BM5602-RADIOLOGICAL EQUIPMENT

Dr. P. Anishiya,
Teaching Fellow,
DECE,
CEG,
AU, Chennai
VARIOUS IMAGING MODALITIES
FLUOROSCOPY
Video
TERMINOLOGIES
Views: Axial coronal Sagital
MRI
SPECT machine
performing a total
body bone scan.
The patient lies on
a table that slides
through the
machine, while a
pair of gamma
cameras rotate
around her.
PET/CT scanner
OPTICAL IMAGING

 It uses light and special properties of photons to obtain detailed images of organs, tissues, cells and even molecules. The
techniques offer minimally or non-invasive methods for looking inside the body.
 It can be combined with other imaging techniques, such as MRI or x-rays, to provide enhanced information for doctors
monitoring complex diseases or researchers working on intricate experiments.
TYPES
 Endoscopy
 Optical Coherence Tomography (OCT)
 Photoacoustic Imaging
 Diffuse Optical Tomography (DOT)
 Raman Spectroscopy
 Super-resolution Microscopy
SYLLABUS
UNIT I MEDICAL X-RAY EQUIPMENT
Nature of X-rays, X-Ray absorption – Tissue contrast. X- Ray Equipment (Block Diagram) – X-Ray Tube,
collimator, Bucky Grid, power supply. Digital Radiography-discrete digital detectors, storage phosphor and
film scanning. Fluoroscopy - X-ray Image Intensifier tubes – Digital Fluoroscopy. Angiography - cine
Angiography, Digital subtraction Angiography. Mammography.
UNIT II COMPUTED TOMOGRAPHY
Principles of tomography, CT Generations - X- Ray sources, collimation, X- Ray detectors, Viewing systems,
spiral CT scanning, ultra fast CT scanners. Image reconstruction techniques back projection and iterative
method.
UNIT III MAGNETICRESONANCE IMAGING
Fundamentals of magnetic resonance- Interaction of Nuclei with static magnetic field and Radiofrequency
wave, rotation and precession. Induction of magnetic resonance signals – bulk Magnetization, Relaxation
processes T1 and T2. Block Diagram approach of MRI system- system Magnet (Permanent, Electromagnet
and Super conductors), Gradient magnetic fields, Radio Frequency coils (sending and receiving), shim coils,
Electronic components. fMRI.
SYLLABUS (CONTD...)
UNIT IV NUCLEAR IMAGING SYSTEM
Radio Isotopes- alpha, beta, and gamma radiations. Radiopharmaceuticals. Radiation detectors – gas filled, ionization
chambers, proportional counter, GM counter and scintillation Detectors. Gamma camera- Principle of operation,
collimator, photo multiplier tube, X-Y positioning circuit, pulse height Analyzer. Principles of SPECT and PET.
UNIT V RADIATION THERAPY AND RADIATION SAFETY
Effects of radiation- direct and indirect. Radiation therapy – linear accelerator, Tele gamma Machine. Recent
Techniques in radiation therapy - Stereotaxic Radiosurgery, Stereotaxic Radiotherapy, 3D CRT, IMRT, IGRT and
Cyber knife. Radiation measuring instruments Dosimeter, film Badges, Thermo Luminescent dosimeters-
electronic dosimeter. Radiation protection in medicine- radiation protection principles, ICRP,AERB.
TEXT BOOKS & REFERENCES
 TEXT BOOKS:

1. Steve Webb, “The Physics of Medical Imaging’’, Adam Hilger, Philadelpia, 1988.
2. Jerrold T.Bushberg, J.Anthony Seibert, Edwin M.Leidholdt,Jr, John M.Boone, ‘The Essential Physics of Medical Imaging’’,
Lippincott Williams and Wilkins, 3rd Edition, 2012.
3. R.Hendee and Russell Ritenour, “Medical Imaging Physics”, William,Wiley- Liss, 4th Edition, 2002.
 REFERENCES:

1. Gopal B. Saha, “Physics and Radiobiology of Nuclear Medicine’’, Springer, 3rd Edition 2006.
2. B.H.Brown, PV Lawford, RH Smallwood, DR Hose, DC Barber, “Medical physics and Biomedical Engineering’’, - CRC
Press,1999.
3. Myer Kutz, “Standard handbook of Biomedical Engineering and design”, McGraw Hill, 2003.
4. P.Ragunathan, “Magnetic Resonance Imaging and Spectroscopy in Medicine concepts and Techniques’’, Orient Longman,
2007
Medical Imaging Signals and Systems by J. L. Prince and J. M. Links, Pearson Prentice
Hall, 2006, ISBN 0130653535
UNIT I
MEDICAL X-RAY EQUIPMENT
RADIOGRAPHY

 Radiography was the first medical

imaging technology, made possible
when the physicist Wilhelm
Roentgen discovered x-rays (using
the fluorescence generated within
barium platinocyanide crystals)on
November 8, 1895.

 Roentgen also made the first Wilhelm Conrad Roentgen

radiographic images of human (1845–1923) in 1896 Roentgen The beginning of diagnostic
anatomy received the first Nobel Prize in radiology – The famous
Physics in 1901 for his discovery radiographic image, made by
of x-rays on November 8, 1895. Roentgen on December 22,
1895 of his wife’s hand
FLUORESCENT CRYSTALS

 They produce scintillations (i.e. minute flashes of light) when they absorb X-rays.
 Numerous other materials were also found to scintillate, e.g. calcium tungstate, gadolinium oxysulfide, cesium
iodide and sodium iodide to name just four which have been widely used in Diagnostic Radiography.
Thomas Edison
examines Clarence
Dally's, his assistant,
hand thru a
fluoroscope of his own
design.
Neuilly, France, 1917. Using a fluoroscope, a field
doctor examines a wounded soldier for deep-seated
bullets. The X-ray tube is visible below the table.
SHOE-FITTING FLUOROSCOPES
Photograph shows an early (1933) fluoroscopic system in use
before the development of image intensification. An actual
fluoroscopic examination with this device would have occurred
in a darkened room
 ELECTROMAGNETIC (EM) RADIATION

 They comprises an electric wave and a magnetic wave traveling together at right angles to each other.
 Examples: Radio waves, microwaves, infrared light, visible light, ultraviolet light, x-rays, and gamma rays
 EM radiation has no rest mass and no charge, and can act like either a particle or a wave (Wave Particle
duality)
 When treated as a ‘‘particle,’’ EM radiation is conceptualized as ‘‘packets’’ of energy termed photons.
 The energy of a photon is given by E = hν (Planck-Einstein relation), where h = 6.626 × 10-34 joule-sec
(Planck’s constant )and ν -frequency of the radiation (in Hz).
 When treated as a wave, EM radiation has a wavelength
λ = c/ν , where c = 3.0 × 108 m/s (speed of light)
 They propagate in a straight line
 Photons are massless, so they always move at the speed of light in vacuum
 They are not deflected by electric or magnetic field.
 They produce interference or diffraction patterns
• X-rays are created in the electron cloud of atoms while gamma rays are created in the nuclei of atoms.
• Gamma rays are associated with radioactivity and x-rays are not.
• X-rays and Gamma rays behave the same in terms of their propagation properties and interaction with
matter.
RADIOLOGY

 It is a most important diagnostic tool available in the practice.

