Chapter 16 Physics of Diagnostic X-Rays

Physics of Diagnostic X-Rays

The x–ray is a form of the electromagnetic radiation (EMR) of very short wave
length (λ ≤ 1 → 0.1Ao) and very high frequency that means x–ray photons
carry very high energies so as a result these photons have a very high
penetration power. The discovery of x-rays was accidental by a physicist called
W. C. Roentgen in 1895, this ray is very useful in diagnosis & radiotherapy fig.
(1).

Fig.1 Electromagnetic waves spectrum

The amount of energy carried by each photon depends on the frequency of radiation :

E=hυ=hc/λ
Where
h = Plan's constant = 6.6*10-34 (joule. sec)
c = velocity of light = 3* 10 8 m/sec
f = frequency of radiation

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Chapter 16 Physics of Diagnostic X-Rays

X–rays production:
To produce x–rays in an x-ray tube fig. (2), we need:
1. Source of electrons, a cathode filament which is negatively charged.
2. An evacuated space (with low pressure 10-6 tor) to remove obstructions to electrons
so they can speed up to reach the anode with high kinetic energy.
3. High positive voltage applied between cathode and anode to accelerate the negative
electrons. In diagnostic radiography, this is usually within the range 40 to 120 Kev.
4. Target or anode which is positively charged to attract electrons to produce x-rays.
99.8% of energy of most electrons striking the target is dissipated in the form of
heat the remaining few energy (0.2%) produce useful x-rays. Anode rotates to
distribute heat, also additional cooling is required.
5. Lead shielding is necessary to contain scattered electrons and x-rays by absorbing
them.
6. Filter usually made of Aluminum is used to absorb low energy photons .
7. The space between the tubes insert (the enveloped and electrode) and the shield is
filled with oil, the oil converts heat from the insert to the tube shield (oil used to
cool the target), Rotating anode is used also for cooling.

Fig.2 X-ray tube

The intensity of x – ray beam produced when the electron strike the anode is highly
dependent on the anode material :

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Chapter 16 Physics of Diagnostic X-Rays

1. The higher the atomic number (Z) of the target, the more efficiency x-ray are
produced .
2. The target material used should also have a high melting point since the heat
produced when the electrons are stopped in the surface of the target is substantial .

Nearly all x– ray tubes use tungsten targets. The atomic number (Z) of tungsten is 74,
and its melting point is about 3400C0.

Types of x-rays
There are two different mechanisms by which X-rays are produce. One give rise to
Bremsstrahlung (continuous) X-rays and the other is characteristic X-rays.

1. Bremsstrahlung (continuous) X-Ray:

Many times electrons get close enough to the nucleus of a target atom to be diverted
from its path and emits an x-ray photon that has some of its energy. X–rays produced
in this way have a fancy German name, bremsstrahlung, which means “braking
radiation”. Bremsstrahlung also called white radiation since it analogous to white
light and has a range of wavelengths.
The amount of Bremsstrahlung produced for a given number of electrons striking the
anode depends upon two factor:

1. The Z of the target, the more protons in the nucleus the greater the acceleration
of electrons.
2. The kilovolt peak-the faster the electrons, the more likely they will penetrate
into the region of the nucleus.

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Chapter 16 Physics of Diagnostic X-Rays

Fig.3 Illustration of Bremsstrahlung process

2. Characteristic X-ray:
Sometimes a-fast electron strikes a K electron in a target atom and knocks it out of its
orbit and free it of the atom. The vacancy in the K shell is filled almost immediately
when an electron from an outer shell of the atom falls into, as indicated in fig. (4), and
in the process, a characteristic K x-ray photon emitted. When an electron falls from
the L level to the K level, the emitted radiation is called a Kα characteristic x-ray and
that emitted when an electron falls from the M shell to the K shell is called a K β x-ray
see fig. 5.

Fig.4 Illustration of characteristic x-ray process

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Chapter 16 Physics of Diagnostic X-Rays

Fig.5 Illustration of Kα and Kβ characteristic x-ray process

X-ray Energy Spectra

X-rays photons produced by an x-ray machine are heterogeneous in energy. As a
result of characteristic and bremsstrahlung radiation generation a spectrum of x-ray
energy is produced within the x-ray beam.
The broad smooth curve is due to the bremsstrahlung and the spikes represent the
characteristic x-ray as shown in fig. (6).
As we know many of the low energy (soft) x-ray photons produced are absorbed in the
glass walls of the x-ray tube, If no filtration inherent or added, of the beam is assumed,
the calculated energy will be a straight line, the purpose of added filtration is to enrich
the beam with higher energy photon by absorbing the lower energy components of the
spectrum, and hence improving the penetration power of the beam.

