Life & Death of a Photon (part 2)

The Little River Band

In part one of this article, we left off with the process of x-ray creation in the tube. Through the process of creating Brems and Characteristic radiation, we have an isotropic beam of x-rays being created at the rotating tungsten anode. Since the beam travels in all directions from the source, the x-ray tube housing is lined with lead to absorb x-ray photons that are traveling in directions that aren’t useful for diagnostics and to prevent unwanted and harmful leakage. The diagnostic x-ray beam is allowed to leave the tube housing through the window of the tube housing where it is directed at a patient subject. As the x-ray photons leave the tube housing through the window, there is some special beam filtration that takes place. When we discussed Brems radiation, we learned that the x-ray photos generated through this process are heterogenous, meaning that they have different levels of energy. Some of the photos do not have enough energy to be useful as diagnostic x-rays. These photons would simply be absorbed by the patient, adding to patient radiation dose and not contribute to diagnostic imaging in any way. Thin aluminum filters are added at this stage to absorb the low-energy photons. The size and shape of the beam leaving the x-ray tube is also controlled by collimators. These lead leaves allow the technician to modify the size and shape of the beam that interacts with the patient. The collimator leaves are made of lead, so they simply absorb additional radiation.

Primary Beam

At this stage of the x-ray process, we have the primary beam. The primary beam consists of x-ray photos that have left the tube housing but have not had any interactions with the patient. The primary beam has two important characteristics which are quantity of photons and the amount of energy they carry.

mAs

The quantity of x-ray photons in the primary beam is controlled by the mAs setting on the controller. mAs stands for milliamperes x time (in seconds). This refers back to the thermionic emission process at the filaments when electrons are boiled off in the x-ray tube. The milliamperage number refers to the number of electrons per second that flow from cathode to anode within the tube, and the time is the duration of that flow. You can consider the mAs setting to represent the total volume of photons that will be produced

kVp

Those photons that are produced at the cathode are pushed from the cathode to the anode by kilovoltage that is applied to the tube. The potential difference between the negatively charged cathode and the positively charged anode determines the velocity of the electron flow within the tube. Higher velocity electrons produce higher energy x-ray photons during their interaction with the tungsten atoms in the anode target. These higher energy photons have more penetrating ability than lower energy photons.

In brief summary of mAs and kVp, the mAs represents the volume of x-ray photons in the beam, and the kVp represents their penetrating ability.

Patient Interaction

Once our x-ray photons in the primary beam interact with the patient, one of three things will happen…

Transmission

The incoming x-ray photon may pass through the anatomy without interacting with any atoms in the body. When this happens, the photon passes directly through to the image receptor and becomes part of the diagnostic x-ray image.

Scatter

The incoming x-ray photon may interact with electrons in the anatomy. If the photon interacts with outer-shell electrons in the anatomy, the electrons will be ejected from their orbit and the photon will change direction and continue with less energy. The photon may or may not find its way to the image receptor after changing direction. If it does hit the image receptor, the exposure that it creates is unwanted and contributes to a phenomenon known as fog. The photon may also scatter in directions other than the image receptor. This scattered photon may also interact with other electrons in the body several times before it either becomes absorbed or leaves the body. At any rate, the scattered photon is not useful in the diagnostic imaging process. This process of scattering photons via interaction with outer shell electrons in the anatomy is known as the Compton Effect.

Absorption

The incoming x-ray photon may be completely absorbed within the body. Complete absorption occurs when the incoming photon ejects an inner-shell (K-shell) electron within the anatomy from its orbit. The incoming photon gives up all of its energy during this process. The ejected electron is called a photoelectron and the photon’s ability to eject this electron is known as ionization. This process is known as the photoelectric effect. When the inner shell electron is ejected from its orbit, an outer shell electron will cascade into the open space. This process gives off a second x-ray photon. This secondary photon is in the form of scatter radiation which may leave the patient or interact with other electrons.

The Secondary Beam

The secondary beam is the radiation that passes through the patient and strikes the image receptor. This beam consists of both transmitted and scatter radiation. Transmitted radiation passes directly through the patient and strikes the image receptor, exposing the film or digital sensor. This exposure creates dark areas on the film or digital image. The unexposed areas on the film or digital sensor are created by absorption of photons in the anatomy. When a photon is absorbed, that photon will not strike and expose the image receptor. The white or light colored areas on the radiograph represent areas of the anatomy that absorbed x-ray photons.

