Equipment for Fluoroscopy

and Angiography
Philip Brentnall
University of the West of England

Definitions

Fluoroscope

An instrument for observing or exhibiting

fluorescence
A fluorescent screen for observing the shadows
cast by objects placed in the path of the xx-rays
An xx-ray machine that combines an xx-ray source
and a fluorescent screen to enable direct
observation

Fluoroscopy

Examination of body structure or organs using a

fluoroscope

Fluoroscopy

Dynamic imaging
Display for immediate viewing
Dynamic images

Recording of still and motion images

(cine)
Storage of still and motion images

Issues in Fluoroscopy/Angiography

Tube cooling
Image reproduction
Dynamic viewing
Recording system
Dynamic
Stills

Storage requirements

Radiation protection

Angiography

A description of blood vessels and

lymphatics
The vessels are demonstrated by
injecting contrast media into the
vascular system.

Principles of Fluoroscopy

Transmitted xx-ray beam emerging from the

patient is incident on the sensitive input
area of an image intensifier
Instantaneous (dim) image is produced by
the phosphor screen
Energy from the fluorescence of the
phosphor screen is magnified (intensified)
by accelerating resultant electrons through
a vacuum
The output phosphor screen demonstrates a
brighter image

Recording systems

100mm cine film

100mm cut film
Video
VHS
Betacam

Spot films
Digital
Magneto Optical Disk
DICOM networked storage

Analogue

Films taken at specific times

Frames per second

Image intensifiers

What does an
image intensifier
do?
Why use an II?

Construction of an II

A vacuum tube - glass or titanium

Encased in lead protection
Minimise xx-ray leakage
Lead glass aperture for access to output
image

Diameter of circular input area ranges

from 12 - 30cm
Size increases bulk and cost of the II

Construction of an II
1 = Evacuated glass envelope
2 = Input phosphor screen
(15 30cm)
3 = Photocathode
4 = Cylindrical electrodes
5 = Aluminium backing of
output phosphor.
6 = Phosphor output screen

Construction of II

Construction of II

Convex front
Maintains a constant distance between every
point on the input image and the eventual
output image

Phosphor layer acting as fluorescent screen

converts xx-rays to light
Commonly sodium activated caesium iodide
High xx-ray absorption and energy conversion
with needle like crystal shapes

High resolution

Phosphor Crystal

Photocathode

lightlight-sensitive, electronelectron-emitting layer

Compounds of
Caesium or
Antimony
Emits electrons
when it receives
energy
Light from the
phosphor crystals

Photocathode

Emits electrons proportional to the

intensity of the light energy it
receives.
Potential difference within the II
increases energy of the electrons
2525-35 kV

Electrodes focus beam of electrons to

converge at the opening of the anode

Anode

Acts as an accelerator
Electrons do not make contact with
anode
Shields electrons from focusing
electrodes

Output Phosphor layer

Electrons diverge after entering anode
Electrons striking the silver activated zinc
cadmium sulphide phosphor layer cause light to
emitted in proportion to the energy of the
electron

Summary
Image generated at the input is recreated as a
smaller and more intense image by accelerating
electrons across a vacuum

Multiply field sizes in an II

Dual field / triple field size (zoom) facility

Restricted central part of input has image
magnified to full size of viewing area.
Achieved by using focusing electrodes

Optical integrity in an II

Maintained by
Accurate alignment of the permanent structures
Accuracy and uniformity of the electric fields

Image Quality

Barrel effect

Pincushion effect

Vignetting

Loss of resolution

Lag

Straight lines appearing to curve inwards

Straight lines appearing to curve outwards
Image fading around the perimeter
Deterioration of phosphor
Time delay between images

Image distribution

Closed circuit television system

CCD chip
Image capture device
Cine film
Spot films

Optic Coupling

Fibre optic link between II and

TV camera

Relatively cheap
Simple
Very compact
Coin shaped disc (25mm x 25mm)
Formed of very fine light pipes
tightly packed into a circular frame
Resolution is well maintained
Can only be used in scenarios
where photofluorography/cine is
not required

Beam Splitting

Very expensive system

Bulky
More versatile system of coupling
Two very high quality fast lenses are used in a tandem
arrangement
Telecentric beam permits the use of a beam splitting mirror

Television camera

Sensitive input surface the same size as the output

phosphor of the II tube.
Converts the light image into an electric signal
Electric signal is transmitted to the television screen
(CRT) to form a visible image
Vidicon tube image persistence, lag (poor for
rapidly moving objects)
Plumbicon tube No perceptible persistence (ideal
for recording rapidly moving structures Higher
noise level)

Television monitor

Signal is amplified from TV camera &

transmitted to the television monitor
TV monitor & TV camera form the closed
circuit TV chain
Consists of a cathode ray tube & its associated
circuits
The intensity of the signal from the TV tube is
transmitted to the fluorescent screen of the
monitor (anode) & causes it to glow
Obviously the intensity of light output is
dependent on the strength of the signal &
hence the xx-ray intensities into the image
intensifier

Power supply to Fluoroscopy equipment

Usually 80 100 kW
medium frequency micromicroprocessor controlled
generator
Integration of control
console typical
Option to select various
examination factors

Fluoroscopy XX-ray tube

Medium - large anode diameter

(100 125 mm)
Focal spot sizes = 0.6/1.2mm
Anode angle = 12 16 degrees
Anode heat capacity = 210 225 kJ
Anode rotation speed = Normal
= 2700 rpm, high speed = 9700
rpm
Water cooled
Adjustable Cu filter

Equipment configurations

10

Notes

Frame Rates
Pulsing

11