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The AAPM/RSNA Physics

Tutorial for Residents


X-ray Interactions1
This article meets the Jerrold T Bushberg, PhD
criteria fcr 1.0 credit
hour in category I of
tI.)e AAIIA Physician .c The diagnostic information in a radiograph or fluoroscopic image is largely the
Recognition A uard.
result of the quantity of x rays that are not removed from the incident x-ray
To obtain credit, see
beam. The information content of the image is delivered by the percentage of
the questionnaire on
noninteracting photons that are successfully recorded. There are four major
pp 45 1-456.
x-ray interactions: Rayleigh (coherent) scattering, Compton scattering, photo-
electric absorption, and pair production. The degree of attenuation and the
predominant mechanisms involved in the interactions are influenced by the
x-ray energy and tissue composition. In the diagnostic energy range, photo-
electric absorption and Compton scattering are the predominant modes of at-
After reading tbis article
and taking The test, t/,c
tenuation. One of the challenges in diagnostic imaging is to optimize image ac-
reader will. quisition by controlling x-ray attenuation to obtain the appropriate contrast
between the tissues while minimizing patient dose and scattered radiation in
I Understand the mechan-
the image. Imaging techniques such as use of contrast material and dedicated
isms of x-ray interactions,
including Rayleigh scatter- mammography equipment exploit the differences in these types of x-ray inter-
ing, Compton scattering, actions to improve the quality and diagnostic utility of the examination. Ray-
photoelectric absorption, leigh scattering and pair production are presented but do not occur to any sig-
and pair production.
nificant degree in diagnostic radiography.
. Be able to predict which
interaction flOde would be U INTRODUCTION
likely to predominate in
Understanding of x-ray interactions is important for a variety of reasons. Selection of
various imaging procedures
specific exposure parameters (eg, kilovolt peak), x-ray target and filter combinations,
and the relative probability
together with the characteristics of the tissues being imaged, all affect the type of x-
of photoelectric interac-
tiOflS LS a function of x-ray
ray interaction that will predominate. The predominant x-ray interaction will in turn
energs and the atomic have a substantial impact on patient dose, the quality of the radiograph, and its ulti-
number of the absnber. mate diagnostic utility. An understanding of these issues enhances the ability of the
radiologist to obtain the highest quality diagnostic images at the lowest possible pa-
. Be able to predict the
types, calculate the ener-
tient dose. Finally, these types of interactions are fundamental to the understanding of
gies, and understand the medical imaging and are often the topic for some of the physics portion of the board
characteristics of second- examination.
ary radiations following The objective of this article is to provide an overview of the various types of x-ray
the x-ray interaction in-
interactions and the mechanisms by which these interactions occur. In addition,
eluding characteristic x
rays and Auger electrons.

. Understand the impact


Index terms: Radiography Physics
of each type of interaction
on image quality in diag- RadloGraphics 1998; 18:457-468
nostic radiology.
From the 1)cpartment ol Radiology. School of Medicine. University of California l)avis. 231 5 Stockton Blvd. Sacramento,
CA 9581. From the AAPM/RSNA Phvsics Tutorial at the 1996 RSNA scientific assembly. Received September 19. 1997:
revision requested October 22 and received November 19; accepted November 28. Address reprint requests to the
author.

. RSNA. 1998

457
Scattered
photon

Figure 1. Rayleigh scatter-


ing. Diagram shows the mci-
dent photon X1 interacting
with an atom and the seat-
Incident
tered photon 2 being emitted
photon
with approximately the same
wavelength. Rayleigh seat-
tered photons are typically
emitted in the forward diree-
tion, fairly close to the trajee-
tory of the incident photon.
K, L, and M are electron
shells. (Redrawn, with permis-
sion, from reference 8.) 1 2

