10/22/2022

‫ميحرلا نمحرلا هللا مسب هتاكربو هللا‬

‫ةمحرو مكيلع ملاسلا‬ Daftar Isi

• Introduction
Medical Imaging • Ionization
Physics of
• Forms of Ionizing Radiation
Radiography
• Nature and Properties of Ionizing Radiation
• Attenuation of Electromagnetic Radiation
Amir Faisal, S.T., M.Eng., Ph.D. • Radiation Dosimetry
Teknik Biomedik
Jurusan Teknologi Produksi &
Industri
Institut Teknologi
Sumatera

• This chapter provides an introduction to the physics behind • X-rays were discovered in 1895 by Roentgen while working with
x- ray imaging modalities. a Crooke’s tube (a precursor to the modern x-ray tube).
• Broadly speaking, these modalities can be divided into • He noticed that ‘‘rays of mysterious origin,’’ which he named
two types, projection radiography and computed x- rays, caused a fluorescent plate to glow.
tomography.
• Upon investigation, he determined that these rays were in
• These modalities do not involve radioactivity (a common fact produced by the tube.
misconception), so we delay the introduction of radioactivity
for the presentation of the nuclear medicine modalities. • The first radiograph of a human being—the hand of Roentgen’s
wife—was made by Roentgen within a month of the discovery.

• Roentgen’s discovery of x-rays and their immediate

application to imaging the human body mark the birth of • It also turns out that an electron beam, which is a form
medical imaging. of particulate radiation, is used in the production of x-
• Today, we know that x-rays are electromagnetic (EM) waves rays.
whose frequencies are much higher than those of visible • So, we need to study certain aspects of particulate radiation
light. in this chapter as well.
• One form of ionizing radiation—that is, radiation capable • Furthermore, gamma rays, like x-rays, are high-frequency EM
of ejecting electrons from atoms—used in medical waves.
imaging.
• Other forms of ionizing radiation used in medical • So, in studying the propagation properties of x-rays, we are
imaging include particulate radiation and gamma rays. also implicitly studying the same for gamma rays.
• Both particulate radiation and gamma rays can be products
of radioactive decay.

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Ionization
• This chapter provides a necessary background for all • Ionization is the ejection of an electron from an atom, creating
imaging modalities that use ionizing radiation, including a free electron and an ion.
projection radiography, computed tomography, planar
scintigraphy, and emission computed tomography. • Radiation that carries enough energy to ionize an atom is
called ionizing radiation.
• We start by describing the basic physical properties of the
atom and the concepts of excitation and ionization. • Here, the term radiation covers a broad range of
physical phenomena.
• We then describe ionizing radiation in a more general context,
concluding with its measurement and interaction with • For example, visible light, x-rays, gamma rays, and
biological tissues. electron beams are all examples of radiation.

Atomic
Structure
• High-energy EM waves such as x-rays and gamma rays • Today’s concept of atomic structure is based on a quantum
are ionizing radiations; light is not. mechanical picture of the atom (from the 1920s), which in
• Particulate radiations such as an electron beam may be turn arose from the Bohr model of the hydrogen atom (in
ionizing depending on the energy each particle possesses. 1913).
• We now discuss the structure of atoms and the process • An atom consists of a nucleus of protons and neutrons, which
of ionization in more detail together are called nucleons, surrounded by orbiting
electrons.
• A common visualization of atomic structure, sometimes
called the planetary atom, is shown in Figure 4.1.
• The atomic number Z is equal to the number of protons in
the nucleus and defines the element.

• The planetary atom: a • Each proton has a positive charge equal in magnitude
common (and useful) and opposite in charge to that of each electron.
visualization of atomic • Since an atom as a whole is electrically neutral, there are
structure. an equal number of electrons and protons in an atom;
hence, Z also represents the number of electrons in the
atom.
• A short table of the elements is given in Table
4.1.
• The mass number A of an atom is equal to the number
of nucleons in the nucleus.
• The term nuclide refers to any unique combination of
protons and neutrons forming a nucleus.

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• Nuclides are typically denoted by either �X or X-A, where X

is the element symbol. 𝑍

• For example, 126X and C-12 are both symbols for the most
abundant carbon atom.
• Notice that the element symbol and atomic number
are redundant.
• As indicated in Table 4.1, the number of neutrons in a given
nucleus is approximately equal to the number of protons;
and certain combinations are stable, while others are
unstable.

• The electrons orbiting the nucleus are organized into so-

• Unstable nuclides are called radionuclides and their atoms called orbits or shells.
are radioactive. • The � shell is closest to the nucleus, the � shell is next,
• Radionuclides are statistically likely to undergo radioactive then the � shell, and so on.
decay, which causes a rearrangement of the nucleus, which • Electrons are restricted to specific quantum states within
in turn gives off energy and results in a more stable nucleus. each shell.
• 146C or C-14 denotes a radioactive carbon atom; it is statistically
likely to decay into 147 N, a stable nitrogen atom, during which a • Only one electron is permitted to be in each state, and this
beta particle will be emitted from the nucleus. leads to a maximum number of electrons per shell, given
by
2�2 , where � is the shell number (� = 1, � = 2, etc.).

• For example, only two electrons are permitted in the K shell,

8 in the L shell, 18 in the M shell, and 32 in the N shell. • The arrangement of electrons
• Each atom has a so-called ground state configuration for its into shells for the carbon
elec-trons, which corresponds to the lowest energy atom.
configuration of the atom—nature’s preferred arrangement
of electrons in a given atom.
• Generally speaking, in the ground state, the electrons will be
in the lowest orbital shells and within the lowest energy
quantum states within each shell.
• A diagram of the arrangement of electrons in shells for
the carbon atom is shown in Figure 4.2.

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Electron Binding Energy

• It is energetically more favorable for an electron to be bound • One electron volt is equal to the kinetic energy gained by
in an atom rather than to be free. an electron when accelerated across one volt potential.
• In other words, the total energy of the atom is less than the • For comparison with more conventional units of energy, 1 eV =
total energy of the atom (minus the electron) and the (free) 1.6 × 10−12 ergs = 1.6 × 10−19 J.
electron.
• A given electron’s binding energy depends on the element to
• The difference between these two energies is called which the electron is bound and the shell within which the
the electron binding energy. given electron resides.
• Binding energy is usually specified in units of electron volts • For any given element, electron binding energy decreases
(eV). with increasing shell number.

