ST.

JUDE COLLEGE CAVITE

URC Ave. Salitran IV, Dasmarinas City, Cavite 4115


QUALITY CONTROL OF SCATTERED RADIATION IN SELECTIVE HOSPITAL IN
CAVITE

A Research Thesis
Presented to
The Faculty of School of Radiologic Technology
St. Jude College Dasmarinas City, Cavite

In Partial Fulfillment Of the Requirement for the Degree
Bachelor of Science in Radiologic Technology

By:
Carl Jason A. Cruz
SY: 2013 2014
APPROVAL SHEET

This thesis here to entitled:
QUALITY CONTROL OF SCATTERED RADIATION IN SELECTIVE HOSPITAL IN
CAVITE
Prepared and submitted by Carl Jason A, Cruz in partial fulfillment of the requirement
for the degree of Bachelor of Science Major in Radiologic Technology has been
examined and is recommended for acceptance and approval for Oral Defense.

____________________________________
VIVIAN S, BLANCO, DMD, RN , MAN
Adviser
Approval in partial fulfillment of the requirements for the subject ELEMENT OF
RESEARCH by the Committee of Oral Examination with the grade of ______________


___________________ ________________________
MEMBER MEMBER

___________________________________
Date



ACKNOWLEDGEMENT
With profound gratitude, the researchers wish to extend their utmost appreciation
to the following.
The Radiologic Technology Students of different school and Hospital Staff or the
Registered Radiologic Technology who have their knowledge and expertise on the said
study.
Ms. Vivian S, Blanco, DMD, RN ,MAN, for her sincere and valuable assistance in
the formation of the study and throughtout its development. Her wisdom of intruction
and discussion of information beaceme an opening torch, hence a flame which triggered
this research to make this thesis a reality.
We would like to Acknowledge and extend our heartfelt gratitude to the following
Panelist
______________________________________________________________________
__________________________________________________ who give time and effort
to listen us and was so kind to lend the books and other material needed in pursuing
this study.
Most especially to our family, friends words alone cannot express what we owe
them for their encouragemnt and whose patient, love enabled us to complete this
Research. And us for going the extra mile with the kind of feedback that put flesh on the
bones.
Above all, to the Divine Almighty God the Father in Heaven who continously
supplies this researcher the spiritual and material needs the made him strong and
determined to pursue this study.















THESIS ABSTRACT

Thesis Tittle : QUALITY CONTROL OF SCATTERED
RADIATION IN SELECTED HOSPITAL IN CAVITE
Researcher : Carl Jason A, Cruz
Number of Pages :
Degree Conferred : Bachelor of Science in Radiologic Technology
Name/Address of Institution : St. Jude College Cavite URC Ave. Salitran IV
Dasmarias City, Cavite
Date Started : November 2013
Date Completed : March 2014









TABLE OF CONTENTS

TITTLE PAGES
APPROVAL SHEET
ACKNOWLEDGEMENT
ABSTRACT
TABLE OF CONTENTS

CHAPTER

1. PROBLEM AND ITS BACKGROUND
Introduction
Statement of the Problem
Hypothesis of the Study
Scope and Delimitation of the Study
Conceptual Framework
Significance of the Study
Definition of Term
2. REVIEW OF RELATED LITERATURE
Foreign Studies
Synthesis
3. METHODOLOGY
Research Design
Data Gathering Instrument
Data Gathering Procedure
Statistical Data
4. PRESENTATION, ANALYSIS AND INTEPRETATION OF THE DATA
Specific Problem No. 1
Specific Problem No.2
Specific Problem No. 3
5. SUMMARY AND CONCLUSION AND RECOMMEDTIONS
Summary of Findings
Conclusion
Recommendation

