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X-ray Imaging

George Zouridakis, Ph.D.

Professor and Director
Biomedical Imaging Lab

University of Houston

http://biomed.uh.edu
[email protected]

Notes based on copyrighted material by Drs. G Zouridakis, KK Shung, MB Smith, BM Tsui, S Sha, AC Bovik, IA Kadadiaris, AC Papanikolaou, A Webb, RC Gonzales, RE
Woods and other sources on the Internet. They are provided free of charge for personal use only. Please do not distribute.
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X-Ray Imaging
- original field from which medical imaging developed
- most commonly employed form of imaging
- typically still images
- "movies" and can also be done
- often used to complement other kinds of imaging

X-ray films
- show different body features in various shades of gray
- darker in areas that do not absorb x-rays well (soft
tissue)
- lighter in dense areas that absorb x-rays better (like
bones)
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What are these x-rays?

- X-rays are a form of EM energy, like radio waves or light

- EM radiation
- stream of massless particles
- each particle
- travels in a wave-like pattern
- moves at the speed of light
- contains a certain amount of energy called a photon
- all EM radiation consists of these photons

Thus,

• To explain EM propagation we need dual concept of

wave and particle

• Only difference among various types of EM radiation is amount of energy in photons

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EM Spectrum

The higher the frequency the higher the energy

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X-rays as waves
• Wave parameters
- electric field
- magnetic field
- dielectric constant
- other EM properties of medium

• Wave properties
Electric field Φ function of space and time controlled by

Wave Equation
∂2Φ = µε ∂2Φ
∂x 2 ∂t 2
with
€
µ: permeability of the medium
ε: permittivity of the medium
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Particular solution

Φ(x,t) = Φ 0 cos(ωt − kx)

with

x: distance traveled by the wave

t: time elapsed €
ω: angular velocity
k: wave number

• Above equation valid for monochromatic radiation only.

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Definitions

Period T: time necessary for one complete cycle

Wavelength λ: distance traveled during one cycle

Thus
Tc = λ
with
c: speed of light (3 × 108 m/sec in vacuum)
Also
and λ=
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X-rays as particles

• Particle Properties
- x-rays travel at the speed of light
- carry energy given by

E = hf

- h: Plank constant = 4.13 × 10-18 keV-sec

- f: frequency
- 1 eV = 1.6 × 10-19 Joules

• Particle names
quanta, bundles, or photons.
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Composition of an Atom
• Atom composed of
- Electrons, negative charge
- Protons, positive charge
- Neutrons, no charge
• Electrons orbit around the nucleus.
• Nucleus is the core of an atom and is composed of nucleons.
• Protons and neutrons are nucleons and have the same mass (1.67x10-24g)
• The mass of an atom and subatomic particles is given in atomic mass units (amu).
• When an atom is balanced
- total number of electrons (- charge) equals the total number of protons (+ charge)
- atom is neutral.
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• Atomic number: number of protons in the nucleus (equal to total positive charge).
• Atomic mass: The total number of nucleons (protons and neutrons).
• Isotopes: Atoms having the same atomic number but different mass numbers.
• Atomic mass on periodic table is the average of all known isotopes of that element.
• Principle Quantum Number ‘n’
n = energy shell (integer values from +1 to ∞)
• The QN ‘n’ has the same interpretation as in the Bohr model: it defines the distance from the
nucleus at which an electron’s density probability is at a maximum.
• In some texts these shells are denoted by letters.
n = 1 ---> K 2 ---> L 3 ---> M etc.
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How X-rays Interact with Matter

• Ionizing radiation
Photons
- can ionize an atom or molecule
(i.e., knock an electron out of its orbit)
- if their energy level is greater than a few eV.

• There are five ways by which x-rays interact with matter:

- Coherent Scattering
- Photoelectric Effect
- Compton Scattering
- Pair Production
- Photodisintegration

• In diagnostic (medical) imaging only first three interactions can occur.

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1) Coherent Scattering
- occurs in low energy radiation
- incident photon deflected
- not enough energy to
- move electron out of orbit or
- cause ionization
- usually negligible in diagnostic imaging
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2) Photoelectric Effect
• incident x-rays
- energy higher than K-shell binding energy
- collide with orbital electron
• photon absorbed; energy given up
• electron (photoelectron) ejected from its orbit
• atom becomes a positive ion
• outer shell electron moves to fill vacancy
• (lower energy state)

Photoelectron energy = K-shell binding energy + kinetic energy

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Accompanying Phenomena: Two Possibilities

a) Characteristic radiation
• vacancy filled by outer shell electron
• fluorescent radiation
- form of x-ray photon
- energy equal to difference in energy levels
• more desirable
• heavier atoms (higher atomic number)

b) Auger Effect
• vacancy filled by outer shell electron
• excess energy transferred to other orbital electron which escapes
• can produce characteristic radiation or Auger effect
• lighter atoms
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Photoelectric Effect
• Always yields three products
- characteristic radiation or Auger electrons
- a negative ion (photoelectron)
- a positive ion (the rest of the atom)