discussions of the factors that affect the mode the incident photon. This type of interaction
of x-ray interaction and how these interactions has a low probability of occurrence in the diag-
influence the x-ray images are presented. Fi- nostic energy range and typically accounts for
nally, examples of differences in x-ray interac- less than 5% of x-ray interactions. Rayleigh in-
tions that can be exploited to enhance the teractions are also referred to as coherent scat-
clinical utility of a diagnostic examination are tering or classical scattering.
presented. The specific modes of x-ray interac- During a Rayleigh interaction, the electric
tions include Rayleigh scattering, Compton field of the electromagnetic wave of the mci-
scattering, photoelectric absorption, and pair dent photon expends energy, which causes all
production. This article discusses the impor- the electrons in the scattering atom to oscillate
tance of these interactions in medical imaging, and radiate in phase. The electron cloud of the
some of their characteristics, and their relative atom immediately reradiates this energy, emit-
probability of occurrence in the energy range ting a photon of the same energy but typically
of x rays used for diagnostic purposes (ie, the in a slightly different direction (Fig i).
diagnostic energy range). (Further reading on
these topics can be found in references 1-8.) U COMPTON SCAflERING
Described by Arthur Compton in i923 (3), the
U RAYLEIGH SCATTERING details of Compton scattering and the factors
In Rayleigh scattering, the incident photon in- that contribute to its probability of occurrence
teracts with, and excites, the total atom, as are very important to medical imaging. X-ray
opposed to individual electrons as is common photons undergoing Compton scattering do so
with the other types of x-ray interactions. Be- by interacting with so-called free or valence
cause this interaction occurs mainly with very shell electrons, in which the incident photon
low energy diagnostic x rays, such as those energy greatly exceeds the binding energy of
used in mammography (15-30 key), there is the valence shell electron that is ejected. For
no ionization and the scattered photon is emit- example, a iOO-keV photon interacting with a
ted with essentially no loss in energy relative to water molecule in soft tissue primarily does so
through Compton scattering interactions, in
which the binding energy of the electrons in
the water molecules (ie, hydrogen and oxygen

458 U Imaging & Therapeutic Technology Volume 18 Number 2


Valence electrons

Figure 2. Compton scatter-


ing. Diagram shows the mci-
Compton dent photon with energy E()
electron (Ee.) interacting with the valence
shell electron, which results
in the ejection of the Comp-
ton ejected electron E and
the simultaneous emission of
Incident
a Compton scattered photon
photon
(E0) E5 emerging at an angle 8 re-
Angle of deflection lative to the trajectory of the
incident photon. K, L, and M
are electron shells. (Redrawn,
-% Scattered with permission, from refer-
..- . - photon (E1) enee 8.)

atoms) is insignificant compared with the mci- tive to the incident photon is denoted as 0.
dent photon energy. In fact, Compton scatter- While the incident photon undergoes Compton
ing predominates not only in the diagnostic en- scattering, the resultant Compton scattered
ergy range of x rays in tissue (ie, above 30 key) photon and ejected (or recoil) electron appear
but continues to predominate well beyond di- simultaneously. The process of Compton scat-
agnostic energies of x rays (to approximately tening is illustrated in Figure 2.
30 MeV). When Compton scattering does oc- The probability of Compton scattering is
cur at the lower x-ray energies associated with proportional to the number of electrons per
diagnostic imaging (25- 1 50 kVp), the majority gram. The number of electrons per gram is
of the incident photon energy interacting with fairly constant in most materials with the ex-
the loosely bound electron is transferred to the ception of hydrogen, which, because of its lack
scattered photon, which, when detected by of neutrons, results in an approximate doubling
the image receptor, contributes to image degra- of electron density. Thus, hydrogenous materi-
dation by reducing the primary photon attenua- als have a higher probability of a Compton scat-
tion differences of the tissues. ten interaction than nonhydnogenous materials
The components of Compton scattering to of equal mass. However, in radiology, we do
keep track of during the interaction are as fol- not usually compare equal masses. We usually
lows: The incident photon wavelength is de- compare regions of an image that correspond
noted as X1 and its energy, as E0. The energy to irradiation of adjacent volumes of tissue.
of the Compton electron is denoted as E, Therefore, density-that is, the mass contained
whereas the scattered photon wavelength is within a given volume-plays an important
denoted as X2 with energy equal to The
angle of deflection of the scattered photon rela-

March-April 1998 Bushberg U RadioGraphics U 459


role. One can radiographically visualize ice in a
glass of water because of the differences in
density of the ice compared with that of the
surrounding water (Fig 3).
Once a Compton electron is ejected from
the atom, it loses kinetic
its energy through
excitation and ionization of atoms in the sun-
rounding material. The Compton scattered
photon, on the other hand, can traverse
through the medium without interaction or
may undergo any of a number of additional
photon interactions, including a subsequent
Compton
or, if the
scattering,
photon energy
photoelectric
is quite
absorption,
low, Rayleigh :1
scattering. Figure 3. Radiograph (acquired at 125 kVp with
As with all types of interactions, both energy an antiscatter grid) of two ice cubes in a plastic eon-
tamer of water. The ice cubes can be visualized be-
and momentum must be conserved. Thus, the
cause of their lower electron density relative to that
energy of the incident photon E) is equal to the
of liquid water. The small radiolucent objects seen
sum of the energy of the scattered photon
at several locations are the result of air bubbles in
and the kinetic energy of the ejected electron
the water.
E:

