Imaging and Radiation

Abstract

This chapter explains in simple terms the background physics of imaging using standard X-rays, computed axial tomography (CT), nuclear medicine (including positron emission tomography-PET), and magnetic resonance imaging (MRI). It covers the basics of ionising radiation, and also discusses lasers, which are a form of non-ionising radiation (imaging using ultrasound is covered in Chapter 10). X-rays, CT, aspects of nuclear medicine, and lasers are covered briefly. MRI is examined in more detail as this is a newer modality that is often difficult to comprehend, and in any case often involves the presence of the anaesthetist. Some isotopes are naturally occurring but many of the radioactive nuclides used in medicine are produced artificially by a nuclear reactor or cyclotron. Each of these will provide isotopes that are useful for different purposes. Unstable radioactive nuclides achieve stability by radioactive decay, during which they can lose energy. This occurs in a number of ways. For example, atoms can lose energy by ejection of an alpha particle (an extremely tightly bound basic atomic structure of 2 protons and 2 neutrons, which is equivalent to a helium nucleus). This occurs if they have too many nucleons (protons or neutrons) and results in the atomic number being reduced by two and the atomic mass by 4. Other ways that unstable radionuclides decay include: emission of an electron (β−) from the nucleus if the atoms have an excess of neutrons, or by, either emitting a positron (β+) or capturing an electron if they are neutron deficient. Normally isotopes produced by a reactor will be neutron rich and decay by emitting an electron and the cyclotron will tend to produce isotopes that are proton rich and the decay will then be by emitting a positron. This is illustrated in Table 29.1. The new nuclide formed by the decay process (the daughter nuclide) may be left in an excited nuclear state and can release this excess energy by emission of gamma (γ) radiation as shown in Figure 29.1. This example is where the electron (β−) has been emitted. The situation is more complex when a positron has been emitted.