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Chapter 16 Physics of Diagnostic X-Rays

Fig.6 x-ray energy spectrum

Attenuation of X-rays:
X-rays are not absorbed equally well by all materials, Heavy elements like calcium are
much better absorbers of x-rays than light elements like carbon, oxygen and hydrogen,
and as a result, structures containing heavy elements, like bones, stand out clearly.
There are five basic radiographic densities, air, fat, soft tissue/ fluids, bone and metal.
The whiteness (density) depends on the amount of x-ray radiation passing through the
tissue fig. (7).

Fig.7 Five basic radiographic densities

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Chapter 16 Physics of Diagnostic X-Rays

The attenuation of an x-ray beam is its reduction due to the absorption & scattering of
some of photons of the beam. It is an exponential process and, therefore, the beam
intensity never reaches zero, fig. (8) shows a simple method of measuring the
attenuation of an x-ray beam.

Attenuation of the beam can be represented numerically by:

1. Linear attenuation coefficient
2. Half value layer
3. Mass attenuation coefficient

Fig. 8 Illustration of the attenuation of an x-ray beam

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Chapter 16 Physics of Diagnostic X-Rays

To measure the unattenuated (transmitted) beam intensity (I), we use,

I = I0 e -µx ---------- (1)

where I0 = unattenuated (transmitted) beam intensity .

I = initial beam intensity .
μ = linear attenuation coefficient.
e = 2.718
x = thickness of the attenuator such as (brain tumor, bone, aluminum)

Linear attenuation Coefficient (μ) measure the probability that photon interact
(absorbed or scattered) per unit length it travel in specified material, It depends on:

1. Energy of x-rays
2. Atomic number (Z)
3. Density (ρ) of material

Half value thickness HVT (X1/2) is the thickness of material which reduces the
intensity of the beam of radiation one half of its value (50%) fig. (9).

Fig.9 Transmitted intensity of x-ray versus thickness of aluminum attenuator

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Chapter 16 Physics of Diagnostic X-Rays

At time x = x 1/2 then I = 1/2 I0

Substitute this condition in the equation (1):
I = I0 e -µx
... 1/2 I0 = I0 e - µ X 1/2
1/2 = e - µ X 1/2
2-1 = e - µ X 1/2
By taking Ln of both sides we get:
- Ln 2 = - µ X 1/2 × Ln e
0.693 = µ X 1/2 × 1
... X1/2 = 0.693 / μ ------------- (2)

Mass attenuation coefficient (μm) is used to remove the effect of density when
comparing attenuation in several materials. The mass attenuation coefficient of a
material is equal to the linear attenuation coefficient μ divided by the density ρ of the
material. So equation (1) can be rewritten as:

I = I0 e (–μ / ρ) (ρ x) = I0 e – μm (ρ x) ----------- (3)

The quantity (ρ x) is called the area density and is in (g/cm2), while (μm) is in (cm2/g).
The mass attenuation coefficient emphasizes that the mass is primarily responsible for
attenuating the x-rays. So if 1.0 g of lead covering an area of 1 cm2 will absorb the
same amount of x-rays whether its density is 11 g/cm3 or whether it is mixed with
plastic to reduce its density to 2 g/cm3.

Fig.10 Mass attenuation coefficient (μ/ρ) for various tissues.

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Chapter 16 Physics of Diagnostic X-Rays

The above quantities only really apply to a monoenergetic (one energy value) beam of
x-rays from a point source (infinitely small area) travelling in a vacuum. In reality, the
x-ray beam focus is not a fine point and contains photons of different energies i.e.
hetrogenous beam that means the beams produced by x-ray tubes are photons of a
wide range of energies, The lower-energy photons are attenuated proportionally more
than the higher energy photons and are removed, leaving behind higher energy
photons the resulting beam is of a higher average energy, therefore, penetrate tissue
easier and the HVL is increased.

Interaction of X-rays with matter:

There are three types of interaction between x-ray with matter contribute to
attenuation:
 Photoelectric effect (P.E).
 Compton effect (C.E).
 Pair Production (P.P).

1. Photoelectric effect (P.E):

The photoelectric effect is one way x-rays lose energy in the body. It occur when the
incident x-ray photon transfers all of its energy to a bound electron which then escapes
from the atom fig. (11), this electron is called photoelectron.
In low Z materials (e.g. tissue and bone) the photoelectron uses some of its energy to
get away from the positive nucleus and spends the reminder ionizing surrounding
atoms while an outer shell electron falls to fill in vacancy and a low energy photon is
released (characteristic radiation) and is absorbed immediately, so all the energy is
said to have been absorbed by the material.
In high Z materials (e.g. iodine) the released radiation may be sufficiently energetic to
leave the body. This is why high Z materials are used as contrast.

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Chapter 16 Physics of Diagnostic X-Rays

The P.E is more apt to occur in the intense electric field near the nucleus than in the
outer levels of atom, and it is more common elements with high (Z) than in those with
low Z. The x ray photon must be equal to or greater than the binding energy of the
orbital electron, the probability that the P.E effect will occur increases greatly.

