X-Rays Moreno, Michael Santana, Patricia Currea, Julian
Discovered by Wilhelm KonradRoetgen in 1895 when investigating effects of cathode rays on barium platinocyanide screen
Generated by applying a high voltage to a cathode plate Photons released strike anode plate and x-rays are emitted X-ray of Mrs. Roetgen’s hand (1895) http://thepirata.com/wp content/uploads/2008/10/the-first-xray.jpg Whaites, Eric; Roderick Cawson (2002). Essentials of Dental Radiography and Radiology. Elsevier Health Sciences. pp. 15–20. ISBN044307027X
Advantages & Disadvantages Advantages Can be used to analyze bone and other dense tissue Technology has been known for years and is widely available Can include other modalities to increase application (i.e. contrast dyes) Safe application if degree of radiation kept within limits Can be used in many parts of the body Can be used to detect abnormalities in the body and diagnose them accordingly (i.e. Early Detection) Relatively little discomfort to the patient being scanned Relatively inexpensive in comparison to other medical imaging modalities (i.e. MRI) http://www.engineersedge.com/inspection/inspection_pro_con.htm http://www.radiologyinfo.org/en/pdf/sfty_xray.pdf http://www.cancer.org/docroot/PED/content/PED_2_3X_Imaging_Radiology_Tests.asp?sitearea=PED
Advantages & Disadvantages Cont. Disadvantages Absorption limited to bony or very dense structures in the body Contrast dyes could be hazardous to certain patients (i.e. those with renal disease) Repeated radiation exposure may be hazardous to the patient Muscle and fat do not appear as detailed as bone on film; therefore, they cannot be analyzed as meticulously as denser anatomical structures Provides less detail about soft tissue than other imaging modalities (i.e. MRI) Can be invasive (such as angiography of the heart) Limited to two dimensions http://allergies.about.com/od/medicationallergies/a/rcmallergy.htm http://www.physics.isu.edu/radinf/risk.htm http://www.engineersedge.com/inspection/inspection_pro_con.htm http://www.radiologyinfo.org/en/info.cfm?pg=bodymr
Medical Applications to Date X-ray can be used to detect, diagnose, and effectively choose treatment for the patient based on the condition the area in question appears to be in. As of today, x-ray can be used in the detection of all of these pathologies: Abdominal aortic aneurysm Kidney stones Acute appendicitis Kidney failure Addison’s disease X-ray can also be used to detect any abnormalities in the joints, ligaments, and gallbladder. These are not the only applications. Esophageal stent in the small bowel Patient with kidney stone http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm http://www.gastrohep.com/classcases/classcases.asp?id=25 http://www.myhealth.gov.my/myhealth/eng/dewasa_content.jsp?lang=dewasa&sub=0&bhs=eng&storyid=1144235261136
Medical Applications to date
X-ray may be used for other portions of the body such as the skull and the neck.
What has to be observed is that significant contrast is difficult to achieve for muscle on the film.
Contrast dye, such as barium sulfate or iodine will assist in differentiating structures.
Used in ICU to monitor patient progress
Chest X-ray can be used to monitor pulmonary disease (pulmonary edema), and abnormalities in the aorta.
Can also be used during surgery as a visual aid in the implantation of medical devices (i.e. stents, pacemakers)
Chest X-ray showing various anatomical structures http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm http://www.mayoclinic.com/health/drug-information/DR600237 http://intensivecare.hsnet.nsw.gov.au/five/images/cxr.jpg
Medical Applications to Date Skull X-ray Spine X-ray http://raincrosschiropractic.com/yahoo_site_admin/assets/images/spine_xray.231195817_std.jpg http://natsci.parkland.edu/bio/121/skull_xray.jpg
Non-Medical Applications X-rays can also be used in industry It is commonly employed as a monitoring device in airports, bus stations, and other locations of mass transit X-ray microscopes have been engineered in order to see through microscopic structures in high resolution. One of these is the CSIRO X-ray microscope The Chandra Observatory in space, supported by NASA, picks up x-ray data from black holes in order to study them. X-ray microscope image of fly from CSIRO Manufacturing and Infrastructure Technology http://www.physorg.com/news71150236.html http://www.nasa.gov/mission_pages/chandra/multimedia/photo10-002.html
Non-Medical Applications X-ray image of briefcase taken at an airport Sgr-A*, a blackhole, image taken by Chadran X-ray Observatory http://www.nasa.gov/mission_pages/chandra/multimedia/photo10-002.html http://static.howstuffworks.com/gif/airport-security-xray2.jpg
X-Ray Evolution Current Medical X-ray Tube http://www.dunlee.com/resources/content/1/0/4/9/images/anatomy.jpg
1895 :Roentgen- Crooke’s tube- photographic plates-> film 1896: First X-Ray Guided SurgeryEdison- fluoroscope- calcium tungstate screenCannon- contrast medium x-ray image-barium sulfateCurie and Becquerel- discovery of natural radioactivity- radium Radium salt Crooke’s Tube Fluoroscope 1.http://www.sciencemuseum.org.uk/images/I057/10324718.aspx2.http://emeshagibbon.blogspot.com/2009/03/linear-tomography.html 3.http://www.inmycommunity.com.au/_uploads/images/myblogs/xray.jpg4.http://home.comcast.net/~znhakim/web5/RadiologyrelatedItems/PattersonOperatingFluoroscope.htm 5.http://www.emory.edu/X-RAYS/century.htm6.http://www.slac.stanford.edu/pubs/beamline/25/2/25-2-linton.pdf7. http://physicsworldarchive.iop.org/index.cfm?action=summary&doc=16%2F8%2Fphwv16i8a36%40pwa-xml&qt= 8. http://micro.magnet.fsu.edu/optics/timeline/1867-1899.html
