Image intensifiers, Fluoroscopy, Angiography, Angioplasty, Real-time imaging, Videocon, input phosphor, Photocathode, C-arm, TV monitors, Mini C-arm system, Operation theatres, Radiation protection devices, X-ray tube, stenting, interventional radiology

1. MOBILE IMAGE INTENSIFIER UNITS
Mr.SAMEERAHMADGANIAE
ASSISTANTPROFESSORCOPMSADESHUNIVERSITY,
BATHINDAPUNAJB

2. TOPICS FOR DISCUSSION
• INTRODUCTION
• COMPONENTS OF AN IMAGE INTENSIFIER
• MOBILE IMAGE INTENSIFIER UNITS
X- RAY TUBE
MOVEMENTS
CONTROL CONSOLE
TECHNICAL & ELECTRONIC CAPABILITIES
TYPE OF TV CAMERA
GENERATOR & RANGE OF EXPOSURES
RISKS & REMEDIES
FUTURE DEVELOPMENTS.

3. INTRODUCTION
FLUOROSCOPY
• IMAGE INTENSIFIERS
• IMAGE INTENSIFICATION
• USES OF IMAGE INTENSIFIERS
• PRINCIPLE OF IMAGE INTENSIFIERS.

4. COMPONENTS OF AN IMAGE
INTENSIFIER
An input screen-
(input phosphor): Na activated
CsI.
12.5-35cm diameter
Photocathode- antimony,
potassium
Output phosphor :
Silver activated Zinc-Cadmium
Sulphite,
1.3cm diameter
Introduced by Philips in 1955.

5. MOBILE IMAGE INTENSIFIER UNIT
- THE C-ARM
Produces a “live “ image which can be
displayed on a TV Screen.
• Two monitors are used which is
possible to compare an image from
the memory circuit with the another
one in real time.
• TV monitors are separate from the
c-arm
• Wheel base is made up of special
conducting rubber. This prevents the
built up of static electric charge.

6. THE C-ARM

7. • Micro focus x-ray tube
(0.02- 0.10mA)
• Tube potential (40-75 kV & uses a
narrow field 10-15cm in
diameter),
• Less ionization radiation than the
usual instruments.

8. X-RAY TUBE
• FIXED ANODE
Anode heat capacity- 30,000-
50,000 HU
• Single/ dual focused anode:
• (0.6mm x 0.6mm – fluoroscopic applications
• 1.8 x1.8mm- radiographic applications).
• ROTATING ANODE
Anode heat capacity: 30 lacs HU
Focal spot : 0.3mm (better
image)

9. MOVEMENTS
Helps rapid and easy positioning of the X-ray
tube & the intensifier tube.
Horizontal travel : about 200mm
Orbital travel : about 115o
Motorized vertical travel :460mm
Wig-Wag about +/-12cm

10. CONTROL CONSOLE
a) Various handles for movement and positioning
b) power switch and exposure switch.
c) cable hanger
d) Brake pedal
e) controls for radiographic and fluoroscopic settings.
f) Hard disc and optical disc writer.
g) Ability to save and swap images between monitors.
h) Advanced image quality enhancement software such as
noise reduction, zoom control
I ) Contrast and brightness controls.

11. ELECTRONIC CAPABILITIES
The images can be manipulated in many ways on the computer screen.
a) Cine loop replay- allows review of a dynamic scene without extra dose.
b) Cine loop editing- shorter loops can be made over review of a dynamic
scene.
c) Zoom –fast magnification
d) Relative stenosis measurement - Can measure the distance of vessels for
vascular procedures.
e) Test annotation- To label all images.

12. TECHNICAL CAPABLITIES
1) Plain fluoroscopy
or
2) DSA (Digital subtraction angiography)
(fluoroscopic technique to clearly visualize blood
vessels in the bony/ dense environment. Pre contrast
image - Post contrast image).
• All image intensifiers are set up with the s/w capable of
adjusting settings to suit different user requirements,
depending on the procedure and body area being
imaged.

13. TYPE OF TV CAMERA
Older machines= Vidicon type pick up tube with direct
fiber- optic coupling to the image intensifier.
Modern machines= CCD cameras
operates at lower voltages than vidicon
more durable than vidicon tubes.
emits electrons in proportion to light striking
photo cathode.
fast discharge eliminates lag.

14. GENERATOR & RANGE OF EXPOSURES
X-ray tube & high frequency generator placed in the tube
head as a tank construction.
multi cord low tension cable connects the
generator to the controls.
• KVp settings = 40 KV-110KV
• Tube current= 0.1mA – 6mA(fluroscopic )
= 20mA- 60mA (radiographic)
• Electronic Timer= 0.1 sec to 3.0 sec

16. RADIATION PROTECTION
• Minimum source to skin distance = 12”
•  distance from tube and patient
• ↓ distance from intensifier tube to the patient
• 5 min Audible Alarm
• At least .25mm lead apron to be worn
• Never place your hand or other body part in primary beam
• Provide gonadal protection for the patient if possible
Achieve maximum distance from the patient and tube (stand 90°
from the patient- SEE Merrills – pg 212)
• Minimum of 6 feet exposure cord for radiography

17. RISKS & REMEDIES
RISKS
• RADIATION
Increased radiation dose & radiation
to every one in the theatre
INFECTION
taking infection into the theatre.
EXPLOSION :
equipment may produce spark &
produce explosion , because of the
anesthetic gas.
REMEDIES
• Use cone / internal diaphragms, wear
aprons.
• use shielding covers, should not use in
other wards.
• Wheels made of special conducting
rubber avoid spark.

18. FUTURE DEVELOPMENTS
• FLAT PANEL DETECTORS-(Image Intensifier
Replacement).
ADVANTAGES
• offers increased sensitivity to X-rays hence low patient dose.
• Increase image quality.
Flat panel detectors are currently offered by
Philips Healthcare under the product name Veradius.

19. THANK YOU