Fig. 11 X-ray lose energy in the photoelectric effect

2. Compton effect (C.E):

Another important x-rays lose energy in the body is done by C.E., In 1922 A. H.
Compton suggested that an x-ray photon can collide with loosely bound outer electron
much like a billiard ball collides with another billiard ball. At the collision, the
electron receives part of energy and the remainder is given to a Compton (scattered)
photon, which then travels in a direction different from that of the original x-ray fig.
(12).
The number of Compton collisions depends only on the number of electrons per cubic
centimeter, which is proportional to the density. However, since the P.E is more apt to
occur in in high Z materials than in low Z materials, the fraction of x-rays that lose
energy by C.E. is greatest in low Z materials for example,

 In water or soft tissue C.E. is more probable occur than the P.E effect at
energies ≥ 30 KeV.
 In bone C.E. is more probable than the P.E. effect at energies ≥ 100 KeV.

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Chapter 16 Physics of Diagnostic X-Rays

Fig.12 X-ray photon loses energy in the Compton effect

3. Pair Production (P.P):

P.P is the third major way x-rays give up energy. When a very energetic photon enters
the intense electric field of the nucleus, it may converted into two particles: an electron
(eˉ) and positron (β+) or positive electron. Providing the mass of the two particles
requires a photon with an energy of at least 1.02 MeV, and the remainder of the
energy over 1.02 MeV is given to the particles as kinetic energy. After it has spent its
kinetic energy in ionization it does a death dance with an electron. Both then vanish,
and their mass energy usually appear as two gamma photons of 511 keV each called
annihilation radiation fig. (13).
Since a minimum of 1.02 MeV is necessary for P.P, this type of interaction is only
impotent at very high energies. Because the intense electric field of the nucleus is
involved, P.P is more apt to occur in high Z elements than low Z elements.

Fig. 13 X-ray lose energy in pair production process

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Now how are these interactions related to diagnostic radiology?

As we can see that P.P. is of no use in diagnostic radiology because of the high
energies needed and that the P.E. is more useful than the C.E. because permits us to
see bones & other heavy material such as bullets in the body fig. (14). At 30 keV bone
absorbs x-rays about 8 times better than tissue due to P.E. effect.

Fig. 14 Mass absorption coefficient for water. The P.E. and C.E. are about equally probable at
about 30 keV, P.P. occurs only at high energies and is of no important in diagnostic radiology.

Making an X-ray Image

X-ray imaging is based on the fact that tissue will absorb photons from x-ray beam in
relation to the electron density of the tissue, as mentioned before, bones absorb more
photons than lean tissue does. The number of photons passing through the body of
interest will then be detected either by film or by image detectors that convert the
body’s direct attenuation of the photons into digital image. The resulting images are a
two-dimensional projection of a three-dimensional structure.

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Chapter 16 Physics of Diagnostic X-Rays

Summarizing the basic principles of x-ray imaging:

1. X-rays are produced in an x-ray tube.

2. The energy distribution of the photons is modified by inherent and additional
filtration.
3. The x-rays are attenuated differently by the various body tissues.
4. Scattered radiation, which impairs image contrast, is reduced.
5. The transmitted photons are detected.
6. The image is processed and in the case of CT reconstructed.

Radiographic Film
Radiography film is the use of silicon films within a cassette being placed behind the
object to be imaged and exposed to an x-ray beam. These films are then processed.

Types of films:

 Double-sided radiographic film: emulsion layer of light-sensitive crystals coated

onto both sides of a transparent base material. Used most in plain film imaging
 Single-sided camera film: one emulsion layer only. Used in mammography
 Non-screen film: x-ray photons used directly to expose film. Used in dental x-rays.

Basic Structure:

Base:

 Clear polyester material ( plastic) about 150µm thick

 Provides physical support of the other film components
 Does not participate in the image forming process

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Chapter 16 Physics of Diagnostic X-Rays

Emulsion:

 Active component in which image is formed

 Typically 5-10µm thick
 Consists of many small, irregularly-shaped silver halide crystals suspended in
gelatin.
 The silver halide used is typically silver iodobromide (10% bromide, 90% iodide)
 Each grain has a structural "defect" built in called the "sensitive spot". Each
crystal is 1µm
 Most sensitive to light energy, therefore intensifying screens used

Gelatin:

Photographic gelatin for X-ray film is made from bone, mostly cattle bone from India.
It keeps the silver halide grains well dispersed and prevents the clumping of grains.
Processing (developing and fixing) solutions can penetrate gelatin rapidly without
destroying, and gelatin is available in a reasonably large quantity and uniform quality.

