Effect of medical care on acute radiation syndrome


Effect of an anti-scatter grid on incident beams.


X-ray  of a left hand, with automatic calculation of bone age by a computer software


Bones of the hand and wrist used for bone age estimation in the Tanner-Whitehouse method.


Bone scan showing multiple bone  metastases  from  prostate cancer .


Method of obtaining Caldwell's view


Example of a particle collimator


An example of an optical collimator with a bulb, an aperture (A), and a plano-convex lens (L)


Collimators used to record gamma rays and neutrons from a nuclear test.


How a Söller collimator filters a stream of rays. Top: without a collimator. Bottom: with a collimator.


Collimator for a  neutron  stream, University of Washington  cyclotron


AP radiograph demonstrating companion shadow of the clavicle


A rib companion shadow (indicated by two arrows)


"Family" phantom series [ 10 ]


Real-life motion data (left) is acquired on a motion capture platform (center) and used to determine the posture of the CHAD phantom (right). [ 34 ]


Drawing of CT fan beam and patient in a CT imaging system


CT scan of the thorax. The axial slice (right) is the image that corresponds to number 2/33 on the coronal slice (left).


CT Perfusion scan of the brain


PET-CT scan of chest


Computed tomography of  human brain , from  base of the skull  to top. Taken with intravenous contrast medium.  Commons: Scrollable computed tomography images of a normal brain


HRCT  images of a normal thorax in  axial ,  coronal  and  sagittal planes , respectively.  Click here to scroll through the image stacks.


Bronchial wall thickness (T) and diameter of the bronchus (D)


Example of a CTPA, demonstrating a saddle  embolus  (dark horizontal line) occluding the  pulmonary arteries  (bright white triangle)


CT scan of a normal abdomen and pelvis, in  sagittal plane ,  coronal  and  axial  planes, respectively.  Click here to scroll through the image stacks.


Types of presentations of CT scans:  − Average intensity projection −  Maximum intensity projection − Thin slice ( median plane ) −  Volume rendering  by high and low threshold for  radiodensity


Typical screen layout for diagnostic software, showing one volume rendering (VR) and multiplanar view of three thin slices in the  axial  (upper right),  sagittal  (lower left), and  coronal planes  (lower right)


Special planes are sometimes useful, such as this oblique longitudinal plane in order to visualize the neuroforamina of the vertebral column, showing narrowing at two levels, causing  radiculopathy . The smaller images are axial plane slices.


3D human skull from computed tomography data


CT scanner with cover removed to show internal components. Legend:  T: X-ray tube  D: X-ray detectors  X: X-ray beam  R: Gantry rotation


Left image is a  sinogram  which is a graphic representation of the raw data obtained from a CT scan. At right is an image sample derived from the raw data. [ 201 ]


Interface of  Medical Sieve , an algorithm by  IBM  for assisting in clinical decisions.


Histogram Equalization Sample Image. Left: Normal gray-scale fundoscopic image. Right: Post-histogram equalization processing. [ 79 ]


Support Vector Machine. Support vectors (dashed lines) are created to maximize the separation between two groups.


DXL Calscan Bone densitometry


DEXA assessment of bone mineral density of the femoral neck (A) and the lumbar spine (B): T scores of - 4.2 and - 4.3 were found at the hip (A) and lumbar spine (B), respectively in a 53-year-old male patient affected with  Fabry disease .


DXA Fat shadow of an obese individual


DXA Fat shadow of a child with rare congenital generalized lipodystrophy


Sonographer doing an echocardiogram of a child


Echocardiogram in the parasternal long-axis view, showing a measurement of the heart's left ventricle


Coronary artery IVUS with lumen inside yellow line and atherosclerotic plaque in green


External dose quantities used in radiation protection and dosimetry


Graphic showing relationships of protection dose quantities in  SI  units


Heart Disease across the world


Biospace Med logo


oneFIT Medical logo


ALARA logo


Main components of a G-arm medical imaging system. Here positioned for a hip surgery.


Multiplan, medical imaging system from 1970. Patented and manufactured by Saab AB, Sweden.


a Hirtz compass


Unprotected experiments in the U.S. in 1896 with an early X-ray tube ( Crookes tube ), when the dangers of radiation were largely unknown. [ 1 ]


Otto Walkhoff:  Invisible rays with photographic effect , Photographic Review, Vol. 14, Publisher Knapp, 1900, pp. 189–191


Auto-photographic documentation of the radiation damage to the hands of Kassabian


Radiology memorial (Hamburg-St. Georg)


In 1947, posters were put up in the United States to draw attention to radiation protection. At the same time, the four-year-old term  health physics  was to be popularized.


Pedoscope from the 1930s by Ernst Gross X-ray equipment, Berlin,  Physikmuseum Salzburg . Later, an additional viewing slit for small children was added at a suitable height so that the child could also see the fluoroscopy.


X-ray therapy for diphtheria, 1922. The X-ray table was designed specifically for the treatment of children to eliminate the dangers of high voltage wires.


Warning sign for MRI scans


Schematic representation of Photoacoustic Tomography


Types of radiation for various examination procedures in radiology:  MRI ,  IR ,  CT ,  PET


First lead aprons and lead gloves to protect against X-rays, around 1920


Radiation protection splint


Dental panoramic X-ray ( orthopantomography , OPG) using DXIS (Direct X-ray Imaging System) in real-time display


Tomotherapy


Prohibition sign in the restricted area of Darmstadt Hospital


A small animal PET


World's first X-ray and ultrasound examination of a  killer whale  (orca), 1980s


Radon experiments at the  Radium Institute in Paris , 1924


Digital radon detector


Memorial to the victims of forced labor in Jáchymov (St. Joachimsthal)


Personal shielding for the work with radium (1929)


Advertising poster for the toothpaste "Kolynos" from the 1940s


Radithor


Advertising for luminous dials (1921)


Radium Girls at work in the USA (1922-1923)


Illuminated dial with radioluminescence


Cosmetic series Tho-Radia.  Curie Museum , Paris


Uranium glazed ceramic cookie jar


Probe to measure environmental radioactivity


Injection syringe of a radionuclide with associated lead coating


PET-CT, Philips, Gemini TF


Lead packaging for  131 I sodium iodide


Injection of  99m Tc. To protect the therapist, the injection syringe with the radionuclide is surrounded by a shield.


Afterloading device


Brachytherapy with radium for the treatment of nasal mucosal inflammation in a young girl, Paris, ca. 1948-1955


Thorotrast


Mushroom cloud from " Fat Man " over  Nagasaki , August 9, 1945


A US shelter from  radioactive fallout  during the  Cold War , 1957


Calculation of casualties from 20 targeted nuclear bombs dropped on the Federal Republic of Germany during the Cold War in 1966 with at least 15 million fatalities (shaded areas) [ 151 ]


Warning sign in front of the Hanford Site


Potassium iodide in a dose for nuclear emergencies


Experts from the  International Atomic Energy Agency  in Fukushima, 2013


Loading of a Castor container in Dannenberg in March 2001; 10th Castor transport to Gorleben/Wendland


Attempt at a more comprehensible warning against radioactive radiation ( ISO 21482 , since 2007)


Measurement of cosmic radiation in an aircraft of the  Environmental Protection Agency  (EPA) founded in 1970, Las Vegas National Research Center, a US agency for the protection of the environment, 1972


NASA  design for a  space station  on  Mars  to protect against radioactive radiation during  Mars colonization . The materials needed for construction would be available on Mars.


Radiation Assessment Detector


Schematic structure of a film dosimeter


Film dosimeter


Geiger counter, 1932,  Science Museum , London.


Thermoluminescence dosimeter in the form of a finger ring for measuring radiation exposure to fingers and hands


Constancy test of a dental X-ray image using a test specimen. The degree of blackening is compared with the original image at regular intervals.


137 Cs   test source . The radioactive material is contained in the two shiny metallic bodies, the enclosed emitters. The yellow shells are lead transport containers.


Trinity obelisk commemorating the first nuclear explosion on July 16, 1945


The on-board radar of the  Lockheed F-104  (Starfighter) had to be adjusted during operation, which led to high radiation exposure.


Russian protective suit for work on radar systems. Hack Green Nuclear Bunker Museum, Nantwich, England


Spectrum of electromagnetic waves; below the range of visible light.


Inuit goggles


Poster warning of eye damage from sunlight, Office for Emergency Management. War Production Board, USA, ca. 1942


Warning of optical radiation in accordance with  DIN EN ISO 7010


UV irradiation of children to stimulate the formation of vitamin D in  rickets , 1925


Advertisement by Philips for a sun lamp, 1946


Warning signs against laser beams according to  DIN EN ISO 7010


Matches can be lit within tenths of a second using a powerful laser pointer.