REFERENCES
A. BOOK

APPENDICES
A. Letter of Request
B. Letter to the Respondents
C. Letter of Validation
D. Questionnaires
CURRICULUM VITAE
CHAPTER 1
THE PROBLEM AND ITS SETTING
INTRODUCTION
Radiographer must conscientiously avoid unnecessary radiation exposure as
well as strive to keep patient dose to an absolute minimum. Radiographer must follow
the ALARA Principle (As low as reasonably achievable) as they carry out their tasks.
The Radiologic facility must undergo appropriate Radiation surveys. Staff must be
proper oriented and regular in service education on radiation safety must take Place.
Proper radiation monitoring and review of monthly radiation report is essential
According to (Dorothy A. Saia - 2008) Occupational Radiation sources
(A) Scattered radiation is when primary photon intercept an object and undergo a
change in direction.
(B) Grid both stationary and moving, function to remove a large percentage of
scattered (primary Compton) radiation from the remnant beam before it reaches the
image receptor, thereby improving radiographic contrast, But necessitate an
increase in exposure.
The most significant occupational radiation hazard in diagnostic radiology is
scattered radiation from the patient, particularly in fluoroscopy, where the use of high
voltage results in energetic Compton Scattering emerging from the patient and posing a
real occupational hazard to radiologist and radiographer. The intensity of Scattered
Radiation one meter from the patient is about 0.1% of the intensity of the primary beam.
That is why in term of radiation protection the patient is considered the most important
source of scatter. Other Scattering object include the x-ray table. The bucky-slot cover/
closer and the control booth wall.
According to Stewart C Bushong (2009) Production of Scatter Radiation
two types of x-rays are responsible for the optical density and contrast on a radiograph
those that pass through the patient without interacting and those that are scattered
within the patient through Compton interaction X-ray that exist from the patient are
remnant x-ray and those that exit and interact with the image receptor are called image-
forming x-rays.
Proper collimation of the x-ray beam has the primary effect of reducing patient
dose by restricting the volume of irradiated tissue. Proper collimation also improve
image contrast. Ideally, only those x-rays that do not interact with the patient should
reach the image receptor.
As scattered radiation increase the radiograph loses contrast and appears grey
and dull. Three primary factors influence the relative intensity of scatter radiation that
reaches the image receptor: Kvp, field size, and patient thickness.
Control of scatter radiation , effect of scatter radiation on image control
One of most important characteristic of image quality is contrast, the visible different
between the light and dark areas of an image contrast is the degree of difference in OD
between areas of radiographic image. Contrast resolution is the ability to image and
distinguish soft tissue. Even under the most favourable condition, must remnant x-ray
are scattered.

Scatter Radiation Control
The radiographer must strive to minimize the quantity of
scatter that reaches the IR
Restrict the x-ray beam size to the size of the anatomical
structures required to demonstrate in the image
No reason to leave collimators open to extend beyond
the IR size
Objective is to decrease patient radiation dose, and
achieve optimum contrast.
Statement of the Problem:
The main emphasis of this research is to determine the Quality Control of
Scattered Radiation and keep patient dose to an absolute minimum. Specifically this
research study to answer the following question:
1. What is the most important beam restriction to reduce the production of scattered
radiation and why?
2. What is the risk and benefits of using Grid in radiographic examination?
3. What is the purpose of air gap technique in decreasing the amount of scattered
radiation reaching the film?
4. What are some method of achieving the ALARA goal?


Hypothesis
1. Collimation is the most important way to reduce patient dose. The collimator
is over all, the most efficient beam restricting device. It is attached to the tube
head, and its upper aperture, the first set shutters, is placed as close as
possible to the x-ray tubes port window. This is done to control the amount of
image degrading off-focus radiation .
2. Grid both stationary and moving, function to remove a large percentage of
scattered (primary Compton) radiation from the remnant beam before it
reaches the image receptor, thereby improving radiographic contrast, But
necessitate an increase in exposure.
3. An air gap technique may be used to function similarly to , or in place of, a
grid. A distance is introduced between the patient and the film. Scattered
photons emerging from the patient will continue to diverge and never reach
the film.
4. Radiographers must follow the ALARA principle as they carry out their task.
The radiologic surveys staff must be properly oriented and regular in service
education or radiation safety must take place.






Scope and Delimitation
This research will cover the Quality Control of Scattered Radiation in our patient
and ourselves to an absolute minimum.

This chapter represent, as description of the method of research used,
respondent of the study, instrumentation and analysis of data and will be finish by the
second semester school year 2013 20014
In the event of this scholarly study, the researchers will use a descriptive method.
Employing the substantial procedure and activities performed will help validate the
findings of this present study.