 It is based on the fact that various anatomical structures of the body have different densities
for the x-rays.
 When x-rays penetrate a section of the body the internal structures absorb varying amount
of the radiation.
 The radiation leaves the body has a spatial intensity variation. (an image)
 X-ray picture is called radiograph which is obtained on photographic film placed in the image
plane.
32
33
X-RAYS

 X-rays were Discovered in 1895 by Roentgen.

Nature of X-Rays:
 They travel in straight lines
 They are uncharged, hence not deflected by electric or magnetic fields.
 They are a wave motion phenomenon.
 The waves are transverse.
 They are electromagnetic waves as visible light and radio waves (wavelength is shorter 10-
8 cm)
PROPERTIES OF X-RAYS

 They are produced when a beam of high-energy electrons strike a metal target
 Short wavelength and extremely high energy.
 It can penetrate through material which absorbs and reflect visible light.
 Absorption depends upon the density of the matter.
 They produce secondary radiation which is composed of scattered radiation,
characteristic radiation and electrons.
 They produce ionization in gases.
 They produce fluorescence in certain materials such as rock salt.
34
 The unit is Roentgen(R) – radiation exposure (milli roentgen and micro
roentgen)
35
TYPES OF X-RAY

Soft X-ray Hard X-ray

 Lower frequency  Higher frequency

 Larger wavelength (1nm)  Shorter wavelength (0.01nm)
 Lower penetration  Higher penetration
 Less energy (.1 to 5kev)  Higher energy (5kev to 100kev)
 Used for therapeutic  Used for diagnostic applications
applications
36
X-RAY TUBE
ATOMIC STRUCTURE

 An atom consists of a nucleus of protons and neutrons, which together are called nucleons, surrounded by
orbiting electrons
 The atomic number Z is equal to the number of protons in the nucleus and defines the element. Each proton
has a positive charge equal in magnitude and opposite in charge to that of each electron. Since an atom as a whole
is electrically neutral, there are an equal number of electrons and protons in an atom; hence, Z also represents
the number of electrons in the atom.
 The mass number A of an atom is equal to the number of nucleons in the nucleus.

The planetary atom: a common (and useful) visualization of

atomic structure.
STABLE AND UNSTABLE STATES

 Stable nuclides:
– # neutrons ~= # protons (A ~= 2Z)

 Unstable nuclides (radionuclides, radioactive atoms)

– Likely to undergo radioactive decay, which gives off energy and results in a more stable nucleus
THE DIFFERENT ORBITS

Ground state: Electrons are in the lowest orbital shells and within the
lowest energy quantum states within each shell
 ELECTRON BINDING ENERGY

 A free electron has higher energy than when it is bounded to an nucleus in an atom

 Orbital Binding energy = The energy required to remove an orbital electron completely from the atom is
called its orbital binding energy
– Depends on the element to which the electron is bound and the shell within which it resides in ground state
– Sufficient to consider “average” binding energy of a given atom
 One electron volt (eV) = kinetic energy gained by an electron when accelerated across one volt potential
– 1 eV = 1.6 x 10^{-19} Joule
 Binding energies of typical elements: hydrogen = 13.6 eV; Air: 29 eV; Lead: 1 KeV;
Tungsten: 4 KeV (considered “heavy” elements)
IONIZATION AND EXCITATION

 Ionization is “knocking” an electron out of an atom

– Creates a free electron + ion (an atom with +1 charge)
– Occurs when radiated with energy above the electron binding energy.
– Single ionizing particle or ray used in medical imaging is capable of ionizing between 10 and 40,000 atoms
before its energy is exhausted.

 Excitation is “knocking” an electron to a higher orbit

– When the radiation energy is lower than the binding energy

 After either ionization or excitation, an atom has higher energy

 Consider an electron accelerated through an X-ray tube where the anode is made of tungsten. If the anode is
held at 120 KV, what is the maximum number of tungsten atoms that can be ionized?
Solution:
– The electron will have 120 KeV kinetic energy when reaching the anode, by definition of eV
– The average binding energy of tungsten = 4 KeV
– # ionized atoms = 120/4=30
EXAMPLE

 What happens to ionized or excited atom?

– Return to ground state by rearrangement of electrons
– Causes atom to give off energy
– Energy given off as characteristic radiation
 Infrared
 Light
 x-rays
 PARTICULATE RADIATION BY ENERGETIC ELECTRONS
 We are only concerned with the electron accelerated in a X-ray tube here ;– An electron accelerated across a tube
with 100 KV potential possesses 100 KeV kinetic energy
 Two primary interactions
– Collisional transfer
>Most common
>Produces heat
– Radiative transfer
>Produces x-ray
>Characteristic radiation
– Collide with K-shell
>Bremsstrahlung radiation Energetic electrons can (a) collide with other electrons
until they lose their energy; (b) eject a K-shell electron,
– Collide with nucleus generating a characteristic x-ray; or (c) be ‘‘braked’’ by a
– More common than characteristic radiation nucleus, generating bremsstrahlung radiation.
 COLLISION TRANSFER
 The energetic electron collides with an atom in the target
 Typically, a small fraction of the kinetic energy of the electron is transferred to another electron in the
atom
– As the affected atom returns to its original state, infrared radiation (heat) is generated
 Occasionally, a large fraction of the incident energy is transferred to another electron, the newly freed
electron may form a delta ray
 The incident electron’s path may be redirected, and many other subsequent interactions may occur, until
the kinetic energy of the incident electron is exhausted
CHARACTERISTIC X-RAY
 The incident electron collides with a K-shell electron, exciting or ionizing the atom, leaving a hole in
that shell.
– As the atom returns to its ground state, the k-shell hole is filled
by a higher shell electron
– The loss of energy creates an EM photon, known as Charac. x-ray
– The energy of the x-ray photon = difference between the energy of the two shells (element
dependent)
CHARACTERISTIC RADIATION

