Filtration in Radiography

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Radiation Exposures
Unit 2
 
CHAPTERS 10, 15, 16, AND 18
 
Objectives
 
Define filtration, inherent filtration, added filtration ,
compound filtration, compensating filtration and total
filtration.
Explain concept of half-value layer equivalency
measurements of filtration.
Appraise various types of filters for specific clinical
situations.
Describe effect of filtration on entire x-ray beam.
Identify the factors that affect scatter.
Discuss types of scatter control used by radiographers
Explain the purpose, construction, advantages and
disadvantages of beam-restricting devices.
Describe the effect of beam restriction on image quality
and patient dose.
Explain the process of attenuation
 
 
Describe the basic composition of the human body and
how they attenuate the x-ray beam
Explain the relationship of the patient to density/image
receptor exposure, contrast, recorded detail and
distortion of the recorded image.
Describe the purpose of a grid and its construction
Explain: material, ratio, frequency and lead content
Differentiate various grid patterns.
Describe: parallel vs focused grids and stationary vs
moving grids.
Explain grid and technique  selection based on : patient ,
procedure, dose and IR exposure.
Discuss proper use and errors with grids and how both
effect the image.
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Chapter 10
 
FILTRATION
Filtration
 
The process of eliminating undesirable low-energy photons by inserting
absorbing material into the primary beam
Shape the photon emissions into a more useful beam
“hardens” the beam
Removes low energy (soft ) photons
Main Purpose
Decreases radiation dose to the patient by removing photons that would not enhance
the image.
Filter
 
Any material designed to selectively absorb photons
Placed between the tube( source)  and the patient
Aluminum
Most common / standard filter material used
All other materials are measured against it ability to filter- Aluminum equivalency
 
 (Al/Eq)
Alternated Materials
 
glass, oil , copper and tin
Measurement of Filtration
 
Express in half-value layer ( HVL ) 
– amount of absorbing material to reduce the
intensity of the primary beam by ½ the original value
Also expressed in Al/Eq  example : HVL = 2.0 mm Al/Eq
Federal govt. specifies min HVL for diagnostic tubes:
2.5 mm Al/Eq
 
 
Types of Filtration
 
2 types:
Inherent – in the design of the tube
Added- between tube and image receptor
Inherent filtration
 
Result of composition of tube and housing
Glass envelope
Oil surrounding tube
Glass window – where most of the filtration comes from
Total inherent is 0.5-1.0
Increases as tube ages because of vaporization of tungsten
HVL testing for QC tests for reduced tube efficiency because of the added filtration
Added Filtration
 
Any filtration that occurs outside the tube but before the IR
Absorb as many low-energy photons as possible while allowing max amount of
high-energy photons through.
Aluminum used as a low energy absorber
Collimators are considered added_ 1.0 mm Al/Eq
Most comes from the silver on the mirror that reflects the positioning light.
Types of Added Filtration
 
Compound filtration ( AKA: K-Edge)
Uses two or more material that work together well to absorb
High atomic number material sandwiched with a lower atomic number material
Cooper ( 29) with Al ( 13)
Built to absorb characteristic photons ( K shell photons) created by the previous layer
The higher atomic number will absorb higher energies but Al is needed to absorb the lower
energy photons created.
Examples: Thoreaus filter- used in radiation therapy
                         Some QC testing uses copper + Al filters
Types of Added Filtration
 
Compensation Filters
Designed to solve a problem of unequal subject densities
Produces a more uniform IR exposure
Components:
AL, Lead, leaded plastic or plastic – saline solution bag
Common types
Wedge- thicker portion is placed over thinner part- foot, t-spine
Trough ( double wedge) – chest to even out mediastinum
Total Filtration
 
Equal to the sum of inherent + added filtration  but DOES not include
compensating filters
Thickness depends on use of equipment
Above 70 kVp 2.5 mm Al
Effect on Output
 
As filtration increases- technical factors must increase to maintain IR exposure
Even though there is an increase in technique necessary for compensation- the
ESE is decreased as compared to no filtration in place at lower techniques
See table 10-4 page 176
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Beam Restriction
 