U = E5. + Ee_ (i) ton scattered photons can be expressed by the


following equation:
The binding energy of the electron that was
ejected is so small, compared with the other AX(flfl,) = 0.00243 (1 - cosO). (4)
energies involved, that it can be ignored.
We can convert between the wavelength of As the incident photon energy increases,
a photon and its energy in kiloelectron volts by both scattered photons and electrons are scat-
using the conversion equation: tered more toward the forward direction (Fig
4). These photons are much more likely to be
E(ke) 1.24iX. (2) detected by the image receptor, thus increas-
ing the overall exposure of the image receptor
The lower energy of the scattered photon rela- and reducing the observability of contrast. In
tive to the incident photon can alternatively be addition, for a given scattering angle, the frac-
expressed as the increase in wavelength of the tion of energy transferred to the scattered pho-
scattered photon relative to the wavelength of ton decreases with increasing incident photon
the incident photon. Stated another way, the energy. Thus, for higher energy photons, the
scattered photon wavelength S equal to the 2 majority of the energy is transferred to the
incident photon wavelength A plus the change Compton scattered electron. For example, at a
in wavelength AX: 60#{176}
scattering angle, the ratio of the scattered
photon energy E. to that of the Compton elec-
X. = X1 + AX. (3) tron E is 0.9 or 90% at 100 keV but approxi-
mately 0. 1 or 10% at 5 MeV.
The wavelength of the scattered photon de- Conservation of energy and momentum die-
pends on the angle 0 of scatter relative to the tate certain limits on both scattering angle and
trajectory of the incident photon. Derived from energy transfer. For example, the maximum en-
an analysis of energy conservation, the change ergy transfer to the Compton electron (and
in wavelength between the incident and Comp- thus the maximum reduction in incident pho-
ton energy) occurs with a 180#{176}photon back-
scatter. In fact, the maximum energy of the
scattered photon is limited to 5 1 1 keV, which

460 U Imaging & Therapeutic Technology Volume 18 Number 2


By using Equation (2), the wavelength of an 80-
I 00
keV photon is 0.0155 nm, which, when added
90 to the change in wavelength AX of 0.00486 nm,
80 is 0.02031 nm. The scattered photon energy is
70 thus calculated as 61 keV by using Equation
c 60 (2). Now, remembering that the energy of the
Compton ejected electron is equal to the differ-
2 50
ence between the incident and scattered pho-
a.
ton energies, one can readily see that the ki-
netic energy associated with the Compton
20 ejected electron is equal to 19 keY (80 keV -

