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    X-rays are one of the main diagnostical tools in medicine

    since its discovery by Wilhelm Roentgen in 1895.

    Current estimates show that there are approximately 650

    medical and dental X-ray examinations per 1000 patients per year.

    X-rays are produced when high energetic electrons

    interact with matter.

    The kinetic energy of the electrons is converted into

    electromagnetic energy by atomic interactions (see chapter 7.1.)

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    The X-ray tube provides an environment for X-ray production

    via bremsstrahlimgand characteristic radiation mechanisms.

    electron source

    electron acceleration potential

    target for X-ray production

    The classical X-ray tube requires:

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    The intensity of the electron beam determines the intensity

    of the X-ray radiation. The electron energy determines the shape of

    the bremsstrahlungs spectrum, in particular the endpoint of the

    spectrum. Low energy X-rays are absorbed in the tube material.

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    The X-ray energy determines also the emission of

    characteristic lines from the target material.

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    The major components of the modern X-ray tube are:

    cathode (electron source)

    anode (acceleration potential)

    rotor/stator(target device)

    glass/metal envelope (vacuum tube)

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    The figure shows a modern X-ray tube and housing assembly.

    Typical operation conditions are:

    Acceleration Voltage: 20 to 150 kV

    Electron Current: 1 to 5 mA (for continuous operation)

    Electron Current: 0.1 to 1.0 A (for short exposures)

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    The cathodeconsists of:

    a. a spiral of heated low resistance R tungsten wire (filament) for

    electron emission. Wire is heated by filament current I = U / R.

    ( U 10 V, I 3-6 A )

    Electrons are released by thermionic emission, the

    electron current is determined by the temperature which depends

    on the wire current. The electron current is approximately 5 to 10times less than the wire current.

    b. a focusing cup with a negative bias voltage applied to focus the

    electron distribution.

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    The anode is the target electrode and is maintained at a positive

    potential difference Vawith respect to the cathode. Electrons are thereforeaccelerated towards the anode: E = wVa

    Upon impact, energy loss of electrons takes place by scattering and

    excitation processes, producing heat, electromagnetic radiation and X-rays.

    0.5% of the electron energy is converted into X-rays.

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    Because of the relatively low X-ray production efficiency,

    most of the released energy comes in form of heat:

    heat generation is a major limitation for X-ray machines

    high melting point material with high X-ray output

    tungsten (high melting point) good overall radiative emission

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    molybdenum (high melting points) high emission of characteristic X-rays

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    The two majoranodeconfigurations are:

    The stationary anode is the classical configuration,

    tungsten target for X-ray production and copper block as heat sink

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    The rotating anode is a tungsten disc, large rotating surface

    area warrants heat distribution, radiative heat loss (thermally

    decoupled from motor to avoid overheating of the shaft)

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    The anode angle is defined as the angle of the target

    surface to the central axis of the X-ray tube.

    The focal spot size is the anode area that is hit by the

    electrons.

    effective focal length = focal length sinq

    The angle qalso determines the X-ray field size coverage. For

    small angles the X-ray field extension is limited due to absorption and

    attenuation effects of X-ray photons parallel to the anode surface.

    The anode angle qdetermines the effective focal spot size:

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    Typical angles are: q = Tto 20.

    A small angle in close distance is recommended for

    small spot coverage, a large angle is necessary for large

    area coverage.

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    The X-rays pass through a tube window (with low X-ray

    absorption) perpendicular to the electron beam.

    Usually the low energy component of the X-ray spectrum

    does not provide any information because it is completely absorbed in

    the body tissue of the patient. It does however contribute significantly

    to the absorbed dose of the patient which excess the acceptable doselimit.

    These lower energies are therefore filtered out by aluminum

    or copper absorbers of various thickness.

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    The minimum thickness d depends on the maximum

    operating potential of the X-ray tube but is typically d 2.5 mm for

    Va 100 kV

    The intensity drops exponentially with the thickness d:

    with eff

    as material dependent absorption coefficient.

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    The absorption coefficient is determined in terms of

    the Half-Value LayerHVLwhich is the thickness of a material

    necessary to reduce the intensity to 50% of its original value.

    The solution yields:

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    Graph showing how the intensity of an x-ray beam

    is reduced by an absorber whose linear absorption

    coefficient is = 0.10 cm1.

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    The spectral distribution of the X-rays can be defined by

    the appropriate choice of filters.

    The filter material depends on the energy range of the

    original X-ray distribution!

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    The influence of different filter combinations for a 200 kV

    X-ray spectrum is shown in the figure.

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    The X-ray beam size is limited by a collimator system, the

    collimators are lead for complete absorption.

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    Collimator design allows to optimize the point exposure!

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    The size of the collimator (object size) determines the

    geometric "unsharpness" (blurring) of the image.

