anode
(cathode to GND)
• Molybdenum anode
(characteristic radiation)
• 28-30 kVp techniques
• Beryllium port (to decrease the
glass filtration)
• Focus 0.1 mm : zoom technique
• Focus 0.4 mm : contact technique
• Molybdenum filter 0.03 mm to
remove hard and soft radiations

p.60

Example of a linear accelerator X-ray system used in the
oncology department for the treatment of cancer. This is not a
diagnostic device.
Courtesy of Varian Medical

p.61
Skill Check
Q: What are the three required components of
an X-ray system?
A: X-rays source; power supply and control;
image receptor
Q: What is an example of a general

radiographic diagnostic X-ray system?
A: DRX-Evolution
Q: Name three optional features of an X-ray

system.
A: Tomography; Mammography; Fluoroscopy

p.62
Summary
You have completed the
Medical Imaging Equipment
module.
• Describe how X-rays are used in
medicine.
• Identify the requirements of a basic
X-ray system.
• Describe the types of X-ray
systems used in medicine today.

WW X-ray
Fundamentals
Training
Module 6: Electrical Basics

p.64
Objectives
Welcome to the Electrical Basics
module.
• Identify the four basic characteristics
of electricity.
• Describe the difference between DC
and AC current.
• Explain AC RMS and DC.
• Describe single-phase supply and power.
• Explain the principles of transformers.
• Describe three-phase electric power systems.
• Describe R, L, or C AC circuit (V and I).
• Describe real power versus true power.
p.65
Four Basic Characteristics of Electricity

Electricity has four basic
characteristics:
• Voltage (Pressure)
• Amperes (Flow)
• Ohms (Resistance) Resistance
Voltage
• Watts (Power)
The flow of electrons through a circuit can
be compared (and commonly is) to the
flow of water through a pipe. Current
The rate of flow of water is analogous to
Amperes, Ohms to pipe diameter,
Voltage to water pressure, and Watts to
liters of water.
p.66
Ohm’s Law
P = Power, in watts (W)
I = Current, in amperes (A)
E = Electromotive force, in volts (V)
R = Resistance, in ohms (Ω)

p.67
DC and AC
Direct Current Alternating Current
(DC) (AC)
I I
I I
DC is voltage or current that AC is voltage or current that

maintains constant polarity changes polarity or direction,
or direction, respectively, respectively, over time.
over time.

p.68
AC RMS and DC
RMS is a "DC equivalent" measurement to any AC voltage
or current: whatever magnitude of DC voltage or current
would produce the same amount of heat energy dissipation
through an equal resistance.
5 A RMS
5W
Power
10 V RMS 2Ω Dissipated
5 A RMS Equal Power

Dissipated Through
Equal Resistance Loads
5A
5W
10 V 2Ω Power
Dissipated
5A
p.69
Single-phase Supply
The live and neutral conductors
should be considered as the
“power supply” to the premises. Live
Supplier’s
Distribution Premises
Although the live and neutral System
conductors both carry current, Neutral
only the live conductor is at a
voltage that could be harmful.
Earth
Connection
The neutral conductor will To Earth
normally be at the same voltage
Joint
as the earth conductor. In fact,
at some point the neutral and Terminal
the earth will be connected
together.

p.70
Single-phase Power
Power consumed by a single-phase load is determined by
using the following formula:
P =V x I
P = power in watts or kilowatts (W or kW)

V = voltage in volts
I = current in amperes

p.71
Transformer Principle
Transformer
AC Voltage Induced AC
Source Voltage
A transformer is a device made of two or more inductors, one of which is powered

by AC, inducing an AC voltage across the second inductor. If the second inductor is
connected to a load, power will be electromagnetically coupled from the first
inductor's power source to that load.
“Step-down” Transformer “Step-up” Transformer

High
High
Voltage
Low Voltage
Voltage
AC Low Voltage
Many Few Load AC
Voltage Turns
Turns Few Many Load
High Current Voltage Turns Turns
Source High Current
Low
Source
Low
Current
Current

p.72
Three-phase Voltages
Three-phase electric power systems have at least three conductors
carrying voltage waveforms that are 120°(1/3 of a cycle) offset in time.
Phase 1 Phase 2 Phase 3
1.0
0.5
0
90° 180° 270° 360°
-0.5
-1.0
120° 120°
Three-phase voltages are produced by three sets of windings, mechanically

fixed to each other. Because there are separate voltages, each one can be
used as a single-phase power source provided a neutral connection is
available, however, in practice, the three windings are interconnected to
form a three-phase AC power source.
p.73
Three-phase Power
The use of three-phase power has
VAB=Vphase
some advantages over the use of
single-phase power: VAN=Vphase/1.73
(e.g., 400/1.73=230)
• Delivers 1.73 times the power as
compared to a single-phase source
• Much thinner and lighter wires
A B
L1 L2
120°
A B
N
120° 120°
DELTA
WYE
L3 C
C

p.74
Three-phase Power (con’t.)

STAR (Y) Connection
Star Point
L1
Vp A2
Vline
Star Point B2 C2
Vline
A1
L2
Vline C1
B1
L3
L1 L2 L3
• Vline = V phase x 1.732 (1.732 = square root of 3)

• I line = I phase

p.75
Three-phase Power (con’t.)

DELTA Connection
L1
A2
Vline
L2 B2 C2
Vp A1
Vline
Vline
B1 C1
L3 L1 L2 L3
• Vp = V line
• I line = I phase x 1.732 (1.732 = square root of 3)
p.76
Three-phaseTransformer
Primary and secondary windings could be connected in either Delta or Y
configurations to form a complete unit.
Y-Y, ∆- ∆
The secondary voltage waveforms are in phase with the primary
waveforms when the primary and secondary windings are connected the
same way. This condition is called “no-phase shift.”
Y-∆, ∆-Y
The primary and secondary windings are connected differently than the
secondary voltage waveforms will differ from the corresponding primary
voltage waveforms by 30 electrical degrees. This is called a “30-degree
phase shift.”
Three-phase
Transformer Core

p.77
Three-phase Input Transformer (con’t.)

Three-phase Input Transformer for X-ray Generators
480 V
415 V
400 V
380 V
380 V
400 V
415 V
480 V
380 V
400 V
415 V
480 V

p.78
Three-phase Power
Power consumed by a three-phase load is determined by using the
following formula:
P = 1.732 x V x I x Pf
P = power in watts or kilowatts (w or kW)

1.732 = square root of 3
V = voltage in volts
I = current in amperes
Pf = power factor (0 to 1)

p.79
R L or C AC Circuit (V and I)
e=
Resistor
i =
R = 100 Ω +
100 Ω
X=0Ω
Z = 100 Ω ∠ 0° Time
-
Inductor
e=
R=0Ω
100 mH i =
X = 100 Ω +
159.15 Hz
Z = 100 Ω ∠ 90° Time
-
Capacitor
e=
R=0Ω
100 µF i =
X = 100 Ω +
159.15 Hz Z = 100 Ω ∠ -90° Time
-
p.80
R L or C AC Circuit (Power)
Resistor e=
i =
R = 100 Ω + p=
100 Ω
X=0Ω
Z = 100 Ω ∠ 0° Time
-
Inductor e=
R=0Ω i =
100 mH p=
X = 100 Ω +
159.15 Hz
Z = 100 Ω ∠ 90° Time
-
Capacitor e=
i =
R=0Ω p=
100 µF X = 100 Ω +
159.15 Hz Z = 100 Ω ∠ -90° Time
-
p.81
Real Power Versus Apparent Power

Real (or true) power is the actual power used in an electrical circuit.
Real power is expressed in watts (W).
Apparent power is the product of voltage and current in a AC circuit,
measured without considering any phase variance between voltage
and current in the circuit. It is expressed in volt amps (VA). Apparent
power is the power measurable with a typical voltmeter and ammeter.
Real power is always less than apparent power in reactive circuits. In
a purely resistive circuit (with no reactance), apparent power is the
same as apparent power. To measure real power, the waveform must
be divided into many segments, and a large number of voltage and
current readings must be taken and then averaged. Specialized watt
meters and reactive power meters are designed to do this.
The ratio of real power to apparent power is called the power factor.

p.82
Real Power Versus Apparent Power (con’t.)

The ratio of real power to apparent power is called the power factor.
A perfect power factor (where there was no difference between real and
apparent power) would be 1.0.
Apparent power is the power measurable with a typical voltmeter and
ammeter. The technical definition is: The measure of alternating current
power that is computed by multiplying RMS (root-mean-square) voltage
and RMS current. This is called apparent power, because it is the power
that is measured by the most common means — the power that appears to
you.
Real power is more complex. In a purely resistive circuit (with no
reactance), apparent power is the same as apparent power. To measure
real power, the waveform must be divided into many segments, and a
large number of voltage and current readings must be taken and then
averaged. Specialized watt meters and reactive power meters are
designed to do this.
p.83
Skill Check
Q: What are the four basic characteristics of
electricity?
A: Voltage, Amperes, Ohms, and Watts
Q: What are some advantages of using three-

phase power over single-phase power?
A: Three-phase power delivers 1.73 times the
power and uses much thinner and lighter
wires.
Q: The ratio of real power to apparent power is

called the ________.
A: power factor

p.84
Summary
You have completed the Electrical
Basics module.
• Identify the four basic characteristics of
electricity.
• Describe the difference between DC and
AC current.
• Explain AC RMS and DC.
• Describe single-phase supply and power.
• Explain the principles of transformers.
• Describe three-phase electric power
systems.
• Describe R, L, or C AC circuit (V and I).
• Describe real power versus true power.
WW X-ray
Fundamentals
Training
Module 7: Mains

p.86
Objectives
Welcome to the Mains module.
When you complete this module, you
will be able to:
• Identify mains terminology.
• Describe mains variation and unbalance.
• Describe mains current.
• Describe real power versus apparent power.
• Describe mains impedance.
• Describe resistance, reactance, and impedance.
• Describe an X-ray generator mains specifications.
• Explain grounding.
• Identify best practices for grounding.
p.87
Mains Terminology
In order to supply an X-ray generator, the Mains has to
comply with the following specifications:
1.Nominal voltage (the way of naming a range of voltage to a
standard)
2.Mains variation and unbalance
3.Line current (peak and stand by)
4.Max peak incoming power (or apparent power)
5.Mains impedance

p.88
Mains Variation and Unbalance

Voltage variation is the capability of the mains to support
instantaneous variation accordingly with the load. It could
be also called voltage fluctuation that is a sudden and
noticeable change in RMS voltage level, usually caused
by changing system load.
Voltage unbalance of a three-phase system is
expressed as a percentage value, and it is often defined
as the maximum deviation from the average of the three-
phase voltages or currents, divided by the average of the
three-phase voltages or currents. This voltage unbalance
is calculated as shown below:
% unbalance = 100 x Maximum Deviation from Average Voltage
Average Voltage

p.89
Mains Current
Peak current:
The figure is the maximum instantaneous current in the line.
Stand-by current:
The figure is the current required by the system in stand-by mode.

p.90
Mains Impedance
Line impedance is the sum of resistance, Branch
inductance, and capacitance found in every Transformer
Circuit
electrical device.
Service
Common sources of line impedance include
Feeder
copper conductors, transformers, contactors,
fuses, and terminals.
Utility
Every electrical device contributes a small
amount to the total line impedance. Circuit
Breaker
Line impedance causes several power quality
problems. Excessive impedance causes voltage
sags when facility loads are energized, especially
loads that have high inrush currents like X-ray
systems.
One of the highest impedance devices that can

be found in a facility is a transformer.

p.91
Resistance, Reactance, and Impedance

Resistance is essentially friction against the motion of electrons. It is present in all
conductors to some extent (except superconductors), most notably in resistors.
When alternating current goes through a resistance, a voltage drop is produced
that is in-phase with the current. Resistance is mathematically symbolized by the
letter "R" and is measured in the unit of Ohms.
Reactance is essentially inertia against the motion of electrons. It is present

anywhere electric or magnetic fields are developed in proportion to applied voltage
or current, respectively, but most notably in capacitors and inductors. When
alternating current goes through a pure reactance, a voltage drop is produced that
is 90° out of phase with the current. Reactance is mathematically symbolized by
the letter "X" and is measured in the unit of Ohms.
Impedance is a comprehensive expression of any and all forms of opposition to

electron flow, including both resistance and reactance. It is present in all circuits,
and in all components. When alternating current goes through an impedance, a
voltage drop is produced that is between 0o and 90o out of phase with the current.
Impedance is mathematically symbolized by the letter "Z" and is measured in the
unit of Ohms, in complex form.

p.92
Mains Impedance Measurement

Mains impedance is a measure of the total resistance to current flow in
an electrical system. In practice, impedance consists of resistive and
inductive elements.
Impedance can be calculated as follows:
No Load Voltage - Load Voltage

Impedance = --------------------------------------
Load Current
Prior to the installation of new X-ray equipment, it is important to ensure
that the supply cable resistance does not exceed the maximum value
quoted by the manufacturers.

p.93
Mains Impedance
Mains impedance has a major influence on the output power of the X-ray
generator.
0-5
80 A 200 mA
a.) The X-ray system is asked to generate 200
mA of tube current @ 100 kVp. This is a 20
kW exposure.
290 V 250 V 100 kV Due to the mains impedance, the voltage
drops by 40V and in order to make the 20kW
exposure, the current on the primary windings
must increase to 80 Amps of peak current in
a.) 1:400 the primary winding of the HV transformer.
0-5 500 mA
200 A
a.) The X-ray system is asked to generate 500
mA of tube current @ 100 kVp. This is a 50
100 kV kW exposure.
350 V 250 V
Due to the mains impedance, the voltage
drops by 100V and in order to make the 50kW
exposure, the current on the primary windings
b.) must increase to 200 Amps of peak current in
the primary winding of the HV transformer.
p.94
X-ray Generator Mains Specifications

Examples:

p.95
Mains Impedance Problems – Example 1

X-ray installation with dimmer room light during power exposures (for
example, spine, abdomen).
Room lights were connected to the same phase of the distribution

transformer. The bad connection created voltage drop visible in room light
as well.
p.96
Mains Impedance Problems – Example 2

Kodak DR9000 installation with random "Power error.”
Hospital electrician measured just the supply voltage.
Measured high ripple Wrong size fuses in the

on HT pulse electrical box

p.97
Grounding
The word grounded means connected to
the earth.
The grounding conductor is:
1. A conductor that does not normally carry current and is used to

connect all exposed, noncurrent-carrying metal surfaces of the
equipment to earth
or
2. A conductor that does not normally carry current and is used to

connect the grounded conductor to the grounding electrode (rod) or
grounding electrode system.

p.98
Grounding (con’t.)
The equipment grounding conductor shall be green with a yellow stripe.
No other colors are specified.
The grounding conductor must be as large as the largest current-

carrying conductor in the system.

p.99
Importance of Grounding
Electrical grounding is important
because it provides a reference voltage
level (called zero potential or ground
potential) against which all other
voltages in a system are established and
measured.
An effective electrical ground connection

also minimizes the susceptibility of
equipment to interference, reduces the
risk of equipment damage due to
lightning, eliminates electrostatic buildup
that can damage system components,
and helps protect personnel who service
and repair electrical, electronic, and
computer systems.

p.100
Importance of Grounding (con’t.)

In effect, an electrical ground drains away any unwanted buildup of
electrical charge.
When a point is connected to a good ground, that point tends to stay

at a constant voltage, regardless of what happens elsewhere in the
circuit or system.
The earth, which forms the ultimate ground, has the ability to absorb
or dissipate an unlimited amount of electrical charge.

p.101
Importance of Grounding (con’t.)

