Radiologic Science for Technologists: Physics, Biology, and Protection

Front Cover
Inside Front Cover
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Radiologic Science for Technologists
Copyright Page
Reviewers
Dedication
This Book is also Dedicated to My Friends Here and Gone:
Dedication – Saintly Stitchers
Preface
	Purpose and Content
	Historical Perspective
	New to This Edition
	Ancillaries
		Student Workbook
		Evolve Resources
	A Note on the Text
	Acknowledgments
Table Of Contents
I Radiologic Physics
	1 Essential Concepts of Radiologic Science
		Outline
		Objectives
		Nature of Our Surroundings
		Matter and Energy
		Sources of Ionizing Radiation
		Discovery of X-Rays
		Development of Medical Imaging
		Reports of Radiation Injury
		Basic Radiation Protection
			Filtration
			Collimation
			Protective Apparel
			Gonadal Shielding
			Protective Barriers
		Standard Units of Measurement
			Length
			Mass
			Time
			Units
		Mechanics
			Velocity
			Acceleration
			Newton’s Laws of Motion
			Weight
			Momentum
			Work
			Power
			Energy
			Heat
		Terminology for Radiologic Science
			Numeric Prefixes
			Radiologic Units
				Air Kerma (Kinetic Energy Released in Matter) (Gya).
				Absorbed Dose (Gyt).
				Effective Dose, Sievert (Sv).
				Radioactivity, Becquerel (Bq).
		The Medical Imaging Team
		Summary
		Challenge Questions
	2 The Structure of Matter
		Outline
		Objectives
		Centuries of Discovery
			Greek Atom
			Dalton Atom
			Thomson Atom
			Bohr Atom
		Fundamental Particles
		Atomic Structure
			Electron Arrangement
			Electron Binding Energy
		Atomic Nomenclature
		Combinations of Atoms
		Radioactivity
			Radioisotopes
			Radioactive Half-life
		Types of Ionizing Radiation
			Particulate Radiation
			Electromagnetic Radiation
		Summary
		Challenge Questions
	3 Electromagnetic Energy
		Outline
		Objectives
		Photons
			Velocity and Amplitude
			Frequency and Wavelength
		Electromagnetic Spectrum
			Measurement of the Electromagnetic Spectrum
			Visible Light
			Radiofrequency
			Ionizing Radiation
		Waves and Particles
			Wave Model: Visible Light
			Inverse Square Law
			Particle Model: Quantum Theory
		Matter and Energy
		Summary
		Challenge Questions
	4 Electricity, Magnetism, and Electromagnetism
		Outline
		Objectives
		Electrostatics
			Electrostatic Laws
				Coulomb’s Law.
			Electric Potential
		Electrodynamics
			Electric Circuits
			Electric Power
		Magnetism
			Magnetic Laws
			Magnetic Induction
		Electromagnetism
			Electromagnetic Induction
			Electromechanical Devices
			The Transformer
		Summary
		Challenge Questions
II X-Radiation
	5 The X-ray Imaging System
		Outline
		Objectives
		Operating Console
		Autotransformer
			Adjustment of Kilovolt Peak (kVp)
			Control of Milliamperage (mA)
			Filament Transformer
		Exposure Timers
			Synchronous Timers
			Electronic Timers
			mAs Timers
			Automatic Exposure Control
		High-Voltage Generator
			High-Voltage Transformer
			Voltage Rectification
			Single-Phase Power
			Three-Phase Power
			High-Frequency Generator
			Capacitor Discharge Generator
			Falling Load Generator
			Voltage Ripple
			Power Rating
			X-ray Circuit
		Summary
		Challenge Questions
	6 The X-ray Tube
		Outline
		Objectives
		External Components
			Ceiling Support System
			Floor-to-Ceiling Support System
			C-Arm Support System
			Protective Housing
			Glass or Metal Enclosure
		Internal Components
			Cathode
			Anode
		X-ray Tube Failure
		Rating Charts
			Radiographic Rating Chart
			Anode Cooling Chart
			Housing Cooling Chart
		Summary
		Challenge Questions
	7 X-ray Production
		Outline
		Objectives
		Electron Target Interactions
			Anode Heat
			Characteristic Radiation
			Bremsstrahlung Radiation
		X-Ray Emission Spectrum
			Characteristic X-ray Spectrum
