Biomedical Imaging

X ray imaging

Patrícia Figueiredo
IST 2013-2014
Overview

• Production of X rays
• Interaction of electrons with matter
• X ray spectrum
• X ray tube

• Interaction of X rays with matter

• Photoelectric effects and Compton effect
• X ray attenuation
• X ray dosimetry
X rays
- X rays are beams of high energy photons, with wavelengths ~ 10-9 – 10-12 m.
- Because of their high penetration power, they are used in the analysis of the structure
of different materials, either through X ray diffraction (crystallography) or
X ray transmission (medical radiography and computed tomography).
Production of X rays

X rays are produced through the acceleration of an electron beam from a cathode
where they are emitted towards an anode where they interact with a target.

Accelerating voltage: ΔVp~15–150kV, I~50–1000mA

Heating through
passage of
electric current Thermionic
emission of Acceleration of
electrons free electrons X ray emission
towards the anode through
interaction of
free electrons
with the target
Interactions of electrons with matter

Atomic excitation:

Ionization:

Joule effect:

Heating!
Interactions of electrons with matter

Bremsstrahlung (braking radiation)

Maximum X ray energy

E max = E 1
E 2 = 0 ⇒ hν = E 1 = E max
ΔE max ∝ kVp

Continuous range of energies

X ray spectrum

Bremsstrahlung

Efficiency of
Bremsstrahlung
radiation:
η ∝ kVpZ
Relative nb photons

Maximum energy
Emax ∝ kVp

Photon energy
[keV]
Interactions of electrons with matter

Ionization: characteristic radiation

e-
Ee=Einc-E0 Eo
X
e-
E1
Einc E1-E0
Eo
e-
E2 X
e-
Eo E2-E0

Ei = ΔEi
Atomic level transitions: discrete enery levels
Interactions of electrons with matter

Ionization: characteristic radiation

Eo
X
E=20-2.6=17.4 eV E=69-11=58 eV e-
E1
E1-E0

E2 X
e-

E=20-0.39=19.61 eV E=69-2.3=66.7 eV Eo E2-E0

X ray spectrum

Bremsstrahlung

Internal filtering Characteristic radiation

Emax ∝ kVp
Maximum energy

[keV]
X ray tube

•High melting point targets (anodes) Target

•Rotating anodes (~3000 rpm)
Z Melting point
•Focusing tube (cathods)
•Beveled targets (angles 5-20°) W 74 3370 °C
Mo 42 2623 °C

1B2YA High Voltage Rectifier Tubes.

Tube on left is manufactured by
Sylvania, the right tube is General
Electric manufactured. Tubes show
glass discoloration (browning) from X-
ray production.
X ray tube

Effective focal spot size:

f = F sinθ
Range = 2 D tanθ
(θ ~ 5-20°⇒ f ~ 0.3-1.2 mm)

Effective focal spot size

Range
D
θ
f
F

Focal spot size

X ray tube
Main characteristics:

- Tube voltage (accelerating voltage): kVp

~15 – 150 kV, ~50 kV for mammography, ~130 kV in torax radiography

-Tube current: mA
~50 – 400 mA in radiography, ~1000 mA em CT, <50 mA in fluoroscopy

- Output power: mA × kVp [Watts]

-Exposition time: [s]

-Maximum power for an exposition of 0.1 s: kW

P = 10 kW per 0.1 s: kVp = 80 kV ⇒ mA = 125 mA

-X ray beam intensity: I ∝ Zalvo × mA × (kVp)2 [J m-2]

-X ray maximum energy: Emax = e kVp ∝ kVp [keV]

-Focal spot size / Effective focal spot size: F / f [mm]

X ray tube

Tube voltage [kVp]: Tube current [mA]:

I ∝ (kVp)2 I ∝ mA
Emax ∝ kVp Emax unchanged
Epeak shifted to higher energies Epeak unchanged
Nb characteristic lines ↑ Nb characteristic lines unchanged
X ray tube

Exposition time [s] / Maximum power in 0.1 s [kW]:

Interaction of X rays with matter

• Contrast between tissues in X-ray images arises from differential

attenuation of the X-rays across the tissues.

• A certain fraction of X-rays pass straight through the body and

undergo no interactions with the tissue: these X-rays are called
primary radiation.

• X-rays can be scattered, an interaction that alters their trajectory

between source and detector. They are called secondary radiation.

• X-rays, can be absorbed, they are called absorbed radiation.