Why grounding is so important ?
Earthing of electrical systems is required for a number of reasons, principally to

ensure the safety of people near the system and to prevent damage to the system
itself in the event of a fault.
The function of the protective conductor, or earth, is to provide a low resistance path
for fault current so that the circuit protective devices operate rapidly to disconnect
the supply.
The purpose of a ground, besides the protection of people, plants, and equipment,
is to provide a safe path for the dissipation of fault currents, lightning strikes, static
discharges, EMI and RFI signals, and Interference.
Improper grounding can create a lethal hazard – protection of people is the prority.
Correct grounding is also essential for correct operation and safety of electrical
equipment.
Faulty electrical grounding results in what is called “dirty electricity.”

p.102
Grounding Example
Example: DR7500
Hospital Ground
Power Ground
Generator
Console
System Ground
System Ground
TDU HT Tank
Tube
Housing
Ground
System Ground
Table Tube
System Ground Crane
Wall
Stand
p.103
Best Practices
The ground conductors must be properly connected according with the
system ground plan.
During maintenance, it is good practice to verify the GND connection for

any loosen terminal/connection.
If you encounter unusual/unexplained issues such as random errors

appearing mainly during higher power exposures, carefully check the
ground wires for continuity and proper connections.
Never take assumption that the GND is correct because nobody has
touched the cables since installation. One GND cable could be loosen or
even disconnected/interrupted by someone else’s mistake.

p.104
Skill Check
Q: What is peak current?
A: The maximum instantaneous current in the
line.
Q: What is Mains impedance?

A: A measure of the total resistance to current
flow in an electrical system.
Q: What are the colors of the grounding

conductor?
A: Green with a yellow stripe.

p.105
Summary
You have completed the Mains
module.
• Identify mains terminology.
• Describe mains variation and unbalance.
• Describe mains current.
• Describe real power versus apparent power.
• Describe resistance, reactance, and
impedance.
• Describe an X-ray generator mains
specifications.
• Explain grounding.
• Identify best practices for grounding.
WW X-ray
Fundamentals
Training
Module 8: Exposure
Control Factors

p.107
Objectives
Welcome to the Exposure Control
Factors module.
• Describe exposure control factors.

p.108
Exposure Factors
The X-ray beam is described in terms of Quantity and Quality.
QUANTITY >>> mA
Fewer photons produced ↓mA ↑mA More photons produced
QUALITY >>> kV
Soft radiation Hard radiation
Lower energy Higher energy
↓kV ↑kV
Longer wavelength Shorter wavelength
Less penetration power More penetration power

p.109
Exposure Factors (con’t.)

The operator controls the characteristics of the X-ray
produced by selecting the output of the generator using the
following X-ray technique factors:
• kilovolts (kV)
• milliamperes (mA)
• time (ms)
Some generators combine the exposure time and mA into a

single quantity known as milliampere-seconds (i.e., mAs,
mA x sec.)

p.110
Exposure Factors – kV
kV – The commonly-used term to describe the tube voltage and is
synonymous with the energy of the X-ray photons.
Increasing the kV increases the energy (speed) of the electrons as they

are accelerated across the X-ray tube.
The kV setting controls the penetrating power of the X-rays.
Higher kV settings produce X-ray photons with greater penetrating

capability.

p.111
Exposure Factors – kV (con’t.)

kV or kVp?
• kVp - Maximum peak voltage
– Maximum value of the X-ray tube potential for a given exposure.
• kVp (avg.) - Mean peak voltage
– Mean value of all X-ray tube potential peaks for a given exposure.
• kVp (eff.) – Effective peak potential
– The X-ray tube potential giving the same image contrast as when
using a constant potential tube voltage. (more common and applicable
for low frequency generators)

p.112

An increase in kV, increases the beam’s energy, and the ability to
penetrate an object or substance.
kV = X kV = X + kV = X ++

p.113

Imaging effects of kV
selection.
Receptor Receptor Receptor
kV too high: over- kV too low: under-

penetration resulting Ideal: good contrast penetration resulting in
Unrestricted Internal Use in poor contrast poor contrast, low signal
p.114
Exposure Factors – mA
mA – milliamperes
mA is the measure of the tube current, or the flow of electrons across the X-ray tube
during the exposure.
The number of free electrons is controlled by the temperature of the cathode

filament. The production of free electrons is accomplished by adjusting the filament
current.
Setting the X-ray machine for a specific mA equates to adjusting the

filament temperature, which is done by adjusting the current applied to the filament.
The hotter the filament, the more electrons are available to form the electron stream.
When the mA is multiplied by the time of exposure, the result is mAs. For a given
kVp setting, the amount of X-ray dose produced increases linearly with mAs.

p.115
Exposure Factors – mA (con’t.)

An increase in mA, equates to more electrons being produced in a given
time, resulting in more X-ray photons being produced for that same
timeframe.
Keeping other exposure mA = 100 mA = 200
factors (kV and time)
constant, a change in
mA results in a change
in density on film, but for
DR, the increase in
photons will increase the
pixel value, providing an
increase in signal,
improving the signal to
noise ratio.
The images show how
the density of the film
changes as mA is
Position
changed. Position
Optical Density (film)

Digital Values (CR and DR)
p.116
Exposure Factors – Time

Exposure time
• The exposure time is defined 100%
90%
as the duration the kV has 75%
reached maintains 75% of the
kV
selected value. Exposure Time
• Exposure times will vary by

exam, and many generators Rise Time Time
can operate up to 6.3 seconds.

• The product of time and mA is
“mAs.” mAs is commonly used
by X-ray techs, and represents
an “amount” of X-ray exposure.

p.117
Example – Generator Control/UI

KV Selection
Indicator for mAs Selection
Fluoroscopy
Exposure
Exposure Time Selection
AEC Chamber
Selection
Exposure Time
Selection
Exposure Parameter
On/Off Dedicated Small/large
for Patient Sizes
Programming Focus
“Station” Selection for Different
(i.e., Bucky, Wall Bucky) Organs
p.118
Exposure Factors – Technique Selection
Manual exposure 3-point 2-point

technique (or “3-knob”)
User can select kV, mA, kV, mAs

expTime

p.119
Skill Check
Q: What does a change in kV do to the X-ray photons being produced?
A: Changes the energy of the photon, which affects penetrating ability.
Q: How does a change in mA affect the X-ray beam being produced?

A1: Changes the amount of electrons being produced, which affects the
amount of photons being produced.
A2: An increase in mA typically results in greater optical density, which may
improve image quality, but increases patient exposure.
Q: What is mA the measure of?

A: The tube current, or the flow of electrons across the X-ray tube during the
exposure.

p.120
Summary
Exposure Control Factors
module.
• Describe exposure control factors.

WW X-ray
Fundamentals
Training
Module 9: X-ray Tube
Assembly

p.122
Objectives
Welcome to the X-ray Tube
Assembly module.
• Explain what an X-ray tube is.
• Identify the components of an X-ray
tube and their function.
• Explain the function of an X-ray tube.
• Explain “heel effect.”
• Explain a rating chart.
• Explain anode heat.
• Identify common X-ray tube problems.

p.123
X-ray Tube
An X-ray tube is an energy converter. It receives electrical energy and
converts it into two forms: X-radiation and heat. The heat is an undesirable
byproduct. X-ray tubes are designed and constructed to maximize X-ray
production and to dissipate heat as rapidly as possible.
Lead
Steel Lining
Housing
Expandable
Gasket
Insulating Lead
Primary
Oil Beam Lining
p.124
X-ray Tube Components

X-ray Tube Insert –
• Actual component that produces X-ray.
X-ray Tube Housing –

• Device that houses the tube insert and
provides X-ray shielding for protection.
Tube Assembly –
• Includes both the insert and the housing.

X-RAY TUBE - function
1. Applying current to the filament(s), electrons are boiled off of the filament forming an
electron “cloud”. The filament(s) are part of the cathode (-) of the x-ray tube.
2. High voltage is applied, creating a large potential difference between the anode (+)
and cathode (-) of the x-ray tube, causing the electrons to flow to, and impact the
surface of, a target located at the anode end of the tube.
3. The impact of the electrons with the target creates an electromagnetic reaction that
results in the conversion of the electrons into x-ray photons
As a result of the interaction between the electrons and the target material, about
95% to 99% of the energy is converted into heat, and about 1% to 5% is converted
into X-ray energy.
p.126
Housing – Function
The housing provides:
• X-ray shielding
• Connections for HV and
filament supply to the
insert
• Electrical insulation
• Stator support (rotating
target)
• Insert cooling
• Beam pre-collimation
• Safety and temperature
sensor

p.127
X-ray Tube Housing – Features

Tube Port
• The exit window in the X-ray tube housing
through which the X-ray beam is emitted is
called the tube output port.
• This port is made of low attenuating material Port
to maximize the X-ray output.
• In X-ray tubes designed for mammography,
beryllium is often used.

p.128
X-ray Tube Housing – Features
Radiation Leakage Protection

• When X-rays are produced, they are emitted in all directions with
various energies and wavelengths.
• X-rays emitted through the window are known as the useful beam.
Other X-rays that escape through the protective housing are
known as leakage radiation.
• Manufacturers of X-ray tubes have standards for leakage radiation
set by the federal government. That standard dictates less then
100 mR (ionizing radiation dose to humans) per hour at one meter.

p.129
X-ray Tube Assembly – Miscellaneous

X-ray Tube - Mounting Provision
Trunnion Ring (clamp) mounting

• The shield is strengthened around its centre to allow for clamp fittings
to be secured to it. The whole unit has to be fitted very firmly and safely
to mounting plate of the tube support. This fitting generally incorporates
function locks and scales which allows the tube to be angled precisely
along both axis.
Port mounting
• The shield is mounted to the tube port and the possible angulation is
made by the support.
End-Cap mounting
• Some mobile units are provided by this type of tube mounting.

p.130
X-ray Tube Assembly – Miscellaneous

High Tension (H.T.) Cable Receptacles
• Two lead lined “horns” attached to the basic cylindrical shape are
designed to receive the Federal-style connector.
• Each receiving connector has three contact points at the base to
receive the pin termination of each conductor. There may be a fourth
pin socket in the cathode connector for grid-controlled fluoroscopy.

p.131
X-ray Tube – Connections
High Voltage
Rotor Connections
“Federal Plugs“
Anode Cathode
p.132
X-ray Tube Assembly – Connections

Horn angle – the relative location of the HT connections to the output port.
Technical Information
Housing Horn Angles
Housing Horn Angles

Viewed from Anode End
Varian, GE, 0° 15° 45° 90° 90°

etc. B – 155
B – 165
B – 185
270°
135° 180° 225° 270° B – 155
B – 165
Unrestricted Internal Use B – 185
p.133
X-ray Tube – Insert

X-ray tube insert - envelope of
Borosilicate glass to accommodate the
high temperatures that occur during
operation.
High vacuum inside a glass container

“tube” where electrons can freely be
accelerated without excessive collisions
with gas molecules.

p.134
X-ray Tube – Cathode

• The cathode is the negative Anode
electrode of the tube, and is Filament
where the –kV connection is Cathode
attached.
• The cathode is typically
25 mm or less from the Glass
anode (target). Envelope
• The cathode is where the

filaments are located. Target Focusing Cup
Window
• The current flowing in the
filament is the filament
current (for example,
3 – 6 A).

X-RAY TUBE - FILAMENT
The filament is typically made of thoriated tungsten with
a high melting point (3380°C) and very low vaporization
which reduces tube port metallization
The filament is embedded in a negatively charged metal
cup called the focusing cup.
All of the electrons being emitted by the cathode to the
anode are electrically negative; therefore the electron
beam tends to spread out because of electrostatic
repulsion. The focusing cup helps to keep the electrons
focussed, and results in a condensed cloud to send to
the anode (target).
Some of the emitted electrons may miss the anode all
together.
Filament is a spiral filament: ~1.5 x ~15mm (very similar
to that of a standard incandescent light bulb)
The filament dimensions along with other factors
determine the size of the focal spot
The filament current controls the amount of emitted
electrons
thoriate – to impregnate with thorium oxide to increase
emission.
p.136
X-ray Tube – Target/Anode

• The anode is the positive electrode of the tube, and is where the +kV is
connected.
• It is typically a block or of copper coated with Tungsten or a disk of
Tungsten and other materials with a high atomic number.
• A high Atomic Weight Metal allows efficient X-ray generation because of
its high heat capacity and durability.
- Tungsten is used in most
Anode
general radiography X-ray tubes. Filament
- Special targets of molybdenum Cathode
or rhodium are often used
for Mammography.
• The current flowing between Glass
anode and cathode is the Envelope
tube current (for example,
25 – 1000mA). Focusing Cup
Target
Window
p.137
X-ray Tube – Target/Anode (Stator)

There are two types of targets: stationary and rotating.
X-ray tubes with stationary anodes are often used in dental X-ray
machines, some portable machines, and other special purpose
units, which do not require high tube currents and power.
In order for diagnostic X-ray tubes to produce high intensity X-ray

beams, they must have rotating anodes.
The rotating anodes operate at 3000 - 3600 rpm for low speed, or
9000 -10400 rpm for high speed. Actual speed may vary depending on
line input frequency, tube specs, and tube condition. High speed
operation typically is required for exposures of ~50 kW or higher.
The rotating speeds are chosen to prevent tube failure due to rotation
resonant frequencies. The critical speed is typically about 5500 rpm
and for this reason either boosting or braking must allow the stator to
pass through this point quickly.
p.138
X-ray Tube – Stationary Target/Anode
Target Focusing Cup

Glass with Filament
Envelope Vacuum
Stationary
Anode
Tube
Window
Filter Metal Housing

p.139
X-ray Tube – Rotating Target/Anode

The stator coils encompassing the anode end, or “neck,” of the tube
operating on the principle of induction.
Glass Envelope Anode Bearing
Driving Coils
Armature
Filament
Leads
Filament Rotating
Molybdenum Portion
Focusing Cup
Neck
Electron Beam
X-ray
Beam
p.140
X-ray Tube – Rotor (Stator)

The rotor, typically made of a copper
cylinder, is a part of the anode.
The outer surface of the rotor is blackened

to improve the loss of heat through
infrared radiation.
The stator is an inductive type of motor.

This is required due to the anode being at
a very high voltage potential during X-ray.
production relative to the stator winding
circuit. There is glass and oil between the
stator windings and the stator itself.
For this reason the energy to spin up the

anode is quite high (up to 9 kW).
p.141
X-ray Tube – Rotating Anode > Focal Track

Why do we have rotating targets?
The purpose of the

3 mm rotating anode is to
Actual Focal Spot
spread the heat
produced during an
exposure over a
large area of the
anode.
9 mm 60 mm Mean
Diameter Rotating increases
the heat capacity by
~500% (compared
to the same size
stationary anode).

X-RAY TUBE – Focal Spot
The ACTUAL focal spot is the area of the target, which is

being hit with electrons.
The EFFECTIVE focal spot is the projected geometrical
dimension of the area of the target being hit with
electrons.
It is from the focal spot, which x-rays are produced, and
is considered to be the actual source of radiation.
Often, we consider the focal spot to be a theoretical
“point” source, but this is not accurate, and all focal spots
have dimensional characteristics.
The mid point of the effective focal spot is often referred
to as the “central ray”.
Smaller focal spots produce sharper images.
In clinical practice the choice of the focal spot size is a
compromise between tube loading & the degree of
geometric un-sharpness that is acceptable.
p.143
X-ray Tube – Focal Spot (con’t.)

The focal spot is directly proportional to the anode angle.
Same filament size

but differing target α1 α2
angle results in
different focal α1 > α2
“SPOT” size. f1 f1 > f2 f2
Differing filament α1 α2
size and differing
target angle can α1> α2
result in the same
f1 = f2
focal “SPOT” size. f1 f2

p.144
X-ray Tube – Focal Spot (con’t.)

Actual focal spot dimensions
are different than the
“nominal” sizes listed on the
tube labels.
The chart shows the nominal

standardized values and the
associated width and length
ranges according to
international standard (IEC,
NEMA).
Actual focal size

determination is
accomplished using specific
procedure/conditions.
Unrestricted Internal Use Carestream Health, © 2014

p.145
X-ray Tube – Heel Effect

The Heel Effect is created when the X-ray intensity is greater at the
cathode end of the X-ray field and lower at the anode end because of
absorption in the target material. The Heel Effect is the primary reason for
X-ray beam non-uniformity or lack of homogeneity.

p.146
X-ray Tube – Target Angle

Target angle is the angle
of the track of the target
upon which the electrons
collide.
As target angle increases,

the size of the maximum
useable X-ray field size
also increases.
Example – At an SID of 1
meter, the following target
angles can produce a
maximum useable field
size of:
• 12º, resulting in ~43cm
(17”)
• 14º, resulting in ~91cm
(36”)
p.147
X-ray Tube – Rating Chart

The rating chart can
be used to determine
if a combination of kV,
mA, and exposure
time are valid or if the
tube will be exceeded
or “over loaded.”
NOTE – Most modern

microprocessor-
controlled X-ray
generators
automatically prevent
conditions that result
in over loading the X-
ray tube.

