Diagnostic X-ray Research Articles

A compact X-ray source via fast microparticle streams.

The spatiotemporal resolution of diagnostic X-ray images is limited by the erosion and rupture of conventional stationary and rotating anodes of X-ray tubes from extreme density of input power and thermal cycling of the anode material. Conversely, detector technology has developed rapidly. Finer detector pixels demand improved output from brilliant keV-type X-ray sources with smaller X-ray focal spots than today and would be available to improve the efficacy of medical imaging. In addition, novel cancer therapy demands for greatly improved output from X-ray sources. However, since its advent in 1929, the technology of high-output compact X-ray tubes has relied upon focused electrons hitting a spinning rigid rotating anode; a technology that, despite of substantial investment in material technology, has become the primary bottleneck of further improvement. In the current study, an alternative target concept employing a stream of fast discrete metallic microparticles that intersect with the electron beam is explored by simulations that cover the most critical uncertainties. The concept is expected to have far-reaching impact in diagnostic imaging, radiation cancer therapy and non-destructive testing. We outline technical implementations that may become the basis of future X-ray source developments based on the suggested paradigm shift.

Development and justification of a method for presenting radiation risks associated with medical exposure of patients

The practical implementation of radiation protection principles in the medical exposure of patients often tends to fall into one of two extremes: either excessive simplification of the methodology for assessing radiation health detriment, or its excessive complexity. An example of an excessively simplified approach is the assessment of radiation risk to patients using effective dose and radiation damage coefficients (nominal risk coefficients) as presented in Norms of the Radiation Safety NRB-99/2009. An example of an unjustifiably complex approach can be considered Tables 1-2 in MR 2.6.1.0215-20 "Assessment of radiation risk to patients during X-ray diagnostic radiological examinations," which indicate "lifetime risk values of death taking into account harm from reduced quality of life due to cancer of various organs and tissues and genetic effects from medical examinations" for a wide range of medical diagnostic X-ray radiological examinations in five-year age groups of patients. The main shortcomings of the simplified approach can be considered the lack of differences in risk assessment between individuals of different sexes and ages, although the fact of higher radiosensitivity in children compared to adults and in women compared to men can be considered universally recognized. The risk assessment approach proposed in MR 2.6.1.0215-20 addresses these shortcomings. However, in the view of the authors of this study, it offers an unnecessarily detailed picture considering uncertainties inherent in risk assessments at low doses, as well as uncertainties in the method of interpopulation transfer of radiation risk proposed by the International Commission on Radiological Protection. The aim of this study was to develop and justify a simpler and more straightforward method of presenting information on radiation risks associated with medical X-ray radiological examinations, free from the main drawbacks of the two aforementioned methods. To achieve this goal, radiation risks were calculated using two methods (using effective dose and using the risk model of the International Commission on Radiological Protection). A comparative analysis of the calculation results was conducted with estimates presented in Tables 1-2 of MR 2.6.1.0215-20. As a result of the analysis, an original applied method for presenting qualitative characteristics of radiation risks was developed for use in prescribing X-ray radiological examinations and informing patients about potential health risks. The practical outcome of the study is the formation of a table of radiation risks associated with conducting studies on patients from the Russian population, using the developed method of presenting information on radiation risks.

Dosimetric evaluation of Rhizophora spp. particleboard bonded with animal protein adhesive at X-ray energies below 100 kVp

This research developed a bio-based adhesive (AP) derived from industrial slaughterhouse waste, comprising over 85% protein. The adhesive was characterized by a melting point of 193.14 °C, a neutral pH of 7, and a viscosity comparable to common wood adhesives such as urea-formaldehyde and phenol-formaldehyde. Utilizing this adhesive, a Rhizophora spp. particleboard phantom was produced, featuring wood particles of ≤149 μm, an adhesive concentration of 12%, and a target density of 1 g/cm³, adhering to a standard phantom dimension of 30 cm × 30 cm × 30 cm. The dosimetric properties of this particleboard phantom were subsequently compared with those of water and Perspex phantoms within an X-ray energy range of 60–100 kVp, employing high-sensitivity thermo-luminescent dosimeters (TL–100H). The findings indicated that the percentage depth dose (PDD) values of the AP-Rhizophora spp. particleboard were closely aligned with those of the Perspex and water phantoms, with the greatest discrepancy observed at 60 kVp. Additionally, the half-value layer (HVL) of the particleboard was similar to those of Perspex and water, particularly at diagnostic X-ray energies. These results demonstrate that the AP adhesive is effective for creating Rhizophora spp. particleboard phantoms, exhibiting dosimetric properties comparable to tissue-equivalent materials.