 Caused by removal of inner shell electrons and subsequent filling of hole with electrons from higher
shell. The shell-energy difference determines the energy of characteristic rays
 Lines are named after the lower shell involved in the process; the upper shell involved is denoted by
Greek letters:Δn = 1 → α-transitions, Δn = 2 → β-transitions, ...
Energy-level diagrams for hydrogen and tungsten. The energy necessary to separate electrons in particular orbits from the
atom (not drawn to scale) increases with Z and decreases with distance from the nucleus. Note that zero energy
represents the point at which the electron is experiencing essentially no Coulomb attractive force from the protons in the
nucleus (often referred to as a “free” electron). For a bound electron to reach that state, energy has to be absorbed. Thus,
the energy states of the electrons within the atom must be below zero and are thus represented as negative numbers. The
vertical lines represent various transitions (e.g., K and L series) of the electrons from one energy level to another.
BREMSSTRAHLUNG RAY
 As the incident electron approaches the nucleus of an atom, the positive charge of the nucleus causes
the incident electron to bend around the nucleus and decelerates
– The loss of energy leads to the Bremsstrahlung x-ray (energy vary over a continuous range, depending
on the speed loss)
 Occasionally when the incident electron collides with the nucleus, the electron is annihilated, emitting a
photon with an energy equal to the kinetic energy of the incident electron (highest possible energy)
 Primary source of x-rays from an x-ray tube
ATOMIC STRUCTURE OF TUNGSTEN
 The energy of a bremsstrahlung x-ray photon can be any value up to and including the entire kinetic energy of the
deflected electron. Thus, when many electrons undergo bremsstrahlung interactions, the result is a continuous
spectrum of x-ray energies. This radiative energy loss is responsible for the majority of the x-rays produced by x-
ray tube
X-RAY SPECTRUM
52
THE X-RAY SPECTRUM

 As a result of characteristic and

bremsstrahlung radiation generation a
spectrum of X-ray energy is produced within
the X-ray beam.
 This spectrum can be manipulated by
changing the X-ray tube current or voltage
settings, or by adding filters to select out low
energy X-rays.
 In these ways radiographers are able to apply
different spectra of X-ray beams to different
body parts.
53
PRODUCTION OF X-RAYS
• When the electron from the cathode hit
 Whenever electrons of high energy strike a the tungsten anode they suddenly stop
and give up their energy in two ways
heavy metal target, like tungsten or copper.
• Characteristic radiation (ionisation)
 When electrons hit this material, some of the line spectrum
electrons will approach the nucleus of the • Bremstrahlung radiation (braking
metal atoms where they are deflected because radiation)
continuous spectrum
of their opposite charges
 This deflection causes the energy of the
electron to decrease, and this decrease in
energy then results in forming an x-ray.
 About only 1% of the electrons produce the
X-ray photon, the rest is lost in heating up the
target
 PRIMARY EM RADIATION INTERACTIONS
 Three main interactions
Radiation with
– Photoelectric effect energy> 13.6eV
 The incoming photon is completely absorbed and ejecting K-shell or is ionizing.
L-shell electrons, producing characteristic x-ray
In medical
imaging typically,
30KeV- 511 KeV
– Compton scattering
can ionize 10-
 The incoming photon changes its direction 40,000 atoms

- Pair production
 Requires atleast 1.02MeV of energy for this to occur, ignored for Medical Imaging application since it uses
photon energies of about 25-500 keV only
PHOTOELECTRIC EFFECT

 An incoming photon interacts with the coulomb field of nucleus of an atom, causing ejection of a K-
shell or L-shell electron (photoelectron)
– Atom completely absorbs incident photon and all energy is transferred
– The photoelectron propagates away with energy Ee- = hv − EB
– The affected atom produces characteristic x-ray, while outer electrons fill the K-shell.
– Sometimes the characteristic x-ray transfers its energy to an outer electron (called Auger electron)

 Both photo electron and Auger electron are energetic electrons that can interact with the matter as
discussed before
PHOTOELECTRIC EFFECT
COMPTON SCATTERING

 An incoming photon ejects an valence (outer shell) electron, yielding a new energetic electron called
Compton electron
 The incident photon loses its energy and changes its direction (Not completely absorbed by the
atom!)

θ
COMPTON ELECTRON ENERGY


 The energy of the scattered photon , so called Compton photon, is given by  ' =
1 + (1 − cos  ) /( m0 c 2 )
m0 c 2 = 511keV

 The maximum energy loss occurs when the photon is deflected Backward , i.e., θ=180o backscatter

 The kinetic energy of the Compton electron = E e − =  −  '

Example
hv=100keV and exits with hv’ ; detector threshold hv’>98keV
What is the maximum angle by which the photon is scattered but still being treated as a photon travelling in straight
line path
According to Einstein's mass-energy equivalence theory, E0=m0c2
• E0 is the rest mass energy,
• m0=9.11×10−31kg is the rest mass of the electron and
• c be the velocity of light.

So, E0=(9.11×10−31kg)×(3×108m/s)2=8.19×10−14J
1 eV= 𝟏. 𝟔 × 𝟏𝟎−𝟏𝟗J
𝟖.𝟏𝟗×𝟏𝟎−𝟏𝟒 𝟔eV= 511 KeV
𝐄𝟎= −𝟏𝟗 = 0.511 X 𝟏𝟎
𝟏.𝟔×𝟏𝟎
 Suppose a photon with energy hν = 100 keV is incident to some material and exits with energy hν . A detector
decides that the photon has not been scattered if hν > 98 keV. What is the maximum angle by which the photon
is scattered but is still being treated as a photon traveling along a straight path?

So, a photon scattered by an angle up to 26.4◦ is still considered as traveling along a straight path by the detector.
COMPTON VS. PHOTOELECTRIC EFFECT

 Photoelectric effect helps to differentiate different human tissues/organs

 Compton scattering causes incident photons to deviate from straight path, and causes unnecessary
exposure of x-ray to untargeted areas

 In medical imaging, we want to increase the likelihood of photoelectric events, while minimizing
Compton scattering
62
X-RAY TUBE
X-RAY TUBE

 Basic components of X-ray tube:

 Air evacuated glass envelope (high vacuum)
 Cathode (tungsten filament)
 Anode (tungsten disc)
1.Stationary Anode (small x-ray capacity machines)
2.Rotating Anode
 Cooling mechanism, window of the tube
63
X-RAY TUBE VOLTAGE CURRENT AND EXPOSURE TIME

Depending upon the type of imaging examination and the characteristics of the anatomy being imaged, the x-ray tube
voltage is set to values from 40 to 150 kV for diagnostic imaging, and 25 to 40 kV for mammography.
X-ray tube current:
It is measured in milliamperes (mA) and is proportional to the number of electrons per second flowing from the
cathode to the anode, where 1 mA = 6.24 X 1015 electrons/s.
Projection radiography : 50 to 1,200 mA in conjunction with short exposure times (typically less than 100 ms).
Continuous fluoroscopy:1 to 5 mA,
In Pulsed fluoroscopy, the tube current is commonly delivered in short pulses instead of being continuous; the
average tube current is typically in the range of 10 to 50 mA, while the overall number of electrons delivered through
the tube is about the same per image.)
 The kV, mA, and exposure time are the three major selectable parameters on the x-ray generator control panel
that determine the x-ray beam characteristics.
 Often, the product of the tube current and exposure time are considered as one entity, the mAs (milliampere-
second; technically, mAs is a product of two units but, in common usage, it serves as a quantity
66
CATHODE

 The cathode is the negative side of the x-ray tube.