X-ray Tube – Rating Chart
Referring to the tube rating chart, notice that in order to
maintain a given mA setting, if kV is changed, the filament
current will also change.
Example – the GE AMX-4 has a single mA setting (not user

selectable), which is 100 mA. As kV is changed, the filament
current must also change in order to maintain the tube
current (mA).
It is for this reason that tube must be ‘adapted’ or calibrated if

kV and/or mA can be changed.
p.149
X-ray Tube – Rating Chart (con’t.)

Each focus has an associated power rating as rated
per IEC standards, which is based on a 100 msec
exposure. The power rating for the exposure is
determined using the following:
• Nominal exposure power = kV * mA = kW

p.150
X-ray Tube – Anode Heat

The anode heat capacity is the quantity of energy/heat that the anode material is
able to store without creating irreversible damaging during X-ray emission.
It is measured in Joules or Heat Unit (1 Joule = 1.41 HU).

1 joule = 1 watt during 1 second
1 Watt = 1 Amp * 1 Volt
It depends on anode mass and construction material.
Practically the anode heat capacity is the quantity of the job which the anode is
able to perform in a time frame.

p.151
X-ray Tube – Heat

X-ray tubes are often chosen based on the
anode’s heat storage capability.
A higher storage capability will offer longer

usage and/or greater duty cycle for given
exposure conditions before the anode reaches
its heat limit.
The anode’s heat storage capability is typically

measured in Heat Units (e.g., 400k HU).

p.152
X-ray Tube – Heat (con’t.)

Anode heat percentage (HU%) is the measure of the anode’s heat
capacity that has been consumed.
For a 400 kHU rated tube, when the HU% reaches 100%, the anode
(target) has reached 400 kHU or 300 kJ.
Most modern generators perform real time calculation of the HU%,

meaning the X-ray technologist no longer has to perform the
calculation manually.

p.153
Anode Heat
Anode Heat Capacity
Examples of anode temperature at:

• 20° C = 100% remaining capacity
Same Heat
4000°
4000°
3000°
3000°
2000°
2000°
1000°
1000°
0°
0°
Temperature
Large Heat Small Heat
Capacity Capacity
p.154
Anode Heat vs Housing Heat

Anode heat % (HU%) is NOT the same as the physical temperature of
the X-ray tube assembly, although the temperature of the housing is
affected by the amount of heat that is transferred from the target.
Example 1 – If starting from a cold tube, a series of high loading

exposures (e.g., > 100 kV, >300 mA, > 2000ms) was made in 30-second
intervals, the HU% would increase dramatically after just a few
exposures. If the exposures continued, the HU% would rise until the limit
was reached.
Key points:
• The tube housing may likely still be relatively cool when the HU% limit
is reached.
• After some time has elapsed, the HU% will decrease back to zero, but
the tube assembly temperature may increase dramatically.
• The tube’s thermal safety cutoff switch may be activated even after
exposures have ceased for some period of time.
p.155
Anode Heat vs Housing Heat (con’t.)

Example 2 – A continuous series of exposures are taken, however, the
HU% never goes above 15%, eventually, the tube housing thermal cutoff
opens, preventing further exposures. The customer calls to report
something must be wrong with the system, as the HU% did not get high.
Key points:
•Target heating is calculated by the generator’s heat unit calculator;
housing temperature is not.
•The target’s HU%, no matter how low it is maintained. It still represents
actual heat, and that heat eventually is transferred to the oil and the
housing through convection.

p.156
Anode Heat vs Housing Heat (con’t.)

Analogy for HU% -
• Consider a 100 Watt incandescent light bulb, and
assume the heating of the filament inside the bulb is
similar to the heating of the target in an X-ray tube.
– When the light is OFF, the HU% of the filaments is 0%.
– When the light is ON, the HU% of the filament is 100%.
• If the bulb is cold to the touch, and turned ON for 2
seconds, then turned OFF.
– The HU% of the filament reaches 100% while the bulb
is ON.
– The bulb housing is not too hot to touch immediately
after the bulb is turned off.
• If the bulb is turned on for five minutes and then turned
off, the bulb housing will remain too hot to touch for
several minutes.
p.157
X-ray Tube Review

Purpose of an X-ray tube assembly:
• Create X-rays for non-invasive investigation.
• Create X-rays for the treatment of some cancers.
How does an X-ray tube produce X-rays?
• By converting electrical energy into X-ray energy.

p.158
X-ray Tube Problems

ANODE ROTATION GLASS TUBE CRACKED
• Defective Bearings • Arcing > Implosion
• Stator windings interruption
FILAMENT
PITTED ANODE • Interruption
• Image Quality • Evaporation
• Less radiation output • Image quality due to geometrical
issues
METALLIZATION
• Dose issue due to increased ARCING
filtration • Ionization “gassy” (insert)
• Image quality at low kV’s • Vacuum leakage (insert)
• Internal arcing (true tube arc) • Insulation issues (housing/HT plugs)
OIL LEAKING THERMAL SWITCH

• Long term decreases insulation • Malfunctioning
capability
• Position adjustment (exp. Bellows)

p.159
X-ray Tube Problems (con’t.)
A B C D
Anode conditions:
A focal track corrupted
B focal track damaged/burned
C anode damaged by exposures without rotation
D focal track/anode OK
p.160

Pitted anode target area:
• Impacts beam
uniformity
• Less radiation output

p.161

A A
Loss of vacuum:
E Air molecules colliding with the
electron stream in a “gassy” X-
A ray tube can result in short-
E circuits >> arcing.
E
E Execute tube seasoning or
A “break in” to remove the air
A
molecules.
A E
E
E = Electron
A = Air Molecule
A

p.162
Skill Check
Q: The ______ is the positive electrode of the
tube, and is where the +kV is connected.
A: Anode
Q: The ______ is the negative electrode of the

tube, and is where the –kV connection is
attached.
A: Cathode
Q: What is the primary reason for X-ray beam

non-uniformity or lack of homogeneity?
A: Heel Effect

p.163
Summary
Tube Assembly module.
• Explain what an X-ray tube is.
• Identify the components of an X-ray
tube and their function.
• Explain the function of an X-ray tube.
• Explain “heel effect.”
• Explain a rating chart.
• Explain anode heat.
• Identify common X-ray tube problems.

WW X-ray
Fundamentals
Training
Module 10: X-ray
Generator Basics

p.165
Objectives
Welcome to the X-ray Generator
Basics module.
When you complete this module, you
will be able to:
• Describe the basic form of the X-ray
generator.
• Explain mains compensation.
• Explain filament control.
• Describe the X-ray tube rotor control
circuit.
• Describe high-voltage generation.
• Explain converter history.
• Explain low to high frequency.
• Explain “single-tank” X-ray tube.
p.166
X-ray Generator
Function / Item LEVEL 1 LEVEL 2
Description of generator’s function in the supplying of the various system Theory / lab Lab
components
Exposure process description Theory / lab Lab

Operation sequence timing/control
Functional description of the filament circuit. Theory / lab Lab

Measurement.
Functional description of tube safety and loading control. Theory / lab Lab
Functional description of the rotor supply and control. Theory / lab Lab
High Voltage Generation Theory / lab Lab
External Interfacing (e.g., room door contacts, room warning lights, etc.) Theory / lab Lab

p.167
X-ray Generator – Basic Form

1. Main breaker
2. Mains adjustment
T1
(compensation) 2 6 7
3. Mains level meter S2 S3 EXP Switch
4. Filament step-down
transformer (voltage down
> current up)
5. Tube current adjustment
6. kV setup adjustment
7. Exposure switch kV 8
8. High voltage step-up 9
1 5
transformer
9. X-ray tube S1
10. Tube current meter
R1 mA 10
3
V R2 4

p.168
Generator – Mains Compensation

Why do we need to have compensation for the mains?
Variation in the main voltage can affect the output of the generator
resulting in variations in exposure dose.
Old design generators required a physical compensator for the mains
variations. Some designed provided manual adjustment, while
others were fully automatic.
Modern generators, due to converter design, provide mains
compensation directly during exposure.

p.169
Filament Control – Circuit

The filament control circuit is the electric circuit used to produce the
heating current to the filament wire of an X-ray tube.
The circuit is basically a step-down transformer from the mains supply

to low-voltage but high current.
The primary and secondary windings must be sufficiently insulated to

withstand the high-potential difference between the cathode and earth.
The stability of the filament current must be carefully regulated

because the tube current is very sensitive to changes in the filament
temperature.

p.170
Filament Pre-heating
The current value to make Time Required to Heat
the filament able to quickly An X-ray Tube Filament
reach the required
With
temperature during
4A “Pre-heat”
radiographic preparation.
3A
(Typical 2.5 Amp)
2A Without
“Pre-heat”
1A
0A
0 1 2
Time (in Seconds) to Reach Stable

Temperature after Commencement of
Preparation for Exposure

p.171
Emission Curves
Filament current
vs. Tube current)

p.172
X-ray Tube Rotor Control Circuit

Low Speed Starter
The simplest power supply is 220 V AC source. It was used in older
generators for a single speed anode.
Most starter circuits are “inductive” drive systems.
Capacitor C provides the stator with a second phase.
The current in the two phases (I and II) have a phase shift of 120 degrees
to each other, which produces the rotating field.
The stator is called a “two-phase stator.”
F x 60
S = _______
n
S = speed RPM
Vac (50/60 Hz) f = frequency
60 = seconds in a minute
3000/3600 rpm n = couple of magnetic poles
p.173
X-ray Tube Rotor Control Circuit (con’t.)

High Speed Starter
For higher speed, the frequency of the power supply is changed to
150/180 HZ.
Vac (50 Hz) F x 60

S = _______
Vac (150 Hz)
n
Saturating
Transformer S = speed RPM
f = frequency
60 = seconds in a minute
n = couple of magnetic poles
Filter
50 Hz * 3 > 150 Hz > 9000 rpm
60 Hz * 3 > 180 Hz > 10400 rpm

p.174
High Speed Starter

High/Low Speed Anode Rotation
450
High
Speed
400
350
300
mA 250
200
Low
Speed
150
100
50
.01 .02 .03 .05 .1 .2 .3 .5 1 2 3 5 10 20
Maximum Exposure Time (Seconds)
High-speed operation allows an increased anode load.

p.175
Dual or High Speed Starter

Today, a DC – AC converter supplies the power, controlled by a microcontroller. This
device is able to produce common frequencies with two or three phases.
Provides boost, run, brake voltages and boost timing to suit the X-ray tube stator.
Provides dynamic braking for high speed operation (DC voltage) to prevent
dangerous resonant frequency which occurs at ~5600 rpm.
Speed
8500
Boosting
Normal
Running
Braking
t
Exposure Radiation Boost Run Brake
Start Start
p.176
Active or Passive Brake

Active Break – Applying an electromagnetic field with the same
magnitude but in the opposite direction to the actual anode rotation.– AC
converter supplies the power, controlled by a microcontroller MC. This
device is able to produce every common frequency wit two or thee
phases.
Passive Break – Applying a constant electromagnetic field (DC current)

in order to stop the rotor completely. (This is the method our generators
utilize)
Actual
Anode
Rotation
Active Brake Passive Brake

(Reverse Electromagnetic Field) (DC Brake)
p.177
High-voltage Generation Circuit

The generator electric circuit produces the high voltage to be applied
to the anode and cathode of an X-ray tube in order to provide the
proper energy to the electrons to leave the filament.
Modern generator design uses the “switching” power supply

philosophy, which was not possible in old design with analog
components.
Input Inverter Output

Output
Mains Rectifier “Chopper” Transformer
Rectifier DC
and Filter and Filter
Input Output
Chopper
Controller

p.178
X-Ray Converter Generator Basics

Inside the high-frequency generator, the AV mains power is rectified
and smoothed by a large-value capacitor to become a DC voltage
supply. The “inverter” converts the DC voltage back into a high-
frequency AC voltage. This, in turn, is fed into the primary wiring of the
high-tension transformer.

p.179
X-Ray Converter Generator Basics (con’t.)
&
Mains SWR
Control
Frequency
Rectifier Inverter High-voltage Transformer
Capacitance smoothes the DC voltage The purpose of the diodes is to keep the current flow in
and absorbs a return current from the the resonant circuit, after “zero crossing,” which turns
converter circuit. off the SCR.
p.180
Converter Generator – kV Control (Basic Circuit)

600 Vdc
D1 D2
400 Vac
Th1 Th2
Th3 Th4
D3 D4
Safety 40-150 kV
contactor
Dumping
resistors
Th1 Th2 Th3 Th4
Thyristors control
(fire frequency
control generator) C
High
Voltage
Soft start
relay
Transformer
x-ray
KV feed back tube
KV set KV actual
point value

p.181
High-voltage Generation
Charging Discharging
• If the current flows through the C through C through
primary winding of the High Converter Converter
Tension generator, a voltage is
induced in the secondary winding. Kv
Set Point
• The voltage is then rectified and
charges the capacitor C.
• The capacitor C discharges
through the X-ray tube (tube
current).
• Just after the first pulses the kV Fire Pulses
feedback starts and the firing
pulses are sent more frequently.
• The fire frequency of the thyristor
determines the amplitude of the
voltage at the X-ray tube.

p.182
X-Ray Converter Generator (Block Diagram)
Power On Starter
Circuit Power Device
High-voltage
T1 Supply Transformer
+24 V M
5V
+15 V
-15 V
T2 Rectifier Inverter
L1
L2
3
L3
Filament
Service LS
Heating
PC
Generator
System Operating Control
Control Desk

p.183
High-voltage Generation Q & A

Q: Why the HT transformer consists of a
single primary winding and center-tapped
secondary winding?
A: To split the high voltage in two parts.
Q: Why?
A: Without the center tap, the insulation
requirements of the high-tension cables
would be double and the cables would then
be cumbersome and more expensive.
Q: What is the total tube potential (kVp)?

A: The sum of the anode and cathode
voltage.

p.184
Converter History
Generator Type High Voltage Converter
Transformer Component
Up to ~1960 “conventional” (or analog) Mains frequency Not applicable

HV Transformer
(2/6-pulse)
~1960 - ~1985 “conventional” (or analog) Mains frequency Not applicable
HV Transformer
(12-pulse)
~1985 - ~1995 Microprocessor controlled High Frequency SCR
(at about this time, converter
technology adopted for use in x-
ray generators)
~1995 to present Microprocessor controlled High Frequency IGBT

p.185
Comparison – Low to High Frequency

Exposure time (seconds) Density on film
Average Voltage

p.186
Advantages
Comparing with 12-pulse generator at same performances.
Converter Generator:
• Smaller and cheaper construction
• Very small high-voltage transformer due to high frequency
• kV/mA real time control (feedback)
• Better reproducibility and linearity at same performance
• Lower high-voltage ripple at high power

p.187
Monoblock X-ray Tube

For some applications, the x-ray tube and the high
voltage transformer may be integrated into a single
assembly.
All of the high voltage components are contained in

a single
oil-filled receptacle having a radiation exit window
through which the X-rays are emitted.
The primary voltage and other necessary signals

are still provided by the x-ray generator.
One advantage to this design is the elimination of

high voltage cables
Also referred to as: Monoblock

p.188
Monoblock X-ray Tube (con’t.)

• Limited X-ray power up to 30 kW.
• Mainly used for dental and mobile units.
• If the tube or other component fails the Connections to mA Meter
entire assembly needs to be replaced.
Metal
Casing
Filament
Transformer HT
Transformer
Lead
Lining
Oil Mid-point
Expansion Of HTT at
Bellows Earth
Potential
Radioluscent
Window

p.189
Skill Check
Q: What is the primary purpose of the
generator?
A: To provide the necessary voltage required
to allow the X-ray tube to conduct (voltage
may be adjustable) and provide current to
the filament (current may be adjustable).
Q: What are secondary generator functions?

