CHAPTER

Essential Concepts
1 of Radiologic
Science
OBJECTIVES
At the completion of this chapter, the student should be able to do the
following:
1. Describe the characteristics of matter and energy.
2. Identify the various forms of energy.
3. Define electromagnetic radiation and ionizing radiation.
4. State the relative intensity of ionizing radiation from various sources.
5. List the concepts of basic radiation protection.
6. Discuss the derivation of scientific systems of measurement.
7. List and define units of radiation and radioactivity.

OUTLINE
Nature of our Surroundings, 3 Gonadal Shielding, 12
Matter and Energy, 3 Protective Barriers, 12
Sources of Ionizing Radiation, 5 Filtration, 13
Discovery of X-Rays, 6 Collimation, 13
Development of Medical Imag- Terminology for Radiologic Sci-
ing, 8 ence, 13
Reports of Radiation Injury, 10 Numeric Prefixes, 13
Basic Radiation Protection, 10 ␣Radiologic Units, 13
Protective Apparel, 10 ␣The Medical Imaging Team, 14

2
 C H A PT E R 1 Essential Concepts of Radiologic Science 3

MATTER AND ENERGY

T
HIS CHAPTER explores the basic concepts of Matter is anything that occupies space. It is the mate-
the science and technology of x-ray imaging. rial substance having mass of which physical objects are
These include the study of matter, energy, the composed. The fundamental, complex building blocks
electromagnetic spectrum, and ionizing radiation. The of matter are atoms and molecules. The kilogram, the
International System (SI) unit of mass, is unrelated to
production and use of ionizing radiation as a diagnos-
gravitational effects. The prefix kilo stands for 1000; a
tic tool serve as the basis for radiography. Radiologic kilogram (kg) is equal to 1000 grams (g).
technologists who deal specifically with x-ray imaging Although mass, the quantity of matter, remains
are radiographers. Radiographers have a great respon- unchanged regardless of its state, it can be transformed
sibility in performing x-ray examinations in accordance from one size, shape, and form to another. Consider a
with established radiation protection standards for the 1-kg block of ice, in which shape changes as the block of
safety of patients and medical personnel.
The instant an x-ray tube produces x-rays, all of A PENGUIN TALE BY BENJAMIN RIPLEY
the laws of physics are evident. The projectile elec- ARCHER, PhD
tron from the cathode hits the target of the anode In the vast expanse of the Antarctic region, there
producing x-rays. Some x-rays interact with tissue, was once a great, beautiful, isolated iceberg floating
in the serene sea. Because of its location and
and other x-rays interact with the image receptor (IR),
accessibility, the great iceberg became a mecca for
forming an image. The physics of radiography deals penguins from the entire area. As more and more
with the production and interaction of x-rays. penguins flocked to their new home and began to
Radiography is a career choice with great oppor- cover the slopes of the ice field, the iceberg began
tunities in a number of diverse fields. Welcome to the to sink farther and farther into the sea. Penguins
field of medical imaging! kept climbing on, forcing others off the iceberg and
back into the ocean. Soon the iceberg became
nearly submerged owing to the sheer number of
penguins that attempted to take up residence there.
NATURE OF OUR SURROUNDINGS Moral: The PENGUIN represents an important
In a physical analysis, all things can be classified as mat- fact or bit of information that we must learn to
ter or energy. Matter is anything that occupies space and understand a subject. The brain, similar to the
has mass. It is the material substance of which physical iceberg, can retain only so much information
objects are composed. All matter is composed of funda- before it becomes overloaded. When this
mental building blocks called atoms, which are arranged happens, concepts begin to become dislodged,
in various complex ways. These atomic arrangements like penguins from the sinking iceberg. So, the key
are considered at great length in Chapter 3. to learning is to reserve space for true “penguins”
A primary, distinguishing characteristic of matter is to fill the valuable and limited confines of our
mass, the quantity of matter contained in any physical brains. Thus key points in this book are highlighted
object. We generally use the term weight when describing and referred to as “PENGUINS.”
the mass of an object, and for our purposes we may con-
sider mass and weight to be the same. Remember, however,
that in the strictest sense they are not the same. Mass is actu-
ally described by its energy equivalence, whereas weight is
the force exerted on a body under the influence of gravity.
Mass is measured in kilograms (kg). For example, on
Earth, a 200-lb (91-kg) man weighs more than a 120-lb (55-
kg) woman. This occurs because of the mutual attraction,
called gravity, between the Earth’s mass and the mass of
the man or woman. On the moon, the man and the woman
would weigh only about one-sixth what they weigh on
Earth because the mass of the moon is much less than that
of the Earth. However, the mass of the man and the woman
remains unchanged at 91 kg and 55 kg, respectively.␣

Mass is the quantity of matter as described by its

energy equivalence.
4 PART I Radiologic Physics

ice melts into a puddle of water. If the puddle is allowed

to dry, the water apparently disappears entirely. How-
ever, we know that the ice is transformed from a solid
state to a liquid state and that liquid water becomes
water vapor suspended in air. If we could gather all the
molecules that make up the ice, the water, and the water
vapor and measure their masses, we would find that
each form has the same mass.
Similar to matter, energy can exist in several forms.
In the SI, energy is measured in joules (J). In radiology
the unit electron volt (eV) is often used.
Potential energy is the ability to do work by virtue of
position. A guillotine blade held aloft by a rope and pulley
is an example of an object that possesses potential energy
(Fig. 1.1). If the rope is cut, the blade will descend and do
its ghastly task. Work is required to get the blade to its
high position, and because of this position, the blade is said
to possess potential energy. Other examples of objects that
possess potential energy include a rollercoaster on top of
the incline and the stretched spring of an open screen door.