CHAPTER 15
Scatter
 
 
Product of Compton interactions ( scatter that contributes to fog and tech dose)
Not part of the useful beam
Impair image quality by adding exposure to the IR unrelated to patient anatomy
Best way to control scatter 
reaching the IR 
is to use a grid.
Best way to control scatter 
to the patient 
is use beam restriction.
Principle factors affecting scatter
1. kilovoltage
2. irradiated material
1. Kilovoltage
 
 
As kVp increases
More photons pass through the patient to interact with the image receptor
Image quality is increased with less scatter
Photons that do not pass through the matter interact as Compton and photoelectric
interactions
Higher kVp will increase Compton( scatter)  and decrease photoelectric ( pt dose)
Since photoelectric contribute to patient dose, dose will be decreased
kVp should be based on part/anatomy thickness /size  and the amount of contrast
desired
Increased kVp with NO change in mAs : increased scatter
Increased kVp and reduction in mAs: decreased scatter
2. Irradiated Material
 
Scatter is affected by the volume and atomic number of the material being x-rayed.
Volume is controlled by field size and patient thickness
Increased volume increases scatter ( more interactions)
Volume increases as part increases and as field size increase
14 x17 has more volume than 10 x 12 – increased scatter , so smallest field size should be used
Large patients should have better collimation to decrease interaction ( decrease scatter)
When collimation is used- more technique is needed ( 14x17 to 10x12- aprox increase is 25% , 14x17
to 8 x 10 aprox increase of 40%)
Higher atomic numbers will have less scatter- they absorb more through
photoelectric absorption- more contrast ( black and white)
Bone absorbs more than soft tissue- less scatter
Iodine, Ba and Pb absorbs more- less scatter
 
Types of Beam Restrictors
 
   1. Collimators
   2. Aperture diaphragms and  cones / cylinders
   3 . Ancillary devices
1. Collimator
 
Most common beam restrictor – results in filtration of the beam – aprox 1 mm
of Al
Multiple size configurations- but should always be minimized to the part being
radiographed
Lead shutters at right angles and move in opposing pairs
3 purposes:
1.
Regulate field size
2.
Reduce penumbra
3.
Act as a light field
Field Size
 
Various square or rectangle shapes
PBL device - positive beam limitation device- automatic collimation of the beam
size- works with a sensor in the Bucky tray to determine film size being used.
Collimator accuracy must be checked yearly – Within 2 % of the distance
 
Penumbra
 
Geometric unsharpness around the edge of the image
Result of off focus radiation – photons emerge at different angles from the tube
and interact with the tissue at various angles and create a “shadow “ image
outside the exposed field of radiation
Reducing penumbra will increase recorded detail
Light Field
 
Provides an exposure field with crosshair
Some units will have an AEC chamber outline
Lightbulb is placed at a 45
0  
 to a mirror – improper placement of the mirror can
cause a mis-projection of the light and misrepresent the field size
2. Aperture diaphragms and  cones / cylinders
 
Aperture diaphragm- flat sheet of metal( Pb) with opening cut in the middle
Attached to the bottom of the collimator box
Simplest of all beam limiting devices
Different sizes for different receptor sizes at different distances
Mostly seen in mammography because they don’t use collimators
Cones and cylinders
Circular aperture diaphragm with metal extensions
Can flare or diverges- small at top than bottom
Most effective use of scatter control
3. Ancillary Devices
 
Designed  for a specific need and are tailored for specific use during a given
procedure
Lead blockers or lead masks
Blockers
 Lead impregnated rubber
Used to absorb scatter created from soft tissue- used a lot on larger patients
May be placed behind a patient’s back on an lateral L-spine
Masks
cut to a specific shape and attached to collimator
undefined
 
Chapter 16
 
THE PATIENT AS A BEAM EMITTER
Attenuation
 
The reduction in the total number of x-ray photons remaining in the beam after
passing through an object
Result of :
x-rays interacting with matter and being absorbed or scattered
The thicker the body part, the more attenuation
Photoelectric absorption( provides information)  and Compton scattering ( no useful
info- only dose to tech )
Determined by the amount or type of irradiated material
High atomic number = higher attenuation – bone , barium, lead
Low atomic number= low attenuation- hydrogen, carbon, oxygen
Lowes to highest attenuators in body by density: Air, fat, water, muscle, bone
The Patient
 