A: Rotor (stator) control, equipment power
supply, safety interfacing, equipment
interfacing for exposure timing or
interlocking.
Q: Why do we need to have compensation for

the mains?
A: Variation in the mains voltage can affect the
output of the generator, resulting in
variations in exposure dose.
p.190
Summary
Generator module.
• Describe the basic form of the
X-ray generator.
• Explain mains compensation.
• Explain filament control.
• Describe the X-ray tube rotor
control circuit.
• Describe high-voltage generation.
• Explain converter history.
• Explain low to high frequency.
• Explain “single-tank” X-ray tube.

WW X-ray
Fundamentals
Training
Module 11: High-voltage
Cables

p.192
Objectives
Welcome to the High-voltage
Cables module.
• Explain the function of high-voltage
cables.
• Explain safety precautions.
• Explain maintenance.
• Explain HT cables – connections.

p.193
High-voltage Cables Function

What is the function of the high-voltage cables?
• Connect the X-ray tube to the Generator in a safe way for the patient
as well as the radiographer.
• Supply the filament.
• Supply the positive and negative high-voltage to the anode and
cathode connections of the x-ray tube.

p.194
High-voltage Tank
Cathode H.V. Anode H.V. Cable
Cable Receptacle Receptacle
(-) (+)
L C
S
H.V X-FMR Silicone

Terminals Rectifiers
Filament Filament
(Large) (Small)
X-FMR X-FMR
XC XC
P2 P1
G
M1 XL
High-voltage X-ray
Transformer

p.195
High-voltage Cable Components

Notch
High Voltage Pins
High Voltage Cables

Insulation Rubber Metal braid
(up to 75 kV) ( for high frequency shield) Common
Federal
plugs
Electrical Wires Conductive PVC Sleeve

(insulated) Foil or Tape (external coating)

p.196
High-voltage Cable Requirements

• They must be able to withstand more than 75 kV, plus a safety margin.
A typical value is 100 kVp.
• The cable requires good flexibility.
• In case of a fault or damage, not to cause danger of electric shock.
High Voltage Cable ASA (Federal) HT
General Construction Cable End Receptacle
Alignment
Woven metal sheath for keyway
high-voltage connection
and filament common
connection. Two insulated
Shield MUST be wires inside for fine
always connected and broad focus.
on both sides of HT
plugs. Bulk high-voltage
insulation
Woven conductive
shield (connects to
ground for safety) Common
Outer protective
insulation
Large focus Small focus

p.197
High-voltage Cables
During beginning of exposure the HV cables are capacitors for several tens of
micro-seconds and the current reaches peak values up to 4000 mA.
•Insulation resistance Mega Ohms
•Capacitance 240 pF/m (to gnd)
The accumulated energy could be very high and a direct discharge to GND could
be destructive for electronic circuits . For this reason a charged cable MUST NOT
discharged/connected to GND before waiting at least five minutes.
WARNING:
The cable charge lasts for hundred of
microseconds if the tube current is at
least 20 mA, but if there is no tube
current, the charge lasts for 20 minutes.

p.198
Safety
When replacing a cable, remove the cable-end first at
the X-ray tube, and then at the high-tension transformer.
This especially applies if the safety earth shield is
damaged at the X-ray tube end.
Handling high-tension cables:

1.Unscrew the metal flange and shift it out.
2.Using a screwdriver, lift the cable ring up 5 mm.
3.Pull out the cable using both hands at 10 cm away
from the HV plug.
4.Connect the cable to GND (metal part) and keep it
for 10 seconds (complete discharging).
Note: The anode / cathode cables are identical, and
may be swapped for troubleshooting – BOTH ENDS
MUST BE SWAPPED.

p.199
High-voltage Cables Grounding Point

Good Grounding Point
on Tube and Tank
The location where the cable connection nuts (“collar”) screw onto the
tube housing and secure the cable is a good grounding point. The
unpainted portion of the tube is an excellent grounding point as long as
the dedicated ground connection between the tube and the tank is
present.
p.200
Maintenance
Follow these maintenance procedures:
• Prior to inserting the high voltage cables into the receptacles, both
must be thoroughly cleaned and dry.
• Carbon traces from previous arcing, if any, must be completely
removed.
• Cables must be replaced if they are darkened or swollen near the
cable terminals, or if the insulation appears stressed or damaged.
• Check the integrity of the terminal pins and restore their spring action if
needed.
• To Insert the cable into the socket, find the location key, fully insert
connector, thread cable nut (collar) and hand-tighten only.
• When the X-ray tube has gone thru warming/cooling cycles, re-check
the cable nut (collar) and ensure it is tight. Do not use tools; tighten by
hand.

p.201
Maintenance (con’t.)
• The HV plugs must be cleaned using alcohol.
• The use of the insulating washer is MANDATORY.
• The washers should be replaced anytime the cables have been
disconnected from the x-ray tube.
• The HV cable pins have to ensure a good electrical connection (for the
filament supply on Cathode side). In case of broken pins the entire
cable must be replaced.
• Refer to Service Bulletin 6H8281.

p.202
Maintenance (con’t.)
• Connections at high voltage
(HT) tank - use insulation oil
only.
• Connections at x-ray tube -
use silicon washers moistened
with few drops of oil to ensure
proper air-tight seal.

p.203
High-tension Connections
HT cables used in our DR systems are rated to carry 75,000 Volts.
Due to the high voltage potential present in the connection, proper insulation
methods must be used to prevent short-circuits (arcing) between the pins of the
connector and the securing nut/collar, which is at ground potential.
We use oil in the HT Tank connections. Oil is a very effective insulator. Since the
tank does not rotate as does the x-ray tube, oil will remain in the connectors due
to gravity.
• Note: The biggest consumer of oil in the connections is the checking and
cleaning of the connectors, as may be done during a PM.
For the X-ray tube connections, we use silicon washers moistened with oil. TL5515
is the number for the kit that contains oil and washers.
• Note – Silicon washers do not normally need to be checked unless high voltage
errors have occurred and the connections are thought to potentially be the root
cause. If the connection is inspected, a new washer moistened with oil should be
used.
• How to install the silicon insulating washer. (click on text to the left)

p.204
Skill Check
Q: High-voltage cables must be able to
withstand more than ___ kV, plus a safety
margin.
A: 75
Q: A charged cable MUST NOT

discharged/connected to GND before
waiting at least ____ minutes.
A: Five

p.205
Summary
You have completed the High-
voltage Cables module.
• Explain the function of high-voltage
cables.
• Explain safety precautions.
• Explain maintenance.
• Explain HT cables connections.

WW X-ray
Fundamentals
Training
Module 12: Collimation

p.207
Objectives
Welcome to the Collimation
module.
• Explain the purpose of collimation.
• Identify the components used in
collimation.
• Identify issues with collimation.

p.208
Collimation
X-ray Tube
Housing
Cone
Collimated X-ray Primary Beam

Beam

p.209
X-ray Collimation
X-ray collimator or beam-limiting device (BLD) is a device attached to
the opening of the X-ray tube housing for the purpose of regulating the
size and shape of an X-ray beam.
Basic functions:
• Protect the patient by reducing the beam to eliminate unnecessary
X-ray radiation.
• Reduce the scatter radiation.
• If supplied with light localizer, show the X-ray field size/shape using
projected light to aid in positioning (light beam collimator).
• Identify the center of the beam (projected cross-hairs).
• Optional added filtration selection.

p.210
Collimation – Typical Design

In “collimating” a beam to a given size and
shape for general X-ray units, a pair of
Near Focus lead shutters is moved perpendicularly into
Shutters the beam to absorb the unwanted portion
(optional) of the emerging beam. A second pair of
Lamp shutters is positioned at right angles to the
Mirror first pair, and again is moved
Far Focus perpendicularly into the beam. In this way,
Shutters/ a continuously variable square/rectangular
Blades beam is formed.
Circular collimators exist as well, and are

often used in fluoroscopy.
X-ray
The field lamp is reflected by a mirror in
such a way that it seems to be located
exactly at the tube focus.

Collimator installation
Refer to the collimator and tube documentation to determine the correct number of spacers for
‘adapting’ the collimator to the x-ray tube
The collimator is to be mounted to the x-ray tube at an FDD/tube distance depending on collimator
spec’s (A+B+C)
A= focal spot to tube port distance

B= rotating flange thickness
C= spacers to be added
Focal spot
Collimator rotating flange
Coll.
Flange
outer face
Allowable tolerance is 1 mm.

p.212
Collimator Blades
Blade selection / orientation (referring to the patient’s long axis).
Cross
Long

Collimator Types
Automatic collimator –
• Can automatically establish the field size based on the receptor being used.
• Can maintain the receptor/field size as SID is changed.
• Allows the operator to manually adjust the field size.
• May provide Positive Beam Limitation (PBL) – this is an optional feature which restricts the
x-ray field to the size of the sensed receptor (will not allow the x-ray field to be larger than
the receptor)
Manual collimator –
• Manual collimator do not automatically adjust to the size of th eimage receptor.
• To establish a desired x-ray field size, the operator must MANUALLY adjust the
blade/shutter controls.
• Manual collimators can have motors, and the motors may be used to automatically
establish ‘pre-set’ field sizes – this is different than automatically sizing to the actual
receptor size.
Fixed diaphragms/cones –
• dental x-ray systems are an example of e product that may provide only a fixed field size.
• May be used in conjunction with a collimator and attached to the collimator output (i.e.,
sinus cone/diaphragm)
p.214
Collimation – Common Issues

Light field not bright enough.
• U.S. - average light field must be >160 LUX measured at 1 meter from focal spot.
• OUS (most locations) - average light field must be >100 LUX measured at 1 meter from focal
spot.
• If light output requirement is not being met:
– Verify nothing is in beam path possibly filtering/blocking the light.
– Check voltage to lamp as power supply may require adjustment.
– Replace lamp.
• DRX-Evolution and DRX-Revolution have LED light sources, and the issues with light output
and lamp replacement are no longer common.
Light field does not coincide with X-ray field.

• Mirror adjustment may be required – most common.
• Lamp mounting adjustment may be required.
Indicated field size (from knobs) is not accurate.
• Adjust blade control knob position.

p.215
Collimation – Associated Issues

Talk about NY PRESBYTERIAN – tube output port aperture
cutoff – not a collimator issue, but was assumed to be by
physicist at NY Pres.
Talk about Bad Nuestadt – penumbra issue in top of image

(penumbra is not strictly a collimator issue, although a
collimator can reduce/improve the penumbra)
Extra focal radiation? – design requirement of collimator,

cannot exceed 15cm (see calculator)
Light-to-X-ray misalignment? – common collimator issue,

easily corrected with mirror and/or light source adjustment

p.216
Skill Check
Q: What is the primary purpose of the X-ray
collimator or beam-limiting device (BLD)?
A: To regulate the size and shape of an X-ray
beam.
Q: What should you do if the light field does

not coincide with X-ray field?
A: Perform mirror adjustment (most common)
or the lamp mounting adjustment.
Q: What should you do if the indicated field

size (from knobs) is not accurate?
A: Adjust the blade control knob position.

p.217
Summary
You have completed the Collimation
module.
• Explain the purpose of collimation.
• Identify the components used in
collimation.
• Identify issues with collimation.

WW X-ray
Fundamentals
Training
Module 12: Bucky

p.219
Objectives
Welcome to the Bucky module.
• Identify the inventor of the Bucky.
• Identify the assemblies of a Bucky.

p.220
What Is a Bucky?
Named after Gustav Bucky, inventor
of the anti-scatter grid. Typically, a
true Bucky cabinet will have a
moving grid.
Bucky (today’s term) – the assembly

that houses the following: Detector’s Sensitive
Ion Chamber
Surface, Cassette
• Grid Film Plane
(CR or Film, etc.)
(AEC)
• AEC Grid
• Receptor Detector
• Grid moving assembly

• Miscellaneous items that may be
design-specific
• Power supplies Bucky Housing
• Detector ID boards (DRX-

Evolution)
p.221
Bucky Assembly
AEC Measuring
Device
Grid
Patient
Tray
• Screen Film
• Phosphor CR Plate
• Digital Detector
X-ray Beam

p.222
Cassette Tray

p.223
Cassette Tray (con’t.)

Some types of cassette trays
enable additional functions in the
system:
• Sensing the cassette size
• Re-charging the grid drive
assembly
• Ensuring “no-double-
exposure” on same cassette
Philips

p.224
Skill Check
Q: Gustav Bucky is the inventor of the
________.
A: Anti-scatter grid
Q: What assemblies often housed in the

Bucky?
A: Grid, AEC, receptor, grid moving
assembly, miscellaneous items that may
be design-specific, power supplies,
detector ID boards (DRX-Evolution)
Q: What are the functions that some types of

cassette trays?
A: Sensing the cassette size, re-charging the
grid drive assembly, ensuring “no-double-
exposure” on same cassette
p.225
Summary
Generator module.
• Identify the inventor of the Bucky.
• Identify the assemblies of a Bucky.

WW X-ray
Fundamentals
Training
Module 13: Anti-scatter Grid

p.227
Objectives
Welcome to the Anti-scatter Grid
module.
• Describe a stationary grid and its
components.
• Describe the “Bucky factor.”
• Describe problems with grid handling.
• Describe grid versions.

p.228
Stationary Grid
A stationary cross-hatch grid was described
by Dr. Gustav Bucky in 1913.
With stationary grids, shadows of the lead strips

are superimposed on the useful image.
These grid lines may be tolerable in a

radiograph when using a grid with very thin,
uniformly-spaced strips. In this case, the very
fine lines are not objectionable in the image, but
are detectable upon close inspection.

p.229
Moving Grid
Dr. Hollis Potter showed in 1920 that the pattern of the stationary cross-
hatch grid could be eliminated by using a grid made up of strips parallel to
the length of the table, which moved perpendicular to the table during an
exposure. The motion blurs the grid lines and makes them
indistinguishable on the image.
The moving grid requires attention to following technical details:

• Motion must be fast enough for a number of strips to pass a given point
on the film during exposure, or blurring will not be sufficient.
• The exposure time used must not be too short or the grid may not be
able to move far enough to avoid a strip pattern or an irregular density
pattern in the image.
• Due to the size of the grid mechanism, the distance between patient
and detector is increased, thereby increasing the geometric blur and
magnification in the image.

p.230
Grid Composition
The grid is a device typically
composed of thin alternating strips
of lead and spacer material, which
is covered with a radiolucent
material, able to reduce X-ray
scatter resulting in improved
structure contrast in the image. Scatter
Source
A grid bears some resemblance
to Venetian blinds.
The absorber strips consist mainly

of lead.
The spacing material is typically

made from paper or aluminum.

p.231
Grid Components
Primary Beam
Absorbed
Unabsorbed Scatter
Scatter Radiation
Radiation
Grid Lead Strip
Image
Receptor X-ray Transparent Interspace

GRID
p.233
Grid Comparison
Portable Chest X-ray Without Grid Portable Chest X-ray With 8:1 Grid
GRID
Grid Focus (f ) 0
In an unfocused grid, the lead strips are typically vertical

and parallel to one another with a very low grid ratio. The
focus distance of a parallel grid is infinity.
A focused grid utilizes lead strips that are progressively

angled so that the lines extended from each strip
converge to a point.
The distance from this point of convergence, or focal

point to the grid is called focal distance (f0). Ideally, the
placement of the focal spot of the X-ray tube should
coincide with the focal point of the grid. Focused grids
normally have a focal range specified by the
manufacturer.
If a grid is not used at the specified focal distance,
bilateral cutoff may be observed.
Increased distance between the scatter source and the
grid will improve grid performance, but this increased
distance may increase magnification, which is also
undesirable.
p.235
Bell Effect
Different uniformity of brightness
is called the “bell effect.”
Distance = A
Focal
Distance = A
Flat/uniform exposure
Bell effect from poor
by adhering to
grid focus selection.
focal distance.

p.236
Grid Focus
Distance = A
Near
stance - A
35 cm
Dis
Focused
Focal
Focal Dist. = A
Distance = A
Far

p.237
Grid Alignment (con’t.)
If a tube is not centered If a tube is rotated, but focal

(“de-centered”), grid cutoff spot is centered, and the
may be an issue. rotation is in parallel with the
grid lines, grid cutoff will not
be an issue, but image cutoff
or misalignment may be.
p.238
Geometrical Grid Characteristics

The grid RATIO express the relationship of the height of the absorber
strips to the distance between them.
Interspacer
h
GRID RATIO =
D
Absorber
lamina
D = Thickness of the interspacer

d = Thickness of the absorber
lamina
h = Height of the absorber lamina
The LINE DENSITY refers to the
number of absorber strips per unit 1
length. # of lines N=
d+D

p.239
Geometrical Grid Characteristics (con’t.)