Definition of terms:
Aperture diaphragm simple beam restricting device that attaches a led-lined metal
diaphragm to the head of the x-ray tube.
Air-Gap technique Practice of moving the image receptor 10 to 15 cm from the patient
so that fewer scattered x-rays interact with the image receptor, thereby
enhancing contrast.
ALARA Principle that states radiation exposure should be kept As Low As Reasonably
Achievable, when economic and social factor are taken into account.
Artifact false features of an image caused by patient instability or equipment
deficiencies.
Beam restrictor Device that restricts the size of the x-ray field to only the anatomic
structure of interest.
Collimation Restriction of the useful x-ray beam to reduce patient dose and improve
image contrast.
Collimator Device used to restrict x-ray beam size and shape.
Cones and cylinders Modification of the aperture diaphragm .
Grid Is a device interposed between the patient and image receptor and absorb a
large percentage of Scattered Radiation.
Kvp A measure of the maximum electrical potential across an x-ray tube; expressed in
kilovolts.
Optical Density (OD) The distance from the image receptor to the object that is to be
imaged.
Radiation The energy emitted and transferred through matter.
Radiography The process and procedure of producing a radiograph
Scattered Radiation - Scattered radiation is when primary photon intercept an object
and undergo a change in direction.


.






Conceptual framework

The conceptual framework of the study presented in the paradigm used the
input- process system model.
The input Section include the Beam restricting device, the use of grid , the
purpose of air gap technique and the method of Achieving the ALARA goal.
the input was identified through questionnaires to be conducted by the
researchers. Such process was facilitated through gathering of information from the
respondents. The process include organization of data and analysis.
The output show the organized data and its implications. It present the plan or
recommendation for the radiologic technology students.








INPUT
1. What is the most important beam
restriction to reduce the production
of scattered radiation and why?
2. What is the risk and benefits of using
Grid in radiographic examination?
3. What is the purpose of air gap
technique in decreasing the amount
of scattered radiation reaching the
film?
4. What are some method of achieving
the ALARA goal?
OUTPUT
Collimation is the most important way to
reduce patient dose, grid are used to
remove a large percentage of scattered
radiation from the remnant beam before
it reaches the image receptor. Air gap
technique may be used to diverge the
scattered and never reach the film. The
radiologic surveys staff must be properly
oriented and regular in service education
or radiation safety must take place.
Implementation of seminar for Quality
Control of Scattered Radiation























PROCESS
Researcher made
questionnaire
Significance of the Study

The findings of this study will be beneficial to student, teachers, registered
radiologic technologist and school authorities.

To the radiologic technology student the study give the student an idea on how
to control the production of scattered radiation and avoid unnecessary radiation
exposure to themselves as well strive to keep patient dose to an absolute minimum.

To the Future Researchers this will actively motivate the future researchers to
take additional studies involving this research the quality control of scattered radiation in
radiographic procedures.

To the College Faculty of Radiologic Technology this will serve as an additional
lecture material and presentation of the course subject.








Chapter 2
REVIEW OF RELATED LITERATURE

A. Related literature
This Chapter contains a review of related literature and studies which have
bearing on the present study. These related readings taken from material are very
necessary in coming up with comprehensive research.

Radiographer must conscientiously avoid unnecessary radiation exposure as
well as strive to keep patient dose to an absolute minimum. Radiographer must follow
the ALARA Principle (As low as reasonably achievable) as they carry out their tasks.
The Radiologic facility must undergo appropriate Radiation surveys. Staff must be
proper oriented and regular in service education on radiation safety must take Place.
Proper radiation monitoring and review of monthly radiation report is essential
According to Dorothy A. Saia (2008) Occupational Radiation sources (A)
Scattered radiation is when primary photon intercept an object and undergo a change in
direction.
The must significant occupational radiation hazard in diagnostic radiology is
scattered radiation from the patient , particularly in fluoroscopy , where the use of high
voltage results in energetic Compton Scattering emerging from the patient and posing a
real occupational hazard to radiologist and radiographer. The intensity of Scattered
Radiation one meter from the patient is about 0.1% of the intensity of the primary beam.
That is why in term of radiation protection the patient is considered the most important
source of scatter. Other Scattering object include the x-ray table. The bucky-slot cover/
closer and the control booth wall.
Leakage radiation is that which is emitted from the x-ray tube housing in direction
other than that of the primary beam.
According to Stewart C Bushong (2009) Production of Scatter Radiation two
types of x-rays are responsible for the optical density and contrast on a radiograph
those that pass through the patient without interacting and those that are scattered
within the patient through Compton interaction X-ray that exist from the patient are
remnant x-ray and those that exit and interact with the image receptor are called image-
forming x-rays.
Proper collimation of the x-ray beam has the primary effect of reducing patient
dose by restricting the volume of irradiated tissue. Proper collimation also improve
image contrast. Ideally , only those x-rays that do not interact with the patient should
reach the image receptor.
As scattered radiation increase the radiograph loses contrast and appears grey
and dull. Three primary factors influence the relative intensity of scatter radiation that
reaches the image receptor: Kvp, field size, and patient thickness.
One of most important characteristic of image quality is contrast , the visible
different between the light and dark areas of an image contrast is the degree of
difference in OD between areas of radiographic image. Contrast resolution is the ability
to image and distinguish soft tissue. Even under the most favorable condition, must
remnant x-ray are scattered.