FIGURE 1.1 The blade of a guillotine offers a dramatic example

Energy is the ability to do work. of both potential and kinetic energy. When the blade is pulled to its
maximum height and is locked into place, it has potential energy.
When the blade is allowed to fall, the potential energy is released
as kinetic energy.
Kinetic energy is the energy of motion. It is possessed
by all matter in motion: a moving automobile, a turning
windmill wheel, a falling guillotine blade. These systems for our purposes because it is the type of energy that
can all do work because of their motion. is used in x-ray imaging. The energy traveling through
Chemical energy is the energy released by a chemical space is a combination of electric and magnetic fields.
reaction. An important example of this type of energy In addition to x-rays and gamma rays, electromagnetic
is that which is provided to our bodies through chemi- energy includes radio waves; microwaves; and ultravio-
cal reactions involving the foods we eat. At the molecu- let, infrared, and visible light. Electromagnetic energy
lar level, this area of science is called biochemistry. The does not include sound or diagnostic ultrasound.
energy released when dynamite explodes is a more dra- Just as matter can be transformed from one size,
matic example of chemical energy. shape, and form to another, so can energy be transformed
Electrical energy represents the work that can be done from one type to another. In radiology, for example,
when an electron moves through an electric potential electrical energy in the x-ray imaging system is used to
difference (voltage). The most familiar form of electrical produce electromagnetic energy (the x-ray), which then
energy is normal household electricity, which involves is converted to an electrical signal in a digital IR.
the movement of electrons through a copper wire by an Reconsider now the statement that all things can be
electric potential difference of 110 volts (V). All electric classified as matter or energy. Look around you and think
apparatus, such as motors, heaters, and blowers, func- of absolutely anything, and you should be convinced of
tion through the use of electrical energy. this statement. You should be able to classify anything
Thermal energy (heat) is the energy of motion at the as matter, energy, or both. Frequently, matter and energy
molecular level. It is the kinetic energy of molecules and exist side by side—a moving automobile has mass and
is closely related to temperature. The faster the molecules kinetic energy; boiling water has mass and thermal energy;
of a substance are vibrating, the more thermal energy the Leaning Tower of Pisa has mass and potential energy.
the substance has and the higher is its temperature. Perhaps the strangest property associated with mat-
Nuclear energy is the energy that is contained within ter and energy is that they are interchangeable, a char-
the nucleus of an atom. We control the release and use of acteristic first described by Albert Einstein in his famous
this type of energy in electric nuclear power plants. An theory of relativity. Einstein’s mass-energy equivalence
example of the uncontrolled release of nuclear energy is equation is a cornerstone of that theory.
the atomic bomb. This mass-energy equivalence serves as the basis for
Electromagnetic energy is perhaps the least famil- the atomic bomb, nuclear power plants, and certain
iar form of energy. However, it is the most important nuclear medicine imaging modalities.
 C H A PT E R 1 Essential Concepts of Radiologic Science 5

MASS-ENERGY
E = mc2 Ionizing radiation
where E is energy, m is mass, and c is the veloc-
ity (speed) of electromagnetic radiation (light) in a
vacuum.

Negative ion
e! (free electron)
Energy emitted and transferred through space is Target
called radiation. When a piano string vibrates, it is atom
said to radiate sound; the sound is a form of radiation. Ion pair
Ripples or waves radiate from the point where a peb-
ble is dropped into a still pond. Visible light, a form
of electromagnetic energy, is radiated by the sun and
is electromagnetic radiation. Electromagnetic energy is Positive ion
usually referred to as electromagnetic radiation or, sim- (remaining atom)
ply, radiation.
Matter that intercepts radiation and absorbs part FIGURE 1.2 Ionization is the removal of an electron from an
or all of it is said to be exposed or irradiated. Spend- atom. The ejected electron and the resulting positively charged
ing a day at the beach exposes you to ultraviolet light. atom together are called an ion pair.
Ultraviolet light is the type of radiation that causes sun-
burn. During a radiographic examination, the patient is
exposed to x-rays. The patient is said to be irradiated. SOURCES OF IONIZING RADIATION
Many types of radiation are harmless, but ionizing
radiation can injure humans. We are exposed to many
sources of ionizing radiation (Fig. 1.3). These sources
Radiation is the transfer of energy. can be divided into two main categories: natural envi-
ronmental radiation and man-made radiation.
Natural environmental radiation results in an annual
dose of approximately 3 millisieverts (mSv). Human-
Ionizing radiation is a special type of radiation that made radiation results in 3.1 mSv annually. The mSv is
includes x-rays. Ionizing radiation is any type of radiation the SI unit of effective dose. It is used to express radia-
that is capable of removing an orbital electron from the tion exposure of populations and radiation risk in those
atom with which it interacts (Fig. 1.2). This type of inter- populations.
action between radiation and matter is called ionization. Natural environmental radiation consists of four
Ionization occurs when an x-ray passes close to an orbital components: cosmic rays, terrestrial radiation, inter-
electron of an atom and transfers sufficient energy to the nally deposited radionuclides, and radon. Cosmic rays
electron to remove it from the atom. The ionizing radia- are particulate and electromagnetic radiation emitted
tion may interact with and ionize additional atoms. The by the sun and stars. On Earth, the intensity of cosmic
orbital electron and the atom from which it was sepa- radiation increases with altitude and latitude. Terrestrial
rated are called an ion pair. The electron is a negative ion, radiation results from deposits of uranium, thorium, and
and the remaining atom is a positive ion. other radionuclides in the Earth. The intensity is highly
dependent on the geology of the local area. Internally
deposited radionuclides, mainly potassium-40 (40K), are
Ionization is the removal of an electron from an natural metabolites. They have always been with us and
atom. contribute an equal dose to each of us.
The largest source of natural environmental radia-
tion is radon. Radon is a radioactive gas that is produced
Thus any type of energy that is capable of ionizing by the natural radioactive decay of uranium, which is
matter is known as ionizing radiation. X-rays, gamma present in trace quantities in the Earth. All Earth-based
rays, and ultraviolet light are the only forms of elec- materials, such as concrete, bricks, and gypsum wall-
tromagnetic radiation with sufficient energy to ionize. board, contain radon. Radon emits alpha particles,
Some fast-moving particles (particles with high kinetic which are not penetrating, and therefore contributes a
energy) are also capable of ionization. Examples of par- radiation dose only to the lung.
ticle-type ionizing radiation are alpha and beta particles Collectively, these sources of natural environmen-
(see Chapter 3). Although alpha and beta particles are tal radiation result in approximately 300 to 1000
sometimes called rays, this designation is incorrect.␣ microsievert (µSv)/h at waist level in the United States
6 PART I Radiologic Physics

FIGURE 1.3 The contribution of various sources to the average US population radiation dose,
1990 and 2006. We will return to this very important pie chart in Chapter 39.