General relationship between radiation penetration and grid ratio.
The absorption of the primary beam also increases with higher grid ratio.
Ideal Grid
1.0
.8 Primary Radiation
Grid
.6 Real Grid
Penetration
.4
.2 Scatter
Real
Ideal
2 4 6 8 10 12 14 16
Grid Ratio

p.240
Bucky Factor
The grid also attenuates
primary radiation. Therefore,
the exposure time has to be
increased in order to reach the Exposure
same exposure level on the With
film. Exposure
Without
The Bucky factor is the ratio of
measured exposure without
the grid in place to that with,
using the same X-ray Grid
exposure setting.
E.g., > grid Ratio 10:1, 44 lines/cm BF = 4.4

GRID –
Acceptable SID (FFD) range for focused grids -
• There are acceptable ranges for focused grid use, but x-ray transmission thru
the grid, and therefore image quality, is optimized when the correct focal
distance is observed.
• IEC 60627 defines the useful distance range for the grid as the “Application
Limits”.
• For general radiography grids, the upper and lower acceptance limits are by
default considered to be the distances the x-ray transmission thru the grid
reaches 60% of the original x-ray beam (or reduced by 40%).
• The useable range increases as grid ratio decreases.
• Multi-focal grids, there are no true multi-focal focused grids. All focused
grids have a discrete focus distance. Some grids, typically those with lower grid
ratios, are constructed such that the actual focus distance is approximately the
mid-point between two popular focus distances for clinical applications.
•Example – vertical examinations are typically performed at either 1 meter
(~40 in) or 1.8 to 2 m (~72 to 78 in).
• A grid used as a multi-focal grid would often have a true focus
distance of ~1.4 m to 1.5 m (56 to 59 in)
• Multi-focal grids often have medium to low grid ratios (<10:1)
p.242
IEC 60627
IEC 60627 defines:
• True central line
• Focus distance
• Annex A from IEC 60627
(See calculation on the right.)
• Upper and lower application
limits
• Grid ratio
• Transmission loss
• Grid de-centering
Annex A from IEC 60627 can
be used to calculate the
actual application limits for a
grid.
p.243
Problems with Grid Handling
Correctly-centered,
Focused Beam De-centered Beam
Different Uniformity of
Brightness Side to Side

p.244
Grid Versions
Lines/cm Application ratio

(Lines/in.)
28 General application and Bucky works 6:1, 8:1,
(70) 10:1, 12:1
36 Ideal for Bucky use 8:1 10:1 12:1

(90) Optimal contrast improvement with relatively low
absorption
44 Very good for stationary application with a fine line 8:1 10:1 12:1
(110) pattern invisible at viewing distance
60 Result in radiographic images with a truly invisible 8:1 10:1 13.1

(150) pattern. It is suited for application where stationary
grids are applied
p.245
Moving Grid – Spring Driven
Oscillating
Exposure Enable
t
The grid movement enables the exposure.

p.246
Moving Grid – Motorized
Motorized
t
The grid movement enables the exposure.

p.247
Skill Check
Q: Why do we use anti-scatter grids?
A: To reduce or eliminate scatter radiation.
Q: Why is it an advantage to remove scatter?

A: Improve image quality by improving image
contrast. X-ray scatter does not add useful
data to the image, but does provide added
exposure to the receptor.
Q: What causes scatter?

A: Anything placed in the X-ray beam path may
cause scatter, including an anti-scatter grid.
The patient is the biggest scatter source.

p.248
Summary
You have completed the Anti-
scatter Grid module.
• Describe a stationary grid and its
components.
• Describe the “Bucky factor.”
• Describe problems with grid handling.
• Describe grid versions.

WW X-ray
Fundamentals
Training
Module 15: Automatic
Exposure Control (AEC)

p.250
Objectives
Welcome to the Automatic
Exposure Control module.
• Describe the purpose of automatic
exposure control.
• Describe how AEC functions.
• Describe exposure parameters.
• Describe potential problems.

p.251
Automatic Exposure Control (AEC)

Automatic exposure control (AEC) systems are designed to adjust
the kilovoltage, milliamperage, or exposure time in order to obtain an
image of diagnostic quality.
These systems sense the amount of radiation immediately in front of

the image receptor and adjust the dose or dose rate to the patient in
order to assure sufficient photons are reaching the image receptor.

p.252
AEC
• AEC automatically varies the exposure time to produce the same image quality (density) over a
wide range of KV settings, patient sizes and other variables.
• An ionization chamber consists of two thin parallel sheets of aluminum across which DC voltage
is applied.
• Struck by radiation, some of the atoms of the enclosed air release electrons and become
positively charged particles or “ions.”
• These ions under the influence of the electrical field across the chamber migrate to the negative
electrode causing a current flow.
• The ionization is directly proportional to the amount of radiation. This information is fed back to
the X-ray generator to stop the X-ray exposure when the proper amount has been received.
• The region of an object which is of diagnostic interest is called the dominant. The imaging region
of interest should maintain a specific average optical density and therefore the AEC takes care
that the right amount of dose is reaching the dominant.
• AEC is suitable for all types of exposures, however AEC is often not used for small body parts
such as extremities and pediatrics. The measuring field of the sensor (ionization chamber,
photomultiplier or solid state radiation detector) must be positioned properly relative to the
dominant during positioning of the patient.
• The measuring field of the sensor (ionization chamber, photomultiplier or solid state radiation
detector) must be positioned properly relative to the dominant during positioning of the patient.

p.253
AEC – Purpose and Function

Purpose:
• AEC automatically varies the
exposure time to produce the
same image quality (density) over
a wide range of KV settings,
patient sizes and other variables.
• The AEC sensor typically includes
multiple measuring sensors/cells
(typically three
sensors/dominants).

p.254
AEC – Purpose and Function (con’t.)

How does it work?
• AEC monitors the amount of Fill Point Flow Cutoff
radiation, and automatically Adjustment Point
terminates the exposure when a
preset exposure level is seen by
the measurement device.
• Keeping all exposure factors
constant, when the thickness of
the material being X-rayed
changes, the resulting exposure
time will change.
• Think of the AEC working like a
toilet tank. The fill point is set to
stop the flow of water when the
water reaches the desired level or
amount.
AEC
The signal generated by most AEC devices is a linear ramp. Since the AEC response is
predictable, it is easy to set a reference value, which equates to an exposure level. When
the ramp and the reference value equal each other, the generator terminates the exposure.
Assuming all exposure factors and the object being imaged are kept constant, the AEC will
terminate the exposure at the same exposure time. If the object in the beam changes, and is
more dense, more of the x-ray will be absorbed by the object, taking longer for the desired
amount of exposure to reach the AEC (and receptor).
AEC
AEC
kV
kV
A.E.C. Functions
The primary purpose of the AEC circuit is to ensure the
receptor is delivered a consistent exposure level from
patient to patient and exam to exam over.
The receptor’s efficiency in converting x-ray photons to

image information may change as kV is changed. The
efficiency of the receptor to convert x-ray photons to image
information has a direct affect on OD (film) or DV (CR,DR).
This change of receptor ‘response’ can be graphically
represented, and is called the “kV characteristic curve”.
Most AEC circuits allow the kV characteristic curve of the

receptor to be compensated for.
p.257
Receptor Response
DV
Desirable
Behavior
kV
DV
Actual
Behavior
0 70 kV
p.258
kVp Compensation Curve

In order to achieve a receptor’s constant behavior (in terms of optical
density or digital value), over all the kVp range, we need to set a kVp
compensation curve in the generator.
Example of kV compensation curve:
DV
0 70 kV

p.259
kVp Compensation
Depending on the Beam energy
(driven by kVp), imaging receptors
are responding in a non linear way.
For a constant exposure dose:
• Low kVp Low OD/DV
• High kVp High OD/DV
kVp compensation is the ability of an
AEC to maintain constant receptor
output when the kV setting is
changed.
This means that the CUT OFF
DOSE will be different depending on
the kVp setting.

p.260
AEC Functions
An AEC device has four functions:
• Sample radiation transmitted through the patient.
• Integrate an electrical signal which is proportional to the accumulated
radiation reaching the image receptor. Describe exposure parameters.
• Set a reference signal which is dependent upon the exposure factors,
field size, image receptor sensitivity, and required optical density.
• Provide a terminate signal to the generator, in order to stop the X-ray
beam when the proper exposure is reached.
It is important to understand that an AEC device may perform each

of the four functions and still not provide clinically-acceptable
radiographs.

p.261
AEC Circuitry
Tube Load kV
Controller Selector
HT Tank Control
and Heat
Integrator Desk
Object
Measuring Device
e.g., Ionization Chamber
AEC
Comparison Density Level

Amplifier Circuit Selection
Measurement Integration Interruption

p.262
AEC Circuitry – common circuit diagram

p.263
AEC Operator Problems

Chamber Incorrect chamber selection relative to the
position and patient anatomy to be imaged will cause
selection inferior imaging results.
Pediatric The physical size of the pediatric patients or
patients or upper extremities, relative to size and position,
upper can lead to positional error or exposure timing
extremities problems.
kVp The correct selection of kVp is a critical factor
selection for image quality and minimizing patient dose.
The use of an AEC device does not relieve the operator of the
responsibility of using good quality radiographic technique.

p.264
Skill Check
Q: What are the exposure parameters you set
up for an AEC exposure?
A: kVp, mA and mAs (or time)
Q: Why mAs?
A: The mAs value is the exposure backup.
Q: Is the receptor response constant (in terms

of OD or Digital Values) over all the kVp
range?
A: The receptor response over all the kV range
is not constant; it changes depending on
the used kV. Compensation is required.

p.265
Summary
Automatic Exposure Control
(AEC) module.
• Describe the purpose of automatic
exposure control.
• Describe how AEC functions.
• Describe exposure parameters.
• Describe potential problems.

WW X-ray
Fundamentals
Training
Module 16: Receptors

p.267
Objectives
Welcome to the Receptors
module.
• Describe the function of a receptor.
• Describe the function of digital
radiography.
• Describe DR detectors.

p.268
Receptor
An image can be captured in three modes:
• Film/screen
• Computed Radiography (CR)
• Digital Radiography (DR)

p.269
Receptor (Analog)
Analog film still used but it is slowly being replaced by new technologies (CR, DR).
Expose Capture Process Transmit
Analog
Film/Screen Sneaker Net
Present
View
Panel
Unrestricted Internal Use Sneaker Net Analog Film Storage

p.270
Receptor (CR)
CR: used in combination with existing X-ray systems.
SP Reader Image Proc.QA
Review Distribution
CR
Storage
Phosphor
Plate
Analog Film
Storage
Networks: Radiology Information

Laser Imager Diagnostic Digital
System Hospital
Workstation Archive
Information System
p.271
CR – Storage Phosphor Screen Scanning

Simulating
Laser
Laser
Photomultiplier Galvo
Mirror
(Electronically
Detector and Filter Controlled)
Photomultiplier
Fast Scan
Moving Table
Low Scan
Clock/Sync
Data Acquisition
Digital Reader Control
Computer
Bessel Filter
Monitor
(Nyquist Filter) A/D
QCW
CR examinations are acquired using a storage phosphor plate instead of screen/film.

p.272
Digital Radiography – Introduction

Analog images are ideal for human
viewing.
The human optical characteristics are

logarithmic in nature and prefer the
continuous nature of analog images to a
matrix of numbers.
Digital images work well for computers.
Through processing and display, the

same image can be made available for
viewing.
DR (Digital Radiography) is an imaging technology

that combines the principles of radiography with digital
technology to produce a medical image.
p.273
Receptor (DR)
DR receptors represent the latest technology.
DR
Radiology Information Laser Imager Diagnostic Digital

System Hospital Workstation Archive
Information System
p.274
Receptor (DR) (con’t.)

What is a flat panel Digital Radiography (DR) receptor?
• An X-ray receptor able to locally convert the X-rays into digital data for
image reconstruction.
• There are a variety of different technologies used to create a flat panel
detector
• CCD
• Amorphous Silicon (ASi) / Selenium (ASe)
• CSi
• GoS
• There are two main technologies for DR detectors:
• Direct (e.g., DRC) – X-ray photons are converted directly to
electrical signals for image data.
• Indirect (e.g., Trixell, Varian, DRX-1) – X-ray photons interact with
a phosphor screen to generate light, which is then converted into
electrical signals for image data.
p.275
DR Detectors (con’t.)
The scintillator converts the X-ray photons Selenium / A-Si array combination forms
into light, and the a-Si array converts the capacitor elements, which converts X-ray
light into an electronic charge. photons directly into an electronic charge.
Amorphous Silicon Method Amorphous Selenium Method
Indirect Digital Direct Digital

Type 1 Type 2
Csi Deposit Csi Crystal Growth X-ray
Photons
X-ray Field
Photons Electrode
Reflector
Dialectric
Scintilator Layer
(Csi)
aSe
aSi aSi
Array Collection
High light scatter. Reduced light Array Electrical signals with
Unrestricted Internal Use scatter. no scatter.
p.276
New Detectors
Due to the cost of film and also film chemistry, it is likely all x-ray
systems will eventually be equipped with the new detectors.
– (similar to digital cameras versus film cameras)

p.277
Skill Check
Q: What are the three common receptor types
in in general radiography today?
A: Film/screen, computed radiography (CR),
and digital radiography (DR)
Q: CR examinations are acquired using a

_________ instead of screen/film.
A: Storage phosphor plate

p.278
Summary
Receptors module.
• Describe the function of a receptor.
• Describe the function of digital
radiography.
• Describe DR detectors.

WW X-ray
Fundamentals
Training
Module 17: Exposure
Sequence

p.280
Objectives
Welcome to the Exposure
Sequence module.
• Describe the exposure process.
• Describe the Bucky exposure
process.
• Describe serial changer exposure.
• Describe the exposure process
sequence.

Exposure process
For most modern generators, there are 4 functional modes of operation:
• ON / STANDBY
• generator is turned on
• if no errors or interlocks, PREPPING phase is possible
• PREPPING
• PREP request is made by pressing the PREP button
• Filaments are boosted
• Rotor circuit is activated (if present)
• PREPPED (or PREP READY)
• All PREPPING activities have completed
• if no errors or interlocks, EXPOSE phase is possible
• most generators can remain in this phase for some amount of time (generator and/or receptor time out)
• EXPOSE
• EXPOSE request is made by pressing the EXPOSE button
• Inverter circuits are activated
• high voltage delivered to x-ray tube, tube is conducting and producing x-ray
• kV and mA being monitored and adjusted
• exposure will terminate,
• when EXPOSE switch is released
• timer reaches preset time
• when mAs counter reaches preset mAs
• when AEC is satisfied
p.282
Stand-by
1. Stand-by
a. Collimators ready Preparation
b. Filament pre-heating
c. Stand(s) ready
Exposure
Ready for PREP

p.283
Preparation
2. Preparation
a. Anode rotation.
b. Console parameters are locked
and applied.
c. Filament current at correct set
point.
d. Interlocks (tube, door) OK.
Ready for EXPOSURE

HOLD-ON PREP: The preparation could be maintained for positioning/
breathing purposes up to a defined time dependent on generator
construction/setting.
p.284
Exposure
3. Exposure
a. Exposure request.
b. Grid moving (if present).
c. HT on (75%).
The X-ray hand switch works as dead-

X-Ray ON man switch: if released, the exposure is
stopped (international law requirement).
p.285
End of Exposure
4. End of exposure
a. Received EXP END from:
i. Timer circuit manual
ii. AEC (automatic)
Stand-by

p.286
Bucky Exposure
X-ray Power Cabinet/
Hand Switch Generator HT Tank OTC
Control Table
HSS
Filament
Bucky in Motion
Bucky Start
Selection
X-ray Tube
Bucky (Table or To Bucky
Wall Stand) Stand
Bucky
Selection Grid in
Motion

p.287
Free Cassette (Table Top) Exposure

Generator
Hand Control Table
Switch Selection
Power Cabinet/
HT Tank OTC
X-ray Tube
Table Top
(Free Cassette)
HSS
Filament
Bucky in Motion
Bucky Start
To Bucky

p.288
Serial ChangerGenerator Power Cabinet/

HT Tank OTC
Exposure Control Table
HSS
Filament
Selection
Bucky in Motion
Bucky Start
X-ray Tube
Remote Control
Table
To Bucky
Remote Control
Table Stand
Selection
Grid in Motion
Shutter in Position
Carriage in
Remote Control Exposure
Table Console Position
Prep/Exposure Serial Changer

Foot Switch
p.289
Exposure Process Sequence

p.290
Skill Check
Q: What are the four parts of the exposure
process?
A: Stand-by, preparation, prep ready, and
exposure.
Q: The prep ready phase can be maintained

for positioning/ breathing purposes up to a
defined time dependent on the _________.
A: Generator and/or the receptor capability.
Q: What happens when the X-ray hand switch

is released?
A: The exposure is stopped/aborted.

p.291
Summary
Exposure Sequence module.
• Describe the exposure process.
• Describe the Bucky exposure
process.
• Describe serial changer exposure.
• Describe the exposure process
sequence.