• The binding energy of the sole electron in a hydrogen atom is • For example, the average binding energy for air is about 34 eV.
13.6 eV, the smallest binding energy among all ‘‘lighter’’
atoms • Metals have significantly larger average electron
(i.e., those having smaller atomic numbers). binding energies.
• There are even smaller electron binding energies in the • For example, the average binding energy of lead is about 1 keV
outer orbits of the ‘‘heavier elements.’’ and for tungsten it is about 4 keV.
• For example, some electrons in the O-shell of mercury
atoms have binding energies equal to 7.8 eV.
• For our purposes, however, it is sufficient to consider an
‘‘average’’ binding energy of the electrons in a given atom
or even in a given molecule.

Ionization and Excitation

• If radiation (particulate or EM) transfers energy to an orbiting • It is possible for a single
electron (in an atom of the material the radiation is passing ionizing radiation emission
through) which is equal to or greater than that electron’s to ionize many atoms along
binding energy, then the electron is ejected from the atom. its path before its energy is
• This process, illustrated in Figure 4.3, is called ionization. exhausted.
• It yields an ion (an atom with a +1 charge in this case) and the • The ionizing radiation we use
electron that came from it, which together are called an ion • After an ionization event, in medical imaging has
pair. the ejected electron plus the energies ranging from about
• By convention, radiation with energy greater than or equal to ion have more energy than 25 keV to 500 keV.
13.6 eV is considered ionizing; all other radiations the original atom.
are considered nonionizing.

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• Broadly speaking, the ‘‘easiest’’ atom to ionize is a hydrogen • If an ionizing particle or ray transfers some energy to a
atom, since it has the smallest average electron binding bound electron but less than the electron’s binding energy,
energy. then the electron is raised to a higher energy state—to a
• Tungsten may be about the ‘‘most difficult’’ to ionize in more outer orbit—but is not ejected.
the substances normally encountered in medical • This process is called excitation.
imaging.
• In both ionization and excitation, an electron shell is left with a
• Using the range of ionizing radiations energies given above ‘‘hole’’ that must be filled in order to return the atom to a
and the binding energies for these two elements, we can lower energy state.
conclude that a single ionizing particle or ray used in medical
imaging is capable of ionizing between 10 and 40,000 atoms • The filling of these open holes comprises an important source
before its energy is exhausted. of secondary radiation called characteristic radiation.

Example 4.1 Forms of Ionizing Radiation

• Suppose an electron is accelerated within a vacuum from a • Ionizing radiation can be divided into two broad categories:
heated cathode held at ground potential to an anode held particulate and electromagnetic.
at
120 kV (DC).
• If the anode is made of tungsten, what is the maximum
number of tungsten atoms that can be ionized on average?
• Answer: The electron will have kinetic energy equal to 120 keV
upon reaching the anode (recall the definition of eV).
• The average binding energy of tungsten is 4 keV. The
maximum number of tungsten atoms that can be ionized on
average is
120 keVΤ4 keV = 30.

Particulate Radiation
• Any subatomic particle (i.e., a proton, neutron, or electron) • From Einstein’s theory of relativity, we know that the (relativistic)
can be considered to be ionizing radiation if it possesses mass of a particle is given by
enough kinetic energy to ionize an atom. �0
•�= 2 Τ� 2
• In calculating the kinetic energy of these particles, 1−��
relativistic effects cannot be ignored since the particles • where �0 is the rest mass of the particle, � is the speed of
often travel at a significant fraction of the speed of light. the particle, and � is the speed of light.
• As a particle approaches the speed of light, its relativistic mass • Einstein’s theory also tells us that there is an
increases, which significantly increases its kinetic energy equivalence between the energy � of a particle and its
above that which would be calculated using the usual low- mass, given by
speed approximation. • � = �� 2

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• The kinetic energy of a particle is the difference in • In nuclear medicine, we consider modes of radioactive decay
energy between the moving particle and the stationary that give rise to different kinds of particulate ionizing
particle: radiations.
• KE = E − E0 = �� 2 − �0 � 2 • In projection radiography and computed tomography, the only
• It is straightforward to show that when � is small relative to particulate radiation we need to consider is due to electrons
�, the kinetic energy reduces to that are not bound in an atom and have gained kinetic energy.
1
• KE = 2 �� 2 , � ≪ �, • These electrons arise from a heated filament and a potential
difference between a cathode and anode within an x-ray
• which is the usual (nonrelativistic) equation for kinetic
tube.
energy.

Example 4.2
• In this case, we know the energies of these particles by • Consider an electron that has been accelerated between
the manner in which they were created. a cathode and anode held at a 120 kV potential
• For example, electrons accelerated across an 80 kV difference.
potential will have energies equal to 80 keV. • Assume the situation is nonrelativistic.
• The speed and mass of these particles is interesting to • What is the speed of the electron when it ‘‘slams’’ into the
know but largely irrelevant from an imaging point of view. anode?
• The rest mass of an electron is 9.11 × 10−31 kg.
• Because it was accelerated across a 120 kV potential,
the electron must have kinetic energy given by KE = 120
keV.

Electromagnetic Radiation
• Therefore, assuming nonrelativistic speeds, we must have
1
• Electromagnetic radiation comprises an electric wave and a
• KE = 2 × 9,11 × 10−31 kg × � 2 = 120 keV magnetic wave traveling together at right angles to each
• Nothing that 1 eV = 1,602.177.33 × 10−19 J and recalling that 1 J other.
= 1 kg m2 Τs 2 , we find that • Radio waves, microwaves, infrared light, visible light,
ultraviolet light, x-rays, and gamma rays are all examples of
EM radiation.
3 −19
2×120×10 ×1,602.177.33×10 J
= 2,054 × 108 • EM radiation has no rest mass and no charge, and can act
•� 9,11×10−31 kg mΤ s like either a particle or a wave.
=
• This speed is a significant fraction of the speed of light, so
our calculations are not accurate; they must be redone. • When treated as a ‘‘particle,’’ EM radiation is conceptualized as
• The electrons in a typical x-ray tube are traveling at ‘‘packets’’ of energy termed photons.
relativistic speeds by the time they strike the anode.