(Fig. 1.4). This equals an annual exposure of approxi- radiation dose, this level takes into account people who
mately 0.2 mSv/yr along the Gulf Coast and Florida to 1 are not receiving a radiologic examination and those
mSv/yr or higher in the Rocky Mountains region. undergoing several within a year.
Remember, however, that humans have existed for The medical radiation exposure for some in our pop-
several hundred thousand years in the presence of this ulation will be zero, but for others it may be quite high.
natural environmental radiation level. Human evolution This average level is comparable with natural environ-
undoubtedly has been influenced by natural environ- mental radiation levels, and therefore one could ques-
mental radiation. Some geneticists contend that evolu- tion why it is necessary to be concerned about radiation
tion is influenced primarily by ionizing radiation. If this control and radiation safety in medical imaging.
is so, then we must indeed be concerned with control of
unnecessary radiation exposure because over the past Question: What percentage of our annual average
century, with increasing medical applications of radia- radiation dose is attributable to medical
tion, the average annual exposure of our population to imaging?
radiation has increased significantly. Answer: 3.0 mSv/6.2 mSv = 0.484 = 48%
Diagnostic x-rays constitute the largest man-made
source of ionizing radiation (3.0 mSv/yr). This estimate Other sources of man-made radiation include
was made in 2006 by the National Council on Radia- nuclear power generation, research applications, indus-
tion Protection and Measurements (NCRP). Earlier esti- trial sources, and consumer items. Nuclear power sta-
mates by the NCRP in 1990 put this source at nearly 0.5 tions and other industrial applications contribute very
mSv/yr. The increase during this 16-year period is prin- little to our radiation dose. Consumer products such as
cipally attributable to the increasing use of computed watch dials, exit signs, smoke detectors, camping lan-
tomography (CT) and high-level fluoroscopy. tern mantles, and airport surveillance systems contrib-
The benefits derived from the application of x-rays in ute only 0.1 mSv to our annual radiation dose.␣
medicine are indisputable; however, such applications
must be made with prudence and with care taken to DISCOVERY OF X-RAYS
reduce unnecessary exposure of patients and personnel. X-rays were not developed; they were discovered and
This responsibility falls primarily on radiologic tech- quite by accident. During the 1870s and 1880s, many
nologists because they usually control the operation of university physics laboratories were investigating the
x-ray imaging systems during radiologic examinations. conduction of cathode rays through a large, partially
The currently accepted approximate annual dose evacuated glass tube known as a Crookes tube. Sir Wil-
resulting from medical applications of ionizing radia- liam Crookes was an Englishman from a rather humble
tion is 3.0 mSv. In contrast to the natural environmental background who was a self-taught genius.
 C H A PT E R 1 Essential Concepts of Radiologic Science 7

Terrestrial Gamma-Ray Exposure at 1 m Above Ground

FIGURE 1.4 Radiation exposure at waist level throughout the

United States. (Courtesy US Geological Survey.)

The tube that bears his name was the forerunner of FIGURE 1.5 The type of Crookes tube Roentgen used when he
discovered x-rays. Cathode rays (electrons) leaving the cathode are
modern fluorescent lamps and x-ray tubes. There were attracted by high voltage to the anode, where they produce x-rays and
many different types of Crookes tubes; most of them fluorescent light. (Courtesy Gary Leach, Memorial Hermann Hospital.)
were capable of producing x-rays. Wilhelm Roentgen
was experimenting with a type of Crookes tube when he
discovered x-rays (Fig. 1.5). TABLE 1.1 Roentgen’s Original Properties of
On November 8, 1895, Roentgen was working in his X-Rays
physics laboratory at Würzburg University in Germany.
He had darkened his laboratory and completely enclosed 1. X-rays are highly penetrating, invisible rays that are a
form of electromagnetic radiation.
his Crookes tube with black photographic paper so he
2. X-rays are electrically neutral and therefore not
could better visualize the effects of the cathode rays in
affected by either electric or magnetic fields.
the tube. A plate coated with barium platinocyanide, a 3. X-rays can be produced over a wide variety of ener-
fluorescent material, happened to be lying on a bench gies and wavelengths.
top several meters from the Crookes tube. 4. X-rays release very small amounts of heat upon pass-
No visible light escaped from the Crookes tube ing through matter.
because of the black paper that enclosed it, but Roent- 5. X-rays travel in straight lines.
gen noted that the barium platinocyanide glowed. The 6. X-rays travel at the speed of light, 3 × 108 m/s in a
intensity of the glow increased as the plate was brought vacuum.
closer to the tube; consequently, there was little doubt 7. X-rays can ionize matter.
about the origin of the stimulus of the glow. This glow 8. X-rays cause fluorescence of certain crystals.
9. X-rays cannot be focused by a lens.
is called fluorescence.
10. X-rays affect photographic film.
Roentgen’s immediate approach to investigating
11. X-rays produce chemical and biological changes in
this “X-light,” as he called it, was to interpose various matter through ionization and excitation.
materials—wood, aluminum, his hand!—between the 12. X-rays produce secondary and scatter radiation.
Crookes tube and the fluorescing plate. The “X” was
for unknown! He feverishly continued these investiga-
tions for several weeks.
Roentgen’s initial investigations were extremely reported to be the first x-ray examination in the United
thorough, and he was able to report his experimental States, conducted in early February 1896, in the physics
results to the scientific community before the end of laboratory at Dartmouth College.
1895 (Table 1.1). For this work, in 1901, he received The discovery of x-rays is characterized by many
the first Nobel Prize in Physics. amazing features, and this causes it to rank high among
Roentgen recognized the value of his discovery to the events in human history. First, the discovery was
medicine. He produced and published the first medical accidental. Second, probably no fewer than a dozen
x-ray image in early 1896. It was an image of his wife’s contemporaries of Roentgen had previously observed
hand (Fig. 1.6). Fig. 1.7 is a photograph of what is x-radiation, but none of these other physicists had
8 PART I Radiologic Physics

recognized its significance or investigated it. Third,

Roentgen followed his discovery with such scientific
vigor that within little more than 1 month, he had
described x-radiation with nearly all of the properties
we currently recognize.␣

DEVELOPMENT OF MEDICAL IMAGING

There are three general types of x-ray examinations: radi-
ography, fluoroscopy, and computed tomography (CT).
Radiography uses a solid-state image receptor (IR) and
usually an x-ray tube mounted from the ceiling on a track
that allows the tube to be moved in any direction. Such
examinations provide the radiologist with fixed images.
Fluoroscopy is usually conducted with an x-ray tube
located under the examination table supporting the
patient. The radiologist is provided with moving images
on a digital display device.
CT uses a rotating x-ray source and detector array.
A volume of data is acquired so that fixed images can be
reconstructed in any anatomic plane—coronal, sagittal,
transverse, or oblique.
There are many variations of these three basic types
of examinations, but in general, x-ray imaging equip-
ment is similar.

