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  • Diagnostic radiology is the largest source of radiation resulting from human activity
    More than 250 million medical and about 100 million dental x-ray examinations are performed every year.
    4 million people or 1.4 percent of total US population Americans are exposed to high doses of x ray radiation

  • X-Rays

    1. 1. M O R E N O , M I C H A E L S A N T A N A , P A T R I C I A C U R R E A , J U L I A N X-Rays
    2. 2. Discovery •Discovered by Wilhelm Konrad Roetgen 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 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. ISBN 044307027X X-ray of Mrs. Roetgen’s hand (1895)
    3. 3. 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_Radiolo gy_Tests.asp?sitearea=PED
    4. 4. 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://www.engineersedge.com/inspection/inspection_pro_con.htm http://allergies.about.com/od/medicationallergies/a/rcmallergy.htmhttp://www.physics.isu.edu/radinf/risk.htm http://www.radiologyinfo.org/en/info.cfm?pg=bodymr
    5. 5. 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. http://www.nlm.nih.gov/medlineplus/ency/article/003337.htm http://www.gastrohep.com/classcases/classcases.asp?id=25 Esophageal stent in the small bowelPatient with kidney stone http://www.myhealth.gov.my/myhealth/eng/dewasa_content.jsp?lan g=dewasa&sub=0&bhs=eng&storyid=1144235261136
    6. 6. 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) 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 Chest X-ray showing various anatomical structures
    7. 7. Medical Applications to Date http://natsci.parkland.edu/bio/121/skull_xray.jpg http://raincrosschiropractic.com/yahoo_site_admin/assets/ima ges/spine_xray.231195817_std.jpg Skull X-ray Spine X-ray
    8. 8. 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. http://www.physorg.com/news71150236.html http://www.nasa.gov/mission_pages/chandra/multimedia/phot o10-002.html X-ray microscope image of fly from CSIRO Manufacturing and Infrastructure Technology
    9. 9. Non-Medical Applications http://www.nasa.gov/mission_pages/chandra/multimedia/phot o10-002.html http://static.howstuffworks.com/gif/airport-security-xray2.jpg X-ray image of briefcase taken at an airport Sgr-A*, a blackhole, image taken by Chadran X-ray Observatory
    10. 10. http://www.dunlee.com/resources/content/1/0/4/9/images/anatomy.jpg X-Ray Evolution Current Medical X-ray Tube
    11. 11. 1895 : Roentgen - Crooke’s tube - photographic plates-> film 1896: First X-Ray Guided Surgery Edison - fluoroscope - calcium tungstate screen Cannon - contrast medium x-ray image -barium sulfate Curie and Becquerel - discovery of natural radioactivity- radium 1.http://www.sciencemuseum.org.uk/images/I057/10324718.aspx 2.http://emeshagibbon.blogspot.com/2009/03/linear-tomography.html 3.http://www.inmycommunity.com.au/_uploads/images/myblogs/xray.jpg 4.http://home.comcast.net/~znhakim/web5/RadiologyrelatedItems/PattersonOperatingFluoroscope.htm 5.http://www.emory.edu/X-RAYS/century.htm 6.http://www.slac.stanford.edu/pubs/beamline/25/2/25-2-linton.pdf 7. 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 Crooke’s Tube Fluoroscope Radium salt