WW X-ray
Fundamentals
Training
Module 18: X-ray Room
Requirements

p.293
Objectives
Welcome to the X-ray Room
Requirements module.
• Describe X-ray room requirements:
– Warning lights
– Safety interlocks

p.294
Warning Lights
Rooms that are used for medical diagnosis by X-ray normally have a warning light
to alert personnel who may inadvertently enter the room during operation of the
machine.
The lamp type, color, and wording depends upon the health care facility’s safety
guidelines and/or the country/region safety regulations.
Most modern generators provide a powered circuit and/or available relay contacts
to drive the room warning lights.
In some cases, the FE has to build a simple interface with a relay to electrically
separate the system supply from room light voltage.
Not all facilities require the use of a room warning light, but most modern and
reputable generators will allow the interfacing of the room warning light if
necessary

p.295
Warning Lights Diagram

AC Supply
Generator
X-ray ON Cabinet
Red
System ON 4 System
White 3 ON
2 Normally Open
1 Contacts
Ground
X-rays
ON

Safety interlocks (door switches)
Rooms that are used for medical diagnosis by x-ray may include a
door switch, when activated, can prevent or even stop the
generator exposure in order to prevent exposing personnel who
may inadvertently enter the room during operation of the
machine.
Many generators in the field include an interface circuit to allow for
interfacing to a door switch
If the door switch circuit is activated (door opened), the PREP
and/or EXPOSE phase of operation typically cannot start or
complete
Not all healthcare facilities require the use of a door switch, but
most modern reputable generators all for the interfacing of a
door switch
Radiation Shielding
Rooms that are used for medical diagnosis by x-ray may include a
x-radiation shielding for both the operator and personnel in the
surrounding areas
As is the case with most facility safety requirements such as room

warning lights and door switches, radiation shielding for the x-
ray room is governed by country and/or local safety
requirements, and is not generally part of the diagnostic x-ray
system equipment
Can you think of a case where an x-ray system is used, but no

radiation shielding may exist in the room in which it is being
operated?
• Mobile x-ray systems are often operated in typical patient rooms

• Mammography systems, due to the lower energy levels, often are operated within rooms that have no
radiation shielding
p.298
Skill Check
Q: True or false? If the door is open, the PREP

/ EXPOSE phases cannot start.
A: True (if the door switch is used)
Q: True or false? In some cases, the FE has to

build a simple interface with a relay to
electrically separate the facility’s supply
from the generator circuit.
A: True

p.299
Summary
Room Requirements module.
• Describe X-ray room requirements:
• Warning lights
• Safety interlocks

WW X-ray
Fundamentals
Training
Module 19: Filtration

p.301
Objectives
Welcome to the Filtration module.
• Describe the purpose of filtration.
• Describe how filters are made.
• Describe how filtration is measured.

p.302
Filtration
The purpose of a filter is to affect the quality of an X-ray beam by
absorbing a portion of the generated radiation before it reaches the
patient.
Diagnostic X-ray beams are composed of photons that have a whole

spectrum of energies (polychromatic).
Most of the low-energy beams are absorbed in the first tissues and only
the higher energy photons penetrate through the patient to expose the
receptor.
The first few centimeters of tissue receive more radiation than the rest of
the body.

p.303
Filtration (con’t.)
The filter’s function is to protect the patient from needless radiation,
reducing skin exposures by as much as 80%.
For diagnostic X-ray units, filters are usually made using thin sheets
of aluminum and/or copper. For mammography X-ray systems, the
filtration is often made of molybdenum and/or rhodium.
One disadvantage of filtration is a reduction in the amount of

photons available to produce an image, often requiring an increase
in the mA and/or time selected for the exam in order to satisfy the
receptor.
When filters are used, and even when it is necessary to increase the
exposure time or mA to get the same film density, the patient may
absorb less radiation than they would from an unfiltered beam.

p.304
Inherent and Added Filtration

Filtration that cannot be removed
X-rays by the operator including, such
items as the glass wall of the X-ray
tube and the insulating oil
surrounding the tube, are referred
to as inherent filtration.
Filtration that can be readily

removed from the X-ray beam by
the operator is called added
filtration.
Filter Low Energy High Energy

p.305
Filtration Measurement
Internationally, the filtration is measured in “aluminum equivalence,”
which is the thickness of aluminum that would produce the same degree
of attenuation of the material in question.
There are regulations that dictate beam quality.

p.306
Half Value Layer (HVL)

The HVL (Half Value Layer) corresponds to the amount of
Aluminum (in mm) necessary to reduce the beam by ½ of the
original unfiltered beam, keeping all exposure factors constant.
The HVL is a measure of “beam quality.”
Many regulatory authorities establish minimum requirements for

the HVL of an x-ray system to ensure the x-ray beam meets
minimum quality requirements

p.307
Total Filtration
Valid for DC, HF, and 3-phase From HVL @ xx kV, we
12- and 6-pulse Units can extrapolate the Total
7
100 kV
Filtration with the graph
90 kV on the left.
6
80 kV
HVL @ 80kV= 3.75 mm Al
HLV mmAl
5
70 kV gives a Total Filtration of
4 4.5mmAl..
4.5mmAl
60 kV
3 50 kV
2
0
1 2 3 4 5 6 7 8 9 10 11
Total Filtration mm Al

p.308
Compensation
Typical Filtration Dependence Compensation graphs of Unfors
pf kVp Sensor, CONV.
300 and 400 series for kV and
dose measurement.
The correction factor for kV

measurement is kV dependent.
NOTE: The Unfors Xi and

Typical Filtration Dependence of Dose SOLO series of meters perform
and Dose Rate Sensors, DENT, CONV, and I.I. internal correction for filtration.

p.309
Skill Check
Q: What is the purpose of a x-ray filter?
A: To reduce the amount of lower energy x-
rays reaching the patient.
Q: What is a disadvantage of filtration?

A: The reduction in the amount of photons
available to produce an image, often
requiring an increase in the mA and/or time
selected for the exam in order to satisfy the
receptor.
Q: The HVL is a measure of ___________.

A: Beam quality

p.310
Summary
You have completed the Filtration
module.
• Describe the purpose of filtration.
• Describe how filters are made.
• Describe how filtration is measured.

WW X-ray
Fundamentals
Training
Module 20: Measurement

p.312
Objectives
Welcome to the Measurement
module.
• Describe the principles of X-ray
measurement.
• Describe the instruments used to
measure X-rays.
• Describe how a digital scope
functions.
• Describe proper grounding.
• Describe the function of scope
probes.

p.313
X-ray Measurement
Measurement Item / Tool Result Level 1 Level 2
Parameter
kV, exposure time, dose, Non-invasive x-ray Numeric value Theory Lab
(HVL, mAs – SOLO only) multi-meter
(e.g., UNFORS 407,
SOLO R/F, Xi)
kV, mA, mAs, exposure oscilloscope Displayed Theory Lab

time, filament current, waveform / level
(feedback signals)
Exposure time, high X-ray detector + Displayed Theory Lab
voltage pulse ripple oscilloscope waveform
Dose Area Product (DAP) DAP meter Numeric value Theory Lab
mAs mAs meter Numeric value Theory Lab
X-ray field lamp output Light meter Numeric value Theory Lab

DOSE (definitions)
Table Image receptor dose

(or dose rate)
Body dose
(effective dose)
Dose area Patient

product meter
Image
receptor
X-ray tube
Surface dose or without
Dose area product patient incident dose
Exit dose
p.315
Dose Definitions (con’t.)

Incident dose: The dose measured on the intended surface of the patient, but
without the presence of the patient (no scatter). System International measuring
unit: 1 Gray = J/kG (1 Gy= 100 Rad).
Surface dose: Incident dose + scattered radiation from the body (Gy).
Body dose: Sum of all organ or partial - body dose (Sievert: 1 Sv = 1 J/Kg = 1
Gy).
Exit dose: Surface dose – body dose.
Image receptor dose: Measured at film cassette, X-ray image intensifier or digital
detector (Gy) (AEC > CUT OFF dose).
Dose rate: Measured dose for the amount of time required to complete the dose
measurement (Gy/sec).
Dose area product: Measurement of the amount of radiation that the patient
absorbs (Gy *sq cm).
Effective dose: The effective dose quantifies the radiation risk undergoing any
diagnostic X-ray examination; always less than patient dose limit.
p.316
Dose Units > mR & micro Gy

The Röntgen or Roentgen (symbol R) is a unit measurement of ionizing
radiation in air (X or gamma rays) and is named after the German
physicist Wilhelm Conrad Röntgen.
One Gray (symbol Gy) is the absorption of one joule of radiation energy
by one kilogram of matter.
1 Gy = 1 J/kg = 1 m2·s–2

p.317
Dose Units > mR & micro Gy

Note that these are the same units as the Sievert. To avoid any risk of
confusion between the absorbed dose and the equivalent dose, one
must use the corresponding special units, namely the gray instead of
the joule per kilogram for absorbed dose and the sievert instead of the
joule per kilogram for the dose equivalent.
Absorbed dose is a measure of the energy deposited in a medium by

ionizing radiation. It is equal to the energy deposited per unit mass of
medium, and so has the unit J/kg, called a Gray (Gy).
1 R ≈ 0.00876 Gy, or 1 Gy ≈ 1.14 mR

p.318
DAP
Dose Area Product Meter
The dose area product is a constant regardless of where it

is measured between the collimator face and the patient.
DAP measuring unit (DICOM standard) = dGy*cm²
(1 dGy*cm² = 10 cGy*cm² = 100 mGy*cm²)
p.319
DAP (con’t.)
The measuring chamber is connected to
the DAP interface/display in order to show
the dose figures to the operator.
The measuring chamber is

attached to the collimator of
the X-ray machine and
completely transparent to
light.

p.320
kVp
Definition: The maximum voltage applied across an X-ray tube. It
determines the kinetic energy of the electrons accelerated in the X-ray
tube and the peak energy of the X-ray spectrum.
The threshold is normally set at 75% of the HT pulse.
Unit of measurement > kV

Range > 40 to 150 kV

p.321
Tube Current (mA)

Definition: mA is the measure of the tube current or the flow of
electrons across the X-ray tube during the exposure.
Channel B in waveform below is mA.
Unit of measurement > kV

Range > 10 to 1000 mA
(depends upon generator).
Cable
Charge
Peak

Exposure time
Definition:
the time-length of the high voltage applied across a X-ray tube.
The measurement method is based on a kV threshold crossing.
The threshold is normally set at 75% of the kVp
Unit of measurement = ms
(0.001 s)
Range = 1 to 6000 ms
kV
X-ray exposure timers are either available as single function devices or on kVp
meters, exposure meters, or other multimeter systems
p.323
Non-invasive Measurement
Measurements of dose and kVp are possible in a “non-invasive” way using
X-ray multimeters.
• UNFORS 407 (UNFORS has changed its name to RAYSAFE.)
• RAYSAFE SOLO or Xi
• Keithley Triad kit
• Radcal 9010/9015
• RTI PMX-III
The values obtained are affected by the beam filtration and selected kVp
(not for Raysafe SOLO or Xi).
The X-Ray analyzer is normally calibrated for a default filtration of

2.5/3 mm Al. The read out must be compensated using the X-ray tube
assembly “total filtration.”

X-ray multimeters Unfors
The Unfors RAD X-ray Systems are optimized to meet the basic needs of simultaneous
measurements of kVp, dose, rate and time on all types of Radiographic machines.
Model 407
External Detector: Dose and Dose Rate Model

Internal Detector: kVp and Exposure Time SOLO R/F
p.325
Compensation – Dose
Typical Filtration Dependence of Dose and
Dose Rate Sensors, DENT, CONV, and I.I.
Unfors 300/400 series
Correction Factor
The correction factor for dose

measurement is also kV
dependent.

p.326
kVp Meter
The kVp meters can provide an accurate measurement in seconds.
In its most basic form, the kVp meter consists of a pair of matched,
closely-spaced detectors (diodes) filtered by different thicknesses of an
attenuating material.
The ratio of the signals from the diodes at any instant in time is a function
of the X-ray tube potential (kV) at that time.
Signal analysis methods within the kVp meter, sensitive to the peak X-ray
tube potentials produced during the X-ray exposure, provide a direct
measurement of the kVp.
This digitally-displayed kVp is usually some type of average of the relative
peaks of the tube potential over the exposure time.

p.327
Compensation – kVp
Unfors 300/400 series
The correction factor for kVp

measurement is also kV-dependent.
kVp

p.328
X-ray Multimeter Keithley

The Keithley triad kit can measure Dose/kVp/exposure time.
Just connecting the kVp meter to

an oscilloscope makes it possible
to visualize the HT pulse.

p.329
mAs Meter
Nuclear associates (Fluke) The mA/mAs meter is
used for the invasive
measurement of
current flowing through
an X-ray tube or for the
measurement of the
tube current-exposure
time product.
Keithley
The device is electrically connected in the
ground return lead of the secondary of the X-ray
generator transformer. The measurement is
frequently accomplished using test points
provided within the generator.
p.330
mAs Meter Connection

The mAs meter connects an integrator to read the product of current
and time in mA-seconds.
mAs
jumper

p.331
mAs Meter Connection (con’t.)

The mAs meter connects an integrator to read the product of current
and time in mA-seconds.
mAs
meter
Do not forget to reinstall the mAs jumper at the end of measurements.

p.332
mAs Meter
The instrument is intended for use by qualified
SAFETY
personnel who recognize shock hazards and are
familiar with the safety precautions required to
avoid possible injury.
Always expect a shock hazard at the input
terminals when the mAs meter is connected to
the X-ray generator and the generator is
powered.
Do not make any contact with the unit during
exposures.
The voltage potential at the input could exceed
the insulating capacity of the case and test leads
under fault conditions.

p.333
Oscilloscope

p.334
Oscilloscope Performance Terms

Bandwidth
• The bandwidth specification tells you the frequency range the oscilloscope
accurately measures.
Rise Time
• Rise time may be a more appropriate performance consideration when you
expect to measure pulses and steps. An oscilloscope cannot accurately display
pulses with rise times faster than the specified rise time of the oscilloscope.
Vertical Sensitivity
• The vertical sensitivity indicates how much the vertical amplifier can amplify a
weak signal. Vertical sensitivity is usually given in millivolts (mV) per division.
Sweep Speed
• For analog oscilloscopes, this specification indicates how fast the trace can
sweep across the screen, allowing you to see fine details. The fastest sweep
speed of an oscilloscope is usually given in nanoseconds/div.
Gain Accuracy
• The gain accuracy indicates how accurately the vertical system attenuates or
amplifies a signal.

p.335
Oscilloscope Performance Terms (con’t.)