Protective clothing designed to protect against the waves of radio telegraphs (1911).


Warning sign about radiation from mobile phone systems, starting from the church tower in  Heiden  in the canton of  Appenzell   Ausserrhoden  in Switzerland, which is reflected in the shop window, 2010.


Warning of non-ionizing radiation in accordance with  DIN EN ISO 7010


Body scanner


Images from a terahertz scanner


Scanner for hand luggage


Short-wave diathermy (1944)


Long-wave diathermy device by the doctor and founder of diathermy  Karl Franz Nagelschmidt , 1908


German radiation passport


Radiation protection areas


Remote-controlled robots with high-purity  germanium  detectors (high-purity  single crystal ) are used to identify radioactive substances.


CT scan of the thorax with window level set to -700 HU (lung)


CT scan of the thorax with window level set to -1,000 HU (air)


CT scan of the thorax with window level set to 0 HU (water)


CT scan of the thorax with window level set to 60 HU (liver)


Unspecific cortical lesion on  CT scan  is confirmed cystic and benign with  contrast-enhanced   renal ultrasonography .


Positive John Thomas sign in patient with right femoral enchondroma


obtained from the  CT  "slices"


Schematic of a cylindrical superconducting MR scanner. Top: cross section of the cylinder with primary coil, gradient coils and RF transmit coils. Bottom: longitudinal section of the cylinder and table, showing the same coils and the RF receive coil.


A mobile MRI unit


Effects of TR and TE on MR signal


Examples of T1-weighted, T2-weighted and  PD-weighted  MRI scans


Diagram of changing magnetization and spin orientations throughout spin-lattice relaxation experiment


Patient being positioned for MR study of the head and abdomen


Radiologist  interpreting MRI images of head and neck


MRI diffusion tensor imaging of  white matter  tracts


MR angiogram in congenital heart disease


Magnetic resonance angiography


Motion artifact (T1 coronal study of cervical vertebrae) [ 142 ]


Marie Curie driving a " Little Curie  [ fr ] " in 1915


Structural magnetic resonance imaging (structural MRI) of a head, from top to base of the skull


Sagittal MRI slice at the midline


Axial MRI slice at the level of the  basal ganglia , showing fMRI  BOLD  signal changes overlaid in red (increase) and blue (decrease) tones


The eye of an  owl


Cytomegalovirus  infection of a lung  pneumocyte , showing owl's eye appearance of a large cell at center


Cytomegalovirus neuronal inclusions showing the owl's eye sign


A child-friendly MRI scanner


A Peruvian child mummy being placed onto a CT machine for imaging


A 3D image of the skull of an Incan mummy


Two mummified Egyptian cats with a radiograph of the cat on the left


An X-ray of Tutankhamun's skull, the arrow pointing to a possible cause of death


Statue of Paramesses (later known as Ramesses I), pharaoh of Egypt during the  19th Dynasty , New Kingdom Egypt


Taking an X-ray image with early  Crookes tube  apparatus, late 1800s.


The first radiograph


Schematic of a basic rectilinear scanning system


Method of obtaining Schuller's view


Surgical planning using  bone segment navigation  for the osteotomy of the jaw bones, based on models fixed into an  articulator  (registration based on infrared devices)


Surgical planning using  bone segment navigation  for the osteotomy of the left  orbit , based on  stereolithographic models  (registration based on infrared devices)


A CT scan of a patient's chest is displayed through  teleradiology .


Figure 1: Parallel beam geometry utilized in tomography and tomographic reconstruction. Each projection, resulting from tomography under a specific angle, is made up of the set of line integrals through the object.


Resulting tomographic image from a plastic skull phantom. Projected X-rays are clearly visible on this slice taken with a CT-scan as image  artifacts , due to limited amount of projection slices over angles.


A fan-beam reconstruction of Shepp-Logan Phantom with different sensor spacing. Smaller spacing between the sensors allow finer reconstruction. The figure was generated by using MATLAB.


The influence of Poisson noise in deep learning reconstruction where Poisson noise causes the U-Net fail to reconstruct an existing high contrast lesion-like object.


An  abscess  and a THAD (white arrow) on a  contrast CT  in native, arterial, portal and delayed phase. [ 1 ] [ predatory publisher ]


Differentiating pathology in maxillary sinus


Onhgren's line


Method of obtaining Waters' view


Charles Alexander Waters


A modern dental X-ray tube. The heated cathode is on the left. Centre is the anode which is made from tungsten and embedded in the copper sleeve.


Spectrum of the X-rays emitted by an X-ray tube with a  rhodium  target, operated at 60  kV . The smooth, continuous curve is due to  bremsstrahlung , and the spikes are  characteristic K lines  for rhodium atoms. Note that the emission starts around wavelength of 20pm corresponding to E=hc/λ.


Crookes X-ray tube from early 1900s. The cathode is on the right, the anode is in the center with attached heat sink at left. The electrode at the 10 o'clock position is the anticathode. The device at top is a 'softener' used to regulate the gas pressure.


Coolidge side-window tube (scheme)  C: filament/cathode (-) A: anode (+) W in  and W out : water inlet and outlet of the cooling device


Simplified rotating anode tube schematic  A: Anode C: cathode T: Anode target W: X-ray window


typical rotating anode X-ray tube


Two high voltage rectifier tubes capable of producing X-rays


Endovascular modalities for intracranial aneurysms [ 2 ]


Endovascular repair of  cerebral aneurysm


Intra-cranial angioplasty and stent of basilar artery  stenosis


TIPS procedure schematic


Biliary stenosis


A very large (9 cm or 3.5 in) fibroid of the uterus causing pelvic congestion on US


TACE


Takayasu arteritis angiography


Venous access port catheter


A  coronary angiogram  (an X-ray with radio-opaque contrast in the coronary arteries) that shows the left  coronary circulation . The distal  left main coronary artery  (LMCA) is in the left upper quadrant of the image. Its main branches (also visible) are the  left circumflex artery  (LCX), which courses top-to-bottom initially and then toward the centre-bottom, and the  left anterior descending  (LAD) artery, which courses from left-to-right on the image and then courses down the middle of the image to project underneath the distal LCX. The LAD, as is usual, has two large diagonal branches, which arise at the centre-top of the image and course toward the centre-right of the image.


Balloon-tipped catheter.


Balloon inflated with stent


Diagram of a balloon catheter


Lung biopsy in a case of suspected lung cancer under control of  computed tomography .


Illustration of an AngioJet; coronary thrombectomy


Post-embolization arteriogram showing coiled aneurysm (indicated by yellow arrows) of the posterior cerebral artery with a residual aneurysmal sac


Abdominal aortic endograft on a CT scan; original aneurysm marked in blue


An example of a physician-modified aortic endograft with fenestrations added to accommodate the visceral branch arteries


Artist's rendering of a branched/fenestrated EVAR in the visceral segment  of the aorta above an abdominal aortic aneurysm


Resected middle cerebral artery aneurysm filled with multiple coils.


A 3D reconstruction of the  Circle of Willis  derived from a CT angiogram.


Hemorrhoids before and after hemorrhoidal artery embolization


Image showing an inferior vena cava filter in its position


Inferior vena cava filter as seen on plain X ray of the abdomen


Abdominal radiograph shows that one of the legs (arrows) of the IVC filter is pointed away from the expected IVC lumen.


Axial CT image confirms that one of the legs (arrow) of the IVC filter has migrated out of the IVC wall into an adjacent tissue.


(A)  Renal ultrasonograph  of  percutaneous  nephrostomy tube placed through a calyx in the lower pole of a kidney with hydronephrosis. (B) The pigtail catheter is placed in the dilated calyx. The tube in (A) and the pigtail in (B) are marked with white arrows. [ 1 ]


Various settings of a 6  French  pigtail catheter with locking string, obturator (also called  stiffening cannula ) and puncture needle.  A . Overview  B . Both puncture needle and obturator engaged, allowing for direct insertion.  C . Puncture needle retracted. Obturator engaged. Used for example in steady advancement of the catheter on a guidewire previously inserted into the renal pelvis through a thin needle. D . Both obturator and puncture needle retracted, when the catheter is in the renal pelvis.  E . Locking string is pulled (bottom center) and then wrapped and attach to the superficial end of the catheter.


Cytopathology  of peritoneal fluid from paracentesis ( Pap stain ), showing typical features of  adenocarcinoma


Large volume abdominal  ascites


Small fluid collection in  Morison's pouch


Ascitic fluid, 7 litres, drained during paracentesis


CT scan showing radiofrequency ablation of a liver lesion


Schematic view of a pulmonary vein ablation. The catheter reaches (from below) through the inferior vena cava, the right atrium and the left atrium, to the orifice of the left upper pulmonary vein.