The greatest variable
Atomic makeup : hydrogen (atomic # 1) , carbon(6), nitrogen(7) and oxygen(8)
calcium (20)
4 Major substances account for most variations in absorption:
Air
Fat
Muscle
Bone
1. Air
 
Higher atomic number than fat or muscle but lower tissue density
Absorbs fewer photons as it passes through allowing more photons to reach IR
Present in : ?????
Lungs
Sinuses
GI tract
2. Fat
 
Similar to muscle- both soft tissue structures- fat has less tissue density
Effective atomic number similar to water- water is used to simulate fat in
experiments
Varies from patient to patient
Fat sometimes allow for better visualization of certain organs during x-raying
kidneys
3. Muscle
 
Higher atomic number and density than fat- cells are packed closer together
Greater attenuator
Can often see psoas muscles on abdomen radiograph
4. Bone
 
Calcium level in bones makes them higher attenuators
Highest effective atomic number and tissue density of the four basic substances
of the body
Results in few photons reaching the IR
Patients Relationship to Image Quality
 
Patient has affect on all properties of image quality
1.
Density/image receptor exposure ( subject density)
2.
Contrast ( subject contrast)
3.
Recorded detail ( subject detail )
4.
Distortion ( subject distortion)
1. Subject Density
 
The impact the subject has on the resultant radiographic density or IR exposure
Varies depending on the amount or type of tissue being irradiated
Thicker the part/ more dense the tissue = less IR exposure
2. Subject Contrast
 
The difference in densities of a recorded image
The degree of differential absorption resulting from the differing absorption
characteristics of the tissue in the body
Dependent  on patient’s tissues
Less difference in adjacent densities- fat and muscle- less contrast
More difference in adjacent densities- bone and air- more contrast
 
3. Subject Detail
 
Primary factor affecting sharpness in distance from structure to IR
Dependent on where structure is in the body
Even size of body- larger patients the part is further away from IR
How the patient is positioned
PA vs AP, RT vs LT lateral
 
4. Subject Distortion
 
The misrepresentation of size or shape of the  structure of interest
Varies with patient position
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Chapter 18
 
THE GRID
Invention of the Grid
 
1913- Gustav Bucky, an American radiologist, designed the first grid
Designed in a cross-hatched pattern using lead strips
Grid showed on image but decrease scatter and improved contrast
1920- Hollis Potter, a Chicago radiologist, improved Bucky’s design
Redesigned lead to run in one direction
Made lead thinner and less obvious on image
 
Potter also designed the Potter-Bucky diaphragm- allowed for the grid move during
exposure
Lead strips became blurred  and were no longer visible
Purpose
 
Improves contrast of the image
Absorbs scatter before reaching the IR
Used with thicker body parts and higher kVp since scatter increases as both of
these increase
Greater than 10cm
kVp above 60
Construction
 
Series of radiopaque strips alternated with interspace strips
Radiopaque strips absorb scatter and are made of high atomic number material
Interspace is radiolucent – allows radiation to pass through without interaction
Construction Involves:
1.
materials
2.
 grid ratio
3.
 grid frequency
 
1. Materials
 
Interspace- aluminum and plastic fiber
Should not absorb any radiation
However, Al has a high atomic number and actually absorbs primary photons-
disadvantage at low-kVp techniques- fiber is better for low kVp techniques
2. Grid Ratio
 
Major influence on the ability of the grid to improve contrast
Defined as the “ ratio of the height of the lead strips to the distance between the strips”
Expressed as a formula:
Grid ratio = h                  h=lead strip height                   3 mm height and .25 mm interspace =
 
               D
 
                D= interspace width                                 3/ .25 = 12:1 grid
Height and distance are inversely proportional:
If height is constant but we decrease the interspace distance, we increase ratio
 
3 mm height  and .25 = 12:1 grid
If height is constant but we increase the interspace distance, we decrease ratio
           3 mm height and .50 = 6:1 grid ratio
Comparing grid ratios
 