Time Base or Horizontal Accuracy
• The time base or horizontal accuracy indicates how accurately the horizontal
system displays the timing of a signal.
• Sample Rate
• On digital oscilloscopes, the sampling rate indicates how many samples per
second the ADC can acquire. Maximum sample rates are usually given in
megasamples per second (MS/s). The faster the oscilloscope can sample,
the more accurately it can represent fine details in a fast signal.
ADC Resolution (Or Vertical Resolution)
• The resolution, in bits, of the ADC indicates how precisely it can turn input
voltages into digital values.
Record Length
• The record length of a digital oscilloscope indicates how many waveform
points the oscilloscope is able to acquire for one waveform record.

p.336
Oscilloscope Graph
The oscilloscope is basically a graph-displaying device.
It draws a graph of an electrical signal.
In most applications the graph shows how signals change over time:
• The vertical (Y) axis represents voltage.
• The horizontal (X) axis represents time.

p.337
Oscilloscope Graph (con’t.)

An oscilloscope graph can tell you many things about a signal:
• You can determine the time and voltage values of a signal.
• You can calculate the frequency of an oscillating signal.
• You can see the "moving parts" of a circuit represented by the signal.
• You can determine if a malfunctioning component is distorting the signal.
• You can find out how much of a signal is direct current (DC) or
alternating current (AC).
• You can tell how much of the signal is noise and whether the noise is
changing with time.

p.338
How Does a Digital Scope Work?

Display
Acquisition System
Vertical System Processing
Analog to Digital
Vertical
Attenuator Digital Memory Display
Amplifier
Converter
System
Horizontal System
Probe
Sample
Trigger Clock
System
Clock Time Base

p.339
Examples of Waveform Shapes
Sine Wave Damped Sine Wave
Square Wave Rectangular Wave
Saw Tooth Wave Triangle Wave
Step Pulse

p.340
Frequency of a Signal
If a signal repeats, it has a frequency.
The frequency is measured in Hertz (Hz) and equals the number of times
the signal repeats itself in one second.
1 2 3
Frequency
S Cycles per
Second = 3 Hz
Period
1
Second

p.341
Triggering
Triggering means synchronizing the time base (x axis) with the repeating
waveform of the signal.
Thus triggering stabilizes a repeating waveform.
Untriggered Triggered
Display Display

p.342
Example: Voltage, Current, and Phase
Voltage
Current
Phase = 90°

p.343
Meter Grounding
• Proper grounding is an important step when setting up to take
measurements.
• Properly grounding the oscilloscope protects you from a
hazardous shock and protects your circuits from damage.
• Grounding the oscilloscope is necessary for safety. If a high
voltage contacts the case of an ungrounded oscilloscope, any part
of the case, including knobs that appear insulated, it can give you
a shock. However, with a properly grounded oscilloscope, the
current travels through the grounding path to earth ground rather
than through you to earth ground.
• To ground the oscilloscope means to connect it to an electrically
neutral reference point (such as earth ground). Ground your
oscilloscope by plugging its three-pronged power cord into an
outlet grounded to earth ground.

p.344
Meter Grounding
• Grounding is also necessary for taking accurate measurements
with your oscilloscope. The oscilloscope needs to share the same
ground as any circuits you are testing.
• Some oscilloscopes do not require the separate connection to
earth ground. These oscilloscopes have insulated cases and
controls, which keeps any possible shock hazard away from the
user.

p.345
Scope Probes
Most passive probes have some degree of attenuation factor, such as
10X, 100X, and so on. By convention, attenuation factors, such as for the
10X attenuator probe, have the X after the factor.
In contrast, magnification factors like X10 have the X first.

Oscilloscope Input
10X Probe One tenth of signal
9 MΩ 10 V p – p at input
10 V p - p x pF
Signal
1 MΩ
Probe 20 pF
Compensation
Adjustment

p.346
Input Coupling
Coupling refers to the method used to connect an electrical signal from one
circuit to another.
DC Coupling of a 1 V p – p Sine AC Coupling

Wave with a 2 V DC Component of the Same Signal
4V 4V
0V 0V

p.347
Vertical Controls
Position and Volts per Division
• The vertical position control lets you move the waveform up or down to
exactly where you want it on the screen.
• The volts per division (usually written volts/div) setting varies the size of
the waveform on the screen. A good general purpose oscilloscope can
accurately display signal levels from about 4 millivolts to 40 volts.
• Often the volts/div scale has either a variable gain or a fine gain control
for scaling a displayed signal to a certain number of divisions.

p.348
Horizontal Controls
Position and Seconds per Division
• The horizontal position control moves the waveform from left and right to
exactly where you want it on the screen.
• The seconds per division (usually written as sec/div) setting lets you
select the rate at which the waveform is drawn across the screen (also
known as the time base setting or sweep speed). This setting is a scale
factor. For example, if the setting is 1 ms, each horizontal division
represents 1 ms and the total screen width represents 10 ms (ten
divisions). Changing the sec/div setting lets you look at longer or shorter
time intervals of the input signal.

p.349
Trigger Position
• The trigger position control may be located in the horizontal control
section of your oscilloscope. It actually represents "the horizontal
position of the trigger in the waveform record." Horizontal trigger
position control is only available on digital oscilloscopes.
• Varying the horizontal trigger position allows you to capture what a
signal did before a trigger event (called pre-trigger viewing).
• Digital oscilloscopes can provide pre-trigger viewing because they
constantly process the input signal whether a trigger has been
received or not. A steady stream of data flows through the
oscilloscope; the trigger merely tells the oscilloscope to save the
present data in memory.
• In contrast, analog oscilloscopes only display the signal after
receiving the trigger.

p.350
Trigger Controls (con’t.)

Positive Negative
Slope Slope
Triggering on
0 Volts the positive
3V slope with the
level set to 3 V
Triggering on
3V the negative
slope with the
level set to 3 V

p.351
Pulse and Rise Time Measurements
Voltage Peak
Voltage
Peak-to-Peak
0 Volts
RMS Voltage

p.352
Skill Check
Q: The __________ is the measurement of the
radiation delivered to the receptor for the
field area (Gy *sq cm).
A: Dose area product
Q: ‘R’ is the symbol for what unit of x-ray

measurement.
A: Roentgen
Q: Synchronizing the time base (x axis) with

the repeating waveform of the signal is
called __________.
A: Triggering

p.353
Summary
Measurement module.
• Describe the principles of X-ray
measurement.
• Describe the instruments used to
measure X-rays.
• Describe how a digital scope
functions.
• Describe proper grounding.
• Describe the function of scope
probes.

WW X-ray
Fundamentals
Training
Module 21: Image Quality

p.355
Objectives
Welcome to the Image Quality
module.
• Describe the factors that contribute to
image quality.
• Describe the effects of enlargement
or magnification.
• Describe the effects of signal to noise
ratio.

p.356
Image Quality
What factors contribute to image quality?
Radiograph
Positioning Exposure
Capabilities of Parameters
Equipment
Receptor
DIAGNOSTIC Quality
Condition of
QUALITY
the Patient
Medical and
Technical
Clinical
Experience
Indication Diagnosis

p.357
Image Quality
Evaluation factors for image quality.
Contrast
Density
Resolution

p.358
Image Quality
Contrast
kV Scatter
“Generation” “Interception”
Grid Filters Air-gap
kV Collimation Compression
Volume

p.359
Contrast (con’t.)
Scattered radiation reduces the image contrast in a direct relation.
More scatter creates less contrast.
Causes for scatter:

• Irradiated field size 100 Contrast Level without Scatter
• Object thickness
80
• Selected kV
Contrast (%)
60
The contribution of the
40
scattered radiation in the
image can be reduced via 20
some methods, but all of them
will involve compromises. 0
1 2 3 4 5 6 7 8
Amount of Scatter

p.360
Contrast (con’t.)
Scattered Radiation
Collimation
By selecting a smaller field

size, the irradiated volume of
the patient is reduced and
therefore the total mass
involved decreases.

p.361
Contrast (con’t.)
Scattered Radiation
Collimation: air gap technique
By introducing a distance between

object and receptor, the scattered Primary
radiation will spread over a larger area.
According to the inverse square law, Scatter

the total amount of scatter in respect
to the primary radiation is reduced and,
therefore, the contrast will be improved. Air Gap
The limitation of this technique is the

Receptor
size of the receptor due to magnification.
Also a smaller focal spot is desired (geometrical unsharpness).

p.362
Density
Density
Energy Level of Quantity of

Photons Photons ( Qtot )
Object
kVp mA s SID
Characteristics
“Electrical Factors” “Non-electrical Factors”

p.363
Density (con’t.)
Density
Linear with
Dose
Linear with
mAs

p.364
Resolution
Resolution
Geometry Movement Signal/Noise
X-ray Tube Object Chassis/Film
Intensifying
Focal Spot Enlargement Receptor
Screen
Size Factor

p.365
Resolution – Geometry
Geometry
Enlargement Factor
• Blurring
• Dimension
• Distortion
Focal Spot Size

p.366
Enlargement or Magnification
show calculator
And do flash-light demonstration
Focal Spot
Object
Effect of the SOD to the enlargement by constant SID (FFD).

p.367
Enlargement or Magnification (con’t.)
Magnification
Image Size = ____
___________ SID
Object Size SOD

p.368
Focal Spot Size

The “point” focal spot does not exist.
• There is no area, therefore, no load.
• Physically impossible.
The focal spot size is the determinant for the loading capability.
Small focal spot:

• Better geometrical conditions lead to a limited load.
Large focal spot:
• Higher load possibility.
• Worse geometrical conditions.

p.369
Focal Spot Size (con’t.)

show calculator
“Point“ Real
Focal Spot Focal Spot
Blurring Zone or
Penumbra
Less Sharpness
Effect of the focal spot size to blurring.

p.370
Distortion
show calculator
F1
F2
View 1
View 2
b a
Distortion results from unequal magnification of different parts of the same

object due to incorrect alignment of the source/object.

p.371
Resolution – Movements
Movements
Equipment design
Mechanical less stable positioning
no immobilization features
Cold
Conditioned contractions
nervous tension
...
Peristaltic
Involuntary pulsations
...

p.372
Movements
Focal
Object Movement Spot
Blurring will occur if the object

imaged moves during
exposure.
Moving
The effect of motion is reduced Objects
contrast and a spread image.
Motion blur can be minimized

by reducing exposure time.
Penumbra
Image Borders Not Sharp

p.373
Signal to Noise
Signal/Noise
Intensifying
Screens
• Blurring
• Sharpness
• Scattering
Receptor

p.374
Skill Check
Q: What are the three evaluation factors for
image quality?
A: Contrast, density, and resolution.
Q: What causes distortion?

A: Results from unequal magnification of
different parts of the same object due to
incorrect alignment of the source/object.

p.375
Summary
You have completed the Image
Quality module.
• Describe the factors that contribute
to image quality.
• Describe the effects of enlargement
or magnification.
• Describe the effects of signal to
noise ratio.

WW X-ray
Fundamentals
Training
Module 22: Regulatory

p.377
Objectives
Welcome to the Regulatory
module.
• Describe why regulation is
important.
• Describe Carestream Health’s role
as a manufacturer and assembler.
• Describe what is included in an
Acceptance and Compliance test
file.

p.378
Regulatory
Diagnostic imaging X-ray equipment is regulated by various regulatory
agencies around the world.
Why is this important to us?
Because X-ray equipment is a regulated product, it must meet specific

compliance criteria for many areas including the following:
• Labeling
• Reporting
• Registration
• Performance
• Others

p.379
Regulatory (con’t.)
In terms of regulated X-ray performance, our equipment must meet
requirements such as:
• FDA 21 CFR Part 1020.30 and 1020.31
• IEC 60601-2-54.
For more information, refer to your location’s regulatory representative.

p.380
Regulatory (con’t.)
For mobile imaging equipment, the device must meet all of the standard
requirements for diagnostic X-ray equipment, but there is one mobile-
specific requirement that Segway must adhere to: Source to Skin
Distance.
1. X-ray systems designed for use with an intraoral image receptor shall
be provided with means to limit the source-skin distance to not less
than:
• Eighteen cm if operable above 50 kVp; or
• Ten cm if not operable above 50 kVp.
2. Mobile and portable X-ray systems other than dental shall be
provided with means to limit the source-skin distance to not less than
30 cm.

p.381
Acceptance and Compliance

Carestream Health’s role can be broken
down into the following categories with
regard to the X-ray equipment we sell:
1. Manufacturer
2. Assembler

p.382
Requirements of Manufacturer
The requirements of Carestream Health as an X-ray equipment
manufacturer are:
• Provide installation (assembly) instructions (These can be produced
by, or leveraged from, supplier documentation.).
• Provide service documentation (periodic maintenance, replacements,
etc.).
• Maintain a Device History Record (DHR).
• Equipment must be produced in accordance with, and be able to meet,
regulatory requirements (performance, labeling, etc.).

p.383
Requirements of Assembler
Assembler – person(s) performing the installation/assembly of the
equipment (does not have to be the manufacturer).
The regulatory requirements of the assembler are:

• Assemble equipment as per the manufacturer’s instructions.
• Test the equipment per manufacturer’s instructions (compliance tests,
etc.).
• Complete and submit required documentation

p.384
Assembler Compliance Testing

Why are the tests performed?
• To ensure the equipment is operating as designed and within the
regulated performance specifications
• To ensure patient and operator safety.
Who is required to test the equipment?
• Carestream Health FE (or dealer’s FE) are required to test the
equipment per the product’s instructions.
• The test is made by completing the Acceptance and Compliance Test.

p.385
Assembler Compliance Testing (con’t.)

When is the equipment required to be tested?
• The frequency of testing varies from state to state. Typically, the cycle
ranges from 12 to 24 months.
• We (Carestream Health) typically perform the tests at the end of an
installation and where applicable thereafter (i.e., PM, replacements,
adjustments, etc.)
Where are compliance tests required?

• All localities where Carestream Health sells equipment today.
• Refer to International Standard IEC 61223-3-1.

p.386
IEC 61223-3-1
The International Electrotechnical Commission (IEC) is the leading global
organization that prepares and publishes international standards for all
electrical, electronic and related technologies. These serve as a basis for
national standardization and as references when drafting international
tenders and contracts.
• The 61223 norm (prepared by subcommittee 62B) addresses the
Evaluation and Routine Testing in Medical Imaging Department.
• Part 3-1 (in the previous norm) addresses the Acceptance Test—
Imaging Performance of X-ray Equipment for Radiographic and
Radioscopic Systems.

p.387
IEC 61223-3-1
Scope
This part of IEC 61223 applies to those components of X-ray equipment
which influence the image quality and patient dose of diagnostic X-ray
systems using radiographic and radioscopic imaging systems.
Objective
This standard defines:
• The parameters which describe the performance of X-ray equipment
with regard to imaging properties and patient dose.
• Methods of testing whether measured quantities related to those
parameters comply with the specified tolerances.
The aim is to verify compliance of the installation with specifications

relating to the image quality and patient dose, and to detect malfunctions
that are not in agreement with those specifications.

p.388
IEC 61223-3-1
Overview
The aim of an Acceptance Test is to demonstrate that the specified
characteristics of the equipment lie within the specified tolerances. Some
requirements are enforced by legislation.
Other requirements and specifications may be in the order contract, in the

supplier's brochure, or in other standards.
Before any Acceptance Test according to this standard is carried out, the
equipment must be installed and put into service according to the set-up
procedure as given in the manufacturer's documentation.
An inventory of the equipment under test, the accompanying documents,

and the test protocols shall be compiled. Each item shall be identified by its
model or type reference (type number) and serial number, and the entire
inventory shall be compared with the order contract.

p.389
Acceptance & Compliance Test File

In some cases, we test to tighter specifications than what is acceptable by
the regulatory agencies.
In the interest of reducing the time required to perform the tests, we do not
test for all regulatory requirements, but we do test all requirements that
may be affected by the manufacturing and/or the final assembly process.
Although there are a variety of regulatory agencies around the world each
of which require testing, most of the tests are similar among the various
regulatory agencies.
Examples of agencies are:
• International Electro-technical Commission (I.E.C.) – Western Europe.
IEC policies are followed, or are paralleled closely, in much of Europe
and Asia.
• Swedish Radiation Protection Institute

p.390
Acceptance & Compliance Test File

The official document for Carestream Health compliance testing is the
TKM version of the tests that resides as part of our service
documentation.
An Excel spreadsheet is provided to:
• Reduce the time required to perform the tests.
• Make it easier to perform the tests.
• Reduce or eliminate errors during data calculation.
• The spreadsheet is pending FDA part-11 certification.

p.391
Acceptance & Compliance Spreadsheet

The following is provided in the spreadsheet:
• Brief theory/explanation of test (not allowed in TKM version)
• Setup instructions
• Troubleshooting tips where applicable
• Measuring device correction data (i.e., KV compensation, filtration
compensation, etc.)
• Distance converters (SAE to metric)
• Radiation unit converter (Rad to micro-grey)
• Illustrations to assist in setup

p.392
Acceptance Test Controls and Indicators

Controls and indicators are required to operate as designed by all
regulatory agencies.
A visual inspection and identification of the control and safety elements is
required.
For example:
• Audible X-ray indicator
• Visual X-ray indicator
• GUI kV control
• Stop motion button

p.393
Acceptance Test Total Filtration

Compliance Testing: Half Value Layer (HVL)
In order to obtain the total filtration value of the X-ray assembly, the HVL
is used.
After the HVL calculation a conversion table is used to obtain the total
filtration of the system.
Meeting a minimum HVL

ensures an acceptable beam
quality.

p.394
Acceptance Test – Linearity

Definition:
If input X to the system results in output X, then an input of 2X will

produce output of 2X. In other words, the magnitude of the system output
is proportional to the magnitude of the system input.
In the X-ray World:
The linearity test is used to ensure the x-ray generation portion of the
system produces a linear response in terms of mGy/mAs between any two
adjacent mA stations.
Remember: Dose = kVx * mAs
In other words, if you double the mA, you double the dose and mAs.

p.395
Acceptance Test – Reproducibility

Definition:
Reproducibility is one of the main principles of the scientific method, and

refers to the ability of a test or experiment to be accurately reproduced, or
replicated.
In the X-ray World:

The reproducibility test is used to ensure that the X-ray generation portion
of the system produces a "repeatable" exposure in terms of dose.

p.396
Acceptance Test – Technique Accuracy

In the fields of science, engineering, industry and statistics, accuracy is
the degree of conformity of a measured or calculated quantity to its actual
(true/set) value.
In the X-ray World:

Technique accuracy measures the accuracy of the generator parameters
(kV, mA, and time).