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• The energy of a photon is given by � = ℎ�, • Table 4.2 summarizes the frequencies, wavelengths,
• where ℎ = 6,626 × 10−34 joule-sec is Planck’s constant and � and photon energies of the EM spectrum relevant to
is the frequency of the radiation (in Hz). medical imaging.
• Viewed as a wave, EM radiation has a wavelength given by • Radio waves are very low frequency, very long wavelength EM
radiations; their photon energy ranges from 10−10 to 10−2 eV.
• � = �Τ�
• Since the photon energies of radio waves are below 13.6
• Where � = 3.0 × 108 meters/sec is the speed of light. eV, radio waves are not considered to be ionizing radiation.

• Visible light is moderate frequency, long wavelength EM

radiation.
• The photon energy of light is about 2 eV, which is also not
large enough to be considered ionizing.
• X-rays and gamma rays, on the other hand, are higher
frequency, shorter wavelength EM radiation, having energies
in the keVs to MeV range.
• Both x-rays and gamma rays are clearly ionizing radiations.

• Although it is suggested by Table 4.2, x-rays and gamma • Although gamma rays tend to have higher frequencies
rays are not distinguished by their frequency or photon (energies) than x-rays, there is a large overlap in the
frequencies (energies) of x-rays and gamma rays used
energies. in medical imaging.
• Instead, they are distinguished by their point of • Furthermore, once produced, x-rays and gamma rays
origin. behave the same in terms of their propagation properties and
• In particular, x-rays are created in the electron cloud of atoms interaction with matter.
while gamma rays are created in the nuclei of atoms, which • Therefore, our understanding of the propagation and
in turn are undergoing reorganization due to radioactive detection of EM waves in the x-ray–gamma ray photon energy
range is essential background material for all the medical
decay. imaging modalities using ionizing radiation.
• Thus, gamma rays are associated with radioactivity and x-
rays are not.

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Nature and Properties of Ionizing Radiation

• It turns out that both the production and detection of EM • Particulate and EM ionizing radiations interact with the
radiation over a large range of frequencies play major roles materials through which they are traveling, imparting energy to
in medical imaging. the material, losing energy from and redirecting their own
• Visible light is used in radiography to improve the efficiency radiation, and generating new types of particles and radiation.
of x-ray detection. • Generally speaking, the effects that we care about fall into
• The attenuation of x-rays is the primary mechanism used two broad categories: (1) those that are used in imaging or
to create images in projection radiography and computed that affect the imaging process and (2) those that are not
tomography. used in imaging but contribute to dose—that is, have
• Finally, gamma rays are detected in order to locate biological consequences.
radiotracers in nuclear medicine.

• Specific concepts related to these two broad categories tend

to apply separately to particulate radiation or EM radiation.
• Table 4.3 lists specific concepts related to ionizing
radiation, positioned according to the categories for which
they largely apply.
• We will now begin to discuss each of these concepts, starting
with those important in forming and analyzing medical
images (column 1) and ending with those important in
understanding the biological effects of radiation (column 2).

Primary Energetic Electron Interactions

• The only particles of direct consequence to the formation • In collisional transfer, by far the most common type of interaction
of medical images are electrons and positrons. at the electron energies used in medical imaging, a (typically
small) fraction of the electron’s kinetic energy is transferred to
• Since positrons are used solely in nuclear medicine, we another electron in the target medium with which it collides.
postpone discussion of the interaction of positrons with • As the affected atom returns to its original state, infrared radiation
matter until Chapter 7. is generated, producing heat in the target medium.
• Here we consider only the interaction of energetic electrons • As shown in Figure 4.4(a), the incident electron’s path may be
with matter. redirected as a result of the collision, and many more interactions,
both collisional and radiative, may subsequently take place, until
• Energetic electrons interact and transfer energy to an the incident electron’s kinetic energy is exhausted.
absorbing medium by two modes: collisional transfer and
radiative
transfer.

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• Energetic electrons can • Occasionally, a large amount of energy may be transferred to

• (a) collide with other electrons a struck electron, creating a new energetic electron, which
until they lose their energy; forms a new path of ionization, called a delta ray, and a new
• (b) eject a K-shell electron, set of collisional and radiative energy transfers.
generating a characteristic x- • In radiative transfer, the energetic electron’s interaction with
ray; or an atom produces x-rays.
• (c) be ‘‘braked’’ by a • This can happen in two ways: characteristic radiation
nucleus, generating or bremsstrahlung radiation.
bremsstrahlung radiation.

• In the generation of characteristic radiation, in Figure 4.4(b), • The loss of energy experienced by the outer-shell
the incident electron collides with a K-shell electron, exciting or electron creates an EM photon.
ionizing the atom, and temporarily leaving a hole in that shell.
• The x-ray is called a characteristic x-ray. The energy of the
• (This can also happen to higher-orbit electrons but is characteristic x-ray photon is exactly equal to the difference
not significant in imaging.) in electron binding energies between the two shells.
• The K-shell hole is then filled by an electron from the L-shell, • In fact, the particular electron ‘‘subshells,’’ which have
M- shell, or N-shell. slightly different energies according to quantum physics, are
• Since the electron binding energy of the K-shell is higher distinguished.
than that of the L-, M-, or N-shell, there is a loss of energy as
the electron fills the K-shell hole or vacancy.

• Since these electron binding energies are determined by the • As the electron approaches the nucleus, the positive charge
particular atom and those transitions allowed by quantum of the nucleus attracts the electron, causing it to bend, as if to
physics, these x-ray energies are ‘‘characteristic’’ of go into orbit around the nucleus.
particular atoms, which is the reason for the name
characteristic x-rays. • As the electron decelerates around the nucleus, it loses
energy in the form of an EM photon, which comprises
• A given atom can be identified by the nature (energies bremsstrahlung radiation (German for ‘‘braking radiation’’).
and proportions) of the characteristic x-rays it generates.
• Unless the electron actually strikes the nucleus, the electron
• Bremsstrahlung radiation is caused by the interaction of an departs the atom with a kinetic energy reduced by the energy
energetic electron with the nucleus of an atom, as shown of the emitted photon.
in Figure 4.4(c).