1900:Radiotherapy- hard x-rays- cancer treatment1913:Coolidge-Developed Vacuum Tube-Production of x-rays at higher energies (~50,000 V)Solomon-Mammography research- became a diagnostic tool for breast cancer1918:Philips- First medical x-ray tubelead to manufacturing of medical x-ray equipment in Europe/USA Retinoblastoma treatment Coolidge’s tube First X-ray Machine Early Mammography 1.Coolidge X-ray Tubes: http://www.orau.org/PTP/collection/xraytubescoolidge/coolidgeinformation.htm. 2.http://www.greatachievements.org/?id=37573. http://www.medical.philips.com/main/about/Company/historyandtimeline.wpd4. http://www.imagingassociates.org/5.http://books.google.com/books?id=EUApAAAAYAAJ&pg=PA848&sig=ahIJE8zRebjXrSV3Jhe4WM--K1c&hl=en#v=onepage&q=&f=false6.http://commons.wikimedia.org/wiki/File:External_beam_radiotherapy_retinoblastoma_nci-vol-1924-300.jpg
Detects intensity and presence of radiation
-Gas discharge tube1950:Morgan/Chamberlain /Coltman- medical fluoroscopy - screen intensificationWatson/Crick/ Franklin- x-ray crystallography-DNA double helix Geiger-Muller Counter X-ray Crystallography DNA structure result Screen Intensification 1. http://www.daviddarling.info/encyclopedia/G/Geiger-Muller_counter.html2. http://commons.wikimedia.org/wiki/File:Geiger_Mueller_Counter_with_Circuit-de.svg3. http://www.uraniumminerals.com/Tutorials/G-M_Counter/G-M_Counter.htm4. http://www.gammascout.com/geiger-counter-design.html5.http://www.makingthemodernworld.org.uk/stories/defiant_modernism/01.ST.02/img/IM.0228_zl.jpg6. http://www.bio.miami.edu/~cmallery/255/255tech/mcb3.38.xray.jpg7. http://shalyssa24.blogspot.com/2009/03/fluroscopy.html
1958: Anger -scintillation cameras- radioisotopes 1980: Fuji- Digital x-rays(computed radiology) - Radiation dosage 90% less - photostimulable phosphors -Introduced in to dentistry in late 1980s- Manipulate image Conventional vs. Digital X-ray Scintillation camera detecting tumor Dentistry Digital X-ray Machine 1. http://docs.google.com/fileview?id=0B89CZuXbiY7mNmQxYmVlNDktNjBiZS00NjcwL Tg0ODgtZjc3NWUwOWUxZDg5&hl=tr2. http://hubpages.com/hub/Digital-X-Ray3. http://www.royalcrestdental.com/advanced_technology/3d_imaging.html4, http://cfi.lbl.gov/instrumentation/projects/scintimammography/PICTURES/bulky_cam.jpg
2000:Digital Mammography- x -rays convert to electrical signals-fixed/mobileComputer –Aided Detection (CAD)- uses digitized image to search for abnormalities 2009: SRI International- New source tube - Less expensive, smaller system - Increased speed, improved image quality - More flexible angular coverage. Digital Mammogram Machines CAD of chest 1. http://www.radiologyinfo.org/en/info.cfm?PG=mammo2. http://www.emedicinehealth.com/mammogram/article_em.htm3.http://www.medical.philips.com/pwc_hc/main/shared/Assets/Images/MRI/clinical/ pd_elitebreast_03_en.jpg4. http://www.highbeam.com/doc/1P2-4532749.html5. 1. SRI International Receives National Institutes of Health Grants to Develop Improved Tomographic Imaging Technology. (9 December 2009). PR Newswire. Retrieved January 21, 2010, from ABI/INFORM Dateline. (Document ID: 1917830961).
Cost of X-Ray examination.
The following is a list is common x ray procedures and their associated cost.
These prices do not include the price of supplies that may be required for some procedures. Physicians bill separately for their services.
Average price for an x-ray in the United States is $ 180.
Miami’s average Price is almost 25 % higher than the National Average.
United States: X-Ray 1.http://www.akrongeneral.org/portal/page?_pageid=153,10351506&_dad=portal&_ 2.http://www.newchoicehealth.com/Directory/Procedures/20/X-Ray
Cost of x-ray machines.
Price depends on clinical Interest:
Radiography & Fluoroscopy .
10 to 15 year life expectancy
Radiography : GE DR Definium AMX 700 Mammography : GE Senographe Essential $ 250,000* $ 650,000* Radiography & Fluoroscopy (R & F) Systems: GE PRECISION 500D Cardiovascular: GEInnova® 2100IQ $ 1,450,000* $ 250,000* 1.http://www.dotmed.com/news/story/6009/ 2.http://www.auntminnie.com/index.asp?Sec=rca&Sub=rsna_2006&Pag=dis&ItemId=73691 3.http://www.gehealthcare.com/usen/xr/index.html 4. http://www.hc-sc.gc.ca/ewh-semt/pubs/radiation/quality-assurance_art-qualite/equip_performance-eng.php * Prices are in US dollars.
Exposure to x-rays
Largest source of radiation resulting from human activity.
> 250 million medical x -ray examinations per year.
100 million dental x-ray examinations per year.
4 million Americans are exposed to high doses of medical x-ray radiation / year.
4 million Americans = Approx 1.4 % of total US population Radiobiology for the radiologist By Eric J. Hall, Amato J. Giaccia
Summary of pertinent conclusions.
X-ray holds an irreplaceable position in medical history
Traditional x-ray will depend on the density of the tissue being analyzed.
4 million Americans are exposed to high doses of medical x-ray radiation / year.
The evolution of x-ray will serve as the foundation of medical imaging and futuristic developments.