A set of equipment to perform the Seldinger technique


A balloon-expandable coronary stent on a balloon catheter


Compressed and expanded peripheral artery stents


Example of a ureteral stent used to alleviate  hydronephrosis  of the kidney


Example of a stent/catheter used in the prostate to treat an enlarged prostate and provide relief in cases of obstructed urination


Endoscopic  image of a  self-expanding metallic stent  in an  esophagus , used to  palliatively  treat  esophageal cancer


Endoscopic image of a biliary stent seen protruding from the  ampulla of Vater  at the time of duodenoscopy


Endovascular aneurysm repair  using large stent grafts


The illustration shows a person having thoracentesis. The person sits upright and leans on a table. Excess fluid from the pleural space is drained into a bag.


Instruments for thoracocentesis and needle biopsy of the pleura [ 8 ]


Steps in a TIPS procedure: A) portal hypertension has caused the  coronary vein  (arrow) and the  umbilical vein  (arrowhead) to dilate and flow in reverse. This leads to varices in the esophagus and stomach, which can bleed; B) a needle has been introduced (via the jugular vein) and is passing from the hepatic vein into the portal vein; c) the tract is dilated with a balloon; D) after placement of a stent, portal pressure is normalized and the coronary and umbilical veins no longer fill.


Illustration of uterine fibroids with examples of their possible locations


After access to the femoral or radial artery is established through needle puncture, interventional radiologists use image guidance to perform the procedure. The screen in front of the doctors provides a live image of the tools that are being used throughout the procedure as they navigate to the artery that they would like to embolize (block off). Administration of embolizing agents that are used to block off the arteries can also be seen in real-time.


An external vascular closure device of radial artery following a cardiac catheterization. The device allows for gradual release of pressure over the puncture site, reducing patient discomfort, until closure is achieved.


Cement in a vertebra as seen on plain Xray.


A CT image of cement used in kyphoplasty that has entered the spinal channel and is pressing on the spinal cord resulting in neurological symptoms


The dark areas on both sides of the intestines indicate that air is present in both sides.  This is called "Rigler's sign".


Sagittal reformat from a CT scan of the chest showing air crescent sign in a patient with invasive fungal infection. There is a rounded cavity in the apical right upper lobe, with a non-dependant soft-tissue nodule within it. Also there is some subtle ground-glass opacity surrounding the lesion.


Chest CT scan showing crazy paving pattern


Frontal view of the abdomen with double bubble sign, patient was found to have duodenal atresia.


Dural tail sign seen associated with a meningioma


Empty sella in MR imaging


High-resolution CT image showing ground-glass opacities in the periphery of both lungs in a patient with COVID-19 (red arrows). The adjacent normal lung tissue with lower attenuation appears as darker areas.


High-Resolution CT image in a patient with Pneumocystis pneumonia infection showing ground-glass opacities.


CT image showing ground-glass opacification in the posterior of the right lung (screen left).


CT image showing patchy areas of ground-glass opacities representing pulmonary edema.


CT image showing diffuse GGOs throughout both lungs. An abscess is also noted in the right lung (screen left).


CT image in patient with COVID-19 showing bilateral ground-glass opacities at the periphery of both lungs.


This PA chest radiograph demonstrates an abnormal contour in the right hilar region, with visualization of the pulmonary vessels through the mass (the hilar overlay sign) indicating its posterior mediastinal location. On resection this was found to be a benign  solitary fibrous tumor  of the pleura.


Radionuclide scan showing no intracranial blood flow. The hot nose sign is manifest.


Large jackstone in the bladder of a 60-year-old man


Kerley B lines in a patient with  congestive heart failure .


X-ray shoulder showing light bulb sign (left) in posterior shoulder dislocation. The image on the right was taken after reposition.


A massive left pleural effusion displacing the heart and trachea to the right


Massive right sided pleural effusion later confirmed to be a hemothorax


Empyema  progression seen on the left side of the chest over the course of 2 weeks.


Axial CT image showing a large left sided mass that appears attached to the pleura.


Chest x-ray demonstrating severe atelectasis or collapse of the right lung and mediastinal shift towards the right.


Chest x-ray demonstrating pulmonary agenesis. There is a mediastinal toward the left and hyperinflation of the right lung.


Chest x-ray showing pectus excavatum with leftward shift of heart shadow.


CT axial view showing pectus excavatum of the chest.


Chest x-ray showing an individual who had their right lung removed with fluid accumulating in the operated side.


Chest x-ray in an infant showing aspiration of a metallic coin without signs of mediastinal shift.


An axial CT image showing bullous emphysema of the lungs. There are larger air pockets on the right than left.


Chest x-ray of infant showing CPAM in the left lung causing a mediastinal shift towards the right. The cysts appear as bubbles in the left lung.


Distinct fibrotic scar and hilar opacity following secondary tuberculosis on chest x-ray


Anatomic illustration of the greater omentum (blue) and its proximity to other peritoneal contents including small intestine, transverse colon, stomach, and liver


Massive pericardial effusion showing 'water bottle heart' sign


A  vestibular schwannoma  (VS) is only one type of tumor


Axial and coronal view of abdominal CT angiography


Volume rendered CTA of renal arteries in patient with medial fibromuscular dysplasia


CTA of a vascular malformation with intraventricular hemorrhage


In  volume renderings , automatic bone removal (used in the right image) is helpful for visualizing the intracranial vessels.


Volume rendered CT scan of abdominal and pelvic blood vessels.


A  CT scan  image showing a ruptured  abdominal aortic aneurysm .


FIGURE 1. Non-contrast CT demonstrating multiple bilateral renal calculi (arrows), which can be obscured on contrast-enhanced images, particularly delayed images when there is excreted contrast in the renal collecting system; axial left, coronal reformat on right. [ citation needed ]


FIGURE 3. Axial (left) and coronal (right) CT angiography images of the abdominal aorta evaluating for aortic aneurysm. [ citation needed ]


FIGURE 4: Arterial and portal venous phase CT of cholangiocarcinoma. Selected images from a biphasic CT demonstrating early arterial enhancement of a posterior right hepatic lobe mass with mild wash out on delayed phase images in the setting of cirrhosis characteristic of hepatocellular carcinoma. [ citation needed ]


FIGURE 5. Selected images form CT performed using a Cholangiocarcinoma specific protocol. 5a is a portal venous phase image demonstrating a single low attenuation mass which does not appear to enhance. 5b is a 15 minute delayed image which demonstrates delayed enhancement of the liver mass (arrow) characteristic of Cholangiocarcinoma. Several other enhancing masses (arrowheads) are also seen which were not evident on the portal venous phase images. [ citation needed ]


FIGURE 6. Selected images from a biphasic CT of Focal Nodular Hyperplasia in the left hepatic lobe (arrow). These masses have characteristic early arterial enhancement (6a) with contrast wash out on the portal venous phase images (6b) from the mass making these lesions difficult to identify on portal venous phase images alone. [ citation needed ]


FIGURE 8. Selected images from a CT Urography protocol CT. 8a is an axial CT image from the renal parenchymal phase. There is a mildly enhancing soft tissue mass in the left renal pelvis (arrow) consistent with a transitional cell carcinoma. Figure 8b (coronal reformats) and 8c (left oblique coronal reformats) demonstrate the double bolus technique of CT Urography. These images confirm soft tissue mass (arrows) in the renal pelvis with contrast excretion into the collecting system (arrowheads). [ citation needed ]


FIGURE 9. Selected images from a pancreatic protocol. 9a is a noncontrast CT image demonstrating subtle fullness in the region of the pancreatic neck (arrow). 9b is a CT image performed during the early arterial phase during which there is opacification of the arterial structure with subtle fullness in the pancreatic neck (arrow). The pancreas is not enhancing during this phase. 9c was performed in a late arterial/pancreatic phase demonstrating normal enhancement of the pancreas (arrowhead) with a hypoenhancing mass (arrow) in the pancreatic neck. The pancreatic mass is more visible during this phase. [ citation needed ]


Volume rendering  of an abdominal CT.