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• In the rare event of a collision with the nucleus, the electron • This is because an x-ray tube works by accelerating
is annihilated, and the photon emitted has energy equal to electrons across a voltage potential in a vacuum.
the kinetic energy of the incident electron.
• When the electrons strike the target or anode, which is
• Otherwise, the emitted photon must have energy lower usually tungsten, they lose energy by both collisional and
than that of the incident electron. radiative transfer; so heat, characteristic x-rays, and
• The intensity of bremsstrahlung radiation increases with the bremsstrahlung x- rays are produced.
energy of the incident electron and the atomic number of • The x-ray energies produced by the characteristic and
the atom with which it interacts. bremsstrahlung interactions differ in character, in Figure
• Bremsstrahlung radiation is the primary source of x-rays 4.5.
from an x-ray tube.

• The bremsstrahlung spectrum, called the continuous • At the lower energies, bremsstrahlung radiation is still
spectrum, has its highest energy equal to the anode-to- produced, but is absorbed by the anode itself, so the
cathode potential. spectrum goes to zero.
• In this figure, different potentials are considered: 45 kV, 61 kV, • Characteristic x-rays can be generated only if the incident
80 kV, 100 kV, and 120 kV.
electrons have sufficient energy to eject inner-shell
• For a given fixed potential, x-rays at the highest energies electrons.
are produced only by the rare direct collisions between
• For a tungsten anode, the K-shell binding energy is 69.5 keV,
energetic electrons and anode nuclei.
the L-shell binding energy is approximately 12 keV, and the
• It is increasingly more likely for lower energy bremsstrahlung M- shell binding energy is under 3 keV.
interactions to take place; it is approximately a linear
increase with frequency decreasing from the maximum •
energy.

• Thus, the characteristic x-rays from tungsten are all under 70 • When energetic electrons
keV, and include energies of approximately 58 keV (from an bombard a target, two kinds
L- shell to K-shell transition), 67 keV (from an M-shell to K- of x-rays are produced:
shell transition), and 69 keV (from a very outer shell to K-shell characteristic x-rays and
transition), in Figure 4.5. bremsstrahlung x-rays.
• Transitions to the L-shell or M-shell result in such low • Low-energy x-rays of both
energy characteristic x-rays that they are either absorbed types are absorbed by the
within the tungsten anode or filtered out by the x-ray tube. medium.

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Primary Electromagnetic Radiation Interactions

• EM ionizing radiation interacts with matter through • In both the photoelectric effect and Compton scattering, an
significantly different mechanisms than particulate ionizing incident x-ray photon interacts with the electron cloud of an atom.
radiation. • The primary difference between the two interactions is that in the
• The three main mechanisms by which EM ionizing photoelectric effect the photon is completely absorbed by the
radiation interacts with materials are (1) the photoelectric atom, while in Compton scattering the photon is not absorbed but
instead loses energy and changes its direction.
effect, (2) Compton scatter, and (3) pair production.
• Both effects are important in imaging human tissues. The
• Since a photon must have at least 1.02 MeV of energy for pair photoelectric effect is the primary mechanism that provides
production to occur and since the range of photon energies in contrast between different types of tissues; Compton scattering is a
medical imaging is about 25–500 keV, we will consider only primary mechanism for limiting the resolution of x-ray images, both
the photoelectric effect and Compton scattering here. in projection radiography and computed tomography.

Photoelectric Effect
• In the photoelectric effect, a photon with energy hν interacts • The remaining atom is now an ion, having a hole, typically in the
with the coulomb field of the nucleus of an atom, causing K-shell, which must be filled.
the ejection of an electron, usually a K-shell electron, from
the atom. • The hole is filled by an electron transition from a higher
orbit, which produces characteristic radiation, as discussed
• This process is illustrated in Figures 4.6(a) and (b). The above and shown in Figure 4.6(a).
incident photon is completely absorbed by the atom, and the
ejected electron, called a photoelectron, propagates away with • Sometimes, the characteristic x-ray transfers its energy to an
energy outer-orbit electron, called an Auger electron, which is ejected
from the atom, accompanied by a readjustment of the
• ��− = ℎ� − �� remaining electron orbits, as shown in Figure 4.6(b).
• where �� is the binding energy of the ejected electron.

• The photoelectric effect, • Photoelectrons and Auger electrons are energetic electrons
shown in (a) and (b), and that are free to interact with matter in the ways we described in
Compton scattering, shown in the previous section.
(c).
• We will see below that these energetic electrons contribute
to the detrimental biological effects of ionizing EM radiation
by contributing radiation dose to the patient.

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Compton Scattering
• In Compton scattering, as shown in Figure 4.6(c), a photon with
energy hν ejects a valence (outer-shell) electron, yielding a • Where �0 � 2 = 511 keV is the energy equivalent to the rest
mass �0 of an electron, and 𝜃 is the angle through which
new energetic electron called a Compton electron.
the photon is scattered [see Figure 4.6(c)].
• As a result of this interaction, the incident photon loses
energy • We see that the amount of energy remaining with the
(to the Compton electron) and changes its Compton photon depends on the scatter angle.
direction. • The more the photon is deflected, the more energy it loses.
• The energy of the scattered photon, the so-called • This implies that the maximum energy loss occurs when
Compton photon, is given by the photon is deflected 180◦ back towards the source, that
ℎ𝑣 is, a
• ℎ� ′ =1+ 1−cos 𝜃 ℎ��Τ �0 � 2
180◦ backscatter. The kinetic energy of the Compton electron
is given by ��− = ℎ� − ℎ�′

Example 4.3
• Compton scattering is usually undesirable in medical • The energy of the photon after Compton scattering is
imaging.
•toIn planar scintigraphy, the energy of a photon is used ℎ𝑣 100 keV
• ℎ� ′ = = = 98 keV
determine whether it has been scattered prior to arrival at the 1+ 1−cos 𝜃 ℎ��Τ �0 � 2 1+ 1−cos 𝜃 100 keVΤ511 keV
511
detector. •𝜃= cos −1 1 − = 26,4°
100∗49
• Suppose a photon with energy ℎ� = 100 keV = 100 keV
is • So, a photon scattered by an angle up to 26.4◦ is still
incident to some material and exits with energy ℎ�′. A considered as traveling along a straight path by the
detector decides that the photon has not been scattered if ℎ� ′ detector.
> 98 keV.
• What is the maximum angle by which the photon is
scattered but is still being treated as a photon traveling
along a straight path?