Higher grid ratios allow less scatter
to pass through- more effective at
removing scatter
Disadvantage to high grid ratio: must
be more precise positioning of grid so
primary isn’t absorbed – higher grid
error
3. Grid Frequency
 
The number of grid lines per inch or cm
Higher grid frequencies have thinner lead strips
Range from 60-200 lines/inch
Most common 85-103 lines / inch
Very high frequencies 178-200 lines/inch are common for digital to minimize
grid lines on image( because digital is more sensitive)
Grid Ratio and Grid Frequency
 
 
The combination of the two variable will determine the total quantity of lead in
the grid.
Lead content is the most important in determining grid efficiency
Lead content is greater in a grid with high radio and lower frequency – because
the strips will be thicker in lower frequency
Grid Patterns: 2 types
 
1.
Linear grids- lead runs in one direction
Most common- used in x-ray table
Allow for tube angle along the direction of the lines ( long axis) – head to feet
Can have short axis grids- helpful for Port CXR where gird is place crosswise.
 
2.
Criss-crossed or cross hatched- lead strips run at right angles
Do not allow for tube angle
Limited applications
 
Grid Cut-off- can occur with ANY grid
when the lead strips “cut-off” or absorb the primary beam- not allowing for it to reach IR-
no image in that area of the IR
 
Grid types
 
1. Parallel – least common
2. Focused
1. Parallel grids
 
Lead and interspace run parallel to each other
 will never intersect
Strips do not coincide with divergence of the beam
Absorb primary beam as a result-more along lateral edges
Worse at short SIDs
Better at long SIDs because beam is more straight
2. Focused Grid
 
Lead and interspace are still parallel but are angle to match the
divergence of the beam at different distances
Would eventually intersect at a convergence line
The distance from the face of the grid to the point of convergence is called
grid radius
Tube must be located across the convergence line
Focused grids are grouped by focal ranges ( distances) 60-72 inch
focus, 30-48 inch focus – grid will be marked
Lower grid ratios allow for greater latitude in tube alignment
Higher grid ratios proper tube alignment is critical
Grid Uses
 
Stationary
Come in various sizes to match cassette size
Grid lines are more noticeable
Low frequency grids( thicker strips)  worse than high frequency ( thinner strips)
Used with portable or in rooms when patient is not on x-ray table- gurney or hosp bed
Grid cassettes- for film/screen- grid was build into cassette
Mounted  moving- AKA Bucky
Mounted below table top (  or upright holder ) and hold cassette in place below (behind) the grid
Moves during exposure so grid lines will be blurred and not seen
Larger than largest cassette size used in machine
Grid lines run along the axis of table ( head to foot)
Movement moves the grid at right angles to the grid- side to side
Two movement types
Reciprocating- side to side- motor driven
Oscillating- circular movement- electromagnet driven
 
Grid Selection
 
Made in equipment purchase- not normally interchangeable
Stationary grids will be selected by size/ focus/ grid ratio
 
Compensation of technique (mAs)  must
be made between type of grid selected
Same technique can’t be used for no grid
vs 16:1
 
Formula:
 
mAs 1       = GCF 1
mAs 2           GCF 2
Image 1 = 8:1 grid 35 mAs
Image 2 = 12:1 grid    ?? mAs
35
 =     4
X            6
4x=210       x= 52.5 mAs
 
Grid Conversion
 
This chart is different than in text- eliminates need
to figure in kVp ( easier to apply and remember! )
 
Grid Performance Evaluation
 
The measuring of a grid in cleanup or removing scatter
Determined by two factors:
1.
Selectivity
2.
 Contrast improvement ability
1. Selectivity
 
The ratio between the quantity (%) of the primary photons transmitted through the grid
to the quantity (%) of scatter photons transmitted
    - The better the grid is at removing scatter ; the greater the selectivity- higher grid ratios have
higher selectivity
 
Formula:
               selectivity =     % of primary radiation transmitted
  
                  % of scatter radiation transmitted
2. Contrast Improvement Ability
 
Best way to determine grid function
Contrast improvement factor ( K) – dependent on the amount of scatter
produced
As scatter increases , contrast decrease, thus lowering the improvement factor
The higher the K factor the greater the contrast improvement
Formula:
 