Interaction of X rays with matter
Compton effect: inelastic diffusion
Photoelectric effect: absorption Secondary radiation
Absorbed Radiation e-

e-
E0
E1<<E0 Valence shell θ
E0 An electron is ejected
E2<<E0
E1<E0
Coherent (Rayleigh): elastic diffusion
Pair production: annihilation Secondary radiation

e-

E0
E0 Incident radiation is θ
γanhilation converted in thermal
e+ vibration of the electrons E1<E0
• there is no ionization
• Scattered angle increases
Interaction of X rays with matter

Photoelectric effect: absorption pPE ∝ Z3/E3

 Interaction of X rays with matter

Compton effect: inelastic diffusion pCompton ∝ ρN0

The relatively small

difference in energy
between incident and
scattered X-rays means that
secondary radiation is
detected with
approximately the same
efficiency as primary
radiation.
Interaction of X rays with matter

Compton effect: inelastic diffusion

Distribuição de Compton:

E X ,inc
E X , scat =
1 + E X ,inc mc 2 (1 − cosθ )

EX,inc [keV]
θ 25 50 100 150
EX,scat [keV]
30° 24.8 49.4 97.5 144.4
60° 24.4 47.4 91.2 131.0
90° 23.8 41.9 72.1 94.6
X ray attenuation

Photoelectric effect Compton Scattering

e- e-

E1<<E0
E0 E0
E2 <<E0
θ

E1 <E0
•Incident X rays are absorbed and energy of •Incident X rays are scattered and energy of
secondary X rays is insufficient to reach detector scattered X rays is sufficient to reach detector
⇒ X rays reaching the detector are: ⇒X rays reaching the detector are:
primary radiation, with preserved energy secondary radiation with modified
and direction. energy and direction.
•Depends on atomic number Z •Does not depend on atomic number Z
⇒ provides contrast betwen materials ⇒ does not provide contrast betwen
materials
X ray attenuation
I0 I0exp{-µlΔx} ΔI = −I 0σ Nv Δx ⇒ I(x ) = I 0e −σ Nv x = I 0e − µl x

CONTINUAR AQUI (IB-MTBiom)

σ,Nv,µl :
Δx I0/2= I0 exp{-σ Nv HVL}
I0 = intensity of incident X-rays HVL = ln 2 / µl Half
Value Layer
N0 = nb of incident photons

σ [cm2] = interaction cross section

Nv [cm-3] = nb of diffusing particles per unit volume of tissue

µl = σ Nv [cm-1] = linear attenuation coefficient

Interaction cross section: σ = σ Photoelectric+ σ Compton+ σ Rayleigh+ σ PairProduction

Linear attenuation coefficient: µl = µl (ρ, N0, Z , E) [cm-1]

Mass attenuation coefficient: µ = µl / ρ ⇒ µ = µ (N0, Z , E) [cm2/g]
X ray attenuation

Dependence on interaction cross section

Mechanism Energy range
E Z N0
Elastic diffusion ∝1/E2 ∝ Z8/3 - 1 – 30 keV
Photoelectric effect ∝1/E3 ∝ Z3 ∝ N0 1 – 100 keV
Compton diffusion Decreases with E - ∝ N0 0.5 – 5 MeV
Pair production Increases with E ∝ Z2 - > 5 MeV

Operation region of
X-rays used in
medical diagnosis
X ray attenuation
I x = I 0e − µ x
µ = µ photoelectric + µCompton + µcoherent
Energy dependence:
The optimum X ray energy is
~ 30 keV (kVp ~ 80-100 kV)
In water where the photoelectric effect
dominates.
X ray attenuation If the X-rays have to pass
through a large amount of
tissue, such as in abdominal
imaging, then beam
Energy dependence: hardening reduces image
contrast by increasing the
Low Energy proportion of Compton-
Beam hardening:
Δx [mm] scattered X-rays due to the
lower energy X
higher effective energy of the
rays suffer more X-ray beam.
attenuation, hence
the mean energy of
the X-ray beam
increases as it goes
through the tissues.
High Energy

- Affects HVL
- Artifacts in CT
X ray attenuation

1
6
7
8
11
12
15
16
19
20
X ray attenuation

Effective atomic number:

1
m
⎡ m ⎤
Z eff = ⎢∑ α i Z i ⎥
⎣ i ⎦

m = 3.8

Ex: Water (H2O)

X ray attenuation

Material dependence (effective atomic number and electronic density):

PE effect dominates
(Zeff dependence)

good
contrast
Compton effect dominates
(ρN0 dependence)

bad
contrast
X ray attenuation

Material dependence (effective atomic number and electronic density):