• Most desirable in x-ray imaging

• Photon completely absorbed
• Little scattered radiation
- scattered radiation health hazard
- image noise
- less desirable

Conditions for photoelectric effect

- Photon energy > electron energy
- maximum probability when photon energy approaches energy of orbital electrons
- probability ∝ (atomic number)3 ×
- plot shows sharp maxima at binding energies
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3) Compton Scattering
- incident x-ray collide with orbital electron
- electron ejected from its orbit
- photon
- partially absorbed
- deflected (scattered) by electron

Energy retained Escat by scattered photon depends on:

- initial photon energy
- binding energy of orbital electron
- scattering angle ϑ
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Einc
Escat = E
Einc: energy of incident photon
1+ inc2 (1− cos ϑ ) Escat: energy of scattered photon
mec me: electron rest mass ~ 511 keV

Let us rewrite above equation:

€
Escat = 1
1 +1−cosϑ
Einc mec2
Case 1:
€
Einc is small, i.e., energy carried by incident photon low:
Einc → 0 ⇒ → ∞,

Thus,
(negligible) <<

So,
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Einc is independent of angle ϑ ⇒ Isotropic scattering

That is,
scattered photons carry same energy in all directions.

Same phenomenon observed in waves when wavelength when

λ >> (size of scatterer).

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Case 2:

Einc is large, i.e.,

Einc → ∞ ⇒ → 0,

Thus,
>> (negligible)

So, ϑ → 0 ⇒ Escat → ∞

Anisotropic scattering:
photons scattered in small angles or in the forward direction carry higher energy.
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Intensity of x-ray beam

1. Defined as power per unit area of the beam
power
intensity =
area
2. Depends on
€ - number of photons per unit area
- energy of photons
3. Measured in Roentgen (R), rad, or gray

• Roentgen = {power of beam} × { time of exposure}

• rad (Radiation Absorbed Dose)

- amount of radiation absorbed
- accounts for different absorption characteristics of different materials
• gray (Gy) = 100 rads
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Attenuation of x-rays
- x-ray beam hits a block of material
- x-ray intensity decreases due to interaction with atoms
- x-ray intensity: I
- cross-section area: A
- atom cross section: σ
- # atoms per unit area: n

total area occupied by atoms

probability of interaction =
area of beam
(# of atoms encountered)• area of atom
=
area of beam
n• A • σ
=
A
= n• σ

Probability of interaction
€ - depends on the properties of the material being radiated
- related to energy loss by (attenuation of) the x-ray beam
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Energy loss (attenuation) dI in thickness dx proportional to product

{probability of interaction} × {initial intensity} × {thickness}

⎫
dI I (x) = c 0 + e−nσx ⎪
dI = −{nσ }{I}{dx} ⇒ = −nσdx ⇒ ⎬ ⇒ I (x) = I 0e−nσx
I I (0) = I 0 ⎪⎭

Define
nσ = β
Thus,

I(x)= I0e−βx

β: linear attenuation coefficient

€

- β represents the energy lost per unit thickness per unit intensity.
- x is the propagation length.
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Half-value layer
The propagation length to reduce the intensity of a beam by half is called half-value layer
(HVL)

0.693
HVL = β

€
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Use of , instead of β, makes attenuation of matter independent of physical state, i.e.,

solid, liquid, or gas.

η: mass density
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Diagnostic Range of X-rays

• Photons interact with matter through
- Compton scattering
- Photoelectric effect
• Coherent scattering negligible

• Thus, attenuation of incident beam primarily due to

- scattering
- absorption

Rate of attenuation is given by coefficient β in I(x)= I0e−βx

β can be expressed as the sum of two parts
β = βs + βa €

with
βa: absorption coefficient
βs: scattering coefficient

Discussion valid also for , the mass attenuation coefficient.

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Question 1:
What factors determine the attenuation properties of a given material?

Answer:

Equation I(x)= I0e−βx gives the following factors:

I0: - initial photon energy, since
€
energy
power energy
intensity = = time =
area area time × area

β: - atomic number Z
€ - density of material
- electron density

x: - thickness of material
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Question 2:
Relative importance of scattering vs. absorption?

Answer:
Can also write β as:

β = β coh + β pho + β com

Can show

Z2
β coh ≈η
• E with Z: atomic number
- Thus, the higher the E, the less significant βcoh
€ - Insignificant in medical imaging
Z3
β pho ≈η 3
• E
ρe N Z
β com ≈ η = η AV
• E Am E with
€

€
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Compton scattering:
• Responsible almost exclusively for scattered energy in medical x-rays
• Background noise on film
• Safety hazard because scattered photons carry high energy
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X-Ray Generation
X-rays are generated when high-energy electrons strike a target, such as tungsten or
molybdenum.

High Energy Electrons

 

General or white radiation Characteristic radiation

interaction with nucleus interaction with orbital
electrons
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X-Ray Generation
→
Current i flowing through tungsten filament increases the temperature so that some
electrons acquire enough energy to leave the wire to form a cloud close to the filament.
€
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Question: where do these electrons go?