Acceptance test – SID Indication
Tests if the indicated SID (using aids provided with the system)
equals the actual SID to within 2% of the actual SID
p.398
Acceptance Test – Position Lamp Luminance

Tests the light output of the collimator
field lamp.

p.399
Acceptance Test – Focal Spot Size

Tests the size of the X-ray tube’s focal spots to ensure they are within
specified guidelines.
Focal spot test tool
Focal Spot Test Tool
(Detector's sensitive surface, cassette film-plane (CR or film), etc.)

Box (or other object) used to tape Focal
Spot tool to.
Place the focal spot test tool as close to
the collimator output as possible as to still
allow the entire test tool to be seen in the
resulting image. This will make the image
of the test tool larger for more accurate
Imaging plane
readings.
x-ray tube
collimator
For DR7100 and DR9000, if smaller SID
Bucky
&
is used, the collimator will open further,

allowing the test tool to be placed very
close to the output of the collimator, you
may actually be able to tape the tool to
the collimator itself.
Example: place the Focal Spot Test Tool at an SOD

of 100cm. The resulting measurments should be as
follows:
Large focus - Bh = 51.32
Large focus - Bv = 32.16
Large focus - Dia = 81.84
Small focus - Bh = 30.07
Small focus - Bv = 19.6
Small focus - Dia = 82.47

p.400
Acceptance Test – Light to X-ray

Mark the corners of the light field with radio-
opaque markers, for example metal wires
(coins).
Make an exposure and measure the
discrepancies between the X-ray field and
light field.
In this way, the position of the light field
relative to the X-ray field is tested.
The discrepancies in the indication of the
light field and the X-ray field shall comply
with the tolerances specified. The x-ray field is shown with
the blue dotted line. The light
field is shown with the yellow
area. In the above example, a
misalignment exists between the
x-ray field and the light field.

p.401
Acceptance Test – X-ray Alignment

The test is used to measure the accuracy of the center of the X-ray beam
relative to the center of the receptor when using the positioning aids (i.e.,
field lamp, centering light, detents, etc.) to center the X-ray beam to the
receptor.
Centered Uncentered

p.402
Acceptance Test – X-ray Field Size

Tests the actual size of the X-ray field versus the indicated size
(indicated on the collimator or elsewhere).
The discrepancies between the collimator indication and the measured

X-ray field shall comply with the tolerances specified.
The figure shows a 14" x 17" (35 cm x 43 cm)

film with the exposed area shown on an angle.
Measure the length and width of the exposed
area to determine collimator accuracy.
A coin was used to help identify orientation.

p.403
Acceptance Test – Collimator Minimum Size

Tests the actual size of the X-ray
field versus the indicated size
(indicated on the collimator or
elsewhere).
The discrepancies between the

collimator indication and the
measured X-ray field shall comply
with the tolerances specified.
The light field cannot exceed 5 cm

in either the X or Y direction
measured at a SID of 100 cm.

p.404
Acceptance Test – DAP

Tests the operation of the
X-ray
components that produce the Tube and
DAP output. Collimator
This test is also used to SID

calibrate the DAP (if needed).
Detector
2.04 uGy
Imaging
Plane
DAP Measuring Unit (DICOM Standard) =

dGy*cm² Bucky
(1 dGy*cm² = 0.01 mGy*cm² = o.1 cGy*cm²) Detector
Actual filed size and

area of beam at point
in beam where probe
is placed.
Width or length of X-ray

beam used to calculate the
area of the X-ray beam
(Measure from monitor.).
p.405
Acceptance Test – AEC Accuracy

Tests the accuracy of the AEC control.
AEC Accuracy
Programmed ECF (density) s teps % increase/decrease
+1
+2
+3
-1 (enter the "-" sign, ex . "-20")
-2 (enter the "-" s ign)
-3 (enter the "-" s ign)
Measured Results Expected Results Tolerance = +/- 10%
Exposure #1 @ 0 ECF (mR or Gy)
Exposure #2 @ +1 ECF (mR or Gy) 0 FAILED
Exposure #7 @ -1 ECF (mR or Gy) 0 FAILED
Equipment complianc e for AEC Ac curacy? FAILED

p.406
Carestream Health Acceptance Test Printout Page
Printout Page contains

customer information and
test results.
Used to provide a summary
of all test results. This page
can be printed and supplied
to the customer.

p.407
Carestream Health Acceptance Test (.xls file)

At the end of Acceptance Test, the file must show all the test results as
“passed.”
Macros within the worksheet provide convenience for the following:

• Automatically create a unique filename for the site, and the filename
will start with the system type for quick and easy identification.
• Results will be mailed automatically for archive purposes to the
responsible people.

p.408
Skill Check
Q: Who is required to test the equipment at the

end of the installation?
A: Carestream Health FE (or dealer’s FE)
Q: __________ accuracy measures the

accuracy of the generator parameters (kV,
mA, and time).
A: Technique

p.409
Summary
Regulatory module.
• Describe why regulation is
important.
• Describe Carestream Health’s role
as a manufacturer and assembler.
• Describe what is included in an
Acceptance and Compliance test
file.

WW X-ray
Fundamentals
Training
Module 23: Safety

p.411
Objectives
Welcome to the Safety module.
• Identify the factors in X-ray safety.
• Identify precautions.
• Identify X-ray user rules.
• Identify the main causes of
accidents.

p.412
Introduction to Safety
Diagnostic imaging X-ray
equipment poses safety
threats from the following:
• X-ray exposure
• Electrical –
Shock/electrocution
hazard Caution – Risk of Caution –
• Mechanical – Weight of Ionizing Radiation High Voltage
supported objects,
equipment movement,
pinch/crush hazard, etc.
LASER Crane Low

BEAM Overhead Headroom

p.413
Safety – X-ray Exposure

What is ionizing radiation and why is it
dangerous?
• Materials can be damaged by electromagnetic
radiation such as gamma rays or X-rays. These
forms of radiation do not displace the atoms in
material but rather strips them of electrons so
they can become ions.
• Ionization is the primary reason for radiation
damage in organic cells because the normal
functions of a cell can be disrupted when highly
reactive ions are present. Ionizing radiation may
affect vital molecules directly by removing
electrons from their structures.
• Larger doses of radiation increase the probability
of damage to larger molecules within a cell,
resulting in cell mutation and/or cell death.
p.414
Safety – X-ray Exposure (con’t.)

• Damage to a single cell is common, and
typically poses no risk to the overall
organism.
• Severe damage to many cells can result in
cell death, which can lead to irreversible
damage to the organism.
• If the cells do not die from the radiation
damage they may become defective. These
defective cells can reproduce and form
more defective cells, which can lead to
cancer.
• Important: When possible, minimize
exposure to ionizing radiation.

p.415
X-ray Exposure Safety Precautions

There are two way to protect yourself
from the risk of X-ray exposure:
• Minimize or eliminate X-ray exposure.
• Use personal precautions.

p.416
X-ray Exposure Safety Precautions (con’t.)

Minimize or eliminate X-ray
exposure.
Equipment precautions:
• Close collimator blades.
• Place source behind shield.
• Point source away from personnel.
• Reduce X-ray beam technique
parameters.

p.417

Minimize or eliminate X-ray
exposure.
Personal precautions:
• Utilize protective barriers (shielding).
• Utilize protective clothing (e.g., Pb
aprons).
– Material with greater atomic mass
has better X-ray-shielding
performance characteristics.
– High-energy X-ray photons will
penetrate further into shielding
material.
• Decrease or eliminate time spent in
or near X-ray beam.

p.418

Increase distance to beam.
• “Distance is your friend.”
• Inverse Square Law: Doubling
your distance from the X-ray
beam decreases the potential D
exposure to ¼ of that found at
the initial distance. The
radiation effluence varies 2D
inversely to the square of the
distance from the source.

p.419
Safety – Electrical
Electrical requirements for X-ray
equipment:
• In order to produce X-rays, electrical
energy is required.
• The X-ray tube for a typical general
radiography diagnostic X-ray machine
typically requires greater than 35K Caution –
volts to conduct. High Voltage
• The operating range of most
mobile/portable equipment is 40K to
~125K volts.
• The operating range of most
stationary X-ray equipment is 40K to
150K volts.

p.420
Preventing Electrical Accidents

To work on or near energized electrical parts or equipment, the user
must have the necessary skills and techniques necessary to:
• Distinguish exposed live parts from other parts of electric equipment.
• Determine the nominal voltage of exposed live parts.
• Know the clearance distances and the corresponding voltages to
which the qualified person will be exposed.
Who is a qualified person?
Someone who is familiar with the construction and operation of the
equipment and the hazards involved.

p.421
Preventing Electrical Accidents (con’t.)

If you do not know if a hazard exists, MEASURE.
Refer to your local organization’s safety

procedures.
In the U.S.:
• Electrical Safety Program – 1F2996
• Equipment Safety - Hazardous Energy
Control (Lockout/Tagout) – 1F4394

p.422
Safety – Mechanical
Mechanical hazards pertaining to X-ray equipment
may include:
• Lifting hazard - component or part weight
– X-ray tube assemblies in CSH DR systems
typically weigh ~23 kg (~50 lbs).
– Ralco 302 series collimator weighs ~9.8 kg
(~22 lbs).
• Fall/drop hazard: Components suspended from
above or held vertical must be installed correctly
to ensure safe operation.
– OTC: Should be attached to ceiling support,
must have end-stops installed properly, must
be secured properly.
– Wall Stand: Should be held vertically by
attachment to ceiling or wall, and must be
secured properly.
p.423
Safety – Mechanical (con’t.)

• Pinch hazard: Moving components
within the system can create pinch
points.
– Bucky movement
– Tabletop movement
– Cassette tray
• Crush hazard: An example is if
motorized elevation movement exist for
the table or other device, care must be
taken the component’s movement is
clear to avoid potentially crushing
patients or other objects.

p.424
Safety Guidelines
General Rules:
A fundamental precept of radiation safety is that the individual must
assume the responsibility not only for their own safety, but must
ensure their actions do not result in hazards to others.
Always be aware:
• The direction of the X-ray beam. (Where is the tube/collimator
pointing?)
• The people in the equipment room.
• The exposure technique factors. (Use the lowest possible.)
All equipment in the X-ray lab/room must be properly shielded and
regularly checked for X-ray leakage. However, everyone must
understand the basic principles and dangers associated with X-
radiation exposure and how this can be avoided.
Departmental Radiation Protection Supervisors provide the necessary
guidance and supervision to workers using X-ray emitting equipment.
p.425
Safety Guidelines (con’t.)

User Rules:
• Only authorized personnel should operate and/or repair X-ray
generating equipment.
• X-ray equipment must be operated according to the manufacturer’s
instructions.
• Know the location of the X-ray source and direction the source will
emit the x-ray beam at all times.
• No unauthorized modifications or incorrect use of equipment is
permitted.
• Overriding interlocks is prohibited.

p.426
Main Causes of Accidents

The main causes of accidents
include:
• Inadequate training.
• Violation of procedure, such as
incorrect use of equipment and
overriding interlocks.

p.427
Accident Prevention
Good practice:
• ALWAYS assume a hazard exists.
• Do not attempt a task you are not qualified for.
• Plan every job.
• Anticipate unexpected events.
• Use the right tool for the job.
• Use procedures as tools.
• Isolate the equipment.
• Identify the hazards.
• Isolate or minimize hazards.
• Protect the person.
• Minimize distractions in the work area.
• Follow applicable procedures for the task.
Remember: Accident prevention depends on you!
p.428
Safety Radiation Officer

Who is the Safety Radiation Officer?
• Each country and/or organization has an assigned Radiation Safety
Officer. Refer to your organization’s listing to determine who you
immediate radiation safety office is.
What is the responsibility of the Safety Radiation Officer?

• Ensure the health and safety of the employee is achieved.
• Provide X-ray safety training based on local regulations and
processes.

p.429
Skill Check
Q: What is the primary reason for radiation
damage in organic cells?
A: Ionization
Q: The main causes of accidents are

inadequate training and __________.
A: Incorrect use of equipment, for example,
overriding interlocks.
Q: What are the fours equipment precautions

you can take?
A: Close the collimator blades, place the
source behind an x-ray shield, point the
source away from personnel, and reduce X-
ray beam technique parameters.

p.430
Summary
You have completed the Safety
module.
• Identify the factors in X-ray safety.
• Identify precautions.
• Identify X-ray user rules.
• Identify the main causes of
accidents.

p.431
Conclusion
Congratulations! You have completed the modules for
X-ray Fundamentals Part 3 Theory training.
Go to eCampus to take the Final Exam.

Search for this Final Exam Code: GEN302_THEORY_Final_Exam


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What is the purpose of the X-ray Fundamentals training curriculum?

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What are the courses that make up the X-ray Fundamentals curriculum?

What are the courses that make up the X-ray Fundamentals curriculum?

WW X-ray

Part 3, Version 1.7

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Some subjects are simply touched

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X-ray Fundamentals Curriculum

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Agenda: Part 3 – Theory

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The First X-ray

Wilhelm Conrad Roentgen

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History of Radiography (con’t.)

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History of Radiography (con’t.)

Benefits of X-rays to Medical Science

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1955 X-ray Image Intensifier - Television units

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Q: Fill in the blanks: “It was the study of

Q: In 2009, Carestream launched the first

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Common Equipment Terms

Common Equipment Terms (con’t.)

Common Equipment Terms (con’t.)

Common Equipment Terms (con’t.)

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Common Equipment Terms (con’t.)

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Common Exam Terms

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Common Exam Terms (con’t.)

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Common Patient Positioning Terms

PA: Posterior/Anterior (X-ray

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Q: What is the name of the device used to

Q: What does “AEC” refer to?

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What Are X-rays?

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Photographs and Radiographs

In radiography, X-rays that pass through the

Differences in the types and amounts of the

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How Are X-rays Produced?