Fluoroscopy
Dr. Hussein Ahmed Hassan
OBJECTIVES
• After completing this lecture, the student should be able to:
• Describe the principle of operation of the im...
Fluoroscopy
• A technique used to furnish images that
reflect near instantaneous changes occurring
in the patient.
It is possible to
view directly,
with naked eyes,
the fluorescent
image produce a
simple phosphor
coated screen.
HISTORY
• Thomas Edison, 1896
• Screen (zinc-cadmium sulfide) placed over patient’s
body in x-ray beam
• Radiologist looke...
• In early fluoroscopic techniques, x rays emerging from
the patient impinged directly on a fluoroscopic
screen.
• Light w...
Using this direct fluoroscopic technique:
 The radiologist perceived a very dim image
with poor visibility of detail.
 R...
CONVENTIONAL FLUOROSCOPY

9
RED GOGGLES?
The eye
•
•
•
•

Light passes thru the cornea
Between the cornea and lens is iris
Iris acts as a diaphragm
Co...
• Light hits lens which focuses the light onto the
retina where the cones and rods await
• Cones- central
• Rods - periphe...
CONES
• Sensitive to low light
• Used in night vision (scotopic
vision)
• Dims objects seen better
peripherally
• Color bl...
….PRESENTLY
• Fluoro viewed at same level of brightness as
radiographs.
• X-ray tube under table/over table or in c-arm
• ...
Image Intensifiers
• Increase the brightness of the fluoroscopic
image.
• Because of the brighter images, dark
adaptation ...
Image Intensifiers

Principles components of an image intensifier tube;
1. The input phosphor, is 25-57 cm in diameter, ex...
Image Intensifiers

3. In the body of the Image Intensifier tube the electron are
accelerated through a potential differen...
FLUOROSCOPIC DATA AQUSITION-IMAGE
INTENSIFIED SYSTEM

1.
2.
3.
4.
5.
6.
17

X-RAY TUBE
PATIENT
IMAGE INTENSIFIER
OUTPUT PH...
Image intensifier x-ray tube configuration. The overcouch, undercouch
intensifier is the more recent development.
(Fluoroscopic Equipment (cont

General
purpose
fluoroscopic
system
(Fluoroscopic Equipment (cont

Mobile fluoroscopic
system for routine
procedures during
surgery
Fluoroscopic Equipment
Fluoroscopic equipment uses electronic image
intensifiers to provide real-time (dynamic)
;imaging

...
(Fluoroscopic Equipment (cont
.Direct fluoroscopy should no longer be used

Direct” fluoroscopy does not use electronic im...
(Fluoroscopic Equipment (cont
:-All fluoroscopic units
• shall display the instantaneous values of x-ray tube voltage (kV
...
)Fluoroscopy : dynamic (real time) imaging (cont
Light amplifier tubes,
in combination with a
television camera,
are the m...
Output phosphor image quality
A.

Unsharpness;

1. Geometric unsharpness may be minimized by
positioning the intensifier i...
3. Due to limitation of electronic focusing, it results in
a slight divergence of and the electrons hit output
phosphor ov...
Output phosphor image quality –con-B. Noise;
1. Quantum mottle, loss of image quality due
quantum effect is minimized by e...
Alignment of caesium iodide
crystal on the input phosphor

Imperfect electron
focusing in an image
intensifier. Focusing
t...
--Output phosphor image quality –con
C. Resolution
•

The output phosphor image is only 2.5-3.5 cm in
diameter and must be...
Thank you
Floroscopy new microsoft office powerpoint 97 2003 presentation (2)
Floroscopy new microsoft office powerpoint 97 2003 presentation (2)
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Floroscopy new microsoft office powerpoint 97 2003 presentation (2)

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Floroscopy new microsoft office powerpoint 97 2003 presentation (2)

