2By the end of the first part of the session you should be able to: Understand what can happen as x-ray interact with matterDescribe Compton scattering and the photoelectric effectDescribe the biological effects of ionizing radiation
3What happens when the x-rays meet the patient? The photons striking matter can:Be scattered with no loss of energyBe absorbed with total loss of energyBe scattered with some absorption and loss of energyPass through unchangedKey terms:Scattering – change in direction of a photonAbsorption – energy removed from the photon beamAttenuation – reduction in x-ray intensityIonization – removing an electron producing negative and positive ions
4Refresh –Ions have the same number of protons (defining the element) but different number of electrons giving an overall charge of the atomInterractions depend on the energy of the incoming photon, including:Photoelectric effect (pure absorption)Pair production (pure absorption)Rayleigh scattering (pure scatter)Compton scattering (scatter and absorption)The two ones of importance in dentistry are:
6Xray photon interacts with inner shell electron All energy gets absorbed and the inner shell electron (photoelectron) is ejected and goes on to interact with other atoms ejecting electronsOuter shell electrons fill the vacancy emitting energy (light or heat)Energy must be greater or equal to inner shell binding energy to eject it.Higher density (higher atomic number) atoms have more bound inner electrons so probability of photoelectric interactions increases
7Photoelectric absorption proportional to cube of the atomic number (Z) since greater number of inner bound electronsLead Z = 82 so good absorber of X-raysSoft tissue Z = 7 Z3 = 343Bone Z = 12 Z3 = 1728This difference in radio-density accounts for contrast on radiographsPredominates at low energiesLow energy = high absorption dose but good radiographsOverall effect ionization, photoelectron can go on to interact with other atoms
8Involving outer shell electrons Electron is ejected energy difference between incident photon and Compton recoil electron emitted as a scattered photonResult ionizationIncoming photon energy must be higher than binding energy of outer shell electronRecoil electrons can continue to interact with other atoms
9The energy of the incoming photon affects the angle of the scatter. The atomic number of the material has no effect on the amount of Compton absorption so will not contribute to increased contrast.The forward scatter could diminish the quality of the image so anti scatter grids are used.
10Compton NOT dependent on atomic number (Z) Pair production at around 1000keV producing an electron and positron pairCompton NOT dependent on atomic number (Z)Energy (1000keV)
11Intensity – the number of photons in the x-ray beam As distance away from the source increases, the intensity reduces by the square of the distanceAt 2r away, the intensity would be ¼ the intensity than at r.At 3r away, the intensity would be 1/9th the intensity than at r.The thickness of the material affects how reduced the intensity is
12Somatic deterministic Somatic Stochastic Genetic Stochastic Biological effects:3 main types:Somatic deterministicSomatic StochasticGenetic StochasticSomatic – relating to ‘normal’ cells of the bodyGenetic – relating to future generationsDeterministic – will happenStochastic – can happenStochastic effects can be:Acute/immediate or chronic/long term
13Somatic deterministic effects: These are effects on the body that WILL happen after dose of radiation has exceeded the threshold dose.e.g. cataracts, reddening of skinSomatic stochastic effects:These are effects on the body that MAY happen when exposed to any dose of radiation (no threshold). Each exposure carries a possibility of inducing stochastic effectlower dose = lower probability of damageStochastic effects can be:Acute/immediate happening shortly after exposure orChronic/long term happening after a long period of time e.g. leukaemia
14Genetic stochastic effects Genetic mutations can happen at random, but MAY also be caused by ionizing radiationaffecting DNA in reproductive cells. There is no threshold dose.Foetal x-rays are regulated by law due to the high sensitivity to deformation, particularly around 2-9 weeks gestation. Large doses can result in congenital deformation, lower doses can result in mental retardation.DNA can be affected since the X-ray or high energy electron (e.g. Compton recoil electron or photoelectron) can ionize important molecules e.g. DNA, RNA, proteins & enzymes
17Genetic code gives instructions about how to build cells Genetic code gives instructions about how to build cells. Some coding doesn’t appear to have an effect or can be recessive, other mutations can alter the instructions and cause problems
18Damage to DNA depends on: Type and number of bonds brokenIntensity/type of radiationTime between exposuresCells ability to repairStage in cell cycle
19Review:What is it called when an incoming photon changes it’s direction?What are the two main attenuating processes that affect x-ray absorption?The photoelectric affect deals with which type of electron shells (inner or outer)?The Compton effect absorbs energy (true or false)The Compton effect involves which type of electron shells (inner or outer)?Which of these depends on the atomic number of the material it is passing through? Photoelectric/ComptonWhich process doesn’t improve contrast on a radiograph?What happens to the intensity of the photon stream as the thickness of material increases?What happens to the intensity of the photon beam as you move away from the source?