6 PART I Foundations

target in an x-ray tube is to convert the kinetic energy of the col- • Provide a low-voltage current to heat the x-ray tube filament.
liding electrons into x-ray photons. The target is made of tungsten, • Generate a high potential difference to accelerate electrons
an element that has several characteristics of an ideal target mate- from the cathode to the focal spot on the anode. The x-ray tube
rial, including the following: and two transformers lie within an electrically grounded metal
• High atomic number (74) housing called the head of the x-ray machine.
• High melting point (3422°C)
• High thermal conductivity (173 W · m−1 · K−1) Tube Current
• Low vapor pressure at the working temperatures of an x-ray tube The filament transformer (Fig. 1-10) reduces the voltage of the
The conversion of the kinetic energy of the electrons into x-ray incoming alternating current (AC) to about 10 volts in the filament
photons is an inefficient process with more than 99% of the elec- circuit. This voltage is regulated by the filament current control
tron kinetic energy converted to heat. A target made of a high (mA selector), which adjusts the resistance and the current flow
atomic number material is most efficient in producing x rays. through the filament; this regulates the filament temperature and
Because heat is generated at the anode, the requirement for a target the number of electrons emitted by the cathode. The tube current
with a high melting point is clear. Tungsten also has high thermal is the flow of electrons through the tube—that is, from the cathode
conductivity, readily dissipating its heat into the copper stem. filament across the tube to the anode. Beyond the anode, this
Finally, the low vapor pressure of tungsten at high temperatures current is carried through the power supply back to the cathode.
helps maintain the vacuum in the tube at high operating tempera- The numerical mA setting on the filament current control refers
tures. The tungsten target is typically embedded in a large block
of copper. Copper, also a good thermal conductor, removes heat
from the tungsten, reducing the risk of the target melting. Addi- Glass tube Anode Stator
tionally, the insulating oil between the glass envelope and the (sectioned)
housing of the tube head carries heat away from the copper stem.
The focal spot is the area on the target to which the focusing
cup directs the electrons and from which x rays are produced. The
sharpness of a radiographic image increases as the size of the focal Rotor
spot decreases (see Chapter 6). However, the heat generated per
unit target area becomes greater as the focal spot decreases in size.
To take advantage of a small focal spot while distributing the
electrons over a larger area of the target, the target is placed at an Focusing cup
angle to the electron beam (see Fig. 1-8). The apparent size of the Filament Focal spot
focal spot seen from a position perpendicular to the electron beam
Electron stream
(the effective focal spot) is smaller than the actual focal spot size.
Typically, the target is inclined about 20 degrees to the central ray X-ray beam
of the x-ray beam; this causes the effective focal spot to be approxi-
mately 1 mm × 1 mm, as opposed to the actual focal spot, which FIGURE 1-9 X-ray tube with a rotating anode allows heat at the focal spot to spread out
is about 1 mm × 3 mm. This smaller effective focal spot results in over a large surface area (dark band). Current applied to the stator induces rapid rotation of
a small apparent source of x rays and an increase in the sharpness the rotor and the anode. The path of the electron beam is shown in yellow, and the useful x-ray
of the image (see Fig. 5-2), with a larger actual focal spot size to beam is shown in blue.
improve heat dissipation. This type of anode is a stationary anode
because it has no moving parts.
Another method of dissipating the heat from a small focal spot kVp selector
is to use a rotating anode. In this design, the tungsten target is in
the form of a beveled disk that rotates when the tube is in opera- Timer
tion (Fig. 1-9). As a result, the electrons strike successive areas of X-ray tube
the target, widening the focal spot by an amount corresponding AC power kVp mA
to the circumference of the beveled disk, distributing the heat over supply
this extended area. The focal spot of a stationary tube is now a
focal track in rotating anode machines. Narrow focal tracks in
rotating anode tubes can be used with tube currents of 100 to 500 High-voltage
Filament
milliamperes (mA), which is 10 to 50 times that possible with transformer
transformer
stationary targets. The target and rotor (armature) of the motor lie
within the x-ray tube, and the stator coils (which drive the rotor
at about 3000 revolutions per minute) lie outside the tube. Such
rotating anodes are not used in intraoral dental x-ray machines but
Autotransformer mA selector
are occasionally used in cephalometric units; are usually used in
cone-beam machines; and are always used in medical computed FIGURE 1-10 Schematic of dental x-ray machine circuitry and x-ray tube with the major
tomography x-ray machines, which require high radiation output components labeled. The operator selects the desired kVp from the autotransformer. The voltage
for longer, sustained exposures. is greatly increased by the high-voltage step-up transformer and applied to the x-ray tube. The
kVp dial measures the voltage on the low-voltage side of the transformer but is scaled to display
POWER SUPPLY the corresponding voltage in the tube circuit. The timer closes the tube circuit for the desired
The primary functions of the power supply of an x-ray machine exposure time interval. The mA dial measures the current flowing through the tube circuit. The
are to: filament circuit heats the cathode filament and is regulated by the mA selector.
 C H A P T E R 1 Physics 7

