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Physics of Radiology

How Is The X-Ray Beam Created?


X-rays are produced when fast moving electrons collide with a metal target. The energy carried in the electrons is
converted to x-rays and heat.
How Do You Control The Production Of The X-rays? &
What Characteristics Of The X-ray Beam Can You Control?
The Operator can control:

The Number of X-Rays produced

The Energy of the X-Ray Beam


These Controls are achieved through the exposure selections made on the x-ray machine operator console.

Knobology:
kVp Selector: kVp stands for kilovolt peak/kilovolt potential. It affects the following:

Selects the voltage differential used to accelerate the electrons.

Gives variable "speed" to the electrons

Selects the penetrating quality of the x-ray beam

Effects the efficiency of x-ray production

Determines the scale of contrast in the image

Determines the Scatter radiation produced by the patient


Because x-ray production is basically the conversion of one type of energy-Kinetic Energy-to two other types of
energy - x-rays and heat - the energy of the x-ray is dependent on the energy of the electron at the time of
conversion. The more energetic the electron, the more energetic the x-ray. The faster an object-the electron-is
moving, the greater the kinetic energy. The electrons kinetic energy is increased by implying an electrical
potential between the cathode and anode of the x-ray tube. The stronger this potential difference the greater the
developed kinetic energy of the electrons.
When you change the kVp you are changing the ability of the x-rays to pass through the object. Thicker and/or
Denser objects require more energetic x-rays to pass through them. Thinner and or less dense objects require less
energetic x-rays to pass through them.
The x-ray image is formed by the differential absorption of the x-ray beam. What you want to depict are the
differences in the bodys tissues. If there are a lot of small differences you want to demonstrate that just as well as
when there is big difference. The most common way of referring to differences is contrast. The range of
differences is typically referred to as a scale of contrast. When there are only one or two big differences this is
referred to as a short scale of contrast. Controversially where there are a lot of small differences it is referred to as
a Log scale of contrast. Obviously you need a kVp that is sufficient to penetrate the body area of interest. The
lower the kVp, the more likely the x-ray is to be absorbed by most any type of tissue. At quite high kVp, the
energy is sufficient enough that just about any tissue will be penetrated. So the objective of kVp selection is to
Diagnostic Imaging Systems, Inc.
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choose so that there is sufficient 4 penetration, but not so great as to over-penetrate. Over-Penetration will not
allow the differences or contrast to be depicted.
mA Selector: mA stands for milliampere: This is the measure of the number of electrons flowing in the x-ray
tube.

Activates a current flowing through the filament

Heats the filament causing electrons to be "boiled off"

Determines the number of x-rays produced per unit time.

The number of x-rays reaching the film determines the degree of blackening of the film.
Exposure Timer: Controls the Duration of electron flow being subjected to the voltage differential.
mAs Selector: mA stands for milliampere-seconds It is the multiplication of mA x seconds = mAs.

This combines the functions of the mA selector and the exposure timer.

Determines the total number of X-Rays produced.


When you change the mAs you change the number of x-rays produced. Film blackening is directly proportional to
the number of x-rays that pass through the object-Room Air or Patient Tissue.
Summary: 1) kVp controls x-ray energy and thus penetrating ability and thus scale of contrast. 2) mA x Sec
controls the total number of x-rays produced and thus film blackening.

Choosing The Appropriate Exposure Factors:


So how do you go about choosing the appropriate technique for the area that you want to display? The factors that
need to be considered are the type of tissue in the region of interest, the type of x-ray machine (Specifically the
type of generator), and the type of film-screen system being used.
General Principles: 1) Rely on kVp to penetrate the area 2) Rely on mAs to provide the film blackening.
The type of tissue in the region of interest constitutes the subject contrast and this is what you want to display. For
Example you want to display the difference between the bone cortex, the bone marrow cavity and the surrounding
muscle; you want to display the difference between the liver, the falciform fat, The intestinal wall and the
intestinal lumen; you want to display the difference between the air filled region of the lung, the pulmonary
vessels and the heart. The major way to depict these is in the
selection of the kVp used to image the area of interest.
In small animals and in the distal extremity region of the large animals where bone is the major structure of
interest, a relatively low kVp (60-70) is sufficient to penetrate the bone and soft tissue. The low kVp will be very
effectively absorbed by the bone mineral and provide good contrast. This level of kVp will provide a rather
"contrasty" image which most find pleasing to use for bone evaluation. To provide the film blackening needed
relatively high mAs will be needed. As always try to use the shortest time possible to prevent blurring from
patient motion.
In the Thorax where there is a large variation in the types of tissue present - Thin pulmonary vessels, thick
volume of the heart, very minimally absorbing aerated portion of the lung - a relatively high kVp (80-100) is
desirable to distinguish this variety of Subject contrast. As these x-rays will be quite energetic, not as many are
Diagnostic Imaging Systems, Inc.
2325 East Saint Charles Street
P.O. Box 3390
Rapid City, SD 57701
1-800-346-9729 Fax: 605-341-0053
www.vetxray.com