Factors that determine the Approximately:

attenuation coefficient of a
material:
-Effective atomic number:
At lower energies, where the
photoelectric effect
dominates;
The attenuation coefficient
depends strongly on the X-ray
energy.
-Electronic density:
At higher energies, where the
Compton effect dominates;
The attenuation coefficient
does not depend much on the
X-ray energy.
X ray attenuation

Material dependence: contrast agents

K-edge

better
contrast

ZI = 53 k-edge: 33.2 keV

ZBa = 56 k-edge: 37.4 keV
ZPb = 82
Dosimetry

Biological tissues Half-Value Layer for Muscle and Bone [cm]

X-ray energy [keV]
Material
30 50 100 150
Bone 0.4 1.2 2.3 2.8
Muscle 1.8 3.0 3.9 4.5
The majority of X rays is absorbed by the tissues (>90%) .

X-ray tube
materials
Dosimetry

Dosimetric measures:
Exposition X: [1 R = 3.33 × 10-10 C/cm3 = 2.58 × 10-4 C/Kg ]
Dose D: [1 Gy = 1 J/Kg ou 1 rad = 100 erg/g ]
Factor f: f=D/X
Equivalent dose: H E = ∑ ωi Di QF [Sv ou rem]
i
+7T
1
CT dose index: CTDI = ∫ Dz dz
T − 7T
Overview

1. X-ray image formation

2. Instrumentation
3. Image characteristics
4. Radiography techniques: angiography, fluoroscopy, mammography
Instrumentation

X ray production:
X ray tube / source

X ray transmission:
X ray attenuation

X ray detection:
X ray detectors
Instrumentation

Image contrast should be optmized

• by minimizing the ratio between secondary (scattered) and primary radiation:

1
CNR ∝
I
1 + scatt
I primary

X ray source FOV X ray detector

Instrumentation

Collimator
• restricts the FOV to the desired value ~10 – 30 cm
• ↑ CNR,
• ↓ dose

X ray source FOV X ray detector

collimator (Pb)

Even with a collimator, scattered radiation can represent 50 – 90% of the detected radiation…
Instrumentation

Anti-scatter grid: absorbs significantly deflected photons (↑ CNR, ↑ dose)

I inc
scatt
1+
Pb I inc
primary
Δ (CNR) =
h I scatt I trans
inc
scatt
1+ inc trans
I primary I primary
t d
Bucky factor:
Exposure with grid
F=
Exposure without grid

X ray source X ray detector

collimator (Pb) anti-scatter grid

Instrumentation

Itensifying screen: phosphor excitation, X-rays → visible light (↑δ ⇒ ↑ SNR, ↑ R)

R=Resolution
plastic base
refelctive layer
δ phosphor layer (Gd, La)
protective layer
film

intensifying
screen

X ray source X ray detector

collimator (Pb) anti-scatter grid

Instrumentation

Conventional radiography:

Photographic emulsion: darkening upon exposure ∝ photon intensity (↑d⇒↑SNR, ↑R)

•Radiation detection ⇒ ionization ⇒ latent Film blackening is quantified

image by a parameter known as
•Film exposure ⇒ reduction of exposed silver Optical Density (OD)
salts to metallic silver ⇒ film darkening

Optical density
linear
d region

latitude

Log exposure

OD 2 − OD1
γ=
log E 2 − log E1
Instrumentation

Computed radiography:
-Instead of a photographic emulsion, a cassette housing a plate of photostimulable phosphor is used.
-Instead of film exposure, a laser scanner is used to read the cassette.

Exposure to radiation ⇒
phosphor excitation ⇒
oxidation of Eu2+

Laser absorption ⇒ blue

light emission upon de-
excitation
⇒ digitization
Instrumentation

X ray detectors: X rays → must be converted into radiation accessible to human vision

Type of X ray detectors:

-itensifying screen + photographic emulsion
-cassette of photostimulable phosphor + laser scanner
-scintillation detectors
-crystals: NaI (Tl), CsI(Tl), BGO
coupled to a photo-multiplier tube (PMT) or a photodiode array (e.g. TFT)
-gas ionizing detectors:
-ionizing chamber, proportional counter, Geiger-Muller counter

Main characteristics of X ray detectors :

-Sensitivity
-Efficiency
-Linearity
-Energy resolution
-Dead time
Instrumentation

Digital radiography:

-Scintillation crystal (CsI) matrix: crystal scintillation, X-rays → visible light

