X-Ray Safety and Quiz

1. X-Ray Safety

2. It is recommended that after the completion of each section that you test your understanding by doing the quiz related to that section.

3. Slide Show 1: Some Background Concepts

4. This slide show will examine: 1. The formation of X-rays 2. X-ray spectra

5. X-rays X-rays and gamma rays are both forms of ionising radiation. Both are forms of electromagnetic radiation But they differ in their source of origin. X-rays are produced through interactions in electron shells. Gamma rays are produced in the nucleus.

6. X-rays are sometimes defined as having wavelengths between 10 -10 and 10 -12 m. A more robust definition of X-rays, however, is their mode of production. X-rays are produced through interactions in electron shells

7. The Formation of X-rays

8. To produce x-rays projectile electrons are accelerated from the negative cathode to the positive anode. cathode Anode Electron beam Xray -ve +ve

9. When the electrons from the cathode are accelerated at high voltage to the anode: 99% of the energy is dissipated as heat (anode materials are selected to withstand the high temperatures they are able to withstand) 1% is given off as x-rays.

10. The x-ray radiation is emitted as: bremsstrahlung x-ray radiation (about 80%) characteristic x-ray radiation. and/or

11. The energy of the x-rays (keV) is determined by the voltage applied (kVp). The amount of x-rays is determined by the current (mA).

12. X-ray Spectra

13. X-ray spectra are composed of: 1. Continuous bremsstrahlung spectra 2. In most cases, discrete spectra peaks known as characteristic x-rays . keV Bremsstrahlung radiation makes up approximately 80% of the x-ray beam

14. Bremsstrahlung Radiation

15. Bremsstrahlung radiation X-ray Projectile electrons originating from the cathode filament impinge on atoms in the anode and will often pass close by the nucleus of these atoms. As the electrons pass through the target atom they slow down, with a loss in kinetic energy. This energy is emitted as x-rays. The process is known as bremsstrahlung or braking energy.

16. Bremsstrahlung xrays form a continuous energy spectra. The frequency distribution is continuous and shows that the Bremsstrahlung process produces more low energy that higher energy x-rays. The average energy is approximately 1/3 of the Emax. E max

17. The Emax or the maximum energy of the x-rays measured as (keV) is equal to voltage applied to the Xray tube (kilovolt peak or kVp). E max For example: An applied voltage of 70 kVp produces an x-ray spectra with Emax of 70 KeV and average energy of about 23 keV. 70KeV 23keV

18. Characteristic X-ray Radiation

19. E max Characteristic X rays To produce characteristic x-rays the projectile electrons must have sufficient energy to displace orbital electrons An outer shell electron (usually from the L or M shells) fills the vacancy in the inner orbital and sheds energy as an x-ray of characteristic energy. If the projectile electron has sufficient energy, it may cause the ejection of an orbital electron (usually in the K shell) from an atom in the anode.

20. The most common transition is from L to K shell. For tungsten the characteristic Xray spectra are represented by peaks at 58 and 69 keV representing L-to-K and M-to-K shell transitions respectively. Each shell transition has a characteristic energy and this energy is dependent on the atomic number of the atom. M-to-K transitions are less common and are of higher energy.

21. X-ray K Shell L shell M shell Production of Characteristic X-rays

22. Note that the impinging electron from the cathode must have sufficient energy to displace the K shell electron of the anode. For a tungsten anode the electrons from the cathode must have at least 69.5 keV to dislodge a K shell electron. Consequently no lines will appear if the x-ray tube with a tungsten anode is operated at 20 kVp or 40 kVp 75keV 40keV This energy is the excitation energy of the electron shells and the energy is characteristic for each and each element

23. Note that characteristic X ray spectra are independent of voltage once the threshold values have been reached

24. Window rotor anode Focusing cup filament cathode focal spot Glass envelope A Schematic X ray Tube electron beam X-ray beam

25. Window rotor anode Focusing cup filament cathode focal spot Glass envelope electron beam X-ray beam The filament is heated to boil off electrons which are then accelerated to the anode The filament is contained within the cathode which is cup shaped to focus the electrons onto the focus spot on the anode Tube currents of 50-800 milliamperes are used whereas filament currents are in the range of 2-5 amperes

26. The anode is usually composed of tungsten or molybdenum as it must withstand very high temperatures (>3000 degrees C) The anode is bevelled at an angle of 12 to 17 degrees in order to maximise the contact area while focussing the resultant beam Correct warm up and stand by procedures are essential to maximise tube and filament life rotor anode Focusing cup filament cathode Glass envelope electron beam