Nowhere: They stay close to the wire because the filament now is positive and the cloud is
negative so there is a balance between the escape and attraction forces
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So, to move these free electrons just need a more positive potential (anode) wrt the wire
(cathode.)
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Schematic Diagram of X-Ray Generator

• Anode is slanted
• Anode is rotating disk
• Electrode focal spot
• Apparent focal spot
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X-Ray Generator Tube

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Factors Affecting x-ray intensity

- Filament temperature (controlled by
filament current, If)
- Tube voltage (Vanode – Vcathode), kVp
- Tube current, mA
- Target (anode) material, Z

I = (material) (tube current) (tube voltage)2 (rectification factor)

I = Z (mA) (kVp)2 F
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X-ray Filtering and Beam Forming

Grid removes noise from scattered x-ray photons

Scattered x-ray photons

- degrade image quality
- increases patient exposure

Grid consists of series of lead strips separated

by x-ray transparent material

Grid ratio h/g

The higher the ratio, the more efficient the
grid in removing noise.
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Image Intensifier

Components:
1) Input Fluorescent Screen
- phosphor
- cathode

2) Focusing plates
3) Anode
4) Output Fluorescent Screen
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Taking X-Ray Images

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1)
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2)
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3)
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4)

Example based on the classic type of tube.

Today's tubes are actually more complicated
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X-ray Recording Media

Photographic Film
Transparent plastic substrate coated on both sides
with light- sensitive emulsion

Main components
- silver bromide
- silver halide crystals
- gelatin

silver bromide crystals + photon → free electron

free electron + silver ion → silver atom (which is black)

Optical Density: Film blackness D = log10( Iincident/Itransmitted)

Characteristic Curve: relationship between optical density and film exposure

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Radiation Detectors

Scintillation Detector

- scintillation crystal
- crystal ( ⇒ photons)
- reflective material
- photomultiplier tube
- photocathode ( ⇒ electrons)
- dynodes ( ⇒ electrons)
- anode
- efficient device (>85%)
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⇓
x-rays
⇓

light photons
⇓
Vcath = 0

photo-electrons
⇓
Vdynode >> Vcath
Number of electrons
• multiplied during propagation
• proportional to number of photons
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Solid State Detector

Ionization Chamber Detector

- chamber filled with gas (Xenon)
- gas molecules ionized by x-rays
- ions attracted to electrodes
- current adjusted to represent x-ray energy
- inefficient, yet cheap
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Direct vs. Indirect Capture

Screen-film systems
Step 1: X-ray photons exit the anatomy and pass through the phosphor in the intensifying
screens which absorb incident x-ray energy and fluoresce during exposure.
Step 2: The emitted light exposes the film emulsion creating a latent image. Some light
energy scatters and can degrade image sharpness.
Step 3: The latent image is made visible by developing the film.

Direct Tecnology
• X-ray photons exit the anatomy and are captured directly as digital signals by the detector
array. The digital signals appear as an image on a monitor and can be output to film.
• No phosphors, no scintillators, no light to diffuse or scatter, nothing to degrade the quality
of the digital signal.
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.
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DirectRay Image
Note the pathology on
the index finger tip.
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Clinical Applications
• Radiography • Cardiology
• Fluoroscopy (barium) • Mobile C-Arm
• Angiography • Mammography

Visibility in some x-ray exams can be improve using contrast, i.e., substances introduced into
the patient by
- swallowing
- injection
- enema.

Types of Diagnostic X-Ray Exams

Most tests do not require special preparation on the patient’s part
e.g., chest X-rays, while some others do

- Myelogram - IVP (Intravenous

- Hysterosalpingogram Pyelogram)
- Barium Enema - Lumbar Puncture
- GI Series
- Gall Bladder Exam
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Radiography
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Fluoroscopy

Mobile C-Arm
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GI Series
• Barium contract
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Angiography
• Iodine contrast
1. ionic agents (cheaper, but
occasionally may give allergic
reaction)
2. nonionic agents (safer, but much
more expensive)
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Other Examples
Myelogram Hysterosalpingogram
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Digital Radiography
• similar to traditional medical x-ray
• internal features of object superimposed in
image.
• images called projection radiographs
• x-ray source and detectors move linearly
along object
or object can move past the source and
detectors
• much higher contrast resolution
detectors 65,000 intensity (gray) levels
• digital image enhancements
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Dual-Energy X-Ray Systems

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Dual-Energy X-Ray Systems in Medicine

• High and low energy levels employed

• Metals and heavy elements absorb low X-ray energy
• Light/organic materials absorb high X-ray
• Energies of 75 kVp and 150 kVp
• Automatic classification in 3 categories:
organic, mixed, and metallic
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Research Opportunities
• Development of electronic planar array detectors with adequate
resolution, size, reliability, and efficiency.

• Development of digital display systems of sufficient resolution

and dynamic range.

• Development of means to detect and use the information in

scattered radiation, including mathematical correction schemes.

• Re-evaluation by physicists of the prospects for monochromatic

sources, novel x-ray generation techniques, and holographic
methods, ambitious research directions that have been resistant to
progress.