K=  Radiographic contrast with the grid
 
        Radiographic contrast w/out the grid
Grid Errors
 
Result of improper use
More frequent with focused grids- tube must be centered and at correct SID
Also has tube side and IR side
Types of Errors
Off- Level
Off-Center
Off-Focus
Upside-down
Moiré Effect
Off-Level
 
Occurs when tube is angled across the long axis of the grid strips
Result of improper tube or grid position
Most common with stationary grid- portable procedures
Result
Absorption of primary beam & decrease in overall exposure – light image
Off-Center
 
When tube is not centered to grid
Does not line up with divergence of beam
The greater degree of lateral off-centering the greater the cut-off
Result :
Decreased exposure across entire image ( light image)
Off-Focus
 
When a grid is used at incorrect SID
Higher grid ratios require greater
accuracy to prevent cutoff
Result:
Grid cutoff along the peripheral edges of
the image
Upside-Down
 
Focused grids have an identified tube side
Result:
If used upside-down- severe peripheral grid cut-
off will occur
The Moire Effect
 
Occurs with digital image receptors when grid lines are captured and scanned
parallel to the scan lines of the imaging plate reader
Grid lines run parallel with the laser
Happens with stationary grids- ran across short axis
Corrected by high-frequency grids w/ 103 lines per inch or higher
Alternate to Grid
 
Restricting beam size
Compress body part- compression band
 
Air-Gap Technique
Increased OID – same amount of scatter will leave patient , but won’t reach patient
10
 air gap has similar clean-up of 15:1 grid
REFERENCES SHEET FOR ALL DOCUMENTS
 
 
 
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Filtration is a crucial process in radiography that involves eliminating undesirable low-energy photons to enhance image quality and reduce radiation dose to patients. This process involves using filters made of materials like aluminum to selectively absorb photons. Measurement of filtration is expressed in terms of half-value layer (HVL), with inherent and added filtration types playing key roles in the imaging process. Proper understanding and implementation of filtration techniques are essential for producing high-quality radiographic images while minimizing patient exposure to radiation.

  • Filtration
  • Radiography
  • Imaging
  • Patient Safety
  • Image Quality

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  1. Radiation Exposures Unit 2 CHAPTERS 10, 15, 16, AND 18

  2. Objectives Define filtration, inherent filtration, added filtration , compound filtration, compensating filtration and total filtration. Describe the basic composition of the human body and how they attenuate the x-ray beam Explain the relationship of the patient to density/image receptor exposure, contrast, recorded detail and distortion of the recorded image. Explain concept of half-value layer equivalency measurements of filtration. Appraise various types of filters for specific clinical situations. Describe the purpose of a grid and its construction Explain: material, ratio, frequency and lead content Describe effect of filtration on entire x-ray beam. Differentiate various grid patterns. Identify the factors that affect scatter. Describe: parallel vs focused grids and stationary vs moving grids. Discuss types of scatter control used by radiographers Explain the purpose, construction, advantages and disadvantages of beam-restricting devices. Explain grid and technique selection based on : patient , procedure, dose and IR exposure. Describe the effect of beam restriction on image quality and patient dose. Discuss proper use and errors with grids and how both effect the image. Explain the process of attenuation

  3. Chapter 10 FILTRATION

  4. Filtration The process of eliminating undesirable low-energy photons by inserting absorbing material into the primary beam Shape the photon emissions into a more useful beam hardens the beam Removes low energy (soft ) photons Main Purpose Decreases radiation dose to the patient by removing photons that would not enhance the image.