needed to establish the degree of blackening so a relatively low mAs is used. A short exposure time is essential in
the thoracic region to stop the blur of respiration motion.
The abdomen is more like the thorax than the skeletal regions when it comes to choosing your exposure factors.
There are three major tissue types in the abdomen, soft tissue, fat and gas. However the individual organs vary
significantly in thickness. A medium kVp (70-90) is desirable coupled with relatively low mAs. Although
respiratory motion is not as great of a problem, it is still best to keep the exposure time as short as possible.
Preferred Relative Exposures:

Skeletal - High mAs with low kVp

Abdomen - Medium mAs with medium kVp

Thorax - Low mAs with high kVp


The best way to create predictably good images in Veterinary radiography is to create and use a Technique Chart
that is particular to each body area. The technique chart is based on standardization of as many different variables
as possible and only changing one component of the exposure factors based on the thickness of the body area. To
create this technique chart initially involves a trial-error process. Once the ideal exposure factors have been
established for the desired area on your trial patient, there are simple mathematical relationships that can be used
to fill in the chart for any other thickness of that body area.
To Be Standardized are:
1) X-Ray Tube to film Distance.
2) Collimator
3) Use of grid or no grid
4) X-Ray film- intensifying screen combination and
5) Film processing.
6) Darkroom Lighting
X-Ray Tube-to-Film Focal Distance: This is a very simple relationship. The closer the x-ray tube is to the film the
greater is the intensity of the radiation exposure to the film. So by altering the x-ray tube to- film distance you can
effectively increase or decrease the blackening of the film. It is best to standardize this and is easiest to
standardize this with an x-ray machine that has the tube mounted on a stand that is fixed to the table and film
holder. This is the typical use in small animal radiography. Of the tube is manually positioned each time and
several different personnel are making images you need to use a measuring device to try to standardize the
distance. Variations in film blackening are often noted when multiple personnel hand position the tube as
everyone stands at just a little bit different distance from the patient. The relationship of x-ray Intensity to
distance is relatively profound - Intensity (1) = 1/d 2, Where d is the distance from the x-ray tube to the film. So
you can see that if you double the distance, you reduce the radiation intensity to 1/4th, most small animal
radiography is done at a fixed tube-film distance of 40 inches (100 cm). Large Animal Skeletal Radiography is
often done with 30 inch (75 cm).
Collimator: The collimator is a device used to restrict the x-ray exposure to a specified surface area of the body.
Its major result, relative to image quality, is that it significantly reduces the scattered radiation produced by the
patient and this improves image contrast. It also serves 2 major radiation safety purposes- #1 to reduce the
exposure to patient; and #2 to reduce the scattered radiation exposure to the animal holders if manual restraint is
Diagnostic Imaging Systems, Inc.
2325 East Saint Charles Street
P.O. Box 3390
Rapid City, SD 57701
1-800-346-9729 Fax: 605-341-0053
www.vetxray.com

used. Collimators are available either as various diameter exchangeable cones or as an adjustable permanent
attachment to the x-ray tube housing the cone type collimators must be removed and exchanged with a different
diameter to achieve a change in x-ray field size. The adjustable collimators typically have dials or slider controls
that allow you to change the field size. The adjustable collimator also usually has a light associated with it that
shows the field size on the patient. The light field type collimator greatly improves the ability to accurately
position the x-ray beam to the area of interest on the patient.
Use of a Grid or No Grid: A Grid is a plate that consists of parallel spaced bars of lead. Lead is a very effective
absorber of x-rays. The interspace material does not appreciably absorb x-rays. The purpose of the grid is to
absorb scattered x-rays between the patient and the film. The scattered x-rays are created within the patient by an
x-ray tissue interaction that results in the conversion of the incoming x-ray to an electron and a "new" x-ray with
somewhat less energy moving in a new direction. In essence the x-ray is deflected off its original straight-line
course. If this redirected "New" x-ray successfully exits the patient it delivers exposure to the film that is untrue
relative to the anatomical structure from which it originated. A fundamental assumption in the formation of the xray image is that the x-rays travel in straight lines from the origin in the x-ray tube through the patient to the film.
Most grids are focused grids. This means that the lead bars are angled in the same plane as the x-rays coming
from the tube. The grid is placed between the patient and the film. Most often in small animal systems the grid is
incorporated into the table positioned just above the film tray. Grids can also be purchased that are laid on top of
or independently affixed to the cassette. Grids are quite effective in removing the scattered x-rays from the image.
Removal of the scattered x-rays improves the contrast in the image. Grids are generally used for area thickness
greater than 10 cm. However, if you decide to use a grid for the area in question it may be easier to use it for all
thicknesses rather than to have to remember to activate it or deactivate it.