The secondary beam is responsible for creating the radiograph. There are a lot more details to be discussed about the radiation that exists in the secondary beam and how we manipulate that radiation through various technique changes. Contrast and density are the two primary photographic qualities of a radiograph. My next essay on this site will dig in to the processes of manipulating contrast and density…

Until then…

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Some Stumbling Points

Marilyn

I have encountered a few points of ‘distress’ in studying for my spinal series tests that come up later this morning. I’m not sure why I can’t wrap my mind around these concepts, but I’m having one hell of a time sorting out oblique x-rays of the spine. Our text book doesn’t seem to clarify this very well, but when I’m looking at a radiograph of an oblique cervical spine, how can I tell if I’m viewing an LPO, RPO, LAO, or RAO position?

Shortly after I started this program, I decided that I wanted to get a copy of the Merrill’s Atlas of Radiographic Positioning as a supplementary text since we weren’t using it in my program. We use Bontrager’s Textbook of Radiographic Positioning and Related Anatomy. I decided to pull out the Merrill’s Atlas to see what it had to offer for my current problem. What I discovered is that the RAO and LPO views look very similar and the RPO and LAO views look similar as well. The differentiation between the two is which side of the spine you are viewing. The oblique view of the cervical spine shows the intervertebral foramina. The anterior obliques show the foramina closest to the image receptor while the posterior obliques show the foramina farthest away from the IR.

  • RPO - shows patient’s left-side cervical spine intervertebral foramina
  • LPO - shows patient’s right-side cervical spine intervertebral foramina
  • RAO - shows patient’s right side cervical spine intervertebral foramina
  • LAO - shows patient’s left side cervical spine intervertebral foramina

In the thoracic spine obliques, the same should hold true.  In the oblique views of the thoracic spine, we are looking for the zygapophyseal joints. 

  • RPO - shows patient’s left side thoracic spine zygapophyseal joints
  • LPO - shows patient’s right side thoracic spine zygapophyseal joints
  • RAO - shows patient’s right side thoracic spine zygapophyseal joints
  • LAO - shows patient’s left side thoracic spine zygapophyseal joints

This situation takes a twist when we get down to the lumbar spine.  The lumbar obliques also show zygapophyseal joints.

  • RPO - shows patient’s right side lumbar spine zygapophyseal joints
  • LPO - shows patient’s left side lumbar spine zygapophyseal joints
  • RAO - shows patient’s left side lumbar spine zygapophyseal joints
  • LAO - shows patient’s right side lumbar spine zygapophyseal joints

The Merrill’s Atlas has markers on the radiographs that demonstrate the patient position.  The Bontrager book seems to avoid that.  The Bontrager book just tags the image as ‘oblique’ rather than giving a right or left indicator for some reason.  I’m finding things l like and dislike about each of these books as we progress.  Having both sets is handy.  I still cant’ seem to identify a radiograph as one position or the other without an extra set of clues.  In our radiograph reviews, it will state ‘prone’ or ’supine’ which tells us if it’s a posterior or anterior oblique.  I guess I’ll try to sort it out in the morning before the test…

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Life & Death of a Photon (part 1)

The Alabama Blues Brothers

Imaging factors and technique are starting to come together for me. Topics such as mA, time, and kVp don’t seem so complicated in the beginning, but they do get a little more complicated as the study continues.  Let’s take a look at how x-rays are produced and what happens to them from that point…

The Creation of an X-Ray

In the x-ray tube, the filament (small or large) is heated through the process of applying electrical current.  These filaments are located on the negatively charged cathode side of the tube.  These filaments are made of tungsten.  As they are heated, electrons from the tungsten atoms are boiled off through a process called thermionic emission.  These electrons that are boiled off form a cloud around the filament called a space charge.  The focusing cup around the filaments has a negative charge and forces the negatively charged electrons in the space charge to remain together. 

While thermionic emission is taking place, the rotor on the anode (positively charged) side of the tube spins the rotating anode target up to speed.  After the anode target (also made of tungsten) is spinning at full speed, kVp (kilovoltage) is applied across the tube from the cathode to the anode.  The application of this voltage creates a highly negatively charged cathode and a highly positively charged anode.  The high positive charge of the anode strongly attracts the negatively charged electrons that have formed on the cathode side of the tube.  When this potential difference occurs, the electrons that have been created in the space charge race from the cathode to the anode side of the tube.  Tube current is the term used to describe the flow of electrons from cathode to anode.  As electrons race from the cathode side of the tube, they crash into the rotating anode target.  The interactions during this ‘collision’ are where x-rays are formed.