Design of Prototype Phantom to Measure Quality Control for Conventional X-ray Machine Using Quantitative Image Parameters

A variety of phantoms that measure image quality parameters are commercially expensive and often complicated to use as they measure only one parameter of a particular x-ray machine, which leads to the difficulty of measuring the quality of x-ray image and thus increase the risk of radiation to the patient and society. The main objective of this study was to design a prototype phantom to measure quality control for conventional x-ray machine using quantitative image parameters. In this study, 5 conventional x-ray machines were investigated using wire phantom designed by the researcher, which consisted of variable thicknesses used to test variable exposure factors. This study introduced a more reliable method of measuring the resolution, which is modulation transfer function, which gives a complete description of the resolution instead of using full width at half maximum or the visibility method, which is more qualitative where modulation transfer function is a real quantitative method, by designing a prototype phantom that consisted of 5 wires with different thicknesses and kVp for 5 x-ray units and assessing the diagnostic x-ray machine resolution by the optimum kV found relative to machine type. This study showed that the one with the best machine resolution was Shimadzu (2011) for Khartoum Emergency Hospital, which had a high resolution of 97% at 46 kV for thickness of 1.4 mm compared with Toshiba 2011 for Almotkamil Hospital, which had 92% at 46 kVp. Also, the result showed that for the 2 types of x-ray machines the x-ray tubes do not produce the same exposure, and the output decreased with age of the x-ray unit; also, the resolution reduced when the thickness of the wires decreased.

Factors affecting distribution of dose in horizontal direction during irradiation

Recording and managing the dose of x-rays in an x-ray machine is an important part of the data. In addition, recording and managing radiation dose data in x-ray devices plays an important role in providing transparency of radiation dose to medical staff and patients by quantifying the radiation dose data. Four mobile diagnostic X-ray units were used to analyze the dose by spatial location. The dose distribution by location was analyzed by identifying and analyzing the dose by angle for both image intensifier and flat panel detector types. The three-dimensional space of the radiation area consisted of 27 sides, and the structure of the space was assumed to be horizontal X, Y, and Z sides and vertical A, B, and C sides, and the dose analysis was performed at the assumed position. On the longitudinal side, the highest dose tissue (highest μSv/min) is B_Center : (R.B.M, Colon, Lung, Stomach, Breasts, Remainder of body) - 330.404 μSv/min, and the lowest dose tissue (lowest μSv/min) is 0.002 μSv/min on the (Skin, Bone surface, Salivary glands, Brain) side at C_270°. The findings from diagnostic X-ray devices have emphasized the importance of managing radiation exposure when using the devices and may raise questions about the management of radiation protection measures to protect the health of healthcare personnel and patients. This can be expected to advance the organization of the use of radiation devices in a safe healthcare environment. A system for managing data will be useful as an indicator to guide medical staff using the equipment and patients participating in procedures and surgeries where they can minimize their dose and avoid harm.

Assessment of foetal dose and occupational exposure for pregnant workers in nuclear medicine using the Taiwanese pregnancy phantom.

For pregnant workers in nuclear medicine, radiation doses can pose a risk to their foetus. However, foetal radiation doses cannot be measured directly. In this study, a method of estimating foetal radiation doses was developed through simulations and measurements of phantoms of pregnant women in the three trimesters. The uterus and abdominal surface doses for monoenergetic photons (137Cs) and medical diagnostic X-rays were measured, and uterine dose conversion coefficients (UDCCs) were calculated. The accuracy of the UDCC estimates were validated for measurements from thermoluminescent dosemeter (TLD) chips and TLD badges on the abdomen or chest. The foetal effective dose could be estimated using TLD chips and TLD badges on the abdomen or chest, or through literature estimation method. The proposed method can be used to easily and accurately estimate foetal effective doses from chest-worn TLD badges, ensuring accurate estimation in the early stage of pregnancy when a worker may not yet be wearing an abdominal badge. A flowchart for applying the UDCC method to approximate a foetal dose is also provided to ensure that total doses remain below the maximum of 1mSv recommended in the International Commission on Radiological Protection 103 guidelines.