27. End of Section 1 Why not test your understanding using the quiz booklet

28. Slide Show 2: Factors affecting x-ray beam quality and quantity

29. This slide show will examine: The factors that affect the quantity of x-rays and their characteristics

30. The energy of the x-rays is determined by the voltage applied. The amount of x-rays is determined by the current.

31. Factors affecting x-ray beam quality and quantity Anode material Voltage applied (kVp) Tube Current (mA) Filters used

32. 1. Anode material Different anode materials will produce different characteristic x-ray spectra and different amounts of bremsstrahlung radiation.

33. 2. Voltage (kVp) Note that increasing the applied voltage or kVp will increase the maximal energy, the average energy and the intensity of the x-rays. Characteristic x rays do not change with a change in kVp 40keV 75keV

34. 3. Tube current (mA) Increasing the current (ie mA) will not change energy of the beam only the intensity (i.e. the amount) of x-rays. The quantity of x-rays is directly proportional to the tube current. 100 mA 200 mA 75 keV

35. 4. Filtration Often filters of thin aluminium or other metals are used to filter out low energy x-rays. Average energy 2mm filter 4mm filter Filters will increase the average x-ray energy but decreases the intensity. The maximum energy and the characteristic x-rays remain unchanged

36. End of Section 2 Why not test your understanding using the quiz booklet

37. Slide Show 3. Interaction of X-ray Radiation with Matter

38. This slide show will: 1. Examine the energy transfer that accompanies interaction of radiation with matter 2. Examine how x-rays interact with matter and the types of interaction

39. Interaction of Radiation with Matter (Transfer of Energy) Ionization occurs when the energy transferred is sufficient to eject electron from the incident atom If energy of particle or photon is absorbed - radiation will appear to have stopped If energy not completely deposited in the matter - remaining energy will pass through. If energy is absorbed ionisation is more likely

40. The Process of Ionisation An Ion Pair is created

41. Slide Show 3: How X-rays Interact with Matter

42. This slide show will: Examine the 5 types of interactions between x-rays and matter

43. Interaction of X-rays with Matter The penetration of x-rays (or conversely the amount of attenuation) is a function of: energy of the photon atomic number of irradiated matter thickness of irradiated material density of irradiated material X-rays are classified as penetrative radiation

44. Attenuation of X-rays X-rays are attenuated as they pass through matter The degree of that any given material is able to attenuate x-rays is a function of its atomic number and its density Half Value Thickness It is conventional to refer to measure attenuation in terms of half value thickness ie the thickness of material required to reduce an x- ray to half its original intensity

45. Photoelectric effect Interaction of X-rays with matter Compton scattering Pair production There are five types of interactions: Coherent Scattering Photodisintegration With the exception of coherent scattering, all can result in ionisation of tissue

46. Photoelectric effect Interaction of X-rays with matter Compton scattering Pair production Dominant in biological materials X-ray is scattered at angle depending on amount of energy transferred X-rays of low energy X-ray transfers energy to an electron which then ejected X-rays > 1.02MeV Four interactions resulting in ionisation: Photodisintegration X-rays> 10MeV

47. Coherent scattering Also known as Classical or Thompson Scattering Change in x-ray direction with no ionisation Occurs at energies <10 keV

48. Photoelectric effect Photoelectron X-ray X-ray transfers energy to an inner shell electron which then ejected. Filling the inner shell electron results in a characteristic x-ray. Characteristic x-rays from nitrogen, carbon and oxygen have very low energies. The final result is absorption of the x-ray (i.e. there is no exit radiation)

49. Compton Scattering Compton electron The incident x-ray is scattered by an outer shell electron which is also ejected (Compton electron) The X-ray is scattered at angle depending on amount of energy transferred The energy of the incident x-ray is shared between the scattered x-ray and the Compton electron The scattered X ray has lower energy and longer wavelength

50. The photoelectric effect is responsible for most x-ray attenuation in tissue Photoelectric attenuation increases with increasing atomic number. Bone absorbs 4x the x-ray than tissue at lower x-ray energies Photoelectric attenuation also decreases with increasing energy of the x-ray Above 26 keV Compton Scattering becomes more dominant The Medical Application of the Photoelectric Effect 100% 50% 25keV 50keV Compton X-ray Energy Photoelectric Relative importance