 The purpose of the cathode is to produce the
thermionic cloud, conduct the high voltage current, and
focus the emitted electrons .
 The cathode is more correctly called the cathode
assembly.
 It consists of the filament (or filaments), the focusing
cup and all the associated wiring.
67
ANODE
 Tungsten material is used
o High atomic no (74)
o Efficient in the production of x-rays
o High melting point (3400ºc)
 copper is also used along with tungsten
o Excellent thermal conductor, it carrying the heat rapidly
away from the tungsten.
 Oil environment
 Shielding (metal container)
 Rotating Anode (speed 3000-3600 rpm)
 Beveled edge (angle 5 -20 degree, typical angle 15
degree)
A rotating anode X-ray ray tube.
 CONTRAST OF THE IMAGE

X-ray absorption = Input radiation energy – output radiation energy.

 To identify how much x-rays are absorbed by different tissue is determined by

Lambert’s Law.

Ix = Io e-ρs
 Ix is intensity of transmitted beam after passing through thickness s
 Io is the intensity of x-ray beam
  is the mass attenuation coefficient
 ρ is the medium density.
69

 S is the thickness of the material

 The focal
FOCAL
 spot is the area of
TRACKS
the anode from which the x-
rays are emitted.

 With a rotating anode, the

electrons strike a moving
target forming focal tracks
on the tube.

70
The Effective Focal Spot is the beam projected onto
the patient.

Large Focal spot : Better heat dissipation

Small Focal spot : Better images

By angling the anode target, one makes the effective

focal spot much smaller than the actual area of
interaction.

The angling of the target (Foreshortening of the focal

spot length at the central ray) is called the line focus
principle.

Effective focal length= Actual focal length X sin 𝜃

f = Fsin𝜽
where 𝜃 is the anode angle.
f is apparent focal spot size
F is real focal spot size
Larger anode angle means a larger focal point
 LINE-FOCUS PRINCIPLE
 Line focus principle explains the relationship
between the anode surface and the effective
focal spot size

 Smaller target angles will produce smaller

effective focal spots and sharper images.

 To cover a 17” the angle must be 12°

 To cover 36” the angle must be 24°

72
 Anode angles in diagnostic x-ray tubes typically range from 7 to 20 degrees, with
12- to 15-degree angles being most common.

 Major factors affected by the anode angle include the effective focal spot size,
tube output intensity, and x-ray field coverage provided at a given focal
spot to detector distance.
 Anode Heel Effect

The heel effect is a loss of intensity on

the anode side of the x-ray field of
view.
It is caused by attenuation of the x-ray
beam by the anode.

Upper right is an expanded view that

shows electrons interacting at depth
within the anode and the resultant “self
attenuation” of produced x-rays that
have a trajectory towards the anode
side of the field.
ANODE HEEL EFFECT
 Some of the x-ray will be absorbed by
the anode so that anode has lower
intensity than cathode.

 It refers to radiation intensity on

the cathode side of x-ray tube is
higher than the anode side.

 The difference in the intensity can vary

by as much as 45%.
 If the center is 100% the anode side of
the beam can as low as 75% and the
cathode as much as 120%.

75
 ANODE
 The heel effect HEEL
should be EFFECT
considered when positioning areas of
the body with different thickness or density.
 The cathode side should be over the area of greatest density.

 The anode should be up and the cathode down for the full
spine x-ray.
 The patient is less dense at the c-spine and more dense at the
pelvis.

76
 X-RAY MACHINE BLOCK DIAGRAM
Basic parts of any x-ray unit
77

High- Voltage
Source High –Voltage Pulse duration
control Transformer timer
(20-200 Kv)

Filament High Voltage

Rotor
Current Rectifier
Control
Control

Thermal
overload Al colli
detection X-Ray Tube X-Rays filte mat
r or

Bucky
X-ray Film patient
diaphragm
Transformer

The voltage induced in the second winding is proportional to the voltage

on the primary winding and the ratio of the number of turns in the two
windings, as stated by the Law of Transformers

For an ideal transformer, because the power output is equal to the power input, the product of voltage and current in
the primary circuit is equal to that in the secondary circuit
The high-voltage section of an x-ray generator contains a step-up transformer, typically with a primary-
to-secondary turns ratio of 1:500 to 1:1,000. Within this range, a tube voltage of 100 kV requires an
input line voltage of 200 to 100 V, respectively
BLOCK DIAGRAM OF X-RAY MACHINE

80
WORKING OF X-RAY MACHINE

 High voltage source and high voltage transformer

 High voltage source is responsible for providing high voltage to the H.V
transformer for a decided time.
 The H.V transformer produces 20 KV to 200 KV at the O/P.
 These voltages are used to determine the contrast of the image.
 High voltages have higher contrast.
 High voltage rectifier
 This rectifier rectifies the high voltage produced by the H.V.T and supplies them
to the anode of the X-ray tube
81
WORKING OF X-RAY MACHINE

 Thermal overload detector

 The heat of the X-ray tube should not be increase by a specified range.
 If the heat is exceed from a specified value, and then the thermal over load detector is
used to turn off system.

 Rotor control
 Most of the X-ray tube anodes are rotated by an induction motor, in order to limit
beam power at any spot and helps to cool the anode.

82
PULSE DURATION TIMER

 The duration of the time must be very small so that

 The patient does not receive the excessive dose
 The film does not become over exposed.
 The X-ray tube does not over heat.

83
 ALUMINIUM FILTER

 An X-ray filter is a device to block or filter out some or all wavelengths in the X-ray spectrum

 X-ray filters are used to selectively attenuate (block) low-energy X-rays during medical x-ray imaging

 Low energy x-rays (less than 30 keV) contribute little to the image as they are so heavily
absorbed by the patient's soft tissues, particularly the skin

 The unwanted frequencies in the x-ray based create side effects e.g. extra dose for patient
causing tumour also reduce the contrast in the image.

 These are called soft x-ray.

84

 To eliminate these effects Aluminium filter is used.

 VARIABLE APERTURE COLLIMATOR

 Proper collimation of the x-ray beam

has the primary effect of reducing
patient dose by restricting the
volume of tissue irradiated.

 Proper collimation also reduces

scatter radiation that improves
contrast.
85
BEAM LIMITING DEVICES

 Beam limiting devices attach directly to the x-

ray tube and confine the useful beam before it
enters the body, which in turn limits the
area irradiated to only the necessary area of
interest.

 Limiting the beam to focus on the correct

anatomy reduces scatter and will reduce
patient dose.