Silver halide:

Silver halide (AgI, AgBr) is the light-sensitive material in the emulsion. The presence
of AgI produces an emulsion of much higher sensitivity than a pure AgBr emulsion.

Firm attachment between the emulsion layer and the film base is achieved by use of a
thin layer of adhesive, as shown in fig. (15), the adhesive layer allows the emulsion
and base to maintain proper contact and integrity during use and processing.

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Chapter 16 Physics of Diagnostic X-Rays

Fig. 15 Cross-sectional view of radiographic film

Forming an image

An image is formed on film by:

1. Exposure to radiation: silver bromide crystals form emulsion. Photons interact

with crystals depositing silver ions in proportion to exposure.
2. Development of film: The latent image is invisible. It is converted into a visible
image through the process of chemical development. The developer supplies
electrons that migrate into the exposed grains in the silver bromide and converts
the other silver ions into black metallic silver:

AgBr + electron = Ag + Br

3. Fixing: The film is immersed in fixer solution so that the unexposed and
unreduced silver halide is removed to render the image stable in white light.
4. Washing: the film washed in running water to remove the fixing chemicals
&dissolve silver halides.
5. Drying : The final step in processing is to dry the radiograph, and this is done
by blowing warm dry air over both surfaces of the film as it is transported
through the drying chamber.

The total sequence the events involved in manual processing requires over 1hr.
Most modern automatic processors are identified as 90 sec.

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Chapter 16 Physics of Diagnostic X-Rays

Film density
The x-ray image is present in the space between the patient and the x-ray film, we
have seen how the energy of the x-ray beam may be used to produce a visible pattern
of black metallic sliver on the x-ray film. The degree of film blackening is directly
related to the intensity of radiation reaching the film in which increases as the
exposure is increased the measurement of film blackness is called "film density" fig.
(16).
When light density is zero (ρ = 0) this allow 100% of the light to pass and there will be
no absorption at all, it is determined by:
1. Quantity of X-rays
2. Sensitivity of the film

Fig. 16 Illustrates optical density vs light penetration

Sandwich Film: Usually put in light box and exposed to the light of this box for about
2 min.

Factors affecting the image quality:

X-ray images are basically images of the shadows cast on film by the various
structures in the body. The image of a stationary structure produce by the beam from
an ideal point source would be perfectly sharp. But if a bigger light source is used the
intensity of x-rays would change suddenly from a height to a low value at the edge of
shadow, the blurred edge of the shadow is called the “Penumbra”.

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Chapter 16 Physics of Diagnostic X-Rays

The penumbra can be reduced by:

1. Using a small focal spot, the nominal sizes of the focal spots on many x-ray units
fig. (17a) are: a. Small focal spot 1 mm. b. Large focal spot 2 mm.

Fig. 17a Reduction of penumbra using smaller x-ray source

3. The patient is placed as close to the film as possible (decreasing the object -
film distance)

Fig. 17b Reduction of penumbra by increasing the distance between film and object

3. Increasing the distance from the X-ray tube to the film (chest film distance is 180).

Fig. 17c Reduction of penumbra by increasing the distance between source and object

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4. Reduction the scattered radiation at the film by using a grid.

Grid
Grids are placed between the patient and the film-screen combination. In fig. (18), an
"antiscatter" grid seen in cross-section, consists of thin (0.07 mm) strips of a heavy
metal (such as lead) sandwiched between thicker (0.18 mm) strips of interspaced
material (plastic, carbon fiber, or aluminum) , which are transparent to x- rays.

Fig. 18 Focused grid

The lead strips absorb (say, 90% of) the scattered rays which hit the grid obliquely,
while allowing (say, 70% of) the primary rays to pass through the gaps and reach the
film.

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Chapter 16 Physics of Diagnostic X-Rays

Contrast media
One of the problems in radiography is the low contrast between soft tissues. One way
to Increasing contrast is to use a lower kV; another way by using a contrast medium.

Radiopaque media: are chosen to have a sufficiently high atomic number to

maximize photoelectric absorption. (Iodine Z=53, Barium Z=56) are used as
contrast media. Contrast media are compounds of one or other of these elements.
Contrasting: This technique is made to make further use of the photoelectric effect
radiologists often inject high Z material into different part of the body (contrasting
media).
e.g.:
1. Iodine injected into the blood stream to show the arteries
2. Oily mist containing iodine is sometimes sprayed into the lungs to make airways
Visible.
3. Barium compound is given oral to see parts of the upper Gl.
4. Barium enemas to view the other end of the digestive system (lower GI).
5. Air is used to replace some of fluid ventricles of the brain, which a
pneumoecephalgram is taken.
6. Air & barium are used separately to show the same organ in a double contrasting
study.
To avoid shadows in x-rays image, the radiologist must often take x-ray images from
different directions, e.g. from the back, the side & intermediate angle. Body section
radiology or image of slices of the body are known as computed tomography.

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