The AAPWRSNA Physics

Tutorial for Residents

X-ray Attenuation1
I
article meets the Marlene H. McKetty, PhD
criteriafor 1.0 credit
hour in category I of
f/ic AMA Plnjsicians Attenuation is the reduction of the intensity of an x-ray beam as it traverses
Recognition Award.
matter. The reduction may be caused by absorption or by deflection (scat-
To obtain credit,see
ten) of photons from the beam and can be affected by different factors such
the questionnaire on
pp 145-150. as beam energy and atomic number of the absorber. An attenuation coeffi-
cient is a measure of the quantity of radiation attenuation by a given thick-
- ness of absorber Linear and mass attenuation coefficients are the coeffi-
LEARNING
cients used most often The equation I = I e expresses the exponential re-
OBJEC11VES _J lationship between incident primary photons and transmitted photons for a
After reading this article monoenergetic beam with respect to the thickness of the absorber and thus
and taking the test, the
may be used to calculate the attenuation by any thickness of material. The
reader will:
quality or penetrating ability of an x-ray beam is usually described by stat-
. Understand the con- ing its half-value layer (HVL). Another parameter used to describe the pen-
cept of attenuation prob-
etrating ability of a beam is the homogeneity coefficient. Among other
ability and the terms
used to describe it. things, use of added filtration reduces the intensity of the x-ray beam, in-
creases the HVL, decreases patient exposure, and improves image quality
. Be aware of the various
factors that affect attenu- for a given radiation dose.
ation and how they affect
it. . INTRODUCTION
. Be familiar with expo-
In conventional radiography and fluoroscopy, an x-ray beam is passed through the
nential attenuation rela- body section and projects an image onto a receptor. The beam that emerges from
tionships and be able to the body varies in intensity. The variation in intensity is caused by x-ray attenua-
perform relevant calcu- tion in the body, which depends on the penetrating characteristics of the beam and
lations.
the physical characteristics of the tissues.
. Know the difference in This article discusses x-ray attenuation, which represents a logical progression
attenuation in monochro- from the topics of production and interaction of x rays but at the same time is in-
matic versus polychro-
tertwined with them. The principles that apply to x-ray attenuation also apply to
matic beams and know
the effects of added
gamma ray attenuation. The article reviews five major areas: (a) the concept of
filtration.

. Be familiar with the

definition and measure-
ment of half-value layer.
Abbreviations: HVL half-value layer, NCRP National Council on Radiation Protection and Measurements, TVL
tenth value layer

Index terms: Physics Radiography

#{149}

RadioGraphics 1998; 18:151-163

From the Department of Radiology, Howard University Hospital, 2041 Georgia Aye, NW, Washington, DC 20060.
From the AAPM/RSNA Physics Tutorial at the 1996 RSNA scientific assembly. Received August 21, 1997; revision re-
quested October 9 and received November 11; accepted November 13. Address reprint requests to the author.

RSNA, 1998

151
 Incident beam, unattenuated

Ionization
Incident beam Attenuated beam

chamber

Figure 1. Diagrams
an unattenuated
show
x-ray beam
(top) and an x-ray beam pass-
Lj
ing through a foil (bottom)
into detectors. Foil

attenuation and the terms used to character- The thickness of a material can be expressed
ize it, (b) the factors that affect attenuation, in different units of measure, for example,
(c) exponential attenuation relationships, meters, kilograms per meter squared, and
(d) concepts involved in the attenuation of electrons pen meter squared.
monochromatic and polychromatic x-ray An attenuation coefficient is a measure of
beams, and (e) half-value layer (HVL) mea- the quantity of radiation attenuated by a
sunements and their significance. given thickness of an absorbing material. The
linear attenuation coefficient, symbolized by the
U DEFINITION OF ATTENUATION Greek letter .t, is the fractional change in x-
Attenuation is the reduction of the intensity of ray intensity per the thickness of the attenu-
an x-ray beam as it traverses matter. The re- ating material because of interactions in a
duction may be caused by absorption (in this given material:
process, energy is transferred from the pho-
tons to atoms of the target or irradiated ma- =N/NAx, (1)
terial) or by deflection of photons from the
beam (scatter). where N is the number of photons removed
In the example of a beam of x rays passing from the x-ray beam in thickness \x. In
through a foil and into an x-ray detector, Equation (1), for any given Ii, Ex must be
some of the photons will interact with the foil chosen so that the number of photons re-
and be absorbed completely from the beam moved from the beam is much smaller than
and some photons may be scattered (Fig 1). If the total number of photons. As the thickness
one measures the intensity of the beam (a) af- of the attenuating material increases, the
ten it has been attenuated by the foil and as it equation is no longer correct and the rela-
strikes the detector and then (b) without the tionship becomes nonlinear.
foil and as it strikes the detector, one obtains The linear attenuation coefficient is mea-
a quantitative measurement of the interaction sured in units of pen unit length, which is
of the x rays with the material contained in most commonly expressed in terms of centi-
the foil. meters or millimeters. Attenuation rate can
The intensity of an x-ray beam passing also be expressed in terms of the mass of the
through a layer of attenuating material de- material encountered by photons. The mass
pends on the thickness and type of material. attenuation coefficient is obtained by dividing
the linear attenuation coefficient by the den-
sity of the material through which the pho-