TYPES
 Aperture Diaphragm
86
 Cones
 Extension Cylinders
APERTURE DIAPHRAGM

 It is the simplest type of beam restricting device.

 It consists of a sheet of lead with a hole in the center that determines

the size and shape of the beam and attaches directly to the x-ray tube.

 The width or size of the aperture is fixed and can not be adjusted.

 The operator must be careful when placing the aperture in the beam.

87
CONES AND CYLINDERS
 Cones and cylinders are modifications to the
aperture.
 Cones are typically used in dental radiography.
 Most cone produce a circular image on a rectangular
film.
 Cones are very effective at reducing scatter.
 Hard to center.

88
COLLIMATORS

 They adjust the size and shape of the x-ray field emerging from the tube port.
 The collimator assembly typically is attached to the tube housing at the tube port with a swivel joint.
 Two pairs of adjustable parallel-opposed lead shutters define a rectangular x-ray field .
 In the collimator housing, a beam of light reflected by a mirror of low x-ray attenuation mimics the x-ray beam.
 Thus, the collimation of the x-ray field is identified by the collimator’s shadows.
 Not all of the x-rays are emitted precisely from the focal spot.
COLLIMATOR
 These rays are called off-focus radiation and they increase image blur.
 First stage shutters extend into the tube housing to control the off-focus
radiation.
 Adjustable second stage shutter pairs are used to restrict the beam.
 Light localization is accomplished by a small projector lamp and mirror to project
the setting of the shutters on the patient.

 The light field and x-ray beam should match to avoid collimator cut-off.

 A scale on the collimator is used to match the beam to the film size.

 In many newer collimators a bright slit of light is provided to properly center the
beam and the film.
 Units manufactured in 1974 has motorized shutters.
 A sensor in the Bucky and the motor were used to automatically collimate the
image to film size.This was called a positive-beam limiting (PBL) device.

91
 THE GRID

 Collimation reduces scatter radiation but

that alone is not sufficient for larger body
parts.
 With thick and dense body parts, almost
all of the remnant rays are scattered many
times. This results in reduced image
contrast.
 An effective means of reducing scatter
radiation that reaches the film is called a
grid. 92
GRID

 In 1913, Gustave Bucky demonstrated that strips of lead interspaced with

radiolucent material is an effective method to reduce scatter radiation reaching the
film.
 Only rays that travel in a relatively straight line from the source are allowed to
reach the film.
 The others are absorbed by the lead.
 Primary beam x-rays striking the interspace material are allowed to pass to the
film.
 Secondary radiation that strike the interspace material may or may not pass on to
the film. 93

 High quality grids will attenuate 80% to 90% of the scatter radiation.
Primary x-ray – Without interaction
Secondary photons- After interaction inside the
patient.
Potter Bucky Grid – Attenuate secondary photons

94
95
GRID CONSTRUCTION

 There are three important aspects of grid construction;

 Grid Ratio
 Grid Frequency
 Grid material

96
GRID RATIO

 There are three important dimensions on a

grid.

 Width of the grid strip (T)

 Width of the interspace material (D)
 Height of the grid (h)

97
98
 GRID RATIO
 High ratio grids are more effective in cleaning up
scatter radiation

 Because the angle of scatter allowed by the high

ratio is less than permitted to pass by low ratio
grids.
 High ratio grids are more expensive and harder
to produce.
 The width of the interspace material is reduced
while increasing the height of the grid material in
order to increase the ratio.
 Ratios range from 5:1 to 16:1
 High ratio grids increase patient dose.
Grid ratio = h/D

99
 GRID FREQUENCY

 The number of grid lines per inch or centimeter is called the Grid Frequency.

 The higher the frequency of the grid, the thinner its strips of interspace material and
the higher the ratio.

 The use of high frequency grids requires high radiographic technique and results in
higher patient radiation dose.

 Grid frequency range from 25 to 45 lines per centimeter or 60 to 145 lines per inch.
100
POTTER-BUCKY DIAPHRAGM

 High frequency grids allow the removal of a mechanism to move the grid during the
exposure.
 This mechanism make the grid a Potter-Bucky Diaphragm instead of a grid holder.

101
 GRID MATERIAL

 The most common grid material is lead because of its cost and ease of forming the
strips.
 Plastic fiber or aluminum is used as the interspace material.
 Plastic fiber is more common as it does not attenuate the beam as it passes through
the interspace.
 Aluminum is used as the cover for the grid to protect it from damage and moisture.

102
AIR GAP TECHNIQUE

 If the film is placed 10 to 15 cm away from the patient,

the scatter generated by the patient will be dispersed
away from the image receptor.

 The neck is naturally far away from the film.

 Exposure factor are comparable to an 8:1 grid.

RADIOGRAPHIC CASSETTE

A screen-film cassette whose configuration is featured by a double-

emulsion sheet in between two phosphor screens
 Radiographic Cassette

 A radiographic cassette is really just a holder for two intensifying screens and the film ‘‘sandwiched’’ between.
 One side of the cassette is radiolucent, while the other usually includes a sheet of lead foil.
 Therefore, the cassette can be loaded only one way into the x-ray machine.
 At least one side of the interior of the cassette contains a spongy, foam material that applies a uniform pressure
against the screen so that a uniform contact is created between the film and all parts of each of the screens.
 Optical mirrors are located outside the screens, pointed inward so that nearly all the light produced in the
screens ends up exposing the film.
 Film must be loaded in a darkroom in order to avoid premature exposure.
 The cassette is opened like a suitcase or briefcase only as much as is required to slip in the radiographic film.
 This minimizes the amount of dust and other contaminants that might end up inside the cassette.
 When the cassette is closed, pressure is applied so that the foam inside compresses, creating a uniform contact
between the screens and the film.
 Cassettes and screens must be cleaned regularly in order to avoid contaminants that might appear in the images.
 INTENSIFYING SCREENS

 In screen-film radiography, a sheet of film with a light-sensitive emulsion on both sides is sandwiched between two
intensifying screens
 A light-tight cassette encapsulates the screens and film.
 The intensifying screens are composed of a scintillator, such as Gd2 O2 S crystals, held together by a binder
material.
 Scintillator: Converts incident x-ray photons to visible light, which then exposes the silver halide emulsion
on the film.
 Close physical contact between the screen and film is very important, as gaps promote excessive lateral light
propagation, which blur the image.
 The screens in a cassette are mounted on compressible foam backing, which presses the screens against the film
to maintain good screen-film contact.
 The intensifying screen is composed of high Z compounds that have high absorption efficiency for x-rays.
CaWO4 (Calcium tungsten oxide) initially was used
Rare-earth scintillators : Gd2 O2 S -Gadolinium oxysulfide, LaOBr- lanthanum oxybromide, YTaO4- yttrium
tantalate
PHOSPHORS