10 61 key). This exercise illustrates an important


0 concept about the energy of the scattered pho-
0 30 60 90 120 150 180 tons. Even with maximal energy loss, the scat-
Scatter Angle (degrees) tered photons still have a relatively high energy
and thus a good probability of detection.
Figure 4. Graph ifiustrates relative Compton seat-
ter probability as a function of scattering angle for
U PHOTOELECTRIC ABSORPTION
20, 80, and 140-keV photons in tissue. Each curve is
Photoelectric absorption is another mechanism
normalized to 100%. (Courtesy ofJohn M. Boone,
of x-ray attenuation important to diagnostic mm-
PhD, Department of Radiology, School of Medicine,
University of California, Davis.) aging in which the incident photon interacts
with a tightly bound electron (typically one
from the K or L shell). The x-ray photon is
occurs at a 90#{176}
scattering angle and a maxi- completely absorbed and the electron is
mum of 255 keV during a backscatter event. ejected (now referred to as an ejected photo-
These maximum limits on photon energy are electron) with a kinetic energy equal to the in-
maintained even when extremely high energy cident photon energy minus the binding en-
photons (eg, therapeutic energy range) interact ergy of the ejected electron. For photoelectric
through a Compton scattering event. The scat- absorption to occur, the photon energy must
ten angle for the ejected electron may occur at be at least equal to or greater than the binding
any angle up to 90#{176}
and that of the Compton energy of the electron that is ejected.
scattered photon at any angle up to a 180#{176} The ejected electron is most likely one
backscatter. In contrast to the scattered pho- whose binding energy is closest to, but less
ton, practically all the energy of the ejected than, the incident photon energy. After this in-
electron will be locally absorbed. teraction, the atom is left in an ionized and ex-
A problem involving Compton scattering is cited state with a vacancy in an inner shell. An
presented to reinforce some of the previously electron with a lower binding energy from a
discussed concepts. Consider an 80-keV pho- nearby shell fills the vacancy, creating a more
ton undergoing Compton scattering with an energetically stable atom. This transition cre-
outer shell electron of an oxygen atom with a ates another vacancy, which is filled in turn by
binding energy of less than 10 eV. The first electrons from higher energy levels. Thus, an
question is What is the minimum energy of electron cascade from higher to lower energy
the scattered photon, and the second question levels occurs. The difference in energy is re-
is What is the maximum energy transferred to leased as either characteristic x rays or Auger
the Compton ejected electron. electrons.
By substituting i80#{176}for 0 (minimum energy
of the scattered photon) into Equation (4), the
change in wavelength is equal to 0.00486 nm.

March-April 1998 Bushberg U RadioGraphics U 461


1- Binding Energy (keV)

100 keV
incident
photon

Characteristic

A:O.6keV(N--M)
B:4.4keV(M--L)

< 22< X3< C:29keV (L-.-K)


Figure 5. Photoelectric absorption. Diagram shows a 100-keV photon undergoing photoelectric absorption
with an iodine atom. In this case, the K-shell electron is ejected with a kinetic energy equal to the difference
between the incident photon energy and the K-shell binding energy of 34 keV or 66 keV. The vacancy created
in the K shell results in the transition of an electron from the L shell to the K shell. The difference in their bind-
ing energies (ie, 34 and 5 key) results in a 29-keV Ka characteristic x ray. This electron cascade will continue,
resulting in the production of other characteristic x rays of lower energies. Note that the sum of the character-
istie x-ray energies equals the binding energy of the ejected photoelectrons. Although not shown in this dia-
gram, Auger electrons of various energies could be emitted in lieu of the characteristic x-ray emissions. (Re-
drawn and modified, with permission, from reference 8.)

To conserve energy during each electron characteristic x ray indicates an electron transi-
transition, characteristic x rays are emitted tion to the K shell from a nonadjacent shell
with an energy that equals the difference be- (eg, the M shell).
tween the binding energies of the electrons Another form of energy dissipation is Auger
from the initial and fmal shells. Consider the electron In this process,
emission. the energy
transition of an electron from the L shell to the that otherwise would appear as a characteristic
K shell in iodine, in which the K-shell binding x ray after an electron transition is transferred
energy is 34 keV and the L-shell binding energy to a orbital electron whose binding energy is
is 5 keV. A Ka characteristic x ray of 34 5 = - less than that of the characteristic x ray and
29 keY will be released (Fig 5). The nomencla- subsequently ejected. The kinetic energy of the
tune used to identify the characteristic x rays Auger electron is equal to that of the character-
is established such that the capital letter mdi- istic x ray minus the binding energy of the
cates the final destination of the cascading ejected electron. For
example, as an alternative
electron and the subscript Greek letter indi- to a Ka characteristic x-ray emission of 29 keY,
cates whether the transition occurred from an that energy may be used to eject an M-shell
adjacent or nonadjacent shell. For example, an electron with a binding energy of 0.6 keY
L0 characteristic x ray indicates a transition within the same atom. The Auger electron
from the M shell to the L shell, in which the would have a kinetic energy of 29 0.6 = 28.4 -

subscript a indicates that the origin of the cas- keY. Insofar as the electron binding energies of
cading electron was the adjacent M shell. A K, hydrogen and oxygen in tissue are very low
and the kinetic energy associated with Auger
electrons would be lower than the alternative
characteristic x-ray energy, both the character-