A "lung window" CT scan showing a  lung cancer  in the left lung


Fig. 1. An incidentally discovered colloid nodule with calcification, shown on CT scan of a 58-year-old female patient. a Non-enhanced axial CT scan of the neck demonstrates a coarse calcification at the left thyroid inferior pole. b Sagittal grey scale ultrasound of the thyroid demonstrates a heterogeneous nodule with a predominant cystic component. Calcification was not seen in the ultrasound, probably due to its lower location in the superior mediastinum. [ 1 ]


Fig. 2. A 51-year-old female patient post left hemithyroidectomy, with incidentally discovered a right thyroid colloid nodule on CT scan. an Enhanced axial CT scan of the neck demonstrates a well-defined, hypodense right thyroid nodule (white arrow) with no internal calcifications or cervical lymphadenopathy. b Transverse greyscale thyroid ultrasound demonstrates a well-defined, hypoechoic right thyroid lobe nodule with a central echogenicity including comet tail (ring down) artefacts (white arrow). No vascularity (not shown) or calcifications were detected.


Fig. 3. An incidental PTC in a 62-year-old male patient with lymphoma. a, b Enhanced axial CT scan and fused PET/CT scan of the neck demonstrate a well-defined, hypodense right thyroid nodule (white arrow) with high FDG uptake. The FDG-avid uptake in the left side (circle) is related to patient's known lymphoma, which resolved after treatment. c, d Transverse greyscale and sagittal colour Doppler ultrasound of the neck demonstrate a right thyroid irregular hypoechoic lesion with some micro-calcifications (white arrows) and increased vascularity. [ 1 ]


Fig. 5. A poorly differentiated invasive left thyroid mass in a 58-year-old female patient. a Sagittal greyscale neck ultrasound shows a large hypoechoic lesion with macro-calcification and micro-calcification. b Sagittal colour Doppler ultrasound shows left internal jugular vein filling defect with detected internal vascularity suggestive of tumour thrombus. c Enhanced axial and coronal CT scans of the neck show heterogeneously enhancing large lesion replacing the left thyroid lobe and extending to the isthmus and the medial aspect of the right thyroid lobe (white arrow). The mass and the conglomerate lymph nodes measure 12.5 × 7 × 5.8 cm (white arrows). d, e Axial enhanced CT scans show enlarged left cervical nodes (white arrow) and left internal jugular vein (IJV) thrombus (black arrows). Note the IJV distention and central enhancing portion in the upper cut (black arrow in e) concerning the tumour thrombus. f, g Enhanced axial CT scan of the upper chest demonstrate a mass extension into the retrosternal area, left tracheoesophageal groove, and posterior to the trachea (white arrows in f). There are multiple bilateral pulmonary nodules (white arrows in g). [ 1 ]


Fig. 10. Metastatic squamous cell carcinoma of unknown origin in a 42-year-old female patient. a, b Axial and coronal enhanced neck CT scan demonstrate infiltrative hypodense left thyroid lobe lesions (white arrows). There are multiple necrotic cervical nodal metastases (white block arrows). [ 1 ]


Fig. 16. Midline ectopic thyroid with Hashimoto's thyroiditis in a 49-year-old female patient. a Transverse greyscale ultrasound shows a 1.6 × 0.8 cm solid, well-defined, heterogeneous area (white arrow) in the midline, superior to the thyroid gland. It is iso-echogenic to the thyroid gland with no definite connection to the thyroid gland. b Transverse colour Doppler ultrasound shows significant increase in vascularity. c Axial enhanced neck CT scan at the level of thyroid cartilage demonstrates midline infrahyoid hyperdense soft tissue mass (white arrow) embedded within the strap muscle. [ 1 ]


Fig. 22. A 26-year-old male patient with elevated serum parathyroid hormones and calcium secondary to intra-thyroid parathyroid adenoma. a, b Enhanced axial and coronal CT scan of the neck demonstrate a well-defined hypodense right thyroid nodule (white arrows). c Bone window coronal CT scan shows lytic expansile lesions at the right mandible and left frontal bone (white arrows). d Transverse colour Doppler ultrasound of the neck demonstrates a well-defined, heterogonous, predominantly hypoechoic right thyroid nodule measuring 2.7 cm, with mild increased vascularity and no internal micro-calcifications (white arrow). e, f Delayed anterior planar and fused SPECT/CT parathyroid Sestamibi scan at 2 hours demonstrate persistent focal activity in the right thyroid lobe (white arrows). Note the scattered mandibular/maxillary uptakes in planar image representing the known brown tumours. [ 1 ]


Principle of CBCT.


Impacted wisdom tooth seen on CBCT.


Pulmonary emboli can be classified according to level along the  pulmonary arterial  tree.


CT pulmonary angiogram showing segmental and subsegmental pulmonary emboli on both sides.


Flat panel detector used in digital radiography


EOD (Explosive Ordnance Disposal) training and material testing. A 105 mm shell is radiographied with battery powered portable X-ray generator and flat panel detector.


Direct x-ray imaging system (DXIS) - real time display


An illustration of the source/detector motion involved in linear tomography, with in-focus objects in the slice plane (red and purple) and blurred objects above and below (orange and green)


Normal (left) versus cancerous (right) mammography image


Illustration of a mammogram


A mobile mammography unit in New Zealand


A panoramic radiograph of a 9 year old in mixed dentition


A basic panoramic radiograph


A Panoramic radiography machine.


Panoramic radiograph showing horizontally impacted lower wisdom teeth.


Minimally-displaced fracture in right mandibular. Arrow marks fracture, root canal on central incisor, teeth to the left of fracture do not touch


Panoramic radiograph showing  Stafne defect  (arrowed).


Dental panoramic radiograph showing  dentigerous cyst  (arrowed).


DXIS - real time display


Arrows point to two vertical white lines which is how calcifications in the first part (proximal component) of the internal carotid artery appear on panoramic radiographs.


A line drawing depicting a panoramic radiograph with an ovoid atheroma in the bifurcation region of the common carotid artery (CCA) as it bifurcates (divides) in the neck into the internal carotid artery (ICA) which supplies blood to the brain and the external carotid artery (ECA) which supplies blood to the face and mouth.


X-ray absorption (left) and differential phase-contrast (right) image of an in-ear headphone obtained with a grating interferometer at 60kVp


A. Snigirev


Drawing of attenuation and phase shift of electromagnetic wave propagating in medium with complex index of refraction n


Drawing of crystal interferometer


Drawing of a grating Bonse-Hart interferometer.


Drawing of analyzer-based imaging


Drawing of Propagation-based imaging


Drawing of Grating-based imaging


The optical Talbot Effect for monochromatic light, shown as a "Talbot Carpet". At the bottom of the figure the light can be seen diffracting through a grating, and this exact pattern is reproduced at the top of the picture (one Talbot Length away from the grating). Halfway down you see the image shifted to the side, and at regular fractions of the Talbot Length the sub-images are clearly seen.


Diagram of Electronic Phase Stepping (EPS). The source spot is moved electronically, which leads to movement of the sample image on the detector.


An x-ray far-field interferometer using only phase gratings is based on the phase moiré effect. The mid grating forms Fourier images of the first grating. These images beat with the 3rd grating to produce broad moiré fringes on the detector at the appropriate distance. Phase shifts and de-coherence of the wavefront by the object cause fringe shifts and attenuation of the fringe contrast.


Drawing of Edge-illumination – sample positions resulting in increased (above) and decreased (below) detected counts are shown.


Drawing of laboratory-based edge-illumination, obtained through (“coded”) aperture x-ray masks.


The benefit of phase contrast mammography relative to absorption contrast for (1) a tumor structure (“tumor”), (2) a glandular structure (“glandular”), (3) a microcalcification (“MC”), and (4) an air cavity (“air”) as a function of target size at optimal energy and equal dose. [ 97 ]


Brain perfusion SPECT shows dental pain patients with  analgesia  (top row) versus  placebo  (bottom row).


Nanotheranostics combines therapy and diagnosis in a single nanoplatform, enhancing treatment results in cancer and other diseases. Targeting nanotherapeutics improves delivery and effectiveness for diverse genetic and translational pathologies.


Tomosynthesis of a lung with  chronic fibrosing pulmonary aspergillosis .


Radiation therapy for a patient with a  diffuse intrinsic pontine glioma , with radiation dose color-coded


Histopathology of radiation cystitis, including atypical stromal cells ("radiation fibroblasts")


The beam's eye view of the radiotherapy portal on the hand's surface with the lead shield cut-out placed in the machine's gantry


A teletherapy radiation capsule composed of the following:  an  international standard source holder  (usually lead), a retaining ring, and a teletherapy "source" composed of two nested stainless steel canisters welded to two stainless steel lids surrounding a protective internal shield (usually uranium metal or a tungsten alloy) and a cylinder of radioactive source material, often but not always  cobalt-60 . The diameter of the "source" is 30 mm.


Varian  TrueBeam  Linear Accelerator , used for delivering IMRT


A SAVI brachytherapy device


X-ray treatment of  tuberculosis  in 1910.  Before the 1920s, the hazards of radiation were not understood, and it was used to treat a wide range of diseases.