152 U Imaging & Therapeutic Technology Volume 18 Number 1

 Table 1
Relationships among the Attenuation Coefficients

Units in Which Thickness is

Coefficient Relationship Units of the Coefficients Measured

Linear (li) . . . /cm cm

Mass (lt/p) J.t/p /g/cm2 g/cm2
Atomic (11a) l1IPZINe /atom/cm2 atom/cm2
Electronic (lie) i/ P4/Ne /electron/cm2 electron/cm2

Note. - Ne number of electrons per gram, Z = atomic number.

Table 2
Physical Properties of Selected Materials

Effective Atomic Density 50 keV Linear Attenuation

Material Number (Z) (g/cm3) Coefficient (cm1)

Water 7.4 1.0 0.214

Ice 7.4 0.917 0.196
Water vapor 7.4 0.000598 0.000128
Compact bone 13.8 1.85 0.573
Air 7.64 0.00129 0.00029
Fat 5.92 0.91 0.193

Note. - Data from reference I.

tons pass and thus is represented by the sym- efficient is obtained by dividing the mass at-
bol pjp. Mass attenuation coefficient is the tenuation coefficient by the number of elec-
rate of photon interactions per unit area mass trons per gram.
and is independent of the physical state of
the material. The typical unit of the mass at- U FACTORS AFFECTING ATTENU-
tenuation coefficient is per gram per centime- ATION
ten squared (cm2/g), since the unit in which Several factors affect attenuation. Some are
thickness is measured is gram per centimeter related to the x-ray beam or radiation and
squared (the mass of a 1-cm2 area of mate- the others to properties of the matter through
na!). The coefficient is the inverse of the unit which the radiation is passing. The factors in-
in which thickness is measured. dude beam energy, the number of photons
Other attenuation coefficients are the elec- traversing the attenuating medium or ab-
tronic and atomic coefficients, in which the sorber, the density of the absorber, and the
thickness of the attenuating medium is ex- atomic number of the absorber. As noted, the
pressed as the number of electrons or atoms greater the thickness of the attenuating mate-
per unit area, respectively. The relationship rial, the greater is the attenuation. Similarly,
among the attenuation coefficients is shown as the atomic number or density of the mate-
in Table 1. nial increases, the attenuation produced by a
The atomic attenuation coefficient 1a is the given thickness increases. Thus, different ma-
fraction of an incident x-ray or gamma ray terials such as water, fat, bone, and air have
beam that is attenuated by a single atom (ie, different linear attenuation coefficients, as do
the probability that an absorber atom will in- the different physical states or densities of a
teract with one of the photons in the beam). material, such as water vapor, ice, and water
The atomic coefficient is obtained by divid- (Table 2; Figs 2, 3).
ing the mass attenuation coefficient by the
number of atoms per gram. The electronic co-

January-February 1998 McKetty U RadioGraphics U 153

 I I

U,
ZA>ZB f E1>E2

a
C
a, 0.5 . 0.5 Energy E1
>

a, a,

0 0
0 5 10

Thickness (cm) Thickness (cm)

2. 3.
Figures 2, 3. (2) Effect of atomic number on x-ray attenuation. Graph shows the variation in intensity
versus thickness of two materials. Material A has a greater atomic number (Z) than material B; therefore,
less thickness of material A is needed to reduce the intensity to any chosen value. (3) Effect of radiation en-
ergy on x-ray attenuation. As photon energy increases, the attenuation produced by a given thickness of
absorber decreases. Graph shows the variation in intensity versus thickness for two beams. Beam I (E1) is
of a greater energy than beam 2 (E,). The lower-energy beam is attenuated more rapidly by a chosen thick-
ness of absorber.