To provide an x-ray beam that is satisfactory for

FIGURE 1.6 The hand shown in this radiograph belongs to Mrs.
Roentgen. This first indication of the possible medical applications imaging, you must supply the x-ray tube with a
of x-rays was made within a few days of the discovery. (Courtesy high voltage and an electric current.
Deutsches Roentgen Museum.)

FIGURE 1.7 This photograph records the first medical x-ray examination in the United States.
A young patient, Eddie McCarthy, broke his wrist while skating on the Connecticut River and
submitted to having it photographed by the “X-light.” With him are (left to right) Professor E.B. Frost,
Dartmouth College, and his brother, Dr. G.D. Frost, Medical Director, Mary Hitchcock Hospital. The
apparatus was assembled by Professor F.G. Austin in his physics laboratory at Reed Hall, Dart-
mouth College, on February 3, 1896. (Courtesy Mary Hitchcock Hospital.)
 C H A PT E R 1 Essential Concepts of Radiologic Science 9

X-ray voltages are measured in kilovolt peak (kVp).

One kilovolt (kV) is equal to 1000 V of electric poten-
tial. X-ray currents are measured in milliampere (mA),
where the ampere (A) is a measure of electric current.
The prefix milli stands for 1/1000 or 0.001.

Question: The usual x-ray source-to-image receptor

distance (SID) during radiography is 1 m.
How many millimeters is that?
Answer: 1 mm = 1/1000 m or 10−3; therefore
1000 mm = 1 m.

Currently, voltage and current are supplied to an

x-ray tube through rather complicated electric circuits,
but in Roentgen’s time, only simple static generators
were available. These units could provide currents of
only a few milliamperes and voltages up to 50 kVp.
Currently, 1000 mA and 150 kVp are commonly used. FIGURE 1.8 Thomas Edison is seen viewing the hand of his un-
Early radiographic procedures often required expo- fortunate assistant, Clarence Dally, through a fluoroscope of his
sure times of 30 minutes or longer. Long exposure time own design. Dally’s hand rests on the box that contains the x-ray
tube.
results in image blur. One development that helped
reduce this exposure time was the use of a fluorescent
intensifying screen in conjunction with the glass photo- research, but he abandoned it when his assistant and
graphic plates. long-time friend, Clarence Dally, experienced a severe
Michael Pupin is said to have demonstrated the use x-ray burn that eventually required amputation of both
of a radiographic intensifying screen in 1896, but only arms. Dally died in 1904 and is counted as the first x-ray
many years later did it receive adequate recognition and fatality in the United States.
use. Radiographs during Roentgen’s time were made Two devices designed to reduce the exposure of
by exposing a glass plate with a layer of photographic patients to x-rays and thereby minimize the possibility of
emulsion coated on one side. x-ray burn were introduced before the turn of the 20th
Charles L. Leonard found that by exposing two century by a Boston dentist, William Rollins. Rollins
glass x-ray plates with the emulsion surfaces together, used x-rays to image teeth and found that restricting the
exposure time was halved, and the image was consider- x-ray beam with a sheet of lead with a hole in the center,
ably enhanced. This demonstration of double-emulsion a diaphragm, and inserting a leather or aluminum filter
radiography was conducted in 1904, but double-emul- improved the diagnostic quality of radiographs.
sion film did not become commercially available until This first application of collimation and filtration
1918. was followed very slowly by general adoption of these
Much of the high-quality glass used in radiography techniques. It was later recognized that these devices
came from Belgium and other European countries. This reduce the hazard associated with x-rays.
supply was interrupted during World War I; therefore Two developments that occurred at approximately
radiologists began to make use of film rather than glass the same time transformed the use of x-rays from a
plates. novelty in the hands of a few physicists into a valu-
The demands of the army for increased radiologic able, large-scale medical specialty. In 1907 H.C. Snook
services made a substitute for the glass plate neces- introduced a substitute high-voltage power supply, an
sary. The substitute was cellulose nitrate, and it quickly interrupterless transformer, for the static machines and
became apparent that the substitute was better than the induction coils then in use.
original glass plate. Although the Snook transformer was far superior
The fluoroscope was developed in 1898 by the Ameri- to these other devices, its capability greatly exceeded
can inventor Thomas A. Edison (Fig. 1.8). Edison’s orig- the capability of the Crookes tube. It was not until the
inal fluorescent material was barium platinocyanide, a introduction of the Coolidge tube that the Snook trans-
widely used laboratory material. He investigated the former was widely adopted.
fluorescent properties of more than 1800 other materi- The type of Crookes tube that Roentgen used in
als, including zinc cadmium sulfide and calcium tung- 1895 had existed for a number of years. Although some
state—two materials in use currently. modifications were made by x-ray workers, it remained
There is no telling what additional inventions Edi- essentially unchanged into the second decade of the
son might have developed had he continued his x-ray 20th century.
10 PART I Radiologic Physics

After considerable clinical testing, William D. Years later, it was discovered that blood disorders
Coolidge unveiled his hot-cathode x-ray tube to the such as aplastic anemia and leukemia were occurring
medical community in 1913. It was immediately rec- in radiologists at a much higher rate than in others.
ognized as far superior to the Crookes tube. It was a Because of these observations, protective devices and
vacuum tube that allowed x-ray intensity and energy apparel, such as lead gloves and aprons, were developed
to be selected separately and with great accuracy. This for use by radiologists. X-ray workers were routinely
had not been possible with gas-filled tubes, which made observed for any effects of their occupational exposure
standards for techniques difficult to obtain. X-ray tubes and were provided with personnel radiation monitoring
in use today are refinements of the Coolidge tube. devices. This attention to radiation safety in radiology
has been effective.
Radiology emerged as a medical specialty
because of the Snook transformer and the Because of effective radiation protection
Coolidge x-ray tube. practices, radiology is now considered a safe
occupation.

