RADIOLOGY IN VETERINARY

PRACTICE

GARRY D. LASAGA
Radiographic Equipment

 An x-ray machine
 A processing system
 A safe working protocol / protective clothing
 A film storage system
X-RAY MACHINES

 It is best to purchase one with as high a milliamperage

rating.
 Need for portability
 Power supply available
 Case load
 Small animal procedures = 50 - 80 kV
 Equine procedures = 100 -120 kV
3 Basic X-Ray Machines

1. Portable Machines
2. Mobile Machines
3. Fixed Installation Machines
Portable Machines

 Used due to relatively low purchase costs; can be

transported away from the practice.
 Low powered (approx. 20-60 mA); low output =
comparatively longer exposure times, making safety
and movement blur a problem when radiographing
larger patients or thicker structures.
Mobile Machines

 Larger and more powerful than portable machines.

 They have wheels and motors to move them from
room to room.
 They cannot be taken from the building or moved up
and down to different floor levels, as they are large,
heavy and cumbersome.
Mobile Machines

 Output: 300 mA; can produce very good radiographs

of small animal patients.
 More expensive than portables.
 Not really appropriate for equine hospitals.
Fixed Installation Machines
 The largest and most powerful type of machine and are
built into the room with the tube head able to move up
and down or across the room.
 Output: 1500 mA; easily cope with all current types of
veterinary radiographic procedures.
 High cost (approx. $100,000 - 250,000) – found in
specialist or equine practices.
Collimators
 Every machine must be fitted with a beam limiting device.
 It is an attachment to the opening in tube-head that
restricts the size and shape of field of the primary beam.
Cone: metallic cone-shaped structure that functions as a beam
restrictor
Coning: the action collimating the primary beam (i.e. same as
”collimating”)
Light beam diaphragm: adjustable device made of lead sheets in the x-ray tube head that
restrict primary x-ray beam.
SCREENS
 Device inserted into a cassette to convert the energy
of the x-ray photons into light photons, increasing the
efficiency of radiographic image formation and reducing
the x-ray exposure necessary to produce an image.
 Intensifying screen