462 U Imaging & Therapeutic Technology Volume 18 Number 2


istic x-ray photon and Auger electron emissions an atomic number of 25, which is irradiated
will be locally absorbed. with 50-keV photons, and another contrast ma-
The benefit of photoelectric absorption is terial B with an atomic number
of 50, which is
that there are no additional nonprimary pho- irradiated with 100-keY photons. What is the
tons to degrade the image; however, the local probability of photoelectric absorption in mate-
deposition of energy increases the radiation rial A relative to material B for the same thick-
dose in a relatively small area, and this effect ness of material? Because the probability of
must be considered with respect to its impact photoelectric absorption is proportional to Z3/
on dosimetry. The laws of conservation of en- E03, the probability of photoelectric absorption
ergy dictate that the sum of the characteristic with respect to atomic number changes as the
x-ray and Auger electron energies equals the ratio of (25/50) = /8 or 0. 125. The probability
binding energy of the ejected photoelectron. of photoelectric absorption with respect to
The probability of Auger electron emission in- photon energy changes as i/(50/iOO)3, which
creases as the atomic number (2) of the ab- is equal to 8. Thus, the overall effect of a de-
sorber increases, and thus this process does crease to one-eighth in photoelectric absorp-
not occur frequently for x-ray interactions in tion probability for a material of lower atomic
soft tissue. number, combined with an eightfold increase
The probability of photoelectric absorption in photoelectric absorption probability associ-
increases dramatically with the atomic number ated with the lower-energy photons, results in
of the absorber (ie, proportional to Z3). Con- no net difference in the probability of photo-
versely, the probability of photoelectric absorp- electric absorption.
tion decreases dramatically with increasing in- At photon energies below 50 keV, the pho-
cident photon energy (ie, proportional to toelectric process plays an important role in
lIE03). Thus, for a given absorbing material, imaging soft tissue. The photoelectric absorp-
there is generally a rapid decrease in attenua- tion process can be used to amplify differences
tion as photon energy is increased. However, in attenuation between tissues with slightly dif-
at photon energies equal to the binding energy ferent atomic numbers, thus improving subject
of inner shell electrons, there is a rapid and contrast. An excellent example of how this
dramatic increase in attenuation. This rapid in- knowledge of differential absorption can be ex-
crease is referred to as an absorption edge, at ploited to improve subject contrast is seen in
which point the number of electrons available mammography.
for interaction dramatically increases, resulting The development of the molybdenum x-ray
in a rapid rise in the attenuation cross section. tube targets and molybdenum filters for dedi-
The phenomenon of the absorption edge is cated mammography systems is a case in point.
used in radiographic contrast agents such as io- Characteristic x rays of i7 and 19.5 keV are
dine and barium. For these materials, the ab- produced in the output energy spectrum of the
sorption edges of 33 and 37 keY, respectively, x-ray tube. The tube port, which is made of be-
create substantially increased values of x-ray at- ryllium, has low atomic number (Z = 4) to al-
tenuation relative to that of surrounding tis- low essentially all the photons of importance
sues. The high atomic number of these con- to be transmitted. Unfortunately, a preponder-
trast agents also dramatically increases the ance of low-energy photons (<1 5 key) are sim-
probability of photoelectric absorption and de- ply absorbed in the breast and a preponder-
creases scattered radiation, which would other- ance of high-energy photons (>20 key) reduce
wise degrade the radiograph. In fact, photo- the subject contrast. Use of a molybdenum fil-
electric absorption is the primary mode of in- ten (typically 25-30 im thick) allows the pref-
teraction of diagnostic x rays with screen erential transmission of the desired characteris-
phosphors, contrast materials, and bone. tic x rays because their energies are just below
A problem involving photoelectric absorp-
tion is presented to reinforce some of these
concepts. Consider a contrast material A with

March-April 1998 Bushberg U RadioGraphics U 463


Relative Photon 6 1E 30 kVp unfiltered
Intensity spectrum

1.1
Bremsstrahlung

I Mo target

I
2
0iL
Photon Energy (keV)
Mass attenuation coeffIcient - Molybdenum Mass attenuation coefficient - Aluminum
srna

80
(cm/gm) 60 (cm2! gm)
40
2: \j< 0

Photon Energy (key) Photon Energy (keV)


3 3
Mo target with 0.03 mm Mo filter Mo target with 0.5 mm Al filter
4

Relative Relative
Photon
Intensity
2

- . . -
Ii I --_-__.
Photon
Intensity

5 10 15 20 25 30 35 5 10 15 20 25 30 35
Photon Energy (key) Photon Energy (key)
Figure 6. Output spectrum of an unfiltered molybdenum (Mo) target at 30 kVp, with attenuation curves and
filtered spectra for a 0.03-mm molybdenum filter and a 0.5-mm aluminum filter directly below on the left and
right, respectively. (Redrawn, with permission, from reference 8.)