To understand the relationship between distribution of energy between the recoil

attenuation and energy, one must be familiar electron and scattered photon depends on
with three of the basic interactions of x and the energy of the incident photon and the
gamma nays with matter: photoelectric, angle of emission of the scattered photon.
Compton, and pair production interactions. The probability that a Compton interaction
In a photoelectric interaction, a photon col- will occur decreases with an increase in en-
lides with an atom and causes an electron to ergy.
be ejected from one of the electron orbital Pair production involves an interaction be-
shells around the nucleus of the atom. The tween a photon and an atomic nucleus, but it
energy of the ejected electron is equal to the can occur only if the energy of the incident
energy of the incoming photon minus the photon is greater than 1.02 MeV. Therefore,
binding energy of the electron. The more this interaction does not occur in the energy
closely bound the electron, the higher is its range of x-ray beams used for diagnostic ra-
binding energy; consequently, the energy of diology.
the ejected electron is lower. The probability Photoelectric and Compton interactions
that a photoelectric interaction will occur is produce attenuation in the diagnostic energy
most likely when the energy of the incoming range. The probability that either interaction
photon and the binding energy of the elec- will occur decreases as photon energy in-
tron are nearly the same. The probability of a creases, but the decrease in the photoelectric
photoelectric interaction varies with photon effect is more rapid than the decrease in
energy approximately as l/E3 and varies Compton scattering. Although beam attenua-
with atomic number (Z) approximately as Z3. tion caused by the photoelectric effect rap-
Thus, as photon energy is increased, the pho- idly decreases with increasing energy, there
toelectric interaction decreases. may be periodic increases in the attenuation.
A Compton interaction on scattering oc- The jumps on increases in attenuation cone-
curs when an incident photon collides with a spond to the orbital shells in which electrons
free electron and causes it to move from its are bound. The highest energy at which the
orbital shell. The photon is deflected at an attenuation jumps or increases is known as
angle and therefore travels in a new direc- the K absorption edge, which corresponds to
tion. The deflected on scattered photon has the binding energy of the K-shell electrons.
reduced energy. The remainder of the energy Additional absorption edges exist at lower
of the incident photon is transferred to the energies that correspond to the binding ener-
electron, which is called a recoil electron. The gies of more loosely bound electrons in outer
shells. At each absorption edge, there is an
abrupt increase in attenuation.

154 U Imaging & Therapeutic Technology Volume 18 Number 1

 - 100 Lead
C
5)

0
Nal - . -.
Photoelectric
a) Water- - - -

8 10
C
0
Ca

C
a)
I Air
C,

0)
-

-
-

. -
-

.
Compton
Rayleigh

Pair
Ca
U)
E
U)
C)
Ca
E 0.1 .

Ca
0

0.01
0.01 0. 10
Energy (MeV) Energy (MeV)
4. 5.
Figures 4, 5. (4) Mass attenuation coefficients for selected materials as a function of photon energy.
Graph shows the variation of si/p for sodium iodide, lead, water, and air. (5) Mass attenuation coefficients
for photons in air. Graph displays the mass attenuation coefficient for air (with an effective atomic number
of about 7.6) for specific interactions with x rays and the total attenuation as a function of energy.

Photoelectric interactions are important ample, the attenuation curve for sodium io-
for a low-energy range (up to 50 keV) and dide will show an increase at 33 keV because
materials with large atomic numbers. Pair the K electron binding energy is 33 keV for
production interaction is important only for a iodine (Figs 4, 5). The attenuation curve for
very high energy range (5-100 MeV) and ma- lead will show an increase at 88 keV (Figs 4,
terials with large atomic numbers. Compton 5). The curves decrease more slowly in the
interaction is predominant in the intermedi- region in which the Compton effect is impor-
ate energy range (60 keV-2 MeV) for all ma- tant. Because the mass attenuation coeffi-
tenials, regardless of atomic number (1). The cients do not depend on density and the
relative probability of each type of interac- physical state of the absorber, numeric data
tion is proportional to the cross section for are often expressed in terms of these coeffi-
that process. Cross section is defined as the cients, rather than linear attenuation coeffi-
probability that a particular reaction will oc- cients.
cur. The total linear attenuation coefficient is The range of energies used in x-ray imag-
equal to the sum of the individual interac- ing is chosen to optimize the diagnostic x-ray
tions and their cross-sectional values: information and to minimize the radiation
absorbed by the patient. Both these factors
totaI = c + K, depend on the mass attenuation coefficients
of various materials and tissues.
where t = photoelectric, Compton and The importance of linear and mass attenu-
classical, and x pair production interac- ation coefficients can be demonstrated in sev-
tions. This equation with the appropriate eral clinical situations. Contrast agents that
subscripts applies to the mass, electronic, and contain iodine and barium are used because
atomic coefficients. of their large attenuation coefficients, which
In radiography performed with low ener- increase the visibility of anatomic structures
gies (<30 keV), photoelectric effect is most that contain the contrast agent. The increased
important in soft tissue and bone. As the x- attenuation is caused by the atomic number
ray energy is increased, Compton scattering and K absorption edge of the contrast agent
becomes the predominant interaction. If t is being greater than those of the surrounding
plotted versus photon energy for air, soft tis- tissue. In cases in which the penetration
sue, and lead, the curves fall rapidly with in- of x rays must be reduced, a shielding mate-
creases in energy because of the rapid de- rial with a large attenuation coefficient is
crease of the photoelectric effect. However, at
the K absorption edge, there will be an in-
crease in the attenuation coefficient. For ex-