51. 0.51MeV positron 0.51MeV electron Pair Production Occurs with high energy x-ray (> 1.02MeV)

52. Photonuclear Disintegration Only occurs with very high energy x-ray (> 10 MeV) Nuclear fragment

53. Linear Energy Transfer (LET) Rate of energy transfer - ionisations per mm or keV/mm High LET radiation is not penetrative (ie energy is deposited in a small distance) Low LET radiation is penetrative (ie much less chance energy is deposited in a small distance) X-rays are lower LET radiation

54. Linear Energy Transfer (LET) Rate of energy transfer - ionisations per mm or keV/mm Alpha Not penetrative Higher LET than beta X-rays More penetrative Slightly lower LET than beta Beta 20 1 1

55. End of Section 4 Why not test your understanding using the quiz booklet

56. Slide Show 4: The Effect of Radiation on Living Organisms

57. This slide show will: 1. Examine the effect of ionising radiation on living organisms 2. Describe units of exposure and dose

58. Effect of Radiation on Living Organisms Molecular Effect of Ionising Radiation Disruption of bonds - reduced molecular weight Alteration of the tertiary and quaternary structure Cross-linking

59. Molecular Effect of Ionising Radiation Direct Effect Radiolysis of DNA Primary feature of high LET radiation Indirect Effect Free radicals by radiolysis of water. 2H 2 0 H 2 O + + H 2 0 - H 2 O + OH . + H + Hydroxyl radicals react with other molecules (such as DNA) damaging them.

60. Effect of Radiation on Cells Relationship to dose rate (cell survival curve) At lower doses cells are able to repair damage without cell death (shoulder region) Dose Cell Survival Higher doses cell death occurs directly proportional to dose Higher LET there is no shoulder region (i.e. cell repair mechanism overwhelmed by radiation

61. Tissue Type (Law of Bergonne and Tribondeau) 1. Rapidly dividing tissue is more radiosensitive 2. Rapidly growing cells are more radiosensitive 3. Younger and more immature cells are more radiosensitive 4. Mature cells are less radiosensitive (cf. tissue weighting factor) NB: Dividing cells are more sensitive in G2 and G1 parts of the cell cycle Organ toxicity Eye lens is particularly sensitive Effect of Radiation on Tissues and Cells

62. Stochastic effects Threshold after which there is an all or nothing effect e.g. Cancer or genetic effects Deterministic Effects Vary with Dose e.g. lens opacification, blood changes Total body irradiation Highly unlikely that an individual would survive a total exposure of more than 3 Gray without intensive medical treatment Partial body irradiation Cataracts are formed if eyes are exposed to more than 2 Gray Hair loss occurs at exposures over 3 Gray Effect of Radiation on Humans

63. Units of Radiation Exposure and Dose

64. Units of Radiation Exposure and Dose Exposure (Roentgens) Dose Equivalence (Sievert) Relative biological effectiveness of different types of ionising radiation The Effective Dose Rate ( Sievert ) Absorbed dose (Gray)

65. Unit is Roentgen Amount of x-rays that will cause 1 gram of air to absorb 86.9 ergs Useful for gamma and x-rays only Exposure

66. Absorbed dose SI Unit is Gray (Gy); old unit is rad Dose absorbed by the irradiated material accompanied by 1 joule (100 ergs) of energy. The quantity of energy absorbed per gram per Roentgen is dependent on the material Therefore the absorbed dose is a useful measure and is applicable to any type or energy of ionising radiation

67. Dose Equivalence Unit is Sievert (Sv); old unit is rem Dose is multiplied by a radiation weighting factor (W R ) similar to LET Dose Equivalence = D x W R Radiation Weighting factors of emissions are approximately: Alpha particles = 20 Protons, neutrons = 10 Beta particles = 1 Gamma rays and x-rays = 1

68. The Sievert takes into account the Biological Effectiveness of the radiation It can be thought of the absorbed dose of any radiation that produces the same biological effect as 1 Gray of therapeutic x-rays For example: If 2.5 Sieverts of radiation are required for a given biological effect then this could be delivered by 2.5 Gray of therapeutic x-rays or 0.25 Gray of neutrons Explanation: neutrons are 10 x more effective at producing the same biological effect (ie: have a Quality Factor of 10) and hence 1/10 effective dose of neutrons is required for the same biological effect.