According to (Dorothy A. Saia ) BEAM RESTRICTION, or limitation of field size,
is probably the single most important factor in keeping patient dose to a minimum. The
primary beam must be confined to the area of interest, thus, only tissues of diagnostic
interest will be irradiated.
- Benefit of beam restriction is that, because a smaller quantity of
tissue is irradiated, less scattered radiation will be produced.
- Remember , scattered radiation does not carry useful
information; it degrades the radiographic image by adding a
layer of fog that impairs image visibility.

THREE BASIC TYPE OF BEAM RESTRICTOR , APERTURE DIAPHRAGMS, CONES,
AND COLLIMATION.
Aperture diaphragm
Aperture diaphragm is the most elementary of the three types, and is
frequently used in dedicated-head units and many of todays dedicated-
chest units. It is simply a flat piece of lead (Pb) with a central opening
whose size and shape determines the size and shape of the x-ray beam.
Whereas head units have a variety of aperture diaphragm sizes available
for various type of skull exams and required film sizes.
Cones and cylinder
Cones are circular, lead-lined devices that slide into place in the tube
head. They may be the straight cylinder type, whose proximal and distal
diameter are identical, or the infrequently used flare type, whose distal
diameter is greater than its proximal diameter. Cylinder cones are
frequently able to extend, like a telescope, by means of a simple thumb
screw adjustment.
Collimation
The collimator is , overall, the most efficient beam restricting device it is
attached to the tube head, and its upper aperture, the first set of shutters,
is placed as close as possible to the x-ray tubes port window.
This is done to control the amount of image degrading off-focus radiation
leaving the x-ray tube. ie, radiation produced when electrons strike anode
surfaces other than the focal track.
The next set of lead shutters ( or blades, or leaves) actually
consists of two pairs of adjustable shutters- one pair for field length and
other pair for field width. It is these shutters that the radiographer adjusts
when changing the field size and shape.



B. Related studies
(Bushong, 2008).In order to reduce radiation exposure it is necessary to
decrease the area of the x-ray beam. Proper beam restriction will reduce the amount of
primary photons emitted from the tube and collimator thereby reducing the dose to the
patient. Also, beam restriction will keep the total amount of tissue irradiated to a
minimum so fewer scattered photons are created consequently the image quality will be
improved. It is important to control scatter since it has no useful diagnostic effect.
Another principle factor in reducing scatter is kilovoltage or the penetrability of the
beam. As kVp is increased, fewer atoms interact with the tissue, and more pass through
to end up on the image receptor. In radiography, kilovoltage is selected based
predominantly on the size of the part examined. Whenever kilovoltage is increased
more scatter will result unless it is accompanied by a reduction in mAs thereby reducing
scatter and the dose to the patient. Thus beam restriction along with technical factors
are very important aspects of radiation protection by reducing the patient dose and
improving the image quality
(Carlton & Adler, 2006). Aperture diaphragms are the simplest type of beam-
restricting device. It is a flat piece of lead containing a hole in the center that attaches to
the x-ray tube port. The opening can be made in any size or shape, but rectangular is
the most common. The main advantages of aperture diaphragms are there simple
design, low cost, and ease of use. The main disadvantage is the increase in the
unsharpness around the periphery of the image known as penumbra. Other
disadvantages include off-focus radiation and no light field for use in positioning.
Aperture diaphragms are used in special procedure angiography studies
Cones or cylinders are essentially aperture diaphragms with metal extensions
that can be either straight or flared and attach to the x-ray tube housing. Cones are
extensions that flare and cylinders are straight but both are routinely called cones. The
longest cone with the smallest diameter will provide the greatest beam restriction. The
advantage of cones is there low cost and ease of use. One difficulty with using cones is
alignment. The physical weight of the cones can sometimes cause the tube to angle
slightly when used with a horizontal beam causing cone cutting if the central ray is not
checked carefully. Today, cones are reserved for select areas of radiology such as
sinuses, L5/S-1 spine, and dental radiographs.