Risk Management and Failure Analysis in Diagnostic X-ray Equipment: A Comprehensive Analysis and Novel Approaches for Failure Prevention and System Reliability

Risk Management and Failure Analysis in Diagnostic X-ray Equipment: A Comprehensive Analysis and Novel Approaches for Failure Prevention and System Reliability

Luminescence Efficiency and Spectral Compatibility of Cerium Fluoride (CeF3) Inorganic Scintillator with Various Optical Sensors in the Diagnostic Radiology X-ray Energy Range

Luminescence Efficiency and Spectral Compatibility of Cerium Fluoride (CeF3) Inorganic Scintillator with Various Optical Sensors in the Diagnostic Radiology X-ray Energy Range

Development of an aid to detect adults acetabular hip dysplasia (the ALPHA alert): A mixed methods study

ObjectivesTo identify the signs and symptoms that people living with acetabular hip dysplasia (AHD) describe and to provide an aid for translating the findings into practice. MethodsA three-phased mixed methods study. Phase 1 employed an open-question online survey that enabled people with AHD (aged ≥16 years) to describe features associated with their condition. Responses were thematically analysed. A Phase 2 survey used these themes to establish how common those features were. Phase 3 created a mnemonic that prompts clinicians to suspect AHD. ResultsNinety-eight respondents completed Phase 1 and sixty-two completed Phase 2. From the responses, five themes were identified: Demographic and Diagnostic Profile; Characteristics of Posture and Gait; Pain; Childhood Hip and Family History; and Hip Joint Characteristics. Within these themes, 19 common signs and symptoms were reported, represented by the ALPHA mnemonic. ALPHA describes a young age at onset of problems (Age), a limp (Limp), progressing pain (Pain), a history of childhood and family hip anomalies (History) as well as hip joint hypermobility and instability (Articulation). ConclusionThe findings extend current understanding of AHD indicators. ALPHA alerts clinicians to suspect a diagnosis of AHD. ALPHA may facilitate timelier referral of patients for diagnostic X-Ray and appropriate treatment. Future studies should evaluate its clinical utility.

Collective Effective Dose from Medical Radiation Use in Indonesia: Si-INTAN Data Study Period 2018-2021

Until now, there has been no information regarding the value of the collective dose per procedure using the X-ray modality in Indonesia. As in the ICRP 103 publication (2007), it is stated that the collective effective dose is an instrument for optimizing protection by comparing radiological technology and the protection procedures that will be taken. This article aims to raise awareness and optimize the use of diagnostic X-ray modalities by providing an estimate of the proportion of Indonesia's total population compared to the number of radiation examinations carried out, the collective annual effective dose, and the potential risks. The information provided is based on a data reported to the Patient Dose Data Information System (Si-INTAN) application from 2018 to 2021. The data is in the form of the number of patient examinations per modality and the national Diagnostic Reference Level (DRL) value for each type of procedure. From the results of the analysis, it was found that the proportion of patient examinations per modality in the sequence was conventional radiology (79.19%), CT Scan (17.56%), dental radiology (1.75%), interventional fluoroscopy (0.70%), medical diagnostic nuclear (0.62%), and mammography (0.18%). The majority of the annual collective effective dose in Indonesia comes from CT Scan (97.45%), interventional fluoroscopy (1.30%), conventional radiology (0.86%), diagnostic nuclear medicine (0.38%), and a small percentage from mammography and dental radiology. It is estimated that around 116.6 million Indonesians receive radiation exposure for medical needs with a collective annual effective dose of 860,000 man-Sv. This collective effective dose provides an estimate of the incidence of cancer in the Indonesian population of around 0.016% of the entire population in 2021. This information can be used as a baseline to evaluate trends in using and monitoring ionizing radiation sources for medical imaging needs in Indonesia. Keywords: effective dose, collective effective dose, diagnostic reference level (DRL), radiation imaging, diagnostic X-rays, radiation protection

A novel silicon PIN photodiode device for radiation exposure monitoring in dental CBCT