Probability of EM Interactions
• We now consider the factors that make photoelectric and • Therefore, if we find a way to increase the likelihood of
Compton events more likely to occur. photoelectric events, we can block or shield objects (or
• There are many reasons why this subject is important. patients, staff, and physicians) from the source of ionizing EM
• For example, the formation of a useful projection radiograph radiation.
depends on the differential attenuation of an x-ray beam • We should therefore be able to understand what makes lead a
passing through a patient, which is caused by the good x-ray shield while plastic is not; we should also be able to
photoelectric effect and Compton scattering. predict whether lead will shield high-energy photons better
• As another example, we observed above that the than low-energy photons.
photoelectric effect causes complete absorption of an incident • As another example, the reason why Compton scattering is
photon. detrimental to imaging is that it causes photons to deviate
from straight-line paths.

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• We would like to know the conditions under which Compton • What are the factors that make a photoelectric effect
scattering is large so that instrumentation can be designed more likely?
to compensate for its effects. • Since a photoelectric event occurs as a result of an interaction
• We might choose to use x-ray energies that minimize the with the coulomb field of the nucleus of an atom and if there
Compton scattering effect to image patients. are more (positively charged) protons in the nucleus, the
likelihood should increase.
• Consider a thin ‘‘slab’’ of material having a fixed thickness.
• The probability of a photoelectric event is related to the
• Suppose that an incident photon can either pass through atom’s atomic number Z.
the material or experience a photoelectric or Compton
• In a compound composed of a variety of different atoms, we
event. define an effective atomic number Zeff, which characterizes
the average atomic number in a certain sense.

• The probability of a photoelectric event is (approximately) • Putting this together, we find

4 e
4f f
proportional to ��eff . 𝑍
• Prob photoelectric event ∝
• The other factor affecting the probability of a photoelectric ℎ𝑣 3
event is the incident photon energy. • Finally, we note that when the photon energy rises above
the binding energy of L-shell or K-shell electrons,
• Intuitively, we might expect that high-energy photons are experiments reveal that the probability of a photoelectric
more penetrating—that is, they pass farther into an object interaction increases abruptly, then begins to diminish as
before being absorbed. the energy is further increased.
• This intuition is correct; in fact, the probability of a • This sudden increase occurs because a large number of
photoelectric event (given all else held constant) is electrons has suddenly become available to be ejected
proportional to 1Τ ℎ� 3 . from their host atoms.

• This property will be important in the use of contrast agents • where NA is Avogadro’s number (atoms/mole), Z is the
in radiography and computed tomography. atomic number (electrons/atom), and Wm is the molecular
• What are the factors that make a Compton scattering weight of the atom (grams/mole).
event more likely? • As shown in Table 4.4, except for hydrogen, the electron
• Since Compton events occur with very loosely bound (or density for various biological materials is nearly the same, 3 ×
‘‘free’’) electrons in the outer shells, what matters is the number 1026 electrons/kg (see Problem 4.7).
of electrons per kilogram of material—the electron density • Therefore, the probability of Compton scattering is
(ED). nearly independent of the atomic number (actual or
�� 𝑍
• The electron density is given by ED = �� 𝐴 effective).
𝑚 • The other factor that might influence the probability of
Compton scatter is the photon energy.

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• There is a fairly complicated relationship described by the

Klein- Nishina formula, which predicts that the probability of a
Compton event generally decreases with increasing energy.
• However, this decrease is a very gradual one, taking place
over the very highest energies of interest in diagnostic
imaging.
• Over the range of energies of importance in x-ray imaging,
the probability is reasonably constant.
• In summary, we conclude that Prob photoelectric event ∝ ED

• Since photoelectric and Compton events affect diagnostic

images differently, it is also important to understand the
relative frequency of occurrence of these two events in body
tissues.
• There are two ways to look at this: by a relative frequency
or percentage of occurrence or by the percentage of energy
deposited by a given type of event.
• Table 4.5 summarizes these two characterizations over
the diagnostic range of energies.

Attenuation of Electromagnetic Radiation

• We see that the relative frequency of Compton interactions • Attenuation is the process describing the loss of strength of
increases as diagnostic x-ray energy increases, becoming a beam of EM radiation.
the dominant type of interaction above 30 keV. • Tissue-dependent attenuation is the primary mechanism
• Even at 60 keV, when Compton events occur over 90 percent by which contrast is created in radiography modalities.
of the time (whenever either event occurs), these events • Although this is actually a statistical process, we
account for only 55 percent of the energy deposited in the study attenuation here as though it were
tissue. deterministic.
• This apparent discrepancy occurs because photoelectric • In Chapter 5, we will include the statistical aspects in a
events deposit all of their incident photon energy, while very natural way, as we study noise in projection
Compton radiographs.
events deposit only a fraction of their incident photon energy.

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Measures of X-Ray Beam Strength

• In radiography, we are generally concerned with a brief burst • This is critical because ionizing radiation is potentially harmful.
of x-rays, also called an x-ray beam.
• At high doses, it can cause burns or cataract formation.
• For many reasons, we are also concerned with the ‘‘strength’’
of the x-ray burst. • Even at low doses, it can increase the risk of cancer.
• For example, in the design of x-ray detection systems used to • It turns out that there are many ways to define and measure
form images, it is critical to characterize the strength of the x- the strength of x-rays.
ray beam in order to characterize the inherent noise in the • In this section, we consider several of the most common
system and to adjust the dynamic range of the detection and important measures of x-ray beam strength.
system. • The conceptually simplest measure of the strength of an x-
• Measures of x-ray beam strength are also used in ray burst is simply the number of photons � in the burst.
estimating the (adverse) biological effects of ionizing
radiation.