Proposed mechanism of the abscopal effect, mediated by the immune system. Here, local radiation causes tumor cell death, which is followed by adaptive immune system recognition, not unlike a vaccine.


Simulated radiation dose of an electron in water, where the ionization energy of water at ~10 eV shows a resonant dose enhancement. The upper and lower curves are the short and long limiting ranges, respectively. In a vacuum, the kinetic energy  1 ⁄ 2 m e v 2  = 1 eV implies an electron velocity of 6×10 7  cm/s, or 0.2 percent of the speed of light.


The Bragg curve of 5.49 MeV alphas in air has its peak to the right and is  skewed  to the left, unlike the x-ray beam below.


The dose produced by a native and by a  modified proton beam  in passing through tissue, compared to the absorption of a photon or x-ray beam


The first cobalt machine in Italy, installed in  Borgo Valsugana  in 1953.


Ève Curie , Coutard, Queen  Mary of Teck , and the  Viscountess Runciman  in 1937


Coutard  (pictured far right)  in 1937 with other leading cancer researchers


DIBH treatment


Another DIBH treatment


A cumulative DVH from a radiotherapy plan.


Joanna Izewska gives Ambassador Frank Recker and his delegation a tour of the  IAEA  Dosimetry Laboratory.


External radiation protection dose quantities in SI units


Graphic showing relationship of SI radiation dose units


Note the rapid falloff for 4 MeV electron compared to X rays and Protons.


Gallium scan showing panda (A) and lambda (B) patterns, considered specific for  sarcoidosis  in the absence of histological confirmation


CT scan (left) and gallium PSMA PET scan (right) of patient with prostate cancer metastases in the bones


The Finsen hospital lamp, 1900. The projecting tubes can be adjusted so as to permit the focusing of the light, which is directed through a hollow lens that's kept pressed down upon the part under treatment. The nurses and patients are wearing dark glasses to protect the eyes from the light.


X-ray apparatus used for treatment of epithelioma of the face, 1915. The tube is in a localizing shield, and a perforated sheet of metal is securely fashioned to the surface by adhesive plaster. [ 16 ]


Small tubes containing radium salts are strapped to a woman's face to treat what was either lupus or rodent ulcer, 1905. [ 22 ]


Glass applicators for radium emanation, 1918 [ 25 ]


Illustration showing a tube for applying radium salts, 1918 [ 26 ]


X-ray treatment of  tuberculosis  in 1910


Advertisement for a scientifically developed radiation emanation activator. [ 5 ]  This particular device is suggested for use by Augustus Callé in a textbook on post-graduate medicine. [ 36 ]


The Revigator "radioactive water crock" (1930s)


"Tho-radia" powder, based on  radium  and  thorium , according to the formula of Dr Alfred Curie


MLC shape of an X-MLCs


Leaves, changing shape, direct the beam to the right  cancer  area


Nuclear physicist at the  Idaho National Laboratory  sets up an experiment using an electronic neutron generator.


Neutristor  in its simplest form as tested by the inventor at Sandia National Laboratories


Neutristor  in an inexpensive vacuum sealed package ready for testing


Relative sensitivity. This figure illustrates the typical change in the relative radiosensitivity for a biological effect such as cell death when exposed to radiations of low ionizing density (e.g. x-rays). The hyperbolic relationship shown has a maximum OER of 2.70 for 100% oxygen (at 760 mmHg), with a half-range OER value at 4.2 mmHg or 0.55% of oxygen.


Change with ionizing density. This figure illustrates the trend in the relative radiosensitivity or OER with oxygen tension for radiations of different ionizing density or linear energy transfer (LET, keV/μm). The inhibition of clone-formation by cultured human cells was measured after exposure to alpha-particles, deuterons and 250 kVp x-rays by Barendsen et al. (1966). The range of the maximum OER for 100% oxygen (at 760 mmHg) was 2.7 for 250 kVp x-rays dropping to 1.0 for 2.5 MeV alpha-particles. In each case the OER curves shown assume a half-range OER value of 4.2 mmHg or 0.55% oxygen.


Cell survival. This figure is illustrative of the reduction in the OER from aerobic to anoxic conditions for lower compared to higher doses, which has a bearing on the choice of dose fractionation exposures for radiotherapy of tumours.


A pencil-beam radar


A moving or sweeping pencil-beam radar


In 1675, a pencil was interpreted as a double cone of rays, as from an object point, through a lens, to an image point.


Definitions of  ray ,  pencil , and  beam  in Henry Coddington's 1829  A System of Optics , Part 1


The two image in the top row (the image on the left hand side is plotted on log scale and on the right hand side is plotted on linear scale) show the output of the spectral analysis showing its frequencies components grouped around three clusters, referred to as high, intermediate and low frequencies, supporting the assumption of three compartments in the Hawkins model corresponding to plasma, bone ECF and bone mineral compartment respectively. The image at the bottom row shows the IRF plotted using the frequency components obtained previously.


A bone TAC is modelled as a convolution of measured arterial input function with IRF. The estimates for IRF are obtained iteratively to minimise the differences between the bone curve and the convolution of estimated IRF with input function curve. The curve in green shows the initial estimates of the IRF and the blue curve is the final IRF which minimises the differences between the estimated bone curve and the true bone curve.  K i  is obtained from the intercept of the linear fit to the slow component of this exponential curve which is considered the plasma clearance to the bone mineral, i.e. were the red line cuts the y axis.


A diagrammatic view of the process of kinetic modelling using Hawkins model used to calculate the rate of bone metabolism at a skeletal site. C p  refers to the plasma concentration of the tracer, C e  refers to the tracer concentration in ECF compartment, C b  refers to the concentration of tracer in bone mineral compartment, M1 refers to mass of tracer in the C e  compartment, M2 refers to the mass of tracer in the C b  compartment, C T  is the total mass in the C e +C b , PVE refers to the partial volume correction, FA refers to the femoral artery, ROI refers to region of the interest, B-Exp refers to the bi-exponential, .


Patlak analysis where a linear regression is fitted between the data on y- and x-axis to obtain the estimates of the Ki, which is the slope of the fitted regression line.


Whole-body PET scan using  18 F-FDG ( fluorodeoxyglucose ). The normal brain and kidneys are labeled, and radioactive urine from breakdown of the FDG is seen in the bladder. In addition, a large metastatic tumor mass from colon cancer is seen in the liver.


PET scan of the human brain


Schematic view of a detector block and ring of a PET scanner


Schema of a PET acquisition process


Complete body PET-CT fusion image


Brain PET-MRI fusion image


A PET scanner released in 2003


Chronic radiodermatitis on the neck and jaw from X-ray exposure


Doctor reviewing a radiation treatment plan


Treatment plan for an  Optic nerve sheath meningioma


Patient undergoing pelvic radiotherapy


Cryopreservation of gametes


A medical radiograph of a skull


Taking an X-ray image with early  Crookes tube  apparatus, late 1800s


The first radiograph


1897 sciagraph (X-ray photograph) of  Pelophylax lessonae  (then  Rana Esculenta ), from James Green & James H. Gardiner's "Sciagraphs of British Batrachians and Reptiles"


Acquisition of  projectional radiography , with an  X-ray generator  and a  detector


Images generated from  computed tomography , including a  3D rendered  image at upper left


Angiogram showing a  transverse projection  of the  vertebro   basilar  and  posterior cerebral  circulation


Radiography may also be used in  paleontology , such as for these radiographs of the  Darwinius  fossil  Ida .


A plain radiograph of the  elbow


AP radiograph of the  lumbar spine


A hand prepared to be X-rayed


Animated sequence of reconstruction steps, one iteration.


An x-ray image receptor, containing an  anti-scatter grid  and three AEC regions (represented by dark grey circles and square) These regions represent anatomical areas, e.g. lungs, spine. They can be selected individually, or all at once depending on the need.


Autoradiography of a coronal brain slice, taken from an embryonal rat.  GAD67 -binding marker is highly expressed in the  subventricular zone .


A radioactive  surgeonfish  makes its own X-ray. The bright area is a meal of fresh algae. The rest of the body has absorbed and distributed enough plutonium to make the scales radioactive. The fish was alive and apparently healthy when captured.


Backscatter technology produces an image that resembles a chalk etching. [ 1 ]


An image of Susan Hallowell, Director of the Transportation Security Administration's research lab taken with backscatter x-ray system.


