BASIC PRINCIPLES OF

RADIOLOGY
Bachtiar Murtala

BASIC PRINCIPLES OF
RADIOLOGY
Bachtiar Murtala

General objective
To provide a basic understanding of
ionizing radiation and other sources as a
tool of diagnosis

Specific objectives :
- Types of radiation sources
- Equipments
- Basics of interpretation
- Biologic effects
- Radiation protection

History in brief
Radiology started when Prof.Wilhelm Conrad Roentgen
discovered of a new kind of rays (x-rays) in November
8,1895 in Germany
He made a first photograph of his wifes (Bertha) hand in
Dec 22, 1895 using the rays, signed the true birthday of
radiology as a medical specialty.
He was awarded Nobel Prize in Physics in 1901
Later, CT (Computed Tomography) and US
(Ultrasonography) introduced in the seventies dan MRI
( Magnetic Resonance Imaging ) in the eighties.
CT was discovered by Sir Godfrey Hounsfield, and
together with Allen Cormack , awarded Nobel Prize in
1979.

Radiology can be categorized as

Diagnostic radiologyRadiations
(ionizing and nonionizing ), used as a tool
to make diagnosis of diseases.
Radiotherapy or radiation oncology
--radiation used as an agent to eradicate
tumor/cancer

Types of radiation source

Radiations can be categorized into two
main forms :
(1) Electromagnetic
X-rays,gamma-rays, uv, infra red, visible
light, radio waves.

(2) Particles
Electron, positron,etc

X-ray
To develop of x-ray beam, we need :
A vacuum tube
Electrons
Focusing cup
Metal filament
Target

 In conventional radiography, after passing the

body, x-ray will create an image directly on
photographic film.
The film is covered by a thin emulsion of Silver
Bromide (AgBr), which is very sensitive to x-rays
and visible light, blackening the film after
having developed in liquid developer ( washing
processing )

Terms in conventional radiography

Darkness to brightness

Hyperradioluscent : free-air
Radioluscent
: lung, fat tissue
Intermediate
: soft tissues,water/fluid
Radiopaque
: Calsium, bone
Hyperrariopaque : metal

CT-Scan
(Computerized Tomography Scan )
The greatest step forward since the discovery of
X-rays. First CT-Scan was introduced in 1972.
X-rays pass the patient and reach detectors ( not
on the film )
Only thin tissue slices are exposed by X-rays
high contrast resolution, no superimposition/
blurring of structures
Tissue and water/fluid can be distinguished ( in
conventional radiography can not be )

Terms in CT
Hyperdense : blood, calcification, bone
Isodense/normodense : normal soft
tissues such as; brain, liver, spleen,etc
Hypodense : fluid, edema, fat, abscess,
tumor, etc

HU=Hounsfield Unit

Radionuclide Imaging
( Nuclear medicine )
Radioactive introduced into the body of
the patients orally or intravenously
Detection of radiation emitted from
radioactive tracer inside the patient
Radioactive tracers, termed
radiopharmaceuticals emit gamma rays.
Gamma camera is used to detect the rays
and produce image.

Two major tomographic methods :

(1) SPECT ( single photon emission
computed tomography)
(2) PET ( positron emission tomography )

Ultrasonography
Ultrasound (US) sound wave freq >20
KHz (above the human hearing range)
Commonly used : 2-10 MHz
No biologic effects

Components
Transducer/probe which contain piezoelectrical crystals ( the main component )
These crystals act as both
transmitter/produce ultrasound and
receiver (of echo)
Computer and dysplay
Printer

 The most important part is transducer

Transducer contains piezoelectric crystals
with two functions : transmitter of US and
receiver of echo
Echo returning to transducer generates
electrical signalscomputer image

Terms in US
Hyperechoic = echorich brightness :
calcification, stone, gas
Isoechoic= normoechoic : normal soft
tissue; liver, spleen, etc
Hypoechoic = echopoor : tumor, abscess
Free-echoic = unechoic : fluid ;water,etc

MRI
( Magnetic Resonance Imaging )
The latest newcomer of radiological modalities
Exploits hydrogen nuclei (proton) of the human
body to develop signal
Images in any plane of any part of the body
No ionizing radiation No biologic effects
Contraindication for patients with using
ferromagnetic material such as pacemaker
More expensive, theoretically more difficult, and
technically more advanced

Main Components

A very strong magnet ( 0.1-1.5 Tesla or > )

A radio transmitter
A radio frequency receiver coil
A computer

Terms in MRI
T1WI, T2WI, DWI, etc
(T1 Weighted Image)
Hyperintense : brightness
Isointense
: same with normal adjacent
tissue
Hypointense : darkness

T1WI
T2WI

Positioning in radiography
In conventional radiography, we should
familiar with the routine positions
PA : Postero-anterior
AP : Anterio-posterior
RLD : Right lateral decubitus
LLD : Left lateral decubitus
etc

Foto2

Biologic effects
Come from X-rays and gamma-rays since
they can ionize atoms/molecules of
human tissue
Can be grouped into : immediately effects,
latent somatic effects, and manifest
genetic damage

Principles of radiation protection

Should be apply to : patient, personnel,
and environment / around people
Work with : - shorten time,
- appropriate distance,
- use protective tools
Avoid and reduce somatic and genetic
doses to as low as possible ( ALARA, As
Low As Reasonably Achievable )

Thank you

Nama Radioaktif

Energi
SinarGamma
( MeV )

Half - life

- Radium-226

0.029-2.43

1620 Th

- Caesium-137

0.662

30 Th

- Cobalt- 60

1.17 & 1.33

5,3 Th

- Iridium-192

0.296 & 0.613

74 hari

- Iodine-131

0.364 & 0.637

8 hari

- Gold-198

0.411

2-7 hari

- Technetium-99m 0.140

6 jam