This paper presents a versatile and cost-effective system for the monitoring of X-ray exposure during dental cone beam computed tomography procedures based on silicon PIN photodiode detectors. The system, developed and implemented at the University of Pisa's School of Engineering, underwent characterization under a range of operational conditions focusing on full field-of-view 3D protocols used in adult patient examinations. This study was facilitated by the Azienda Ospedaliero Universitaria Pisana, which provided access to a Planmeca ProMax 3D Classic scanner for the research. During the investigation, photodiodes were placed both on the surface and inside an Alderson RANDO phantom head to assess the dose delivered to regions near radiation-sensitive areas such as the salivary glands, thyroid, eye lens, and laryngopharynx. The evaluation process spanned a spectrum of tube voltages, ranging from 60 to 90 kVp, and tube currents, extending up to 16 mA, to ensure a broad and thorough analysis. Furthermore, to reinforce the effectiveness of the silicon photodiodes' measurement capabilities, calibrated GR-200 A-type thermoluminescent dosimeters were positioned within the phantom head inserts to serve as a reference point. Complementing this setup, PCXMC Rotation 2.0 simulations were conducted to further the efficacy of the monitoring system, particularly tailored to the specific dental CBCT protocols being investigated. In conclusion, while the research revealed a generally consistent correlation across PCXMC simulations, photodiode readings, and thermoluminescent dosimeter measurements, it is important to note that a direct comparison was not exactly possible due to limitations in the size and positioning of the systems. Variations up to 20–35% were observed, primarily due to the different positioning of the dosimeters and the unique physical and operational traits of the different measurement methods employed. Nevertheless, the development of an affordable, easily deployable, and scalable dosimetry monitoring system may provide a substantial contribution to enhancing patient safety in dental radiology and aid in the optimization of diagnostic X-ray protocols.

Eggshell-enhanced composites: Innovative radiation shielding materials for diagnostic X-ray applications

Concrete, a widely-utilized construction material for diagnostic room, heavily relies on Portland cement which is a major contributor to carbon emissions. Thus, this study focused on replacing cement with combination with clay (bentonite and kaolin) and eggshell powder (ESP) as possible shielding materials for diagnostic x-rays. 2 cm blocks are made from combination of clay-ESP, clay-cement and cement-ESP with replacement portions of 0%, 25%, 50% and 75%. Radiation shielding parameters (RAR, LAC, MAC and HVL) of these samples are investigated using a general x-ray machine at 60, 80, 100 and 120 kVp. In addition, elemental composition and compressive strength test are also performed on the blocks. As a result, between all combination, cement-ESP shows the highest RAR, LAC and MAC, however addition of ESP in cement did not show a significant photon absorption capability. Meanwhile, addition of ESP in the mixing portion for both clay results the RAR and MAC to increase due to presence of Si and Ca element in the blocks. In addition, clay-cement combination shows comparable shielding properties value and compressive strength to pure cement block. Therefore, since the objective of this study is to substitute cement with an environmentally friendly material, this particular combination is adequate for serving as a protective barrier for diagnostic purposes.

Evaluation of the measurement accuracy and uncertainty of a solid-state detector under diagnostic x-ray beam conditions.

An accurate measurement of x-ray beams is expected to reduce the uncertainties associated with estimating radiation risk to patients in clinical settings. To perform assessment tasks based on the readings of a solid-state detector (SSD) using semiconductor technology, the characteristics of the detector should be elucidated. In this study, we evaluated the measurement accuracy of a new SSD under diagnostic x-ray beam conditions in terms of air kerma, tube voltage, and half-value layer (HVL). The performance of the SSD was then compared with those of reference instruments. The tube voltage was varied within the range of 50-120kV in steps of 10kV and the thickness and materials of additional filters were concurrently changed (several combinations were tested). In addition, the dose rate and energy dependence of the SSD were also investigated. These effects were analyzed based on statistical significance tests. Furthermore, the expanded uncertainties in the series of measurements were meticulously calculated. The results showed average relative differences of -3.26±1.33%, 0.44±1.01%, and -2.60±3.31% for air kerma, tube voltage, and HVL, respectively. Furthermore, air kerma did not exhibit any dependence on dose rate and energy, in contrast to tube voltage and HVL measurements. The measurement values of the SSD fall within the acceptable range of uncertainty, highlighting its measurement accuracy and reliability. Furthermore, based on the characteristics elucidated by this study, valuable insights are provided concerning the assurance of appropriate measurement values in clinical settings.