			Bremsstrahlung X-ray Spectrum
		Factors Affecing the X-ray Emission Spectrum
			Effect of mA and mAs
			Effect of kVp
			Effect of Added Filtration
			Effect of Target Material
			Effect of Voltage Waveform
		Summary
		Challenge Questions
	8 X-ray Emission
		Outline
		Objectives
		X-ray Quantity
			X-ray Intensity
			Factors That Affect X-ray Quantity
		X-ray Quality
			Penetrability
			Half-Value Layer
			Factors That Affect X-ray Quality
			Types of Filtration
		Summary
		Challenge Questions
	9 X-ray Interaction With Matter
		Outline
		Objectives
		Five X-ray Interactions With Matter
			Coherent Scattering
			Compton Scattering
			Photoelectric Effect
			Pair Production
			Photodisintegration
		Differential Absorption
			Dependence on Atomic Number
			Dependence on Mass Density
		Contrast Examinations
		Exponential Attenuation
		Summary
		Challenge Questions
III The Radiographic Image
	10 Radiographic Image Quality
		Outline
		Objectives
		Definitions
			Radiographic Image Quality
			Resolution
			Noise
			Speed
		Film Factors
			Characteristic Curve
			Optical Density
			Film Processing
		Geometric Factors
			Magnification
			Distortion
			Focal-Spot Blur
			Heel Effect
		Subject Factors
			Subject Contrast
				Patient Thickness.
				Tissue Mass Density.
				Effective Atomic Number.
				Object Shape.
				Kilovolt Peak.
			Motion Blur
		Tools for Improved Radiographic Image Quality
			Patient Positioning
			Image Receptors
			Selection of Technique Factors
		Summary
		Challenge Questions
	11 Scatter Radiation
		Outline
		Objectives
		Production of Scatter Radiation
			kVp
			Field Size
			Patient Thickness
		Control of Scatter Radiation
			Effect of Scatter Radiation on Image Contrast
			Beam Restrictors
			Radiographic Grids
		Grid Performance
			Contrast Improvement Factor
			Bucky Factor
		Grid Types
			Parallel Grid
			Crossed Grid
			Focused Grid
			Moving Grid
		Grid Problems
			Off-Level Grid
			Off-Center Grid
			Off-Focus Grid
			Upside-Down Grid
		Grid Selection
			Patient Radiation Dose
			Air-Gap Technique
		Summary
		Challenge Questions
	12 Screen-Film Radiography
		Outline
		Objectives
		Radiographic Film
			Base
			Emulsion
		Types of Film
			Screen Film
			Direct-Exposure Film
			Mammography Film
		Handling and Storage of Film
			Heat and Humidity
			Light
			Radiation
		Formation of the Latent Image
			Silver Halide Crystal
			Photon Interaction With Silver Halide Crystal
			Latent Image
		Radiographic Intensifying Screens
			Protective Coating
			Phosphor
			Reflective Layer
			Base
		Screen Characteristics
			Screen Speed
			Image Noise
			Spatial Resolution
		Screen-Film Combinations
			Cassette
			Carbon Fiber
			Screen-Film Radiographic Exposure
			Rare Earth Screens
		Care of Screens
		Film Processing
		Processing Chemistry
			Wetting
			Development
			Fixing
			Washing
			Drying
		Automatic Processing
			Transport System
			Temperature Control System
			Circulation System
			Replenishment System
			Dryer System
		Summary
		Challenge Questions
	13 Screen-Film Radiographic Technique
		Outline
		Objectives
		Exposure Factors
			Kilovolt Peak
			Milliamperes
			Exposure Time
			Distance
		Imaging System Characteristics
			Focal-Spot Size
			Filtration
			High-Voltage Generation
		Patient Factors
			Thickness
			Composition
			Pathology
		Image-Quality Factors
			Optical Density
			Image Contrast
			Image Detail
			Distortion
		Radiographic Technique Charts
		Automatic Exposure Techniques
		Tomography
		Magnification Radiography
		Summary
		Challenge Questions
IV The Digital Radiographic Image
	14 Medical Imaging Computer Science
		Outline
		Objectives
		History of Computers
		Computer Architecture
			Computer Language
			Components
		Applications to Medical Imaging
		Summary
		Challenge Questions