January-February 1998 McKetty U RadioGraphics U 155

 Transmission-.l000 800 640 512
.n ____ N
...

_____
.
,- a,..
______
5
a,. .

p:-.
:5
____ a,.

,,
.; . -
Figure 6. Exponential attenuation .. ____
a, .

relationships. Each absorber re-

Attenuation 20% 20% 20%
duces the transmission of x rays by
20%. if one starts with 1,000 pho-
tons, the first absorber will reduce N(x)=N0e
the number of photons to 800; the
second, from 800 to 640; the next,
from 640 to 512; and so on to an ex-
ponentially diminishing number of
photons. Thickness of tissue

required. Shielding is achieved by using ma- number of photons in a beam weighted by its
tenials with a high atomic number, such as energy) is the quantity that is most often
lead. measured. Exponential reduction in the num-
ben of photons is demonstrated in Figure 6. If
U EXPONENTIAL ATTENUATION I/Jo 5 plotted as a function of x on linear
RELATIONSHIPS graph paper, an exponential curve will be ob-
Attenuation measurements of a monoener- tamed (Fig 7). The logarithm of the number
getic (monochromatic) beam of x or gamma of photons transmitted varies linearly with
rays depend on the number of photons inci- the thickness of the attenuating material;
dent on an absorber, the number of photons therefore, if the logarithm of I/I,, is plotted
transmitted through the absorber, and the against x, a straight line graph will result.
absorber thickness. The expression j.t = This plot is referred to as a semilogarithmic
Lx previously discussed must be trans- plot because one axis is logarithmic and the
formed into a more convenient form. If N other linear.
and Ex are very small, they are known as dif- Polychromatic beams contain a spectrum
ferentials and the differential equation is of photon energies. With an x-ray beam, the
solved by using calculus to give the follow- maximum photon energy is determined by
ing equations: the peak kilovoltage (kVp) used to generate
the beam. Because of the spectrum of photon
I = I et
0
(2) energies, the transmission of a polychromatic
and beam through an absorber does not strictly
N = N e, 0
(3) follow Equation (3). When a polychromatic
beam passes through an absorber, photons of
where I = beam intensity at an absorber low energy are attenuated more rapidly than
thickness of zero, x absorber thickness, I the higher energy photons; therefore, both
beam intensity transmitted through an ab- the number of transmitted photons and the
sonben of thickness of x, e base of the natu- quality of the beam change with increasing
nal logarithm system, .t attenuation coeffi- amounts of an absorber. A semilogarithmic
cient, N = number of transmitted photons, plot of the number of photons in a polychro-
and N0 = number of incident photons. matic beam as a function of the thickness
These equations may be used to calculate of the attenuating materials will not be a
attenuation by any thickness of material straight line but will be a curve (Fig 8). The
when the incident and transmitted photon in- initial slope of the curve is steep because the
tensity or photon number is measured. In di- low-energy photons are attenuated, but, as
agnostic radiology, photon intensity (ie, the the beam becomes more monochromatic, the
slope decreases. A comparison of the curves
for polychromatic and monochromatic radia-
tion is shown in Figure 9.

156 U Imaging & Therapeutic Technology Volume 18 Number 1

 Linear Scale Semi-log Scale
1000 1000

U, U,
C 800 C

a 2
0 0

800
100
E 400 E
#{149}1 U,
C C
a, a,
I- 200

Figure 7. Attenuation of
0 10
monochromatic radiation
0 4 8 12 16 20 0 4 8 12 16 20 plotted on a linear scale and
cm of water cm of water semilogarithmic scale.

100 kVp spectrum Semi-log Scale

2.5 mm Al Inherent filtration
I mmAlinciema,ts 100

C
0
U,
Ce
E
U,
C
a,
I-
C
a,
U

a,
0.