Assessment of radiation dose received from knee joint X-ray examinations

BackgroundMedical exposure from diagnostic X-ray machines represents the primary artificial source of human exposure to low ionizing radiation. Knee X-rays are a standard examination to diagnose multiple conditions ranging from traumatic injuries, degeneration, and cancer. In Saudi Arabia, there is a lack of available data and pertinent information regarding the assessment of the patient entrance surface dose (ESD) from knee X-rays. This study aims to estimate the ESD for adult patients undergoing knee X-ray examinations at four major medical centres in Saudi Arabia. Methods and materialsThe ESD was estimated indirectly using X-ray exposure factors for patients and directly using optically stimulated luminescence (OSL). The results were compared with previous studies conducted nationally and internationally and with international reference levels. ResultsThe results of this research showed that the mean patient ESD was 1.4 ± 0.37 mGy using the direct method and 1.12 ± 0.20 mGy using the indirect method. The estimated mean ESD values were found to be much higher than the mean ESD reference values, emphasizing the crucial requirement for optimizing radiation doses in conventional radiology to improve patient safety and diagnostic effectiveness. ConclusionThis confirms the requirement for reducing patients’ doses to the tolerable levels recommended by many international radiation protection commissions.

Feasibility study of CdMnTeSe based diagnostic X-ray detector

Despite their initial commercialization, CdTe-based materials are continuously being developed. However, an approach for obtaining the X-ray response with a current-mode CdMnTeSe (CMTS) detector remains to be explored. This study investigated the feasibility of using CMTS as a potential material in diagnostic X-ray detectors. The CMTS crystals were grown using the Bridgman method and treated with a radiation detector. The X-ray response of the CMTS detector was evaluated under various conditions, including tube voltage, tube current, and bias voltage. In addition, the mass attenuation coefficients of CdTe-based materials, including CMTS, were investigated. Our results demonstrated that CMTS exhibited promising properties for diagnostic X-ray detection, with stable and linear responses across various tube voltages and currents. In addition, the calculated sensitivity of the CMTS detector increased at higher bias voltages, demonstrating its practical applicability. However, problems such as signal loss were observed at higher dose rates, suggesting the need for further optimization of the CMTS growth techniques. Overall, this study indicated the requirement for further improvement in the CMTS crystal properties; however, the potential of CMTS as a candidate material for the next generation of diagnostic X-ray detectors was evident.

Effectiveness of an X-ray shielding sheet with lower shielding ability to enable both bone mineral density determination and morphological diagnosis

Bone Mineral Density (BMD) can be determined by applying the Digital Image Processing (DIP) method using medical X-ray diagnosis. Although only the second metacarpal bone is analyzed in this approach, other parts of the body are exposed to X-ray radiation. We here propose a novel procedure in which parts of the hand surrounding the area of interest are shielded with an X-ray shielding sheet having low shielding performance. In our procedure, the main diagnostic area is not shielded, and other areas are covered with an X-ray shielding sheet with a low shielding performance. The sheet was fabricated by embedding Bi2O3 particles in resin sheet. We assessed the clinical performance of this method using three types of hand phantoms and conventional diagnostic X-ray equipment. The dose reduction for the entire hand region was evaluated by the Dose Area Product (DAPHand), which was measured with a small dosimeter, and the hand area was determined from the X-ray image. The X-ray image of the second metacarpal bone is affected by the contribution of X-rays that penetrate the object of interest and are scattered in other areas of the hand. Because our X-ray shielding sheet suppressed the generation of scattered X-rays, the pixel value of the second metacarpal bone and corresponding BMD value are varied. To address this issue, we developed a correction algorithm. We found that the X-ray shields with Dose Reduction Factor (DRF) values of 40–60% were appropriate for our methodology. Our method was estimated to have a percentage uncertainty of approximately 5% for the derivation of BMD values. Morphological information of the hand and bones could thus be clearly observed. We verified that both morphological diagnosis and quantitative determination of BMD are possible when DIP procedure is conducted using our shield.