	15 Computed Radiography
		Outline
		Objectives
		The Computed Radiography Image Receptor
			Photostimulable Luminescence
			Imaging Plate
			Light Stimulation–Emission
		The Computed Radiography Reader
			Mechanical Features
			Optical Features
			Computer Control
		Imaging Characteristics
			Image Receptor Response Function
			Image Noise
		Patient Characteristics
			Patient Radiation Dose
			Workload
		Summary
		Challenge Questions
	16 Digital Radiography
		Outline
		Objectives
		Scanned Projection Radiography
		Charge-Coupled Device
		Cesium Iodide/Charge- Coupled Device
		Cesium Iodide/Amorphous Silicon
		Amorphous Selenium
		Digital Mammography
		Summary
		Challenge Questions
	17 Digital Radiographic Technique
		Outline
		Objectives
		Spatial Resolution
			Spatial Frequency
			Modulation Transfer Function
		Contrast Resolution
			Dynamic Range
			Postprocessing
			Signal-to-Noise Ratio
		Contrast-Detail Curve
		Patient Radiation Dose Considerations
			Image Receptor Response
			Detective Quantum Efficiency
		Summary
		Challenge Questions
	18 Viewing the Digital Image
		Outline
		Objectives
		Photometric Quantities
			Response of the Eye
			Photometric Units
			Cosine Law
		Hard Copy–Soft Copy
		Liquid Crystal Display
			Display Characteristics
			Image Luminance
		Light-Emitting Diode Display
			Backlight
			Ambient Light
		Preprocessing the Digital Radiographic Image
		Postprocessing the Digital Radiographic Image
		Picture Archiving and Communication System
			Network
			Storage System
		Summary
		Challenge Questions
V Image Artifacts and Quality Control
	19 Screen-Film Radiographic Artifacts
		Outline
		Objectives
		Exposure Artifacts
		Processing Artifacts
			Roller Marks
			Dirty Rollers
			Chemical Fog
			Wet-Pressure Sensitization
		Handling and Storage Artifacts
			Light or Radiation Fog
			Pressure or Kink Marks
			Static
			Hypo Retention
		Summary
		Challenge Questions
	20 Screen-Film Radiographic Quality Control
		Outline
		Objectives
		Quality Assurance
		Quality Control
		Screen-Film Radiographic Quality Control
			Filtration
			Collimation
			Focal-Spot Size
			Kilovolt Peak Calibration
			Exposure Timer Accuracy
			Exposure Linearity
			Exposure Reproducibility
			Radiographic Intensifying Screens
			Protective Apparel
			Film Illuminators
		Tomography Quality Control
		Processor Quality Control
			Processor Cleaning
			Processor Maintenance
			Processor Monitoring
		Summary
		Challenge Questions
	21 Digital Radiographic Artifacts
		Outline
		Objectives
		Image Receptor Artifacts
		Software Artifacts
			Preprocessing
			Image Compression
		Object Artifacts
			Image Histogram
			Collimation and Partition
			Alignment
		Challenge Questions
	22 Digital Radiographic Quality Control
		Outline
		Objectives
		Performance Assessment Standards
			SMPTE
			NEMA-DICOM
			DIN 2001
			VESA
			AAPM TG 18
		Luminance Meter
		Digital Display Device Quality Control
			Geometric Distortion
			Reflection
			Luminance Response
			Display Resolution
			Display Noise
		Quality Control by the Radiologic Technologist
		Summary
		Challenge Questions
VI Advanced X-Ray Imaging
	23 Mammography
		Outline
		Objectives
		Soft Tissue Radiography
		Basis for Mammography
			Risk of Breast Cancer
			Types of Mammography
			Breast Anatomy
		The Mammographic Imaging System
			High-Voltage Generation
			Target Composition
			Focal-Spot Size
			Filtration
			Heel Effect
			Compression
			Grids
			Automatic Exposure Control
			Magnification Mammography
		Screen-Film Mammography
		Digital Mammography
		Summary
		Challenge Questions
	24 Mammography Quality Control
		Outline
		Objectives
		Quality Control Team
			Radiologist
			Medical Physicist
			Mammographer
		Screen-Film Quality Control
			Daily Tasks
				Darkroom Cleanliness.