  5. Filter Any material designed to selectively absorb photons Placed between the tube( source) and the patient Aluminum Most common / standard filter material used All other materials are measured against it ability to filter- Aluminum equivalency (Al/Eq) Alternated Materials glass, oil , copper and tin

  6. Measurement of Filtration Express in half-value layer ( HVL ) amount of absorbing material to reduce the intensity of the primary beam by the original value Also expressed in Al/Eq example : HVL = 2.0 mm Al/Eq Federal govt. specifies min HVL for diagnostic tubes: 2.5 mm Al/Eq

  7. Types of Filtration 2 types: Inherent in the design of the tube Added- between tube and image receptor

  8. Inherent filtration Result of composition of tube and housing Glass envelope Oil surrounding tube Glass window where most of the filtration comes from Total inherent is 0.5-1.0 Increases as tube ages because of vaporization of tungsten HVL testing for QC tests for reduced tube efficiency because of the added filtration

  9. Added Filtration Any filtration that occurs outside the tube but before the IR Absorb as many low-energy photons as possible while allowing max amount of high-energy photons through. Aluminum used as a low energy absorber Collimators are considered added_ 1.0 mm Al/Eq Most comes from the silver on the mirror that reflects the positioning light.

  10. Types of Added Filtration Compound filtration ( AKA: K-Edge) Uses two or more material that work together well to absorb High atomic number material sandwiched with a lower atomic number material Cooper ( 29) with Al ( 13) Built to absorb characteristic photons ( K shell photons) created by the previous layer The higher atomic number will absorb higher energies but Al is needed to absorb the lower energy photons created. Examples: Thoreaus filter- used in radiation therapy Some QC testing uses copper + Al filters

  11. Types of Added Filtration Compensation Filters Designed to solve a problem of unequal subject densities Produces a more uniform IR exposure Components: AL, Lead, leaded plastic or plastic saline solution bag Common types Wedge- thicker portion is placed over thinner part- foot, t-spine Trough ( double wedge) chest to even out mediastinum

  12. Total Filtration Equal to the sum of inherent + added filtration but DOES not include compensating filters Thickness depends on use of equipment Above 70 kVp 2.5 mm Al

  13. Effect on Output As filtration increases- technical factors must increase to maintain IR exposure Even though there is an increase in technique necessary for compensation- the ESE is decreased as compared to no filtration in place at lower techniques See table 10-4 page 176

  14. Beam Restriction CHAPTER 15

  15. Scatter Product of Compton interactions ( scatter that contributes to fog and tech dose) Not part of the useful beam Impair image quality by adding exposure to the IR unrelated to patient anatomy Best way to control scatter reaching the IR is to use a grid. Best way to control scatter to the patient is use beam restriction. Principle factors affecting scatter 1. kilovoltage 2. irradiated material

  16. 1. Kilovoltage As kVp increases More photons pass through the patient to interact with the image receptor Image quality is increased with less scatter Photons that do not pass through the matter interact as Compton and photoelectric interactions Higher kVp will increase Compton( scatter) and decrease photoelectric ( pt dose) Since photoelectric contribute to patient dose, dose will be decreased kVp should be based on part/anatomy thickness /size and the amount of contrast desired Increased kVp with NO change in mAs : increased scatter Increased kVp and reduction in mAs: decreased scatter

  17. 2. Irradiated Material Scatter is affected by the volume and atomic number of the material being x-rayed. Volume is controlled by field size and patient thickness Increased volume increases scatter ( more interactions) Volume increases as part increases and as field size increase 14 x17 has more volume than 10 x 12 increased scatter , so smallest field size should be used Large patients should have better collimation to decrease interaction ( decrease scatter) When collimation is used- more technique is needed ( 14x17 to 10x12- aprox increase is 25% , 14x17 to 8 x 10 aprox increase of 40%) Higher atomic numbers will have less scatter- they absorb more through photoelectric absorption- more contrast ( black and white) Bone absorbs more than soft tissue- less scatter Iodine, Ba and Pb absorbs more- less scatter

  18. Types of Beam Restrictors 1. Collimators 2. Aperture diaphragms and cones / cylinders 3 . Ancillary devices

  19. 1. Collimator Most common beam restrictor results in filtration of the beam aprox 1 mm of Al Multiple size configurations- but should always be minimized to the part being radiographed Lead shutters at right angles and move in opposing pairs 3 purposes: 1. Regulate field size 2. Reduce penumbra 3. Act as a light field

  20. Field Size Various square or rectangle shapes PBL device - positive beam limitation device- automatic collimation of the beam size- works with a sensor in the Bucky tray to determine film size being used. Collimator accuracy must be checked yearly Within 2 % of the distance