the absorption edge. At lower energies, the x- phantom that was imaged with both molybde-
ray photons are readily absorbed, and, at ener- num and aluminum filters (Fig 7).
gies just beyond the
K-absorption edge, in- The clinical impact of the x-ray energy spec-
creased attenuation due to photoelectric ab- trum can also be seen in Figure 8, which
sorption reduces the transmission of higher- shows mammograms of the same breast oh-
energy photons through the filter. A pseudo- tamed approximately 10 years apart. The
monoenergetic spectrum is thus achieved; this change in imaging techniques over the period
spectrum maximizes the subject contrast of results in substantial improvement in subject
the soft tissues of the breast with a minimal ra- contrast. The mammogram obtained in the
diation dose. early 1980s used 30 kYp. The higher effective
Aluminum is the material most commonly energy, together with screen-film technology
used for x-ray tube filters in radiography; how- of the era and absence of substantial com-
ever, molybdenum is used for mammography. pression resulted in reduced subject contrast
The K-absorption edge of aluminum is not at (Fig 8a). The contemporary mammogram was
the energy range of interest for mammographic obtained with 26 kYp. A lower tube voltage
applications, which results in suboptimal at- and more accurate automatic exposure control
tenuation of the spectrum, allowing increased results in a energy spectrum tuned to provide
transmission of high-energy photons and conse- a beam of lower effective energy (Fig 8b). A
quently a reduction in subject contrast (Fig 6). substantial improvement in subject and radio-
This effect is illustrated with a mammography graphic contrast is achieved
by enhancements
in screen-film technology, such as increasing
the gradient of the characteristic curve re-
sponse of the film and greater breast compres-
sion.

464 U Imaging & Therapeutic Technology Volume 18 Number 2


a. b.
Figure 7. Images of an American College of Radiology mammography test phantom made of poly-
merized methyl methacrylate (Lucite) were obtained with a mammography unit with a molybdenum
target and molybdenum filter (a) and with a molybdenum target and aluminum filter (b). The im-
provement in subject contrast for the calcification specks and other test objects embedded within
the test phantom is readily evident in a.

Figure 8. Mammograms of the same breast imaged


10 years apart. (a) Mammognam acquired with a mam-
mography unit with a three-phase six-pulse generator
(CGR Sentograph 500T; GE Medical Systems, Milwau-
kee, Wis) at 30 kVp and a Min-R screen with Ortho M
film (Eastman Kodak, Rochester, NY) demonstrates the
image quality resulting from older imaging techniques,
including higher effective energies, film with lower
contrast and lower speed, and minimal breast corn-
pression. (b) Mammogram acquired 10 years later with
a mammography unit with a high-frequency generator
(CGR Sentograph 600HT; GE Medical Systems) at 26
kVp and a Kodak Min-R screen with Microvision film
(Du Pont, Wilmington, Del) demonstrates greater sub-
ject contrast and was obtained at lower dose. The
much improved image was produced with a lower ef-
feetive energy x-ray beam, higher speed screen-film
technology, and better breast compression. (Modified,
with permission, from reference 8.)

a. b.