 They are luminescent; that is, they convert one form of energy, in this case x-rays, into light.
 Types of luminescence :
 1. fluorescence: The emission of light takes place entirely within 1 × 10−8 second of the excitation,
 2. phosphorescence: Light emission can be delayed and extended over a longer period of time.
For intensifying screens, it is desirable to use a luminescent material that is much more fluorescent than
phosphorescent.
 Characteristics of good intensifying screen phosphors: They should also be highly x-ray attenuating and should
emit many light photons for every x-ray photon that is stopped. Thus, the best phosphors have high atomic
numbers (so the linear attenuation coefficient is large) and high conversion efficiencies.
SPEED OF A SCREEN

 It is a measure of the number of light photons emitted per incident x-ray photon.
 Typical conversion efficiencies are between 5 and 20 percent depending on the type of phosphor used and its
thickness.
 A typical conversion efficiency for modern screens yields 1 × 103 light photons per incident 50 keV x-ray photon.
 This number depends on the energy of the incident x-ray photon as well since the conversion of a higher energy x-ray
photon will produce more light.
 Total light output depends on the combination of attenuation of the material at a given x-ray energy and the conversion
efficiency at that energy.
 The speed of a screen is really just a measure of its conversion efficiency.
 If the conversion efficiency is higher, then the screen is ‘‘faster,’’ because the larger numbers of light photons emitted
by the phosphor will expose the film faster.
SCREEN THICKNESS

 With respect to screen thickness, there is a trade-off between the spatial resolution of the image and the
efficiency of X-ray absorption.

 When the screen thickness increases, more incident X-ray photons are absorbed by the screen, but the visible
light photons have a broader spread before reaching the film, leading to a blurred image.

 When the screen thickness decreases, less blurring of the image is expected at the expense of a more
grainy/noisy image.
RADIOGRAPHIC CASSETTE

A screen-film cassette whose configuration is featured by a double-

emulsion sheet in between two phosphor screens
 X-RAY FILMS
 They are the most important material used to “decode” the information carried by the x-ray beam, when they are
made to pass through the tissue

 They capture the invisible image into visible form.

 Initially x-ray were taken on glass plates.

 In 1918 cellulose nitrate based film replaced glass plates due to WWI and a shortage of glass.
 Cellulose Nitrate was flammable so x-ray film was a fire hazard.
 Several severe hospital fire were caused by the x-ray film.
 In 1920 Cellulose triacetate based film was introduced.
 Not flammable.
 In the 1960 Polyester based film replaced Cellulose Triacetate
111

 Still used today.

 It is semi-rigid and about 150 to 250 µm thick.
RADIOGRAPHIC FILM

112
FILM CONSTRUCTION

 Radiographic Film has two basic parts.

 Base
 Emulsion
 Most film has two layers of emulsion so it is
referred to as Double Emulsion Film
 An adhesive layer attaches the emulsion to the
base.
 The emulsion is enclosed in a protective layer
or overcoat.
TINTED BLUE FILM

 Triacetate and Polyester are clear and colorless.

 In 1983, blue tint was added to the x-ray film in an effort to produce a film that
was “easier” to look at.

 Causes less eye strain.

 Blue tint can be added to either to the base or to the emulsion.

 All present x ray films are blue tinted.

114
115
EMULSION

 The emulsion is the heart of the film.

 The x-rays or light from the intensifying

screens interact with the emulsion and

transfer information to the film

 Key ingredients:
 Gelatin
 Silver Halide

 Thickness not more than 3-5 µm

GELATIN

 The gelatin is clear so it transmits the light to the silver halide crystals.

 It is able to absorb fluids so the processing chemicals can penetrate to the silver halide crystals.

 The primary function of the gelatin is to provide a support medium for the silver halide crystals by holding them
in place.

116
SILVER HALIDE

 Light sensitive material in emulsion.

 Composition:
 90-99% Silver Bromide
 1-10% Silver Iodide - it increases sensitivity
 The Silver Iodo-Bromide crystals in the emulsion is in the form of crystals
suspended in gelatin.
 Crystals are formed by Ions of Ag+, Br-, I- arranged in Cubic Lattice

117
 Screen-Film Radiography

Double-sided screen-film cassette

A micrograph of the emulsion

layer is shown. The individual
grains of silver halide are seen
within the gelatin layer.

A micrograph of the intensifying

screen phosphor, attached to a
plastic base.
The scintillating layer consists of
small (.25 mm) crystals of
phosphor (i.e., Gd2 O2 S:Eu),
packed with a binder into a screen.
This is an unstructured or
amorphous intensifying screen.
 Film

 It is composed of a thin plastic base coated on one or both sides with a layer of light-sensitive emulsion
consisting of silver halide (95% AgBr and 15% AgI) crystals held in water-soluble gelatin .

 The shapes of the silver halide crystals incorporated in radiographic film are engineered in a tabular T” grain
shape to increase surface area for improving light capture efficiency and reducing silver content to save cost.

 Silver halide grains have a small amount of AgS that introduces defects in the ionic crystal structures, where the
negative charge (from Br- and I-) builds up on the surfaces and a net positive charge (Ag+) is more central in the
crystals.

 A sensitivity speck, induced by the lattice defects caused by AgS, is a protrusion of the positive charge that reaches
the surface of the crystal.
 When a silver halide grain is exposed to visible light, a small number of Ag+ ions are reduced (gain electrons) and
are converted into metallic Ag (Ag+ + e- → Ag). If ≥5 Ag+ ions are reduced, which depends on the incident light
intensity, a stable latent image center is formed.
 An exposed film that has not been chemically developed contains a latent image consisting of a pattern of invisible
silver halide grains with latent image centers.
 Film Processing

 The gelatin layer is permeable to aqueous solutions, which is necessary for the aqueous developing chemicals to
come into contact with the silver crystals.
 When the film is developed in an aqueous chemical bath containing a reducing agent, called the developer, the
metallic Ag atoms at the latent image centers act as a catalyst reduces the remaining silver ions in the grain.
 A grain of reduced metallic silver atoms appears as a black speck on the film.
 After the film has passed through the developer, it passes through a bath of an aqueous oxidizing solution
called fixer that dissolves the remaining (inactivated) silver halide from the emulsion layer areas that were not
exposed (or were underexposed) to light.
 The film is then rinsed with water to remove residual developer and fixer, and is dried
 In this way, the visible light striking the film emulsion acts locally to cause film darkening.
 The film appears darker to the human eye as a result of an increasing density of microscopic black silver grains in
the emulsion layer.
 Thus, when the film is placed on a light box, a gray scale image is produced that is darker where the x-ray beam
incident on the screen-film detector was more intense (where x-ray attenuation in the patient was lower), and
the film is lighter where the x-ray beam was less intense (where the attenuation in the patient was higher).
 Film radiographs are negative images—higher exposure to the detector produces darker images.
 It is worth noting that the catalytic reaction that is promoted by the sensitivity speck in the presence of a strong
reducing agent results in an approximately 109 gain in optical density on the film with very little added noise—
this is a chemical amplification process that few electronic detector systems can match.
DIGITAL RADIOGRAPHY

Discrete digital detectors, storage phosphor and film scanning

 DIGITAL RADIOGRAPHY
 Digital radiographic systems have largely replaced film-screen combinations.
 There are four types of digital systems in clinical use today.
 They are
1. Computed radiography
2. CCD-Based Digital Radiography Systems
3. Thin-Film-Transistor-Based Digital Radiography Systems
4. CMOS-Based Digital Radiography Systems

Source:

1. Jerrold T.Bushberg, J.Anthony Seibert, Edwin M.Leidholdt,Jr, John M.Boone, ‘The Essential Physics of Medical Imaging’’,
Lippincott Williams and Wilkins, 3rd Edition, 2012.