The interactions between the speeding electrons and the tungsten atoms that make up the anode target are the source of x-ray photons.  There are two possibilities for the creation of an diagnostic radiation when the electrons interact with the tungsten atoms:

1. Bremsstrahlung (Brems) Radiaton

Brems radiation is created when the incoming electron passes close to the nucleus of the target tungsten atom.  The positive charge of the nucleus attracts the incoming electron causing it to change course and lose some speed.  When the electron slows down and changes course, it loses some of its energy.  This energy is lost by the electron in the form of heat and an x-ray photon.  The path that the x-ray photon takes is totally random.  The amount of energy the x-ray photon has depends on how much interaction it had with the tungsten nucleus.  The closer the electron passes to the nucleus, the more energy it will scrub off in the form of heat and the x-ray photon.  Heterogenous or polyenergetic are terms used to describe the varying energies of Brems Radiation. Isotropic is the term used to describe the path photons take when they are created.  They travel in all directions from the source. 

2. Characteristic Radiation

Incoming electrons may enter the tungsten atom and collide with an inner-shell (K-Shell) electron, causing the inner-shell electron to be ejected from its orbit around the nucleus.  This makes the tungsten atom unstable.  Electrons from the outer shells cascade in to fill the holes.  The energy difference created by the outer shell electron falling into the K-shell creates another x-ray photon.  Electrons from outer shells of the tungsten atom may also be ejected by the incoming electron.  These ejections also cause a cascade of electrons to fill the hole, but the energy of the x-ray photons created by those cascades are very low energy and not useful for diagnostic purposes.  Characteristic radiation differs from Brems radiation because the photon emitted when the outer shell electron drops in to fill the empty spot in the K shell is a known and fixed amount of energy.  The radiation created by this process is homogenous, but like Brems radiation, it is also isotropic.

The process of creating x-ray radiation is very inefficient.  99% of the energy harvested from the process is in the form of heat, while only 1% comes in the form of x-ray photons.  Since the generation of x-ray photons is isotropic (spreading in all directions), a lot of the radiation is absorbed by the protective lead lining of the x-ray tube.  The diagnostic portion of the radiation exits the tube through the tube window.  The collimator in the tube is used to shape the beam leaving the tube to the desired dimensions. 

… to be continued …

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Photoelectric and Compton Effect

Photoelectric Effect

As photons that make up the primary x-ray beam pass into the body, some of them will be completely absorbed by the body, which means they do not pass through to the image receptor.  This complete absorption of the photon happens when it has enough energy to eject an inner-shell electron from the atom it comes into contact with.  The ejected electron is called a photoelectron and the ability to remove these electrons is known as ionization.  This interaction of the x-ray photon and the inner-shell electron of the atom is known as the photoelectric effect.  The ejection of the inner-shell electron causes the atom to become unstable, and an electron from an upper-level shell will drop down into the inner shell to fill the vacancy.  The outer shell electron that falls into the inner shell to fill the void must give up some of its energy to make the transition.  The energy that it gives up is in the form of a secondary x-ray photon.  This secondary x-ray photon is classified as scatter radiation which may exit the patient or interact with other tissue electrons.

Compton Effect

An x-ray photon may not be absorbed as it passes through the body.   It may, however, lose energy when it interacts with atoms in the body tissues.  This process creates scatter radiation and is known as the Compton effect.  When a photon ejects an outer shell electron from an atom, the ejected electron is called a Compton electron or a secondary electron.  The original x-ray photon loses some of its energy and changes direction.  It may continue to interact with other atoms, and it may pass through the anatomic part to interact with the image receptor.  Compton interactions occur within all diagnostic x-ray energies.

Notes:

  • The main difference between the Photoelectric effect and Compton effect is that in the photoelectric effect, the original photon gives up all of its energy when it comes into contact with the inner-shell electron.   In the Compton effect, the original photon only gives up part of its energy when encountering an outer-shell electron.
  • Photoelectric interactions generally decrease at higher kVp.
  • Compton interactions generally increase at higher kVp.

Transmission occurs when when the incoming x-ray photon passes through the body without any interactions with the anatomic structures.  More transmission occurs at higher kVp.