CO2 Angiogram showing Abdominal Aorta, visceral arteries and iliac arteries


Intermodal  shipping containers


Gamma-ray  image of a shipping container showing two  stowaways  hidden inside


Gamma-ray image of a truck showing goods inside a shipping container


A truck entering a gamma-ray radiography system


Cosmic radiation  image identifying  muon  production mechanisms in  Earth's atmosphere


An early unit for producing medical X-radiographs. The set up does not drastically differ for taking X-rays of cultural objects.


The  Ghent Altarpiece  at the  Altaussee Mine , where it was stored by the Nazis after it was taken from  St Bavo's Cathedral, Ghent . It was later recovered by the  Monuments Men .


The Syndics of the Drapers' Guild  by Rembrandt is in the collection of the  Rijksmuseum  in Amsterdam.


An X-ray of the  Syndics  reveals Rembrandt's earlier compositions for the group portrait.


Detail of  Tiffany glass


Radiograph of the African Songye Power Figure at the Indianapolis Museum of Art


An X-ray of foot inside a shoe


A mummy on display at the Louvre. X-rays provide a non-obtrusive way to research mummies.


Images of the Archimedes Palimpsest were taken under various lighting conditions to uncover gaps and alterations to the text.


Comparison of kinetic images(KIN) and DSA images in abdominal (top row) and iliac regions (bottom row).


DSA (left) and DVA (KIN, right) image pairs, which were created by administering iodinated contrast agent. From top to bottom: abdominal, iliac, femoral, popliteal and crural regions.


DSA (left) and DVA (right) carbon-dioxide angiography image pairs. Top row: abdominal, iliac and femoral region. Bottom row: Popliteal,crural and ankle regions.


A portable aSi flat-panel detector is used to visualise the movement of liquids in sand cores under high pressure.


Light spreading in the scintillator material leads to loss of resolution in indirect detectors which direct detectors do not experience


Flat-panel detector used in  digital radiography


Making a radiograph


A portable wireless controlled battery powered X-ray generator for use in  non-destructive testing  and security.


Gamma-ray  image of  intermodal  cargo container with  stowaways


This torch-type camera uses a hinge. The radioactive source is in red, the shielding is blue/green, and the gamma rays are yellow.


This torch-type camera uses a wheel design. The radioactive source is in red, and the gamma rays are yellow.


A diagram of the S-shaped hole through a metal block; the source is stored at point A and is driven out on a cable through a hole to point B. It often goes a long way along a guide tube to where it is needed.


Single Medipix 2 assembly mounted and wire-bonded on a carrier board.


Principle of photon counting in a single pixel. The radiation generates electron-hole pairs (charge) in the sensor. The charge is collected to the appropriate pixel, amplified and compared with a pre-set comparator level (energy threshold). The counter is increased if the detected pulse is above the energy level.


A density gauge being used to ensure proper  compaction  for the foundation of a school construction project.


Asphalt Density Gauge


AGFA  photographic plates, 1880


Mimosa Panchroma-Studio-Antihalo Panchromatic glass plates, 9 x 12cm, Mimosa A.-G. Dresden


Negative plate


Image resulting from a glass plate negative showing Devil's Cascade in 1900.


The phosphor plate radiography process


A circular cut of a PSP plate


Readout of a PSP plate


CeReO - PSP plate scanner


Linear attenuation as a function of photon energy. The attenuation of a typical human head consisting of 10% bone and 90% brain tissue is decomposed into  photo-electric  +  Compton  bases (blue) and  polyvinyl chloride  (PVC) +  polyethylene  bases (red). The linear attenuation of  iodine  illustrates the effect of a contrast material with a  K absorption edge  at 33.2 keV.


Natural color X-ray  photogram  of a wine scene. Note the edges of hollow cylinders as compared to the solid candle.


Example of a  Crookes tube , a type of  discharge tube  that emitted X-rays


Wilhelm Röntgen


Hand mit Ringen  (Hand with Rings): print of Wilhelm Röntgen's first "medical" X-ray, of his wife's hand, taken on 22 December 1895 and presented to  Ludwig Zehnder  of the Physik Institut,  University of Freiburg , on 1 January 1896 [ 25 ] [ 26 ]


Taking an X-ray image with early  Crookes tube  apparatus, late 1800s. The Crookes tube is visible in center. The standing man is viewing his hand with a  fluoroscope  screen. The seated man is taking a  radiograph  of his hand by placing it on a  photographic plate . No precautions against radiation exposure are taken; its hazards were not known at the time.


Surgical removal of a bullet whose location was diagnosed with X-rays (see inset) in 1897


Images by James Green, from "Sciagraphs of British Batrachians and Reptiles" (1897), featuring (from left)  Rana esculenta  (now  Pelophylax lessonae ),  Lacerta vivipara  (now  Zootoca vivipara ), and  Lacerta agilis


1896 plaque published in  "Nouvelle Iconographie de la Salpetrière" , a medical journal. In the left a hand deformity, in the right same hand seen using  radiography . The authors named the technique  Röntgen photography .


A patient being examined with a thoracic  fluoroscope  in  1940 , which displayed continuous moving images. This image was used to argue that  radiation exposure  during the X-ray procedure would be negligible.


Chandra's image of the galaxy cluster Abell 2125 reveals a complex of several massive multimillion-degree-Celsius gas clouds in the process of merging.


Phase-contrast X-ray image of a spider


X-rays are part of the  electromagnetic spectrum , with wavelengths shorter than  UV light . Different applications use different parts of the X-ray spectrum.


Ionizing radiation hazard symbol


Attenuation length of X-rays in water showing the oxygen  absorption edge  at 540 eV, the energy −3  dependence of  photoabsorption , as well as a leveling off at higher photon energies due to  Compton scattering . The attenuation length is about four orders of magnitude longer for hard X-rays (right half) compared to soft X-rays (left half).


Spectrum of the X-rays emitted by an X-ray tube with a  rhodium  target, operated at 60  kV . The smooth, continuous curve is due to  bremsstrahlung , and the spikes are  characteristic K lines  for rhodium atoms.


Patient undergoing an X-ray exam in a hospital radiology room


A  chest radiograph  of a female patient, demonstrating a  hiatal hernia


Plain radiograph of the right knee


Head  CT scan  ( transverse plane ) slice – a modern application of  medical radiography


Abdominal radiograph  of a pregnant woman


An X-ray protective window at  Birmingham Dental Hospital , England. The maker's sticker states that it is equivalent to 2.24mm of lead at 150Kv.


Each dot, called a reflection, in this diffraction pattern forms from the constructive interference of scattered X-rays passing through a crystal. The data can be used to determine the crystalline structure.


Using X-ray for inspection and quality control: the differences in the structures of the die and bond wires reveal the left chip to be counterfeit. [ 144 ]


X-ray fine art photography of  needlefish  by  Peter Dazeley


Acquisition of  projectional radiography , with an  X-ray generator  and an imaging detector.


Fish bone pierced in the upper esophagus. Right image without contrast medium, left image during swallowing with contrast medium.


A piece of photostimulable phosphor plate


Radiograph  taken during  cholecystectomy


Plot of ion current as function of applied voltage for a wire cylinder gaseous radiation detector.


A radiology room table. The X-ray housing is turned by 90° for a chest radiograph


GemX-160  - portable wireless controlled battery-powered X-ray generator for use in  non-destructive testing  and security.


XR150  - portable pulsed X-ray battery powered X-ray generator used in security.


Acquisition of  projectional radiography , with an X-ray generator and a  detector .


Mobile fluoroscopy units can produce images continuously.


Hand-luggage inspection machine at  Berlin Schönefeld Airport .


X-ray image of a backpack. Organic and inorganic materials are discriminated in using dual energy techniques.


5.5-pound (2.5 kg) dental digital X-ray system under testing in 2011 [ 5 ]


Schematic of an X-ray image intensifier


C-arm of a mobile X-ray unit containing an image intensifier (top)


A planar X-ray system.


An example of a biplanar fluoroscopy system setup, capturing skeletal movements of a rat on a treadmill.


A polycapillary lens for focusing X-rays


Designs based on grazing-incidence reflection used in X-ray telescopes include that by  Kirkpatrick–Baez , and several by Wolter ( Wolter I–IV )


Symmetrically spaced atoms cause re-radiated X-rays to reinforce each other in the specific directions where their path-length difference 2 d  sin  θ  equals an integer multiple of the wavelength  λ


One of the mirrors of  XRISM  made of 203 foils


Chandra X-ray Observatory , launched by NASA in 1999, is still operational as of 2024


Uhuru  X-ray satellite


Photo of  supernova  remnant  Cassiopeia A , taken by the first imaging X-ray telescope,  Einstein Observatory .


Focusing X-rays with glancing reflection


X-rays start at ~0.008 nm and extend across the electromagnetic spectrum to ~8 nm, over which Earth's atmosphere is  opaque .