to this tube current, typically about 10 mA, which is measured by cathode. When the polarity of the voltage applied across the tube
the milliammeter. This current is not the same as the current causes the target anode to be positive and the filament to be
flowing through the filament to heat it. negative, the electrons around the filament accelerate toward the
positive target, and current flows through the tube (Fig. 1-11, B).
Tube Voltage As the tube voltage is increased, the speed of the electrons
A high voltage is required between the anode and cathode to give moving toward the anode increases. When the electrons strike the
electrons sufficient energy to generate x rays. The actual voltage focal spot of the target, some of their energy converts to x-ray
used on an x-ray machine is adjusted with the autotransformer photons. X rays are produced at the target with greatest efficiency
(see Fig. 1-10). By using the kilovolt peak (kVp) selector, the opera- when the voltage applied across the tube is high. Therefore the
tor adjusts the autotransformer and converts the primary voltage intensity of x-ray pulses tends to be sharply peaked at the center
from the input source into the desired secondary voltage. The of each cycle (Fig. 1-11, C). During the following half (or negative
selected secondary voltage is applied to the primary winding of half) of each cycle, the filament becomes positive, and the target
the high-voltage transformer, which boosts the peak voltage of becomes negative (see Fig. 1-11, B). At these times, the electrons
the incoming line current (110 V) up to 60,000 to 120,000 V (60 do not flow across the gap between the two elements of the tube.
to 120 kV); this boosts the peak energy of the electrons passing This half of the cycle is called inverse voltage or reverse bias (see
through the tube to 60 to 120 keV and provides them sufficient Fig. 1-11, B). No x rays are generated during this half of the voltage
energy to generate x rays. The kVp dial selects the peak operating cycle (see Fig. 1-11, C). When an x-ray tube is powered with
voltage between the anode and cathode. Typically, intraoral, 60-cycle AC, 60 pulses of x rays are generated each second, each
panoramic, and cephalometric machines (see Chapter 10) operate having a duration of 1120 second. This type of power supply cir-
between 60 and 90 kVp, whereas cone-beam computed tomo- cuitry, in which the alternating high voltage is applied directly
graphic machines (see Chapter 11) operate at 90 to 120 kVp. across the x-ray tube, limits x-ray production to half the AC cycle
Because the polarity of the line current alternates (60 cycles per and is called self-rectified or half-wave rectified. Almost all
second), the polarity of the x-ray tube alternates at the same fre- conventional dental x-ray machines are self-rectified.
quency (Fig. 1-11, A). Additionally, because the line voltage varies Some dental x-ray manufacturers produce machines that replace
continuously, so does the voltage potential between the anode and the conventional 60-cycle AC, half-wave rectified power supply
with a full-wave rectified, high-frequency power supply. This results
in an essentially constant potential between the anode and cathode.
The result is that the mean energy of the x-ray beam produced by
+110V these x-ray machines is higher than the mean energy from a con-
ventional half-wave rectified machine operated at the same voltage.
Line voltage (V)

For a given voltage setting and radiographic density, the images

resulting from these constant-potential machines have a longer
A
contrast scale, and the patient receives a lower dose compared with
conventional x-ray machines.
Figure 1-11, C, also shows that the tube current is dependent
-110V on the tube voltage; as the voltage increases between the anode
and cathode, so does the current flow. The reason for this is subtle.
1/ 1/ 3/ When the hot filament releases electrons, it creates a cloud of
120 sec 60 sec 120 sec
electrons around the filament, a negative space charge. This nega-
Anode voltage (kV)

+70kV tive space charge impedes the further release of electrons. The
higher the voltage, the greater the removal of the electrons from
B the space charge, and the greater the tube current.