The era of modern radiography is dated from the

matching of the Coolidge tube with the Snook trans-
former; only then did acceptable kVp and mA levels BASIC RADIATION PROTECTION
become possible. Few developments since that time have Today, the emphasis on radiation control in diagnos-
had such a major influence on medical imaging. tic radiology has shifted back to protection of patients.
In 1913 Gustav Bucky (German) invented the sta- Current studies suggest that even the low doses of
tionary grid (“Glitterblende”); 2 months later he applied x-radiation used in routine diagnostic procedures may
for a second patent for a moving grid. In 1915 H. Pot- result in a small incidence of latent harmful effects. It is
ter (American), probably unaware of Bucky’s patent also well established that human fetuses are sensitive to
because of World War I, also invented a moving grid. x-radiation early in pregnancy.
To his credit, Potter recognized Bucky’s work, and the It is hoped that this introduction has emphasized the
Potter-Bucky grid was introduced in 1921. importance of providing adequate protection for both
In 1946 the light amplifier tube was demonstrated at radiologic technologists and patients. As you progress
Bell Telephone Laboratories. This device was adapted through your training in radiologic technology, you will
for fluoroscopy by 1950 as an image intensifier tube. quickly learn how to operate your x-ray imaging sys-
Currently, image-intensified fluoroscopy is being tems safely, with minimal radiation exposures, by fol-
replaced by solid-state IRs. lowing standard radiation protection procedures.
Each recent decade has seen remarkable improve- One caution is in order early in your training—after
ments in medical imaging. Diagnostic ultrasonography you have worked with x-ray imaging systems, you will
appeared in the 1960s, as did the gamma camera. Posi- become so familiar with your work environment that
tron emission tomography and x-ray CT were devel- you may become complacent about radiation control.
oped in the 1970s. Magnetic resonance imaging (MRI) Do not allow yourself to develop this attitude because it
became an accepted modality in the 1980s, and cur- can lead to unnecessary radiation exposure. Radiation
rently digital radiography and digital fluoroscopy are protection must be an important consideration during
rapidly replacing screen-film radiography and image- each x-ray procedure. Table 1.3 reports the Ten Com-
intensified fluoroscopy. Table 1.2 chronologically sum- mandments of Radiation Protection.
marizes some of the more important developments.␣

REPORTS OF RADIATION INJURY Always practice ALARA. Keep radiation

The first x-ray fatality in the United States occurred in exposures as low as reasonably achievable.
1904. Unfortunately, radiation injuries occurred rather
frequently in the early years. These injuries usually took
the form of skin damage (sometimes severe), loss of hair, Minimizing radiation exposure to radiologic tech-
and anemia. Physicians and, more commonly, patients nologists and to patients is easy if the x-ray imaging
were injured, primarily because the low energy of radi- systems designed for this purpose are recognized and
ation then available resulted in the necessity for long understood. A brief description of some of the primary
exposure times to obtain acceptable images. radiation protection devices follows.
By about 1910, these acute injuries began to be con-
trolled as the biologic effects of x-rays were scientifically Protective Apparel
investigated and reported. With the introduction of the Lead-impregnated material is used to make aprons and
Coolidge tube and the Snook transformer, the frequency gloves worn by radiologists and radiologic technologists
of reports of injuries to superficial tissues decreased. during fluoroscopy and some radiographic procedures.␣
TABLE 1.2 Important Dates in the Development of Modern Radiology
Date Event Date Event

1895 Roentgen discovers x-rays. 1979 The Nobel Prize in Physiology or Medicine is
1896 First medical applications of x-rays in diagnosis awarded to Allan Cormack and Godfrey
and therapy are made. Hounsfield for CT.
1900 The American Roentgen Society, the first 1980 The first commercial superconducting MRI system
American radiology organization, is founded. is introduced.
1901 Roentgen receives the first Nobel Prize in Physics. 1981 Slot scan chest radiography is demonstrated by
1905 Einstein introduces his theory of relativity and the Barnes.
famous equation E = mc2. 1981 The International System of Units (SI) is adopted
1907 The Snook interrupterless transformer is introduced. by the International Commission on Radiation
1913 Bohr theorizes his model of the atom, featuring a Units and Measurements (ICRU).
nucleus and planetary electrons. 1982 Picture Archiving and Communication System
1913 The Coolidge hot-filament x-ray tube is developed. (PACS) becomes available.
1917 The cellulose nitrate film base is widely adopted. 1983 First tabular grain film emulsion (Eastman Kodak)
is developed.
1920 Several investigators demonstrate the use of
soluble iodine compounds as contrast media. 1984 Laser-stimulable phosphors for computed
radiography appear (Fuji).
1920 The American Society of Radiologic Technologists
(ASRT) is founded. 1988 A superconducting quantum interference device
(SQUID) for magnetoencephalography (MEG)
1921 The Potter-Bucky grid is introduced.
is first used.
1922 Compton describes the scattering of x-rays.
1989 The SI is adopted by the NCRP and most
1923 Cellulose acetate “safety” x-ray film is introduced
scientific and medical societies.
(Eastman Kodak).
1990 The last xeromammography system is produced.
1925 The First International Congress of Radiology is
1990 Helical CT is introduced (Toshiba).
convened in London.
1991 Twin-slice CT is developed (Elscint).
1928 The roentgen is defined as the unit of x-ray intensity.
1992 The Mammography Quality Standard Acts
1929 Forssmann demonstrates cardiac catheterization
(MQSA) is passed.
… on himself!
1996 Digital radiography that uses thin-film transistors
1929 The rotating anode x-ray tube is introduced.
(TFTs) is developed.
1930 Tomographic devices are shown by several
1997 Charge-coupled device (CCD) digital radiography
independent investigators.
is introduced by Swissray.
1932 Blue tint is added to x-ray film (DuPont).
1997 Amorphous selenium flat panel image receptor is
1932 The US Committee on X-Ray and Radium Protection
demonstrated by Rowlands.
(now the NCRP) issues the first dose limits.
1998 Multislice CT is introduced (General Electric).
1942 Morgan exhibits an electronic photo-timing device.
1998 Amorphous silicon-CsI image receptor is
1942 The first automatic film processor (Pako) is
demonstrated for digital radiography.
introduced.
2000 The first direct digital mammographic imaging
1948 Coltman develops the first fluoroscopic image
system is made available (General Electric).
intensifier.
2002 Sixteen-slice helical CT is introduced.
1951 Multidirectional tomography (polytomography) is
2002 Positron emission tomography (PET) is placed into
introduced.
routine clinical service.
1953 The rad is officially adopted as the unit of
2003 The Nobel Prize in Physiology or Medicine is
absorbed dose.
awarded to Paul Lauterbur and Sir Peter
1956 Xeroradiography is demonstrated.
Mansfield for MRI.
1956 First automatic roller transport film processing
2003 Digital radiographic tomosynthesis is
(Eastman Kodak) is introduced.
demonstrated.
1960 Polyester base film is introduced (DuPont).
2004 The 64-slice helical CT is introduced.
1963 Kuhl and Edwards demonstrate single-photon
2005 Dual-source CT is announced (Siemens).
emission computed tomography (SPECT).
2007 The 320-slice helical CT is introduced (Toshiba).
1965 Ninety-second rapid processor is introduced
2009 NCRP Report No. 160, Ionizing radiation exposure
(Eastman Kodak).
of the population of the United States: 2006, is
1966 Diagnostic ultrasonography enters routine use.
published.
1972 Single-emulsion film and one-screen
2011 Digital mammographic tomosynthesis is clinically
mammography become available (DuPont).
approved.
1973 Hounsfield completes development of first computed
2012 Discovery of the Higgs boson at the CERN Large
tomography (CT) imaging system (EMI).
Hadron Collider, Switzerland.
1973 Damadian and Lauterbur produce the first
2017 3D printers and segmentation algorithms expand
magnetic resonance image (MRI).
CT and MRI applications.
1974 Rare earth radiographic intensifying screens are
2018 Artificial intelligence (AI) appears in special journals
introduced.
and meetings.
1977 Mistretta demonstrates digital subtraction
fluoroscopy.
12 PART I Radiologic Physics