30 40 50 80 70 80 90 100 10
Energy(keV) 0 1 2 3 4 5

Increase in effective energy (keV): Absorbflr thickness (mm Al)

48.5. 50.2.51.7, 53.0, 54.1
Figure 8. Attenuation of polychromatic radiation. Photons of low en-
ergy are attenuated more rapidly than the higher-energy photons, result-
ing in a change in the number of photons with increasing amounts of ab-
sorber and a change in the quality of the x-ray beam. This is illustrated in
the left graph of a bremsstrahlung spectrum, progressively attenuated by
1 mm aluminum filters. A semilogarithmic plot of the number of photons
in a polychromatic beam as a function of thickness of the attenuating ma-
terial will be a curve, as shown in the right graph.

1000 Figure 9. Graph shows a comparison of the curves

U,
- 100 keV for polychromatic and monochromatic radiation. An
C
0
0
monochromatic important point here is the comparison between kilo-
100 electron volt and peak kilovoltage. A monoenergetic
x-ray photon beam at 100 keV (effective energy, 100
E
U,
keV) is substantially more penetrating than a compa-
C 10
I 00 kVp rable x-ray photon beam produced at 100 kVp (effec-
C-

polychromatic tive energy, -40 keV, depending on filtration of the

beam). Most of the x-ray photons in a bremsstrah-
lung spectrum are composed of substantially lower
0 1I20
energies than the peak energy, thus resulting in a sig-
cm of water
nificant increase in attenuation, which is nonlinear
on the semilogarithmic graph illustrated. (Redrawn
from reference 2 and reprinted with permission.)

January-February 1998 McKetty U RadioGraphics U 157

 Narrow beam geometry

Figure 10. Diagram demonstrates

the ideal setup for measurement of
HVL. The sensitive volume of the 50 cm (Cu or Al)
exposure meter is positioned on or more
the axis of the x-ray beam, at a
minimum of 50 cm from the colli-
mator and from the walls and
floor. The x-ray beam should be Detector:
collimated tightly around but to- ionization
tally include the sensitive volume chamber
of the radiation detector.

U HVL MEASUREMENTS collimator or beam-defining system of the x-

The penetrating ability or quality of an x-ray ray unit so that radiation scattered from the
beam is described explicitly by its spectral added absorbers is avoided. There should be
distribution, which indicates the energy no scattering material in the vicinity of the
present in each energy interval. However, the detector, which should be at least 50 cm from
HVL or half-value thickness is the concept the walls or floor. The x-ray beam should be
used most often to describe the penetrating about 5 x 5 cm at the detector and should
ability of x-ray beams of different energy 1ev- completely include the sensitive volume of
els and the penetration through specific ma- the detector.
tenials. The HVL is defined as the thickness of The conditions just described under which
a standard material that reduces the beam in- the HVL measurements should be made are
tensity to one-half. At energy levels below referred to as narrow-beani conditions or con-
120 kV, HVLs are usually measured in mlii- ditions of good geometry. This is in contrast
meters of aluminum; at energy levels of 120- to broad-beam conditions, in which a large x-
400 kV, HVLs may be expressed in millime- ray beam is used and only a small distance
tens of copper. exists between the absorber and detector.
The HVL of an x-ray beam is obtained by With broad-beam geometry, a large number
measuring the exposure rate from the x-ray of photons from the absorber are scattered
generator for a series of attenuating materials into the detector.
or attenuators placed in the beam. The first HVL measurements should always be
measurement is made with no attenuator be- made under narrow-beam geometry condi-
tween the x-ray source and detector, and tions to ensure that the only photons that
then measurements are made for succes- reach the detector are primary photons trans-
sively thicker attenuating materials. The at- mitted by the attenuating material. Figure 11
tenuators should have constant composition shows the two types of measurement condi-
and should not contain impurities. The setup tions.
for HVL measurements is shown in Figure A graph is made of exposure readings (or-
10. dinate or y axis) versus thickness of the at-
The sensitive volume of the exposure tenuating material (abscissa or x axis). The x-
meter is positioned on the axis of the x-ray ray intensity equal to one-half the original in-
beam. It should be at least 50 cm from the tensity and the corresponding thickness of
the attenuating material (ie, HVL) are deter-
mined. Results of a typical measurement se-
nies are shown in Figure 12.

158 U Imaging & Therapeutic Technology Volume 18 Number 1

 Collimator Collimator

Attenuator
Figure 11. Diagrams illus-
Attenuator
trate the geometry for nar-
row-beam and broad-beam
Source I, Source
conditions. HVL measure-
----p Detector Detector ments should always be
made under narrow-beam
INScattered photons
geometry conditions to en-
arc sure that only primary (unat-
not detected
scattered into the tenuated) photons reach the
detector detector. (Redrawn from ref-
erence 3 and reprinted with
Narrow-Beam Geometry Broad-Beam Geometry permission.)