69. The Effective Dose Unit = Sievert (Sv) Takes into account how different parts of the body react to ionising radiation Effective Dose Rate = D x Q x w T w T is a tissue weighting factor for organs and tissues e.g. w T gonads = 0.2 while w T Skin is 0.01

70. Prescribed Limits for Dose

71. Dose ICRP Prescribed Limits per annum Members of public Radiation workers 20 mSv per annum above background 150 mSv to eye 500 mSv to hands 1 mSv per annum above background 5 mSv to eye 20 mSv to hands Pregnant women must receive no more than 2mSv per annum

72. Note that: Exposure limits are set for all members of the public including pregnant women, babies etc. University staff members and students should consider themselves members of the public for the purposes of setting exposure limits

73. Background Dose in NZ Background depends on activity (e.g. number of medical x-rays received in a year) Is approx 1.8 mSv per annum Note- that airline crew on international flights are the most occupationally exposed group in NZ - 6-8 mSv per annum received as a result of increased cosmic radiation received at higher altitudes

74. Measurement of dose Geiger Muller meters Geiger Muller meters only measure ionisation events impinging on the tube. These meters are useful for detecting point leakage from x-ray apparatus. Any readings obtained should be used with care as the high x-ray intensity can give alarming results Always verify any reading with a dosimeter Dosimeters Measurement of dose can only really be obtained with dosimeters. These range from film badges, to thermiluminescent detectors to hand-held monitors. Hand held dosimeters are available in the University

75. End of Section 4 Why not test your understanding using the quiz booklet

76. Slide Show 5: Safety with X-ray Apparatus

77. While most X-ray generated in analytical x-ray units are of low energy and the x-ray beam is very narrow, their intensity is very high. If an operator was able to put their hand in the path of the xray beam they would sustain an x-ray burn. In order to ensure safe operation of such machines the manufacturers have installed interlocks and designed the operation of the machine so that it is extremely difficult for the operator to come in contact with the x-ray beam. X-ray Analytical Equipment

78. X-ray Diffraction Equipment X-ray Tubes employ special anode (Mo, Cu, Fe, CO and Cr) to prouce the correct type of characteristic radiation Special windows are employed Berrylium, mica or low absorption glass to minimise loss of low energy radiation Voltages are characteristically (30-50 kV) low but amperages employed are high (15-20 mA) Incidents with X-ray diffraction equipment are rare, but those that have occurred are serious

79. The cornerstone of safe operation of these units is to ensure: 1. Only trained operators who are aware of the safe operation use these machines. 2. The safe operation of the interlocks are checked regularly 3. X-ray leakage and scatter are monitored on a regular basis 4. The equipment is secured against unauthorised and untrained use

80. Safety with X-ray Apparatus Four Principles of Radiation Safety: 1. Minimise Exposure Time 2. Maximise Distance from Source 3. Use Correct Shielding 4. Follow Manufacturers Instructions 5. Follow the ALARA principle - keep dose A Low As Reasonably Achievable

81. 1. Time Ensure all personnel minimise time spent close to machine 2. Distance Exposure falls at the square of distance from source Therefore use distance to your advantage

82. 3. Shielding It is important to periodically verify that shielding is functioning properly Most analytical X-ray machines have adequate shielding provided Never tamper with or alter shielding

83. 4. Follow Manufacturers Instructions Never over-ride safety interlocks Only authorised operators of X-ray apparatus who are familiar with safe operation of machine use the apparatus. Document all repairs Ensure there are procedures to prevent unauthorised use of or access to X-ray equipment (ie only authorised key-holders can use apparatus)

84. Legal Obligations All x-ray apparatus must have a current licence-holder in charge of the apparatus. The National Radiation Laboratory (NRL) is the New Zealand statutory body which regulates use of radioisotopes and irradiating apparatus. All x-ray apparatus must be operated in accordance with the current NRL Safe Code of Practice (NRL C17 - X-ray Analytical Equipment) All x-ray equipment must be secured against unauthorised use NRL must be notified of any disposal of x-ray equipment

85. Requirements of NRL C17 - Safe Code of Practice for X-ray Analytical Equipment There must be a current licence holder in charge All users are authorised by licence holder Prominent warning signs on doors and equipment Access to the machine is restricted by locking access to room and restricting access to switch Log of authorised users and log of use and repairs All users are properly trained (training is documented)

86. Code of Practice readily available to all users Interlocks are tested periodically Repairs are undertaken by authorised persons Equipment is periodically monitored for x-ray scatter and leakage Emergency procedures are in place to ensure machine is powered down in an emergency

87. End of Section 5 Why not test your understanding using the quiz booklet