Making A Technique Chart:


Now that you have standardized as many factors as you can you are ready to do some trial exposures, looking for
the best for the area of interest. You can make charts that are variable kVp or variable mAs or those that are a
combination. Which type you make depends somewhat on the type of machine that you have to use. If you are
using a fixed kV, fixed mA, but variable time machine (like many of the smaller portable machines) then your
chart will by default be a variable mA chart. If your machine has mAs and kVp selector controls or if it has
independent mA, Time, and kVp selectors then you could make either type of a chart.
The basis for making a chart is to make several trial exposures until you find one that works vest for that area in
your trial patient. You then apply some mathematical relations to construct the selection factors for different sizes
of that area. For an example, if you were to make a variable kVp chart for the canine abdomen you would make 3
trial exposures of the area with the dog lying in lateral recumbency. Measure the thickness of the trial patient and
record it in cm. Because of the tissues within the abdomen use a fairly high kVp with relatively low mAs. Keep
exposure time short to do away with respiratory motion effects on the cranial organs. Pick 3 exposure settings: #1
- 300 mA for 1/60 sec (5 mAs) at 70 kVp; #2 - 300 mA at 1/120 sec (2.5 mAs) at 70 kVp; and #3 - 300 mA at
1/30 sec (10 mAs) at 70 kVp. One has double the mAs and one has half the mAs. Using good collimation for the
abdominal region, expose the three films and process them using standard processing technique. When the images
are viewed hopefully one will be of good quality - adequate background blackness (room air space around the
patient) and good contrast scale for the abdomen. One should also be underexposed (overall too white) and one
should be overexposed (overall too black). If none were acceptable, you would repeat the test exposure modifying
Diagnostic Imaging Systems, Inc.
2325 East Saint Charles Street
P.O. Box 3390
Rapid City, SD 57701
1-800-346-9729 Fax: 605-341-0053
www.vetxray.com

from the one that came the closest to what you want the image to look like. If you must repeat a second set of trial
exposures you could modify any of the exposure factors, however it is preferable to alter the mA or exposure
time.
Once you have found the optimal or best set of exposure factors for the trial dog'
s lateral abdomen you are ready
to fill in the working chart for other thicknesses. There is a fairly linear relationship between kVp, area thickness,
and response of the film-screen system.
In the range of kVp less than 80 a change of 2 kVp for each cm change in thickness will maintain a quality
image.
Between 80-100 kVp the change is 3 kVp for each cm change in thickness.
For kVp greater than 100 the change must be 4 kVp for every cm change.
This allows you to make a variable kVp chart for the abdomen. You would try this out on the same dog by taking
the VD view. Measure the abdomen, look up the kVp calculated for that thickness on your working chart & try it
out. You would then repeat this process for every body area that you anticipate will need to be looked at
radiographically. Most small animal charts contain factors for Head; Spine; thorax; abdomen; pelvis/hip joints;
shoulder; elbow/stifle/bones distal to elbow & stifle. Most equine charts have different settings for a region and
for a specific view within that region. For example the equine foot requires increased exposure factors to
emphasize the navicular bone versus the thin solar margin of the 3rd phalanx.
As you repeat the trial process for each body region some general guidelines for modifying the general chart are:
Low kVp settings with concurrent high mAs settings give the best contrast for the skeletal regions.
High kVp setting with concurrent low mAs Settings give the best scale of contrast for the thorax and abdomen.
Film blackening is directly proportional to the product of the mA and the exposure time = mAs factor.
Film blackening will also change with a change in kVp. This is best used to change the film blackness by a
small amount. If you need a large change in film blackening you need to change the mAs. This is preferred in that
it retains the contrast scale for the area being evaluated. However a 15% increase in kVp will effectively double
the film blackness (would have the same effect as doubling the mAs). Controversially a 15% decrease in kVp will
effectively half the film blackness (would have the same effect as halving the mAs) these latter two changes have
then most profound effect between 70-90 kVp.
Any technique chart when first developed is a working chart. You may find that you need to make minor
adjustments as you use it for the first several weeks. However, it then should become quite reliable. It is also good
practice to record the exposure factors used for each patient. Then if a re-check of that region is needed, you can
use the same exposure factors and be more likely to detect true change in the patient. We find it easiest to record
the area, exposure factors, film-screen type on the outside of the patients radiographic film filing envelope.

Diagnostic Imaging Systems, Inc.


2325 East Saint Charles Street
P.O. Box 3390
Rapid City, SD 57701
1-800-346-9729 Fax: 605-341-0053
www.vetxray.com

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