    12. 12. 1.Coolidge X-ray Tubes: http://www.orau.org/PTP/collection/xraytubescoolidge/coolidgeinformation.htm. 2.http://www.greatachievements.org/?id=3757 3. http://www.medical.philips.com/main/about/Company/historyandtimeline.wpd 4. http://www.imagingassociates.org/ 5.http://books.google.com/books?id=EUApAAAAYAAJ&pg=PA848&sig=ahIJE8zRebjXrSV3Jhe 4WM--K1c&hl=en#v=onepage&q=&f=false 6.http://commons.wikimedia.org/wiki/File:External_beam_radiotherapy_retinoblastoma_nci -vol-1924-300.jpg 1900: Radiotherapy - hard x-rays - cancer treatment 1913: Coolidge -Developed Vacuum Tube -Production of x-rays at higher energies (~50,000 V) Solomon -Mammography research - became a diagnostic tool for breast cancer 1918: Philips - First medical x-ray tube lead to manufacturing of medical x-ray equipment in Europe/USA Coolidge’s tube First X-ray Machine Early Mammography Retinoblastoma treatment
    13. 13. 1. http://www.daviddarling.info/encyclopedia/G/Geiger-Muller_counter.html 2. http://commons.wikimedia.org/wiki/File:Geiger_Mueller_Counter_with_Circuit-de.svg 3. http://www.uraniumminerals.com/Tutorials/G-M_Counter/G-M_Counter.htm 4. http://www.gammascout.com/geiger-counter-design.html 5.http://www.makingthemodernworld.org.uk/stories/defiant_modernism/01.ST.02/img/IM.02 28_zl.jpg 6. http://www.bio.miami.edu/~cmallery/255/255tech/mcb3.38.xray.jpg 7. http://shalyssa24.blogspot.com/2009/03/fluroscopy.html 1928: Geiger-Muller Counter -Detects intensity and presence of radiation -Gas discharge tube 1950: Morgan/Chamberlain /Coltman - medical fluoroscopy - screen intensification Watson/Crick/ Franklin - x-ray crystallography -DNA double helix Geiger-Muller Counter X-ray Crystallography DNA structure result Screen Intensification
    14. 14. 1. http://docs.google.com/fileview?id=0B89CZuXbiY7mNmQxYmVlNDktNjBiZS00NjcwL Tg0ODgtZjc3NWUwOWUxZDg5&hl=tr 2. http://hubpages.com/hub/Digital-X-Ray 3. http://www.royalcrestdental.com/advanced_technology/3d_imaging.html 4, http://cfi.lbl.gov/instrumentation/projects/scintimammography/PICTURES/bulky_cam.jpg 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 Dentistry Digital X-ray Machine Scintillation camera detecting tumor
    15. 15. 1. http://www.radiologyinfo.org/en/info.cfm?PG=mammo 2. http://www.emedicinehealth.com/mammogram/article_em.htm 3.http://www.medical.philips.com/pwc_hc/main/shared/Assets/Images/MRI/clinical/ pd_elitebreast_03_en.jpg 4. http://www.highbeam.com/doc/1P2-4532749.html 5. 1. SRI International Receives National Institutes of Health Grants to Develop Improved Tomographic Imaging Technology. (9 December 2009). PR Newswire. Retrieved January 21, 2000: Digital Mammography - x -rays convert to electrical signals -fixed/mobile Computer –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
    16. 16. 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 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 Procedure Average Price Abdominal X-Ray $240 Ankle X-Ray $180 Chest X-Ray $370 Elbow X-Ray $240 Foot X-Ray $170 Knee X-Ray $200 Aorta X-Ray (Aortography) $15,100 National Minimum: $120 National Average: $180 Miami Average: $223
    17. 17. Cost of x-ray machines. •Price depends on clinical Interest: • Radiography . • Radiography & Fluoroscopy . • Mammography. • Cardiovascular . • Interventional. • Surgery . • 10 to 15 year life expectancy 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 Radiography : GE DR Definium AMX 700 Radiography & Fluoroscopy (R & F) Systems: GE PRECISION 500D Mammography : GE Senographe Essential Cardiovascular: GE Innova® 2100IQ $ 250,000* $ 650,000* $ 250,000* $ 1,450,000* * Prices are in US dollars.
    18. 18. •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. Radiobiology for the radiologist By Eric J. Hall, Amato J. Giaccia Exposure to x-rays 4 million Americans = Approx 1.4 % of total US population
    19. 19. 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.
    20. 20. Questions ???