• It is also important to consider the area over which 𝑁

these photons are spread. • Accordingly, photon fluence rate 𝜙 is defined as 𝜙 = �∆𝑡
• Accordingly, we define the photon fluence Φ as the number • It may be of interest to know how much energy the burst is
of photons � per unit area ��, carrying and could deposit into a material if totally
𝑁 absorbed.
•Φ= � • If each photon in the burst has the same energy ℎ�—that is,
• where the area is oriented at a right angle to the direction of the beam is monoenergetic—then the total energy of the burst
the radiation beam propagation. is simply �ℎ�.
• It is sometimes important to account for time, since • We define the energy fluence Ψ and energy fluence rate 𝜓 as
measurements may take place over a fixed ��ℎ𝑣 ��ℎ 𝑣
interval∆��. •Ψ= �
and 𝜓 =
�∆𝑡

• The energy fluence rate is also known as the intensity of an • In x-ray imaging, a photon burst is always polyenergetic, since
x- ray beam, and it is often given the symbol I. it arises mainly from bremsstrahlung.
• From (4.14) and (4.16), we see that • In principle, if only the photon count were important, photon
• � = �𝜙 , (4.17) fluence rate could still be used as a valid measure of
• where � = ℎ�. radiation strength.
• Intensity has units of energy per unit area per unit time. • However, these measures are not very important in practice,
since photons are not counted in x-ray imaging modalities,
but instead their total energy is measured.
• It is more useful, therefore, to capture the idea of intensity
for polyenergetic sources.

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• Since each x-ray photon carries its own discrete energy, a • The energies at which S(E) is large have larger numbers of
plot of N as a function of E for polyenergetic sources is a line x- ray photons per unit energy.
spectrum.
• Since the integral of a line density yields the number of
• Because of the random nature of bremsstrahlung, the fine lines, from the definition of S(E) and (4.14), the integral of
details of a line spectrum change with each photon burst; ∞
the spectrum yields the photon fluence rate 𝜙0= ‫� 𝑆 ׬‬′
however, the line density—for example, number of photons ��′
per unit energy as a function of E—remains constant for a
given source. • a quantity that does not depend on energy.
• The x-ray spectrum S(E) is this line density per unit area per • Furthermore, by analogy to (4.17), it is natural to define
∞
unit time. Examples of x-ray spectra were shown in Figure the intensity of a polyenergetic source as �0 = ‫� ׬‬′𝑆 �′
4.5. ��′

Example 4.4
∞
• It is often desirable to model a polyenergetic x-ray beam as ′
‫׬‬0 �� 𝑆 𝐸′ �𝐸′
a monoenergetic source. • The energy of this equivalent beam must be � = ∞
𝑆 𝐸′ ���′
0‫׬‬
• What energy would a (hypothetical) monoenergetic source • This expression should look vaguely familiar; it is the
have to be in order to produce the same intensity as the (true) expression for center of mass of a sheetlike object having
polyenergetic source using the same number of photons? mass density S(E).
• For a given area A and time interval ∆��, the number ∞ of • Alternatively, the numerator is the expression for the mean of
photons in the polyenergetic source
𝑝 is �0 = 𝐴∆𝑡 ‫� 𝑆 ׬‬′ a random variable if S(E) were its pdf.
��′ • The denominator normalizes S(E) so that the ratio
• The intensity of the polyenergetic source is �
𝑝
∞
=0 ‫� ׬‬′𝑆 �′ effectively does compute the mean. The energy computed
this way is sometimes called the effective energy of a
��′ polyenergetic source.
• The equivalent monoenergetic beam has intensity �
𝑝 =�
��𝑝
�∆𝑡

Narrow Beam, Monoenergetic Photons

• Consider a beam of � monoenergetic photons incident upon
a thin slab of homogeneous material, in Figure 4.7(a). • Overall, the detector count �′ will be smaller than �, which
• The depicted geometry is called narrow beam geometry is the primary characteristic of attenuation.
because the photon beam is no wider than the detector used • Suppose � photons are ‘‘lost’’ in the above experiment.
to detect or count the photons. • Provided that ∆� is small, we would expect that doubling ∆�
• In this case, if the slab were not present (and ignoring should double �, and doubling � should also double �.
statistical effects and problems of detector efficiency), the
detector would record � photons. • In other words, � is proportional to both � and ∆�, or � = ��∆�
• With the slab present, however, some photons will be absorbed • where � is a constant of proportionality called the
within the slab by the photoelectric effect, and other photons linear attenuation coefficient.
will be deflected away from the detector by Compton events.

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• Rearranging (4.20) yields a definition of the linear

attenuation coefficient,
Τ
• � =� 𝑁
∆𝑥
• which can be interpreted as the fraction of photons that are
lost per unit length.
• The change in the number of photons upon interaction with
the slab is ∆� = � ′ − � = −� = −��∆�
Two geometries by which to study attenuation:
(a) narrow beam geometry and (b) broad beam geometry.

• Letting the slab become incrementally thin and treating � as • where �0 is the intensity of the incident beam.
�𝑁
a continuous quantity leads to the differential equation
𝑁
= • Using (4.24), we can compute the fraction of
− ���, which can be integrated to yield � = �0 � −��∆𝑥 (monoenergetic) photons that will be stopped or transmitted
• where �0 is the number of photons at � = 0. by a non- infinitesimal layer of homogeneous material.
• This equation can be called the fundamental photon • What thickness of a given material will attenuate half of the
attenuation law; it is of central importance throughout all of x- incident photons? This thickness, called the half value
ray layer
radiography. (HVL), satisfies𝑁��= 1 =2 �−𝜇HVL
0
ln 2 0,693
• It should be noted that in the monoenergetic case, this law can • A simple series of manipulations yields HVL = =
also be written in terms of intensity as � = 𝜇 𝜇

�0 � −��∆𝑥

Example 4.5
• We will see in Chapter 7 that 140 keV gamma rays are
generated by the radioactive decay of technetium-99m, and • Suppose the slab is not homogeneous.
that sodium iodide crystals are used to detect such gamma • In this case, the linear attenuation coefficient depends on
rays. Assume that the HVL of sodium iodide at 140 keV is 0.3 the position �, and we are faced with solving
cm. �𝑁
• What percentage of gamma rays will pass right through a • 𝑁
= −� � ��
1.2 cm sodium iodide crystal? • Straightforward integration yields the number of photons
𝑁
• Percent transmitted = 100% × � = 100% × � −𝜇1,2 cm at position �,
𝑥
�0 • � � = � exp − ‫ � � ׬‬′ ��′
• Since
𝑁 � = ln 2ΤHVL, we have Percent transmitted = 100% ×
0
��0
0
= 100% × � − ln2Τ0,3 cm×1,2 cm = 100% × � −4 ln 2 = • where �′ is a dummy variable for integration.
6,25%