Cassette: a re-useable, radiolucent, light-tight device, that

positions the x-ray film next to the intensifying screens
Types of Screens
 Calcium tungstate – emit blue light
 Rare earth – emit both blue and green light
Screen Maintenance
 Avoid dropping or scratching the films.
 Avoid exposure to chemical splashes and dust.
 Cleaned with commercial screen cleaner and
swabs.
FILM
 Made up of a plastic sheet coated on both sides
with photographic emulsion.
 As xrays pass through the film, both sides are
exposed simultaneously.
Screen Film
 Designed for use in cassettes with intensifying
screens.
 The density on the radiograph is produced when
the phosphor crystals fluoresce when irradiated.
Monochromatic Film
 Blue-sensitive film
 Used with calcium tungstate or blue light
emitting rare earth screens as it is sensitive only
to visible light in the blue part of the spectrum.
Orthochromatic Film
 Sensitive
to both blue and green light and is
used with green light emitting rare earth
screens.
Film Screen Combinations
 Make sure that the films and screens match.
 Ensure the film speed is adequate for your
needs.
 Fast screen-film combinations
 Slow screen-film combinations
Film Screen Combinations
 Second-hand cassette/screens are probably a
false economy as they do wear out.
 It is advisable to have several different sizes so
as not to waste film by radiographing small
areas on large plates.
FILM PROCESSING SYSTEMS
 The latent or invisible image on the exposed film must first
be made visible and permanent.
 (1) The film is passed into a developing solution to
convert exposed silver bromide crystals into black metallic
silver.
 (2) It is then rinsed and fixed, where any unexposed silver
halides are removed.
 (3) Finally the film is washed to remove any residual
processing chemicals and dried.
Manual or Wet Processing
 Becoming less common in veterinary practice.
 Disadvantages: time consuming, messy, open to human
error; it must be carried out in safe light conditions to
prevent fogging; it requires a large amount of work space.
 Requisite: drying cabinet or area where the films can
dry safely without contamination and without dripping onto
other areas.
Automatic Processing
 More expensive; they reduce the need for repeat
radiographs by maintaining consistent film quality, they are
very fast, producing dry films in approximately 90 - 120
seconds, thus saving manpower time, and use lower levels
of expensive processing chemicals.
 They need a smaller work area for film processing.
DARKROOM DESIGN
 Must be adequate is size.
 It must be light proof, and be lockable from the inside.
 It must have electricity, mains water, and drainage.
 It must be dry and have a constant temperature.
 Ventilation is important, with floor entry and ceiling exit to
outside.
DARKROOM DESIGN
 Walls, floor and ceiling should be painted white or cream
as this allows better reflection of subdued lighting.
 The walls should be washable and resistant to chemical
splashes.
 A darkroom should have a wet and a dry work area.
 These should be two distinct areas in order to stop
contamination and splashes from the wet to dry areas.
Dry Area
 The area where the unexposed film is stored.
 Unexposed radiographic film should be stored at a
temperature of 13°C & a humidity of 50%.
 KEEP AWAY FROM: (1) light, (2) heat, (3) radiation, (4)
radioactive substances, (5) chemicals and chemical fumes.
 Film should be stored upright so that the film is not able to
roll or bend and so that there is no pressure on the film.
Wet Area
 The area where the processing chemicals are mixed and
used.
 It should be easy to clean and protective aprons, gloves
and eye goggles should be available at all times.
 Processing chemicals should be stored in a cool, dark area
and stacked no more than two high.
Safe Lights
 Radiographic film is sensitive to normal light until fixed so
the dark room must be fitted with low intensity safe
lights.
 They must be at least 1.2 metres above the work area.
 Even safe lights are not completely safe over prolonged
exposure so make sure that you work quickly and
efficiently to avoid fogging.
PROCESSING THE FILM
 Developing the film renders the latent image visible and
permanent.
 It need to be done in relative darkness to avoid fogging
(blackening by exposure to white light).
Development
 PHENIDONE-HYDROQUINONE
 The main active ingredient of developer solutions.
 It converts exposed silver bromide crystals into minute black
metallic silver.
 This process is called REDUCTION and the developer is a
REDUCING AGENT.
Development
 Development takes a set amount of time, usually 3 - 5
minutes.
 Chemical or Development Fog
 It is usually carried out at about 20°C.
 Developer
deteriorates due to oxidation and will lead to
underdevelopment.
Development
 Developer needs to be changed completely every three
months.
 APPROPRIATE Gloves should be worn when handling
chemicals.
 Surplus developer on the wet film should not be
allowed to drain back into the developer.
Development
 Ten seconds of agitation in water removes excess
developer and prevents carryover of developer into the
fixing solution.
 The rinsing tank is located between the developer and
fixer so as to prevent cross contamination.
Rinsing
Fixing
 The process by which the image is made permanent.
 It removes unexposed silver bromide crystals and
renders the silver grains or image visible in normal
light.
Fixing
 SODIUM or AMMONIUM THIOSULPHATE
 Main ingredient of the fixing solutions.
 CLEARING TIME
 The time required to remove all the unexposed silver
bromide crystals converting the film from a milky
appearance to shades of black and white.
Rinsing
Washing
 Required to remove any residual chemicals which
would cause fading and yellow brown staining of
the film.
 Requires total immersion of the film in constantly
circulating water for 15 - 30 minutes.
Drying
 Carried out over a sink, in a dust free
environment with good air circulation.
 Warm, slow drying is preferable as hot drying
can cause streaking on the film.
RADIATION SAFETY AND
PROTECTION

