1. Factors affecting the X-Ray output
Dr. Nahla Nagy

2. What is intensity? Quantity Quality Intensity:
Total energy contained in the beam (product of quality and quantity of x-ray photons) per unit area per unit time
Quantity is the number
Quality is the energy
Together = the intensity of the X-ray

3. X-Ray Quantity
X-ray quantity: measure of the number of x-ray photons in the useful beam.
AKA x-ray output, intensity, or exposure
Unit Roentgen (R)
Directly affected by:
Miliamperage-second (mAs)
Kilovoltage (kVp)
Distance (d)

4. X-Ray Quality
X-ray quality: : measurement of the penetrating ability of the x-ray beam.
Describes the distance an x-ray beam travels in matter.
High energy x-ray photons travel farther in matter- more penetrating
Numerically represented by the Half-value layer (HVL).

5. Factors Affecting Intensity
Factors affecting intensity of x-ray beam actually affect no. of photons or penetration power of photon in x-ray beam.
Target Material
X-ray Tube Current (Miliamperage- mA)
Tube voltage (kVp)
Exposure time (s)
Filtration
Collimation
Source to film distance

6. Target Material Determines efficiency of X-ray production
Higher the atomic number- greater will be the efficiency of the production of x rays

7. X-ray Tube Current (mA)
Produced by flow of electrons from their point of origin (filament) to the anode (target) of x-ray tube
A change in filament voltage of about 5% result in % change in x-ray tube current (mA)
Hotter filament emits more electrons and adds electrons to the current electrons (mA) across the x-ray tube
Increased mA means increase in quantity of electrons available to hit the target -that results an increase in the quantity of x-ray photons

8. mA is directly proportional to quantity of x-ray beam
y axis = number of X-ray photons (quantity)
x axis = energy of X-ray photons (quality)
Area under the curve = intensity (product of quantity and quality)

9. Exposure Time (s)
1) Increasing time (s) heats filament for a longer time.
2) Longer the filament is heated more electrons are produced.
3) Increase in quantity of electrons

10. mAs (miliamperage seconds)
mA multiplied by s
mA and exposure time have a direct effect on the quantity of X-ray photons produced
mAs is the product of mA (current) and exposure time (seconds); determine total number of x-ray photons produced
The miliamperage required for a given exposure is inversely proportional to the exposure time
mAs Rule:
Original mA x Original time = New mA x New time

11. (original mA x original time = new mA x new time)
Example
In an examination controls are set for 10 mA and time is 30 sec, what is the mAs?
10mA x 30s = 300 mAs
If mA is increased to 15, how much time is required to produce same mAs?
(original mA x original time = new mA x new time)
10mA x 30s = 15mA x Xs
           X = 20 sec.

12. Tube Voltage (kVp)
Increasing kVp increases potential difference between the cathode and anode.
kVp controls the speed of the electrons, increasing kVp will
increase the number of x ray photons produced per unit time
Shorter wavelength and more penetrating photons of x-ray radiation are produced (i.e., increases speed)
Increase in quantity and quality of x-rays.
Quantity = number (speed)
Quality = energy

13. Increasing kVp, increases both number and energy of x-rays
Drastic increase in intensity (area under the graph)

14. Tube Voltage (kVp) Intensity is proportional to (kVp)2
In dentistry to maintain same density :rule of thumb
Increase of 15 kVp requires halving the exposure time
Decrease of 15 kVp requires doubling the exposure time
If kvp doubled from 50 to 100-x ray intensity increases by factor of four

15. Filtration
Filtration is the removal of low energy, less penetrating photons from x-ray beam by placing filter in the path of x- ray beam.
Filters are aluminum sheets placed at the end of the tube where x-rays exit

16. Filtration Types of Filtration Inherent-X-ray tube and its housing
Added-Sheets of metal placed in the path of the beam
The patient

17. Filtration No. of photons decreas
Mean (average) energy of photons increase
Maximum energy is unchanged
Effects quality and quantity of x-ray beam

18. Half value Layer
Definition: The thickness of an absorber required to reduce the number of x-ray photons passing through it by one half of its original value
In dentistry :
69 kVp/ below         HVL of 1.5mm Al
70-90 kVp               HVL of 2.5 mm Al

19. Collimation
A collimator is a metallic barrier with an aperture in the middle used to reduce the size of the x-ray beam, thus, the volume of irradiated tissue within patient is also reduced
Main Functions
Protect the patient
Decrease the scatter radiation

20. Collimation Reduces patient exposure Reduces scatter radiation
Increases film quality

21. Round beam limiting device, 20 cm (8”) focus-film distance, 6 cm (2,36”) output field diameter. 
Rectangular beam limiting device as an option to reduce patient’s exposure to radiation.

22. Collimation Number of photons decreases
Mean energy of photons is unchanged
Maximum energy of the photons is unchanged

23. Source –film distance Inverse Square Law
The x-rays of primary beam emerge from the
protective tube housing not as parallel rays but as divergent rays
Intensity of the x-ray beam decreases as the distance from the
source increases
Inverse Square Law
The intensity of the X ray beam is inversely proportional to square of the source-film distance
I1/I2 = (D2)2/(D1)2

24. Source –film distance
Doubling the SFD distance ,exposure time will have to be increased by the factor of 4 to maintain the same density on the film

25. Inverse Square Law No of photons decreases
Mean energy of photons is unchanged
Maximum energy of the photons is unchanged

26. Review Factors affecting Quality kVp Factors affecting intensity
Filtration
Factors affecting intensity
Tube voltage (kVp)
Current (mA)
exposure time (s)
Filtration
Collimation
Source to film
distance
Factors affecting Quantity
kVp mA
Exposure time Filtration Collimation
Distance

27. Thank You