Absorber X-ray exposure Filtration Exposure rate UVI.

thickness (mm) mmCu R man mm Cu
0 68 0.35
0 I iS 100
20 1.3
82 1.8
11.4
63
3 7.6 2.3
3 51
.1 5.5 2.7
.1 38
29

120

E 100 10
E
;8o
Ce
0 60
0.
C
a,
>.

a,
* 20

0 I
0 1 2 3 4 5
01234567
Absorber thickness (mm Al)
Filtration (mm Cu)

Figure 12. Results of a typical measurement series for HVL determination are shown
for a lower-energy beam (left) measured with aluminum and a higher-energy beam
(right) measured with copper. The graph on the right has several sequential HVLs mdi-
cated below the curve. For example, the first HVL is the thickness required to reduce the
original intensity of the beam from 68 R/min (1.75 x 102 C/kg/mm) to 34 R/min (8.77 x
10-s C/kg/mm), which graphically is determined as 0.35 mm copper. After the addition
of 1 mm copper, the beam is now reduced to 20 R/min (5.16 x 10 C/kg/mm). The HVL
of the beam including the 1 mm copper is the thickness required to reduce the beam to
10 R/min (2.58 x 10 C/kg/mm). The thickness is graphically determined as 1.3 mm
copper, indicating the greater penetrability of the beam with added filtration. Several
other HVLs indicated on the graph are determined in a similar fashion. (Right graph re-
drawn from reference 1 and reprinted with permission; left graph redrawn from refer-
ence 4 and reprinted with permission.)

January-February 1998 McKetty U RadioGraphics U 159

 I 00 I 00

75
E

I)
50
Broad a
11)

25 0 rge Filter
deor tector
near (B)field

sotwce (A) Small field

Ui

0 10

0 1 2345 01234567

Thickness (cm) Filtration (mm Cu)

Figure 13. Attenuation curves and HVLs for narrow- and broad-beam geometry.
Broad-beam conditions will indicate a greater penetrating power of the beam (ie, a
greater HVL or haif-value thickness), which is not truly representative of the actual
value. This result is chiefly due to attenuation caused by scatter, which reaches the de-
tector in broad-beam or poor geometry conditions because either the field area is too
large or the attenuating material is too close to the detector, as shown in the right graph
and diagram. Right graph shows the results for the filter near the detector and the filter
near the source for a small field and a large field. (Values for R/min can be converted to
SI units with the factor 10 R/min 2.58 x 10 C/kg/mm.) = Note that as four measure-
ment conditions are varied, one can obtain four different apparent HVLs. Left graph in-
dicates an HVL of 2 cm with narrow-beam geometry and 2.8 cm with broad-beam con-
ditions. (Modified from reference 1 and reprinted with permission.)

A complete attenuation curve is not essen- (ie, if the thickness of the absorber is 1 HVL),
tial for routine dosimetry; rather, thicknesses then:
of the attenuating material that reduce the
exposure rate to slightly more than haif and 1/10 - 0.5;
to slightly less than half are required. The therefore,
difference in apparent attenuation for broad 1/10 = 0.5 = e-
and narrow beams is seen in Figure 13. Un-
den broad-beam conditions, the beam will ap- If the natural logarithm (inverse function
pear to have greater penetrating power (ie, a of the exponential) is calculated for each side
greater HVL or half-value thickness) than if it of the equality,
were measured with narrow-beam geometry.
in [0.5] = in [e-]
U RELATIONSHIP OF HVL AND -0.693 = jiHVL
LINEAR ATTENUATION COEFFI-
CIENT HVL = 0.693/si (4)
For a monoenergetic beam of x-ray or gam-
ma ray photons, it was already determined l 0.693/I-IVL. (5)
in Equation (2) that I I0e. When x HVL =

Thus, knowledge of the HYL allows the

calculation of the effective attenuation coef-
ficient, and similarly, knowledge of the effec-
tive attenuation coefficient allows the determi-
nation of the HVL of the radiation beam. This
is particularly important for polychromatic

160 U Imaging & Therapeutic Technology Volume 18 Number 1

 t = 0.693 I HVL = 0.693/0.24 cm
given: HVL 2.4 mm Al
= 0.24 cm Al

Figure 14. Illustra-

Energy (keV) tion shows how effec-
interpolate table values to estimate Eff: tive energy can be de-
10 70.74
termined by measur-
15 21.33 Energj (keV) ing HVL (eg in mil-
20 9.153 limeters of aluminum)
3.024 30 and calculating the lin-
30
ear attenuation coeffi-
40 2.888 ? 30.9
cient j.t with Equations
50 (4) and (5). Effective
60 0.748 energy is determined
1.525 40
from interpolating val-
80 0.543
ues in the table of ji
I 00 0.459 Effective Energy = 30.9 keV versus energy.