2. Medical Imaging Signals and Systems by J. L. Prince and J. M. Links, Pearson Prentice Hall, 2006, ISBN 0130653535
 COMPUTED RADIOGRAPHY

 They store latent images in photostimulable imaging plates (PSPs), which are removed from the x-ray system
and scanned using a special laser scanner to form a digital image.
 The PSP is a phosphor typically made from barium fluorohalide bromides and iodides with europium
activators.
 Detected x-ray photons are absorbed in the phospor by the photoelectric effect, which causes electrons to be ejected
from atoms in the detector.
 About half of these electrons will recombine with the resulting ions causing light to be emitted (as in a typical image
intensifying screen).
 The remaining electrons will be temporarily trapped in the fluorohalides leaving ‘‘holes’’ in the europium; it is these
holes that represent the latent image that is stored in the PSP.
 Latent images last for hours, but as electrons find ways to recombine with the holes, they will be unrecoverable after a
few days of storage.
PHOTOSTIMULABLE PHOSPHOR PLATES

 Also known as storage phosphor plates (ssp) or image plates.

 PSP material used for radiographic imaging is europium doped barium fluorohalide.
 Barium in combination with iodine, chlorine or bromine forms a crystal lattice.
 The addition of europium (Eu +2) creates imperfections in this lattice.
READING PSP

 A focused laser stimulates the trapped electrons so that they will recombine with the holes and produce light.
 A mechanical device, much like the paper roller in a laser printer, is used to slide the PSP to a position where a
focused laser is scanned across a row of the PSP; the PSP is then slid to a new position and a new row is scanned,
and so on.
 At each position of the laser (~ 700 nm in wavelength (red in color)), blue light is emitted from the PSP in
proportion to the number of trapped electrons that are liberated by the laser excitation.
 This emitted light is directed by mirrors toward a photodetector that is sensitive only to blue light, and
the resultant electrical signal is digitized using an analog to digital converter (ADC).
 This produces a digital value—a pixel value— that is proportional to the x-ray intensity at the spot on the PSP
being probed by the laser.
 Since the PSP is by design ‘‘raster scanned’’ row-by-row, the resulting data comprise rectilinear samples of a digital
image, which can be directly manipulated and stored on a computer and displayed on a digital display.
Image readout of a photostimulable phosphor plate inside a reader.
CCD-BASED DIGITAL RADIOGRAPHY SYSTEMS

 Willard Boyle and George E. Smith invented the Charge Coupled Device (CCD) in 1969 in the United States at
AT&T Bell Labs.
 In 1970, Boyle and Smith submitted a paper on their invention of the CCD to the Bell System Technical Journal.
 Their original ideas for the CCD was to create a memory device.
 However, with the publication of Boyle and Smith’s research in 1970, other scientists began experimenting with
the technology on a range of applications.
 Astronomers discovered that they could produce high-resolution images of distant objects, because CCDs
offered a photosensitivity one hundred times greater than film.
 A charge-coupled device (CCD) is an integrated circuit containing an array of linked, or coupled, capacitors.
 Under the control of an external circuit, each capacitor can transfer its electric charge to a neighboring capacitor.
 CCD sensors are a major technology used in digital imaging.
 In a CCD image sensor, pixels are represented by p-doped metal–oxide–semiconductor (MOS) capacitors.
 These MOS capacitors, the basic building blocks of a CCD are biased above the threshold for inversion when image
acquisition begins, allowing the conversion of incoming photons into electron charges at the semiconductor-oxide
interface; the CCD is then used to read out these charges.
 The basis for the CCD is the metal–oxide–semiconductor (MOS) structure, with MOS capacitors being the basic
building blocks of a CCD and a depleted MOS structure used as the photodetector in early CCD devices.
CCD

 It is a highly sensitive photon detector.

 It is divided up into a large number of light-sensitive small areas (known
as pixels) which can be used to build up an image of the scene of
interest.
 A photon of light which falls within the area defined by one of the pixels
will be converted into one (or more) electrons and the number of
electrons collected will be directly proportional to the intensity of the
scene at each pixel.
 When the CCD is clocked out, the number of electrons in each pixel are
measured and the scene can be reconstructed.
For most of the CCD, the electrodes in each pixel are
arranged so that the charge is transferred downwards along
the columns.

Hence, during the CCD clocking operation, rows are

transferred downwards to the final row (the readout
register) which is used to transfer the charge in each pixel
out of the CCD so it can be measured.

In the read out register, the electrodes are arranged so that

the charge is transferred in the horizontal direction, along
the readout register.

When charge has been collected and is to be read-out it is

transferred one charge packet at a time to an output where
the charge is converted to a voltage.
READOUT

 During the readout operation,

electrodes are alternately biased
with high and low voltages to
transfer charge down the array.
 A single transfer step is shown
 A CCD camera or instrument will consist of the CCD chip, and associated electronics, which is used at this point
to amplify the small voltage on the CCD, remove noise components, digitize the pixel values and output the
values of each pixel for example to a processor.
 The CCD is an analogue device, and the analogue voltage values are converted into a digital form by the camera
electronics
QUANTUM EFFICIENCY The percentage of photons that are detected is known as the Quantum Efficiency (QE) of a
detector. The human eye has a QE of approximately 20%, photographic film has a QE of around 10%, and modern day
CCDs achieve a QE of over 90%. Quantum efficiency varies with wavelength.

DYNAMIC RANGE The ability to view bright and faint sources correctly in the same image is a very useful property
of a detector. The difference between a brightest possible source and the faintest possible source that the detector
can accurately see in the same image is known as the dynamic range.

LINEARITY An important consideration in a detector is its ability to respond linearly to any image it views. If the
CCD detects 100 photons it will convert these to 100 electrons (assuming 100% QE). In such a situation, the
detector has a linear response. A linear response is useful as there is no need for additional processing on the image
to determine the real or true intensity of for example different objects in an image.