-Photodiodes in TFT array: visible light → electric signal → digital signal

X rays ⇒ crystal excitation ⇒ electron-hole pairs ⇒ electron-hole pairs collected

at p-n junctions ⇒ electrical current ⇒ pre-amplifier
Image characteristics

Geometric unsharpness (penumbra/Blur, PSF) due to a finite size X ray source:

Effective spot size: f [~ 0.6 – 1.2 mm]

f (S1 − S0 )
Penumbra (PSF): P= = f (m − 1)
S0
S1
Magnification factor: m=
S0

δ P
θ
f δ d0 d1

S0
S1
Image characteristics

Measurement of the effective spot size → PSF using a pinhole camera:

S1

S0

~75 µm

f (S1 − S0 ) S0
P= ⇒f =P
S0 S1 − S0
Image characteristics

Measurement of the LSF using a grid of parallel lead septa:

Measurement of the MTF using a line phantom:

Using test objects:

Image characteristics

Spatial resolution:

R = R 2 spotsize + R 2 mag + R 2 screen + R 2 film

↑ effective focal spotsize f (tube) ⇒ ↑ R (↓ S1-S0 , fixed S0 ⇒ ↓ R)

↑ magnification factor (patient-film-detectot distances) ⇒ ↑ R (↑ S0 , fixed S1-S0 ⇒ ↓ R)

↑ screen thickness (diffusion distance) ⇒ ↑R

↑ film speed (size of silverparticles), or equivalent ⇒ ↑R

Image characteristics

Signal to noise ratio (SNR)

Main noise source in X ray imaging:

-Quantum mottle: statistical variance of the distribution of X rays from the source

µ N e −µ
Poisson distribution: p( N ) =
N!

describes the number of occurences N of a

random phenomenon per unit time and space,
with mean µ and standard deviation σ= µ
µ
For large N: µ ≈ N ⇒ SNR ∝ = N
σ
After attenuation by a material, X ray photons continue to follow Poisson statistics...
Image characteristics

Signal to noise ratio (SNR)

Factors affecting the SNR:

-X ray tube voltage: ↑ kVp ⇒ ↑ SNR

-X ray tube current and exposure time: ↑ mA×s ⇒ ↑ SNR

-X ray filtration: ↑ filtration ⇒ ↓ SNR

N
-Object size (thickness): ↑ object ⇒ ↓ SNR

-Antiscatter grid ratio: ↑ h/d ⇒ ↓ SNR

-Intensifying screen thickness: ↑ δ ⇒ ↑ SNR

Image characteristics

Contrast to noise ratio (CNR)

CNR depends on SNR and R.

Other factors affecting the CNR:

-X ray energy: ↑ E ⇒ ↑ Iscatt/Iprimary ⇒ ↓ CNR

-Object size (thickness): ↑ thickness ⇒ ↑ Iscatt/Iprimary ⇒ ↓ CNR

-Field-of-view (FOV ~10-30 cm): ↑ FOV ⇒ ↑ Iscatt ⇒ ↓ CNR

-Antiscatter grid ratio: ↑ h/d ⇒ ↑ CNR

Radiography techniques

Contrast agents

K-edge
Iodinated contrast agents are
used to enhance contrast:

-between vessels and better

contrast
surrounding tissues, by
injection into the circulation;

-between the gastro-intestinal

tract (GI) and surrounding
tissues, by oral
administration.
Radiography techniques
Angiography: imaging of blood vessels
(by intra-venous or intra-arterial contrast injection)
Conventional angiography vs

Digital Subtraction Angiography

(DSA):

In this case, the subtraction of a pre-

contrast image suppresses interfering
structures from the 2D projection image
so that the arteries become clearly
defined (resolution ~100 µm).

This image shows the pelvis of a patient

that has had a kidney transplant and a
stent placement.
Radiography techniques
Fluoroscopy: continuous imaging (at very low energies ~25-30 keV) – cine mode
(cardiac and GI studies, stent and catheter placement, interventional radiology)

Fluorescent image intensifier (CsI:Na) → optimize SNR (in face of low energy)
Radiography techniques
Mammography: imaging soft tissue with high resolution and CNR

Low energies (~25-30 keV)

- Mo target, high (and not low) energy filtering ⇒ low energy to optimize CNR
- Fast intensifying screen / film combinations ⇒ to allow enough SNR at low energy
- Large source to detector distance and small focal spot size ⇒ high resolution (<1mm)
References

• Webb, “Introduction to Biomedical Imaging”, Wiley 2003.

• Cho, “Foundations of Medical Imaging”, Wiley 1993.
• Hendee, “Medical Imaging Physics”, Wiley 2002.