spectra with a variable attenuation that de- U DETERMINATION OF EFFECTIVE

pends on the energy intensity and filtration of ENERGY
the beam. For polychromatic x-ray beams (which contain
The HVL can be easily calculated from the a spectrum of photon energies), the penetra-
linear attenuation coefficient for a monoen- tion and thus the HVL is different for each en-
ergetic photon beam and vice versa. For ex- ergy. The effective energy of an x-ray beam is
ample, if the linear attenuation coefficient for the energy of a monoenergetic beam of pho-
aluminum at an energy level of 100 keV is tons that is attenuated at the same rate as the
0.459/cm, then using the equation HVL x-ray beam, in other words, that has the same
0.693/j.t, the HVL for aluminum is 0.693/0.459 HVL as the spectrum of photons in the beam.
or 1.51 cm. The effective energy is about 30%-50% of peak
For a polychromatic beam (eg, from an x- energy.
ray tube), the attenuation coefficient is not if the HVL and mass attenuation coeffi-
explicitly known. In this situation, a measure- cients or linear attenuation coefficients for a
ment of the HVL with narrow-beam geom- given material are known, the effective energy
etry methods allows determination of the ef- of a polychromatic beam can be calculated
fective attenuation coefficient of the attenuat- (Fig 14). First, the effective linear attenua-
ing material for the specific polychromatic tion coefficient is determined on the basis of
beam. the HVL through the relationship of .t and
HVL previously discussed. This value is then
U TENTH VALUE LAYER compared with tabulated values. To deter-
The tenth-value layer (TVL) is the thickness mine an accurate energy value, interpolation
of a material that will reduce the incident in- of the values in the table is performed. If a
tensity by a factor of 10 (90% attenuation, mass attenuation curve is available for a given
10% transmission): material as a function of energy, the interpola-
tion is automatically determined by using
I/I, = 0.1 = eMW the effective mass attenuation value. In this
TVL = 2.303/si. case, the effective energy value is determined
at the intersection of the attenuation curve and
TVL is often used for shielding calcula- the effective mass attenuation coefficient value
tions, in which barriers can be specified in (Fig 15).
the number of TVLs. The shielding calcula-
tions determine the amount of attenuating
material required to protect individuals
working with or near radiation sources or x-
ray units.

January-February 1998 McKetty U RadioGraphics U 161

 U HOMOGENEITY COEFFICIENT Aluminum attenuation
20
The
used
homogeneity
in addition to the
coefficient
HVL
is sometimes
as a descriptor
C
a,
U
10 I I I I I I I I
of beam quality for polychromatic spectra. 5

A monoenergetic beam is attenuated ac- U

C
2 ii T1 S ii iii i: ii ii iii iii
cording to the exponential attenuation law. 0

a,
I = EEE =
Thus, if the first HVL reduces the beam to = = = = = = = = =
C 0.5 - - - - - - - - -

one-half, a second HVL will reduce it by one- - - - - - -

-
-
-
- -

a,
half again to one-quarter. With a monoenen- U, 0.2
U,
getic beam, the first and second HVLs are a, 0.1
E 10 20 30 40 50 60
equal.
Energy (key)
With a polychromatic beam, photons of
Figure 15. Illustration shows how effective en-
low energy are attenuated more rapidly than
ergy can be determined with use of graphical in-
photons of higher energy. The second HVL
terpolation. HVL is measured in the same way as
(ie, the thickness required to reduce the pen- in Figure 14 (eg, in millimeters of aluminum), and
etration to one-quarter) is larger than the first the linear attenuation coefficient is calculated with
HVL. The ratio of the two HVLs first HVL/ - Equations (4) and (5). The correct energy is deter-
second HVL is called
- the homogeneity coef- mined from the graph at the intersection of the at-
ficient. It follows that the homogeneity coeffi- tenuation curve and the effective mass attenuation
coefficient value.
cient for a polychromatic beam is less than
one.

