optimisation in radiography e lec Flashcards
to look at methods of dose reduction in radiography
what are the three principles of radiation protection
justification
optimisation
limitation
how to reduce dose
is called optimisation- this happens by selection criteria avoiding lapses in quality assurance unnecessary duplication of x rays equipment and technique factors
what is the x ray tube made up from
sealed glass envelope
vacuum
anode(copper) with tungsten inset
cathode filament of tungsten wire
where do electrons move
from negative to positive
what is the mains supply to the x ray tube
240 volts
how do we generate an x ray
we can generate a high potential difference kV to accelerate electrons across the x ray tube using a step up transformer
we can also provide low current to heat up the tube filament using a step down transformer
why is a low current needed
to heat up the tube filament
what is the low current caused by
by a step down transformer
how can we make this more efficient
constant potential or DC unit
what is the advantages of using a constant potential
keeps the KV at its peak throughout exposure more high energy useful x rays produced fewer low energy useless x rays produced shorter exposure time eliminates the filament warm up time reduces dose by 0.8
what is the disadvantage of a constant potential
decreased contrast
what is the effect on dose altering kvp
at a lower dose the photoelectric effect predominates which is pure absorption
lower energy electrons produced which may reach the patient
by increasing the KVP from 50 to 65, it can reduce thr effective dose by half
what happens at a lower dose
the photoelectric effect predominates which is pure absorption
what tube potential do we use for intraoral radiography tube
no lower than 50 kV
what do we do if the tube potential is under 45 kV
withdrawn immediately
what should the potential of new equipment be
60-70 kV
what haooens when the kV is increased
it reduces the dose to the patient
what happens to the film in low kV
a very contrasty film
what type of filtration do we have
inherent and added
how much aluminium do we need for 70 kv
1.55mm
what should be the length of aluminium above 70kV
2.5mm of which 1.5mm should be permanent
what happens if you add too much filtration
then the exposure times get too long
what does collimation do
shapes and limits the size of the beam
what can we use as a collimater
metal disc or cylinder
what was previously recommended as a collimater
circular and as 6cm
what do we now use as a collimatar
size 2 film rectangular collimation
what happens to the dose when you use a rectangular collimater instead of a circular
you can half the dose
what is the spacer cone length
dose follows the inverse square law
what does the intensity equal
1/d2 where d is the distance
how do we reduce magnification
we can reduce magnification by the focal spot to object distance to be as long as possible- but the x ray beam intensity reduces
what is the long cone paralleling technique
produces images with minimal distortion
what is the minimum focus to skin distance if greater than 60kV
20cm
what is the focus to skin distance if it is less than 60kV
10cm minimum
what happens to the dose when you have a short cone
if you are greater than 60kV and a short cone it increases the dose by 1.5
which spacer cone shape is better
the open ended cone is better than the pointer cone
which is the fastest conventional film for intraoral
F speed
how much faster is E speed from D speed
twice as fast
how much % decrease is digital image receptors
dose reductions of upto 90% but usually in comparison of D speed
how much is rare earth intensifying screens reduce dosage in extraoral image receptors
REDUCED BY 50% compared with calcium tungstate
what do we use for intra oral x rays
film holders
what is the adv of film holders
reduces retakes
more reproducible
the projection geometry was optimal
what is recommended with the panoramic technique
field trimming and sectional option
what are diagnostic reference levels
national levels which you can compare equipment on
may have ti set your own standards
what is the achievable dose
intraoral radiography
1.8mG
on a 70kV with E speed film
what is the diagnostic reference level of panoramic x ray
66.7mGy/mm
what do we do if we operating at or above the diagnostic reference level
withdraw ASAP doesn’t matter about operating kV
what do we do if we operating 2x above diagnostic reference level
withdraw immediately doesn’t matter about operating kV
what is the equivalent background radiation of 2 bitewings
8-16 hrs
what is the equivalent background radiation of panoramic
2-5 days
what is the equivalent background radiation of the skull
40 hours
what is the equivalent background radiation of barium meal
15 months
what is the effective dose in microSv for intraoral radiograph
1-8.3 microSv
what is the effective dose in microSv for anterior maxillary occlusal
8 microSv
what is the effective dose in microSv for panoramic
3.85-30 microSv
what is the effective dose in microSv for lateral cephalometric radiograph
2-3 microSv
what is the effective dose in microSv for cross sectional tomography
1-189 microSv
what is the risk of fatal cancer from a intraoral radiograph
0.02-0.6 per million
what is the risk of fatal cancer from a panoramic
0.21-1.9 per million
what is the risk of fatal cancer from a anterior maxillary occlusal
0.4 per million
what is the risk of fatal cancer from a lateral cephalometric radiograph
0.34 per million
what is the risk of fatal cancer from a cross sectional tomography
1-14 per million
what is the risk in relation to age under 10
multiplication factor for risk is x3
what is the risk in relation to age 10-20
multiplication factor for risk is x2
what is the risk in relation to age 20-30
multiplication factor for risk is x1.5
what is the risk in relation to age 30-50
multiplication factor for risk is x0.5
what is the risk in relation to age 50-80
multiplication factor for risk is x0.3
what is the risk in relation to age 80+
negligible risk
what are other forms of lead protection
thyroid collar
what do we use a thyroid collar for
our lateral cephalometric radiograph
why do we use a thyroid collar
the thyroid is in the field of view and the younger patients have multiplicand associated risk
what is CBCT
CONE BEAM computed tomography