(Forshier, 2009) Collimators are the most widely used beam restricting
device because they contain a light source to help the radiographer center the x-ray
beam. They are composed of a lamp, mirror, and a pair of upper and lower lead
shutters that are at right angles to each other and move independently. Upper shutters
absorb the off focus radiation before it leaves the tube and the lower shutters further
restrict the beam to the area of interest. Collimators permit an infinite number of field
sizes using only one device and hence reduce the light field to only the area of interest
resulting in reduced patient exposure. Some equipment is supplied with automatic
collimators that are electronically interlocked with the Bucky tray so the x-ray beam is
automatically restricted to the size of the cassette. These devices are known as positive
beam limitation (PBL) devices. Accuracy within 2% of the SID is required with all PBL
devices

Ultimately, it is the responsibility of the radiographer to use proper collimation
and under no circumstances should the exposure field exceed the size of the image
receptor. The radiographer should always limit the field to the part being examined
thereby improving the image quality and minimizing the patient dose.



















C. Synthesis
The review of related literature gave richer concepts on Quality
Control of Scattered Radiation .Radiographer must conscientiously avoid unnecessary
radiation exposure as well as strive to keep patient dose to an absolute minimum.
Radiographer must follow the ALARA Principle (As low as reasonably achievable) as
they carry out their tasks.
The work of the authors were focused on broad and informational
function books. This present study is all about using beam restricting device , or
limitation of field size, and probably the single most important factor in keeping
patient dose to a minimum.

Three basic type of Beam Restrictor , Aperture Diaphragm , Cone and Cylinder
and Collimation.
Aperture diaphragms are the simplest type of beam-restricting device. It is a flat
piece of lead containing a hole in the center that attaches to the x-ray tube port.

Cones or cylinders are essentially aperture diaphragms with metal extensions
that can be either straight or flared and attach to the x-ray tube housing.

Collimators are the most widely used beam restricting device because they
contain a light source to help the radiographer center the x-ray beam.

Scatter Radiation Control
The radiographer must strive to minimize the quantity of
scatter that reaches the IR
Restrict the x-ray beam size to the size of the anatomical
structures required to demonstrate in the image
No reason to leave collimators open to extend beyond
the IR size
Objective is to decrease patient radiation dose, and
achieve optimum contrast.

However, the present study is quite similar to the studies mentioned in the sense
that all deal with professional job related tasks of the researchers.












Chapter 3
Research Methodology
This Chapter represents a description of the method of research used,
respondent of the study, instrumentation, and analysis of data.

In the event of this study the researchers will use a descriptive method.
Employing the substantial procedures and activities performed will help validate
the findings of this present study.
Research Design
In conducting the study, the researcher will use a descriptive method, which is
considered the objective of the study of the study. This involves collecting
numerical data to test hypotheses or answer question concerning validated were
the primary source of data which were utilized in this study. Data that were
gathered were tabulated, statistically analyze and interpreted.
Research Participants
The researchers will be using purposing sampling, due to special
characteristics that the research participants possess. The individual that are
selected are those who have the expertise or experience related to the purpose
of the study.
Research Instrument
Questionnaire was used as a research instrument. It is used to
gather data on the profile of the respondents in terms of age, gender, specialty
and imaging technique performed by the technologist and the competency and
their skill in diagnostic radiography.

The instrumentation used in the collection of data was twenty (20)
questionnaires.
Different schools were consulted as to the authenticity of every area; the
respondents became local pint who answered the questionnaires.
In the questionnaire, each respondent was asked to answer the questionnaire
that contains question related to hypothesis which include the Quality Control of
Scattered Radiation. The respondent were asked topic related on how to restrict
and reduce the production of scattered radiation as well as to strive to keep
patient dose to an absolute minimum and criticize according to the level of choice
by A. - YES, B. NO, C. MAYBE, D. SOMETIMES, E. NONE AT ALL.
Finally, they were asked how, according to there expertise.

Data gathering procedure
The survey was conducted at M.V Santiago Medical Center.
Questionnaires were distributed to the respondents and collected after one week.
The data collected, tabulated, analyzed, and interpreted by using statistical
formulas.



Statistical Treatment

the researcher were able to interpret the data gathered using the
statistical formula. Data respondents, profile and the Quality Control of Scattered
Radiation were quantified using percentage.
PERCENTAGE. This test is used in order to describe the profile of the
respondents:

The Following:

F P = Percentage
P = _____________ x100 F = Frequency
N
N = No. Of
Respondents (population)