U EFFECTS OF ADDED FILTRATION Inherentfiltration occurs when the x-ray

Diagnostic x-ray beams are polychromatic, beam is attenuated by the glass envelope sun-
and the mean energy is approximately 30%- rounding the anode and cathode in the x-ray
50% of the peak energy. As a polychromatic tube, the insulating oil, and the exit window
beam passes through matter, the low-energy or port. Added filtration consists of absorbers
photons are attenuated more rapidly than the that are deliberately added to the beam to
high-energy photons and the effective energy provide filtration. In diagnostic radiology,
of the beam increases. The increase in effec- aluminum is usually used for added filtra-
tive energy that occurs with increasing thick- tion, but compound filters containing copper
ness of attenuating material is called beam and aluminum or other materials may be
hardening. Therefore, any absorber, whether used. The filter is positioned in the exit port
the patient or an added filter, will cause the of the x-ray tube between the housing and
beam to harden. collimator assembly. The collimator assembly
The x-ray beam is filtered by (a) inherent also adds to the filtration. The total amount
filtration, (b) added filtration, and (c) the pa- of added filtration is specified in terms of
tient. The primary purpose of added filtra- aluminum equivalent thickness and, in a
tion is to remove the low-energy photons that typical x-ray unit, is about 2-3 mm alumi-
are not energetic enough to reach the film. If num equivalent thickness, 1 mm of which is
these photons are not removed by a filter, from the collimator assembly. Inherent filtra-
they will expose the patient to radiation but tion adds about 0.5 mm aluminum equiva-
will not arrive at the film to form the radio- lent.
graph. Added filtration provides several advan-
tages: (a) it alters the shape of the x-ray spec-
trum, (b) it causes a shift in the effective en-
ergy of the x-ray beam by selectively remov-

162 U Imaging & Therapeutic Technology Volume 18 Number 1

 tages. The NCRP values are shown in Table
>.

U,
3. HVL measurements and values are used to
C
a, indicate if these filtration criteria are met.
C
Figure 16 demonstrates the effect of added
a,
filtration on a polychromatic x-ray beam.
a,
U CONCLUSIONS
a, One of the technical principles on which radi-
a,
ography is based is the difference in attenua-
tion by different materials; thus, an under-
0 20 40 60 80 100 standing of attenuation probability, the units
Photon Energy (key) for describing it, and the factors affecting it is
Figure 16. Graph demonstrates the effect of essential. A practical way of expressing the
added filtration on the energy and intensity of a penetrating ability of x-ray beams from dif-
polychromatic x-ray beam. (Modified from refer- ferent x-ray tubes is by using the concept of
ence 2 and reprinted with permission.) HVL, which must be measured under nar-
row-beam geometry conditions.

Table 3 Acknowledgments: The author thanks Diana M.

Required Minimum Total Filtration for Roach for her assistance in the preparation of the
X-ray Tubes manuscript, and J. Anthony Seibert, PhD, for as-
sistance in preparing the figures.
Operating Tube
Potential (kVp) Total Filtration
U REFERENCES
Below 50 0.5 mm aluminum 1. Johns HE, Cunningham JR. The interaction of
(0.03 mm Mo for mo- ionizing radiation with matter. In: The phys-
lybdenum target ics of radiology. 4th ed. Springfield, Ill: Tho-
tubes) mas, 1983; 133-164.
50-70 1.5 mm aluminum 2. Curry TS III, Dowdy JE, Murry RC Jr. Attenu-
Above 70 2.5 mm aluminum ation. In: Christensens physics of diagnostic
radiology. 4th ed. Philadelphia, Pa: Lea &
Note. - Recommended by NCRP (7).
Febiger, 1990; 70-92.
3. Bushberg JT, Seibert JA, Leidholdt EM Jr.
Boone JM. Interaction of radiation with mat-
ing more low-energy photons than high-en- ter. In: The essential physics of medical imag-
ing. Baltimore, Md: Williams & Wilkins, 1994;
ergy photons, (c) it reduces the intensity of
17-38.
the beam (ie, the total number of photons in
4. Bushong SC. X-ray emission. In: Radiologic
the beam), (d) it increases the H\TL of an x- science for technologists: physics, biology,
ray beam, (e) it decreases patient exposure, and protection. 3rd ed. St Louis, Mo: Mosby,
and (f) it improves image quality for a given 1984; 173-181.
dose. A disadvantage of added filtration is 5. National Council on Radiation Protection and
that it necessitates the increase of exposure Measurements. Medical x-ray, electron beam,
and gamma-ray protection for energies up to
factors (kilovolts or milliampere seconds) to
50 MeV (equipment design, performance, and
compensate for the reduction in intensity of
use). NCRP report no. 102. Bethesda, Md:
the beam. NCRP, 1989.
The National Council on Radiation Protec-
tion and Measurements (NCRP) has recom-
mended and other regulatory bodies have
mandated minimum filtration values for x-
ray tubes operating at certain peak kilovol-

This article meets the criteria for I .0 credit hour in category I of f/ic AMA Physician s Recognition Award.
To obtain credit, see the questionnaire on pp 145-150.

January-February 1998 McKetty U RadioGraphics U 163