			Weekly Tasks
			Monthly Tasks
			Quarterly Tasks
			Semiannual Tasks
			Nonroutine Tasks
		Digital Quality Control
		Summary
		Challenge Questions
	25 Fluoroscopy
		Outline
		Objectives
		An Overview
		Special Demands of Fluoroscopy
			Illumination
			Visual Physiology
		Fluoroscopic Technique
		Image Intensification
			Image-Intensifier Tube
			Multifield Image Intensification
		Fluoroscopic Image Monitoring
			Television Monitoring
			Image Recording
		Fluoroscopy Quality Control
			Exposure Rate
			Spot-Film Exposures
			Automatic Exposure Systems
		Summary
		Challenge Questions
	26 Digital Fluoroscopy
		Outline
		Objectives
		Digital Fluoroscopy Imaging System
		Image Receptor
			Charge-Coupled Device
			Flat Panel Image Receptor
		Image Display
			Video System
			Flat Panel Image Display
		Digital Subtraction Angiography
			Image Formation
			Roadmapping
			Patient Radiation Dose
		Summary
		Challenge Questions
	27 Interventional Radiology
		Outline
		Objectives
		Types of Interventional Procedures
		Basic Principles
			Arterial Access
			Guidewires
			Catheters
			Contrast Media
			Patient Preparation and Monitoring
			Risks of Arteriography
		Interventional Radiology Suite
			Personnel
			Equipment
		Summary
		Challenge Questions
	28 Computed Tomography
		Outline
		Objectives
		Principles of Operation
		Generations of Computed Tomography
		Multislice Helical Computed Tomography
			Interpolation Algorithms
			Pitch
			Sensitivity Profile
		Imaging System Design
			Operating Console
			Computer
			Gantry
			Slip-Ring Technology
		Image Characteristics
			Image Matrix
			Computed Tomography Numbers
			Image Reconstruction
			Multiplanar Reformation
		Image Quality
			Spatial Resolution
			Contrast Resolution
			Noise
			Linearity
			Uniformity
		Imaging Technique
			Multislice Detector Array
			Data Acquisition Rate
		Computed Tomography Quality Control
			Noise and Uniformity
			Linearity
			Spatial Resolution
			Contrast Resolution
			Slice Thickness
			Couch Incrementation
			Laser Localizer
		Summary
		Challenge Questions
VII Radiobiology
	29 Human Biology
		Outline
		Objectives
		Human Radiation Response
		Composition of the Human Body
		Cell Theory
			Molecular Composition
		The Human Cell
			Cell Function
			Cell Proliferation
			Mitosis
			Meiosis
		Tissues and Organs
		Summary
		Challenge Questions
	30 Fundamental Principles of Radiobiology
		Outline
		Objectives
		Law of Bergonie and Tribondeau
		Physical Factors That Affect Radiosensitivity
			Linear Energy Transfer
			Relative Biologic Effectiveness
			Protraction and Fractionation
		Biologic Factors That Affect Radiosensitivity
			Oxygen Effect
			Age
			Recovery
			Chemical Agents
			Hormesis
		Radiation Dose-Response Relationships
			Linear Dose-Response Relationships
			Nonlinear Dose-Response Relationships
			Constructing a Dose-Response Relationship
		Summary
		Challenge Questions
	31 Molecular Radiobiology
		Outline
		Objectives
		Irradiation of Macromolecules
			Main-Chain Scission
			Cross-Linking
			Point Lesions
			Macromolecular Synthesis
			Radiation Effects on DNA
			Radiolysis of Water
		Direct and Indirect Effects
		Summary
		Challenge Questions
	32 Cellular Radiobiology
		Outline
		Objectives
		Target Theory
		Cell-Survival Kinetics
			Single-Target, Single-Hit Model
			Multi-Target, Single-Hit Model
			Recovery
		Cell-Cycle Effects
		Radiation Effect Modification
		Summary
		Challenge Questions
	33 Deterministic Effects of Radiation
		Outline
		Objectives
		Acute Radiation Lethality
			Prodromal Period
			Latent Period
			Manifest Illness
			LD50/60
			Mean Survival Time
		Local Tissue Damage
			Effects on the Skin
			Effects on the Gonads
		Hematologic Effects
			Hemopoietic System
			Hemopoietic Cell Survival
		Cytogenetic Effects