WAVELENGTH RANGE CCDs can have a wide wavelength range ranging from about 0.1nm (soft x-ray) to 400 nm
(blue visible) through to about 1000 nm (near infrared) with a peak sensitivity at around 700 nm. Detection in the
shorter x-ray and ultraviolet wavelengths is made possible through back illumination and increased sensitivity in the
longer near infrared wavelengths through lower noise and high resistivity silicon.
 DRAWBACKS OF CCD
 They are small devices, while the field of view of most x-ray examinations is large.
 The most straightforward approach to solve this problem is the use of a lens to demagnify the scintillator image
so that it fits within the optical window of the CCD array.
 With a typical field-of-view and typical CCD detector size, demagnification by a factor of roughly 10:1 is
necessary.
 For example, to match a 44 cm × 44 cm field of view (FOV) to a 4 cm × 4 cm CCD with 3,000 × 3,000
pixels, each 0.013 mm × 0.013 mm, a demagnification factor of just over 11 is required.
 However, it turns out that there is a significant loss of light—as much as 99%—with such demagnification, and this
yields significantly higher quantum noise in the resultant images.
 Use of higher x-ray doses can compensate for this loss, and because of the very low cost of CCD detectors, this
is one approach that has been used to produce very low-cost digital x-ray systems.
 Another way to use CCD detectors is in a so-called slot-scan geometry. In this geometry, multiple CCD detector
arrays are positioned in a line, long enough to cover the entire field of view (or a significant fraction of the FOV)
in one dimension (termed horizontal)— for example, the expected maximum width of a human chest.
 For example, a typical complete coverage geometry would use eight detector arrays, each 5.5 cm by 1.1
cm, tiled together to yield a single linear detector of dimension 44 cm by 1.1 cm.
 Patients having a chest x-ray using this type of system would be required to hold their breath for the duration of
the scan in order to minimize motion artifacts due to breathing.
THIN-FILM-TRANSISTOR-BASED DIGITAL RADIOGRAPHY SYSTEMS

 Flat-panel TFT arrays are made of amorphous silicon, where lithographic etching techniques are used to deposit
electronic components and connections necessary for x-ray detector operation.
 The large area TFT array is divided into individual detector elements (dexels), arranged in a row and column
matrix.
 Electronic components within each dexel include a TFT, a charge collection electrode, and a storage capacitor.
 The TFT is an electronic switch that is comprised of three connections: gate, source, and drain. Gate and drain
lines connect the source and drain of the TFT’s along the row and columns, respectively.
 Instead of producing individual electrical connections to each one of the elements in a flat panel display, a series of
horizontal and vertical electrical lines is used which, when combined with appropriate readout logic, can address
each individual display element.
 Only 2000 connections between the display and the electronics are required for a 1000 X 1000 display, instead of
1,000,000 individual connections.
 For a flat panel display, the wiring is used to send signals from the computer graphics card to each display element,
whereas in an x-ray detector the wiring is used to measure the signal generated in each detector element.
The gate is the transistor’s “on” – “off” switch, and is attached to the gate conductor line along each row of the array.

The source is attached to the storage capacitor, and the drain is attached to the drain conductor line running along each
column of the array.

The charge collection electrode captures the charge produced by incident x-ray energy deposited over the area of the
dexel (either by indirect or direct conversion, as discussed below), and the storage capacitor stores it.

During x-ray exposure, the TFT switch is closed, allowing charge in each dexel to be accumulated and stored.

After the exposure is completed, sequential activation of the TFT array occurs one row at a time, by sequentially turning
on the gate line to every dexel in the row (Fig 7-14).

This allows the accumulated charge in each dexel capacitor to flow through the transistor to the drain line, and
subsequently to the connected charge amplifier.

The charge amplifiers are positioned outside of the panel active area.

They amplify the charge, convert it to a proportional voltage, and digitize the voltage level, resulting in a gray scale value
for each dexel in the row.

This sequence is repeated row by row, to fully read out the array.

The speed of the detector readout is governed by the intrinsic electronic characteristics of the x-ray converter material
and the TFT array electronics.
FLAT PANEL STRUCTURE
A. flat panel detector systems are pixelated discrete detector
systems. The detector array is comprised of a large number of
individual detector elements (dexels). Each dexel has a light
sensitive region and a light-insensitive area where the electronic
components are located. B. A photomicrograph of an actual TFT
system is shown. The electronics component can be seen in the
upper left corner of each dexel (Image courtesy John Sabol and
Bill Hennessy, GE Healthcare).
Circuitry of TFT flat panel detector system.
Indirect and direct detector TFT–based x-ray detectors are shown.

A. Photons in the indirect system propagate laterally, compromising resolution. The detected signal shown for
the indirect detector shows this lateral spread in the signal from one x-ray photons interaction.

B. For the direct detector system, the ion pairs liberated by x-ray interaction follow the electric field lines
(electron holes travel upwards, electrons travel downwards) and have negligible lateral spread. Here, the
detected electronic signal from one x-ray photons interaction is collected almost entirely in one detector
element, and therefore better spatial resolution is achieved.
CMOS-BASED DIGITAL RADIOGRAPHY SYSTEMS

 Complementary metal oxide semiconductor (CMOS) active-pixel sensor (APS) imagers are the most common
optical sensor for consumer cameras.
 Their use in x-ray detection is relatively new and the advantages and disadvantages are still being discovered even
as the technology continues to improve.
 Current technology allows for pixels in CMOS sensors to be made larger than CCD elements, they have low cost
and low power consumption, they are tolerant to x-ray irradiation, and they have fast pixel readout capability.
 Each pixel in a CMOS APS comprises a photodiode and three or more MOSFET transistors.
 Because light is used as an input, these detectors are indirect and must be coupled to a scintillator as in a-Si TFT
detectors.
 Like TFTs, the pixels within a CMOS APS are accessed by activating an access enable conductor, which identifies
the row and then reads a particular output conductor, which identifies the column.
As opposed to the CMOS passive-pixel sensor (an earlier design that has only has one transistor per pixel), the CMOS
APS uses extra transistors to amplify the signal (accumulated charge) prior to readout, yielding much lower noise and
faster readouts.

The pixel size in CMOS sensors can be much larger than that of CCD detectors, which is an advantage.

A typical pixel size is 0.075 mm × 0.075 mm, and they can be grouped together to make larger ‘‘superpixels’’— for
example, up to 4 × 4 to make pixels of size 0.3 mm × 0.3 mm—which enables faster readout rates for real-time
applications.

Like CCD imaging arrays, CMOS imaging arrays must be manufactured on a single semiconductor substrate and this is a
limiting factor in comparison to TFT-based detectors.

Second generation sizes support up to 5 cm × 10 cm substrates and these can be tiled (with greater ease than tiling
CCD arrays) to make up larger panels, currently up to 290 mm × 230 mm, which is suitable for mammography
applications.