March-April 1998 Bushberg U RadioGrapbics U 465


The photoelectric process predominates Diagnostic Nuclear
Radiology Medicine
when lower energy photons interact with ma-
terials of high atomic number (Fig 9). In the
diagnostic energy range, the photoelectric pro- -U
cess predominates in materials such as lead U
used in protective aprons, contrast agents, and .b 0
P.
the sodium iodide in the crystals used in gam-
C.)
ma scintigraphic cameras. Conversely, Comp- 0
2- B
ton scattering wifi predominate at higher pho- 0 . 50i
ton energies with materials of lower atomic
numbers such as tissue and air. Cl)
0
2
U PAIR PRODUCTION a.
Inpalrproductlon, a high-energy photon, un-
den the influence of the atomic nucleus, is
converted into a matter and antimatter pair,
namely the electron andpositron. The thresh- keV
old photon energy required for this interaction Figure 9. Graph plots the percentage of contnibu-
is 1 .02 MeV, which is equal to the rest mass en- tion of the photoelectric (left scale) and Compton
ergy equivalent of the positron-electron pair. (right scale) attenuation processes for various tis-
The electron loses its kinetic energy through
sues as a function of energy. When diagnostic en-
ergy photons interact with materials of low atomic
excitation and ionization and becomes associ-
number (eg, soft tissues), the Compton process
ated with another atom or is eventually ab-
dominates. (Redrawn and modified, with permis-
sorbed into the free electron pool. The posi-
sion, from reference 8.)
tron (a form of antimatter) also loses its kinetic
energy by excitation and ionization, but its fate
is much different than that of the electron. The
positron will eventually combine with an elec- MeY. After a pair production
reaction, any en-
tron in an annihilation reaction, in which the ergy in excess
of 1 .02 MeY is distributed as Id-
rest mass energy of the positron-electron pair is netic energy to the positron-electron pair.
completely converted into electromagnetic ra- Positrons, however, are important in nuclear
diation in the form of two 51 1-keV photons. imaging, as certain types of radioactive materi-
These photons, emitted at approximately 180#{176} als emit positrons as a form of radioactive de-
to one another, are referred to as annihilation cay. The resultant annihilation radiation emit-
radiation and
are illustrated in Figure 10. ted from the patient can be detected by posi-
The process of pair production is of no con- tron emission tomographic (PET) scanners (4).
sequence in diagnostic radiography because of
the extremely high energies required for pair U CONCLUSIONS
production to occur. In fact, pair production Four types of x-ray interaction have been re-
does not become significant unless the photon viewed: Rayleigh scattering, Compton scatter-
energies greatly exceed the minimum energy ing, photoelectric absorption, and pair produc-
of 1 .02 MeY. As previously stated, Compton tion. As one can see from the summary of mass
scattering predominates in tissue at diagnostic attenuation coefficients in soft tissue as a func-
energies and beyond up to approximately 30 tion of energy (Fig 1 1), pair production does
not contribute substantially to the types of in-
teractions important in the energy range used
in diagnostic radiology. Photoelectric absorp-
tion is an important process in diagnostic stud-
ies in which contrast agents are employed
because of the high atomic number of the

466 U Imaging & Therapeutic Technology Volume 18 Number 2


n and

incident
photon
(Negation)

A (Positron)

4rMeH800 Annihilation Radiation


B
Figure 10. Pair production. Diagram illustrates the pair production process in which a high-energy incident
photon, under the influence of the atomic nucleus, is converted to a matter and antimatter pair. The electron
expends its kinetic energy by excitation and ionization as does the positron. However, when the positron
comes to rest, it combines with an electron, producing the two 51 1-keV annihilation radiation photons. K, L,
and M are electron shells. (Redrawn, with permission, from reference 8.)

10

E
U 3
C
0 1
U
/TOt1
0
0
U
C
0 \ ,.-.- Photoelectric
0
C 1m...I..uI.__

Compton
Rayleigh<1
< 0.01
U) Pair
..

0.003

N
Figure 11. Graph plots the
Rayleigh, photoelectric, Compton,
0.001 pair production, and total mass at-
10 100 1,000 10,000 tenuation coefficients for soft tissue
Energy (keV) (Z 7) as a function of energy.

March-April 1998 Bushberg U RadioGraphics U 467


absorber. It is also important in special applica- Acknowledginent The comments and suggestions
tions such as mammography, in which the ofJ. Anthony Seibert, PhD, who served as chair for
photoelectric absorption process aids in the the 1996 AAPM/RSNA Physics Tutorial for Residents
are greatly appreciated.
ability to amplify subtle differences in tissue at-
tenuation. Compton scattering interactions pre-
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of radiographic contrast. ing of x-rays by light elements. Phys Rev 1923;
An understanding of how these interactions 21:483.
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to yield the best possible diagnostic mnforma- physics. 3rd ed. St Louis, Mo: Mosby-Year
Book, 1992.
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6. Sprawls P Jr. Physical principals of medical im-
then reading on this and related topics can be
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found in several excellent texts in medical
7. Bushong SC. Radiologic science for technolo-
physics (5-8). gists: physics, biology, and protection. 6th ed.
St Louis, Mo: Mosby, 1997.
8. Bushberg JT, Seibert JA, Leidholdt EM, Boone
JM. The essential physics of medical imaging.
Baltimore, Md: Williams & Wilkins, 199-I.

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