Chandra 's image of  Saturn  (left) and  Hubble optical image  of Saturn (right). Saturn's  X-ray  spectrum is similar to that of X-rays from the  Sun . 14 April 2003


Scintillation crystal surrounded by various scintillation detector assemblies


Celedonio Calatayud.


Marie Curie  at the Radiological Institute of C. Calatayud


C.Calatayud with  Marie Curie  and  King Alfonso XIII  at the First National Medical Congress, Madrid, 1919


Reception in honor of C. Calatayud held by the  American Medical Association [ 5 ]  at  The Ansonia , New York, 1928


Skiagraph of three-month-old infant by Rowland, 1896


Figure 11-1: Locations that need to be examined during the FAST and eFAST exams.


Figure 11-2: Parasternal long-axis view of the heart.


Figure 11-4: Subxiphoid view of the heart.


Figure 11-6: Cross-sectional diagram demonstrating Morrison’s pouch (hepatorenal) and the splenorenal recess.


Figure 11-7: Hepatorenal view in the right upper quadrant.


Figure 11-9: Splenorenal view in the left upper quadrant.


Figure 11-11: Pouches (recess) in the male and female.


Figure 11-12: Ultrasound of the bladder.


Figure 10-1: Anatomy of the venous system.


Figure 10-2: Valves in the venous system of the leg.


Figure 10-3: Side-by-side transverse ultrasound views of the right common femoral vein without compression and with compression.


Figure 10-5: Side-by-side transverse image of the right profunda femoral vein without and with compression.


Figure 10-7: Side-by-side right femoral vein transverse view without and with compression.


Figure 10-9: Side-by-side right popliteal vein transverse view without and with compression.


Figure 10-11: Side-by-side right gastrocnemius vein transverse view without and with compression.


Figure 10-13: Side-by-side right posterior tibial veins transverse view without and with compression.


Figure 10-15: Side-by-side right peroneal veins transverse view without and with compression.


Figure 10-17: Side-by-side right anterior tibial vein transverse view without and with compression.


Figure 10-19: Side-by-side right great saphenous vein at the saphenofemoral junction transverse view without and with color Doppler.


Figure 10-21: Right great saphenous vein transverse view above the knee.


Figure 10-23: Right great saphenous vein below the knee transverse view.


Figure 10-25: Right small saphenous vein at the saphenopopliteal junction transverse view.


Figure 10-27: Anatomy of the arterial system.


Figure 10-28: Transcranial Doppler probe.


Figure 10-30: The three most common acoustic windows that provide direction to evaluate the intracranial vessels are the transtemporal, transorbital, and transforaminal windows.


Figure 10-31: Side-by-side flow patterns and velocities of the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery on transcranial Doppler.


Figure 10-32: Side-by-side velocities and flow patterns of the right ophthalmic artery and carotid siphon on transcranial Doppler.


Figure 10-33: Side-by-side velocities and flow patterns of the left vertebral artery and basilar artery on transcranial Doppler.


Figure 10-34: Carotid Doppler probe.


Figure 10-35: Right common carotid artery in the proximal transverse plane with the jugular vein on top, demonstrating blood flow in opposite directions.


Figure 10-36: Pulsed wave Doppler with spectral analysis of the common carotid artery in the distal sagittal plane.


Figure 10-39: Sagittal view of the right vertebral artery with color flow.


Figure 10-40: Normal waveform of the right external carotid artery.


Figure 10-41: Schematic of the abdominal aorta showing that it branches into the right and left iliac arteries.


Figure 10-42: Transducer position in the transverse and sagittal planes to evaluate the abdominal aorta.


Figure 10-45: Schematic showing normal anatomical branches of the arterial system in the lower extremity.


Figure 10-48: Sagittal image of the right common femoral artery with color Doppler and waveform analysis.


Figure 10-51: Sagittal image of the right profunda femoral artery with color Doppler and waveform analysis.


Figure 10-54: Sagittal image of the right proximal superficial femoral artery with color Doppler and waveform analysis.


Figure 10-57: Sagittal image of the right middle superficial femoral artery with color Doppler and waveform analysis.


Figure 10-60: Sagittal image of the right distal superficial femoral artery with color Doppler and waveform analysis.


Figure 10-63: Sagittal image of the right popliteal artery with color Doppler and waveform analysis.


Figure 10-66: Sagittal image of the right posterior tibial artery with color Doppler and waveform analysis.


Figure 10-69: Sagittal image of the right peroneal artery with color Doppler and waveform analysis.


Figure 10-70: Side-by-side sagittal images of the right anterior tibial artery without color Doppler and with color Doppler.


Figure 10-72: Side-by-side transverse images of the right dorsalis pedis artery without color Doppler and with color Doppler.


Figure 10-73: Sagittal image of the right dorsalis pedis artery with color Doppler and waveform analysis.


Figure 9-1: Ultrasound image of the longitudinal view of the normal left kidney. Kidney ultrasound 110315132820 1329070 by Nevit Dilmen licensed under CC BY-SA 3.0


Figure 9-2: Ultrasonography of end-stage hydronephrosis. End-stage hydronephrosis with cortical thinning by Hansen KL, Nielsen MB, Ewertsen C licensed under CC BY 4.0


Figure 9-3: Ultrasound scan of renal stone located at the pyeloureteral junction. Renal stone located at the pyeloureteric junciton with accompanying hydronephrosis by Hansen KL, Nielsen MB, Ewertsen C licensed under CC BY 4.0


Figure 9-4: Ultrasound image of gallbladder stone. Ultrasound image of gallbladder stone Gallstone 091937515 by Nevit Dilmen licensed under CC BY-SA 3.0


Figure 9-5: Acute cholecystitis as seen on the ultrasound axial view. Acute cholecystitis as seen on ultrasound axial view by Cerebisae licensed under CC BY-SA 4.0


Figure 9-6: Abdominal ultrasound showing the right lobe of the liver and right kidney. Ultrasound liver right lobe and right kidney by Ptrump16 licensed under CC BY-SA 4.0


Figure 8-1: Ultrasound image of the intercostal space with the ribs shown by the vertical arrows. Rib shadows are displayed below. The upper horizontal arrows represent the pleural line, and the lower horizontal arrows represent the artifact of the pleural line, called the A-line. Normal lung surface by Daniel A. Lichtenstein licensed under CC BY 2.0


Figure 8-2: Pleural line with A-lines similar to Figure 8-1, indicating gas below the pleural line. Pneumothorax and the stratosphere sign by Daniel A. Lichtenstein licensed under CC BY 2.0


Figure 8-3: The image on the left shows four or five B-lines. The image on the right shows twice as many B-lines with two examples of pulmonary edema. Interstitial syndrome and the lung rockets by Daniel A. Lichtenstein licensed under CC BY 2.0


Figure 8-4: B-line artifacts arising from an apparently thickened pleural line. B-line artifacts by Buda N, Cylwik J, Mróz K, Rudzińska R, Dubik P, Malczewska A, Oraczewska A, Skoczyński S, Suska A, Górecki T, Mendrala K, Piotrkowski J, Gola W, Segura-Grau E, Zamojska A, and Wełnicki M licensed under CC BY 4.0


Figure 7-1: Parasternal long-axis view of the heart.


Figure 7-2: Blood circulation in the heart. Blood Circulation by Wapcaplet licensed under CC BY-SA 3.0


Figure 6-1: Some examples of commonly used transducers in musculoskeletal ultrasound assessment.


Figure 6-2: Anterior view of shoulder anatomy.


Figure 6-3: Structure of the biceps tendon viewed in the transverse and longitudinal planes.


Figure 6-4: Examination of the subscapularis tendon in the sagittal plane.


Figure 6-5: Examination of the acromioclavicular joint in the sagittal plane.


Figure 6-6: Supraspinatus in the longitudinal (sagittal) view showing the bird’s beak appearance.


Figure 6-7: The infraspinatus in the longitudinal (sagittal) plane.


Figure 6-8: The posterior glenohumeral joint on ultrasound.


Figure 6-11: Side-by-side pictures of the transducer position on the elbow and anterior transverse elbow imaging of the anterior recess (AR), radial nerve (RN), brachial artery (BA), median nerve (MN), biceps (BI), and brachialis (BR) just proximal to the elbow crease. The abbreviations given here and labeled on the ultrasound images represent the corresponding structures.


Figure 6-12: Side-by-side pictures of the transducer position and a longitudinal image of the medial elbow showing the common flexor tendon (CFT).