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Narrow Beam, Polyenergetic Photons

• The analogous relationship holds for intensity as well, • In the narrow beam case, photons (of any energy) are either
𝑥 completely absorbed or scattered away from the detector.
•� � = 0 � exp0 − ‫׬‬ � • Therefore, we can consider the attenuation principles in the
� �′ �′
• This form can be thought of as the integral form of narrow beam, polyenergetic case to be the same as in the
the fundamental x-ray attenuation law. monoenergetic case, except that they take place at each
energy independently.
• This equation is the most important physical model
for projection radiography and computed tomography. • In general, the linear attenuation coefficient is different for
different materials, and it also varies as a function of energy
• It is also a valid model for the attenuation of gamma rays for the same material.
in nuclear medicine modalities. • A plot showing these relationships for bone, muscle, and fat
is given in Figure 4.8.

• Linear attenuation coefficient • This plot shows that bone is more attenuating than
for bone, muscle, and fat as a muscle, which is in turn more attenuating than fat.
function of incident x-ray
photon energy. • This plot shows as well that x-rays experience less attenuation
at higher energies—that is, they are more penetrating at
higher energies.
• For a polyenergetic x-ray beam, we must treat the linear
attenuation coefficient of a given material as a function of �
— that is, � � .

• Consider a homogeneous slab of material of thickness ∆�

with an incident x-ray beam having spectrum ��0 � . • If the overall intensity of the beam is of interest, then we
can use (4.19) together with (4.31) and (4.32) to yield
• The spectrum leaving the slab is attenuated in a fashion 𝑥
identical with that of the monoenergetic case [see (4.25)], • � = 0 𝑆 0‫�׬‬′ �′ exp −� � ′ ∆� ��′ and
𝑥 𝑥
except that the linear attenuation coefficient depends on ′
• � = ‫� ׬‬′ �′ exp − ‫� ; � � ׬‬′ ��′ ��′
�, 𝑆 0 0 0
• 𝑆 � = ��0 � � −𝜇 𝐸 ∆𝑥 • Although (4.34) is a valid model for heterogeneous materials,
• For a heterogeneous slab, the linear attenuation coefficient including the body, we will not find it useful in developing
is dependent on both position along the line and energy. In imaging equations for x-ray modalities. The energy
this case, the integral form of the attenuation law obeys 𝑆
�; � = dependence of �, while useful in helping to under-standing the
𝑥
𝑆0 � exp − 0‫ � � ׬‬′ ; � ��′ basic imaging properties, is intractable from a mathe-matical
standpoint. The concept of effective energy is more useful.

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Broad Beam Case

• Now consider the broad beam geometry in Figure 4.7(b), • When the slab is in place, photons previously directed at
which should be compared with the narrow beam geometry in the detector might be absorbed by photoelectric interactions
Figure or scattered by Compton events—just as they are in the
4.7(a).
narrow beam case.
• In (b), the x-ray beam is seven times wider and has 7N as
• However, there is an additional possibility here: photons from
many photons (the number 7 being used here for illustration
outside the detector’s line-of-sight geometry might get
purposes).
scattered toward the detector by Compton interactions.
• When the slab is removed, the detector, having the same
• Thus, in the broad beam case, more photons are generally
width as in (a), will detect only N photons, since the remaining
detected than is predicted by a monoenergetic, narrow
photons miss the detector.
beam analysis.

• The general attenuation law does not hold in this case, and • Therefore, from an imaging standpoint, the narrow
the assumption of straight propagation of x-rays is also beam geometry assumption can be viewed as fairly
violated. accurate.
• The photons that comprise the detected burst are no longer • We make the assumption of narrow beam geometry
monoenergetic, since the Compton scattering process throughout this book.
reduces photon energy.
• From the point of view of calculating the dose to the patient or
• In such a situation, the average or effective energy of the x- determining how much lead is needed to shield a radiologist
ray beam is reduced, a process called beam softening. or technician, however, broad beam geometry must be
• Fortunately, most x-ray imaging modalities use considered.
detector collimation, which reduces the number of x- • After all, there is no detector collimation on the
rays from nonnormal directions that can hit the ‘‘human detectors’’ involved in the imaging process.
detectors.

Radiation Dosimetry Exposure

• There are many ways to report the presence and amount • By definition, ionizing radiation is capable of ionizing
of radiation. the hydrogen atom.
• We have already described the ideas related to photon • Therefore, it is capable of producing ions in air.
and energy flow via fluence and intensity concepts.
• It is straightforward to build and calibrate an ionization
• We did so with a focus on the production of medical images. chamber that measures the current produced between two
• However, radiation also produces adverse biological effects. plates held at a fixed potential due to radiation producing ions
• Here, we are now more concerned with what EM radiation in the air between the two plates.
does than what it is.
• That is the essence of the concept of dose.

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Example 4.6
• The term exposure, which is given the symbol X, refers to the • For a point source of radiation, the exposure at a distance
number of ion pairs produced in a specific volume of air by d from the source follows an inverse square law.
EM radiation.
• Question If the exposure at d = 30 cm from a point source is 1
• The International System unit for exposure is coulombs per R, what is the exposure at d = 5 cm from the source?
kilogram of air (C/kg); however, a more useful unit in
medical imaging is the roentgen (R), which equals 2.58 × • Answer The exposure at d = 5 cm is 36 ((30/5)2 = 36) times
10−4 C/kg. The conversion between the two is 1 C/kg = that at d = 30 cm. So the exposure at d = 5 cm is X5 = 36X30 =
3,876 R. 36
R.