TIMER
Inverse voltage
(reverse bias) A timer is built into the high-voltage circuit to control the duration
-70kV of the x-ray exposure (see Fig. 1-10). The electronic timer controls
the length of time that high voltage is applied to the tube and the
time during which tube current flows and x rays are produced.
X-radiation intensity However, before the high voltage is applied across the tube, the
Tube current (mA)

10
X-ray intensity

Tube current
filament must be brought to operating temperature to ensure an
adequate rate of electron emission. Subjecting the filament to
C continuous heating at normal operating current shortens its life.
To minimize filament damage, the timing circuit first sends a
Time current through the filament for about half a second to bring it to
One impulse
the proper operating temperature and then applies power to the
1/ 1/ 3/ high-voltage circuit. In some circuit designs, a continuous low-level
120 sec 60 sec 120 sec
current passing through the filament maintains it at a safe low
FIGURE 1-11 A, A 60-cycle AC line voltage at autotransformer. B, Voltage at the temperature, further shortening the delay to preheat the filament.
anode varies from zero up to the kVp setting (70 kVp in this case). C, The intensity of radiation For these reasons, an x-ray machine may be left on continuously
produced at the anode (blue) is strongly dependent on the anode voltage and is highest when during working hours.
the tube voltage is at its peak. (Modified from Johns HE, Cunningham JR: The physics of radiol- Some x-ray machine timers are calibrated in fractions of a
ogy, ed 3, Springfield, IL, 1974, Charles C Thomas.) second, whereas others are expressed as number of pulses in an
8 PART I Foundations

Bremsstrahlung photon
of maximal energy
e e Altered path of deflected
decelerated electron
e e

e e
A B
e
e e

e Incident high- e

Incident high- e energy electron e

e
Bremsstrahlung photon
energy electron
of lower energy

Direct-hit interaction Near-miss interaction

FIGURE 1-12 Bremsstrahlung radiation is produced by the direct hit of an electron on a nucleus in the target (A) or, much more
frequently, by the passage of an electron near a nucleus, which results in electrons being deflected and decelerated (B). For the sake of
clarity, this diagram and other similar figures in this chapter show only the 1s, 2s, or 3s orbitals.

exposure (e.g., 3, 6, 9, 15). The number of pulses divided by 60

(the frequency of the power source) gives the exposure time in

Relative number of photons

seconds. A setting of 30 pulses means that there will be 30 pulses
of radiation, equivalent to a 0.5-second exposure.
Characteristic
TUBE RATING AND DUTY CYCLE radiation
X-ray tubes produce heat at the target while in operation. The heat
buildup at the anode is measured in heat units (HU), where HU
= kVp × mA × seconds. The heat storage capacity for anodes of Bremsstrahlung radiation
dental diagnostic tubes is approximately 20 kHU. Heat is removed
from the target by conduction to the copper anode and then to
the surrounding oil and tube housing and by convection to the 10 20 30 40 50 60 70
Photon energy (keV)
atmosphere.
Each x-ray machine comes with a tube rating chart that describes
FIGURE 1-13 Spectrum of photons emitted from an x-ray machine operating at 70 kVp.
the longest exposure time the tube can be energized for a range of
The vast preponderance of radiation is bremsstrahlung (blue), with a minor addition of charac-
voltages (kVp) and tube current (mA) values without risk of damage
teristic radiation.
to the target from overheating. These tube ratings generally do not
impose any restrictions on tube use for intraoral radiography.
However, if a dental x-ray unit is used for extraoral exposures, it is this happens, all the kinetic energy of the electron is transformed
wise to mount the tube-rating chart by the machine for easy refer- into a single x-ray photon (Fig. 1-12, A). The energy of the resultant
ence. Duty cycle relates to the frequency with which successive photon (in keV) is numerically equal to the energy of the electron—
exposures can be made without overheating the anode. The inter- that is, the voltage applied across the x-ray tube at that instant.
val between successive exposures must be long enough for heat More frequently, high-speed electrons pass by tungsten nuclei
dissipation. This characteristic is a function of the size of the with near or wide misses (Fig. 1-12, B). In these interactions, the
anode, the exposure kVp and mA, and the method used to cool electron is attracted toward the positively charged nuclei, its path
the tube. A typical duty cycle is 1 : 60, meaning that one could is altered toward the nucleus, and it loses some of its velocity. This
make a 0.25-second exposure every 15 seconds. deceleration causes the electron to lose kinetic energy that is given
off in the form of many new photons. The closer the high-speed
PRODUCTION OF X RAYS electron approaches the nuclei, the greater the electrostatic attrac-
tion between the nucleus and the electron, the braking effect, and
Most high-speed electrons traveling from the filament to the target the energy of the resulting bremsstrahlung photons. The efficiency
interact with target electrons and release their energy as heat. of this process is proportional to the square of the atomic number
Occasionally, these electrons convert their kinetic energy into x-ray of the target; high Z metals are more effective in deflecting the
photons by the formation of bremsstrahlung radiation and char- path of the incident electrons.
acteristic radiation. Bremsstrahlung interactions generate x-ray photons with a con-
tinuous spectrum of energy. The energy of an x-ray beam is usually
BREMSSTRAHLUNG RADIATION described by identifying the peak operating voltage (in kVp). For
The sudden stopping or slowing of high-speed electrons by tung- example, a dental x-ray machine operating at a peak voltage of
sten nuclei in the target produces bremsstrahlung photons, the 70 kVp applies a fluctuating voltage of up to 70 kVp across the
primary source of radiation from an x-ray tube. (Bremsstrahlung tube. This tube therefore produces a continuous spectrum of x-ray
means “braking radiation” in German.) Occasionally, electrons photons with energies ranging to a maximum of 70 keV (Fig. 1-13).
from the filament directly hit the nucleus of a target atom. When The reasons for this continuous spectrum are as follows:
 C H A P T E R 1 Physics 9