  1. 1. Fluoroscopy Dr. Hussein Ahmed Hassan
  2. 2. OBJECTIVES • After completing this lecture, the student should be able to: • Describe the principle of operation of the image intensifier. • know limitation of the sharpness, and resolution of a image intensifier. • Explain how design features can be used to improve image quality. • Name the events that take place when imaging with image intensifier is performed. •
  3. 3. Fluoroscopy • A technique used to furnish images that reflect near instantaneous changes occurring in the patient.
  4. 4. It is possible to view directly, with naked eyes, the fluorescent image produce a simple phosphor coated screen.
  5. 5. HISTORY • Thomas Edison, 1896 • Screen (zinc-cadmium sulfide) placed over patient’s body in x-ray beam • Radiologist looked directly at screen • Red goggles-30 minutes before exam • 1950 image intensifiers developed 5
  6. 6. • In early fluoroscopic techniques, x rays emerging from the patient impinged directly on a fluoroscopic screen. • Light was emitted from each region of the screen in response to the rate at which energy was deposited by the incident x rays. The light image on • The fluoroscopic screen was viewed by the radiologist from a distance of 10 or 15 in. • A thin plate of lead glass on the back of the fluoroscopic screen shielded the radiologist from x radiation transmitted by the screen.
  7. 7. Using this direct fluoroscopic technique:  The radiologist perceived a very dim image with poor visibility of detail.  Radiologists had to “dark adapt” their eyes by remaining in the dark for extended periods in order to view the images.
  8. 8. CONVENTIONAL FLUOROSCOPY 9
  9. 9. RED GOGGLES? The eye • • • • Light passes thru the cornea Between the cornea and lens is iris Iris acts as a diaphragm Contracts in bright, dilates in dark 10
  10. 10. • Light hits lens which focuses the light onto the retina where the cones and rods await • Cones- central • Rods - periphery 11
  11. 11. CONES • Sensitive to low light • Used in night vision (scotopic vision) • Dims objects seen better peripherally • Color blind • Do not perceive detail 12 RODS • Less sensitive to light (threshold of 100 lux) • Will respond to bright light • Daylight vision (phototopic vision) • Perceive color, differences in brightness • Perceive fine detail
  12. 12. ….PRESENTLY • Fluoro viewed at same level of brightness as radiographs. • X-ray tube under table/over table or in c-arm • Image intensifier above patient in carriage • Carriage also has the power drive control, spot film selection and tube shutters 13
  13. 13. Image Intensifiers • Increase the brightness of the fluoroscopic image. • Because of the brighter images, dark adaptation is not required.
  14. 14. Image Intensifiers Principles components of an image intensifier tube; 1. The input phosphor, is 25-57 cm in diameter, exposure of input phosphor to x-ray beam that has been transmitted through the patient causes it to emit light. 2. Photocathode layer, which release electrons in number related to intensity of light (electronic image is produced).
  15. 15. Image Intensifiers 3. In the body of the Image Intensifier tube the electron are accelerated through a potential difference of 25-35 kv and focused electronically onto a circular output phosphors 2.5-3.5 cm in diameter, which is coated of zinc-cadmium sulphite, which fluoresces when bombarded with electrons. 4. The light image so produced may up to 9000 times brighter than the input phosphor image.
  16. 16. FLUOROSCOPIC DATA AQUSITION-IMAGE INTENSIFIED SYSTEM 1. 2. 3. 4. 5. 6. 17 X-RAY TUBE PATIENT IMAGE INTENSIFIER OUTPUT PHOSPHOR CAMERA MONITOR
  17. 17. Image intensifier x-ray tube configuration. The overcouch, undercouch intensifier is the more recent development.
  18. 18. (Fluoroscopic Equipment (cont General purpose fluoroscopic system
  19. 19. (Fluoroscopic Equipment (cont Mobile fluoroscopic system for routine procedures during surgery
  20. 20. Fluoroscopic Equipment Fluoroscopic equipment uses electronic image intensifiers to provide real-time (dynamic) ;imaging • Fluoroscopy is used for the dynamic evaluation of functional disorders and guidance during routine surgical procedures, biopsies, etc. • Fluoroscopy is used during interventional radiology procedures
  21. 21. (Fluoroscopic Equipment (cont .Direct fluoroscopy should no longer be used Direct” fluoroscopy does not use electronic image“ amplification. The real-time image is viewed on a fluorescent screen in a completely darkened room and requires the fluoroscopist to dark adapt for . approximately 20 minutes before the examination Improper attention to these requirements can significantly increase the radiation dose to patients . and users
  22. 22. (Fluoroscopic Equipment (cont :-All fluoroscopic units • shall display the instantaneous values of x-ray tube voltage (kV peak), tube current (mA) and accumulated fluoroscopic exposure time at the control or to the user. should be provided with a Dose-Area Product meter or a measuring system .to indicate patient exposure The dose rate at the image intensifier input phosphor shall not exceed the . relevant IEC recommended values
  23. 23. )Fluoroscopy : dynamic (real time) imaging (cont Light amplifier tubes, in combination with a television camera, are the most widely used image intensification .systems
  24. 24. Output phosphor image quality A. Unsharpness; 1. Geometric unsharpness may be minimized by positioning the intensifier input phosphor as close as possible to the patient. 2. Spreading of light within the input phosphor is minimized by using needle-shaped caesium iodide micromcrystals. Light emitted with each crystal is internally reflected within the crystal and exits only at its end.
  25. 25. 3. Due to limitation of electronic focusing, it results in a slight divergence of and the electrons hit output phosphor over a finite area rather than a point.
  26. 26. Output phosphor image quality –con-B. Noise; 1. Quantum mottle, loss of image quality due quantum effect is minimized by ensuring that the input phosphor has a high quantum detection efficiency. 2. Structures mottle, input phosphor, photocathode and output phosphor display a graininess, which produce grainy appearance on the output phosphor image.
  27. 27. Alignment of caesium iodide crystal on the input phosphor Imperfect electron focusing in an image intensifier. Focusing tents to deteriorate toward the edges. The light-pipe principle operating in a caesium iodide crystal. Lateral spread of light is minimized by internal reflection.
  28. 28. --Output phosphor image quality –con C. Resolution • The output phosphor image is only 2.5-3.5 cm in diameter and must be magnified before it is displayed to observer. D. Distortion • The electron image or pattern created as electrons from the photocathode, should be duplicated in miniature at output phosphor, any deviation from this pattern results distortion of the intensified image.
  29. 29. Thank you

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