  21. Penumbra Geometric unsharpness around the edge of the image Result of off focus radiation photons emerge at different angles from the tube and interact with the tissue at various angles and create a shadow image outside the exposed field of radiation Reducing penumbra will increase recorded detail

  22. Light Field Provides an exposure field with crosshair Some units will have an AEC chamber outline Lightbulb is placed at a 450 to a mirror improper placement of the mirror can cause a mis-projection of the light and misrepresent the field size

  23. 2. Aperture diaphragms and cones / cylinders Aperture diaphragm- flat sheet of metal( Pb) with opening cut in the middle Attached to the bottom of the collimator box Simplest of all beam limiting devices Different sizes for different receptor sizes at different distances Mostly seen in mammography because they don t use collimators Cones and cylinders Circular aperture diaphragm with metal extensions Can flare or diverges- small at top than bottom Most effective use of scatter control

  24. 3. Ancillary Devices Designed for a specific need and are tailored for specific use during a given procedure Lead blockers or lead masks Blockers Lead impregnated rubber Used to absorb scatter created from soft tissue- used a lot on larger patients May be placed behind a patient s back on an lateral L-spine Masks cut to a specific shape and attached to collimator

  25. Chapter 16 THE PATIENT AS A BEAM EMITTER

  26. Attenuation The reduction in the total number of x-ray photons remaining in the beam after passing through an object Result of : x-rays interacting with matter and being absorbed or scattered The thicker the body part, the more attenuation Photoelectric absorption( provides information) and Compton scattering ( no useful info- only dose to tech ) Determined by the amount or type of irradiated material High atomic number = higher attenuation bone , barium, lead Low atomic number= low attenuation- hydrogen, carbon, oxygen Lowes to highest attenuators in body by density: Air, fat, water, muscle, bone

  27. The Patient The greatest variable Atomic makeup : hydrogen (atomic # 1) , carbon(6), nitrogen(7) and oxygen(8) calcium (20) 4 Major substances account for most variations in absorption: Air Fat Muscle Bone

  28. 1. Air Higher atomic number than fat or muscle but lower tissue density Absorbs fewer photons as it passes through allowing more photons to reach IR Present in : ????? Lungs Sinuses GI tract

  29. 2. Fat Similar to muscle- both soft tissue structures- fat has less tissue density Effective atomic number similar to water- water is used to simulate fat in experiments Varies from patient to patient Fat sometimes allow for better visualization of certain organs during x-raying kidneys

  30. 3. Muscle Higher atomic number and density than fat- cells are packed closer together Greater attenuator Can often see psoas muscles on abdomen radiograph

  31. 4. Bone Calcium level in bones makes them higher attenuators Highest effective atomic number and tissue density of the four basic substances of the body Results in few photons reaching the IR

  32. Patients Relationship to Image Quality Patient has affect on all properties of image quality 1. Density/image receptor exposure ( subject density) 2. Contrast ( subject contrast) 3. Recorded detail ( subject detail ) 4. Distortion ( subject distortion)

  33. 1. Subject Density The impact the subject has on the resultant radiographic density or IR exposure Varies depending on the amount or type of tissue being irradiated Thicker the part/ more dense the tissue = less IR exposure

  34. 2. Subject Contrast The difference in densities of a recorded image The degree of differential absorption resulting from the differing absorption characteristics of the tissue in the body Dependent on patient s tissues Less difference in adjacent densities- fat and muscle- less contrast More difference in adjacent densities- bone and air- more contrast

  35. 3. Subject Detail Primary factor affecting sharpness in distance from structure to IR Dependent on where structure is in the body Even size of body- larger patients the part is further away from IR How the patient is positioned PA vs AP, RT vs LT lateral

  36. 4. Subject Distortion The misrepresentation of size or shape of the structure of interest Varies with patient position