GARRY D. LASAGA
TOPICS
 Radiation protection (animal and staff and public)
 Code of Safe Practice for the Use of X-rays in Diagnosis
(Veterinary)
X-Rays
 Ability to penetrate substances or tissues.
 They can be useful for diagnostic radiography.
 Can also have potential for harmful effects on all living
tissues.
Reasons for underestimation
 Invisible
 Painless
 Latent - effects may not be immediately apparent
 Effects are cumulative
 high dose - nuclear accident
 repeated small doses - veterinary radiography
Probabilities of Irradiation
1. Ionisation
2. Secondary ionization
3. Chemical change
4. Biological change – when a radiation-induced chemical
change causes abnormal cell behaviour.
Stochastic Effect
 Effects that occur at random, with the severity of the effect
being independent of the size of the dose.
 Disease incidence increases proportionally with dose (the
more dose the - the more disease) and there is no
threshold.
 There is no safe dose.
2 important Stochastic Effects
 Radiation-induced cancer (such as leukaemia)
 Genetic (hereditary) effects
Non-stochastic Effect
 Effects that can be related directly to the dose received.
 The effect is more severe with a higher dose a burn gets
worse as dose increases.
 It typically has a threshold below which the effect will not
occur.
 Examples: radiation skin burn, erythema, acute
radiation sickness
Somatic Effects
 Effects of radiation dose seen in the individual
(person/animal) who receives the agent.
 This will occur during the lifetime of the person.
 Examples: skin reddening, blood disorders, cataracts or
intestinal upset; such as cancer, leukemia
Genetic Effects
 Effects are cause by radiation-induced damage to the
genes or chromosomes in the ova or sperm by a radiation
dose to the gonads of a person or animal of reproductive
capacity.
 The radiation must be encountered pre-conception.
Genetic Effects
 The animal/person receiving the dose will not be affected
in their lifetime, however future generations may be.
 Mutations of genes and inherited abnormalities can occur
in future generations so take extra care if the animal is
young or is of valuable breeding stock.
Teratogenic Effects
 These are effects from radiation dose that are seen in the
offspring of the individual who received radiation while
pregnant.
 The radiation dose must be encountered during the
gestational period.
Basics radiation protection principles
1. Keep dose to a minimum - No maximum dose limit should
be exceeded.
2. Exposure to personnel should be kept to a minimum.
3. Unnecessary procedures should not be performed.
ALARA
 “As low as reasonably achievable”
 Justification: procedure must produce a positive benefit to
exposed individuals/ society. There must be valid clinical
indications.
 Limitation: radiation dose shall not exceed the max limits
set for that class of individuals.
The Patient
 Radiographs must be done only if absolutely necessary.
 The animal must be compliant which usually means
anaesthesia or sedation.
 The animal must be adequately prepared before the
radiographic procedures.
The Patient
 The minimum number of radiographs must be taken.
 Lead covering can be placed over the areas of the animal
not being x-rayed especially the reproductive organs.
The Equipment
 This must be serviced and maintained in proper working
order.
 The room & surroundings must be safe to conduct
radiographic procedures.
 Lead gloves/aprons must be available & handled carefully
to prevent damage & cracking.
The Equipment
 Thyroid shields that wrap around the neck & protect the sensitive
thyroid gland should be available.
 Portable x-ray equipment should never be held when taking a
radiograph. Stands should be used instead.
 X-ray film must be stored where it is cool, dry, free from radiation,
free from chemicals and chemical vapours, stored upright to avoid
pressure artefact damage to the emulsion. It should also be
labelled with dates so that it can be used before its expiry date
to accomplish optimum radiographs.
The Exposure
 This must only be taken when the animal is correctly
positioned.
 The kV must be kept as high as practicable for the
examination requested; considering the film/screen
combination.
 The production of scatter must be kept to a minimum by
coning down the primary beam preferably only to the
area of interest.
The Exposure
 The effects of scatter must be minimized by:
 Accurate collimation of the beam
 Use of a Grid – reduces the amount of scatter to reach the
film
 Inverse square law – distance from the beam is a safety
factor that helps to keeps you and other staff safe
Processing
 This must be standardized.
 Correct chemicals must be used and changed as often as
necessary.
The Staff
 Should perform regular and frequent safety checks of all
protective clothing such as gowns and gloves i.e. x-ray
them every 6 months.
 Restraint and positioning aids must be used to minimise
staff holding patients during radiography.
 Personnel must stand as far away as possible when the
exposure takes place.
The Staff
 Nopart of your body should ever be in the primary
beam even when protected by lead gowns or gloves.
 Whilean x-ray is being taken – limit the people in the
controlled area to only those who are absolutely
required.
The Staff
 Owners to hold their animals only if they are:
 necessary to the procedure
 over 18 years of age
 not pregnant
 not undergoing any form of radiotherapy
The Pregnant Radiographer
 The use of a wrap-around lead apron is preferred during
fluoroscopy while pregnant.
 “MAX Limit: Radiation Personnel: effective dose 20 mSv
/year over 5 years & 50mSv in one yr. “
 For women who declare themselves pregnant, a
maximum dose of 2 mSv at surface of abdomen over
remainder of the pregnancy”
The Pregnant Radiographer

CARDINAL RULES OF RADIATION PROTECTION:
MINIMIZE TIME, MAXIMIZE DISTANCE FROM THE
PRIMARY BEAM, USE AVAILABLE SHIELDING