Gonadal Shielding
TABLE 1.3 The Ten Commandments of
Radiation Protection The same lead-impregnated material used in aprons
and gloves is used to fabricate gonadal shields. Gonadal
1. Understand and apply the cardinal principles of radia- shields should be used with all persons of childbearing
tion control: time, distance, and shielding. age or younger when the gonads are in or near the use-
2. Do not allow familiarity to result in false security. ful x-ray beam and when use of such shielding will not
3. Never stand in the primary beam. interfere with the diagnostic value of the examination.␣
4. Always wear protective apparel when not behind a
protective barrier. Protective Barriers
5. Always wear an occupational radiation monitor
and position it outside the protective apron at the
The radiographic or CT control console is always
collar. located behind a protective barrier. Often, the barrier is
6. Never hold a patient during radiographic examina- lead lined and is equipped with a leaded-glass window.
tion. Use mechanical restraining devices when pos- Under normal circumstances, personnel remain behind
sible. Otherwise, have family or friends hold the the barrier during x-ray examination. Fig. 1.9 is a ren-
patient. dering of a radiographic and fluoroscopic examination
7. The person who is holding the patient must always room. Many radiation safety features are illustrated.
wear a protective apron and, if possible, protective Other procedures should be followed. Abdominal
gloves. and pelvic x-ray examinations of expectant mothers
8. Use gonadal shields on all people of childbearing age should not be conducted during the first trimester unless
or younger when such use will not interfere with the
absolutely necessary. Every effort should be made to
examination.
9. Examination of the pelvis and lower abdomen of
ensure that an examination will not have to be repeated
pregnant patients should be avoided whenever pos- because of technical error. Repeat examinations subject
sible, especially during the first trimester. the patient to twice the necessary radiation.
10. Always collimate to the smallest field size appropriate When shielding patients for x-ray examination, one
for the examination. should consider the medical management of the patient.
Except for proper screening, x-ray examination of
asymptomatic patients is not acceptable.

A
G
IR F
D
B
E

FIGURE 1.9 The general purpose radiographic and fluoroscopic imaging system includes an over-
head radiographic tube (A) and a fluoroscopic examining table (B) with an x-ray tube under the table
(C). Some of the more common radiation protection devices are the lead curtain (D), the Bucky slot
cover (E), a lead apron and gloves (F), and the protective viewing window (G). The location of the
image receptor (IR) and associated imaging equipment is shown.
 C H A PT E R 1 Essential Concepts of Radiologic Science 13

Patients who require assistance during exami-

TABLE 1.4 Standard Scientific Prefixes
nation should never be held by x-ray personnel.
Mechanical immobilization devices should be used. Multiple Prefix Symbol
When necessary, a member of the patient’s family,
appropriately shielded, should provide the necessary 1018 exa- E
assistance.␣ 1015 peta- P
1012 tera- T
Filtration 109 giga- G
106 mega- M
Metal filters, usually aluminum or copper, are inserted
103 kilo- k
into the x-ray tube housing so that low-energy x-rays
102 hecto- h
are absorbed before they reach the patient. These x-rays
10 deka- da
have little diagnostic value.␣
10−1 deci- d
10−2 centi c
Collimation
10−3 milli- m
Collimation restricts the useful x-ray beam to that part 10−6 micro- µ
of the body to be imaged and thereby spares adjacent 10−9 nano- n
tissue from unnecessary radiation exposure. Collima- 10−12 pico- p
tors take many different forms. Adjustable light-locat- 10−15 femto- f
ing collimators are the most frequently used collimating 10−18 atto- a
devices. Collimation also reduces scatter radiation and
thus improves image contrast.␣ Boldfaced prefixes and symbols are those most used in radiologic science.

TERMINOLOGY FOR RADIOLOGIC

SCIENCE
be used. Table 1.5 shows the relationship of the earlier
Every profession has its own language. Radiologic science
radiologic units to their SI equivalents.
is no exception. Several words and phrases characteristic of
In 1981 the International Commission on Radiation
radiologic science already have been identified; many more
Units and Measurements issued standard units based on
will be defined and used throughout this book. For now,
SI that have since been adopted by all countries except
an introduction to this terminology should be sufficient.
the United States. The NCRP and all US scientific and
Numeric Prefixes medical societies adopted the SI units by the early
1990s. It was not until 2017 that the American Registry
Often in radiologic science, we must describe very large
of Radiologic Technologists (ARRT) adopted SI in their
or very small multiples of standard units. Two units, the
examination process.
milliampere (mA) and kilovolt peak (kVp), already have
Air Kerma (Kinetic Energy Released in Matter) (Gya). Air
been discussed. By writing 70 kVp instead of 70,000 volt
kerma is the kinetic energy transferred from photons to
peak, we can understandably express the same quantity
electrons during ionization and excitation. Air kerma is
with fewer characters. For such economy of expression,
measured in joules per kilogram (J/kg), where 1 J/kg is
scientists have devised a system of prefixes and symbols
1 gray (Gya).
(Table 1.4).
In keeping with the adoption of the Wagner/Archer
method described in the preface, the SI unit of air kerma
Question: How many kilovolts equal 37,000 V? (mGya) is used to express radiation exposure.␣

Answer: 37, 000 V = 37 × 103 V

= 37 kV
Air kerma (Gya) is the unit of radiation exposure.
Question: The diameter of a blood cell is
approximately 10 micrometers (µm). How
many meters is that?
Answer: 10 µm = 10 × 10−6 m Absorbed Dose (Gyt). Biologic effects usually are
= 10−5 m related to the radiation absorbed dose (rad). Absorbed
= 0.00001 m dose is the radiation energy absorbed per unit mass
and has units of J/kg or Gyt. The units Gya and Gyt
␣Radiologic Units refer to radiation dose in air and tissue, respectively.
For a given air kerma (radiation exposure), the
The four units used to measure radiation should become
absorbed dose depends on the type of tissue being
a familiar part of your vocabulary. Fig. 1.10 relates
irradiated. More about this is found in Chapters 9
them to a hypothetical situation in which they would
and 37.␣
14 PART I Radiologic Physics

The gray (Gyt) is the unit of radiation absorbed The sievert (Sv) is the unit of occupational
dose (rad). radiation exposure and effective dose.