  37. Chapter 18 THE GRID

  38. Invention of the Grid 1913- Gustav Bucky, an American radiologist, designed the first grid Designed in a cross-hatched pattern using lead strips Grid showed on image but decrease scatter and improved contrast 1920- Hollis Potter, a Chicago radiologist, improved Bucky s design Redesigned lead to run in one direction Made lead thinner and less obvious on image Potter also designed the Potter-Bucky diaphragm- allowed for the grid move during exposure Lead strips became blurred and were no longer visible

  39. Purpose Improves contrast of the image Absorbs scatter before reaching the IR Used with thicker body parts and higher kVp since scatter increases as both of these increase Greater than 10cm kVp above 60

  40. Construction Series of radiopaque strips alternated with interspace strips Radiopaque strips absorb scatter and are made of high atomic number material Interspace is radiolucent allows radiation to pass through without interaction Construction Involves: 1. materials 2. 3. grid ratio grid frequency

  41. 1. Materials Interspace- aluminum and plastic fiber Should not absorb any radiation However, Al has a high atomic number and actually absorbs primary photons- disadvantage at low-kVp techniques- fiber is better for low kVp techniques

  42. 2. Grid Ratio Major influence on the ability of the grid to improve contrast Defined as the ratio of the height of the lead strips to the distance between the strips Expressed as a formula: Grid ratio = h h=lead strip height 3 mm height and .25 mm interspace = D D= interspace width 3/ .25 = 12:1 grid Height and distance are inversely proportional: If height is constant but we decrease the interspace distance, we increase ratio 3 mm height and .25 = 12:1 grid If height is constant but we increase the interspace distance, we decrease ratio 3 mm height and .50 = 6:1 grid ratio

  43. Comparing grid ratios Higher grid ratios allow less scatter to pass through- more effective at removing scatter Disadvantage to high grid ratio: must be more precise positioning of grid so primary isn t absorbed higher grid error

  44. 3. Grid Frequency The number of grid lines per inch or cm Higher grid frequencies have thinner lead strips Range from 60-200 lines/inch Most common 85-103 lines / inch Very high frequencies 178-200 lines/inch are common for digital to minimize grid lines on image( because digital is more sensitive)

  45. Grid Ratio and Grid Frequency The combination of the two variable will determine the total quantity of lead in the grid. Lead content is the most important in determining grid efficiency Lead content is greater in a grid with high radio and lower frequency because the strips will be thicker in lower frequency

  46. Grid Patterns: 2 types 1. Linear grids- lead runs in one direction Most common- used in x-ray table Allow for tube angle along the direction of the lines ( long axis) head to feet Can have short axis grids- helpful for Port CXR where gird is place crosswise. 2. Criss-crossed or cross hatched- lead strips run at right angles Do not allow for tube angle Limited applications Grid Cut-off- can occur with ANY grid when the lead strips cut-off or absorb the primary beam- not allowing for it to reach IR- no image in that area of the IR

  47. Grid types 1. Parallel least common 2. Focused

  48. 1. Parallel grids Lead and interspace run parallel to each other will never intersect Strips do not coincide with divergence of the beam Absorb primary beam as a result-more along lateral edges Worse at short SIDs Better at long SIDs because beam is more straight

  49. 2. Focused Grid Lead and interspace are still parallel but are angle to match the divergence of the beam at different distances Would eventually intersect at a convergence line The distance from the face of the grid to the point of convergence is called grid radius Tube must be located across the convergence line Focused grids are grouped by focal ranges ( distances) 60-72 inch focus, 30-48 inch focus grid will be marked Lower grid ratios allow for greater latitude in tube alignment Higher grid ratios proper tube alignment is critical

  50. Grid Uses Stationary Come in various sizes to match cassette size Grid lines are more noticeable Low frequency grids( thicker strips) worse than high frequency ( thinner strips) Used with portable or in rooms when patient is not on x-ray table- gurney or hosp bed Grid cassettes- for film/screen- grid was build into cassette Mounted moving- AKA Bucky Mounted below table top ( or upright holder ) and hold cassette in place below (behind) the grid Moves during exposure so grid lines will be blurred and not seen Larger than largest cassette size used in machine Grid lines run along the axis of table ( head to foot) Movement moves the grid at right angles to the grid- side to side Two movement types Reciprocating- side to side- motor driven Oscillating- circular movement- electromagnet driven

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