Figure 6-13: Side-by-side pictures of the transducer position and a longitudinal image of the lateral elbow showing the common extensor tendon (CET), lateral epicondyle (LE), and radial head (RH). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-14: Side-by-side pictures of the transducer position and a posterior longitudinal image of the elbow showing the triceps tendon (TT) and the olecranon fossa (F). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-15: Schematic of the wrist and hand anatomy.


Figure 6-17: Schematic of the cross-sectional view of the wrist.


Figure 6-18: Dorsal wrist image of the scapholunate ligament (SCL).


Figure 6-19: Side-by-side pictures of the transducer position and volar wrist showing the median nerve (MN) and flexor carpi radialis (FCR). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-20: Side-by-side pictures of the transducer position and sagittal volar hand imaging of the metacarpal phalangeal joint (MCP) and the flexor tendon (FT). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-21: Anterior schematic of the skeletal structure and tendons of the hip.


Figure 6-25: Side-by-side pictures of the transducer position and image of the gluteus maximus (GMAX) in the sagittal plane.


Figure 6-24: Side-by-side pictures of the transducer position and image of the gluteus medius (GMED) in the sagittal plane.


Figure 6-26: Sagittal hip image of the conjoined tendons (CT) of the biceps femoris and semitendinosus into the ischial tuberosity (IT). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-28: Side-by-side pictures of the transducer position and transverse image of rectus femoris (RF), vastus medialis (VM), vastus lateralis (VL), and vastus intermedius (VI). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-33: Side-by-side pictures of the transducer position and image of the lateral meniscus (LM), lateral collateral ligament (LCL), and popliteus (P). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-34: Side-by-side pictures of the sagittal image of the patellar ligament (PL).


Figure 6-35: Side-by-side pictures of the transducer position and transverse image of the posterior knee viewing of the medial head of the gastrocnemius muscle (MHG), popliteal artery (PA), and the popliteal vein (PV). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-36: Anatomical view of the foot (Lateral collateral ligament of ankle joint by Laboratiores Servier licensed under CC BY-SA 4.0) and ankle (Dorsal superficial muscles of the right foot (lateral view) by Betts JG, Young kA, Wise JA, Johnson E, Poe B, Kruse DH, Korol O, Johnson JE, Womble M, and DeSaix P licensed under CC BY 4.0).


Figure 6-41: Side-by-side pictures of the transducer position and transverse image of the medial ankle, including the medial malleolus (MM), tibialis posterior tendon (PTT), flexor digitorum longus tendon (FDL), posterior tibial vein (V) and artery (A), tibial nerve (N), and flexor hallucis longus tendon (FHL). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 6-44: Side-by-side pictures of the transducer position and plantar sagittal view with plantar fascia (PF) insertion into the calcaneus (C). The abbreviations given here and labeled on the ultrasound image represent the corresponding structures.


Figure 5-2: Ultrasound image at 23 weeks showing fetus, amniotic fluid, and normal fetal morphology. Ultrasonography picture at 23 weeks showing fetus, amniotic fluid and normal fetal morphology by Dahab AA, Aburass R, Shawkat W, Babgi R, Essa O, and Mujallid RH licensed under CC BY 2.0


Figure 5-3: The figure on the left shows the internal view of the cardiac right chambers, and the one on the right is the echocardiographic image showing the ventricular septal defect. Internal view of cardiac right chambers by Muñoz-Castellanos L, Espinola-Zavaleta N, Kuri-Nivón M, and Keirns C. licensed under CC BY 2.0


Figure 5-4: An ectopic pregnancy adjacent to the left ovary. Ectopicleftmass by James Heilman, MD licensed under CC BY-SA 3.0


Figure 5-5 Ultrasound image of fetal hydrocephalus. Aorta duplication artifact 131206105958250c by Nevit Dilmen licensed under CC BY-SA 3.0


Figure 5-6: Ultrasound images of a fetus’s face and arms during week 20.


Figure 4-1: Ultrasound image showing the thermal index and mechanical index of a carotid exam in the top right corner.


Figure 3-1: Orthogonal planes of the uterus.


Figure 3-2: 2D grayscale image on the left (Scan20semanas1 by Guimi licensed under CC BY-SA 2.5) and 3D colored image on the right (4215.600×450 by Clayuyu licensed under CC BY-SA 4.0).


Figure 3-3: A schematic of the formation of a 4D ultrasound image. Figure 1 by Yagel S, Cohen SM, Shapiro I, and Valsky DV licensed under CC BY 2.0


Figure 2-1: A typical ultrasound machine. ALOKA SSD-3500SV by Kitmondo Marketplace licensed under CC BY 2.0


Figure 2-2: Schematic of the mode of operation of ultrasound machines.


Figure 2-3: An illustrative diagram of the behavior of piezoelectric materials used in ultrasound probes.


Figure 2-4: Components of an ultrasound probe.


Figure 2-5: Block diagram of an ultrasound imaging system.


Figure 2-6: An illustration of the pulse-echo imaging operation.


Figure 2-7: The stones in gallbladders are very bright, and they cast an acoustic shadow posterior to the stones. Ultrasonography of sludge and gallstones, annotated by Kitmondo Marketplace licensed under CC0 2.0


Figure 2-8: A mirror image artifact appears as a symmetric image with less intensity than the actual image on the opposite side of the baseline. The mirror image artifact is apparently outside the liver. Leberhaemangiom mit Spiegelartefakt 56M – US – 001 by Hellerhoff licensed under CC BY-SA 4.0


Figure 2-9a: One of the assumptions of ultrasound imaging is that the beam travels in a straight line.


Figure 2-9b: Schematic of the formation of a ghost artifact.


Figure 2-10: Image illustration of a side lobe effect.


Figure 2-11: An ultrasound energy beam that deviates from the central beam results in side or grating lobes, which, upon encountering a reflector, can produce echoes that return to the transducer. The machine erroneously assumes the echoes are due to reflection from the main beam axis and displays the image in the wrong location.


Figure 2-12: A schematic of multiple reflections from two surfaces.


Figure 2-13: Reflections from an oblique surface.


Figure 2-14: Beam width artifact can cause an image to appear in the wrong location due to side echoes that are erroneously interpreted by the machine as part of the central beam.


Figure 2-15: Reverberation artifacts are characterized as multiple horizontal lines that are equidistant from one another, and they are more pronounced as the intensity decreases with the depth. Ultrasonography of diastasis recti – annotated by Mikael Häggström, M.D. licensed under CC0 1.0


Figure 2-16: Comet tail artifact seen in the intercostal space.  Interstitial syndrome adn the lung rockers by Daniel A Lichtenstein licensed under CC BY 2.0


Figure 2-17: Schematics of the different types of transducer arrays: (a) linear sequential, (b) curvilinear, and (c) linear phased.


Figure 2-18: The vertical position is expressed as a voltage signal amplitude, indicating the relative amplitude of the echoes.


Figure 2-19: The B-mode displays anatomic structures by utilizing different gray brightness in a 2-dimensional space. Scan20semanas1 by Guimi licensed under CC BY-SA 2.5


Figure 2-20: Typical example of the M-mode showing a four-chamber view of the heart. Echokardiographie M-Mode 4KB TAPSE by Wolff-BI licensed under CC BY-SA 3.0


Figure 2-21: Ultrasound image of the right common carotid artery and the corresponding Doppler waveform.


Figure 2-22: Physiological features of the pulmonary and systemic circuits. Diagram of the pulmonary and systemic circuits by Colorado Community College System licensed under CC BY-NC-SA 4.0


Figure 2-23: Systemic blood pressure throughout different paths of the body. Systemic Blood Pressure by Betts JG, Young KA, Wise JA, Johnson E, Poe B, Kruse DH, Korol O, Johnson JE, Womble M, and DeSaix P. licensed under CC BY 4.0


Figure 2-24: Diagram representing laminar flow on the left and turbulent flow on the right. Turbulent pipe flow by Ryan Toomey, University of South Florida licensed under CC BY-SA 4.0


Figure 1-1: Characteristics of a longitudinal wave on a slinky.


Figure 1-2: Characteristics of a longitudinal wave.


Figure 1-3: Transverse wave characteristics.


Figure 1-4: The intensity of a wave decreases inversely with the square of the distance from its source.


Figure 1-5. Ultrasound reflection at the boundary between two tissues with different acoustic impedances.


Figure 1-6: Different types of ultrasound reflections.


Figure 1-8: Ultrasound refraction at surface boundaries.


Figure 1-9: The figure on the left illustrates how a double image artifact is formed, and the one on the right is the actual double image artifact of an aorta on an ultrasound image. Aorta duplication artifact by Nevit Dilmen licensed under CC BY-SA 3.0


Figure 1-10: An illustration of attenuation at multiple tissue boundaries.


Figure 1-11: Schematic of an ultrasound diffraction.