Radioactivity: Becquerel (Bq). The becquerel is the unit

Effective Dose: Sievert (Sv). Occupational radiation of quantity of radioactive material, not the radiation
monitoring devices are analyzed in terms of sievert, emitted by that material. One becquerel is that quantity
which is used to express the quantity of radiation of radioactivity in which a nucleus disintegrates every
received by radiation workers and populations. The second (1 d/s = 1 Bq). Megabecquerels (MBq) are com-
sievert also expresses a patient dose that accounts for mon quantities of radioactive material. The traditional
partial-body irradiation. unit of radioactivity was the curie (Ci), where 1 Ci = 3.7
Some types of radiation produce more damage than × 1010 Bq.
x-rays. The sievert accounts for these differences in bio- Radioactivity and the becquerel have nothing to do
logic effectiveness. This is particularly important for with x-rays.
persons working near nuclear reactors or particle accelera-
tors. More about effective dose is discussed in Chapter 35.
Fig. 1.11 summarizes the conversion from the tra-
ditional units of occupational radiation exposure to SI The becquerel (Bq) is the unit of radioactivity.
units.␣

Intensity of
gamma rays Question: 0.05 µCi iodine-125 is used for
measured in Effective dose
measure in sievert (Sv) radioimmunoassay. What is this
gray in air (Gya)
radioactivity in becquerels?
Absorbed Answer: 0.05 µCi = 0.05 × 10−6 Ci
Radioactive material dose
measured measured = (0.05 × 10−6 Ci)(3.7 × 1010 Bq/Ci)
in bequerel (Bq) in gray = 0.185 × 104 Bq = 1850 Bq
in tissue
(Gyt)
␣THE MEDICAL IMAGING TEAM
To become part of this exciting profession, a student
must complete the prescribed academic courses, obtain
clinical experience, and pass the national certification
examination given by the ARRT. Both academic exper-
tise and clinical skills are required of radiographers
(Table 1.6).
FIGURE 1.10 Radiation is emitted by radioactive material. The
Radiologic science programs accredited by the
quantity of radioactive material is measured in becquerel. Radiation
quantity is measured in gray or sievert, depending on the precise use. Joint Review Committee on Education in Radiologic

TABLE 1.5 Special Quantities of Radiologic Science and Their Associated Special Units
INTERNATIONAL SYSTEM
CUSTOMARY UNIT OF UNITS (SI)
Quantity Name Symbol Name Symbol

Exposure Roentgen R air kerma Gya

Absorbed dose rad rad Gray Gyt
Effective dose rem rem Sievert Sv
Radioactivity Curie Ci Becquerel Bq
Multiply R by 0.01 to obtain Gya
Multiply rad by 0.01 to obtain Gyt
Multiply rem by 0.01 to obtain Sv
Multiply Ci by 3.7 × 1010 to obtain Bq
 Occupational Radiation Exposure

Technology (JRCERT) must follow a JRCERT-adopted

Old (rem) New (sievert)
curriculum. One such curriculum is the latest American
100 rem 1 Sv Society of Radiologic Technologists (ASRT) Radiogra-
50 rem 500 mSv phy Curriculum (www.asrt.org/docs/curriculum), which
15 rem outlines a common body of knowledge is essential for
150 mSv
entry-level radiographers.
10 rem 100 mSv The national certification examination for radiogra-
phers is administered by the ARRT. The primary pur-
5 rem 50 mSv
pose of ARRT examinations is to assess the knowledge
1.5 rem 15 mSv and cognitive skills entry-level radiographers need to
1 rem 10 mSv perform their jobs. The ARRT Content Specifications for
Radiography Examination (www.asrt.org/docs/content
500 mrem 5 mSv -specification) outlines the topics covered on the
exam. In addition, the ARRT Task Inventory
100 mrem 1 mSv (www.asrt.org/docs/task-inventory) lists the job respon-
sibilities typically required of entry-level radiographers.
10 mrem 100 !Sv Every medical profession has a scope of practice
which delineates parameters and identifies boundaries
2.5 mrem 25 !Sv for their respected practice, and is formatted as lists of
1 mrem 10 !Sv tasks appropriate as part of the work of the individual
0.75 mrem 7.5 !Sv who is educated and clinically competent for that profes-
sion. The scope of practice for radiographers is outlined
0.5 mrem 5 !Sv
by the ASRT within the Radiography Practice Standards
0.25 mrem 2.5 !Sv (www.asrt.org/docs/practice-standards). Additionally,
0.1 mrem 1 !Sv federal and state laws and accreditation standards are
necessary for participation in medical imaging as a
FIGURE 1.11 Scales for effective dose. radiologic technologist.␣

TABLE 1.6 Task Inventory for Radiography as Required for Examination by the American Registry of
Radiologic Technologists
PATIENT CARE
1. Confirm the patient’s identity.
2. Evaluate the patient’s ability to understand and comply with requirements for the requested examination.
3. Explain and confirm the patient’s preparation (e.g., dietary restrictions, preparatory medications) before performing radio-
graphic and fluoroscopic examinations.
4. Examine radiographic requisition to verify accuracy and completeness of information (e.g., patient history, clinical diagnosis).
5. Sequence imaging procedures to avoid effects of residual contrast material on future examinations.
6. Maintain responsibility for medical equipment attached to patients (e.g., intravenous lines, oxygen) during radiographic
procedures.
7. Provide for patient safety, comfort, and modesty.
8. Communicate scheduling delays to waiting patients.
9. Verify or obtain patient consent as necessary (e.g., with contrast studies).
10. Explain procedure instructions to the patient or the patient’s family.
11. Practice standard precautions.
12. Follow appropriate procedures when in contact with a patient in isolation.
13. Select immobilization devices, when indicated, to prevent patient movement.
14. Use proper body mechanics or mechanical transfer devices when assisting patients.
15. Before administration of a contrast agent, gather information to determine the appropriate dosage and to discern whether
patient is at increased risk for an adverse reaction.
16. Confirm type of contrast media to be used and prepare for administration.
17. Use sterile or aseptic technique when indicated.
18. Perform venipuncture.
19. Administer intravenous contrast media.
20. Observe patient after administration of contrast media to detect adverse reactions.
21. Obtain vital signs.
22. Recognize need for prompt medical attention and administer emergency care.
23. Explain postprocedural instructions to the patient or the patient’s family.
24. Maintain confidentiality of the patient’s information.
25. Document required information (e.g., radiographic requisitions, radiographs) on the patient’s medical record.
16 PART I Radiologic Physics