Characteristic Higher-energy–
Recoil electron radiation (photon) level electron
e
Photoelectron Vacancy
Incident high-
energy photon e

e e e e

e e

e e
e e

e e e e

A B C D
FIGURE 1-14 Production of characteristic radiation. An incident electron (A) ejects an electron from an inner orbital creating a
photoelectron, a recoil electron, and an electron vacancy (B). C, An electron from an outer orbital fills this vacancy, and a photon is
emitted with energy equal to the difference in energy levels between the two orbitals. D, Electrons from various orbitals may be involved,
giving rise to other characteristic photons. The energies of the photons released are characteristic of the target atom.

• The continuously varying voltage difference between the target

and filament causes the electrons striking the target to have 100
varying levels of kinetic energy.
• The bombarding electrons pass at varying distances around
Relative number of photons

tungsten nuclei and are thus deflected to varying extents. As a

2-second exposure
result, they give up varying amounts of energy in the form of
bremsstrahlung photons.
• Most electrons participate in multiple bremsstrahlung interac- 50
tions in the target before losing all their kinetic energy. As a 1-second
consequence, an electron carries differing amounts of energy exposure
after successive interactions with tungsten nuclei.

CHARACTERISTIC RADIATION
Characteristic radiation contributes only a small fraction of the 0 10 20 30 40 50 60 70
photons in an x-ray beam. It is made when an incident electron Photon energy (keV)
ejects an inner electron from the tungsten target. When this
happens, an electron from an outer orbital is quickly attracted to FIGURE 1-15 Spectrum of photon energies generated in an x-ray machine showing that
the void in the deficient inner orbital (Fig. 1-14). When the outer as exposure time increases (kVp and tube voltage held constant), so does the total number of
orbital electron replaces the displaced electron, a photon is emitted photons. The mean energy and maximal energies of the beams are unchanged.
with energy equivalent to the difference in the binding energies of
the two orbitals. The energies of characteristic photons are discrete
because they represent the difference of the energy levels of specific TUBE CURRENT (mA)
electron orbitals and are characteristic of the target atoms. The quantity of radiation produced by an x-ray tube (i.e., the
number of photons that reach the patient and film) is directly
FACTORS CONTROLLING THE X-RAY BEAM proportional to the tube current (mA) and the time the tube is
operated (Fig. 1-16). As the mA setting is increased, more power
An x-ray beam may be modified by altering the beam exposure is applied to the filament, which heats up and releases more elec-
duration (timer), exposure rate (mA), energy (kVp and filtration), trons that collide with the target to produce radiation. Thus the
shape (collimation), or intensity (target-patient distance). quantity of radiation produced is proportional to the product of
time and tube current. The quantity of radiation remains constant
EXPOSURE TIME (s) regardless of variations in mA and time as long as their product
Changing the exposure time—typically measured in fractions of a remains constant. For instance, a machine operating at 10 mA for
second (s)—modifies the duration of the exposure and thus the 1 second (10 mAs) produces the same quantity of radiation when
number of photons generated (Fig. 1-15). When the exposure time operated at 20 mA for 0.5 second (10 mAs). In practice, some
is doubled, the number of photons generated at all energies in the dental x-ray machines fall slightly short of this ideal constancy. The
x-ray emission spectrum is doubled. The range of photon energies term beam quantity or beam intensity refers to the number of
is unchanged. photons in an x-ray beam.