Molecular form factor data for tissue equivalent materials

In the diagnostic X-ray energy range, elastic (Coherent) scattering is dominant and can be obtained using an appropriate form factor. When experimental Form Factor data is not available at certain momentum transfer values, molecular form factor data that can be compatible with experimental data should be theoretically obtained. Using these molecular form factor data, molecular coherent scattering coefficients can be calculated, and linear attenuation coefficients of tissue equivalent structures can be estimated. In this study, PMMA, CIRS 70/30, CIRS 50/50, CIRS 30/70, RMI 454, and BR 12, which are equivalent complex molecular structures to human breast tissue, were examined, and the theoretical molecular form factor F(x) values compatible with the experimental form factor values for each were obtained. We believe that our results will find a significant place in the literature and will be beneficial for our future studies and also in the studies of other researchers who make models.

Effect of backscatter radiation on the occupational eye-lens dose.

We quantified the level of backscatter radiation generated from physicians' heads using a phantom. We also evaluated the shielding rate of the protective eyewear and optimal placement of the eye-dedicated dosimeter (skin surface or behind the Pb-eyewear). We performed diagnostic X-rays of two head phantoms: Styrofoam (negligible backscatter radiation) and anthropomorphic (included backscatter radiation). Radiophotoluminescence glass dosimeters were used to measure the eye-lens dose, with or without 0.07-mm Pb-equivalent protective eyewear. We used tube voltages of 50, 65 and 80kV because the scattered radiation has a lower mean energy than the primary X-ray beam. The backscatter radiation accounted for 17.3-22.3% of the eye-lens dose, with the percentage increasing with increasing tube voltage. Furthermore, the shielding rate of the protective eyewear was overestimated, and the eye-lens dose was underestimated when the eye-dedicated dosimeter was placed behind the protective eyewear. We quantified the backscatter radiation generated from physicians' heads. To account for the effect of backscatter radiation, an anthropomorphic, rather than Styrofoam, phantom should be used. Close contact of the dosimeter with the skin surface is essential for accurate evaluation of backscatter radiation from physician's own heads. To assess the eye-lens dose accurately, the dosimeter should be placed near the eye. If the dosimeter is placed behind the lens of the protective eyewear, we recommend using a backscatter radiation calibration factor of 1.2-1.3.

Comparing the efficiency of fly ash geopolymer attenuation and cement mortar as diagnostic x-ray shielding materials through theory and experiment

This study compared ordinary Portland cement (OPC) and Fine Aggregate Graded Polymer (FAGP) samples mixed with 0%, 5%, 10%, and 15% barium sulfate (BaSO4). Theory using the XCOM program and experiments using x-ray fluorescence (XRF) within a specified energy range of 16–25 keV were used to calculate the samples’ mass attenuation coefficients. The comparison involved calculating the linear attenuation coefficients (μ/ρ) and attenuation coefficients (μ) of the samples. Both theoretical and experimental results show that the FAGP containing 15% BaSO4 at 16.61 keV has the best attenuation. The findings show that BaSO4 improves radiation shielding. A negative association was found between the attenuation coefficient (μ) and the energy level of radiated radiation. The analysis also found significant concordance between experimental and theoretical methods. In conclusion, the XCOM program had slightly higher mass attenuation coefficients, especially at lower energy levels.

Mn(II)-Based Metal Halide with Near-Unity Quantum Yield for White LEDs and High-Resolution X-ray Imaging.

Metal halides have drawn great interest as luminescent materials and scintillators due to their outstanding optical properties. Exploring new types of phosphors with easy production processes, excellent photophysical properties, high light yields, and environmentally friendly compositions is crucial and quite challenging. Herein, a novel Mn(II)-based metal halide (4-BTP)2MnBr4 was produced using a facile solvent evaporation method, which exhibited a strong green emission peaking at 524 nm from the d-d transition of tetrahedral-coordinated Mn2+ ion and a near-unity quantum yield. The prepared white light-emitting diode device has a wide color gamut of 100.7% NTSC with CIE chromaticity coordinates of (0.32, 0.32). In addition, (4-BTP)2MnBr4 demonstrates excellent characteristics in X-ray scintillation, including a high light yield of 98 000 photons/MeV, a sensitive detection limit of 37.4 nGy/s, excellent resistance to radiation damage, and successful demonstration of X-ray imaging with high resolution at 21.3 lp/mm, revealing the potential for application in diagnostic X-ray medical imaging and industry radiation detection.