    The blurring B in the image is given by:

    where a is the effective size of the collimator of the

    X-ray tube and m is the image magnification:

    The resulting geometric unsharpeness Ugis defined:

    Additional unsharpeness can be caused by the image

    receptor (grain size, resolution of the film, etc) and by movement of

    the object (restless person).

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    For general radiography purposes the geometric

    unsharpeness dominates the other components

    Therefore the unsharpeness will increase with increasingmagnification. To keep magnification small (close to m=1) requires

    the image receptor to be as close as possible to the patient and the

    focus patient distance to be large.

    Typical conditions are:

    a 1mm

    d1 1 m

    d2 10 cm

    110cm= =1.1100cm

    m

    1=1mm 1- =0.091mm

    1.1g

    U

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    For a close dental X-ray shot the conditions are:

    a 1mm

    d1 5 cm

    d2 1 cm

    6cm= =1.25cm

    m

    1=1mm 1- =0.167mm

    1.2

    gU

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    The radiographic image of the X-ray exposure is

    determined by the interaction of the X-rays which are transmitted

    through the patient with a photon detector (film, camera etc.)

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    Primary X-ray photons have passed through the patient

    without interaction, they carry useful information.

    They give a measure for the probability that a photon pass through

    the patient without interaction which is a function of the body tissue

    attenuation coefficients.

    Secondary photons result from interaction inside the patient, they

    are usually deflected from their original direction and carry therefore only

    little information. They create background noise which degrades the

    contrast of the image.

    Scattered photons are often absorbed in grids between the patient

    and the image receptor.

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    The two dimensional image I(x, y)of the three dimensional

    distribution of the X-ray attenuating body tissue of the patient can be

    described as a function of the initial photon intensity Nof energy E,

    the energy absorption efficiency of the image receptor(E)(film) and

    the attenuation coefficients which have to be considered along thephoton path in z-direction.

    with S(E)as distribution of the scattered secondary X-ray photons.

    The expression can be simplified to:

    with Ras the ratio of secondary to primary radiation.

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    As higher the attenuation coefficient, as larger absorption,

    as lower the final intensity of the image.

    For bone tissue the attenuation coefficient is considerably larger

    than for soft body tissue, therefore increased absorption.

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    The quality of the image can be assessed by a few physical parameters:

    radiographic contrast

    noise and dose

    CONTRAST OF THE IMAGE

    Consider that you want to image clearly a target tissue of thickness x

    with an attenuation coefficient 2 inside the body of thickness twith a lower softbody tissue attenuation coefficient 1

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    The contrast Cof the target tissue volume is defined

    in terms of the image distribution function I1and I

    2:

    I1gives the energy absorbed outside the target tissue

    I2

    gives the energy absorbed inside the target volume.

    Approximating for an X-ray energy E:

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    The expression can be simplified to:

    The contrast depends mainly on the difference of attenuation coefficients1 and 2as well as on the ratio of scattered to primary X-ray photons.

    As higher the ratio R (the number of scattered photons), as lower the contrast.

    Therefore it is important to understand and to reduce secondary

    scattered photon intensity to minimize R.

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    The number of scattered photons depends on several parameters:

    X-ray field size; an increase in field size increases R3.5

    Thickness of radiated volume (increase is roughly proportional

    with thickness due to increase in scattering events)

    X-ray energy dependence - decrease of scatter with increasing energy

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    To reduce the number of secondary scattered photons a

    led grid is typically between object and image receptor. Because

    scattered photons will not meet the grid at normal incidence, they

    will be absorbed by the grid stripes.

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    NOISE AND DOSE

    Even if the imaging system may have high contrast the noise

    level may prevent identification of the object.

    Two major noise components are:

    statistical fluctuations in the number of X-ray photons

    fluctuations in the receptor and display system

    Th fi t t f th i i ll d t i ll

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    The first component of the noise is called quantum noise can usually

    be reduced by increasing the number of photons used to form an image.

    What is the minimum surface dose required on a body of

    thickness t to see a contrast C for an object of size x over an area A

    against a background of pure quantum noise?

    The signal to be detect is:

    The image noise in an areaA results from a statistical Poisson processand can be derived as:

    This however will increase the dose absorbed by the patient which

    should be minimized.

    Thi i ld f th i l t i ti SNR

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    This yields for the signal to noise ratio SNR:

    An object becomes detectable if the SNRexceeds a threshold value of:

    At these conditions the number of incident photons Nfor the patient can

    be calculated to:

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    The absorbed dose D for the patient is determined by the

    number of photons per area N, the mass energy absorption coefficient

    for tissue (), and the photon energy E:

    The minimum dose required to visualize a fixed object increases with

    the fourth power of the object size.

    For a fixed dose and contrast there is a minimum object size which

    can be visualized.

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