TABLE 1.6 Task Inventory for Radiography as Required for Examination by the American Registry of
Radiologic Technologists—cont’d
RADIATION PROTECTION
26. Clean, disinfect, or sterilize facilities and equipment and dispose of contaminated items in preparation for the next examina-
tion.
27. Evaluate the need for and use of protective shielding.
28. Take appropriate precautions to minimize radiation exposure to the patient.
29. Question female patient of childbearing age about possible pregnancy and take appropriate action (e.g., document
response, contact physician).
30. Restrict the beam to limit the exposure area, improve image quality, and reduce radiation dose.
31. Set kVp, mA, and time or automatic exposure system to achieve optimum image quality, safe operating conditions, and
minimum radiation dose.
32. Prevent all unnecessary persons from remaining in the area during x-ray exposure.
33. Take appropriate precaution to minimize occupational radiation exposure.
34. Wear a personnel radiation monitoring device while on duty.
35. Evaluate individual occupational exposure reports to determine whether values for the reporting period are within estab-
lished limits.
EQUIPMENT OPERATION
36. Prepare and operate the radiographic unit and accessories.
37. Prepare and operate the fluoroscopy unit and accessories.
38. Prepare and operate specialized units.
39. Prepare and operate digital imaging devices.
IMAGE PRODUCTION
40. Remove from the patient or table all radiopaque materials that could interfere with the radiographic image.
41. Select appropriate equipment and accessories (e.g., grid, compensating filters, shielding) for the examination requested.
42. Use radiopaque markers to indicate anatomic side, position, or other relevant information (e.g., time, upright, decubitus,
postvoid).
43. Explain breathing instructions before beginning the exposure.
44. Position the patient to demonstrate the desired anatomy with body landmarks.
45. Using calipers and technique charts, determine appropriate exposure factors.
46. Modify exposure factors for circumstances such as involuntary motion, casts and splints, pathologic conditions, and the
patient’s inability to cooperate.
47. Process exposed images.
48. Prepare the digital or computed image receptor for exposure.
49. Verify the accuracy of patient identification on radiography.
50. Evaluate radiographs for diagnostic quality.
51. Determine corrective measures that should be used if radiographs are not of diagnostic quality and take appropriate action.
52. Store and handle the film or cassette in a manner that will reduce the possibility of artifact production.
EQUIPMENT MAINTENANCE
53. Recognize and report malfunctions in the radiographic or fluoroscopic unit and accessories.
54. Perform basic evaluations of radiographic equipment and accessories.
55. Recognize and report malfunctions in processing equipment.
56. Perform basic evaluations of processing equipment and accessories.
RADIOGRAPHIC PROCEDURES
57. Position the patient, x-ray tube, and image receptor to produce diagnostic images of the following:
a. Thorax
b. Abdomen and gastrointestinal studies
c. Urologic studies
d. Spine and pelvis
e. Cranium
f. Extremities
g. Other: arthrography, myelography, venography, and so on
 C H A PT E R 1 Essential Concepts of Radiologic Science 17

SUMMARY 3. Describe how weight is different from mass.

Radiology offers a career in many areas of medical 4. Name four examples of electromagnetic radiation.
imaging, and it requires knowledge of medicine, biol- 5. How is x-ray interaction different from that seen in
ogy, and physics (radiologic science). This first chapter other types of electromagnetic radiation?
weaves the history and development of radiography 6. What is the purpose of x-ray beam filtration?
with an introduction to medical physics. 7. Describe the process that results in the formation of
Medical physics includes the study of matter, energy, a negative ion and a positive ion.
and the electromagnetic spectrum of which x-rays are a 8. What percentage of average radiation exposure to a
part. The production of x-radiation and its safe, diag- human is attributable to medical imaging?
nostic use serve as the basis of medical imaging. As well 9. What is the velocity of the mobile x-ray imaging
as emphasizing the importance of radiation safety, this system if the hospital elevator travels 20 m to the
chapter presents a detailed list of clinical and patient next floor in 30 s?
care skills required of radiographers. 10. A radiographer has a mass of 58 kg. What is her
This chapter also introduces the various standards weight on Earth? On the moon?
of measurement and applies them to concepts associ- 11. The acronym ALARA stands for what?
ated with several areas within radiologic science. The 12. Name devices designed to minimize radiation expo-
technical aspects of radiologic science require the sure to the patient and the operator.
identification and proper use of the units of radiation 13. Liquid hydrogen with a boiling temperature of 77
measurements. K is used to cool some superconducting magnets.
What is this temperature in degrees Celsius? In
degrees Fahrenheit?
CHALLENGE QUESTIONS 14. What are the three natural sources of whole-body
1. Define or otherwise identify the following: radiation exposure?
a. Energy 15. What naturally occurring radiation source is
b. Derived quantity responsible for radiation dose to lung tissue?
c. Ionizing radiation 16. How would you define the term “radiation”?
d. Air kerma 17. What are the four special quantities of radiation
e. The average level of natural environmental radia- measurement?
tion 18. Place the following in chronologic order of appear-
f. The Coolidge tube ance:
g. Fluoroscopy a. Digital fluoroscopy
h. Acceleration b. American Society of Radiologic Technologists
i. The term applied to the chemistry of the body (ASRT)
j. Barium platinocyanide c. Computed tomography (CT)
2. Match the following dates with the appropriate d. Radiographic grids
event: e. Automatic film processing
a. 1901 1. Roentgen discovers x-rays. 19. List five clinical skills required by the ARRT.
b. 1907 2. Roentgen wins the first Nobel Prize in 20. What are the three units common to the SI and
Physics. MKS systems?
c. 1913 3. The Snook transformer is developed.
d. 1895 4. The Coolidge hot-cathode x-ray tube The answers to the Challenge Questions can be found by logging on
to our website at http://evolve.elsevier.com.
is introduced.