			Normal Karyotype
			Single-Hit Chromosome Aberrations
			Multi-Hit Chromosome Aberrations
			Kinetics of Chromosome Aberration
		The Human Genome
		Summary
		Challenge Questions
	34 Stochastic Effects of Radiation
		Outline
		Objectives
		Local Tissue Effects
			Skin
			Chromosomes
			Cataracts
		Life Span Shortening
		Risk Estimates
			Relative Risk
			Excess Risk
			Absolute Risk
		Radiation-Induced Malignancy
			Leukemia
			Cancer
		Total Risk of Malignancy
			Nuclear Reactor Incidents
			BEIR Committee
		Radiation and Pregnancy
			Effects on Fertility
			Irradiation in Utero
			Genetic Effects
		Summary
		Challenge Questions
VIII Radiation Protection
	35 Health Physics
		Outline
		Objectives
		Radiation and Health
		Cardinal Principles of Radiation Protection
			Minimize Time
			Maximize Distance
			Use Shielding
		Effective Dose
		Radiologic Terrorism
			Radiologic Device
			Radiation Protection Guidance
			Radiation Detection and Measurement Equipment
		Summary
		Challenge Questions
	36 Designing for Radiation Protection
		Outline
		Objectives
		Radiographic Protection Features
			Protective X-ray Tube Housing
			Control Panel
			Source-to-Image Receptor Distance Indicator
			Collimation
			Positive-Beam Limitation
			Beam Alignment
			Filtration
			Reproducibility
			Linearity
			Operator Shield
			Mobile X-ray Imaging System
		Fluoroscopic Protection Features
			Source-to-Skin Distance
			Primary Protective Barrier
			Filtration
			Collimation
			Exposure Control
			Bucky Slot Cover
			Protective Curtain
			Cumulative Timer
			Dose Area Product
		Design of Protective Barriers
			Type of Radiation
			Factors That Affect Barrier Thickness
		Radiation Detection and Measurement
			Gas-Filled Detectors
			Scintillation Detectors
			Thermoluminescence Dosimetry
			Optically Stimulated Luminescence Dosimetry
		Summary
		Challenge Questions
	37 Radiography/Fluoroscopy Patient Radiation Dose
		Outline
		Objectives
		Characteristics of Projection Imaging
		Patient Radiation Dose Descriptions
			Entrance Skin Exposure
			Mean Marrow Dose
			Genetically Significant Dose
			Tissue Dose
			Digital Radiographic Tomosynthesis
		Fluoroscopic Patient Radiation Dose
		Effective Dose
		Summary
		Challenge Questions
	38 Computed Tomography Patient Radiation Dose
		Outline
		Objectives
		Computed Tomography Dose Delivery
			Patient Radiation Dose Distribution
			Radiation Dose Profile
			Computed Tomography Output Intensity
		Computed Tomography Dose Index
		Dose Length Product
		Size-Specific Dose Estimates
		Effective Dose
		Challenge Questions
	39 Patient Radiation Dose Management
		Outline
		Objectives
		Patient Radiation Dose in Special Examinations
		Reduction of Unnecessary Patient Radiation Dose
			Unnecessary Examinations
			Repeat Examinations
			Radiographic Technique
			Image Receptor
			Patient Positioning
			Specific Area Shielding
		The Pregnant Patient
			Radiobiologic Considerations
			Patient Information
		Patient Radiation Dose Trends
		Appropriateness
		Summary
		Challenge Questions
	40 Occupational Radiation Dose Management
		Outline
		Objectives
		Occupational Radiation Exposure
			Fluoroscopy
			Interventional Radiology
			Mammography
			Computed Tomography
			Surgery
			Mobile Radiology
		Radiation Dose Limits
			Whole-Body Dose Limits
			Dose Limits for Tissues and Organs
			Public Exposure
			Educational Considerations
		Reduction of Occupational Radiation Exposure
			Occupational Radiation Monitoring
			Where to Wear the Occupational Radiation Monitor
			Occupational Radiation Monitoring Report
			Protective Apparel
			Position
			Patient Holding
			Pregnant Technologist/Radiologist
			Management Principles
		Summary
		Challenge Questions
Glossary
Index
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