Dose and Kerma

• As ionizing EM radiation passes through a material, it • For the degree of accuracy required in biomedical
deposits energy into the material by both the photoelectric dosimetry, one roentgen of exposure yields one rad of
effect and Compton scattering. This is the concept of dose. absorbed dose in soft tissue.
• The unit of absorbed dose is the rad, defined as the • There is a another quantity closely related to dose, called
absorption of 100 ergs per gram of material. It is given the kerma, given the symbol K. Kerma is defined as the amount
symbol D. of energy per unit mass imparted directly to the electrons in a
• Notice that this unit refers to an energy-deposition given material. It is also measured in units of gray (Gy).
concentration rather than a total amount of energy. • As a practical matter, at diagnostic x-ray energies, kerma
• The SI unit for absorbed dose is the gray (Gy); 1 Gy = 1 J/kg = and dose are essentially equivalent.
100 rads.
• When kerma is being used in air for calibration purposes, it
is referred to as air kerma and is given the symbol Kair.

Linear Energy Transfer (LET) The f-Factor

• The linear energy transfer is a measure of the energy • It is often useful to be able to measure exposure but to
transferred by radiation to the material through which it is express the results as dose to an individual in that radiation
passing per unit length; higher LET radiation tends to field.
produce greater adverse biological consequences.
• Because of the way in which the roentgen and rad are
• Specific ionization (SI) is the number of ion pairs formed defined, a relationship between exposure in air and dose in air
per unit length. may be easily derived: 1 R = 0.87 rad.
• LET and SI are related to each other by the average amount • To compute the dose to a material other than air, the f-factor
of energy required to form one ion pair (often referred to as is used as a conversion, � = �𝑋
W), 𝜇 Τ 𝜌 m at er
which is a characteristic of the material. • The f -factor is defined as � = i al
0,87 �� air
Τ𝜌
• where μ is the linear attenuation coefficient and ρ is the mass
density of the material (numerator) and air (denominator).
The quantity (μ/ρ) is called the mass attenuation coefficient.

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Dose Equivalent
• We are all exposed to ionizing radiation, from cosmic • For example, the quality factor of x-rays, gamma rays,
rays, radioactivity in building materials and soil, and even electrons, and beta particles is Q ≈ 1, whereas that for
from radioactivity in our bodies. neutrons and protons is Q ≈ 10, and for alpha particles is Q ≈
• Although dose itself is a well-defined quantity, different types 20.
of radiation, when delivering the same dose, can actually have • Since Q ≈ 1 for radiation used in medical imaging,
different effects on the body. dose equivalent is equal to dose.
• In order to account for this, the concept of dose equivalent, • When D is measured in rads H is considered to have the
given the symbol H, is used. Dose equivalent is defined as units rems.
�
= ���, where Q is the so-called quality factor, a property • In SI units, the dose is measured in grays. For a dose of 1
of the type of radiation used. gray and Q = 1 the dose equivalent H is 1 sievert (Sv).

Example 4.7 Effective Dose

• Consider a chest x-ray at an energy of 20 keV. For • For the purpose of relating dose of ionizing radiation to risk,
simplicity ignore all tissues except the lung. an extension of the dose equivalent is used to express dose
• Question If we want to keep the absorbed dose below 10 mrads as that which would have been received if the whole body had
(i.e., 0.01 rads), what should be the limit on the exposure? been irradiated uniformly.
• Answer: From Table 4.6, we find that at 20 keV, • The effective dose is obtained as the sum of dose equivalents
• �Τ𝜌 air = 0,78 cm2 Τ� and �Τ𝜌 lung = 0, 83 cm2 Τ� to different organs or body tissues weighted in such a fashion
as to provide a value proportional to radiation-induced
somatic
• So the f-factor is � = 𝜇 Τ 𝜌 m at er 0,
= 0,87 83 = 0,93 and genetic risk even when the body is not uniformly irradiated.
0,87 i al
0,78
��Τ𝜌
air
• The absorbed dose is related to the exposure by (4.35). If we
want to limit the dose to be under 10 mrads, the exposure
must be under 10/0.93 = 10.8 mR.

• This can be expressed as �effective = σorgans �𝑗 �𝑗 • Medical imaging procedures produce doses over a wide
• where �effective is effective dose, �𝑗 is the dose equivalent range, depending on the specific procedure.
for organ ��, and �𝑗 is the weighting factor for organ ��. • At the low end, a typical chest x-ray might result in a dose of 3–
• The sum is over all organs; note that σorgans �𝑗 = 1 4 mrem; at the high end, a fluoroscopic study might
yield several rem.
• In this fashion, risks may be compared for different
radiations and different target tissues. • The main risk from ionizing radiation at the doses involved
in medical imaging is cancer production (radiogenic
• On average our annual individual effective dose (exclusive carcinogenesis).
of medical imaging procedures) is about 300 mrem.

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• In practice, we assume that any dose of radiation increases • Ionizing radiation is used in several imaging
the risk of getting cancer, with larger doses proportionately modalities, including projection radiography and CT.
increasing risk.
• The interaction of particulate radiation creates x-rays used
• Of importance, the physician and patient together usually in these modalities; the interaction of the x-rays in the
make the decision that the medical benefits of the imaging patient creates the radiograph.
procedure outweigh any potential risks.
1. Ionization is the ejection of an orbiting electron from an atom;
ionizing radiation has sufficient energy to produce ionization.
2. Ionizing radiation may be particulate or electromagnetic;
the main ionizing radiations of interest in medical imaging
are x- rays, gamma rays, energetic electrons, and
positrons.

3. Particulate ionizing radiation transfers energy via collisional 6. The probability of electromagnetic interactions depends on the
transfer and radiative transfer (which results in photon’s energy and the effective atomic number, density, and
bremsstrahlung x-rays). molecular weight of the material through which the EM
radiation passes.
4. The probability of radiative transfer increases with
increasing effective atomic number of the material through 7. Attenuation of the intensity of a beam of EM radiation by some
which the particulate radiation passes. material is described by a monoexponential relation and is a
function of the thickness of the material and the linear
5. EM ionizing radiation transfers energy in medical imaging attenuation coefficient, which itself depends on characteristics of
applications via the photoelectric effect or Compton the material and photon energy.
scattering. 8. Radiation dose to tissues is characterized by effective dose,
which itself includes considerations of deposited energy,
the biological effectiveness of a given ionizing radiation, and
the relative radiosensitivity of different tissues.

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‫ةمحرو مكيلع ملسلاو‬

Thank you for your attention!

Engineering is essentially a problem-

solving.

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